I remember when medical-assisted suicide and Death with Dignity laws were first entering public discourse. My family member said over breakfast, “I don’t see the problem with it. If someone is suffering and death is imminent, why make them suffer through it? We don’t even do that to dogs.”
To date, eleven states have passed so-called Death with Dignity laws to legalize assisted suicide. Ten additional states are considering similar legislation in 2024.
In many ways, the United States is following in the footsteps of Canada, the Netherlands, Spain, and Belgium. Along with others, those nations are further down the Death with Dignity legislative path, so Americans can use them to see probable outcomes.
Death with Dignity advocates say they want to prevent people from dying painful and undignified deaths. They want to “empower people with terminal illnesses to have the control they want during the last days of their lives.”
The “Death with Dignity” branding sounds honorable. But is it? How should Christians think about medical aid in dying?
Clear Language Is Essential
Words have power. In Orwell’s book 1984, Orwell described “Big Brother” as controlling what people think by controlling the language they used. Although words are not always used to manipulate others’ actions, they are often used to manipulate others’ emotions.
Euphemisms are purposefully indirect or mild expressions substituted when something might be offensive or unpleasant if stated directly. They make unpalatable realities more palatable.
If you have been in a professional setting, you know people rarely get fired. Instead, they get “transitioned out” or “let go.” Similarly, we don’t typically say someone is unemployed. We say they are “between jobs.”
When someone dies, we often say the person “passed away,” “is no longer with us,” or “went to heaven.”
If “killing a baby in utero” sounds too harsh, we refer to it as “ending a pregnancy” or “having an abortion.” Instead of referring to an unborn baby, we might refer to a fetus when discussing reproductive healthcare (another euphemism), even though fetus means the same thing.
Euphemisms can serve a good purpose. For example, referring to someone’s death as his “passing” makes for a gentler and more respectful presentation of a difficult truth.
On the other hand, euphemisms can make something reprehensible seem so benign that otherwise upright people might give their approval without a second thought.
The first step to a reasonable consideration of “medical aid in dying” and “Death with Dignity” laws is to stop using euphemisms. If describing it in straightforward terms is uncomfortable, we should ask why.
Merriam-Webster defines suicide as “the act or an instance of taking one’s own life voluntarily or intentionally.” Likewise, homicide is “the killing of one human being by another and can refer to a criminal or noncriminal act.”
In some instances, “medical aid in dying” is described as physician-assisted suicide (PAS). In those instances, a physician provides a lethal dose of medicine to a person he knows will ingest them.
In other circumstances, “medical aid in dying” is more accurately described as homicide. In those instances, a physician administers a lethal dose if medicine to someone he knows it will kill. Often, the lethal dose is administered to consenting adults, but that isn’t always the case.
Having dispensed with the euphemisms, one can more accurately assess the ethics of euthanasia and “death with dignity.”
How Does Society Usually View Suicide and Homicide?
If you search “suicide” using an internet search engine, several organizations that work to prevent suicide will be among the top search findings.
In 2023, the U.S. Department of Health and Human Services (HHS) awarded more than $200 million in grants for suicide prevention. The Center for Disease Control (CDC) also makes available many resources for suicide prevention.
The existence of so many resources for suicide prevention suggests that the government and secular society agree that suicide should be prevented.
Similarly, homicide is typically considered a criminal act, although self-defense laws protect some instances of homicide.
In addition to society’s understanding that suicide and homicide should be prevented, physicians take oaths to seek the best interest of their patients. One of the oaths often recited at medical school graduations states, “I will give no drugs for deadly purposes to any person, though it be asked of me.”
A reasonable question to ask is, “If suicide and homicide are wrong and doctors are supposed to do no harm, how could physician-assisted suicide ever be good?” In a nation dedicated to mental health awareness and suicide prevention, why are legislators passing “Death with Dignity” laws?
In recent history, a Michigan doctor was found guilty of assisting terminally ill patients’ suicides and convicted of murder. He received a lengthy prison sentence for his crimes. What changed?
The Slippery Slope
Physician-assisted suicide (PAS) initially aimed to ease the suffering of patients with terminal illnesses. In 2001, the Netherlands was the first nation to legalize PAS.
Since 2001, many nations have passed laws decriminalizing PAS. Many states in the U.S. followed suit.
The specific verbiage of laws governing PAS varies, but most began by reserving PAS for patients experiencing “unbearable suffering from terminal illnesses.” One might wonder who defines unbearable and terminal.
The truth is that everyone has a terminal condition. We call it mortality. Furthermore, everyone experiences suffering. The question of whether a person’s suffering is bearable is subjective.
Of course, the more conservative PAS laws require a person’s death to be imminent (e.g., six months), which differs from typical mortality. However, doctors’ prognoses are often incorrect.
In 2008, specialists said I would die in a matter of days. When that did not happen, they said I would remain in a vegetative state for the rest of my life. Subsequently, they said I would have brain function, but I would be paralyzed, partially blind, and live the rest of my life in an assisted-living facility.
My circumstances improved dramatically after I received those prognoses. I went back to work as a career fireman for ten more years, married a beautiful wife, fathered three sons, moved to Central Asia, learned a second language, earned college degrees, and became a pastor.
I experienced what most would describe as unbearable suffering. I appeared hopeless and undignified, and specialists said I would die within days. The doctors were wrong.
Almost everyone knows of someone who has defied the best physicians’ expectations. With that in mind, is it reasonable to trust their prognoses so much that we preemptively end people’s lives accordingly?
Today, nations are shifting their stance toward PAS. Although all nations initially restricted PAS to people with terminal illnesses, many governments have broadened their legislation to offer PAS to people with mental illnesses because excluding them was considered discriminatory.
In April 2024, a 28-year-old Dutch woman decided to end her mental health struggles when psychiatrists told her, “There is nothing more we can do for you. [Your condition will] never get any better.”
Stef Groenewoud, a healthcare ethicist in the Netherlands, said, “I’m seeing euthanasia as some sort of acceptable option brought to the table by physicians, by psychiatrists, when previously it was the ultimate last resort…. I see the phenomenon, especially in people with psychiatric diseases, and especially young people with psychiatric disorders, where the health care professional seems to give up on them more easily.”
Similar patterns are emerging in Canada, Switzerland, and elsewhere. When Kathrin Mentlerwent to Vancouver General Hospital because she felt depressed, a doctor asked Mentler if she had considered PAS due to the broken healthcare system that prevented her from receiving help promptly.
Many fear that assisted suicide might become a more efficient way for governments to reduce the cost of caring for the terminally ill.
Dignity is Not Affected by Circumstances
The problem with the “Death with Dignity” euphemism is it assumes a person’s physical state determines his dignity. It insinuates that a person’s dignity can be lost if she loses certain faculties.
Does someone with a disability have less dignity than an able person? Is someone less dignified because he needs help using the restroom? Does relying on others to care for her strip a woman of her dignity?
A person’s physical abilities and circumstances do not determine his dignity. However, how one responds to difficult circumstances might. Although a person’s response has no bearing on his intrinsic value, his actions can undoubtedly demonstrate if he has dignity.
“Death with Dignity” (DWD) equates dignity with pride because it implies an undignified death is one that strips a person of his pride. An undignified death is one that requires a person to rely on others as he loses his faculties.
Independence is not synonymous with dignity. Many independent people lack even a shred of dignity. The converse is true of many residents at assisted living residences. Most advocates for DWD would agree.
Since dignity is not at stake in our death’s circumstances, what are DWD advocates seeking? They want to avoid suffering. To do so, they are willing to promote and advocate for things that they would otherwise adamantly oppose – including suicide and homicide.
Dignified Suffering is Valuable
My relative asked why we shouldn’t allow physician-assisted suicide to avert suffering. They argued that we euthanize dogs to prevent suffering, so why not humans? The answer is painfully apparent: Humans and dogs are not the same.
If a dog is terminally sick or injured, there is nothing good that can come from his suffering. That is not true in the lives of humans.
Nabeel Qureshi wrote Seeking Allah Finding Jesus. He was an incredibly gifted author, speaker, and Christian apologist. In his early 30’s, Nabeel was diagnosed with an aggressive form of throat cancer. From the outset, he knew it was terminal.
Following his diagnosis, Nabeel persevered through pain and treatment to continue speaking, writing, and updating his YouTube channel. Meanwhile, the world watched his physical demise as he lost weight, color, and hair. In his last YouTube video, Nabeel was a weak, frail, and bedridden shell of a man.
Nabeel used his final months to publicly stand firm in his faith and proclaim God’s goodness. The acclaimed author and speaker suffered and died in weakness before the eyes of the whole world because he wanted to continue encouraging others even as he suffered.
Nabeel determined he would use his suffering for others’ benefit. He accomplished his goal. No dog in the world could do that.
Despite unbearable suffering and the loss of his strength and independence, Nabeel Qureshi’s death was a perfect picture of dignity.
What if Nabeel had chosen to avoid the suffering and end his life several months in advance? Thousands of people would have been deprived of the encouragement he used his last days to provide. More importantly, his wife, children, parents, and friends would have been deprived of the opportunity to have him near – even in the moments when they had to care for his every need.
PAS would have allowed Nabeel to avoid temporary suffering, but at what cost? It would have come at a cost to those of us who never had the opportunity to meet him but received encouragement from his journey. It would have come at a much higher price for the people who knew and loved him.
No one considers someone dignified who acts for his own interest without considering the pain he causes others. Contrasted with the dignified death he died, PAS would have been a way for Nabeel to die selfishly without regard for the people he claimed to love. To escape his suffering, he would have deprived the people who loved him of all that was left of their time with him. That would have been a genuinely undignified death and a stain on his legacy.
People euthanize terminally ill animals because animal suffering has no redemptive purpose. That isn’t true of human suffering.
Hope for the Hopeless
The Bible does not avoid discussions about mental, physical, or spiritual suffering. It is filled with stories of people who suffered and died – some with dignity and others without.
Christians can take hope amid suffering. Psalm 23:4 says, “Even though I walk through the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.” Aware of God’s unceasing presence in his life, the persecuted and eventual martyr, Paul, asked, “Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword?”
Paul answered his question, “No, in all these things, we are more than conquerors through him who loved us. For I am sure 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.”
Christians need not fear death, pain, or suffering. They are not alone. Their Savior is with them, comforting and sustaining them through every trial and hardship. Therefore, they are never hopeless, and no pain should ever be considered “unbearable.”
James 1:2-4 says God uses suffering to make us spiritually mature and complete. For Christians, God uses suffering as a means of sanctification. For unbelievers, God often uses suffering as a means of drawing them to Jesus.
God has often used seasons of suffering to cause unbelievers to turn to him for eternal life. Circumstances beyond their control or pain too difficult to bear are often catalysts for drawing even the most stubborn heart to Jesus.
If temporary suffering – no matter how painful – can be used to bring someone destined for hell to eternal life, then we would be guilty of the worst kind of hatred to encourage them to avoid that suffering and expedite their death.
Conclusion
In either circumstance, whether for the Christian or unbeliever, suffering has a purpose. Ultimately, a person’s response to suffering determines if that purpose is fulfilled.
Humans do not experience inherently purposeless suffering like animals. Given the proper response, human suffering can accomplish much in the lives of the sufferer and the lives of others.
Jesus said Satan comes to steal, kill, and destroy. Considering Satan’s purpose, Christians should be very skeptical of any cause championing an expedited death.
Although Christians should always have empathy, give support, and show compassion to others who are suffering, they should never allow their emotions to convince them that a premature death is desirable. Instead, they should pray for God to accomplish His good purposes amid suffering.
Considering the meaningful ways in which sufferers can continue contributing to the lives of others, along with God’s ability to use suffering as a means for eternal good, Christians should always oppose Death with Dignity practices and laws.
Reasonable Christianity 
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