In his recent blog post on euthanasia, pastor Kerry Bender wrestles with the conflicting emotions he feels as he contemplates his father’s demise from Alzheimer’s. Kerry asserts that belief trumps feelings, even though he recognizes belief is shaped by both feelings and intellect. For him, belief in God, resurrection, and image-bearing stay any impulse to hasten his father’s death through human manipulation.
Bender goes farther than many when he decides to treat his father as if he were a person, even a parent, despite the loss of any relationship between them other than the historical. Even so, many people can treat their loved ones, and themselves, as a person and even an image-bearer, but still argue that euthanasia is a viable option (pun intended). Of course, there are different types of euthanasia, passive or active and involuntary or voluntary.
The laws in the US are concerned only with the permitting voluntary euthanasia, typically in an active form. That is, the person who is the patient must make a fully informed consent to die. Not only that, but someone must give assistance so that the death is actively hastened—pull the plug so to speak, or tender the poison.
What many anxious relatives don’t understand, whether they are from a faith-based worldview or not, is that human beings are endowed with mechanisms that soften and hasten death as suffering and demise reach critical levels. Many elderly patients will turn to a wall and refuse to eat or drink as they resign themselves to dying. Is this voluntary passive euthanasia? Technically, yes. Should we force the terminally ill, whether from dementia or cancer, to be fed and hydrated? Not when it actively suspends their natural dying. And yet, as more people spend their last days in institutional settings and fewer of us have witnessed an “ordinary” or “natural” death, we are increasingly uncertain of how to respond.
In the case of Kerry’s father, most physicians would find it reasonable to limit antibiotic use for infection or to avoid any invasive feeding such as intravenous or nasogastric. Certainly, “DNR” as Kerry mentioned, would be appropriate and not at all within the realm of euthanasia. There are lots of very good indications for deciding a DNR order is reasonable, including a proactive stance related to one’s own dementia.
Personally, I do not support any of the US euthanasia laws, mostly because the evidence used in creating the laws is simply unfounded. Supporters always cite pain and suffering as intractable concerns. But the data I’ve seen suggests that those who do choose suicide (self-death, ie: active voluntary euthanasia) typically have accent to decent pain management, adequate financial resources, and uncomplaining family members. In 100% of those taking their life under WA state law, autonomy was the reason recorded. The person did not want to lose their autonomy—even if that autonomy culminated in the ironic act of ending one’s life.
Autonomy is an odd concept and one that our society seems to think little about in any meaningful way. Autonomy is one of the four primary principles of Western bioethics. But what does it really mean? Certainly we support the patient’s right to choose their care, their participation in research and their informed knowledge of options in a context of justice and beneficence. The German Holocaust and American syphilis experiments are two horrible reminders of why autonomy has come to be prized. But today’s application of autonomy in cases of euthanasia far exceeds these initial ideas about protection of the weak or vulnerable.
Today, characteristics such as “strength” and “invulnerability” are regarded as near synonyms to autonomy. In this strange reversal, autonomy is used as a shield against human interdependence. Holding onto self-power, even if it destroys oneself, is lauded as better than accepting and yielding to the care of another, particularly in humiliating, bodily ways.
Sadly, this idolization of autonomy is in fact a deep cut in the fabric of what it means to be truly human, or—in the language of faith—what it means to be an image-bearer. Rescinding our finite bodily presence in all its manifestations, refusing community and the risk of being intimately known by others, rejecting brokenness and uncertainty and grief; this is in fact an abdication of what it means to live, even now, as a Trinity-bearer.
Who is most at risk with all this language of autonomy? It is still the weak and vulnerable. We haven’t really bettered their position in this new era. We have so little tolerance for what seems a prolonged disability or worse, a “futile” form of life. Our position on autonomy is a judgment on the worth of our society’s weakest members. And I believe—to use Kerry’s words—that it is only with a renewed sense of community, of humility, and of mystery that we might approach death with dignity.