Notes on End-of-Life Issues – Euthanasia and Assisted Suicide
Themes from the Scriptures
1] Human life is unique and
special. Genesis 1:1; Genesis 1:27.
2] Human life begins at conception. Jeremiah 1:5; Matthew
1:20.
3] Human life requires stewardship. Ecclesiastes 5:18; 1
Peter 3:7.
4] Human life ends in natural death. 1 Samuel 2:6; Psalm
104:29.
5] Human life is not to be taken. Genesis 4:9-10; Exodus
20:13.
6] Human life demands special care. Exodus 4:10-12; Isaiah
35:5-6.
History of Medical Ethics and Practice
1] Hippocratic oath and the
Judaeo-Christian doctrines.
2] The indisputable link between abortion and euthanasia.
Euthanasia and Assisted Suicide Defined
1] Voluntary, non-voluntary
and involuntary euthanasia.
2] Active and passive euthanasia – a false distinction,
intention is the key.
Lexical and Social Engineering
1] Abortion is now not really
killing a human being, it is a TOP or a RPOC.
2] Euthanasia was once ‘mercy killing’, then ‘the right to
die’ and ‘death with
dignity’ and ‘assisted suicide’, now
‘assisted dying’.
3] Voluntary Euthanasia Society [VES] is now called Dignity
in Dying.
Understanding Suicide
1] The Suicide Act 1961 – it
punishes those who assist, it protects the vulnerable.
2] Suicides in the Bible – none was approved by God.
The Current Situation – Worldwide
1] Netherlands, Belgium,
Switzerland, Oregon, Washington State and Quebec(?).
2] Recent rejections by legislations around the world.
Euthanasia in the Netherlands
1] The Remmelink Report
(1991). Voluntary leads to non-voluntary euthanasia.
2] Groenewoud et al. (2000) New England Journal of
Medicine 342: 551-556.
Recent Challenges to UK Law
1] Lord Joffe Bills – 2003,
2004 and 2005.
2] 2006 ADTI Bill – assisted dying only – defeated in the
Lords by 148 vs. 100.
3] 2009 Coroners and Justice Bill.
4] 2011 The Commission on Assisted Dying.
5] 2014 Lord Falconer and Margo MacDonald (Patrick Harvie) Bills.
Euthanasia and Palliative Care – the Great Paradox
1] Symptom control has now
taken the greater part of pain out of dying.
2] Not perfect – hospices vs. hospitals vs. homes.
3] Needs to be extended to more non-cancer patients.
4] The dying need better care and more resources, not
killing.
The ‘Clamour’ for Euthanasia Legislation
1] Polls show 82% of the
public favour some form of legalisation.
2] Medical professions show little interest and it is opposed
by disability groups.
3] Few MPs and politicians advocate it – all Bills at
Westminster defeated.
4] Members of the general public not exactly queuing up to be
euthanased.
Doctors and Euthanasia
1] Dedicated healer would
become life terminator – an eerie prospect.
2] Historic patient-doctor relationship of trust and respect
would end.
3] Would need a new profession of euthanasiasts – social
executioners.
4] Second-rate, end-of-life care fosters substandard
medicine, DNR, etc.
Legal Criteria for Euthanasia
1] Could not be simply for
‘incurable’ diseases.
2] Fatal diagnosis does not necessarily mean an imminent
death.
3] Misdiagnoses and spontaneous remissions do occur.
4] Could not be degree of pain – many distressing illnesses
are painless.
5] Depressives often change their minds and a buoyancy
returns.
6] End of ‘rational existence’ is unreliable – ‘the last days
must not be lost days.’
Burdens of Legalised Euthanasia
1] The elderly would feel a
burden – ‘the right to die’ becomes ‘the duty to die’.
2] Emotional burdens – dutiful carers would feel cheated.
3] Financial burdens - 'Is it my time to decide to go?'
4] Formalised ‘quality of life’ assessments – a mathematical
balancing act.
5] Decisions made under acute depression/duress are often
bad.
6] Burdens must be faced and solved, not ignored
and shelved.
Fears Associated with Dying
1] Most of us will die simply
and quietly, not hooked up to life support.
2] Life support is used properly to get over an acute crisis.
3] The hunt for transplantable organs – probably not.
4] Futile and burdensome medicine – ‘heroic’ measures for
what?
5] Lethal doses of drugs and painkillers – unlikely.
6] The Liverpool Care Pathway – good and bad, depending on
medical staff.
7] There really is a time to die! Ecclesiastes 3:2.
The Cases of Anthony Bland, ‘M’, Tony Nicklinson,
‘Martin’ and Paul Lamb
1] Anthony Bland – a victim
of the Hillsborough disaster, 1989.
2] He was in PVS, able to breathe, tube fed, not on
life support.
3] 4 February 1993, the Law Lords’ decision and Peter
Singer’s assessment.
4] ‘M’ is in a ‘minimally conscious state’, not PVS.
5] 28 September 2011, Mr Justice Baker refused to sanction
her death.
6] 16 August 2012, the locked-in syndrome Tony Nicklinson and
‘Martin’ decisions.
7] 31 July 2013, Paul Lamb's case dismissed,
'Martin's' upheld - DPP to clarify professionals' roles.
The Three Medical Dominoes
Abortion, infanticide and
euthanasia – medicine corrupted.
What Must We Do?
1] Pray, 2] Educate, 3]
Engage, 4] Care, 5] Join and Give.
How to Die Well
1] Hebrews 9:27 The reality,
proximity and finality of death.
2] Amos 4:12 ‘... prepare to meet your God.’
3] Prepare for our own death and that of others.
4] Grasp Genesis 1-3, Ecclesiastes 7:2, Romans 5:12, 1 Cor.
15:26, etc.
5] Hope in John 14:2-3, Deut. 31:6 to Hebrews 13:5, Matthew
5:4, etc.
6] Think about death and heaven – they’re coming!
Ling, John R. (2002). The Edge of Life – Dying, Death
and Euthanasia. Day One.
Ling, John R. (2014). Bioethical Issues - Understanding and Responding to the Culture of Death. Day One.
The best UK website dealing with these issues is, www.carenotkilling.org.uk
compiled,
24 September 2013.