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Quality-of-Life vs. Sanctity-of-Life

Interview With Bioethicist Father Víctor Pajares

ROME, MAY 31, 2005 (Zenit) - Misconceptions about "quality of life" are having deadly consequences, as seen in the recent case of Terri Schiavo, the brain-damaged Florida woman who succumbed after having her feeding tube removed.

To learn more about the matter, we interviewed Father Víctor Pajares, a bioethicist who teaches at the School of Bioethics of the Regina Apostolorum Pontifical University.

Q: Why did you choose the topic of "quality of life" for your doctoral thesis in bioethics?

Father Pajares: Well, there are personal reasons, like my own background and choices that suit my research and former studies. But there are also objective reasons, and one that has been very much present is the fact that quality-of-life was an idea that would surface sooner or later in every single subject I undertook.

"Quality of life" struck me as a constant point that well-known bioethicists employed to justify their stances on abortion, euthanasia, in vitro fertilization and so on. It's as simple as opening a book of Peter Singer's and waiting until the magical words appear.

Q: Do you think that the expression "quality of life" has been hijacked by certain bioethicists, its meaning distorted?

Father Pajares: In fact, many scholars who deal with this issue have avoided the "either-or" kind of approach. In this sense, you don't have to set the ideas of quality of life and sanctity of life against each other, as if one necessarily excluded the other.

Q: Could you expound on this line of thought?

Father Pajares: The easiest way to understand this is to refer to the papal magisterium.

In "Evangelium Vitae," the most bioethical encyclical so far, John Paul II mentioned "quality of life." The Holy Father was careful to outline a nuanced teaching.

He warned, for instance, about when "the so-called 'quality of life' is interpreted primarily or exclusively as economic efficiency, inordinate consumerism, physical beauty and pleasure, to the neglect of the more profound dimensions -- interpersonal, spiritual and religious -- of existence." It's obvious that we can't be at ease with such an idea.

The Holy Father spells out the consequences of this narrow and radical concept, which sees suffering as "an inescapable burden of human existence" which can never be "a factor of possible personal growth," and therefore is "rejected as useless, indeed opposed as an evil, always and in every way to be avoided."

We could name this the "unbridled" idea of quality of life. But it's not the only choice we have.

By quality of life can also be meant the endeavor to meet people's expectations, especially in more developed societies, which "are no longer concentrated so much on problems of survival as on the search for an overall improvement of living conditions." It's clear that there is nothing wrong with this cultural development.

Q: But if this is so, don't we still have to choose between one of the two descriptions of quality of life? Don't they exclude each other?

Father Pajares: I think they are set at different levels. The first is more health-related, while the second is more environment-related.

Furthermore, the first one is rather hedonistic, with all the negative consequences that it entails, while the second is not. Coming back to my previous answer, the division we are to avoid is choosing between sanctity of life and quality of life, as if there were no way to reconcile them.

To illustrate this point, I would like to recall a statement President Ronald Reagan issued after the Baby Doe scandal. This involved a baby born with Down syndrome whose intestinal blockage wasn't repaired, and who died on that account.

Reagan said: "Every legislator, every doctor, and every citizen needs to recognize that the real issue is whether to affirm and protect the sanctity of all human life, or to embrace a social ethic where some human lives are valued and others are not. As a nation, we must choose between the sanctity-of-life ethic and the quality-of-life ethic."

If you pay close attention to this declaration, the key word here is "ethic," where there would be a sanctity-of-life ethic that protects all human life, and a quality-of-life ethic that values some but not all human lives.

An ethic that is wholly centered on the quality of life, and doesn't consider the sanctity of life, values only some lives. But this doesn't mean a sanctity-of-life ethic cannot take into account at all the quality of our lives.

Q: So, this leaves us with the question: Is there a wholesome ethic that can combine both elements: quality and sanctity of life?

Father Pajares: Exactly, and we can identify it in the mainstream Catholic moral tradition, which is based on these three principles: defense of all human lives against intentional killing, mandatory use only of ordinary means to preserve health and life, and promotion of compassion and solidarity especially toward the most exposed in society.

These three principles comprise both sanctity and quality of life. And so the Catholic ethic is not faltering in theory.

Q: But it seems it runs into problems when we face situations where the sanctity and quality of a life are conflicting. In these cases, which element should we favor?

Father Pajares: The answer is sanctity. And here the gift of faith is a great advantage, because it allows you to see that the most profound reason to sustain the dignity of any human life is our likelihood to God, so that even when our outer image deteriorates, our inner image of him remains unaltered. However, the kind of society we want to build is also a strong motive not to let quality of life have the upper hand.

Q: In what sense is the societal motive determinative to upholding sanctity of life for those who don't believe that man is made in the image of God?

Father Pajares: I can explain it with an example taken from Italy. Here the authorities have created the driving license "by points," so that when you break a traffic law, you lose an established amount of points, until you run out of the full amount with which you started when you received the license.

Now apply this to our human condition. Can our humanity be linked essentially to the human qualities we had some day but for some reason will not be able to have any longer? If it were so, there would be no firm obstacle to legalize euthanasia.

And the biggest problem would be that we wouldn't be able to guarantee a total lack of abuse, since a human dignity that is so dependent on change would not be a strong enough motive to enforce the proper conduct expected from family members, health professionals and judges. Once you've lost your qualities, you've lost your dignity ...

Q: We could conclude this has been the case with Terri Schiavo. Could we say that from Terry on, we are willing to allow society to redefine the essence of our humanity?

Father Pajares: Well, you see, when you drive this point home, the bien pensants of the moment label you as a prophet of doom. They will explain to you that Terri finally was allowed to rest in peace and was spared all her terrible sufferings. And every time you would object, they would give you another outlook that makes more sense, at least to them.

Nonetheless, the problem is that if quality of life makes more sense than sanctity of life, we are always going to be quite nervous about who picks the qualities and who judges to what extent you hold those qualities required.

Of course, nobody says Nazism will be back, because things will be done better now. History teaches, we hope.

But still, I will not be able to go to bed every night taking everything for granted the next morning. ... And not because I could die in the meantime, but because perhaps I wouldn't be allowed to keep on living if something unforeseen went wrong.

This is not pushing the thing too far, since a quality-of-life ethic would be very serious about maintaining the quality of the product, indeed, all human lives after having lost their sanctity.

Q: Can we still hope for a less somber future?

Father Pajares: Not only can we, but we ought to. God doesn't abandon us, the Church and the world. Otherwise it would be impossible to explain why he has granted us such a gifted Pope!

By the way, our Holy Father Benedict XVI has also spoken very clearly on this subject.

In 1997 he wrote about the philosophy of the New World Order, which, unlike Marxism, would be realistic and not utopian. Because in the future we will be used only to affluence and well-being, this realistic philosophy would not demand us to be ready to make the necessary sacrifices to protect the well-being for all, including the least among us.

Therefore, this so-called humanitarian philosophy will propose policies to reduce the number of those who will seat at the table of humanity, in order to secure the supposed happiness that some have already reached.

Since we have recently heard what Benedict XVI has said about the "desert," above all about those inner ones carved by selfishness, and about the only true and lasting solution, that is, the living water that springs from Christ, we can rely on the grace of God and be sure that the culture of life will continue to expand, against the death of the desert.


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Life, Quality, Sanctity, bioethics, Pajares, Schiavo

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