“Voluntary euthanasia is a question of basic human rights,” writes Labor
MP Paul O’Grady. “It is about the right of individuals to choose for
themselves the quality of life they want and when they no longer enjoy that
quality of life.”1
Is it? Is this really what we are debating?
The more basic issue in the euthanasia debate is that of who rules: God or
man. Who has the right to determine who lives and who dies? Who has the right
to determine under what conditions human life may be taken? The euthanasia
proposals being discussed in Australia and other parts of the world today seek
to give to one group of humans—doctors—the right to end human life. They do
this without reference to God, or to the circumstances under which God has said
human life may be taken. Their moral justification comes from the wishes of the
patient. That is, these proposals bestow ultimate moral sovereignty on the
human agent. Humans are understood to be morally autonomous, accountable only
to themselves and thus free to do as they wish with their own lives.
In this form, euthanasia is a rejection of the Bible’s understanding of both
God and humanity, usurping God’s sovereignty over human life and denying the
reality of our ‘creatureliness’. It will be disastrous for the individuals
and the society that embraces it.
The value of life
In the Scriptures, God reveals himself as Creator of all. Especially, he is the Creator of humanity, over whom he deliberates, and upon whom he bestows the dignity of being his image in the world (Gen 1:26-27). Humanity represents God as the ruler to the non-human creation and is equipped for that role by the form God bestows on him at creation. Further, God shows himself especially interested in the welfare of humanity even after the fall, and of protecting people from the destructive assaults of other creatures, human and non-human. He makes humanity corporately responsible for safeguarding the dignity of his image on earth (Gen 9:5-6).
In making humans in his image, God has joined his honour to human dignity. From the time of creation, how we treat other humans has been a direct indicator of our attitude to God. It is no coincidence that Cain in his anger with God slays Abel, or that Jesus connects love of God with love of our neighbour (Matt 22:36-40). What you think about God is inevitably expressed in the way you treat those created in his image. What’s more, humanity has never ceased to be in his image (1 Cor 11:7, Jas 3:9).
In Scripture, God prohibits the taking of human life in ways other than his word allows. “Thou shalt not kill” stands as his word still (Ex 20:13; Rom13:9-10). We see God allowing the destruction of human life under judicial sentence, in war (Lev 18:24-27; Deut 9:5)2, and, under strictly regulated circumstances, in self defence (Ex 22:2-3). Death by accident, while distinguished from murder, is still viewed very seriously, for the shedding of innocent blood defiles the land (Num 35). But there is no place in Scripture where God condones suicide, or where ‘mercy killing’ is regarded as a legitimate form of obedience to God. Those who do commit suicide are seen as having already abandoned God by their earlier disobedience (Judg 9:54-57; 1 Sam 31:3-6; 2 Sam 1:9-16; 1 Chr 10:13-14; 2 Sam 17:23; 1 Kgs 16:15-19; Matt 27:5; Acts 1:18).
If our society seeks to create another category of circumstances in which humans may take human life, we usurp God’s royal prerogatives as Creator, and fly in the face of his expressed will. It is yet another assault upon God in the name of human autonomy, one which, like all such assaults, will end by further eroding the human creature’s significance and security.
Enshrined in the euthanasia proposal is a denial that we are truly creatures. It is, I suspect, an attempt to maintain the illusion of control until the last. Just as we have determined the nature of our lives, so we determine the nature of our deaths. This can only be seen as a proud deceit of the wealthy, who have never had the course of their life changed by illness or bereavement that robbed them of opportunities; have not had their lives caught up in civil unrest or national disaster; have never found themselves with an ambition they did not have the resources to satisfy. Yet to maintain this illusion of control we will all pay a high price in the further erosion of the sacredness of life, as we seek to bestow on some humans the right to destroy life. Better to humble ourselves and acknowledge the dependant nature of our existence.
The power of sin
But the move to euthanasia does more than deny the reality of our frailty and finitude. This proposal is unrealistic about our sinfulness. Believing people are basically good, the pro-euthanasia lobbyists are not only confident that the sick individual will choose rightly, but that the people about her or him will make decisions in a disinterested way. They assume that relatives won’t communicate their other agendas, their inability to cope with their loved one’s suffering, their own fears when faced with death. Medical and nursing staff won’t communicate their frustration at the consumption of resources in the care of one with no hope of improving, nor their anger at the dying patient’s demonstration of their own impotence. Because we are all ‘good’,these possibilities (though sometimes acknowledged) are played down.
Further, because we are ‘good’, the argument runs, we need not be concerned that this power will be abused. Doctors—some of whom have already acknowledged that they have broken the law in taking human life—will not start to terminate the lives of those who can make no request, such as congenitally deformed babies or senile old people. (We should note that such doctors have a vested interest in gaining support for euthanasia, for it is a support for their troubled consciences.) But we are not like Germany of the1930s. This power will be safe with us!
Having denied sin, its reality and its pervasiveness, we have become a people unrealistic about our own capacity for evil, and thus we do not see the need to build and maintain strong protections about the sacredness of human life. And yet it is only a short step between saying “Because my own life is not worth living due to pain and lack of mental satisfaction, it is right to end it”, and saying, “Because of that person’s inability to communicate,their life is not worth living, therefore it is permissible to take it”. Endorsing euthanasia enshrines ‘quality of life’ as what determines the value of a life, with all the consequences for the disabled that such a judgement brings.
Further, euthanasia denies future reality. In effect it makes pain the greatest evil, and avoidance of pain the greatest good. But the greatest evil is continuing in rebellion to God, and what is to be avoided is his judgement,which endures beyond this life (Matt 10:28). Encouraging rebellion against God at the end of life is only consistent with a denial of both God and his judgement. It is profoundly unloving. Is it not better to encourage each other to humble ourselves under God’s hand, and to tum to him in repentance at this time?
What about compassion for the dying?
Having raised the question of love, isn’t it time to admit that perhaps I’ve come on a bit strong thus far, and that the euthanasia debate is really about loving people who are terminally ill and helping them to get relief from their pain? The answer to that is yes and no. Yes, in that, in caring for the terminally ill, we should respond to their needs as people. We should address their need for a secure, loving, pain-free (or pain kept to manageable proportions) time in preparation for death. That is, we should help them live well so they can die well. This may well involve relief for their relatives, skilled pain management, wisdom in not pursuing excessive and burdensome treatments, and a commitment from the wider society to making these things readily available.
But no, I haven’t been too strong in rejecting euthanasia. Euthanasia as it is presented in our society is not about patients’ needs, but about patients’ rights. It is not about helping people live well to the end, but about bringing a premature death. And in the end it will be unhelpful to the terminally ill and those caring for them. It will take our society in exactly the wrong direction.
We need to bolster the availability of good palliative care. It will be the poor and those already disadvantaged by distance who will lose out, because of the disincentive for good care which the practice of euthanasia will create. We need to create an atmosphere where those dying can relate to their relatives securely, and where the time spent with the dying prepares those relatives to keep on living. What new tensions will enter into those weeks if the patient is feeling that there is an expectation, real or unreal, that they should just end it—that others resent their ‘hanging on’? Think of the strain for relatives who might be asked to give orders that follow the earlier expressed wishes of the patient, even though they have no certainty that such would be the wish of the patient now? What if the relatives personally disagree with the planned course? What seeds of discord could be sown where there is family disagreement about what is best, and one party feels that another is unduly influencing their aged parent to a course of action that will serve the influencing relative, and where the decision is not just disposal of property but disposal of life? We are not dealing with abstract rights in euthanasia, but people, of varying degrees of articulateness, in relationship at a highly emotionally charged time in their lives.
It is also the wrong direction for the medical profession, who need neither more power nor the burdensome responsibility of adjudicating on when it is right to end a person’s life (not even our courts do that now). Those who might feel confident of their capacity to make such decisions are all the less to be relied upon. Do they have no mixed motives? Are they not susceptible to pressure from relatives, or administrators seeking to redirect resources, or state directives? Do they never make mistakes in diagnosis or prognosis? What in their training could equip them for the exercise of this power?
This move has the capacity to corrupt the relationship of trust so necessary for the practice of good medicine, by bringing in an element of fear (will she or he truly be committed to helping me live?) or reluctance (if I commit myself to care for this person am I going to be put under immense pressure to do something I am loathe to do?). It will further distance modem medicine from the ideal of care, as doctors continue down the path of seeing themselves as the ones who find solutions. Now they have a ‘solution’ to terminal illness,something to offer patient and relative that will ‘solve’ the pain of the patient and the pain of our own helplessness when faced with pain and death.What will this do for their continuing relationships with those for whom they have no solution—the physically handicapped, the mentally retarded, the chronically ill, especially the psychiatrically ill? This move will not help us train physicians who can care.
What is the place of personal autonomy?
It is plain that the proposed legal changes should find no support amongst Christians for they express neither love of God, nor of neighbour. They are a disaster, and they carry in themselves the seeds of further disaster. They area disaster because of the ethic they enshrine, and the view of God and humanity they perpetuate. Maintaining the autonomy of the individual as the ultimate guiding principle for our society’s ethical judgements is bad news. Rather than stressing each one’s duty to care for others, this supports the popular expressions of selfishness that destroy the groups we all depend on, such as our families. It can lead only to conflict in society, as the rights of one clash with those of others.
Further, it is a flawed principle. It provides no guidance as to how to resolve those conflicting rights, and how to safeguard the community’s interest as a whole. It threatens to elevate a person’s subjective desire to the point of law. Ironically, it is not a principle we recognize in either motoring or town planning, where individual rights are clearly circumscribed. Are we going to become a society where it is harder to get permission to add on a room to a house than to get permission to take someone’s life?
It is also an unreal principle, since no-one is autonomous. We all live in a web of relationships, and our actions have consequences, often ones we cannot foresee. Enshrining this kind of sovereign autonomy only serves the proud and strong, who will be given the sanction to insist on their own way, and will further disadvantage the poor and the weak, who will have less than ideal treatment options open to them and will be susceptible to emotional coercion.
We need to fashion an ethic of duty, where privileges go hand in hand with obligation; where authority is proportionate to responsibility; where law is seen as the context for freedom; where the promotion of the good of others, not ourselves, is the priority.
Paradoxically, the principle of human autonomy further minimises the dignity of the human person. When we abandon the transcendent measure of human dignity—humanity created in the image of God—we can never break free from the confines of our own poor valuation of our life. This devaluing of humanity is accompanied by a devaluing of God, who is sidelined from the debate—uninvolved and uncaring, if he is there at all.
Of course, that is a lie, leading to the further disaster of God’s judgement. God is the sovereign Creator, and he will not be mocked. The assault on those made in his image by any society brings his wrath and judgement upon them (consider Amos 1-2). While non-Christians may be complacent about this, living with the illusion that because we have chosen corporately to ignore God he will ignore us, Christians should not be. We should tremble at the thought of the judgement that our society is storing up through its proud and wilful ignoring of God. We should be prayerful, urgently seeking the merciful God to grant repentance to us and our non-Christian neighbours.
1 Sydney Morning Herald, June 5,1995. p. 13.
2 Note that the wars by which the Israelites took possession of Canaan were seen as God’s judgement on the wickedness of its inhabitants.