“Not…..like the rest of men, who have no hope” (1 Thessalonians 4 v 13)
1. Definitions: Derived from the Greek meaning “good-death”, contemporary euphemisms include “mercy killing”, “assisted dying” and “assisted suicide”. It has been further defined as “the intentional killing by act or omission of a person whose life is felt not to be worth living” usually by a doctor responsible for the persons care. Distinctions are made between withholding medical treatment, withdrawing medical treatment, withholding or withdrawing food and water (artificially administered by tubes and drips or not) and actively administering something to kill the patient (usually a drug to stop the heart or breathing with anesthetics). It is not considered euthanasia to withhold or withdraw futile medical treatment (that’s to say when it wouldn’t work and therefore be pointless and possibly cruel). Additional distinction is made between voluntary and non-voluntary euthanasia; the latter where it is not the patient’s own choice.
2. Related issues: “Not For Resuscitation” – this is an appropriate decision when it would be futile, pointless, undignified and cruel as for other medical treatments (this is the case more often than not as it is a highly unsuccessful treatment for most patients). “Advanced directives/living will” – a legal document expressing a persons intentions not to receive certain treatments under certain conditions in anticipation of a time when they would lack the ability to make or express that choice (common in the USA and increasing in the UK). “Double Effect” – when drugs used to control symptoms such as pain and breathlessness hasten a persons death, this is not considered euthanasia where the intent is to control the symptoms and not to hasten the death. “Overtreatment” – the administration of futile, pointless, undignified and cruel medical treatment – the flip side of euthanasia and an issue swamped in the current euthanasia debate. “Palliative care” – a positive approach to actively address the physical, psychological and spiritual suffering of a dying person.
3. Voluntary death: Jesus “obedience to death” (Philippians 2 v 8) was the very instrument of his victory over it! He made it plain that “I lay down my life – only to take it up again. No one takes it from me, but I lay it down of my own accord. I have authority to lay it down and authority to take it up again” (John 10 v 18). Nonetheless this was not suicide, he was crucified by the joint actions of the Jewish religious leaders, Jewish people and Pontius Pilate (Acts 2 v 23). For the joy set before him he endured the cross (Hebrews 12 v 2). Daniel and his friends faced death rather than apostasy and were delivered. Many of the other prophets however, including John the Baptist and many early Christians “did not love their lives so much as to shrink from death” and were martyred (Revelation 12 v 11, 6 v9; Hebrews 11 v 35-38).
4. Biblical case histories of despair: Job, Elijah, Jonah and Jeremiah all asked God to kill them (Job repeatedly did so) when in the depths of despair (Job 3, 6v8, 7 v15&16, 10v18/19, 14v13, 17v13; 1 Kings 19 v4; Jonah 4 v3; Jeremiah 20 v 14-18) but God declined! Job is a particularly salient example for consideration as his suffering included unremitting physical suffering including pain and itching both day and night with no hope of recovery, indeed his own wife counseled him “Curse God and die!” (Job 2 v 8). Job’s wife’s prognosis was very wrong, after a full recovery “the Lord blessed the latter part of Job’s life more than the first” (Job 42 v 12). Hospices have frequently taken in people with a wrong terminal diagnosis! Job also emerged with a deeper respect for God and a greater love for life. Most importantly of all: Job made God famous!
5. Biblical parallels to euthanasia: There are 6 cases of suicide recorded in scripture – Abimelech (Judges 9 v 50-57); Samson (Judges 16 v 28-31 – could be disputed as military sacrifice rather than suicide); Saul (1Samuel 31v1-4 & 2 Samuel 1); Saul’s armour bearer (1 Sam 31 v 5); Ahithophel (2 Samuel 17 v 23), Zimri (1 Kings 16 v 17-19) and Judas Iscariot (Matthew 27 v 3-5). Of these 2 were potentially cases of euthanasia – Saul (from the second account of his death in 2 Samuel which differs from 1 Samuel) and Abimelech. The Amalekite who claimed to have killed Saul at the King’s own request, whilst in the throes of death, was summarily executed by David for killing the Lord’s anointed. Comparison with a similar episode in 2 Samuel 4 where Ish-Bosheth (Saul’s son) is murdered and his murderer meets the same fate as the Amalekite suggests it was not specifically the euthanasia but rather the killing of the Lord’s anointed at issue. We are not told what happened to Abimelech’s servant who killed him at his own request after a millstone had been dropped on his head from a wall by a woman thus cracking his skull, in order to spare him the humiliation of being killed by a woman!
6. Medical ethics: The key areas at issue are Autonomy and Compassion. Autonomy can be summarized as “my right to die”. This is a double-edged sword as “my right to die” inevitably impinges on the doctor’s right not to have to kill. The consequent changes in law both fundamentally alter the nature of the doctor-patient relationship and open the way for the abuse of the vulnerable. This has been seen in Holland and Origen USA where legalized euthanasia has been associated with more than 1000 non-voluntary euthanasia cases per year and also the elderly feeling under pressure to “do the honorable thing” to reduce their economic burden. Fears also are raised by the concept of the “slippery-slope” – where would such a shift in attitude to the sanctity of human life end? The holocaust had its origins in pre-war Germany where euthanasia became commonplace in nursing homes! Autonomy also denies the proprietorship of God, that we are not really our own but rather His creation and doubly His as we were “bought at a price” (1 Corinthians 6 v 20). Is it really Compassionate to kill someone who is suffering? In reality it is the lazy option – a substitute for the time, effort and expense necessary to provide and develop the care needed to palliate someone’s suffering. Even where palliative care is currently inadequate, the short-term “quick fix” of euthanasia undermines the long-term development of proper care (as seen in the lack of Hospice care in Holland).
7. High profile cases: difficult cases make for bad law! In the UK a sea change occurred following the decision to allow artificial nutrition and hydration to be removed from Tony Bland – a brain damaged young football fan – in 1992. His doctor argued “let poor Tony die” but the fact was that Tony was not dying. He was alive for 4 years in a “persistent vegetative state” – what the doctor really meant was – let us stop feeding him and giving him fluid so that he will die, which was not the same thing. The recent death of Terry Schiavo in the USA raised similar issues. Patients such as Diane Pretty have taken their cases to the European court of human rights to be allowed to die or have traveled to countries where euthanasia is legal.
8. Playing Politics: Aside from these high profile cases, where individual decisions have been made or decisions for individual groups of patients such as those in a persistent vegetative state, a steady concerted effort has been underway to legalize euthanasia generally. The most recent decision within the last few weeks was a failure to reject the pro-euthanasia Lord Joffe assisted dying bill at the house of Lord’s select committee convened to consider it. This was a significant step towards this eventually becoming legislation. Recently the Mental capacity bill, which gives full statutory force to advance refusals of food and fluids, passed its third reading in the House of Commons (euthanasia by the back door?). In this country euthanasia is a cross-party rather than party political issue although in this election we have for the first time seen a toe dipped in the American waters of such issues becoming party political issues. There is a danger in this trend as polarized views create political footballs out of moral issues and the truth can become submerged by the pursuit of agendas of personal gain. Nonetheless it has left the pro-euthanasia (largely humanist) bandwagon largely unchallenged by a clear unified voice.
9. Don’t curse the darkness – light a candle: “Precious in the sight of the Lord is the death of his saints” (Psalm 116 v 15) The hospice movement has largely developed as a response by Christians to desire to dignify people in their death, to relieve suffering and to bring hope. In hospitals palliative care teams, Macmillan nurses and hospital chaplains bring this service. This was also the main ministry of Mother Teresa of Calcutta – caring for the dying who were considered human refuse. It is these who are considered “the least”, the expendable, the worthless that Jesus exhorts us to champion and to minister to in power and in love (Matthew 25 v 34-40). We can follow the web-link to pray for and write to MP’s, members of the House of Lords and their committees involved in the legislative process surrounding euthanasia. We can find out about our local hospices and support their work financially. We can contact our local hospital Chaplaincy and see how we can help with visiting the sick and the dying to bring prayer and words of hope and life. For “where there is hope, there is life