BreakPoint: Who Lives, Who Dies?

Life or Death Medical Decisions

John Stonestreet: We’ve talked recently about who should make life and death decisions when it comes to medical care.

What would Chuck Colson have said about the case of little Charlie Gard?  Who should decide who lives and who dies?

Back in 2009, Chuck prophetically warned that with nationalized healthcare comes increased government control over these decisions—especially when it comes to “quality of life” issues.

If all that matters is what an individual can contribute to society as opposed to the fact that we’re made in the image of God, we are all in danger.

So please listen today to Chuck Colson.

Chuck Colson: Maybe the biggest single issue in the debate over healthcare reform is cost. And by “cost” most people mean how are we going to pay for the president’s and Congress’s proposals.

But there’s a more important question of cost when it comes to healthcare reform: that is, the price paid by the most vulnerable among us.

In a recent New York Times magazine article, ethicist Peter Singer explains “why we must ration health care.” Singer, a brilliant writer and a master logician, begins by pooh-poohing the idea that “it’s immoral to apply monetary considerations to saving lives.”

Well, Singer is right when he says that “we already put a dollar value on human life.” Mattresses aren’t as fire-resistant, he says, as they could be because government officials have decided it would be too expensive to save those additional lives.

Still, Singer couldn’t resist the temptation to play God. He rejects the idea that the “good achieved by health care is the number of lives saved.” In his utilitarian calculus, the “death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities.”

How? Through the use of a “quality-adjusted-life-year,” or QALY. Say, for example, people prefer living five years disability free to living ten years with quadriplegia. Then, Singer reasons, when it comes to rationing health care, we ought to treat “life with quadriplegia as half as good as non-disabled life.” Believe me, he’s not kidding.

What’s even more telling are the considerations Singer says we should not take into account: for instance, whether a patient is a mom or a dad. Thinking about a patient’s children, he says, “increases the scope for subjective—and prejudiced—judgments.”

As abhorrent as Singer’s ideas are, they’re coldly consistent with utilitarian thinking that now dominates medical ethics. As early as the 1990s, Ezekiel Emanuel, the brother of the president’s chief of staff Rahm Emanuel, envisioned “not guaranteeing health services to patients with dementia.” Why? Because, he claimed, they’re “prevented from being or becoming participating citizens.”

I’m sorry, but this is the precise same logic the Nazis used to exterminate the physically and mentally handicapped.

The only viable alternative to this horrific utilitarian, materialistic vision is the Imago Dei: the Christian belief that man is created in the image of God.

Being created in the Imago Dei endows every person with dignity—a dignity that is not derived from the majority’s opinion (or a government definition) about the quality of their life or their contribution to society.

In the absence of this belief, every decision about the allocation of healthcare—and indeed about any area of life—becomes an occasion for the young and strong to impose their will on the old and weak.

The word for this is “tyranny.” And all the hand-wringing and rationalizations about the need to overhaul the healthcare system shouldn’t distract us from the very real danger of nationalizing health care and granting government the power to decide whose life is worth living.

I say leave it to the family and the doctors, as it is today.

(This commentary originally aired on July 27, 2009).


Who Lives, Who Dies? Life or Death Medical Decisions

Chuck’s thoughts on life-and-death healthcare decisions are still relevant today as debate continues on this topic. For further discussion, check out the resources linked below.


Why We Must Ration Health Care
  • Peter Singer | New York Times | July 19, 2009
A Religious Scientist?: Dr. Francis Collins Picked for NIH
  • Chuck Colson | BreakPoint Commentary | July 13, 2009
Charlie Gard's Death Sentence
  • John Stonestreet | BreakPoint Commentary | July 6, 2017

Comment Policy: Commenters are welcome to argue all points of view, but they are asked to do it civilly and respectfully. Comments that call names, insult other people or groups, use profanity or obscenity, repeat the same points over and over, or make personal remarks about other commenters will be deleted. After multiple infractions, commenters may be banned.

  • ah.1960

    The idea of the government deciding when a life is not worth saving is indeed abhorrent. The classic example was at an Obama town hall meeting on healthcare before Obamacare became law. A woman asked the President whether her mother who is in her 90’s and had a vibrant “quality of life” would be permitted under his law to get a new pacemaker. Just the idea of a private citizen having to petition the government for a loved one to receive medical care and then waiting for Caesar to give thumbs up or thumbs down is shocking in itself. Obama’s answer was no more comforting when he suggested that she might just need to take a pill instead of having a more expensive pacemaker operation.

    Today’s culture of unlimited abortion and doctor assisted suicide breeds a culture of death that is uniblical and therefore one which we must counter.

    In fairness on the other side, though, isn’t there a time when we make that decision to add a DNR (do not resuscitate) notation to an aging relative’s health record in a nursing home or hospital? I am not averse to making that hard decision, but it is one that should only be made after careful deliberation by the person themselves (if competent) and their relatives in consultation with medical staff. In no case should an insurer or government agency/person.

    Although such hard decisions might have to be made, our default position must be to choose life.

    • Steve

      I agree with your points. Adding a DNR to a health record is quite different than rationing health care. It is acknowledging the reality of the situation and choosing not to have certain heroic measures taken in the case of natural occurrences which lead to death.
      Letting nature take its course is different from the government deciding whether you can choose life.

      • Guy McClung

        Steve-Check it out-how many states in the US allow doctors to enter DNRs without the consent of the patient or his/her loved ones-and how such a decision is FINAL – final because there is no appeal here and final because the person dies. This is law in Texas and I think in some other states. MD = M Deity. Guy McClung, Texas

    • ah.1960

      Oops. Just noticed I didn’t finish a sentence. “In no case should an insurer or government agency/person be the ones making this decision.”

  • Abovethesun

    The core issue is, whose children are they? Parental rights are in danger of being entirely lost. Parental rights must be protected in law. At this time, they are not.

  • Guy McClung

    It Takes A Village To Raise A Child. Totalitarian translation: It Takes A Village To Take A Child. Guy McClung, Texas

    “Precious Child”

    by Guy McClung
    Catholic Lane site Feb 11, 2017

    If we wants the child,
    The precious,
    Get it from mommy and daddy,
    How can we does it?

    We hides us,
    We sneaks around,
    Near the ground,
    And we calls us, “Village”.

    We means “steal,” but we says “raise”.
    “Village” is good, “raise” is good.
    Takes a village to raise a child!
    We gets the precious child !

    The child loves us, Village,
    And hates mommy
    Hates daddy.
    We gets the child to dead them all.

    Dead the mommy and the daddy ,
    Dead the aunties and the uncles.
    Dead the brothers and the sisters, and
    Grandma and Granddad, dead.

    All done dead, the family – dead.
    Us Village alive.
    The precious, the child,

    Copyright © Guy McClung 2017

    • Momma Beth

      Wow…scarily accurate

  • gladys1071

    The problem is that healthcare is already rationed by insurance companies. All of us are beholden to the insurance company and the willingness to pay for medical care. The big elephant in the room that nobody wants to address is COST.

    The cost of medical care is so completely out of control yet nobody talks about it. We can talk all day about life/death, ultimately the person or entity that pays whether it be government or insurance company has the final say. Unless everyone has millions of dollars to pay for their own healthcare, we are beholden to someone else.