Almost all the papers in this book flow from the Linacre Centre Conference of 2007. They treat many different aspects of the care of “the least of our brethren” and together they provide a properly human and Christian response to concrete medical dilemmas which the popular press loves to highlight.

In “Incapacity and Personhood” Professor David Albert Jones discusses the subtle distinction between the traditional phrase “human being” and the modern phrase “human person”. A “person” is seen as someone with attributes they can lose; the implication then follows that they become less of a person, with fewer rights. The idea that we give someone respect and dignity simply because they are human beings comes from Christianity. It is not a surprise, therefore, that almost all those in the forefront of the pro-life battle in its broadest sense, tend to be Christians. Jones challenges the notion that it is rational autonomy that makes us fully human; he would replace it with the more accurate and humane definition: “We are essentially dependent and interdependent rational animals.” Indeed, by showing respect for a comatose patient “we will discover ourselves as persons...”

This paper sets the tone for those that follow. Aaron Kheriaty, in “From Beneficence to Love”, develops Jones’s argument. Referring to the L’Arche communities set up by Jean Vanier to provide loving care for persons with learning disabilities, he concludes: “Mentally disabled persons live by the heart rather than by the intellect and the will.” Does this make their lives less valid? Kheriaty sees contraception, sterilization and abortion as technical solutions to non-technical problems – to human and social problems. As always, GK Chesterton provides a trenchant witticism:” Eugenicists have discovered how to combine hardening of the heart with softening of the head.” It is a deadly combination.

In a thoughtful essay, “Justifying Research without Consent” Dr Helen Watt asks if it is ethical to use mentally incapacitated people for the purposes of research. Initially I would have said “No”, but Dr Watt argues that although such people need protection from exploitation because of their vulnerability, “they should not be deprived of the chance to contribute to the welfare of their fellow human beings.” Again, she regards handicapped persons not as discrete, problematic entities but as active members of the co-dependent human family.

Wendy Hiscox provides all the figures necessary to argue against euthanasia in her paper, “Non-Voluntary Euthanasia in Holland and Belgium”. It will not surprise readers of this paper to know that Holland is already well down the “slippery slope” in the practice of euthanasia: ending lives without consent and extending euthanasia to new categories. She points out that the logic of euthanasia will inexorably move from a conscious request. “If killing patients can constitute a benefit, why deny them that benefit merely because they cannot request it?”

The question of frequent tube-feeding for very elderly or demented patients has recently been in the news. Here, Johanna Valiquette, in her essay “PEG tubes in end-stage dementia”, provides the wider picture, arguing that many patients with advanced dementia (which makes it difficult to swallow) do not need tube-feeding. There are many arguments against this practice: the risk of infection, the distress caused to patients, the likelihood of incontinence and the possibility of abuse. Apparently nursing homes receive financial reimbursements from medical insurance for the use of PEG tubes. Most important of all, patients are separated from the comfort of food when spoon-feeding is interrupted and relatives are denied a potent aspect of their care-giving.

The final paper, “Very Quiet People," by AA Howsepian, discusses so-called “Persistent vegetative states.” The author does not like the use of the word “vegetative” with good reason, as it implies that the patient is not conscious; in fact consciousness might not be absent at all – as recent cases have shown – but simply not detectable. He would rather use the word “hypokinetic” which does not preclude a measure of consciousness, despite profound incapacity. “Locked-in” states are also discussed, with the hopeful possibility of “thought translation devices” which, although somewhat crude at present, will allow communication through the brain itself. Again, echoing David Albert Jones, the author emphasises that disabled persons are our neighbours; thus to abandon them or treat them as less than fully human, diminishes our own humanity.

These are only some of the essays in this slim volume, easily accessible to a lay, as opposed to expert, reader. At a time when the media jostles our awareness of these painful ethical issues by its constant lurid coverage of highly emotive stories, we need to be able to offer reasoned and knowledgeable counter-arguments. This book suggests effective ways to do so.

© 2010 Francis Phillips

Theotokos Catholic Books - Book Reviews Section - www.theotokos.org.uk