In September, the MP Rob Marris will introduce a Private Members Bill into the House of Commons.
It is designed to allow doctors to assist in the suicide of patients with a terminal illness who have less than six months to live. Those in favour of this Bill argue that it will allow a small number of determined individuals who wish to kill themselves to be given a medically and legally approved method to achieve their wishes.
Support and wording
There is no doubt that there seems to be widespread public support for a change in the law, although in public surveys the percentage in favour changes dramatically depending on the wording of the question.
Lord Carey, former archbishop of the Church of England, has added his voice in favour of a change in the law. Speaking in a debate in the House of Lords in 2014, he said that he had changed his previous opposition to assisted suicide. ‘When suffering is so great that some patients, already knowing that they are at the end of life, make repeated pleas to die, it seems a denial of that loving compassion which is the hallmark of Christianity to refuse to allow them to fulfil their own clearly stated request– after, of course, a proper process of safeguards has been observed. If we truly love our neighbours as ourselves, how can we deny them the death that we would wish for ourselves in such a condition? That is what I would want… .’
Best compassionate response?
Lord Carey and others are arguing that Christian believers have a duty to provide the option of a quick and painless suicide for those who request it at the end of life. The emotional power of Carey’s words are obvious. Both Christian teaching and common humanity demand that we respond with compassion to ‘the desperate cries for help of terminally ill patients’.
But is killing the best practical and compassionate response that is available? Can’t practical compassion drive us instead to the provision of expert pain relief, psychological and spiritual support, and human companionship through the terminal phases of illness?
Christianity and suicide
Historic biblical Christianity has always been opposed not only to homicide, the taking of another human life, but also to suicide. Like murder, the deliberate destruction of one’s own life is a desecration of God’s image. In many ancient cultures, suicide was glorified as a noble way to die, the death of a nobleman, the death of a hero. In ancient Greece, the Stoics supported suicide as justifiable and virtuous under circumstances when happiness was not possible.
Cicero, the prominent Stoic philosopher, wrote: ‘When a man’s circumstances contain a preponderance of things in accordance with nature, it is appropriate for him to remain alive; when he possesses or sees in prospect a majority of the contrary things, it is appropriate for him to depart from life.’
But in all cultures influenced by the Christian revelation, suicide has been opposed. It is never glorified in the Bible but instead is seen as act of hopelessness and despair, for example in the tragic ends of King Saul, the first king of Israel, and Judas Iscariot. Despite this, it is clear that suicidal thoughts are not uncommon in God’s people. Elijah wanted to die, but was sent on a sabbatical instead. Jeremiah wishes he had died in his mother’s womb but discovers that God has plans for welfare and not for evil, to give ‘a future and a hope’. Job, too, wishes he had never been born, but learns that God is infinitely greater than his own perceptions.
So suicidal thoughts are not unusual in God’s people, but suicide itself is not to be honoured and glorified, because human life is worth more than that. Both intentional killing and suicide are ultimately contrary to the Christian understanding of creation. Even when tempted to kill out of compassion, we come up against the limits of our creatureliness.
Pressures with change of law
At present the law that prohibits intentional killing and assisting suicide provides protection both for patients and doctors. As a practising physician I know that doctors can come under intense pressure from relatives, and sometimes from their own emotions, to hasten death. On several occasions I have appealed to the law to resist pressure from well-meaning relatives.
But once assisted suicide is legalised then both doctors and patients will find themselves under new stresses. Pressure on terminally ill patients to kill themselves may come from family members or health professionals, but it may also come from the person themself, especially if they are concerned about the impact that their illness is having on loved ones.
I have heard many elderly people, including Christian people who ought to know better, say something like ‘I just don’t want to be a burden to my family’ or ‘I think it would be much better for you if I wasn’t here any longer.’ Once the law is available then those with a progressive illness will need to provide a justification for wishing to live. It is ironic that it is precisely those elderly people who are most concerned for the needs and welfare of others who may be at special risk of being emotionally manipulated into committing legally approved suicide.
Hardening our hearts?
Does this mean that, when faced with someone who is suffering unbearably, we must just harden our hearts? Is our Christian instinct towards compassionate action misguided and dangerous? No, on the contrary we must always act with genuine compassion towards those who are suffering. But true compassion, when directed by wisdom and judgment, points away from suicide and towards gentle and respectful caring.
Cicely Saunders and many other pioneers of palliative care in the middle of the 20th century were motivated by Christian compassion to find ways of controlling physical and other forms of pain at the end of life. They discovered that, with skilled modern medical care, ‘it’s not necessary to kill the patient in order to kill the pain’. Instead of medical killing, Christian compassion led directly to caring – skilled, costly and life-affirming.
‘It’s good that you exist’
At its most fundamental, Christian love says to every person ‘It’s good that you exist, it’s good that you are in the world’, to use the words of the philosopher Josef Pieper. The problem with euthanasia and assisted suicide is that in effect they say precisely the opposite: ‘It’s bad that you exist. It would be much better if you were not in the world,’
There is an interesting ambivalence in historic biblical Christian attitudes towards death. On the one hand, death is seen as an enemy and an outrage. We are called to fight against it with all our courage, skill and commitment. And yet death can also be a mercy, a release, even a strange kind of healing. In the biblical narrative human lifespan is limited, not just as a curse, but out of God’s grace.
To live for ever in a fallen and decaying body is not a blessing, but a curse. So, in God’s providence, death may be a merciful release from an existence trapped in a disintegrating body. Not only that, the Christian faith helps us to see that dying need not be a totally negative experience. There is the surprising opportunity of intense and wonderful life in the last days. As many who have gone before us have found, the end of our lives on this earth may be transformed by God’s grace into an opportunity for growth and internal healing. This means that there may be a time in our lives to say no to medical technology, because it is time for a deeper healing, a profound transformation that medicine cannot provide. Of course we want to benefit from the best in the way of pain relief and symptom control that modern medicine can offer, but we need to emphasise that dying is really a spiritual event, even if it has medical implications.
Shepherd in the valley
Of course we must not sentimentalise what the end of life may bring. In Christian thinking, suffering is not to be sought, but there are times when it should, at least to some degree, be accepted. We are still called to walk the valley of the shadow of death, but we do it in the knowledge that the Good Shepherd himself is with us. God, in the person of Jesus, has experienced death and he has defeated it. Death has lost its sting. In the New Testament it is very significant that believers are not described as ‘dying’, instead they ‘fall asleep’. The terror of death has been destroyed for ever in the resurrection life of Christ.
This period in the history of the UK is a time of danger, but also of opportunity. As our society asks whether we should deal with the fear of death by legalising assisted suicide, there is a renewed opportunity for those of us who are Christian believers to proclaim and to model a radical and coun-tercultural alternative. By dying well and dying faithfully we demonstrate the reality of Christian hope.
John Wyatt is Emeritus Professor of Neonatal Paediatrics at University College London. His book Matters of Life and Death is published by IVP. Finishing Line, a series of five Bible discussions for church groups or individuals, is published jointly by Keswick Resources and CARE. His new book ‘Right to Die – euthanasia, assisted suicide and end of life care’ will be published by IVP in November 2015.