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A Christian Case for Assisted Dying

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A Christian Case for Assisted Dying A Christian case for Assisted Dying The teaching of Jesus In exploring Christian perspectives on death and dying one starting point is to look again at Jesus’ teaching. For Jesus the whole of religious law and prophetic teaching can be summed up by saying that we should love God and love our neighbours as we love ourselves. Jesus’ golden rule was that we should always treat others as we would like them to treat us.i These sayings of Jesus are is highly relevant to the question of assisted dying. In his Essays in Bioethics, Professor R.M. Hare argued that “there is no moral question on which Jesus teaching has a more direct bearing that on euthanasia”ii It was this that led the Church of England report On Dying Well to the conclusion that although they did not want euthanasia to be legalized, they could not say it was always wrong. They admitted that “there are bound to be cases where any of us who is honest with himself would wish to have our own deaths hastened so that the manner of them might be less unbearable. Thus a direct application of the teaching of Jesus to these cases would legitimize at least some instances of euthanasia”.iii This is relevant to the present debate because polls show that between 81 and 87 % of the population would like the option of an assisted death if they found themselves suffering unbearably in the final stages of a terminal illness.iv Some doctors share this perspective and have made pacts to help each other out if they should ever be in the condition of some of their patients.v Allowing such assistance to be given openly would enable such doctors to treat their patients as they themselves wish to be treated. Thou shalt do no murder In the face of this why are some Christians opposed to assisted dying? One reason is that the 6th. of the 10 commandments says “Do no Murder”vi and to give a person a deadly poison is to kill them. However the reason every human civilization sees murder as the worst crime of all is that murder deprives a person of every good thing that life can offer. But a person in the final stages of a terminal illness is already being deprived of every good thing that life can offer by the dying. They simply want help to hasten that process. That alters the situation. However the natural abhorrence at taking another person’s life is the reason why in Britain the campaign is for assisted dying rather than voluntary euthanasia. In voluntary euthanasia, the doctor administers a lethal drug. In assisted dying it is essential that patients are able to self-administer so that right to the very end it is their own decision to bring their suffering to an end. 1 Suffering as part of God’s plan However, bringing suffering to an end is not always seen as a good thing. According to Pope John Paul II “suffering, especially in the final stages of life, has a special place in God’s plan of salvation.” Consequently he argued that dying Christians should moderate their use of pain killers so they can share in the suffering of Christ vii This view challenges both palliative care and assisted dying and is, of course, very similar to what all Christians used to think about the pains of giving birth. According to the Bible ‘women shall bring forth children in pain’.viii That suffering too was seen as part of God’s plan of salvation. But few Christians think like that today and women can be grateful that Queen Victoria insisted on her right to chloroform in childbirth and thereby changed the situation for all women. Should only God determine the hour of our death? One argument often used against assisted dying is that only God should determine the hour of our death. The difficulty with this is that today almost no-one consistently believes it. If we did believe it then we would think it just as wrong to use medical means to extend life as to shorten it. In past ages many Christians held precisely that view. Today if a person’s heart stops we assume that resuscitation should be attempted ‘unless there are convincing reasons not to’ ix Yet for most of human history the time when the heart stopped was seen as the time God had chosen to end that person’s life. The parallel between birth and death There is also another parallel to note .At the beginning of the twentieth century almost all Churches opposed family planning, on the grounds that God alone should determine when a new human life begins. The Vatican still teaches that but almost all other Christians think it right to plan their families for themselves. But if it is right to seek medical help and assistance in the timing of birth and in the avoidance of suffering during birth , why is it wrong to seek medical help and assistance in the timing of death and in the avoidance of suffering while dying? The peril of ‘sliding down a slippery slope’ By far the strongest argument against changing the law is that it might have unforeseen consequences. During the 1960’s Parliament legalized abortion, made divorce easier and decriminalized homosexuality. In all three cases the legislation was directed at ‘hard cases’. Abortion was for when a mother’s health was at serious risk, divorce was for when a marriage had irretrievably broken down, and homosexual reform was to prevent consenting adults being blackmailed. No-one imagined that within fifty years we would have abortion virtually on demand, 40% of marriages ending in divorce and homosexuality being seen as on a par with heterosexual relationships. So to it is argued once we “cross a line” and allow 2 assisted dying for the terminally ill, we might set ourselves on a course which could end very differently The fears of religious leaders about allowing assisted dying. In their response to Lord Falconer’s Commission the Catholic Bishops in England and Wales predicted that “A Right to die would rapidly lead to a duty to die”. The Church of England Council on Mission and Public Affairs claimed that that allowing assisted dying would negatively redefine health care, damage the relationship between doctors and patients and have far reaching effects on the nature of our society. An editorial in the Church Times argued that allowing assisted dying would lead to the dismantling of palliative care. x But are these worries justified? To find the answer to that we need to look at what has actually happened in jurisdictions which allow assisted dying. Does a right to die lead to a duty to die? The best country to look at is Switzerland. This is because Switzerland has the most liberal law on assisted dying, which it has allowed for more than seventy years. However, Switzerland has more hospital beds and more doctors per capita than Britain; it spends more on healthcare, and has considerably better overall life expectancy and cancer survival rates. Indeed the average Swiss person lives two and half years longer than we do.xi What this comparison shows is that allowing assisting dying does not harm health care. It also shows that having a right to die has not led the Swiss to feel a duty to die. Instead the evidence indicates that a country which shows compassion to people who want assistance to die will be more, rather than less, likely to show compassion to others who want assistance to continue to live. This would seem supported by noting that while around 100 foreigners a year travel to the Dignitas Clinic in Zurich for an assisted death, 30,000 foreigners a year travel to Swiss hospitals and sanatoria for the latest and best medical treatments. xii Does legalizing assisted dying weaken the demand for palliative care? It is often claimed that allowing assisted dying would weaken the development of palliative care, but there is no evidence that this happens. Consider the experience of the Oregon Hospice Association, which like Hospice associations everywhere, was passionately opposed to the Death with Dignity Act and fought it every step of the way. Then, when the Act became law in Oregon, the Hospice Association appealed to the United States Supreme Court to get the Act declared unconstitutional. But the American appeal system is notoriously slow and it took eight years for the case to reach the Supreme Court. Then, when that Court ruled that individual US states had the constitutional power to pass such a law, the Oregon Hospice Association put out a new position statement saying that they were 3 glad they had lost. This was because in the first eight years of the working of the Act ‘absolutely none of our dire predictions has been realized’. Instead there had been an enormous expansion of Hospice care. In fact the percentage of Oregonians who died in hospices rose from 22% to 51% during those eight years.xiii Seeing how well the Act was working in Oregon the people of neighbouring Washington State voted for a similar Death with Dignity Act and the courts in Montana have made clear that they will no longer prosecute people who act in accord with such legislation. More recently The States of California, Vermont and New Mexico have passed similar legislation as has Canada. Why this debate needs to be evidentially based Whether or not legalizing assisted dying leads to a slippery slope is an empirical question on which we now have factual answers from the experience of the seven jurisdictions which have embarked on this process.
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