Euthanasia

Euthanasia/Voluntary Assisted Dying: Some Theological and Pastoral Resources

‘People clearly do not need [pastors and theologians] to live. But it seems like they want to use us to die; their entire lives stand in the shadow of death. History marches along at its pace without us, but when the eschatological, the final things, appear on their horizons – and which problems in history do not ride the wave of the final things? – we apparently ought to be there and have open and decisive words to say. They are for the most part well adjusted in themselves and their own capacities and life possibilities. But amazingly, when it comes to the state of the gossamer upon which the entire net of this life hangs, when it comes to the razor-sharp ridge between time and eternity along which they suddenly find themselves wandering, after having long forgotten it, they want to hear from us. The theological problem comes into being on the boundaries of humanity. The philosophers know this, but quite often, it appears that we theologians do not’. – Karl Barth, ‘The Word of God as the Task of Theology, 1922’, in The Word of God and Theology (London: T&T Clark, 2011), 178.

I thought I’d start to put together in one place a list of resources that I have found helpful and that might serve as a resource to guide the church in its responses to the challenges posed by Euthanasia/Voluntary Assisted Dying. The list is by no means exhaustive, but hopefully it will be constructive. I intend to keep editing it as other resources become known to me. Suggestions welcome.

Theological Resources

  • Allison Jr., Dale C. Night Comes: Death, Imagination, and the Last Things. Grand Rapids: Wm. B. Eerdmans, 2016.
  • Anderson, Ray S. Theology, Death and Dying. Oxford: Basil Blackwell, 1986.
  • Badham, Paul. ‘A Theological Examination of the Case for Euthanasia’, In Facing Death: An Interdisciplinary Approach, edited by Paul Badham, and Paul Ballard, 101–16. Cardiff: University of Wales Press, 1996.
  • Banner, Michael. ‘Christian Anthropology at the Beginning and End of Life’, In Christian Ethics and Contemporary Moral Problems, 47–85. Cambridge: Cambridge University Press, 1999.
  • ––––––––––. ‘Scripts for Modern Dying: The Death before Death We Have Invented, the Death before Death We Fear and Some Take Too Literally, and the Death before Death Christians Believe in’. Studies in Christian Ethics 29, no. 3 (2016): 249–55.
  • Barth, Karl. Church Dogmatics III.4. Translated by A. T. Mackay, T. H. L. Parker, Harold Knight, H. A. Kennedy, and J. Marks. Edinburgh: T&T Clark, 1961.
  • Bonhoeffer, Dietrich. Ethics. Translated by Reinhard Krauss, Charles C. West, and Douglas W. Scott. Dietrich Bonhoeffer Works, Vol. 6. Minneapolis: Fortress Press, 2005.
  • Catholic Church. Catechism of the Catholic Church. Homebush: Society of St Pauls, 1994.
  • Duff, Nancy J. Making Faithful Decisions at the End of Life Paperback. Louisville: Westminster John Knox Press, 2018.
  • Dutney, Andrew. ‘Christian Support for Voluntary Euthanasia’. Monash Bioethics Review 16, no. 2 (1997 April): 15–22.
  • Fiddes, Paul S. ‘Acceptance and Resistance in a Theology of Death’, Modern Believing 56, no. 2 (2015): 223–36.
  • ––––––––––. ‘The Living God and the Threat of Death’, In Participating in God: A Pastoral Doctrine of the Trinity, 224–50. London: Darton Longman & Todd, 2000.
  • Goroncy, Jason A. ‘Dying Without a Script: Some Theological Reflections on Voluntary Assisted Dying’. Colloquium 51, no. 1 (2019): 23–37.
  • ––––––––––. ‘Euthanasia: Some Theological Considerations for Living Responsibly’. Pacifica 29, no. 3 (2016): 221–43.
  • Gustafson, James M. ‘Suicide’, In Ethics from a Theocentric Perspective, Volume 2: Ethics and Theology, 187–216. Chicago: The University of Chicago Press, 1984.
  • Hauerwas, Stanley. Naming the Silences: God, Medicine, and the Problem of Suffering. London: T&T Clark, 2004.
  • ––––––––––. ‘Rational Suicide and Reasons for Living’, In On Moral Medicine: Theological Perspectives in Medical Ethics, edited by Stephen E. Lammers, and Allen Verhey, 461–66. Grand Rapids: Wm. B. Eerdmans, 1987.
  • Jenson, Robert W. ‘Thinking Death’, in On Thinking the Human: Resolutions of Difficult Notions, 1–15. Grand Rapids/Cambridge: Wm. B. Eerdmans, 2003.
  • John Paul II. ‘Declaration on Euthanasia: The Sacred Congregation for the Doctrine of the Faith, May 5, 1980’.
  • ––––––––––. ‘Evangelium Vitae’.
  • ––––––––––. The Theology of the Body: Human Love in the Divine Plan. Boston: Pauline Books & Media, 1997.
  • Jüngel, Eberhard. Death: The Riddle and the Mystery. Translated by Iain Nicol, and Ute Nicol. Edinburgh: The Saint Andrew Press, 1975.
  • Küng, Hans. ‘Assisted Dying – Also Active?’, in Eternal Life?: Life After Death as a Medical, Philosophical, and Theological Problem, trans. Edward Quinn, 209–13. London: Collins, 1984.
  • Küng, Hans, and Walter Jens. A Dignified Dying: A Plea for Personal Responsibility. Translated by John Bowden. London: SCM Press, 1995.
  • Lewis, Alan E. ‘The Theology of Death and the Care of the Dying: Affirmations, Attitudes and Actions’. Theology in Scotland 2, no. 2 (1994): 7–20.
  • Messer, Neil. Respecting Life: Theology and Bioethics. London: SCM Press, 2011.
  • Rahner, Karl. On the Theology of Death. Translated by Charles H. Henkey. Frieburg: Herder, 1961.
  • Stoneking, Carole Bailey. ‘Receiving Communion: Euthanasia, Suicide, and Letting Die’, In The Blackwell Companion to Christian Ethics, edited by Stanley Hauerwas, and Samuel Wells, 375–87. Malden: Blackwell Publishing, 2004.
  • Sutherland, D. Dixon. ‘From Terri Schiavo toward a Theology of Dying’, In Resurrection and Responsibility: Essays on Theology, Scripture, and Ethics in Honor of Thorwald Lorenzen, edited by Keith D. Dyer, and David J. Neville, 225–46. Eugene: Pickwick Publications, 2009.
  • Swinton, John. Becoming Friends of Time: Disability, Timefullness, and Gentle Discipleship. Waco: Baylor University Press, 2016.
  • Swinton, John, and Richard Payne, eds. Living Well and Dying Faithfully: Christian Practices for End-of-Life Care. Grand Rapids: Wm. B. Eerdmans, 2009.
  • Williams, Rowan. ‘On Making Moral Decisions’. Anglican Theological Review 81, no. 2 (1999): 295–308.

Pastoral Resources

Other Resources

  • Duckett, Stephen. ‘Arguing in the Public Square: Christian Voices Against Assisted Dying in Victoria’. Journal for the Academic Study of Religion 30, no. 2 (2017): 165–87.
  • Gleeson, Gerald. ‘Is it Always Good to be Alive?’. Interface: A Forum for Theology on the World 13, no. 1 & 2 (2010): 97–111
  • Hitchcock, Karen. Dear Life: On Caring for the Elderly. Carlton: Black Inc., 2016.
  • May, Arnd T. ‘Physician-Assisted Suicide, Euthanasia, and Christian Bioethics: Moral Controversy in Germany’. Christian Bioethics: Non-Ecumenical Studies in Medical Morality 9, no. 2/3 (2003 Aug-Dec): 273–83.
  • Singer, Peter. Rethinking Life and Death: The Collapse of Our Traditional Ethics. Melbourne: The Text Publishing Company, 1994.
  • ––––––––––. ‘Taking Life: Humans’. In Practical Ethics. 2nd ed., 175–217. Cambridge: Cambridge University Press, 1993.
  • Stefan, Susan. Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law. New York: Oxford University Press, 2016.
  • Tolstoy, Leo. ‘The Death of Ivan Ilyich’, in The Death of Ivan Ilyich and Other Stories, 39–91. New York: Alfred A. Knopf, 2009
  • Waters, Brent P. ‘From Death as Necessity to Death as Choice’. Ethics, Medicine and Public Health 2, no. 3 (July–September 2016): 442–47.

Dying Without a Script

The latest edition of Colloquium includes a little piece that I wrote on Voluntary Assisted Dying:

“Dying Without a Script: Some Theological Reflections on Voluntary Assisted Dying.” Colloquium 51, no. 1 (2019): 25–39.

Abstract

In theological discourse about voluntary assisted dying, two of the most contested areas are those that relate broadly to matters of individualism, autonomy, and rights, and those that are concerned with interpretations around the sanctity of human life given by God. These two areas represent unavoidably difficult theological spaces, with profound implications for Christian theology, especially for theological anthropology and for theologies of death. Drawing upon a range of sources mostly from Christian traditions, this essay locates these two concerns in a broader milieu, and engages in some critical discussion around their theological complexities. It argues that fidelity to competing theological commitments presses against the temptation to make the terrain of relevant moral judgements incontrovertible.

Voluntary Assisted Dying – a public forum

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Explore the practical, legal, pastoral, and theological implications of Victoria’s new Voluntary Assisted Dying legislation.

Presenters:

  • Jenika Graze is a palliative care nurse who serves in numerous roles in the residential and community aged care sector.
  • Joel Hallinan is the Inquiry Officer with the Legal and Social Issues Committee, Parliament of Victoria, which led the inquiry into and reporting on the end of life choices legislation.
  • Jason Goroncy is a church minister who teaches in the area of systematic theology at Whitley College, University of Divinity.

Register-now

On euthanasia for Alzheimer’s patients

‘If only euthanasia advocates could be sued for false advocacy. For years, they have soothingly assured wary societies that only those with the capacity to choose to be killed would have access to facilitated death. That promise was always highly questionable. “Choice” has never been the point of euthanasia—otherwise euthanasia should be available to anyone, sick or well, who wants to die. Rather, the goal is to normalize killing as an acceptable remedy to suffering, even—as we are seeing with the Alzheimer’s policy—when the patient is incapable of making a rational decision’.

– Wesley J. Smith, ‘Euthanasia for Alzheimer’s patients?’

A little piece on voluntary assisted dying in The Conversation

 

The Conversation.pngRobyn Whitaker and I teamed up to offer a few thoughts for The Conversation on voluntary assisted dying – ‘Voluntary assisted dying is not a black-and-white issue for Christians’.

My longer essay on the subject – ‘Euthanasia: Some theological considerations for living responsibly’ – can be accessed via this link. I am grateful that SAGE have granted free public access to the article until the end of October.

Physician assisted suicide, euthanasia, and capitalism

There’s a good little piece here by Daniel Fleming, who reminds us of the larger economic context in which debates about physician assisted suicide and euthanasia are taking place; and, should the legislation be passed, of the context in which the legislation will be enacted. Here’s a taster:

Where we make social interventions in our context, we should also remember that it will inevitably become someone’s business to deliver on them. Correlatively, in answer to the first question, we should consider what the impact of private, for-profit, companies which specialise in the provision of euthanasia might be. Such companies would have as their primary purpose profit or return to share-holders. They would, assumedly, be required to increase business in order to produce better annual results. What would their marketing strategies look like? Who would their target market be?

One can quickly imagine a strategic planning meeting whereby the market of those who are dying or those who are close to someone who is dying become the aim of the product, perhaps also particularly those who would not be able to afford other forms of end of life care, or those who are suffering from some form of depression. The current proposed legislation [in Victoria and New South Wales] rests on the possibility of someone making a free and fully informed decision, but freedom and coercion have a tenuous relationship when it comes to marketing strategies – especially those directed at vulnerable groups, and that is something we should consider in this case.

To put it crudely, if we agree to this legislation we should be willing to accept active and aggressive marketing strategies from companies who enact it …

Such companies do not currently exist, but for-profit health insurance companies do, and so we should also consider what the proposed legislation might look like from the perspective of an insurance company which is trying to improve its bottom line. Could it be that insurance companies would direct patients toward the cheaper option instead of agreeing to a larger payout for more expensive care?

In the United States, for example, a physician recently claimed that “insurance companies in states where assisted suicide is legal have refused to cover expensive, life-saving treatments for his patients but have offered to help them end their lives instead.” As anyone who has sat in a budget meeting will know, the logic applied here by the insurance companies is perfectly compatible with the value-set imposed by capitalism.

These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose.

You can read the full article here.

Euthanasia and misplaced compassion?

jacques-louis-david_the-death-of-maratI am relieved to learn that the Victorian Government has, at somewhere near the eleventh hour and yet even then only for a little while, put some brakes on its inchoate proposal to establish assisted suicide legislation for the terminally ill. Plans are still underway to introduce the bill sometime during the second half of next year, but today’s confession by the Government-appointed committee that its recommendation lacked ‘the legal, clinical and organisational detail about the implementation, practicalities and issues related to introducing an assisted dying framework’ is a confession that this Government still has some serious homework to do on this piece of very important public policy and, presumably, on the paper being prepared for public consultation from early next year.

Upon hearing this news, however, I was reminded of these words from Daniel Callahan – words which are, to be sure, not the only kind of words that need to be registered in this discussion, but which nevertheless offer some good reasons to welcome the pause:

We need a healthcare system that can learn better how to meet the abiding human need for care, develop moderate and feasible aspirations for cure, and come to see the value of living within restricted frontiers.

The movement for legalized euthanasia, far from helping us achieve goals of that kind, actually rests upon precisely the same assumption about human need, health, and the role of medicine that have created our present crisis the right to, and necessity of, full control over our fate. Legally available active euthanasia would worsen, not help, that crisis. By assuming that, in the face of a failure of medicine to cure our illness or stop our dying, we should have the right to be killed, the euthanasia movement gives to the value of control over self and nature too high a place at too high a social cost. The contemporary medical enterprise has increasingly become one that considers the triumph of illness and the persistence of death both a human failure and a supreme challenge still to be overcome. It is an enterprise that feeds on hope, that constantly tells itself how much farther it has to go, that takes all progress to date as simply a prologue to the further progress that can be achieved. Nothing less than total control of human nature, the banishment of its illnesses and diseases, seems to be the implicit ultimate goal.

The argument for euthanasia seems to be agreeing about the centrality and validity of control as a goal: if medicine cannot now give us the health and continued life we want, it can and should at least give us a total control over the timing and circumstances of our death, bringing its skills to bear to achieve that end. By making a denial of the distinction between killing and allowing to die central to its argument, the euthanasia movement has embodied the assumption, the conceit actually, that man is now wholly in control of everything, responsible for all life and all death. Allowing a disease to take its course is no longer to be morally distinguished from outright killing. Either way, it is our doing.

There is a clear consequence of this view: our slavery to our power over nature is now complete. Euthanasia is, in that respect, the other side of the coin of unlimited medical progress.

The compassion it seeks is not just in response to pain and suffering. It is more deeply a response to our failure to achieve final control over our destiny. That is why we cannot be rid of the pain.

The compassion is misplaced. It seems to be a way of saying that just as we have a full right to control our living, we should have a full right to control our dying. Even more, the right to control our death offers a saving antidote to our failure to control life; it makes up for the progress medicine has not yet achieved. We design a healthcare system oriented to meeting individual curative needs and then, with euthanasia, guarantee that, when the skills and knowledge of the system fail, medicine can at least give us a decisive control over our dying. The last word, long sought, becomes ours.

– Daniel Callahan, What Kind of Life: The Limits of Medical Progress (Washington, D.C.: Georgetown University Press, 1990), 242–43.