Does Refusing Medical Treatment Mean Refusing Life?
ASK yourself, “Do I have the right to decide which, if any, medical treatment I will accept?” That is an important question for you to consider, because some claim that a person shows lack of appreciation for his life if he refuses a therapy that doctors recommend. Further, it can be asked whether it is unloving for parents who have weighed the risks involved to decline a certain treatment advised for a sick child.
Some people who speak dogmatically on this matter often reduce it to the assertion: “Saying no to the therapy means saying no to a child’s life.” But you can easily see what an oversimplification, what a superficial view, that is. It plays on the emotions while ignoring (1) conscience and fundamental ethics, (2) your personal and family rights and (3) medical and legal aspects of an issue that now has been given worldwide attention.
Conscience is an intimate and inviolable part of you and of every sane, moral human. Well-known Catholic cardinal John Henry Newman held ‘that the way to the light is to be found through obedience to conscience.’ Thus when Nazi war criminals said that they were only obeying orders, moral people earth wide replied that despite orders these people should have followed their conscience. Similarly, in January 1982, Pope John Paul II ‘raised his voice to God that consciences not be suffocated.’ He said that forcing someone to violate his conscience “is the most painful blow inflicted to human dignity. In a certain sense, it is worse than inflicting physical death, of killing.”
His remarks may harmonize with your own feeling that conscience should play a vital role in medical decisions.
Conscience and Medical Questions
Here is an example: Whatever your faith, likely you know that Catholic doctrine condemns a woman’s seeking an abortion, even when a pregnancy presents risks for mother or child. Imagine what a problem this poses for a Roman Catholic physician in a land where abortion is legal, as it is in Italy since Law Number 194 of May 22, 1978 was enacted. This law allows for conscientious objection to abortion on the part of medical personnel. However, article 9 specifies that “conscientious objection cannot be invoked” by a doctor when a woman’s life may be in danger. What, then, is a sincere, practicing Catholic doctor to do?
If no other physician were around and he did all he could, short of violating his conscience, would we accuse him of being a murderer? On the contrary, it ‘would be worse than killing’ to force the doctor to violate his conscience even if a woman or the authorities insisted. This illustrates how demands of conscience can affect medical decisions regarding health and life.
Parents, Children and Life
We can see this clearly, too, from what the early Christians did. You probably know that they refused to burn incense before the emperor’s statue, considering the act to be idolatry. But their religious and conscientious view had a direct bearing on their health and life, and that of their children too. Why? When forced to choose—‘Offer incense or your family will die in a Roman arena!’—the Christians would not deny their convictions. They were loyal to their faith even when that course was risky or fatal to them and their children.
The Christians were also tested as to blood, since the Bible commanded them to ‘abstain from blood.’ (Acts 15:20) Tertullian, a Latin theologian of the third century, reports that as a supposed cure epileptics drank the fresh blood of slain gladiators. Would Christians take in blood for such “medical” reasons? Never. Tertullian added that ‘Christians would not even eat the blood of animals.’ In fact, when Roman officials wanted to test whether someone really was a Christian, they pressured him to eat blood sausage, knowing that a genuine Christian would not, even on pain of death, eat it. This is worth noting since the Christian witnesses of Jehovah today also refuse to take in blood.
Now we might ask, Did those early Christians have little regard for life or did they want to be martyrs? No, it was the Roman authorities who forced death on them and their children. And do we not respect the memory of those devoted Christians who knew, as the pope recently said, that violating their conscience would have been worse than death?
If someone feels that this is in a different field from medical decisions, note what Dr. D. N. Goldstein wrote:
“Doctors taking this position [forcing a treatment on people who refuse it] have denied the sacrifices of all the martyrs that have glorified history with their supreme devotion to principle even at the expense of their own lives. For those patients who choose certain death rather than violate a religious scruple are of the same stuff as those who paid with their lives . . . rather than accept [forced] baptism. . . . No doctor should seek legal assistance to save a body by destroying a soul. The patient’s life is his own.”—The Wisconsin Medical Journal.
Choosing Real Life
Most of us would agree that “life” means more than a mere biological existence. Life is an existence centered around ideals or values (political, religious, scientific, artistic, etc.); without such, existence may be worthless. Thus during World War II patriotic men and women risked their lives to defend political ideals, values such as democracy and freedom of speech, worship and conscience. As a result of this defense of ideals, many children died. Countless others became orphans.
Indicative of this is the dramatic case of Italian statesman Aldo Moro. He was barbarously murdered in 1978 when authorities refused to comply with terrorist demands. Clearly, at times lives are sacrificed in the name of higher interests.
You can thus appreciate that a moral person could decide to risk his biological existence rather than compromise his ideals. In doing so he is making a choice of real life, life in its fullest sense. This certainly applies to Christian ideals.
Christians view human life as sacred, as a precious gift from God. Consider the apostle Paul, who was an intelligent, educated person. He suffered beatings and life-threatening situations but said: “I have taken the loss of all things and I consider them as a lot of refuse, that I may gain Christ . . . to see if I may by any means attain to the earlier resurrection from the dead.”—Philippians 3:8-11.
We can be sure that Paul would never have shared in something that he knew God condemned. Unquestionably, Paul would not have risked losing out on “the real life,” which for him would be life in heaven, just to extend his human life or health by a few years. (1 Timothy 6:19) But consider:
There are millions of churchgoers today who look forward to life in heaven; perhaps you do. So if a seriously ill person with a hope of future eternal life refused a therapy that he felt God forbade, it certainly would be unfair to accuse him of refusing life. Rather, he has lived on earth for years, and he may recover to live here longer. But in any case, and even if his doctors are unbelievers, it would be reasonable for him to consider his lasting future life and make medical decisions accordingly.
Physicians seldom discuss that aspect of things when recommending some therapy for you or your loved ones. But there is a vital aspect that they should inform you about. It could be called risk/benefit. You owe it to yourself and to your family to consider this feature, for it may help you to make a wise decision and to understand the wisdom of what others have done.
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Health Care for Children—A Jesuit’s View
John J. Paris, S.J., associate professor, College of the Holy Cross (U.S.A.), spoke at the conference Legal and Ethical Aspects of Health Care for Children. (April 1, 1982) He told of a Jewish judge who ordered that a blood transfusion be given to one of Jehovah’s Witnesses. Professor Paris said: “The judge obeyed his religion and did what he thought was right, but in doing so, violated the religion of the patient.”
He added: “Christian theology does not support that mere breathing is life. In the hospital, no one dies; they arrest. . . . [In the hospital] life is not sacred, it’s ultimate, and death is a failure. But in the Judeo-Christian tradition, death is part of the human condition, part of the journey of life. There is no avoiding the fact that these are quality of life decisions. Sometimes the best treatment is no treatment.”
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Eternity Changes the Analysis
Dr. Ruth Macklin is a philosopher at Albert Einstein College of Medicine (New York). In a class discussion of ethics a medical student told of a Witness patient who was a “victim of sickle-cell anemia [and] who risked bleeding to death without a transfusion.” The student said: “He was logical. His thought processes were intact. What do you do when religious beliefs are against the only source of treatment?”
In response, Dr. Macklin said: “We may believe very strongly this man is making a mistake. But Jehovah’s Witnesses believe that to be transfused is to ‘eat blood’ and that eating blood [may] result in eternal damnation. We are trained to do risk-benefit analyses in medicine but if you weigh eternal damnation against remaining life on earth, the analysis assumes a different angle.”—The New York Times, January 23, 1984.