The decision by the Dutch and Belgian Governments and a few others some years ago to legalise euthanasia or mercy killing put this whole difficult issue very much before the world. Now with this question ever more prominently before South Africans, it’s worth pausing reflectively in our tracks before we all walk down the Netherlands road to mercy killing and assisted suicide. To help us reflect on this difficult issue there are some key principles I’d like to consider.
What is euthanasia?
The Oxford Dictionary describes it as “the act of causing somebody to die gently and without pain, especially when they are suffering from a painful, incurable disease.” Euthanasia proper does not in essence include the removal of a person from a life support system although some call this “passive euthanasia”, in contrast to “active euthanasia”. Perhaps it is less confusing to confine the term primarily to acts which hasten the death of someone who would otherwise still live. Even so, we note that much secular ethical discussion focuses on whether there is a morally significant distinction between causing death (active euthanasia) and allowing death to happen (passive euthanasia).
The Christian, I believe will not ever sanction active euthanasia, but may in some cases be comfortable with passive euthanasia.
What we do however have to guard against is the kind of contemporary neo-pagan humanism which goes well beyond the old justification for euthanasia of giving a good and quick death to the incredibly ill and suffering. Here mercy killing was for the sake of the sufferer. Now it can be considered in utilitarian categories for the convenience of those who are alive and left behind.
So, unless the Church rises as a contrary voice, the day will be progressively carried in our neo-pagan age by utilitarianism (is this death useful to us?), or sentiment (is this suffering too much?), or choice (do you want the option to die now or to suffer on?). But the Christian, starting with God and His Word, operates under Divine principle and moral law, the Creature under the Creator. The questions then are theological. “How does God see this? What does He want? What biblical principles are there to guide us in this matter? How can I obey my Lord and His Word?”
In all this there are some key principles to note.
Sanctity of life
The first principle is the sanctity of life. This is the view that all human life is sacred, holy, God-created and God-valued, and it is a foundational principle for those who oppose euthanasia. Believing that all humans are created in God’s image provides every person with inherent, inviolate value and dignity, no matter how old or young, sick or healthy.
For medical people, the sanctity of life principle makes motivation a critical factor in the euthanasia debate. If a doctor with the sole motivation of alleviating pain allows doses of morphine which he knows in cumulative terms will ultimately be fatal, he is not violating the sanctity of life because his motive is not to bring about death but rather to alleviate pain. If, however, the medical doctor administers the lethal dose with the express motivation of killing the patient, he does violate the sanctity of life. The distinction may be subtle but it is critically important – the one motivation being morally valid and the other morally perilous.
The sovereignty of God in Christ over life and death
The second principle has to do with the sovereignty of God over life and death. God is ultimately and finally the one in charge. “This is God’s call,” said the doctor to me many years ago when my mother was dying. Said the Lord to Hezekiah: “I will add 15 years to your life”(II Kings 20:6). The time of Hezekiah’s birth and death was God’s call. The Psalmist knew God’s sovereignty as well when he affirmed: “My times are in Thy hand” (Ps. 31:15). In other words, both our life destiny and our death destiny are in His hands. To interfere with that is no light matter.
The dealings of God with the dying
Another principle involves the mysterious ways which God uses to minister to those who are dying. A senior nursing sister once told me of the deep sense she had when her husband was dying that God was doing deep things within him. Spending hours and days at the bedside of my dying mother, I also had the profound sense of eternal things happening with her right up to the last minutes – though both she and I were longing for weeks beforehand for her release. To interrupt that eternal business, to terminate someone’s life prematurely, is to step dangerously and recklessly into God’s sacred territory.
The role in the Christian life of suffering
Then there is the principle of the role of suffering. No one says suffering is good. It is evil. It is part of our fallen estate. But it is not a biblical principle to avoid all suffering at all costs. In reality, our faith is often deepened and matured by the trials and sufferings that come our way. Take the seemingly inexplicable sufferings of Job. We now know that these had meaning in God’s plan. When we seek to end someone’s suffering by ending their life, we are ruling out the possibility of God’s healing work in their lives and ending any chance of God completing a work in the person that may only be completed through suffering.
The death experiment
Euthanasia in places where it has been fully legalised has now enabled researchers to see how it has affected people. We can ask questions like “Is euthanasia really being used in the best interests of the people and has it brought about comfort in the minds of those who fear suffering a long and lingering death?”
What we do know about, by way of illustration, is that a Dutch governmental review some years ago revealed that 45% of hospital-based assisted deaths in Holland in the last few years have occurred without adequate patient or family consent. This has happened even though it is illegal there to “mercy” kill someone without personal or family consent. And it is this potential abuse of euthanasia by medical doctors which causes deep ripples of disturbance and fear throughout the Dutch population, and particularly with Dutch elderly. When your doctor is given the legal right to terminate your life, which goes in direct contradiction to the Hippocratic oath doctors have been bound by for hundreds of year, is it any surprise that a 1990 Dutch study done in nursing homes revealed that more than half feared being euthanised against their will. Even beyond that, 9 out of every 10 people in this same survey opposed euthanasia altogether.
And so we need to register in my view that neither Christian conscience, nor the Bible, nor precedent from current practice can sanction active, deliberate euthanasia. Its irrevocability, its interference with God as Lord of life and death, its interruption of what the dying person may be doing in the Spirit for others, its terminating of the sufferer’s eternal business with his or her Maker, its violation of the sanctity of life, its destruction of the trust that needs to be in place between patient in doctor — all these make euthanasia unacceptable. May we never legalise this in our nation.