An International Journal for Pastors and Students of Theological and Religious Studies
An International Journal for Pastors and Students of Theological and Religious Studies
This book is an admirable effort to discover the riches of the Christian tradition in thinking about death and to apply them to contemporary controversies. Author David Albert Jones is Professor of Bioethics, Academic Director of the School of Theology, and Director of the MA Program in Bioethics at St. Mary's University College, Twickenham, United Kingdom. His perspective is Roman Catholic, and he represents Christianity as a whole with great sensitivity and skill.
Although death is universal in human experience and has been with us from the beginning of our history, the opportunity and the need to make decisions about life prolonging technologies is quite recent. The public debate about end-of-life decision-making from both moral and legal perspectives has been dominated by the disciplines of psychology and philosophy, but believers need the direction of Christian theology as well. This is true because we need guidance in sorting various psychological and philosophical theories within each discipline and because there is tension between the advice generated by these two sources. A theological account of death can help unite the more clinical or pastoral concern of the psychologist and the more doctrinal or normative perspective of the ethicist.
Jones develops his systematic theological account of death by offering chapter-length treatments of four theologians of different ages, "each of whom developed a distinctive and influential theological account of human death" (p. 2). They are Ambrose of Milan, Augustine of Hippo, Thomas Aquinas, and Karl Rahner. Despite their temporal distances from one another, there is so much continuity between them that they "constitute a single extended argument on the theology of death" (pp. 7, 187). This does not mean that they offer a uniform account, but that each develops themes in the thought of his predecessors. Although Ambrose is credited with developing "an explicitly Christian account of death" (p. 187), his Platonism inclined him to view the death of the body and the separation of body and soul as "something in every way good in itself" (p. 187), because it enables the body to rest while remedying the punitive hardships of post-Fall existence, as well as freeing the soul. Augustine cannot conclude that death is a good thing because of his higher estimation of the body, and he declares that body and soul are in a natural union. Aquinas was able to develop this theme more fully, having access to Aristotle, who teaches him that death is natural. Rahner, making use of existentialist and post-Kantian thought, emphasizes "the distinctively human character of death as the end of our earthly pilgrimage" (p. 189).
Jones applies the Christian understanding of death to the issues of grief, hope, killing, suicide and martyrdom, assisted suicide and euthanasia, withholding and withdrawing treatment, and sustaining the unconscious. Jones criticizes the tendency of Christians to attempt to influence public policy by offering secular arguments and leaving Christian rationales unstated. The problems are that the secular arguments may be in fact weaker than the religious ones, that secular interlocutors will suspect hidden agendas in believers, and that secular people will misunderstand the religious reasons that actually do motivate Christians. Jones cites as an example Glanville Williams who dismissed the Christian view of infanticide by implausibly alleging that early Christians condemned infanticide out of the fear that unbaptized infants would go to Hell. In fact, Christian condemnation of infanticide resembled that of contemporary Jews and predated infant baptism by centuries.
Jones summarizes the Christian perspective on end-of-life decisions by noting, "The Christian tradition, as represented in this study by Ambrose, Augustine, Thomas, and Rahner, is united in arguing that it is never legitimate to kill oneself or to kill another unless under the command of God" (p. 212). With regard to withholding and withdrawing treatment, Jones points out that "neither in the case of one's own life, nor in the case of the life of another, can there be an absolute obligation to preserve or extend life at all costs" (p. 213). He proposes using the category of extraordinary care, that is, care that is either futile or unduly burdensome in light of expected benefits, and ordinary care, in which burdens are outweighed by clinical benefits. Extraordinary care is not morally obligatory either to provide to others or to receive, but ordinary care must be given and received. In addition to that distinction, Jones insists on the importance of intention. "It is never right to withhold or withdraw treatment in order to bring about someone's death" (p. 214).
In the vexing matter of supplying artificial nutrition and hydration (ANH) to persons in persistent vegetative states, such as the U. S. case of Terri Schiavo and Tony Bland in the U.K., Jones cites with approval Pope John Paul II's 2004 declaration that such treatment is ordinary care, to be withheld only in exceptional circumstances. He raises some doubts about the reliability of such diagnoses and supports maintaining the permanently unconscious by ANH because of its symbolic value as basic human care, as an affirmation that the unconscious are not beyond human care, even if they cannot experience it, and because it cannot be deemed futile unless one were to claim that such lives are worthless. Readers who are not Roman Catholic, as well as many who are, will find this troubling, since many have believed for some time that ANH need not be given nor received for those in PVS. The issue remains controversial among evangelicals. (See Dr. Robert Cranston's guide to the issues at http://www.cbhd.org/resources/endoflife/cranston_2001-11-19.htm).
This is a fascinating treatment of four foundational thinkers in the Christian tradition, important not only for Roman Catholics but for all Christians and those who live among them. Jones' writing is a model of clarity and readability, and his critical interaction with the four thinkers is skillful. Jones ably demonstrates the relevance of theology to contemporary issues and of the past to the present.