Alex Tang
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Medical Students /Paediatric notes
On Euthanasia
This is the full version of the article that was published in Asian Beacon Volume 50.2 (April - June 2018)
The edited version Let Me Die, Let Me Die was published in the magazine. You can download the whole magazine here.
A Christian Doctor’s Perspective on Euthanasia
By Dr Alex Tang
We cannot decide when we are born but we can decide when we die. Janet Adkins was 54 when she was diagnosed with early stage Alzheimer’s disease. When informed about the progressively deteriorating condition of the disease, she decided to kill herself but she wanted a painless and dignified death. She sought help from Dr Jack Kevorkian, a pathologist from Michigan, USA. On June 4, 1990, Dr Kevorkian hooked her up to a heart monitor and an intravenous line. Janet Adkins pushed a button that released a lethal dose of medication, which killed her in 5 minutes. A murder charge was filed against Dr Kevorkian but it was dismissed because of the vague about assisted suicide. Since then, the “right-to-die” or euthanasia movement has been steadily gaining momentum.
On April 11, 2001, the Netherlands became the first country to legalise euthanasia. Since then, many Western countries as well as some states in the US and Japan have followed suit.
Commonly, euthanasia means mercy killing or assisted suicide and is often considered by patients suffering painful incurable diseases. It is not euthanasia when doctors discontinue a treatment that is no longer effective and the patient then dies. For euthanasia to happen, doctors are needed to inject the lethal dose of medication. But doctors are healers, not killers. Will they be forced to kill or assist in a suicide if their country legalise euthanasia?
RIGHT TO DIE
Two strong cultural trends – absolute autonomy and fear of pain – that originate from the West and are sweeping the globe have provided the groundswell of support for euthanasia. Absolute autonomy says, “This is my body and I decide what I want to do with it and society has no right to interfere.” Autonomy demands that people have a say in when and how they die, and is closely related to the fear of pain and suffering.
Modern medicine has not only prolonged life but it has also prolonged death. Many people fear constant unrelieved pain. Others fear they may reach a point where they want to die in relative peace, only to find that they are forced to receive intensive and intrusive medical treatments that desperately attempt to prolong their lives. Yet others dread being bedridden for months or years. With the high cost of medical care, some fear their terminal illness may put their families in debts for years.
All these fears are real and therefore, people want a “right-to-die” option to end their misery. We are now less likely to die from accidents and infectious diseases than stroke, heart attacks and cancer – often associated with disabilities, pain and expensive treatment. Doesn’t it make sense to have an opportunity to “check out” if the going gets tough?
SCRIPTURAL PERSPECTIVE
Surprisingly, the Bible says little about euthanasia. Theologian Karl Barth says in his multivolume Church Dogmatics that it is “a remarkable fact that in the Bible, suicide is nowhere explicitly forbidden”. But there are two Scriptural principles that can help us in facing the issue of euthanasia – firstly, the sanctity of human life and secondly, human autonomy and divine sovereignty.
Firstly, Scripture provides four inferences about the sanctity of human life.
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Human dignity comes from God since we are created in God’s image (Gen. 1:26-27). Human life is a gift from God. In response, we should approach this life with gratitude, thanksgiving and deep responsibility.
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All human lives have equal dignity. In Gen. 1:27, men and women bear the same dignity and this applies to all. However incapacitated, mentally retarded, chronically ill, physically dependent or in a persistent vegetative state, that person bears that same dignity.
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The sixth commandment, “Thou shalt not kill” (Exo. 20:13; Deut. 5:17), has its roots in the Creation narrative – “Let us make man in our own image” (Gen. 1:26) and in the Noahic Covenant of “Whosoever sheds the blood of man, by man shall his blood be shed” (Gen. 9:6). Man, being made in the image of God, is not to be intentionally killed.
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Love your neighbour – Christians are called to love their neighbour, including caring for one another. It excludes helping each other to die.
Secondly, human autonomy and divine sovereignty. Christians must seriously take the claims of autonomy, which is the main argument for euthanasia. We are created in God’s image. An essential part of that image is our ability to make free choices. The Scriptural model for human autonomy, self-determination and human responsibility is portrayed in Gen. 2:19. As Hebrew scholars have noted, to ‘name’ something is not simply to label it; it is to give it a meaning and order it in the nature of things, Hence, Adam is called upon to continue the creation by bringing order into being, rather than simply replicating preordained orders. This is stewardship.
The fundamental distinction between the Creator and the created is the limits to the freedom and scope of our stewardship. The limitations to human autonomy are found earlier in Genesis 2:15-17. The story asserts a fundamental conviction of biblical faith that from the very beginning, human freedom over life was limited. God alone is sovereign over life and death.
The principles of divine sovereignty and human stewardship and responsibility argue against unlimited autonomy. Euthanasia violates both these principles.
What then?
Christians must be in the forefront of offering viable alternatives to euthanasia to face the realities of pain and suffering during terminal or serious illnesses. Instead of an action to end life, the alternative to euthanasia is death with dignity.
Firstly, advances in pain control medication have allowed better pain reduction with minimal side effects while precision surgical procedure can disconnect pain pathways.
Secondly, palliative care (care of the dying) has made significant advances in recent years. For example, patients now have more say in their treatment. With better information, they may decide the treatments to receive, when to stop when the treatments fail and when not to be given extraordinary medical measures (such as putting a terminally ill patient on a ventilator when there is no hope for recovery). All these may be written up in a will and/or a medical directive.
Modern hospice care is remarkably helping terminally ill patients to die with dignity. In Malaysia, Hospis Malaysia and a few other NGOs have a few centres but there is a great need for the Church to be involved in setting up and running hospices.
Thirdly, prayer is a powerful alternative to euthanasia and the Church has a God-given role to pray for the sick (James 5:14-16) and those facing death. The Church will have failed in its mission if it does not pray for and with the sick and dying.
Finally, with the escalating medical costs, a good medical insurance plan will alleviate any financial burden to the family, so plan well.
Euthanasia is laudable because it is based on compassion. Unfortunately, its basic premise is flawed as it goes against the Scriptural principles of the sanctity of human life, divine sovereignty and human autonomy. The Christian alternative of death with dignity is a better choice.
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Dr Alex Tang is a Consultant Paediatrician at Johor Specialist Hospital and Associate Professor of Paediatrics at Monash University Malaysia. He is also an independent scholar in Practical Theology and teaches spiritual formation and biomedical ethics to seminaries and churches worldwide. Check out his website @ www.alextang.org
