Sometimes we see quandaries when the answers are quite simple.

 

Those in favor of euthanasia have created a false quandary with talk of people being “kept alive by machines” and dehumanizing phraseology referring to those human beings as vegetables. Add to this the bizarre distortion of the difference between omission and commission and we find our heads swirling, believing there are serious decisions to contend with. I suggest there are simple principles especially for those of us who belong to the Kingdom.

 

With the marvels of modern technology it may be tempting to ascribe the powers of life to a machine, but as Christians, we know better. As we read in Acts 17:28, “For in Him we live and move and have our being.” Furthermore, Job 14:5 observes, “Since his days are determined, and the number of his months is with thee, and thou has appointed his bounds that he cannot pass.” The NIV says it like this: “Man’s days are determined you have decreed the number of his months and have set limits he cannot exceed.”

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We cannot live past our time.  

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Some would argue that having living wills and do not resuscitate orders (DNR’s) are basically the same as saying you will leave your fate to God, but I would argue that God is not pleased when we act in ways that jeopardize our own lives and then simply wait for Him to intervene. For example, Matthew 4:7 offers a case of Jesus not jumping off the cliff. Surely His faith was not lacking, and yet he resisted challenging God by putting Himself in unnecessary danger.

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It is not our place to “put God to the test.”

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There are people who say the Bible does not speak directly to these issues and furthermore the remedies and technology that exist now did not exist in the past, and certainly, the Bible does not speak to every single circumstance, especially if one is looking to find their circumstance spelled out. It does often, though, speak “directly” through principles. For example, the Bible does not speak to giving antibiotics to a toddler with bacterial pneumonia -- if you are searching for those words. If a baby had pneumonia in Biblical times, he would probably die, and you would not be guilty if you took care of him the best you could. If, however, your toddler died today because you decided not to give him the medicine his doctor prescribed, you would be guilty. A person should not die from something we have a remedy for now.

 

If a person with Alzheimer’s has pneumonia, we must apply the same principle, which is to do what you can (with understandable deference to the century in which you live) -- to do that which has a reasonable expectation of working. While the antibiotics will not cure the Alzheimer’s, it will cure the pneumonia. We must never judge a treatment’s value by inappropriately judging the value of the person instead.
 

Our bodies are designed to require certain things -- food, water, and, oxygen being the most fundamental physical needs. To withhold any of these from someone who is not imminently dying is to ensure his death -- and not from the underlying disease. Just as we would not withhold an inhaler from an asthmatic child, we cannot suffocate an adult who needs help breathing by withholding a ventilator.

 

Every member of the human family has intrinsic value equal to every other.

There are, generally, five reasons for withdrawing or withholding treatment. I will outline all five with a note that only the first three are actually acceptable reasons.

Reasons for Withdrawing or Withholding Treatment:

 

Reason 1: It Won’t Work

An example of this would be withholding chemotherapy treatment from a person who is clearly in their final days of life.
 

Reason 2: It Won’t Hurt

This case would again be when death is truly imminent -- and not imminent as in months but rather within a time frame that we would measure in hours. An example of this is a person with a disease or injury that will end the person’s life before the effects of, say, withholding a feeding tube, would result in suffering with starvation or dehydration. By extension, if a person lives longer than expected, a feeding tube or IV must be inserted to avoid causing harm.
 

Reason 3: The Risk is Too High, Given the Potential Benefit

This scenario could involve a person foregoing a leg amputation if the risk of dying during surgery is high, and the leg amputation, if successful, is not likely to preserve their life for more than a minimal amount of time. Another example would be a person at risk for cardiac arrest opting to leave the hospital to go home with family instead of staying in the hospital “just in case.” To me, this example is akin to choosing to live in LA where the air quality will probably shorten your life. In both cases, we must look at the genuine intent of the choices to properly analyze them. In the first case, if the person declined the amputation because he decided life would not be worth living without a leg, the person is choosing death. The second case is, of course, wholly turned around if the person leaves the hospital with the hope in the remote possibility of death, rather than leaving the hospital to be with family.

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Reason 4: Autonomy

As noted above, this reason for withdrawing or withholding treatment does not hold up when considered in relation to scripture. There are legal and constitutional reasons that make it impossible for this decision to be made by only one person and impact only that person, and there are medical reasons that are truly not an autonomous decision, but for the purposes of this discussion, a single answer should suffice, which is found in 1 Corinthians 6:19-20, which says, “You are not your own.”

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Reason 5: Quality of Life

This final reason for withdrawing or withholding medical treatment is, like the previous one, a false justification. Looking to the Bible, we see that God’s word is clear on the subject: human life is precious -- a gift from God. Created in His image (Genesis 1:26), each human being is unique yet of equal worth regardless of appearance or abilities. We must value each person because he/she bears the image of God (Genesis 9:6). There exists intrinsic value in the life of every person, regardless of the actual or perceived quality of that life in our eyes.

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Additionally, a person generally functions in a recognizable-as-a-person way, but it does not follow that a person who does not act in a typical way is not a person. This is seen when some people say that tiny embryos in dishes don’t look human, but clearly, that is precisely what a human looks like at that point of existence. This is also true with others who are severely disabled, very sick, or otherwise compromised: they are human simply because they are.

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A person isn’t and should never be referred to as, a “vegetable.”

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In thinking about these matters we also must remember that God’s purposes for us could be for others. We may not see the value of a person lying in a state of seeming irrelevance, but God has His own reasons for everything. Perhaps the reason is related to obedience, or maybe His plan for another is playing out through their treatment of the ailing person. Or perhaps the reason relates to the witness we supply when we make it clear to the rest of the world this is God’s domain and life is precious, regardless of how it seems on the surface. For others to see Christians faithful in difficult circumstances goes a lot further than seeing them faithful when it’s easy to be faithful. Regardless, He doesn’t need to justify what He has in mind for us: remember that the potter has power over the clay (Romans 9:20-21). Compellingly, even Jesus was ordained to experience obedience through suffering as we learn in Hebrews 5:8, “Although He was a Son, yet He learned obedience through what He suffered.” And if you need further convincing, you might want to revisit God’s response to Job’s complaining in Job 38.

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Essentially, we must understand that the human being, created in the image of Almighty God, is no less or more human because they function less or more. Our bodies are temples of the Holy Spirit, and there is no Biblical evidence that He checks out before we are dead.

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It is important to note that a person is either alive or dead. Dying is something that had begun as soon as we were conceived, but we do not speak of our lives as stages of death but rather as stages of life! These stages of life are a continuum, but there is a definite beginning and a definite end. We are no less human and no less alive when we are comatose, when we are suffering from dementia, when we have Down syndrome, or when we struggle in any other way that is, in actuality, intrinsically human.

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Therefore, the same policies or inclinations we have regarding ethical treatment of the young also apply to ethical treatment of an elderly person with dementia. If we cannot starve our child who is dependent upon us for food to death, we cannot starve our grandmother who lies helpless in a coma. The same applies to suffocating her by withdrawing oxygen.

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Some say ordinary care is required but not extraordinary care. I must point out that one needs be very careful with this terminology because more often than not it is used not to describe the benefit of treatment to the person, but rather the value of the particular person who is receiving treatment. We also must acknowledge these are slippery terms what was once extraordinary (and may still be in a third world country) is here and now often quite ordinary.

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It is further argued that the kind of care I am suggesting is keeping an otherwise dead person alive, but surely we don’t have the hubris to suggest we can keep someone alive who God wants dead. People die on full codes all the time. People on ventilators and with feeding tubes die. You and I will die. (See again Acts 17:28 and Job 14:5.)

 

On the issue of omission vs. commission I recount a conversation I once had with a Christian physician. He said they needed to be careful not to start a ventilator if the prognosis was bleak because it would be unethical to remove it. I asked to be enlightened as to the moral difference. He paused and, in a manner indicating he had truly not ever considered the question said, “Well, I guess there is none.”  We must consider the intent of our actions. This is not as difficult as we make it. When we withdraw a ventilator saying, “It is time to let go. She should be allowed to go to God,” our intent is crystal clear. We are withdrawing the ventilator because we have decided it is time for her to die. Conversely, if we stop chemotherapy because it is causing pain itself and the patient’s prognosis is imminent death, our intent is to relieve pain not to cause death.

 

Consider this, it was the Euthanasia Educational Council that developed the living will. Let that sink in.

 

All those who hate me love death. (Proverbs 8:36)

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We are not our own. We are His and are precious in God’s eyes. We must remember the God who hung the stars in the sky and raised His Son from the dead is not confused by a coma. He can take you home if He so chooses, and He can likewise communicate with you in the meantime, if He chooses to. Also Romans 8:26 says in the same way the Spirit helps us in our weakness, we do not know what we ought to pray for, but the Spirit intercedes for us. Imagine: the Holy Spirit prays for us all the time, so even when we sleep, God Himself is praying for us. We serve an awesome, sovereign-in-all-ways God. He will determine His purposes. It is ours to be obedient.
 

In closing, I note the example of Paul in Philippians saying it is not weak to cling to life, but rather, it is good to resist death. Resisting death is not inconsistent with longing for Heaven.  Psalm 116:15 reminds us that “precious in the sight of the Lord is the death of His saints.” We’re just not allowed to rush it.