THE VALUE OF A HEARTBEAT
Within the past month a close friend of many years passed on. He had been an avid health advocate who exercised regularly, maintained his slim physique by eating sensibly, and avoided the unhealthful habits of smoking, drinking or drug use of any sort. By rights he deserved to make it well past the 74 years he reached, but the stoke he suffered refused to play favorites. During his last couple of weeks his three offspring argued over whether to remove the feeding and breathing tubes keeping him alive. The fracas reminded me of a similar controversy in 2005 concerning Terri Schiavo, the Florida woman whose feeding tube removal required a court order, and the nationwide obsession at the time over the sanctity of life.
Amidst the controversy, and despite the differences of opinion expressed, often vehemently, three fundamental pronouncements are often accepted as unquestionable truths. As is often the case, matters universally embraced are most suspect, just as the worst laws enacted are invariably those passed without opposition. Let me rectify each of these pronouncements.
Pronouncement I: The death of anyone is a tragedy.
Reality I: Actually, death is the final and inevitable consequence of birth. With America’s population now past three hundred million, and a typical 75-year lifespan comprising 27,375 days, approximately 11,000 persons die in this country each day. Rather than a multitude of tragedies, many of those deaths represent the natural culmination of life and come as a welcome relief to the decedent as well as to family and friends.
Pronouncement II: Prior written instructions of a person in a persistent vegetative state constitute the determining factor on whether to sustain life support.
Reality II: Regardless of dogma to the contrary, a human life reduced to perpetual bodily function, but devoid of mental awareness, ceases to be life in any meaningful form. The proper determining factor in providing life support should be its probable restorative outcome.
Pronouncement III: No monetary value can be placed on a human life.
Reality III: Throughout the history of mankind, the reverse is true. Nowhere is this better exemplified than in the military service, an organization dedicated to killing people. It cost Caesar 75 cents to kill a man, the estimated expenditure per enemy dead for the support of the Roman armies. The war machine of Napoleon almost bankrupted France as the per capita cost of slaying rose substantially. With the Napoleonic wars’ cost at $6.25 billion and the slain totaling 2.1 million, the outlay came to just under $3,000 per man. The $180 billion expense of the First World War, resulting in 8,538,315 deaths, brought the cost of a life to a bit over $21,000. Finally, with the expensive equipment and support required by today’s fighting forces, dollar cost per resultant death remains a vital factor in national policy. And you may be certain that in the civilian sector, a similar consideration is given regularly to the value of a human life.
Let’s now descend into the realm of how the system really works. Modern medical technology is sufficiently sophisticated to sustain bodily functions for many years beyond that possible just a generation ago. There are, of course, practical considerations. As two examples, both Rose Kennedy, mother of President John Kennedy, and Madame Chiang Kai-shek, widow of the one-time ruler of Taiwan, managed to live to their 106th birthdays. Most likely, only the resources of the Kennedy fortune and the Taiwanese government made this possible. Of course, what’s available for persons of such prominence will not be shared with retired scullery maid Jane Doe. If extraordinary measures are required to prolong her life, they may not be forthcoming. I say may not rather than will not, for circumstances vary. I’m aware of a woman of nonexistent means who’s currently sustained on life support. Essentially blind and paralyzed while attached to breathing and feeding tubes, this 87-year-old woman survives, thanks to a knowledgeable attorney who arranged the transfer of all family assets elsewhere so she’s supported on Medicaid. However, if such abuses of the system become rampant, the practice will grind to a halt. Despite the illusion government is a bottomless pocket, it is not. There’s a limit, untested as yet, beyond which funds will not be available. Irrespective of rumors to the contrary, money is a finite substance.
Death with Dignity laws permit terminally ill patients to hasten an unavoidable death. However, an additional consideration must be the attitude of the nation’s religious communities. While many faiths adhere to ancient traditions, modern medical technology opens the door for faith leaders to actively reconsider some beliefs.
The position of the Roman Catholic Church is strict: The killing of a human violates divine law and offends the dignity of the person. However, many Catholics – particularly in the United States – cite various quotations by Pope Benedict XVI as a source for disagreement on this controversial issue. To compound confusion, physician-assisted dying is frequently and erroneously considered euthanasia.
As for the Evangelical Lutheran Church, a 1992 statement on end-of-life matters supports physician-assisted death: “Health care professionals are not required to use all available medical treatment in all circumstances. Medical treatment may be limited in some instances, and death allowed to occur.” However, they oppose euthanasia because it “deliberately destroys life created in the image of God.” You might note, Death with Dignity is a hotly debated topic they do not comment on.
The Orthodox Jewish Congregations are heavily involved in efforts to restrict physician assisted death. In 2000, Rabbi J. David Bleich, Jewish Law Professor at Yeshiva University’s stated “Judaism places the highest importance on palliation of pain, particularly in the case of terminal patients,” and “Judaism teaches that suicide is an offense against the Deity who is the Author of life.” Conservative and Reform leaders call for increased discussion of end-of-life issues, but they issue no official positions on assisted dying.
Methodists generally accept the individual’s freedom of conscience to determine the means and timing of death. Some regional conferences endorse the legalization of medical aid in dying.
Muslims are against physician-assisted dying. They believe all human life is sacred because it is given by Allah, and Allah chooses how long each person will live. Humans should not interfere in this. Thus, an end-of-life option is forbidden. Physicians must not take active measures to terminate a patient’s life. The Qur’an states: “Take not life which Allah made sacred otherwise than in the course of justice”
And lastly, a 1988 Presbyterian Church position paper on “heroic measures” states “Euthanasia, or ‘mercy-killing’ of a patient by a physician or by anyone else, including the patient himself (suicide) is murder. To withhold or to withdraw medical treatment, as is discussed here, does not constitute euthanasia and should not be placed into the same category with it.” However, Presbyterians are devoting further study and discussion to the specific issue of physician-assisted dying.
This finally gets us to the question posed by this article’s title: What’s the value of a heartbeat? I’ll offer a prediction. With each successive year medical technology will become more innovative and expensive; the aging American population will become less robust; and governmental resources will, despite innovative ways to increase taxes, dissipate due to entitlement payments. For these reasons, permitting lives to terminate will become acceptable. Perhaps Jack Kevorkian will return from the grave to resume his chosen occupation.