Musings of an Anglican/Episcopal Priest

Month: November 2006 (Page 2 of 2)

To treat or not to treat

I just ran across a headline over at Titusonenine that says the following: “Outrage as Church backs calls for severely disabled babies to be killed at birth.” You can see the article, published in the Daily Mail, here. The section that relates specifically to what the report offered by the Church said is below:

In the Church of England’s contribution to the inquiry, Bishop Butler wrote: “It may in some circumstances be right to choose to withold or withdraw treatment, knowing it will possibly, probably, or even certainly result in death.”

The church stressed that it was not saying some lives were not worth living, but said there were “strong proportionate reasons” for “overriding the presupposition that life should be maintained”.

The bishop’s submission continued: “There may be occasions where, for a Christian, compassion will override the ‘rule’ that life should inevitably be preserved.

“Disproportionate treatment for the sake of prolonging life is an example of this.

The church said it would support the potentially fatal withdrawal of treatment only if all alternatives had been considered, “so that the possibly lethal act would only be performed with manifest reluctance.”

Yet the Revd Butler’s submission makes clear that there are a wide range of acceptable reasons to withdraw care from a child – with the cost of the care among the considerations.

“Great caution should be exercised in brining questions of cost into the equation when considering what treatment might be provided,” he wrote.

“The principle of justice inevitably means that the potential cost of treatment itself, the longer term costs of health care and education and opportunity cost to the NHS in terms of saving other lives have to be considered.”

The church also urges all the parties involved in care for critically ill babies should be realistic in their expectations, demands, and claims.

The submission says: “The principle of humility asks that members of the medical profession restrain themselves from claiming greater powers to heal than they can deliver.

“It asks that parents restrain themselves from demanding the impossible.”

I see very little to take issue with in the details of what the Church of England said with the exception of (most) financial considerations because of the difficulty of maintaining any sense of equity once money enters the equation. It’s important to note that the report is not talking about infanticide, it’s sanctioning a healthy dose of humility on the part of mortals in facing mortality. That being said, I am nervous about and am against any process that would take such decisions out of the hands of parents. Who makes the decision not to pursue treatment… is it the parents, the doctors or the state? Some combination thereof? Ideally one would hope parents could arrive at a decision based upon consultation with their physicians, but a board or the state should not be able to trump parents, there’s too much chance for abuse or neglect and too many grey areas. What is hopeless to one doctor may not be hopeless to another, so the final decision must remain with the family in order to be equitable and moral. We may not agree that a family has made the best choice, but it is their choice to make in these situations.

This discussion reminds me of one of the questions from the general ordination exams from lat year… I’ll post my answer above to further flesh out my thinking in this area.

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