Doctor-assisted dying

nigel-bby Nigel J. Bunce

Now that Parliament has passed legislation permitting doctor-assisted dying, the question of whether this should be allowed has become moot.

What has received much less attention is how faithful Christians might respond. The Anglican Church of Canada’s latest document on this subject, In Sure and Certain Hope, includes a theological reflection, but addresses Scripture only in very general terms, and the Gospels not at all.

What advice might the teachings of Jesus have for us on this subject?

Ancient Jewish tradition calls us to love God, and love our neighbours as ourselves (Deuteronomy 6: 4-5; Leviticus 19: 18). Jesus called us to embrace a new commandment to love one another (John 15: 12), and Paul explained love in his famous passage (1 Corinthians 13).

What, then, is the most loving response to the person who is terminally ill and asks for a merciful release from his/her intolerable suffering?

The Sixth Commandment— You shall not kill (Deuteronomy 5: 17)—makes the deliberate taking of a life problematic, even if the term is sugar-coated by calling it merciful release; hence the careful exclusions in the parliamentary legislation. Independent of physician-assisted dying, pain control using opioids can incidentally hasten death, as noted in In Sure and Certain Hope. Even though the primary reason for giving the drug is pain control, some might reasonably argue that even the incidental hastening of death abrogates the Sixth Commandment, especially when pain control is not implemented at the patient’s specific request.

“doctor-assisted death might be justi ed theologically as the least bad option in certain circumstances”

Doctor-assisted dying may be the least bad ethical option when the patient’s pain cannot be mitigated by medication, or when the person with a degenerative disease faces a hopeless future with increasing debility and loss of personal dignity. In these situations, a caring friend, relative or pastor might conclude that supporting the request of their friend, relative or parishioner for merciful release was the most loving option. As recognized in the legislation, this must always be at the instigation of a cognitively aware patient and never through external pressure.

Scripture offers precedent for sometimes upholding the spirit rather than the letter of the Law. In Mark 2:27, concerning plucking grain on the Sabbath, Jesus commented the Sabbath was made for humanity and not the other way round. In Mark 3:5, where Jesus healed on the Sabbath, he was angry at the Pharisees for their hardness of heart. In these passages Jesus favoured upholding the spirit of the Law (the Fourth Commandment) over the letter of the law; he did not rescind the whole concept of Sabbath observance.

Likewise, Jesus’ apparently dismissive attitude towards his family in Mark 3:33 can be seen, not as disregarding the Fifth Commandment (Honour your father and mother). Rather, the accident of his birth did not give them special access.

To summarize, doctor-assisted death might be justified theologically as the least bad option in certain circumstances. Even though it abrogates the letter of the Sixth Commandment, it could be argued to be consistent with the Scriptural idea that the Commandments were given as our guide, and not the other way round. This approach does not rescind the normal prohibition against taking life. Moreover, to deny this course of action to someone whose life has become intolerable could be argued to display the same hardness of heart for which Jesus criticized the Pharisees.

Should the Church decide to take this theological approach to doctor-assisted dying, it is essential that those who hold the traditional position about taking life feel respected and not marginalized. It would also be proper to develop appropriate and relevant prayers and liturgies to support patients and their families in this new situation.

The Reverend Nigel J. Bunce is Priest-in-Charge of St. George’s Rowville.  You can contact him below.