Medical Issues in Family Ministry -- By: William R. Cutrer
JFM 1:1 (Fall 2010) p. 48
Medical Issues in Family Ministry
William Cutrer, M.D. is the C. Edwin Gheens Professor of Christian ministry and the director of the Gheens Center for Christian Family ministry at the Southern Baptist Theological Seminary. Dr. Cutrer has authored or coauthored several publications, including Sexual Intimacy in Marriage (Kregel), The Infertility Companion (Zondervan), The Contraception Guidebook (Zondervan), and most recently The Church Leader’s Handbook: A Guide to Counseling Families and Individuals in Crisis (Kregel).
Each life has immeasurable value as it bears the image of God (Gen 1:26-28). So even in the face of suffering and disease, with death and eternity looming, life is a precious gift and, in general, should be sustained when possible. Yet we must distinguish between prolonging life and prolonging death.
End-of-Life Decision Making: Physician’s Perspective
Medically, physical death can be hard to define. Years ago the cessation of heartbeat and breathing signaled clinical death. Yet with cardiac bypass machines, people can live during a surgical procedure without a beating heart—and, during a transplant operation, without a heart at all!—while “breathing” by way of oxygen supplied to the blood by a machine. Currently brainwave activity constitutes “life,” but lower brain activity (not thinking and feeling, but with the signals that initiate respiratory effort) may persist for some time after clinical death. These distinctions become important when speaking of “brain death,” persistent vegetative state (PVS), and suitability for organ transplant. For doctors to transplant organs when an individual “dies,” the organs must be perfused with blood and oxygen to keep them usable.
When death appears imminent, complex questions arise. What treatments will be instituted, and what procedures will be withheld or withdrawn? Deciding to designate a patient as “do not resuscitate” (DNR) means that in the event of cardiac arrest, secondary stroke, convulsion, or other life-threatening event, the medical staff will not intervene; they will allow the patient to die. They may institute comfort measures—pain medications, perhaps an oxygen mask—but no breathing tubes, ventilators, or heart- shocking efforts to resuscitate the patient.
By understanding common bioethical principles1—beneficence, non-maleficence, autonomy, and justice—ministers can better understand the point of view of the medical care team in the hospital setting.
Once physicians obtain an accurate diagnosis, treatment options are considered ...
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