Assisted dying and controlling death

Tue, 12/11/2024 - 10:11 -- James Oakley
The palace of Westminster
Image Credit: Naveem Annam

Today, Kim Leadbeater's private member's bill is published. It proposes legalising assisted dying, with certain safeguards in place. MPs will debate and vote on the 29th November. If approved, a series of amendments will pass back and forth between the two houses of parliament before, presumably, it becomes law.

The Debate in Brief

The debate over this is both complex and by now well-trodden. Those in favour point to stories of the terminally ill suffering a slow death, and want them to be able to choose to cut that short. Dame Esther Rantzen has been a high-profile figure pushing for such a bill for just over a year. She points out that she plans to travel to Switzerland to end her life when the time comes, but that under the current law her family could not accompany her for fear of prosecution on their return (did they "help" her in any way).

Those against point to the sanctity of life. Ed Davey did a good job on the Today Programme this morning at explaining the (maybe unarticulated) pressure the terminally ill may feel to end their lives so as not to be a burden. The slippery slope is often cited as a reason to oppose such a change in the law. What starts as a compassionate case for a few very carefully defined cases can easily become something that is used far more widely. We should, instead, improve palliative care. Proponents of the bill would reply that improving palliative care does not mean we need to reject the bill.

Christian Ethics

For a Christian, the morality of this is relatively simple. God gives life, and God takes it away. He forbids murder. We belong to him, so taking a life is also theft. We resent our own discomfort and illness and wish we had a different death, so suicide is also coveting.

Not all killing is wrong. God permits a state to go to war against another to keep its citizens safe (although that is not justification for any and every war), and in certain cases God permits (but does not require modern states to sanction) capital punishment.

But murder, the taking of an innocent life, is always wrong, even if that life is your own.

Roman Catholics distinguish venial and mortal sins, and taking a life is a mortal sin. They therefore teach that suicide is unforgivable because you commit a mortal sin immediately before dying, necessarily removing the chance for repentance. The Bible does not teach this distinction, so suicide is wrong, but no more sinful and no more unforgivable than any other sin. Sometimes deep mental illness leads people to take their lives, and people can draw comfort that Christians who do this will receive the gentle compassion of God on the last day; Jesus paid for all their sin.

Having said "relatively simple", let me stress the "relatively". Christian ethics is never absolutely simple. We do need to have regard to the circumstances and consequences of our choices, as well as the commandments. But at the level of commandment, God's will is pretty clear, and while there will be hard cases, we cannot argue that suicide or assisted dying are absolutely right based on circumstances we could think up when it may be the right choice.

What's Really Going On

So far, I've just sketched the contours of the debate. What I really want to do is look at what's really going on here. Now, please don't misunderstand me. I'm not wishing to speak for everyone as I generalise. I've just said that ethics is complex because every situation is different. I'm not for one moment claiming that I'm about to describe every person who is in favour of assisted dying, every person who has ended their life when terminally ill, or every person who has walked with someone down that road. Rather, I'm making some general observations about the tone of the conversation and the general cultural trends in which this conversation lies.

Kim Leadbeater MP said to the BBC today that this is "about shortening death rather than ending life".

If you listen to people talking, this is actually about control.

Don't get me wrong. I've known people who are terminally ill, and watched them suffer. I've wondered why God did not take them sooner than he did. All suffering is terrible and deserves our compassion. And if we could find a way to take the suffering away, we'd do it.

So what do I mean? We live our lives denying that there is a sovereign God, who is really in control of our lives. That is the very nature of sin. We like to think that we are in control. We want to plan where we live, if and who we marry, what job we do, when we retire, how many kids to have (if any). This desire to be in control leads to many very good things. Not everyone has social mobility, but to be free to move somewhere else, to take a different job, is a good thing. This desire to be in control affects many other ethical issues around life and death. Those who want fewer kids argue for the right to contraception and abortion; those who want more kids argue for the right to IVF.

Death cuts across all of that. Death is the moment when God asserts that he is in charge. We can delay it happening by various medical treatments. But we cannot stop it. All have sinned and fall short of the glory of God, and therefore God's words to Adam in the Garden "you will surely die" hang over every one of us. For the Christian, we live on when we die physically, and we will be raised physically, but physical death still awaits us all. We can do all kinds of things to hide from the fact God is sovereign (that is bad), and we can do all kinds of things to take control of our own lives (that is good, and part of what it means to be in the image of God). But the day will come when God steps in and cuts across all of that.

This is one of the things that makes death so terrible. We feel powerless. We cannot bring back the loved one we have lost. Someone who is ill may have much help from the doctors. But if they cannot cure the illness, we are powerless to stop this person passing from this life to the next. And, if some of us have made an idol out of being in control, death is the moment that the idol fails us.

If you listen to people advocating for assisted dying, they accept the reality that they will die, but want control over how they die and when they die. Faced with the harsh truth that death is the moment when we are utterly powerless and out of control, this is a last-ditch attempt to take control over death. People may not articulate things this way, but there is a sense that if you can end your life at a moment of your choosing, you have just managed to stay in control of your whole life, right to the very end.

So this is not actually about a wish to shorten death. It's a wish to take control of death. But given God chooses the time of our death, it's actually a wish to take control of God. We're very close to the heart of what sin is.

To see through this, we need to realise that real control would be to retain the choice of whether to die. We don't have that choice. We can choose to die later, with medical intervention if it succeeds; we can choose to die sooner, by passing a law that allows it. But we cannot choose not to die at all.

You've only remained in control "right to the very end" if you think the moment of your physical death is "the very end".

If you believe that "people are destined to die once, and after that to face judgement" (Hebrews 9:27), that God "has set a day when he will judge the world with justice by the man he has appointed" and "has given proof of this to everyone by raising him from the dead" (Acts 17:31), and that "a time is coming when all who are in their graves will hear his [Jesus'] voice and come out" (John 5:28-29), then death is not "the very end".

God is God. We are not. We can use our God-given creativity to take control of many things, and we can do that to his praise and glory. Modern medicine is one wonderful example of this. But we cannot make ourselves gods, and we are not in control of our lives. Taking control of the timing and manner of your death is very appealing, because it feels like we never reach the point where something happens outside of our control. But death is not the end, and we must all give an account to God.

The only hope in the face of death is the one who died to take away our sins (including any sins to do with the way we handle our approaching death), and the one who rose again not only to be our judge but to give true and eternal life to all who trust him.

Ultimately, the answer to terminal illness is not assisted dying. It's to hold the hands of those who are sick, as they hold the hand of the one who healed the sick, until they can join him in a future of perfect wholeness.

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