Assisted Suicide


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As you are well aware, only rarely does the preaching here depart from the consecutive exposition of some book of the Bible or the development of some biblical subject. But from time to time there is reason to depart from the ordinary course of preaching to deal with a subject of importance and of great public interest. We have such an interest before us as citizens of the State of Washington with ballot initiative 1000. You heard from Elder O’Ban last Lord’s Day morning of the elders’ concern that the congregation be informed about the issue and that it hear the church’s leadership say that it regards the initiative as proposing that the state undertake a policy that is morally reprehensible and dangerous in various ways. But it is not a subject that the Bible speaks to directly very often. We are not likely to come to a text that bears on the question within the next two weeks. Hence the sermon out of order, so to speak. However infrequently it may speak to some issues, Holy Scripture speaks to every issue of life and, being a book about life and death, it certainly speaks to the issue of assisted suicide, of what used to be called mercy killing.

We tend to associate suicide with the profoundly depressed person, the person who, though in good health and having every reason to live, nevertheless cannot find the reason and takes his or her life. This is the person, often a relatively young person, who jumps off the Tacoma Narrows Bridge, or slits her wrists, or takes an overdose of pills. We have suffered such a suicide in the life of this congregation and it is and was heartbreaking. Another woman who came to us for a time took her own life for a similar reason a few years ago. I went to her funeral at another church. It was all so utterly unnatural, even irrational. There are many such suicides, 30,000 annually in the United States, eighty-three per day, one every seventeen seconds. Almost none of them is reported in the newspaper or on the television news. It is standard policy not to report suicides. Almost all of these are suicides under the influence of deep depression or other psychological disorders. More than 90% of American suicides are thought to result from mental illness. You might be interested to know that men are four times more likely to commit suicide than women, that suicide is the eighth leading cause of death in our land, that suicide rates are highest among the separated, divorced, and widowed and lowest among the married, that the elderly are 50% more likely to take their own life than those younger than 65 years of age, and that native Americans are the ethnic group with the highest suicide rate. You can easily see from these facts that certain life situations exacerbate the pressures that lead people to take their own lives.

But no one is recommending that. No one, at least no one yet, is recommending that profoundly depressed people in the middle of their lives or even in their later years be hurried on their way to what they imagine to be release from the crushing troubles of their lives.

The initiative is recommending suicide of a different kind. The proponents of the initiative refer to what is being proposed not as suicide but as “aid in dying” and mean that terminally ill people who are mentally competent and are predicted to die within six months ought to be free to choose to end their pain and that of their loved ones earlier than the disease itself will end it.

The notion of ending one’s life on purpose for reasons other than mental imbalance is, of course, not a new one. Students of Latin have read for generations in Caesar’s Gallic Wars of Orgetorix, the first man among the Helvetians, who, when his conspiracy was discovered, killed himself to avoid execution by the state. Mark Antony and Nero both commit suicide so as not to fall into the hands of their enemies. After the turning point in the war with Russia and after the Normandy invasion of June 1944 suicides among German generals became an almost regular occurrence, preferable to the humiliation that would be meted out by Hitler. Hitler himself was a suicide for the same reason, as was his wife Eva Braun and his associate Joseph Goebbels and his wife Magda. The idea that there may be good reasons for mentally competent people to kill themselves is certainly not a new one.

Nor is the argument that there ought to be the freedom to kill oneself. David Hume, the 18th century Scottish philosopher, wrote in a work entitled On Suicide that “prudence and courage should engage us to rid ourselves…of existence, when it becomes a burden.” At the beginning of the 20th century Nietzsche in Thus Spake Zarathustra speaks similarly of suicide.

I hear only slow death preached,
and patience for everything “earthly.”

But he prefers:

Free to die and free in death,
able to say a holy No
When the time for Yes has passed.

And so Sigmund Freud had his doctor deliver to him a lethal dose after he had been diagnosed with terminal cancer. He told his doctor at the time, “Now it’s nothing but torture and makes no sense anymore.” [In Nicolai, The Question of God, 229-230]

Now, before taking up the question of whether it could be right to kill oneself or to have a doctor kill you – it is always best to use straightforward language when talking about such issues; that way we are more sure to engage the real issue – I say, before taking up that question, let me lay a foundation with some preliminary considerations.

  1. First, the question of suicide has long been discussed by ethicists and by Christian ethicists. Without taking the time to survey that debate, it is worth pointing out that careful distinctions need to be made. Is it ever right to end one’s life on purpose? The answer to that question is certainly “Yes.” During the Second World War the Reformed military chaplain, Allard Pieron, was captured by the Japanese. He was en route by sea to Japan where he was to be placed in a prisoner of war camp. Before he arrived, however, his ship was torpedoed. Pieron made it into a lifeboat, but there was one too many souls aboard; the boat was in danger of sinking. One man had to be sacrificed. Pieron volunteered and disappeared under the waves. His last words were, “I can die. I have a savior who has bought me with his blood.” [J. Douma, Responsible Conduct, 176, 183] He ended his life on purpose. But to call that suicide is to commit the logical fallacy of ambiguity or equivocation. Jesus Christ was not a suicide. Father Maximilian Kolbe did not commit suicide by offering to suffer the punishment of another prisoner at Auschwitz. A soldier does not commit suicide when he falls on a grenade to save the lives of his comrades. A death for others is not a suicide in the ordinary sense of the term. The point in such actions is not to kill oneself, but to save others. One would gladly live if the others could also live.One of the complexities of the current debate is that assisted suicide in the case of the terminally ill can be made out to be an act of noble self-sacrifice for others. Why make my family endure the long months of my dying; why burden them with the expense of it; why extend their torture? No one should underestimate the appeal of this argument. I’m sure a great many Christians who have had terminal illnesses and have watched their loved ones suffer with them have been tempted to think that love would end this suffering, if not for themselves, for their loved ones. Again, however, we are comparing apples and oranges. Your loved ones are not about to die and your death will not save their lives. What you would be sparing them by ending your own life is inconvenience only. Death for the sake of inconvenience and death for the sake of life are two dramatically different things. One remains a suicide; the other is not a suicide.
  2. Second, at the bottom of the issue raised by Initiative 1000 are two fundamentally different moralities. Whether or not a human being should be considered free to kill himself or herself and even obtain the assistance of a doctor in doing so is so obviously a question unmasking fundamental assumptions about the meaning of human life that nothing offends me more in the present political context than that those larger, deeper issues are never discussed. Albert Camus, the existentialist philosopher of the mid-20th century, wrote, “Judging whether life is…worth living amounts to answering the fundamental question of philosophy.” [The Myth of Sisyphus] But hardly anyone in the political debate is discussing that question!It is no surprise that we are discussing this question at this moment in the history of our country and our civilization. Western culture has more and more embraced a pagan view of human life and consequently pagan practices based upon that view are inevitably beginning to surface in the West. We are likely to think that the problem being posed by Initiative 1000 is the product of advances in medical technology. It is not so. There have been relatively painless ways to kill oneself for thousands of years as the existence of the Hemlock Society bears witness! People have been terminally ill and have known that they were terminally ill for thousands of years. The issue is not changed a whit by the existence of modern medical technology. What has changed is our society’s view of human life.

    I read an article recently in which the author recollected a conversation he had with a young German in Berlin. Asking whether she was a Christian she replied unaffectedly, “Ich bin Heide,” “I am a heathen or a pagan.” He was struck by the fact that she wasn’t making a controversial statement or trying to be funny, but simply identifying her viewpoint. Well, a great many people in Western Washington are heathens or pagans in the original sense of the term. They are not Christian; whatever spirituality they may claim, their view of God, man, and human life is much closer to that of traditional paganism than to historic Western ideas shaped as they were by the Christian faith.

    It is very important for Christians to realize this and to begin to speak about the issue from this vantage point. Initiative 1000 is rooted in a particular outlook on human life, on human freedom, and on meaning. It is a faithful reflection of a specific worldview. It is based on the ethics of that worldview. People are proposing a legal change that is in perfect harmony with their philosophy of life. I hear some Christians argue against Initiative 1000 as if it were a preposterous idea for Americans to favor such a thing. There is nothing preposterous about it.

    A little history is useful here. Pagan philosophy, the philosophy of Plato, Aristotle, and Plotinus, of Seneca and Marcus Aurelius, was remarkably sophisticated. When Alfred North Whitehead in the 20th century remarked that “All philosophy is a footnote to Plato,” he was saying that ancient philosophy loses nothing in comparison with what has been achieved by intellectuals ever since. But, interested as that world was in philosophical questions, respected as philosophers were – then much more than now – pagan philosophy was powerless, even if it were interested, to overcome the moral depravity of antiquity. It did not cleanse and could not elevate the habits of pagan society.

    “The golden age of ancient philosophy was in some important respects morally infamous, and the grosser scandals of antiquity – slavery, infanticide, sexual perversion, suicide, and the bloody shows of the arena – flourished in a society which held philosophers in high regard.” [H.H Henson, cited in C.F.H. Henry, Christian Personal Ethics, 437]

    “The Gentile world lay irrecoverably in the grip of that wickedness which the New Testament sums up in its index of vices.” [Henry, Ibid] It was precisely the rise of Christianity with its redemptive ethics, the purity of the lives of its adherents, and its testimony to the judgments of a holy God that gradually shifted the ethical sense of the world. The early Christian apologists could make the argument only because everyone felt the force of it and no one could deny it: by embracing the gospel both individuals and the society at large were shedding their dishonor and being changed into something obviously better.

    “The greatest religious change in the history of mankind took place under the eyes of a brilliant galaxy of philosophers and historians who disregarded as simply contemptible an agency which all men must now admit to have been, for good or for evil, the most powerful moral level that has ever been applied to the affairs of men.” [W.E.H. Lecky in Henry, 439n]

    The philosophers were aware of the categorical imperative, they knew and themselves felt the “ought,” the moral obligation that loomed over human conduct, but they were powerless to transform human hearts. They were embarrassed by the bloody arena shows, as some modern philosophers are deeply embarrassed by the violent and sexually abusive video games that are now so popular. But ancient philosophy really had no answer to this and no power to change people’s desires and the reborn pagan philosophy, now returned with a vengeance to the centers of Western thinking, has no answer either, if, indeed, it has sufficient moral interest even to seek an answer. The fact is that while pagan philosophers may have been offended by crucifixion or bloody shows in the arena, they found slavery, infanticide, and suicide perfectly normal and even necessary.

    It should surprise us not at all that Initiative 1000 is on the ballot. It is pagans thinking and acting like pagans. An ascendant paganism in America today – and, again, I am using the term not as a slur but in its technical sense as a description of polytheistic or pantheistic religious views coupled with humanistic and hedonistic ethics – an ascendant paganism was bound to lead to pagan practices.

  3. Third, there are a number of arguments that may be deployed against Initiative 1000 that are sound and weighty but are not arguments that Christians can derive directly from the Bible. There is nothing wrong with such arguments, but they need to be recognized for what they are: arguments of prudence, of historical perspective, of predictable outcomes, and the like.For example, there is the argument of the slippery slope, the gradual extension of assisted suicide to widening groups of patients after it is legally permitted for the terminally ill. This is precisely what has happened in Holland. People who are not terminally ill are now permitted to request assistance with suicide if they are chronically ill or even if they suffer from psychological distress not associated with disease, and what is more involuntary euthanasia, as it is called, is being performed for people who are not capable of requesting it. [H. Hendin, “The Dutch Experience,” K. Foley and H. Hendin (eds.), The Case Against Assisted Suicide, 101] In Holland to offer it to some and refuse it to others came to be regarded as an act of discrimination. A fifty year old woman in good health who had lost a son to cancer and was despondent was assisted in suicide as was a 41 year-old man who had been diagnosed as HIV positive, though he had as yet no symptoms. [Hendin, 109-111] It would take a brave man, or perhaps simply a disingenuous one, to argue that the culture’s acceptance of assisted suicide by the mentally competent will not lead in time to the justification of the killing of the elderly who are consuming vast quantities of medical care and are soon to die anyway or the severely disabled or the mentally incompetent. Why should resources be consumed by the soon-to-die or by those who cannot live a whole life when they could be devoted to those who have many years to live? The governor of Colorado a few years back suggested that in a time of limited medical resources the elderly sick need simply to get out of the way.

    Or there is the argument of the psychological corruption of the medical profession by the breaching of the principle of the Hippocratic Oath that a doctor is to do no harm. If the doctor no longer is to live by that principle, then what is to prevent him, especially when money is as involved in modern medicine as it is, from alternately helping or harming his patients as may be required by those who pay or reimburse him or her? You have all heard the statistics. Enormous percentages of health care expenditures are consumed by the dying. When the government or an HMO decides that it is too expensive to care for the terminally ill, will doctors resist the pressure once they have grown used to the idea of killing patients near the end of their lives? Will they resist the pressure to kill when they have a patient who is in great need of the organs the dying can supply?

    We have now in the United States OB-GYN doctors who alternately deliver babies and kill them. If now we have internists and geriatric specialists who alternately work to heal the elderly and dispatch them, what will this do to the very nature of the calling of a physician? He is no longer and can no longer think of himself as a healer, but as an instrument of a medical bureaucracy dispensing life and death as may be. Dr. Everett Koop said years ago, “I don’t think a medical student is ever told what his mission in life is.” [Cited in F. Payne, Biblical/Medical Ethics, 186] If a doctor has not had his sense of the sacredness of his calling nourished and protected, does anyone think that such a different view of medicine will not have consequences in the long run? Does anyone think that people will think the same way about their doctors? The Dutch situation is not encouraging. The Dutch now refer to assisted suicide and even involuntary euthanasia as an act of healing. When the doctor thinks he is being a healer by killing a patient what is in store for Dutch patients? There are plenty of elderly folk in the Netherlands these days who have a very jaundiced view of their doctors, now that involuntary euthanasia has become an accepted medical practice. As long ago as 1990 in more than a thousand cases Dutch physicians admitted they actively caused death without the consent of the patient. [Hendin, 104] The number of such involuntary deaths had gone up significantly by 1995 and still more in 2001. But the public does not seem to care. As one observer points out, “The Dutch tend to equate morality with religion, and most see themselves as nonreligious.” That particular observer saw the Dutch as distinctly lacking in moral passion. It doesn’t bother the population in general or doctors in particular that a person may have been killed against his or her wishes. Nobody gets angry or upset. [Hendin, 120]

    There are other such arguments against Initiative 1000. Making assisted suicide legal will in many cases drive a wedge between a family and its sick member. In a study done in a Dutch hospital, doctors and nurses reported that more requests for euthanasia came from families than from the patients themselves. There will be pressure brought to bear upon an individual from his own family to end his or her life. In one reported case, a wife who longer wished to care for her sick husband gave him the choice between euthanasia and admission to a home for the chronically ill. The man, afraid to be left to the mercy of strangers in an unfamiliar place chose to have his life ended; the Dutch doctor, though aware of the coercion, ended the man’s life. [Hinden, 109]

As I say, these are important arguments, but they are not the basis of a Christian opposition to assisted suicide. These arguments indeed may be the only ones that can be successfully deployed in the current political debate as theological arguments are likely to be regarded as irrelevant. But we Christians need to be clear as to why it is wrong to kill another human being even if that person is already dying.

The advocates of assisted suicide speak of a “right to die.” No one needs a right to die. Death is inevitable in every case. The question here is always and only whether anyone has the right to end his own life, that is, to kill himself, and, so, whether anyone has the right to assist him or her in doing so. And the Christian answer to that question is an emphatic “No!” And the reasons are fundamental, profound, and insurmountable.

  1. First, man does not own his life. It does not belong to him. He does not have the freedom to do with it what he pleases. This principle has long lay beneath the Western view of man, but in the modern world, the principle of human autonomy has largely replaced it. The modern exaltation of freedom is what lies behind Initiative 1000. It is an explicit denial that man has a creator to whom he owes his existence and that that existence must be honored as the possession of another, a greater Person, a Person who has absolute rights over it. Man has been made, the Scripture says, in the image of God. His is an existence shaped and ordered by its relationship to God. Its destruction, therefore, is an act of supreme rebellion against God and against human nature itself. Suicide is man’s attempt to declare himself his own god.This is what Dietrich Bonhoeffer meant when he wrote that “…a purely moral judgement on suicide is impossible, and indeed….suicide has nothing to fear from an atheistic ethic. The right to suicide is nullified only by the living God.” [Ethics, 172]
  2. Second, the Law of God strictly limits the taking of human life and does not permit an individual to kill himself or to help another kill himself. The occasions when life can be taken – the execution of a criminal, the waging of war, self-defense – all pass the test of life being exchanged for life. A murderer must suffer the loss of his own life; in self-defense the home-owner takes a life to protect the life of himself and his family, and so on. There is no provision for killing on any other terms. It is striking that the Bible never condemns suicide in so many words. But its strict limitation on killing and its general ban on killing suffice. What is more, the Bible does show us the practice of suicide in the case of several egregious sinners: for example Ahithophel and Judas, two notorious traitors. This is hardly a recommendation of the practice! Suicide is what evil men do.
  3. Third, the judgment of a human life, at any moment and in its entirety, is absolutely dependent upon the purpose of that life and the end of that life. Suffering in dying is one thing if it is nothing but the final gasp of an animal soon to decompose and return to the earth. Suffering in dying is an entirely different thing if man is made to exist forever and his life in this world, the decisions he makes, the commitments he undertakes, the things he believes, the laws he obeys or disobeys, determine the nature of that eternal existence. The reason you can’t kill yourself or help another kill you is precisely because you will have to answer for that in the next world. It matters what you do; it matters forever!It was the enormity of the crime and its likely consequences in the world to come that led Christian societies in the past to impose penalties on suicides: the forfeiture of his estate, the denial of the rites of Christian burial, and sometimes even his corpse interred at a crossroads with a stake driven through his heart. [N. Anderson, Issues of Life and Death, 98] We needn’t condone that practice to appreciate that it was thought important to inculcate in the society a total aversion to suicide. It was a crime for which punishment could be expected, even if we admit, as we should and as has sometimes been denied, that under certain circumstances believers may commit that crime and still be saved.

    But paganism lacks all teleology, all final causes, and any eternal purpose for human life. Both modern society and the modern medical community are largely unaware of the transcendent nature of man. Quite the contrary. Suicide is the index of the meaninglessness of life. As Bonhoeffer put it, “Suicide is a man’s attempt to give a final human meaning to a life which has become humanly meaningless.” [Ethics, 167] But it is the ultimate mistake. However as Christians we can understand the desire for suicide in certain cases, we can never accept the conclusion because it rests on a galactic error. It assumes that human life and behavior do not ultimately matter and, of course, they matter forever. Suicide is the supreme act of unbelief toward God. [Ibid, 168] It amounts to the denial that the infinite personal God gave you life, that he cares about your life, that he will judge your conduct, and reward or punish it accordingly. It is also the ultimate denial that suffering is meaningful and that in that suffering the Lord God offers the comfort of his own love and presence, power and help to those who look to him.

We oppose Initiative 1000 because it is a pagan’s way of thinking about human beings and because it will lead to a pagan way of living and dying for human beings. And while Christians might think that pagans can do whatever they please – that it might even be to the advantage of the Christian faith for paganism to be shown for what it is – no person who loves his neighbor wishes to visit on that neighbor the view of life enshrined in Initiative 1000.

In The Problem of Pain C.S. Lewis describes how, as an atheist, the problem of human suffering made it difficult for him to believe in a creator. Before he became a Christian death was the inevitable end to a gloomy and pessimistic existence. Death equaled extinction and though it was dreaded and feared, it provided a way out. When just seventeen he wrote to his friend Arthur Greeves,

“My father seemed in very poor form when I got home, and fussed a lot about my cold: so everything is beastly, and I have decided – of course – to commit suicide again.”

Many a truth is told in jest and we know from his autobiography that Lewis considered suicide as an escape if life were to have become unbearable. After his conversion, Lewis believed that the only person to decide the time of one’s death was the Person who gave one life. It is an impregnable moral and philosophical position and can be dislodged only by the denial that there is such a creator. And of course, that denial opens the floodgates to every manner of mischief and despair that come from man’s asserting his freedom from God.

What we see in Initiative 1000 is the gulf that has opened between a Christian view of man and his life and that of the culture in general. We are back to the world of the first few centuries of the Christian era. If there is a silver lining in this cloud it is that paganism’s view of life will prove bleak as it always has and, if only Christians will be faithful to their principles in word and deed, the light emanating from the church of Jesus Christ will grow brighter by degrees.

The age’s progress fears no God,
No righteous law, no Judge’s throne;
Man bounds along his new-found road,
And calls this universe his own.

Old mischief becomes earth’s creed;
The falsehood lives, the truth has died;
Man leans upon a broken reed,
And falls in helplessness of pride.

He spurns the hand that would have led,
The lips that would have spoken love;
The book that would his soul have fed,
And taught the wisdom from above.

Eternal Light, hide not Thy face;
Eternal Truth, direct our way;
Eternal Love, shine forth in grace,
Reveal our darkness and Thy day!
—Horatius Bonar