Human Dignity: Euthanasia, Assisted Suicide, And The Moral Dilemma (Essay)
Estimated reading time: 33 minutes
Content Warning: Discussions of Death, Dying, and Suicide
This is, of course, a delicate and emotive subject. The question of Human Dignity and Euthanasia is an important one which must be discussed, but we also need to take care of our own well-being within that discussion.
Please be aware of your own circumstances when reading this piece and, if necessary, seek support afterwards if any of the points for discussion have left you feeling unsafe or if you have been negatively affected by the points of discussion.
Introduction
I am intending to give an overview of the questions and issues surrounding Euthanasia and offer a starting place for further reading. This is not an in-depth discussion as that would take an entire book. But it can help to show where the discussion is going, what questions need to be asked, and where we can go to learn more for ourselves about this important issue.
Assisted suicide, intentionally helping another person to end their life, is illegal in England, Northern Ireland, and Wales, carrying a maximum prison term of 14 years.
In 2015, in the UK a bill to make assisted dying legal was brought forward and defeated by 300 to 118.
The question of the morality and ethics of Euthanasia is a significant factor in our current life. For the church, this is a key question which goes to the very heart of some key Christian assumptions about what it means to be human and the value of life.
Taboos, Death, and Suffering
Where do we die?
Most of us have a distant relationship with death. We very rarely encounter it until an elder member of our family dies. Unless we are involved in an accident or one of our friends gets ill, it is unlikely that we will have a direct experience of death.
Even when people we know die, they are now more likely to die at hospital than at home. It used to be the case that most people would die at home, with people around them. Now, most people die in hospital. More than at any other time in history, we are protected from the experience of death by the context and structures of our society.
Similarly, we are generally protected from real suffering in our lives. Unless we have an accident or someone we know gets seriously ill, we are generally protected from most forms of suffering.
We have painkillers that would have been considered almost magical to people just a few centuries ago. When we get ill, we can receive medical treatment, and when we get seriously ill, we will go to the hospital and get treated there.
Just as we are insulated from death, we are insulated from suffering. When we are confronted by death or serious suffering, it is a disruptive event. That experience can have lasting and traumatic consequences for the observer because we are so set apart from experiences which were once an everyday part of life.
This means that, in many ways, the debate around euthanasia is one which draws from personal trauma.
A Good Death? – The Classical World
The word euthanasia means a ‘good death.’
The idea of bringing about a good death predates the recorded use of the word. The use of Hemlock to hasten death was used on the island of Kea and in Massalia. Plato and Socrates both wrote in favour of hastening a person’s death to avoid a bad death and bring a good death.
However, Hippocrates (of the Hippocratic Oath) wrote: I will not prescribe a deadly drug to please someone, nor give advice that may cause his death. Although there is some discussion about whether this specifically included Euthanasia.
The first recorded use of the word comes from the historian Suetonius, who described Emperor Augustus’s death as the ‘euthanasia’ he had wished for because it was quick, without suffering, and in the arms of his wife, Livia.
Euthanasia – the theologians and the philosophers
Euthanasia was used in a medical sense for the first time by Francis Bacon in the 17th century, referring to an easy and painless death where the patient was happy, during which it was the physician’s responsibility to alleviate the physical suffering of the body.
Bacon made a distinction between outward euthanasia, where the physical sufferings of the person end through a painless and happy death, and inward euthanasia as a spiritual concept where the soul is prepared for death and so experiences it as a positive moment.
There were two elements of what a good death meant. A death without pain where the person could easily pass from one life to the next with their family around, and a death where the soul of the believer is prepared to meet God and is not in fear of what comes next.
A good death was not only about the person’s physical experience but about their spiritual reality.
The Impact of Thomas Aquinas on Euthanasia
Thomas Aquinas wrote against the practice of Euthanasia, arguing that it contradicted both our natural human instinct for survival and our sacred nature as God’s creations.
Aquinas draws out two elements of human nature which he believes Euthanasia is opposed to. For Aquinas, the instinct for survival is inherent to being human. Aquinas builds upon Aristotle for his philosophical approach, which includes the idea that the nature of a creature is integral to their behaviour.
Part of being human is the desire, the need to stay alive. For Aquinas, to go against the desire for self-preservation is to go against what it means to be human.
Aquinas also brings out a second element which other people will draw upon in the discussion of Euthanasia – that life has a sacred quality to it.
The Sanctity of Life
There is a quality to humanity which is not determined by humanity alone but by the relationship between humanity and God.
Humanity exists in relationship to God as created and sustained by God’s desire and intent. Humans, as bearers of God’s image, are sacred representatives of God in the world.
To attack, harm, denigrate, or kill a human being is to attack God. In this sense, Euthanasia is seen as an affront to God by destroying something that is made in God’s image and shares in the sacred quality of who God is.
The Western understanding of suicide, and thus Euthanasia, has been heavily influenced by the language of sin.
Especially when such actions have been directly understood as a form of self-murder. Suicide was a crime in the UK until 1961. Prior to 1961, if someone was successful, then their family could be prosecuted. If they failed, they could be imprisoned.
Suicide was understood as self-murder, drawing on those ideas of the sacredness of human life. A person did not have the right to die.
But a distinction was made between martyrdom or an heroic sacrifice for others and suicide. Like with so much of this debate, it comes down to context.
The Historical Context of Euthanasia
King George V was euthanised through an injection of morphine and cocaine to hasten his death when he was struggling with respiratory failure. It was not revealed at the time but came out later when the diaries of the doctor became public.
There is some discussion whether that decision was made to end the King’s suffering or to make sure the Palace could secure the news cycle to announce the next monarch in the morning press.
The massive elephant in the room in discussions around Euthanasia is that the Nazis murdered more than 70,000 adults and children with physical and mental disabilities.
They regarded this as Euthanasia. It wasn’t Euthanasia, it was murder. There was no good death in that process.
However, this was not far from the opinions of many people in Britain. There was a movement in Britain in the 1880s through to the 1930s calling for a Eugenics programme based on the practice of Euthanasia.
They regarded the killing of ‘undesirable elements’ as offering them a good death. Obviously, no one except racists holds that position.
Government Definition of Euthanasia
The British House of Lords Select Committee on Medical Ethics defines euthanasia as a deliberate intervention undertaken with the express intention of ending a life to relieve intractable suffering.
This means that Euthanasia must be to relieve intractable suffering. Not boredom or because a person feels it’s the right time to die. It is about ending a person’s suffering.
The key point of a good death is that it is voluntary, that it is painless, that the person dies happy, and that the killing is undertaken to end suffering. Not just any suffering, but intractable, unending, unendurable suffering.
Who Decides How Much Suffering Is Too Much Suffering?
One element to consider is who determines how much suffering is too much.
Does the person get to determine for themselves that their suffering is too much? In that case, it will always be a subjective measure. What one person considers to be intractable suffering will be different from another.
Should there be any other systems in place or is it only the experience of the individual suffering that determines when they are eligible for euthanasia?
Suppose there is another system, another set of rules against which a person’s suffering must be measured to be approved for euthanasia. In that case, it means that someone who is not experiencing that suffering gets to determine if that suffering is too much.
In one case, you might have someone seek euthanasia for something which seems trivial to other people but is subjectively experienced as intractable suffering by the person who wishes to die. In the other, you must have someone feeling that they are going through extreme suffering but a committee does not agree with them and refuses them permission to be euthanised.
There is no easy answer to who determines if someone’s suffering is too much. Either case has problems.
Is it Ever Morally Right to Kill?
A crucial part of this question is whether it’s ever ok to take a life.
The legislation being put forward in the House of Commons is for assisted dying – helping someone else to act to end their life. There is no direct action by the doctor.
However, there is a degree to which the doctor is helping that person to die. Also, other forms of Euthanasia include more direct action.
Whether it is helping a person to kill themselves or actively ending someone’s life, euthanasia is a form of killing. Either killing oneself or killing another person. Thus, we must ask whether it’s ever ok to kill.
There are some Christians who say it is never ok to kill a person. Each human life is sacred and unique, of infinite value, and should not be brought to an end.
For other Christians, there are times when it is ok to kill. Some Christians support capital punishment. Some support killing during a war and do not think it is morally wrong. Others will believe that it is ok to kill in defence of your family or loved ones. Some will say it is ok to prevent another person from being oppressed, tortured, and killed.
When Christians cannot agree on when it is or is not ok to kill, then it should not be surprising that Christians disagree on euthanasia.
I suggest that unless you are a hard-line pacifist and regard all killing as always morally wrong, then the question is not about the death but the circumstances of the death. When is it ok to kill.
If it’s ok to kill to protect a person’s life or prevent someone from being oppressed or tortured, then wouldn’t it also be on to kill to end a person’s suffering when it is their own body or kind which is torturing them, especially if they have asked for it?
Do we regard suicide as a sin? Some Christians do think suicide is a sin and consider it as self-murder and hold that no forgiveness is possible because there is no time for repentance after the act.
Others say that suicide is a sin but is forgiven because of the circumstances. Others say it is not a sin because it is not killing or murder but is the end of pain and suffering by a person against themselves.
If you are thinking about Euthanasia, then you need to ask yourself some hard questions about fundamental principles even before you get to whether it’s ok to help people die. How are you reading the Bible when it comes to killing? How are you reading the Sermon on the Mount?
Then, ask what is more important to you. A principle or a person. Is your system of beliefs more important than another person’s decisions? Do you think that your beliefs are correct for everyone, even if they don’t share your beliefs?
If you can’t answer those questions, you won’t be able to get to grips with the question of Euthanasia.
The Primacy of Individual Autonomy in Euthanasia Ethics
We live in a society that prioritises individual Freedom.
The personal liberty of each individual is an almost sacred element of Western Democracies. In the UK, the foundations of the idea of a person’s essential liberties can be found as far back as the law codes of Alfred the Great or, more famously, in Magna Carta.
Since the seventeenth century, politicians have had to balance the individual’s liberty against the well-being and safety of the group. In the eighteenth and nineteenth centuries, the growing abolitionist movement highlighted the dangers of a democracy—it is essentially mob rule.
The role of elected representatives is sometimes not to represent the interests of the majority but of the minority, especially when those interests are at odds.
A Populus poll taken of the UK public in 2015 showed that 82% of people supported introducing assisted dying laws. Amongst people with disabilities, that number was 86%.
In the US state of Oregon, where euthanasia was legalised, research showed that in 2013, the top reasons for euthanasia were a loss of dignity and not wanting to be a burden on others.
Part of the Euthanasia question revolves around these very old debates. What has priority: the freedom of the individual to choose for themselves or the safeguarding of a society or subsection of that society?
Absolute or Relative Morality?
Is something true for everyone, or is morality based on culture and context?
There are competing truth claims at work in the discussion about Euthanasia. Some say it’s a person’s right to decide when and how they die. Some say they think the act is wrong but that people should choose. Some say killing is always wrong, but in some specific circumstances, it is understandable and acceptable. Some say it will never be okay at all, ever in any circumstance.
These claims are in competition with each other. They cannot be held together because for the people who think Euthanasia is a moral good and for the people who think it is a moral evil, there is no middle ground. Death is an absolute, and thinking around the morality of killing tends to be absolute as well.
Both sides of the absolutist perspective clash with those who hold a more relative perspective.
Some argue that something might be morally wrong as an act in the abstract, but in the concrete personal context, what was morally wrong in the abstract becomes morally correct in the particular. Killing is wrong, but sometimes killing is the right thing to do.
This often results in what’s called moral injury, where a person feels compelled to act against their core mortality in order to love and care for someone in need. This causes a moral injury, which results in guilt and sometimes shame. But a person can choose to accept that guilt for the other person’s sake.
For others, it is simply a matter of freedom under the Law.
The law of the land is not a moral construct but is designed to constrain chaos and destruction while promoting order and equality. British law might have originated with some basic Christian principles, but it was developed across the millennia in specific cultural contexts that were not Christian.
British law owes as much to Erasmus, Hobbes, Locke, and Gladstone as it does to Scripture.
For some, the law should give the greatest possible freedom to the greatest possible number of people to the extent that one person’s freedom does not harm another.
From a Christian perspective, how do we reconcile a moral stance based on an absolute system of morals with an issue that is deeply rooted in the lived experience of human life?
From a position that emphasises personal autonomy, how do we balance personal freedom with our responsibility for collective well-being?
Individual Freedom vs. Collective Freedom
How do we balance personal freedom with our responsibility for others?
With Euthanasia, we take the position that people should be free to make the decision to end their life or seek help to end their life, and we also need to be aware of the need to protect the more vulnerable elements in society.
As I will mention later, it is easier for people with more personal resources and wealth to support their loved ones or themselves through times of suffering and dying. They can afford private health care, hire live-in carers, and take time from work to be with family members.
People with fewer resources or who have less money may have less recourse to support or may not be paid the same attention by the system, and so may feel that Euthanasia is the only option left when suffering or facing an undignified death.
Key Areas of Concern
As a society, we have prioritised reason and communication as a sign of capacity and personhood. This is part of the reason that dementia and other forms of cognitive impairment provoke such intense fear and revulsion. Because we feel that it robs us of who we are.
Rather than lose ourselves, we would prefer to choose while we still think and act like ourselves, or at least who we believe ourselves to be. But if we de-prioritise intellect and communication, then we can arrive at an alternative perspective on identity and personhood, which can free us from that fear.
Alongside that fear is the choice whether to act on behalf of another person when they are experiencing something we are scared of. If someone has not made their desires clear, then is it possible to make a decision about their life without them?
This is different from someone in a coma on life support in a vegetative state. It’s the person who is suffering, who is still alive but is unable to make a decision. Can someone decide for them if they should live or die?
Older people and people with long-term care needs asking for Euthanasia where it is legal have said one of the main reasons was not wanting to be a burden. The modern-day equivalent of the grandparents walking into the storm so the rest of the family can survive the winter with two fewer mouths to feed.
How do we give the freedom for someone to choose to end their life without putting pressure, implicit or explicit, on older people or vulnerable people to end their lives so they are not a burden on their loved ones. There needs to be clear protections, but laws change as opinions change. Is it easier to just always say no?
People with long-term and severe mental ill-health or personality disorders might be open to abuse and pressure to undergo euthanasia. Again, this does not have to be explicit pressure. It is simply from an increasing societal expectation that people who are in that condition are more likely to undertake Euthanasia.
Will being homeless become a reason to seek euthanasia? It is a form of suffering. For some, it is unendurable and unending. At what point does it become acceptable for someone who is experiencing homelessness to seek Euthanasia? It’s cheaper for the government than housing them. It’s easier for society than to be made to feel guilty about them.
Another concern is the rise of ‘influencers’ as part of society, especially amongst young people. How long would it be before there were Euthanasia influencers? People who encouraged others to seek Euthanasia, and in response, people who wanted to livestream their Euthanasia.
Clear and specific safeguards need to be in place to ensure that an individual’s freedom does not harmfully impact the most vulnerable members of our society.
The problem is, as will be seen later in the Netherlands’ example, once one element has become legal, it becomes easier for other forms of Euthanasia to become legal as well, especially as society’s views adapt and change over time.
Different Kinds of Euthanasia: Voluntary, Non-Voluntary, and Involuntary
There is a distinction that must be drawn between voluntary, non-voluntary, and involuntary euthanasia.
Voluntary euthanasia is where the person has made an informed decision and given their express consent to be euthanised.
Non-voluntary euthanasia is where the person is unable to give informed consent.
Involuntary is where the person can give informed consent but does not, either because they do not want to die, or because they were not asked.
Involuntary euthanasia is a crime and has a dark history of being used within the practices of eugenics.
Non-voluntary euthanasia has a complicated moral dimension because someone else is making the decisions for another person’s life. There is a degree to which turning off a life support machine for someone can be considered non-voluntary euthanasia, depending upon definitions of life at that point.
Fears about involuntary and non-voluntary euthanasia frequently affect the debate about voluntary euthanasia. The concern is that once one form of euthanasia becomes acceptable, there will be a ‘slippery slope’ which will lead to non-voluntary euthanasia becoming legal for people who are not able to give consent such as children or people with cognitive impairment for example.
Further, we can consider the difference between passive and active Euthanasia.
Passive Vs Active Euthanasia
Passive Euthanasia is the withholding of treatment necessary for the continuance of life. Some also consider stopping eating to be passive Euthanasia.
Active Euthanasia is a procedure which directly leads to the death of a person.
Some practices, like giving increasingly potent doses of painkillers with decreasing intervals in-between, which are intended to relieve pain but are at a toxic level, walk a line between passive and active Euthanasia.
There is a difference between the intention and the consequences. Something which we will return to in a moment.
A Slippery Slope? A Case Study of The Netherlands
In 2002, Euthanasia and physician-assisted suicide became legal where the individual was suffering, they requested the procedure, and there was not a reasonable alternative.
In practice, this means that it is limited to those suffering from serious medical conditions like severe pain, exhaustion or asphyxia. Sometimes, psychiatric patients that have proven to be untreatable can get euthanasia.
In 2003, in the Netherlands, 1,626 cases were officially reported of euthanasia in the sense of a physician assisting the death. Here, the doctor administered a series of injections to induce a coma and then to end breathing.
Officially reported were also 148 cases of physician-assisted dying where the person drinks a ‘potion’ provided by a doctor while the doctor observes. In 41 cases, the potion did not cause death but rather vomiting, so the doctor had to inject drugs instead.
In 2010, there were 3,136 cases reported of a physician assisting the death of a patient. When categorised, there were 2,910 cases of “end of life on request”, 182 cases of assisted suicide, and in 44 cases it was a combination. The evaluation commissions decided that in 9 cases, the procedures were not according to protocol.
In 2016, the number of official cases of euthanasia in the Netherlands was 6,091, which was 4 % of total deaths in the Netherlands.
In 2017, the number of reported euthanasia had increased to 6,585. An average increase in numbers seeking the procedure of around 8% per year.
In August 2019, a Dutch doctor was prosecuted for failings in a 2016 case in which sedatives were put in a dementia patient’s coffee, and her family asked to hold her down when she struggled against the euthanasia injection.
Cases involving psychiatric suffering and dementia are, however, relatively rare. In 2010, there were two cases involving psychiatric suffering; in 2023, there were 138 – 1.5% of the 9,068 euthanasia deaths. In 2018, there were 6,126 cases of euthanasia (compared to 6,585 in 2017): 1% involved psychiatric conditions and 2.4% dementia. Two-thirds were requested by people with terminal cancer. Assisted dying for people with psychiatric illnesses in the Netherlands remains unusual, although the numbers are increasing.
In April 2023, euthanasia was expanded to include children of all ages who are in unbearable suffering. Children between 12 and 16 need the consent of their parents. Between 16 and 18, the parents don’t need to consent but should be included in the process. Also legal for babies up to a year old with parental consent.
In 2024, Zoraya ter Beek received the final approval for assisted dying after a three-and-a-half-year process. She said to the Guardian: People think that when you’re mentally ill, you can’t think straight, which is insulting…I understand the fears that some disabled people have about assisted dying, and worries about people being under pressure to die…But in the Netherlands, we’ve had this law for more than 20 years. There are really strict rules, and it’s really safe.
Ter Beek’s difficulties began in early childhood. She has chronic depression, anxiety, trauma and unspecified personality disorder. She has also been diagnosed with autism.
Now the point has come, we’re ready for it and we’re finding a certain peace. I feel guilty too. But sometimes when you love someone, you have to let them go
A 2009 paper entitled “Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain?” It was written by researchers from the Department of Public Health in the Netherlands. It found that:
…public control and transparency of the practice of euthanasia is to a large extent possible…The frequency of ending of life without explicit patient request did not increase over the studied years
The researchers claim that there has not been a slippery slope within the practice and legality of euthanasia within the Netherlands. However, it is clear that once the practice was legalised, the number of people seeking the practice increased. The practice has also widened to include mental illness and children.
This shows that once the practice becomes legal, it will become more acceptable and understandable. Which can lead more people to seek it out. It also makes it easier to broaden the practice. Whilst the fundamental rules that it must be consenting and based on unendurable suffering have remained throughout the process, there are examples of a breakdown in the policy. There are also debates on what constitutes unbearable suffering.
If Assisted dying became legal, it would be easier for other forms of Euthanasia to become legal, and it is likely that the number of people seeking the practice would also slowly trend upwards.
Investment in Community and Palliative Care
The alternative to Euthanasia is an increase in investment for care in the community and for palliative care, from central and local government as well as through faith groups and charities.
In order to avoid people desiring to kill themselves, there must be alternatives which work to decrease pain and increase personal dignity whilst also being cost-effective for the user and their supporters.
The Cost of Caring
The cost of caring includes both finances and time.
For the person suffering or experiencing a loss of dignity, it is increasingly difficult to get medical appointments in a timely fashion. Especially with support for mental health, the waiting time for treatment can be up to or over a year.
People who cannot afford to go private for treatment or care or to gain access to drugs and services not available through the NHS might be more likely to seek assisted dying or other forms of Euthanasia than those with more resources.
However, at the moment, the converse is true, as those with resources can afford to leave the country for a clinic for assisted dying.
Caring for a loved one who is suffering, who has lost physical or mental capacity, and who might still live a long time whilst in such a condition of suffering is costly in both finances and resources.
Decisions have to be made about whether they can afford home help and carers or whether they can afford a place in a care home.
For those who can’t afford it, they will have to decide how much of their own time they can give for looking after a loved one. They might have to give up their job and rely on government support. They might be able to use their annual leave or sick leave to help their loved one.
There is also the cost to family life. If time is invested in supporting and caring for a loved one, that has an impact on other family members. There might be less time available for children or partners.
Looking after a loved one who is suffering or dying has a cost to the wider family.
Better workplace options for supporting loved ones in those situations are needed. Carers and home help new need to be more readily available and better trained in their roles. Effective care in the community is essential. An increase in carer’s allowance for those looking after their loved ones would also be needed.
Networked Family and the Difficulty of Distance
A century ago, most families lived in the same area of the country. They would often share a multi-generational house. People lived and worked in the same community and were more able to support each other during times of suffering or when someone was dying.
Now, we live in an increasingly networked society. People often live away from parents or siblings. Travel can take a long time. Also, we increasingly lack relationships with people in our local area.
When something goes wrong, there may not be someone nearby to support us. This can make it difficult for family to look after a loved one who is dying and suffering.
Some people temporarily move in with a family member or move them into their own home. But many do not have the space to do so or are trapped by their work and cannot leave their homes.
Others travel long distances regularly to be available and around for their loved ones. But this is not always possible because of time and costs.
For people suffering or dying, being far away from their family or supporters can increase isolation, which increases relative suffering. It can also make a person feel guilty when their family or friends have to keep travelling to see them.
Being isolated and alone makes everything worse, especially when experiencing suffering or facing death.
Who Fills The Gaps in an Individualistic Society?
When the family isn’t able to support a person, or when they are socially isolated, who is there to support a person when they are in unbearable suffering or when they are facing their decline and death?
Unless there are sweeping and serious changes to the way that health and community services are funded, there will be a huge gap in the welfare state for people who are in chronic and unbearable pain and for those who are increasingly feeling a lack of dignity as they head towards their death.
Due to the general economic problems facing the country and the wider world, charities have less financing to provide direct support for people in need.
Faith groups are increasingly bearing the burden of filling the gap between stage and charity in the provision of care for people in need, a gap that cannot simply be filled with energetic amateurs.
There is a need for trained home help as well as community carers. Specialist medical practitioners working in the community with the capacity to provide pain relief. Financial relief for people with terminal illnesses, especially where there is significant pain and physical or cognitive impairment.
Befriending services to make sure people aren’t alone. The ministry of final presence so no one has to die alone and afraid. There is no single answer, but there are lots of things that can be done together to transform the way that people die.
Dignity and Sanctity
People on every side of the debate about Euthanasia appeal to human dignity. But it is used in different ways.
For some people, dignity refers to the sense that they have control over their decisions and are listened to and attended to. A person’s dignity in the sense of personal freedom also means the things that make a person feel comfortable, respected, and in control. This can be emotional and physical.
This is dignity, which can be taken away or lost. It is contingent upon circumstance and, crucially, upon appearance to the people around them.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355899/
In contrast to this is an understanding of dignity which is dependent not upon contingent circumstances but upon what it means to be a person. Rowan Williams writes:
Another way of putting this is that we ascribe personal dignity or worth to people – to
human individuals – because of that sense that in relationship each of us has a presence
or a meaning in someone else’s existence. We live in another’s life. To be the point
where lines of a relationship intersect means that we can’t simply lift some abstract
thing called ‘the person’ out of it all. We’re talking about a reality in which people enter
into the experience, the aspiration, the sense of self, of others. And that capacity to live
in the life of another – to have a life in someone else’s life – is part of the implication of
this profound mysteriousness about personal reality. Deny this, and you are back with
that deeply unsatisfactory model in which somebody decides who is going to count as
human.
This kind of dignity emerges simply from the fact that a person has meaning inherent in themselves, not for what they can do, for what they experience, or for the context within which they are located. We experience this sense of dignity in each other because we participate in each other’s lives. We see in that person a common and shared humanity. This also has something to do with what Aquinas was talking about. That our identity as humans is not dependent upon us alone but also in who Christ is.
The Salvation Army Position Statement on Euthanasia and Assisted Suicide
The Army believes that everyone deserves compassion and dignity in their suffering and death but that Euthanasia and Assisted Suicide are not acceptable responses to that suffering. The Army sees Euthanasia and Assisted Suicide as undermining human dignity.
The positional statement gives these clarifications:
- All people deserve to have their suffering minimised in every possible way, consistent with respect for the sanctity of life.
- It is not suicide for people to choose to refuse or terminate medical treatment.
- It is not euthanasia for health care professionals to withhold or withdraw medical treatment that only prolongs the dying process.
- To provide supportive care for the alleviation of intolerable pain and suffering (e.g., by way of analgesics) may be appropriate even if the dying process is shortened as a side effect.
The Army emphasises its support of human autonomy but puts that into the context of the infinite value possessed by all human life. Humans don’t have the right to death by their own act or to commission someone else to end their life.
Human life is a gift from God, inherently sacred, and possessing an eternal destiny. This life is not our end goal, and death is a transition from one life to the next. Pain and suffering cannot always be overcome, and in those moments, the Christian community is called to demonstrate the love of Christ in their relationships with each other.
https://www.salvationarmy.org/ihq/ipseuthanasia
Primary Intention and Secondary Consequences
This is an ethical model called the rule of double effect. It can get quite complicated, but in essence, it says that a person may take an action based upon one intention and that, as a result of that action, secondary, unintended consequences occurs.
In this context, the intention is to end pain and suffering. The consequence of the action is to hasten death or cause the death of the individual suffering. However, if the secondary consequence could be foreseen or could be reasonably prevented by altering the initial intention, then the person is still responsible for the secondary consequence.
This principle has been used in palliative care and the withdrawal of life support for people in end-of-life care. It is less applicable for people who are actively seeking to end their life because in those cases the primary intention is death and the secondary consequence is the end of suffering or the restoration of dignity.
https://plato.stanford.edu/entries/double-effect/
Loving The Neighbour – Who Determines What the Most Loving Thing Is?
We are commanded to love our neighbour as ourselves. This underpins Christian ethics and morality. But who determines what loving thing to do for our neighbour is? Is it loving to do what they ask and ease their suffering, or is loving to stand with them in their pain and hold space for their humanity in the experience of dying?
There is a question to be asked here, similar to the ones already asked. Do we owe allegiance to our moral principles or to the needs of the person directly in front of us?
If someone we love asks us to end their suffering, is it better for us to say it is wrong to do so and that you must remain in your suffering, or is it better to say, “I believe that this is the wrong thing to do, but I will do it because I love you?”
Where do we draw the distinction between what we believe and what the other person believes? Which again comes back to the question of whether the beliefs of one group of people should be taken into consideration when passing a law that over 80% of the population want to happen.
Does loving the neighbour mean putting our own moral position to one side, accepting any guilt that we feel, in order to serve the person in need? Or, does loving the neighbour mean campaigning on their behalf, speaking for them, fighting for them, that they know they do not need to go through with the end of their life, there are other options for them.
A Prophetic Role?
The church has a prophetic role to play in the discussion about whether Euthanasia is something which should become law. Even in the smaller degree which has been suggested by the new legislation. The church has something distinctive to say about life and death and suffering, something which can only be said in the context of Christ.
Suffering and the Cross
Historically, there has been a great tradition of identifying our sufferings with the sufferings of Christ.
From about the 12th Century for roughly four hundred years or so, there was a sense that suffering, especially suffering as a process leading to death, was a deeply mystical experience. The person in pain, and the person who was dying, was closest to Christ. Closer than priest or pope. This was because they were experiencing part of what Christ experienced when he died for us on the cross.
This mystical understanding of suffering has been lost following the religious wars of the seventeenth century and the tragedies of the 20th century. But for a long time, it held sway within the Christian idea of suffering.
People were encouraged to accept and embrace the sufferings of life. Sir Thomas Moore famously said that no one gets to heaven on a feather bed but that only suffering will open the gates of heaven. It raised up the poor and the broken to the heights of spiritual experience.
It did have the unfortunate consequence that people started to inflict suffering on themselves by starving themselves, harming themselves, and putting themselves through extreme hardship. This was done to bring the person into the experience of the crucifixion and so share with Christ in his passion.
Is there a chance for the church today to reclaim some of that mystical understanding of suffering? Rather than understanding suffering as something to flee from, as something to be avoided, it is instead embraced as a way of being close to Christ.
Perhaps, the church should return to a way of understanding suffering and death which is held in relationship and unity with the experiences of Christ. Can suffering be transformed into something holy?
To Speak for Those With No Voice
The church has a sacred duty to advocate for those who are not heard or who have no voice. This includes people from social demographics who are overlooked or who lack the social capital to affect change in their community.
The church should have a public voice to ensure that the good of the vulnerable is not forgotten in the cult of personal freedom. This can put the church at odds with society, and it can be seen that the church is seeking to impose a particular set of values onto people who don’t hold to them.
But the reality of the Gospel is that it is universal.
The truths it proclaims are true for everyone, regardless of whether a person believes them or not. People do have an inherent dignity which is not determined by contingent factors. People have unique and infinite value in who they are, not in what they can do, and this must be protected.
Return of the Goodwill Department
Perhaps the Army is particularly well placed to try and provide an alternative. Regardless of whether Euthanasia in some measure becomes law, if there are alternative options then it is less likely to happen.
There are historical examples in the Slum Sisters and the Goodwill department of the Army providing incredibly effective community service. Female officers were trained to lay out dead bodies for paupers’ funerals.
Slum Sisters would live and serve in the poorest communities, take qualifications in community nursing or first aid, and would take care of the ill and the dying, being with them and caring for them in practical ways which allowed for the family to continue to go to school and to work.
Goodwill officers provided spaces where people could find fellowship and friendship, practical assistance with food and heating, and where people would receive care at home as well.
Could this element of Army service be reclaimed? Perhaps through hiring ‘parish nurses’ or having a community care worker in every corps who can provide subsidised home help to people who need it.
Demonstrating Christ’s Love and Compassion
But regardless of what we believe about the morality of euthanasia, we must always approach the decisions that people make with absolute and enduring compassion.
We must not judge people’s decisions but be there with them, loving and caring for them, holding them in prayer and providing practical service to support them through the most difficult times in their lives.
This may be difficult for us, but it is the only way that people will listen to them when we offer a different way of living.
Further Reading
https://www.christianitytoday.com/1976/02/mercy-killingis-it-biblical/
https://www.christianity.org.uk/article/assisted-dying
https://christianconcern.com/resource/what-does-the-bible-say-about-euthanasia-and-assisted-suicide/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402774/
Conclusion
I hope that this article has been helpful and constructive for you. It’s a big topic and one which has very real consequences for some of the most vulnerable and suffering people in our society.
This must always be more than just an intellectual debate – this is about people’s lives and can inspire hire emotions. Thank you for reading to the end, and I hope that it inspires you to undertake further reading and to think more about this question.
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