As our medical technology advances, and the skill of surgeons and other medical professionals is able to refine complex procedures prolonging life we find ourselves being faced with a raft of new questions directly linked to the theology and ethics of treatment. Two questions are attracting my attention this week due to a recent event here in the UK.

A teenage girl who has battled leukemia since the age of four or five has, because of the medication, developed a heart condition. The hospital beleives that the only solution available to her – to prolong her life – is a heart transplant. The young lady has declined, in part (according to media reports) because there is no guarantee she’ll survive the procedure, she would need another transplant within 10 years, she would have to committ to an extensive drug regime, and there is a real possibility that the leukemia would return, and start the whole process again. The hospital then sought to remove her from the care and custody of her parents (her mother is an ER nurse) so as to force her to have the operation. A child protection officer was called in to interview the teenager, and, as a result of her testimony, legal proceedings at the High Court were abandoned.

I am sitting here, thinking about this scenario, wondering what I would have done were I in her place, and finding that given the circumstances I would probably do exactly as she has done; but it does raise some interesting questions. At which point does the possible treatment (in this case a heart transplant) cause more suffering than it is designed to relieve? How doe we assess this, and what theological and pastoral issues does it raise? By refusing to continue down the path of this particular treatment is this young lady abandoning hope (an issue raised in my earlier post)? Or is she simply choosing the wiser course – actively breaking the cycle of suffering? Finally, I find myself asking about the hubris of the local hospital, in attempting to force their will upon this young lady and her family – in so doing, having caused distress and upset, forgetting that this is a very human situation.

What I mean when I say that this is a very human situation is that our modern medical advances have made significant strides in extending life – but is that extension always of a “whole” life, or is it often merely of the basic animal functions of breathing, eating and sleeping? Naturally this raises “quality of life” issues which are at the heart of the debate over assisted suicide.

In addition, because it is possible to mechanically extend life – I have seen on more than one occasion, how the mechanics of medicine, seems to overtake, or overwhelm the ability of practitioners to treat patients humainly, seeing the “whole” person, and not merely a broken toy, or malfunctioning robot. One, naturally feeds the other here, but the point is the same, something is lost in the process, something very important – the touch of humanity, and a response to the patient’s needs grouned in that human experience. How then, do we restore what has been lost?

Last week’s Guardian (and other media here in the UK) reported the death by suicide of a 23 year old man paralysed in a rugby accident in March 2007; this is in addition to the recent reporting of Debbie Purdy, awaiting clarification from the High Court on the law that forbids others aiding those wishing to end their life. The difference between the two cases is that Daniel James’ condition was not a terminal illness in the usual sense, Debbie Purdy on the other hand has progressive MS.

One of the principal arguments in favour of a planned (and as necessary, assisted) death, is the relief of suffering, and ending one’s life with dignity. It is admittedly a strong point – one which from an OC/IC perspective we cannot discount. Is there value in life, purely for the sake of being alive; or does that life require . . . . something else, something personally tangible in order to . . . “justify” . . .  its continuance?

What also emerges here is the rather painful sense of loss . . . . and not just any loss, but the loss of hope. Daniel James described his situation as a prison, a second class existence . . . it was a life not worth living. He could no longer “justify” continuing.

“Hope” is, for us, is embodied in the Incarnation (Mt. 12.21); is expounded upon by the teaching, and actions of Christ, and the Apostle (Rom. 8.24ff): “for in hope we were saved. Now hope that sees for itself is not hope. For who hopes for what one sees? But if we hope for what we do not see, we wait with endurance.” Enduring hope and confidence in Christ then is an essential element shaping our Christian identity. How then are we to discern a way forward in the face of what can only be described as an overwhelmingly “hopeless” situation?

These are not easy questions, and they do not have easy answers. To merely espouse the inherited thinking we bring to the table from our past denominational lives is, I think, short-sighted and does not contribute to expressing the independence of our own discernment and thought as OC/IC believers.