Life and Death Ethical Issues
Solomon once observed that there is “a time to be born, and a time to die” (Eccl. 3:2). Dying, which ultimately is the price tag attached to human rebellion (Gen. 2:17; Rom. 5:12), is man’s final earthly experience. It shuts the door to this-world activity (Eccl. 9:6; Heb. 9:27) — the views of many fanciful speculators to the contrary notwithstanding — and opens vistas into eternity.
By virtue of humanity’s accelerated technological advances, the modern mind is challenged with numerous questions that pertain to the dying phenomenon. We have gathered several of these inquiries that have been posed to us in recent times, and, in this article, explore them for study and reflection.
“Is it ethical to provide morphine to a terminally ill patient, when it is a known fact that this drug can hasten death. Is not this a form of euthanasia?”
This is a most interesting question, and one that many of us have had to deal with on occasion as loved ones faced death. The morphine remedy is, in a manner of speaking, a “double-edged sword.”
The design of the medication is to provide the cancer victim, for instance, with some relief from pain in the agonizing final phases of terminal illness. In the cases with which I’ve been acquainted, there is no hope of recovery. While it is true that the morphine does tend to restrict certain bodily functions, as a by-product of the relief of suffering, it is not the intent of the administering physician, and the family, to terminate the life of the patient.
In the judgment of most morally sensitive people, it is much better to provide some easement from the torturous pain — even if life is abbreviated slightly — than it is to allow the victim to languish in agony as the inevitable approaches. This may not be the most ideal situation imaginable, but until something better is developed, most caring people see no ethical problem in the humane relief of suffering.
There are numerous medical techniques that are risky. Nonetheless, in many cases the physicians, in concert with the patient and his or her family, will opt for a procedure, knowing full well that such could result in death. At times, we struggle in knowing precisely what to do in attempting to save life or to provide comfort. We try to do the very best that we can for the patient.
There is a distinct difference, though, in attempting to save life, or to provide easement from pain, and in a deliberate intention to terminate a person’s life. The latter is not an ethical option.
Prolongation of Terminal Illness
“Is the Christian morally obligated to prolong his life by the use of artificial techniques? May he refuse chemotherapy, knowing that such would only add a few months to his life (and that with considerable suffering)? Is it wrong to refuse permission to be connected to a machine that can sustain biological functions, when one knows that death will result otherwise?”
Life and death issues entail some of the most difficult decisions one will ever be called upon to make. The Bible does not provide us with explicit answers to the complex medical questions with which we are confronted in today’s technological world. The Scriptures, however, are perpetually relevant, and they do contain principles that will enable the devout person to make reasonably confident decisions in many of these areas of ethical concern. Let us consider the following.
- The Christian must acknowledge that human life is a gift from God (Acts 17:25; 1 Tim. 6:13). No person, therefore, has the arbitrary right to destroy that life — either by homicide or suicide. And this includes what has come to be called “euthanasia” (a term meaning “good death”). Mercy-killing is morally wrong. It is an infringement into divine territory.
- It is a grim reality, taught both by experience and the Bible, that death is the inevitable destiny of all human beings (with the exception of those who will be alive at the time of Christ’s return — 1 Cor. 15:51; 1 Thes. 4:15). As a consequence of human rebellion, death has passed to all people (Rom. 5:12), and so it is “appointed” to man to die eventually (Heb. 9:27). One may, with good health habits and sound medical procedure, delay the “grim reaper” for a brief while, but the fact is, all of us are terminal!
What, then, is one to do if he is informed that he has terminal cancer? Suppose your physician tells you: “With chemotherapy you may be able to live a year; without it, you will likely have only two to three months.” Is the Christian morally obligated to subject himself to additional months of inch-by-inch wasting away?
Some may decide to take the treatment (hope springs eternal), feeling that such will provide them with the opportunity to continue doing good works, even under dire circumstances. Perhaps, they envision, a dramatic cure will be discovered. One certainly could not argue against that choice, should a person elect to make it.
On the other hand, it would be extremely presumptuous to contend that this prolonged agony was divinely required. Could one be morally faulted for not wanting to retard his journey to heaven? Here is the point: There is a marked difference in deliberately terminating one’s life, and letting natural processes take their providentially permitted course. Allowing death is not the equivalent of producing death.
And what about the accident victim who is “brain-dead,” but whose biological functions still are maintained by sophisticated machinery? Must a Christian family prolong the physiological processes of a loved one who is in a state of suspended animation — and that for years? There is nothing in the Scriptures that would mandate this.
Where is our hope ultimately focused? There is something to be said for “quality of life” (though this expression is abused frequently by modern advocates of euthanasia). Sometimes the very best thing that one can do for a Christian loved one is to let him go on home to be with the Lord (2 Cor. 5:8).
The Right to Terminal Information
“A loved one has undergone exploratory surgery. In the process it has been discovered that he is consumed with cancer, and he has only a short time to live — under the most ideal circumstances. Should he or she be told of his or her condition, or may we simply let our beloved die in peace without added anxiety over his or her impending fate?”
If one may say so delicately, what the question contemplates (providing the patient still has cognition) is whether or not it is acceptable to deceive the person about his or her eminent condition. In other words, is it ethical to “lie” under certain circumstances? The rational patient is bound to ask about his status.
First, it must be noted that death is the most serious event that a human being will experience — ever! Death is not the cessation of human existence. It is a transition from the environment of this earth to a region that accommodates a purely “spirit” existence.
The New Testament uses the term “Hades” to depict the post-death, pre-resurrection state of both the wicked and the righteous (cf. Lk. 16:23; Acts 2:27). Some derive the word “Hades” from the Greek roots a (not), and eido (seen), hence, the “not seen” state. Others feels that the etymology most likely is from hado, signifying “all receiving” (W.E. Vine, Expository Dictionary of New Testament Words).
One thing is clear to the careful Bible student. Death does not introduce a person into a state of “nothingness;” rather, it is a realm of “somethingness” — and the quality of that “somethingness” is determined by how the individual has responded to the will of his Creator. One cannot live wrong and die right (cf. Mt. 25:1-13; Heb. 9:27; 1 Pet. 4:17-18). In view of this, the following observations are in order.
- The lucid person has the right to know that he or she is dying. There may be physical and material decisions (e.g., as the disposition of property, etc.) that need to be made. And the dying person should have an opportunity to make such arrangements.
More importantly, there may be spiritual decisions — with eternal consequences — that need to be confronted. One must remember that Christ taught that even “eleventh hour” decisions can be crucial (Mt. 20:1-16). It is never too late to surrender to God as long as one retains his ability to make responsible choices. And no person should be deprived of that opportunity.
- Facing death provides one with the opportunity of exhibiting some of the best qualities of which the human being is capable. We may grossly underestimate a person when we assume that an awareness of his approaching death will bring only terror.
In her book, titled, On Death and Dying, Dr. Elisabeth Kubler-Ross, who studied the matter with considerable detail, set forth five mental stages through which she perceived that most people pass in facing the certainty of approaching death.
First, there is denial and possible isolation — with silence and self contemplation. Second, an anger phase may set in — “Why me?” Third, there may be a period during which one tends to bargain, i.e., he may (in desperation) promise God, “If you will only let me live, I will ….” Fourth, there can be a phase of depression when the reality sets in that all future plans will never materialize.
Finally, though, if there is enough time, the dying person frequently arrives at a tranquil state that may be characterized as “quiet expectation” — especially if he or she is a person of faith, having committed his or her life to the care and keeping of the loving Savior. Many examples of the most radiant faith, in the face of death’s blast, could be cited.
- The situation of impending death does not justify lying. The faÃ‚ade rarely deceives the ailing person, and it cheapens the character of the “miserable comforter” (cf. Job 16:2). It is far better to allow the patient his liberty of making choices, and face the reality of his mortality with dignity, than to follow the crooked road of duplicity. The dying deserve honesty from those who love them most.
“Is it ethical for a Christian to donate one of his body organs (e.g., a kidney) to help save the life of another, even though it might endanger his own life?”
While there is a risk in any significant surgical endeavor, such procedures as kidney and lung transplants are rather common these days, and have been implemented thousands of times quite successfully. I know of no Bible principle that would be violated by the benevolent act of donating a kidney to help save the life of another.
The fact is, it frequently is the case that one diminishes his own life in the interest of others. A mother or father may work herself or himself into an earlier grave in the interest of their children. A fireman may rush into a burning building to save a helpless victim. A hero may dart into the path of a car to save a straying toddler. There are many examples of such nobility. Paul commended the saints in Galatia by suggesting that while he was with them initially, had it been possible, they would have plucked out their eyes and donated them to him (Gal. 4:15).
Christ once said: “Greater love has no man than this, that a man lay down his life for his friends” (Jn. 15:13). Contemplate, then, the love of Jesus, who gave his life for us while we were yet sinners (Rom. 5:8). There are causes nobler than that of the mere preservation of one’s life. Many of the early Christians were willing to forfeit their lives rather than withhold the saving gospel from those who are lost. The Lord admonished, “Be faithful unto death [i.e., even if it causes your death], and I will give you the crown of life” (Rev. 2:10).
But there are two points that must be made before departing from this inquiry.
- The sacrificial surrender of one’s life on behalf of another must never be equated with suicide, which, in the case of a rational person (although some suicides clearly are irrational acts — for which the unfortunate victim is not culpable) is a supreme act of selfishness.
One does not have the right to arbitrarily take his own life. Self-murder is not a responsible, benevolent attempt to sacrifice for others; rather, it is a self-willed attempt to escape responsibility. Every suicide recorded in the Scriptures is presented in a negative light.
- While the surrender of one’s life on behalf of another may be a courageous and loving act, there is no redemptive value in such an act alone. There is no biblical evidence that a “good work,” even of that magnitude, is a substitute for obedience to the Lord (Jn. 3:36, ASV; Heb. 5:9; 1 Pet. 4:17). In the aftermath of the tragedy of September 11, 2001, during which many brave souls lost their lives attempting to rescue others, society, with a casual wave of the hand, assigned the heroes an eternal abode in heaven. While such an emotional response may be understandable to a degree, it is without validity.
Finally, we must note that there is nothing unethical in one’s decision that, upon his death, his useful organs be removed from his body, so that such might be made available to those who could benefit therefrom (e.g., kidneys, hearts, eye cornea, etc.).
Post-mortem Organ Removal
“Suppose a person decides to donate certain body organs to others following his death. How does a doctor know when a patient is actually dead? Could not a physician act prematurely, removing a vital organ, when the patient only appears to be dead? As I understand it, these procedures must be enacted quickly before the organs deteriorate.”
There are strict procedures employed in determining when death actually has occurred. There is not a mere single criterion by which to measure this terminal event; rather, a combination of factors is employed in making such decisions. These are: respiration, pulse, nerve response, electrical activity in the brain (flat EEG – electroencephalograph), etc. It is an extremely rare event when a “death” is misdiagnosed, and even then, there is most probably carelessness involved.
Finally, it would never be permissible to arbitrarily and forcefully remove an organ from a patient who is close to death, in order to provide a benefit for someone else who is critically ill. That would be nothing short of murder. And yet such proposals are being suggested increasingly by some in the medical world, particularly with reference to the elderly, who, presumably, have nothing of further value to contribute to society. Organ donations are a matter of one’s personal choice. No one has a right to override the patient’s will. Yet, we may live to see horrors unspeakable become commonplace in such matters!
Again we must emphasize that one must look to the Author of life for answers pertaining to critical life and death decisions. As we stated earlier, many of these issues are not spelled out explicitly in the Scriptures. However, there are principles in the Sacred Book that guide us in making these crucial judgments. For further information, one may wish to consult our book, Biblical Ethics & Modern Science.