Showing posts with label health ethics. Show all posts
Showing posts with label health ethics. Show all posts

14 July 2017

Homily for the Fifth Sunday after Pentecost (Tone 4): Ukrainian Catholic Cathedral of the Holy Family, 9th July 2017

At university, we were amused by a much older student, who wanted to be known not as a Christian of one kind or another but as “The Seeker”. No explanation of belief or experience, or even any demonstration of fact, was satisfactory to her. We liked her a lot, although we naughtily teased her; she was ever so serious. But it struck me that she was, after all, never interested in finding what she said she was seeking. To her kind and interested spirit, it was in the quest that she felt safe, not at any point of arrival. Decision was to be resisted; it was taking a risk you could not back out from.

I admired the integrity of The Seeker. I hope she found something - or at least found out what it is that Christians are talking about, when they say that they are following Christ. After all, we Christians realise that it is not we who follow Christ, but He Who has been following us around all along. So much for thinking that being His disciple is all down to our own intellectual and moral efforts! It is He who dogs our every step away from His own. Francis Thompson’s poem The Hound of Heaven tells our familiar story:

I fled Him, down the nights and down the days
I hid from Him …
From those strong Feet that … followed after
But with unhurrying chase,
And unperturbèd pace,
Deliberate speed, majestic instancy …


Not that the lady Seeker was evading Christ. It simply had not dawned on her that, wherever her heart and her thinking took her, He was attached to her. She had not noticed that wherever she went and found nothing, she took Him with her. Perhaps one day she happened to turn round and saw Someone keeping up with her step by step. Perhaps one day she asked the right question at the time of the right answer, and cried out, “Rabboni!”

Contrast this virtuous, honest lady’s search with others, who say they are open-minded, liberal-hearted, vigorous in pursuit of human rights and values, and zealous about the truth, but who really want to deflect the light from their deeds and motives, and close humanity and its freedom down. They know full well that Christ our Light follows their every move; yet (as in Thompson’s poem) they call to the dawn, and say,

Float thy vague veil about me, lest He see!


All through the enervating news in recent days, there has loomed a crisis that sums up what is currently amiss. It is the case of Charlie Gard at Great Ormond Street Hospital for Children, and the rights of his parents to find healing for his life and to protect him until the day he dies. An experimental new means of treatment offers a ray of hope; but Great Ormond Street’s medical professionals, scientists and ethicists have dragged the family through to the European Court of Human Rights to seek to ensure that their expert opinion will prevail, and that Charlie’s life-support and sustenance be turned off, causing him to die. The justices of the United Kingdom and of the European Human Rights Court – which was established expressly to prevent the power of the state to deny Europe’s citizens their right to life and freedom - have declared that he is incurable; so, to prolong his life, or to attempt the treatment only available in America, is futile. Their thinking is chilling: not to bring about his death would cause him greater harm than causing him to die.

Lord Winston, Britain’s avuncular clinician, has pronounced that Pope Francis’ offer of care at his hospital in Rome, Bambino Gesù, may be well intentioned; but (he says) it has no scientific expertise in the child’s condition, and so the intervention of the Catholic Church in this field is cruel to Charlie. In this double-think it is "cruel" for Christians to offer the chance of treatment or, if it does not work, loving palliative care; yet it is not cruel for medics to induce the death of an infant patient against its parents’ will. Our jocular Foreign Secretary, Boris Johnson, weighs in to say that it would be illegal to move Charlie to Rome for treatment or care, because the courts have agreed with the hospital and, therefore, Charlie must be subject to its expert ethical and medical determination. This is not that Charlie be allowed to die - surrounded with our best love and protection, if the right to search for a possible cure is forbidden to the parents - but that his life be hastened to a close. Pope St John Paul declared that it is evil to deny the sick and dying the means of sustenance for life. Instead, this Catholic morality, which honours the sacredness of humanity - in which Christ Himself shared and suffered thirst and pain alike - must not be allowed to take precedence over the thinking of contemporary medical and scientific ethicists: supposedly objective, but actually relativist without roots in the principles of Christian civilisation, as it balances the fluctuating weights of conflicting medical knowledge and research, theories of care and wellbeing, political and economic expediency and public opinion. In the midst of all this, the Christian ethic that is needed cannot be tolerated, because it points to absolute truth. Thus respect for life is said to inspire and shape other considerations, but only as one belief among others that people are no less freely entitled to profess, and that states are democratically entitled to impose.

Now, hearing today’s Gospel (Matthew 8.28-9.1), most people think of the Gadarene swine throwing themselves into the sea of Galilee. But the point is about the two men who emerged from the tombs and encountered the uncomfortable light and truth of Jesus. They could not bear the sight or sound of it. Likewise, Lord Winston said that the Holy Father is cruel, and Boris Johnson says the Vatican’s request to care for Charlie is illegal interference. Likewise, Canada’s camera-loving Prime Minister Justin Trudeau, revelling in his rock-star treatment around the world, has appointed a Foreign Minister who confronts all objectors, including Canada’s Catholic bishops, by saying that women’s rights to abort children in the womb is at the forefront of his government’s furtherance of human rights. The demoniacs said much the same: “It has got nothing to do with You. As Son of God, You have nothing to do with us.” Thus we are not welcome to talk of human rights, when those who pretend to be its promoters want the unmoderated power to facilitate the death of children, the sick and the elderly. Thus our protests about the right to life are scorned, while real abuses to minorities, religions and whole populations on political and ideological grounds go unchecked. Thus we are presented as the enemy of women’s freedom and wellbeing by those who hide behind those noble aims, in order to un-restrict the destruction of the unborn. Thus we are presented as lacking compassion, while our carers in disguise, affronted that someone else may offer more effective treatment, decide what values they - not we - deem acceptable, and set their limitations on who is allowed to live on what conditions.

The interesting detail in today’s Gospel is that, whereas everywhere else in Galilee people flock to Jesus, when He comes to Gadara-Gerasa town, they plead with Him to go away. He has come from the cemetery and brought unclean contact with those who are dead from the inside. The men appeared to come out of the tombs, but they were not risen from the dead. They appeared to have come to life but they were dark - no light on. Today we sang, “Death has been plundered” and we understand that it has nothing in its vast domains to offer or detain us. My friend the Seeker looked everywhere. She could not find Christ among the dead to bring Him up, or cut down out of heaven and bring Him here below (see today’s Epistle, Romans 10.1-10). For He comes to us, not from out of death, but towards the Kingdom of heaven. His life all along is upon us, behind us, behind, within ahead. It is our own vital sign, sacrosanct. This is why Charlie has “everything to do” with us, as does the fate of so many in the world, where privilege, vested-interest expertise and power trump the right to life, and the wellbeing of the created order. It is not just that all life is sacred in the Name of its Maker, and the Redeemer Who died for its sake. It is because all humanity is destined towards, and even now endowed with, the blazing fact of life that is the Resurrection, and the restoration of all things in Christ. We may never harm and destroy what is on its way to glorification. We must love our own who are in the world to the end (cf. John 13.1). This we cannot turn away from; we cannot tell the Lord this time to go. For if we do, it is our own life, and our resurrection that we turn away, as Love unperturbed pursues us “down the nights and down the days” – with “unhurrying chase … His majestic instancy”. I turn and see: "Rabboni!"

11 May 2013

Liverpool Care Pathway: A Homily

Three or four times a year, a group of fellow Catholics and friends meet to discuss a matter of current social, public or ecclesiastical interest. At the preceding celebration of Mass, I try to find in the Scripture readings of the day something that will reflect on the subject of the discussion.

On Thursday, the matter concerned was the controversial Liverpool Care Pathway. Intended to provide the framework for the best nursing and medical care for the dying, in the hands of some practitioners it is used as the basis for proactive judgments that determine the course resulting in the ending of life. It seems that withdrawal of sustenance or life-saving intervention can be decided, without the consultation of family or respect for a patient's faith or wishes, on a pragmatic (or economic) assessment that takes into account such considerations as the average likelihood of recovery, age, social demography and so on. As it has manifested itself in England – following a series of terrible instances of not only negligent but harmful nursing practice – it looks like the pressure of a “culture of death” from a medical establishment that steers people, either through persuasion or as a result of the ethic applied to the way the care programme is being applied, to a non-illegalised version of euthanasia.

Without getting into the technicalities, my homily sought to stress that human mortality can never be seen as “end of life” but as the setting of its resurrection. The dying person is thus not an animal being managed out of existence, but an integral member of the creation which has been and is being restored in Christ, all humanity in it, and him.

 
6th May 2013
Thursday of the Sixth Week of Easter
The Frame of Risen Humanity and its Care
Acts 18.1-8
John 16.16-20
 
Through the readings, today we have witnessed that moment that so incensed St Paul that he turned his attention from revealing the true significance of Christ’s passion and resurrection just to the members of the Jewish diaspora, and oriented it to the rest of the world too. And we almost missed it, but we also saw the moment when St Paul baptised and thus admitted to the Church not just personal converts, but a whole family household. In other words, the resurrection to new life is not just for those who believe in it, or for those who form a religious group or, as we might relativise ourselves nowadays, a “world faith”, but for the whole world. Indeed it has happened TO the whole world, and it has re-created the nature of ALL humanity.
Similarly, we have stood before Jesus on the verge of his taking leave of us in this world, only to be told that his going away is nothing other than his constant returning. In other words, just as his death was not the end but the means to a new creation, so his new life, which cannot be contained within this world, is by no means restricted to the next.
If there is a weakness in the way we proclaim the Gospel of the Resurrection in the Christian West it is that we seem to be locked into the philosophy that heaven is an after-life, that life after death is a realm for the body’s leftover spirit, that rest eternal is inertia, that resurrection is a scientific conundrum to be explained away spiritually, or even denied materially. It is as though we more truly believe that this life here and now is what matters, that here is where we find the concrete reality.
In truth, however, as C S Lewis pointed out in The Great Divorce, here is the world of shadows, false impressions and soft authenticity – heaven is the hard and vivid reality, at first too hard and vivid to be bearable. Thus famously he also said that the suffering now is part of the glory then – the two are not only connected, they are the same thing as they impinge, the first in the fallen world, the second in the life that is to come and is already upon us. St Paul, with his massive impression of the way in which everything is integral to Christ who fills the universe, put it another way – “your life is hid with Christ in God”; and again, “it is not I who live, but Christ who lives within me”. Thus it is the great intuition of the Christian East that the resurrection is not some far off and distant result, still less a merely spiritual phenomenon appropriated now only through faith and grace, but it is the true, harsh, vivid, pointed reality of existence as it stands now, since Christ burst the tomb and ascended the heavens, and to which those who are baptised in the Spirit are – we trust – acutely attuned.
The resurrection is not then; it is now. Heaven is not hereafter; it is the present Kingdom that we pray may “come on earth - as it is … “.
All humanity is of one piece before it – not in one group, or nation, or religion; still less in one individual’s mind for faith. Just as we all belong to each other in this world, so this world belongs to heaven and in heaven. By the same token, there is no difference of separation now to the humanity that fell from grace, and the humanity in which Christ redeemed it from loss and endued it with the everlasting life, which is the quality of the Kingdom of Heaven. As St Paul also said, “it was sown a material body; it is raised a spiritual body”. Christ is risen – we are risen: “As in Adam all die, even so in Christ all are made alive”. The living of the resurrection in the body is not something from which this life and the barrier of death insulate us – this resurrection is the truth of who we are with the nature of human beings. And it is now. More vivid, harder, more blindingly apparent for all we believe we cannot see it. This is not a mere opinion of how Christians regard themselves. It is how Christians understand the created, fallen, forgiven and resurrected order in which we find ourselves, because this is where we see that Christ, who went “beyond” in his act of constantly being present again and again in it. This is what his going to the Father means: for ever being seen “on earth, as it is in heaven”.
This evening we turn our attention to the ethical questions surrounding end of life care, and the response of the Catholic Church, in its members, to those whose bodies decline, fade and falter, as well as to those who attend to their needs. For us, the first response must arise from our faith. And that is to profess the faith of St Paul that, despite appearances to the contrary in the physical changes that affect and challenge our living through this world, the body is not a manifestation of a person’s death and dying:  always it belongs to a person whose humanity is raised from mortality and restored to the Kingdom. The body is integral to their living within the resurrection, the “beyond” that has not departed, but still fills the universe. It is the frame of suffering now that is inseparable from the glory then. It is not the advent of decline, but of ascension.
The care of the end of any human being’s course through this world should hardly be marked by an attitude that looks upon it as loss, decline, ending and closure. Truly these are realities in the flesh that Christ our God went through too. But our eye is set at the same time on “the things that are above” them - a restoration after sin and suffering, and the working of a new creation as it is coming to pass in them. Thus, as the Prayer over the Gifts we are about to offer says,  even now we are being “conformed to the mysteries of … mighty love”.