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Can we choose our end?

Assisted suicide and euthanasia are not the answer

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On 1 November, Brittany Maynard, a young newly-married woman, took her own life rather than suffer the effects of her rapidly progressing brain cancer. In the UK recently, a mother won the right to kill her severely disabled autistic daughter who was in continual pain.1 Increasingly, assisted suicide and euthanasia are being championed as brave and ethical ways to end the suffering of oneself or a loved one who is unable to make that decision for him-or herself.

While few of us have experienced the terrible situations that are increasingly driving people to seek to hasten death, the Bible speaks clearly about this issue and forbids self-murder or ‘compassionate’ murder of another person. So while we should certainly empathize with those who are facing what seem like impossibly painful choices, we should also point them to the hope we have in the Gospel.

Life is valuable

Life is a gift from God; Genesis 2:7 states “the Lord God formed the man of dust from the ground and breathed into his nostrils the breath of life, and the man became a living creature.” Job 12:10 says “In his hand is the life of every living thing and the breath of all mankind.” Paul concurs: “he himself gives to all mankind life and breath and everything” (Acts 17:25). Not only does He give life, but He knows the exact lifespan that each person will have and sustains that life; “his [man’s] days are determined, and the number of his months is with you, and you have appointed his limits that he cannot pass” (Job 14:5), and “in your book were written, every one of them, the days that were formed for me, when as yet there were none of them” (Psalm 139:16).

Because life comes from God, and because people are created in God’s image, murder is a severe sin against God. Cain, the first murderer, is held up in Scripture as the ultimate cautionary tale of a wicked person (1 John 3:12; Jude 1:11). After the Flood, God commands Noah’s descendants to carry out capital punishment on any murderer (Genesis 9:5–6). In the Mosaic Law, murder was punished with mandatory execution; no ransom could be accepted (Numbers 35:31). And even in the case of accidental death, the manslaughterer faced exile to one of the cities of refuge, meaning his entire life was uprooted in an instant for an indefinite period of time (until the death of the current high priest).

Suicide was seen as a supremely dishonorable death. In fact, the only cases of true suicide in Scripture are Saul, Ahithophel and Judas, all infamous characters. Saul had disobeyed God and was rejected by Him, and had continued in his rebellion as far as necromancy. His suicide was to avoid an inevitable slaughter at the hands of the Philistines, but it was still a dishonorable and nearly unprecedented act (1 Samuel 31). Ahithophel was a counselor to Absalom when he attempted a coup of his father's kingdom, so his suicide was just a further confirmation of his dishonorable character (2 Samuel 17). Judas despaired after betraying Jesus; he knew what a terrible sin he had committed, but rather than repent and seek forgiveness, he went and hung himself (Matthew 27). There is no case of approved suicide or murder in the Bible.

Even life with suffering is valuable

Some people may affirm the broader principle of the value of life, but may argue that there is a point at which a person’s suffering outweighs the value of his or her life, and it thus becomes acceptable to end that life. However, this is not biblical. We are not given many biblical examples of the extreme sorts of disability and suffering that we see today. One reason may be that globalization and mass communication means that things that were once rarely known are now beamed across the world into our living rooms. Another may be because medical technology allows us to care for and prolong the lives of disabled people in a way that wasn’t possible in the biblical world.

However, we do see the presence of many sick and disabled people Jesus healed throughout His ministry—some of whom had been disabled for years before Jesus healed them, with no prospect for natural recovery—and Scripture never indicates that these people were less valuable than their able-bodied neighbors. Indeed, some of the most touching characters of the Gospels are the people who assist the disabled: the friends of the paralytic, for example, who dismantled the roof of a house to get him near Jesus (Matthew 9). Or the parents of demon-possessed children, who had cared for them for an undisclosed amount of time before Jesus cast the demons out (Matthew 15:21–28; 17:14–18).

The biblical mandate to alleviate suffering

Jesus’ example shows us that the appropriate thing to do for disabled and suffering people is to alleviate their pain, but not to kill them. We may not have the power to do healing miracles for people, but modern medicine has come a long way regarding palliative and hospice care. In many cases, even people with serious illnesses can live out their final days in relative comfort. Sometimes if certain medication is given in high enough doses to adequately alleviate suffering, it is known that it will likely have an unintended side effect of hastening a death that was coming soon anyway. In such cases, a delicate ‘tradeoff’ decision has to be made, with the patient, the medical carers and the family all involved in finding the appropriate balance between alleviating suffering and prolonging the process of dying.

This is however quite different from providing people with pills that have the primary purpose of ending their life. That is not a legitimate extension of this principle. In fact it would compromise the quality of the efforts to provide the best care possible. It is much less expensive to kill someone than to medicate them so their final days are more comfortable, so if this became widely seen as an ‘ethical’ way to deal with terminal illnesses, it would tend to undermine the good work of palliative and hospice care.

The ‘death with dignity’ crowd claims to care about the suffering person in the last stages of a terminal illness. If that is really true, they should be throwing their efforts and funding into efforts to improve the care that is already available to ease the pain of people who are dying, not trying to get them to die sooner.2

In fact, it is likely that caring about the comfort of dying people may not be the highest priority of most activists, especially those who promote the stategy of Voluntary Stop Eating and Drinking (VSED) to people who want to die, as it does not require anyone else to participate. Anyone will die from starvation and dehydration if they refuse to eat and drink, but it is a terrible, painful way to die. A fact sheet from the Patients’ Rights Council states:

As a person dies from dehydration, his or her mouth dries out and becomes caked or coated with thick material; lips become parched and cracked; the tongue swells and could crack; eyes recede back into their orbits; cheeks become hollow; lining of the nose might crack and cause the nose to bleed; skin begins to hang loose on the body and becomes dry and scaly; urine would become highly concentrated, leading to burning of the bladder; lining of the stomach dries out, likely causing the person to experience dry heaves and vomiting; body temperature can become very high; brain cells dry out, causing convulsions; respiratory tract also dries out causing thick secretions that could plug the lungs and cause death. At some point the person’s major organs, including the lungs, heart, and brain give out and death occurs.3

In fact, euthanasia advocate Dr Helga Kuhse said 30 years ago: “If we can get people to accept the removal of all treatment and care—especially the removal of food and fluids—they will see what a painful way this is to die and then, in the patient’s best interest, they will accept the lethal injection.”4 So one might be justified in seeing the VSED strategy as promoting ill people killing themselves in a horrifically painful way, in order to get a less painful way of killing ill people legalized.

The danger of seeing death as a solution, not a problem

Where assisted suicide has been legalized, it has rapidly expanded to allow killing of people who are not terminally ill. In the Netherlands, people have committed assisted suicide because they are depressed.5 One woman killed herself because she didn’t like ‘losing her looks’ as she aged. In this horrifying case, the healthy woman left for Switzerland without telling her children where she was going. They only learned of their mother’s death when they received her ashes and death certificate.6 And most worryingly, disabled children may now be euthanized in Belgium and the Netherlands.7

These cases are not part of the ‘face of assisted suicide’ that proponents put forward as those who should be allowed to bypass terrible suffering followed by inevitable death. But these cases are the logical extension of the idea that death is a solution to suffering.

Also, assisted suicide and euthanasia inherently devalue disabled life. The right to die may become a ‘duty to die’. In fact, one strong motivator for people seeking assisted suicide is the desire not to become a burden on loved ones. What these people need is assurance that they are loved and that their life still has value, not a prescription of lethal amounts of medication.

What Jesus promises the dying

There is an urgent spiritual question for those who face death in months or weeks, precisely the people who may seek assisted suicide: are you ready for eternal life? Scripture teaches clearly that when we die, we will go to one of two destinations. Our default destination is a place of judgment, away from the presence of God and all the good things He gives to His people. We all deserve to go there, because we have all broken God’s law.

However, God’s Son, Jesus Christ, died to pay the penalty for our sin, so that we could be reconciled to God and adopted into His family. Furthermore, Christ was raised and promises that we will be raised to bodies like His that will never die or get sick or old. Those who trust in Him will go to be with Him at death to await the resurrection of the dead. He describes this place as Paradise, a lovely, restful place where we will be with Him and other believers.

It may seem unloving to tell dying people that they are going to Hell unless they believe in Jesus, but quite the opposite: it is the most loving thing we can do. In weeks or months, those facing terminal illnesses will face eternity either with Jesus or apart from Him, and so the dying person has only a little time left to repent from their sins and trust in Christ.

Even fading life is worth living

It is too late for Brittany Maynard, who unfortunately committed suicide, despite pleas from other people suffering similar terminal illness to avail herself of the option of palliative care. However, it is important for Christians to know that when faced with a terminal illness, killing oneself is not an option. And we should support the efforts of those who help to ease the last days of dying.

Published: 8 November 2014

References and notes

  1. Gilmour, P., Why I begged judge to end my sick daughter’s life: ‘Nancy is no longer my girl, she’s a shell’, 25 October 2014, mirror.co.uk. Return to text.
  2. For an excellent, in-depth treatment of this issue, see Doerflinger, R. and Gomez, C., Killing the pain not the patient, palliative care vs assisted suicide, www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/killing-the-pain.cfm. Return to text.
  3. Patient’s Rights Council, Voluntary Stop Eating & Drinking: Important questions & answers, www.patientsrightscouncil.org/site/vsed-voluntarily-stopping-eating-drinking. Return to text.
  4. Fifth Biennial Congress of Societies for the Right to Die, held in Nice, September 1984; cited in Methods of euthanasia, life.org.nz. Return to text.
  5. Visser, N., The Dutch debate doctor-assisted suicide for depression, The Daily Beast 3 February 2014, thedailybeast.com. Return to text.
  6. Roberts, H., Italian woman, 85, ends her life at Swiss euthanasia clinic because she was upset about losing her looks, 20 February 2014, dailymail.co.uk. Return to text.
  7. Children’s euthanasia bill signed by Belgium king, 3 March 2014, rt.com. Return to text.