This is not an attempt to defend physician assisted suicide, but a critique of the commonplace arguments employed against it. If the discussion is to maintain integrity it necessarily must be wider in scope. Like it or not we must acknowledge that quality of life, technology and the associated financial costs play a very large part in how we address medical issues and as a result the end of life.
Listening to both the reports and especially the Christian commentaries regarding this young woman and her situation, I am struck by the following...
Most Christian critics of euthanasia argue this is secular man trying to be the master of his own destiny. Refusing to submit to Providence, secular man seeks autonomy in all things, even the time of his own death. We should allow God to choose the day we die.
However it drives me to raise several issues...
Are we not doing the same thing when we employ medical technology to prolong life? Are we not trying to thwart Providence and be the masters of our own destiny?
There's medical treatment in the sense of dealing with a broken limb, an infection or torn flesh. These are injuries.
Then there are what we might call chronic conditions.
No one disputes the idea of treating arthritis or diabetes. These are not necessarily life-threatening but certainly can be if left unchecked.
But then we have life threatening chronic conditions, things like heart disease, cancer, or some kind of organ failure, isn't our intervention also (in a way) calling Providence into question?
I realize that we don't tempt God. As Christians we know that if God means for us to die, then we will, but at the same time we don't tempt Him. We wear the seatbelt. We try to maintain our health. We use the means he has provided, the tools that we're able to develop to make our lives better and help others.
But is all technology good?
This seems to me a critical issue here that's not being addressed. The technology we use to heal and prolong life also creates ethical tangles that force us to also in effect 'decide' when the person dies.
To some degree there are many people who make this decision. It's cast differently so it 'appears' different than what this girl is doing, but I'm not so sure it is in its entirety. The attitude is different, certainly in one's posture toward God, or in the case of this woman, her non-acknowledgement of God. But the act itself is largely the same.
Most people will agree that medical treatment reaches a point where it no longer becomes helpful. Maybe I should change that 'most' to 'some' as I increasingly meet and interact with people who don't think this way. A lot of people disagree with me and think that 92 year olds should keep going through chemotherapy and surgeries in order to prolong life... even if it just means a few months.
Others vehemently disagree and argue in terms of quality of life. Conservatives don't like that line of thought or the employment of that criterion and yet it's something that modern technology has forced us to entertain.
Death of course is not merely a physical phenomenon. Machines can keep the human body functioning, but the machines cannot measure the vitality of the mind. They can to some degree measure the activity and vitality of the brain, but not the mind. It's not always easy to tell when someone is alive or dead. This speaks to both ends of this debate, those who would turn a machine off as well as those who would insist on keeping it on.
At some point we are limited in our ability to fully consider or even ascertain the facts. We've built machines that raise moral conundrums for us that in some cases we cannot solve.
At what point do we turn off the machine as it were, or stop treatment? We're okay with that because we say death is inevitable. But the criteria for saying 'stop' are pretty subjective. One person might say this is the point, "Stop now." Someone else might say if you stop there, you're causing premature death... you're not using the means God has given.
But then we might say that using technology to prolong the death process pretty much guarantees that we're going to be forced to deal with the ethics of when to stop or turn it off. We judge people for saying 'no more' and yet the question wouldn't even be a possibility if it were not for the treatment to begin with.
The use of technology has generated ethical dilemmas. This is an old story. Of course the technology itself should have been viewed as an ethical dilemma. We tend to only deal with the consequences. If we do address the thing in and of itself, it's usually too late.
For those that say we always promote life... well, first of all I would question their commitment to that principle on many other fronts. But when it comes to medicine the reality is more complicated.
One thinks of the utilization of morphine in order to ward off the unbearable pain and respiratory suffering often associated with cancer. The morphine is a tool that alleviates suffering but the dosages necessarily reach a point that the morphine itself can possibly kill the person. The jury is still out on this contested point but it's an interesting tangle when trying to consider all of these issues and the mindset promoted by the Christian community in the name of 'life'.
There's a great deal of talk regarding the need to suffer and the profitability of this experience. This of course can be debated but I will say to expect non-believers to embrace this way of thinking is unrealistic and unwarranted.
Personally I don't want to live hooked up to machines. That's not really what I would consider life and for me is a moral issue. I don't want to burden my family with years of care and hundreds of thousands of dollars of medical bills. I kind of figure when my time is up... then it's up.
How does that translate into medical care? How far will I go to intervene? I don't know. It will of course depend on the situation and the prognosis. I think about these things differently now as a father than I did as a single young man. And I may think differently again when my children are all adults.
There's a lot of medical technology and technology in general I don't agree with. Perhaps at this point I'm displaying some of my Neo-Luddite proclivities. I believe all technology has a moral component and we need to think these things through before we embrace them. Often we don't have the option. The innovations enter common use long before we as a society or even as individuals have had time to consider them. Obviously I'm not opposed to all technology per se, but I'm starting to seriously question a lot of things we take for granted.
I realize these are forbidden questions for a Christian to ask in our present politicized climate but I do question the ethics of spending hundreds of thousands of dollars in order to prolong someone's life for just a few months. I also question spending trillions of dollars on weapons of war. So-called Pro-lifers say this is to defend life, but this only goes to show they haven't learned some basic lessons from history regarding the realities of war. Armies and weapons help to create wars to begin with it. Weaponization leads to violence. This is true whether we're talking about tanks or handguns.
As far as the cost of prolonging life, this also touches on the whole nature of costs and the structuring of the medical industry and health system. There are profound ethical components and questions surrounding the nature of commercialized and profit motivated medical care. None of these issues stand alone.
It's the same with Capital Punishment. Whether you are for it or against it, in principle it cannot be looked at without considering the present state of the judiciary and how it is applied in our society... and indeed the economic factors also play a part in how one must assess its current advisability.
Am I muddying the waters on these questions?
I am indeed. This is not due to vacillation. When I was a younger man, I might have accused someone talking the way I am with such a moral shortfall. I hope this is the result of some wisdom and reflection, a realization that life is unbelievably complicated. There are answers but oversimplification is not the equivalent of moral clarity. It can sometimes be just stubborn foolishness, willful ignorance or excuse-making.
All of our technological advances are to some extent man's attempt to control his own destiny. We can convince ourselves that we innovate to God's glory and build his Kingdom in doing so. But starting in Genesis after The Fall we learn that cultural endeavours are in fact the province of Cain and his descendants.
This does not mean that we have to eschew culture and civilization. Not at all. But we also learn that these things while not necessarily evil are not in and of themselves good either. We can use them for good but they are temporary tools and will (with all of man's works) burn in the fires of Judgment at the end of this age (2 Peter 3.10). The tools are part of Providential mercy for this age, but the tools and the technology don't build the Kingdom of God nor are they part of it. They are not the province of the Holy Spirit's redemptive programme.
Technology's greatest danger is that it quickly becomes idolatrous. We use our tools to build the Tower of Babel and make a name for ourselves. We use the tools (the technology) for our own glory and then like the Babelites claim that God is with us and among us. We claim divine sanction. We sanctify our tower project. This heresy has long been reckoned orthodox and in recent years has been considerably fortified and promoted within the confines of larger Protestantism. Dominionism cannot be divorced from a certain posture toward technology and its relationship to civilizational advancement. For the Dominionist these concepts are directly related to this concept of the Kingdom and its progress.
We can be thankful for the many things Providence has given mankind. We certainly do not deserve these kindnesses and just because fallen man turns everything into idols and evil uses doesn't mean that we have to.
But to avoid this, we're going to have to stop, think and consider what we do.
Not all technology is good. Most of it is in fact a mix of good and bad and we must be careful in how we use it.
The same is true of medical technology.