Comprehensive Case StudyOn End of Life Decisions-George Case of ALS

Comprehensive Case StudyOn End of Life Decisions-George Case of ALS

End-of-life decisions can be challenging not just for the patient but also for their families and caregivers and therefore require to be handled with great care, compassion, and concern. With the increasing incidence of chronic progressive conditions, evidence indicates that most patients prefer to die peacefully instead of getting aggressive life-prolonging treatments. In this case, the ethical dilemma arises from the case of George, whose condition’s prognosis is that over the next 3 to 5 years, he will not be able to walk, talk, eat and breathe. The complications pose the moral and ethical question of whether or not he can opt to end his life through voluntary euthanasia, considering that ALS has no cure.It is imperative to explore George’s case, an attorney diagnosed with amyotrophic lateral sclerosis (ALS) in his mid-fifties, and the end-of-life decisions through a Christian worldview.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

George’s Interpretation of His Suffering In Light Of the Christian Narrative

Many people, inclusive of George, in the world, ascribe to the religious view that holds that there exists a supreme being above humans who controls all the things that happen in this world. A significant number of these faithful are Christians who entertain the notion that there is a God who is omnipotent (all-powerful), omnipresent (exists everywhere in the universe), and omniscient (all-knowing). All Christians rely on the Holy Bible- their sacred book containing guiding principles and teachings that govern their everyday lives. Therefore, one would expect George to draw from biblical ethical and moral principles upon being diagnosed with ALS.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

In his mid-fifties, George is at the prime of a successful career as a lawyer who doubles as a legal scholar at the university. He is also married and actively coaching his son’s basketball, thus undermining the man’s physical and athletic fitness. However, George’s health has fallen following a confirmed diagnosis of ALS, whose health implications are that his motor neurons are bound to deteriorate, albeit slowly. Furthermore, as the disease course progresses, it is anticipated that a time will come when George cannot breathe without the help of a machine for the rest of his life. Subsequently, the nerve cells that control the movement of voluntary muscles like walking, talking, and walking would be significantly hampered. Masrori & Van Dame (2020) further opine that ALS is a multisystem neurodegenerative disorder with its heterogeneity cutting across the clinical, genetic, and neurological levels with no known today. The sudden change of fortunes in George’s health reminds one of how according to the bible teaching, Job underwent the loss of all forms but still set his sights on God and trusted God(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

 George’s Interpretation of His Suffering Premised on the Hope of Resurrection

As a practicing Christian, George can draw lessons from biblical figures like Job, whom God allowed suffering, although Job had not committed any transgressions to merit his suffering. In the case of George, ALS disease heterogeneity indicates that over 20 genes are linked to ALS, meaning some are beyond the patient’s control (Masrori & Van Damme, 2020). Like his biblical counterpart, George can consider the suffering arising from ALS disease to test his faith and his belief in God. The test of faith will not only get him through the suffering but also act as an inspiration to others, both old and young.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Most importantly, George would also get inspiration from the suffering of Jesus Christ in the New Testament, who overcame evil through his resurrection after persecution and crucifixion. The bible teaches that Jesus is the Son of God whose earthly mission is to redeem the fallen man through his crucifixion on the cross, three days of a death, and then rising from the dead on the third day. George is at liberty to believe that although he would die a physical death, he is bound to resurrect to a new heaven and a new earth where pain, suffering, and evil will be no more as the fallen world comes to an end as written in the bible. George’s faith in eternal life after resurrection would override his body and earthly state of illness. In this context of eternal life, a short life of suffering while respecting life and acknowledging that only God gives and takes life is a worthy quest.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

How the Christian World View Would Inform His View about the Value of His Life

A confirmed diagnosis of ALS, a disease with no known cure, is bound to trigger the patient’s thoughts on the value of his life as a productive and useful human being. Biblical principles regard life as sacred, and no person can create, implying that life must be preserved irrespective of its quality or costs. The Christian worldview propagates the notion that only God bestows life on human beings and that He is the only one who should take it at His own appointed time. By extension, no other being, least of all humans, has a right to take another person’s life, including their own. Living this Christian principle in the context of George can use the ethical principle of autonomy to safeguard his life. Under the said concept, a patient afflicted by a disease has the autonomy to make a conscious decision about how care should proceed.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

According to Dickinson (2019), a fundamental source of conflict here is to decide whether the decision of voluntary euthanasia should prevail as the greatest good to both himself and his family through beneficence or whether the Christian world view of respect to the sanctity of life which would translate to more suffering to him. Other principles that George will have to factor in besides autonomy and beneficence are no maleficence and justice. The ethical dilemma generated by the Christian belief in the value of life is one that George will have to tackle eventually.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Sorts of Values and Considerations That the Christian Worldview Would Focus On

From the very beginning, the decision on whether to take voluntary euthanasia using the Christian worldview lens means it violates the principle of no maleficence as it decrees one should not cause harm to anyone, including oneself. In terms of justice, the Christian worldview prohibits George from going through euthanasia as Christianity is opposed to any decision involving taking one’s life before the Creator’s appointed time. However, George has a confirmed diagnosis of ALS, an incurable disease where the nerve cells of his body are expected to degenerate to a level where he will not be able to participate in the activities of his family, community, and the general society at large. George considers euthanasia which to most Christians is tantamount to killing oneself before God has decreed one should die.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Options Morally Justifiable In the Christian Worldview for George

 The ethical dilemma can be approached from different perspectives and still be defensible and morally justifiable. The morally justifiable option is to live through the suffering and let death occur naturally. George and the family would take the diagnosis and complications as part of life and endure through the long-term psychological, emotional, and economic turmoil hoping for an eventual spiritual relief in the afterlife. The option may guarantee pain and suffering, but it also respects the Christian principles of George coupled with autonomy. The option would strengthen George’s faith in God and respect life’s sanctity and sacred nature.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

The Decision Make If you Were in George’s Situation Based on the Author’s Worldview

In my worldview, I would opt to live through the pain and suffering despite the high costs, uncertainity, and progressive deterioration of my condition. I would take the diagnosis as the potentially last fight of my life and trust God to take me through it all. My decision would be the respect the life and the blessings God has given me in my life. My prayer would be that even though I may never live to work again, my family never lacks, and I gather the strength to wake up each day.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

The key tenets of the Christian worldview are the value and sanctity of human life. The trust is an Omnipotent, Omnipresent, and Omniscient God who grants and protects life and gives hope to those going through chronic progressive pain and suffering. Once sick, the individual has to strike a balance between what is moral and ethical versus what is not, as captured in George’s case of whether to have euthanasia or not. His decision would impact his life and his entire family, hence the importance of George’s spirituality in the decision and respect for the ethical principle that protects his decision. George and his provider must also consider assessing his family’s needs even as they respect his belief and religion and nurture a healthy trust in them.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

References

Basinger, D. (2015). Religious diversity (pluralism).URL: (Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)http://www.newworldencyclopedia.org/entry/Pluralism

Batstone, E., Bailey, C., & Hallett, N. (2020). Spiritual care provision to end‐of‐life patients: A systematic literature review. Journal of Clinical Nursing, 29(19-20), 3609-3624.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Choudry, M., Latif, A., & Warburton, K. G. (2018). An overview of the spiritual importance of end-of-life care among the five major faiths of the United Kingdom. Clinical Medicine, 18(1), 23.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

 Dickinson, T. ( 2019). Christianity’s extraordinary solution to believing in God in a world of evil and pain(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Kaier, K., Heister, T., Wolff, J., & Wolkewitz, M. (2020). Mechanical ventilation and the daily cost of ICU care. BMC health services research, 20(1), 1-5.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Koper, I., Pasman, H. R. W., Schweitzer, B. P., Kuin, A., & Onwuteaka-Philipsen, B. D. (2019). Spiritual care at the end of life in the primary care setting: experiences from spiritual caregivers-a mixed methods study. BMC palliative care, 18(1), 1-10.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Martins Pereira, S., Fradique, E., Hernandez-Marrero, P., & DELiCaSP, InPalIn, and Subproject ETHICS II of Project ENSURE. (2018). End-of-Life decision making in palliative care and recommendations of the Council of Europe: qualitative secondary analysis of interviews and observation field notes. Journal of Palliative Medicine, 21(5), 604-615.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Masrori, P., & Van Damme, P. (2020). Amyotrophic lateral sclerosis: a clinical review. European journal of neurology, 27(10), 1918-1929.(Comprehensive Case StudyOn End of Life Decisions-George Case of ALS)

Rego, F., Gonçalves, F., Moutinho, S., Castro, L., & Nunes, R. (2020). The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study. BMC palliative care, 19(1), 1-14.