Patterson, Aimee. “A New Final Enemy: Reflections on Dying, Suffering and Autonomy.” Paper presented at the Wesley Ministry Conference and Symposium, Tyndale University College & Seminary, Toronto, Ontario, April 25, 2017. (MPEG-3, 24:10 min.) 1 00:00:00.880 --> 00:00:06.820 The last enemy to be destroyed is death. 2 00:00:06.850 --> 00:00:13.980 We read this in one Corinthians 1526, and Christians have traditionally held to a 3 00:00:14.010 --> 00:00:19.700 theology that frames death as the last enemy. 4 00:00:19.720 --> 00:00:22.900 It can be taken as a personal statement, 5 00:00:22.920 --> 00:00:28.700 as a psalmist says, who can live and never see death. 6 00:00:28.730 --> 00:00:32.540 That statement, though, is also escatological. 7 00:00:32.570 --> 00:00:41.860 Jesus died eternal life to bring and lives that death may die. 8 00:00:41.890 --> 00:00:45.860 Now, we know this is not the dominant view in Western culture today. 9 00:00:45.890 --> 00:00:52.660 A significant shift in values is taking place in Canada and other Western nations, 10 00:00:52.680 --> 00:01:01.060 and it's a shift that is downgrading death from final enemy to enemy. 11 00:01:01.090 --> 00:01:03.840 More and more, it appears that people do 12 00:01:03.870 --> 00:01:08.770 not fear death as much as they fear dying and decline. 13 00:01:08.800 --> 00:01:15.410 And many people claim they would rather die than suffer a loss of autonomy. 14 00:01:15.440 --> 00:01:17.740 In my reflections, I'm going to illustrate 15 00:01:17.770 --> 00:01:22.740 this value shift by referring to the new federal legislation around medical 16 00:01:22.770 --> 00:01:29.620 assistance in dying, sometimes called made, which is just an awful acronym. 17 00:01:29.650 --> 00:01:35.290 This is Canada's version of Euthanasia and assisted suicide. 18 00:01:35.320 --> 00:01:40.700 I'll argue that requests form Made are grounded in what I perceive to be a 19 00:01:40.730 --> 00:01:47.060 growing attitude of fear, of losing autonomy. 20 00:01:47.090 --> 00:01:50.570 I will suggest finally 21 00:01:50.600 --> 00:01:58.440 what a Christian response to this culture shift looks like or might look like. 22 00:02:00.880 --> 00:02:05.020 Since June 2016, federal law in Canada has 23 00:02:05.050 --> 00:02:11.610 permitted eligible individuals to request and receive medical assistance in dying. 24 00:02:11.640 --> 00:02:14.300 That is, the provision or administration 25 00:02:14.330 --> 00:02:19.780 of medication that intentionally brings about a patient's death. 26 00:02:19.810 --> 00:02:24.660 So who is eligible to receive Made? 27 00:02:24.690 --> 00:02:32.300 The legislation frames it this way a person must be 18 years or older. 28 00:02:32.330 --> 00:02:35.540 They must be deemed mentally competent and 29 00:02:35.570 --> 00:02:40.610 capable of making decisions about their request. 30 00:02:40.640 --> 00:02:46.060 And they must be competent at the time that maid is offered to them. 31 00:02:46.090 --> 00:02:51.980 At the time of their death, they must have a grievous medical 32 00:02:52.010 --> 00:02:59.220 condition, which may include illness, disease or disability. 33 00:02:59.250 --> 00:03:05.540 And they must be in an advanced state of irreversible decline. 34 00:03:05.570 --> 00:03:09.180 They must also be at a point where natural 35 00:03:09.210 --> 00:03:15.300 death death apart from maid is, quote unquote, reasonably foreseeable, taking 36 00:03:15.330 --> 00:03:19.460 into account all of their medical circumstances. 37 00:03:19.490 --> 00:03:26.140 And finally, they must be suffering intolerably, whether from illness, 38 00:03:26.170 --> 00:03:33.420 disease, disability or from their state of decline. 39 00:03:33.450 --> 00:03:40.140 And while their medical condition must be physical, their suffering can be the 40 00:03:40.170 --> 00:03:46.140 result of a physical illness or a psychological condition. 41 00:03:46.170 --> 00:03:48.980 This requirement of intolerable suffering 42 00:03:49.010 --> 00:03:55.120 is fundamental to the legislation around Made. 43 00:03:57.680 --> 00:04:01.340 So what counts as intolerable suffering? 44 00:04:01.370 --> 00:04:06.380 Our minds might turn to the suffering caused by pain and discomfort. 45 00:04:06.410 --> 00:04:08.860 Now, the legislation in Canada doesn't 46 00:04:08.890 --> 00:04:14.740 define suffering for us, but the data coming out of places where hastening death 47 00:04:14.770 --> 00:04:20.380 has been practiced much longer than it has in Canada provide us with some insight 48 00:04:20.410 --> 00:04:25.100 into what people claim they are suffering from. 49 00:04:25.130 --> 00:04:27.460 Washington and Oregon are two states where 50 00:04:27.480 --> 00:04:33.940 physician assisted suicide is legal, and each of them issues annual reports based 51 00:04:33.970 --> 00:04:42.940 on physician documentation of patients whose requests for Pad or Pas are granted. 52 00:04:42.970 --> 00:04:44.940 The latest available reports they've 53 00:04:44.970 --> 00:04:50.380 issued identify the top concerns behind patient requests, and I suspect that these 54 00:04:50.410 --> 00:04:57.600 results are not far off from the concerns Canadians might have. 55 00:04:57.840 --> 00:05:01.740 So you see here, listed at the very top, 56 00:05:01.770 --> 00:05:04.660 loss of autonomy or the fear of losing autonomy. 57 00:05:04.690 --> 00:05:08.220 And very close in the figures reported, 58 00:05:08.250 --> 00:05:15.220 less able to engage in activities making life enjoyable. 59 00:05:15.250 --> 00:05:19.560 Following that quite a bit further down in terms of 60 00:05:19.590 --> 00:05:27.860 concern, is loss of dignity also burden on family, friends, and caregivers? 61 00:05:27.890 --> 00:05:30.340 Fear of losing control of bodily 62 00:05:30.360 --> 00:05:39.580 functions, inadequate pain control, or concern about inadequate pain control? 63 00:05:39.600 --> 00:05:45.420 And finally, way down the list, financial implications of treatment. 64 00:05:45.440 --> 00:05:47.300 And I also found it noteworthy, as I was 65 00:05:47.330 --> 00:05:51.960 looking through these reports, that in the case of Oregon, the concern about being a 66 00:05:51.980 --> 00:05:57.560 burden to one's family was statistically lower than the loss of 67 00:05:57.590 --> 00:06:02.820 control of bodily functions in reports prior to 2016. 68 00:06:02.850 --> 00:06:06.420 So that shift happened in 2016, where the 69 00:06:06.450 --> 00:06:13.700 loss of control of bodily functions took a lower place along the list of concerns. 70 00:06:13.730 --> 00:06:16.260 What strikes me is that concern about 71 00:06:16.290 --> 00:06:21.180 losing autonomy is listed in both reports, both reports issued from both states. 72 00:06:21.210 --> 00:06:25.780 At the top, it's numerically even with the second concern. 73 00:06:25.800 --> 00:06:31.260 Yet both states list at first, and the remaining concerns, in my mind at least, 74 00:06:31.290 --> 00:06:36.460 go hand in hand with this fear of losing autonomy. 75 00:06:36.480 --> 00:06:42.040 The attribute of autonomy or self determination is considered central, I 76 00:06:42.070 --> 00:06:46.420 think, in our culture to what it means to be human. 77 00:06:46.450 --> 00:06:52.420 And so the rights and choices of the individual are to be respected by others. 78 00:06:52.450 --> 00:06:55.060 We think it's important for everyone to 79 00:06:55.090 --> 00:07:00.420 have the freedom to shape their lives in a manner of their choosing. 80 00:07:00.450 --> 00:07:03.820 We're taught and encouraged to do things 81 00:07:03.850 --> 00:07:09.780 well, to do our best, to make a success of our lives. 82 00:07:09.800 --> 00:07:12.260 Now, I don't want to demonize autonomy 83 00:07:12.290 --> 00:07:16.640 because many of us would conclude that the good life looks like a life that is one 84 00:07:16.670 --> 00:07:22.380 that helps others, one that is not self centered. 85 00:07:22.410 --> 00:07:29.500 But we do, I think, still struggle against a tendency to pity those who are perhaps 86 00:07:29.530 --> 00:07:38.440 more compliant, more deferential, or those who appear to be failing at life. 87 00:07:38.840 --> 00:07:41.220 Autonomy doesn't prevent commitment and 88 00:07:41.250 --> 00:07:47.260 loyalty to people who are deemed pitiable, but it does seem to create a certain 89 00:07:47.290 --> 00:07:55.300 social distance between them and those among us who are more capable. 90 00:07:55.330 --> 00:07:58.440 With all that said, uncompromised autonomy 91 00:07:58.470 --> 00:08:04.060 is simply not a condition that is true to our nature. 92 00:08:04.090 --> 00:08:12.060 No one of us is capable of maintaining a state of permanent autonomy. 93 00:08:12.090 --> 00:08:17.020 Human beings are by nature vulnerable. 94 00:08:17.040 --> 00:08:22.460 When our bodies and minds are affected by illness, disease, disability, or a state 95 00:08:22.480 --> 00:08:28.580 of decline, we lose our ability to contribute to society in the way we are 96 00:08:28.600 --> 00:08:32.900 accustomed to or in the way we might have before. 97 00:08:32.930 --> 00:08:40.980 And it can be difficult at that juncture to be able to find meaning in life. 98 00:08:41.010 --> 00:08:43.980 And this, I believe, is in large part due 99 00:08:44.010 --> 00:08:48.100 to the way our culture interprets meaning in life. 100 00:08:48.130 --> 00:08:52.040 Our culture of autonomy. 101 00:08:53.120 --> 00:08:55.780 Consider the example of Kay Carter. 102 00:08:55.810 --> 00:09:00.580 Is anyone familiar with Kay Carter? One person? 103 00:09:00.610 --> 00:09:08.620 Okay, so Kay Carter was an elderly woman living in a care facility in Vancouver. 104 00:09:08.650 --> 00:09:11.500 She suffered from spinal stenosis, which 105 00:09:11.530 --> 00:09:17.380 is a terminal condition that involves the progressive deterioration of the nerves. 106 00:09:17.410 --> 00:09:24.200 It left her bedridden incontinent, unable to eat independently. 107 00:09:25.240 --> 00:09:33.780 One of her daughters is quoted as saying she didn't want to sit in the care home 108 00:09:33.810 --> 00:09:39.840 like many others around her with her tongue hanging out of her mouth. 109 00:09:40.760 --> 00:09:47.540 In 2010, Carter, who was 89 years old, traveled to Switzerland to receive 110 00:09:47.560 --> 00:09:52.700 assisted suicide through an organization called Dignitas. 111 00:09:52.730 --> 00:09:59.260 Carter's daughter and son in law were among the plaintiffs in the Supreme Court 112 00:09:59.290 --> 00:10:07.040 case that led to the new legislation that has made a legitimate medical act. 113 00:10:09.160 --> 00:10:16.140 The felt indignity in situations like Kay Carter's is compounded by our social 114 00:10:16.170 --> 00:10:24.000 infrastructure, which is not adequate to support people like Kay who are suffering. 115 00:10:24.360 --> 00:10:27.060 We don't operate out of a culture that 116 00:10:27.080 --> 00:10:32.700 presumes patients in decline will live with relatives or those closest to them. 117 00:10:32.730 --> 00:10:35.980 We're not set up for that anymore. 118 00:10:36.010 --> 00:10:42.620 And while work is being done to improve possibilities for good quality of life in 119 00:10:42.650 --> 00:10:47.580 long term care facilities and hospices, most of us would still prefer to spend our 120 00:10:47.610 --> 00:10:54.400 last days among those we love in our home in an environment familiar to us. 121 00:10:54.920 --> 00:11:02.940 And yet most of our loved ones are unable to offer frequent, lengthy visits, perhaps 122 00:11:02.970 --> 00:11:09.560 due to distance, perhaps due to the sheer busyness of work and family life. 123 00:11:12.640 --> 00:11:19.280 I feel deep compassion for people like Kay Carter, people who seek to avoid suffering 124 00:11:19.310 --> 00:11:24.680 a loss of autonomy by choosing to hasten their death. 125 00:11:24.760 --> 00:11:30.760 Nobody wants to be in the situation that Kay Carter was facing. 126 00:11:32.520 --> 00:11:38.100 Yet I come from a faith tradition that holds to the theological conviction that 127 00:11:38.130 --> 00:11:44.940 God has created each of us with a value that exists apart from any capacity. 128 00:11:44.970 --> 00:11:48.560 We have to be autonomous. 129 00:11:49.760 --> 00:11:52.800 Christians are called to be a witness to 130 00:11:52.830 --> 00:11:58.560 this truth, while never forsaking those who suffer intolerably 131 00:11:59.360 --> 00:12:05.260 so what does this witness look like in the midst of this cultural shift? 132 00:12:05.290 --> 00:12:08.260 What is it to be a witness of indelible 133 00:12:08.290 --> 00:12:14.960 human dignity in a culture that values autonomy in such an extreme way? 134 00:12:15.160 --> 00:12:19.320 I think there's something to be said for learning to suffer well. 135 00:12:19.350 --> 00:12:22.340 As how Ross has it, suffering is something 136 00:12:22.370 --> 00:12:25.860 that is unavoidable in human life, after all. 137 00:12:25.890 --> 00:12:32.880 So Christians are called to suffer with grace and patience. 138 00:12:33.880 --> 00:12:37.180 But I've never been in a class or Sunday 139 00:12:37.210 --> 00:12:42.040 school class or a Bible study where I've been taught how to suffer well. 140 00:12:42.880 --> 00:12:47.200 And I don't think many of us are taught how to decline. 141 00:12:48.560 --> 00:12:53.840 So I also think there's something to be said for learning to care well, 142 00:12:55.680 --> 00:13:00.060 learning to care well for those who are suffering a loss of autonomy. 143 00:13:00.080 --> 00:13:02.900 And I'd like to illustrate this by 144 00:13:02.930 --> 00:13:09.920 providing two examples, one from the past and one from the present. 145 00:13:10.680 --> 00:13:13.420 So I have a favorite example of Christian 146 00:13:13.450 --> 00:13:18.260 compassion, and it happened very early on in Christian history. 147 00:13:18.290 --> 00:13:21.860 Came to my attention while reading a book by Rodney Stark. 148 00:13:21.890 --> 00:13:24.280 He's a prolific sociologist of religion. 149 00:13:24.310 --> 00:13:30.700 He's got a dubious reputation, but Stark, I think, is a very entertaining read. 150 00:13:30.730 --> 00:13:35.860 He chronicles two epidemics that swept through the Roman Empire. 151 00:13:35.890 --> 00:13:38.780 First, the Antonine Plague in 165. 152 00:13:38.810 --> 00:13:40.060 Ce Or Ad. 153 00:13:40.080 --> 00:13:45.660 And the plague of Cyprian, which occurred nearly a century later. 154 00:13:45.690 --> 00:13:51.160 Both these plagues are thought to have wiped out about a third of the population. 155 00:13:51.320 --> 00:13:54.600 The best Greco Roman medical science of 156 00:13:54.630 --> 00:14:00.920 the day failed to provide a remedy or to prevent contagion. 157 00:14:01.160 --> 00:14:04.560 People stopped visiting one another. 158 00:14:05.000 --> 00:14:08.420 Family members who showed signs of illness 159 00:14:08.450 --> 00:14:13.060 were tossed out into the streets to suffer and die. 160 00:14:13.080 --> 00:14:16.500 Communities and cities collapsed, and 161 00:14:16.530 --> 00:14:22.080 survivors found that their society had been totally upended. 162 00:14:23.200 --> 00:14:30.400 But the Christian community on the margins of that society looked different. 163 00:14:30.640 --> 00:14:36.300 Christians were bound together by an ethic of compassion, 164 00:14:36.330 --> 00:14:41.560 and not the kind of compassion that's characterized by pity, but the kind of 165 00:14:41.580 --> 00:14:49.120 compassion that's expressed in its literal meaning to suffer with. 166 00:14:50.600 --> 00:14:56.380 Christians risked and often lost their lives caring for each other in very simple 167 00:14:56.410 --> 00:15:07.440 ways providing food, water, shelter, company, a safe place to sleep. 168 00:15:08.320 --> 00:15:10.540 And their shared suffering strengthened 169 00:15:10.570 --> 00:15:16.340 them in their belief that death would die and that soon there would be no more pain, 170 00:15:16.370 --> 00:15:19.460 no more suffering, no more tears, no more mourning. 171 00:15:19.490 --> 00:15:24.320 And this, they believed, was a truth worth suffering for. 172 00:15:25.280 --> 00:15:30.540 Stark goes on to speculate that this contributed to a higher rate of survival 173 00:15:30.570 --> 00:15:34.940 among the Christian population as compared to the pagan population. 174 00:15:34.970 --> 00:15:40.740 And he also notes that when Christians extended compassion to the pagans who had 175 00:15:40.770 --> 00:15:47.560 been just tossed out by their own families, the result was not only healing 176 00:15:47.580 --> 00:15:52.080 for them, but mass conversion to Christianity. 177 00:15:54.440 --> 00:15:57.420 Now to a more contemporary expression of 178 00:15:57.450 --> 00:16:02.880 compassionate care in the face of the loss of autonomy. 179 00:16:03.040 --> 00:16:05.120 And I hope 180 00:16:06.240 --> 00:16:11.160 you will be gracious in allowing me to share some of my own story. 181 00:16:12.240 --> 00:16:15.420 I speak as a person of faith who has long 182 00:16:15.450 --> 00:16:20.760 believed that human beings have been created in the image of God. 183 00:16:20.840 --> 00:16:26.040 I speak as a student of ethics whose doctoral dissertation addressed end of 184 00:16:26.070 --> 00:16:32.800 life care issues and was grounded in an assertion of inherent human dignity. 185 00:16:33.640 --> 00:16:39.800 I also speak as a person suffering a serious, incurable health condition. 186 00:16:41.080 --> 00:16:47.500 I was about three weeks into my job at the Salvation Army Ethics Center. 187 00:16:47.530 --> 00:16:55.800 I was still nursing my second child when I had what is explained as a focal seizure. 188 00:16:56.160 --> 00:16:59.180 Within weeks, I was diagnosed with brain 189 00:16:59.210 --> 00:17:06.530 cancer, and I began a 15 month course of very taxing treatment that included 190 00:17:06.560 --> 00:17:11.640 surgery, radiation therapy, and chemotherapy. 191 00:17:12.320 --> 00:17:16.740 Throughout this, I had a number of distressing experiences of pain and 192 00:17:16.770 --> 00:17:22.080 discomfort, and honestly, some of these made me wish 193 00:17:23.000 --> 00:17:29.120 I would rather have died than to have had to experience them over again. 194 00:17:29.320 --> 00:17:34.180 And yet the deepest sources of my suffering were. 195 00:17:34.210 --> 00:17:40.480 The limitations that I found were put upon my public life and my personal life. 196 00:17:41.280 --> 00:17:45.520 Everything I had achieved, all the work I 197 00:17:45.550 --> 00:17:50.380 had put into my life at that point was turned upside down. 198 00:17:50.410 --> 00:17:54.700 I feared never returning to work. 199 00:17:54.730 --> 00:17:59.080 I feared leaving my husband a widower, 200 00:17:59.440 --> 00:18:04.680 and most of all, I feared abandoning the children I had given birth to. 201 00:18:05.840 --> 00:18:08.090 All of these fears were wrapped up in the 202 00:18:08.120 --> 00:18:14.200 decisions I had made in order to live what I conceived of as a good life. 203 00:18:14.600 --> 00:18:18.330 They hadn't been bad decisions or unreasonable decisions. 204 00:18:18.360 --> 00:18:20.140 They were decisions, though, that would 205 00:18:20.170 --> 00:18:25.760 have profound ramifications on the lives of others. 206 00:18:26.040 --> 00:18:30.420 My darkest hours of suffering were isolating, both physically and 207 00:18:30.450 --> 00:18:35.380 spiritually, and it became easy for me to question 208 00:18:35.410 --> 00:18:41.810 whether God felt any compassion for me or whether God would express that 209 00:18:41.840 --> 00:18:45.500 compassion in a way that I could recognize. 210 00:18:45.530 --> 00:18:47.640 And in some of these darkest hours, I 211 00:18:47.670 --> 00:18:52.530 would turn to Scripture for hope of enlightenment. 212 00:18:52.560 --> 00:18:54.280 There were many Scriptures I looked at, 213 00:18:54.310 --> 00:18:59.010 but the story of Job is certainly the obvious choice for those of us who suffer. 214 00:18:59.040 --> 00:19:03.380 And I read Job's Lament here in chapter six. 215 00:19:03.410 --> 00:19:10.680 This is taken from the Niv version, coming from 1987. 216 00:19:11.000 --> 00:19:14.420 What strength do I have that I should still hope? 217 00:19:14.450 --> 00:19:18.460 What prospects that I should be patient? 218 00:19:18.490 --> 00:19:20.180 Do I have strength of stone? 219 00:19:20.210 --> 00:19:21.530 Is my flesh bronze? 220 00:19:21.560 --> 00:19:28.140 Do I have any power to help myself now that success has been driven from me? 221 00:19:28.170 --> 00:19:31.420 A despairing man should have the devotion 222 00:19:31.450 --> 00:19:37.120 of his friends, even though he forsakes the fear of the Almighty. 223 00:19:40.640 --> 00:19:46.280 Job characterized his own friends as undependable. 224 00:19:46.640 --> 00:19:49.520 So did Jesus. 225 00:19:50.480 --> 00:19:53.700 But as I read this portion of Scripture, 226 00:19:53.730 --> 00:19:59.760 this lament, I realized I couldn't make this complaint. 227 00:19:59.960 --> 00:20:04.570 In fact, I believe it was the compassionate care of others that 228 00:20:04.600 --> 00:20:09.440 convinced me that God had not abandoned me. 229 00:20:10.280 --> 00:20:14.000 So what did this care look like? 230 00:20:14.920 --> 00:20:20.220 It looked like friends and family who worked together to make and deliver meals 231 00:20:20.250 --> 00:20:26.530 five nights a week to my household for over 13 months. 232 00:20:26.560 --> 00:20:28.620 It looked like babysitters and daycare 233 00:20:28.650 --> 00:20:33.050 providers who volunteered to take care of my children so that I could rest. 234 00:20:33.080 --> 00:20:35.250 It looked like colleagues who provided 235 00:20:35.280 --> 00:20:39.250 opportunities for me to work on small projects at work. 236 00:20:39.280 --> 00:20:43.570 It looked like neighbors who drove me to my medical appointments. 237 00:20:43.600 --> 00:20:50.420 It looked like global neighbors who kept in touch by snail mail and email. 238 00:20:50.450 --> 00:20:55.120 And it looked like people who prayed without ceasing. 239 00:20:56.760 --> 00:21:03.770 I couldn't help but see the truth that if imperfect human beings could be so 240 00:21:03.800 --> 00:21:11.180 loving and so compassionate, that must mean that a perfect God 241 00:21:11.210 --> 00:21:16.120 loved me as well and felt compassion in my situation. 242 00:21:18.240 --> 00:21:20.620 I still do experience treatment side 243 00:21:20.650 --> 00:21:23.660 effects that are reminders of my mortality. 244 00:21:23.690 --> 00:21:30.460 I have painful neuropathy in my calves and feet and toes, and this haunts me almost 245 00:21:30.490 --> 00:21:33.500 every night, reminding me that it's not over. 246 00:21:33.530 --> 00:21:36.290 And yet I remain convinced because of this 247 00:21:36.320 --> 00:21:43.360 witness, that as I suffer, God suffers with me. 248 00:21:46.800 --> 00:21:48.860 What I hope has come across in these 249 00:21:48.890 --> 00:21:53.840 examples is that suffering in itself is not good. 250 00:21:55.240 --> 00:21:57.940 Still, suffering is an unavoidable part of 251 00:21:57.970 --> 00:22:03.860 life, and its source is deeper than human flesh. 252 00:22:03.890 --> 00:22:08.000 It cuts to the very heart of a person. 253 00:22:08.040 --> 00:22:13.500 The Christian witness is that healing is more than relief from a loss of autonomy, 254 00:22:13.530 --> 00:22:18.540 though it's a transformation of the whole person. 255 00:22:18.570 --> 00:22:23.660 However valuable autonomy might be, it's not at the heart of our being. 256 00:22:23.690 --> 00:22:26.700 Closer to the heart of our being is our 257 00:22:26.730 --> 00:22:32.380 capacity to respond compassionately to those who suffer. 258 00:22:32.410 --> 00:22:34.260 And when someone else is suffering 259 00:22:34.290 --> 00:22:41.720 unavoidably, then suffering with that person can be good. 260 00:22:42.920 --> 00:22:47.810 Compassion, as the early Christians show us, does not require expertise. 261 00:22:47.840 --> 00:22:50.900 It's often expressed in humble ways. 262 00:22:50.930 --> 00:22:54.500 And yet its effects can be enormous. 263 00:22:54.530 --> 00:22:56.860 When a person recognizes the dignity of 264 00:22:56.890 --> 00:23:04.180 someone who suffers a loss of autonomy and treats that person as someone of value, 265 00:23:04.210 --> 00:23:10.440 they show that suffering does not wipe out that person's meaning. 266 00:23:10.960 --> 00:23:16.140 Now, I can't say that I can predict the outcome of such a witness. 267 00:23:16.170 --> 00:23:20.700 Would it, for instance, reverse the legislation that surrounds Made? 268 00:23:20.730 --> 00:23:23.720 I don't know that I could say yes, and I'm 269 00:23:23.750 --> 00:23:29.500 not even sure that's really where we're going with an ethic of compassionate care. 270 00:23:29.530 --> 00:23:32.810 I think, rather, the aspiration would be 271 00:23:32.840 --> 00:23:38.780 to shift our culture to such a point that no one would ever even want to receive 272 00:23:38.810 --> 00:23:44.090 Made because people were suffering with them. 273 00:23:44.120 --> 00:23:49.290 It's a lofty goal, but whatever the outcome, I am convinced that we are called 274 00:23:49.320 --> 00:23:54.810 to suffer with those who suffer, to reassure them of their inherent value, 275 00:23:54.840 --> 00:24:02.860 and to witness to the truth that Christ lives, that death may die. 276 00:24:02.880 --> 00:24:03.760 Thank you very much.