Unpopular Opinion: Assisted Dying

For some, the subject of physician-assisted dying or physician-assisted suicide is clear and unequivocal. "Of course it should be legal," many would say. "Of course it should be outlawed," many others would claim. It is a highly emotional issue that provokes strong reactions. For some, the intellectual, philosophical, religious issue is inseparable from real life circumstances--a parent or a spouse who is struggling with a terminal condition or who has recently succumb to such an illness. Although, as a clergyperson, I am sensitive to those pastoral concerns, this is not an overly pastoral post. I am given the luxury of not facing those realities in my own family or parish--for now--and cannot assume to speak for those who do. Still, their voices are important to me, and I try not to ignore them.

Last week, California became the fourth state to legalize physician-assisted suicide, as it is known in this country. Coincidentally, that same day the students in the Advanced Degrees Program at the School of Theology at the University of the South in Sewanee were invited to a presentation and discussion on the subject of assisted dying. Our presenter was Bishop Jim White, Assistant Bishop of Auckland. Bishop White acknowledge to us that he had been asked to present on this topic when news broke that the bishops in New Zealand had issued a statement in opposition to legalized physician-assisted dying in their country. Perhaps ironically, however, Bishop White was the only bishop in New Zealand not to sign that statement. In his presentation, he gave a thorough and beautifully pastoral perspective on the subject, and I agreed with everything he said...except his conclusion. He is in support of physician-assisted dying, and I am opposed to it. But more on that in a minute.

Suicide still carries an unhelpful, unchristian stigma, and I think that stigma should end. That's why I prefer the term physician-assisted dying. People still ask me if those who kill themselves go to hell. They don't--at least not because of the way they died. People still ask me whether those who committed suicide can be buried from the church. They can, and I cannot think of a more important time for the ministrations of the church to be offered to the family and friends of one who has died. Parents and grandparents still ask me how they should tell their children and grandchildren about their family member's suicide. I say something like, "Be honest and open, avoid any sense of shame or guilt, and encourage them to talk with you or another person about it if they want to," but, as a parent, I also recognize how hard that is. In general, as Christians our aversion to death and talking about death undermines our proclamation of the gospel--that God's love in Jesus Christ is stronger than death--and those of us in leadership positions in the church (lay and ordained) need to do a better job of modeling our beliefs about death, including suicide, by talking about it.

Going a step further, no matter what one believes about suicide (physician-assisted or otherwise), we should be clear that there is no shame associated with how one dies. I believe that God loves us regardless of how we live or how we die. Despite what Jesus says about blaspheming the Holy Spirit, which has nothing to do with suicide, there is no one sin that God will not forgive. Suicide is almost always the result of mental illness like depression. It is, therefore, a manifestation of our brokenness, and God came to heal that brokenness--in this life and, more importantly and fully, in the next. There should be no shame attached to depression. There should be no shame associated with suicide. My opinion about physician-assisted dying has nothing to do with sin or guilt or shame.

In fact, when it comes to the political process, I am not opposed to physician-assisted dying. I am not persuaded by arguments that individuals will be pressured by their family members to take their own life because of financial reasons, nor am I persuaded by arguments that individuals who are not capable of making rational choices will be "choosing" to kill themselves. I trust that a process can be put in place to prevent that. On the other hand, I am persuaded that there are many people who would rather end their suffering and could benefit from the help of a physician. If someone is diagnosed as being in the end stages of a terminal illness that causes great pain and suffering both for the patient and for the patient's family, why wouldn't we let that person choose to die on her or his own terms? As Bishop White pointed out, many hospice care providers already provide morphine or similar drugs to relieve pain even though it speeds up the dying process. Are we really basing our laws on this issue around the pretense of one layer of intent? We could get bogged down debates over whether the patient must be the one to administer a fatal dose or whether, in the case of physical incapacity, we would allow a physician or family member to carry out the wishes of the patient. For me, those are still ancillary.

Politically speaking, when it comes to ending one's life, I am a Libertarian. Religiously speaking, however, I am opposed to physician-assisted dying because our faith has a different understanding of the value of life and the place of suffering in it. All life is sacred. Young or old, sick or well, barely breathing or fully thriving--all life is valuable to God. Over and over, the prayers of the psalmist remind us that God is with those who "walk through the valley of the shadow of death." Psalm 71 contains the confident cry of the aged to God, "Do not cast me off in the time of old age; forsake me not when my strength is spent." Through the prophet Isaiah, God says to his people, "Listen to me, O house of Jacob, all the remnant of the house of Israel, who have been borne by me from before your birth, carried from the womb; even to your old age I am he, and to gray hairs I will carry you" (46:3-4).

Likewise, we believe resolutely that God is present in our time of suffering. In Exodus, God declares, "I have surely seen the affliction of my people who are in Egypt and have heard their cry because of their taskmasters. I know their sufferings" (3:7). Paul writes, "[W]e rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God's love has been poured into our hearts through the Holy Spirit who has been given to us" (Romans 5:3-5). Since the earliest days of Christianity, our tradition has encouraged us to embrace suffering and not run from it because we believe that pain in this life is temporary. We do not seek to escape it but to be delivered from it as God shepherds us through death and into the next life. Pain and suffering are not indicative of God's absence but are sure signs of his presence with us.

Assisted dying runs counter to these principles of the faith. If the church supports efforts to legalize assisted dying, we undermine our belief that all life is equally valuable. To suggest that those who have only six months left to live or who have otherwise been diagnosed with a terminal illness are right in ending their lives in a way that others aren't places greater value on the lives of those who are not expected to die in the short term--those who aren't afflicted with an illness. But that cannot be the case. A life has equal value to God and to God's church no matter how many days are ahead. Life itself is a terminal condition, and we do not measure its value on how long it will last. Likewise, all life--whether lived in comfort and ease or in struggle and pain--is of equal value to God and to God's church. Yes, our response should be to alleviate pain but not to end the life of those who suffer from it. Otherwise, we declare that a life with pain is not worth living--that suffering and struggle win out--but for Christians that cannot be further from the truth.

I do not blame those who choose to end their own lives. I do not blame the physicians who help them or the politicians who give them that right. If someone in my parish with a terminal illness came to me and asked me what I thought, I would tell them my understanding of the faith, but I would not hold them to it any more than I would ask someone to adopt my particular and quirky way of understanding how atonement works or how prayers are answered. This is my reading of the gospel. This is how it is lived out in my life. In my opinion, the church should not support assisted dying, but it should provide every pastoral support to those who are suffering and to those who choose to end their suffering.