Reproduced here is an article on the Sanctity of Life with reference to Asia posted on the FIAMC website by Dr Freddie Loh, Immediate Past President of AFCMA:
Introduction: This article tries to sum up the various bioethical issues affecting life with particular reference to the situation in Asia. Bioethics is defined as the application of moral principles to the life sciences, to the many problems in relation to human life that has resulted from the rapid advancement in science and technology. Asia consists of more than 12 countries of various sizes and each with different races, cultures and religions eg. the main religion in Malaysia and Indonesia is Muslim, in Philippines is Catholicism, in Japan and China is Buddhism, etc..The Catholic population in these countries with the the exception of the Philippines is very small e.g. the percentage of Catholics in Japan is 0.4%, in Thailand <1%, Indonesia 2’7% and Malaysia 4%.
The issues confronting the Catholic Church in Asia are the same as those in Europe and the advanced countries and can be divided into (A) Beginning of life issues and (B) End of life issues.
Due to limited space only those issues which are common will be discussed in some detail. Our catholic Church teaches us that life begins at conception and is inviolable and should be protected until its natural end (Charter for Health Care Workers). Also Human Life is Sacred–all men must recognise that fact (Humanae Vitae).
A. Beginning of Life Issues:
- Abortion: The inviolability of the human person from conception prohibits abortion as it is the suppression of prenatal life. This is a direct violation of the fundamental right to life of the human being and is an abominable crime (Holy See, Charter in the rights of the family). Unfortunately although most faiths do not condone abortion considering it as a vicious crime of murder, some countries have legalised abortion due to pressure from individuals in their own country. In Malaysia and Indonesia abortion is legal under certain vital conditions when the pregnancy itself may endanger the lives of the mother.
- Stem cell research: Stem cells can be divided into embryonic, umbilical and adult types. Stem cells are undifferentiated cells which own the potential to grow into various types of cells in the body.Embryonic Stem Cell Research should not be allowed because they are harvested from embryos which are then destroyed. Stem cells can be used to treat Alzheimer’s disease, Parkinsonism, repair damaged tissues in knee and myocardium, etc. Stem cell therapy has been used in Singapore for sometime.
- Assisted Reproduction: Procedures which assist the marital act to achieve its purpose are morally permissible but those which substituted for it are not.These procedures include IVF (in vitro fertilisation), FIVET (fertilisation in vitro with embryonic transfer), IVM (in vitro maturation) where the ovum is allowed to mature in the lab before it is fertilised, ICSI (intra cytoplasmic injection), GIFT (gamette intra fallopian tube transfer) and LTOT (lower tubal ovum transfer). GIFT involves transferring the gamettes (oocyte and sperm) collected and then transferred by laparoscopy for fertilisation to take place. Some consider this method as illicit. LTOT involves transferring the ovum that cannot get into the blocked fallopian tube to a lower position in the tube or the womb so as to make fertilisation possible. It may be considered morally acceptable as long as the sperm is collected by methods not contrary to nature. With regards to IVF a recent survey on 118 Indonesian Catholic Doctors from Jakarta and Surabaya showed that 52.5% of catholic doctors knew before hand that the Catholic Church has taught about the immorality of IVF. However 73.7% did not agree with this Teaching.IVF is immoral because it does not respect the unitative aspect of the conjugal act (Charter for Health Care workers).However IVF is widely acceptable in Indonesia within its own target market and has recently made inroads into Malaysia.
- Contraception: This is defined as a means to avoid conception with the help of drugs or devices.Types of contraception include condom, diaphragm, spermicide, contraceptive pills, contraceptive injections like depo provera, implants, intra uterine devices, vasectomy, tubectomy, etc. Different countries prefer using different methods. Unfortunately in the Philippines a staunch Catholic country of late contraception has been legalised with the passing of the RH (Reproductive Health) Bill. To counter the negative effect of contraception Natural Family Planning Methods are used and are accepted by the Church.Their success depend on regulating sexual activity to the wife’s immediate fertile state, to postpone or to even to achieve pregnancy. The Billing’s Ovulation Method (BOM) is widely practised in Asia and has a high success rate. Another Method is the Creighton Model System and Napro Technology discovered by Dr. Hilgers at St. Paul VI Institute in the U.S. It is being used in Taiwan and Japan. Both Methods involve examination of the cervical mucus by the woman herself feeling its changes from cloudy and sticky to stringy and slippery. This slipperiness is used as a marker for ovulation. In the Creighton and Napro Method the couples are taught that whilst genital contact is to avoided during the days of fertility, sexual contact(activity) should never be avoided as this will lead to a respect for the dignity of woman and marriage.
- Cloning: Cloning is a technique of creating offspring with the same genetic code as its parent. It duplicates the same genetics as an organism and replace the nucleus of the ovum with the nucleus of another cell. Life begins at the time of fertilisation and interventions such as abortion, IVF, embryonic stem cell research and cloning in some way or other interfere with this process.
- Prenatal diagnosis: The ever expanding knowledge of intrauterine life and the development of instruments granting access to it has made it possible to diagnose prenatal life thus opening the way for more timely and effective interventions. Its purpose should always be for the benefit for the Child and the Mother and to make possible therapeutic interventions, to bring assurance and peace to women who are tortured by doubts about foetal abnormalities and tempted to have an abortion. If the prognosis is an unhappy one the mother should be given proper counselling so as to prepare for the welcoming of the handicapped child.
(B) End of Life Issues:
What is Euthanasia? By Euthanasia is meant an act or omission which by its nature or intention causes death in order that all suffering may be eliminated. The pity aroused by the pain and suffering of terminally ill patients, abnormal babies, the mentally ill, the elderly and those suffering from incurable disease does not authorise any form of Euthanasia either active or passive. It is not a question of helping a sick person but rather the intentional killing of a person. Health Care personnel should always remain faithful to the task of giving service to the service of life and assisting it to the end. Dysthanasia is defined as the undue prolongation of life which ends in an undignified death. It is an abusive use of extraordinary or inappropriate technological means to prolong life and is usually costly and done for fear of a malpractice lawsuit. Orthothanasia: means correct dying. The patient is allowed to die in a dignified way. Human life must be protected and even dutifully prolonged but should not be unduly or uselessly prolonged. It is not a form of passive euthanasia. It is important to differentiate between allowing death to occur and intending death to occur.
Ordinary and Extraordinary Care: ANH or Artificial Nutrition and Hydration is regarded as ordinary care and cannot be legitimately withheld even if death is imminent. For a dying patient in severe pain e.g. prostate cancer it is licit to administer to relieve the pain even when the result is decreased consciousness and shortening of life. A DNR (do not resuscitate) order is usually given when death is imminent. Life sustaining treatment is withdrawn from a patient either in a terminal condition or a permanently unconscious state when a medical practitioner sign a DNR order on the request of the patient or his representative if the patient lacks capacity. The life sustaining treatment typically withheld is cardiopulmonary resuscitation (CPR).
(C) Organ Transplant:
Organ transplant for the purpose of transplantation is good and is to be encouraged as it can save lives. However all risks and harm to the donor and the recipient must be kept to a minimum. Buying and selling an organ is wrong and is against the dignity and worth of a person.It is a known fact that kidneys are sold in India for a price.
(D) Death Penalty:
In certain Asian countries including Malaysia the death penalty is given to murderers and drug traffickers by hanging. However I understand that Malaysians and Indonesians are trying to convince their respective Parliaments to abolish the Death penalty for drug traffickers and replace it with one of life imprisonment.
Conclusion : Different issues concerning Beginning of Life and End of Life with reference to the situation in Asia has been briefly discussed. With the exception of the Philippines, the Catholic population of the Asian countries are small and relatively insignificant. However with the help of the other communities i.e. our Muslim, Buddhist, Hindu brothers and sisters we hope to influence our respective Governments to give added value to life from its beginning to its end. It is the duty of the Catholic Doctors from our various Catholic Doctors Associations to teach their fellow members as well as the other Catholic Health Care Workers including priests, nurses and medical students to update them on the various bioethical issues confronting the Catholic Fraternity and respond to them according to the Teachings of the Magisterium.
INTERESTED READERS may also wish to access our archives for other related articles: AUGUST 2010 (Billings Ovulation)
MAY 2009 (Stem Cells)
October 2007 (Bioethics)