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Book Reviews by Dr Pravin Thevathasan

Debating Euthanasia
Emily Jackson and John Keown
Hart Publishing
ISBN 978-1-84946-178-8

In this highly readable work, Professor Emily Jackson first presents the case for legalizing assisted suicide and voluntary euthanasia. The arguments are well presented and they demand a cogent response. For a small number of people, she argues, a good death is only made possible by means of assisted suicide and in a pluralistic society people should not be forced to endure a death they find intolerable. She cites the case of a doctor who meets a patient for the first time and performs an act of illegal euthanasia even though that patient might have been depressed. This should not have occurred, she says, if there is legal voluntary euthanasia with adequate safeguards.

Professor Keown then presents the case against legalizing assisted suicide and voluntary euthanasia. He argues that the safeguards in place where euthanasia is already legal have been "illusory." In the Netherlands, for example, being depressed or being tired of life is reason enough for becoming a candidate for euthanasia. Besides, the Dutch flout their own guidelines.

Keown also reminds us that clinicians are autonomous beings who make specific clinical decisions. Why should they withhold euthanasia from a patient who in their opinion requires it simply because the patient has not requested it? The slippery slope is both a practical and logical one. He further reminds us that Professor Jackson has already stated prior to this debate that only certain human beings qualify as "persons." Clinicians with this belief are unlikely to suffer disquiet after disposing of "non-persons" who are unable to consent to their own demise. One is reminded of the case of Tony Bland who was effectively de-personalized by the Courts prior to being put to death.
Little wonder then that disability rights groups are among the strongest to oppose legalizing assisted suicide and euthanasia. There is a real alternative and this is excellence in clinical care.

Given that neither author read what the other wrote, the overall work is coherent and flows well. This work is informative and a welcome summary of the arguments for and against legalizing euthanasia.

Both A Servant And Free
(Scroll down to find book)
A Primer In Fundamental Moral Theology
Fr Brian Thomas Beckett Mullady O.P.
New Hope Publications
ISBN 978-1-892875-53-2

This excellent work is based on the teachings of St Thomas Aquinas, The Catechism of the Catholic Church and the encyclical Veritatis Splendor. It is completely loyal to the Catholic tradition. The title is from St Augustine and it reminds us that we are called to obey the laws of God and also to pursue the truth in order to be truly free. We become free when living in accordance with our nature.

Fr Mullady notes that ethics is dependant on a realistic metaphysics. However, beginning with Descartes, there has been a "turn to the subject" instead of the object as the source of truth.The scepticism of Hume is discussed as well as the subjectivism of Kant. Max Scheler's ultimately futile attempt to redress the balance is discussed : Scheler failed to recognize a real objective universal human nature. We thus end in moral relativism.

The nature of moral theology as the study of the free actions of man as made in the image of God is then discussed. For some moral theologians, moral theology is all about obligation and not about acting for happiness. The author notes that Catholic tradition has never been of this opinion.

There is a helpful critique of the errors of Rahner and McCormick among others. Their false understanding of moral principles leads to moral subjectivism and relativism. The theories discussed include proportionalism and the fundamental option.

Fr Mullady makes a balanced and fair assessment of the beliefs of the new natural law theorists who are on the side of tradition when it comes to issues such as abortion and contraception.

However, they fail to accept that real universals can be derived from the sense experience of man and which could be applied to specific human actions.

There are chapters on law, conscience, virtue, sin and grace.
This work is a very helpful primer in moral theology.

Christ at the Bedside: The Lord's Love at the Term of Life
by Joseph M Mauceri
New Hope Publications

This booklet is the perfect antidote to the pro-euthanasia television programmes that have become so fashionable of late. Dr Mauceri's approach is a holistic one. He explains why euthanasia is wrong and he tells us of the importance of pain relief. But he also reminds us of the mental suffering of the terminally ill. If the dying person feels abandoned or unloved, then there is a real possibility that he or she will seek euthanasia or assisted suicide. So we need to address the whole person. The dying person receives the merciful care of those looking after him and he or she in turn will teach them patience, hope and courage for "there is a profound school of theology at the bedside of the dying."

There are ordinary and extraordinary means of treating the dying and they are discussed by means of some helpful examples. The five guiding principles to help us through the ethical problems at the end of life is especially noteworthy.
The author notes that human nature recoils from suffering and fears death. However, we are favoured by the image of the suffering Christ to whom we are called to join our own suffering.

This is a beautiful, reflective work.

Stem Cells : The Hope, The Hype and The Truth
by James M Rossetti and Dan Mohan
New Hope Publications

Stem cells are unspecialised or undifferentiated cells that have the ability to develop into many different cell types of the body, They can replace diseased or damaged cells and can therefore treat a number of conditions including spinal cord injuries, parkinsons disease and cancer.

It is noted in this informative booklet that adult stem cells are those found in existing adult tissue whereas embryonic stem cells are developed from human embryos destroyed in the process. The use of embryonic stem cells is therefore unethical. However it is not only for ethical reasons that we should favour adult stem cell therapy but for clinical reasons as well. Many people are being treated for a range of conditions already with adult stem cell, including lymphoma and heart disease. The science of using adult stem cells is more advanced in comparison to the alternative and the future in this area is, as the authors note, bright.

This is a really helpful introduction to a complex subject.

Therapy or Theology?
by Joseph Mauceri M.D.
Cephas Institute


In the introduction to this excellent study, there is mention of Bertha Pappenheimer, a patient who was in search of meaning. Unfortunately for her, her therapist was Sigmund Freud and he was merely in search of a theory.The atheist Freud did not believe in the existence of the soul, instead believing that science would reduce the emotions to chemical imbalances in the brain. Thus, according to Freud, our emotions lack metaphysical meaning. The incredible mystery that IS each person eluded him.

In contrast, Dr Mauceri believes that even the most common psychological problems such as anxiety needs to be perceived as something mysterious and which has a direct bearing on the spiritual condition of the person. In other words, the doctor must believe in the soul. After many years of clinical experience, Dr Mauceri has concluded that anxiety is itself a symptom of a deeper struggle and often relates to a fear of death.

Dr Mauceri is rightly critical of the superficialities of New Age spiritualities as well as "undirected " psychotherapy. The latter refers to the humanistic psychology of Carl Rogers and colleagues that has had such a negative impact within the Church. Dr Mauceri is equally critical of behaviour therapy which rejects free will and so the existence of a moral order.
The section on the philosopher Nietzsche states that " The great diagnostician of the nihilistic age was himself a man plunged into the abyss of mental illness in his last years... He saw the destruction coming where others saw progress."

The nihilism which Nietzsche foresaw is really the death of meaning. The meaningless individualism we hear proclaimed widely today ( one thinks of the slogan "my body, my choice" ) is a direct consequence of this nihilism. Without meaning, there is dread and anxiety. Dr Mauceri argues that only the Judeo-Christian world view can deal coherently with the problems of dread, suffering and evil.

So the ultimate choice is God or nihilism. The source of consolation for mankind is not therapy but the healing truths of religion. Dr Mauceri writes that " We are genetically religious, and all men seek to worship something. " Only a strong faith grounded in truth, love, reason and psychological maturity prepares us to " go forth in courage and prudence. "
Dr Mauceri holds a balanced view on the use of medication in the management of anxiety. There is a place for its appropriate use but ethical problems ensue when drugs are used to alleviate feelings of guilt. Guilt should not be dismissed as something inherently bad for when confronted appropriately it leads to healing and maturity.

The problem with psychotherapy is not there is too much of it but there is not enough of the right sort. This is a book that I will be returning to again and again.

Copyright ©; Dr Pravin Thevathasan 2012

Version: 20th March 2012

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