The Battle For Life
by Raymond G. Bohlin and Kerby Anderson
The History of Euthanasia
The debate over euthanasia is not a modern phenomenon. The Greeks carried on a robust debate on the subject. The Pythagoreans opposed euthanasia, while the Stoics favored it in the case of incurable disease. Plato approved of it in cases of terminal illness. But these influences lost out to Christian principles as well as the spread of acceptance of the Hippocratic Oath: "I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to that effect."
In 1935 the Euthanasia Society of England was formed to promote the notion of a painless death for patients with incurable diseases. A few years later the Euthanasia Society of America was formed with essentially the same goals. In the last few years, debate about euthanasia has been advanced by two individuals: Derek Humphry and Dr. Jack Kevorkian.
Derek Humphry has used his prominence as head of the Hemlock Society to promote euthanasia in the United States. His book Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying became a bestseller and further influenced public opinion.
Another influential figure is Jack Kevorkian, who has been instrumental in helping people commit suicide. His book Prescription Medicide: The Goodness of Planned Death promotes his views of euthanasia and describes his patented suicide machine which he calls "the Mercitron." He first gained national attention by enabling Janet Adkins of Portland, Oregon, to kill herself in 1990. They met for dinner and then drove to a Volkswagen van where the machine waited. He placed an intravenous tube into her arm and dripped a saline solution until she pushed a button which delivered first a drug causing unconsciousness, and then a lethal drug that killed her. Since then he has helped dozens of other people do the same.
Over the years, public opinion has also been influenced by the tragic cases of a number of women described as being in a "persistent vegetative state." In the U.S. the first was Karen Ann Quinlan. Her parents, wanting to turn the respirator off, won approval in court. However, when it was turned off in 1976, Karen continued breathing and lived for another ten years. Another case was Nancy Cruzan, who was hurt in an automobile accident in 1983. Her parents went to court in 1987 to receive approval to remove her feeding tube. Various court cases ensued in Missouri, including her parents' appeal that was heard by the Supreme Court in 1990. Eventually they won the right to pull the feeding tube, and Nancy Cruzan died shortly thereafter. Most recently in 2005, Terri Schiavo's fate was sealed by the U.S. 11th circuit court of appeals, which granted Terri's husband the right to remove her feeding tube. The decision was unsuccessfully challenged by Terri's parents.
Seven years after the Cruzan case, the U.S. Supreme Court had occasion to rule again on the issue of euthanasia. On June 26, 1997 the Supreme Court rejected euthanasia by stating that state laws banning physician-assisted suicide were constitutional. Some feared that these cases (Glucksburg v. Washington and Vacco v. Quill) would become for euthanasia what Roe v. Wade became for abortion. Instead, the justices rejected the concept of finding a constitutional "right to die" and chose not to interrupt the political debate (as Roe v. Wade did), and instead urged that the debate on euthanasia continue, "as it should in a democratic society."
Voluntary Active Euthanasia
It is helpful to distinguish between "mercy killing" (or active euthanasia) and what could be called "mercy dying" (or passive euthanasia). Taking a human life is not the same as allowing a terminal patient to die, that is, allowing nature to take its course. The former is immoral (and perhaps even criminal), while the latter is not.
However, drawing a sharp line between these two categories is not as easy as it used to be. Modern medical technology has significantly blurred the line between hastening death and allowing death.
Certain analgesics, for example, ease pain, but they can also shorten a patient's life by affecting respiration. An artificial heart will continue to beat even after the patient has died and therefore must be turned off by the doctor. So the distinction between actively promoting death and passively allowing nature to take its course is sometimes difficult to determine in practice. But this fundamental distinction between "mercy killing" and "mercy dying" is still an important philosophical distinction.
Another concern with active euthanasia is that it eliminates the possibility for recovery. While this should be obvious, somehow this problem is frequently ignored in the euthanasia debate. Terminating a human life eliminates all possibility of recovery, while passively ceasing extraordinary means may not. Miraculous recovery from a bleak prognosis sometimes occurs. A doctor who prescribes active euthanasia for a patient may unwittingly prevent a possible recovery he did not anticipate.
A further concern with this so-called voluntary active euthanasia is that these decisions might not always be freely made. The possibility for coercion is always present. Richard D. Lamm, former governor of Colorado, said that elderly, terminally ill patients have "a duty to die and get out of the way." Though those words were reported somewhat out of context, they nonetheless illustrate the pressure many elderly feel from hospital personnel.
The Dutch experience is also instructive. A survey of Dutch physicians was done in 1990 by the Remmelink Committee. They found that 1,030 patients were killed without their consent. Of these, 140 were fully mentally competent and 110 were only slightly mentally impaired. The report also found that another 14,175 patients (1,701 of whom were mentally competent) were denied medical treatment without their consent and died.
A more recent survey of the Dutch experience is even less encouraging. Doctors in the United States and the Netherlands have found that though euthanasia was originally intended for exceptional cases, it has become an accepted way of dealing with serious or terminal illness. The original guidelines (that patients with a terminal illness make a voluntary, persistent request that their lives be ended) have been expanded to include chronic ailments and psychological distress. They also found that 60 percent of Dutch physicians do not report their cases of assisted suicide (even though reporting is required by law) and about 25 percent of the physicians admit to ending patients' lives without their consent.
Involuntary Active Euthanasia
Involuntary active euthanasia requires a second party who makes decisions about whether active measures should be taken to end a life. Foundational to this discussion is an erosion of the doctrine of the sanctity of life. Ever since the Supreme Court ruled in Roe v. Wade that the life of unborn babies could be terminated for reasons of convenience, the slide down society's slippery slope has continued even though the Supreme Court has been reluctant to legalize euthanasia.
The progression was inevitable. Once society begins to devalue the life of an unborn child, it is but a small step to begin to do the same with a child who has been born. Abortion slides naturally into infanticide and eventually into euthanasia. In the past few years doctors have allowed a number of so-called "Baby Does" to die — either by failing to perform lifesaving operations or else by not feeding the infants.
The progression toward euthanasia is inevitable. Once society becomes conformed to a "quality of life" standard for infants, it will more willingly accept the same standard for the elderly. As former Surgeon General C. Everett Koop has said, "Nothing surprises me anymore. My great concern is that there will be 10,000 Grandma Does for every Baby Doe."
Again the Dutch experience is instructive. In the Netherlands, physicians have performed involuntary euthanasia because they thought the family had suffered too much or were tired of taking care of patients. American surgeon Robin Bernhoft relates an incident in which a Dutch doctor euthanized a twenty-six-year-old ballerina with arthritis in her toes. Since she could no longer pursue her career as a dancer, she was depressed and requested to be put to death. The doctor complied with her request and merely noted that "one doesn't enjoy such things, but it was her choice."
Why People Seek Euthanasia
Why is such a large segment of our society enamored with the possibility of physician-assisted suicide? While there can be many roads that will lead to this conclusion, the primary one is fear. People today fear being at the mercy of technology, of being kept alive with no hope of recovery by machines. Few seem to realize that it is already legal for a terminally ill patient to refuse life-prolonging measures. We must realize that there is a difference between simply allowing nature to take its course when someone is clearly dying and taking direct measures to hasten someone's death. Former Surgeon General C. Everett Koop acknowledges,
If someone is dying and there is no doubt about that, and you believe as I do that there is a difference between giving a person all the life to which he is entitled as opposed to prolonging the act of dying, then you might come to a time when you say this person can take certain amounts of fluid by mouth and we're not going to continue this intravenous solution because he is on the way out.
Extraordinary measures are not required to keep a dying person alive at all costs. But some people fear exactly that. Removing this fear will take a lot of the wind out of the euthanasia sails.
Secondly, people fear the pain of the dying process. Intractable pain is a real fear, but few people today realize that most of the pain of terminally ill patients can be dealt with. Many doctors, particularly in the U.S., are not aware of all the measures at their disposal. There are new ways of administering morphine, for example, that can achieve effective pain management with lower doses and therefore a lower risk of respiratory complications.
Dr. Paul Cundiff, practicing oncologist and hospice care physician with 18 years of experience treating dying patients says,
It is a disgrace that the majority of our health care providers lack the knowledge and the skills to treat pain and other symptoms of terminal disease properly. The absence of palliative care training for medical professionals results in sub-optimal care for almost all terminally ill patients and elicits the wish to hasten their own deaths in a few.
But many would even be willing to live with the pain if they knew that they would not be left alone. The growth in the hospice movement will help alleviate this fear as well. The staff at a hospice is trained to deal not only with physical pain, but with psychological, social, and spiritual pain as well. If you have seen pictures of the many people Jack Kevorkian has assisted to commit suicide, you cannot help but notice that these are lonely, miserable people. Pain has had little to do with their desire to commit suicide. As a nation we have in large part abandoned our elderly population. When God commanded Israel to honor their fathers and their mothers, this was understood to mean primarily in their older years. Extended families no longer live together even when the medical needs of parents are not severe or terribly limiting. No one wants to be a burden or to be burdened.
Why Life Is Worth Living
As we discuss the issue of euthanasia and physician-assisted suicide, it is critical that we not only understand what is going on in the world around us but that we also understand what the Bible clearly teaches about, life, death, pain, suffering, and the value of each human life.
First, The Bible teaches that we are made in the image of God and therefore, every human life is sacred (Genesis 1:26). In Psalm 139:13–16 we learn that each of us is fearfully and wonderfully made. God himself has knit us together in our mother's womb. We must be very important to Him if He has taken such care to bring us into existence.
Second, the Bible is very clear that God is sovereign over life, death and judgment. In Deuteronomy 32:39 The Lord says, "See now that I myself am He! There is no god besides me, I put to death and I bring to life, I have wounded and I will heal, and no one can deliver out of my hand." Psalm 139:16 says that it is God who has ordained all of our days before there is even one of them. Paul says essentially the same thing in Ephesians 1:11.
Third, to assist someone in committing suicide is to commit murder and this breaks God's unequivocal commandment in Exodus 20:13.
Fourth, God's purposes are beyond our understanding. We often appeal to God as to why some tragedy has happened to us or someone we know. Yet listen to Job's reply to the Lord in Job 42:1–3:
I know that you can do all things; no plan of yours can be thwarted. [You asked,] 'Who is this that obscures My counsel without knowledge?' Surely I spoke of things I did not understand, things too wonderful for me to know.
We forget that our minds are finite and His is infinite. We cannot always expect to understand all of what God is about. To think that we can step in and declare that someone's life is no longer worth living is simply not our decision to make. Only God knows when it is time. In Isaiah 55:8–9 the Lord declares, "For my thoughts are not your thoughts, neither are your ways my ways. As the heavens are higher than the earth, so are my ways higher than your ways and my thoughts higher than your thoughts."
Fifth, our bodies belong to God anyway. Paul reminds us in 1 Corinthians 6:15,19 that we are members of Christ's body and that we have been bought with a price. Therefore we should glorify God with our bodies. The only one to receive glory when someone requests doctor-assisted suicide is not God, not the doctor, not even the family but the patient for being willing to "nobly" face the realities of life and "unselfishly" end everyone else's misery. There is no glory for God in this decision.
Lastly, suffering draws us closer to God. In light of the euthanasia controversy, listen to Paul's words from 2 Corinthians 1:8:
We were under great pressure, far beyond our ability to endure, so that we despaired even of life. Indeed, in our hearts we felt the sentence of death. But this happened that we might not rely on ourselves but on God, who raises the dead.
Not only does He raise the dead but there is nothing that can separate us from His love (Romans 8:38). For an inspiring and thoroughly biblical discussion of the euthanasia issue, read Joni Earickson Tada's book When is it Right to Die? (Zondervan, 1992). Her testimony and clear thinking is in stark contrast to the conventional wisdom of the world today. We must do the same.
What Will You Do? What Can You Do?
The Christian Medical and Dental Society has produced an excellent resource on physician-assisted suicide titled The Battle for Life. As a part of the package they provide several cases to test your grasp of the principles involved and to help Christians be aware of the tough decisions that have to be made. I would like to share two of those with you and then discuss what you can do now to combat the "right to die" forces in this country.
Here is test case one: Your 80 year-old grandmother has been fighting cancer for some time now and feels the emotional strain. She feels like she'll become a burden to the family. Her doctor notes that she seems to have lost her desire to live. Should she be able to have her doctor give her a prescription expressly designed to kill her?
This is precisely what the courts have legalized and precisely what God's word says is wrong. It is wrong because it would be taking her life into our hands and violating God's sovereignty. Because physician-assisted suicide goes beyond letting someone die naturally to actually causing the death, it violates God's commandment, "You shall not murder." There is a clear distinction between allowing death to take its natural course in someone who is clearly dying with no hope of a cure, and taking specific measures to end someone's life. There comes a time when the body is imminently dying. Bodily functions begin to shut down. At this point, people should be made as comfortable as possible, be supported and encouraged by their family and doctors, and allowed to die. This is death with dignity. Taking a lethal injection or breathing poisonous carbon monoxide takes life out of God's hands and into our own.
Test case number two: Your spouse has an incurable fatal disease, has lost control of bodily functions, and is unable to communicate. Special treatment and equipment can extend your spouse's life for a few weeks or even months but will involve much pain and exhaustion. Would it be morally right for you to not arrange for the treatment?
Many would accept a decision not to arrange for treatment because that would not be killing but simply allowing death to take its natural course. Such decisions are not always clear-cut, however, and a physician and family members must take into account the pros and cons of intervention versus a faster natural death. Sometimes we rationalize that we need to keep the patient alive as long as possible because God may still work a miracle. But just how much time does God need to work a miracle? If God is going to intervene He will do so on His time and not ours.
Now that we have a better understanding of the issues, you may be wondering just what we can do about this threat among us. Three things:
Pray — Pray that God will turn the hearts of people back to Himself and back to protecting life. Pray for righteousness and justice in our legal system, that we enact laws that preserve life, punish the guilty and protect the innocent.
Speak Out — Present this information to other groups. Talk with your friends and family and discuss the reasons for protecting life. Contact your state and federal legislators and tell them to stand against physician-assisted suicide.
Reach Out — Visit the elderly, care for those who can't care for themselves, comfort the sick. Consider joining or starting a church ministry to the elderly, handicapped, or other individuals with special needs. As Christians we must lead the way with our hearts and actions and not just our words. If we devote our energies to providing quality and loving care and effective pain control, the euthanasia issue will die from a lack of interest.
- Plato, Republic 3. 405.
- R. Finigsen, "The Report of the Dutch Committee on Euthanasia," Issues in Law and Medicine, July 1991, 339–344.
- Herbert Hendlin, Chris Rutenfrans, and Zbigniew Zylicz, "Physician-Assisted Suicide and Euthanasia in the Netherlands: Lessons from the Dutch," Journal of the American Medical Association 277 (4 June 1997): 1720–172.
- Interview with C. Everett Koop, "Focus on the Family" radio broadcast.
- Robin Bernhoft, quoted in Euthanasia: False Light, produced by IAETF, P.O. Box 760, Steubenville, OH 43952.
- C. Everett Koop, "The Surgeon General on Euthanasia." Presbyterian Journal. Sept. 25, 1985:8.
- David Cundiff. 1992. Quoted in review of Euthanasia is NOT the Answer: A Hospice Physician's View by Debbie Decker. CURRENTS in Science, Technology, and Society. 1(2):20.
- The Battle for Life is an educational resource kit produced by the Christian Medical and Dental Society. The Kit includes an award winning video, Euthanasia: False Light, a leader's presentation guide with discussion questions, handouts for Christian and secular audiences, overhead transparencies, Biblical principles summary, research synopsis, cassette tape of public service announcements, and bulletin inserts. The Kit is available from the Christian Medical and Dental Society, P.O. Box 5, Bristol, TN 37621, Phone (615) 844–1000, FAX: (615) 844–1005. The retail price for the complete kit is $30. The Kit can also be purchased through Probe Ministries.