Wednesday, May 09, 2007

The Bioethical Dilemma

By Seminarian Dave Larson

Question at hand – How are Christians to view assisted suicide/euthanasia, and similar end of life issues, based upon our baptismal identity?

An elderly woman, who is a member of your congregation, is dying from cancer. The cancer has progressed to the stage where nothing can possibly stop or even slow it. The only thing the doctors can do is prescribe morphine, but even then the pain is unbearable. Her husband, to whom she has been married for fifty-five years, loves her deeply and it is too much for him to see her in such pain. When the pain peaks, she cries out for relief, but her husband is helpless to ease her suffering. One day the husband comes to you and tells you that both he and his wife have had enough of this accursed cancer. They have planned for the husband to provide an overdose of morphine and end his wife’s life.

Brothers and sisters in Christ, what do you say to this man? How do you respond as a trained theologian and as his spiritual guide? I am sure that every single one of you has dealt with a situation like this. It may not have been an instance that included a plan for euthanasia, but you have all been involved with people dealing with great amounts of pain or other end of life issues. So again, I ask you, what do you say? But before we get to your response, we must know what the world’s response to the man is. After all, this man will hear two things: what the world tells him and what you tell him.

Essentially there are five different arguments for assisted suicide/euthanasia. We will take up each argument on a one-by-one basis. The first argument is the argument of burden. The patient does not want to be a burden to others, whether they be family, friends, hospital, self, society, etc. The patient sees himself as a drain, both financially and emotionally, on those around him. This patient believes that since he no longer contributes to the world in which he lives, but rather takes away from it, he should no longer be in it. With his death there is one less burden for everyone to carry.

The second argument is the right-to-choose argument. This is the argument that Americans have made famous! The patient believes that she has the right to choose what to do with her life. After all, it’s her body and her life, is it not? She has the right to either keep her life or lose it. Therefore, if her life has become unbearable to live, then it is her right to end it.

The third argument is the quality of life argument. This is closely tied into the burden argument. Here the patient believes that since his life is no longer at the level of quality that he desires, it is no longer worth living. So rather than living a life that he has determined to be valueless, he will die. A life without a certain level of quality is a life not worth living.

The fourth argument is the fatalism argument. Here the patient has come to the conclusion that she will die anyway, so why not now? She begs the question that if everyone will die sooner or later, why not simply die now and skip the pain and suffering of the disease.

The fifth, and probably the most popular argument, is the “patient has suffered enough” argument. This is the argument used by the husband in our scenario. Here, the patient has suffered the torments of her disease for far too long and it would be better for her to be dead than to keep on living such an awful life.

As theologians we have been trained to realize that whenever such arguments are made, there is typically a bigger issue lying in the background. The real issue at hand here is concerned with one’s view of the world and oneself. All arguments for euthanasia/assisted suicide are supported by the core presupposition of autonomy. The world will tell the man that people are truly independent, autonomous persons who are subject to no one.

Gilbert Meilaender has this to say concerning autonomy, “We have taken autonomy so for granted, accepted it so much as the natural state of affairs, that we have lost our ability to question it or to see that – every bit as much as religion – it also presupposes a metaphysic and a view of human nature.” Autonomy, in our Orthodox understanding of the world, is an upside-down philosophy. To steal a term from C.S. Lewis, this mode of understanding is “bent.” Autonomy views people as being masters over all things, including themselves. Therefore, people are their own “gods” who are lords over their own lives and can decide whether or not their lives are worth living.

The question is then begged: what is the proper view of the world and of ourselves? This is the question that we must be able to answer not only for ourselves but especially for our parishioners. Remember, they will always hear two things: what you tell them and what the world tells them. We know what the world has to say regarding euthanasia/assisted suicide via an autonomous viewpoint. Now we will discuss what we, as Orthodox Christians, have to say regarding euthanasia/assisted suicide via a dependent viewpoint.

As with all so many scenarios, baptism is central to our framework. AC IX makes this statement concerning baptism, “They are received into the grace of God when they are offered to God through baptism.” Luther also writes in the Large Catechism regarding baptism, “For no one is baptized in order to become a prince, but, as the words say, ‘to be saved.’ To be saved, as everyone well knows, is nothing else than to be delivered from sin, death, and the devil, to enter into Christ’s kingdom, and to live with him forever.” Likewise, Paul writes in Romans 6, “Or don’t you know that all of us who were baptized into Christ Jesus were baptized into his death? We were therefore buried with him through baptism into death in order that, just as Christ was raised from the dead through the glory of the Father, we too may live a new life.”

As Lutherans, we tend to focus on certain key aspects of baptism. We focus on the salvific work of Christ in and through baptism. We like to highlight Luther’s words in the Small Catechism regarding the benefits of baptism, “It brings about forgiveness of sins, redeems from death and the devil, and gives eternal salvation to all who believe, as the words and promise of God declare.” It is well and good that we should emphasize the salvific benefits that come about through baptism. However, if this is all we stress, then we are cheating our people. In and through baptism we are given a new identity. Before baptism we are completely and utterly dead. Before baptism we belong to Satan and live in his kingdom. However, through baptism Christ makes us alive and gives us his name. Through baptism we belong to Christ and live in His kingdom. Paul makes this point extremely clear in Galatians 2, which is deeply connected to Romans 6, “I have been crucified with Christ and I no longer live, but Christ lives in me. The life I live in the body, I live by faith in the Son of God, who loved me and gave himself for me.”

To illustrate the connection between baptism and our identity, I point you to the work of C.S. Lewis. In book three of The Chronicles of Narnia, The Voyage of the Dawn Treader, we are introduced to the character Eustace Clarence Scrubb. Eustace was a wicked little boy and Lewis writes that he deserved to have such an obnoxious name. During his voyage upon the Dawn Treader with Lucy, Edmund, and Caspian, Eustace does nothing but complain and create problems. When they come upon a certain island, Eustace has no desire to do any work so he wanders off. He stumbles upon a cave that is full of treasures and falls asleep on a pile of gold. Well, we all know what happens to a person with dragonish thoughts who falls asleep on a pile of gold: they turn into a dragon! After some time Eustace is sick and tired of being a dragon. This is when Aslan makes his appearance to Eustace. Aslan leads him to a well at the top of a mountain. At the well Aslan strips the dragon skin right off of Eustace, dunks him in the water, and dresses him in new clothes. From this point forward in the book Eustace was a new person. That is to say, he had a new identity. In fact, Lewis writes at the end of the book, “Back in our own world everyone soon started saying how Eustace had improved, and how ‘You’d never know him for the same boy.’”

In and through baptism God gives us a new identity, which is grounded in Him. This baptismal identity then impacts how we view the world and ourselves. For us, the questions of “who are we?” and “whose are we?” are one in the same. Our identities are completely enveloped in the fact that we belong to Christ. Unlike the world, we believe that we are not autonomous peoples. Rather, we are people who are completely and utterly dependent upon God. Meilaender writes, “We do not start with the language of independence. Within the story of my life I have the relative freedom of a creature, but it is not simply ‘my’ life to do with as I please. I am free to end it, of course, but not free to do so without risking something as important to my nature as freedom: namely, the sense of myself as one who always exists in relation to God.”

So then, how do we apply this baptismal identity to euthanasia/assisted suicide and other end of life issues? Dr. Robert Weiss from Concordia Seminary in St. Louis has this to say, “The care of fellow members [is] based on ‘seeing’ them as what they have been given and NOT based on what they have. Therefore, who we are is a work of Whose we are. Our integrity and identity lies in His righteousness, innocence and blessed given to us. Therefore, we ask the question of care: In Christ, who are these persons and who are we showing ourselves to be as we respond to their presence and needs, as fellow members of the body of Christ.”

We believe that our identity is entirely wrapped-up in Christ and, as such, we are wholly dependent upon Him. We are not gods who are masters over life and can decide whether our lives and the lives of others are worth living or not. As Meilaender writes, “For Christians, each person’s life is a divine gift and trust, taken up into God’s own eternal life in Jesus, to be guarded and respected in others and in ourselves.” The act of euthanasia/assisted suicide assumes lordship over our own lives and the lives of others. Such an assumption is diametrically opposed to the reality found in our baptismal identity.

Since we have established the Orthodox view of ourselves and the world, we are easily able to tackle the five arguments for euthanasia/assisted suicide that are mentioned above. The first four arguments require an autonomous viewpoint, which we believe is an erroneous one. For the Christian whose identity and worldview have been shaped by his baptismal identity the arguments based on burden, right-to-choose, quality of life, and fatalism are easily dismissed. However, the fifth argument, which is the one used in our example at the beginning of our discussion, is the hardest one for Christians to dispute. Meilaender makes this point as he writes, “Christians are, I suspect, more likely to be drawn to the argument that describes euthanasia as compassionate relief of suffering. And, to be sure, we all know the fear of suffering and the frustration of being unable to relieve it fully in those whom we love.” As baptized children of God we know that pain and suffering is the result of this broken world. However, to take the step of relieving pain and suffering through euthanasia/assisted suicide is the wrong one. Such a step is a gross denial of our baptismal identity.

At last we return to our scenario. Have you decided what you will say to the man? Obviously such a scenario would be an extremely difficult one that would require a great amount of wisdom and sensitivity. However, in such a situation we must find one way or another to express the Orthodox understanding of our baptismal identity. In this we know that we are not the ones who give life nor are we the ones who take it away. We are members of the body of Christ whose identity and worldview are wrapped up in Christ. We are fully dependent upon God and not autonomous creatures free to do whatever we wish. Therefore, with such an understanding we are able to follow the advice of Meilaender who writes, “The principle that governs Christian compassion, however, is not ‘minimize suffering.’ It is ‘maximize care.’ Were our goal only to minimize suffering, no doubt we could sometimes achieve it most effectively by eliminating sufferers.”

The goal of this paper has not been to provide you with a plug-and-play type of answer. As a matter of fact, in theology such answers rarely exist. Rather, the goal of this paper has been to provide you with a theological framework that you are able to use when dealing with euthanasia/assisted suicide issues along with other end of life issues that you may encounter in your congregations. Your people are the people of God. They have been baptized into Christ and have been given the new identity of children of God. Their selves have been brought up into Christ so that it is not they who live but Christ who lives in them. In this new identity they are creatures fully dependent upon God and not autonomous creatures dependent upon no one but themselves. To say that such a viewpoint will not be easily accepted by Americans is a vast understatement. However, it is our duty to educate our people. We must have patience and tact, but we must lead them to the Garden of Gethsemane so that they too can pray the prayer of Christ, “Not my will, but thy will, be done.”

In closing, we listen to the words of Meilaender, “Understanding care and compassion in this way, we seek to learn to stand with and beside those who suffer – with them as an equal, not as a lord over life and death, but determined not to abandon them as they live out their personal histories up against that limit of death which we all share. For us, the governing imperative should be not ‘minimize suffering,’ but ‘maximize care.’” Thank you.

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