5-1-2016 Bioethics Part 55

Rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeith iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, on dw i'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio y byddwn yn gweithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n gobeithio'n fawr iawn, ond rwy'n physician-assisted suicide. The definition goes a little something like this, when a doctor knowingly and intentionally provides a person with the knowledge or means, or both, required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses, or supplying the drugs themselves. This is known as passive euthanasia. We'll look at active euthanasia in the coming weeks. The difference being in passive euthanasia, the doctor is not actually doing the In active euthanasia, there's two forms. There would be voluntary and involuntary. What do you think voluntary active euthanasia would look like? Any ideas? As opposed to involuntary. That's right, so involuntary, you're essentially going to the doctor and saying, I'd like to die, and the doctor goes, okay, are you sure? And you go, yeah, I'm sure. And the doctor is the one who's actually killing you. Usually it's not painful or anything, it's seeking to avoid as much pain as humanly possible. So voluntary is when you go to the doctor, what would involuntary be? They decide it's time for you to die. And if you think, well, only the Nazis participated in involuntary euthanasia, you would be wrong. There are people at very prominent research universities in the United States of America who are arguing that this is exactly what we ought to do. How's that? Right, yeah, nobody currently, at least legally, is being a victim of, we would say they'd be victims, of involuntary active euthanasia. Nobody. So, this is passive euthanasia. This is just the giving of the drugs or the counseling about the drugs or the prescribing of the drugs to somebody so that they can then take their own life. So why should we talk about something like this? Humans have always lived in a very pain-filled and difficult world. You do. Maybe you know that this morning. I'm sure at some point you have known that. You will know that in many days to come should you live for any length of time. This world is a hard, difficult, and painful place a lot of times. As we saw at the beginning of our time on suicide, living longer is, I'll ask the question, is living longer inherently a blessing? No. Why not? Because it's painful, right? So then this is a simple math equation. Shout out to Blake. Simple math equation, right? The longer you live, the more pain there will be to be experienced, at least hypothetically, right? If I live for ten days, short amount of time. Ten years, a bit longer. A hundred years, a whole lot more. What else? Is there anything else to living longer? Your body starts breaking down. That's right. You do not just go on for a certain number of years, talk to those who are older in the congregation, and you will find that the longer you live, the more aches and pains you have. It's just an inevitable part of getting older. We could have Larry come up here this morning. He could testify for the next four hours about all the things he's got going on with his body. There you go, yeah, amen, right? It's just the thing. The longer you live, then yes, there's the probability of pain on all forms of pain, but there's also just the fact that you're deteriorating as you go along. There are real things that are going to come about as we continue to push the boundaries of what it means to be human. The longer we live, the more things people get. Things that used to be incredibly rare are now seemingly common because people are just living longer. When everybody dies at 42, dementia, not really a problem. When people start pushing 90 on a regular basis, all of a sudden it becomes a national epidemic. It just wasn't the case a century ago. This will become more of an issue, not only because we're going to live longer, or we are living longer, but also because of medical technology. Medical technology, as we've seen in bits and pieces as we've gone along, we've seen that medical technology does not only fix us. The tools that we use as humans also use us in a very real sense. So, if there is no, let's say there's no cure for, something there's a cure for today, that we know is something, let's go with, should have had something written down, polio. Let's say there's no cure for polio. Then when people get polio, if we lived in a society where there was no polio vaccine, and people got polio, what would we think? Okay, they're going to die, or even if not that, it's like, well, yeah, I mean, they got polio. That's what people do in our society. It's sad, but like, we just live in a world where there's polio. Now, think about today, where polio is likely eradicated. We're not exactly sure, it could spring back up. What happens when somebody gets polio today? We're shocked, right? It is just an absolute, what? No, we live in the same world, but we have the technology, a very simple technology, just a couple of drops in your mouth, boom, you're vaccinated against polio for your entire life. But because that technology exists, and all of a sudden, when somebody gets the thing, that people got for thousands of years, all of a sudden, it's like, what? So, as medical technology improves, then us getting sicker, because we're living longer, becomes harder to deal with. This is why progress is very much a double-edged sword. People just used to die. Some of my greatest heroes in the faith, take John Owen, for example, buried 11 children before he died, and that was a lot, but it wasn't completely uncommon. In some societies, they didn't even name their children until they were 3 or 4 years old, because they thought they were probably going to die. We don't live in that world anymore. A child dies today, and we all lose our minds, because children just don't, that's not what children ordinarily do. This all is leading into this thing on physician-assisted suicide. The more we tend to think that our lives ought to be perfect, the less we will be able to deal with the pain and suffering that's in our lives. So, you and I better get comfortable talking about suicide right now. We're going to go over the arguments for it. I'd like for you to, this is going to be a thought experiment, I've got a number of things that are arguments that people are currently using for physician-assisted suicide. Again, voluntary, passive euthanasia. I'm not talking about doctors just going around killing people. What are the reasons, what might be the reasons that you can think of in the moment, on a Sunday morning, after hopefully you've caffeinated yourself to the hilt, why would somebody say this is something we should pursue as a society? Okay, so we have people that have chronic pain that will never go away, therefore... Okay, so it's a merciful act, is that what you're going to? Yep. Yes. Great. Indeed. Great, so it is a merciful act. Good. What else? Physician-assisted suicide. Stage 4 cancer, right, but why would be the reason we would pursue it in that person's case? Okay, so they're just going to die anyways, so you're essentially just speeding up the inevitable. Right, they're going to die anyways, just helping them out. There's a real one, that's the ugly monkey in the room, that we live in a society that is incredibly, incredibly costly to die in. You will spend, if you are an average American, half of your healthcare dollars in the last six months of your life. End of care treatment today is absurdly expensive. And you go, that's fine, I have insurance. Guess what? You're going to be paying for that somehow. If you're not, then everybody else is. We just all can't spend $800,000 in six months and then be like, ta-da, we're fine. It costs a ton of money. How much do you think it costs to take medication that would kill you? Anybody know? That's real close, 45 bucks on today's market is the cocktail that you need in order to kill yourself. Now, of course, you could kill yourself on all kinds of things, right? You could drink a bottle of Drano and die. But what I'm talking about is there's a series of medications that will make you die painlessly. It just takes you out. 45 bucks, done. That is an incredible amount of cost savings. And you go, well, that is sick. That is economics, friends. Here's the thing. This comes in two forms. There is the bottom-up approach and the top-down approach. The top-down approach seems a lot sicker. This is government-regulated healthcare needs to cut costs. Therefore, this is one of the fears, is that they will come along and say, you have reached a point. We have a sheet with a number of things that need to be checked off. We've checked off this number of things. You are essentially a life not worth continuing to live. Therefore, here's your medication. It's your time to die. Right? And it's probably going to be something like this. This is a totally hypothetical scenario, by the way. This is not a conspiracy theory. So, you know, just don't walk away from what I'm saying. Jeremy said the idea would be something like this. We're going to stop your treatment because it's too costly. So here's your option. You die suffering a miserable death. You'll survive for some period of time. But pain management is too expensive. Or you take the pills that are in this little box. Step one, step two, step three. You're done. That's the top-down approach. Then there's the bottom-up approach, though, where it comes to people and essentially gives them some kind of death benefit. Now, this is the real interesting one where the insurance company would come to you in some way like this. Here's the thing. You have stage four cancer. You're going to die. We can do two things as this insurance company. We have figured out, as an actuary, that your treatment is going to cost $500,000. So you can either take the insurance money that we're going to spend on you, probably, or we'll give you half of that money in cash right now, $250,000. And you can do anything you want with it. We think you've got three months to live. You could use that money to go on a vacation. You can give it away to your kids. You can do whatever. And here's the medicine to kill you at the end of the day. So you could literally just sign over to your kids, take the pills the next day, dead. Okay? Because we're saving money around here. Sounds like something. Anything else? What am I thinking of? Yes. Right. So this gets back to something we talked about yesterday, or last week, last couple of weeks. Your body is yours. We live in a liberal democracy. We believe in the rights of private property. This is mine. I might not own anything else in the world. I might not even own the clothes on my body. But what is my body is mine, and I can do with it whatever I want. I have the right to kill myself. This is a bold claim to tell somebody they can't do something with their own body. And then the kind of physician-assisted suicide thing on that is, because this is my body, I can do whatever I want with it. I don't only have the right to choose to die. I have the right to choose to die when I want to die. Okay? Good? Anything else? You guys have knocked most of them off the list. Okay, here's a few more. Number one. This is what do no harm actually looks like. Do no harm is something that's found in the Hippocratic statements on medicine. It's not actually in the Hippocratic Oath, but it's this idea. It's kind of the core of medicine. Do no harm. And people go, that's why you can't do physician-assisted suicide. We'll look at that in a minute. But they go, no, this is what do no harm looks like. Because harm is allowing people to suffer. Therefore, we get them out of their misery by assisting them in ending their own lives. That's one idea. Also, it's kind of like a C-section. A planned C-section. Our first child, Alexis, was born. We did not plan a C-section. The C-section was terrible and it was just a disaster. Our second child was a planned C-section. And it could not have been more different. Still Nicaragua, right? Those kind of complications. But we had planned for it, right? We knew what day it was coming on. We knew everything about it. It was just like, this is what we're going to do. So we got to plan. We had to set everything up. Days before, we're like, whoo, going to have a baby. You're not even sitting there going, oh man, oh man, oh man, when, when, when, when. We know. January 23rd. That's your birthday, right? Nailed it. January 23rd, we're going to have a baby. And we went on January 23rd. And they had shut down the hospital so we had to find a clinic. It was a long story. But anyways, it was way simpler than the first one because we had planned it. That's a cute story. Same thing goes for physician-assisted suicide. Your loved one is going to be in misery for months, maybe years. How much better would it be to plan out the death, to have a death party? This is a real thing that people do. We're all going to get around and celebrate. For one last go around and then you're going to kill yourself. It's going to be great. Because this is much easier emotionally to deal with. At least that's the argument. The last one is the same one we used, an argument that is also used for legalized abortions. Why ought we to have legalized abortions in America? I'm going to throw out some reasons. I'm not saying like what you believe, but just like what the arguments are. Rape. It's your body, you can do whatever you want with it. There's a big one. What's the women's health argument? Oh, it's OK, there's the Save the Mother's Life argument. There's another one I'm thinking of. Here it is. Women are going to get abortions. They're going to get them, one way or another. And so, if we have legalized abortions, then we have regulated clinics, therefore we have safe abortions. Abortions are going to happen, so let's make it safe. That's the argument, that's the way it goes. Same thing goes for physician-assisted suicide. People are going to kill themselves. People usually do a terrible job of killing themselves, or they don't get the help they need in order to facilitate killing themselves, and the professional counseling to get them to the place where they can truly determine whether they should kill themselves or not. So we're helping them kill themselves, because people are going to kill themselves. It's an act of mercy. We could go on, those are the biggest reasons. What's the problem with these reasons? There's a legion of them. Starting with this, there are two core commitments in healthcare. Sustaining life and relieving suffering. Both of those are so key. Think about it. What if we had a society that did not hold to both of those equally? Sustaining life and relieving suffering. What if we just said, we are a society that sustains life. What might be the case? You have vegetables left and right. That's right. We keep them alive. It does not matter. They will be kept alive. What else? There is no concern for actual human beings. We don't actually care what's going on with you. We just care whether you're dead or alive. That's it. So whatever measures, there's never a time to call it quits. We are going to keep you alive. Which would lead to a sick and weird society. In assisted suicide, however, the second principle is elevated above the first. Relieving suffering. We want to relieve suffering. And yeah, we know that relieving suffering gets in the way of sustaining life, but we're relieving suffering. And that's a big thing. Because suffering, or the lack of suffering, is our God today. One of the many. As long as I can get through this world pain-free, I'm good to go. Any kind of suffering on my part is bad. So I should take pills to control my cholesterol instead of changing my eating habits. I know that there's people who have cholesterol and can't control eating. Most of them can. I need to take pills to control my mood, right? Because I can't, there's nothing I can do to alter that. It's a must. Again, we've talked about depression. Medicine's fine for some people. It's just the idea that I can't put up with suffering. Any kind of pain, I'm going to take medication for. So we have a large amount of this population addicted to painkillers. Any kind of suffering needs to be alleviated. Therefore, if somebody is suffering at the end of their lives, then forget sustaining life, we're just going to relieve their suffering. It might be argued by some that there is not much of a life worth sustaining in the case of somebody who has some chronic pain. But what might be the problem with that? Where the doctor goes, The doctor goes, I don't think, Andy, that your life is worth living. What's the problem with that statement? There's a number of them. Yeah, so it's the doctor's opinion of Andy's life. Right? Okay. There's bias in that decision. Yeah? It's not his body. It's not his body? Ulterior motives could come in. Right? Cost saving measures, whatever. Those are all very true. These are all circled around this larger point. That is not a medical determination. That is a philosophical judgment. It is based on what it means for life to be worth living. That's not what a doctor does. A doctor could say, like this medication, this thing's not going to help you out. But it's a very different thing from saying that than to say you don't deserve to live. Doctors don't have the right to say that. Trust is a fundamental thing in healthcare. Right? Talk to our nursing students. They will tell you that they probably get pounded in their heads. Trust, trust, trust. Get bedside manner. You just got to get in there with your patient. Trust is fundamental to healthcare. There are some very large examples of what happens when there is a lack of trust. Let me give you a few. When a lack of trust does not exist in healthcare. This is true around the world. So we have in Nicaragua, for example, people die a lot from curable, regular diseases and maladies because people do not go to the doctor. Why do you think people do not go to the doctor? They are scared of the doctor. Anybody know why people are scared of the doctor in Nicaragua? This is a crazy reason. What happens when people go to the doctor in Nicaragua? They die. Why do people die when they go to the doctor in Nicaragua? Because they wait too long. And over generations, you get this sick society where people go, of course I'm not going to go to the doctor. My aunt went to the doctor one time and when she went to the doctor, she died. So if I go to the doctor, I'm going to die. Now this isn't just some kind of old wives tale. I was a medic in the army and that news spread fast in Nicaragua. And people would come to my house all the time to have procedures done on them because I was not the doctor's office and I was not the hospital, therefore they thought they were not going to die if they came to my house. So I got to do some from minor to fairly serious surgery on human beings in my living room because people were like, look, I hit myself in the leg with a machete three weeks ago and now it's turning gangrene and there's maggots in there and stuff and we just deal with it. It's awesome. It was the greatest. So I'd sew up people, cut stuff out of people, all kinds of stuff because they were like, look, I mean, what are you going to say? Like, no, you should go to the doctor. They don't go to the doctor. Yeah, don't let someone show them. I didn't have to deal with any broken fingernails because that's disgusting. So, oh yeah, anything else is fine. So people don't go to the doctor because when they go to the doctor they die. They don't go to the doctor because they're too... they die at the doctor because they're sick, so it just repeats the cycle. There's no trust of healthcare there. Jerry told me a story about what happens in Zimbabwe. People in Zimbabwe often get sick and die, sadly, from meningitis. Meningitis is something that is ravaging and terrible but curable if you catch it early enough. You catch it early enough by doing a very painful procedure called lumbar puncture. You stick a big fat needle into somebody's back. It's crazy to watch how big that needle is. You jam that thing in there. That's how they test it because that's where it first shows up. Now, here's the thing. People don't get it done because when they get it done, what do they find out oftentimes about themselves? No, they don't die. If you got a lumbar puncture to find out if you had meningitis, what would ordinarily be the result? You have meningitis. Thank you very much. You have meningitis because that's what the test does. However, what do you think the culture has come to believe about lumbar punctures? Gives you meningitis. So they don't get the procedure that catches the meningitis, therefore they die from meningitis. Or it is so ravaging to their bodies that they die eventually because they didn't catch it quick enough. You go, man, those backwards, third world, terrible countries. Anybody ever hear of the Tuskegee experiment? The Tuskegee syphilis experiment took place in the United States of America from 1932 till 1972. 1972, right? That was eight years before I was born, which makes you feel really stinking old. However, 50 years, American medical professionals gave syphilis to black men just to see what would happen. If you ever meet an old black couple who has a serious suspicion of health care, you go, I don't know why they don't like doctors. There's a solid reason that this is exactly the reason. Because doctors gave black men syphilis for decades. That's here, right here. Right here at home. A major problem with physician-assisted suicide is that it switches medicine away from sustaining life and creates this absolute massive breach of trust. Massive breach of trust. Even if it's something small. Most of the genetic research done in the United States of America today is done on the genes of a black woman who died who did not give her consent for her genes to be used. Something small, right? Only affected like one person. Many people have been helped as a result of this woman's genes. However, there's a lot of people who are going, wait, but I've given blood. But I've donated this, but I've donated that. Are they using my genes for something? And the answer is, hope not. Don't know. But your biological material is out there all over the place probably. Trust is fundamental. If we went down the route of physician-assisted suicide, all of medicine would be corrupted and tainted with this idea of are doctors, are the medical professionals that I'm going to those who sustain life or will they be this time agents of death? So this is the thing. People go, slippery slope arguments are lame. Not always. They can function very well. And we know this to be true in other cases. If we have something, physician-assisted suicide, you go, well, that only affects old people that have problems or people who are severely chronically ill. That's not me. It's not going to affect me. I guarantee you it will because you're going to be like, dang, dude. Sometimes doctors tell people they're going to die. They should just die. That's their counsel. And let's say that you wake up tomorrow and you have a severe pain in your leg. And you're even slightly hypochondriac, right? So the first thought you have is, I've got cancer in my leg, right? Which could be true. Then there will at least be, at least be a split-second thought in your brain that goes, I don't know if I should go to the doctor. Maybe they're going to tell me I should die. Why? Because, well, we have the society in which doctors function in this way, if we were to have it, which we don't yet, but we will soon enough. Probably. Now the argument here is that there are very detailed processes. In medicine, they're currently set up in places like the Netherlands. They kill more people than you could possibly imagine. We'll talk about that next week. Also, kind of in a state like Washington or Oregon, where there is legalized physician-assisted suicide, there's all these kind of steps that a person has to go through. You can't just go to the doctor one day. It's not like getting a marijuana card where you go in and you're like, oh man, I've got some pain in my back. And the doctor's like, well, how about I give you a card for some weed? And you go, oh, that would be great. And then you walk away. That exists. This is not the same as physician-assisted suicide. You have to go through some counseling steps. You have to see a number of people. You have to have a number of people check things off and then boom. All right, now you're good to go. That's the argument. It's going to be protected. And while that's true, that there are these steps, and thankfully there are these steps, when people are sick and dying, they're not in much of a place to determine whether their life is worth living or not. Case in point, think about the most depressed day of your life. And how willing you were to go on. And maybe you were not suicidal. Maybe you were. I have been severely suicidal. Now, make that day happen every day for months. And then think about the person in that state and go, okay, is that person in a place to determine whether they should go on living or not? What these people need is not a series of checklists and a series of professionals that can counsel them into what they should be doing with their own autonomy. What they need is our love and care and concern. Because what they desire for themselves is not good. And what love is, is not letting people do what they want. We don't believe that when it comes to six-year-olds or fellow church members, which are sometimes one and the same, we tell people, rightly, what you want, I understand, but what you want is not the right thing. And that's what people who are severely suffering need to hear. So, next week, we're going to talk about why physician-assisted suicide seems to be such a real option for many people. And then we'll get into looking at euthanasia itself. Friends, know this. This requires something of you. We're not here for an information session. This isn't just to make you feel better or make you feel like you're in college or something. Or for those of you who are in college, to make you think, what the heck did I show up early on Sunday morning for? We are dealing with other human beings as human beings ourselves. And as a result, our calling to love our neighbor goes beyond saying hi. So part of the entailment is like knowing what the heck you should do when you face these situations. And since we have started this thing on bioethics, we've run into stuff time and time again where people have either conceptually talked with something, to somebody about something, or had to actually deal with one of these circumstances. I hope that nobody ever around you goes, thinking about ending it, boy, I'm moving to Oregon so that I can kill myself. But the likelihood is that that will happen. The likelihood is that it will come up for a vote here in Tennessee. You will have a blessed wide door to talk to other human beings about this kind of stuff. If you want to get serious about stuff with people, there's fewer better ways than to talk about whether or not humans should receive the aid from doctors to kill themselves. That will get you on some serious ground real quick. So my prayer for us is that we would know these things and that we would be the kinds of people that don't just long for doctors to do something, but as we'll see next week, that we would long to be the kinds of people who would be part of helping people to not even desire to kill themselves. Because it will require you. It will not just require somebody else. Let's pray. I would thank you for this morning. Thank you for the call to love other people and to not just get rid of problems. We pray that we would first and foremost live ourselves in a way that is truthful. For we know that if we live as if we ought not to be suffering in any way, shape, or form, that if we live with no hope, that if we live without the ability to suffer well, then we will have zero place to tell others that they ought to suffer well. Nor will we be able to help them in their own suffering. So we pray that you would shape us, mold us, by the truth of your word, by the person of Jesus, by the work of the Holy Spirit in our lives, into people who suffer well and have hope in the midst of even our greatest trials. In Jesus' name we pray. Amen.