The tragic case of young Charlie Gard left many conflicting emotions, and conflicted people, in its wake. Hearts went out to Charlie’s parents, Connie Yates and Chris Gard, as they battled for a possible chance to prolong their baby’s life.
At the same time, people admired the supreme professionalism displayed by the doctors of Great Ormond Street Hospital, faced with the impossible task of making difficult medical decisions under the glare of public scrutiny.
The significance of this case goes far beyond the specific circumstances it concerns. It raises critical questions around the limits of personal autonomy, the rights of parents to make decisions on behalf of their children, and what happens when those rights conflict with what doctors believe is in the best interests of the patient.
More fundamentally, the case also raises the problem of what parameters society should use for moral dilemmas of this magnitude. The doctors say one thing, the parents another, and the child himself cannot respond. Who is right?
A central argument made by the contemporary moral philosopher Alasdair Macintyre, in his classic work After Virtue, is that moral dilemmas in modern society have become what he calls “interminable”. That is because they are essentially a judgment call.
From a human perspective, there is no clear “right” or “wrong”. Both sides present very coherent arguments, and each can make a very strong case that they are morally correct.
Macintyre uses examples of scenarios similar to that of the Charlie Gard case to make a vital point. Without an accepted overriding moral code guiding society’s approach to issues such as these, human ability to resolve them is effectively impossible. Moral dilemmas risk remaining subject to ceaseless argument without any hope of resolution.
This, argues Macintyre, was the Achilles heel of the entire Enlightenment project. True, it brought with it immeasurable benefits to society. For the first time, ordinary people had the opportunity to significantly improve their lot in life.
But it also swept away the external moral code, greatly dependent upon what is broadly referred to as the Judeo-Christian tradition, that preceded it.
And, despite 200 years of trying, modernity has essentially failed to replace it.
Furthermore, as numerous contemporary bioethicists have noted, these dilemmas will undoubtedly only increase as our technical ability to manipulate nature increases.
Crucially, Macintyre’s honest assessment illustrates that having the humility to recognise that human beings do not have the ability to resolve all moral dilemmas alone is not a sign of weakness, nor an abdication of human responsibility. It is because the interminable dilemmas we face in life cannot be solved without recourse to a higher authority, an external moral code providing direction on issues such as end-of-life care.
Without it, humanity flounders. But, with it, there can be some guidance even through the most complex situations that life delivers.
Macintyre argues for a return to the values of Aristotelian ethics, the principles of “virtue”, after which the book takes its name.
But there is another perspective which may be particularly helpful for those in the Jewish community facing tragic and difficult moral dilemmas of this nature.
Jewish law and tradition have a deeply meaningful view on end-of-life care, based upon values that respect the sanctity of life, while remaining highly sensitive to the relevant expert medical advice. Jewish law also recognises the fact that, although the principles remain constant, the precise guidance to be given in this area is highly case-specific.
For many, the presence of highly trained rabbis in the community who specialise in this area, both by offering detailed halachic guidance as well as providing empathetic support, is vital. No one would ever wish to be in the immensely tragic situation of the Gard family. But, sadly, most people will encounter questions surrounding end-of-life care for a close relative at some point in their lives.
When that happens, the knowledge that their own religious tradition can be accessed in order to ensure that the family does not have to face these seemingly interminable moral dilemmas alone can be an enormous source of comfort.
Rabbi Birnbaum is Rabbi of the Hadley Wood Jewish Community