Ice-Bucket Challenge: Defining when Life Begins and Ends

Ice-Bucket Challenge: Defining when Life Begins and Ends

Pouring ice-cold water onto ourselves is indeed a “bone-chilling” challenge. This has picked up steam nationwide with participation from regular folks, celebrities and even billionaire Bill Gates(1). Funds “have come from 1.7 million donors.The ALS Association (as of August 25) has raised $79.7 million to combat Lou Gehrig’s Disease since July 29, as the Ice Bucket Challenge continues to encourage people around the world to dump ice over their heads and send in money.”(2). This did not come without detractors from animal rights’ supporter like Pamela Anderson and others of different views , including those against embryonic stem cell research (3).

McClaren & Beeson (4,5) commented that “much recent interest has focused on whether stem cell therapy could alleviate or even cure common degenerative diseases. This has been accompanied by debate on the ethics of destructive research on early human embryos. Stem cells derived from various sources raise different ethical issues, but their contribution to medical research could be immense.” While there are tailwinds for placental and adult tissue sources, headwinds to embryonic stem cell research surfaced and related to an issue not dissimilar to debates between pro-life vs. pro-choice and questions related to the other end of the spectrum, end-of-life.

When life is defined as beginning at conception, rights are conferred at that time and had to be championed and supported (6). Similarly, end-of-life issues bring to bear the rights of those still “living” even in a “vegetative state” or, for any other reason, at the throes of death. In our healthcare system, private and public resources are at stake to fund efforts to support, terminate or prolong life. Reflexively, what then follow are moral values, religious overtones, socio-political agenda, personal upbringing and citizenship that stoke the fire of controversy. When does life really begin and when does it end, are questions that rise to a decibel of priority for society , whether personal or national.

This article is not about casting aspersions nor endorsing the merits of either side of the debate, a controversy aplenty (7,8,9,10,11,12,13). Rather, the goal is to give pause to the animus, make time for reflection and provide salutary perspective. Some may not like to hear the truth, but somehow, one needs “to tell how the cow ate the cabbage”, a Southern catchphrase. This subject is a difficult one to resolve in its entirety and we will not be able to “carry forests on my back” but at least let us put a “crack” on this “nut”(14). People have to muster gumption to tackle this dilemma of “when life begins and ends”. It is a yeoman’s task to venture on finding a balance among different perspectives, biblical or secular, cerebral or emotional they may be. That said, one recognizes the consequences emanating from issues about pro-life/pro-choice and life/death dilemma.

Consequences
“Incidents of violence have included destruction of property, in the form of vandalism; crimes against people, including kidnapping, stalking, assault, attempted murder, and murder; and crimes affecting both people and property, including arson and bombings” (15). In the U.S., violence directed towards abortion providers has killed at least eight people, including four doctors, two clinic employees, a security guard, and a clinic escort” (16). “Another abortion doctor, George Wayne Patterson, was shot and killed outside an adult movie theater in Mobile, Alabama on August 21, 1993, but authorities attribute his death to a botched robbery”(17). Other links are accessible regarding the problem (18,19,20).
End-of-life issues also affect society’s responses to longer longevity that “presents unprecedented ethical and fiscal challenge”, rationing healthcare, hospice care, etc.(21,22,23,24). Disregard for life may lead to the horrors and slippery slope of euthanasia and assisted suicide according to Krauthammer (25, 26,27).

Who defines?
All things considered, the trunk-of-the-tree origin of these conflicting positions stems from the question “when does life begin and end?”. While progress in scientific knowledge, like ultrasound, helps us determine a “functioning entity” in the womb, does life really begin “at conception”? Pro-lifers use biblical passages frequently to make the case for human life beginning at conception(28,29). Consider the following excerpts::

Luke 1:39-44: Mary’s visit to Elizabeth: “… And it happened, when Elizabeth heard the greeting of Mary, that the babe leaped in her womb; and Elizabeth was filled with the Holy Spirit. Then she spoke out with a loud voice and said, “Blessed are you among women, and blessed is the fruit of your womb! But why is this granted to me, that the mother of my Lord should come to me? For indeed, as soon as the voice of your greeting sounded in my ears, the babe leaped in my womb for joy”. (N.B. Does heart beat, motor function like “fetal kick”, response to pain sensation or Mozart effect in the womb constitute or define “life”?
And for that matter, do dummy patient simulators with heart beat, etc.,have life?(30)

Psalm 139:13–16
For You formed my inward parts:You covered me in my mother’s womb….My frame was not hidden from You, When I was made in secret….Your eyes saw my substance, being yet unformed….The days fashioned for me, When as yet there were none of them.

Jeremiah 1:4–5
...“Before I formed you in the womb I knew you; Before you were born I sanctified you;….”

Psalm 51:5
Behold, I was brought forth in iniquity, And in sin my mother conceived me.

All the preceding verses confirm the omniscience, omnipresence and omnipotence of God Almighty. They are related to specific people who were already born and were living. They did not define when life begins, as these verses also include the period ” being yet unformed, “as yet they were none of them, “before formed in the womb”. It appears to be a stretch of one’s imagination to assume that the preceding verses support that “life” begins at conception. Moreover, this extrapolation minimizes other verses that actually define it. Let us now consider the following and comments that follow:

Gen. 2:7
And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.

Notice, that a fully formed Adam from the “dust of the ground” was still “non-living” until the “breath of life” got into him from God. Then, he became a “living” being. This is akin to a “still birth” baby who was not breathing and therefore “non-living”. Or, a fully formed baby immediately after delivery, cyanotic and not breathing , no life in it although with heart rate and brain activity, “non-living”, but after a few seconds, with or without resuscitation, started to breathe in natural air as an evidence of “life”. This also reminds us of patients that are “brain-dead”, in a vegetative state, with flat-line EEG, sustained only by life-supporting means like ventilator and/or therapeutic interventions. Yet, when ventilator is turned off, they do not breath spontaneously, no natural breathing and subsequently declared “dead”, i.e., not breathing or no breath of life. Atmospheric air has to be breathe into, “before life begins”. It is arguable that by virtue of the oxygen derived from the mother, i.e., fetal respiration, that this is “breathing”. But, this denies the biblical definition of “living”, viz., presence of functional lungs (mature or premature) that have to breathe in natural and environmental air. The breath cycle continues until the last breath at death. Breathing air defines and sustains life. “In with your very first breath, out with your very last”(31). Without this “breath of life”, a person is “non-living”, as in:

Job 34: 14-15
If he should set his heart to it and gather to himself his spirit and his breath, all flesh would perish together, and man would return to dust. ( N.B. Without breath, the flesh is dead).

Ecclesiastes12:7
Then shall the dust return to the earth as it was: and the spirit shall return unto God who gave it.

Psalm 146:4
His spirit departs, he returns to the earth; In that very day his thoughts perish.

Also, notice the function of this “breath of life” to the “non-living”:
Ezekiel 37 9-10, 13-14
9 Then said he unto me, Prophesy unto the wind, prophesy, son of man, and say to the wind, Thus saith the Lord God; Come from the four winds, O breath, and breathe upon these slain, that they may live. 10 So I prophesied as he commanded me, and the breath came into them, and they lived, and stood up upon their feet, an exceeding great army.
13 And ye shall know that I am the Lord, when I have opened your graves, O my people, and brought you up out of your graves, And shall put my spirit in you, and ye shall live, and I shall place you in your own land: then shall ye know that I the Lord have spoken it, and performed it, saith the Lord.
(N.B.the word “spirit” comes from “ruwach” from 07306 in Concordance meaning breath or wind).

Schwartz concurs, “there is nothing in the bible to indicate that a fetus is considered to be anything other than living tissue and, according to scripture, it does not become a living being until after it has taken a breath” (32).

Also, notice the following controversial verses:

Exodus 21:22–24

If men fight, and hurt a woman with child, so that she gives birth prematurely, yet no harm follows, he shall surely be punished accordingly as the woman’s husband imposes on him; and he shall pay as the judges determine. But if any harm follows, then you shall give life for life, eye for eye, tooth for tooth, hand for hand, foot for foot . ( NB. When the “child” is viable and delivered prematurely but “no harm” done, then compensation maybe sought by the husband since the fetus did not mature to full term; if any “harm” follows after birth as when the fetus perished, then life for life, etc. In this accidental death after birth, the key point is viability by natural means to exact redress at that time. Today, by artificial means, fetal viability can be extended as a dying person’s life/suffering can be prolonged. However, this example should not be used to justify voluntary/intentional abortion, especially to viable fetus still in the womb).

Numbers 5:11-31
” …. And he shall cause the woman to drink the bitter water that causeth the curse: and the water that causeth the curse shall enter into her, and become bitter. Then the priest shall take the jealousy offering out of the woman’s hand, and shall wave the offering before the LORD, and offer it upon the altar: And the priest shall take an handful of the offering, even the memorial thereof, and burn it upon the altar, and afterward shall cause the woman to drink the water. And when he hath made her to drink the water, then it shall come to pass, that, if she be defiled, and have done trespass against her husband, that the water that causeth the curse shall enter into her, and become bitter, and her belly shall swell, and her thigh shall rot: and the woman shall be a curse among her people. And if the woman be not defiled, but be clean; then she shall be free, and shall conceive seed. This is the law of jealousies, when a wife goeth aside to another instead of her husband, and is defiled; ….. ” (N.B. This is what is generally known by biblical scholars as an “adultery test” by ritual of intentional abortion performed by a priest through drinking “bitter/curse water”. But this is not done anymore, even by priest; it has ceased a long time ago(33). Similarly, if Jewish priest discontinued this practice, all the more reason for this not be used to justify abortion by anyone, through pharmacological means.)

Job 3:3, 10-11, 16
Let the day perish in which I was born. … Because it shut not up the doors of my mother’s womb, nor hid sorrow from my eyes. Why died I not from the womb? Why did I not give up the spirit when I came out of the belly? … Or as an untimely birth I had NOT been; as infants which never saw light.” ( NB. According to Martin & Sielaff (34) in their commentary, “…fetus was reckoned as “NOT HAVING BEEN” — and that is how God and the Bible defines the status of the fetus.” I do not support the connotation of outright disregard for fetus nor should it be summarily disrespected. The alternative interpretation may well be that Job may just be too remorseful for his suffering that he wished “NOT HAVING BEEN”; this was Job’s wish and not God defining the status of the fetus or how we should regard it.) From the same link, (which I could not confirm,) “An April 8, 2004 United Press International reported about this limitation:
“At what point is a human fetus viable? … a government witness testified in U.S. District Court in Nebraska that a 20-week fetus can feel pain, suggesting the fetus is a living being. Neonatology specialists have countered, however, that a 20-week fetus cannot yet survive outside the mother’s womb. … [Dr. Avroy] Fanaroff 2 [notes], ‘There may be a beating heart, there may even be some gasping attempts at breathing, but this is not a baby that can be resuscitated — it is not viable,’ … ‘such signs of life typically ‘last only seconds.’ …What, then, differentiates between live birth and viable birth? The maturity of the lungs, Goldsmith said. ‘It is the ability of the lungs to exchange oxygen and carbon dioxide,’ he said, which explains the reason why a non-viable fetus in 1973 can be a viable baby today.”On viability 3 See http://www.washtimes.com/upi-breaking/20040406-051104-8080r.htm.

Difference in counting child’s age among cultures
In Jewish culture, “....it is their day of birth (or the year in which they first exited the womb) that gives them a legal existence. Thus, for a man to be able to go to war he had to be twenty years of age, or a priest to commence his official duties had to be thirty years of age. These ages for legal purposes were always reckoned from birth, not from conception. The reason for this is plain. No one could be sure in all cases just when conception took place, and even if one knew the exact moment of conception, for legal purposes one had to wait to be born to enter human society.”(35).

In Korea, China and East Asia, “..the countdown of children’s age does not begin with the birth of a child, like in the West, but starts in the beginning of the year, rounding up the time spent by a child in the mother’s womb. In addition, people become older not on the day of birth, but on January 1st, according to the lunar calendar. For example, a child born in late December of 2013 will turn two on January 1st, 2014“(36).

Summary
Now that the major elements firing the debate have been presented, the question still remains as to what the correct response should be? The decision to act, one way or another, for anyone at the crossroads of this question may still be problematic for any particular set of circumstances. Without being facetious, when one reaches “the fork of the road”, Yogi Berra(37) quipped,”take it”, but which side of the fork should one take? Even the advice from Apostle Paul about moderation (Phil. 4:5) may not suffice to confer peace of mind. Raw courage is needed to face criticism of whatever action one takes, as there will always be “Cannon to right of them, Cannon to left of them, Cannon behind them Volley’d and thunder’d” as in “Charge of the Light Brigade” by Alfred Tennyson (38).

As one may now deduce, the operative word for when life begins and ends, is “natural”,i.e., natural development to viability, not ex-vivo or in-vitro; natural breathing, not fetal respiration nor through artificial means; natural air, even augmented, but not artificial. How then should one respond to the biblical truth that breathing air defines and sustains life? “In with your very first breath, out with your very last“. The advice from Martin & Sielaff resonates well, “Children are an heritage of the Lord: and the fruit of the womb is his [God’s] reward” (Psalm 127:3). Adoption should always be considered, so someone else can receive the “reward” from God. Life is important. Christians should respect it very highly. Not only should they recognize the sanctity of their own lives, but they should acknowledge that God has granted the same life to all in the world. All people should be honored and respected. This is a Christian duty which no one can deny.”(39). When the choice is between the life of mother vs. the fetus, there should be no hesitation that life of the mother takes precedence; there maybe exception even on this that we may not know. As to rape and incest, adoption is a better alternative; here again, there can be exception and the victim needs tremendous emotional support to overcome an excruciating experience. A non-breathing baby just delivered and an adult who had a cardiac arrest should also be resuscitated to life. After sometime, how long artificial breathing should continue would depend on other factors, most especially the ability to be weaned off respirator and breathe spontaneously. Currently, with technology, the status of brain activity helps in decision-making. Similarly, judgment has to be made regarding sources that potentiate stem cell research depending on overwhelming evidence for “overall good”. Failure to act can delay progress to the detriment of population that needed it most. Vaccine and immunization have detractors, yet society as a whole decided in favor of general use; again this has exception, especially invoking the 1st( religion) and 4th ( privacy) amendments rights. When it comes to “euthanasia and assisted suicide”, our stance should be to advise against these methods. But, who will have the final say? Should it be the patient and/or immediate relative, society or the “death-provider”? Not privy to all the facts surrounding every case and in whatever action is decided by the “stakeholders”, one should not be judgmental but, in love, be commiserating and (sans approval) empathizing with the difficulties in arriving at any decision. True, one should not be dogmatic nor flexible every time and be mindful of the cautionary verses in Ecclesiastes 3:1-8 :
“To every thing there is a season, and a time to every purpose under the heaven: A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted; A time to kill, and a time to heal; a time to break down, and a time to build up; A time to weep, and a time to laugh; a time to mourn, and a time to dance; A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; A time to get, and a time to lose; a time to keep, and a time to cast away; A time to rend, and a time to sew; a time to keep silence, and a time to speak; A time to love, and a time to hate; a time of war, and a time of peace.

Defining when life begins and ends just opens doors. What action plan for any specific situation may still leave us with conflicted conscience and second-guessing. Hopefully, people will choose life and seek an obstetrician, rather than death from an obitiatrist (death-doctor)(40). Flee from temptation. Decide we must, is an “ice-bucket challenge” for all of us.

References:
1. Retrieved from: http://youtube/XS6ysDFTbLU

2. Retrieved from:http://time.com/3173833/als-ice-bucket-challenge-fundraising-total/

3. Retrieved from:http://www.politico.com/story/2014/08/ice-bucket-challenge-haters-110298.html

4. Retrieved from:Anne McLaren. Nature 414, 129-131 (1 November 2001) | doi:10.1038/35102194

5. Retrieved from: http://www.sciencedirect.com/science/article/pii/S1472648310606475

6. Retrieved from :http://www.nrlc.org

7. Retrieved from:Why is abortion so controversial? http://news-basics.com/2011/abortion/

8. End of life controversies. Retrieved from:http://ajcc.aacnjournals.org/content/18/5/401.1.full.pdf
85% of hospital trusts adopt controversial end-of-life care regime

9. Retrieved from:http://www.independent.co.uk/life-style/health-and-families/health-news/85-of-hospital-trusts-adopt-controversial-endoflife-care-regime-8273345.html

10. Baby Joseph.Retrieved from: http://abcnews.go.com/Health/baby-josephs-treatment-sparks-controversy-pediatric-end-life/story?id=13032001

11. Terri Schiavo case. Retrieved from:http://en.m.wikipedia.org/wiki/Terri_Schiavo_case

12. Survey of Controversial Issues.
Retrieved from:http://www.ncbi.nlm.nih.gov/pubmed/24093519

13. New and Lingering Controversies in Pediatric End-of-Life Care. Retrieved from: http://pediatrics.aappublications.org/content/116/4/872.abstract.

14. The mountain and the squirrel: retrieved from: http://www.familyfriendpoems.com/poem/the-mountain-and-the-squirrel-by-ralph-waldo-emerson#ixzz3AvpOfLJS

15. Retrieved from:http://en.m.wikipedia.org/wiki/Anti-abortion_violence

16. Retrieved from:Clinic violence and intimidation”. NARAL Pro-Choice America Foundation. 2006. Archived from the original on February 11, 2010.

17. Man Arrested in Killing of Mobile Abortion Doctor. Retrieved from:The New York Times. September 5, 1993.; H. Kushner, Encyclopedia of Terrorism, Sage Publications, 2003, p.39.

18.”Mental Health Risks of Abortion: Scientific Studies Reveal Significant Risk of Major Psychological Sequelae Of Abortion” . Retrieved from: http://www.wprc.org/21.46.0.0.1.0.phtml.

19. “The Emotional Effects of Induced Abortion”. Retrieved from: http://www4.plannedparenthood.org/pp2/portal/medicalinfo/abortion/fact-010600-emoteff.xml#1097838460671::-3808445079817008491.

20. Retrieved from:http://www.justfacts.com/abortion.asp#%5B184%5D

21. Callaghan, D. and Lawler, P., Ethics & health: Rethinking end-of-life care, Retrieved from:http://www.heritage.org/research/reports/2012/07/ethics-and-health-care-rethinking-end-of-life-care

22. Shepherd, Lois Rationing health care at end-of-life. Retrieved from: http://web1.millercenter.org/debates/whitepaper/deb_2010_0324_life.pdf

23. Ration end-of-life care. Retrieved from: http://intelligencesquaredus.org/iq2-tv/item/769-ration-end-of-life-care

24. Debate on hospice care. Retrieved from: http://jop.ascopubs.org/content/4/3/153.full

25. Krauthammer, Charles. The Dutch example, Things That Matter: Three Decades of Passions, Pastimes and Politics – 13 edition, Chapter 9, ISBN13: 978-0385349178
ISBN10: 0385349173, Publisher: Crown Business, Published: 10/22/2013

26.The lady of Assen and Dr Chabot in Holland. Retrieved from:http://articles.philly.com/1997-01-15/news/25560299_1_terminally-euthanasia-dutch-doctors

27. A Judge In Washington State Says The People Had No Right To Veto Mercy Killing by Charles Krauthammer. Retrieved from: http://articles.philly.com/1994-05-17/news/25826934_1_personal-dignity-and-autonomy-physician-assisted-suicide-abortion-decisions

28. Tommy Mitchell,Retrieved from:https://answersingenesis.org/sanctity-of-life/when-does-life-begin/)

29. When life begins. Retrieved from: http://www.openbible.info/topics/when_life_begin

30.One Smart Dummy: Patient Simulators Help Save Lives. Retrieved from: http://rushnews.rush.edu/2014/09/02/one-smart-dummy-patient-simulators-help-save-lives/

31. Life Begins at Breath, Not Conception
, originally posted by Will McLeod on Mar. 19/2014 ; http://www.dailykos.com/story/2014/03/19/1285933/-Bible-Life-Begins-at-Breath-Not-Conception

32. Retrieved from: http://joeschwartz.net/life.htm

33. Retrieved from: http://en.m.wikipedia.org/wiki/Ordeal_of_the_bitter_water

34. Abortion and the Bible by Ernest L. Martin, Ph.D., July 1991
Edited and expanded by David Sielaff, February 2005.
Retrieved from:http://www.askelm.com/doctrine/d050201.htm

35. Ibid

36. Retrieved from:http://english.pravda.ru/society/stories/16-07-2013/125145-korea_children-0/

37.Retrieved from: http://www.brainyquote.com/quotes/quotes/y/yogiberra105761.html

38. Charge of the Light Brigade” by Alfred Tennyson. Retrieved from: http://www.nationalcenter.org/ChargeoftheLightBrigade.html

39.Retrieved from:
http://www.askelm.com/doctrine/d050201.htm

40. Obitiatrist: Goodman, Ellen. Retrieved from:http://articles.baltimoresun.com/1993-12-28/news/1993362063_1_word-for-death-happy-mistakes-column

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