Editorial
September/October, 1998
Volume 33, Number 5
Euthanasia is a term we hear more frequently today. The word is derived from two Greek words–one meaning “well” and the other meaning “death” — and so the word “euthanasia” has come to mean “an easy or painless death.” In current usage, euthanasia refers to the practice commonly called “mercy killing.” To painlessly put to death persons who suffer from incurable and extremely painful diseases seems like an act of mercy to many unthinking people.
The article, which follows, explains that “pulling the plug” is a common term used to indicate the withdrawal of all life support-‘including mechanical ventilation, intravenous fluids, and tube feeding for nutritional support when there is no hope of recovery.”
Today there are increasing pressures on medical professionals, pastors, families, and individuals to hasten the death of those under their care. Such hastening sometimes takes the form of direct action (including lethal injection), or it may also take a passive form (the neglect or withdrawal of the necessary means of preserving life). Most of us hope that our death will come naturally. We generally prefer not to be kept alive on a machine when we are irreversibly dying, but neither is it ethical to hasten the end of physical life.
When “assisted suicide” once becomes acceptable for elderly dying patients on life support, it can quickly become acceptable to use the procedure for cases that do not fit that stereotype. When paralyzed 21 year old Roosevelt Dawson was released from a Michigan hospital in February, 1998 so that he could die at the hands of Jack Kevorkian, we were shown how easily active euthanasia can become a widespread practice.
Human life is a gift of God and only He has the right to terminate it. In the Bible, life is regarded as precious. The Scriptures have a different perspective on death and life–from that on which the modern euthanasia debate is usually based. The Bible consistently presents the hope of a life after death. The Scriptures repeatedly testify to the certainty of the world to come, with a guarantee of freedom from death for those who belong to God.
The writer of this article is a medical doctor, and in the following essay, he presents insights that are important for Christians to think about in this age of respirators, heart pumps, and feeding tubes. We must distinguish between treatments that preserve life and those that simply prolong death.
Pulling the Plug
The Christian’s Response to Assisted Suicide and Euthanasia
“Why don’t you just give me enough medicine to put me asleep forever?” asked Mary pathetically. Mary asked me that question one morning as I visited her in the hospital a few months ago just before she died a natural death from a painfully malignant tumor of the bowel.
But Mary is not the only patient asking that question and many who support assisted suicide and euthanasia are clamoring for legislation and court decisions to legalize this practice in the United States. Several developments have combined to open this once forbidden subject to current public debate. Francis Schaeffer and C. Everett Koop, in a book co-authored 25 years ago entitled Whatever Happened to the Human Race, postulated that the legalization of abortion, which devalues human life prior to birth, would quickly usher in the legalization of assisted suicide and euthanasia, which is the devaluation of life at the end of life. Abortion became legal in the United States in 1973 and many believe that the legalization of assisted suicide and euthanasia is now imminent.
In order to understand the argument surrounding this controversy, a clear definition of terms is necessary. Euthanasia is the direct act of another person, usually a physician, administering lethal doses of medication to kill another person either with or without the person’s consent Assisted suicide is supplying patients who have voluntarily requested to end their lives, with the medications to kill themselves. “Pulling the plug” is a common term used to indicate the withdrawal of ail life support including mechanical ventilation, intravenous fluids, and tube feeding for nutritional support when there is no hope for meaningful recovery.
1. THE CURRENT SITUATION IN THE UNITED STATES IN 1998
Several recent legal decisions in the United States have brought a discussion of this controversy to the forefront In March 1996, the Ninth Circuit Court of Appeals in California struck down a Washington state law banning assisted suicide with the explanation that this violated the due process of law under the Fourteenth Amendment. Just one month later the Second Circuit Court of Appeals in New York struck down a New York state law with the explanation that this also violated the Fourteenth Amendment under the Equal Protection Under the Laws clause. The legal opinion in that decision included a statement by the court which said, “A physician doesn’t fulfill the role of killer by providing drugs to hasten death any more than by disconnecting life support systems.” The court reasoned that the ban on assisted suicide was discriminatory because it allowed some patients to die by permitting removal of life support, but refused others the choice because they had no life support to remove. These court decisions essentially made assisted suicide legal in New York, California, and Washington. The California court also wrote in its opinion that the question of legalizing euthanasia in the United States must be directly answered in the future by cases brought before the United States Supreme Court.
Further appeals later did bring these decisions to the United States Supreme Court, which ruled in the summer of 1997 that the state court opinions were invalid, thus reimposing the ban on assisted suicide in those states.
Not to be outdone, the proponents of mercy killing were able to bring a referendum to the Oregon state ballot in the fall of 1997 to legalize assisted suicide. This referendum was ratified, preparing the way for Oregon to become the first state to legalize assisted suicide.
Not only have judicial opinions been influential in fueling this controversy, but the medical community is also divided on the issue. The official s~ance of the American Medical Association states that physician assisted suicide is incompatible with the role of the physician as a healer and caregiver. Nevertheless, in a poll taken of Washington state physicians in 1994 and published in the New England Journal of Medicine a dight majority of physicians in that state favored the legalization of assisted suicide; although the same physicians were not willing to participate in such an act.
The American Nurses Association also has a statement in their constitution asserting the incompatibility of assisted suicide with the role of healer. Yet in a survey of 1500 critical care nurses published in the March, 1996 New England Journal of Medicine, 20% of the 800 responders stated that they had actually killed a patient mercifully while taking care of them in an intensive care unit, without the patient’s consent.
Just as legal and medical opinions are divided, so is popular opinion. In an article published in the March, 1996 issue of The Journal of the American Medical Association, 12% of physicians polled stated that they had received requests for assisted suicide and 4% stated they had received requests from patients for euthanasia. Many lay persons are sympathetic with the work of Jack Kevorkian, the retired Detroit pathologist who is no longer a practicing physician, but who has publicly acknowledged assisting with dozens of suicides in patients who have terminal or severely debilitating illnesses. Although Kevorkian has been arrested on several occasions, not once has he been successfully convicted of a criminal act. In addition, the Hemlock Society is an organization which actively promotes a patient’s taking his own life at any time, and has published materials giving details of the various methods to accomplish this. When patients are asked why they have requested assisted suicide or information regarding euthanasia, their stated reasons are often that they want the satisfaction of knowing how and when their life will end if faced with suffering or disability.
The promotion of mercy killing is born out of a rampant disrespect for the sanctity of human life in our society. This disrespect for human life is rooted in secular humanism which places man at the center of his existence rather than espousing a God centered existence. Society measures the value of a person’s life by its own standards and not by God’s. Society today wants to avoid suffering at all costs. Suffering is viewed as an extreme evil, so laws are created to help us avoid suffering. Now a mother can obtain an abortion rather than suffer the heartache of an unwanted child. Parents can obtain a late term abortion after it is discovered that a baby has a severely disabling condition rather than face the pain of raising a disabled child. And soon patients who are facing debilitating and terminal illnesses will be allowed to end their own suffering by assisted suicide and euthanasia.
Another factor also complicates the debate. Medical technology has advanced to the point where there is the ability to extend life almost indefinitely. The average age of death has increased from forty-five in 1900 to seventy-six for women and seventy-two for men in 1990. Vaccines and antibiotics fight infectious diseases that once meant an early death. Advance diagnostic procedures, surgical techniques, and even organ transplantation which once were considered experimental, are now treatments of choice for many heart, lung and kidney diseases, as well as for many cancers. The question now is when should life be allowed to end.
2. THE SANCTITY OF HUMAN LIFE
In considering the ethical questions surrounding assisted suicide and euthanasia the Christian must consider the biblical perspective on the sanctity of human life. Christians need to base their opinions not on judicial, medical, or popular opinion, but on God’s opinion, which is recorded in the Scripture. Although there is no chapter and verse which states thou shalt not commit assisted suicide or euthanasia,” the Scripture gives a high value to human life which is opposed to the value which society places on life .
This value to human life begins in the book of Genesis where it says God created man “in his own image.” It also states that God breathed into him “the breath of life”;’he became a living soul” and ‘God saw that it was very good.” The argument follows that if God created life, do human beings have the right to end it? The sixth commandment, “Thou shall not kill,” precludes premeditated murder. God does provide a system of capital punishment for specific sins but never is murder used for sickness or disability in either the Old or New Testament.
Jesus himself speaks to the sanctity of human life when he speaks of God’s knowledge of sparrows in the air and states that we are more important in God’s sight than these. Jesus also makes reference to the value of a person’s life with disabilities when he speaks of the purpose for the man born blind in John 9. Paul speaks to God’s authority and rule over our lives in Romans 14:7-9, “For none of us lives to himself, and no one dies to himself. For if we live, we live to the Lord; and if we die, we die to the Lord. Therefore, whether we live or die, we are the Lord’s.” Again in 1 Corinthians 6:19b-20, Paul speaks concerning the authority and rule of God in our lives: “Do you not know that … you are not your own? For you were bought with a price; therefore, glorify God in your body and in your spirit, which are God’s.” The New Testament also states that it is appointed unto man once to die and after this the judgment. It should be noted that this is scheduled in God’s appointment book and it is not our own decision to make.
Even the psalmist David realized that God was in control of his life. In Psalm 31:10-12 David’s life was fast coming to an end as he wrote “For my life is spent with grief, and my years with sighing; my strength fails because of my iniquity, and my bones waste away … I am like a dead man out of mind; I am like a broken vessel.” Doesn’t this remind us of a person who is coming to the end of life with ill health and being abandoned by his friends and family? Yet David did not ask for euthanasia, for in verse 15 he says, “My times are in Your hand.”
The Bible speaks of the sanctity of human life in God’s sight, and of the authority and rule of God in our lives. The Bible says that our times are in God’s hands and that He has appointed the day of our death. It also reveals to us the purpose of suffering in our lives as we study the lives of Job, Paul, and Jesus.
Because human life is sacred according to Biblical principles, we have no right to end life prematurely. Job stated that the Lord gives and the Lord takes away, and although this probably referred to his material possessions, it can also be assumed that since the Lord took away his entire family, that Job could be speaking about his own life. Joni Erickson Tada, the paraplegic who has a worldwide ministry to disabled persons, states that instead of making it easier for people with disabilities to die, the focus should be on making it easier for them to live. When making life and death decisions (such as pulling the plug or withholding medical support), we should not ask the question, “Does this life have value?”–or, “Is this life worth living?”–but rather, “Is this treatment worth giving?” There is a difference between prolonging life and preventing death in a hopeless situation, and causing premature death by euthanasia and assisted suicide.
3. SOLUTIONS TO THE PROBLEMS OF ASSISTED SUICIDE AND EUTHANASIA
As Christians we must understand that the most important part of preparing for death is not to be concerned about the advanced directives, medical technology or asking for assisted suicide in the face of disability and terminal illness. The most important part of living is preparing to meet the Lord. We must have the attitude of the Apostle Paul when he states, “For to me, to live is Christ, and to die is gain” (Philippians 1:21). We must take comfort in the words of the Lord Jesus, “I am the resurrection and the life. He who believes in Me, though he may die, he shall live” (John 11:25). Not only do we need to prepare for our own deaths by accepting God’s plan of salvation, but we need to vigorously minister to others the Gospel message and the hope of life after death. God gives grace even in the midst of suffering.
In our congregations we need to make concerted efforts to minister to those who are suffering terminal illnesses. We need to treat the disabled with kindness and respect and try to meet their needs physically, emotionally, socially, and spiritually. We need to cultivate the attitude that if the patient can’t be cured, still others will care for their well being. Finally, we need to understand that there is no legal or moral obligation to accept life support or any type of medical technology. This does not mean that we have a fatalistic attitude when it comes to medical decision making, but it does mean that we should seriously and prayerfully evaluate what kinds of medical treatment are necessary and would be acceptable in fulfilling God’s plan for our life, rather than trying to orchestrate the circumstances of our death.