Dying rose

Thinking Critically About Euthanasia

Warning: This article discusses suicide.

Euthanasia, assisted suicide, assisted dying, end of life choice; all are different names for the same thing: helping to end someone’s life with a deadly dose of drugs. Catch-cries such as: “If people want to die, it’s compassionate to help end their lives,” “I don’t want to see my relative suffer,” or “Their body, their choice,” sound reasonable and even kind, yet when looking closely at the issues, they overlook or ignore some important consequences.

This article highlights some of those negative consequences and also offers a Christian perspective.

As a society called to protect it’s weakest and most vulnerable, and yet often fails, the acceptance of assisted suicide and euthanasia sends two very dangerous messages.

First, we must consider how that message could be interpreted by sick and elderly people, who are confronted with the idea that their lives are no longer worth living. This opens the potential where what some see as a right to die, will become for others a duty to die.

Second, it potentially sends the message to caregivers and family that assisted dying can relieve them of their ‘duty of care.’ 

Currently, society accepts that people who are sick, elderly, or disabled, need to be cared for until their natural death. However, when assisted dying is offered as a choice, then staying alive to be cared for can soon become optional, not the default.

The option of euthanasia can increase guilt and worry upon the sick and elderly, because in their vulnerability they may feel they are a financial and emotional burden to their families. This can increase the pressure for them to justify to themselves, their doctors and their families, why they are choosing to live.

In the U.S. State of Oregon, for example, where assisted suicide is legal, 59%—more than half—of those who received a lethal overdose in 2019 gave being a “burden on family, friends/caregivers” as one of their reasons. [1] That is truly tragic. The ‘right to die’ could too easily become a ‘duty to die’, thereby removing it as a truly “free” choice.

One of the more chilling potential outcomes of a ‘right to die’ culture is that people could be pressured to die as victims of abuse and neglect by their family or caregiver. Director of LifeNET NZ, Brendon Malone, records the following story from a nurse who works in a New Zealand hospital. Originally, she had no problem with the concept of euthanasia—but all this changed when she experienced just how common family neglect was.

The nurse recounts:

“There was the family that stood in the corridor of a very busy ward and argued about why the individual who held Power of Attorney was wasting everyone’s time by requesting medical staff keep the patient alive, and that they instead needed to refuse treatment and let nature take its course otherwise, on discharge, the patient would have to go into care and that would eat into their inheritance.

What was this horrible disease that was stripping this individual of their dignity?

A chest infection, which was responding well to intravenous antibiotics.”

She goes on…

“There’s been countless family members who tell me that the patient is no longer their parent, their spouse, their sibling, that they’re dead inside, and could I please just give them more morphine to hurry things up a bit.

Then there’s the recent media attention over the practice of ‘granny dumping.’

This is where a family dumps their elderly relative at the emergency department so they can take off on an overseas holiday, or because they just can’t be bothered checking in on them over a long weekend.

I have found myself comforting many elderly patients who, through heaving sobs, recount their belief that they are a burden on their families, that they’d be better off dead, that they are cutting into their family’s inheritance, or they are of no more use to anyone.”

Assisted dying leads some people to request a lethal dose because they are being coerced, abused, or develop the mindset of being a burden. No legal safeguards and guidelines can fully protect against this.

There are other negative consequences which need to be considered:

  1. No second chances.

Doctors can get it wrong. Correctly diagnosing a terminal illness and then estimating how long a person has left to live is not an exact science. Despite modern medical knowledge, mistakes are made. A terminal prognosis can turn out to be wrong. And even when the diagnosis is correct, many patients still recover and survive long term.

It is important to acknowledge that with assisted death the result is final—there is no second chance. The chance to allow a misdiagnosis to come to light, or a natural recovery to play out is removed.

  1. The normalisation of ending another person’s life.

Euthanasia sends the message that it is OK for a doctor to deliberately end a person’s life in some circumstances. In countries that allow assisted suicide or euthanasia, there tends to be an increase in the number of assisted deaths over time. For example, the Netherlands has reached a point where doctor-induced deaths account for more than a quarter of all deaths in that country.[2]

  1. The expansion of criteria.

The criteria of who is eligible for assisted dying tends to expand over time. In countries that have allowed assisted dying, a relaxation of safeguards, and of how the law is interpreted become broader over time. An example of this can be seen in Canada where the requirement for a person’s death to be “reasonably foreseeable,” has been removed, allowing more disabled people to be eligible.

In the Netherlands, euthanasia was initially restricted to the terminally ill, but now it is given to increasing numbers of people with mental illnesses, and to people with advanced dementia or an accumulation of age-related conditions.[3]  

The Dutch are debating whether to allow euthanasia for anyone over a certain age who is feeling “tired of life.” And even though it is not officially part of the Dutch euthanasia law, new-born babies can and do receive lethal injections if they have disabilities—even if those disabilities are survivable and treatable.[4]

  1. A mixed message on suicide.

Far too many of us have been deeply impacted by the painful tragedy of a loved one choosing to end their life. Assisted dying sends a frightening and dangerous mixed message to those struggling with depression and suicidal thoughts. 

Suicide is an individual act, while assisted suicide and euthanasia always involve someone else in the ending of a life. Euthanasia creates a dangerous double standard in an age where suicide rates are already far too high. How can we tell a loved one, suffering from a treatable mental illness like depression, that it’s wrong to end their life by taking an overdose, when others can receive an overdose to legally end their life as long as it’s from a doctor?

This mixed message seriously erodes the valuable work of suicide prevention.

  1. A change in the ethic doctors live by.

Many of us have experienced the pain of watching loved ones suffer through a terminal illness, and it is normal to fear suffering at the end of our own lives. However, law changes are not needed in order to effectively treat severe pain. It is entirely legal for a doctor to administer as much medication as needed to relieve a patient’s pain and other symptoms—even if such medication hastens the patient’s death as a side effect of that treatment.

If a patient were to die as a result of the medication, the doctor would not be at fault because of their “intention,” which was to relieve the patient’s symptoms—not cause their death. This practice comes from thousands of years of established medical ethics—which have maintained the principle that it is unethical for a doctor to kill their patients intentionally.

Euthanasia shatters this principle and makes it legal for a doctor to intentionally kill their patients, in certain circumstances, with a fatal dose of drugs. This is why the World Medical Association, and the medical associations of almost all countries around the world including New Zealand, oppose euthanasia.

“Doctors should not be involved in interventions that have as their primary intention the ending of a person’s life” – Australian Medical Association.[5]

Categorising euthanasia as a “health service” legitimises it, making it sound somehow, safe. As people generally trust health professionals, euthanasia becomes more acceptable, simply because a doctor is doing it.

But many leading medical associations have declared euthanasia unethical.[6]

Labelling intentional killing as “healthcare” creates some disturbing consequences. If euthanasia becomes just another treatment option, there will be increasing pressure on health practitioners to be involved even if they do not want to be.

As the concept of Euthanasia is discussed and debated around the world, this raises legitimate questions: Is it right to force doctors to be involved in a medical system that condones intentional killing, contrary to established medical ethics? Is it appropriate for politicians to pass laws that redefine the concept of “healthcare”—overriding thousands of years of medical tradition?

  1. What are doctors saying?

Here in New Zealand, 17 doctors signed an open letter in support of euthanasia leading up to the country’s 2020 Referendum on the issue. By contrast, more than 1500 New Zealand doctors signed an open letter saying “No.”[7] Their letter ended with this request: “Leave doctors to focus on saving lives and providing real care to the dying.”[8]

Dr Sinéad Donnelly, a specialist in the care for terminally ill people, said of the proposed law change at the time:

“…only include doctors to provide a cloak of medical legitimacy.  Killing is not caring…If you are really determined to legalise euthanasia, find another profession to do it. Please leave doctors out of it so that we can focus on caring for our patients.”[9]

  1. The Christian perspective.

The points of discussion we have covered so far show that the ideas that give us pause for thought about euthanasia are not due to christian bias, but rather are potential consequences we should look at if we are a responsible society that looks after its most vulnerable. Yet, caring for our most vulnerable has always been core to true Christian expression within a community.

The Christian perspective is important because implicit within a responsible and caring society are the doctrines and values of Christianity which helped form such a society.

In Genesis 9:6 we are warned against the killing of another human being as humanity was created in the Image of God – Imago Dei – and because of this each human person has intrinsic worth and purpose and should be treated accordingly.

How we do this for the sick and dying can be found in Jesus’s story of the Good Samaritan found in Luke 10:30-37:

Jesus replied, “A man went from Jerusalem to Jericho. On the way robbers stripped him, beat him, and left him for dead. “By chance, a priest was traveling along that road. When he saw the man, he went around him and continued on his way. Then a Levite came to that place. When he saw the man, he, too, went around him and continued on his way. “But a Samaritan, as he was traveling along, came across the man. When the Samaritan saw him, he felt sorry for the man, went to him, and cleaned and bandaged his wounds. Then he put him on his own animal, brought him to an inn, and took care of him. The next day the Samaritan took out two silver coins and gave them to the innkeeper. He told the innkeeper, ‘Take care of him. If you spend more than that, I’ll pay you on my return trip. “Of these three men, who do you think was a neighbour to the man who was attacked by robbers?” The expert said, “The one who was kind enough to help him.” Jesus told him, “Go and imitate his example!”

As Professor David Richmond states:

“The parable of the Good Samaritan condemns those who *speak about* compassion but are *not* prepared to sacrifice the time and personal attention demanded for the care of suffering people. It is one thing to promote euthanasia as a compassionate response, [but] quite another to make the sacrifices involved in bringing love, comfort and care to the dying.”[8] 

Romans 15:1 asks that ‘we that are strong ought to bear the infirmities of the weak, and not please ourselves.’ Selflessness is a core Christian value. In fact, Timothy goes so far to say in 1 Timothy 5:8 that ‘if someone does not provide for his own, especially his own family, he has denied the faith and is worse than an unbeliever.’

These verses remind us of the importance God places on our caring and taking responsibility for others, and nowhere in Scripture is the intentional killing or assisted suicide of someone unwell or injured, seen as a positive part of a healthy society.  

People on both sides of this debate care very much about suffering. No one wants to experience intolerable ongoing pain and suffering—or force someone else to endure it. But as we have seen, the introduction of euthanasia into a community can have many unintended negative consequences.  

Assisted suicide and euthanasia might make sense at first glance, but like an iceberg, there are dangerous and hidden repercussions below the surface. A compassionate response to suffering is absolutely necessary, but only if that compassion is also extended to everyone who could ultimately be hurt through the normalisation of assisted death in a community.

 

Authorised by C. Booth, Board Chairman of Thinking Matters, 183 Moffat Road, Bethlehem, Tauranga 3110

 

If you would like someone to talk to please contact any of the following people:

Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)

Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)

Healthline – 0800 611 116

Samaritans – 0800 726 666

For prayer support:

Prayerline – 0800 508 080

 

References:

[1] https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year22.pdf

[2] https://www.theguardian.com/news/2019/jan/18/death-on-demand-has-euthanasia-gone-too-far-netherlands-assisted-dying; One may also read https://www.nationalreview.com/corner/doctors-induce-twenty-five-percent-of-dutch-deaths/. Calculated based on 150,214 total deaths in the Netherlands during 2017.  6,600 euthanasia deaths + 32,000 deaths by continuous sedation, divided by 150,214 = 25.7% of total deaths.”

[3] https://nltimes.nl/2020/01/30/10000-older-nl-residents-say-theyre-ready-die-new-euthanasia-study

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240050/; https://www.ucsfbenioffchildrens.org/conditions/spina_bifida/treatment.htm; https://www.parliament.nz/resource/en-NZ/52SCJU_EVI_74307_40438/8a0a8d96b6a34c3d1c8c2c822f18775d4ff65a43 (Submission by Dutch journalist, Gerbert van Loenen)

[5] https://ama.com.au/media/ama-calls-greater-investment-and-community-awareness-quality-end-life-care 

[6] https://bioethicsobservatory.org/2017/10/three-international-organizations-euthanasia/23110/

[7] https://www.scoop.co.nz/stories/PO1911/S00124/doctors-letter-opposing-euthanasia-gets-1500th-signature.htm

[8] http://doctorssayno.nz/?fbclid=IwAR2JGsDfQIfZiUbivStK3qYFuc0DfZSuUOl8PkUXWmO7gsRnl3wCuMfjfbg

[8] https://www.scoop.co.nz/stories/PO1904/S00183/doctors-open-letter-gets-1000th-signature.htm

[9] Trayes, Caralise, The Final Choice, Published by Capture and Tell Media, 2020, (p243)