Case Study: End Of Life Decisions

Case Study: End of Life Decisions

George is a successful attorney and a law professor who has recently been diagnosed with ALS, a progressive neurodegenerative disease that leads to muscle atrophy, loss of mobility, speech, and eventual inability to breathe without assistance. The diagnosis prompts George to reconsider his future life quality and his options concerning end-of-life decisions, including voluntary euthanasia. This case presents complex ethical, moral, and worldview considerations regarding end-of-life care, autonomy, and the sanctity of life.

The primary ethical issues in this scenario revolve around respecting patient autonomy, the principle of beneficence, non-maleficence, and the sanctity of life. First, George faces the dilemma of whether he has the right to choose the timing and manner of his death through voluntary euthanasia, emphasizing patient autonomy. Respecting autonomy means recognizing an individual's right to make decisions about their own body and life, particularly when suffering and loss of dignity are involved (Beauchamp & Childress, 2013). On the other hand, the principle of beneficence and non-maleficence compel healthcare professionals and family members to act in the patient's best interests, avoiding harm and alleviating suffering. In the context of ALS, these principles may conflict: easing suffering might involve assisting in euthanasia, but this can challenge societal and personal beliefs about the sanctity of life.

The principle of sanctity of life, often rooted in religious and cultural values, asserts that life is inherently valuable and should be preserved regardless of suffering or loss of autonomy (Kass, 1997). From a religious perspective, especially within Christian worldview traditions, life is sacred because it is a gift from God, and intentionally ending life is morally problematic. Conversely, secular or humanist worldviews may place greater emphasis on individual autonomy and quality of life over the intrinsic sanctity of life (Singer, 2011). These conflicting perspectives significantly influence opinions about euthanasia and end-of-life care.

Christian and Secular Worldview Analysis

The Christian worldview fundamentally upholds the sanctity of life based on biblical teachings that life is a divine gift. From this perspective, euthanasia is generally considered morally unacceptable because it violates God's commandment "Thou shalt not kill" (Exodus 20:13). Christian morality emphasizes caring for the suffering through compassionate means that preserve life, such as palliative care, rather than ending life prematurely (Pence, 2010). The Christian worldview advocates for acceptance of suffering as part of God's plan, and death is viewed as a transition to eternal life, not as an escape from suffering (Kelley, 2014).

In contrast, secular humanist or naturalist worldviews prioritize individual autonomy, dignity, and the relief of suffering. These perspectives assert that individuals should have the right to choose death if their quality of life has severely deteriorated and suffering is unbearable. They argue that autonomy and personal choice should take precedence over religious doctrines concerning the sanctity of life (James & Stuart, 2012). In this view, ending suffering through euthanasia might be morally permissible and, in some cases, ethically obligatory to respect a person's autonomy and desired quality of life.

Ethical Decision-Making from Worldview Considerations

George’s decision involves a complex interplay of these worldviews. From a Christian perspective, he might lean towards pursuing aggressive palliative care, pain management, and emotional support, trusting that God’s plan includes divine purpose even in suffering (Pence, 2010). However, his personal suffering and loss of dignity might lead him to reconsider, especially if he perceives enduring a future of complete dependency as a form of torture or dehumanization.

From a secular standpoint, George might emphasize his autonomy and desire for control over his life and death, viewing euthanasia as an act of compassion and respect for individual choice (Singer, 2011). He might consider the use of advance directives or living wills to ensure his wishes are honored if he becomes unable to communicate. Such decisions would be rooted in the value of preserving dignity and minimizing suffering, consistent with the principles of beneficence and non-maleficence.

Personal Recommendation

Considering the complex ethical interplay and individual autonomy, I personally lean toward respecting George's right to choose euthanasia if he qualifies under legal standards and if his decision is made voluntarily and with full comprehension of his condition and options. Respecting autonomy is fundamental to ethical medical practice, especially when the patient is capable of making informed decisions (Beauchamp & Childress, 2013). However, such a choice must be made after thorough discussions with healthcare professionals, spiritual advisors, and family members, ensuring that George's decision is entirely informed and free of coercion.

Moreover, ensuring access to compassionate palliative care and psychological support is essential, regardless of whether euthanasia is pursued. This approach aligns with both respecting individual autonomy and adhering to ethical principles of beneficence, by providing comfort and dignity in the face of terminal illness. While religious and cultural values influence personal and societal attitudes toward euthanasia, ultimately, honoring a patient's informed choice fosters respect for human dignity and personal agency (Kass, 1997; Singer, 2011).

Conclusion

End-of-life decisions like euthanasia involve intricate ethical considerations rooted in diverse worldviews. The Christian perspective underscores the sanctity of life and the importance of accepting suffering with faith, whereas secular perspectives emphasize personal autonomy and relief from suffering. In George’s case, a balanced approach that respects his autonomy, ensures informed decision-making, and provides compassionate care is ethically justifiable. Recognizing the importance of individual dignity and moral integrity, healthcare providers and family members must support terminally ill patients in making decisions consistent with their values and beliefs, fostering a compassionate and ethically sound environment.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
• Kass, L. R. (1997). Philosophical Foundations of Medical Ethics. In Health Care Ethics: Critical Concerns for the 21st Century (pp. 3-28). Georgetown University Press.
• Kelley, J. (2014). Christian Medical Ethics: Contemporary Medical Moral Issues. Routledge.
• James, R., & Stuart, M. (2012). Ethics and Society. Routledge.
• Pence, G. E. (2010). God and the Cure of Suffering. Journal of Christian Nursing, 27(4), 204-209.
• Singer, P. (2011). Practical Ethics (3rd ed.). Cambridge University Press.