Dignity and Death: Part I
In a landmark case on September 11, 2015, the California State Legislature approved a bill allowing for physician-assisted suicide. California Governor Jerry Brown signed the End of Life Option Act into law on October 5. The legislation now allows physicians to prescribe medicine for terminally ill patients to end their own lives.
The political backdrop to this bill is interesting because the California legislature declined similar legislation just a few weeks before the bill passed. However, proponents of the bill pushed it through and passed it in a special session called on September 11. The law adopted in California is very similar to the one that Oregon adopted several years earlier. Along with California, four other states now have some form of legislation allowing for physician-assisted suicide.[1]
Mark Leno, a Democrat from San Francisco, commented on the new legislation saying, “It allows for individual liberty and freedom, freedom of choice.”[2] He goes on to compare the issue of assisted suicide with same-sex marriage. These comments reveal how many proponents of these issues worship personal liberty and personal autonomy—which has now extended to end of life discussions.
The Supreme Court of the United States has denied a constitutional right-to-die, but it has left open the possibility of individual states to permit physician-assisted suicide. As noted, five states currently have laws in place permitting some form of physician-assisted suicide, and several states have recently considered some form of Death with Dignity legislation.[3]
The interpretation of such choice is often referred to as choosing a “good death.” However, the Christian worldview reminds us that our lives are gifts from God. Death is a direct consequence of sin and should not be described as “good.” We have no right to terminate the gift of life, and we have no right to claim autonomy to consider doing so.
This leads us to ask the question, “How should Christians think about dying?” The human life is filled with pain, suffering, and specifically scenarios involving terminal illness. Should we show compassion and help end the suffering of those wanting to die? Scripture speaks to these issues and motivates us to see our suffering with redemptive purposes.
In these next two essays, we’ll see that our lives belong to God. They are not ours to dispose of as we choose. Although suicide is often considered an escape from this world’s pain, claiming a moral right to suicide does not take into account the biblical understanding of the value of life. We’ll also examine how physician-assisted suicide is a “slippery slope” that is closely related to active euthanasia. Death is our enemy and any effort to approach the end of life is an affront to God’s will and the imago Dei.
History of Physician Assisted Suicide
Mention the terms euthanasia or physician-assisted suicide and the first person who might come to mind is Dr. Jack Kevorkian. Kevorkian was a Michigan physician who advocated physician-assisted suicide during the 1990s. A Michigan judge sentenced Kevorkian to twenty-five years in prison in 1999 for second-degree murder. While end of life issues had been debated for many years before Kevorkian, he popularized the discussion. And today the question of whether doctors have the right to administer medication to end life is becoming increasingly problematic. Before we look further into historical considerations, we should define some terms.
Ben Mitchell defines physician-assisted suicide as the “practice of the physician providing the means for the patient to kill himself or herself.”[4] In scenarios that allow, doctors accordingly have the right to prescribe a lethal dose of medication for patients, and then instruct them on how much to take so that they can actively end their lives. The key word in this form of euthanasia is actively. The patient does something to cause his or her own death.[5]
Discussion surrounding the right-to-die came to the legal landscape in the lawsuit Compassion in Dying v. State of Washington (1994). Ronald Dworkin calls this lawsuit the “Roe v. Wade of euthanasia.”[6] Federal District Court Judge Barbara Rothstein struck down Washington state’s anti-assisted law, and concluded that terminally-ill patients have a right to a willing doctor’s help in killing themselves. Judge Rothstein admitted the Supreme Court’s 1992 decision in Planned Parenthood v. Casey influenced her own decision. Notice the similarities between Casey’s central opinion and modern arguments for physician-assisted suicide: “Matters involving the most ultimate and personal choices a person may make in a lifetime . . . are central to the liberty protected by the Fourteenth Amendment. At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life.”[7] Judge Rothesin argued for the personal freedom of a dying person to take his or her own life. She equated this right to personal autonomy to the right of a pregnant woman to choose abortion.
Another landmark decision came in 1997. The Supreme Court handed down a decision relating to physician-assisted suicide in the Washington v. Glucksberg and Vacco v. Quill cases. They carefully made the distinction between the withdrawal of life-sustaining medication, and treatments where doctors end the life of patients by request. The Court further argued that assisted suicide could not be found anywhere in the Constitution, or in American legal tradition. However, they did not indicate the act of physician-assisted suicide is entirely illegal. As Scott Rae points out, “It simply ruled that states are not violating anyone’s rights if they prohibit assisted suicide, since there is no constitutionally protected right to die.”[8]
Although the Supreme Court ruled physician-assisted suicide could not be found in the Constitution, they did leave the door open for any state to rule in favor of the practice. On November 4, 2008, Washington state residents voted in favor of Washington’s Death with Dignity Act. Washington would become the second state during this time to advocate for doctors to assist in ending the life of terminally ill patients by request. On December 31, 2009, the Montana Supreme Court ruled in a 4-2 decision that no current state law prohibits patients from seeking physician-assisted suicide.
Vermont would follow as the fourth state when Governor Peter Shumlin signed a Death with Dignity law on May 20, 2013. As noted before, California would become the most recent state to sign into law a Death with Dignity Act on September 11, 2015. Currently, twenty-three states have recently considered, or are in the process of considering a Death with Dignity Act, while twenty-two states have no legislative activity around the issue.[9]
Biblical and Theological Considerations
Perhaps the most obvious case against physician-assisted suicide is the unique value of human life. This value comes from the fact that God creates humanity in His image and likeness. This gives human beings inherent dignity. We are not some sort of cosmic accident or mistake, nor animal that has gained the power to reason with one another. The Free Will Baptist Treatise states, “God created man, consisting of a material body and a thinking, rational soul. He was made in the image of God, to glorify his Maker.”[10]
All humanity is affirmed as being made in the image of God (Gen. 1:26-27; 5:1-2, 9:6; Jas. 3:9). From Genesis 9:6 and James 3:9, Scripture indicates the idea that humans have a unique status that demands they be treated with special dignity because they have been created in God’s image. This status reveals the value of every human being. F. Leroy Forlines comments on this truth,
Saying that a human being is a sinner tells you about a serious problem he has, but it does not tell you what a human being is. It is important in identifying man to say that God created him, but that still does not tell you what a human being is. God also created plants and animals. We have not told what a human being is until we say that he or she is created in the image of God.[11]
This dignity expresses itself in our purpose: to glorify God and to enjoy Him forever, as the Westminster Shorter Catechism makes clear. Indeed, we are created with the freedom to choose to accept who we are and what we are created for, but this is accompanied by responsibility and not complete autonomy. Therefore, God not only creates us with value; we are created for God and His glory.
The image of God is important in a variety of ways. For the purpose of these two essays, we should note that it is the basis for human dignity and the sanctity of all human life. This basis for the sanctity of all human life extends to those issues surrounding the end of life. In Part II, we’ll look more closely at the disastrous effects of active euthanasia and a proper view of dying well.
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[1] States with some form of physician-assisted suicide include California, Oregon, Vermont, Montana, and Washington.
[2] Ian Lovett, “California Legislature Approves Assisted Suicide” The New York Times, September 11, 2015, http://www.nytimes.com/2015/09/12/us/california-legislature-approves-assisted-suicide.html?_r=1 (accessed October 27, 2015).
[3] See “Death With Dignity Around The U.S.” here: https://www.deathwithdignity.org/take-action/ (accessed January 28, 2016).
[4] C. Ben Mitchell, Christian Bioethics: A Guide for Pastors, Health Care Professionals, and Families (Nashville: B&H Academic, 2014), 91.
[5] While euthanasia can take on different forms, for our purposes, euthanasia is active in that the patient actively does something to cause his or her own death.
[6] Ronald Dworkin, Last Rights? Assisted Suicide and Euthanasia Debated (Washington: Ethics and Public Policy Center, 1998), 90.
[7] Ronald Dworkin, Freedom’s Law: The Moral Reading of the American Constitution (New York: Oxford University Press, 1996), 144.
[8] Scott B. Rae, Moral Choices: An Introduction to Ethics (Grand Rapids: Zondervan, 2009), 218.
[9] “Death with Dignity,” https://www.deathwithdignity.org/take-action/. States that have recently considered Death with Dignity legislation include Alaska, Colorado, Connecticut, Delaware, District of Columbia, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Utah, Wisconsin, and Wyoming. States with no legislative activity surrounding a Death with Dignity Act include Alabama, Arizona, Arkansas, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Nebraska, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, and West Virginia.
[10] Treatise of the Faith and Practice of the National Association of Free Will Baptists, Inc. (Nashville: The Executive Office, 2013), Chapter IV, 5, accessed October 27, 2015, http://nafwb.org/site/wp-content/uploads/2013/07/13Treatise.pdf
[11] F. Leroy Forlines, The Quest For Truth: Answering Life’s Inescapable Questions (Nashville: Randall House Publications, 2001), 136.
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