Man and the value of life; #5 (Reel 2)

I need to tell you that I'm not competent to. Have any judgment about. The criteria for debt. And as I said earlier these are the kinds of decisions of the people who are going to be involved in the process. I have to. Have to work hard and have to make suggestions and. When it comes to the legal institution which will have to implement them they will accept them if they comport with the with the morality of the day the understanding of the day. I am interested only in the process involved. And the suggestion has been made there's nothing new about it. I made a lot of other people that in transplantation for example. You have one team of doctors. Who should decide about they don't know or have one about the Doni and the third team to do the surgical. Operation the. Surgical procedures. That is a matter of process not a matter of. When you think about one. When death ought to occur. This is the old checks and balances

idea where we do it this way it's likely to be better. Tell you what experience about this that the rich this whole problem I was and I was invited to a University of Medical School in me and I'm not a clock. One morning on the general University Hospital it was a conference and they had about 12 heads of departments sitting there and they were to decide. They had seven applicants for the dialysis machine and only three places. So you had the real stuff the real sophomore philosophy class question who should have an official diet but they were all through this for about an hour and I just listened insanely then they turned to me they said what about what would you say about this. And I said to them I I don't have any wisdom about this but one thing I can tell you I would. Open that door. I would not make this decision behind this closed door. Sure you have to have somebody. This has to happen at 3 o'clock this afternoon so you can't go and consult the community right now. I'm not saying that. But what goes on here are the reasons why you made the decision the reason why you

chose a rather than B. The number of children his age his contribution whatever it. These are the things which ought to be made public in some way or other they ought to be ventilated So the community can react to this and that over time you'll distill some idea of what the real values are. Now that's kind of a very rough piece of business to say to people well not just do what you think you have to do but don't do it. Behind locked doors I can't guarantee that the principals are going to be disturbed when the public doesn't react they're going to be better or worse but that is our system and it's coming which is because so many would agree that you shouldn't. But we we we do not need to do it behind locked doors because what I think takes place certainly in our experience has no and there's no reason it needs to be done like that. Now there are guidelines for decisions that

you've indicated. I'm someone. That there develops these questions these false awkward questions that arise about who should live and who should die and making decisions this kind. I must say that all of my experiences has rarely have I received. What I thought scares me very well. I think perhaps you misunderstand what I'm saying when I have what I'm trying to point out is that in my own experience of making a decision as to whether or not a patient needs to be treated by certain method. Of decision about equal deciding between two individuals as to who should have treatment and who should. In terms of you know that I was a kidney transplant. That in my experience just the surgeon never has had to be made it was made far

by the facts that existed at the time and by the way. Let's save the factors for example. I've had as many form five in six patients at one time 13 patients are needed cardiac transplant patients. I never had to make a decision as to which one not to have it when the next Don't you mean they should Blanchard which you take up the question. You imply that like the use must be considered in the light of a future life. Jews do not believe in a future life. With this influence your attitude about promoting a useful life through extraordinary methods. I would simply say that I am far more interested in life after birth than I am. Life after death you. Hear here and consequently I would say that. Insofar as one's religious convictions are concerned that. Whether or not one used extraordinary methods would not be particularly relevant. Insofar as the Christian conviction

is concerned. Future life is that which is determined by the way one lives in this life and eternal life is not something that begins at death but begins. With the response of a person to God in this life and therefore it has to do with today not the future. It might be helpful in addition to what I. Brought try to bring out in my paper. To further define or to describe what I mean by an extraordinary means. And extraordinary means according to a Jesuit model theologian. General Kelly is one which cannot be obtained without expense and pain. And then this very key line. Offers no reasonable hope of benefit. The decisive words here are no reasonable hope of benefit. Thank you for your discussion on this from the panel.

To the boroughs. Would you like to ask Mr. Blatchford to define what reasonable means. Reasonable sir would depend upon what the scientist or the physician said in this case. Any. Comment to this. Judge as one would to take one of your questions please. Oh some of the doctors want to know about their legal liability when I take a look at how you let them sweat. Your law school are you doing what are you. Given the facts situation and then sometimes a professor such he says can he sue. My answer was sure again if you've got 15 hours but. I'm trying to say that none of these things are settled. I just can repeat it again.

I don't think that as a practical matter I don't think any court's going to hold a doctor. Guilty of murder. Or even guilty or hold them liable and civil damages. Were as one questioner says if the family wants him to do it and all that sort of thing. These. I can understand the people who ask these questions are a little bit worried about what but what they would do. But all I can tell you is there aren't any rules. There's a great deal of discretion about how or how courts and prosecutors will proceed in these matters I don't know of any prosecutions yet. I haven't. Well there was one in Pennsylvania there was a there was a pretty gross situation and there was an acquittal. I don't think good prosecutors and the public generally are going to push

these things. First place are not generally known. No not enough informed layman but not enough informed layman. Think of the women knew they would lay off. But I. I do think that the questions do show a sensitivity that's important and that is that these decisions are not to be made by. The professionals. These are not professional decisions. The professional judgment is important very important and reaching the ultimate the ultimate judgment. But we cannot leave these decisions to the. Profession to the profession and I I think that as a practical matter they do make the decision when it comes to whether or not they're going to

put the patient in the West you know in the. Intense intense treatment and intensive care room. The decisions we made in a kind of sub rosa way. But the decisions we're talking about as to transplantation as to. How this is all the other things and the decisions that are to be taken for example as to whether or not we spend our money or money one way or another the professional judgment is important. But it certainly cannot be controlled when one is napping all of these questions relate to the same thing. I'm going to said that in. Tents hospitals make for intense doctors and intensive care. Dr. Carson would you someone would like to know my definition of the concept of equality. Does it really mean only that everyone is just like everyone else. But the

concept of equality is is not dependent on any one person's definition. It is a quantitative idea that we are all familiar with from Euclid and arithmetic. And there it's easy. But by a political metaphor. The word equality has come to mean a number of things in society. Perhaps derived from the religious idea of the equality of souls in the sight of God. The notion has come to mean that society and the law certainly should consider all men alike. Perhaps it's easier if one says equivalent or if one says incommensurable. So there is an assumption behind the idea of social and political equality. Nobody goes really to test it but takes it

for granted as one does in fact in in. In sociability you invite your guests to dinner and you serve them roughly equal portions of ice cream without going into their attributes or qualifications for it. No I'm being serious but there's more than that. There's the emotion of equality. I'm as good as you are if not better. That's that's the fundamental phrase of the feeling of equality. And it is what generated what generates what I called the envy and competition in the art of justifying oneself to one's fellows. And then finally there is what you might call the inverted emotion of equality.

I mean the feeling that because we're presumed to be all alike and all equivalent that none of us matters. And some people begin to feel that they don't matter to themselves. So there's the spectrum of emotions and ideas of useful and indeed sublime social principles as embodied in the declaration of independence declaration the rights of man and so on and all sorts of side effects from that which are perhaps. Reinforced or exaggerated by the kind of life imposed upon us by the industrial technological system. Equality though this is a writer not an answer to the no part of the answer to the question. But in my mind. Something connected with the organ

transplants I'm all for prolonging the life of anybody who can enjoy it or use it. But it seems to me that the organ transplants would really be of great use to mankind if there were not limited by the first criterion that Dr airing mentioned namely brain death because brain transplant would really be something. It's the only kind of transplant I want provided I can choose the donor. I'm broad minded I would take Whitehead Plato. You see the idea. I don't think there's any answer to that. To the bug here. This is the question. Assuming we did not have the. Tacit. Economic basis. Of medical morality.

In other words practice what we do determine economic limitations. Could you suggest an attic. Or metaphysical principle to my neighbor to my right. Could you suggest an epic or metaphysical principle which might guide for example determining who should have been or dialysis. I think everybody is getting bored with pulling out the renal dialysis and I bet even Dr. DeBakey is getting bored with transplants. So I'm going to answer with example of a situation in which I participated in not very long ago. The insurance company's. Symposium. On. Problems of medical ethics.

But then came a very specific example. For discussion. Namely the. Kind of commercial. Firms. Provide for some of their employees. Annual or biannual medical examination. Just to make sure that to make sure in the hope that this will help those people. Being caught. With disease that and being that it could not exist. And everybody was debating what the heck is baiting the cost. Of the search.

And about undergoing medical examination when I speak of course I'm not speaking my name spin doctors. And. So on and everybody pointing out of course that only a small percentage of the population could take advantage of this kind of service. And good it was. In the room where representatives from labor organization. Especially the person whose name just came back to my mind but someone mentioned it could if you wish to personally negotiate fringe benefits for the Raiders organization for the accountability. Workers. And he just ask. This question. There were many infamous people people there said well just tell me for the sake of information. What

part of your staff receive this contact. And let's say it was placed on the vice president's spot I stopped there and everybody agreed that in practice I had to stop it. So he just. Got your you in the back. He got up one smoke and just asked this question are we here then it took class society. And everybody was floored. Nobody wanted to discuss the subject further. And I think this is implicit. In this question that in the reality there are many things. However even if we know how to do that but we cannot do for everybody because there are not enough Dr. DeBakey in the world and he could not train enough skilled technicians to take care of four but he would have to do.

So in practice we have to introduce some kind of criteria. And my suspicion is that the criteria will differ vary greatly from one society to another. If you operate within the banking community when will decide. But for the good of everybody including the good of the employees its most important that a medical exam and the examination be given to the president the vice president and the directors. Because in the long run it affects all sorts of welfare of. All of the employees but you could imagine that a different kind of society it would be other kinds of people that would be selected. In other words the answer to these I believe that you know you see this is determined by the social values and the social values might be purely economy committee that might be purely physical

differently constructed so psychic. Were very nearly and there Heres a question for the whole panel but the panel offers no comfort to those of us who are doomed to end in bodily failures which creates a nullity and already human vegetables. We protest the thought of consignment to what are you for mystically known as Rest Homes convalescent homes etc.. What is left for us. Our organs are too old to be desirable. But euthanasia involves unthinkable evils. Suicide. Can it become socially acceptable. Anybody would like that in their cars. I'd like to take the question as a peg for the discussion. Not by myself alone of the important point that was raised by the Bishop when he quoted who had

borrowed from cart. The idea that the person is defined as an end in himself and must never be used as a means. And there's plenty of indication in the things that were said today that our society like every other society that I know anything about uses people as as means. I don't see how any society can live without doing that and the bishop himself you remember got into something of an inconsistency when he said that he wanted to preserve lives for service and if service is a good thing it means that somebody is the means to end this now. Now to the question of of old age in our society is an acute expression of the belief in

people as means so that I think we are driven to the necessity of saying that what we want are not persons considered as ends in themselves or possessing inherent and permanent dignity because we don't act that way and probably can't but that we must strike a balance between those two functions of any human person. And I foolish share the general tempo and direction of the Bishop's conception of a person. And furthermore that we must develop if we can cultural attitude that will. Sustain this balance and one of them is is a piece of self-restraint. You see in other cultures let us say warrior cultures people are not nearly so much interested in prolonging life.

The Habit of the necessities of of the tribe or the society induce a certain kind of courage which make people willing to throw away their lives. I don't know what it is about industry that's made us cling to every little bit of a heartbeat or a breath. But here we are all petrified at the thought of leaving the scene. We might relate that to the absence of work because a real worker at the end of 50 60 70 years wants to retire in that permanent way which Nature provides. And I think that anybody who's finished his job is ready to go. So between the ideas that a culture should have about life and death and the balance between service and and. Self-justifying activities and the non

manipulative attitude that we're getting for example the geriatrics we should be able to solve this problem but get out of the predicament that we've got into our arms. I just can't you know I'm. Not sure of that. The assumption that one is ready to go it's. Been my experience that people are ready to GO HOME I WANT TO EAT A R I think it's a fine you already find the individual years are I disabled heroes really ready to go when I'm done you know. Actually now opening up the material Well I'm talking about today. I don't let people today see and maybe they ought to be ready to go. But from a practical standpoint I see them every day. They're not ready to go and I am not at all

sure that busy or logically we are ready to accept the idea. Individually I society that I don't we don't misunderstand me philosophically you may be absolutely correct we ought to be ready to go and you know I'm not saying that those two boys who burn themselves alive and prosperous were ready to go for something. We've well lost that. I'm not at all sure they were ready to go over something they're willing to sacrifice to make the ultimate so-called ultimate sacrifice for what they believe this is something and this is motivation and a very high degree of motivation they're willing to give their life to it. In much the same way that you are willing to give up your lives over a longer period of time to what we're doing. But I'm talking about this business of being ready to go that is to accept death as a companion of life and I'm not. I what I'm trying to get at really is whether you believe that this is something that

exists as a part of life that is we accept this as a part of living at the end of it and therefore should have should make voluntarily the decision when we have finished it. No I'm talking about a complex of attitudes that are obvious that you can. Generate just soloing yourself. But for example when the average expectation was somewhere between 37 and 40 years of age people who lived beyond that to consider themselves so lucky that they had an entirely different attitude towards the span in itself. You married and the vicissitudes and contingencies of life. I would have to disagree with Dr. DeBakey in that. Professionally I have been involved with many many people. Who were more than ready to go. Furthermore. I. Know many others.

Who although they would. Want to. Hang on for a time to see something done would not in the least mind going. I mean there's no problem with them. Death is no problem for them. I would like to return to a doctor of bars on pointed out about meaning and service in response to a question does the value of a person to society replace the absolute value of the individual considered as an eternal soul or spirit. I would insist that. The meaning of individual spirit can only be discovered. Or development take place in relation to others. That one is constantly giving oneself in service to others or he cannot possibly know the meaning of his own existence.

So that I don't I don't see this is being used in the negative sense but rather a very positive sense. It gives me great pleasure to thank our distinguished panelists all of whom I think of it put it in themselves notably. In the thank you for spending this long day with us. You've been listening to the final program in this series on the man and the value of life. Today we presented excerpts from a panel discussion which closed the all day man and life symposium held at the University of Cincinnati College of Medicine as one of the special programs highlighting the university sesquicentennial celebration. They distinguished panel members where doctors yok bars on historian philosopher and the university professor at Columbia University Dr. Renee Dubow microbiologist and author from Rockefeller University

Dr. Michael DeBakey heart transplant surgeon from the Baylor University Medical College. The Honorable David L. Basil lawn chief judge of the U.S. Court of Appeals in Washington D.C. and the Right Reverend Roger W. Blanchard bishop of the Episcopal Diocese of southern Ohio. The discussion was moderated by Dr. Charles aring professor of neurology at the University of Cincinnati and the program chairman of the man and life symposium. These programs were produced at the University of Cincinnati station WAGA U.S. and were distributed by the national educational radio network.