THESITIC

EUTHANASIA, Explained in light of Christian Views

Against the will of God
Life is sacred
Slippery slope argument
Devalues life
Against best interests
Improvement of palliative care
Regulation fears
Doctors play gods
Pressure (Financial) and abuse on vulnerable patients
Against the will of God
Religious people don't argue that we can't kill ourselves, or get others to do it. They know that we can do it because God has
given us free will. Their argument is that it would be wrong for us to do so.
They believe that every human being is the creation of God, and that this imposes certain limits on us. Our lives are not only
our lives for us to do with as we see fit.
To kill oneself, or to get someone else to do it for us, is to deny God, and to deny God's rights over our lives and his right to
choose the length of our lives and the way our lives end.
The value of suffering
Religious people sometimes argue against euthanasia because they see positive value in suffering.
Down through the centuries and generations it has been seen that in suffering there is concealed a particular power that
draws a person interiorly close to Christ, a special grace.
Pope John Paul II: Salvifici Doloris, 1984
The religious attitude to suffering
Most religions would say something like this:
We should relieve suffering when we can, and be with those who suffer, helping them to bear their suffering, when we can't.
We should never deal with the problem of suffering by eliminating those who suffer.
The nature of suffering
Christianity teaches that suffering can have a place in God's plan, in that it allows the sufferer to share in Christ's agonyand his
redeeming sacrifice. They believe that Christ will be present to share in the suffering of the believer.
Pope John Paul II wrote that "It is suffering, more than anything else, which clears the way for the grace which transforms
human souls."
However while the churches acknowledge that some Christians will want to accept some suffering for this reason, most
Christians are not so heroic.
So there is nothing wrong in trying to relieve someone's suffering. In fact, Christians believe that it is a good to do so, as long
as one does not intentionally cause death.
Dying is good for us
Some people think that dying is just one of the tests that God sets for human beings, and that the way we react to it shows
the sort of person we are, and how deep our faith and trust in God is.
Others, while acknowledging that a loving God doesn't set his creations such a horrible test, say that the process of dying is
the ultimate opportunity for human beings to develop their souls.
When people are dying they may be able, more than at any time in their life, to concentrate on the important things in life,
and to set aside the present-day 'consumer culture', and their own ego and desire to control the world. Curtailing the process
of dying would deny them this opportunity.
The nature of suffering
It isn't easy to define suffering - most of us can decide when we are suffering but what is suffering for one person may not be
suffering for another.
It's also impossible to measure suffering in any useful way, and it's particularly hard to come up with any objective idea of
what constitutes unbearable suffering, since each individual will react to the same physical and mental conditions in a
different way.
Sanctity of life
This argument says that euthanasia is bad because of the sanctity of human life.
There are four main reasons why people think we shouldn't kill human beings:
All human beings are to be valued, irrespective of age, sex, race, religion, social status or their potential for achievement
Human life is a basic good as opposed to an instrumental good, a good in itself rather than as a means to an end
Human life is sacred because it's a gift from God
Therefore the deliberate taking of human life should be prohibited except in self-defence or the legitimate defence of
others
We are valuable for ourselves
The philosopher Immanuel Kant said that rational human beings should be treated as an end in themselves and not as a
means to something else. The fact that we are human has value in itself.
Our inherent value doesn't depend on anything else - it doesn't depend on whether we are having a good life that we enjoy,
or whether we are making other people's lives better. We exist, so we have value.
Most of us agree with that - though we don't put it in philosopher-speak. We say that we don't think that we should use other
people - which is a plain English way of saying that we shouldn't treat other people as a means to our own ends.
We must respect our own value
It applies to us too. We shouldn't treat ourselves as a means to our own ends.
And this means that we shouldn't end our lives just because it seems the most effective way of putting an end to our
suffering. To do that is not to respect our inherent worth.
The slippery slope
Many people worry that if voluntary euthanasia were to become legal, it would not be long before involuntary euthanasia
would start to happen.
We concluded that it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any
liberalisation of the law in the United Kingdom could not be abused.
We were also concerned that vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or
imagined, to request early death.
Lord Walton, Chairman, House of Lords Select Committee on Medical Ethics looking into euthanasia, 1993
This is called the slippery slope argument. In general form it says that if we allow something relatively harmless today, we may
start a trend that results in something currently unthinkable becoming accepted.
Those who oppose this argument say that properly drafted legislation can draw a firm barrier across the slippery slope.
Various forms of the slippery slope argument
If we change the law and accept voluntary euthanasia, we will not be able to keep it under control.
Proponents of euthanasia say: Euthanasia would never be legalised without proper regulation and control mechanisms in
place
Doctors may soon start killing people without bothering with their permission.
Proponents say: There is a huge difference between killing people who ask for death under appropriate circumstances,
and killing people without their permission
Very few people are so lacking in moral understanding that they would ignore this distinction
Very few people are so lacking in intellect that they can't make the distinction above
Any doctor who would ignore this distinction probably wouldn't worry about the law anyway
Health care costs will lead to doctors killing patients to save money or free up beds:
Proponents say: The main reason some doctors support voluntary euthanasia is because they believe that they should
respect their patients' right to be treated as autonomous human beings
That is, when doctors are in favour of euthanasia it's because they want to respect the wishes of their patients
So doctors are unlikely to kill people without their permission because that contradicts the whole motivation for allowing
voluntary euthanasia
But cost-conscious doctors are more likely to honour their patients' requests for death
A 1998 study found that doctors who are cost-conscious and 'practice resource-conserving medicine' are significantly more
likely to write a lethal prescription for terminally-ill patients [Arch. Intern. Med., 5/11/98, p. 974]
This suggests that medical costs do influence doctors' opinions in this area of medical ethics
The Nazis engaged in massive programmes of involuntary euthanasia, so we shouldn't place our trust in the good moral sense
of doctors.
Proponents say: The Nazis are not a useful moral example, because their actions are almost universally regarded as both
criminal and morally wrong
The Nazis embarked on invountary euthanasia as a deliberate political act - they didn't slip into it from voluntary euthanasia
(although at first they did pretend it was for the benefit of the patient)
What the Nazis did wasn't euthanasia by even the widest definition, it was the use of murder to get rid of people they
disapproved of
The universal horror at Nazi euthanasia demonstrates that almost everyone can make the distinction between voluntary
and involuntary euthanasia
The example of the Nazis has made people more sensitive to the dangers of involuntary euthanasia
Allowing voluntary euthanasia makes it easier to commit murder, since the perpetrators can disguise it as active voluntary
euthanasia.
Proponents say: The law is able to deal with the possibility of self-defence or suicide being used as disguises for murder. It
will thus be able to deal with this case equally well
To dress murder up as euthanasia will involve medical co-operation. The need for a conspiracy will make it an unattractive
option
Many are needlessly condemned to suffering by the chief anti-euthanasia argument: that murder might lurk under the cloak
of kindness.
A C Grayling, Guardian 2001
The disabled person's perspective
Part of the problem is that able-bodied people look at things from their own perspective and see life with a disability as a
disaster, filled with suffering and frustration.
Some societies have regarded people with disabilities as inferior, or as a burden on society. Those in favour of eugenics go
further, and say that society should prevent 'defective' people from having children. Others go further still and say that those
who are a burden on society should be eliminated.
People with disabilities don't agree. They say:
All people should have equal rights and opportunities to live good lives
Many individuals with disabilities enjoy living
Many individuals without disabilities don't enjoy living, and no-one is threatening them
The proper approach to people with disabilities is to provide them with appropriate support, not to kill them
The quality of a person's life should not be assessed by other people
The quality of life of a person with disabilities should not be assessed without providing proper support first
Opposition to this argument
Supporters of euthanasia would respond that this argument includes a number of completely misleading suggestions, and
refute them:
Dying is not the same as never having been born
The debate is nothing to do with preventing disabled babies being born, or preventing people with disabilities from
becoming parents
Nobody is asking for patients to be killed against their wishes - whether or not those patients are disabled
The euthanasia procedure is intended for use by patients who are dying, or in a condition that will get worse - most
disabilities don't come under that category
The normal procedure for euthanasia would have to be initiated at the patient's request
Disabled people who are not mentally impaired are just as capable as able-bodied people of deciding what they want
Protections will be in place for patients who are mentally impaired, whether through disability or some other reason
It is possible that someone who has just become disabled may feel depressed enough to ask for death, which is why any
proposed system of euthanasia must include psychological support and assessment before the patient's wish is granted
All people should have equal rights and opportunities to live, or to choose not to go on living
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Patient's best interests
A serious problem for supporters of euthanasia are the number of cases in which a patient may ask for euthanasia, or feel
obliged to ask for it, when it isn't in their best interest. Some examples are listed below:
the diagnosis is wrong and the patient is not terminally ill
the prognosis (the doctor's prediction as to how the disease will progress) is wrong and the patient is not going to die soon
the patient is getting bad medical care and their suffering could be relieved by other means
the doctor is unaware of all the non-fatal options that could be offered to the patient
the patient's request for euthanasia is actually a 'cry for help', implying that life is not worth living now but could be worth
living if various symptoms or fears were managed
the patient is depressed and so believes things are much worse than they are
the patient is confused and unable to make sensible judgements
the patient has an unrealistic fear of the pain and suffering that lies ahead
the patient is feeling vulnerable
the patient feels that they are a worthless burden on others
the patient feels that their sickness is causing unbearable anguish to their family
the patient is under pressure from other people to feel that they are a burden
the patient is under pressure because of a shortage of resources to care for them
the patient requests euthanasia because of a passing phase of their disease, but is likely to feel much better in a while
Supporters of euthanasia say these are good reasons to make sure the euthanasia process will not be rushed, and agree that a
well-designed system for euthanasia will have to take all these points into account. They say that most of these problems can
be identified by assessing the patient properly, and, if necessary, the system should discriminate against the opinions of
people who are particularly vulnerable.
Chochinov and colleagues found that fleeting or occasional thoughts of a desire for death were common in a study of people
who were terminally ill, but few patients expressed a genuine desire for death. (Chochinov HM, Tataryn D, Clinch JJ, Dudgeon
D. Will to live in the terminally ill. Lancet 1999; 354: 816-819)
They also found that the will to live fluctuates substantially in dying patients, particularly in relation to depression, anxiety,
shortness of breath, and their sense of wellbeing.
Other people have rights too
Euthanasia is usually viewed from the viewpoint of the person who wants to die, but it affects other people too, and their
rights should be considered.
family and friends
medical and other carers
other people in a similar situation who may feel pressured by the decision of this patient
society in general
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Proper palliative care
Palliative care is physical, emotional and spiritual care for a dying person when cure is not possible. It includes compassion and
support for family and friends.
Competent palliative care may well be enough to prevent a person feeling any need to contemplate euthanasia.
You matter because you are you. You matter to the last moment of your life and we will do all we can to help you die
peacefully, but also to live until you die.
Dame Cicely Saunders, founder of the modern hospice movement
The key to successful palliative care is to treat the patient as a person, not as a set of symptoms, or medical problems.
The World Health Organisation states that palliative care affirms life and regards dying as a normal process; it neither hastens
nor postpones death; it provides relief from pain and suffering; it integrates the psychological and spiritual aspects of the
patient.
Making things better for patient, family and friends
The patient's family and friends will need care too. Palliative care aims to enhance the quality of life for the family as well as
the patient.
Effective palliative care gives the patient and their loved ones a chance to spend quality time together, with as much distress
removed as possible. They can (if they want to) use this time to bring any unfinished business in their lives to a proper closure
and to say their last goodbyes.
Palliative care should aim to make it easier and more attractive for family and friends to visit the dying person. A survey (USA
2001) showed that terminally ill patients actually spent the vast majority of their time on their own, with few visits from
medical personnel or family members.
Spiritual care
Spiritual care may be important even for non-religious people. Spiritual care should be interpreted in a very wide sense, since
patients and families facing death often want to search for the meaning of their lives in their own way.
Palliative care and euthanasia
Good palliative care is the alternative to euthanasia. If it was available to every patient, it would certainly reduce the desire for
death to be brought about sooner.
But providing palliative care can be very hard work, both physically and psychologically. Ending a patient's life by injection is
quicker and easier and cheaper. This may tempt people away from palliative care.
Legalising euthanasia may reduce the availability of palliative care
Some fear that the introduction of euthanasia will reduce the availability of palliative care in the community, because health
systems will want to choose the most cost effective ways of dealing with dying patients.
Medical decision-makers already face difficult moral dilemmas in choosing between competing demands for their limited
funds. So making euthanasia easier could exacerbate the slippery slope, pushing people towards euthanasia who may not
otherwise choose it.
When palliative care is not enough
Palliative care will not always be an adequate solution:
Pain: Some doctors estimate that about 5% of patients don't have their pain properly relieved during the terminal phase of
their illness, despite good palliative and hospice care
Dependency: Some patients may prefer death to dependency, because they hate relying on other people for all their bodily
functions, and the consequent loss of privacy and dignity
Lack of home care: Other patients will not wish to have palliative care if that means that they have to die in a hospital and
not at home
Loss of alertness: Some people would prefer to die while they are fully alert and and able to say goodbye to their family;
they fear that palliative care would involve a level of pain-killing drugs that would leave them semi-anaesthetised
Not in the final stages: Other people are grateful for palliative care to a certain point in their disease, but after that would
prefer to die rather than live in a state of helplessness and distress, regardless of what is available in terms of pain-killing
and comfort.
There should be no law or morality that would limit a clinical team or doctor from administering the frequent dosages of pain
medication that are necessary to free people's minds from pain that shrivels the spirit and leaves no time for speaking when,
at times, there are very few hours or days left for such communication.
Dr. David Roy, Director of the Centre for Bioethics, Clinical Research Institute of Montreal
It gives doctors too much power
This argument often appears as 'doctors should not be allowed to play God'. Since God arguments are of no interest to people
without faith, it's presented here with the God bit removed.
Doctors should not be allowed to decide when people die:
Doctors do this all the time
Any medical action that extends life changes the time when a person dies and we don't worry about that
This is a different sort of decision, because it involves shortening life
Doctors take this sort of decision all the time when they make choices about treatment
As long as doctors recognise the seriousness of euthanasia and take decisions about it within a properly regulatedstructure
and with proper safeguards, such decisions should be acceptable
In most of these cases the decision will not be taken by the doctor, but by the patient. The doctor will provide information
to the patient to help them make their decision
Since doctors give patients the information on which they will base their decisions about euthanasia, any legalisation of
euthanasia, no matter how strictly regulated, puts doctors in an unacceptable position of power.
Doctors have been shown to take these decisions improperly, defying the guidelines of the British Medical Association, the
Resuscitation Council (UK), and the Royal College of Nursing:
An Age Concern dossier in 2000 showed that doctors put Do Not Resuscitate orders in place on elderly patients without
consulting them or their families
Do Not Resuscitate orders are more commonly used for older people and, in the United States, for black people, alcohol
misusers, non-English speakers, and people infected with Human Immunodeficiency Virus. This suggests that doctors have
stereotypes of who is not worth saving
Pressure on the vulnerable
The fear is that if euthanasia is allowed, vulnerable people will be put under pressure to end their lives. It would be difficult,
and possibly impossible, to stop people using persuasion or coercion to get people to request euthanasia when they don't
really want it.
Nonetheless, if euthanasia is available, the sick person may pressure themselves into asking for euthanasia.
Family or others involved with the sick person may regard them as a burden that they don't wish to carry, and may put
pressure (which may be very subtle) on the sick person to ask for euthanasia.
The last few months of a patient's life are often the most expensive in terms of medical and other care. Shortening this period
through euthanasia could be seen as a way of relieving pressure on scarce medical resources, or family finances.
It's worth noting that cost of the lethal medication required for euthanasia is less than 50, which is much cheaper than
continuing treatment for many medical conditions.
Some people argue that refusing patients drugs because they are too expensive is a form of euthanasia, and that while this
produces public anger at present, legal euthanasia provides a less obvious solution to drug costs.
If there was 'ageism' in health services, and certain types of care were denied to those over a certain age, euthanasia could be
seen as a logical extension of this practice.
General Christian view
Christians are mostly against euthanasia. The arguments are usually based on the beliefs that life is given by God, and that
human beings are made in God's image. Some churches also emphasise the importance of not interfering with the natural
process of death.
Life is a gift from God
all life is God-given
birth and death are part of the life processes which God has created, so we should respect them
therefore no human being has the authority to take the life of any innocent person, even if that person wants to die
Human beings are valuable because they are made in God's image
human life possesses an intrinsic dignity and value because it is created by God in his own image for the distinctive destiny
of sharing in God's own life
saying that God created humankind in his own image doesn't mean that people actually look like God, but that people
have a unique capacity for rational existence that enables them to see what is good and to want what is good
as people develop these abilities they live a life that is as close as possible to God's life of love
this is a good thing, and life should be preserved so that people can go on doing this
to propose euthanasia for an individual is to judge that the current life of that individual is not worthwhile
such a judgement is incompatible with recognising the worth and dignity of the person to be killed
therefore arguements based on the quality of life are completely irrelevant
nor should anyone ask for euthanasia for themselves because no-one has the right to value anyone, even themselves, as
worthless
The process of dying is spiritually important, and should not be disrupted
Many churches believe that the period just before death is a profoundly spiritual time
They think it is wrong to interfere with the process of dying, as this would interrupt the process of the spirit moving towards
God
All human lives are equally valuable
Christians believe that the intrinsic dignity and value of human lives means that the value of each human life is identical. They
don't think that human dignity and value are measured by mobility, intelligence, or any achievements in life.
Valuing human beings as equal just because they are human beings has clear implications for thinking about euthanasia:
patients in a persistent vegetative state, although seriously damaged, remain living human beings, and so their intrinsic
value remains the same as anyone else's
so it would be wrong to treat their lives as worthless and to conclude that they 'would be better off dead'
patients who are old or sick, and who are near the end of earthly life have the same value as any other human being
people who have mental or physical handicaps have the same value as any other human being
Exceptions and omissions
Some features of Christianity suggest that there are some obligations that go against the general view that euthanasia is a bad
thing:
Christianity requires us to respect every human being
If we respect a person we should respect their decisions about the end of their life
We should accept their rational decisions to refuse burdensome and futile treatment
Perhaps we should accept their rational decision to refuse excessively burdensome treatment even if it may provide several
weeks more of life
End of life care
The Christian faith leads those who follow it to some clear-cut views about the way terminally ill patients should be treated:
the community should care for people who are dying, and for those who are close to them
the community should provide the best possible palliative care
the community should face death and dying with honesty and support
the community should recognise that when people suffer death on earth they entrust their future to the risen Christ
religious people, both lay and professional, should help the terminally ill to prepare for death
they should be open to their hopes and fears
they should be open to discussion
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The Roman Catholic view
The Roman Catholic church regards euthanasia as morally wrong. It has always taught the absolute and unchanging value of
the commandment "You shall not kill".
Pope John Paul II has spoken out against what he calls a 'culture of death' in modern society, and said that human beings
should always prefer the way of life to the way of death.
The church regards any law permitting euthanasia as an intrinsically unjust law.
The value of life
Life is a thing of value in itself; it's value doesn't depend on the extent that it brings pleasure and well-being.
This means that suffering and pain do not stop life being valuable, and are not a reason for ending life.
The church believes that each person should enter the dying process with all its mysteries with trust in God and in solidarity
with their fellow human beings; they should die with the dignity of letting themselves be loved unconditionally.