File this one under the “Questions worth Asking” category.  Rob Moll has an excellent summation of a few articles highlighting the way medical expenses are altering how we think about end-of-life decisions and the recommendations doctors make:

Certainly life is priceless. But is more life equally invaluable?

Dying is different these days. Once, vast resources could go toward treating a man suffering from a heart attack. If he lived, he could continue living for decades, and those resources justifiably provided years of good living. Now, people die slowly, consuming those vast resources over the course of years–and often crippling relatives financially.

Economic factors shouldn’t be ignored in making end-of-life decisions.  We are not a country of infinite resources, and even if we were it is not clear that we ought devote infinite resources to the preservation of this life.  Sometimes letting go is the responsible thing to do.

Of course, such questions are excruciatingly difficult to answer. Moll frames them well:

Yet, what is that extra time worth? Any universal health care system seems unlikely to provide expensive and marginally beneficial treatment. The government would decide it’s not worth $1 million in taxpayer money to give an 85-year-old six more months of life. But unless and until the state starts making those decisions for us, we Christians need to think this one through: How much is longer life worth?

Here’s another one: How should pastors help their parishoners to make that choice. This is enough. It’s time to see God.

Moll’s language of “unless and until” seems to suggest that Christians ought deliberate about such questions only as a stop-gap until the government makes the final determinations.  I would disagree with him here, and argue that it is family’s job, not the government, to make these judgments.  But that quibble doesn’t answer his underlying question:  when is it time to say goodbye?

Of course, the question is almost certainly unanswerable in the abstract.  But sometimes the asking is more important than the answering.

Print Friendly, PDF & Email

Posted by Matthew Lee Anderson

Matthew Lee Anderson is the Founder and Lead Writer of Mere Orthodoxy. He is the author of Earthen Vessels: Why Our Bodies Matter to our Faith and The End of Our Exploring: A Book about Questioning and the Confidence of Faith. Follow him on Twitter or on Facebook.

4 Comments

  1. One standard that the state may use in deciding end-of-life decisions for patients is Quality-Adjusted Life-Years. The key considerations here are the patient’s “capacity to benefit” and the cost that will be imposed on society.

    The risk-wage tradeoff is another attempt to measure the value of a human life as the amount of compensation that the individual employee requires in risky job. It is a problematic measure because some people cannot afford not to work that dangerous job.

    One thought that comes to mind for me is the apparent difficulty with applying Christian morality to these situations, which could not have been foreseen by its expositors. Or is it that God has given us the ability to prolong life to the point that it is not worth living?

    How do we decide when God’s gift of life is no longer precious enough to prolong by any means necessary? Wait, wait. Because their life has been artificially lengthened, the patient’s decision at the end of life is low in moral gravity since it is a choice to succumb to the natural, foreordained process of dying that should have happened earlier.

    It is the family’s decision but I do think that the cost and the patient’s continued quality of life should be considerations.

    Reply

  2. “I would disagree with him here, and argue that it is family’s job, not the government, to make these judgments.”
    I would in fact, go further and say that these issues need to be discussed and wrestled with before one can even have an intelligent opinion on the issue of government health care. After all, rationing is a fact of life, and in a universal system, rationing takes place in part by denying services to those who are no longer “worth” them.

    This is an interesting question for me personally, because I recently had a grandfather go through a very nasty and unexpected period of surgical complications for several months before finally passing away. I can honestly say that the whole family would have preferred that he had died “under the knife” rather than had his life extended a few months. Meanwhile, I have a 93 year-old grandmother whose quality of life is continuing to deteriorate, though in a more gradual process. Interestingly enough, had the grandfather gone through what the grandmother is going through, I think he would have been quite happy to continue living, while she seems determined to stay unhappy and force those around her away through her attitude and actions.

    I think that the problem with any government system is that it is ill-equipped to deal with intangibles. Were my grandmother to need life-sustaining care at this point (she needs lots of care, but none of it is actually life-sustaining), I’m not sure it would be worth it in an objective sense. However, like I said, had the grandfather who died been put into the same circumstances, I’d say without hesitation that it would be worth it. It primarily revolves around their differing attitudes. How does one quantify that in a meaningful way?

    Ok, enough rambling. Thanks for the thought-provoking post though.

    Reply

  3. Prufrock,

    That’s an interesting standard. I’ll have to do some more reading on that. Thanks for pointing it out.

    “One thought that comes to mind for me is the apparent difficulty with applying Christian morality to these situations, which could not have been foreseen by its expositors. Or is it that God has given us the ability to prolong life to the point that it is not worth living?”

    It is difficult, yes, but not any more difficult than any other issues not obviously articulated in the Good Book (gun control anyone?). The interesting phrase you use is “worth living.” On some level, as a pro-lifer, I think that all life is worth living. On the other hand, I think that all life is not so worth living that we ought to seek to live it perpetually (as some transhumanists are seeking).

    “It is the family’s decision but I do think that the cost and the patient’s continued quality of life should be considerations.”

    In this, we agree.

    Josh,

    You wrote:

    “I would in fact, go further and say that these issues need to be discussed and wrestled with before one can even have an intelligent opinion on the issue of government health care. After all, rationing is a fact of life, and in a universal system, rationing takes place in part by denying services to those who are no longer “worth” them.”

    I agree wholeheartedly. Well put.

    “I think that the problem with any government system is that it is ill-equipped to deal with intangibles. Were my grandmother to need life-sustaining care at this point (she needs lots of care, but none of it is actually life-sustaining), I’m not sure it would be worth it in an objective sense. However, like I said, had the grandfather who died been put into the same circumstances, I’d say without hesitation that it would be worth it. It primarily revolves around their differing attitudes. How does one quantify that in a meaningful way?”

    That’s a great question, which is why I wish the government would stay out of such issues as much as possible and hand over more control to medical ethics boards. Whether that happens has yet to be determined. But these sorts of issues are simply one reason to avoid universalized health care. I’m no expert, but I could forsee a standardized code of how to deal with such situations that could be positively disastrous.

    Reply

  4. Per your example, I am curious what the Christian perspective on gun control would be, as distinct from the conservative view. The two are obviously distinguishable and I would guess that we stand opposite on the issue in question.

    Reply

Leave a reply

Your email address will not be published. Required fields are marked *