The End of Life Options Act: A Religious Defense
By Sylvia Shaw, Massachusetts
Today’s palliative care helps most people manage their pain at a tolerable level. Most of us can hope to die without writhing in agony. But what about those terminally ill patients who are not that lucky?
My Sister’s Death
My family and I had to watch my sister die of starvation when Bulbar ALS slowly paralyzed her tongue. She begged for medical assistance to die. Texas law gave her no options for escaping a dreadful death. Even though Massachusetts offered no aid either, I brought her to my home so she wouldn’t die alone.
Hospice was wonderful in that last week of her life. But given the choice, she would have ended her ordeal a lot earlier.
Do We Have the Right?
Do we have the right to legislate that such patients must endure to the very end, no matter how much they beg for a merciful death? This is a question that we need to examine closely.
If Massachusetts were to pass the proposed End of Life Options Act, it would become the ninth state in the country to do so. California, Colorado, Hawaii, Maine, New Jersey, Oregon, Vermont, Washington, Washington, D.C., have authorized via ballot initiative or the legislative process the option of a peaceful and humane death via a self-administered medication prescribed by the patient’s physician. (In Montana, death with dignity is legal by Supreme Court decision.)
The rules for our state’s bill are stringent: a patient must be diagnosed by two physicians as being terminally ill, and a third professional must deem him/her mentally capable of making such a serious decision.
A Religious Perspective
There are valid qualms on all sides of the debate, just as there are valid reasons to support a more compassionate way of dying. I wish to offer a religious defense of the bill, not from the perspective of Judaism, or Islam, or Buddhism, or Hinduism, or any other religious tradition for which I am not qualified to speak. Instead, I offer these thoughts from my own understanding of Christianity. And though I direct my observations primarily to fellow Christians, I respectfully invite others from both a religious or non-religious worldview to join me in examining this issue that is so very universal.
Author Sylvia Shaw with her father, Daniel Binney Montgomery, 95. Montgomery is a retired Eastern Orthodox Church priest and strong supporter of assisted dying.
“Let God.” But do we?
Seven years ago the Catholic Church in Massachusetts launched a vigorous advertising campaign against the bill proposed on the state’s 2012 ballot as Ballot Question 2. It was defeated by a narrow margin.
Many of my Catholic friends disagree with their church’s opposition to the End of Life Options Act. Others argue that we need to let God decide our fate. I respect their desire not to interfere with the Divine. But in our decision-making, do we really step back at all times and ‘let God’?
Most theists believe that we have been given free will—hence, the gift of making choices. If faced with cancer, most of us take action: chemotherapy, radiation, medications—whatever our oncologists suggest. We humans have developed the means for delaying death as the end approaches, often by putting the terminally ill on life support rather than step back and “let God” take them.
At heart, do we fear that death may be the end? What about our avowed belief in the resurrection of the dead and the life of the world to come? Do we Christians truly believe what we recite in the Nicene Creed, or do we merely give lip service to it? If we truly believed in Christ’s promise to the crucified thief—“This very day you will be with me in paradise”—would we still choose to let the dying die in excruciating pain rather than to release them into that new life?
Fellow Christians, let us affirm our faith in Christ and in the afterlife by fearlessly allowing all people of all faiths to choose for themselves how to meet their end. Fellow non-Christians, please encourage our legislators to protect everyone’s right to self-determination in this most personal of all decisions by voting for The End of Life Options Act. It forces no one to act against their conscience while at the same time allowing all to act in accord with their conscience.
(November 2019)
20 Comments.
Sue McKeown
I write as an Anglican (Anglican Church of North America) Christian and a dues-paying member of Democrats for Life. The Christian faith does not require anyone, regardless of religion or lack of religion, to be put on life support near the end of their life if it is not his or her wish. Similarly, it does not require anyone to avail him or herself of every last-ditch effort to stay alive at all costs. Presented with the opportunity for one more clinical trial or a “Hail Mary” (no offense intended) intervention with little chance of success, a patient can say, “No”. There is no prohibition on using increasing doses of pain medication even if that may slow respiration to the point of death if the *primary* reason is to relieve pain, not to hasten death. But that is different than deliberately doing anything to intentionally take his or life prematurely with a lethal dose of physician-prescribed medication.
My dear husband is a relatively young man (nearly 64 years old) who will likely die of complications of frontotemporal degeneration, a form of dementia, within the next five years. I discussed what end-of-life treatment might be morally appropriate for him with one of my priests. He told me that I must never do anything to end his life prematurely (such as discontinue life-saving medication), but I do not necessarily need to do everything to keep him alive at all costs near the end of his life.
He also told me that physician-assisted suicide or medical assisted in dying (take your pick of language) could well become legal in our state, in Ohio, during our lifetime. It is something we must never ask for under any circumstances. Nor can we participate in “suicide/euthanasia” tourism to Switzerland.
So here we have one clergyman’s word against another. God will sort it out in the end.
Ginger Gunter
It’s so much a matter of region with me, I was born with hydrocephalus and neurosurgeons placed two vp shunts in my head at 10 weeks old. At some point my condition could drastically change at any moment. I’d like to think that state and federal government would actually allow me to make my own decisions. Not to mention I also have epileptic seizures as well, as that factors in to the death with dignity as well.
Glenn Jacobs
I am a humanist and I support this merciful act.
Glenn Jacobs
As a humanist I believe one comes to this point from the standpoint of the dignity of human LIFE because the person who takes this option does so as a living sentient being.
Alice James
I have suffered for years, pain level extreme, can’t swallow, etc
Would like a supportive, peaceful way to let go
Lee Fasoli
I agree with your advocacy to allow free choice regardless of religious affiliation. I would take your argument a step further and suggest that members of any one religious affiliation have no right to impose their beliefs upon me. In my interactions with others, I try very hard not to interfere with or question their religious beliefs and consequent actions. But Almost always, the laws of our country are based around the religious beliefs of Christians. I understand and agree with the requirements for our laws to protect people from being taken advantage of, and sometimes to protect the mentally ill from themselves. However, in a classic catch 22, if one decides to take ones on life it is assumed that they must be mentally ill, and not just making a reasoned decision. I keep hoping for greater enlightenment, but I don’t think it’s going to happen in my lifetime!
William Markland
As a Hospice Volunteer I see how end of life issues affect the patient and family, particularly the main caregiver.
I am a humanist, but was once religious. No omniscient “God” of the major religions would “want” end of life to be onerous.
On a pragmatic line of thought, the increasing number of dementia patients, longer life expectations and the financial burdens on State and family, euthanasia will soon become more available.
donna skinner
I totally support Death With Dignity. Bodies become devastatingly ravaged by diabetes, cancer, arthritis, lost vision, and much more. Pain is the victor. Ultimately, overtaken by the indignities of pain and suffering, some people are driven to the edge of a cliff. Just as choosing a long-suffering death is a right, choosing to die sooner and with dignity should also be a right, not a crime. No one has the right to make the decision for someone else, NO ONE. If a prisoner could be made to have cancer, then forced to suffer months or years until he/she died, it would be called cruel and unusual punishment. .
J.
Thank you for pointing that out Lee! Choice is the basis of who we are spiritually. Laws don’t actually stop people from doing what they’re going to do. They only produce consequence. The act is still reality. And if an act ends suffering, why would any kind being want to make that more difficult or undignified or label that act criminal?
Alan Bingham
Se, medical professionals rendering care will take all steps to preserve a person’s life if there is no directive otherwise. Nowadays there is MOLST which defines the end of life care one wants. So while no one is ‘required’ to put themselves on life support, the medical professionals are duty, legally and ethically bound to do so if there is no information to the contrary. This they will do if the patient is unable to communicate for any reason.
Patricia Williams
My feelings exactly ! No one is suggesting requiring anyone to use the right to die option if their religious beliefs preclude it or if they are “ comfortable” and pain free at the end…I just ask that those who ARE in agonizing pain or suffering other symptoms THEY feel are unbearable should be allowed to make THEIR own choices in this supposed “ Land of Freedom”.
Patricia Williams
If you are in agonizing pain at the end of life…Good luck getting the increased doses of opiates/opioids that might quell suffering. Especially in today’s climate of hysteria surrounding pain meds. A friend’s mother is now dying of cancer on hospice …she sobs non stop and screams in pain when touched..hospice says she is receiving the “ maximum” allowed pain meds…They must “ protect themselves” from accusations of over prescribing etc
Victoria Marcello
From a religious standpoint, if we believe the Creator has given us free will, who are we to deny others their free will or right to self-determination? From a secular perspective, one of the universal ethical principles is that of autonomy, ie, respect for individuals’ right to make choices for themselves. We do not have to approve of other people’s choices for themselves; in fact, from a Christian perspective, we should not even be judging them. I certainly hope this bill passes, but it is wrong that it is limited to only respecting the right to choose assisted dying for terminally ill persons. There are many persons who might choose assisted dying but who are sentenced to having to suffer for many years with horrible illnesses or disabilities.
Gerard Walsh
As an individual with severe COPD I have no desire, when the time comes, to die gasping for breath that will not come. As a non-practicing Christian, who believes in God, I do not believe that the God of any formal religion would disapprove of a merciful death at the end of life. It angers me that legislators have the right to determine when I have the right to die. These situation has nothing to do with suicide, but everything to do with morality.
Shirley Miller
As a nurse in my younger days, I was with many people as they struggled through their last days. Some more than others. I grew to fear my own demise, due to the fact that I react badly to many medications. Prior to a colonoscopy, I was given Demerol. The reaction was immediate…non-stop wretching because I had had nothing to eat, and there was nothing to vomit.
This reaction happened after several times when I received pain medication. I am unable to get relief. Knowing this, makes me concerned about my final days should i be in pain or discomfort. I am 85 now and think about this quite often. I had hoped things would be better by now.
Sue McKeown
just my own $.02 worth; take it with a huge grain of salt, which you should. New medications are discovered all the time. How do you know that a new medication won’t be developed that could relieve your pain without your very real side effects? Why live in fear about something that might never happen? And as a very last resort, terminal sedation is always an option. It is a painless death, but not physician-assisted suicide.
My three siblings and I are at double the normal risk of developing Alzheimer’s disease (18% vs. 9%) because our late father died of complications of this dreadful illness. Should we cover in fear because of this increased risk? Why? Now ranging in age from age 59 to age 65, in addition to being at still relatively low risk, our chances are very good that a medication that will, at least, stop the disease at the mild cognitive impairment stage should we develop it at the age our late father did (age 76). That would still allow us to live a relatively normal life. Life should be about looking on the bright side. People who see the glass as half-full, nor half-empty generally lead happier, more fulfilling lives. Not being Pollyanish, nor putting their heads in the sand, but choosing to be optimistic.
Sue McKeown
God has indeed given us free will, but that free will is to do good, and not harm. To ever end one’s life prematurely *is* harn and is never a completely autonomous decision. We must consider those around us. Would our decision to end our life prematurely via physician-assisted suicide or medical assistance in dying (choose your preferred term whether you are con or pro) cause others to give up hope? Would it lead to pressure by family members who want to inherit money that might otherwise be used on long-term care or other expensive medical treatment? Our current Medicare system (much less a very costly Medicare for All scheme) will collapse under its own weight with a flood of aging Baby Boomers without a huge infusion of money, rising premiums, and co-pays for those of us who can and should pay them? Could a societal acceptance of medically hastened death lead to pressure for the old, weak, and disabled (of any age) to “get out of the way” and save medical dollars on the young, strong, and healthy who are more “deserving” of them? That is what we must consider and not our own autonomy.
Nothing in the above, precludes having to go the “extra mile” to preserve life at all costs when death nears. Nor does it mean that one need pursue every last ditch treatment to extend life for only a few months. Develop pancreatic cancer? I’d want Alex Trebek’s phone number and a referral to his treatment team if it were me; he appears to be doing great. You don’t want that, fine. Decline all treatment and opt for palliative and hospice care. But don’t expect people to laud you as heroic for demanding an early exit.
PS. Not singling you out personally. Just the culture that says, *I want it my way and I want it *now*!”
Sue McKeown
Suffering is a part of life. Deal with it. From being bullied and teased as children (not that is right; it must be dealt with), to being dumped by a boyfriend or girlfriend, losing a job, losing a spouse through divorce or death, family dysfunction, sexual assault/abuse, dealing with a serious chronic or terminal illness, violent crime, war…these are all part of a fallen world. No one escapes life without it. If God wanted to wipe suffering off the face of this earth, He could. But He gave us the choice to be kind, compassionate, and generous or to act no better than vile beasts. Euthanazing other human beings to save money would be just another manifestation of our selfishness. We cannot pin that on Him.
Sandra
Well said Gerard I agree with everything you said.
Caitanya Min
Then that hospice is not doing its job and it is uneducated on what hospice is about and what hospice is supposed to do.
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