The Garden, the Tree and the Gift of Obedience: A Christian Perspective on the Proper Expression and Limits of Autonomy
Nicole
Last Name Shirilla
Terminal Degree(s) MD
Title/Position assistant professor/palliative medicine physician and clinical ethics consultant
Institution/Organization Ohio State University Medical Center
Are there limits to human autonomy, and if so, how ought we define them especially in the work of end of life care? Looking at two garden stories may provide insight. In the Garden of Eden God settled the man and woman he had created garden with this order: “You are free to eat from any of the trees of the garden except the tree of knowledge of good and evil. From that tree you shall not eat; when you eat from it you shall die.” (Genesis 2:16-17). A snake inhabiting the garden tempted the man and woman that “God knows well that when you eat of it your eyes will be opened and you will be like gods, who know good and evil.” (Genesis 3:5) The fruit was taken and the result is well known. “The eyes of both of them were opened, and they knew that they were naked,” banished from the garden with parting words “For you are dust, and to dust you shall return.” (Genesis 3:19) Looking again to a garden, the garden of Gethsemane, Jesus in a deep expression of obedience states, “Father, if you are willing, take this cup away from me; still, not my will but yours be done.” The result is well known. Nailed on a cross, he dies. For those who believe, though, the wood of the cross ultimately becomes the tree of eternal life.
Reflecting on these two stories, how might we think of the relationship between autonomy, obedience, authority and freedom, especially in the practice of medicine that deals with care at the end of life? Pope John Paul II teaches in his papal encyclical Evangelium Vitae that there is a perverse idea of human freedom that it is within the autonomy of individuals to be the arbiters of good and evil. “Freedom negates and destroys itself, and becomes a factor leading to the destruction of others,” he explains, “when it no longer recognizes and respects its essential link with the truth.” While medicine is often involved with waging a war against finitude, pain and suffering often by the principle of respect for autonomy, the Christian perspective encourages reflection on the reality that true freedom is ultimately found in obedience to the “definitive limits which delineate our lives as finite creatures.” In other words, autonomy is not absolute, and we ought properly order and reconcile the necessary and the temporal with the good and the eternal when considering its limits. In my presentation I would explore this Christian perspective further, especially in regards end of life care.
Reflecting on these two stories, how might we think of the relationship between autonomy, obedience, authority and freedom, especially in the practice of medicine that deals with care at the end of life? Pope John Paul II teaches in his papal encyclical Evangelium Vitae that there is a perverse idea of human freedom that it is within the autonomy of individuals to be the arbiters of good and evil. “Freedom negates and destroys itself, and becomes a factor leading to the destruction of others,” he explains, “when it no longer recognizes and respects its essential link with the truth.” While medicine is often involved with waging a war against finitude, pain and suffering often by the principle of respect for autonomy, the Christian perspective encourages reflection on the reality that true freedom is ultimately found in obedience to the “definitive limits which delineate our lives as finite creatures.” In other words, autonomy is not absolute, and we ought properly order and reconcile the necessary and the temporal with the good and the eternal when considering its limits. In my presentation I would explore this Christian perspective further, especially in regards end of life care.