Tuesday, January 8, 2019

The Views of Orthodox Theology on Bioethical Issues (3 of 6)

...continued from part two.

4. The End of Biological Life

a) Euthanasia

The Church faces the issue of euthanasia from the Orthodox perspective that we saw earlier, when we identified the way in which the Church handles other bioethical problems. Four important points will be mainly emphasized here.

1) Life was given to human beings by God, so it is God’s gift to humankind. This means that God alone, not man, has exclusive rights over life. God has power over life, and He takes life when the right time comes. A human being is not entitled to take his life, as he is not the cause of life.

2) Biological life is not an absolute. Human life does not end with the death of the body. Liturgical texts contain the phrase “perfected in peace”, referring to the death of saints. Lifetime ends with death, but life is perfected. The end of a lifetime is one thing, and the perfection of life is another. In any case, the departure of the soul from the body is not called death but falling asleep. The soul lives after its departure from the body; the human being is not abolished. At Christ’s Second Coming the body will rise, the soul will enter it, and the human being will live for ever with both soul and body, a spiritual body, according to the degree of purification, illumination and deification. It is significant that the way of life after death depends on the way of life before death.

3) Pain is beneficial for human beings as it opens a new perspective on life, gives life meaning, and enables them to see everything in their lives, and the whole world, in a different light. The attempt to free oneself from pain is a sign of a false way of life, a life in accordance with the senses that increases another, existential, pain. What is the point of someone getting rid of bodily pain and drowning in existential pain, which is worse torture?

4) The whole dying process is regarded by most people as lost time, but this is not correct. For the patient, it is a time of repentance and preparation for meeting Christ. For family members it is a time to restore relations with their sick relative and among themselves. At the same time, all those who are near the patient’s bed express feelings of affection, love and sympathy towards the patient in various ways. It is not, therefore, wasted time, but important time for those who are ill and those close to them.

5) The dilemma of euthanasia was created by the development and use of life-support techniques and technologies that prolong life. For doctors, nursing staff and patients’ relatives, however, life-support machines create the dilemma of “prolonging life or hindering death”. What is more, the prolongation of life is only worthwhile when it has meaning, just as hindering death is only worthwhile when it has meaning.

6) When Christians, in spite of their efforts to stay alive in order to repent, understand that nothing else is going to help, it is not a sin for them to wish for a ‘natural’ death, without life-support machines and with only the necessary conservative treatment, with consciousness and prayer. And when doctors realise, on the basis of their experience, knowledge and faith in God, that they cannot do anything more, and therefore they do not use life-support machines to prolong life, but only conservative treatment, they are not ethically discredited.

In such cases we cannot refer to euthanasia.

In general, science is beneficial when it helps people to give their lives meaning, to repent, and to live with God, and when it helps them to die in a Christian way.

b) Intensive Care Units

Treating patients in intensive care units creates many ethical problems. We shall mention some of these.

1) Most patients who are admitted to Intensive Care Units are under sedation and intubated, so they cannot make decisions about future developments. Consequently the loss of ‘personal consciousness’ is replaced by ‘social consent’, in this case, the consent of the relatives. Certainly, in the case of brain death the so-called ‘presumed consent’ of patients ought not to apply.

2) Another problem is the state of the relatives of patients being treated in Intensive Care Units. The area of the intensive care ward does not lend itself to frequent or prolonged visits, so relatives crowd into waiting rooms for long periods in a state of anxiety, psychological insecurity, shock, fear, and so on. This obviously gives relatives the chance to express their love for the sick, to pray and also to restore strained relationships between themselves. On no account should they argue or take decisions about their sick family members based on economic interests.

3) Another ethical and spiritual problem to be faced concerns the nursing staff. Their work is certainly difficult and calls for attention, seriousness, courtesy, sensitivity and composure. As well as these professional qualities, those of them who believe in God ought to have a prayerful attitude towards patients. Sensitive movements and prayer for the patients help effectively. Because patients in Intensive Care Units are unable to pray, and their relatives are not able to help, as they are not allowed to be present, nursing staff ought to be like angels of prayer and kindness. It is they who stand beside dying patients and face the mystery of death with all its consequences. They are the only ones who are with these people in the last hours of their life.

In conclusion we ought to say that science with its achievements should help people to have quality of life. It must not, however, make them die unconscious and without prayer. It ought to help them, particularly if they are Christians, up to a point, and subsequently, using conservative treatment, it should leave them to prepare themselves for their meeting with Christ, provided, of course, that this is what they wish, because their freedom must never be violated. On the other hand, those who are sick ought not to choose this way of ‘natural’ death because they reject medical science, but because they know that there are limits to human efforts, and that in the end they must leave themselves in God’s hands with absolute faith in Him.

Christians know that death is the end of biological life, but it is not the end of life, which continues after death, as the Orthodox Christian Tradition teaches. Both biological life and biological death ought to have meaning, and above all a Christian meaning. When this meaning is lost, human beings lose their aim and their destiny.