A sermon on euthanasia

Job 14:5-13; 2 Peter 1:2-4

When I was asked to preach a topical sermon on the subject of euthanasia, my thoughts turned to the tragic and mysterious Old Testament character named Job.

There are many life lessons for us in the Book of Job, many opportunities to pause from frantic attempts to make a life for ourselves and our families, and consider the bigger picture – the essence of it all, the purpose of existence, the meaning of life.

Job is particularly relevant because he goes where we don’t want to go, or can’t bear to explore alone. Job reflects deeply on the frailty and misery and brevity of human existence. As Mike Mason puts it in his fine commentary on Job:

Job finds himself in an impossible situation. His agony is so great that one of the few thoughts that brings him any significant measure of comfort is the thought of death. Yet at the same time, even death holds no real comfort for him, since he knows full well that it will only leave him worse off than before.

Is it any wonder if his feelings about death swing back and forth in wild ambivalence? On the one hand, there are times when he passionately longs for the grave, extolling it as a realm of comparative ‘peace’ where ‘the weary are at rest’ (3:13, 17). But on the other hand, he knows in his heart of hearts that the grave is the one thing to be feared more than anything else, for it is the ‘place of no return … of deep shadow and disorder’ (10:21-22). What a grim realist Job is![1]

In chapter 14, Job compares his irreversible slide from life into death, from birth to grave, with an apparently dead tree (vv. 7-10), able to revive itself from within, and a dried-up lake (vv. 11-12), incapable of renewal and restoration apart from assistance from beyond:

A person’s days are determined; you have decreed the number of his months and have set limits he cannot exceed. So look away from him and let him alone, till he has put in his time like a hired labourer.

At least there is hope for a tree: If it is cut down, it will sprout again, and its new shoots will not fail. Its roots may grow old in the ground and its stump die in the soil, yet at the scent of water it will bud and put forth shoots like a plant. But a man dies and is laid low; he breathes his last and is no more.

As the water of a lake dries up or a riverbed becomes parched and dry, so he lies down and does not rise; till the heavens are no more, people will not awake or be roused from their sleep.

If only you would hide me in the grave and conceal me till your anger has passed! If only you would set me a time and then remember me!

These two images reflect human responses to physical and psychological trauma, especially the kind that poses a threat to life, or that erodes our quality of life to the point of being unbearable.

One solution to such existential challenges is euthanasia: the deliberate killing of a person, whether by act or omission, in order to avoid unnecessary pain and suffering because their life is deemed not to be worth living.

The word “euthanasia” derives from classical Greek and literally means, “good death.” Euthanasia is “voluntary” when conducted at the request, or with the consent, of the person to be killed. It is “nonvoluntary” when it is done without such request or consent, usually because the patient is deemed not competent to express their wishes, either through immaturity, intellectual disability, or because they were not asked.

For many people of faith, and for many who profess to hold no religious beliefs, euthanasia is a profoundly moral issue. There are strong moral and practical arguments on both sides of the debate. Often these focus on fear of pain, indignity and dependency.[2]

Common arguments for euthanasia

1. Euthanasia is compassionate killing. Modern medicine and medical technology prolong life and may unintentionally increase suffering; euthanasia simply relieves such suffering.
2. Euthanasia promotes the greatest good of the greatest number. If the benefits outweigh the harms caused, the practice should be pursued.
3. Suicide is legal – therefore assisted suicide should also be legal.
4. Active and passive euthanasia are the same thing. There is no morally relevant difference between killing a patient and allowing them to die.
5. Euthanasia is compatible with medical ethics. It is not a violation of the Hippocratic Oath.
6. Personal autonomy. The state should not interfere with a person’s right to make their own health care decisions.
7. May not involve killing. A distinction may be made between a patient’s biological life (their physical existence) and biographical life (aspects of one’s life which render it meaningful). Not all human beings are persons, and non-persons may be euthanased.

Common arguments against euthanasia

1. Sanctity of life. Humans are created in the image of God, and human life is therefore of incalculable value. Taking an innocent human life dishonours God who gave it and cannot be condoned.
2. Abuse of vulnerable persons. A patient may feel obliged to consent to euthanasia out of convenience to others (such as healthy relatives, or taxpayers who fund the public health system).
3. Misdiagnoses are possible. Though rare, the misdiagnosis of a terminal illness is possible and death cannot be reversed.
4. Benefits of suffering. The experience of suffering may facilitate character development. Also, suffering may be more in the eyes of the relative or friend than the patient.
5. Playing God. Legalisation of euthanasia would place physicians (or others) in the place of God in determining how and when death occurs.
6. Slippery slope. Legalisation of voluntary euthanasia may lead society to accept involuntary euthanasia.
7. Patient-doctor relationship. Legalisation of euthanasia may undermine the trust between a patient and their physician, as well as the moral integrity of the medical profession.
8. Health care funding. Legalisation of euthanasia may weaken a society’s resolve to provide adequate funding to care for the dying.
9. Health care methods. Legalisation of euthanasia may undermine the impetus to develop better approaches to the care of the suffering and the dying.
10. Smokescreen for murder. Euthanasia may be used as a justification for an act which would otherwise be classified as murder.

These are the chief arguments for and against euthanasia. But this is not merely an academic or theoretical issue. From time to time, concerted attempts are made to legalise euthanasia, leading to ethical dilemmas for doctors and other health professionals.

Dr Brendan Nelson stated recently in NSW that doctors must never be “sanctioned to kill.” It may be judged necessary, in some circumstances, to withdraw or withhold certain medical treatments because they are considered futile or unduly burdensome, but this is significantly different from acting with the intent to kill a patient.

The most compassionate response to terminal illness and terrible physical and mental suffering is, in my opinion, to provide the best possible palliative care and other medical services for terminally ill patients, and to provide comfort and support to all who are affected by the pain and suffering of loved ones.

From a Christian point of view – and as Job, I think, finally came to understand – even in the midst of horrendous suffering and misery, the real hope of a good life beyond death shines forth, giving dignity and meaning to death itself, as the person of faith rests in the love and grace of God.

A 1995 statement by the NSW Council of Churches offers a thoughtful evangelical response to pressure on legislators and health care providers to relax prohibitions on euthanasia. There are six principles:

(a)  All persons are made in the image of God and therefore possess intrinsic worth;

(b)  Intentional killing can never be a compassionate response to suffering;

(c)  The state has an obligation to protect its citizens, particularly the weak and vulnerable, from abuse;

(d)  Legalisation of euthanasia would place an unacceptable burden on health-care professionals;

(e)  Best medical practice may require the withdrawal or withholding of certain treatments because they are considered futile or unduly burdensome to the patient; and

(f)   The preferred compassionate response to suffering is to provide the best possible palliative care and medical services.

Biblical principles undergirding this statement include the sanctity of human life (see Gen 1:27; Ecc 3:1-2; 1 Cor 6:19-20; Heb 9:27); an ethic of compassionate care (Micah 6:8; Lk 10:25-37); and the Christian hope beyond death (1 Cor 15, etc).

Those who follow Jesus are called to heal the sick, comfort the dying, and entrust the dead to God. But we are never called, and are never free, to hasten the dying across the threshold into eternity.[3] And, for the Christian, a natural death is by definition a “good death” because it is the means by which, in a real and permanent way, the person enters into the presence of Christ.

The Bible teaches that God is ultimately sovereign over human life and death (Job 14:5; Eccl 3:2; James 4:13-15). But the Bible also teaches that death is not a friend: it is the last enemy to be overcome (1 Cor 15:26). In Job 14:13, toward the end of his long and harrowing reply to Zophar, one of his three supposed friends, Job cries out to God:

If only you would hide me in the grave and conceal me till your anger has passed! If only you would set me a time and then remember me!

It’s a desperate plea from the heart and mind of a person who has experienced immense and ongoing suffering. And it’s a plea foreshadowing the culmination of the great gospel events of the New Testament, in particular the resurrection of Jesus, and the ultimate end to human finitude and pain and loss that began to be fulfilled on that first Easter morning, and to which all the faithful through all the ages are being inexorably drawn, with hope and great joy, despite the trials and hardships along the way: the eternal form of what Peter describes as “participation in the divine nature” (2 Pet 1:4).

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Sermon 620 copyright © 2014 Rod Benson. Preached at Christ Church Blacktown, Sydney, Australia, on Sunday 8 June 2014. Unless otherwise noted, Scripture quotations are from The Holy Bible, New International Version (Grand Rapids: Zondervan, 2011).

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References:

[1] Mike Mason, The Gospel According to Job: An Honest Look at Pain and Doubt from the Life of One Who Lost Everything (Wheaton: Crossway Books, 1994), p. 161.

[2] See especially John Wyatt, Matters of Life and Death: Human Dilemmas in the Light of the Christian Faith (second edition; Nottingham, UK: IVP, 2009), pp. 197-200.

[3] David P. Gushee, “Killing with kindness,” Christianity Today, 7 Dec 2004, p. 62.