(Editor’s note: Illinois Governor JB Pritzker is considering signing SB 1950, a bill passed Oct. 31 as House Floor Amendment No. 2 to the Sanitary Food Preparation Act by the state senate, that would allow physicians to help terminally ill patients end their lives. If he does, Illinois will join 11 states and the District of Columbia which have similar laws. One week before the Illinois bill was stealthily passed, the SBC’s Ethics and Religious Liberty Commission published this column by Texas pastor Jeremy Bell.)
Jeremy Bell
The Church has been discussing topics like abortion, embryo adoption, in vitro fertilization, and vaccines for many years. However, one area gaining more attention both within culture and the body of Christ is the morality, practice, and legalization of physician-assisted suicide (PAS). The practice for this type of medicalized killing is growing in acceptance by the American people. A Lifeway Research study found that half of Americans believe that it is morally acceptable for a person who is facing a terminal illness to ask a physician for assistance in ending his or her life. The theological, moral, and policy implications of PAS require the Church to enter the conversation.
We should offer viable solutions that hold to our unwavering scriptural convictions while showing Christ-like compassion.
As Christians, we uphold the value and sanctity of all human life while also desiring to show compassion for those who are suffering and experiencing the dying process. Many believers feel a tension between relieving suffering and honoring life. On its face, PAS alleviates pain and suffering, but this practice also stands in direct opposition to the Church’s core beliefs. How does the Church navigate this topic? What biblical parameters inform a Christian’s response? Why does this form of medicalized killing seem to be gaining traction nationally and globally? This article will summarize what PAS is, the underlying reason for its growing popularity and legalization, and the core doctrines that should shape our response.
What is physician-assisted suicide?
Physician-assisted suicide is a precise form of medical killing which consists of three moral agents. The first moral agent is the patient. The patient requests and procures the medical means to kill themselves. Currently, in all the states where PAS legislation has been legalized, these state laws require patients to ingest lethal amounts of medicine to hasten their death (see Oregon’s Death with Dignity Act).
The second moral agent is the patient’s physician. They ensure that a terminally ill prognosis of 6 months or less to live has been met, the patient makes a voluntary request, and they write the prescription. State legislations allow for conscientious objectors to opt out of such practices.
The third moral agent is a pharmacist. These doctors fulfill the prescription—again, only those who are not conscientiously against it.
The term “physician-assisted suicide” can be misleading because the patient uses medical personnel to hasten their own deaths. The physician does not assist by making them ingest a lethal amount of medicine, nor are they required to be present when the act is committed.
Physician-assisted suicide remains the primary legal means for hastening death in some U.S. states. The current states that have some form of PAS legislation are Oregon, California, Delaware, Washington, Hawaii, Vermont, Colorado, New Jersey, Maine, Montana, New Mexico, and the District of Columbia. Since this form of medicalized killing has been legalized in certain parts of the country, it is important for the Church to have a clear understanding of what PAS entails in practice and the law.
Why is PAS gaining traction?
The reasons surrounding why people choose to or advocate for this form of medicalized killing are many and complex. Some fear prolonged suffering. Others wonder if pain management techniques will be sufficient as their illness progresses. Many patients would like to prevent becoming a burden to their families as they experience the dying process or the possible medical bills that accumulate from prolonged care. No matter the “why,” the underlying concept that drives this form of medicalized killing is autonomy.
American culture affirms autonomy as a moral absolute and one of the highest moral goods. Within the practice of PAS and its associated legislation, autonomy demands that I have the right to choose my own death on my terms.
The Church should be aware that PAS legislation affirms autonomy as a universal norm, but this is a cultural and biblical misconception. Humanity’s fallen condition makes people think they are in total control over their lives, but the Bible paints a different reality. God, in his sovereignty, has allowed human beings some autonomy, but only in submission to his rule and created order.
Even American law limits some human freedoms for the flourishing and safety of society—e.g., speed limits, teen suicide prevention programs, and the consumption of illegal narcotics. To put it another way, Americans do have freedom, but it is a freedom granted and governed for the social good of ourselves and others. Both the sovereignty of God and human law require parameters for an individual’s autonomy. PAS legislation and acceptance deny the restraining conditions for the autonomy of all individuals involved in this killing act.
When ministry leaders engage with this topic, they must be aware of the individualistic governance that drives PAS legislation and practice. Christians surrender their autonomy to follow Jesus (cf. Matt. 16:24; Rom. 6:4). Culture requires its citizens to surrender their autonomy in situations that harm the fabric of society and order. Why is PAS legislation—and those who advocate for it—not held to the same standards?
The Church should acknowledge the inconsistencies of such thinking and provide a better way forward. Therefore, I would like to offer some core doctrines that might shape our response to PAS.
- The Church must remain compassionate and loving to those who are irretrievably dying, suffering, and in pain. We know from Genesis 3 that these are inevitable realities of living in a fallen world. So, we should weep for and with people and their families. We should sympathize with them if we have experienced these scenarios ourselves. Like Jesus, God gave us emotions to feel deeply for people. Yes, the Church theologically affirms the immoral nature and practice of PAS, but ought to handle this topic with Christ-like compassion while holding firm to our convictions.
- The Church historically has rightly acknowledged that every person from the moment of fertilization until death exists as an image-bearer (cf. Gen. 1:27). [This is] something the Baptist Faith & Message explicitly affirms (Art. III.) The Bible forbids murder, which includes practices of self-murder like PAS. The Word of God consistently portrays suicide negatively (cf. Judg. 9:52–54; 1 Sam. 31:3–5; 2 Sam. 17:23; 1 Kgs. 16:18–19; and Matt. 27:3–5).The Church should be aware that there is a difference between suicide and sacrifice. The former has selfish motives attached to it, while the latter exists as a selfless act. The people of God must maintain a proper balance between compassion for human pain and suffering and biblical conviction. Compassion does not lead to affirmation of PAS, but rather causes us to love people made in God’s image by caring for them well at the end of life.
- Believers can walk through this phase of life knowing Jesus is walking alongside them. Jesus promised, “Behold, I am with you always, even to the end of the age” (Matt. 28:20). Jesus has firsthand experience with suffering because he went to a cross to pay for our sins. He knows what those at the end of life are experiencing. Yet, he grants us peace that surpasses all understanding and unspeakable joy at the end of life (Phil. 4:7, 13).
- Human beings were created to enjoy community and not walk through the various seasons of life alone (Gen. 2:18). Physician-assisted suicide typically occurs in isolation. Think about the fear and anxiety one may experience as they prepare to ingest lethal amounts of prescribed medicine to kill themselves. God’s common grace allows people to walk through life with others. This time can be a strengthening moment for those who are irretrievably dying and those who will grieve their passing. Medical killing for hastening death denies people of opportune moments where reconciliation, hope, grief, and sharing the gospel can take place.
- The Church must become more involved when people transition from cure to care. We must seek to improve and fund things like hospice care. We should consider broadening its scope by including things like counseling, community, gospel-centered outreach, and adequate pain management. This shows compassion while simultaneously upholding the sanctity of life, and would help create a culture of valuing life instead of submitting to the hastening of death through PAS.
Conclusion
Physician-assisted suicide is being increasingly viewed as a morally and legally acceptable practice both nationally and globally. The Church has an opportunity to enter that conversation and provide the true counternarrative. In other words, we believe PAS does not affirm life but wrongfully takes it. We should offer viable solutions that hold to our unwavering scriptural convictions while showing Christ-like compassion within the biblical boundaries of upholding the worth and dignity of all human beings. God has placed his people in areas of influence to promote the sanctity of life ethic, which means our advocacy should include the moment of conception to natural death and all the life stages in between.
Jeremy Bell is pastor of First Baptist Church of Holland, Texas. He writes frequently on issues related to faith and ethics.