The pastoral and ethical question of what constitutes a ‘good death’ is a core question of Christian theology. However there is no single answer to this question, and Christian views have changed over time and across different contexts. There are a variety of factors to take into consideration when arriving at a position on the contemporary issue of whether a medically assisted death is compatible with Christian faith.
If you are considering ending your own life, please call a suicide prevention helpline: http://www.suicide.org/international-suicide-hotlines.html
The Biblical Tradition
The biblical tradition takes the experience of death seriously, but offers a perspective on it where death is not seen as an ultimate enemy to be avoided at all costs. Rather, the resurrection of Jesus is seen as God’s defeat of the power of death (Acts 2.24), and the first letter of John speaks of Christian believers having already passed from death to life because of the love they have for one another (1 John 3.14).
Death will be no more; mourning and crying and pain will be no more.
The creation story from the book of Genesis does not offer a picture of a world without death, but rather of a world where death is a friend and not an enemy. The vision of Eden is not of a world rapidly facing over-population and resource-scarcity due to the immortality of the animals and humans that live there; rather it is a vision of a world where death is a part of life, only becoming an enemy to be fought and feared after the idyll of Eden is disrupted by the fall (Genesis 2.17; 3.3-4).
The early church faced the very real possibility of early and horrific death through martyrdom, and it was in the light of this that St Paul maintained a remarkably ambiguous perspective on life and death, commenting that, ‘for me, living is Christ and dying is gain’ (Philippians 1.21). Martyrdom is also in the background to the book of Revelation, which offers its readers a vision of the death of Death, saying ‘Death and Hades gave up the dead that were in them, and … then Death and Hades were thrown into the lake of fire. … Death will be no more; mourning and crying and pain will be no more.’ (Rev. 20.13,14; 21.4). The author of the book of Revelation knew all about suffering and pain and death, but refused to accept that death gets the last word on life.
The Ten Commandments contain the command to not kill another human being (Exodus 20.13; Deuteronomy 5.17), and the Torah also includes an injunction to refrain from killing the innocent (Exodus 23.7), and these pose challenges to any Christian ethical position that affirms positive action to end the life of another human being, including engaging in war or self-defence, or action by a medical practitioner to end the life of a suffering patient without consent.
The question of whether suicide is a sin has received a variety of answers through Christian history. The dominant culture of the ancient world was a system of shame and honour, with death by suicide being seen as an ‘honourable’ death compared to being executed or exiled (e.g. ‘falling on one’s sword’ or drinking hemlock as Socrates did).
There are examples in the Bible where people attempt or succeed in killing themselves (Abimelech in Judges 9:52-54; Samson in Judges 16.28-30; Saul in 1 Samuel 31.4-5; Ahithophel in 2 Samuel 17.23; Zimri in 1 Kings 16.18-19; Judas in Matthew 27:3-5; The Philippian Jailer in Acts 16.27), but there is no clear-cut biblical condemnation of suicide. Rather, as Paul Middleton notes, ‘There is nothing in any of these stories to suggest that the biblical narrators disapprove of the characters’ suicides.’
The tradition of Christian opposition to suicide came to prominence in the writings of Augustine of Hippo (354-430 CE), who interpreted the commandment ‘do not kill’ as applying to killing oneself as well as others. Suicide came to be seen as a sin, with those who took their own life being denied a Christian burial. Suicide was decriminalised in the United Kingdom in 1961, but the language of illegality remains in the popular phraseology that someone ‘committed suicide’: it is preferable to say that someone ‘died by suicide’. It remains a criminal offence for a third party to assist or encourage another to commit suicide. In 1983 the Roman Catholic Church removed suicide from the list of mortal sins, however it remains a ‘grave offence’, with the catechism stating that ‘we are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of’, however the catechism continues by recognising that certain circumstances such as grave psychological disturbance, anguish, or grave fear of hardship or suffering can diminish a person’s responsibility, concluding that ‘we should not despair of the eternal salvation of persons who have taken their own lives’ (Nos. 2280, 2282-83). In 2017 the Church of England amended canon law to allow those who died by suicide to receive a standard burial service.
As with all issues where theological debate and human identity and suffering intersect, this is not a topic that can be discussed in the abstract
Euthanasia or Assisted Dying?
There are important distinctions to be made in terms of the language Christians use to describe different practices. Euthanasia denotes positive action by a doctor to end the life of a patient, and is further divided into ‘Voluntary Euthanasia’ (where someone has requested this), and ‘Involuntary Euthanasia’ (where the decision to end a person’s life is taken without their request, perhaps because of dementia). Christians often object to Euthanasia because it is the active ending of a life, and so could be considered to be condemned by the commandment not to kill. Assisted Dying denotes a patient who is dying and requests assistance in ending their own life at a time and manner of their choosing. In 2021 a bill was introduced to the UK parliament ‘to enable competent adults who are terminally ill to be provided at their request with specified assistance to end their own life’.
How are Christians responding to Assisted Dying?
Some Christians oppose any form of Assisted Dying, either on biblical grounds or because they fear it is ‘the thin end of the wedge’ and once legalised could then open the door to the legalisation of Euthanasia. The Evangelical Alliance have called for Christians to oppose Assisted Dying legislation on the grounds of protecting ‘the inherent dignity of every human being’. CARE (Christian Action, Research and Education) have voiced a concern that people will feel pressured to end their lives to avoid becoming a burden on others, and that the law could be misused to forcibly end the lives of those who are disabled or depressed. Conversely, the Religious Alliance for Dignity in Dying, a group that exists to change the perception that religious people are universally against assisted dying, note that ‘a Populus survey commissioned in 2019 found that 80% of people with faith supported the legalisation of assisted dying for terminally ill adults with mental capacity, whether they would want the choice for themselves or not.’
As with all issues where theological debate and human identity and suffering intersect, this is not a topic that can be discussed in the abstract. People are living with terminal illness, people are facing death with courage and with fear, people are bereaved or about to be bereaved. Christians will reach different conclusions on whether or not they wish to support Assisted Dying legislation, but the Christian gospel of God’s love transcends all such discussions. As Paul said to the church in Rome, who were no strangers to suffering and death:
‘For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.’ (Romans 8.38-39)