Death and Dying Ethical Analysis of Euthanasia

Everyone's perspective of the world is different and unique. A worldview is the fundamental basis of reality, theoretical, beliefs, practices, relationships, and is shared by religion and/or culture (Shelly and Miller, 2006). In my nursing practice, it is important to consider the meaning of spirituality and provide compassionate care to each patient and/or caregiver which can influence a person’s worldview in order to holistically care for any patient in a respectful manner. However, patient spirituality is due to the wide perspective of worldviews and has a positive effect that can be helpful in satisfying patients for better care, an increase in coping skills, recovery time and as well as decrease in mortality (Puchalski, 2001).

This essay will discuss the comparative ethical analysis of George’s situation and his end of life decision from the perspective of two diverse religious worldviews values and spirituality.

George is an attorney in his mid-fifties who has been diagnosed and tested positive for amyotrophic lateral sclerosis (ALS) which is a degenerative disease affecting the nerve cells of the brain and spinal cord. He teaches at the local law university in Oregon. He plays an active role in his son’s basketball playing. George understands that medication could only slow down the progression of this disease and there is no cure. He is depended on by his family members for support of his basic everyday functions. The disease will progressively cause motor deterioration and the muscle atrophy will reach complete muscle control loss, and the inability to speak, walk, eat, and breath progressively. He is also aware that the life expectancy for this disease can be three to five years, but in rare situations, it could also be more than ten years. When weighing out the imminent suffering that was going to come with this disease, George considered the option of voluntary euthanasia. The discussion proceeds with a comparative analysis of the views of Christianity and Buddhism and how they influence decision making in medical health care and how each religion interprets the nature of George's condition such as sickness, suffering, life, death, and modern practices like euthanasia and humanity in general. Also how this religions provide answers to basic worldview questions. My personal reflection is included and presented in the context from my own beliefs and interpretation of morality.

Worldviews are made up of assumptions, categories, and values that provide the lens in which individuals view the universe. Therefore, “they give meaning to life, both personally and for humanity as a whole,” (Shelly & Miller, 2006). In order to understand one’s concept of worldviews, there are seven questions provided by an American Christian author, speaker, and editor for InterVarsity Press; his name is James Sire. The responses to those questions will be varied depending on which religions will be considered (James W. Sire, 2004). The seven questions to be asked to help identify one’s worldview are: What is prime reality?; What is the nature of the world around us?; What is a human being?; What happens to a person at death?; How is it possible to know anything at all?; How do people know what is right and what is wrong?; and What is the meaning of human history?

The prime reality is simply what is important to our lives. According to Shelly and Miller, Christianity believes that God is the prime reality, reason for living and He is the eternal being, righteousness, powerful, magnificent and perfection. For Buddhism, the reality is everything and is compounded as an impersonal being and can be described as a energy, force and consciousness. They don't believe that there is external God (Anderson, R. E. 2013). Additional, External reality is the belief of how the earth was created and the material or matter that is around everyone of us. Christianity believe that God created the world in seven days and it was set forth with a good purpose. Buddhism have a belief that the world has no value if an individual does not have a main goal and should focus in the world by escaping to Nirvana. They don’t believe that God create the universe and that all exists was a result of a sudden inner impulse or external stimulus phenomenon. Instead they focus on upon beings that are mindful of their actions and attempts to live a life that is pure of simplicity, humble and kindness (Anderson, R. E. 2013). In Christianity, human beings are made in reflection of God and are created to share and spread the word of God. This also follows principles to obtain more souls into Heaven and the afterlife and the process of obtaining salvation. In Buddhism, human beings are sentient beings with a mindstream. These sentient being controlled by the five “skandhas” are consciousness, mental formations, perception, matter and sensation.

Furthermore, this sentient being is gained through meditation and denying worldly happiness. Christians believe that there exists an objective moral law that is based on the nature of God. God reveals his perfect moral nature both through moral commands which he has communicated in the Bible, and through a common moral conscience which God has given all humans. Buddhism follows more of a cycle of rebirth and reincarnation and is essentially based on a person’s behavior or acts that they do or don't’ commit in their present life. Because of this cycle, if a buddhist is successful in their current life and takes the steps of enlightenment this will lead to their heaven which is called Nirvana. However, Buddhism believes in cycle and life after death and rebirth called samsara. They hope to escape samsara and achieve nirvana, in order to end suffering Through eventual enlightenment. The Buddha's enlightenment was the perception knowledge of the Four Noble Truths. The four Noble Truths for buddhism in life is suffering, denying the nature of reality, overcoming the ignorance that can be ended in suffering and finally the path for prevention or handel suffering is the Noble Eightfold Path. What’s included consists of right meditation, right mindedness, right efforts, right actions, right speech, right intentions, right views and the right way of maintenance (Aich T. K. 2013). Christians believe that for every human there is an afterlife which can be either separated from God or presence of God forever. The only means for any human to spend eternity with God provided by Jesus Christ’s sacrificial death and resurrection. They believe if someone reject Jesus’ sacrifice for humanity will forever be separated from the Lord God.

Christians believe that the purpose of life is to enjoy having a strong faith with God forever. However, no one should take their own life because only God has that option and determined the outcomes Himself. God created a plan for each of us and that this is God’s plan for George’s life. Even though in the disease of George, God gave him this disease so in the end of him can honor and respect God. In a case of George suffering, God is able to prove how he is powerful to handle it. However, Christians believe that God knows about human suffering/ sickness and that through suffering human beings will eventually have the eternal salvation (wills, 2014). George suffering with the disease in christian’s view is a way of building strength or power not just physically but spiritually and he will be close to God by his faith and supported by God’s belief. “God promises for all His childerens that one day, suffering and proceedings will cease (Revelation 21:4). According to Meilaender, suffering and death are normal expected thing to happen for human’s life and only God has the power to decide in taking our suffering away or not (Meilaender, 2013).

Buddhists as Christians share the same view in suffering that is a part of all human life occurrence and can’t be avoided or denied. During suffering, the Buddhist focus on mental health and power because it gives the individual time to determine options made in life. They believe the main problem is not the suffering with illnesses but instead how individual response to it. Buddhism views each individual life as a reflection, manifestation, indication and privilege with a unique responsibility of a universal life (Littlefair, S., & Littlefair, S.2018). Although in the case study of George who has been suffering from ALS, Buddhists believe that suffering should use meditation, morality, enlightenment and wisdom, not hospitalized or spend money to treat it. Buddhists and Christians have different perspectives when it comes to voluntary euthanasia. Christians seem to be completely against the act while Buddhists don’t believe it to be the recommended path to follow- still allow it. A part of the Buddhist oath includes not killing; this may include or exclude killing oneself or killing another out of mercy. They believe in removing suffering, and they also believe that one should die while most calm and in a state of peacefulness. In George’s case, they wouldn’t believe that euthanasia should be considered as a way to die, as it may result in a negative karma in his rebirth/next life. With that being said, euthanasia is not forbidden; it is rather frowned upon.

In conclusion, as a healthcare professional, I meet in a daily basis a patients with diverse values, viewpoints, backgrounds, traditions, ethnicities and religious. Personally I understand the power of spirituality has in patients with their care and their worldview. God always remains to be the most powerful and He is the one who created the earth using His powers and in times of sickness he holds all capacity of powers. I believe God give the doctors the ability and opportunity to be educated in many subjects with interest of practice to treat patients as medically, but the only one can heal us is God. I always find comfort and hope through my faith in God. Illness or non-illness related issues I believe as well that God causes sickness or suffering to any person to make him or her close to Him; in other words, the Lord likes to hear our voices for help at all times.

Therefore, no matter how’s the situation is we should be thankful to all that we have in the world. The most valuable time to do so is when we are healthy and happy to thank Him, not only when we are sick or suffering. I'm always thankful to God, starting every morning when I open my eyes, for giving me life. I don't think God wants to punish his children by making them sick or causing pain, however I do think that He allows us to go through trials so that we may draw closer to him and become more compassionate towards others. I once heard someone say that when things go wrong it's always blamed on God, yet when things are going well in our lives God isn't given the credit. Regarding George case I don't agree at all with his thought about voluntary euthanasia, since God give our soul in the body He the only one can take it at His time. The deterioration condition of George's disease ALS which make him suffer and being depended on someone to help him, I believe this make him close to God and the more he suffered the more will take his sinners away. Human being not perfect, and always all of us has in life somewhere a sins. I try to thank him daily for what is right in my life, but I do also pray more intensely when I'm struggling and expect anything come sometimes not well in life from God. overall, Whatever the outcome, God is always with those who suffer and He understands their every pain and need.

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