Caring for those who don't care

Matthew 5:7 "Blessed are the merciful, for they shall be shown mercy"

This week of nursing school has opened my eyes to an aspect of this profession that I had never considered... and I still don't know how I feel about.

As many of you know, I started clinicals this week, and my first community placement was at AIDS Vancouver Island. Leaving that evening after an afternoon spent with people who are suffering and dying, there was so much on my mind.

First a excerpt from my personal journal about my experience (edited a little so you can better understand):

I realized I had a view of those with HIV/AIDS that was both ignorant and biased. I've always seen this virus as the 'disease of homosexuals', and thinking back on it now... I'm really not sure how I got that impression. How wrong I was!

AIDS is contracted through the exchange of body fluids, such as semen, cervical or vaginal secretions, and blood. At AIDS Vancouver Island (AVI), the majority of patients have been diagnosed with AIDS due to intravenous drug use, presumably having used a needle previously used by someone HIV positive (blood to blood).

However, AIDS is also commonly contracted through any sex act where there is an exchange of bodily fluids, as well as through the placenta of a HIV positive mother to her child.

If the world was perfect, then AIDS would not exist. It is the direct result of an immoral and fallen world... a world where sexual sin and having multiple partners is not only common but even applauded. A world where husbands cheat and then infect not only their wives (who are innocent), but their future children as well. There are stories out of Africa and Asia about clinics that are so short on supplies and funding that they have to reuse needles in order to be able to immunize children and families, not realizing they are infecting hundreds of people with the disease that will kill them by extension.

So, despite the fact that HIV/AIDS is spread to a large extent by sinful acts, aren't we all sinners here? I've heard brothers and sisters in Christ say we shouldn't support research for a cure, or assist the sufferers - that AIDS is a punishment from God on these people who live so immorally. Can they really say that? Surely we are all equally as fallen, and we aren't saved by any righteousness or worthiness that we ourselves possess, but solely by the grace of God. Right? Does having contracted a disease because of an ungodly lifestyle make someone unworthy of treatment? Aren't we called to show mercy and the love of Christ to those who don't know Him? I don't know what to think. I do know that the people I met today were lovely human beings, making the most out of a horrible situation. And I know that I want to help them. I want to heal their bodies, but more than that, I want to heal their souls... or more accurately, I want my Savior to heal their souls. To fix their brokenness, to give them peace instead of evil, to give them a future and a hope (Jeremiah 29:11).

I wrote that on Tuesday. Then today I had a nursing practice class and we had the chance to talk about our different experiences in clinical this week, since we all have various placements around the city. During my turn, I spoke about my realization that as nurses we won't always be working on patients that want to get better... my example was of the addicts at AVI who come each week for their antiretroviral meds , but go right on shooting up and getting high the rest of the time. Bringing up this point led to a discussion that lasted over an hour. This same idea applies to smokers who come in for cancer treatment, go into remission, then grab a pack of smokes from the hospital gift shop on their way out the door... or an obese patient admitted for a heart attack, who then drives to the nearest McDonald's as soon as they are released.

Do these people deserve to get expensive treatments if they aren't even willing to take care of themselves? Shouldn't people who try to stay healthy take priority over those who repeatedly poison their bodies? Canadian Health Care seems to say yes.

Our teacher told a story about a friend of hers who lived up island and was a chain smoker. As a result, he required coronary bypass surgery, but the surgeon refused. He asked the patient if he would be willing to quit smoking after the surgery and when the patient said no, the doctor told him it would be a waste of time to perform an operation on someone who would just reverse it all in a matter of months. He never got the surgery. Now he's dead. This is allowed in Canada.

And it happens much more often than you would think. Alcoholics are repeatedly bumped to the bottom of waiting lists for liver transplants, because preference is given to those without a history of alcohol abuse, for example.

I don't know how to feel about this issue. On one hand, I do struggle to see the point of striving to save someone's life when they'll just be in the following week with the same issues. I've heard stories about alcoholics who come in weekly for kidney dialysis. It seems as though it's only fair that they be working to make changes to their lifestyle as well expecting hospital treatment (again and again).

On the other hand, I am outraged that someone, anyone, would be refused treatment and essentially left to die. It just doesn't sit right with me... and as much as I don't like that they aren't putting in an effort to change their lifestyle, I dread having to look into the face of one of these people and tell them we won't give them life-saving surgery because of the way they live their life.

The way I see it, giving them even a few more days on this earth is giving them a few more days to come to a saving faith in Christ and spend eternity praising His name.

It's definitely an tricky issue, and one that requires a lot of thought and prayer for me. However, regardless of my personal beliefs, if I work in Canada I am bound by their regulations. The nursing knowledge base teaches that everyone is worthy of care and no one should be turned away. What do you think?