This is the third of a 3-part case against physician-assisted suicide. It is reprinted from a presentation made to the Blackstone Fellowship of Alliance Defending Freedom on June 12, 2018, by pro-life apologist Scott Klusendorf. Used by permission. Please refer to the case study and help from theology in part 1 and Part 2: Help from Ethics.
HELP FROM PASTORAL CARE
1. Help dying patients finish well. A “good” death:
- Is a culmination of life well-lived
- Affirms the value of the person
- Follows a change in longing from earth to heaven
- Minimizes suffering when possible and affirms human dignity
- Comes after closure with family and loved ones
- Uses medical technology appropriately
- Does not involve euthanasia or assisted-suicide
- Involves resting in Jesus
- Brings people to God
- Brings glory to God
2. Help dying patients bring closure. They want the truth about what they’ll experience. They want a “heads-up” that it’s time to say what needs to be said, to wrap up. Four key things dying patients need to hear and say, frequently:
- I love you
- Thank you
- Forgive me
- I forgive you
3. Help church members anticipate objections, before they're in the situation:
Argument from “autonomy”—Christians are not masters of their own fate. They belong to God (1 Cor. 6:19-20). They are to honor God with their bodies, not destroy them. The timing of one’s death belongs to God alone (Heb. 9:27). Meanwhile, the appeal to autonomy is flawed in other ways.
First, a desire to die is not the same as a right to die. In her book Rights Talk, Harvard law scholar Mary Ann Glendon writes that Americans mistakenly tend to express personal desires in the language of personal rights. And they do so within the context of extreme individualism. But rights claims, unlike desire claims, go way beyond the individual. They unavoidably draw obligations from the surrounding community. Doctors must prescribe lethal doses to secure the right to die. Legislative bodies must craft laws to enshrine that right. The criminal justice system must enforce it.
Second autonomy is not absolute. You cannot sell yourself to chattel slavery. A doctor should not mutilate your healthy body, even if you desire him to do so. You cannot use your body for prostitution or illegal drugs.
Third, if the right to die is grounded in autonomy, you can’t limit that right to dying people. Anyone—sick or well, old or young—must be able to exercise it and government must compel others to help them exercise it. Yet most proponents of assisted-suicide want to limit the right to die to terminal patients.
Fourth, the coupling of autonomy with the right to die undermines the autonomy of the elderly, sick, and dying—who may feel the need to justify their existence. The right to die becomes a duty to die— as true in the Netherlands.
Fifth, the right to die also undermines the autonomy of physicians who are forced to participate in assisted-suicides or quit.
Sixth, are we promoting autonomy or abandonment? A depressed patient suffering from a debilitating injury or illness may express an initial desire to die, but later change her mind. As Wesley J. Smith points out, what she most needs in her moment of profound emotional crisis is not “cold autonomy,” but “intervention and sufficient time” to recover her equilibrium. Her most urgent need is not “choice,” but for others to show her that they value her life more than she herself does.
Argument against “religion”—Any challenge to autonomy is dismissed by secularists as “religious.” This is a dismissal rather than rejoinder. Arguments are true or false, valid or invalid. Calling an argument “religious” is a category error like asking, “How tall is the number five?” Moreover, the claim that my ultimate good in life is to be independent is itself a deeply metaphysical commitment every bit as religious as a Christian view of the human person.
The Christian worldview states my ultimate purpose is to serve my Creator. I am not my own; I belong to Christ, who purchased me with His own blood. The secular-autonomy view says I am master of my own fate and my ultimate good is to be independent. Notice that both views are doing metaphysics—that is, advancing a philosophical anthropology about the nature of human persons and how they ought to order their lives. One view is no more religious than the other.
Argument from “mercy”—The claim goes like this: "The most merciful thing you can do for a dying patient is end their misery with assisted-suicide or euthanasia. After all, that is what we do with animals." However, we don’t have to kill people to control their pain. Even if we heavily sedate them so they “sleep” before they die, the intent is not killing, only controlling their suffering.
Argument from utility—The argument goes that the right to die results in good consequences for all. Patients are relieved of suffering and society saves on health costs. The worldview in play here is utilitarianism—namely, does it produce the greatest good for the greatest number? However, utilitarianism is flawed.
First, some acts are wrong in themselves, such as torturing toddlers for fun or framing innocent people for crimes they didn’t commit.
Second, it’s an incomplete theory: Utilitarianism can’t define “good” without borrowing from other, deontological systems.
Third, utilitarianism fails to give guidance on decision making. That is, it can’t calculate the greatest good. For example, suppose you have $5,000,000 to help the poor. Should you give one dollar to 5,000,000 people or give the whole sum to an agency that will feed one thousand orphans for a decade?
Fourth, the consequences of an act are difficult to measure. If city planners displace 200 families from their homes to build revenue-generating zones, how do they know the greatest good for the greatest number will follow? Suppose those displaced families are forced to relocate to crime zones where their quality of life suffers greatly while only a small percentage of the population benefits from new businesses. How long must we wait to know if the greatest good was served?
Finally, who decides what is useful/good? "Might makes right" in this system.
Debates over euthanasia and physician-assisted suicide are not about individual autonomy, personal choice, or dying with dignity, but a larger worldview premise—namely, that some lives are not worth living. That premise corrupts everything it touches:
- It corrupts our philosophical anthropology, grounding human dignity in body-self dualism rather than intrinsic worth.
- It corrupts our understanding of rights, confusing a desire to die with a right to die.
- It corrupts end of life care, confusing a right to withhold treatment with a right to intentionally kill.
- It corrupts our theological understanding of what it means to provide pastoral care to dying patients.
Related: Link to authors (suggested reading)