It must be conceded that the topic of medical assistance in dying is first and foremost an ethical question that must be carefully considered. Is there a basis for morality? Is morality derived from public opinion? Lobby groups? The vocal minority? A God-given ethic? No matter how one answers that question, it must be conceded that the western world has been built on a Judeo-Christian ethic. God’s law was given in the desert of the Sinai peninsula where he said, “You shall not murder” (Exodus 20:13). This law, along with other biblical principles, still remains as the foundation for our morality in the western world. Should we be so quick to abandon it?
The prohibition against murder (frequently called the “shedding of innocent blood” [Ex 23:7; Deut 19:10, 13; Ps 10:8; Prov 6:17]) includes the elderly, the terminally ill, depressed, disabled, and those wishing to die.
Saul and Assisted Suicide
Saul, the king of Israel, was badly wounded in battle by archers (1 Sam 31:3). He commanded his armor-bearer to draw his sword and kill him fearing the enemy would find him and mistreat him. The armor bearer refused because of fear so Saul took matters into his own hands and fell on his own sword (1 Sam 31:4).
Later a man from Saul’s camp came to David to tell him the news of Saul’s death. This young man, thinking that David would be pleased to hear about Saul’s death since Saul had tried to kill David in the past took credit for ending Saul’s life. The young man explained that he came across Saul surrounded by the enemy and wounded and that Saul asked him to end his life (2 Sam 1:9). He claimed that he took Saul’s life and confirmed that there was no way Saul would survive his injuries (2 Sam 1:10). Upon hearing this news, rather than rejoice, David mourned.
After a period of mourning, David said to this young man, “How is it you were not afraid to put out your hand to destroy the Lord’s anointed?” (2 Sam 1:14). The young man was executed as a murderer. The last words said to him by David were, “Your blood be on your head, for your own mouth has testified against you, saying, ‘I have killed the Lord’s anointed'” (2 Sam 1:16).
What do we learn from this historical account? We learn that assisting someone in their death, even when they are mortally wounded is murder.
Why Is It Wrong?
Two main reasons are given in God’s word for why assisted suicide is always wrong.
1. The Image of God. All life is important, even the terminally ill, because we all are created in the image of God (Gen 1:26–27). We have dignity, value and worth as human beings that is categorically different than animals or other forms of life. Our value is not imposed upon us by society or any human invention, it is intrinsic, coming for the fact that we are made by God himself (Acts 17:28). For example, murder is wrong “for God made man in his own image” (Gen 9:6). This is the foundation for the doctrine of the sanctity, or sacredness, of every human life.
2. God Is the Author and Sustainer of Life. Life and Death are in God’s hands, not ours (1 Sam 2:6). I can’t choose when and where I’m born, this is God’s prerogative. Likewise, I can’t choose when and where I die. That is God’s right, not mine or any other person’s.
Practical Concerns
There is no higher authority than God and his word, as such medical assistance in dying is clearly wrong. Not only has God spoken on the subject, there are also a number of practical concerns. A few are considered here.
1. Impact on Palliative Care. Palliative care involves medical professionals helping the patient and family cope physically and emotionally with the distress of advanced illness. It’s an important field where today almost no patient is beyond the help of pain-relieving medicine. As medical assistance in dying becomes legal and people avail themselves of this “service” our palliative care facilities will suffer. It’s inevitable that less funds, research, medicine, and personnel would be directed toward palliative care. Medical assistance in dying is obviously more attractive for its lower cost and minimal burden on the health care system. Palliative care is a fulfillment of the command to “love your neighbor as yourself” (Matt 22:39, see also the story of the good Samaritan in Luke 10:20–37).
2. Moral Quandary. Why would it be morally acceptable for a doctor to assist in suicide but not someone else? Is it wrong to assist someone in their death or not? If the intention is to cause a person’s death at their request, how can it be wrong and illegal for one person to do it, but right and legal for another person to do it?
3. The Myth of Legislating Safe Guards to Prevent Abuse. Likely, the answer to the moral quandary mentioned above is that if medical assistance in dying is handled by qualified medical professionals abuse will be eliminated or minimized. However, there is simply no way to legislate safe guards to prevent abuse. How can legislation guarantee the absence of coercion? Quite simply, it cannot. It can attempt to minimize it, but it must be admitted that abuse will occur. How much abuse of the most vulnerable in our society is acceptable?
4. Protecting the Vulnerable. It doesn’t take a research paper to understand that many of our elderly, disabled, and terminally ill patients already feel like a burden to their family, nurses, and those close to them. They need our help and support, not medical assistance to kill themselves to alleviate what they perceive as the suffering of others.
5. Duty Bound to Die. Related to the previous point as the acceptance of medical assistance in dying grows, so will the expectation to avail yourself of that “right.” It will grow not only to allow people to die, but it will become the duty for people to die. The terminally ill, disabled, the elderly, the vulnerable people we’re called to love and protect will feel coerced and duty bound to end their life in this culture of death.
6. Never Enough Allowances and More Lives Deemed Unworthy to Live. As seen in other countries, legalizing medical assistance in dying will not stop with the current legislation. More and more allowances will follow. Why is this an issue? More and more abuses, less and less services for helping those in difficult circumstances, and a growing mindset in our society that those who qualify for medical assistance in dying are not worth anything alive. As these allowances increase we are in fact saying that there are more circumstances where a person’s life is not even worthy to be lived. If you were living in a state that qualified you for medical assistance in dying, regardless if you desired it or not, you will feel unworthy and without dignity since others have deemed your life of such a low quality that it’s acceptable to end your life. To have the right to die means your life is less worthy to live.
7. Religious Liberty of Doctors/Nurses. Canada’s 1982 Charter of Rights and Freedoms says, “Everyone has the fundamental freedom of conscience and religion.” Legalizing medical assistance in dying sets the so-called “right to die” on a collision course with freedom of conscience and religion. Allowances for doctors to opt-out of administering fatal medicine by forcing them to make a referral to another doctor is simply unacceptable. Whether one pulls the trigger, or sends you to someone who pulls the trigger is still murder and still violates the fundamental freedom of conscience and religion.
8. Personal Experience. It doesn’t take long to find stories of those who thought about dying with medical assistance but have been proved wrong.[1] Michael Wenham, having a rare form of motor neurone disease, has not found his life any “less valuable.” He says that for the disabled, chronically ill and the elderly, the campaign for weakening the law “feeds on and fuels our fear” of being regarded as “disposable burdens.” He also believes that for doctor assisted suicide would be an “intolerable reversal of their raison d’être.”[2]
In another case, Martin, facing terrible pain and fearing “being a nuisance” to his hospice nurses, cancer stricken and dying, this ex-soldier asked a doctor to help him die. Instead she arranged for him to attend a parade of cadets he had trained who threw a party in his honor. His remaining days were transformed by new purpose and a realization of his own value to others. Martin died peacefully two days later.[3]
[1] For example, see http://www.independent.co.uk/news/people/profiles/locked-in-but-still-lost-in-music-uks-bravest-dj-7604143.html and http://matthampsonfoundation.org/about-us/matt-hampson
[2] http://tinyurl.com/ks7xtm8
[3] Jeffrey, D. Against Physician Assisted Suicide: A Palliative Care Perspective, Radcliffe Publishing Ltd, 2009, pp. 95–97.