Genetic ethics raise questions
Medical answers raise tough moral questions
By Jeff Kurowski
Compass Assistant Editor
Would you like to know your medical future?
How would your life change if you knew the likelihood of a disease diagnosis in the years to come?
Genetic medicine is making this possible and raising moral questions in the process, said Fr. Thomas Nairn, O.F.M., an associate professor of Christian Ethics at Catholic Theological Union in Chicago. Fr. Nairn recently presented Death and Dying: The Moral Issues at the Theological Institute 2000 at St. Norbert College, De Pere. He began studying medical ethics more than 20 years ago and has provided medical-moral workshops for numerous hospitals throughout the United States.
"Where you once treated the disease, you now are treating the predisposition of disease," said Fr. Nairn. "This introduces ethical concerns considering no sign of disease exists."
For example, a woman with a family history of breast cancer and the genetic makeup that increases the likelihood of breast cancer may decide to have a mastectomy.
Mapping of the human genome is also allowing researchers to identify genes more quickly and discover more targeted and effective medicines. Genetic medicine is the latest in technological advances that changes how we view disease and illness, said Fr. Nairn.
"Technology has raised expectations," he said. "We believe that all we need is a pill or an operation to heal us. We push death off. Death is no longer natural. We need to reclaim the naturalness of death."
Fr. Nairn points to the late Card. Joseph Bernadine, former archbishop of Chicago, as a good example of embracing the naturalness of death.
"He fought the cancer using all the available treatments with the goal of recovery," explained Fr. Nairn. "When there was no longer a chance for recovery, he was made comfortable and died surrounded by loved ones. This makes more sense than dying alone hooked up to a machine, which happens too often."
"We are taught that sickness and death are evils," he added. "Death and sickness are not the absolute enemies. We use all of the technology to enter into a process of care. When the chance for recovery disappears, we should make the person comfortable and free of pain. Let the person see the meaning of life through death. Hospice is doing this well."
When teaching a course or facilitating a workshop on death and dying, Fr. Nairn does not teach students how to be moral, but encourages them to let their own faith experience guide them.
"They must develop confidence that their morals will speak in times of decision making," he said. "The most important thing is our dignity as human beings."
Moral issues are never a closed book. It is important to revisit and rethink medical ethics cases, said Fr. Nairn. The use of feeding tubes is one example.
"We immediately think of starvation and insert a feeding tub," he explained. "With cancer, the body begins shutting down. By not eating, it is deadening the pain. It is sometimes beneficial not to eat. It took six or seven years of research and debate for this to change and there is still a lot of debate about the use of feeding tubes."
Civil and criminal law also plays an important role in medical ethics and must be considered along with our faith tradition, said Fr. Nairn. Both are designed to preserve human dignity, but in different ways.
"Law, the language of rights, preserves human dignity autonomously, while with faith tradition we must consider that we are part of a community. Some decisions are communal," said Fr. Nairn. "We must consider how the decision relates or affects others."
"It's amazing how scientists now have a genetic blueprint. Today genetic testing is a major topic of discussion, in the future it will be something different," he said. "Conditions that are treatable today, killed people 30 or 40 years ago. We must embrace the technology, but keep in perspective our Christian vision and an understanding of who we are."
On Our Own Terms, Moyers on Dying, a four-part PBS series with Bill Moyers premieres Sept. 10-13. Moyers documents personal storyies of dying as they struggle to live their final days and come to terms with their life and death. As a follow up to the PBS series, the Fox Cities Coalition for End of Life Care is encouraging Fox Valley parishes to recognize Compassion Sunday on Sept. 17.