John Stonestreet: We’ve talked recently about who should make life and death decisions when it comes to medical care.

What would Chuck Colson have said about the case of little Charlie Gard?  Who should decide who lives and who dies?

Back in 2009, Chuck prophetically warned that with nationalized healthcare comes increased government control over these decisions—especially when it comes to “quality of life” issues.

If all that matters is what an individual can contribute to society as opposed to the fact that we’re made in the image of God, we are all in danger.

So please listen today to Chuck Colson.

Chuck Colson: Maybe the biggest single issue in the debate over healthcare reform is cost. And by “cost” most people mean how are we going to pay for the president’s and Congress’s proposals.

But there’s a more important question of cost when it comes to healthcare reform: that is, the price paid by the most vulnerable among us.

In a recent New York Times magazine article, ethicist Peter Singer explains “why we must ration health care.” Singer, a brilliant writer and a master logician, begins by pooh-poohing the idea that “it’s immoral to apply monetary considerations to saving lives.”

Well, Singer is right when he says that “we already put a dollar value on human life.” Mattresses aren’t as fire-resistant, he says, as they could be because government officials have decided it would be too expensive to save those additional lives.

Still, Singer couldn’t resist the temptation to play God. He rejects the idea that the “good achieved by health care is the number of lives saved.” In his utilitarian calculus, the “death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities.”

How? Through the use of a “quality-adjusted-life-year,” or QALY. Say, for example, people prefer living five years disability free to living ten years with quadriplegia. Then, Singer reasons, when it comes to rationing health care, we ought to treat “life with quadriplegia as half as good as non-disabled life.” Believe me, he’s not kidding.

What’s even more telling are the considerations Singer says we should not take into account: for instance, whether a patient is a mom or a dad. Thinking about a patient’s children, he says, “increases the scope for subjective—and prejudiced—judgments.”

As abhorrent as Singer’s ideas are, they’re coldly consistent with utilitarian thinking that now dominates medical ethics. As early as the 1990s, Ezekiel Emanuel, the brother of the president’s chief of staff Rahm Emanuel, envisioned “not guaranteeing health services to patients with dementia.” Why? Because, he claimed, they’re “prevented from being or becoming participating citizens.”

I’m sorry, but this is the precise same logic the Nazis used to exterminate the physically and mentally handicapped.

The only viable alternative to this horrific utilitarian, materialistic vision is the Imago Dei: the Christian belief that man is created in the image of God.

Being created in the Imago Dei endows every person with dignity—a dignity that is not derived from the majority’s opinion (or a government definition) about the quality of their life or their contribution to society.

In the absence of this belief, every decision about the allocation of healthcare—and indeed about any area of life—becomes an occasion for the young and strong to impose their will on the old and weak.

The word for this is “tyranny.” And all the hand-wringing and rationalizations about the need to overhaul the healthcare system shouldn’t distract us from the very real danger of nationalizing health care and granting government the power to decide whose life is worth living.

I say leave it to the family and the doctors, as it is today.

(This commentary originally aired on July 27, 2009).

Who Lives, Who Dies? Life or Death Medical Decisions

Chuck’s thoughts on life-and-death healthcare decisions are still relevant today as debate continues on this topic. For further discussion, check out the resources linked below.