A matter of life and death (euthanasia) - Proverbs 3:29

This is a sermon by Melvin Tinker from the morning service on 1st May 2005.

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They call him Dr. Death. His real name is Dr. Jack Kevorkian. Until his licence to practise medicine had been withdrawn, he achieved some notoriety in the United States by inventing a suicide machine. His whole purpose was to help people kill themselves, to exercise what some would consider to be the ultimate right to, `die with dignity'. The organization in the States which seeks to legalise this activity called euthanasia, is known as the Hemlock society. It has even listed leading churchmen to aid its cause. So the Reverend John Pridonoff has gone on record as saying that euthanasia is OK because God wouldn't want people to suffer. When a local reporter challenged him on this, asking `Isn't the Bible against suicide?' he simply replied, `But there are lots of things in the Bible we've grown beyond as a society:'

If you will excuse the pun, euthanasia is an issue which refuses to die. 'Euthanasia' is a word which literally means `dying well', and as such is a fairly neutral term-everyone wants to die well. However, in recent years, largely, through the work of the Voluntary Euthanasia Society (formerly know as EXIT), it has taken on a more specialised meaning. Put simply, euthanasia refers to `medically assisted suicide'. A more precise definition would be, `The deliberate bringing about of the death of a human being as part of the medical care being given him or her.' That is what we are talking about and it sounds so humane, linking the taking of someone life with medical care.

Now advocates of euthanasia often muddy the ethical waters by raising the question, `Should life be preserved at all costs?', and assume that if the answer is `no,' then this legitimizes euthanasia. Well two things need to be said in response to that.

First, even Christians who would place a high value on the sanctity of human life would not advocate preserving life at all costs. One only has to think of the extraordinary lengths taken (which were politically motivated by the way) to preserve the `lives' of Tito and Franco in their last moments. This would not be considered justified, medically or ethically.

Secondly, there is a world of difference in terms of intention between deliberately shortening a life (euthanasia) and choosing not to prolong the dying process unnecessarily. The former involves the intention of killing, the latter the intention of not prolonging the dying. The difference between them is morally very important and the two should not be confused. You might think of the difference like this; not prolonging the dying process is like allowing an actor to leave the stage gracefully when his performance is coming to an end. Euthanasia is pushing the actor of the stage before the performance is finished. Do you see?

We must realise that over the years events have taken place which have helped pave the way to making euthanasia acceptable within the collective consciousness of our society. So back in 1992, Dr. Nigel Cox was prosecuted for the attempted murder of Lilian Boyes, a long-standing patient of his who was suffering from severe rheumatoid arthritis. Her life expectancy was short and she asked Dr. Cox to end it for her. At first he refused. But then he gave her a lethal injection of potassium chloride and she died within minutes. He was found guilty and received a twelve-month suspended sentence. He was also reprimanded by the General Medical Council but continues in practice today. This is an example of voluntary euthanasia, assisting the death of someone who has requested it.

A few years earlier, a Downs syndrome baby, John Pearson, was given a deliberate overdose of dihydrocodeine by his doctor, Leonard Arthur. The doctor was acquitted and again treated leniently by the medical authorities. This is an example of non-voluntary euthanasia - a case when the sick patient is not able to request death but the decision is taken on their behalf.

Now some might ask: what's the problem? Don't people have a right to do with their lives as they choose? If you were to see an animal in pain with no hope of recovery and you had a gun in your hand you would put it out of its misery, wouldn't you? So why not offer the same compassionate way out for a fellow human being? When put like that, the arguments for euthanasia do seem so compelling- it's just common sense. But is it all as straightforward as that? Is there in fact an alternative- a third way between allowing people to suffer needlessly and ending their lives prematurely? The Christian would reply well, yes there is, and it is the way of wisdom.

You see, in the Book of Proverbs we are given insights which help us begin to get this important subject into some kind of focus. As we have already seen, wisdom is essentially God's truth, enabling God's people to live in God's world, God's way.

It is all too easy to respond to this issue emotionally- and when you see people suffering you cannot but be emotional, especially if it is someone you love. But wisdom is all to do with thinking evangelically, that is biblically, not emotionally, because emotions are not the most reliable indicators of the way we should behave. In fact there are three questions which biblical wisdom raises which, when taken together, would guide us on this subject of euthanasia- a matter of life and death. There are questions of principle, questions of motive, and questions of consequences.

There are three principles which are relevant as to whether medically assisted suicide is something we ought to be encouraging as a society.

First there is the principle of love. As we have seen, those in favour of euthanasia argue it is the most loving thing to do in some cases. Granny is in pain, you have a hypodermic in your bag, why not do the most loving thing? But to borrow a phrase coined by Professor Joad, `It all depends on what you mean by 'love.'

There are two words we find in Proverbs translated `love' which often mean different things. There is the word aheb which tends to mean being fond of something; so 12:1 we read, `Whoever loves discipline loves knowledge.' It is affection. And that is how we tend to think of love; little more than a feeling, an attraction. So we use the same word for love when we say 'I love ice cream' and 'I love my wife'. The other word is hesed, which can be translated steadfast love, unfailing love, indeed, grace. It is the word most often used to describe God's love- and this is the love a human being is to have towards a fellow human being. This is a love of the will which takes into account what in the long term will be the best for a person, or society as a whole, and what is morally right. So Proverbs 14:22, `Those who plan what is good show love (hesed) and faithfulness.' Now just think of how God expresses this type of love to Israel. It is compassionate - moved with pity as he saw his people in slavery in Egypt and he took steps to do something positive. It is creative - when Israel kept failing, God didn't just give up on them saying, `Let me put them out of their misery and me out of mine, so I will get rid of them and find another nation with a bit more potential.' No, he creatively finds ways to correct them, teach them, and woo them on to better things. It is also costly -sticking by these people through thick and thin, feeling the pain of spurned love and patiently going on with them- read Hosea sometime. As we are made to be like God in this respect, so our love is to be like his, not taking the short-term, easy way out, but the more costly, creative way forward.

The second principle is justice, not showing bias against certain classes of people. Therefore, in Proverbs 1:3 we are told that wisdom is for `doing what is right and just and fair'. Throughout Scripture, God is concerned with championing the cause of the powerless and unrepresented in society -what we may call the `poor.' So Proverbs 14:31, `He who oppresses the poor shows contempt for their Maker.' Certainly in the case of non-voluntary euthanasia, where perhaps a little Downs syndrome baby or a frail elderly relative has their life cut short simply because they are classed as having no hope or potential for a so called quality life, does seem to smack of injustice, a bias against the ill and the aged, what may be called infirmism or ageism.

Thirdly, there is the principle of life. Life is a good gift of Wisdom, `Long life is in her right hand' (3:16). The very creation of mankind flows out of God's loving wisdom. In 8:31, Wisdom having done its creating work is said to `rejoice in the whole of mankind'. In another wisdom book, Job 1:21, we read that it is `the Lord who gave and the Lord who has taken away.' Words often used at a funeral. Life is a gift of God on loan to us, not to do with as we please but in a way that pleases him. By way of contrast, death is generally seen as a bad thing, a curse resulting from our sinful rebellion: `The fear of the LORD adds length to life, but the years of the wicked are cut short' (10:27). The whole concept of the sanctity of life which has undergirded our medical profession for years is based upon this biblical view - human life is sacred - and that is why it is so serious to take away life without divine sanction. It is, in short, murder.

Furthermore, the Christian would wish to contend that it is in Wisdom incarnate that we find all of these principles expressed perfectly, that is, in the life of the Lord Jesus Christ. When we look at him what do we see? Well, we see that he is the one who shows creative love - healing at personal cost to himself and in a variety of ways. He didn't just pronounce en masse for people to be healed, he dealt with them all individually and differently, which was taxing and tiring. He was impartial too in his care for the sick; whether they be Jew or non-Jew, male, female, child, adult, he tendered to them all, not writing any off as beyond the pale. Also in Jesus we see God as the great life giver- as well as healing the sick he raised the dead, and he himself died in order to redeem us from the curse of death, so that by his wounds we are healed (1 Pet. 2:24). Therefore, if Jesus is all that God intended man to be, as well as God himself, then surely how he treated the sick is how we are to treat them. In fact it is the example of Christ which provided the model and impetus for Christian medical care. And so, the first institution for the blind was founded by Thalasius, a Christian monk. The first free dispensary was founded by Apollonius, a Christian merchant. The first hospital was founded by Fabiola a Christian woman

But also, we need to take into account the question of people's motives. Proverbs 16:2 says, `All a man's ways seem innocent to him, but motives are weighed by the LORD.' The point is this: we may convince ourselves that the early death of a patient is for their good, while all the while other ulterior motives are at work. Could it not be that sometimes it is for our self-interest we urge euthanasia? For we simply don't want to bear the emotional toil of seeing a loved one suffer. A friend of mine who used to teach ethics to medical students at Oxford has remarked that one of the things he has real problems with is medics who can't cope with death and see it as failure. One result is an attraction to the idea of euthanasia as an answer to this. So by the doctor supervising death, there is some psychological comfort that it is part of the treatment, the doctor keeping total control.

But perhaps more of a factor will be the economic motive for euthanasia. With the current financial crisis in health care in Britain, coupled with an increasing elderly population, it would not be too difficult, would it? Envisaging us reaching a situation where euthanasia of the elderly or terminally ill could be seen as a means of easing the financial burden. Are these noble motives which God would weigh favourably? Hardly. They are plain selfish.

Further, wisdom would have us think of the wider consequences of a euthanasia policy. In Proverbs 1:4 we are told that wisdom gives discretion, that is the ability to plan and foresee consequences. Let me just give you a few which touches on this subject.

Proverbs 3:29 says, `Do not plot to harm your neighbour who lives trustfully near you.' We need to ask: how would euthanasia affect the doctor patient relationship? In the Netherlands where voluntary euthanasia is an accepted part of medical practice, around a third of euthanasia deaths are involuntary- the patient has no say. Now can imagine the un-nerving effect that has had amongst the elderly there? Just think about what would be going through your mind if you are elderly in a residential home or hospital which allows this: ` Is this nice doctor who has been giving me pink pills for the last two months, now giving me a yellow pill to cure me or kill me?' The doctor/patient relationship is based on trust. But euthanasia replaces trust with suspicion.

Also, should doctors and nurses whose traditional motivation is based on striving to save lives be put in a position where they would legally be required to take away lives? How loving and just would that be for them? The psychological strain would be considerable, witness the stress on the performing of abortions. What is more, there would be a gradual erosion of motivation for care: with increasing demands on the health care system and less money, the easy option towards euthanasia would be so attractive. But we might also want to ask: what sort of message would widespread acceptance of euthanasia send to society as a whole about the value of the elderly and infirm? It has been suggested that there is a link between abortion on demand and child abuse - if we treat our young in this way in the womb as being of little value, and inconvenience perhaps, then why not when they are out of the womb? How long, then, would it take for similar attitudes to be engendered towards the elderly? So-called Granny bashing would become more common. The fact is actions create and reinforce attitudes, as do government laws.

Is there a third way? Well, there are basically three courses of action open to us when dealing with a terminally ill patient.

First, there is euthanasia which as we have seen is immoral.

Secondly, there is the prolonging of the dying process artificially in a way that is disproportionate to any advantage that might be gained by the patient, i.e. pursuing futile treatment. This may not always be immoral but it certainly can be unwise and very distressing for all concerned. A minister I know once visited a hospital patient who was linked up with tubes and electrodes and was expected to live only a very short time. At one point visitors were asked to leave while the nurse quickly administered some treatment. She said afterwards with more than a hint of desperation in her voice, `I nearly lost her then.' Why, they wondered, wasn't the patient allowed to die peacefully? In fact, she lived one more day.

There is, however, a third way and that is in the provision of palliative care and relief, best exemplified by the hospice movement, as pioneered by the late Dame Cecily Saunders.

Here they do follow the way of Wisdom by bringing together spiritual, moral and physical aspects of health as we see focused in Proverbs 3:7: `Do not be wise in your own eyes; fear the LORD, shun evil. This will bring health to your body and nourishment to your bones.' Instead of rushing the terminally ill off the stage of life by killing them, the hospice movement specializes in treating the person as a whole, as someone loved and valued, using counselling to work through emotional concerns, Christian ministers to attend to spiritual needs, careful use of pain-relieving analgesics so that there is a dignified, gradual letting go. Instead of dying lonely, frightened and bewildered, there is a quiet, confident, caring passage from this world to the next. As Dame Cecily Saunders would often say to her patients, `You matter because you are you, and we will not only enable you to die with dignity, but to live until you die.'

Now let me ask: which approach captures more the spirit of Wisdom and the spirit of Christ: Dr. Kevorkian with his suicide machine or Dr. Saunders and her hospice? Perhaps more to the point: who would you rather have treating you?

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