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Is It Right to Choose Death?
Psalm 139; Galatians 5:13
Joanna M. Adams
Trinity Presbyterian Church, Atlanta, Georgia
The issues surrounding death and dying are more in the forefront of public consciousness than ever before. Dr. Kevorkian is one reason. His name is in the news with more frequency than that of the secretary of state. To some people he is a hero; in others, he evokes rage and indignation. I suspect that for the majority of Americans, the feeling is more uneasy than anything else, though they would be hardpressed to articulate exactly why the discomfort.1 The other reason that the matter of death and dying is so much in our consciousness has to do with recent rulings by two federal appeals courts, two rulings that overturned state laws prohibiting physician-assisted suicide. In both cases, the judges found constitutional protection for a patient’s decision to ask to have his or her physician end his life. Sooner or later the matter is likely to come before the Supreme Court, and that court’s decision would have a profound, nationwide impact.2 In the meantime, the American public faces every day the complex ethical and emotional dilemmas having to do with death and dying. The patient with a cruel, incurable illness faces it, as does the family that has to watch a loved one languish in pain, as does the physician who is torn between his or her commitment to preserve life and his or her compassion, which longs to relieve suffering. Where do these people turn for guidance? Their own private consciences? The legal system? The medical ethics committee at the hospital? The faith community? Ironically, the latter, the faith community, has been a place where people have seemed to be least comfortable in broaching the subject of death. Life after death is certainly considered to be an appropriate subject here. The church has no more vital reason for being than to articulate the resurrection hope that is ours in Jesus Christ. Pastoral care during a time of illness and death is among the church’s most essential ministries, but questions of when and how we die are rarely addressed. The reasons are manifold, having to do with everything from Paul’s body/spirit duality to the Christian tradition’s tendency to de-emphasize the physical aspects of human existence. Primarily, though, I believe that the reason can be traced to the discomfort and dismay most modern people have, whether they go to church or not, with the whole notion of mortality. If we don’t talk about it, then perhaps it will not happen to us. Besides, why even think about it until one has to? And yet, we deal with death on a regular basis. Is there anyone in this congregation today who has not lost to death someone you loved? Sooner or later, all of us will have to come to grips with our own deaths. Some of us are already dealing with the physical and mental limits imposed by aging. Some are increasingly troubled by their growing need to be dependent on others. Some are caring for ill elderly parents, whose extended stays in nursing homes are bone-wearying and heartbreaking for all concerned. We have so little choice in these matters, and choice is so important here. I recall a family in another church who wanted to honor the choice of their beloved, gravely ill father who wanted not to die in the hospital. They rented a hospital bed and had
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Hospice come in. He died at home. They were there, I was there, when he died. Each had a chance to say “good bye.” The family joined hands around the bed and thanked God for his life. They then adjourned to the kitchen to greet friends at the back door, who were stopping by to express their love and to deliver platters of ham, potato salad, and pound cake. If such a thing can be said, it was a good death. The mixed blessing of modern medicine is that it has the power to change the conditions of our dying and the number of choices we have to make before we die. There are treatment options and procedure options beyond counting. We like that. We like having choices. We Americans especially dislike the notion of not being in control.3 I am Exhibit A in that regard. Think about it. When you are sitting in an airplane on a runway with a few hundred other wilted souls waiting to take off on a busy day at Hartsfield, when you are stuck in a traffic jam on 1-285, you have to have a little talk with yourself to keep from getting really frustrated. We do not like to be in situations in which we cannot make choices. No, not one little bit. This is one reason why modern society has such a hard time with the whole notion of sickness and death, because we cannot stand the thought of illness, mortality, having power over our lives. The thought of losing our autonomy, our dignity, is terrible to us. We want to do something. I was recently involved with a family from another state whom I had met several years ago when I preached and lectured at their church for a week. I got to know them. I had not heard from them in years, and then a call came from the blue. The husband had been told by his doctor that he needed heart surgery, but that he stood virtually no chance of surviving such a procedure. The patient asked for surgery, anyway, but the doctor refused to operate. The man and his wife got in the car, drove to Atlanta, found a doctor who would perform the surgery, and into the operating room he went. He lived. He felt it was his choice. Freedom of choice is very important. “For freedom, Christ has set you free,” Paul wrote. “You were called to freedom; only do not use your freedom as an opportunity for indulgence, but, through love, become stewards of one another.” In the Christian faith, the freedom of the individual cannot be understood apart from responsibility to the community. Consequently, no decision about life and death is ever to be assumed to be an absolutely individual choice. Our choices always have consequences, both personal and social. (Just ask a child who has lost a parent, or a parent who has lost a child, to suicide.) Our choices matter not only to ourselves. They determine what kind of person we are. They affect other people. And collectively, they shape our common life, for good or ill. I have a choice before me today. I can choose to tell you what I think, and what I think you ought to think about these ethically complex matters. Or I can offer you some ways to think through them yourself, using the resources of the Christian tradition. I am going to choose the latter, but I do so aware that we human creatures can, at best, only see through the glass dimly, aware that the spirit of truth is to be found through ongoing moral discourse as well as through the tradition. I am very aware that medical technology now presents us with perplexities heretofore unheard of in the human experience. Nevertheless, here are some thoughts from the tradition. First, the Christian tradition has always considered death to be both a friend and an enemy. An enemy in the sense that it takes away something precious, namely life: the opportunity to create, the opportunity to love and be loved. The opportunity to
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make a contribution. Death rends the fabric of the human family. It is, the scriptures promise, one of those enemies of life that will come to an end when the reign of God is full and complete. “Death will be no more. Mourning and crying and pain will be no more. For the first things will have passed away.” So it is written in Revelation. But as it now stands, death is a necessary component of life. The grass withers. The flower fades. The mountains fall into the sea. Parts of the human body wear out, sooner or later. Modern medicine cannot deliver life without end. Would you want it, anyway? Is your goal to live as long as you can, or as well as you can for as long as you have? “Dust to dust, ashes to ashes,” the scriptures say, and on some level, we are able to accept the finitude of life, if for no other reason than to vacate the earth so that we can make room for the next generation. As Daniel Callahan writes in his brilliant book, The Troubled Dream of Life, “Both science and religion know this to be true: the continuation of life in general requires the particular death of each and every creature that exists.”3 One way to think about it is that our death is our contribution, our sacrifice to the ongoing enterprise that is life. William Paley, the founder of CBS, is said to have asked in anger and frustration on his deathbed, “Why do I have to die?” (as quoted by Callahan). The same reason that everybody has to, sooner or later. It is in the nature of things. The thing that I want to say that grows out of my understanding of the tradition is that a moral distinction has always been made between allowing someone’s life to end, discontinuing treatment, and acting to take a life. Morally, two different things altogether, in the Christian tradition.David Heim, managing editor of the Christian Century, puts it clearly:
Christians have traditionally believed that, in the face of terrible suffering and imminent death, it is legitimate for a patient and doctor to decide not to undertake further treatment which promises only to prolong the suffering. But Christians have rejected the idea that it is legitimate to decide that someone else’s life is so marked by suffering that he should be put to death—even if that is what the patient himself requests. Because one is not obliged to attempt further cure when cure has become impossible does not mean that one may kill someone when cure has become impossible.
Heim goes on to say that “Ethical dilemmas arise, not when we want to do something bad but when we want to do something good: to end suffering, to honor choice.” Heim offers the opinion, from his perspective on the Christian tradition, that in the case of physician-assisted suicide, two out of ten commandments are broken: “Thou shalt not kill,” and “Thou shalt not have any other gods before me.” “No human creature,” he writes, “ought to play the role of God in deciding when a person’s life shall end.” One could argue with Heim that the tradition does allow for killing in certain circumstances – war, for example. One could also say that human agony is as much God’s enemy as it is our own. What do you think about that? As you work out your own salvation and wrestle with decisions involving life and death, I encourage you to hang on to a few basic teachings of the faith: First, that death will not have the last word. God will have the last word.
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Second, no suffering is meaningless. No suffering goes unnoticed in the heart of God. Third, the point of our deepest human anguish is the place where the presence of God is most strongly with us. “Yea, though I walk through the valley of the shadow of death, I will fear no evil, for thou art with me, thy rod and thy staff they comfort me.” Fourth, faith teaches that God alone is worthy of our ultimate respect and reverence, which means that as good as life is, life itself should not be our God. Fifth, faith teaches that freedom is a priceless gift from God, but it also warns against placing ultimate value in the human right to exercise control. Finally, the tradition has always known that the greatest human achievement comes from accepting with courage and dignity whatever life places before us. Paul said it so beautifully: “I have learned in all circumstances to be content. I can do all things through him who strengthens me.” This is the best human condition, the crown of every human life. That we die, we have no control over, but how we handle it, that is the choice that is finally and fully ours. In the main, I have found that people who have lived well are able to die well. No matter how ignominious the circumstances, they have the courage to accept and endure. Even in death, they choose community and completion. I close with words written by the great essayist Michel de Montaigne: “In this last scene between us and death, there is no more pretense. We must use plain words, and display such goodness or purity as we have at the bottom of the pot. If I can, I will keep my death from saying anything that my life has not already said” (as quoted by Callahan). And we, if we can, shall we not wish to do the same?
Notes
1 David Heim, “Being Creatures,” Christian Century (July 17-24, 1996): 709.
2 Ibid.
3 Daniel Callahan, The Troubled Dream of Life (Simon and Schuster, 1993), 16.
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