The following question came
from a concerned Baptist: What is Baptist
thinking on a person being on a life-support system and the family being asked
by the doctor whether to have the life-support turned off? If the person
concerned had previously expressed a view on this would the family be bound by
that view?
Dr Lachlan Dunjey, the
Acting Director of Pathways Counselling, provided the following thoughts.
The medical view on this
issue is to uphold the principle of the sanctity of life by seeking to sustain
and preserve life where that possibility exists, and is opposed to action to
initiate death.
There is sometimes confusion
between the issue of euthanasia and the withdrawal of life support. We need to
draw a clear distinction between the two. Euthanasia is an interference in the natural process, but ceasing
(futile) life-support is a withdrawal of an interference in the
natural process. It is misleading to
call the latter ‘passive euthanasia’ and I will clarify the issues re
definition in a subsequent article.
It is obviously important to
know when the life-support is futile i.e. when death is
inevitable and imminent. The decision
is not always easy - it has been known in the past for life support to be
switched off and for the patient to keep on breathing and eventually recover.
Doctors interfere with
‘natural’ processes all the time however this interference is to preserve life
where the possibility of recovery exists, and not to hasten death. The preservation of life by life support
will continue until such a time as the body’s natural physiological processes
can resume life maintenance or until it is deemed that life is no longer - and
will not become - sustainable without such support.
In fact, doctors sustain
life in many circumstances where support is needed in a specific area but other
body functions are preserved e.g. by giving insulin to a diabetic; by assisting
breathing in a person with paralysis.
The withdrawal of life-support is reserved for cases where such support
is deemed futile i.e. where the person is considered to be brain dead by
appropriate medical evidence and therefore life is not sustainable.
Practical considerations and examples:
In the event of serious head
injury a decision needs to be made as to whether a person being ventilated is
‘brain-dead’ i.e. with no chance of recovery.
A rigorous process involving two specialist doctors performing about ten
clinical tests at two different times determines this. When this diagnosis is certain then the
medical view is that life-support should cease and I believe this to be the
right ethical and Christian position i.e. we should not interfere with the
process of ‘natural’ death when this is inevitable.
As in the above instance the
issue is clear in the event of a serious ‘stroke’ with a definite ‘brain-dead’
diagnosis. But the issue becomes much
more complex in the event of a serious stroke possibly just compatible with
life and yet holding little recovery of ‘useful’ (a very dangerous concept!)
existence. Again, the issues are
probably fairly clear in the instance of an elderly person, say 95 years of
age, whose partner in life has recently died, who has dementia, is bed-ridden
and who has previously expressed a request not to be kept alive! In my view it would be a very uncompassionate thing to keep that
person alive by artificial means - with the exception being to allow a close
relative to see that person in hospital before death e.g. a child returning
from overseas the next day.
At the opposite end of the
spectrum may be a young person with a brain haemorrhage due to a congenital abnormality
which is capable of surgical correction and where some degree of functional
recovery is possible. In this instance
it becomes a medical decision to maintain life support to allow the appropriate
surgery and then await clarification of the situation with the passage of time.
Most of the time it is
clear, in consultation with the doctors concerned, what needs to be done. If there is any doubt, then further
consultation should occur.
The above is a personal view
and, although representative of Christian doctors, is not to be interpreted as
Baptist policy.
Dr Lachlan Dunjey MBBS FRACGP DObstRCOG