Caring Decisions

Religion, culture and life support

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    Is it against my religion to stop life support?

    Religious leaders from every major religion have stated clearly that doctors do not have to provide life support treatment if it would be harmful or wouldn't help. Doctors are encouraged to provide pain relief to dying patients.

    There are different viewpoints about life support expressed by some people within religions. You may find it helpful to speak to a hospital chaplain or to someone from your own religious community about any concerns that you have.

    It is difficult to make a general statement because there are many different religions, and there are different viewpoints within each religion.

    All religions accept death as part of life's cycle and have built structures of belief, prayer and law around it. Most religions make a distinction between artificially shortening life and avoiding artificially prolonging death.

    Many religions also emphasise the importance of intent. If their aim is a good one (for example relieving pain or suffering) and they are acting in the interests of the child, then doctors are allowed to stop treatment, or to give medicines. However, if doctors are aiming to deliberately shorten life, then that is not allowed.

    You may find that within your own religion there are some people who are for and others who are against life support treatments for children and adults who are dying.

    You could ask if there is a hospital chaplain who you can speak to. Often hospital chaplains are particularly helpful because their job is to support families and patients. They often have a long experience of supporting parents who are facing decisions about life support. That practical experience can mean that they have thought hard about how to interpret religious teachings relating to medical treatment.

    Sometimes families who have religious beliefs ask doctors to continue life support treatment. That may be because of their religion. But often, like all families who are facing the death of a child, it is most of all because they desperately want the child to survive, and do not want to believe that they might die. As powerfully described by one Anglican expert on ethics "In our grief and pain, we may desperately cling to life at all costs, as if humans never need die, and as if medical science has conquered death. We may forget to trust our Lord, as if this life is all there is, and as if there is no hope for eternity."

    See also Why am I being asked these questions? It is not given to me to decide about life or death.

    Is it playing God to stop life support?

    Some people worry that stopping life support means that doctors are 'playing God'.

    But others worry that it is 'playing God' to keep someone connected to life support treatment when their illness can't be treated.

    What about the sanctity of life?

    I don't want to stop life support because I am waiting for a miracle

    Sometimes families are praying hard for God to save their child. Although doctors have told them that this is very unlikely, they are praying for a miracle. They might worry that if they agree to stop life support that this shows a lack of faith in their God.

    But continuing life support when it isn't working might also be seen as a lack of faith.

    Life support machines are artificial. If a child is able to get better they have a place. But for many people, being dependent on these machines is not the way God made us to live. One way of thinking about it is that when we stop life support treatment and provide comfort care for a child we are putting our trust in God's hands. If it is God's will for the child to survive, the child will keep going without life support treatment. A miracle does not need life support machines.

    Can I talk to my doctor about my cultural or religious beliefs?

    Yes you can. Your child's doctor is interested in supporting you and your family to make the best decisions for your child and the right decisions for your family. Your culture and religion are part of that. The doctors' cultural background and religious beliefs may be different to yours. Let the doctors and nurses know what things are important to you and why they are important. That will help them to understand and support you.

    There are other people who can also help you to talk about your beliefs and values. For example, Aboriginal health workers are often able to help Aboriginal families in talking with medical professionals. Hospital chaplains may be able to help you to discuss laws and principles that affect people from your religious background.

    Can I ask doctors to speak to my elder or religious advisor?

    Yes. If it is important to you that someone outside your immediate family is part of decisions let the doctors know.

    For Aboriginal families, it may be important for members of their extended family or community elders to be part of discussions about life support, or even to make decisions. For other families, this might be a spiritual advisor or leader.

    The doctors and nurses may not have experience of your cultural or religious tradition. Let them know what is important to you, and how they can respect your culture or faith.

    What do different religions say about stopping life support?

    Many religions distinguish between active steps to cause death (euthanasia) and decisions to stop life support. Religions are often opposed to euthanasia, but accept "letting nature take its course". Most religions allow doctors to decide to stop or not start life support.

    This section summarises some religious teaching about life support decisions, however, religious views in this area are complex and diverse. We would not presume to tell families what their religion does or does not allow. It may be more helpful to speak to an advisor from your religion or to a hospital chaplain.

    Roman Catholic perspective: The Catholic church supports decisions to stop or not start life support treatment if treatment would be futile or overly burdensome. In these situations life support treatment is sometimes referred to as 'extraordinary'. There is strong support by the Catholic church for palliative care for babies, children or adults with terminal illnesses. The aim of decisions about life support is not to end life, but to stop treatment that is burdensome and not helpful. These decisions respect human dignity, and reflect "an acceptance of the human condition in the face of death".

    Evangelical/Protestant perspective: Most Protestant experts in medical ethics accept stopping life support treatments if there is little or no hope of recovery. They do not require life to be preserved at all costs. Reverend Andrew Cameron noted that "we urge and expect doctors to continue fighting for as long as they can, and we trust that they will have the wisdom and expertise to know when the battle is lost."

    Eastern Orthodox perspective: There is no official position on end-of-life decisions. Although orthodox religious scholars are opposed to active euthanasia, they accept that life-support treatments are not always beneficial. One scholar has written "Artificial support is justifiable only when it offers therapy, prospect for life and hope for recovery to the patient. … Just as we are not entitled to speed up death, so we are also not entitled to prolong its process. When the inevitable moment of death comes, we ought to humbly accept it and respect it." Father Nikolaos Hatzinikolaou

    Jewish perspective: Jewish parents are recommended to consult their Rabbi for advice. There is a general view among Jewish experts that doctors should not speed up or hasten death, but also that they are not required to prolong the life of someone who is dying. Doctors are allowed and encouraged to provide pain relief to dying patients.

    Doctors are permitted to decide not to start life support treatments. There are different views about stopping treatment (for example ventilators). Some will allow the ventilator to be stopped. Other orthodox experts hold that this is not allowed, but will allow breathing machines not to be restarted (for example if they are on a timer).

    Islamic perspective: Muslim writers emphasise that it is important to prevent premature death. Islamic law allows doctors to stop treatment that would be futile, where family members agree. One expert has written "If there is no hope of treatment, you may withdraw the life support equipment. In an attempt to prolong life without quality, one must not prolong the misery at a high cost".

    In general, treatment can be stopped if a child is brain dead, or if treatment merely prolongs "a natural and inevitable death". Doctors are allowed to give medicines to relieve pain.

    Hindu perspective: For Hindus, it may be important to avoid a 'bad death'. For example it could be desirable to avoid dying in intensive care, and there is often acceptance of DNAR orders to ensure a more peaceful death. One scholar has written "Their karma is our dharma. We have a duty to our fellow human beings. If they are suffering because of some sin, it is not less a sin to let them suffer."

    Buddhist perspective: There is no official teaching in Buddhism on medical ethics or treatment. However, death is seen as an integral part of life. It is usually accepted that there is no requirement to prolong life at all costs. Palliative care and treatment of pain is accepted.

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