A dying man’s view on Euthanasia

Profound words from a dying man

I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability.  Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living.


For several years, until I objected, I received from my health insurer a letter that tells me how much it costs the fund to maintain my health care.  I dreaded receiving that letter and the psychological reasoning that would seem to have motivated it.  Each year I was reminded how much of a burden I am to my community.  The fear of being a burden is a major risk to the survival of those who are chronically ill.  If euthanasia were lawful, that sense of burden would be greatly increased for there would be even greater moral pressure to relinquish one’s hold on a burdensome life.  Seriously ill people do not need euthanasia. We need better provision of palliative care services aimed at managing symptoms and maximising function, especially as we approach death.  Rather than help to die, the cause of dignity would be more greatly helped if more was done to help people live more fully with the dying process.

The proposal to make provision for a terminally person who is suffering to request, and a doctor to provide, assistance to die makes it less likely that adequate efforts will be made to make better provision for palliative care services.  Legalised euthanasia would give those responsible for funding and providing palliative care a political “out” in that respect.

In Australia, too little is done to make adequate palliative care available to those who need it:

  • Current entry requirements for palliative care usually exclude people with chronic pain and is often limited to people who are in the last stage of cancer with a prognosis of less than eight weeks;

  • The pharmaceutical subsidies for the more effective forms of pain relief are often restricted to cancer patients;

  • People living outside major cities have little access to palliative care facilities.  • Few doctors are adequately trained to provide palliative care.

  • Such palliative care services as exist are chronically underfunded and struggle to provide the complex range of services that are needed to assist a person to live with pain and disability.

  • Most pain clinics are over subscribed and have long waiting lists.  For people who are left suffering, such waiting is unconscionable.

Medical research in this area indicates that the desire for euthanasia is not confined to physical or psychosocial concerns relating to advanced disease, but incorporates hidden existential yearnings for connectedness, care and respect, understood within the context of the patient’s lived experience. Euthanasia requests cannot be taken at face value but require in-depth exploration of their covert meaning, in order to ensure that the patients’ needs are being addressed adequately.  In Australia, what is needed is often not available or not available in time.  It is distressing to note that in the US State of Oregon in 2009, none of the patients who were lawfully killed at their own request were referred for formal psychiatric or psychological evaluation.  It is also distressing to note that two thirds of people lawfully killed under euthanasia laws, in those jurisdictions that permit it, are women.

If euthanasia is a legitimate option with a determined structure, such as was the case in the Northern Territory for a brief period, and is now proposed for South Australia, then life for the chronically seriously ill would become contingent upon maintaining a desire to continue in the face of being classified as a burden to others.  Essentially the Bill involves setting up a category for people whose lives may be deliberately ended.  Their protected status as a member of the South Australian and Australian communities depends on a contingency.  Passage of the Bill would imply that our community considers that our continued survival depends on us not succumbing to the effects of pain and suffering, depends on us not losing hope.

Read the whole letter here.

Euthanasia question needs wider discussion

An excellent article from Dr Andrew Cameron. From SMH.

Australians are overwhelmingly in favour of euthanasia. Who can resist the will of the people? So goes the pro-death argument for this sweeping social change.

A much quoted 2009 survey, commissioned by the pro-euthanasia group Dying with Dignity, reports 85 per cent support for the practice. As is always the case, support is more muted among the over-65s: the prospect of death, it turns out, does concentrate the mind.

Even so, the survey elicited more than 80 per cent support among each age bracket of its 1201 respondents.

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There is just one problem: it consisted of a telephone poll asking a single leading question. Interviewers emphasised the syllables as printed: ”If a hopelessly ill patient, experiencing unrelievable suffering, with absolutely no chance of recovering asks for a lethal dose, should a doctor be allowed to provide a lethal dose, or not?”

Try answering that while you are cooking the dinner or bathing the kids. The question is wildly emotive (”hopelessly”, ”unrelievable suffering”, ”absolutely no chance”).

We hate the thought of death and pain, and in the moment, most of us would simply respond out of shock and without much thought. The question leverages our preference to politely say ”yes” instead of ”no”.

Its assumptions are also completely contestable. Illness does not have to be ”hopeless”, and suffering is often very relievable. Where euthanasia is legal, more ask for it due to loneliness than pain, or so as not to burden another. The survey, therefore, distracts us from other options.

It does not ask, ”Would you change your mind if the lonely had companions, and the fearful someone to listen?” Nor does it ask, ”What would enable people to accept care without shame?” Nor does it ask, ”Would you like to see more funding for pain management research and practice?”

We are seeing a deliberate blurring of the lines at the very time society needs clarity on such a serious and far-reaching measure. The deliberate killing of a person in euthanasia must be distinguished from the withdrawal of treatment, and from management of symptoms at the end of life.

I write as a Christian. Before we hare off on the usual mantra that I am ”imposing my values” – as if those who support euthanasia are not – here is a case where the Bible’s prohibition of killing innocent humans is a no-brainer, even if we agree about little else. For this prohibition generates a community that upholds and cares for others at their weakest and most vulnerable. The prohibition against deliberate killing of innocent human life is what impels us to research and practise good palliative care.

It enables trust within patient-carer and patient-relative relationships. It frees the ill person from constantly having to interrogate the hidden motives of those around them, and allows them to accept their care without shame. It says to all of us that, burden or not, we can stop being productive, and allow others to help us.

Without this prohibition, we will see a creeping expansion of candidates for euthanasia. By the time voluntary euthanasia was legalised in the Netherlands in 2002 you didn’t have to be terminally ill to qualify: ”mental torment” sufficed. Those in that country who support euthanasia now argue that elderly people should have the option if they are simply ”tired of life”.

At the other end of life, a Dutch hospital published the Groningen Protocol in 2005 for euthanising newborns – nothing ”voluntary” there.

This creeping expansion simply corrodes a society’s will to fund care and cures for the poor, the elderly, the depressed, the disabled and the otherwise vulnerable.

There are far more pressing matters for our limited political will and energy, if only we could get to them, such as indigenous health.

Meanwhile, we are saddled with the prospect of a subversion of healthcare that deserves no place on any government’s agenda.

If Greens politicians believe voluntary euthanasia is the public policy priority of first importance for the new Parliament, so be it. But this total about-face on a central principle of healthcare deserves an election mandate; or at very least, some appropriately convened committee of parliamentary inquiry. A phone call and a badly worded question over dinner does not quite cut it.

Dr Andrew Cameron is chairman of the Social Issues Executive for the Anglican Diocese of Sydney.


John Wyatt on Bioethics and Redemption


Lecture number 2 was just as helpful as number 1. Again I apologise for any randomness in the flow of my notes.

Christian thinking about the human embryo

We cannot think of the human embryo as either a baby that isn’t yet born, or as a collection of matter that has the potential to be a baby. We need to create a new category of thinking which holds together the physical and the immaterial. Human beings are at the same time fully physical (the body) and fully immaterial (the spirit/soul). The existence of a physical body is a sign than an immaterial person is present.

Materialist would argue that humans are merely physical. Platonists would argue that humans are fully spiritual and just happen to be associated with a particular body. But biblical anthropology denies both of these and hold the physical and the immaterial together.

The human embryo is ‘just’ a bundle of cellular material, but  at the same time God is calling a life into existence.

We must hold together the already and the not-yet. The embryo is in the process of becoming what it already is – as are we in Christ. We are all in the process of becoming – ‘we are locked into a narrative that we did not create’.

‘It is God’s grace which confers on the unborn child, from the moment of its conception, both the unique status which it already enjoys and the unique destiny to which it will later inherit. It is grace which holds together the duality of the actual and the potential, the already and the not-yet.’ John Stott

There are some problems with some of the language used in these discussions. The term ‘human embryo’ makes ’embryo’ the noun and somewhat removes the adjective ‘human’. There are many kinds of embryos, and this phrase just adds the human embryo to a long list. A better phrase is ’embryonic human’, which focuses back on the fact that we are not dealing with an embryo, but a person.

The language of ‘potential’ – e.g. the embryo is a potential life – is also unhelpful. This implies that it is not yet a life and cuts through the unity of the already and not-yet which we must firmly hold together.

Some people want to argue for a later moment as the standard of ‘start of life’ but our standard will never come from science.

‘We discern persons only by love, by discovering through interaction and commitment that this human being is irreplaceable… We must approach new human beings, including those whose humanity is ambiguous ad uncertain to us, with the expectancy and hope that we shall discern how God has called them out of nothing into personal being.’ Oliver O’Donavan

The implications of this is that we should not create embryonic humans, for the purpose of destroying them, even in the name of medial research.

But, as with abortion, it is not enough to oppose this. With must offer an alternative.

Currently an alternative to embryonic stem cell research already exists. There are currently over 2000 clinical trials and 70 different therapies being used which have come from Adult stem cell research. This is an alternative that doesn’t not include or necessitate the destruction of embryos.

Conflicting perspectives on evil, suffering and death

Charles Darwin said ‘ What a book a devil’s chaplain might write on the clumsy, wasteful, blundering, low and horridly cruel works of nature.’

As modern people we have lost the ability to believe that suffering has any good, because our purpose is maximum personal happiness. The thinking of most materialist has become that suffering is meaningless and therefore the supreme moral good in ethical thinking has become the minimisation of suffering.

Two examples of this are Christian Rossiter and Daniel James.

‘I’m Christian Rossiter and I’d like to die. I am a prisoner in my own body. I can’t move. I can’t even wipe the tears from my eyes.’

Mr Rossiter was a bush walker, rock climber and cyclist until he was hit by a car and left a quadriplegic. He is fed by a tube in his stomach. On Friday the 14th August the WA Supreme Court ruled that he has the right to refuse food from his care providers.

Mr James was a young rugby player who was left paralysed from the chest down after an accident during training. He tried to kill himself 3 times before traveling with parents to a Swiss Clinic where assisted suicide is legal.

“Over the last six months he constantly expressed his wish to die and was determined to achieve this in some way.”

The contemporary debate about euthanasia and suicide is driven by fear, fear of pain, fear of indignity and fear of independence. 10 years ago the arguments for euthanasia were all about pain, but since palliative care in the last decade has become so effective the argument has changed.

‘An individual’s way of death should fit with how that person has lived the rest of their life. Otherwise a bad death might mar the whole story of life, just like a bad ending can ruin a beautiful novel.’ Ronald Dworkin

The worst thing has become, not a life of pain, but one where autonomy is lost, and all that is left is the need to be dependent on others. This is not only related to physical injuries but also that of the mind, for example Alzheimer’s with which 11% of Americans are afflicted.

‘If you’re demented, you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the National Health Service. I’m absolutely, fully, in agreement with the argument that if pain is insufferable, then someone should be given help to die, but I feel there’s a wider argument that if somebody absolutely, desperately wants to die because they’re a burden to their family, or the state, then I think they too should be allowed to die.’ Mary Warnock

Sadly, Warnock’s opinion represents one that some of our population see as merciful.

Christian perspectives on death and suffering

In Genesis 1 & 2 Adam and Eve lived with access to the Tree of Life and with no limit on their time. Death was an outrage and an alien interruption in the nature of being.

C.S. Lewis once remarked how strange he found our constant surprise at time. How many times have you said things like ‘it that the time?’ or ‘has it been that long?’? We live in a constant state of time and yet it never stops surprising us. Perhaps our surprise at time reflects that we will one day be without time.

The limit on life is not just a curse, but can also be a severe mercy, a gateway to a new reality, and even a strange form of healing. ‘Christian professionals are called to struggle against death whilst seeking to recognise the point at which death becomes a severe mercy.’

Many people try to make ‘end of life’ decision based on quality of life. But who are we to judge someone else’s quality of life. A doctor is not able to make quality of life decisions, but they can make quality of treatment decisions. Do the benefits of a particular treatment outweigh the downsides?

Modern ways of thinking don’t recognise that suffering also comes from the hand of a good God.

Suffering is not a question that demands an answer, it’s not a problem that demands a solution, it’s a mystery which demands a presence.

Suicide is a pagan way to die. But many of God’s people have experienced suicidal thoughts. God gives us freedom but there are limits to that freedom.

‘Within the story of my life I have the relative freedom of a creature, but it is not simply my life to do with it as I please… Suicide expresses a desire to be free and not also finite – a desire to be more like the Creator than creature.’ Gilbert Meilaender

The Significance of the incarnation, death and resurrection of Christ

Why do we treat the human body with unique respect? Because it is the form in which God became flesh – and at that the form of a helpless baby!

‘Jesus has been with us in the darkness of the womb as he will be with us in the darkness of the tomb.’ Gilbert Meilaender

The state of dependence cannot be seen as a bad experience because it was good enough for Christ – he came and left that way. Because he was a baby all babies are special, because he was a dying person all dying people are special, because he was an embryo all embryos are special.

‘The process of dying need not be an entirely negative experience. Dying well can be an opportunity for personal growth, for reconciliation of painful and damaged relationships, for fulfilling dreams, for letting go.’

This was the idea behind palliative care, which was developed almost entirely by Christians. There pseudo-motto was ‘not only will we help you to die but we will help you to live before you do.’

Behind the blessings, richness and joy of the natural order of creation, in which our human bodies and lives are embedded, there lies an even greater and more wonderful story. It is the story of inexplicable and all-pervasive evil which is overcome and transmuted into blessing, but only through profound suffering, the self-sacrifice of the Lamb of God.

Redemption is what C.S. Lewis calls the ‘deeper magic from before the dawn of time’.

The stories we all have of those who die well are cameos, reflections of the big story. It is as though our own little story can become penetrated, interwoven and caught up into the big story. Our experience can reflect and become interwoven with the suffering and redeeming power of the Lamb of God.

This is our story. The uniquely Christian understanding of redemption.

Random notes from Q & A

  • The thinking that babies are special was introduced to the secular world by Christianity
  • The info on embryo use above will have implications for IVF, when it comes to ‘spare’ embryos. Sometimes to bare witness to God’s good creation means suffering exclusion from it
  • Ultimately we cannot use science to understand the merging of physical and immaterial (body & soul) – rather we discern by love. What we do know is that one upon a time I was that embryo, you were that embryo and, amazingly, Jesus was that embryo – so how do we say it is just a cluster of matter?
  • Christian perspective on technology should be that we use it to up hold the created order, not to go beyond it
  • Our primary duty of care – to anyone, babies and the dying alike – is hospitality… food, water, and TLC
  • There is a difference between allowing death and introducing it

Tonight’s lecture is Bioethics and Future Hope. Details here