The term euthanasia has been applied to a variety of situations, ranging from the cancer patient who legitimately refuses further therapy, to the gassing of the mentally retarded and the senile in Nazi Germany. In order to clarify what is being discussed, words like voluntary and involuntary, active and passive are added. But many grey areas remain. If, for instance, a doctor decides not to treat pneumonia in a patient already dying of cancer, is he (or she) practising euthanasia?
Debate on euthanasia in Australia has focussed on the question of voluntary euthanasia. Should it be legal for one person (such as a doctor) to assist another person to die, at their request? That will also be the focus of this article.
What does the bible say?
The bible does not discuss euthanasia, or provide any clear examples. King Saul's plea to his armour bearer to kill him rather than letting him die at the hands of the Philistines (1 Samuel 31:4) might be construed as a case. The servant's refusal to carry out his request probably related more to who Saul was than to a well thought-out position on euthanasia.
Our attitude to euthanasia, then, must be drawn from the teaching of the bible as a whole. Some argue that to end a person's suffering by helping them to die is consistent with Jesus' teaching on love and mercy. Yet the prohibition on the taking of human life runs through both Old and New Testaments. Only in the case of serious crime or war is an exception made.
As Christians, our attitude to our own suffering is likely to be different to that of non-Christians. We worship a Lord who was willing to suffer and die on our behalf. We have his promise that we will never be left alone. Although we do not seek suffering, we know that in all things, God works for good for those who love him. (Romans 8:28). It would be unfeeling and arrogant, however, to speak of the merits of suffering to those who don't know Christ.
Most of those who support the use of voluntary euthanasia do so out of genuine compassion towards the dying. Some misunderstand what is being proposed, thinking the argument is about whether or not a person has the right to refuse life-prolonging treatment, (which they do), or to receive adequate pain relief, even if it may shorten their life (which is also already accepted as ethical by most). Others are motivated more by a fear of their own death.
What is being debated is the deliberate taking of life. While it is right to state God's word as truth, not everyone will accept it. There are rational arguments against voluntary euthanasia which many well-meaning people have not considered.
Arguments against euthanasia
Advocates of voluntary euthanasia argue that the terminally ill have a right to die, that the community should not interfere with individuals' rights, and that adequate legal safeguards will prevent euthanasia being abused.
It is unlikely that legal safeguards will protect the sick who do not wish to die by euthanasia. No law can protect people from subtle pressures. The dying often place a heavy burden on their family, physically, emotionally and financially. Medical and nursing staff can find dealing with the dying frustrating and harrowing, especially if they lack training in palliative care. A hint that euthanasia would provide an acceptable end to everyone's suffering need not be voiced to be understood.
The difference in cost between providing palliative care services (good or bad) and euthanasia must make euthanasia seem an enticing option to governments concerned about health expenditure and committed to economic rationalism. No-one is arguing this way at the moment, but if euthanasia became an option, palliative care would surely languish.
Many people suffer for years from illnesses which are not fatal. If we argue that the terminally ill have a right to die on compassionate grounds, why should we not treat these people with similar compassion? If they went to court and demanded the same right, could they be legally deterred? If so, on what basis? All other human rights apply universally.
Of course some people would argue that everyone should have that right. Most would hesitate at the idea of allowing, say, a physically healthy but depressed twenty-five year old to die with a doctor's assistance, even if all treatment had failed. They would feel that the twenty-five year old still had a "useful" life to live. In wanting to restrict euthanasia to the terminally ill, people are in effect saying that the dying person's life is of less value than others.
Some of those requesting euthanasia have argued this way themselves. They believe that their life as a useful, productive member of society is over, so there is no point in continuing. They fear losing their independence and having their bodily needs cared for by others.
Judging the value of a life by its productivity and independence is dangerous. It is only a small step from judging the value of one's own life to judging that of another. Our society already sanctions the use of such judgments in the case of "therapeutic" abortions for handicapped fetuses.
There is no logical reason for restricting euthanasia to the dying, once the decision has been made that some lives are less worth living than others. Why not extend the use of "mercy killing" to the severely retarded, the demented or the frail elderly?
What are the deeper issues?
Our ability to relieve pain and suffering is greater now than at any other time in history. No doubt euthanasia occurred in the past despite it being illegal, but why is it now becoming openly accepted?
Advances in medical technology have blurred the boundaries between life and death and sometimes prolonged the process of dying. But underlying the debate on voluntary euthanasia is a deeper struggle between two world views. At stake is the right to determine the future direction of our society.
On the one hand is the Judeo-Christian view which has shaped our laws, customs and taboos for centuries. It recognises that human life is different to that of other animals and has intrinsic value because it is made in God's image. The good of the individual is inextricably bound up with the good of the community. Death is followed by judgment and an after-life.
On the other hand is a secular humanist view which measures and grades the value of life on such things as consciousness of self, the ability to develop and the experience of pleasure. The good of the individual takes precedence over the good of the community. Death brings either non-existence or peace. It is not possible for both these views to form the basis of our laws.
In one sense the debate over whether or not voluntary euthanasia should be legal is already irrelevant. For several years now, juries in Australia and other western countries have refused to convict people charged with assisting another person to die. In the face of public opinion, the law is helpless. (Abortion and prostitution are both illegal but freely available.)
In Australia, Christians are a minority living in a democracy. We cannot insist on our view being accepted just because it has been accepted in the past. Our only option is to work to change the hearts and minds of those around us. In the short term that means pointing out the dangers and fallacies in what is being said. In the long term, it means spreading the gospel and praying that God's kingdom will come.
By Dr Stella Budrikis
© Copyright 1998