In a mere three days, I fly out to Boston to attend the conference of the Orthodox Christian Association of Medicine, Psychology and Religion, at which I will talk about our micropreemie and the bioethical dilemma of babies born at a high risk of death. The donations of friends and supporters have made this possible and I cannot thank you enough!
Since I’m going to be talking to a bunch of Orthodox practitioners and thinkers and I am Orthodox myself, I thought that it would be worthwhile to propose my own set of guidelines for priests providing pastoral care to families in the same dilemma that we were in:
Statements on suffering:
1. When we suffer, we enter in to the suffering of Jesus, and this suffering has positive spiritual value, no matter the age or the awareness of the person.
2. A life that is lived for a short time, even if it includes suffering, glorifies God.
3. An unsuccessful attempt to preserve life should not be viewed as sinful, even if it includes suffering of the patient.
1. Clergy should help parents prayerfully consider their motivations. Parents should be willing to accept a disabled child. Willful inaction with the purpose of preventing the survival of a disabled child is not allowable.
2. A desire to save a child from suffering discomfort during treatment may serve the best interests of the child, but it should be balanced with the need to protect life, especially when survival is still possible.
3. The baby is to be regarded as an individual. Group statistics on survival and other outcomes at each gestational age may be helpful in discerning a course of action, but an individual baby’s signs of improving or deteriorating health should be the primary evidence that supports a decision to initiate, continue or withhold treatment.
1. Even at such an overwhelming moment as the birth of a critically ill baby, parents should not base decisions on fear of the future, should not doubt in God’s providence, and should believe that God will give them what they need to make the right decision. They should not make a hasty decision immediately to save themselves from a difficult decision later.
2. Current AAP guidelines consider a decision to withhold treatment at birth and a decision to withdraw it later to be ethically equivalent when survival appears unlikely. Similarly, it is allowable for Orthodox parents to request treatment at birth and later ask for it to be withdrawn if a baby’s condition rapidly deteriorates.
Withdrawal of treatment:
Withholding or withdrawal of artificial life support should be considered in consultation with one’s spiritual father when there is overwhelming evidence that survival is not possible. Artificial life support should not prolong the dying process.
Any thoughts? I’d love to hear them!