Suffering, medical ethics, and the glory of God

It is normal to desire health and a long life. Tending to the health of our bodies is holy and commendable. Several beautiful verses in the Bible (Ps. 91 and Dt. 5:33, for example) invoke blessings for long life in the Lord. In the early Church, Saint Irenaeus insisted that the glory of God is man fully alive. With body and soul right with God, we have the fullness of humanity. We are normal.

But our bodies give way to age. We weaken. We suffer infirmities. Some day we will die. God is not the author of suffering and death. “God did not make death, and he does not delight in the death of the living” (Wis. 1:13). Jesus reveals our natural existence when He heals the suffering and even raises Lazarus and the young daughter of Jairus from the dead. Suffering and death are the consequence of sin, Original and, of course, our personal sins.

Developing an accurate cause-and-effect understanding of the relationship between personal sin and suffering is a healthy exercise for young and old alike. Except for bad habits such as smoking too much or consuming too much alcohol, our sex-drenched culture refuses to acknowledge self-evident behavior-related diseases and emotional disorders. But when we deny the sinful behavior that harms us, we deny our humanity.

In medical matters, we have the reasonable obligation to use “ordinary means” to sustain and maintain our own lives and health and those of our loved ones. The question of what constitutes “ordinary means” of life support can be complicated, especially in our twilight years. But the basic requirements are not mysterious.

End-of-life circumstances compel us to apply the principles of “ordinary means” in medical care. Traditional moral theology requires medical treatment under the following conditions (considered together):

• Does the treatment offer a reasonable hope of benefit (but not necessarily recovery)? We must avoid two errors: first, to do everything possible, or second, to do nothing. Reasonable hope of benefit justifies the medical treatment.

• If death is inevitable and imminent, there is no need to provide treatment except to keep the person comfortable. Catholic teaching permits the administration of pain medication – even if death is hastened – provided there is no intention to kill.

• If the treatment causes excessive pain or grave psychological burdens, the patient or caretakers may waive the medical procedures without sin. The denial must be reasonable and not rooted in evil motives such as a desire for suicide.

• Costs may be prohibitive. Ordinary care excludes treatments that would impoverish a family, although modern insurance plans usually cover most major medical expenses. (But even with insurance, major expenses raise thorny questions of social responsibility.)

We must always provide “minimal means” of life support, including food and water (if the body is able to receive it), hygiene, bed rest, and other comforts. The mechanical delivery of these “minimal means” may be necessary and is not “extraordinary” simply because delivery is “artificial.”

The application of these principles varies in time and place. Medical practices in parts of the world with limited medical technology differ from countries with advanced medical care. There should be no discrimination between those who are aware and those who are unconscious. Regardless of the state of consciousness, sick people have a body and a soul with inestimable God-given dignity.

Health care practices that are patient-centered and use “ordinary means” respect human dignity. But medical professionals occasionally use terminology that deflects attention from the humanity of a patient. Here are a few examples of terms and phrases that may facilitate objectifying of human beings.

Persistent vegetative state. Studies reveal that when doctors have applied this diagnosis, nearly 50% of the time, the patient recovers consciousness. Further, just as a person cannot be “transgendered,” a human being cannot transition to “vegetable” status when losing consciousness. “Persistent vegetative state” reveals an attitude of dehumanization and is unworthy of use by medical authorities.

Nutrition and hydration. When we say “nutrition and hydration,” we mean “food and water.” As a rule in medical matters – and in most cultural contexts – Standard English better respects the dignity of the human person.

Biologically tenacious individual. Some use this high-sounding phrase to justify removing food and water and other ordinary means to hasten death and justify mercy killing.

Merely physiological existence. This term is a lie. Even when we lose consciousness, we are body-soul persons until we die.

Artificial. Some hold that we can deny a patient food and water if the procedures by which they are delivered are “artificial”. But air conditioning is “artificial.” It is better to say “assisted” nutrition or “feeding.”

The gibberish of technical descriptions often obscures the human dignity of sick people.

A growing number of social engineers view bodily existence as valuable as long as it is a productive cog in the economy. But the human body is the sacrament – the outward sign – of an immortal soul and is good in itself. A person is as much the “soul of the body” as the “body of the soul.” Our body is essential to our humanity. Habitually focusing on the dignity of the human person prepares us to make the correct decisions in times of trauma.

We are not obliged to submit to every medical intervention suggested to us by eager research teams. Years ago, the father of a priest suffered a massive heart attack. Before retirement, he was a prominent judge and active in the pro-life movement. When his family came upon him, they promised to take him to the ICU. He knew the seriousness of his condition and wanted to die at home surrounded by his family. So they took care of him, tending to him, feeding him, comforting him. He died with the sacraments and was surrounded by a loving family. Not an unworthy way to depart this earth!

In heavenly glory, on the Last Day, God will reunite our bodies with our souls, and we will live for eternity in glorified bliss. Respect the humanity of our bodies as expressions of our soul. The glory of God is man fully alive.