Case Study on Death and Dying
Nowadays, we live in a multicultural world, where individuals who represent different traditions have to engage in contact and coexistence in a wide array of situations. In particular, patients of clinics may often belong to different cultural and/or religious traditions.
This means that it is paramount for medics to take into account the cultural peculiarities of their patients so as to be able to satisfy the needs and desires of these clients rather than act in a way that is appropriate for the medic, but unacceptable for the patient. This paper provides a discussion on a case study of a man named George, who finds out he has amyotrophic lateral sclerosis (ALS), a severe disease that will disable him within several years. The problem of euthanasia for George is considered from two perspectives: Christian and Buddhist.
The Nature of George’s Suffering and Disease
Generally speaking, Christians tend to view all the forms of suffering as the result of the original sin of Adam and Eve, which caused the human to become a creature that is predisposed to sinning (Josephson & Peteet, 2004). In addition, the human, the being with a free will, can sometimes choose to behave sinfully, rebelling against God, which is then punished by additional suffering and disease (Josephson & Peteet, 2004).
Many Protestant traditions, such as Pentecostal, Fundamentalist, and some Evangelical Protestants, view disease as a punishment for personal sin (Josephson & Peteet, 2004, p. 65). Many Protestants also try to behave non-sinfully so as to avoid such punishment, which is a vain effort due to the fact that, according to Protestants, it is required to behave appropriately because one is good and not because they wish to avoid punishment (Josephson & Peteet, 2004). Similarly, Catholics may view George’s disease as an outcome of his moral transgressions and vice (Josephson & Peteet, 2004).
On the whole, most Christians would be convinced that the severe condition George suffers from is a form of punishment for the sins he has committed (Josephson & Peteet, 2004).
On the whole, Buddhism teaches that suffering is an inevitable part of life and that there is no simple way out of it; one must learn and follow the path of the Four Noble Truths in order to end suffering (Josephson & Peteet, 2004, pp. 129-130). Therefore, the disease is virtually unavoidable (unless one completely frees oneself from suffering via the path that was just described); it may occur due to the bad karma (actions) of a person, which accumulate and affect one’s faith.
The Value of George’s Life as a Person, and the Value of His Life With ALS
In general, most Christian traditions declare that every human has a soul, which was created by God, and that means that every human life is invaluable (Woodhead, 2014). At the same time, several traditions, such as Evangelical Protestants, may believe that the life in this world is only a step towards the life in the next world, in the Heaven (or Hell), from which it follows that dying is not an entirely tragic occurrence, but merely a transition.
The value of George’s life is also high according to the Catholic tradition; its value should not become much lower due to the disease (Weber, 1958/2003). The value of his life prior to his illness is apparently high in several Protestant traditions, which may view being successful, rich, or well-off as signs of one’s being chosen by God for salvation (Weber, 1958/2003). Simultaneously, experiencing a failure or suffering from a major problem such as serious illness (e.g., ALS) might be the sign of losing God’s disposition, which decreases the total value of the life of the ill person, but does not make it worthless (Weber, 1958/2003).
Because George can be considered “successful” in his life according to the Western cultural traditions, and he probably accepted Buddhism after being raised in the Western culture, perhaps he follows some adapted and changed form of Buddhism such as Protestant Buddhism (Josephson & Peteet, 2004, p. 130). In this case, he is also likely to consider his life successful.
If this is so, George probably would believe that his life was valuable and not full of suffering. Also, Buddhists tend to view life as a series of suffering, and do not believe that a person is a permanent, stable entity (such as a soul) (Josephson & Peteet, 2004). Nevertheless, they still value life and the chance to cultivate and practice the desirable mental states (e.g., patience, forbearance, etc.) (Georgetown University, n.d.). George’s life with ALS would still be valuable because he would still be able to practice the proper actions, which would permit him to obtain good karma and improve the starting conditions for his next “reincarnation.”
Values and Considerations Pertaining to Euthanasia
On the whole, as has been previously stressed, Christians perceive the life of a human being as a life of a soul that has been created by God (Woodhead, 2014). The death occurs naturally, but it is ultimately the result of the original sin; as the consequence of death, the person’s soul is then transferred to the next world.
However, most Christians tend to believe that suicide is a severe sin (Richmond, 2014), for death should occur when God decides so, and must not be the result of an arbitrary decision of a person to end their earthly life. In addition, for some Christian churches, suicide is a serious sin because the person who committed suicide also deprives themselves of the chance to reconsider, and cannot pray or feel remorse for what they have done. Most Christians would primarily focus on these considerations.
Buddhists would in many cases be against euthanasia. For instance, they often consider voluntary euthanasia wrong, because the latter means that one has succumbed to physical suffering and permitted it to cause the suffering of the mind (BBC, 2009). In addition, Buddhists believe that ending life is wrong, so euthanasia is also wrong for both the patient and the one who administers it (BBC, 2009). Also, because death is a type of transition which causes new life, suicide or euthanasia should also be wrong, because 1) killing oneself is bad karma, so the new creature will end up with worse karma in the case when euthanasia took place; 2) the new creature might be born in a state that is worse than the condition of the patient (BBC, 2009).
The Options That Are Morally Justified for the Religions
From the discussion which was provided above, it should be clear that at least a large proportion of Christians would view euthanasia, or assisted suicide, as a severe sin, a mistake for which a person cannot feel remorse due to depriving oneself of any chance to do so (Richmond, 2014). Thus, George should not agree to have euthanasia, but ought to focus on making efforts towards redeeming the sins which led him to this condition. In different Christian churches, such efforts may be made via praying, attempting to help others, and so on.
In the case of Buddhism, it would be morally justified to avoid voluntarily ending one’s life via assisted suicide. Suffering is unavoidable, but, according to Buddhism, such as the way of life, and permitting a physical disease to result in the illness of the mind would be inappropriate (BBC, 2009). On the contrary, George should focus on practicing the desirable actions and cultivating the appropriate karma via the implementation of the Four Noble Truths. Even when George becomes physically disabled, it will probably still be possible for him to engage in the practice of meditation.
With respect to assisted suicide, my position is rather ambiguous. On the one hand, euthanasia is probably a merciful way to end the pain of an individual who is suffering immensely, and for whom there is no chance of survival. On the other hand, there may also exist a chance of a medical mistake or a wrong prognosis, when it was decided that a person would be unable to live further, but he or she would actually recover and live for a considerable amount of time in spite of the fact that the disease they suffered from was extremely severe. In addition, the provision of the right to supply patients with euthanasia may result in and the additional possibility for medics to engage in certain violations and misconducts.
In the case of George, it is unclear whether agreeing to euthanasia is an adequate option. On the one hand, due to his ALS, he will become paralyzed and may be unable to perform even the basic functions which are required for self-sustenance. He will also probably experience mental suffering due to the need to use the assistance of others in order to sustain himself. Also, others will have to dedicate a large amount of time and effort to help George. On the other hand, such mental suffering may not be very severe if George also loses his cognitive abilities; also, he may not experience serious physical pain.
On the whole, my position is that George should be supported as long as he has the ability to perform the basic self-maintenance functions, and beyond that; he should be assisted if he becomes immobile. However, if his paralysis progresses to the point where his life is impossible without the use of additional equipment (such as the machine for the artificial lung ventilation), it is possible to stop the treatment, which would not be direct euthanasia, but simply stopping extending the life of the man beyond its “natural” borders by using artificial means.
On the whole, it should be stressed that both Christianity (different confessions) and Buddhism tend to view euthanasia as an adverse and highly undesirable act. Therefore, if George is a Christian or Buddhist, such an option might be mentioned to him just in case, but no insistent proposals should be made. Simultaneously, it might be possible to simply offer George or his family to “unplug” George from life support once he is in a condition when he cannot sustain himself at all (e.g., cannot breathe on his own), which perhaps will not be euthanasia, but simply stopping the procedures extending his lifespan beyond the “natural limits” as introduced by his ALS.
BBC. (2009). Buddhism, euthanasia and suicide. Web.
Georgetown University. (n.d.). Buddhism on health and illness. Web.
Josephson, A. M., & Peteet, J. R. (Eds.). (2004). Handbook of spirituality and worldview in clinical practice. Arlington, VA: American Psychiatric Publishing, Inc.
Richmond, D. (2014). How should Christians respond to proposals to legalise euthanasia and assisted suicide? Stimulus: The New Zealand Journal of Christian Thought and Practice, 21(1), 20-28.
Weber, M. (2003). The Protestant ethic and the spirit of capitalism. (T. Parsons, Trans.). Mineola, NY: Courier Publishing. (Original work published 1958.).
Woodhead, L. (2014). Christianity: A very short introduction (2nd ed.). Oxford, UK: Oxford University Press.