Lamb, Michael G.

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The Linacre QuarterlyVolume 55 | Number 2 Article 9May 1988A Thousand Lost GoltballsMichael G. LambFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationLamb, Michael G. (1988) "A Thousand Lost Goltballs," The Linacre Quarterly: Vol. 55: No. 2, Article 9.Available at: http://epublications.marquette.edu/lnq/vol55/iss2/9A Thousand Lost Goltballs Michael G. Lamb, M.D. Doctor Lamb is Medical Director, Internist at St . Francis Family Health Center, Mars, Pennsylvania. Every so often it seems, mankind has a ritual need for resurrecting the practice of euthanasia from its mouldering grave. Proponents of euthanasia have, for a time, held the center stage in ancient Rome, Napoleonic France, Hitler's Germany and in the United States during the 1950's. Alas, it seems that this spectre is rising to haunt us again. In Holland , euthanasia has been recently decriminalized and in the United States, since the Karen Quinlan case, there has been increasing pressure applied to organized medicine to accept mercy killing. Of late, even the respected Journal of the American Medical Association published an essay which was sympathetic toward euthanasia. It is this article ("It's Over, Debbie", JAMA, Jan. 8, 1988) which I wish to discuss in further detail ; especially since I believe it shows many of the flaws in the pro-euthanasia movement. The essay describes a weary, irritated, half-asleep gynecology resident who performs an act which is clearly mercy killing. This resident, tired and stressed, is awakened in the middle of the night to attend to a patient suffering from far advanced ovarian carcinoma which had not responded to chemotherapy treatment. He decides, solely on his own, to administer 20 mg. of intravenous morphine to allay her respiratory distress and "give her rest". The obvious intent of such a large dose of morphine would be to cause death. I find this act to be very distressing, saddening and reprehensible, regardless of whether it is examined from the medical-scientific point of view or from a philosophical-ethical viewpoint. A sleep-deprived resident should not be making a calamitous decision of this nature without consulting with the patient, her family and her attending physician. There are many methods and means of relieving pain and decreasing respiratory distress which were seemingly ignored in this case. For example, one could have tried lower doses of morphine, a morphine intravenous drip , or sedatives such as phenobarbital or diazepam . I have cared for many terminally ill, suffering patients and I have always been able to keep these people comfortable using conventional medical treatment. Obviously, the May, 1988 31 resident involved in this case chose to ignore these options and proceeded rather to assume omnipotence and induce death . From the ethical perspective, this behavior can be attacked as being impulsive, thoughtless and wanton. For centuries, the physician has stood as a centurion, guarding the sanctity of human life. This stewardship has been somewhat eroded and challenged in recent years by various self-interest groups. In lieu of the rampant self-centered morality which has attempted to stampede and crush the ideals which have stood for ages, I am not terribly surprised that this gynecology resident performed such an act. Major Tenets to Consider There are two major philosophical tenets which must be considered when the question of mercy killing arises . One of these principles is that physicians and , indeed, all men and women should develop and cultivate an abiding "reverence for life". This concept was the cornerstone of the philosophical system of Dr. Albert Schweitzer who believed that deep respect must be accorded to all life, irrespective of race, deformity, infirmity, or intellectual ability. Schweitzer states, "To the man who is truly ethical all life is sacred ."1 This reverence for life, then, manifests itself in love, including "fellowship in suffering, in joy, and in effort."2 The sanctity of life has been paramount in man's ethics for centuries as is demonstrated in the Hindu Bhaghavad Gita. Tolstoy's The Kingdom of God is Within You. Thoreau's Walden. the New Testament teachings of Christ, Martin Buber's I and Thou and Mohandas Gandhi's doctrine of "ahimsa." The famed psychiatrist, Dr. Karl Menninger, also felt that life in and of itself was noble . He wrote, "There are positive motivations in the human spirit not born of fear, guilt and hate but of life and love. The life instinct not only battles against death, it has an autonomy and purpose of its own."3 Today, unfortunately, this unbridled respect for life, this love oflife, this awareness of life's own intimate, though sometimes secret purpose, has become all too scarce. In its place has been set up a litany of clever neologisms, a pseudo-ethical golden calf bursting forth with a diatribe of concepts such as "the wrongful life", "the worthwhile life", "the quality of life" and "the fulfillment of life potential". The problem with all of these "modern humbugs" is that they are all dependent upon one's frame of reference. Who is to determine what life has quality, meaning and potential? In this light such ideas become quite relative, and indeed, dangerous. To see how obscene such precepts can become, one needs only to explore the euthanasia literature of the past. In 1895, Adolf lost issued a call for a direct medical killing in his book, The Right to Death. This work was influential in affecting the ideas of later German physicians and scholars and indirectly led to the publication in 1920 of the key document, 32 Linacre Quarterly The Permission to Destroy Life Unworthy of Life, by Karl Binding and Alfred Hoche. In their work, the term "mercy killing" is quite typically changed to the more benevolent terms "healing work" and "healing treatment".4 The euthanasia literature abounds with such euphemisms for obvious reasons, specifically, man at his innermost core is repulsed by the destroying of life. However, I think I hardly need to emphasize what were the consequences of the German euthanasia movement. The ensuing Nazi holocaust not only engaged in race purification by killing millions of Jews, Slavs and gypsies but also was responsible for exterminating millions of physical and mental defectives and the incurably ill. It should be well noted that the euthanasia and eugenics movements preceded the eventual horrors of wholesale race extermination. Another Issue in Debate The other major issue in the euthanasia debate is whether there is any purpose or meaning in suffering. All physicians wish to relieve suffering and fortunately we are now in possession of tremendous therapies and tools to help us in this goal. Suffering, however, will continue to occur and we will continue to have varying degrees of success in treating it. Yet I do not think suffering is totally devoid of meaning. In my practice, the vast majority of patients seems to have actually acquired spiritual and psychological benefits during their sufferings. In his book about his Nazi death camp experiences, Man's Search for Meaning, Viktor Frankl expressed similar feelings about his own suffering. He and his colleagues suffered unspeakable horrors while in the prison camp and yet, for the most part, they believed that through this an added meaning was given to their lives which enriched them spiritually. We must try to sympathize and do all in our means to help those who suffer and perhaps sometimes this means we have to cry with them. Our sympathetic tears and empathy should lead us to give as much courage as possible to the suffering and should never lead us to recommend mercy killing. Dag Hammarskjold once commented, "Is life so wretched? Isn' t it rather your hands which are too small , your field of vision too narrow? You are the one who must grow Up."5 This growth is not easy and perhaps suffering is a part of it at times. Hopefully, with skill, knowledge, thought and with reflection on the beauty of life, we will be better able to minister and care for the severely ill and suffering of the world. If we do not do this, if we do not adhere to the age-old love for life which is imbued in all of us, then I am afraid our age will end much like T. S. Eliot said, "Here were a decent godless people, their only monument the asphalt road and a thousand lost golf balls."6 References I. Schweitzer, Albert, OUI o/My Life and Thought (New York: New American Library, 1953), p. 181. May, 1988 33 2. Schweitzer, Albert , The Philosophy of Civilization (New York: Macmillan. 1951). p.309. 3. Menn inger, Karl, A Psychiatrist's World (New York: Mac millan . 1959). p. 120. 4 . Lifton , R. 1.. The Nazi Doctors (New York: Basic Books. Inc .. 1986) , p. 46. 5. Hammarskjo ld, Dag. (translated by Leif Sjobe rg and W. H. Auden) (New York: Alfred Knopf Inc. , 1964), p. 210. 6. Elio t, T. S., The Norton Anthologr of British Literature(New York: W. W. Norton & Co., 1972), p. 2480. 34 Are You Moving? If the next issue of this journal should be delivered to a different address, please advise AT ONCE. The return postage and cost of remail ing this publication is becoming more and more costly. Your cooperation in keeping us up-to-date with your address will be most helpful. Li nacre Quarterly 

A Thousand Lost Goltballs

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