Abstract
This paper offers an analysis of Christian and Buddhist perspectives George’s case, eventually making a recommendation that his Primary Care Physician should take him through euthanasia. George is an ALS patient in his mid-fifties, who is considering euthanasia as a quick solution to future suffering. However, based on Buddhism consider the fact that there is no need for George to suffer during his last days alive. On the other hand, while they value respect for persons, Christians grapple with the idea that George has no moral mandate to take his life. Nonetheless, an application of these worldviews in light of the four ethical principles results in the recommendation that it would be justifiable for George’s physician to help him end his life through euthanasia.
Key Words: Ethical Principles, ALS, Christianity, Buddhism, Worldview, Euthanasia
In today’s multicultural society, ethical issues are commonplace in health care decision making for patients with diverse values. Given such diversities, health care providers use moral action guidelines to arrive at an appropriate decision. These guidelines utilize the four principles of principlism, which include nonmaleficence, beneficence, autonomy, and justice. They figure ideal choices are those that exist as widely acceptable among different worldviews. This analysis follows a bi-religious perspective in light with George’s case, eventually making a recommendation that his Primary Care Physician should take him through euthanasia.
This case follows George, an attorney in his mid-fifties. George is also a family man and legal scholar at a campus in Oregon. Recently, George tested positive for Amyotrophic Lateral Sclerosis (ALS). Now, ALS is a progressive and degenerative illness that affects one’s brain cells and the spinal cord. Currently, ALS remains non-curable, with a median life expectancy of between 3 and five years upon diagnosis. Notably, therefore, George would, eventually, lose control of his vital muscles due to progressive muscle atrophy and neuron deterioration.
George and his family are devastated by this diagnosis. George is aware that modern pharmacological alternatives may only slow down the degradation within minimal success. Eventually, he will be unable to eat, talk, breathe and move without external assistance. One day, when contemplating his future, George begins to dread the thought of becoming a burden to his family. As a result, he starts considering about possible euthanasia.
Should George go ahead and choose euthanasia as the easy way out? Does this move go against the views of his family and religion? In response to these ethical issues, his primary care physician (PCP) ought to consider the four principles of principlism, which include nonmaleficence, beneficence, autonomy, and justice. The respect for George’s freedom implies that the PCP acts in a way that recognizes and promotes his autonomous decisions (McCormick, 2013).
Second, the principle of nonmaleficence requires PCPs not to harm George, through omission and commission intentionally. Third, the beneficence principle implies that PCPs have the mandate to act in their patient’s best interest. Here, they should take the necessary steps associated with preventing and removing harm from George. Finally, the justice principle implies a fair distribution of actions across the community concerning George’s decision to choose assisted suicide (McCormick, 2013).
Response to Worldview questions: Buddhism and Christianity Buddhism
For Buddhism, the prime reality is Karma and the Brahma. In this sense, Buddhists belief in the existence of unity among all things. Their impersonality of the excellent results in various descriptions of the prime reality as a force, energy, essence, and being (Wattis & Tomatsu, 2012).
The nature of the world remains unreal and a dream in the believer’s existence. Therefore, the traditional Buddhist sees no value in the current world. According to them, salvation comes with dying and escaping from materialism (Pew Research Center, 2013).
Buddhists describe human beings as one with nature. They underplay individual personality and emphasize unity with all matter.
At death, Buddhists experience a rebirth in a never-ending cycle of reincarnation. One’s form in the next life, however, depends on their behavior in the present life, as seen through Karma.
The possibility of knowing comes from a significant withdrawal from the material world and being in touch with the inner divine self.
The Buddhist’s knowledge of right and wrong emanates from one’s interpretation of sin. Here, crime exists as an ignorance of reality in its nature. Therefore, it would be vital to seek enlightenment as opposed to repentance and suffering as opposed to evil (Ratanakul, 2008).
The meaning of human history bears little or no relevance in Buddhism. The reason is that people exist in a constant cycle of life.
Christianity
For Christianity, the prime reality is that the universe owes its existence to God. That said, as defined by God, the universe has a beginning, present, and ultimate end.
The nature of the world around individuals remains good and real. In essence, God created and maintained the world with help from Jesus Christ. However, he remains distinct from his creation, existing beyond time and space.
Christianity views human beings as the principal guardians of the universe. The religion believes that Good created people in his image and consciousness. He then granted them the ability to make personal choices on intelligence, spiritual qualities, and accountability (The Holy Bible, 2015).
At death, people go into an eternal relationship with or without God. This relationship relies on the choices individuals make in their current life. Eventually, everyone will resurrect with Jesus Christ’s second coming, taking on a new life form similar to the Holy Ghosts.
People have the ability to gain and share knowledge as a God-given quality. This quality means that God expects them to utilize their intelligence in understanding the universe.
The ability of individuals to know right from wrong originates from God’s requirement that they follow a moral code. However, people have tainted this code with sin, thus negatively affecting their relationship with God (The Holy Bible, 2015).
Finally, history is essential in telling the story of God, the Universe, Jesus Christ, and the future. In essence, through history, one learns that the universe had a beginning and will end on judgment day with the second coming of Christ.
Analysis of Ethical Issues through Christian and Buddhist Worldviews
Buddhist versus Christianity’s view on George’s suffering
The Buddhist view of George’s malady and pain revolves around karma. In this case, George’s bad health experienced a correlated effect of bad karma in his past. This factor emphasizes that morality has a significant influence on one’s health. In essence, George’s health depends on his lifestyle as applied to thoughts, feelings, and dietary. Contrarily, ALS occurred as a result of an unhealthy way of life. From a Buddhist perspective, therefore, illness offers one a chance to reflect on their religious practices aimed at the promotion of health as well as healing (Ratanakul, 2008).
On the other hand, Christianity asserts that people suffer as a result of living in a tainted world. George’s condition, however, remains a mystery of sorts. Nonetheless, individuals tend to advance their connection with God when they become sick. Insight from James 1: 2-4 reveals, therefore, that George’s illness offers him a chance to attain a spiritual growth and maturity. Given his ALS, George needs to turn towards God for an opportunity to enhance his interpretation of the universe (The Holy Bible, 2015).
The value of George as a person from Buddhist versus Christianity’s perspective concerning his ALS
On the other hand, Buddhism treats George’s life concerning other essential parts of the universe. That said, the ALS implies a disturbed harmony in George’s life. Given its symptoms and clinical manifestations, the ALS will draw George’s attention towards this disturbance. Thus, suffering and healing will play a significant role in revealing the combine efforts taken in overcoming the disease. Healing, therefore, occurs as evidence that medicine played a vital role in serving the value of George’s life and welfare (Wattis & Tomatsu, 2012).
Values and Considerations in deliberating whether or not George should consider Euthanasia
Overall, Buddhism opposes euthanasia and assisted suicide. According to the Pew Research Center, PRC, (2013), Buddhism would teach that it is ethically wrong for George to opt for euthanasia. This position, as PRC suggests, shows the religion’s value for life in both psychological and physical status. However, they also believe that the society should not go out of its way in protecting a terminally ill patient’s life. This idea implies that George could refuse forms of care that are unduly burdensome to himself and his family (Pew Research Center, 2013).
On the other hand, Christianity largely opposes euthanasia at all costs. The argument here is that life is God-given in his image. Therefore, people have no right to break the natural process of life, even in great suffering. That said, George’s eventual death is part of the life process developed by God. Further, PCPs have no authority to help George take his life, even if it was his decision (Lawrence & Curlin, 2009).
Options that are Morally Justifiable under both Religions for George
Buddhists hold that that PCPs should let George live if by continuing treatment results in unnecessary suffering. This position justifies the idea that PCPs respect George’s autonomy, thereby reducing harm. The situation goes beyond the typical religious views and embraces the secular understanding of health and illness. The move’s concern with one’s need to end suffering offers a unique contribution to secularism (Wattis & Tomatsu, 2012).
Also, some elements within Christianity will suggest that there are strong arguments for euthanasia. For instance, Christianity demands that individuals respect each other. That said, family and friends should respect George’s decisions concerning end-of-life care. Furthermore, there is a need to accept such decisions as long as they are rational and aimed at refusing unnecessary suffering (The Holy Bible, 2015).
Personal Recommendations
The ultimate solution to this case place emphasis on the four ethical principles discussed above. Now, the limited life expectancy, non-curability, and degenerative nature of ALS proves the fact that George has a terminal illness. That said, the PCP’s medical objective should be to offer the best possible benefit through medication, an indication of prolonged life.
However, extended life as a result of this treatment plan offers a risk of excessive financial, physical, and psychological strain to both George and his family. In this case, PCPs should remember that they are under the mandate to do no harm to the patient. Further, the PCP would be willing to work in a way that enhanced distributive justice across the society. Therefore, weighing the possible risks and benefits tied to this case recommends that one proceeds with euthanasia, believing that George used the rational thought to choose this alternative.
References
Lawrence, R., & Curlin, F. (2009). Autonomy, religion and clinical decisions: findings from a national physician survey. Journal of Medical Ethics, 35 (4), 214-218.
McCormick, T. (2013). Principles of Bioethics. Retrieved from University of Washington: https://depts.washington.edu/bioethx/tools/princpl.html
Pew Research Center. (2013). Religious Groups’ Views on End-of-Life Issues. Retrieved from Pew Research Center : http://www.pewforum.org/2013/11/21/religious-groups-views-on-end-of-life-issues/
Ratanakul, P. (2008). Health, Disease, and Healing: The Buddhist Contribution. Retrieved from Dharma World Magazine: http://www.rk-world.org/dharmaworld/dw_2008odhealth.aspx
The Holy Bible. (2015). The Holy Bible King James Version. Retrieved from Online Bible : http://www.o-bible.com/kjv.html
Wattis, J., & Tomatsu, Y. (2012). Buddhist Care for the Dying and Bereaved. Sommerville, MA: Simon and Schuster.
