John F. Kilner, Arlene B. Miller, and Edmund D. Pellegrino, eds.
Eerdmans Publishing, Grand Rapids, MI, 1996, 256 pp., $19
Recent medical studies show that patients who have a strong spiritual view of life face sickness and death with greater peace and equanimity than those with no religious beliefs. Many believe these patients often experience reduced symptoms and even healing partly because of their spiritual values. And yet, public discourse about the controversial topics of death, dying, and euthanasia is characterized more by polemics, name-calling, and legal posturing than by serious reflection on faith, theology, and ethical principles. Dignity and Dying brings a much-needed religious perspective to one of the most contentious debates in healthcare.
Discussions that are too academic, removed from reality, or religiously or professionally narrow frequently limit moral discourse about euthanasia. This book has none of these limitations. Editors Kilner, Miller, and Pellegrino have gathered essays from Christian women and men committed to both the sanctity of life and the compassionate care of patients. The contributors include nurses, pastors, philosophers, and theologians from various Christian denominations.
Although the authors argue from a sound intellectual perspective, they use human experience as the basis of their thinking, having spent many years caring for sick and dying persons. An unapologetic Christian appraisal, this collection is "catholic" in the "all-inclusive" meaning of the word. Arguments presented and solutions proposed will be credible to and respected by non-Christians as well as the Christian audience for whom the book is intended.
Roman Catholic theologian Karl Rahner believed that true theological analysis must begin with one's experience of God, and likewise this book begins with reflections of a physician, nurse, and pastor caring for dying patients. Part 1 shows how contemporary notions of human rights and autonomy can lead to the erroneous belief that dying is a "right." The excellent essays include nurse-theologian Marsha Fowler's "Suffering" and Reformed theologian Allen Verhey's "Faithfulness in the Face of Death," which emphasizes a commitment to Christian virtue even in the face of life's most pressing exigencies.
Part 2 presents the ethical challenges that dying persons and their caregivers encounter. The authors use the best current scholarly resources to discuss such divisive topics as definition of death, forgoing treatment, and medical futility. In "Euthanasia and Assisted Suicide," Pellegrino recognizes that Christians may be at odds with popular opinion on this topic. A careful scholar, he declares that his response is philosophical rather than theological. He crafts a solid argument against euthanasia addressed to the Jack Kevorkians of this world and to the persons who confront suffering and dying. Pellegrino eloquently argues for the need for Christians to assume a leading role in the public discourse on legalization of euthanasia.
Because the American debate about death and dying is within a broader world context, part 3 examines Nazi Germany's role in medicalized murder, analyzes Oregon's Death with Dignity Act, and explores the failure of the Dutch experience in attempting to regulate euthanasia. In "North American Law and Public Policy," Arthur Dyck contends that Christian beliefs are relevant, appropriate, and necessary to the shaping of American public policy.
In its final section the book goes beyond the philosophical arguments for or against euthanasia or clinical delineation on when to forgo treatment. The Christian faith, it proposes, calls us to care for dying persons, reverencing each life until the moment of entry into new life. Examining alternatives (e.g., hospice, long-term care), parish nursing, and patient advocacy, the experienced contributors suggest compassionate, concrete options that dying persons, their families, and caregivers will find compelling, reassuring, and filled with hope.
Dignity and Dying is both accessible and scholarly. Researchers will find each chapter's well-documented endnotes invaluable as they explore the vast field of literature. The book will serve as an excellent resource for medical or nursing students as well as in theology or philosophy courses. Ethics committees will find its experienced-based arguments helpful for their continued educational development.
Religious persons must continue to bring their faith, intellectual tradition, and lived communal experience to influence the public debate on the moral issues surrounding end-of-life decisions. Dignity and Dying is a significant contribution to that discourse and deserves careful reading by those who confront these challenging issues daily.
Reviewed by Patricia Talone, RSM, PhD, Unity Health System, St. Louis