Throughout the ages, people of faith have tended to believe that the end of human life lies within the Divine prerogative – that is to say that life belongs to God and thus is His to give and take, so God alone has the right to determine when and how any human being’s life on earth ceases. Such a belief has naturally impacted two modern day moral debates – those of abortion and euthanasia. In this short article, I will consider some aspects of the latter – i.e. euthanasia.
Euthanasia comes into our language as a combination of two Greek words – “eu” meaning good or well plus the Greek word for death “Thanatos”. Thus euthanasia means “good death”. This word is used to describe the act of putting to death painlessly (or allowing to die), a living creature that is suffering an incurable disease that may lead to a painful and extended process of death.
It is reasonable to divide the practice of euthanasia into two distinct categories – active euthanasia and passive euthanasia.
Active euthanasia is where a deliberate action is taken to end a life – usually this takes the form of administration of a drug that will quickly bring about death. Passive euthanasia is where medication and/or any artificial means of sustaining life is withdrawn, and natural processes are allowed to bring about death.
Many argue that passive euthanasia is simply removing artificial life support and allowing nature to take its course or simply leaving the question of life or death in God’s hands completely. Allowing someone to die naturally by withdrawing life support is thought by many to be morally justifiable, especially when one considers that medical resources are finite and intervention for one person may mean that needed and potentially life saving medical care may not available to others.
Many thus accept passive euthanasia as a natural process and therefore do not raise the same moral objection to it. It must be said however, that the line between these two forms of “euthanasia” is not as clear as it once was. Modern science and medical technology has significantly blurred the line between actively causing death and simply allowing nature to take its course.
Some forms of palliation and some analgesics, for example, may ease pain but at the same time they may also shorten a patient’s life by diminishing respiration. Even after a patient’s brain has ceased to function, a heart machine and respirator may continue to cause blood flow and breathing to continue until those machines are physically turned off, raising the question of whether turning off the machine is actually an act of termination of the life – so the distinction between actively promoting death and passively allowing nature to take its course, may sometimes be difficult to determine in practice.
However, the area of moral debate is centred more on the issue of active euthanasia and this fundamental distinction between life-taking and death-permitting remains an important philosophical distinction.
Within the definition of active euthanasia, there are two further divisions – Voluntary (often called physician assisted suicide or PAS in order to identify is as something other than euthanasia) and involuntary.
Voluntary euthanasia is where a person has the mental capacity and understanding to make the choice to terminate their life and is given assistance to carry out their request. Involuntary euthanasia is where a person is incapacitated and unable to make an informed choice to die, so the choice is made for them by a doctor, family members or friends. The patient’s incapacity may be severe retardation or advanced dementia or they may be in a permanent coma.
Those who argue in favour of euthanasia generally do so for reasons that may seem reasonable and understandable. They wish to take away the suffering of those who are terminally ill and they may even claim that there is a moral obligation to do so.
Some may argue that personal autonomy and freedom of choice gives a person the right to choose when and how they will die. In the case of involuntary euthanasia, some argue that the life of a person who is functionally unable to make choices for themselves has less intrinsic value than functional human life, and may not have enough value to justify the cost or inconvenience of keeping them alive.
Medical practitioners have long been bound by the Hippocratic Oath and one of the clauses of that oath says “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” Even though a doctor intentionally ending the life of a patient was considered unthinkable for centuries, opinion and sentiment seem to have dramatically changed in recent times, to such an extent that euthanasia is sometimes seen to be outside of the Hippocratic Oath and is often referred to as “death with dignity.”
To the person of faith however, there is a factor that must take an absolute precedence – a factor that absolutely supersedes all of the natural sympathy and concern for the terminally ill; and that factor is God’s ownership of life. God is seen as the absolute authority over all aspects of life and thus has an absolute prerogative over its termination.
The obvious question that is raised frequently relates to where pain is involved – wouldn’t it simply be compassionate to end suffering? This is without doubt the hardest question to answer, because the denial of euthanasia will mean some people have to endure significant suffering.
At the heart of the Christian understanding of euthanasia is the absolute acceptance that life is a gift from God that has a divinely ordained beginning and end. In Job 14:5, Job notes that “A person’s days are determined; you have decreed the number of his months and have set limits he cannot exceed”. Such an understanding creates a dependence on God to be not only the giver of life, but also the controller of death.
One of the fundamental doctrines of Christian theology defines all human beings as bearing Imago Dei—the Image of God. (see Genesis 1:27 “So God created human beings in His own image. In the image of God He created them; male and female He created them”). It is the fact that we bear the image of God that gives human life inherent dignity and a value. To determine at any point that a human life is not worth living, fundamentally rejects this dignity. Psalm 139 tells us that humans are fearfully and wonderfully made and should thus be treated with honour and respect.
Human life is sacred and should not be terminated merely because it is deemed appropriate to do so from a human understanding. We have no right to place an arbitrary standard of quality above God’s absolute standard of human value and worth. So whilst proponents of euthanasia may claim to seek to eliminate human suffering, the Christian view would contend that they instead eliminate the fundamental objective value of life and, rather than allowing death “with dignity”, in fact deny and remove its dignity at this point of death. Thus euthanasia, rather than being the source of dignity in death is in reality the enemy of dignity.
The value of human life in all its forms from conception to birth and then throughout life and ultimately to its eternal state is central to Christian doctrine and the focus of the gospel message, for it is the very purpose of Christ’s birth, death, and resurrection. To lessen the value of life, or to fail to grant it the dignity and respect that it has as Imago Dei, undermines the absolute essence of Christ’s mission to humanity.
Of course, such a view places an obligation on the Church to do all that it can to optimise the palliative care that is available to all people regardless of their age, or economic or social circumstances, certainly everything possible should be done to alleviate as much physical and emotional pain as possible.
Clearly, the use of medication to relieve pain is morally justifiable. In Proverbs 31:6, the Bible says that we should “Give strong drink to those who are dying and give wine to drink to those in pain.” As noted above, it is understood that some palliative drugs may have a secondary effect of shortening life, however the primary purpose is to relieve pain, so even though they may ultimately shorten life they can be legitimately given in good conscience.
Likewise, the church should provide appropriate counsel and spiritual care to dying patients and their family. This has been reflected by the church’s involvement in the provision of medical services, palliative care centres, chaplaincy (in hospitals, hospices etc.), counselling services etc., in modern times.
It is important that we do not replace the sanctity of human life with a “quality of life” standard. The disabled, the sick and dying were seen as having a special place in God’s world, but today some medical standards determine a person’s fitness for life on the basis of a perceived quality of life or lack of such quality. If a life is judged not worthy to be lived any longer, people feel obliged to end that life. Such a view is beyond the scope of the Christian understanding of the value of life.
As noted earlier, the Bible teaches that human beings are created in the image of God and therefore have dignity and value. Respecting this view does not mean that people will no longer need to make difficult decisions about treatment and care, but it does mean that these decisions should be guided by an objective, absolute standard of human worth.
There are many philosophical arguments that can be raised on this issue, a short article such as this cannot really deal with such a complex issue is its entirety. However it must be said that difficult philosophical and biblical questions will certainly rise from time to time on the issue of euthanasia.
But for the Christian, regardless of how confusing and emotive these issues may become, the objective, absolute standards of Scripture must remain the primary source of guidance for us. Our faith is in God alone, His Word is our guide and the ultimate authority in determining our response to such matters.
The National Council of Churches in Australia brings together a number of Australia’s Christian churches in dialogue. It has a statement on this issue that can be found at http://www.ucaqld.com.au/mission/sr/bioethics/resolutions/euthanasia.html.