Pro-Life Series: Physician-Assisted Suicide

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When the doctors told my wife and me that our infant son, Dylan, would die in the next few days, they gave us a choice: remove life support or allow him to die while on life support. Our family members came to the hospital that day, where we spent an afternoon with Dylan, weeping at his impending passing. We all were allowed to hold him, which had not been possible since his birth, and I baptized him. That night, life support was removed, and Dylan died in the loving arms of my wife and I rather than dying alone in a plastic incubator. 

A couple of years later, my dad was given three to six months to live after receiving a diagnosis of liver cancer. Dad was in excellent physical condition and lived out the full six months. The first four of those months his life wasn’t all that much different than before, except that he had some pain and was more tired than usual. The final two months he was mostly confined to the hospital bed in mom’s and dad’s living room. In the final weeks, his pain increased significantly, and he received more and more morphine. The people from hospice told dad and us that higher doses of morphine might hasten his passing. The morphine and the hospital bed kept him fairly comfortable, and he died quietly one morning.

A woman with an advanced stage of cancer lived in an area where physician assisted suicide is legal. With her family this woman decided to ask to receive a drug that would bring about her death. She received this permission and died when she took the drug.

In all three of these situations, the person was close to death. In all three, their deaths were hastened by decisions they made or decisions made for them. In all three, the individuals were surrounded by people they loved, and the bests interests of the person dying were kept at the forefront. They have one glaring difference: in the third scenario, physician assisted suicide, the medication was specifically intended to cause the death of the person receiving it.

Earlier this week California governor, Jerry Brown, signed into law ABX2 15, which is also called the "End of Life Option Act," permitting physician assisted suicide. With this act, California joins four other states that allow physician assisted suicide. Last February, the Supreme Court of Canada ruled that laws prohibiting assisted suicide are unconstitutional, and the court gave federal and provincial governments one year to craft legislation allowing assisted suicide.  (For more information on this ruling, and ideas for contacting government officials about it, see the excellent resource page put together by the Christian Reformed Centre for Public Dialogue. ) For me, being “pro-life” includes a wide spectrum of beliefs and practices including support for excellent end-of-life care and opposition to physician assisted suicide.

Numerous organizations in Canada and in the U.S. have come out strongly against “right to die” or “physician assisted death” legislation. When the Supreme Court of Canada made their decision in February, I and several other CRC denominational staff issued a statement about the ruling, including these words: “Compassion for suffering, protection of vulnerable people, and the celebration and affirmation of life are all Biblical values that our communities hold dear. The national dialogue needs the voices of Christians who graciously speak these values into the deeply controversial issue of physician-assisted suicide.” Compassion for suffering, protection of vulnerable people, and celebration and affirmation of life are three reasons why I am pro-life and oppose assisted suicide.

Compassion for suffering

When the fight has been long and difficult, some people want a clear and decisive end to the frustrations, discomforts, and indignities of terminal illness. Life-affirming legislation must include provision for excellent end-of-life care which includes pain management and good social work. Modern pain management has reduced the level of physical pain that nearly anyone must endure at the end of life, which was the approach taken by hospice personnel at the end of my dad’s life. Good social work helps not only the person who is dying but also his or her loved ones to deal with the reality of the impending death, and do so in a way that affirms relationships while confronting death’s final reality.

Protection of Vulnerable People

People with disabilities have good reason to fear laws that permit assisted suicide. Legislation allowing for physician assisted suicide puts vulnerable people at risk no matter how many “safeguards” are put in place. The Council of Canadians with Disabilities has said “Assisted suicide is not a free choice as long as [people with disabilities] are denied adequate healthcare, affordable personal assistance in their communities, and equal access to social structures and systems.” In addition, Not Dead Yet, an organization which opposes assisted suicide legislation, has argued that people with disabilities are especially vulnerable. “Although intractable pain has been emphasized as the primary reason for enacting assisted suicide laws, the top five reasons Oregon doctors actually report for issuing lethal prescriptions are ‘loss of autonomy’ (91%), ‘less able to engage in activities’ (89%), ‘loss of dignity’ (81%), ‘loss of control of bodily functions’ (50%), and ‘feelings of being a burden’ (40%).(Death With Dignity Act Annual Reports) These are disability issues.”

Affirmation of Life

The Supreme Court of Canada decision follows the argument of many assisted suicide advocates: people have a variety of rights, including the right to die. The Bible has no room in theory or in practice for a “right to die.” The deliberate choice to extinguish a human life under most circumstances is murder according to the 10 commandments, whether the life is someone else’s or one’s own. In addition, our bodies are not our own according to I Corinthians 6:19-20: “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.” Still, Christ’s finished work covers all the sins of those who believe in him, even sins done deliberately, even sins for which confession is never made. Suicide is not an unforgivable sin.

God can work great good even at the end of a difficult journey. During the last six months of my dad’s life, family members and friends had conversations with dad that we might never have had if we had not been “put on notice” that he would pass away, or if he had chosen an assisted suicide. For example, throughout his life dad never wanted to talk much about his experiences with the 3rd Armored Division in World War II, but his grandkids asked to talk with him about it. Dad got out his old maps and memorabilia, and talked with his grandkids about the war for nearly two hours. The tape recording we have of that conversation is dear to us. Earlier this month, Christianity Today published an article by Kim Kuo about the death of her husband who battled cancer for 10 years before it took him. The battle was physical, emotional, and spiritual. Kuo looked this suffering squarely in the face and still was able to conclude, “Especially in suffering, we can dive below the shallow waters and touch another’s heart and soul.”

Kuo concludes with a call to action, not just to oppose assisted suicide, but to come alongside people who are terminally ill and their loved ones. I can’t say it any better, so I’ll conclude with her words: “On behalf of people who are facing terminal illness, severe depression, or any acute suffering: Act with true compassion. Get involved in their lives. Be present in their suffering. Pray for their healing. Let the reality of death change your life. And rest assured that defending life is not merciless or judgmental—and that to endorse assisted suicide is simply to give up hope.”

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Thanks Mark for your insights into the topic of euthanasia or physician assisted suicide.  I noticed that in painting a picture of three different end of life situations, you painted the first two examples with a greater sense of compassion for the person dying than you did in the third example.  From that alone, I knew where you stood on the topic of physician assisted suicide.  In a sense, the rest of the article was not necessary to know where you stand.  Had you painted a much more compassionate view of the third, your viewpoint would have not been so obvious from the start, and might have shown some balance.

Most Christians oppose physician assisted suicide because of their view of human life. Human life is sacred, not just valuable.  The sanctity of human life stems fundamentally from people (as opposed to animals) being created in the image of God.  And because humans are created in God’s image, we do not have the right to take that life from anyone.  If humans were simply one step up the evolutionary ladder from monkeys, we might not feel the same.  So it is our Christian perspective that pushes us in the direction of being pro-life, whether at the beginning or end of human life.

The fundamental question in our informed age is, do Christians have the right to impose their religious views on the general population?  Because Christians believe in the sanctity of human life, should they dictate to the public that particular view?  Wouldn’t that be like people of the Islamic religion wanting to impose sharia law on the general population of a democracy such as the U.S. or Canada?  It is one thing for Christians to say that they believe in the sanctity of human life, but it’s entirely a different thing to impose our beliefs on others.  The church should be staunch supports of such principles within their church communities, without imposing their views on others outside the church. Don’t we believe in a separation of church and state?  I don’t know if the church does such an effective job within the church community, why should they go outside the church to impose their beliefs?

As for those promoting physician assisted suicide, they can definitely present and promote a much more compassionate and loving perspective on the topic than you have done with your third example.  In fact, if shown in the way promoters intend, it is the most loving, compassionate, and hopeful thing that can be done (or allowed) for those facing severe pain and hopelessness.

Guide

Roger, thanks for your comments. Clearly, you have thought a lot about this issue. My third example is made up, so it is difficult to paint as full a picture as with the other two which come out of my own experience. 

You imply that the primary reason to oppose assisted suicide is that we live in a pluralistic society, and must not "impose our values" on others. I'm far from an expert in political science, but I would disagree with you on two fronts. First, Christians and other people of faith are part of that pluralistic society, so we and our values have as significant a place at the table as people with other value systems. We do have a right to add our voices to other's voices concerning what we believe to be best for people in society, and that should be done with the kind of respect that God calls us to have toward all people. Second, the primary opponents of legislation permitting assisted suicide are people of faith (various faiths) and disability rights groups. Not Dead Yet is a disability rights organization that vigorously opposes assisted suicide legislation. You'll find that none of their arguments are based on "Christian values", yet are powerful reminders of the dangers of such legislation for many vulnerable people in our society. 

Compassion is a value I aspire to live by in all of life. If what I wrote appears to be uncompassionate toward people facing suffering and trail at the end of life, I'm sorry. However, if we only consider compassion toward people contemplating assisted suicide, we will be mislead. We must also have compassion toward other people, such as those for whom assisted suicide legislation endangers their lives (see the Not Dead Yet article referenced above). And if we are guided only by compassion, we will forget about other important values like justice. 

Thanks Mark for your clarifications.  As to your examples, if the third was a made up example, as you say, you could have, at least, added some compassion to show the concern and suffering that such a cancer victim was likely experiencing.  As it stands, it is still obvious where you stand simply from your examples.

When you suggest that opponents of physician assisted suicide are not faith based and do not use religious arguments to make their case, I hope that is not the case for you, as you represent a Christian organization, the CRC and Disability Concerns of the CRC.   And you are addressing a Christian audience.   As such, I would think your opposition to euthanasia would mainly lie in a distinctly Christian argument.  Unless, of course, the Christian argument doesn’t carry much weight.  Unless the Christian argument doesn’t represent ultimate truth. Unless you feel you can only argue from a humanistic point of view.

But then if you are arguing from a humanist point of view and not a Christian perspective, then there is no ultimate authority from which to argue.  You can only argue from a position of opinion.  And your opinion carries no more weight than that of others.  I hope you recognize that  Western opinion on a number of issues (including euthanasia) has been strongly informed and shaped by a long standing Christian tradition that has spanned centuries of thinking.  That is rapidly changing in our pluralistic Western societies.  

You suggest that Christians are part of our pluralistic society and have a right to add their voice to the mix of many voices.  I think you have a right to add your opinion and certainly impose your own opinion on yourself.  But to tell someone who fundamentally believes differently from you that they have to act according to your opinions or values in a pluralistic society is unjust.  Christianity is no longer seen as the guardian of our society and culture.  That is why groups such as “No Longer Dead” will argue their position from a humanistic perspective.  But their humanistic perspective is no more compelling or authoritative than the humanistic perspective of those advocating for physician assisted suicide.  Those wanting to legalize physician assisted suicide are not suggesting that anyone suffering or in pain must submit to such action.   That would be wrong, as well.  They simply want this to be an option.  In contrast those protesting euthanasia are giving no options.  People in severe pain or greatly disabled are not allowed to make such a decision for themselves.  Therein lies the error of your view advocating for a Christian position ruling our pluralistic society.

If the Christian church (or Christians) wants to prohibit physician assisted suicide it should prohibit it within their own church or denomination.  But why go outside of their own church (of like thinking) and try to prohibit it in society which is not under the jurisdiction of the church.   If the church cannot enforce such a law in their own churches why should the church or Christians be allowed such authority in society.

There are other valid arguments for those advocating for physician assisted suicide, but I’ve said too much already.  Thanks for listening and responding.

Guide

Hi Roger, you are right. I could have done a much better job illustrating the painful situation in which many people find themselves when considering the option of physician-assisted suicide. 

I believe that as Christians we can give arguments against physician assisted suicide from within a Christian worldview, and submit these as part of the public discourse. As I said, we have as much right to participate in the public square as others. In addition, there are organizations like Not Dead Yet that oppose assisted suicide that do not use arguments from a Christian worldview but from a humanist point of view. They too have as much right to be part of the public discourse on the topic as those who favor assisted suicide. This is not "imposing our opinion" on others but contributing to society's discussion on this topic. 

I disagree with you that those who oppose assisted suicide "offer no options" to people in severe pain or living with severe disabilities. As I argued in my article, the options include excellent palliative care and excellent social supports (from the public and private sectors - this is where the church comes in) to do as much as possible to give difficult lives meaning, to keep people in meaningful relationships with other people, and to provide as much comfort as possible. 

One more time Mark.  You are right that Christians, like anyone else, should be allowed to voice an opinion.  If I were facing a situation of great pain, or physical disability and hopelessness (for the future), I would want to know what opinions are being voiced and weigh the validity of each point of view.  But I would not want someone telling me what I had to do, especially if I didn’t agree with a particular point of view.  I wouldn’t want someone else’s viewpoint or religion imposed on me.  After hearing the different arguments let me make my own choice.  That’s what the physician assisted suicide advocates are recommending, allowing a person to make their own choice..  Not so for those opposed to euthanasia.

I think that Christians are caught between a rock and a hard place.  The Christian’s strongest argument is the teaching that people have been created in the image of God (the sanctity of human life).  Therefore because of the ultimate value of human life, a Christian or anyone cannot even consider suicide as an escape from pain and suffering.  But this is a Christian argument and doesn’t argue well when establishing law in a pluralistic society.

The humanistic argument for forbidding euthanasia depends on logic and reasonableness in coming to a solution. What is the most humane way of handling such a situation?  Does those arguing “for” or “against” euthanasia have the most reasoned and logical point of view.  Christian and other religious points of view should be put aside when establishing law in a pluralistic culture.  Based upon reason, I think that those favoring physician assisted suicide have the stronger argument on this front.

Thinking of the humane treatment of a much loved pet dog who has lost all of its legs, what would be the most humane treatment for this pet?  No doubt, it would be to put the dog down (end its life).  It would be inhumane to expect such an animal to live out its years without legs.  But that’s what you are suggesting for a person.  The owner of the dog would make the decision for his/her pet.  In regard to a person (in a humane society) facing a life or death decision, he/she would be primary in coming to such a decision.  You can think of all kinds situations of suffering pets, in which the most humane treatment is to put the pet down.  But in the treatment of suffering and hopeless people, you suggest giving them no choice but to live in likely hopelessness.  

Of course animals and people are different.   People have the capability of logic and reason.  Adults can logically and reasonably make important decisions for themselves, even in life and death situations.  They should be given the dignity and the honor that belongs to human beings  to do so.  If they choose life, then by all means, those close to such a person will do all they can to make the remainder of their life comfortable and meaningful.  If they choose death, then those close will also make the passing as comfortable and guilt free as possible.  To give an individual the right of choice gives the individual the dignity and honor that humans deserve.  The right to choose seems, to me, to be the only reasonable and Christian option.

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