following - not because I think I alone am right on each account, but because I think worldview is
as vitally important as progress and hope to provoke thought. In seeing how much national trauma and devastation that ideologies, deception, and lack of truth has brought to past and current
societies, I feel burdened that we should refuse to accept the world's proposals without combing
through Scripture for guidance. This is our individual responsibility. In prefacing this post, I realize it is not exhaustive and only addresses one issue of our culture which happens to be in the medical
field. However, before drawing conclusions about current events and issues or new philosophies, I
hope each will give time to consider your convictions. This paper was immediately in my mind even while walking through the Holocaust museum - not to belittle such atrocities - but because near the root of each is a deviation from Truth, a change in thinking, a dehumanization, and the loss of life's sanctity.
A few years ago, my grandfather quickly slipped away progressively relying on more oxygen,
lessening in his ability to respond, and increasingly necessitating hospitalization. Initially I struggled watching him no longer doing things he once enjoyed, and finally my grandmother honored his
request to withdraw care allowing a natural death. We knew it would not be the most pleasant way
to die; COPD meant that eventually he would essentially suffocate. He was given three to ten years
to live and barely made it three. My grandmother faithfully cared for him those last few years; we
watched their steadfastness one ambulance call after another. For the first time in my life I
personally experienced grief and death, the reality of caring for the dying, and suffering’s meaning
in our lives. Understanding differences between hospice, withdrawal of life-sustaining measures,
and physician-assisted suicide through God’s Word were foundational for my developing a Biblical worldview.
Graduating into a nursing career, I will increasingly be impacted by physician-assisted suicide as its prevalence in legislation and culture grow. For clarity, I define physician-assisted suicide as the
prescription or provision of means for cessation of one’s life upon request and consent,
understanding that criteria for implementation and qualifying patients differ among legislative acts. Beginning as a treatment for those terminally ill, assisted-suicide is raising concern within
communities of the intellectually disabled, mentally ill, elderly and even youth as already seen in
the Netherlands, Belgium, Luxembourg, Canada, South Africa, and Switzerland. An American
Psychiatric Association ethics committee member notes, “So far, no other country that has
implemented physician-assisted suicide has been able to constrain its application to the terminally
ill, eventually including non-terminal patients as legally eligible as well” (Crossland, 2016).
Another psychiatrist says, “It is dangerous to give anyone the right or power to kill another person, especially when the criteria of what defines the victim keeps changing. The physician is often the
last voice protecting the vulnerable population” (Crossland, 2016). Physician-assisted suicide is
currently legalized in Washington D.C., Colorado, Oregon, Vermont, Washington, and California.
Montana may also provide indirect clearance from homicide charges dependent on patient consent. Proposed as a peaceful, dignified, and autonomous death in a suffering world, it easily seems the
more pleasant or desirable option. Thanks to publicity from Jack Kevorkian, nick-named Dr. Death, in the 1990s and recently from Brittany Maynard, supporters are fighting to not have to cross state
lines to end their life the way they choose. Many organizations and non-profits including
Compassion in Dying, Compassion & Choices, Death with Dignity, Patient Choices, and Final Exit
have evolved to lobby for this proposed option. Hundreds of patients in each legalized state ask
physicians to end their lives with thousands more calling these organizations for information
annually. The issue is not one we can afford to ignore, nor will it dissipate. The question of life and death, of homicide or innocence, of keeping a practicing medical license or having a malpractice
revocation, and if or how to comply with the law must be answered.
While physician-assisted suicide is a current issue, it is not new. The ancient Greeks, Stoics and
Romans deemed suicide, mercy killings, abortion, infanticide, and euthanasia acceptable despite the contemporaneous declaration of the Hippocratic Oath. Per Manning (1998), “physicians actually
gave their patients the poison for which they were asked” (6). While Plato was impressionable in
cases of chronic suffering, he still held with the Pythagoreans that decisions of life and death were
the god’s from whom life had meaning. The rise of Christianity in the Mediterranean during the
middle ages, turned society against suicide and euthanasia. By the modern age and immediately
before the Reformation, Manning (1998) relates “one of the earliest theoretical discussions of
euthanasia in English literature was presented by Sir Thomas More in Utopia;” in which More “did
not advocate euthanasia,” but Utopians did with patient consent (9). Church tradition, especially
Judeo-Christians and Catholics, did not support physician-assisted suicide, and the Enlightenment and Renaissance challenged the church to no avail. The American colonies rejected physician-
assisted suicide following British common law and officially passed law against it in 1828.
Morphine’s discovery in the 1870s resurfaced the debate yet again without acceptance; even in 1980 the Pope made an official statement opposing euthanasia. Now medical schools which formerly
taught Hippocrates’s oath, “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect” no longer even read it (Edelstein, 1943). Today, according to The
Christian Post not only are the majority of Americans accepting physician-assisted suicide, but 40% of “evangelicals” justify it as “morally acceptable” (Smith, 2016). Yet in legalizing states, entire
hospital systems with religious roots including Seventh-day Adventists and Catholics have chosen
not to offer assisted-suicide. Californian doctors may personally choose to not prescribe lethal drugs or doses, but Act 39 in Vermont “requires healthcare professionals” to present assisted-suicide for qualifying patients “regardless of conscience or oath” (Crossland, 2016). Individual state medical associations have given their stamp of approval, yet the American Medical Association holds that
assisted-suicide is “fundamentally incompatible with the physician’s role as healer” (Gobba, 2016). Amidst the confusion of responses, society’s acceptance or proposal of morality does not direct our actions and thoughts as a Christian.
Facing the world’s watching eyes, we are called to be able to give an answer for the hope that is
within us (1 Pet 3:15). I take great comfort that God’s Word is true and unchanging (John 17:17).
While the same US Supreme Court that declared physician-assisted suicide illegal in 1997 now says
t is debatable, God’s character remains the same (Malachi 3:6, Ps 102:27). Compassion & Choices
lists “Seven Principles of Person-Centered Care”; the first of which is self-determination (https://www.compassionandchoices.org). Similarly, the principles of autonomy and personal values argue for freedom to choose life’s ending uninhibited by anyone’s opinion; some do not even wait for legality (Navasky & O’Connor, 2012). In contrast Obadiah 1:3 clearly says “the pride of thine heart hath
deceived thee.” Only God is all knowing (Pro 16:5, Jer 10:23, Is 47:10); and control over life and
death is not mine (James 4:13-17, Rom 14:7-10, Ecc 9:11). Life’s creation was not by my causation (Is 44:2, 24); God gave us breath (Acts 17:24-28, Job 33:4, John 1:3). Life therefore is a privilege and
sacred gift (Ecc 7:17, Job 10:12, 12;10, Duet 30:19). In truth, Compassion & Choices states that each
patient can handle different levels of pain. As healthcare providers aim to keep patients
comfortable, it is foolishness to think we can remove all painful effects of sin when new research
becomes available. Suffering is part of living, in which we can approach God honestly with our fears and sorrows (Is 43:1-2, 1 Cor 10:13). Grief and brokenness are undeniable and necessary (Pro 15:33,
18:14, Matt 5:4, Ps 23, 51, 30:1-12, Ecc 3). Principles of self-determination and autonomy strive for
control, and that control is the Lord’s.
Other principles of Compassion & Choices, informed consent and notice, state patients should be
informed to decide from all the options their physician offers. As a patient, I must realize I am not my own, but Christ’s bondservant and steward (Rom 4:7-8, 1 Cor 3:16-17, Gal 2:20). Bearing God’s
image (Gen 1:27), it would violate that image to cause death even in dignity’s name and defile the
same God’s dignity who originally created life. Even families of patients who chose physician-
assisted suicide admit it was “demoralizing to pick a time and day;” Final Exit reported half of the
patients possessing medication never bring themselves to take it (Navasky & O’Connor, 2012). We
are never sanctioned to tell life’s Creator we know better plans of living or dying (Is 29:15-16; 45:9, 64:8, Rom 9:20). God gives us a free will to love Him (John 1:12-13, 7:17) and obey (Josh 24:15, Pro
16:9) and likewise holds us accountable for our actions (Ps 62:12) which affect more than just
ourselves (Ex 34:6-7, Matt 5:16, 12:26, Rom 14:12). As a nurse, I am individually held accountable to use judgment in administration or implementation of orders and legally am only protected by the
hospital while following policy. Furthermore, I am to obey the law until it violates God’s Word (Acts 5:29) because God establishes authority in our lives for good (Rom 13:1-5, 1 Peter 2:13-17). This,
however, does not remove my responsibility to think and just comply. Answering God for my
actions, I cannot justify taking another’s life (Gen 9:6, Lev 24:27, Ex 21:12, Deut 5:17). As applied in the world of ethics, the ability to act does not equate the justification of such.
Within the right-to-die movement, healthcare improvements include hospice’s establishment in
1974, the American Hospital Association patient’s bill of rights in 1973, and living wills in 1967.
Patients can clarify their wishes by means of advanced directives, healthcare proxies, power of
attorney, or DNR orders as alternatives to physician-assisted suicide. Appropriately, Meilaender
states in Bioethics, our calling is to come alongside the hurting (1996). Lovingly we do not belittle
suffering but aim to extend care even if palliative. We must also realize that prolonging life at all
cost, denying our body’s mortality, or denying our dependence on God and death’s inevitability is
not biblical either. Who decides to withdraw care has transitioned from doctors to patients; yet the
intention divides between seeking death or realizing it as the ultimate outcome. Meilaender wisely
summarizes, “In learning to say no, in becoming people who give thanks for medical progress but
do not worship it or place out trust in it, we may bear a different life-giving witness to the world”
(103).
God’s lovingkindness is not without comfort or wisdom regarding suffering (Ps 73:26, Lam 3:24). As surely as the words “physician-assisted suicide” do not appear explicitly in God’s Word, the
principles to direct our choices are (Micah 6:8). God’s will for our lives is not nebulous, but neither
is it easy. We are not called to a life of pleasure, but surrender with the comfort that He will walk
with us (1 Peter 5:19). “We rejoice in our suffering, knowing that it produces character” (Rom 5:1-5) and live with expectant hope that the battle against sin and pain will be won (Phil 2:10-11). Only
God is our heart’s judge, but the world can see our actions (Titus 2:7-8). As Meilaender says in
Bioethics, God asks us “to live out our personal stories – the stories of which God is the author – as
faithfully as we can” (65).
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