098 Euthanasia and Bioethics

While I find N. Scott Peck’s books a mixed lot, especially insofar as they tend to embrace some “New Age” pabulum, his Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and Mortality (New York: Harmony Books, c. 1997) is a fine contribution to the subject. Predictably, he shies away from “judging” others’ actions, but he does build a strong case against both suicide and mercy killing. Of all the bioethical quandaries we face, he thinks euthanasia may be the most “critical” (p. 1). And this is because it more clearly divides us concerning “the existence or nonexistence of the human soul” (p. 3).

Peck’s medical background enables him to make careful, cogent distinctions, essential to any discussion of euthanasia. “Pulling the plug,” he argues, refers to allowing a dying patient to die naturally, free from sophisticated machines which can keep a cadaver “breathing.” He sets forth criteria whereby family and physicians rightly “pull the plug”: (1) the clinical evidence must absolutely demonstrate that the patient is in the final stage of a terminal illness; (2) no fuzzy “quality of life” rhetoric should be allowed; and (3) all the ones deciding (including the patient if possible) must agree.

Staunchly opposed to “mercy killing,” Peck stands equally committed to pain management. Physical pain, he insists, need never be overwhelming, for we have the means to prevent it. Morphine pumps can effectively control the amount of pain a patient feels, and every possible medication should be made available to ease the discomfort of the terminally ill. Roman Catholic ethicists have carefully formulated the principle of “double effect,” showing how one can primarily intend to relieve pain while knowingly hastening a patient’s death by using toxic drugs.

But physical pain does not drive the euthanasia advocates! Emotional pain, ironically, is the “real issue” (p. 56). Peck’s psychotherapeutic experience provides him illustrations and explanations of how many emotionally-distressed people want to escape, by any means possible, their suffering. What they need, he insists, is to face their problems and do the demanding work necessary to attain psychological and spiritual health. Discipline, soul-developing struggle, is their deepest need. Let us prescribe spiritual disciplines, not death! Many of the fears which paralyze people are rooted in their deep fear of death. Dealing with their fears, overcoming their distresses, not euthanasia, is the answer!

His discussion of euthanasia leads Peck to ponder the deeper spiritual implications of the issue. Eating away at the innards of our society is Secularism, the faith of the modernist. Peck cites the distressing suicide pact of Dr. and Mrs. Henry Van Dusen, who took their lives rather than suffer. Van Dusen was a prominent “Liberal” Protestant theologian; he and his wife were prominent members of the Euthanasia Society of America, and their “final exit” illustrated the bankruptcy of the “theology” he championed. When the Van Dusens killed themselves, their lives, Peck was shocked and bewildered. But once he came to understand the essence of Secularism, he saw that they followed its dictates.

Secularists, quite simply, regard themselves as the center of the universe. They want to be autonomous, free to live according to their own standards, unconcerned with the broader implications of their decisions. Conversely, folks “with a sacred consciousness” find their center in God and His “Sacred Order.” Ironically, Secularists frequently find life meaningless while the devoutly religious find it filled with purpose. Widespread support for euthanasia “bespeaks the depth of secularism in our society” and reveals “the widespread denial of the human soul. And it is this pervasive lack of acknowledgment of the soul that seems to me to bode so ill for our future . . . unless we can awaken” (p. 127).

“The soul,” says Peck, “is a God-created, God-nurtured, unique, developable, immortal human spirit” (p. 132). A secular society, by definition, leaves out God. We’re simply material things, briefly alive but nothing in the end. Nothing worse could have happened to us! For, Peck insists, “God subtly works through our genes, our childhood, our culture–and through other means–in our creation” (p. 134). Without an awareness of Him, and His workings in our lives, we fail in life. We come from Him and return to Him. Quite frankly, “If there is no afterlife, much of what I have been saying is rot” (p. 153). We’re persons, not things! Persons are spiritual beings, and life is a process of becoming the persons we’re designed to be.

Tragically, today’s religious folks generally espouse a “pallid religion. The fact of the matter is that most people in the United States do not take their religion, their God, or their souls very seriously” (p. 233). The same goes for public education, which is highly secularized–rarely if ever addressing questions concerning the meaning of life or the reality of “soul.” Consequently, “we are indirectly teaching our children nihilism–a diabolic philosophy that there is no meaning and consequently anything goes” (p. 234). All sorts of “theories”–Big Bang, Darwinian Natural Selection–are taught as “factual,” but “soul theory” cannot even be mentioned! So dying is reduced to a purely biological process, treated with purely medical means.

For persons, dying should be a learning experience. The final stages of life should be a learning stage, preparing us for eternity. In the words of Seneca: “Throughout the whole of life one must continue to learn how to live and, what will amaze you even more, dear friends, throughout life one must continue to learn how to die” (p. 167). So, Peck says, we need to learn Kubler-Ross’s five stages of dying: denial; anger; bargaining; depression; acceptance. To help others rightly deal with these stages, to grow through them ourselves, provides a key to dying well. Sadly enough, many folks die while still in the denial stage! “Given our freedom, we may choose to submit our will to a Higher Power–be it God, truth, love, or even reality. But if our will is not truly submitted, we are free to think and believe whatever we want. The facts be damned. It is actually easier to deny reality than submit to it. Not right, but easier” (p. 163).

This is one of Peck’s best books! He writes well, has much experience in this area, and brings to his treatise a passion for the issue. While he cannot be trusted to espouse orthodox Christian theology, much that he says certainly complement more solid theological treatises.

Other writers share Peck’s concern, for few issues pose more momentous questions than “bioethics.” A good, succinct guide to the issue is Gilbert Meilaender’s Bioethics: A Primer for Christians (Grand Rapids: William B. Eerdmans, c. 1996). A Lutheran professor of theological ethics as Valparaiso University, Meilaender is one of this nation’s finest thinkers, and he seeks, in this treatise, “to say what we Christians ought to say in order to be faithful to the truth that has claimed us in Jesus” (p. xi). Uniquely bonded to God in baptism, Christians “belong, to the whole extent of our being, only to God” and are accountable ultimately to Him (p. 2) . God call s us not to self-actualization but self-giving.

Consequently, in marriage, we’re called to join God in His procreative work. We’re begotten, not made. Today’s talk about “reproduction” rather than “procreation” reveals a subtle but significant shift in our thinking, for we “reproduce” things in factories. Then, it follows, “artificial reproduction gives babies without sex, contraception makes possible sex without babies. In each case, one might argue, the sexual act of husband and wife is separated from the procreative good of marriage” (p. 15). But godly couples should cooperate with God by mutual self-giving, and their conjugal, “love-giving” union is thus “life-giving; it is truly procreation” (p. 15). Free though we be, Christians must ever beware of engaging in wrong means to secure good ends.

Christians, Meilaender reminds us, have always and still should oppose abortion. “We know what we ought to do, but we find it hard to act in accord with that knowledge” (p. 26). The biological evidence grows ever more persuasive: one’s life begins at conception and flourishes as nourished thereafter. “After fertilization it is hared to find any other equally decisive break in the process of development” (p. 30). Yet Christians should oppose abortion not simply because it takes an innocent person’s life. “Rather, we seek daily to learn how to see the whole of life in the light of God’s creative and redemptive activity. The life of the child in the womb in God’s creation, and that child is part of the world Christ came to redeem” (p. 37).

Turning to genetics, Meilaender ponders how far we can go, playing God in such areas as germ cell therapy. To do things just because we can do them–to exert power over nature simply because we have the power–easily leads to contempt not simply for weaker creatures but for weaker humans as well. He further cautions against prenatal screening, especially insofar as it is often used to discard undesirable children. The same caution must be extended to organ donations. The body, to Christians, is sacred, and zealous folks may easily profane it in their zeal to use it as a machine.

Nor should suicide or euthanasia be approved by Christians. Both acts reveal a deep desire to remain in control of one’s life, to sustain that independence from God and others which probably characterized one’s life. Suicide “has about it a Promethean quality, a rejection of our status as creatures” (p. 59). Since we Christians know we’re God’s, we’re called to maximize care for the dying, but never to kill. On the other hand, since we’re God’s we ought not resist His final call in death. We need not prolong the dying process to demonstrate our control over it. Meilaender gives clear directions concerning such things as “who decides” to refuse treatment and urges us to draft “a health care power of attorney” which allows those we love and trust to make end-of-life decisions.

Finally, we’re urged to ponder “sickness and health” and the spiritual ramifications “about the way we live toward death in a world marked by illness and suffering” (p. 114). Christ Jesus came to suffer and die for us. He entered fully into our fallenness. We who join Him in His will for us cannot avoid suffering and death. Indeed, we may well become spiritually healthy as we endure physical pain.

Vigen Guroian, writing from the Orthodox perspective and drawing from its rich burial rites, provides us an equally worthwhile book entitled Life’s Living toward Dying: A Theological and Medical-Ethical Study (Grand Rapids: William B. Eerdmans Publishing Company, c. 1996). He shares Meilaender’s lament for the “culture of death” around us, personified by Jack Kevorkian’s enthusiasm for “medicide.” He writes to urge Christians to engage in the important work of restoring the “fundamental presuppositions of the Judeo-Christian tradition and the moral limits it sets on the giving and taking of life” (p. xiii).

Both aversion and obsession typify our “culture of death.” We won’t talk about death, but our music and art often obsess over it. When we deny the reality of death we evade the reality of life! It seems, paradoxi- cally, that love and death cannot be disjointed. When love fails, we fail to deal with over death–for we die well only when immersed in love. In the memorable words of John Cheever, “‘How can a people who do not mean to understand death hope to understand love, and who will sound the alarm?‘” (p. 21). This was theologically clarified by St. Gregory of Nazianzus, giving his father’s funeral oration, who reminded hearers of Christ’s sacrifice on the Cross, “‘Life and death, as they are called, apparently so different, are in a sense resolved into, and successive to each other'” (p. 34). Living with Him, we learn to die; dying with Him, we live forever.

So, “as the Anglican theologian Austin Farrer so rightly said, ‘God does not give us explanations; he gives up a Son'” (p. 41). We live in a world-a-dying. That’s reality! It’s worth lamenting, as did St. John of Damascus, who wrote: “‘I weep and wail when I think upon death and behold our beauty, fashioned after the image of God, lying in the tomb disfigured, dishonored, bereft of form'” (p. 45). With C. S. Lewis, whose A Grief Observed provides Guroian with powerful insights, those who love cannot but grieve when deprived of their lover. But joined with Christ we have hope. Such hope comes not from blithe “don’t worry” lyrics but from repentance and conversion. This is the message Guroian finds in Tolstoy’s classic The Death of Ivan Ilych. Near death, Ivan Ilych faces an even more troubling prospect: “What if my whole life has been wrong?” As life ebbs away, he finds new life! He “converted” through confession, repentance, and faith. Finally surrendering to God in death, he found the truth he’d never discovered in life. At the very end, he “‘caught sight of the light, and it was revealed to him that though his life had not been what it should have been, this could still be rectified'” (p. 60).

Having discussed “the vision of death,” Guroian turns to “the Christian ethics of caring for the dying.” Secularists, bereft of God’s Presence, resort to starkly utilitarian techniques when dealing with the dying. Eliminate pain, maximize the greatest good for the greatest number, forget the dignity of the terminally ill! Thus, on the one hand, they easily prolong the dying process for some and shorten life for others. But Christians are called to rightly care for the dying, which primarily means helping them “reconcile” with God and others. As the director of a hospice says, “‘Even as their bodies are disintegrating they are becoming whole'” (p. 87). More than anything, folks near death need to be forgiven. To do this they must confess, repent, accept God’s Grace as mediated through Word and Sacrament. Nothing, Guroian insists, is better for the dying than “liturgy and rite” which enable them to express their pain and lay hold of God’s mercy.

Edited volumes frequently fail to coherently discuss their subjects, but this is not true of Dignity and Dying: A Christian Appraisal, edited by John F. Kilner, Arlene B. Miller, and Edmund D. Pellegrino (Grand Rapids: William B. Eerdmans Publishing Company, c. 1996). Twenty contributors–physicians, nurses, professors–bring considerable expertise to their presentations, and their ample notes make this a good guide to recent literature. While they write as specialists, they write clearly, and the volume is quite accessible to readers who are concerned with in-depth discussions.

Pressure to change traditional values has been building in our society, and today “the field of discourse is dominated by a secular, autonomy-driven, privacy-oriented approach” (p. ix). It’s clear, writes Holly Vautier, “that the once-dominant moral ethos of western society is ‘fundamentally broken'” (p. 99). A Polish philosopher, L. Kolakowski, predicts that the growing tendency to devalue the worth of human beings, killing those who inconvenience us, will lead to the “cultural suicide” of the West. Obviously, the ideas contested have enormous implications, and Christians must gain a hearing in this discussion. They have much to contribute, and the “Good News” both helps people honestly confront death and provides the strength to deal with it. The noted columnist William Raspberry thinks the Church needs to assert its rightful role, giving folks moral guidance. Yet too often the Church compromises its spirituality and divine authority, slipping into a political lobbying or psychological therapeutics of some sort. But it is only by teaching and preaching her doctrines that the Church can help people confront their mortality and learn how to minister to those in the final stages of life.

Secularists, trumpeting the “right to die,” deeply hunger for autonomy. As Bruno Bettelheim, the noted psychologist who committed suicide, admitted, he was not afraid to die but he feared “suffering” and the possibility of being “kept alive without purpose” (p. 47). He illustrates how differently Christians and secularists view suffering. To secularists, suffering makes no sense, and any means necessary to escape it are rationalized. To Christians, suffering should be relieved, as much as possible, but it cannot be absolutely avoided and may well prove valuable in spiritual development. “It seems,” says James Reitman, “not so much the suffering per se that makes life unlivable as the perception that life has no ‘goodness’, which in Ecclesiastes carries the nuance of ‘satisfying meaning'” (p. 212). “Christianity,” says Edmund Pellegrino, “gives meaning to suffering because it is linked to the sufferings of God Incarnate, who willingly suffered and died for our redemption” (p. 111).

Secularists have also manipulated euphemisms to sway public opinion. The words we use, the ways we talk, shape society. Hitler, Ben Mitchell asserts, successfully deployed “euphemisms for medicalized murder” (p. 124), and German doctors “ethanized” 400,000 mentally and physically disabled people. When folks today talk about “merciful death” and “death with dignity” and “managed death,” we see how words are used to disguise the truth. Derek Humphry, and those whojealously draft initiatives to permit “assisted suicide,” deliberately misguide the public, deliberately using Orwellian “doublespeak” which sounds compassionate and moderate.

Finally, there is a strongly utilitarian strain in euthanasia proposals. John Stuart Mill and his successors have, especially in legal circles, won a resounding victory, meshing together apparent contradictions: individual liberty (in sexual conduct, for example) and socialistic systems (redistributionist economics). “The greatest good for the greatest number” guides us. The majority dictates political decisions. So, we have a strange mix, in health care, of personal autonomy within managed care systems! And yet, a woman’s “right to privacy” grants allows her to kill her unborn child, ignoring the “greatest good” for others if necessary. Or the troubled cancer patient has a “right to die,” even if it adversely affects friends and family.

Beyond critiquing the current scene, however, some of the contributors set forth helptufl ways to assess and address it. Hospice care recieves careful and positive discussion. One essay on “long-term care” helps us grasp some of the ways to deal with prolonged institutional confinements. Another urges us to move away from the “radical individualism” which underlies so many of our health-care problems and develop a “wise advocacy” rooted in the Wisdom literature of the Old Testament. Much can be learned from such thinkers!

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