Tag: Abortion

Grander RoundsThe Lord Thy Surgeon

Death: A Gateway to…

An aneurysm ruptures as an 85 y/o woman talks on the phone with her only relative, a niece, 150 miles away. She dies hours later in my Emergency Room. A 40 y/o woman and her 6 y/o child have their passenger side destroyed by a driver running a stoplight. They never make it from the scene.

At times, it seems as though I am (we are) surrounded by death. I joke with my staff and residents to ease the tension, “All of us are dying. Some of us just get moved to the front of the line.” Death is experienced by all of us. Sometimes we look in. Sometimes we endure the loss. Sometimes, we are up. All of us deal with it differently. We all fear the unknown.

My wife worries about something happening to me. Finishing my will seems morbid and is difficult to complete. Though important, I know that when the will is “executed” I will be dead. It is a plan for what I hope won’t happen, at least not any time soon. My parents are essentially my oldest relatives. One by one, my grandparents departed.

“I’m ready to meet my Jesus.” A few nights ago, I prayed with a patient for the first time in a long time. The words proceeded from my mouth jumbled and awkward. It was short and not so eloquent. “Watch over this child of God. Comfort her in her pain. Bring Mrs. H to be with you,” was the gist of it. I had just diagnosed Mrs. H with pancreatic cancer at age 89. She had been trying to get a CT scan for the past several weeks with insurance not approving it because certain tests had not been ordered yet. She showed up in the ED with worsening pain and looking for answers with her daughter. She seemed otherwise content but desiring to know why she continued to have persistent abdominal pain. A CT scan a few hours after her arrival delivered to me the answer, “Pancreatic mass concerning for pancreatic adenocarcinoma with severe dilation of the pancreatic duct.” This diagnosis hits me like a train. As we have been told in medical school and on our surgical rotations, “Don’t mess with the pancreas!” (Using slightly more colorful language typically.) I knew that this was likely a terminal diagnosis. For a 30 or 40 year old, it might be a diagnosis of struggle and a year or two of intense pain before the inevitable death. Or if extra lucky, a longer course with the constant fear of return of the cancer of the “Whipple procedure” (which again is one of the most intense surgeries one can have.) In the face of death, this 89 year old didn’t ask about surgery or how long she had to live or what chemo she could have. She didn’t even ask for more pain medication. After I had explained to her daughters about the mass, she succinctly said, “I’m ready to meet my Jesus.”

I’ve met death many times in my emergency room. Some people fear it fiercely and others, like the 89 y/o woman above, seem relieved. For the Christian, death is a departure. Physical death is the body releasing the soul to be with God. The early church fathers viewed death not as the endpoint but as the beginning. Paul states, “For I am already being poured out as an offering, and the time for me to depart is at hand. I have competed well; I have finished the race; I have kept the faith! Finally the crown of righteousness is reserved for me. The Lord, the righteous Judge, will award it to me in that day – and not to me only, but also to all who have set their affection on his appearing.” 2 Tim 4:6-8

Nearly 50 executed in a nightclub. Dozens shot in a theater. Schools seem unsafe. This year freshmen in high school will learn about 9/11 as history. I feel old(er).

For the atheist, death is “the end.” It is nothingness. What does the atheist have to say at your suffering and dying? Is death (and this life) not absurdity and meaningless? “I’m glad it’s you and not me.”

As Christians, do we not have a different outlook? What have we “to fear”? Christ conquered death. For the Christian, spiritual death is put to death by Christ. Spiritual death comes from the fall.   Christ, who knew no sin, took on the likeness of sinful flesh and was sinless. Hosea and Paul exclaim, “Where, O death, is your victory? Where, O death, is your sting?” 1 Cor 15:55

Our favorite comedians die of overdoses. 5000 abortions happen every day in America. Every day. A prominent and influential Christian writer is diagnosed with advanced stomach cancer. A 28 y/o is on hospice, dying of ovarian cancer. A toddler dies of methamphetamine overdose after he puts a filter paper in his mouth in a rat infested basement while his mother gets a pop with her boyfriend at the local gas station. At times, it seems like death is on every corner and takes the most innocent.

In my emergency room, there is no shortage of those suffering and dying. In some senses, we only prolong the inevitable. I think it would be a grim profession if this was all we did. There is hope. The only place I know of this hope is in Jesus. We fell away from God when we transgressed His Law. Only one command existed at the beginning, “Do not eat of the tree of the knowledge of good and evil or you will surely die.” We did. It has been separation ever since.   Spiritual death reigns over us. The consequence is physical death. HOWEVER, God gave His only Son. Christ died that we should LIVE. Death is not the end. Christ resurrected from the dead. Death is a gateway to eternity with God for all who believe in Jesus. Jesus is the Way, the Truth, and the Life. John 14:6

For the Christian, death is not to be feared. Death is a reunion with God. We will shed off this body of death and live with Him in eternity. This life is only the beginning. As Paul states, “For to me, living is Christ and dying is gain. Now if I am to go on living in the body, this will mean productive work for me, yet I don’t know which I prefer: I feel torn between the two, because I have a desire to depart and be with Christ, which is better by far, but it is more vital for your sake that I remain in the body.” Phil 1:22-24

The word “depart” is just like a ship leaving harbor. The journey is just beginning. May we have confidence that Christ paid the price that we may be united with Him. Christ is our forerunner. He has conquered death. We have nothing to fear about death. As my 89 y/o sister said, “I’m ready to meet my Jesus.”

The Lord Thy Surgeon

Doing Justice: What is Legal is not always Right.

What is Legal is not always Right.

Does the law determine what is right? Where do we determine what is right? Is our country based in majoritarianism or are we in submission to God? Much debate surrounds the appointment of the next Supreme Court justice to replace Justice Scalia. Will the Republicans confirm Obama’s appointment? Will the next President choose the appointment? Five of the eight current justices are Catholic (Kennedy, Thomas, Alito, Roberts, and Sotomayor) The other three are Jewish (Ginsburg, Breyer, Kagan) One might expect them to come to overwhelming decisions that reflect that true justice can only be obtained if the law comes from God. This seems not to be the case.

Let us back up though. Arthur Leff in 1979 may have framed the situation best in an article in the Duke Law Journal regarding constitutional law. “I want to believe—and so do you—in a complete, transcendent, and immanent set of propositions about right and wrong, findable rules that authoratively and unambiguously direct us how to live righteously. I also want to believe—and so do you—in no such thing, but rather that we are wholly free, not only to choose for ourselves what we ought to do, but to decide for ourselves, individually and as a species, what we ought to be. What we want, Heaven help us, is simultaneously to be perfectly ruled and perfectly free, that is, at the same time to discover the right and the good and to create it.”

By “findable” rules, he’s referring to the Torah. It is the law of God written down. It is a natural law of the universe that is found by man and written down. Something that is more eternal than creation. However, we want to rule ourselves. We want to create the law that fits us best. However, we cannot escape the sensation to want to find an order that is right outside of ourselves. As Leff puts it, each law that is written down ultimately someone may ask, “sez, who?” Who will enforce it? By what authority does it come?

We can think of many different setups of government. 1. A majority of the people decides what is law. 2. A committee of people decides the law. 3. A tyrant decides. If we talk about a democracy or majoritarianism, does the majority always choose what is right? Put another way; is the majority always in the right? In our country, blacks and women would have a very different position if the majority were right. If a minority had not pointed to a higher law, blacks and women would have much different standing.

If we speak of a committee ruling or communist party or socialist group or even a republic, or ultimately a small group of people, either chosen by the people or not, do they decide correctly what is right? Or perhaps a king, dictator, despot, or supreme leader, can they decide what is right?

Where do these people come up with the law? Is it in nature? Is it from God? Is it from inside themselves and how they feel? Eventually, we find that the speaker(s) of the law must have power. It is the ones with power ruling over the ones without. Even if those with the so-called “power” may be minority groups. The question of law comes down to, “sez who?” These are the legislators of the law.

The judges of the law are to determine what the law says. They are to judge whether any action is lawful or not. In the United States, we separated the powers of the legislators of the law and the evaluators of the law. My question is: how do we know that the law is right if God’s Word is not the foundation? How do we keep a legislator (or group) from deciding something “legal” but that does not agree with the natural law? How do we keep the judge honest? If they are not submitted to God, does not their power come from themselves? God is the only one who is the Ultimate Legislator and Ultimate Judge.

God’s speech is in the form of “performative utterances.” An example of a “performative utterance” is “I apologize” or “I promise.” The act of saying the speech is the action as well. God is the only one Who when He says, “Light be!” light instantly appears. He is the ultimate backer of His Word. He will judge those in eternity whether they have met the requirement of the law. Only in Him can we find true justice.   He determines and judges what is right.

The law of our world today is about power; not about justice. I would argue that everyone knows that “the taking of an innocent life is wrong.” What we have done today is to add-on qualifications for that understanding. We redefine what “innocent” is and what “life” is. “Life begins at 24 weeks…err…sometime around then…” “Having cystic fibrosis or Downs syndrome is not really a good life. It is a life of suffering.” Where do legislators and judges get their power to say when a life begins? Scientifically we know that an implanted fertilized egg has everything needed chromosomally and environmentally to grow into an adult person. How is removal from the uterus premature not unlike suffocating or starving an adult? Why is convenience (99% of the time), whether be it financial, emotional, or social convenience, a justifiable reason for ending this human’s life? To be an ethical abortionist, one would have to set out with the premise that “life is utterly absurd and meaningless.” It would not be hard then to ethically end any human life.

“But I don’t have the resources.” Or “this child will be suffering and deformed.” Is not all life about suffering? Does not suffering tell us that something is wrong? Where is the justification not to finish off any one who might break an arm or even stub a toe? Even the most deformed person can bring a joy to those around them.

Before 1973, every child born had the “right” to exist. After 1973, every child was “chosen” to exist. It was your “legal” right to end your pregnancy after 1973. It disagreed with the natural law that “all life is sacred.”

But what if I’ve fallen short of that natural law? What if I’ve had an abortion? Here’s the good news, the Ultimate Judge and Legislator is also the God of mercy. He is able to heal your wounds. We know that all have fallen short of the glory of God (Rom 3:23) and the penalty (wages) for sin is death. (Rom 6:23) But God established His righteousness apart from the law in Christ. (Rom 3:21-22). He paid the penalty for our sin. He established your right to life by Christ’s faithfulness.

What is legal is not always right. The founders of this nation knew that we had the “right” to life, liberty and the pursuit of happiness. All of the current Supreme Court justices claim to come from Judeo-Christian beliefs. The law of the court and the judge of the justices may not agree with the natural law. Some may not find justice in this world. It took over a hundred years for us to recognized that a black man/woman had the “right” to life, liberty and the pursuit of happiness. We set out knowing that “all men are created equal.” We had to relearn what we already knew that a black man is a man. We have redefined what is “innocent” and what is “life” in order to justify our convenience. Where will it end if any “minor defect” will be criteria for ending a pregnancy? Between a Muhammad Ali or a Stephen Hawking in utero, who would we choose? Should we discard a man with Marfan’s-like characteristics with multiple endrocrine neoplasias; a man with a large jaw, drooping eyelids and “pseudo-depression”; a man that likely has MEN2B malformation? Would we be better off without that tall intermittently depressed Abraham Lincoln?

And what about liberty or freedom? “For freedom Christ has set us free. Stand firm, then, and do not be subject again to the yoke of slavery.” (Gal 5:1) Christ set us free for freedom’s sake. He set us free so that we are not under the bondage of men. If the law is from God, we are FREE to serve Him. We are not free to do whatever we want. (Gal 5:13-14) True freedom is granted in serving Him. And for the Christian, happiness is tied up in trusting the Lord. “Taste and see that the Lord is good. How Blessed is the one who takes shelter in Him” (Psalm 34:8) How happy is the one who trusts in Him!

It may be legal but it isn’t always right. Nevertheless, “He chose us in Christ before the foundation of the world that we may be holy and unblemished in his sight in love.” (Eph 1:4) We were deformed and imperfect but He adopted us as His own through Christ. (Eph 1:5) What shall we do now then? “He has told you, O man, what is good; And what does the Lord require of you? But to do justice, and to love kindness, and to walk humbly with your God.” (Micah 6:8)

 

Arthur Leff’s “Unspeakable Ethics, Unnatural Law”

Grander RoundsThe Lord Thy Surgeon

Life Unworthy to be Lived – To Heal or Kill?

Some of the men in my bible study group, “Grander Rounds”, will remember that I started it with: “Why does human life matter?” It seemed like a straightforward question. My desire to finally start the group stirred again by the undercover Planned Parenthood videos in 2015 that were released by the Center for Medical Progress. Whether or not the videos are real or not, I do not want to debate but the questions that they raise are very thought provoking.

In the U.S. and around the world, body parts and organs cannot be sold. Now, legally one can charge for services related to delivery or procurement, but not for the organs themselves. (I.e. you cannot sell your kidney or even your blood.) But what about parts of aborted dead fetuses? For research? Is it not a good thing for humanity and may perhaps save several people some day? Many compared the Holocaust to the abortion situation that happens everyday in the world. Doctors are at the center of both. But what was the mentality of the Nazi doctor? How did those “healers” stray so far to killing millions of Jews?

To answer my questions, I purchased two books on the Nazi Doctors; The Nazi Doctors by Robert Jay Lifton and Doctors from Hell by Vivien Spitz. I read Ms. Spitz’s book first which was the easier of the two. Ms. Spitz was one of the court reporters on the medical trials at Nuremburg and Dr. Lifton interviewed several of the doctors for several years of his life.

Immediately apparent was that most of the doctors were not strongly ideological with regards to extermination of the Jewish people. A few people at the top like Himmler, Mengele and others pressed the rest who were mostly compliant. A couple decades earlier, the Eugenics movement started in the U.S. Compulsory sterilization and immigration restriction tried to find legal ground but eventually failed. Hitler, however picked up the movement with the purpose to improve the German people and to rid disease within the German people. Bad science with wrong ideas about “Aryan origin” and poor understanding of genetics led eventually to a legal declaration of noble purpose for the German people. Wouldn’t the German people be better off if the disease and weak genes were eliminated?

Who were the first ones that were killed? They were individuals that I think most doctors today would agree are poorly interactive with their environment. Colloquially, some people call these individuals “vegetables.” Schizophrenics and other mentally affected patients or “idiots, imbiciles, and epileptics” were also included. These people were deemed as being Lebensunwertes Leben, or “Lives unworthy to be lived.” The doctors saw the suffering of these people in homes and institutions and some were classified as “useless eaters.” In some sense, the doctors considered these people already dead. It was for them, a humane act to kill these people to free up food for others and to keep them from suffering longer. For the schizophrenic and epileptic, it was helpful to society to keep those bad genes from continuing by forced sterilization. The “preservation” of the race was at hand. However, it was a reversal of “healing” and “killing.” They were “killing” to “heal” the society.

The reversal provided that any unwanted or undesirable group of people found themselves scheduled to be discarded. But aren’t doctors supposed to “do no harm?” As Fritz Klein, a Nazi doctor, put it regarding the Hippocratic Oath and what was happening, “Of course I am a doctor and I want to preserve life. And out of respect for human life, I would remove a gangrenous appendix from a diseased body. The Jew is the gangrenous appendix in the body of mankind.” A legal justification for the execution of 6 million Jews had been found.

Now, where are we today?   4000-5000 fetuses are voluntarily aborted in the U.S. alone, each day. Now I specify voluntarily aborted because medically speaking, an abortion is any time the uterus does not carry a fetus to a viable state and is lost. We call this colloquially “a miscarriage” when it happens by accident or due to some problem in development. When it is done by choice, we call it “an abortion.”

Words over time develop new semantics and “abortion” carries a lot of emotion in our society. One of the more immediate recognitions of the Nazi community was that shooting the individuals that were chosen for “mercy deaths” gave uneasiness to the soldiers that had to carry out the act. It became necessary to separate and reduce any guilt of the executioner and the judge(s). The person to be executed had to be “less than human” or a “defective human.” A system was created slowly and a series of judges determined who was eligible to have a mercy death such that not one doctor/person/judge/executioner was responsible for the death. The executioners were convinced slowly that these individuals were “less than human” and that the individual’s fate had already been determined by a series of judges. The executioners were separated from the actual execution. Rather than having to look directly at the victims, the victims were put in chambers and gas was instilled. Healthier working Jews were forced to remove and burn the bodies. At the end of the day, it was no “one” person’s fault and of course, these Jews were “less than human.”

We now come to the crux of the modern abortion issue. Are these fetuses human? Is a fetus “a person”? What is required to be a “person”? Scientifically, we know that a fertilized embryo has everything it needs to become an individual human being. A fertilized embryo developing in a uterus has even the correct conditions set for living. The embryo is genetically independent of the carrier mother. This embryo that is not deprived of its developing environment will continue to grow into an adult as its DNA instructs its cellular machinery to do. When does this embryo/fetus become a person? Conception? 12 weeks? 24 weeks (viability)? At birth? If someone murders a pregnant woman, the suspect is charged with a double murder as the developing infant is considered killed as well.

A child may be born struggling in an environment or to a parent without many resources. Are not some of our greatest leaders from meager beginnings? Has the next hero been executed before exiting the womb?

Why does it require a doctor to carry out these abortions? Are not these men and women that swore an oath to “do no harm?” A non-doctor could easily perform the abortion procedures. Where will it lead us as doctors and patients if the Hippocratic oath is eroded away?

My bible study started and purposed itself in answering these difficult questions of life. How can secularism or science answer these questions and more? Medicine is a “moral” activity. Science tells us what “is” but it cannot tell us what “should” or “ought” to be done. Science can tell us how big the cancer is or what the CD4 count is but it cannot tell us what is “good” or “bad” or what one “should” do. “Should” and “ought” are moral issues. If medicine is a moral activity, what “should” we do when it comes to abortion and medicine?

I believe the answer to these problems centers around two major questions. Does all human life have value? Can you trust your doctor?

We will begin to explore these questions in more detail in the next volume of The Lord Thy Surgeon.