59. Religion and Euthanasia [Part II]

Since religion concerns itself with issues of life, death and morality, it is not surprising that for many people, religious beliefs form the foundation of their views on euthanasia. Alas, more and more mortals spend their final hours hooked up to bewildering electronic equipment, surrounded by unfamiliar faces, lit up by fluorescent lights in a sterile setting, and overwhelmed by their vulnerability. This spiritual void was never the way in which they had imagined they would die.1

Globally, the problem seems to be that sectors of different religions are fierce in their belief and conviction that it is against God’s will to take one’s own life or to have it voluntarily ended by others. Some religions also maintain that suffering is an aspect of all human life which itself was of God’s creation. Consequently they contend that putting an end to suffering is a violation of God’s will.

It is one of the prevalent misunderstandings and misinterpretations of Western religious culture that The Bible forbids suicide. There is no such prohibition in either the Old or New Testaments. Indeed, although about eleven cases of suicides are mentioned in these two texts, there are no passages commenting on the morality of such an act nor is there even any explicit examination of the ethical issues which might be involved.

It was St Augustine in the Fourth Century who made the first Christian formulations against suicide: “Patricide is more wicked than homicide, but suicide is the most wicked of all.”2 For Augustine the Resurrection had changed Man’s perspective: Tolerating suicide when one could be brought back to life seemed like a defiance of God’s will. During the early phases of Christianity a self-chosen death had been a goal to which many of the devout aspired. The number of converted Christian martyrs and mass suicides (among Jews who had converted to Christianity) rose so sharply that Rabbis decided to forbid public mourning for those who died by their own hands. Jewish leaders then refused to allow the bodies of such victims to be buried in their hallowed grounds.

The Italian philosopher and theologian, St Thomas Aquinas, ranked among the most influential thinkers of medieval Scholasticism, considered the problems of suicide at great length. He wrote “it follows that the words ‘Thou shalt not kill’ refer to the killing of a man — not another man therefore; not even thyself. For he who kills himself, kills nothing else than a man.”3

The Catholic Church, as it gained control in Europe, held that every human being was the creation of God and that consequently to kill oneself was to deny God and to deny God’s right over our lives. Suicide was deemed morally wrong. Catholicism taught that suffering had a place in God’s plan in that it permitted those in pain to share Christ’s final agony. Rome also continued to hold that those who insisted that they had a right to die were denying the essence of their fundamental relationship with God.

Only after the Reformation did it become possible for thinkers to reconsider the question of suicide. Thomas More wrote of euthanasia in his great work, Utopia, although it is not known whether he was intending to endorse the practice. Caspar Questel, a German recorder, was among the first to examine the different ways which, in effect, were being used to hasten death for the dying but which he thought were against nature and against God’s will.4 However, gradually, during the Age of Enlightenment suicide and euthanasia became more acceptable to some of the European Protestant sects.

Jewish law forbade euthanasia in all forms and was considered an act of homicide. The life of a man is not “his” — rather, it belongs to the One who granted him life. It could therefore be reclaimed only by the true Owner of that life. Despite any noble intentions, an act of mercy-killing was regarded as a flagrant intervention of God’s will. In the 20th century the Jewish outlook on euthanasia and assisted suicide has become divided along denominational lines. The Orthodox continue to reject it while both Reform and Secular Judaism are beginning to support forms of “mercy killing.”

Islam continues to categorically forbid all forms of suicide and any action that may help someone else to commit suicide. The precedent for this approach came directly from the Prophet Muhammad who refused to bless the body of a man who had committed suicide or to permit him from being buried in hallowed ground. Given the ease with which a few outlaw Muslims today commit murder, one cannot help but wonder if the ancient commandments of the Koran can continue to hold their meaning.

In Japan suicide has not traditionally been seen as a sin. Falling on one’s sword was understood as essential under certain circumstances. Shinto, the dominant religion, now generally tends to regard euthanasia as unwelcome but acceptable under certain circumstances. However, the prolongation of life by artificial means in hospitals is regarded as offensive by both Shinto and Buddhist organizations.

Some Eastern religions, such as the Buddhist, believe we have many lives and the way we live each life in part is determined by past lives and will impact on our future lives. Cutting life short can thus interfere with our progress towards ultimate liberation. Euthanasia is consequently denied as a way out of suffering. It is regarded as immoral to destroy human life, irrespective of the quality of the individual’s motive.

In surveying how these different religious groups around the world have considered euthanasia and assisted suicide over many centuries, it is evident that these are opposed, and have been influential in having governments pass laws forbidding them. This should be viewed from the perspective that both governments and religions have always sought to exert control on individuals as well as on the population. The steady decline of religious power in the 20th century has had a profound impact on our views on euthanasia. After centuries of acceptance, public opinion has been shifting with the startling advances in medical science. Governments may gradually follow, much as they have on other social issues like homosexuality.

To shorten the “throes of death” is seen by increasing numbers of people as a way of showing respect to a life approaching its natural end. Humanitarianism holds that we should at least try to spare those in their last months a sequence of pain-filled and degrading physical and psychological humiliations. We can pretend that a life artificially kept going month after month by a battery of high tech machines is worthwhile, but should we not re-examine such attitudes?5 Fortunately for the patients, chronic suffering in such situations has been reduced by the widespread use of morphine and pain killers.

Some fifty years ago, the French sociologist Alfred Fabre-Luce summed the challenge facing many of us brilliantly: “Man is born to act, believe, venture. Let us save him from the state of despair in which, as the body triumphs over the mind, he ceases to hope for recovery and can no longer sublimate his suffering. To shorten the transition is not to go against the divine plan. To prolong a state of degradation, to pit oneself against an imminent and ineluctable death by misusing the resources of science — it is surely that which is an act of impiety.”6

1 See: Atul Gawande, Being Mortal: Medicine and What Matters at the End, (2014)

2St Augustine, On Patience, c.425 AD

3Thomas Aquinas, De Civitate Dei, 20

4Caspar Questel, De pulvinari morientibus non subtrahend (On the pillow of which the dying should not be deprived) 1678

5End-of-life Care, The Economist, October 4, 2014, p. 92

6Alfred Fabre-Luce, Man or Insects? (1965) p. 82

58. Euthanasia & Assisted Suicide [Part I]

When it comes to the contentious topics of euthanasia and assisted suicide I remained as bewildered as I was at university about the ill-defined divisions between church and state, and between religion and the law. The state maintains that it owns your body, as evidenced by the fact that it is a criminal offense to commit or attempt suicide. Possession aside, this would seem to be gross interference of the state in our freedom of action.

The subject, pro and con, remains immensely broad with numbers of religious groups opposing Euthanasia on the ground that we are all God’s creations and remain at his disposition. Because of the complexity of the subject, I have divided this blog into two parts: The first will focus on the secular, the second will focus on the religious.

Euthanasia was practiced by the ancient Greeks and Romans as evidenced by the support by Plato, Seneca, and most dramatically by Socrates who ended his life with poison hemlock. The doctrine of the “sanctity of human life” arose later with St Augustine and its adoption by Christianity, which held sway until the 19th Century. Problems started to arise when doctors began to use morphine to treat those suffering “the pains of death.” In 1870 an English school teacher, Samuel Williams, proposed the use of chloroform to deliberately end the suffering of terminally ill patients.1 The great outspoken reformer, Annie Besant, endorsed that position considering it a social duty to society to “die voluntarily and painlessly” when one reached the point of becoming “a burden.”2 At that time, however, the medical profession did not take part in the debates on euthanasia which followed as this was regarded as a philosophical proposal tied inextricably to objections from Christians citing the sanctity of human life.

Felix Adler was the first prominent American to contend in 1891 that suicide in certain chronic illnesses should be permitted. He argued from an Ethical Culture perspective that it should be permissible for a doctor to assist in such instances. Robert Ingersoll, rejecting religion, argued in 1894 in favor of Euthanasia and also agreed that patients suffering from a terminal illness, as in certain cancers, should have the right to end their pains. However, humane end-of-life practices were slow to be introduced. There was a reluctance to recognize that those who were dying should be given choices. Objections were raised that once such practices were accepted, terminally ill patients might feel it was their “duty to die” because of the enormous burden they were placing on their relatives as well as on society.

In Britain the Voluntary Euthanasia Legalization Society (now called Dignity in Dying) was founded in 1935. The death of George V in January 1936 coincided with the proposed legislation in the House of Lords to legalize euthanasia. However, the public was unaware at the time that the King had been given a fatal dose of morphine in order to hasten his death. It was kept secret for 50 years that the decision to end his life had been made by his physician, Lord Dawson. What was deemed acceptable for royalty was obviously not suitable for his subjects.

The introduction in Nazi Germany in 1939 of state sponsored euthanasia caused long term setbacks to Euthanasia groups in both the UK and the US. The killing of a severely disabled infant, endorsed by Hitler’s office and pseudo-scientific parties concerned with purifying the “Aryan” heritage in Germany, was described by a 1939 BBC radio program titled “Genocide Under the Nazi’s Timeline” as the first “state sponsored euthanasia.” Eventually this secret Nazi exercise led to “mercy killings” of almost 300,000 physically and mentally handicapped people including thousands of children forcibly taken from their parents. The horrors to which these human beings were submitted ended serious discussion of euthanasia for decades.

The “Death with Dignity Act” came into force in Oregon in December 1994 after “Measure 16”, a long debated proposition, had been narrowly passed in state elections. It allowed doctors to prescribe lethal drugs so that terminally ill patients, who were to be provided with certain rigid safeguards, could end their own lives. However, the doctor could not administer such lethal doses until the patient had requested it in writing at least once and two doctors had concluded that the patient was sane, acting voluntarily, and not suffering from depression. The doctor then had to wait at least 17 days before issuing the prescription and during the waiting period the patient had to be informed of all the possible options.

To some extent the legal argument for euthanasia was brought into the open in the US by Judge Stephen Reinhardt summing up for the majority of the 9th Circuit Court of Appeals when he said in March 1996 that there was constitutional protection “for determining the time and manner of one’s own death.” Reinhardt argued that “a mentally competent, terminally ill adult, having lived nearly the full measure of his life, has a strong liberty interest in choosing a dignified and humane death.”3 Five US states now have laws that allow assisted suicide whereby a mentally competent person who is terminally ill can legally be prescribed a lethal dose of medication. And three state legislatures — in Connecticut, Massachusetts, and New Jersey — are expected to give similar laws a full hearing this year.

In Europe, because of mounting demographic pressure, end-of-life care has become an increasingly contentious moral, legal, economic and medical issue. Because the costs of care for the elderly in the closing months of life rise sharply, governments are looking for ways to economize. Doctors in the Netherlands, Belgium, Luxembourg and France now are able to make end-of-life choices for patients in their care, which, by American standards, might be regarded as unthinkable.4 The New York Times reported that in 2012 about 130,000 of the 570,000 registered hospital deaths in France were preceded by a physician’s decision to raise the dosage of pain killers and sedatives, or to limit the treatment. In France, an overwhelming percentage of those polled agree that assisted suicide should be permitted for those with a terminal illness. A broad spectrum of the French believe that doctors are bound by their medical and legal principles; that they are free from economic or emotional considerations and can consequently make value free decisions on ending a patient’s life.

It is generally recognized that, motivated by compassion, doctors want to protect their patients, the families and the medical profession. However, at a trial of one French doctor who had prepared a lethal dose of sedatives for a comatose patient in his care, the state prosecutor charged that “To be too compassionate is to deem others disposable. It is to unburden them of a responsibility that, in fact, belongs to them.”5

In the final scenes of the superb French film, “Amour,” the actor ends the life of his suffering wife, suggesting that “what will survive us is love.” The inference is clear that euthanasia must be seen as an often difficult but kinder way of death for the terminally ill. Parts of the media, such as the tabloids, have been persistent in their pursuit and exposure of those terminally ill who fly to Switzerland to die with dignity and in a humane manner. Some governments have also been keen on pursuing those who accompany them on their journey as criminals abetting murder. I believe there eventually needs to be a binding international agreement on the legality of assisted suicide. The notion that a patient seeking to end suffering is committing a crime by going to another nation in order to end it seems obscene to me. Our free-will demands greater respect than that!

1Samuel Williams, Euthanasia, (1872)
2Ian Dowbiggin (March 2007). A Concise History of Euthanasia: Life, Death, God, and Medicine. Rowman & Littlefield. pp. 51,
3Yorick Blumenfeld, Towards the Millennium (1997) p.589
4Scott Sayare, “France asks why doctors get the last word to end a life,” The New York Times, August 1, 2014