May Christian Doctors Help Patients Die If the Law Permits?
A podcast listener named Marna writes in: “Hello Pastor John! I am a physician in Canada that would soon face requests from my patients regarding assisted dying for possibly elderly, chronically ill, or cancer patients. Legislation would be approved next year. How do I have such a conversation with patients and family, given the fact that it is not God’s perfect will and not Christ/gospel centered? What is your view on it?”
The first thing that comes to my min d right now as we are talking, which hadn’t come to mind before as I was thinking about this kind of issue is that the phrase she used — assisted dying — that is a tricky phrase. Instead of assisted suicide, assisted dying. Nobody is going to have a problem with assisted dying if assisted dying means give me a drug, please, to help the pain not be so great as I am dying.
So that phrase is one of those slippery ones. Oh, it just kind of galls me that when we invent phrases that are okay in one sense and not okay in another, and then we use them to talk about what is not okay and, thus, muddy the water. Well, anyway, that just came to my mind as I was hearing you ask me the question afresh.
But here I have a whole lot of thoughts about this. And it seems to me we should start with some clear things and then end with some ambiguous things, because I really, really sympathize with the ambiguities that doctors, especially, and family members, face in these moments. But establishing what is clear will help us with the ambiguities, I think.
1) It seems clear to me that Christian conviction is the dominant control of the behavior of a Christian, rather than any laws passed by governments. We submit to laws as Christians, but not if they contradict clear biblical convictions. So no law concerning physician-assisted suicide should be the guide for a Christian doctor in what he or she is willing to do. That is clear thing number one.
2) God wants us to obey him even if we can’t see all the good fruit that will come, or that he designs to come, from our obedience. God usually gives some of his reasons for his commands, but leaves many of those reasons for us to discover long after the act of obedience, even decades or centuries after. Sometimes God commands us to do something and only much later do we or the world discover how many good effects come from obeying God and/or would have come if we had obeyed God. So that is the second clear thing. God wants obedience even if we can’t see all the good that will come.
3) Both the Old and New Testament command us not to murder, that is, not to take the life of an innocent person who doesn’t deserve to be put to death (see Romans 13:9, for example). The Bible underscores this command repeatedly by using various phrases. And one dominant one is, Don’t shed innocent blood, 19 times in the Bible, telling us to cleanse our land from the shedding of innocent blood, which is a circumlocution of, Don’t take the life of a person who doesn’t deserve to have his life taken away.
4) The fourth clear thing that it seems to me stands out in this discussion: Human life, which is distinct from all other earthly life in being created in the image of God and designed to exist forever, is the gift of God. And he owns it and may do with it as he please, take it any time he please without wronging anyone, and this is his unique prerogative.
- 1 Timothy 6:13, “[He] gives life to all things.”
- Deuteronomy 32:39, “See now that I, even I, am he, and there is no god besides me; I kill and I make alive; I wound and I heal; and there is none that can deliver out of my hand.”
- 1 Samuel 2:6, “The Lord kills and brings to life; he brings down to Sheol and raises up.”
- James 4:15, “Instead you ought to say, ‘If the Lord wills, we will live and do this or that.’”
Now it seems to me that all those passages from the Bible teach that giving and taking life is ultimately God’s right. Human life in its fullest sense is a miracle that only he can create and only he has the right to take, unless he has given the state the right to use the sword in various settings to take life. But as far as medical things are concerned, I think it is clear that God’s rights are at stake here and we dare not intrude on what he alone has the right to do.
5) A fifth clear thing is the truth that physicians historically have been life-givers and life-sustainers, not life-takers. The Hippocratic oath, it goes back four or five centuries before Christ, has guided physicians for centuries. And it has got a sentence in it like this: “Nor shall any man’s entreaty prevail upon me to administer poison to anyone. Neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman with a view to destroy the child.” That is the Hippocratic oath for babies in the womb and old people outside the womb. And so it is just a clear thing historically. This is what doctors do. They have pledged themselves not to use their remarkable gifting to take life.
6) A sixth clear thing is that suffering, human suffering, is horrible beyond words in some cases. And it is right and loving for physicians to use whatever medicines they have at their disposal, if the patient wants it, to minimize the pain of their patients. Nothing I say should be considered to contradict that, and I think it could be shown from Scripture that the fall of man into all the miseries that we have doesn’t justify the refusal to help men avoid being in pain.
7) And a seventh truth is that suffering is not viewed in the Bible as the worst thing. The Bible describes how God often uses it for good and wise and loving purposes and, therefore, suffering never becomes such an evil so great that it justifies disobedience to one of the commands of God like the command not to take innocent life.
So you can see where those seven things lead us. I don’t think a Christian physician will use his or her skill to take a person’s life or help someone else take it. Now here is what remains ambiguous: The line between taking life and not unduly sustaining life is not always clear. That is the rub. Yes, I am admitting that. I am saying that there are times when death should be allowed to run its course or to arrive naturally without any extraordinary efforts to keep a person alive. Clearly death comes to all of us. God wills that it come.
Discerning that time is not easy in these modern, remarkably wonderful medical days in which we live, which have created new possibilities for sustaining life beyond all ordinary means of life. And so I am just admitting great ambiguity here. The will of the patient to live is one key factor. Yes, strive to sustain life for a patient who desires life. But the will of the patient to die is not a decisive word, for the simple reason that many patients in the crisis of depression have attempted suicide, been rescued, and gone on to be thankful for the rest of their lives that someone contradicted their dark desires at that moment. And there are other reasons.
So my conclusion is that we do not have the right to help a patient take his own life or the right to take it ourselves. The laws that put such things into our hands are bad laws and should not constrain Christian physicians to act against their convictions even if they have to lose their job in the process. The ambiguities of end of life decisions regarding what is fitting life support and what blocks a timely, natural death, those decisions remain very, very difficult.