Hell is a place of mercy

Hell is not really a bioethical issue, at least not directly. Hell is the negative reinforcement, the deterrent factor, in having a workable ethics. We naturally want to do what is good and right – but why do we want to avoid what is evil and wrong? If there is no hell, there is no reason to “do good and avoid evil,” the very first principle of anything that can be called “ethics.” Hell is life opposed to good. If there is no hell, then there is nothing opposed to good.

There is a new book out about hell, written by Protestant pastor, Rob Bell. Bell basically thinks hell is on earth, and that everyone will be saved and go to heaven. He has a hard time accepting that a loving God would “send” anyone, anyone at all, to a place of eternal torment.

Unfortunately, justice is a part of love. If everyone gets to heaven, regardless of the evil perpetrated in earthly life, then there is no justice and no love. If there is no recompense for evil actions, there is no reward for good.

Without hell, there is no need to do good and avoid evil, because the outcome is the same. Self-sacrifice is meaningless. Suffering is meaningless. Not indulging oneself regardless of who it hurts or what the outcomes are is meaningless. Murder, genocide, global warming, Ponzi schemes, exploitation, dishonesty – it’s all meaningless because you go to heaven anyway.

Likewise, even if there is neither heaven nor hell as atheists believe, then there is also no reason to do good and avoid evil. You die, and that’s it. You no longer exist. So why bother about what your reputation will be when you’re gone? Why not live entirely for yourself, even if it hurts others along the way? It seems unconscionable, but think about it. Once you die, neither you nor the people you use and hurt matter any longer. You cannot be harmed by other people's hate and their hatred has no object. Whether or not they are harmed is irrelevant, because you're dead and they'll eventually die, too.

Now, I don’t know many atheists who would agree with that, as many do try to lead good lives. But I’m talking about the ethical principles at work. Why do they try to lead good lives? Without hell and heaven, there is no ethical principle higher than “what I want for myself.” And that might include being kind to people and accepting a loss of a personal good for the sake of something greater. However, it would be a totally personal choice. It would be “good” because it is what you want. If God doesn't exist, there is no universal and objective good or principle of behavior that demands assent. And some people could quite ethically choose to please themselves and hurt others. We might disagree with it, but we can't say it's “wrong” or “evil.”

Atheists and relativists I think have a hard time accepting the notion of hell because they feel entitled to define things like “love” and “good” for themselves. “If God is 'love' (the way 'I' define it), then there is no hell.” Well, who can argue against that? If you define love to exclude the possibility of hell, then you have to be right—if “love” is actually something you can define for yourself.

What if love is an objective reality, not subject to idiosyncratic definitions? What if it has its own attributes and properties, that we must recognize and accept if we call ourselves reasonable and open-minded?

Justice has to be a part of love, because it means given each one his due, be it reward or punishment. It is out of love for persons that we strive to give each his due. 

But, if justice is a part of love, then some people go to hell. God loves himself after all, and he loves human beings. God is love, and he is what he does. Can he love himself –can he be love – if he rewards hate, and in particular hatred of himself? Can people who hate him be in a mutual relationship of love with him, which is what heaven is? Can a square be a circle?

If everyone goes to heaven, then the people who hate God must at some point come to love him. If that does not happen before the end of their earthly life, then it has to happen after death. I suppose it is possible. But there are only two ways it can happen. One is, God reveals himself to those about to die, and the true, loving nature of God melts the cold, hateful heart of those who hate him, and they come to love him. And this happens without fail in every case. The other is, God more or less forces the hateful person to love him. Some people do not distinguish the two.

The second at any rate does not happen, because we are free and we cannot be both free and subject to that kind of force. Besides, a loving God would not use that kind of force. And, it is not love if it is forced out of us, it has to be freely given. Being free makes the first unlikely, too. In seeing the true nature of God, there will surely be those who hate him all the more, because in creating them as finite and frail humans, he deprived them of being gods and caused all the hardships in their earthly lives. Seeing his majesty and goodness, such persons would resent him. They would hate him for not sharing his divinity with them.

Ironically, heaven is a participation in the divine nature. Those who hate God could have had it, if they only loved God instead. But they hated him. If such hatred persists after death as it seems it must, there is a hell. It is what such people want and deserve after all. 

However, hell is eternal. Is that really just? Is that loving? I say it is. I say hell actually is a place of mercy. 

Whoever hates God as described has achieved an evil that is in some respect infinite. It is infinite insofar as the hated object is infinite, and it is infinite because the person has refused to change. Therefore, the punishment, which the person freely prefers over being with God, has to have a dimension of infinity as well.

A punishment has two dimensions. One is duration. The other is severity. Since the punishment lasts forever, we know that the duration is infinite. However, the severity need not be. In fact, it cannot be infinite, or else it would annihilate the person. Perhaps the sufferings of hell are not even as intense as the person deserves them to be, because God in his mercy can make them less intense. There is no need for them to be overly severe, because there is no escape from them.

And in that sense, hell is a place of mercy.

It is like the criminal court judge sentencing a serial killer who deserves the death penalty. Would it not be an act of mercy to give him life in prison instead? Either way, his life in society with good people is over forever. Yet it is a mercy to let him live.

The question some might have is the purpose of the sufferings of hell. Punishment is usually ordered to correction of behavior, which would be out of love of the guilty party in some way. Sometimes it is for retribution, which in some respect reflects love of the injured party. Neither applies to hell, because the person cannot change his ways after death, and because God needs no retribution nor do the human victims once they are in heaven. In some respects, the sufferings simply are – suffering is the way things are apart from God.

The sufferings of those in hell might serve other purposes for those not in hell as well, so that some good might come from it. The sufferings inspire the good to be good and to repent of their evil while they can. That is the deterrent factor. 

The sufferings can also be looked at like this. Most people who hate God love themselves more. They have chosen themselves (or some other creature) as their own gods, and in death they realize that they are not and can never be gods. And so the horrors of hell are: The realization of how pathetic their gods are, being doomed to serve the pathetic gods they chose in life, and seeing the infinite good that they have forsaken forever in favor of the infinitesimal good they preferred.

These things will surely torment someone forever.

God cannot change the fact that hell has torments. God is Truth, and it is against the nature of truth to make that which is true to become untrue. Rejecting and hating God means accepting and preferring torment to heaven. God can mitigate those torments and order those torments to the good of those not in hell, which are acts of mercy. So hell does serve God’s mercy, even for those in it.

To deny the existence of an eternal hell is to deny the attributes of justice and mercy to God. Justice, because evil earns the same eternal reward as good. Mercy, because if there is no possibility of punishment, than there can be no mitigation of punishment. 

It also, in a way, denies God’s power. For if there is no eternal, inescapable hell, then no one needs to be saved from it. God lets everyone into heaven because he has no power to keep them out.

Hell therefore affirms God’s existence, complete with his perfect power, justice, and mercy.

GPS for bioethics

When we go on a trip, we put our destination into the GPS, click Go, and it we have our route laid out. Once in a while after we start going, we realize that we put in the wrong destination, so we pick the right destination and turn aside from the first one.

A recent post at Secondhand Smoke talks about how permitting assisted suicide quickly evolves into promoting it. I certainly agree. It's time to take a look at the destination keyed into the bioethics GPS and pick a new one.

Wesley Smith makes a great observation that I will not soon forget: How heartbreaking it must be for a terminally sick or injured person to say to his loved ones that he's thinking of ending it all, and they agree it's a good idea.

Chilling. Creepy. But it happens.

Surely, the sick person wants to hear, "NO! NEVER!! C'mon, Dad/Mom/Sis/Granny, we LOVE you, we want you around as long as possible! I know you're suffering, but we NEED you!! The kids need you!!! I'll talk to the doctor about pain medication for you, we'll do everything we can to make you comfortable. BUT DON'T LEAVE US!!!"  Even if the sick person is adamant about ending his life, surely it must be a huge slap in the face to have no resistance.

It must equally hurt to have only token resistance, fake but polite, like a friend resisting when we offer to pick up the tab at lunch. We appreciate a sincere, "No, let me pay my share," but more often than not it's just his way to say Thank You, and our guest would feel slighted if we agreed to let him pay for his food. We're duty-bound to follow through on our offer.

But when we offer to kill ourselves? "Well, Dad/Mom/Sis/Granny, we want you around, but if that's your decision..." Surely if our loved ones -- our reasons for living -- indicate that they endorse our decision, we really have no reason left to live except selfishness. We would feel duty-bound to die as soon as possible.

So our loved ones' attempt at neutrality fails. Their lack of resistance is tacit endorsement.

Neutrality is simply illusory in these sorts of issues. Not stopping someone from killing himself is endorsement of the deed. We can be neutral about buying a car: "It matters not to me if you buy this one or that one." But neutrality fails when a life is at stake: "It matters not to me if you kill yourself." That is clearly a statement of the lack of worth of the life in question. The same applies to law. A law that permits a thing endorses it. It is seen as a Good Thing To Do.

The article at Secondhand Smoke references a news story about the possibility of Vermont joining Oregon and Washington in permitting assisted suicide. The news article is far from neutral.

It seems that apparent neutrality is really endorsement. And endorsement becomes pressure to those not considering it. Smith argues in part that our society, our culture, must always and actively discourage suicide and voluntary euthanasia, or else we start down the path of duty-bound suicide and involuntary euthanasia.

If we start down a road that leads to a particular destination, we are not obliged to arrive at that destination if we stop or turn off along the way. But if we do not stop, we cannot claim to be surprised if arrive at the destination.

We are on the road to enforced euthanasia according to the bioethics GPS. Faux neutrality is the on-ramp. We've already missed the exit before Assisted Suicide. We really should turn back.

How to Defeat Death Panels

Government death panels are not all-powerful.  The one in Canada that has been holding Baby Joseph’s life in its hands has been defeated. Fr. Pavone from Priests for Life has arranged for Baby Joseph to be transferred to a Catholic, charitable children’s hospital in St. Louis.

St. Louis, the city, is named after King Louis IX of France, who had 11 children. He became king at age 9 under a regent, and reigned from the age of 19 until his death at 55 in 1270.

As for the death panel, the Priests for Life website notes, "The medical board overseeing his case is apparently convinced that giving proper care to 'Baby Joseph' is futile. They don’t mean that the medical care won’t help him. They mean his life in its current condition isn’t worth the trouble."

Baby Joseph is not likely ever to recover from his neurological disease. His life will be short. According to the Canadian death panel, the kid’s life is a waste of time and resources. That is what happens when health care is rationed artificially. 

What Priests for Life has done is to ensure he will be given humane care until the end.

It's MARIO Day!

It has nothing to do with bioethics that I know of, but it is nonetheless an interesting thing.

The Tenth of March, when written MAR 10, looks a lot like MARIO.

So it's Mario Day.

Do something nice for anyone you know named Mario.

And I'm sure you know someone named Mario... Don't you?

Vatican Invests in Stem Cell Company

Adult stem cells, that is. According to this story, the Vatican has invested a million bucks into the tiny biotech firm, NeoStem.

NeoStem focuses its efforts on adult stem cells, not embryonic ones.  Adult stem cells are called adult because they are made by the body precisely as fully mature stem cells. As stem cells, they can develop into various other kinds of cells. Bone marrow, skin, umbilical cord blood, and even baby teeth (lost naturally of course) are rich sources of adult stem cells.  These are the kind of stem cells that are being used whenever a therapeutic breakthrough is obtained using stem cells.  In fact, bone marrow transplants for people with leukemia is a kind of stem cell therapy.

Embryonic stem cells are the cells that form shortly after fertilization. Embryonic stem cells cannot be obtained in large quantities except by destruction of human embryos. As the very first cells of human development, they have the potential to become any other kind of cell in the body. In theory, this ability would make them more attractive for therapeutic applications.  However, no therapies have been developed to date with this kind of cell. In fact, using embryonic cells is fraught with setbacks.

NeoStem also has a foothold in China, a vast country where the economic possibilities are limitless.  The US Government has also invested some $1.7. Over and above the therapeutic promise of NeoStem's technologies, which the Vatican clearly appreciates, Rome also hopes to build awareness about the value of researching adult stem cells, both for their therapeutic potential and their ethical grounding.

The biotech company has a technology that identifies Very Small Embryonic-Like (VSEL) stem cells. The therapeutic potential of stem cells comes from the way they develop into different kinds of cells. If you think about a damaged organ, your heart, for instance, stem cells could in theory be placed in the damaged areas of the heart to grow into new, healthy heart tissue.  The problem is that most adult stem cells are versatile enough only to become a limited range of new cells. VSELs, like embryonic cells, have a greater potential to become any other kind of cell that is desired.

I cannot vouch for the Vatican's investment strategies, but I can say that the investment makes good bioethical sense.

Death Panels - Further Thoughts

I do not know much about the health system in New Zealand. I do know that apparently hospitals are authorized to overrule parents in determining whether their child would receive life support.

A girl nearly died in a car accident down there last December. She was placed on life support. Doctors decided that she had enough care and had no chance to live, but the parents wanted to keep trying. The doctors overrode the parents and decided to pull the plug, since life support for someone who is going to die just doesn't make sense.

The girl lived. She not only lived, she's now walking and talking and expected to make a complete recovery.

One argument against the death penalty, which is imposed after someone has been convicted in a court of law of a serious crime that warrants death, is that the system sometimes convicts innocent people. Innocent people die, and we should not take that chance.

Well, with death panels like the one in New Zealand, almost everyone who is slated to die is innocent. Some criminals might be seriously injured or sick and be in the same predicament, but mostly those on "death row" are innocent people. There is no legal appeal system - you have to sue to get the legal ball rolling.

I find it funny, disturbingly funny. On the one hand, imposing death is considered an inhumane penalty for someone who clearly does not deserve to live in a free society. And the same thing is considered so wonderful and therapeutic for someone totally innocent that governments feel the need to step in and impose it against the wishes of the caregivers.

Speaking of lawsuits, I wonder if the parents have given any thought to how much better their daughter would be doing if she weren't taken off life support.

Government Death Panels, Alive and Kicking

Baby Joseph of Canada has dropped from the mainstream media, but his plight continues. The boy cannot breathe on his own due to a severe but specifically undiagnosed neurological problem. His parents want him to have a tracheotomy to get him off the respirator, and the Canadian health system refuses to perform it, saying it is too risky. They also believe Baby Joseph has no chance at recovery and will die in any case.

So they simply wish to remove the respirator and let him die.

Note the irony: They do not want to perform the tracheotomy because it’s too risky. I don’t know what the risks are, the news didn’t specify them. I can’t imagine any risk being greater than certain death. “No, the tracheotomy has too much risk of adverse consequences. It would be far less risky for the patient if he were to die.”

Give me a break.

In all the international, public controversy, they have delayed their plans and have offered to disconnect the device at the parents’ home.

The parents want to bring him to the US to get the procedure done, but so far no hospital has agreed to take the case. In fact, Children’s Hospital of Michigan in Detroit has reviewed the case and refused to take it, even after initially saying they would.

Now, in US politics, when President Obama’s health reform plan was being debated, people talked about it establishing government death panels. Supporters of “Obamacare” derided those who worried about the death panels, saying it would be preposterous.

Yet let’s look north a bit, just above our borders, to Canada and see what is happening there. Right now, Baby Joseph’s life is in the hands of the Office of the Public Guardian. That governmental office will decide if and when to remove Baby Joseph’s respirator, and it can make that decision autocratically.

Folks, that is what a death panel looks like.

We might imagine a special conference room in some government office somewhere, with a folder of a patient’s medical records on the table. People in business suits or white coats sitting around the table, looking at various pieces of paper from the folder. Then, someone says, “Shall this patient die? All in favor?” Hands go up around the table. A majority vote. The patient dies. A new folder is brought forth….

The Canadian death panel looks far different. But it is what it is.

Canada rations healthcare. Some people like Baby Joseph use a lot of healthcare. Too much, in fact. A death panel is whoever is authorized by law to decide that a patient like him has used enough health resources and to let him die. It is a “government” death panel whether or not the person(s) involved are government workers because it is authorized by the government.

One could make a car analogy. If you have a car, say, a go-kart, that is too small to be of practical value for commuting or shopping, and it needs constant mechanical attention just to run, and you can’t take it out of the shop, and it has no hope of ever being repaired – what do you do? You get rid of it, right? But couldn’t you, if you wish, keep it? Couldn’t you bring it home to tinker with it? Couldn’t you change mechanics if you pleased? Of course you could.

And what if the mechanics refused to let you even look at your go-kart? What if they abdicated all their responsibility to you, and handed things over to a government agency? What if that government agency wants to force you to scrap it, but is only waiting to decide when? It would be absurd.

But that is only an analogy. We’re talking about a human being. The baby is too small to be of use to society in terms of working or consuming. He needs constant attention and will never recover. And his parents are completely helpless, powerless to do anything.

One way to bring down healthcare costs is by limiting how much healthcare people use. If people stay healthy, they will use the health system only when they need to, and even then not use health services and products unnecessarily. People also have to be less sue-happy with their doctors. And they should not expect insurance companies to pay for everything, because insurers will always charge premiums that are more than they pay out.

Another way to reduce costs is to limit how much healthcare everyone can get. This will begin by reasoning that only those “who really need it” will be able to get it. But then…

…who are those “who really need it”? Who are those who will make that decision? Will not the criteria have to be put into law?

The Canadian government authorities have decided that Baby Joseph is someone who does not really need the care he is getting and should get no further care.

Maybe the care he is receiving is futile and should be discontinued. There is no ethical obligation to use futile and burdensome care. However, there are two issues here that must be considered.

One is, are all possible alternatives, such as that proposed by Baby Joseph’s parents, equally futile and burdensome? The lack of US hospitals willing to step suggests that may be so. On the other hand, there may be other (political) reasons the US hospitals haven’t offered any help – or maybe I’m just getting paranoid about that sort of thing.

There other is who makes the decision that care is futile and burdensome?

In Canada, it is the government’s choice. The government chooses who gets healthcare and how much.

And that is what a death panel looks like.