Euthanasia is often defined as mercy killing, meaning a relatively painless death. People use the term for a variety of practices that run from the passive withholding of treatment to the active use of lethal substances or forces to kill. Some are widely accepted, such as giving medications to relieve pain knowing that they may also result in death.
The debate revolves around many questions, some moral and some very practical. People acknowledge many of these are the result of modern technology’s tremendous power when they characterize the problem as knowing when to “pull the plug”.
Technology has destroyed any common understanding of what entails a “natural death”. Dying usually now takes place in a clinic surrounded by professional care givers and machines rather than in the home with family and pastor. It often involves the anxiety about making technical decisions rather than waiting for death to occur. Everyone has their own stories about medical interventions.
All the possibilities offered by technology make affordability a problem. Doctors speak of the cost of dying rather than the cost of living, citing figures such as 85% of medical cost occurring in the last 6 months of life. Although people often agree intellectually that rationing health care has become necessary, their emotional involvement prevents discussing what this means. Opponents of a national health plan easily got support when they claimed it would introduce procedures to “kill grandma”.
Pain management has become a priority. People now assume quality of life includes lack of suffering. They have come to accept suicide, if it relieves such pain. Just about everyone desires a quick, painless death rather than a slow one that would enable them to get their affairs in order and prepare for life after death.
Often the public debate centers on legal issues, such as living wills and power of attorney. It asks whether the government has the right to extend its license to kill beyond war and capital punishment, and even more whether that license should be extended to individuals and groups. It also raises questions about the separation of church and state, such as whether the government can force the treatment of minors if parents refuse for religious reasons.
Those on the right worry we are again on a slippery slope. They regard much of the talk about self determination and relief of suffering to be rationalizations for ignoring the “Always care, never kill” precept at the foundation of a moral society. I find it somewhat puzzling that even conservative groups, such as the Ramsey Colloquium, are willing to accept the rejection of treatment if it is deemed useless or “excessively burdensome”. Even though they claim this is justified if we judge the value of treatment rather than value of life and keep the distinction between “ allowing to die” and “killing”, the problematic “exceedingly burdensome” seems to be already part way down the slippery slope.
The easy part is listing the basic principles which Christians can assume: Life is a gift from God to be cherished and protected. Christian love is to care for each person as a child of God. That love always involves compassion, which is sharing the sufferings of another person. (There is no doubt some of the talk about not wanting to see others suffer really is about not wanting to suffer with them). A Christian does not abandon those in her or his care. Death is real; humans die, God resurrects.
The difficult part is working out how these relate to the highly complex and difficult decisions that have to be made in our society. Among the more extreme I faced in the ministry were: 1) A person unable to feed himself in the final stages of Lou Gerhig’s disease asks his family to stop providing nourishment for him. They ask me if it is right to honor his request. 2) A father with a chronic illness refuses treatment so his three sons have the money for college. 3) Doctors who do not want to make a decision on their own ask a pastor’s opinion about withholding treatment from people who can not speak for themselves. They say the alternative is to continue indefinitely with expensive measures that they believe will never offer a cure.