“Can I Die?” The Christian Response to Assisted Suicide
He was given six months to live. Robert’s body remained riddled with cancer, despite having pursued an aggressive course of chemo and radiation. The doctor said there would be no further point to treatment – he should just try to be comfortable and enjoy the remaining time with his family. Hospice would provide medication to alleviate the pain. As for his family, well, hospice couldn’t provide that. Robert divorced his wife 20 years ago. Sometimes he saw his son on Thanksgiving; he wasn’t on speaking terms with his daughter.
Six months was short and at the same time unimaginably long. It disgusted Robert to imagine how needy he would be in the end; it seemed pathetic. He dreaded that now familiar pain sharpening, his body weakening and his mind melting away into drug-induced oblivion. His gaze was drawn to the nightstand. He was retired from the police force, but he still kept his pistol there. Who he was kidding, he couldn’t do that. He knew what those scenes looked like – why should he give one of the guys on the job another sleepless night. Still the thought lingered.
He flicked on the television to find his thought taken up by the local news anchor: “Governor Tarpen signed into law today the ‘Death with Dignity’ act authorizing medical doctors to provide terminally ill patients with prescriptions that would end their life. Reporter Alicia Carwell has more for us on this groundbreaking legislation from the state house … ” Robert’s gaze turned to his cellphone on the dresser. He got up and called his doctor.
The preceding account is a fictitious representation of prevailing attitudes in Western society toward suffering and death. Rather than enduring intense physical pain that will end in death, a growing number of people are persuaded that individuals should have the right to medical assistance in ending their life under the circumstances of their choosing. Though often referred to as euthanasia, many of the options being put forward are more accurately designated as “assisted suicide.” In the case of euthanasia, a doctor has a direct hand in ending a patient’s life, such as by administering an injection. In the case of assisted suicide, a doctor plays an indirect role by only providing the patient with the medicine that they would need to self-administer to end his or her life. Euthanasia is not legal in the United State; currently 10 states and the District of Columbia permit physician assisted suicide.[1]
As proponents continue to push legalization across the United States and across the world, Christians are increasingly pressured to relent of their resistance. This pressure is often applied in the name of neighbor love, preserving human dignity and maintaining a wall of separation between church and state. What can the Christian say in response?
[1] https://www.catholicnewsagency.com/news/254197/assisted-suicide-in-the-united-states-where-is-it-legal
Life and Murder
We can start with the existence of God, how life is consistent with his purpose and point to his established order.
The foundation of Christian ethics is based upon the existence of God. If God does not exist, if the universe is a cosmic accident rather than a divine order, then moral law is reduced to a human construct determined by whichever human authorities happen to have the most power at any given time. Because God exists, creates and establishes order and purpose in the universe, moral law is possible. Every divine command simply coincides with God’s design and purpose for human beings, guiding us to our end.
This end is revealed in Genesis 1:26-31, wherein God created human beings to bear his image, made provision for their existence and called this and all his creation very good. From the start, it is clear that death is completely contrary to God’s purpose for human beings; it is only when alive that they can fulfill their purpose. Adam and Eve rebelled against God’s order and God willed that outside of this order they would die.
Nevertheless, within a fallen creation, God continues to point human beings toward his order by his commands. Murder is prohibited and killing is only licensed by God insofar as he uses human agents as his instruments of judgment or for upholding justice (Ex.20:13; Gen. 15:16; Ex. 21:12). In Leviticus 17, even the slaughter of animals is restricted in such a way as to make clear that all life belongs to God and that this life must be handled with great reverence.
Point to Scripture that prohibits murder and explain how suicide conflicts with God’s divine order.
Retracing our steps, God (1) creates human beings, (2) wills that they would live as his image-bearers, and (3) institutes order within a fallen creation; he prohibits killing human beings except when upholding justice or under divine command. There is no command that explicitly prohibits suicide of any sort, but God’s purpose for human beings and the strict regulation on taking human life indicates that suicide is out of bounds.
One seeming exception that may come to mind is Jesus Christ. He himself said that he laid down his life, that no one took it from him (John 10:18). While it is true that Christ laid down his life of his own accord, this was not for his own sake but for the sake of others, out of great love for his friends (John 15:13). This is not suicide, just as it would not be suicide for a soldier to jump on a grenade to save his comrades. The purpose in both instances is to save life, not take it, even if it must come at the cost of one’s own life. Besides this, it could also be said that Jesus offered his life under divine command and that this was for the sake of justice.
Love, Suffering and Human Dignity
Make much of the sacrificial gift of Jesus and point out the redemptive element of suffering.
God has made clear that his design for human beings is that we should live. Death has been provisionally allowed to afflict humanity, but God’s intent for life remains; he sent the Son to deliver human beings from death. For now, humans are subject to death and to the suffering that comes with death. Does immense suffering give us license to kill ourselves to end such suffering?
As already noted, we find no such provision in the Bible. Scripture exalts the examples of human beings who persevere in their suffering. Consider the man Job, who experienced immense personal and material loss and became ravaged by a skin disease. His wife tells him to curse God and die (Job 2:9). Job neither curses God nor does he reach for another means of killing himself (which would only be a different form of cursing God); he persists and lives to see a better day. In Hebrews 12, the author recounts the immense suffering that God’s saints endured because of their faith, none of them resorting to suicide to end their suffering. In the case of Jesus, we have a person who knows that his life will come to a very painful end. Rather than seeking an easier death or avoiding it altogether, Jesus perseveres to the cross.
Proponents of assisted suicide contend that a death marked by suffering is undignified. Christians have immediate cause to reject this claim because Jesus Christ suffered and died. The Son in taking on flesh has dignified the human condition. He did not share in our sin nature, but he has shared in our suffering in every respect. Not all suffering is due to personal sin, but all suffering is due to sin itself which has disrupted God’s good order. Jesus Christ has now come and redeemed this suffering, dignifying it, so that by faith it is put to good work in making us more like Jesus, restoring us to our created purpose (James 1:2-4).
Besides this, it is not obvious that suffering is in fact undignified. When suffering, a person has the opportunity to show forth the dignity of his or her character. When suffering, a person may receive care and honor that was withheld or demonstrated in other ways when he or she was physically well. Human dignity is not threatened by suffering. It is threatened when other human beings are unwilling to care for another in his or her time of need. It is threatened when we ourselves treat our lives as something that we can throw away, rather than understanding life as a God-given gift that all must honor, including ourselves.
While suffering has been redeemed in Christ, this does not require us to needlessly suffer when legitimate relief can be found. If I suffer the pain of hunger, I can eat food to relieve that pain, eating again and again as needed. If I suffer the pain of approaching death, I can receive the best palliative care available until I meet my end. If we are commanded to love our neighbors, then we should seek to offer this medicinal comfort. Nevertheless, this love for neighbor does not put us on the throne of God; we have no authority to determine whether it is better that a person lives or dies on the mere basis of suffering, even if that person himself believes it would be better that he die. Paul submits himself to the divine will in this regard, acknowledging that while death is gain for the Christian, he knew it to be God’s will that his present life continue for the sake of the Philippians (Phil. 1:21-26).
The Role of Government
Get clear in your own thinking on the relationship between church and state and be prepared to articulate it.
Everything I have stated above might be acknowledged as correct Christian belief, and yet be denied as having any ramifications for determining the law of the land. It is often said that religion must be strictly excluded in making any such determinations. This is an assertion that must be pressed. A distinction should be made between church and state (they are not one and same) and it is true that the New Testament instructs believers under the assumption that Christians do not occupy seats of governmental power. Nevertheless, it is completely naïve to suppose that government and law can be sealed off from religious influence.
Every authority and every law are established on the basis of certain metaphysical claims, claims that fall within the sphere of religion, but which are not limited to organized religions. These are truth claims that surpass physical observation and which cannot be proved in a laboratory – claims like “all people are created equal” and every other claim regarding human rights. It is literally impossible for humans to leave these metaphysical claims at the door when making determinations about government; it is deceptive for atheists and secularists to claim that they alone can do this. Christians are under no compulsion to bury the biblical origins of their convictions in order to legitimately participate in the democratic political process. Living together in a diverse and democratic society requires building consensus and this will naturally lead the Christian politician to argue her point on grounds that will appeal to those she must persuade; this can be done without denying the biblical foundations of her position.
Any determination on the legalization of assisted suicide may reveal a certain consensus on the existence, sovereignty and character of God. In relation to this, it may also reveal a certain consensus on human nature and what it means for human beings to flourish. Apart from these, it may reveal a certain consensus on the role of government. Assuming the Christian has sound convictions in the first two respects, it is this question of the role government that becomes most important. The Christian must be able to answer the question, “What is government for?”
Invite discussions on the biblical role of government: It’s value, it’s purpose and it’s limited authority.
The complete role of government is no less hotly disputed than assisted suicide; it would be impossible to sort through all the competing perspectives in this space. Instead, I will put forward the most basic biblical answer and deploy this against the legalization of assisted suicide. The governments featured in the biblical record are monarchies and autocracies, not democratic republics. God does not prescribe a particular form of human government, but he does prescribe the role and responsibility of government. In Jeremiah 22, God exhorts King Shallum of Judah to uphold justice and to protect those who are vulnerable. In Romans 13 [ESV], Paul teaches that God has established government to maintain justice and that the governor is “God’s servant for your good.” Taking these passages as representative of a more comprehensive biblical account, we could conclude that the purpose of government is to promote justice and seek the common good of its citizens.
If this is the role of government, it is difficult to imagine it being within the authority and interest of a government to facilitate the death of its citizens. With regard to justice, the state is only licensed to take life as far as it is responsible for punishing evil (Rom. 13). This does not apply in the case of those enduring physical suffering. In fact, rather than licensing death, the government is responsible to protect the lives of the innocent. Separated from consideration of guilt or innocence, all judgment is liable to become arbitrary if judges are compelled to discriminate between physical suffering, mental suffering and suffering due to impoverished life circumstances. Who is to say that one or another of these forms of suffering does not merit the relief of assisted suicide? Which pain is the worst? If a government cannot maintain that it is better for her citizens to live than to die and thereby seek their good by protecting them, then she will soon be overseeing a suicidal society that cannot flourish.
There are other ways in which assisted suicide threatens justice and the good of citizens. Doctors who have sworn themselves to the Hippocratic oath (“Do no harm”) may now be compelled to accomplice suicide in violation of their oath and their conscience. Terminally ill patients would now live under the guilt of requesting continued care from others, the pressure of family members to preserve an inheritance that will be eaten by medical care and the legal judgment of a society that has said their life is not worth living. How many would be able to withstand such pressures and continue to live?
Should they end their lives, it would be impossible to know what has been forfeited. As much confidence as we have in medical science, doctors are not beyond error. Before I met my wife her grandfather was diagnosed with cancer and given six months to live. Instead, he lived seven more years, saw us wed and got to meet his first great-grandchild. By legalizing assisted suicide, what potential good is a government depriving its citizens? A government threatens its own good by facilitating the pre-emptive death of its own citizens, citizens who may miraculously recover or benefit from new medical advances and who would potentially contribute to society in a multitude of ways in the future.
Stated simply, it is not in the interest of government to legalize assisted suicide. It is also not within its authority. A natural case can be made on the basis of justice, but the biblical revelation supplies us with even more. God has created us for himself and our created purpose as God’s image-bearers calls us to live and honor life. We do endure the conditions of suffering and death, but these have been dignified and redeemed by Christ’s own suffering and death. Like Paul, we can say that as long as we continue, it is necessary that we continue, even while we yearn for those better things to come.
Tom Loghry, “’Can I Die?’: The Christian Response to Assisted Suicide,” The Advent Christian Witness, Winter 2024