How Should We View Euthanasia And Physician-Assisted Suicide?

Dr. Norman Geisler sheds light on how Christians are to deal with the practices of euthanasia and physician-assisted suicide.

Quebec MDs and euthanasia

Yesterday, the Federation des Medecins Specialistes du Quebec (FMSQ) released results of a survey of their membership in which 3/4 of respondents indicate support for the concept of euthanasia. The FMSQ is a collective of 35 different specialists organizations, interestingly none of them being palliative care specialists.

A story in today's National Post accurately quotes Don Hutchinson of the Evangelical Fellowship of Canada as comparing euthanasia with capital punishment, however the analogy is not completed in the text.

"The laws in our country don't forbid suicide but they do forbid helping someone to take someone's life and there's good reason for that," he said. "An individual may have a moment of expression about dying without a genuine desire to really do so. Look at the number of people who have been let out of prison because we found out they didn't commit a crime. If we had the death penalty, we wouldn't be able to do that."

The completed analogy is that just as a momentary decision on capital punishment can have irrevocable consequences, so to would such a decision in regard to euthanasia or assisted suicide. [MORE]

Executive VP of Ottawa's Society of Obstetricians & Gynecologists: Worried That Palin's Example Will Mean Less Downs Babies Killed

From Andrew Malcom's LA Times blog:

Sarah and Todd Palin's decision to complete her recent pregnancy, despite advance notice that their baby Trig had Down syndrome, is hailed by many in the pro-life movement as walking the walk as well as talking the talk.

But a senior Canadian doctor is now expressing concerns that such a prominent public role model as the governor of Alaska and potential vice president of the United States completing a Down syndrome pregnancy may prompt other women to make the same decision against abortion because of that genetic abnormality. And thereby reduce the number of abortions.

Published reports in Canada say about 9 out of 10 women given a diagnosis of Down syndrome choose to terminate the pregnancy through abortion.

Dr. Andre Lalonde, executive vice president of the Society of Obstetricians and Gynecologists in Ottawa, worries that Palin's now renowned decision may cause abortions in Canada to decline as other women there and elsewhere opt to follow suit.

He says not every woman is prepared to deal with the consequences of Down babies, who have developmental delays, some physical difficulties and often a shortened lifespan.

Wider use of blood screening and amniocentesis during pregnancies can now accurately predict the presence of Down syndrome.

Lalonde says his primary concern is that women have the....

...choice of abortion and that greater public awareness of women making choices like Palin to complete a pregnancy and give birth to their genetically-abnormal baby could be detrimental and confusing to the women and their families.

Read the whole thing @ the LA Times .

Christians and Euthanasia

From www.sfpulpit.com

They list some key definitions:

• Euthanasia consists of any act or deliberate omission taken by oneself and/or others with the specific intention of causing the death of a person and actually causing that death. It is believed by proponents of euthanasia that the death being caused is for the good of the person who is being killed.
• “Active euthanasia” consists of the effort of a person to cause his own death or the death of another. With active euthanasia, the medical cause of death is not disease or injury, but rather the act taken to cause death.
• “Passive euthanasia” is the withholding, withdrawal or refusal of available medical treatment that could clearly enable a person to live significantly longer. The intent of passive euthanasia is to cause a person’s death at a time when death is not imminent.
• “Letting die” (which is distinct from euthanasia) consists of the withholding or withdrawing of all life-prolonging and life-sustaining medications and technologies from a terminally or irreversibly ill patient with whom death is imminent even with treatment. The intention of “letting die” is not to choose or intend death but to enhance the well-being of the patient by avoiding useless prolonging of the dying process.

(Note: These definitions are from Keith H. Essex, “Euthanasia,” The Master’s Seminary Journal 11/2 (2000): 191-212.)

They then provide a Biblical Response: "Death is inevitable and its timing ultimately rests in the hand of God (Deut. 32:39; 1 Sam. 2:6; Heb. 9:27). Life is a gift from God, and everyone has an obligation to value his own life and the life of others regardless of the circumstances. Because Scripture prohibits murder and suicide (Gen. 9:6; Exod. 20:13; Deut. 5:17), euthanasia is never an acceptable option for the believer. In addition to violating the prohibition of suicide, the act of killing oneself is the ultimate expression of selfishness. In the case that the patient is irreversibly terminal and death is imminent regardless of the treatment provided, it is acceptable for the patient or—if the patient is unconscious—a legally authorized third party (e.g., a spouse or family member) to choose to withhold any of the following forms of treatment:

- life-sustaining medication
- life-sustaining, medically-administered nourishment
- life-sustaining support systems

In other words, although Scripture forbids all forms of euthanasia, we believe that “letting die” is an acceptable option in the circumstances described above.

Their summary has some good practical advice: " You and your loved ones may want to consider creating a living will that indicates your wishes regarding medical treatment in order to guide medical personnel in a situation when you are unable to make decisions or choose treatment options".

Sign Your Way to a "Good Death?" -- The Soft Slide to Euthanasia

By Albert Mohler @ http://www.albertmohler.com

Charlotte Allen doesn't want to sign a roadmap that could lead to euthanasia. That's why she refused to sign what is now commonly known as a "living will" when she was diagnosed last year with breast cancer. Writing in Sunday's edition of The Washington Post, Allen recounted her experience overcoming "efforts to persuade me to sign onto the currently fashionable notion of a 'good death.'"

During her hospitalization, Allen was frequently asked to sign a living will. The suggestions came with the implication that such a step was the responsible thing to do -- just accepting one's own responsibility to tidy things up at the end of life. Eventually, she came to feel "ever-so-slightly harassed."

In reality, living wills are a central fact of life and death in medical centers, nursing homes, hospices, and hospitals. Groups such as the American Bar Association and the American Medical Association push living wills and advanced directives as a way of limiting some care at the end of life. In other words, the whole point of a living will is to allow medical personnel not to resuscitate or to deny "artificial" food, water, and breathing assistance.

In the course of her hospitalization and treatment, Charlotte Allen had time to consider what the living will and the concept of a "good death" might really mean. She explains:

In fact, when I contemplate the concept of "dying well," I can't avoid the uneasy feeling that it actually means "dying when we, the intellectual elite, think it is appropriate for you to die." Consider what's happened in recent years: The classic Hippocratic Oath and its prohibition against physicians giving people a "deadly drug" has collapsed with the growing acceptance of such notions as physician-assisted suicide, the "right to die," and even giving some very sick, disabled or demented people a little push over the edge, as seems to be the case in the Netherlands. People facing end-of-life decisions may well feel subtle pressure from the medical and bioethical establishments to make the choice that will save the most money, as well as spare their relatives and society at large the burden of their continued existence. A "good death" -- that's the English translation of the Greek word that begins with an "e." You know, euthanasia.

She also traced how the movement toward a "good death" has spread to places once thought safe from the temptation, such as hospices. As she reports, just a few months ago "the American Academy of Hospice and Palliative Medicine reversed its long-standing opposition to physician-assisted suicide (which is legal in Oregon and said to be quietly practiced by many doctors elsewhere) and adopted a new set of rules that effectively endorsed the practice. The academy even decided on a new euphemism for the procedure: "physician-assisted death." Even where assisted suicide is illegal, many hospices now endorse "terminal sedation," the ethically murky practice of anesthetizing terminal patients, then cutting off their nutrition and liquids."

Changing "physician-assisted suicide" to "physician-assisted death" is a clever manipulation of the language, but it cannot disguise the fact that the key word to the concept is death -- assisted by a physician.

Allen concludes her article in The Washington Post with a flourish:

I wish we lived in a different kind of society, one with agreed ideas about what a "good death" means -- but we don't, at least not now. So I say: Go ahead and sign a living will if you want. Have your doctor pull out your feeding tube or inject you with cyanide or do whatever fulfills your idea of death with dignity. But count me out. I don't want to "die well"; I just want to die in peace.

Christians understand the reality of death, but we must also affirm the gift of life. Furthermore, the Bible makes clear that we are not the masters of our own fates, nor the sovereigns of our own souls. In the end, our lives are in God's hands. This society's transit down a freeway to euthanasia should concern all citizens, but Christians in particular.

The idea of a self-defined "good death" has its place in the pagan cultures of antiquity, but not in the biblical culture of Christianity. Given advances in medical treatments and technologies, end of life issues can be truly vexing and excruciatingly difficult -- even for those who attempt to think ahead. Be sure you know what you are signing when someone presents you with a form for a living will. Are you sure that it is truly consistent with your Christian beliefs? Are you sure that those reading the document will understand -- and follow -- what you sign?

A Threat to the Disabled . . . and to Us All

By Albert Mohler @ http://www.albertmohler.com

The logic of the disability rights movement is easy to understand. Once a society adopts a right to die as a matter of policy, a duty to die cannot be far behind. This logic is already evident when it comes to babies born with Down syndrome. Among many doctors and ethicists, the question has shifted from the right of parents to abort a baby diagnosed with Down syndrome to a duty to abort.

These doctors and ethicists frame the question this way: What right do you have to bring such a child into this world when we already face huge social costs of health care and face scarce resources? This is the logic of the Culture of Death, but it is a logic now argued rather openly.

Disability rights activists understand that this same logic threatens persons with disabilities. When does the argument for a right to die morph into an argument for a duty to die? The question is not merely a matter of intellectual interest. It is a question of life or death.

The Los Angeles Times reports that a bill modeled on the Oregon legislation failed to make it out of a General Assembly committee in June. As the paper explained:

Many disability rights activists contend that the increasingly cost-conscious healthcare system, especially health maintenance organizations, inevitably would respond to legalized suicide by withholding expensive care from the disabled and terminally ill until they chose to end their lives.

Paul Longmore, a history professor at San Francisco State University, argued that assisted suicide would lead to inequities and would not be limited to those with a terminal illness. "Our concern is not just how this will affect us. Given the way the U.S. healthcare system is getting increasingly unjust and even savage, I don't think this system could be trusted to implement such a system equitably, or confine it to people who are immediately terminally ill."

His concerns are clearly justified. These patterns are already clear in countries such as the Netherlands, where the so-called "Dutch cure" now includes policies for infanticide when a baby is born with severe abnormalities. Professor Longmore is also right when he asserts that the grounds for assisted suicide will be broadened beyond what is sold to the public when the legislation is adopted. A look just to the north will be sufficient to prove that point.

Even if legislation could protect those with disabilities from the threat of involuntary elimination, how long will it be before the disabled, the elderly, and others requiring extra care begin to wonder if their loved ones would not be better off with them gone?

Calls for assisted suicide arise at the intersection of human despair and political opportunity. The absence of a Christian worldview leaves personal autonomy as the foundation of ethical choice. Death becomes, of all things, a matter of individual rights.

The only real alternative to this logic is the framework of the biblical worldview -- a worldview that understands every single human life to be sacred, every individual to possess full human dignity, all life to be a stewardship, and death to be a matter for God, not we ourselves, to decide.

Make no mistake. When death is claimed as a right, it will soon become a duty. You don't have to be in a wheelchair to see where that leads.

Euthanasia and the Christian

From http://www.sfpulpit.com

Key Definitions

Euthanasia consists of any act or deliberate omission taken by oneself and/or others with the specific intention of causing the death of a person and actually causing that death. It is believed by proponents of euthanasia that the death being caused is for the good of the person who is being killed.

“Active euthanasia” consists of the effort of a person to cause his own death or the death of another. With active euthanasia, the medical cause of death is not disease or injury, but rather the act taken to cause death.

“Passive euthanasia” is the withholding, withdrawal or refusal of available medical treatment that could clearly enable a person to live significantly longer. The intent of passive euthanasia is to cause a person’s death at a time when death is not imminent.

“Letting die” (which is distinct from euthanasia) consists of the withholding or withdrawing of all life-prolonging and life-sustaining medications and technologies from a terminally or irreversibly ill patient with whom death is imminent even with treatment. The intention of “letting die” is not to choose or intend death but to enhance the well-being of the patient by avoiding useless prolonging of the dying process.

The difference between “letting die” and “passive euthanasia,” then, is this: With “passive euthanasia,” death is not imminent and medical treatment could clearly enable a person to live significantly longer, but with “letting die” the patient’s death is imminent even with treatment (i.e., medical technologies can no longer prevent death). Whereas the former seeks to cause a person’s death, the latter seeks to enhance the well-being of the patient by avoiding the prolongation of the dying process.

(Note: These definitions are from Keith H. Essex, “Euthanasia,” The Master’s Seminary Journal 11/2 (2000): 191-212.)

Biblical Response

Death is inevitable and its timing ultimately rests in the hand of God (Deut. 32:39; 1 Sam. 2:6; Heb. 9:27). Life is a gift from God, and everyone has an obligation to value his own life and the life of others regardless of the circumstances.

Because Scripture prohibits murder and suicide (Gen. 9:6; Exod. 20:13; Deut. 5:17), euthanasia is never an acceptable option for the believer. In addition to violating the prohibition of suicide, the act of killing oneself is the ultimate expression of selfishness.

In the case that the patient is irreversibly terminal and death is imminent regardless of the treatment provided, it is acceptable for the patient or—if the patient is unconscious—a legally authorized third party (e.g., a spouse or family member) to choose to withhold any of the following forms of treatment:

- life-sustaining medication
- life-sustaining, medically-administered nourishment
- life-sustaining support systems

In other words, although Scripture forbids all forms of euthanasia, we believe that “letting die” is an acceptable option in the circumstances described above.

You and your loved ones may want to consider creating a living will that indicates your wishes regarding medical treatment in order to guide medical personnel in a situation when you are unable to make decisions or choose treatment options.