Advance directives: Make reality-based medical decisions

By The Gazette Editorial Board

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Members of our organization in your area been following your articles on end-of-life decision-making with great interest and have expressed their concern to us.

That concern is about the extent to which sectarian religious beliefs may sometimes enter into the decision-making process and be reflected in law and public policy.

Atheists For Human Rights has as its primary function a strong opposition to such intrusions, expressed through our Moral High Ground project, which aids groups victimized by such intrusions. We are encouraged that your articles may help open up a useful public discussion of this matter.

There is no place in law and public policy, or in publicly funded medical facilities, for treatment to be controlled according to the specific doctrines of any one religion, however disguised with secular arguments they might be. We have been involved in this issue (among others) long enough to see that it is primarily religious beliefs that motivate opposition to medical care that, by any rational humane standards, requires allowing life to end.

Recently you reported on two end-of-life, decision-making controversies. One involved a Catholic hospital and its insistence that treatment for all patients conform to the Ethical and Religious Directives for Catholic Health Care Services. The other concerned the exemption of minors from laws that otherwise protect adults from violation of out-of-hospital, do-not-resuscitate (DNR) orders.

Attempts to treat all patients in accordance with their wishes, best interests and best medical practices often run up against religious beliefs that suffering has spiritual merit and/or that only God can determine when life ends.

These beliefs, while sometimes stated openly, more often are suppressed in favor of arguments that doctors don't always diagnose correctly, or the patient is too depressed to make a rational decision, or a cure may yet be found, or the patient is actually being coerced (as in the “death panel” nonsense that deleted end-of-life counseling from the Obama health care plan).

Or, in the case of a child, the parent - against the most powerful of parental instincts - may want the child to die. Certainly, in the case of a child denied DNR rights, it is heartbreaking to face the fact that the child cannot be saved, but that fact must be faced. To do otherwise is to subject that child to even more suffering.

These arguments have never been shown to have a valid secular purpose in maintaining life when put up against the medical fact that a life is ending. Their purpose is to validate in law the doctrines of a particular religion.

It is hardly a sign of compassion to maintain a dying person's suffering out of a belief that suffering has some spiritual benefit and only one's God can determine when life ends.

It is hardly a sign of compassion to insist that a dying loved one's suffering be extended because one's own pain of loss when death finally comes might be unbearable. That is not compassion - it is self-indulgence of the worst kind. It uses a “compassion” motive to extend another's suffering in pursuit of one's own spiritual and psychological comfort.

End-of-life decisions should be made and protected out of respect for the dying person's wishes and an honest facing of the medical facts. Government has only one role to play: Ensure that the decisions are made freely, competently, and with no coercion of any kind.

There is no place in all this for religious doctrines. They are a private matter for patients to adhere to or not, as they wish.

Marie Alena Castle, of Minneapolis, is communications director of Atheists For Human Rights, a national affiliate of American Atheists, a member society of the international Atheist Alliance, and a member of the Minnesota Alliance of Peacemakers. The group advocates for state-church separation, human rights and respect for diversity. Comments: www.atheistsfor

humanrights.org