23 Dec 2005
What makes the definitions of life and death so hard in the practice of medicine? It is the fact that we never know for sure what will happen when we choose to treat. Dr. Ari Mosenkis details an anecdotal experience he had with "The Man Who Had No Heart" at . If only every outcome were so easy and straight forward.
23 Dec 2005 13:18:34
The link ot the article is below. I thought I put itin the original post but I guess I don't know what I am doing with this computer stuff:)
http://www.annals.org/cgi/c...
23 Dec 2005 14:05:07
Dr. Mick,
It looks like we need a subscription to view that article.
23 Dec 2005 15:50:01
Yeah..unfortunately that's a pay-site accessible only to subscribers. Maybe Dr. Denen can give us the gist of the article.
23 Dec 2005 16:06:55
I am so sorry. I was able to go directly to the site from the office computer and was not aware the site required a sign in. Dr. Mosenkis does a much better job of telling the story, but I will do my best.
It is the story of a man is in his 40's who has a weak heart and requires a heart transplant. The surgery goes very well until the heart has to work on it's own. The heart is immediately rejected and the man goes into heart and kidney failure. His lungs fill woth fluid and are not able to oxygenate his blood.
Dr. Mosenkis details all of the life support the man receives in the ICU. A machine does the work of his heart and lungs. Another does the work of his kidneys. He is kept alive with this technology for 3 days until another heart is found to take the place of his newly rejected and failed heart. One is found after a tragic accident that leaves another young person "brain dead".
The man recieves the new heart and several months later leaves the hospital with no artificial life support of any kind.
Dr. Mosenkis reflects briefly on the various lines we draw that define death and points out that the man who recived the heart transplant would have met some definitions of death. Yet, physicains took steps to stop the process and the man recoved what sounds like completely. I am sure he is on a boatload of medicine to keep him from rejecting his heart.
The point I wanted to make is that when physicains intervene to save the life of a patient we have no idea what the out come will be. Many will have the outcome of Dr. Mosenkis's patient.
Some will have less satisfactory results, that is they will be dependent on various technologies.
Some of these patients will be ventilator dependent, g-tube dependent and/or dependent on other technologies.
They all deserve the chance at ongoing life. The choice to support some of these patients has a high societal and emotional cost.
We need to develop an ethic that will guide our society that is based upon a Biblical ethic rather than a Utilitarian one which many would promote.
23 Dec 2005 16:11:56
Mick,
The other irony of it all was that the heart he received came from someone who was "brain dead". Why was his brain-deadness any more dead than the other fellows "vital organ" deadness? What qualified the one to die, and the other to live with the dead guy's heart? Is it just because we can do heart transplants and not brain transplants?
I think a biblical view of death is that, when someone's organs stop functioning, they are dead. Where in the bible is someone literally given a new heart? I said, "literally" here, so please no jokes about us getting a new heart when we are born again.
ed
24 Dec 2005 02:26:21
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from the bottom up of Mick's summary above:
1st -- A Biblical ethic is not necessarily mutually exclusive to a Utilitarian ethic.
2nd -- With or without "choice", human life on all levels is heavily subsidized by "a high societal and emotional cost"
AND(or including) -- the very real diminishment of resources & the expenditure or even extinguishing of other human life.
3rd -- The assertion that: "all deserve the chance at ongoing life" -- is a moral judgment. "Worthiness" and "costs" are Biblical themes that no doubt qualify "deserve"
Additional thoughts:
Is LIFE an absolute? Or is *liFE* and *liVInG* a matter of degree and quality on a continuum scale?
Perhaps a mix of absolute and relative values??
Doesn't life have its value not only in its preservation but also in expenditure, even its extinguishing?
I think the foregoing are reasonable conclusions based on observations of reality and accounts. They may or may not be axiomatic; the subject is certainly subject to continuing deliberation.
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While catching up on e-mail newsletter reading, I came on the following article:
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(The Associated Press: Updated: 3:44 p.m. ET Sept. 29, 2005)
Dutch to set guidelines for euthanasia of babies - Children's Health - MSNBC.com
*Doctors could end lives of terminally ill newborns with parents' consent*
http://www.msnbc.msn.com/id...
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"The Netherlands became the first nation to legalize euthanasia for adults under some conditions in 2001, and the latest move is likely to spark an outcry from the Vatican, right-to-life proponents and advocacy groups for the handicapped.(para#3)
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"The change in Dutch policy is especially significant because it will provide the model for how the country treats other cases in which patients are unable to say whether they want to live or die, such as those involving the mentally retarded or elderly people who have become demented.(para#6)
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"'Prone to abuse'
The government will establish a vetting commission — modeled on commissions currently in place for adult euthanasia — to determine whether conditions have been met in each case and to refer the case to public prosecutors if they do not. But unlike with adult euthanasia, prosecutors will not be bound to follow the commission’s judgment that conditions have been satisfied."(para#11)
[25 total,short line, paragraphs + scroll window at para#17 --
( at a glance: Euthanasia in industrial countries)]
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G1
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24 Dec 2005 05:12:33
I did not mean to imply that Biblical morality and Utilitarianism were mutually exclusive. My fear is that much of mainstream western bioethics sees Utilitarianism as the major guiding principle.
The point is well made that the reason a heart is transplanted in a brain dead person is the technology currently exists to do this. Genesis 11:6 (ESV) warns of a basic characteristic of humanity, “And the Lord said, “Behold, they are one people, and they have all one language, and this is only the beginning of what they will do. And nothing that they propose to do will now be impossible for them.” I fear that as a society we again moved in a direction that infuriates God.
Most discussions of medical bioethics proclaim three major principles. They are: 1) beneficence (or at a minimum nonmaleficence) which is the “do no harm” of the Hippocratic Oath, 2) respect for persons and 3) justice. Yet, often these principles seem to be sacrificed when it comes to promoting the life of others at the expense of the “already dead” or more recently not yet born.
Others far wiser than me have warned that there is currently more concern over the effects of experimentation on embryos than the effects of an embryo using society. The same could be said of a society that has already accepted the “harvesting” of organs from people that still have circulating oxygenated blood, be they supported by machines or volunteering to donate “unnecessary organs” because they are poor. The one we accept, the other we abhor at our current morality. We seem to well on our way to becoming a society that looks upon human life as a resource to be harvested, subjugated or modified as we se fit.
When discussing similar thoughts in his book, “Life, Liberty and the Defense of Dignity,” Leon Kass, M.D. expresses that people who can hold nascent in their hands coolly and without awe have deadened something in their souls.
Christians need to be actively engaging society with a Biblical worldview. Jesus’ salvation is not just about were we are spending eternity, but it also involves salvation from contemporary mainstream thoughts. As preterists we understand that Jesus came to bring about our resurrection deadened souls, not bodies out of graves.
24 Dec 2005 09:16:31
"...who can hold nascent______in their hands coolly and without awe have deadened something in their souls."
Is the word *life* missing at the blank? -- or some other? *human life*?
24 Dec 2005 11:39:23
I am so sorry. The quote should say, "People who can hold nascent human life in their hands coolly and without awe have deadened something in their souls."
Thanks for your wonderful proof read.(:0