June 23, 2023

Live and Let Die? Responding to the Expanding Spectre of Euthanasia

The notion of dying well has a certain appeal. As translated from the Greek words eu and thanatos,as good death, euthanasia would seem like something we would all want. As children, my friends and I would sometimes ask each other how we would wish to die. No one said, “burned alive” or “drowned at sea” or “electrocuted.” And aside from my quip, “to be pulled apart by lions,” offered up in jest, everyone unanimously agreed that dying peacefully in one’s sleep, at the end of a long life, was the preferred way to go.  Now, with the expanded euthanasia laws in Canada, such a controlled ending is well within reach. And why should that be a problem either for ourselves or for others to choose? What’s the big deal if we simply live and let die? Certainly, as represented by its advocates, euthanasia sounds innocuous enough. Its portrayal even seems tempting: to time your exit in a controlled fashion, mentally prepared and emotionally composed, while planning it to occur, say, after you eat a special meal over a glass of vintage Cabernet Sauvignon, and play that favorite song one last time with the opportunity to say your heartfelt goodbyes to those family and friends of your assembled choosing. And just as the intravenous line gets opened up and the deadly concoction moves its way to take your life, you articulate your well-crafted last words… and then… drip, drip, drip… you’re done. C’est fini! Everyone in the room weeps and agrees how “really nice” a person you were, and like the dramatic departure of the hero or heroine at the finale of a classic silver screen gem, the curtain drops, and all applaud a life well-lived, right to the very end. Who wouldn’t want such a poetic finish? Of course, for those of us who claim to hold a biblical worldview and follow Jesus, there is that rub about the sanctity of human life, and that bit about “The Lord bringing death and making alive; and bringing down to the grave and raising up” (1 Sam 2:6), and also that “a man’s life is not his own; nor is it for man to direct his steps” (Jer. 10:23) … as well as numerous other biblical exhortations unequivocally proscribing euthanasia. So, with the Gospel in mind, and in light of the normalization of doctor-assisted suicide in our culture, what’s a Christian to think or do?

As a clinical cardiologist working in a downtown tertiary care centre, I’ve seen a lot of dying and death. End-of-life has always presented certain challenges for both patients and their caregivers. From the day-to-day logistics of coping with loss of independence and capacity, to managing ongoing symptoms of discomfort or shortness of breath, to the existential struggles of considering life’s meaning and purpose as years dwindle to days and hours, dying isn’t an easy thing to do, nor watch others do, particularly when it’s a loved one. And yet, the challenges posed at the end-of-life have become all the more complex in our current era of euthanasia-on-demand. The readily accessible option of choosing the timing, setting and mode of one’s death has forever changed the landscape of the deathbed. The ambition of this essay is to critique the common arguments used to promote doctor-assisted suicide in light of the Gospel of Christ, and emphasize the importance of having a separate two-pronged response to this issue: one to challenge those who advocate for euthanasia; and one to gently come alongside those who are considering such an option for themselves. My hope is to provide the necessary equipping for the Christian community to not only meet this daunting challenge, but to be emboldened to seek out such opportunities for Gospel witness and favor.

I well recall the debates leading up to the legalization of doctor-assisted suicide in our country. In 2014, the Canadian Medical Association arranged a series of townhall meetings live-streamed across Canada. There were on-line discussion boards designed to promote public discourse on the topic of end-of-life care, and address the “terminology and nuances in this complex and emotional area.”[1] I was involved in the Edmonton gatherings, where medical personnel and members of the public were given equal opportunity to share their thoughts and apprehensions on an open microphone. Although medical culture has since shifted leftward, at that time, I wasn’t alone in standing against euthanasia. Numerous well-spoken physicians took their turn at the mic, clearly articulating their concerns about adopting such a diametrically opposed, non-medical practice in medicine. Making use of the traditional Hippocratic Oath[2] as their base – that doctors should “neither give a deadly drug to a person if asked for it, nor make a suggestion to this effect” – cogent arguments were raised detailing the moral trespass of doctor-assisted suicide.  Others explained that there was no need for resorting to euthanasia to ease a patient’s suffering. They stated that we’ve never been in a better position to expertly parry disease and provide compassionate care for the dying, nor have we had more effective means of pain control than what is currently available in Canadian hospitals today. Still others warned about the dangers of opening such a Pandora’s box. Slippery slope arguments were put forward, and cautions were clearly stated, explaining how the incorporation of euthanasia into the practice of medicine would not only compromise the trust required for sound doctor-patient relationships, but put vulnerable members of our society at risk, including the elderly, disabled, and destitute. In countering these concerns, however, members of the public overwhelmingly hijacked the discussion by either sharing emotive stories of loved ones dying difficult and painful deaths, or parroting the media reports of the day, confident that numerous safeguards would be in place to prevent abuse of euthanasia, and that it would be reserved for only terminally ill patients suffering from extreme pain.

Less than a decade later and here we are, euthanasia-on-demand, the sixth-leading cause of death in our country. Since the unanimous Supreme Court of Canada decision in February 2015 to remove euthanasia from the criminal code for “grievous illness and irremediable suffering,”[3] the end-of-life landscape has continued to change. The utilization of MAiD (medical assistance in dying) has steadily climbed with each passing year, particularly so during the shutdowns and isolation of COVID-19. Of the 30,000 Canadians who have received assisted suicide since the its legalization in our country, the majority – representing some of our most vulnerable citizens – were given their fatal injection during the pandemic, receiving death over compassionate care.[4] To underscore the scale of our growing euthanasia program, the State of California, which legalized euthanasia at a similar time to Canada and has roughly the same population as Canada, had 486 deaths from euthanasia in 2021, in contrast to our 10,064![5] As it turned out, the pandemic served as the perfect distraction to expand the eligibility criteria for euthanasia with minimal opposition. With all attention drawn to COVID case number reporting, little bandwidth was left to push back on the advancement of this liberal agenda. Despite the steady increase in euthanasia deaths in Canada,[6] as well as the staggering number of suicides occurring during the pandemic from existential suffering,[7] the government pushed ahead to broaden the indications for MAiD under the pandemic cloak. As Winston Churchill said, “Never let a good crisis go to waste.” So, despite the myriad problems created by the handling of the pandemic in our nation, our newly elected Liberal government snapped into action by ignoring them all, and instead made expanding euthanasia a top priority.

In March 2021, the landmark Bill C-7 removed the foreseeable death clause from the original legislation – that a person’s natural death must be reasonably foreseeable to qualify for MAiD – allowing people who are not dying to be considered eligible for death by lethal injection.[8]  As a result, now not being limited to end-of-life, euthanasia eligibility has been extended to include persons with any non-terminal chronic illness or disability, such as arthritis, emphysema, or vision loss. Although two-doctor approval is still required for MAiD applications, it is the applicant’s sense of “intolerability” of their medical condition that arbitrates approval for death. This fits squarely with our culture’s supreme and irrational elevation of subjective feelings over objective reality. Afterall, if a 40-year-old man can identify as a girl and use the women’s washroom – and that’s acceptable in our society – who’s a doctor to say a person’s feelings of intolerability for a given ailment aren’t valid and in need of lethal remedy?

In addition, Bill C-7 further extended the eligibility criteria for MAiD by taking out other safeguards – hard-won protections that Parliament deemed necessary in 2016 to defend the lives of vulnerable individuals from wrongful death. These included the removal of the 10-day reflection period for those whose deaths were considered reasonably foreseeable. This means that a person could request death by euthanasia when they’re experiencing a bad day, for example, with no need to die another day. Thanks to this reckless legislation, same-day MAiD service is now available in Canada. The amendment not only fast-tracks the decision for suicide – an irreversible choice of enormous gravity – it completely ignores the reality of how illness affects the variability of mood and the will to live. This is particularly the case in the context of advanced illness, where the desire for death can move up and down along a continuum, sometimes within a given day, sometimes within a given hour. As Canadian psychiatrist, Dr. Harvey Chochinov attests, “there are significant correlations between the will to live and existential, psychological, social, and, to a lesser degree, physical sources of distress. Existential variables proved to have the most influence, with hopelessness, burden to others, and dignity being the most important.” Chochinov goes on to emphasize that “Health care providers must learn to appreciate the importance of existential issues and their ability to influence the will to live among patients.”[9] Considering that Canadian physicians are now being encouraged to raise the option of MAiD with their patients as a means of remedy – “I see that your arthritis is really acting up today… have you considered lethal injection?” – this bill places patients, whose moods and will-to-live will invariably fluctuate, in serious jeopardy.[10] As well, Bill C-7 removed the final consent requirement and the stipulation for mental competency at the time of lethal injection. By stark contrast to the Supreme Court of Canada vs. Carter decision, which stated that only competent people could die by euthanasia, the bill permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, as long as that person was previously approved for assisted death. Little imagination is required to see how this can lead to an increase in coerced and tragically unconsidered deaths.

If these loosened restrictions weren’t enough, the spectre of euthanasia expansion is planned to broaden even further. Mental illnesses, including clinical depression, are currently being debated as a standalone indication for lethal injection, and projected to be included on the list of euthanasia eligibility criteria by March 2024.[11] While this is extremely problematic on a number of levels – not the least of which is that suicidal ideation is a cardinal symptom of clinical depression and a routine trigger for a physician to commit a patient to hospital for their safety – the proposed inclusion of mental illness will very likely proceed as planned. Using cultural Marxist arguments, MAiD advocates are demanding that “Patients with a psychiatric illness should not be discriminated against solely on the basis of their disability, and should have access to the same options regarding MAiD as all other patients.”[12] And there’s even more: the eligibility of mature minors and advance requests are presently under parliamentary review. This will allow further expansion of euthanasia to those under 18 years of age, as well as for anyone who wishes to stipulate the desire for MAiD along with their medical goals of care and estate planning. The upshot of all of this is that Canada has become a world leader in administering death.

To add macabre to mortality, killing in our country has now become a business. There is no denying the substantial healthcare cost savings for hospitals and nursing homes related to MAiD.[13]After all,  it was this financial benefit that first allowed Hitler’s Nazi party to establish the Tiergartenstrasse-4 euthanasia program to euthanize “lives unworthy of continuance,” which as Uwe Neumaerker, Director of the T4 memorial foundation, said, lead to “the murder of tens of thousands of patients and residents of care homes, and was the first systematic mass crime of the National Socialist regime.”[14] With the aforementioned expansions to the eligibility criteria for lethal injection in Canada, funeral homes are now also positioned to make a buck. Recognizing the growing market for death-on-demand, a number of funeral homes have responded to the business opportunity by offering a one-stop MAiD funeral service.[15] Those who have been accepted for euthanasia are given the opportunity to rent a death room where they can have their last meal, watch one final movie, listen to their favorite song, and invite friends and family for their final goodbyes, even incorporating ritualized dance and involving death doulas. Then, at their chosen time, clients receive doctor-assisted lethal injection, followed by their funeral service. It’s a one-way, walk-in, ashes out, pragmatic, and pagan, death rite.

As we consider the Christian response to this growing spectre, it’s important to be clear about what euthanasia is and what it isn’t. Euphemistic terminology is rife within the euthanasia landscape. Of course, its primary purpose is to confuse and desensitize patients and professionals alike. Our Canadian adopted term, Medical Assistance in Dying (MAiD), for example, which on first blush sounds very much like something we’d all want to receive as we’re nearing the end – not to be abandoned in suffering and to receive compassionate care and medical assistance… is not at all what it means. Terms like death with dignity, compassionate dying, right-to-die, terminal sedation, are all more palatable and function to soften, cushion, and foster agreement on what has been historically a very divisive issue. The word murder is disturbing for our contemporary sensibilities, but murder is what we are talking about – the premeditated intentional killing of an innocent human being. This is why the term, doctor-assisted suicide (whether lethal injection or lethal prescription) is a more accurate designation. It calls the spade for the spade it is, and helps to differentiate euthanasia from other actions which are not euthanasia.

Refusing medical care, for example, is not euthanasia, even if the refusal eventually results in death. Patients have the right to bodily integrity (or at least, historically, people have had that right until Covid vaccines were mandated). Despite governmental coercion, we in the medical community need to respect a patient’s right to refuse treatment or intervention. This is the case, even when this might lead to furthering of the disease process and death, such as when a Jehovah Witness refuses blood products. Likewise, the withdrawal of medical interventions, such as disconnecting a patient from a ventilator, or the withholding of nutrition and hydration, are not euthanasia, even if they result in the hastening of the death of the patient. The difference lies in the intention of the intervention. The burden of any medical therapy or intervention needs to be continually weighed and balanced against the expected benefits. This requires transparent practice and ongoing honest conversations with patients and their families about end-of-life. We need to not only avoid futile heroic interventions, but also any interventions – in some cases even food and water – if they are futile and only add misery and needlessly prolong the dying process.

Next, as we consider our response to MAiD, it’s critical to separate out the philosophical debate of euthanasia on one side, from the discussion with someone who is considering doctor-assisted suicide for themselves, on the other. We need to realize that these are two very separate conversations. The first is the firm defending of the Christian worldview, underscoring the sanctity of human life; the second is a gentle response of care and compassion to someone struggling in their time of personal crisis. For the former we must be “prepared to give an answer to everyone who asks you to give the reason for the hope we have, but do so with gentleness and respect” (1 Pet. 3:15). By contrast, for the latter, it’s not about winning an argument but witnessing God’s love. As such, we need to quietly listen, to empathize, encourage, and give testimony to “the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God” (2 Cor. 1:4). To emphasize this distinction and underscore the necessity for winsome tact in talking with those in crisis, I’ll begin by addressing this latter discussion first and the approach to debate afterwards.

In my experience of caring for dying patients, the expressed request for MAiD is not a desire to die, but rather a symptom of an unmet need. No one really wants to die. However, many choose death over living when the psychological stresses of unmet needs become too overwhelming. Death is preferred over the difficulty of living another day, or even the perceived anticipation of difficulty in living another day. There is a general misperception that patients die in inexorable pain, but this is simply not the case. Although there are always exceptions, the deathbed is most often a quiet place, a sacred space, and (pre-pandemic at least) a meeting place of family and friends, with their soft voices admixed with prayers, music, lingering embraces, lots of stories, and sometimes humour and even laughing. Interviews conducted with family members of patients in Oregon who opted for assisted suicide clearly demonstrated that the patient’s decision to proceed with suicide was not because of poor pain control or suffering.[16] Of the list of symptoms on the survey to assess degree of suffering, none were graded at higher than two out of five on the severity scale, pain included. Instances of “irremediable suffering” expose substandard palliative care provision rather than underscore the need for lethal injections. What most commonly lies behind the request to die is existential suffering. rather than physical. Pain is rarely, if ever, the driver for the request of euthanasia.

Existential suffering can take many forms. Feelings of abandonment and loneliness, for example, intensified during the hospitals’ isolation mandates during COVID-19. Some people suffer with grief over the anticipated separation from their loved ones, not being able to see their grandchildren grow up or graduate, the loss of their vocational identity, and the loss of their independence and physical abilities. Some find these changes in their function humiliating and would rather choose dying from lethal injection over dying of embarrassment. Guilt plagues others, including feelings of remorse over broken relationships, missed opportunities, and precious moments frittered away by work or sloth. Overcome by fatigue, some patients reflect a sense of futility with their failing health, and dwell on feelings of defeat, helplessness, and frustration of being misunderstood. Still others fear dependency, the loss of control, as well as the possibility of future pain. These forms of suffering are not only just as real and anguishing as physical suffering, they are just as treatable, and not with killing, but with caring.

The body of Christ is uniquely suited to address these sorts of challenges. Working through existential suffering is our thing; it’s what we as followers of Jesus need to be able to do, and what we can do. This is because we have been promised the Holy Spirit to empower us in this vital outreach. Jesus said, “I will ask the Father, and he will give you another advocate to help you and be with you forever” (John 14:16). The apostle John uses the Greek term paráklētos to describe the role of the Holy Spirit, which means to “come alongside” as advocate, helper, and comforter. As a result of the Holy Spirit indwelling us, we are empowered in our words of comfort, prayers of intercession, sacrificial deeds of care, and simple presence of support and encouragement to speak truth into the lives of those who suffer. Extreme existential suffering is alienation from God. To address this, we have ready access to God-breathed Holy Scripture to console and to convict. The biblical answer to suffering is not one of indifference, denial, defeat, or shoulder shrugging, but rather it tackles the problem of pain square-on. In the oldest book of the Bible, Job’s cry of anguish doesn’t evade or honey-coat suffering, but honestly lays it out in full view:

“Why is light given to those in misery, and life to the bitter of soul, to those who long for death that does not come, who search for it more than for hidden treasure, who are filled with gladness and rejoice when they reach the grave? Why is life given to a man whose way is hidden, whom God has hedged in? For sighing has become my daily food; my groans pour out like water. What I feared has come upon me; what I dreaded has happened to me. I have no peace, no quietness; I have no rest, but only turmoil” (Job 3:20-26).

The Bible doesn’t end there, of course. God has not abandoned us to the world of suffering and despair. Rather, our pains of suffering are ultimately answered by God’s intimate involvement in the human condition at the cross. As Martin Luther said, “When you look around and wonder whether God cares, you must always hurry to the cross and you must see Him there.”  The cross reminds us that God is not distant from human suffering but has become part of it. The Lord draws near to us in our times of suffering, so we can draw near to those who suffer. And as John Piper says of suffering, “the aim is that our faith might be refined, our holiness might be enlarged, our soul might be saved, and our God might be glorified.”[17] Ending lives by MAiD does not allow any of this to happen.

So, as believers, our role is to come alongside those who suffer this way, and gently uncover their unmet needs and thoughtfully address them. This will entail taking time to visit them, to provide a listening ear, a hand to hold, and offer steadfast support and Scriptural encouragement. As well, we must be prepared to advocate for patients and rally for adequate symptom control management, as needed. Contemporary palliative care is proven-effective therapy that neither hastens death nor prolongs the dying process. Hospice care support can allay concerns of abandonment and provide essential support for patients and their families until natural death ensues. Studies have repeatedly shown that patients who receive palliative care not only have higher quality of life, improved mood, and live longer, but are less likely to request doctor-assisted suicide.[18] Not surprisingly, hospice-styled palliative care as we have it in Canada is virtually unknown in the Netherlands where euthanasia has been permitted since 1984.

Depending on the situation and our relationship to the patient, we can be creative in looking for opportunities to care for some of their physical needs ourselves: applying a cool face cloth for the forehead, moistening their lips with an oral care swab, getting an extra blanket or pillow, massaging their feet, bringing in some homemade soup, and even arranging some framed family photos for the bedside table are just a few ready examples. Patients who are in the end-stage of their illness and facing death are often quite open to hearing Scripture and to prayer. I often write down Bible verses I think might speak to them on a card, sometimes even on a prescription pad, so they can have it on their bedside table and access as desired. During our visits, we should look for such opportunities, and not be shy to pray with patients, share our testimony, or read to them from our Bibles. This is the case even if they are sharing a room with others. I have had patients in neighboring beds, on more than one occasion, ask me to pray for them as well, some even coming to a saving faith. God’s plan A is not for humankind to suffer, but “for all to be saved and come to a knowledge of the truth” (1 Tim 2:4), This, of course, can only be accomplished by grace alone, through faith alone, in Christ alone.

Switching gears now, as we consider our response to the philosophical issues raised by euthanasia, it’s helpful to realize that the pro-euthanasia camp includes a wide spectrum of people with varying beliefs and views. On the one extreme, there’s the radical promotion of the culture of death, as popularized by singer and activist Chris Korda. As the founder of the anti-human Church of Euthanasia, sheencourages others to “save the planet and kill yourself!”[19] While Korda’s self-contradictory radical views may be eyebrow-raising, they are, nonetheless, refreshingly honest, and at least consistent with her anti-natalist position – that “birth and procreation are morally wrong.” More insidious in nature are those folks on the other extreme who hold a laissez-faire position on euthanasia. In a desire to avoid conflict, they believe that choosing MAiD is a personal decision that people should be free to make. Some within the Christian community have slid into this muddled live-and-let-die way of thinking, including those in leadership. The Archbishop of the Anglican Church of Canada, for example, one of our country’s largest and historically most influential Christian denominations, said, “the church should not oppose MAiD law, nor impose Christian values, but focus on providing pastoral care to people who are considering medical assistance in dying, ensuring they have the support they need to make decisions based on the value of their life.”[20] As well, the United Church of Canada (a former denominational leader in our land) has followed suit; claiming to be acting out of the “compassion of Jesus,” they offer Christianese prayers for those choosing MAiD.[21]

Soaking in the cultural decay of our land, it’s certainly easy to see how many can get caught up in the humanistic fervor of our times, fall prey to the emotive arguments, and be duped. As the Christian influence on our culture wanes, so too, has the understanding of Scripture. Biblical illiteracy has become the norm in our society, and even churches and many within the church suffer from doctrinal confusion and biblical misinterpretation. Consequently, they can become prone to liberal trends, the acceptance of euthanasia included, or least a general complacency about its importance. As Francis Schaeffer observed, “Modern man has not only thrown away Christian theology, he has thrown away the possibility of what our forefathers had as a basis for morality and law.”[22]

At the core of euthanasia is a desire for autonomy, to be a law unto ourselves. As detailed in the opening pages of the Bible, this desire was our first parents’ grave error. Original sin wasn’t sexual immorality, as many wrongly think, but a desire to “be as God” (Gen 3:5). Autonomy is an illusion; we are all dependent beings upon our holy God. As such, doctor-assisted suicide is nothing short of a direct act of defiance, and represents a flagrant and brazen rejection of God’s Sovereignty over our lives and of His Holy Law-word by which we are to live and die. Choosing to have MAiD then, is not a triviality for the Christian, nor a mere trifling misdemeanor or minor indiscretion. There is no exception when it might be permissible, nor neutral ground where it might be acceptable. “The thief comes to steal, kill and destroy” (John 10:10), and euthanasia is the Devil’s ploy to do just that. Therefore, as members of the body of Christ, we must stand firm in our faith and be prepared to defend the Gospel from such attack. As Martin Luther said, “If I profess with loudest voice and clearest exposition every portion of the truth of God except that little point which the world and the Devil are at that moment attacking, I am not confessing Christ, however boldly I may be professing Christ. Where the battle rages, there the loyalty of the soldier is proved.”

Nonetheless, many within the Christian community continue to advocate for euthanasia, some even citing biblical instances of assisted suicide to give Scriptural sanction for doctor-assisted suicide. There is the account of Abimelech from the book of Judges, for example, who asked his armour-bearer to kill him “so that they can’t say ‘a woman killed him’” (Jdg. 9:52-54), and the death of King Saul, when he said to the Amalekite to “stand over me and kill me! I am in the throes of death, but I’m still alive” (2 Sam 1:9). Of course, the mere recording of assisted suicide in Scripture doesn’t qualify as biblical sanction any more than adultery or murder recorded in Scripture would be considered approval of those sins. Abimelech’s death is God’s judgement on him in return for the evil he had done in killing his brothers, and Saul’s suicide, assisted or not, is the ultimate expression of his faithlessness towards God, not trusting in him and fighting to the end or surrendering. Furthermore, the execution of the Amalekite who had confessed to the killing of Saul made clear that his act of assisting in the King’s death was very much considered “murder of the Lord’s anointed” (1 Sam 1:14). As explicitly highlighted throughout the Torah (Exodus 20:13, 21:12-14; Leviticus 24:17-21; Numbers 35:16-31; Deuteronomy 5:17, 19:4-13),) and reinforced elsewhere in the Bible (Ps 106:37-8), we are not to be involved in the taking of innocent life, our own included.

It’s important to emphasize, then, that the acceptance and practice of MAiD – despite whatever euphemisms of compassion, care or dignity get attached to it by its advocates – is not consistent with a Christian worldview, nor compatible with the life of a follower of Jesus. Suicide may have been considered a noble act in ancient Greece, but it stands diametrically opposed to the Gospel. We Christians recognize the tragedy of death, that “the wages of sin is death” (Rom. 6:23), and place our hope not in the release of some rational immortal soul substance from the prison of our bodies at the moment of our death, as the pagan Greeks did, but in the resurrection from the dead, both body and soul inseparably together. Any attempt to blend pagan ideology with Christianity distorts the Gospel and forfeits its saving power. As stated in the book of Proverbs, “There is a way that seems right to a man, but in the end, it leads to death” (Prov 14:12).

Considering our response to euthanasia advocates, we would do well to draw from biblical wisdom and take a lesson from King Solomon. In the book of Proverbs he said, “Do not answer a fool according to his folly, or you yourself will be just like him. Answer a fool according to his folly, or he will be wise in his own eyes” (Prov 26:4-5). While on first reading these two verses may seem contradictory, their purposeful juxtaposition underscores how they necessarily complement each other and work together. In verse 4, we are warned not to be drawn into argumentation based on secular thought, otherwise we will also get mired in confusion. In the case of euthanasia, this would mean rather than conceding that doctor-assisted suicide is a reasonable form of medical treatment (as its advocates claim), we are to hold to a Scriptural viewpoint and maintain that euthanasia as nothing less than suicide, a social tragedy rather than a medical obligation. Authors Blaise Alleyne and Jonathon Van Maren rightly stress this critical point in their excellent book, A Guide to Discussing Assisted Suicide, which is packed full of immensely practical tactics and conversational tips.[23] The emphasis is to keep the Bible as the foundation for our thoughts. Holy Scripture needs to remain our fundamental metaphysical starting point for how we view and understand reality, since only the transcendent Word of God can provide us an objective understanding of knowledge, and an absolute standard for how we are to live our lives, and determine right from wrong. While we can’t assume biblical literacy nor deference on the part of the euthanasia advocates whom we encounter, the Bible must remain central in our response to them. Our desire is to not only attempt to persuade those in favour of euthanasia, that it’s suicide and wrong, but to demonstrate the beauty of the gospel to them, in the hopes that some might be saved.

To look further at Proverb 26, the term fool used in this context carries moral rather than intellectual meaning, referring not to stupidity, but to emptiness of belief. A similar usage would be found in Psalm 14, where Solomon states, “A fool says in his heart there is no God.” As applied to verse 5 of Proverb 26, “answering the unbeliever according to their folly,” means that we should initially show understanding of their viewpoint and temporarily put on their worldview glasses. In so doing, we demonstrate our openness to their perspective, and create a place of common ground, perhaps even helping to diffuse initial tensions around the topic. Then we attempt to show the folly of their position by drawing it out to its natural conclusions, showing its inconsistency, contradiction, or absurdity.

In the case of euthanasia, then, if the advocate emphasizes the importance of alleviating suffering, we can whole-heartedly agree. As per the parable of the Good Samaritan, alleviating suffering sits squarely with the Christian worldview of love of neighbor. With this contact point of compassion established, we can then show how the practice of MAiD doesn’t actually alleviate suffering (but rather eliminates the sufferer) and is therefore not compassionate. Not only does euthanasia fail to address a person’s underlying existential cause of suffering, but by making lethal injection available to the populace, the vulnerable in our society – the terminally-ill, frail elderly, disabled, destitute, those suffering from clinical depression or PTSD – are placed directly into harm’s way. Considering what Mahatma Ghandhi said, “The true measure of any society is how it treats its weakest members;” what does that say about euthanasia advocacy? Instead of offering the most helpless and marginalized of our society needed care and compassion, they are offered death by assisted suicide – killed, not cared for.

Alternatively, if the euthanasia advocate emphasizes the importance of ensuring equal rights for all, we can also agree. All people have been created in God’s image, and as image-bearers, we each have inalienable rights and dignity. From this contact point of equality, we can then demonstrate that the practice of MAiD actually counters equal rights. Offering MAiD to the population raises the challenging question of how we are to determine who has the right to choose their own death, and who has a right to be prevented from self-harm. In brief, who is to receive suicide promotion, and who is to receive suicide prevention? Any attempt to solve this conundrum necessarily requires us to draw some arbitrary line in the sand. In so doing, we end up producing two classes of citizens, one protected and one unprotected, which fundamentally counters equal rights. A so-called Expert Panel has been recently established by the Canadian Government to address this very challenge, with recommendations due March 2024, and will very likely lead to the expansion of euthanasia eligibility criteria to include those suffering from mental illness as their sole diagnosis.[24] And again, they will be offered assisted suicide instead of proven-effective therapy, death over dutiful care.

The philosophical discussion of euthanasia is a prime opportunity to share the Gospel. As the pro-euthanasia position is shown to be contradictory and unworkable, attention can be turned to what is consistent and workable. Only God’s Word can make sense of our experiences and provide the necessary preconditions for intelligibility, including the existence of compassion and equality. As Greg Bahnsen wisely said, “the Christian worldview is not only our hope of future salvation, it’s our only present intellectual hope.”[25] So, as followers of the risen Lord, we need to lean into that reality and push back against the culture of death with the witness of His truth. We can do so by contrasting our Christian worldview with the pagan worldview that underpins euthanasia. Points of emphasis would include that God is ultimate, not man. Only the transcendent word of God can provide the necessary standard for matters of life and death, not man’s arbitrary shifting sentiments. The explanation of our troubles is the result of the Fall and derives from our sinful nature, not because of oppression of the oppressed with paternalistic doctors “making us live too long” or “preventing us from dying with dignity.” Medicine can’t save us, nor can “following the science.” Our most fundamental troubles are not physical, but moral. The solution to our ills is certainly not to provide an unqualified equal access to death – to annihilate the sufferer – but it is to be found in Christ alone and His atoning work on the cross.

We have been called to co-labour with the Holy Spirit in the ministry of reconciliation by bringing all things under the lordship of Christ – care of the dying, disabled, and destitute included. Our hope lies not in receiving lethal injection and extinction, but in God’s promises of a time when the earth and heavens will be made new, when “there will be no more death’ or mourning or crying or pain, for the former things will have passed away” (Rev. 21:4). So, let’s not live and let die, but live unto Him in all we do, living and dying, until we see “the whole world filled with the knowledge of the glory of the Lord as the waters cover the sea” (Hab. 2:14).

[1] https://cmadialogue.ca

[2] “Hippocartic Oath,” Britannica, accessed June 12, 2023, https://www.britannica.com/topic/Hippocratic-oath.

[3] “Supreme Court of Canada Ruling” on Bill C-14, Department of Justice Canada, accessed June 12, 2023, https://www.justice.gc.ca/eng/cj-jp/ad-am/scc-csc.html.

[4] David Cooke, Trudeau’s MAiD Service: A Euthanasia Program for Canada (Baptist House: Baker Brook, NB, 2022), p. 17.

[5]Alexander Raikin, “No Other Options: Newly revealed documents depict a Canadian euthanasia regime that efficiently ushers the vulnerable to a “beautiful” death,” The New Atlantis, accessed June 12, 2023, https://www.thenewatlantis.com/publications/no-other-options

[6] “Second Annual Report on Medical Assistance in Dying in Canada 2020,” Health Canada, accessed June 12, 2023, https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2020.

[7] Gunnell D, Appleby L, Arensman E, et al, “COVID-19 Suicide Prevention Research Collaboration.  Suicide risk and prevention during the COVID-19 pandemic,”  Lancet Psychiatry. 2020;7(6):468-471.

[8] “Bill C-7: An Act to amend the Parliament of Canada Act and to make consequential and related amendments to other Acts,” Department of Justice Canada, accessed June 12, 2023, https://www.justice.gc.ca/eng/csj-sjc/pl/charter-charte/c7_1.html.

[9] Chochinov, HM, “Dignity and the Eye of the Beholder,: Journal of Clinical Oncology. Volume 22, Issue 7. Sept 2016.

[10] Nationalpost.com/news/canada/canada-maid-medical-aid-in-dying-consent-doctors

[11] “MAID for mental disorders,” Dying with Dignity Canada, accessed June 12, 2023, https://www.dyingwithdignity.ca/advocacy/parliamentary-review/maid-for-mental-illness

[12] Chaimowitz G, Freeland A, Neilson GE, et al. “Medical assistance in dying,” Canadian Psychiatric Association, February 10, 2020

[13] Trachtenberg, AJ. “Cost analysis of medical assistance in dying in Canada,” CMAJ 2017 Jan 23; 189(3): E101–E105.

[14] Associated Free Press, “Berlin to open memorial to Nazis’ disabled victims,” Times of Israel, last modified August 31, 2014, https://www.timesofisrael.com/berlin-to-open-memorial-to-nazis-disabled-victims

[15] Andrew Lupton, “Funeral Homes Pivot to Offer Rooms for Medically Assisted Deaths,” CBC, last modified October 26, 2021, https://www.cbc.ca/news/canada/london/funeral-homes-pivot-to-offer-rooms-for-medically-assisted-deaths.

[16] Ganzini, L et al. J Gen Intern Med. 2008;23(2):154

[17] John Piper, “If All My Sins Are Forgiven, Why Pursue Holiness?” Desiring God, last modified August 9, 2021, https://www.desiringgod.org/interviews/if-all-my-sins-are-forgiven-why-pursue-holiness

[18] Temel, JS. “Early Palliative Care for Patients with terminal disease,” N Engl J Med 2010; 363:733-742.

[19] Chris Korda, “Save The Planet Kill Yourself,” Bandcamp, accessed June 12, 2023, https://chriskorda.bandcamp.com/track/save-the-planet-kill-yourself

[20] Sean Frankling, “Church Should Not Oppose MAID Law, Primate Says,” Anglican Journal, last modified September 30, 2022, https://anglicanjournal.com/church-should-not-oppose-maid-law

[21] “Death and Dying,” The United Church of Canada, accessed June 12, 2023, https://united-church.ca/worship-theme/death-and-dying

[22] Francis Schaeffer, Escape from Reason (InterVarsity Press, 2007).

[23] J. Alleyne, B. Van Maren, A Guide to Discussing Assisted Suicide, (Life Cycle Books, 2017).

[24] “Canada’s Medical Assistance in Dying (MAID) Law,” Department of Justice Canada, accessed June 12, 2023, https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#e

[25] Greg L. Bahnsen, Always Ready: Directions for Defending the Faith, (Covenant Media Press, 1996).

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