SAYING THE UNSAID VOICING QUALITY-OF-LIFE CRITERIA IN AN….pdfVIP

JETS 39/1 (March 1996) 103–122 SAYING THE UNSAID: VOICING QUALITY-OF-LIFE CRITERIA IN AN EVANGELICAL SANCTITY-OF-LIFE PRINCIPLE JEROME R. WERNOW* The advances made in life-sustaining technology over the last twenty years have permitted the prolongation of biological life with questionable outcomes. Patients’ experiences with pain, suˆering, indignity and ˜nancial burdens have forced the medical community to reconsider sustaining life at all costs. Currently this reconsideration has issued into the acceptance of quality-of-life (QoL) criteria over an ever-weakening sanctity-of-life (SL) principle in the majority of medical literature guidelines and praxis studies that address life-sustaining care in the United States.1 Evangelical theologians and ethicists have recognized the dilemma of the latest medical technological advances as well. The majority have re- sponded to this dilemma by qualifying their SL position while rejecting * Jerome Wernow is Hoover Scholar in medical ethics at the Center for Biomedical Ethics and Law, Catholic University, Kapucijnenvoer 35, B-3000 Leuven, Belgium. 1ÙThe President’s Commission Report is an early benchmark document using these criteria in the context of surrogate decision-making. In this context the QoL standard is used to constitute the criterion determining the patient’s best interest. In assessing whether a procedure or course of treatment would be in the patient’s best interest, the surrogate must take into account such factors as the relief of suˆering, the preservation or restoration of functioning, and the quality as well as extent of life sustained. Cf. the President’s Commission for the Study of Ethical Prob- lems in Medicine and Biomedical and Behavioral Research, Deciding to Forego Lifesustaining Treatment: Ethical, Medical,