Death and Dying

Abstract

This essay explores the concepts of death and dying from a Christian point of view. It is based on a case study of an individual called George who was recently diagnosed with a condition known as amyotrophic lateral sclerosis, which cannot be cured. The condition is known to cause complete loss of muscle control, rendered patients incapable of moving, eating, speaking and breathing unaided. George cannot imagine becoming totally dependent on others and has begun considering voluntary euthanasia. The Christian worldview of death, illness, pain and suffering is used to determine the morally justifiable options for George. The concepts of the fallenness of the world and the hope of resurrection explain that much as suffering, pain and death are inevitable for mankind because of the rebellion in the Garden of Eden; greater glory awaits men and women when they enter into eternal life at the resurrection. More hope for George can be found in the Christian narrative that George is created in God’s image and is highly valued by His Maker. Much as George has the autonomy to decide what happens with his life, he should remember that Christianity considers life to be sacred and an inviolable gift from God, meaning that only God can take away life. Based on these values and considerations, the morally justifiable options for George are to obtain the highest quality of medical care, receive adequate support from family and friends, seek pastoral care and counseling, and obtain pain management therapies together with palliative care. In summary, this essay concludes that when making end-of-life decisions, Christian values such as sanctity of life and the narrative of the hope of resurrection should prevail.

Death and Dying

The Christian Narrative of Pain and Suffering: The Fallenness of the World

The suffering and pain that George is going through may be interpreted from the perspective of the fall of man and its consequences as narrated in the Bible. Contrary to most secular worldviews that depict a pain free life as the ultimate mark of good, the Christian narrative acknowledges that as long as man exists, he is prone to pain, sickness, suffering and death. Contrary to the popular perception that death is a natural, inevitable part of life, the Christian narrative is that God never intended people to suffer or die; these are the results of man’s rebelliousness and sinfulness as seen in the Garden of Eden. Adam’s and Eve’s disobedience to God’s command not to eat from the Tree of the Knowledge of Good and Evil angered God so much that punished them with suffering, pain and death.  As Hoehner (2020) observes, all illness, suffering and pain in the post-fall world has ultimate roots in sin and are punishment for sin. The fall of man at the Garden of Eden made all human beings sinners by nature, both through their rebellion and by nature (Hoehner, 2020). Viewed from this perspective, the pain and suffering that George is going through may be interpreted as not a result of his choice but inevitable outcomes of mankind’s rebellious, sinful nature.

The Hope of Resurrection

The condition that George is in is certainly devastating, especially considering that he will ultimately be unable to breathe unaided, move, speak, or eat. One can understand why George has started contemplating being put on euthanasia rather than face the inevitable torture that awaits him. Nevertheless, he could draw hope from the Bible; that amid the untold pain and suffering that he is undergoing, there is Jesus Christ through whose sufferings on the cross mankind has received healing and salvation. As Hoehner (2020) puts it, the Christian narrative on the hope of resurrection postulates that by the wounds of Jesus Christ on the cross human beings have received healing. As such, George may find renewed hope and consolation for his suffering in the idea that the dying and resurrecting of Jesus Christ signifies an end to the punishment meted on God on man for their sinfulness. In other words, George may be encouraged in the knowledge that Christ has paid it all and that it is possible for him to be totally healed of the disease he is suffering regardless of the fact that ALS currently does not have a cure. Holding onto this faith, George can hope to receive healing from God.

On the same note, the hope of resurrection portrays death as an enemy that has already been conquered. What this means to Christians is that although one may die physically, he/she will receive eternal life as long as he/she has placed his/her hope in Christ and lives a blameless life. This hope is captured by Renée Mirkes (2017, p.107) in the statement that “[the] Christian faith affirms the fact that our soul, the spiritual form of our bodies, is immortal and therefore continues after death”. This implies that although George is presently suffering from an illness that has no cure, the inevitable death is insignificant when compared with the greater glory and happiness that he will enter into once he is united with his Creator in eternal life.

The Christian Worldview of the Dignity and Value of Human Life

Losing the ability to move, speak, eat and breathe unaided is, without doubt, a very uncomfortable situation to be in for any adult. It is therefore understandable why George cannot bear the thought of becoming fully dependent upon his family for assistance with basic daily functions. As stated in the case scenario, George would rather undergo mercy killing than getting to a point where his power and dignity are lost. However, George should find strength and encouragement in the Christian worldview that he is created in God’s image and possesses inviolable dignity together with worth, his current condition notwithstanding (Hoehner, 2020).

The Christian worldview regarding the concept of human dignity is that individuals have a right to determine when and how to do. This is embodied in the motto of a Swiss organization by the name Dignitas, whose philosophy is that individuals ought to be allowed to live in a dignified manner and die in an equally dignified manner (Hoehner, 2020). Going by this philosophy and the whole idea of human dignity, it means that George’s thoughts about euthanasia cannot be condemned from a Christian worldview. The fact that George, like every other individual, has the right to self-determination suggests that he is free to choose how to die if he feels that his life with ASL is depriving him of his dignity.

Core Christian Values and Considerations

Much as the concept of human dignity, which in this case refers to freedom of choice on how to live and how to die, is recognized by Christians, there are several values and considerations that seem to oppose this view. To begin with, it has been observed that human dignity is a term that means different things to different people. The Catholic Church, for example, supports the concept of dignity yet it is known for its strong stand against euthanasia and abortion (Hoehner, 2020). Being one of the most vocal pro-life organizations, the Catholic Church does not embrace practices that involve deliberate taking away of people’s lives.

Secondly, there is the argument dignity is a useless concept unless it is founded on the values of genuine respect and honor. The Christian worldview holds that the value together with worth of human beings is derived from the concept that man is created in God’s image (Hoehner, 2020). This makes human life incalculably valuable by virtue of it being created and sustained by God Himself. At the same time, the idea of man representing God’s image means that God has redeemed mankind and made man’s ultimate destiny an eternal communion with Him. Based on this consideration, it is wrong for George to go for euthanasia as he would be messing up with the ultimate destiny intended for him by God. It also means that this decision would disqualify George from enjoying eternal glory with His Maker.

A third consideration when handling the dilemma that George is faced with is the principle of sanctity as it applies to human life. According to the Christian tradition, life’s sanctity is paramount over dignity. As used in the Bible, sanctity, which also means holiness, has a more profound connotation of something that has been set apart to be used for special/sacred purposes (Hoehner, 2020). The sanctity of life, precisely human life, is seen in the special status that God assigned man when he created him. He gave man dominion over the rest of the creation, giving him the power to subdue the earth. This shows that man’s purpose on earth is special. Similarly, being created in God’s own image gives man an exceptional relationship with God which should not be violated in any way. Hoehner (2020, para.47) states:

This sacredness, because it is given by God, confers a transcendent or alien dignity that is absolute and inviolable. It is absolute because it does not depend on any arbitrary characteristic that a human being may or may not possess, gain, or lose. It is inviolable because it is not relative or dependent on the changing utilitarian needs of society or the majority.

The above quote means that much as George feels that his suffering is too much and he would not want to be a burden to the people around him, opting for euthanasia is the worst mistake he could make. Referring to the aspect of sanctity, George should realize that his life is not his own; it was given to him by God and he is expected to take the best care of it regardless of the health condition he is in. In short, George should recognize the fact that his life belongs to God and it is only God who has the right to determine what happens with his life.

Morally Justifiable Options

Based on the above discussion, the concept of human dignity generates a huge dilemma where euthanasia is concerned. On one hand, dignity is understood by some people as implying that human beings ought to be allowed to choose how they live and how they die. On the other hand, there is the seemingly stronger opinion that the right to self-determination is subordinate to the value of life’s sanctity. These two conflicting viewpoints may be taken as suggesting that there are two options for George. The first would be to request to be put on euthanasia. This option is supported by the visibly less popular worldview of dignity as denoting that individuals have the autonomy to determine when and how to die. If this view is allowed to prevail, George could opt for active euthanasia, passive euthanasia, or physician-assisted suicide. The motive of all these three options would be to relieve George of the pain and suffering he is going through by hastening his death.

Active euthanasia differs from passive euthanasia in that in the former, doctors intentionally administer lethal drug doses, causing direct death of patients. In contrast, passive euthanasia involves withholding readily available medical treatments with the motive of ending the life of a patient (Hoehner, 2020). Active euthanasia is initiated by a physician, unlike physician-assisted suicide-PAS in which patients are the active agents. The difference between the two is that in PAS, the physician only facilitates access to lethal drug doses and issues instructions on how the patient will take these drugs. The patient remains the active agent with exclusive powers and discretion to take the drugs at his/her own appropriate time (Hoehner, 2020). These options are arguably morally justifiable from the Christina worldview of dignity and the principle of self-determination.

Nonetheless and as clearly discussed above, the sanctity of life overrides the principles of autonomy and self-determination for most Christians. Having said that man is created in God’s image and that God intends that man enjoys eternal glory with Him, euthanasia or physician-assisted suicide are not morally justifiable options for George. The Christian worldview of hope of resurrection as discussed earlier offers an excellent suffering of why intentional killing and suicide cannot be condoned by Christians. Although the sinful nature of man subjects him to unavoidable pain, suffering and death, the most important thing-which is the hope of all Christians- is that there is a higher glory. For Christian believers, suffering is temporary; Christians ought to look forward to a peaceful life after death where pain, crying or mourning do not exist (Hoehner, 2020).

The concept of sanctity of life makes physician-assisted suicide and euthanasia invalid options for George. Instead, George should demand the best medical care from his doctors as well as adequate support from his family members. Focus should be on addressing and responding to George’s physical, social and psychological needs. As recommended by Hoehner (2020), the Christian worldview of life’s sanctity requires all caregivers to address the entire person and provide counseling and pastoral care when needed. This is to say that instead of insisting on euthanasia, George should begin to understand that with proper counseling, pastoral care and unwavering support and encouragement from family and friends, he can still enjoy life despite having been diagnosed with ASL. This is particularly true considering that the biggest problem that George is facing is not about pain, it is the impending loss of mobility and crucial body functions. He dreads reaching a point where he becomes entirely dependent on others to eat and move around. With enough social support, counseling and pastoral care, George will find his condition manageable and can still lead a fulfilling life despite suffering from ASL.

Still in reference to the aspect of the sanctity of life, George should recognize that euthanasia does not uphold his dignity; it only violates it. Anderson (2015) outlines four reasons why physician-assisted suicide must be outlawed. Among these is the argument that PAS betrays the dignity of human beings. Anderson (2015) is of the view that instead of supporting or embracing PAS, physicians, caregivers, family members and patients themselves ought to respond to pain and suffering with utmost compassion. Besides pastoral care, social support and counseling, George should focus on obtaining effective pain management therapies and appropriate palliative care to manage his condition effectively (Orr, 2001). When it reaches a time when death becomes imminent, George could opt for fellowship together with hospice care, thus being in a position to die with dignity (Anderson, 2015).

Illustrating or rather reinforcing the viewpoint that euthanasia cannot be morally justified, especially from a Christian worldview is the availability of a range of treatment options for patients who have lost functionality of certain body organs. Concepts such as organ transplants (Roberts, 2017) and the availability of assistive equipment such as feeding tubes (Orr, 2004) all serve to indicate that euthanasia should not be an option for patients. For George, being unable to eat should not be a big deal since he can still use feeding tubes for the same purpose. In any case, feeding tubes are said to be relatively cheap, not extremely burdensome to patients, easy to use, and readily available (Orr, 2004).

Suggestion/Advice

In view of all the above considerations, if I were in George’s situation, I would allow the doctrine of sanctity of life and the Christian narrative of the hope of resurrection to prevail. I know that it is not easy to come into terms with the fact that I will not be able to live as normally as I used to; that a disease is gradually reducing me to a helpless person and that no matter how much money I may have, I cannot obtain a cure for my illness simply because no cure exists. Like George, the thought of taking away my life will certainly cross my mind. However, being a firm believer in God and the sanctity of life, I would not bring myself to accept euthanasia. My worldview on matters of life and death is that life is a God-given gift and that we will be answerable to God about what we did with our lives. Rather than facing judgment from my Maker on the Day of Judgment, I would opt for pain management therapies, palliative care, counseling and pastoral care if I were in George’s situation.

References

Anderson, R. T. (2015). Always care, never kill: How physician-assisted suicide endangers the weak, corrupts medicine, compromises the family, and violates human dignity and equality. The Heritage Foundation Backgrounder, (3004). www.heritage.org/health-care-reform/report/always-care-never-kill-how-physician-assisted-suicide-endangers-the-weak

Hoehner, P. (2020). Death, dying, and grief. In Grand Canyon University (Ed.), Practicing dignity: An introduction to Christian values and decision making in health care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/home

Orr, R. D. (2001). Pain management rather than assisted suicide: The ethical high ground. Pain Medicine, 2(2), 131-137.

Orr, R. D. (2004). Ethics & life’s ending: an exchange. First Things: A Monthly Journal of Religion and Public Life, (145), 31-36.

Renée Mirkes, O. S. F. (2017). Three End-of-Life Cases: Resolving Their Moral Dilemmas. Ethics & Medicine, 33(2), 107.

Roberts II, A. H. (2017). The Higher-Brain Concept of Death: A Christian Theological Appraisal. Ethics & Medicine, 33(3), 177-131.