Saying The Unsaid: Voicing Quality-Of-Life Criteria In An Evangelical Sanctity-Of-Life Principle -- By: Jerome R. Wernow

Journal: Journal of the Evangelical Theological Society
Volume: JETS 39:1 (Mar 1996)
Article: Saying The Unsaid: Voicing Quality-Of-Life Criteria In An Evangelical Sanctity-Of-Life Principle
Author: Jerome R. Wernow


Saying The Unsaid: Voicing Quality-Of-Life Criteria In An Evangelical Sanctity-Of-Life Principle

Jerome R. Wernow*

The advances made in life-sustaining technology over the last twenty years have permitted the prolongation of biological life with questionable outcomes. Patients’ experiences with pain, suffering, indignity and financial burdens have forced the medical community to reconsider sustaining life at all costs. Currently this reconsideration has issued into the acceptance of quality-of-life (QoL) criteria over an ever-weakening sanctity-of-life (SL) principle in the majority of medical literature guidelines and praxis studies that address life-sustaining care in the United States. 1

Evangelical theologians and ethicists have recognized the dilemma of the latest medical technological advances as well. The majority have responded to this dilemma by qualifying their SL position while rejecting

* Jerome Wernow is Hoover Scholar in medical ethics at the Center for Biomedical Ethics and Law, Catholic University, Kapucijnenvoer 35, B-3000 Leuven, Belgium.

QoL criteria by implication or statement. A few appear to maintain an absolute SL position while stating that they reject QoL criteria. Such rejections and qualifications have left these positions open to criticism. One of the more articulate critics of any form of the SL position is Australian bio-ethicist Helga Kuhse.

Kuhse portrays those who hold to an absolute SL position as cruel vitalists. 2 She accuses those who reject vitalism by qualifying the SL principle as doing so by utilizing “unsaid” QoL criteria. 3 She criticizes such qualifications as an “unarticulated and obtuse” use of QoL criteria.

What we have in the qualified SLP (sanctity of life principle) is a principle that says that it is never permissible intentionally to kill a patient, but that it is sometimes permissible to refrain from preventing her death as long as the latter decision is a means-related one not based on quality or kind of life in question. But this is where the confusion comes in, because judgments that it is sometimes permissible to withdraw or withhold life-prolonging means are, in fact, based on quality of life criteria that are unarticulated and obtuse. 4

Kuhse concludes that because of the common usage of QoL criteria it is better to scrap the antiquated notion of a SL position altogether:

When we refrain from preventing the deaths of handicapped infant...

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