In this section, Lia is again admitted to the hospital with a high fever. Despite her doctors’ efforts, nothing seems to help. Lia’s parents take her home, opting instead for traditional Hmong rituals and herbs. In their minds, since Western medicine has failed to produce immediate results, they ought to fall back on what they believe to be true- Hmong rituals. Fadiman also discusses why the Hmong hold so strongly to their traditions and language. The Hmong people have no country to call their own or geographical boundaries to define their homeland, so their language and traditions are paramount To adopt another culture or language would mean a loss of identity. Indeed, the Hmong came to American not out of choice, but out of desperation due to political turmoil. The conditions under which they left their homeland further their steadfast commitment to their culture and language. Despite Lia’s continued health problems, Fadiman notes that Foua and Nao Kao never see Lia as a burden. Hmong parents rarely set their newborn children down, as Hmong culture values children very highly, and regards their care with the utmost respect.
I’ve been thinking further about last week’s discussion of autonomy and morality. Autonomy is an inadequate criterion for evaluating issues of morality because it accords with the ethics of autonomy, but not with morality as a whole. Using autonomy as a moral criterion is insufficient because it fails to account for why people decide or should decide to stay alive. If use autonomy as the highest moral criterion with respect to the issue of physician-assisted suicide, one would argue that once a person no longer desires to live, he/she has no reason to live. Autonomy prevails, and a person’s choice to end his or her life to some degree categorizes that choice as moral. If we uphold autonomy as the highest good in moral evaluation, we can categorize any choice that a person freely comes to as moral. This is a pretty general statement, but I’m thinking about this in terms of patient autonomy now. If a patient decides he or she wants to die, and the patient meets the criteria for socially acceptable physician-assisted suicide (such as having a terminal disease, being in pain, or being elderly), American medical culture tends to categorize this as moral. However, it fails to address the possibility that life may be worth living out of obligation to the conditions under which it was granted: as a gift.
Autonomy also fails to take into consideration that we live not only for ourselves, but also for each other, as our lives can find purpose in serving others. I don’t say this to suggest that elderly patients on their deathbed should stay alive out of a sense of obligations to serve others. I mean this to say that elderly patients on their deathbed can value their lives and themselves not only when they are productive members of society, but even when they are not. Their lives are to be valued not only because of what they can do, but because they were created in the image and likeness of God. They (and the rest of us) can recognize that their value lies not in what society deems it to be, but in Christ, or at least in something far more eternal than the world’s standards. As a future physician, I can similarly value them simply because they were divinely created, and if they are Christian, respect them as fellow members of the Body of Christ.
The point of this whole spiel on autonomy in general and patient autonomy is not to denigrate patient autonomy. Autonomy is how American medical culture respects a patient’s humanity and all the rights they are entitled to that stem from their humanity. I’m suggesting that we look further, and recognize that autonomy is a means to an end, but not the end itself. To regard people in this way, I think, respects their personhood in a much richer and fuller way than to simply respect their autonomy or utility.
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