Extracts from
'The Edge of Life - Dying Death and Euthanasia'.
A warning to all readers
Dear Reader,
It may seem impertinent, even rude, at the very beginning of a book, to cause
you alarm, but I have some disturbing news for you. Let me tell you straight.
Hopefully, you are sitting down. Ready? Here it is - you are going to die. Most
of us have already had some brushes with death - we have fallen off ladders,
been in car accidents, and so on - but the real thing, the big one, your very
own finale, is coming. When it will happen, I cannot be sure, but I think it
will be sooner than most of you imagine. It is already a few minutes nearer than
when you first picked up this book. Death is that most certain of certainties.
Axiomatically, life is so uncertain. It is so fragile. Now we inhale, then
exhale, inhale, exhale, but it will not continue like this, will it? It will
come to a halt. It will finish. Your breathing, heartbeat, brain, and then your
entire life, will come to a stop. As the title of this book suggests, you and I
are already living on the edge of life. This certainty and proximity of death
should unsettle us. They should also cause us to ask the fundamental question
that underlies this book - am I ready to die? If not, then it would be wise to
start thinking about dying and death, and even to begin making some preparations
to face them. This book has been written to help you do exactly that.
Preface
When I began writing this book, it was to be a straightforward examination of just the one issue, euthanasia. To tell the truth, the partly-written manuscript grew to be so irksome that I hid it away in a box for several months and instead wrote an easier and more heartening book entitled, Responding to the Culture of Death - A Primer of Bioethical Issues. Then I realized that a book about euthanasia alone was bound to be dreary because the subject is skewed. What it needed was to be balanced by the topics of dying and death. These may not seem like jolly corrective themes, but believe me, they are. So, I broadened my original remit and have now written about these three edge-of-life topics, together with some of the other bioethical issues that surround them.
Throughout, I have had three simple aims. First, I want to persuade you that thinking about dying and death is not only prudent, but also beneficial. Such contemplations need not be morbid or depressing. In fact, I expect the outcome to be quite the opposite. With death in view, we are much more likely to live well. ‘My people live well and die well.’ That boast, or something pretty similar, has often been attributed to John Wesley, that remarkable eighteenth-century Christian leader. Strangely, I can find no evidence, anywhere, that he actually said or wrote it, but no matter, because it remains a grand and fitting epitaph for every Christian. All Christians should aim for a good life and a good death. Thinking about dying and death will turn us into realists. We will realize what little time we have left - the clock is ticking and its ratchet goes only one way. That thought alone should provoke us to become more useful people, and it should preserve us from idleness and triviality. Carpe diem should be our motto. For the non-Christian and the Christian alike, the end of this life is coming into view, fast. Are you prepared for your last lap? When Christians see that finishing tape, they should want to run faster and better (Hebrews 12:1-3). For the non-Christian, there must be hesitation, serious doubt, and some stark questions to ponder. That is my number one aim, to get you to think about, understand, and prepare for dying and death.
My second aim is to persuade you
of the horrors of modern-day euthanasia. Euthanasia is like a wretched spanner
in the works. The fact that people out there might want to kill you and me
before our natural end, the fact that some doctors are willing to do the dirty
deed, and the fact that some politicians and other influential decision-makers
approve of such a course of action, is alarming. Euthanasia should make us all
uneasy. Most Christians, indeed, most morally-sensitive people, feel that they
should be opposed to euthanasia, but they are usually none too sure why - they
have not yet thought sufficiently seriously about the issue. Euthanasia is
wrong, above all, because it is counter to a proper understanding of the dignity
and value of human life, and because it distrusts the providence of God.
Supporters of euthanasia argue in its favour mainly on the grounds of so-called
compassion and personal autonomy - these people are gravely mistaken and
misguided. Aim number two is therefore to help you unravel and understand
modern-day euthanasia and several other of its associated topics.
Whenever a family member or a friend is dying, and death becomes imminent, all
kinds of new problems and complex burdens arise. And when you and I are dying,
we too will create similar difficulties and become the cause of stress and
strain for our loved ones. These problems will need solving and these burdens
will need bearing. Usually, it is not easy. At these crucial times, what we, and
they, will need are not anodyne instructions or lukewarm platitudes, but
‘principled compassion’. This is the proper PC, namely, the sort of care and
caring that is deeply rooted within the ethical framework of the Bible. This is
another of the enduring themes of this book. That you will become genuinely
convinced of the need to give, and one day, to receive, this principled
compassion is my aim number three.
We all want to live well and die well. Therefore we all need a deep, deep understanding of both living and dying. The raw truth is that we need a practical theology of living and of dying. The latter is a particularly scarce item. Overall, this book seeks to begin to redress that dearth. If reading it helps anyone perform these two great tasks of living and dying any better, then my labours will have been well rewarded.
John R
Ling
Aberystwyth
January 2002.
Introduction
‘But in this world nothing can be said to be certain, except death and taxes.’
In a book with a title like this one, I knew it would be tricky to avoid quoting this droll adage. In the end, obviously, I could not resist. However, I want to put a somewhat different spin on it from Benjamin Franklin’s eighteenth-century original. While taxes and death remain unavoidable, my contention is that nowadays taxes are being used for death. That is, more and more countries are adopting public policies that are putting to death their very own citizens, and we are all paying for this human slaughter with our taxes. Abortion, infanticide and euthanasia are costing us dear. And the cost is not just financial, it is also psychological, medical, social and bioethical. In truth, the three issues of abortion, infanticide, and latterly, euthanasia are ripping us all apart.
1.1 Three
issues - one mindset
There seem to be no limits to the cruelty inflicted on humans by humans. Indeed,
much of our history can be viewed as a catalogue of cruelty by the human race
towards the human race - men, women and children. And we are not talking here
about the cruelties of war, or famine, or political strife, or personal
animosity. No - there is this other, far more remarkable, category of human
cruelty.
It is one of the curious, even bizarre, features of our so-called civilized,
educated, wealthy and sophisticated societies that we insist on, and persist in,
deliberately putting to death our own defenceless, young offspring. And
currently, we do it to millions and millions each year. This is a human cruelty
above all others. It is spearheaded by the practice of abortion and then, by
default, infanticide. And now, our world is displaying an increasing enthusiasm
for hastening the death of its more elderly citizens, by euthanasia.
Euthanasia is undeniably linked to these two already well-established,
life-ending practices. To be sure, it comes from the same mindset, the same
songsheet, as abortion and infanticide. Others have used a different, perhaps
more striking, analogy. They have likened this lethal trio to a row of three
upended dominoes - when the first practice is initially tolerated, then
sanctioned, and finally legalized, it topples over and inexorably knocks over
the second, and then the third. This is the ‘domino theory’ applied to
bioethics. Abortion leads to infanticide leads to euthanasia. And so it has come
to pass, not just in theory, but also in earnest practice.
1.2 Abortion - the number one issue
Abortion was the number one bioethical issue of the twentieth century -
euthanasia is set to collect the same accolade for the twenty-first. History is
full of lessons and warnings, so a brief examination of some of the events that
precipitated changes in abortion law, and some of the features that have
developed in the aftermath of legalized abortion, can be salutary, yet
instructive.
For centuries, legal safeguards for the unborn child had been enshrined in
several Acts of Parliament. Calls for changes to these protective laws had been
isolated and muted until the 1930s, when some concerted and strident voices
started to be raised. This pro-abortion rhetoric came initially from just a few
propagandists, especially from members of the Abortion Law Reform Association (ALRA),
and it was largely countered by those from within the medical, political and
legal establishments. Then, some illegal abortions were revealed. Next, a few
hard cases were placarded. Finally, one or two lawsuits ensued. It was all
shrewd publicity. The notion that ‘hard cases make bad law’ was conveniently
forgotten. These various colliding elements, foisted on a largely uninformed,
but by now, anxious public, by a vocal, well-organized and well-heeled minority,
culminated in the 1967 Abortion Act - arguably the most cruel and discriminatory
piece of legislation ever to appear on our Statute Book.
What was legalized, or, at least, declared to be no longer ‘unlawful’, in Great
Britain in 1967, spread across the USA in 1973, and subsequently has become the
norm in almost every country. This legalization of abortion has profoundly
changed our world, forever, and entirely for the worse. It has wrecked the
medical profession in both its ethics and practice. The supposed beneficiaries,
namely, pregnant women, have been damaged physically, and especially
psychologically. It has helped undermine marriage. It has abrogated the
protective role of fathers. It has distorted family life and increased grief,
guilt and remorse among its members. It has subverted deep relationships between
men, women and children. It has brought uncertainty to born children and
grandparents. It has confounded adoption. It has reintroduced eugenics. It has
hardened our compassion towards the weak. It has upset our demographic balance.
More could be added to this blacklist, but these are enough. The aftermath of
legalized abortion certainly makes for a breathtaking compendium of personal
tragedy and social decline. One cruel law, written on just three-and-a-half
sides of official Parliamentary paper, ushered in the practice of a cruel
medicine, the ramifications of which have affected, and infected, us all.
Pre-eminently, this advent of easy, legal abortion has changed our view of
unborn human life. What was once protected by law and described by adjectives
such as, ‘unique’, ‘precious’ and ‘inviolable’, is now legally vulnerable and
regarded in many quarters as ‘cheap’, ‘insignificant’ and ‘disposable’. The
irrefutable evidence to support such seemingly-audacious statements is found
among the tens of millions of abortions that are carried out each year,
worldwide. The vast, vast majority of these are performed on preborn children
who are both completely normal and entirely healthy - can this practice be
anything other than savage medicine?
1.3 Infanticide - the go-between issue
The abortion domino has well and truly fallen, and it has knocked over the next
one - infanticide is now part of our scheme of things. Uncounted and untold
thousands, even millions, of newborn children are deliberately killed every
year. Infanticide stands, or rather, falls, as the inevitable intermediary
between abortion and euthanasia. Unlike abortion, infanticide is still widely
unlawful, but like abortion that does not stop it being widely practised. It is
linked to abortion because one kills the unborn child, and the other kills the
newborn child. It is linked to euthanasia because it is in reality, neonatal
euthanasia. Truly, it is the go-between issue.
Abortion and infanticide are two horrible examples of medical practices that
have thrived under such frivolous euphemisms as, ‘freedom of choice’ and ‘a
woman’s right to choose’. To choose what? To destroy her own offspring, her own
unborn, or newborn, child? When abortion and infanticide are put together with
the more recent practice of human embryo experimentation, they demonstrate how
entirely comprehensive our medicalized destruction of human life has become
during the first part of the age spectrum. Indeed, early human life itself has
become trivialized.
But why stop there? What about life at the other end of the age spectrum? If a
six-month-old unborn child, who is sentient and viable, can be legally killed,
just because his mother so chooses, and a kicking and whimpering child, who just
happens to display some disability six hours after birth, can also suffer the
same outcome, then why cannot a six-year-old child, or, most poignantly in the
context of this book, a sixty-six-year-old man, be killed? After all, they too
can be inconvenient and unwanted by their relatives, unproductive and costly for
society. Just what is the logic of our current prohibition on euthanasia?
Surely, it cannot be medical squeamishness? Surely, it cannot be anything as
philosophically flimsy as an age-related barrier? Surely, sauce for the little
gosling can also be sauce for that old goose and gander? What holds us back from
a wholesale purging of our old people’s homes and hospital wards? Just think,
for one moment, of the financial savings that such a policy would bring to the
National Health Service. Consider the benefits that euthanasia would bring in
terms of sparing scarce medical resources, preserving personal peace and
reducing emotional turmoil. Can you see how near the surface the implementation
of a public policy of euthanasia must be in the minds of some? Such a move would
also bring about a neat and tidy symmetry. The legalization of euthanasia for
the elderly would complete our control of all human life. We already have
abortion for the unborn, and infanticide for the newborn. Euthanasia for the
elderly would allow us to regard any, and even all, human life as worthless,
futile and expendable.
1.4 Euthanasia - the current issue
Euthanasia is one of the central issues of this book. It may be difficult to
believe, but once upon a time, euthanasia was a wonderful word. It originally
referred to what everybody wanted, ‘a good, happy death’. Then, during the
nineteenth century, the meaning of the word was changed so that it became
associated with putting people to death before their natural end. Now,
modern-day, twenty-first century euthanasia has become a decidedly ugly word.
Despite this somewhat confusing etymology, euthanasia, that is, the deliberate
killing of people prematurely, has been practised, albeit probably sporadically,
and in smallish numbers, from ancient times. Now, at the beginning of the third
millennium, it has mushroomed into one of the most controversial issues of
medical ethics and practice. So it is not a new issue. Nor is it a simple issue.
Euthanasia is enmeshed with several other topics as complex and diverse as dying
and death, autonomy, eugenics, permanent vegetative state, ageing, and the like.
Furthermore, the same long and winding process that preceded the legalization of
abortion has already begun with respect to euthanasia, and the outcome looks
similarly bleak, and almost as inevitable.
The great social experiment of euthanasia must never be allowed to be conducted.
There are good reasons, derived from the precedents of abortion and infanticide,
to believe that legalized euthanasia, even of the voluntary variety, will launch
an ethical disintegration and an additional dimension of dehumanization within
society that we have not yet even dared to consider. It will distort our
bioethical perceptions to such an extent that once legalized it will be
prescribed for those who are neither dying, nor able to give their consent.
Furthermore, we would be wholly naive to assume that any law permitting
euthanasia will not produce widespread, inhumane abuses. The poor and the
vulnerable will be further marginalized. Care for the elderly will inevitably
decline. ‘Why waste time and money on them?’, will become the popular cry. Human
life will be further demeaned. We must never allow all this to happen. Herein is
one of the challenges of this book - will you be part of the problem, or part of
the solution?
1.5 The approach of other books
Of all the books about euthanasia published during the last two decades, any
listing of the most influential would have to include The End of Life -
Euthanasia and Morality, by James Rachels (1986), Should the Baby Live?, by
Helga Kuhse and Peter Singer (1986), and An Intelligent Person’s Guide to
Ethics, by Mary Warnock (1998).
It is intriguing to note that all of these pro-euthanasia authors, and many
others too, begin their books by describing one or two exceptionally difficult
human cases. They would, I am sure, say that they were simply ‘setting the
scene’. Nevertheless, it is reminiscent of the tactics used by members of ALRA
as part of their scare-mongering strategy to liberalize abortion law during the
last century. I would contend that the selection, by these authors, of such
emotionally-charged examples are designed to confuse genuinely-inquiring readers
in order to win them over to the author’s viewpoint. Furthermore, this approach
demonstrates just how muddled these moral philosophers are. They all have got it
the wrong way round - they have put the cartload of examples before the ethical
horse. For them, the hard cases become the centre of focus. Such an approach
inevitably gives rise to their beloved ‘situation ethics’, whereby the
particular case, rather than the search for an underlying general principle,
takes centre stage and determines the ethic as well as the ensuing action. Their
back-to-front arguments are from the particular to the general - welcome to the
topsy-turvy world of modern moral philosophy! And, since these authors’
worldviews are, without exception, secular humanistic and utilitarian, their
recommended practical responses are, naturally, unprincipled and pragmatic.
After all, that is what situation ethics is all about. And whatever you do,
don’t mention ‘absolutes’ - they all despise them. Of course they do. For them,
the only absolute is that there are no absolutes!
1.6 The approach of this book
This book begins quite differently. Part 1 begins, not with individual cases,
but with foundational principles - plain, universal principles, derived from the
Bible. Once these ethical principles have been laid down, the primary issues
will be bolted on in Part 2. This is the proper way to build, be it a house, or
an ethical worldview - foundations first, then the superstructure. And because
the threat and awfulness of euthanasia cannot be grasped adequately without a
decent understanding of dying and death, it is these three grand topics that
become interwoven and highlighted throughout all the Parts of this book. To
ensure that the primary issues of Part 2 cannot be dismissed as merely abstract
concepts, some traumatic, ground-breaking case studies are examined in Part 3.
Next, a whole raft of other secondary, but related, bioethical issues are
explained in Part 4. Then, and as important as any other portion of this book,
Part 5 contains some practical, pro-life responses to these issues. Part 6 is
the coda. An adequate appreciation of edge-of-life issues requires some
historical background, some contemporary quotations, some ethical perspective,
some unsentimental analysis, and some up-to-date information - these too are
included throughout the following pages.
But to begin at the beginning, these issues will be considered within the
ethical warp and weft of biblical truth. This is no antediluvian,
anti-intellectual, quasi-religious cop-out. Indeed, it is quite the reverse, for
two very good reasons. First, the Bible declares itself to be true (John 17:17;
2 Timothy 3:16). This means that the information it conveys is inerrant, and the
standards it sets are absolute. In other words, we are here dealing with
unconditional, non-negotiable, true, truths. The Bible therefore provides us
with the real basis for discussing, for example, who we are as human beings, and
how we should live, individually, in families, and in society - both before men
and before God. This is immensely liberating - it releases us from the bondage
and uncertainty of the shifting relativism of society’s current mindset, namely,
secular humanism.
Second, the Bible makes far greater demands upon those who follow its teaching
than does any man-made system of ethics. It compels us, for instance, not just
to care for our families, and help our friends, but, revolutionarily, it
commands us to love our enemies (Luke 6:27). The normal Christian life is one of
cross-bearing and denial of self (Matthew 16:24). The Scriptures’ portrayal of
the good life is one of service, giving of our time, energy and talents for the
benefit of others. In the context of this book, it means that we are to uphold
and promote the utmost respect for all human life. We are to defend, protect and
cherish all men, women and children. Such a valiant enterprise will be neither
effortless, nor trouble-free. Legalizing and giving in to euthanasia, that is
the real cop-out, the easy evasion, the secular humanist’s dodge, the
utilitarian’s fudge.
Opposing euthanasia will never be the simple or comfortable option. There are
some rather clever people out there who are bent on legalizing euthanasia - some
of them are the most engaging people you will ever meet, and sometimes their
arguments sound so plausible. Countering them will be demanding. Many of them
are from the political and medical establishments and they often have high media
profiles, as well as friends in high places. Therefore, we need to be sure of
our principles and the veracity of our cause. Yet, however clever their
pro-euthanasia arguments and tactics are, it is profoundly reassuring to know
that there are objective truths upon which we can construct and sustain an
entirely robust anti-euthanasia stance. And in the final analysis, euthanasia
will be defeated because ordinary people, like you and me (no, not like you and
me, but actually you and me), not only knew, but also acted upon, these truths.
This is the Bible’s two-fold configuration for all aspects of Christian living.
First, the truths, the doctrines, the statutes, the precepts, the principles are
presented. These are the credenda - things to be believed. Second, comes the
call to think, to speak, and to live those very truths. These are the agenda -
things to be done. So it must be for those who are mandated to care for all
those made in the image of God, and who are therefore implacably opposed to
euthanasia. First, principles. Second, action. This is the overall pattern of
this book. First, the ethical bedrock is assembled, and upon this, all the major
and minor edge-of-life issues are examined and judged. Second, the answers and
practical responses to these issues are developed and applied. Together, the
credenda and agenda generate that greatest of all responses, principled
compassion.
1.7 This book is for all
But this book is not just for Christians, it is aimed at a much wider readership
- all the living. Whatever your mindset or worldview, dying, death and
euthanasia are issues that you will be forced to confront. And they will require
answers from you. So where will you find a solid ethical grounding, a sure
philosophical base, upon which you can build a secure bioethical superstructure
to provide those answers? Currently, the predominant driving force behind
ethics, and particularly medical ethics, is secular humanism. This is a
man-made, man-centred, shifting utilitarianism - it believes that whatever
action produces the greatest good for the greatest number of people must be
true. But just look at what this mindset has produced. Its fruit are a bunch of
horrors including abortion-on-demand, destructive experimentation on human
embryos, infanticide, and now, euthanasia. Medicine’s once-proud ethics and
practices have come to this miserable end - its modern mantra has become,
‘killing the patient can be OK’.
Of course, medical personnel are at the sharp end of these fatal practices.
Nevertheless, this book is not a vendetta, or some smug diatribe, against
doctors and other healthcare professionals - all of us are, to some extent,
blameworthy. Nevertheless, doctors and their associates should know better than
to participate in abortion, infanticide and euthanasia, but many of them have
become little more than the unthinking pawns of society. They have become our
social executioners - we have asked them to carry out these ghastly deeds, and
they have complied, usually, it must be said, without much honourable
resistance, or praiseworthy hesitation. Thus, one by one, healthcare
professionals, and their previously-illustrious medical specialties, have
fallen. Obstetrics and gynaecology have already been ruined by the practice of
abortion. Paediatrics has become contaminated by infanticide. And now geriatrics
is under siege from euthanasia. There is currently a widespread belief
throughout the medical profession, and elsewhere, that some human beings are
morally valueless, substandard non-persons who can, and even should, be put
down. That is, they should be selected, and then culled by abortion,
infanticide, or euthanasia.
So this book is not just for Christians, nor just for healthcare professionals.
It is for all, because none can escape dying and death. Many of us have already
had to face them, as it were, by proxy, usually with the loss of our parents, or
elderly relatives. Such times are invariably difficult and we were probably
surprised how unprepared and how emotionally affected we were, even when these
events were anticipated. Such times will come again, and next time, hopefully,
we will be more prepared and better able to cope. But dying and death have an
additional and intensely personal edge to them - our own dying and death are not
far away. Their inevitability and nearness should rattle us.
If dying and death are inescapable, and have always been challenging and tough,
now there is this additional edge-of-life obstacle, euthanasia. Recent
developments in medical ethics and practice confirm the increasing probability
of our having to face such a predicament. It may be on behalf of an aged aunt, a
father, a brother, or a wife, and eventually, on behalf of no one else, but
ourself. And what will you think, and say, and do then? To be forewarned is to
be forearmed. Now is the time to understand the issues, rehearse the arguments
and formulate your responses - in the heat of the moment, at the hospital
bedside, will generally be too late.
This book seeks to be a guidebook to the edge of life. It is not a comprehensive
book, though it does seek to tackle the key issues and answer the main
questions. It is not a medical textbook, though a little medical knowledge will
be provided where necessary. It is not a counselling handbook, though
communicating with others and seeking their advice and support is a recommended
strategy. It is not an academic book, though it remains serious rather than
lightweight, yet also warm-hearted rather than frosty. In addition, there is an
intentional development of ideas and themes throughout its six Parts and it
therefore makes most sense to read it from beginning to end. However, that will
not be everyone’s practice - many readers will want to dip into single chapters.
To allow for this, most chapters have been written to be largely free-standing.
This, of course, demands some repetition - please bear with it. On the other
hand, who does not benefit from a little recapitulation now and again?
These edge-of-life issues will test us all to the full. How then will you think,
speak, and act realistically and properly when confronted by them? Hopefully,
this book will help. We can be very good at evading reality, avoiding the truth,
and seeking to minimize our discomfort as we press on, searching for that life
of personal peace and affluence. Getting to grips with these edge-of-life issues
will shatter some of these pursuits. But it will also highlight the fundamentals
of life and death. And this is the huge payoff from facing dying and death - it
exchanges doubt, and fatuity for certainty and reality.
Whenever I walk through our local cemetery, I always pause by one grave. On it
is inscribed this message for the living from Psalm 90:12, ‘Teach us to number
our days aright, that we may gain a heart of wisdom.’ It will not be long before
we will all be in a similar graveyard somewhere, scattered on the ground, or
buried six feet under. For some people, death is the ultimate unknown and
therefore frightening. For others, death itself holds little fear, but the
process of dying can be a fearful prospect. The wise will therefore start now to
number their days and begin to prepare for a good death, for what will be their
‘true euthanasia’. And the preparation starts here. In the realm of bioethics,
we must learn how to walk before we can run, but, even before that, we must
discover how to get up onto our bioethical feet and simply stand. Principles and
themes from the Scriptures will enable us to do just that - so, look to the next
page.
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