Assisted dying

WHAT ARE WE TALKING ABOUT?


In what follows, we are talking about a person in a situation where, medically, death is the only outcome; not through age or the normal passage of time, but because he or she has a condition that will, according to the best medical understanding, bring life to an end. In addition, the person concerned is suffering to a degree that makes life a burden,and a burden that he or she no longer wishes to bear.

We are not talking about any situation in which the decision to end the life of another is taken against that person's wishes. We are not talking about most cases of suicide, where the criteria outlined above do not all apply. We are not talking about chronic illness which, though it may be certain to end in death, nevertheless allows a satisfactory life. We are certainly not talking about decisions to end the life of another in circumstances other than those described, for personal or social or political reasons. Such a decision, however rationalised, would be regarded by most as criminal.

We should recognise that at the heart of this argument is the intention to the end the life of another. The Roman Catholic Church, for example, makes a clear distinction between suspending 'burdensome, dangerous, extraordinary or disproportionate' treatment because death is accepted as inevitable, and any act or omission with the intention of ending life. Only the former is morally permissible.

In summary: assisted dying can be understood as deliberate intervention to end the life of another person approaching inevitable death in a state of great suffering, who does not wish to continue living in that state and who wishes that intervention to take place.

ARGUMENTS IN FAVOUR

Christians may argue in favour of such intervention on a number of grounds.

1. There is a duty to show compassion to another human being. This compassion, by which we seek to minimise or end the suffering of another, is part of love of our neighbour. To have the means to limit the suffering of another, and not to do so, could be judged a failure in love toward our neighbour.
2. God's first gift to his creation, and to us as a part of that creation, is freedom. With freedom comes responsibility. God has given to us the responsibility of judging the rightness or wrongness of our actions. To place one class of actions, helping others to die, outside that responsibility is to refuse the freedom and responsibility which God has given us and which defines us as human beings.
3. Bodily life is not, for Christians, the only or the ultimate good. The ultimate good is our life toward God, a life that we enter through participation in the eternal life of Jesus Christ. This life is not dependent on the physical life of the body, though it is through the life of the body, our life in this world, that we come to know both Christ and God. Nevertheless, the life of the body is not the ultimate consideration.

ARGUMENTS AGAINST

Christians can argue against assisted dying on a number of grounds.

1. Though Christians believe that their ultimate life lies beyond death with God, death is nevertheless the great enemy ('the last enemy', according to St Paul),and not something to be colluded with. We should resist secular arguments that naturalise death 'as part of life', and insist that death (traditionally seen as the consequence of sin) is the enemy of what is human and divine, the antithesis of God's gift of life.
2. God has given the commandment 'thou shalt not kill', which is not qualified (e.g., by 'except in battle', or 'except in cases of terminal illness'). From this it follows that the intention to kill, however well motivated, must always be wrong.
3. Life and death are not ours to decide, but God's. Sometimes this view is expressed by saying 'we should not play God.' People die when God decides they should die. It is his decision not ours.
4. A more nuanced argument might say that we do not determine the meaning of our lives for ourselves. Secular society deeply believes that we do exactly that; but for Christians, the shape and meaning of a life is what flows from our relationship with God. It is God who gives meaning to experience that to us is meaningless or unendurable. So it is not up to us to decide that our life has ceased to have meaning and should therefore be terminated.
5. There are also a number of practical or procedural problems, not specific to Christians, which need careful consideration. The situation proposed - a person facing death in circumstances of great suffering, who does not wish to continue living - sounds clear and easily identifiable. In practice, it may be less so. There may be some question about the medical outcome. There may be questions about the inevitability of the suffering. Above all, there may be questions about the validity of the person's decision to die: does their situation allow a decision in full clarity? Is that decision genuinely their own, or has it been influenced by the wishes of others?
6. There is the further problem of decisions taken in advance, 'living will' decisions in which a person, not facing immediate suffering and death, gives instructions for future intervention. How valid can such decisions be when they are, by definition, taken in quite different circumstances? Should there be any time limit on the applicability of such decisions? Any legislation allowing for assisted dying would need to take careful account of such problems.

THEOLOGICAL PERSPECTIVES

How we decide this issue will arise from assumptions which we may not recognise as theological but in fact are so, in that they shape our understanding of what Christianity is.

If your theology emphasises God's creation of humanity in freedom and responsibility, you may be more likely to favour arguments for assisted dying. You will be less impressed by accusations of 'playing God'; you may say that God has given us, as dignified, responsible beings, our own domain of choice and action, and that this includes decisions about our own death and the deaths of others.

If your theology has at its centre the love of one's neighbour, you may also be inclined to favour assisted dying on grounds of compassion. You may feel that the arguments against such intervention are remote and abstract in a situation of desperate immediacy where someone is in acute torment.

If you see this world as a fallen reality, hiding a truer and greater reality, you may be inclined to feel that the maintenance of life under any circumstances is not an absolute consideration.

If you see God as primarily a lawgiver, you are likely to feel that the argument stops with the sixth commandment.

If you see death as the antithesis of God's creation, the negation of his being which is always life, you will be suspicious of any argument which makes terms with death, which allows death free entry on whatever justification. You may suspect that death tempts us in many circumstances (war, abortion, suicide) with specious offers of convenience or release; whereas the only true freedom is the life of God.

If you believe that our lives have their meaning only in relation to God; that our decisions are held within a pattern that is God's loving purpose for us; then you will be less inclined to take the major decision about death out of God's hands, whether for yourself or for another.