23 January 2007

Speaking Ethically No. 9

By Rod Benson

March 2007

Christians often invoke the parable of the “Good Samaritan” to illustrate the need for compassion and altruism in response to human need. It is one of the most ethically significant stories Jesus used to teach right attitudes and right action.

But as Alan Verhey well points out in his fascinating book, Reading the Bible in the Strange World of Medicine, the high cost of health care and the scarcity of medical resources may limit the extent to which the Good Samaritan ethic applies today.

What if the oil and wine, and the stay at the inn, leave the patient barely alive and in permanent care? Should the Samaritan continue to pay for this care? What if there are ten, or a hundred, patients? Which ones should he rescue? What if all the beds in all the inns are in use? What happens when funds dry up?

Peter Singer raises similar issues in the care of extremely premature babies, citing a report in the November 2006 issue of the Medical Journal of Australia.

He observes that no babies under 26 weeks gestation in NSW and ACT between 1998 and 2006 survived without admission to a neonatal intensive care unit. Between 23 and 25 weeks, 65 per cent survived, but up to two-thirds had severe functional disability. Of those born at 25 weeks, only 13 per cent had severe functional disability.

To draw a line, say at 24 weeks, and say that no child born prior to that cut-off should be treated would avoid much soul-searching and save the community the expense of medical treatment likely to prove futile, as well as the need to support severely disabled children who survive. But it represents institutional interference, and removes parental freedom.

Instead, a workshop of health professionals has defined a “grey zone,” between 23 and 26 weeks, within which the decision to administer treatment is left with the parents.

This recognises the need for parents to participate in life-and-death decisions about infants at the margins of viability, and acknowledges that reasonable limits to medical treatment are desirable.

In a less-than-perfect world, some situations may call for “Fair Samaritans.”

Rev Rod Benson is Director of the Centre for Christian Ethics at Morling College, Sydney.

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