Euthanasia: will we care or will we kill?
January 2002

A ccfwebsite.com briefing on this increasingly important issue

· Euthanasia, with its implication that a life is so worthless that it must be terminated, flies in the face of the Christian belief that every human life is intrinsically precious because it has been given by God.

· There is a danger that a 'right to die' might swiftly become a 'duty to die'; at the end of this general briefing there is a shorter briefing on the Diane Pretty case.

· Funding for palliative care and the hospice movement should be increased.

*****

What is euthanasia?

The following definition is taken from the Papal Encyclical Evangelium Vitae:

Euthanasia in the strict sense is understood to be an action or omission which of itself and by intention causes death, with the purpose of eliminating all suffering. Euthanasia's terms of reference, therefore, are to be found in the intention of the will and in the methods used.

Euthanasia must be distinguished from the decision to forego so-called 'aggressive medical treatment', in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose a burden on the patient and his family.

In such situations, when death is clearly imminent and inevitable, one can in conscience refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted. Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances.

It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death.

The 'culture of death'

Christians unite to condemn those attitudes towards the unwell or handicapped which cheapen the value we place on life. In 'The Gospel Of Life' (Evangelium Vitae), the Pope warned the world that it is developing a 'culture of death' where 'life is cheap'. He identified abortion, embryology and euthanasia as activities that contribute to a "profound change in the way life and relationships between people are considered". In a key passage of his document the Pope described a 'veritable structure of sin', where the powerful, the able-bodied and the mentally capable are at war with the physically and mentally weak:

"A person who, because of illness or handicap or, more simply, just by existing, compromises the well-being or lifestyle of those who are more favoured, tends to be looked upon as an enemy to be resisted or eliminated. In this way a kind of conspiracy against life is unleashed".

Abortion and the roots of the euthanasia movement

Gilbert Meilaender in the Weekly Standard said: "It may be that abortion is foundational in the culture of death. It has embedded in our public morality the priority of the language of choice. It has taught us to believe that our dignity as moral beings lies not in accepting what may be unwanted and unexpected not in accepting as sheer gifts our own lives and the lives of others but in being free self-creators who shape our own directions. It is ironic that an age which seeks to recapture our relation to the earth and bids us tread lightly on this planet should simultaneously encourage us to think of ourselves not as bodies, not as animated earth, but simply as masterful wills.

But that vision of the human being as fundamentally a chooser, as will, as free self-creator, is actually narrow and sterile. It cannot comprehend the mystery of erotic love or of the bond between parent and child. It can make no sense of death as a limit up against which we live. It is baffled by a compassion that, rather than holding suffering or sufferers at arm's length, accepts and shares that suffering. And most of all perhaps, it cannot comprehend the mystery of a creature drawn by longing to bend the knee to the God whose very being constitutes our limit."

It is vital that Christians always take care to marshal biblically-coherent arguments against unwelcome social developments. Some have mistakenly tried to advance the pro-life cause on abortion by talking about the individual unborn child's right to choose to live. there is obviously merit in this view but it has led to the development of a culturewhere it is acceptable to choose the end one's life. A biblically-faithful pro-life campaigner will focus upon the sanctity of all human life - full stop.

The case against euthanasia

Revd Dr John Stott (Rector Emeritus at Ml Souls, Langham Place) put the case against euthanasia powerfully at a recent conference of the Chelmsford Diocesan Evangelical Association and also in his book 'Issues Facing Christians Today'.

Our worth stems from God's love for us, not through any personal merit

John Stott began his CDEA talk by noting that the worth of our humanity stems not from our deeds or our abilities or our potential but through the working of God's grace in our lives. God took the initiative in sending Jesus to die for us. It was love to the loveless to the unresponsive; the unworthy; the undeserving. Can we love someone, the foetus or the person in the vegetative state, who cannot love us?

The answer is that God has already shown us the way in His love for us in our unresponsive, unregenerate state. As Christians our love for our neighbour must be expressed in terms of valuing the sanctity of life, and not in mirroring the world's preoccupation with its quality.

God was father of the fatherless, friend of the widow, defender of aliens and the voiceless (Psalm 68:5 and Deut 10:18). Our prayer must be to reflect His care for all in our own lives.

Dr John Wyatt, a specialist in caring for babies born prematurely, and who spoke alongside John Stott, linked Stott's message to the example of Mother Teresa. On her arrival in Calcutta she noticed a woman dying of leprosy. The stench around her was almost unbearable and the wounds that disfigured her were full of maggots.

Yet Mother Teresa took this leper to her home, bathed her and cared for her until she died. There was no expectation that this leper would recover; instead Mother Tersea recognized the image of God in that disease-stricken woman, as Jesus commanded. In Matthew 25, anticipating Judgement Day, he tells us that he will say:

"Come, you blessed of my Father, inherit the kingdom prepared for you from the foundation of the world: for I was hungry and you gave Me food; I was thirsty and you gave Me drink; I was a stranger and you took Me in; I was naked and you clothed Me; I was sick and you visited me; I was in prison and you came to Me.'

Then the righteous will answer Him saying 'Lord, when did we see You hungry and feed You, or thirsty and give You drink? When did we see You a stranger and take You in.?' And the King will answer and say to them, Assuredly, I say to you, inasmuch as you did it to one of the least of these My brethren, you did it to Me.' Matthew 25: 34-40

Life is a gift from God

John Stott further noted that God's gift of life to us was for Him to take away (Deut 32:39). He also warned against Christians losing a sense of humanity's unique position in God's created order. We are distinct from the animal kingdom made as we are in God's image (Genesis 9:6 and James 3:9).

The Hippocratic oath has come under attack from the medical profession recently but its rejection of abortion and euthanasia in the society of 500BC, when both were actually common, represents a proud heritage for a caring profession which, unfortunately, is now increasingly forgetting its roots.

Three fear factors behind euthanasia

Dr Wyatt suggested that there were three key human fears that prompt us to consider euthanasia:

(1) Fear of pain and its futility

(2) Fear of loss of dignity

(3) Fear of loss of dependence. In our individualistic society we strongly fear the loss of power in determining the conclusion to our own life in way of our own choosing.

Christian responses to these fear factors

Palliative care

Not all pain can be eliminated but major advances have been made in palliative care in recent years which, in the vast majority of cases, have substantially eased a patient's lot. It is regrettable that palliative care does not receive as much public or charitable funding as it merits, thought Wyatt, and tends to lose out to the more glamorous research projects, which focus on cures.

He testified to his excitement at what could be possible if palliative care won more research funding. He also looked forward to the extension of knowledge of palliative care outside of the hospice movement and into hospitals and General Practice.

Emphasise individual dignity through Christ

With regard to fear of loss of dignity, John Wyatt turned again to Mother Teresa's witness and the fact that all of our dignity and humanity is not a human quality but reaches its high point in our recognition of Christ's image in us.

The Christian body is not a machine to be transformed or shut down when working unsatisfactorily, but it is an art treasure, thought Wyatt, created by God, and the medical profession is charged with its preservation. Recognising the Creator's work, its task is not to change or distort it.

We are all dependent on others, and on God

There is no antidote to dependence, Wyatt concluded. We come into the world dependent as babies and we usually leave it in a similar state of dependence. Only when we recognise our dependence on others and ultimately our dependence upon God can we enjoy His peace.

Supporting the Hospice movement

Christians have been in the forefront of the hospice movement in Britain but let us not slacken our efforts. The burden on hospice care will increase as the elderly population continues to grow. Let us also consider whether church or personal giving could go to palliative care. Does your church understand the issues? If not, contact Christian Impact at All Souls Church, Langham Place, London W1 for details on how you can be equipped to tackle the issue.

Should euthanasia ever be legalized, many old people would choose euthanasia so as not to be a burden on society and family during their last days. Let us ensure that consideration never has to darken the closing days of the ill and elderly by choosing to care and not to kill.

THE DIANE PRETTY CASE
Implications for severely disabled and very elderly people of the Diane Pretty case.

The Conservative Christian Fellowship produced this briefing in Autumn 2001 for the Conservative Parliamentary Party, following consultations with interested churches and Christian charities.

"[The Right to Die] places upon incredibly vulnerable people the added burden of having to justify their own existence, if not to others, at least to themselves. And this at a time when they may feel useless, discouraged and a burden to others.... From now on their continued existence is a choice they must make and can be called upon to justify.... People like this can be asked why, when other people are choosing physician-assisted suicide, giving up their medical equipment for others and ending the burden and expense of family and society, why they would like to live on - as, of course, the vast majority will want to." Taken from Final Wishes by Paul Chamberlain (IVP, 2000); a highly recommended book on how a 'right-to-die' would seriously imperil the lives of vulnerable people throughout society.

The Diane Pretty case is about euthanasia

Diane Pretty is backed by pro-euthanasia groups: VES (Voluntary Euthanasia Society) and Liberty. Mrs Pretty is suffering from Motor Neurone Disease: a progressive degenerative disease of the nerves which control movement of the voluntary muscles. No treatment is available yet (although one researcher suggests that a treatment may be available within 5 years). It is generally fatal after 2 to 5 years from onset.

The Diane Pretty case represents a misuse of the European Convention on Human Rights

Mrs Pretty has cited Article 3 of the European Convention on Human Rights (within the Human Rights Act 1998) which is headed "Prohibition of torture" and says: "No one shall be subjected to torture or to inhuman or degrading treatment or punishment."

Apparently, because of her high level of dependency on others, Mrs Pretty is said to be subjected to inhuman or degrading treatment. But:

- This is being taken out of its proper context (torture).
- If applied in this way, it could jeopardise the care provided to thousands of highly dependent elderly, or sick or disabled people who need assistance with, for example, bowel and bladder function.
- The Convention includes an explicit requirement that the right to life be protected by law.

There is no mention of a "right-to-die" in the Convention (nor in any other national law or constitution, international convention, code of medical ethics, etc.).

How a 'right-to-die' would quickly become a 'duty-to-die'

The quote at the top of this briefing from Paul Chamberlain illustrates the impact of a 'right-to-die' on vulnerable people: they feel they have a 'duty-to-die'. It is impossible to know if vulnerable people are voluntarily choosing their right to die or actually feeling obliged to choose that right. The feeling of obligation may be particularly acute during periods of depression - which, of course, pass.

Journalist Penny Relph has written: "Just imagine the plight of a sick elderly woman occupying an NHS bed. She knows that if she goes home it will be a struggle for her family to look after her and the last thing she wants is to be a burden. She might well feel that for their sake, for the sake of the busy medical staff desperate for more beds, even for the sake of society as a whole, it would be best if she asked for euthanasia. Rights have a danger of turning into duties." Relph continues: "Perhaps the right question is not so much whether these people have worthwhile lives but whether we are the kind of society who will care for them without doubting their worth."

What comes after a legal 'right-to-die'?

Once society allows a right-to-die other dangers follow. Holland, for example, where euthanasia is now legal and where there is no hospice movement, is now considering the issue of suicide pills to sick, elderly people.

What is the compassionate alternative to a 'right-to-die' for people like Diane Pretty?

(1) Greater investment in hospice care. Hospices provide high quality care to sick people and their families - no one needs to be alone during the difficult days of a major illness. Sadly the hospice movement is badly supported by the public purse. In our 2001 manifesto Conservatives pledged to increase NHS funding to hospices to 40% of their funding needs. This would give them much greater financial security whilst preserving their vital links with local communities.

(2) Greater investment in palliative medicine. Few doctors are adequately trained in this branch of medicine but few kinds of pain are now untreatable. With a little more investment it is possible that palliative medicine could soon cover all forms of pain.

(3) To continue to strive for a cure for MND and other diseases. There must be a risk that a 'right-to-die' will reduce society's interest in finding solutions to burdensome illnesses.

(4) These issues should be decided democratically in Parliament - not in the Courts. Perhaps it is time to revisit proposals such as those put forward by Ann Winterton MP last year (2000).

FACTFILE

· Each year, around 60,000 people are admitted to hospices - with nearly half returning home again. The average length of time as an in-patient is 13 days.

· Over 200 hospices for adults provide more than three thousand beds throughout the UK. There are also 21 hospices for children, providing 159 beds.

· Around 120,000 patients living at home are supported by hospice care. This is well over half of all people dying of cancer.

· Throughout the UK, there are about 370 community-based teams and people may be under the care of a home-care team for an average of 3 - 4 months. (Source: The Hospice Movement)

CONSERVATIVE PARTY POLICY

· The 2001 general election manifesto contained pledges to increase the state's contribution to adult hospices from 32% to 40%, and from 4% to 40% for children's hospices.

· Whilst it recognises that euthanasia is an issue of conscience, and will not whip its members to vote one way or the other, the Conservative Party's official position is that it is opposed to euthanasia. Iain Duncan Smith told Steve Chalke, in interview in November 2001: "These are free vote issues in parliament because all these sort of moral issues are. The party does have a position when it comes to euthanasia, which is we are opposed to it. We allow people to express their view but I think the Party's position sends a message. I think we want people to learn and demonstrate how to look after people, not how to get rid of them."

FURTHER READING

Final Wishes, by Paul Chamberlain (IVP, 2000).

Euthanasia - The Heart of the Matter, by Andrew Dunnett (Hodder)