When doctors invoke God’s will

Beware of consigning people to prolonged suffering in the name of ‘not playing God’

Source: The Sunday Times  Dec 18, 2011

By Lee Wei Ling

In medicine, we often come across situations where an attempt to save a patient’s life may well condemn that patient to a severe disability and a life devoid of meaning. Though alive, the patient may be unaware of his surroundings and unable to think or communicate. This condition is termed the ‘chronic vegetative state’.

The politically correct response that many doctors parrot when faced with such a situation is to say: ‘I can’t play God.’

That statement can imply that the doctor does not know God’s will, and will therefore not act to take extreme measures. Rather, he would leave the patient’s survival in God’s hands, or to the natural course of the disease.

But more often than not, when doctors say they ‘can’t play God’, what they mean is they don’t know when to stop medical treatment. They end up trying to prolong the life of the patient, though they know that if he survives he may be faced with a meaningless existence filled with suffering and misery.

When a doctor claims he cannot play God, the truth is that he does not have the courage to leave the patient alone and save his family from years of suffering. Ironically, in deciding to save such a patient, the doctor is in fact playing God – and a possibly vindictive God too.

I have seen such situations too often, and have refrained from writing about them because I did not wish to offend anyone. But after witnessing so many cases of unnecessary suffering, I feel I should speak out against consigning people to years of suffering in the name of ‘not playing God’.

When faced with a situation where saving a patient may well condemn that patient and his family to years of suffering, a doctor would usually hold discussions with the patient’s family, and where possible with the patient himself.

Doctors try their best to abide by their patients’ wishes if their patients have already communicated them. If not, we rely on the family or whoever the patient has given the power of attorney to. We try to put across the best medical advice in a form that is comprehensible to patients and their families.

Patient autonomy is considered the basis on which we make medical decisions. But when faced with the shock of imminent death, very few patients or their families can make rational decisions. In this situation, emotion usually overrides reason.

A few years ago, the mother of a good friend of mine had a serious bleed in her brain. As my friend himself is a doctor, we all rallied around to save his mother, with no effort or expense being spared. In the end, the mother survived, but was extremely disabled, unable even to eat or drink by herself.

My friend, a devout Christian, would probably have accepted whatever outcome as ‘God’s will’. But was it God’s will that his fellow doctors should have used all the powerful weapons of medicine that they possessed to pull this elderly woman through a medical crisis and leave her and her family facing months, if not years, of suffering?

It seems to me that those who invoke ‘God’s will’ should be more humble. At the very least, they should avoid ‘playing God’ themselves and blaming the terrible results on ‘God’s will’.

There is an often repeated story of an observant Jew that is of relevance in this context.

This Jew’s village was flooded in a terrible rainstorm. The police instructed the villagers to evacuate their homes immediately and leave for higher ground. But our deeply religious man decided to stay put, telling the police, ‘God will save me’.

Soon, he was forced up to the first floor of his house because of the rising water. Some villagers in a dinghy sailed past and pleaded with him to join them. The pious man declined, calling out: ‘Don’t worry – God will save me!’

But the water continued to rise, and he was forced to climb to the roof of his house. A helicopter came by and threw down a rope. Again, the devout man refused all assistance, exclaiming: ‘No need, God will save me!’

Eventually, the water rose so high that the roof was covered, and he drowned. On arrival at the pearly gates, he asked to see God.

‘Oh God,’ he said, ‘I trusted you, I put my life in your hands, I had faith in you, and you let me drown. How can I believe in you and your beneficence?’

God looked him up and down and replied: ‘You nebbish (a Yiddish word meaning a pitiful, ineffectual and inept person), I sent the police, a boat and a helicopter. What more did you want me to do?’

Often in life, we have to make important decisions, some of them with life-and-death consequences. Those who believe in God try to abide by His will. Yet God’s will is not known to us – and as the above story indicates, very often we can miss the obvious (God sent a boat) while looking out for some special signal.