September 2004 – When does life begin? That thorny question has been at the center of our national debate about abortion for over 30 years. Even for skeptics, advances in medical imaging have pushed the answer earlier and earlier.

On the other end of the life-death continuum, the ability of modern medicine to sustain life has brought its own set of difficult ethical and moral questions: When does life end? Or perhaps more practically, how should life end? 

For a country in which life expectancy is approaching 80 years, and for whom 20% of the population will be between the ages of 66 and 84 by 2030, these questions are more than theoretical. Now and in the near future, millions of American families will deal with issues of long-term care of aging or chronically ill loved ones. Many will face troubling end-of-life decisions, such as when to administer or withhold measures that could sustain life.  

In the midst of such confusing and emotional issues, powerful social and cultural factors threaten to convince families that “quality of life” supercedes “sanctity of life.” These factors, according to Dr. Kenneth Simcic, include: 

• A culture in which God is respected less and less as the only giver and taker of life;
• A lack of accepted moral absolutes;
• The popularity of radical personal autonomy (“my body, my right”);
• Families with fewer children to care for aging parents; 
• Pressure to reduce the cost of health care.

And perhaps most significantly, families will be making life and death decisions against a cultural background of over three decades of killing the most defenseless members of our human community. Is there any doubt that the deaths of 50 million babies since the 1972 Roe v. Wade decision that legalized abortion on demand, have softened many in our society to the notion that underlies the euthanasia movement: some lives are not worth living. 

For these reasons and others, euthanasia – also known by such euphemisms as “mercy killing,” “death with dignity” and “the right to die” – is an issue that is certain to come center stage in the near future – or so it would logically seem. 

According to Burke J. Balch, director of the Robert Powell Center for Medical Ethics in Washington, D.C., and affiliated with the National Right to Life Committee (NRLC), proponents of euthanasia are achieving their goal without public debate, court decisions or legislation. Balch says that the practice of euthanasia is already quietly but quickly spreading to hospitals across the nation, not in the form of active killing, but through “futile care” policies. 

Recognized and argued in prestigious publications such as The Journal of the American Medical Association and The New England Journal of Medicine, the theory of futile care empowers doctors and hospitals to refuse service to patients they deem unworthy of treatment. Practically, that means patients can be killed by withholding nourishment or treatment, even over the objections of the family. 

“Unfortunately, many doctors and hospital ethics committees are now arguing they should have a veto over a patient’s request to be allowed to live if the doctor, in disagreement with the patient or the patient’s family, thinks the patient’s ‘quality of life’ is so poor her or his life is not worth living,” Balch wrote in a paper for the NRLC. “They consider ‘medically inappropriate’ not just treatment that will not save a patient’s life, but also treatment that would save life if the life’s quality is deemed poor.”

It’s a “bombshell story” that has largely been ignored by the popular media, according to Wesley Smith, a senior fellow at the Discovery Institute and author of Culture of Death: The Assault on Medical Ethics in America. Smith writes in an article at National Review Online: “The first time most patients and their families become aware that doctors are being given the right to say ‘no’ to wanted medical treatment (other than comfort care) is during a medical crisis when they are at their most defenseless and vulnerable.”

In the crucible
Surrounded by powerful social forces and a modern bioethic that does not believe that all human life is of intrinsic and equal value, how are Christian families to prepare for making decisions that uphold the “sanctity of life” and reject the “quality of life” ethic? 

In a recent speech, NRLC Senior Congressional Liaison Lori Kehoe said that although treatment decisions may be complex in their circumstances, the ethics are not difficult for ethical people. “It’s not hard to wrap your mind around when you get down to the basics,” she said. 

The difficult part even for mature Christians, however, is practicing those basic principles. To demonstrate the proper application of the “sanctity of life” ethic, Kehoe said, “It is just as wrong for you to fail to preserve your own life as it is for you to shoot yourself in the head. The ethics are simple. If something will work to preserve your own life and you would quickly do it for someone who is young and otherwise healthy, you must do it for your grandmother or yourself.” 

Biblical principles
Below is a selection of biblical principles summarized from the teachings of orthodox Christian authors, theologians and ethicists. For a more complete treatment of these and related issues, see the suggested resources below.

1. All human beings are created in the image of God (Gen. 1:26) and therefore have unique dignity and value. This principle is the foundation of the belief that life is sacred from the moment of conception until natural birth.

This view is rejected by many because the values of our society have shifted from a Judeo-Christian foundation to a humanistic and utilitarian one, according to the late Christian thinker Francis Schaeffer. In his 1972 book, Whatever Happened to the Human Race? Schaeffer said that having rejected the Creator God, humanists have convinced our society that all reality, including humans, is simply “one big machine.” 

This worldview, in which all things have come into being by chance, drastically reduces the value of human beings, Schaeffer argued, and naturally leads to the practices of abortion and euthanasia.

2. God is sovereign over life and death and we cannot always know His purposes. (Job 1:21; Job 14:5; Acts 17:28; Ps. 139:16) 

“Not even the gods of medicine can keep us alive when we are supposed to be dead,” says Kehoe. “We cannot live past our time.” She says this is not only a great comfort when making difficult treatment decisions, but a warning against presuming on God through advanced directives or living wills that could give permission to end a life prematurely. 

In applying the principle of God’s sovereignty over all things, Balch observes that by cutting short the dying process, Christians may miss profound opportunities for service, witness and personal growth. “Death is one thing that shows that we are not self-sufficient,” he said.

3. The Bible condemns murder. Kirby Anderson of Probe Ministries writes that this includes hastening death in a patient by any means and certainly includes suicide.

“It is not ethical to die simply because you want to,” Kehoe said. Christians must remember that according to 1 Cor. 6:19-20, our bodies are not our own, but belong to Christ, she explained.  

On the other hand, Anderson writes that death, being part of the fallen nature of man, is inevitable. Therefore, Christians must reject the notion that everything must be done to save life at all costs. For example, when the time comes that death is imminent, treatments that will only preserve life momentarily need not be administered.

Quality vs. sanctity of life
The practice of euthanasia is under way in many American hospitals, according to Balch, Smith and others. And the stage has been set for the downward slide toward “euthanasia by action,” in which lethal injections are administered by a third party. 

“The progression was inevitable,” Anderson writes. “Once society begins to devalue the life of the unborn child, it is but a small step to begin to do the same with a child who has been born. Abortion slides naturally into infanticide and eventually euthanasia.”

If Christians would resist further erosion of the value of life, we must start by clarifying in our own lives – and be willing to publicly declare – the difference in quality of life and sanctity of life.  

THE CANDIDATES ON EUTHANASIA
President Bush: In a video address to the 2003 National Right To Life Committee convention, President Bush reminded attendees, “In our time, respect for the right to life calls us to defend the sick and dying, those with disabilities and birth defects, and all who are weak and vulnerable. And it also calls our nation to set a great goal: that unborn children will be welcomed in life and protected in law.”

John Kerry: Concerning the federal government’s roll in assisted suicide, John Kerry told the Oregon Statesman Journal that “in principle” he opposed assisted suicide. Later he said, “It’s a very complicated, thorny, moral, ethical issue that people wrestle with. And I don’t think it’s the government’s job to step in.”

www.nrlc.org/news/2004/NRL06/stark_differences_make_for_clear.htm

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RESOURCES TO HELP FORM A CHRISTIAN VIEW OF EUTHANASIA
•  Whatever Happened To The Human Race? By Francis Schaeffer and C. Everett Koop. Crossway Books. Available in paperback and audio cassette from local and online booksellers.
•  www.nrlc.org/medethics –  Web site of National Right To Life Committee 
•  Culture of Death: The Assault on Medical Ethics in America by Wesley J. Smith. Encounter Books.
•  www.wesleyjsmith.com – Web site of Wesley J. Smith
•  www.leaderu.com/orgs/probe/docs/euthan.html and www.leaderu.com/orgs/tul/ott-euthanasia.html – Two excellent overviews of the euthanasia issue from a Christian perspective
•  www.lifenews.com – An independent news agency specifically devoted to reporting news that affects the pro-life community.