By Rev. Clay Nelson.
Clay Nelson © 12 July 2015
Thanks to Lecretia Seales the issue of euthanasia has once again been raised to public consciousness. You will remember that Lecretia suffered from a very aggressive form of brain cancer that depending on how it progressed could deprive her of dignity prior to death. She sought from the high court a ruling that would allow her physician to assist her to die should her suffering become unbearable. On June 5th, the day she died, she got the ruling that in New Zealand it is against the law for a physician to assist someone to die.
Yet New Zealand has a very strong right to die movement and polls suggest that at least 60% of us support voluntary euthanasia. On June 23rd Parliament received a petition with 9000 names from the Voluntary Euthanasia Society calling for decriminalisation of assisted dying.
However, the minority is equally passionate in their opposition. From the perspective of a politician, becoming the face of the right to die movement may appear to be a no-win situation, perhaps explaining why Andrew Little asked Iain Lees-Galloway to remove his bill from the private member bin. This issue has been avoided for twenty years since a bill presented in 1995 was soundly defeated. In my view, unless a private member’s bill for the right to die wins the lottery and is selected, it will be avoided for many more years to come. That said, it does not mean we should not individually be informing ourselves on the issues involved, even though thinking about it involves confronting our own mortality.
For the history buffs amongst us this issue has been being debated internationally since the Ohio state legislature failed to pass a bill legalising euthanasia in 1906. Since then the right to die debate is littered with court cases, papal encyclicals, the establishment of right to die societies around the world, bestselling books on how to die with dignity (one of which was banned in New Zealand), votes in parliaments and US state legislatures, referendums, ballot measures, and names like Dr Jack Kevorkian, Karen Ann Quinlan, Terry Schiavo, Elisabeth Kuber-Ross, Australian Dr Philip Nitschke who assisted nine people to die under the Northern Territory’s voluntary euthanasia law before it was quashed by the Federal Parliament, New Zealander Lesley Martin who completed a seven month prison term for attempting to assist her mother to die and now, Lecretia Seales. During that time only Switzerland, the Netherlands, Belgium, Luxembourg, and the US states of Oregon, Washington, Montana and Vermont have managed to make it possible for people to die with dignity.
So why has it been so difficult even in places where the idea is generally popular? Part of the reason is confusion about terms. While euthanasia is the most commonly used term, it differs in an important way from physician-assisted death. Euthanasia allows the physician or someone other than the terminally ill to cause death. Physician-assisted death only allows the doctor to prescribe drugs to hasten death but not to administer them. Only the dying can administer them. European countries allow for euthanasia, US states allow physician-assisted dying. Opponents of euthanasia will sometimes support physician-assisted dying when the difference is explained to them.
Another challenging issue is passive euthanasia. This involves either the patient refusing treatment that would prolong life, a physician giving palliative care to reduce suffering which will also speed up death, or a physician or family member refusing extraordinary measures to prolong someone’s life. Twice I have had to be the one to make that decision when my family members had not made advance directives and were unable to make their wishes known. The first time was for my grandmother who had suffered a massive stroke and was not discovered for three days. In that time she developed gangrene. The doctor wanted to amputate her leg but I would not permit it. The second was for my mother who suffered from advanced Alzheimer’s. She developed pneumonia. I refused permission for the doctors to treat her. Both died peacefully and painlessly. And I still live with it.
Many believe that this is the only acceptable form of euthanasia in a world where the ability to alleviate pain in a hospice environment dedicated to dignity is now widely available.
However, the biggest obstacle to passing right to die legislation is religion.
Hindus, Buddhists, Muslims, Jews, Mormons, Roman Catholics, and most Protestant and Pentecostal denominations reject euthanasia, or physician-assisted dying, although most support the patient’s refusal of further treatment if the burden is too great to justify a treatment with little to offer. Hindus do allow the terminally ill to choose to fast until death as a spiritual practice.
The primary reason most of these faith groups oppose euthanasia or physician-assisted death is because they consider life to be sacred. They use language like, “Life is sacred because it is a gift of God and only God has the right to end it.” Buddhists, who have no belief in God, nonetheless believe that it is morally wrong to take life, which implies its sacredness. Hindus believe ending life negatively impacts Karma, which could interfere with one’s next life. Again, sacredness is implied.
If we accept unquestioningly that life is sacred because God gave it to us, then that ends the debate on euthanasia and physician-assisted death no matter what the quality of life is; no matter how much physical and psychological suffering is to be endured. However, asking whether or not life is sacred is a legitimate question. And if life isn’t sacred, what is it?
For Humanists and non-theists the question has no meaning. Something that is sacred belongs to God. If God does not play a role in your belief system then nothing is considered sacred. That does not mean they do not hold that life is without value or meaning in and of itself. It is a wonder to be protected and appreciated. A humanist might consider life sacrosanct, that is, too important or valuable to be interfered with lightly.
For those who do believe life is sacred there are questions worth asking. If God is the reason for its sacredness, why does not God appear to consider life to be sacred? There are innumerable times in the Bible where God takes life–as in the flood–or demands that his people commit genocide. If life is so sacred why have holy people been killing each other since God was a boy? Did the Inquisition consider life sacred as it put people on the rack? When Muslims declare jihad, mostly on other Muslims, are their brothers’ and sisters’ lives not sacred? When Hindus and Muslims terrorise one another in India or when Israel and Palestine attack each other where does the question of the sacredness of life get raised? How do some Christians who argue for the sanctity of life where a foetus is concerned reconcile that with their support for the death penalty? And don’t get me started on those who say they care about the unborn and but neglect to see that children are well-fed, safely housed and educated after they are born.
George Carlin, an American stand-up comedian renown for his use of colourful Anglo-Saxon language, used to do a bit that focused on the hypocrisy in sanctity of life arguments. Here is a portion of what he had to say. If you have ever heard him you will understand why I’ve had to edit it extensively: “We can’t blame God for the idea of the sanctity of life because… we made it up. Why? Because we’re alive. Basic self-interest. Living people have a strong interest in promoting the idea that somehow life is sacred. You don’t hear Abbot and Costello running around talking about this do you? We aren’t hearing a whole lot from Mussolini on the subject. What’s the latest from JFK? Not a thing. The reason Abbot and Costello, Mussolini and JFK aren’t talking about the sanctity of life is,,, they are all dead. Dead people couldn’t give less than a [expletive deleted] about the sanctity of life. Only living people care about it… and we’re biased. It is one of those things we tell ourselves so we will feel noble. But if everything that ever lived is dead and everything alive is going to die, where does the sacred part come in? Even when we preach about the sanctity of life we don’t practise it. Look at what we kill: mosquitoes and flies…because they are pests. Lions and tigers…because it’s fun. Chickens and pigs…because we’re hungry. Pheasants and quail…because it’s fun…and we’re hungry. And we kill people…because they’re pests and it’s fun. And you may have noticed something else; the sanctity of life doesn’t seem to apply to cancer cells. You don’t ever see bumper stickers that say ‘Save the Tumours’ or ‘I brake for advanced melanoma.’ At best the sanctity of life is kind of a selective thing. We get to choose what forms of life are sacred and we get to kill the rest.”
So, I’m not prepared to say life is sacred. But because I find it valuable and important, that is, sacrosanct, I think there are legitimate concerns to be considered about euthanasia and physician-assisted death. I would want protections against the terminally ill being in anyway coerced to hasten the end of their life. I would want them to have plenty of time to change their mind. I would want them to have counselling. I would want their physician, minister or designated proxy present to witness the death to assure all protocols are followed to protect the patient as well as the family. My biggest reservation about passing right to death legislation is that the most vulnerable in our society such as the disabled or the poor could be victimised. We haven’t treated them all that well when they were healthy.
That said I concur with the ethical argument that suggests that life for the terminally ill should last only as long as the person feels life is worth living. Only the terminally ill can determine if for them the pain is insufferable and their quality of life is no longer worth enduring. No one can decide this for them. If they subscribe to teachings of any one of the faiths I’ve described they will not even consider it nor be required to do so, but those not so encumbered by their faith should have the option.
In closing, let me acknowledge that two denominations do not fall in line with other faith groups. The United Church of Christ, a progressive Christian denomination, supports the right of terminally ill patients to make their own decisions about when to die – including whether to hasten death. This position is in keeping with broader church teachings that stress the importance of respecting individual conscience and choice.
The second is the Unitarian Universalist Association, which passed a resolution in 1988 advocating “the right to self-determination in dying.” As a result, the church supports laws such as those in Oregon and Vermont that enable terminally ill patients, under carefully defined circumstances, to seek physician assistance in hastening their own death. Unitarian Universalists also support the right of a legally designated proxy to make life-and-death decisions for a patient, including withdrawal of life support, in cases in which the patient is unable to make such choices. The UUA position on end-of-life issues is grounded in the church’s honouring the integrity of the individual conscience. These ultimate questions of life and death belong with the person most intimately affected, not with the church, a legislative committee or a bureaucratic panel.
Since the United Church of Christ does not have a presence in New Zealand that leaves only us to continue Lecretia’s valiant fight for the right to die with dignity. No other faith group is likely to do so.