Assisted suicide legislation

In January, a law legalizing assisted suicide went into effect in Hawaii, making it the seventh state in the United States to allow patients to seek physician assistance in ending their lives under particular circumstances. These laws exist to protect physicians and other medical personnel from prosecution if they write a prescription for a lethal dose of medication for a terminally ill person. This legalized form of assisted suicide is distinct from euthanasia, in which another party acts directly to bring about a person’s death in order to end their suffering. Some activists prefer the term assisted death over assisted suicide, although organizations such as the Campaign for Dignity in Dying argue that there are clear distinctions between the two.

Specifics vary depending upon the state, but in jurisdictions where assisted suicide is legal, patients must meet certain criteria, such as having a terminal illness, proving they’re of sound mind, and voluntarily and repeatedly expressing a wish to die. Patients must also have the physical ability to take a specified, legal dose of drugs themselves, as the drugs cannot be administered by someone else.

In 1999, the prosecution of Michigan physician Dr. Jack Kevorkian, who assisted more than 130 people with suicide and was subsequently charged with murder, brought the issue of assisted suicide into the public sphere. More recently, in 2014, a young woman named Brittany Maynard was diagnosed with brain cancer and advocated for the legalization of assisted death, including penning an opinion piece for CNN on the topic. She ultimately moved from California to Oregon to take advantage of their assisted death legislation.

According to a May 2018 Gallup poll, almost three-quarters of Americans support legalized euthanasia, which allows a doctor to help end a terminally ill patient’s life via painless means. That number remains relatively high among those who attend church services on a monthly basis (69%) but drops significantly among those who attend weekly (37%). The same poll shows that 65% of Americans support doctor-assisted suicide, with the variance falling at 58% among monthly church attendees and 41% among weekly attendees.

Considering that the idea of assisted suicide goes against most mainstream Christian teaching, this broad popularity is startling. Even so, many view a quick, quiet, painless death assisted by medication as a blessing when compared to the challenges of aging and debilitating diseases such as Parkinson’s, ALS, Alzheimer’s or terminal cancer, particularly when the person is faced with almost unbearable pain. In states where assisted suicide is legal, there hasn’t been a particularly noticeable spike in physician-assisted deaths, although some states have reported steady increases. Some patients who are given access to these lethal medications ultimately choose not to take them. In Oregon, where laws have been on the books since 1997, 1,967 prescriptions have been written, with 1,275 patients dying from ingesting those drugs, according to a January 2018 report posted at Oregon.gov. It may be that while people think doctors assisting with death shouldn’t be punished by the law and find comfort in having the option available, fewer desire to go through with this final act regardless of its legality.

Aging and dying in America

As they reach retirement age and beyond, members of the baby boomer generation are beginning to face significant questions about aging and death. Many have cared for their parents at the end of their lives, and that experience, in addition to the natural fear of pain and suffering, has led to an increased desire for control and additional options regarding the final stages of life.

Americans highly value independence, but the aging process often leaves individuals reliant on others to help them perform the most basic tasks like going to the bathroom or getting dressed. Many times, those with a terminal diagnosis express that they “don’t want to be a burden” to their families or loved ones. Furthermore, many express fear about having a stranger in a long-term care facility tasked with their care. The fracturing of our communities and social bonds and the consequent loneliness, especially among the elderly, may also make assisted death more appealing.

Over the years we’ve segregated the aged and the dying away from the rest of society in addition to outsourcing their care to professionals. In turn, our cultural familiarity and proficiency with the process of death have lessened significantly. While an increased focus on the importance of both palliative and hospice care is welcome, neither can fully relieve pain or prevent a difficult death.

Historically, care for the aging and dying took place within the family or community, but as society has become more transient, families are more likely to be geographically distant. Our society also highly values productivity, and as people age and leave the workforce, they can feel useless. When our significance and dignity are tied to what we produce rather than being inherent to our personhood, we can begin to question whether we “deserve” to be alive if we aren’t contributing to society in some concrete way.

The Christian perspective

The Christian tradition has long considered and taught about what makes a “good death.” Within the context of the Black Plague, the Ars Moriendi (“The Art of Dying”) was published in the 15th century, offering advice on a good death. Rather than something to be feared or avoided, the journey toward death offered the dying person a way of growing closer to Christ. A slower dying process was preferred to “dying suddenly and unprepared,” in the words of Protestant reformer Thomas Cranmer’s Great Litany, lest death find someone not in a right state with God.

The vast majority of Christian denominations oppose both assisted death and euthanasia, but even in opposition, it’s hard not to have compassion and sympathy for those in difficult and painful situations where the option seems attractive. No one actively wants to face the suffering of progressive, terminal illnesses or experience the decline of their physical independence or brain function.

While God never desires our suffering, it’s an inevitable part of our human lives. We’re mortal creatures, and we will all face death. Suffering, pain and sorrow can overwhelm us, or we can use them as an insight into the suffering that Jesus faced on our behalf. Though out of favor in many Protestant traditions, the Catholic idea of redemptive suffering — being united with Christ’s suffering in our own — can help us bear our sufferings rather than seeking to avoid them at all costs.

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