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ss nucleus - September 2013,  euthanasia - what does the Bible say?

euthanasia - what does the Bible say?

Peter Saunders, CEO of CMF, examines the biblical case against compassionate killing.

Despite huge pressure from lobby groups, and two bills (1) currently under consideration by British parliaments, both euthanasia and assisted suicide remain illegal in the UK. The opposition to legalisation from faith groups, the medical profession and disabled people's advocates has been strong and the key argument (2) that changing the law would open up vulnerable people to exploitation and abuse has so far held sway with politicians. CMF, through the Care Not Killing Alliance, (3) has been strongly outspoken in this arena, in the mass media, Parliament and through medical bodies like the BMA.

It's appropriate, when addressing the issue in a public square occupied largely by people who do not share our faith, to use secular arguments in order to connect with a non-Christian audience, but what does the Bible have to say about the issue? Many Christians are uncertain or confused about this. (4) Can a strong argument be brought against euthanasia from our scriptures? I believe that it can and that all Christian doctors should be able to argue the biblical case. Space does not allow a wider consideration of to what extent Christians should become involved in helping to shape our nation's public policy so I am here concentrating on why it is wrong for Christians to seek, or to administer, euthanasia themselves.

When addressing contemporary ethical issues biblically, we can't simply look up words like 'euthanasia' and 'abortion' in a concordance. But this does not mean that the Bible has nothing to say about them. God's Word enables us to be 'thoroughly equipped for every good work' and he intends us to know and apply his timeless godly principles to all situations (2 Timothy 3:16-17).

There are in fact two instances of voluntary euthanasia in the Bible.

In the first, Abimelek, believing himself to be fatally wounded (with a fractured skull after being hit on the head by a millstone), asks his armour-bearer to kill him. His request is granted and the Israelite leader is thus spared the 'indignity' of being killed by a woman. The death is seen as just retribution for Abimelek's own murder of his seventy brothers, and we are not told what happened, if anything, to the armourbearer (Judges 9:52-55).

In the second, an Amalekite despatches the mortally injured Saul, still alive after a failed attempt at suicide.

'I happened to be on Mount Gilboa', the young man said, 'and there was Saul, leaning on his spear, with the chariots and their drivers in hot pursuit. When he turned around and saw me, he called out to me and I said, "What can I do?"...Then he said to me "Stand here by me and kill me. I'm in the throes of death but I'm still alive." So I stood beside him and killed him because I knew that after he had fallen he could not survive' (2 Samuel 1:6-10).

Whether the story is true (it varies from the account of Saul's death at the end of 1 Samuel 31) or the Amalekite's fabrication in order to win favour in David's eyes for despatching Saul and delivering him the crown, the new king's reaction is interesting.

'Why weren't you afraid to lift your hand to destroy the Lord's anointed?' (2 Samuel 1:14), he asks, and then apparently before receiving a reply, as if the confession in itself were sufficient grounds for a judgment to be made, orders the Amalekite's execution.

In the mind of David at least, the compassionate killing of Saul constituted a capital offence, despite him being in great pain (presumably with peritonitis) and close to death without the possibility of analgesia, and most significantly of all, despite Saul's own request to be killed.

These two cases demonstrate the two main arguments for euthanasia, autonomy ('death with dignity') and compassion ('release from suffering'). But we have to be careful not to derive moral principles solely from narrative passages in Scripture.

The creation narrative tells us that human beings are unique in being made in the image of God (Genesis 1:26) and it is on this basis, after the flood, that God introduces to all humankind the death penalty for murder (Genesis 9:5-6). Human beings, being made in the image of God, are not to be unjustly killed. Note that these are principles given to all humankind. All human beings belong to God (Psalm 24:1) and all human beings are accountable to God and will one day face judgment (Revelation 20:11-15; 21:8; 22:14-15).

The prohibition against killing legally innocent people is later formalised in God's covenant agreement with his chosen people Israel in the sixth of the ten commandments, 'You shall not murder' (Exodus 20:13; Deuteronomy 5:17). But what does this mean? The English language has created for us a confusion that is not present in the original text. There are in fact ten Hebrew words translated 'kill' in the Authorised Version of the Bible, all with different shades of meaning, but only one of them is implicated in the sixth commandment, the word ratsach. Its Greek equivalent is phoneuo and its most accurate translation is murder (NIV). The meaning of the word is further defined in four main passages in the Pentateuch (Exodus 21:12-14; Leviticus 24:17-21; Numbers 35:16-31; Deuteronomy 19:4-13).

These passages resolve any ambiguity for us and leave us with a precise definition of what is prohibited, namely the 'intentional killing of an innocent human being'. Let us consider this in more detail.

First, the sixth commandment forbids intentional killing. Anyone killing another human being unintentionally was able to flee to a city of refuge where he would gain some protection from the 'avenger of blood'. The natural death of the high priest would later atone for the killing and the guilty party would be freed (Numbers 35:28). However this 'manslaughter' provision applied only in very limited circumstances: 'For instance, a man may go into the forest with his neighbour to cut wood, and as he swings his axe to fell a tree, the head may fly off and hit his neighbour and kill him' (Deuteronomy 19:5).

Killing resulting from negligence was not excused as unintentional (Exodus 21:29). Neither was killing 'in hostility' even if not necessarily premeditated (Numbers 35:21).

Second, the commandment forbids the killing of an innocent human being. Under the Old Covenant God authorised or permitted killing in three situations: in the context of holy war, for capital offences and in self-defence (Exodus 22:2). The holy war conditions are clearly spelt out by Moses (Deuteronomy 20:10-18). In cities within the promised land everybody was to be killed, in cities at a distance the men only were to be killed and only if a preliminary offer of peace was not accepted.

There were also over 20 capital offences ranging from murder to contempt of court. In these situations the Israelites had the obligation of carrying out the judicial killing as God's representatives. The self-defence provision only operated if someone who had broken into a house after dark intending to commit a crime was killed by the owner while protecting his family and property.

God only authorised the killing of the guilty. 'Innocent blood' could not be shed intentionally under any circumstances and the shedding of innocent blood is in fact uniformly condemned throughout Scripture (Exodus 23:7; 2 Kings 21:16; Psalms 106:37-38; Jeremiah 19:4).

We must not become confused here with legal, psychological or social definitions of murder. The Bible does not support the conclusions of others that murder is 'the killing of a human being unlawfully with malice aforethought' or killing with 'a feeling of ill-will' or 'illegal killing inimical to the community'. (5) It is rather the intentional killing of an innocent human being.

Euthanasia clearly falls within this biblical definition. There is no provision for killing on grounds of diminished responsibility (on the basis age or illness) and there is no provision for compassionate killing, even at the person's request. Similarly there is no recognition of a 'right to die' as all human life belongs to God (Psalms 24:1). Our lives are not actually our own. Suicide (and therefore assisted suicide) is equally a breach of the sixth commandment. Only God has the authority to take human life and human beings may only do so under God's delegated authority (eg Romans 13:4).

dealing with objections

Loving God means obeying him (John 14:15) and if God commands something clearly then that should be the end of any debate. However, many Christians today are not convinced that euthanasia is wrong in all circumstances.

Those who believe that it can sometimes be justified usually fall into one of two categories - which, for convenience, we shall call antinomians and situationists. Let us consider them in turn.

Antinomians try to dispense with law altogether. They argue correctly that we are saved by God's grace through Jesus' death on the cross and not by good works (Ephesians 2:8-9), but incorrectly assume that therefore our moral behaviour doesn't matter to God. The apostle Paul addresses this misunderstanding with his rhetorical question 'Shall we sin because we are not under law but under grace?' to which he supplies his own answer 'By no means!' He goes on to point out that our freedom from the condemnation of the Old Testament law means that we are no longer 'slaves to sin' but have become 'slaves to God'. As Christians we are both enabled and obliged to obey God's commands (Romans 6:15-18). We are not saved by this obedience - but rather this obedience is part of the evidence of our being saved. The taking of innocent human life, 'murder', is as wrong in the New Testament as it is in the Old (Matthew 5:21-22; Luke 18:20; Romans 13:9-10; Revelation 21:8, 22:14-15).

Situationists claim that in certain situations God's commands may be suspended in favour of the higher principle of 'loving one's neighbour' (Matthew 22:39-40). The situationist argues therefore that a Christian may intentionally kill in certain situations and yet be acting 'in love'. There are two main problems with this. Firstly it clearly contravenes Christ's own teaching that obedience to the greater commandments of the law did not in any way excuse disobedience to the lesser (Matthew 5:17-20, 23:23). In the mind of Christ these 'conflicts of duty' with the law of love simply do not occur. Secondly it begs the question of what a truly 'loving' action is. The practical reality is that right and wrong is simply left up to individual conviction or conscience - a return to the Israelite's error of each doing 'as he sees fit' (Deuteronomy 12:8). This has tremendous dangers. The Bible is quite clear that the commandment 'do not murder' is summed up in the commandment 'love your neighbour as yourself' (Romans 13:8-10). Love does no harm to its neighbour (Romans 13:10) and murder, even for seemingly compassionate motives, constitutes harm.

Of course the danger is that we may fall into the trap of merely becoming legalists. The legalist may be so obsessed with avoiding killing that he goes to the opposite extreme and strives to sustain life at all costs. A tragic consequence can be that the attainable goals of caring, consoling and comforting are forgotten as the Christian doctor, driven more by guilt than compassion, feels he must do everything technologically possible for the patient. The result is that the most important principles of love, justice and mercy are ultimately lost sight of (Matthew 23:23). We need to recognise that there comes a point when death is inevitable and when the burden of treatment outweighs its benefit. It is not euthanasia to withdraw treatment in such circumstances when the intention is simply to make the dying process as comfortable as possible.

Antinomianism, situationism and legalism are all distortions of Christian teaching. We must never intentionally kill our patients. However, we need to recognise that each of these wrong approaches is in part an overreaction to mistakes of the past: antinomianism is a reaction to legalism, situationism to obedience without love in handling hard cases and legalism to lawless indulgence. In rejecting these false 'isms' we need to recognise that the best argument against them is joyful, compassionate and obedient Christian service.

With the patient dying in pain it may seem that we have only two equally undesirable alternatives to choose from - either 'living hell' or the euthanasia needle. In reality there is a third way - the way of the cross. It calls us to walk in the footsteps of Jesus in giving our whole selves to the service of others (Matthew 22:37-40; Mark 8:34; Galatians 6:2, 10; Philippians 2:4-11; 1 John 2:6). This will involve expending our time, money and energy to find compassionate solutions to human suffering and has found practical shape historically in the hospice movement and good palliative care - pioneered in large part by Christian doctors.

But perhaps the most powerful Christian argument against euthanasia is that death is not the end. God created a perfect world that has 'fallen' as a consequence of our rebellion as human beings against God. But God's intervention through Christ's death and resurrection for our sins and on our behalf (Romans 5:8; 1 Corinthians 15:3) means that through the eyes of faith we can look forward to a new world after death with God where there is 'no more death or mourning or crying or pain' (Revelation 21:4). For those, however, who do not know God euthanasia is not a 'merciful release' at all. It may rather be propelling them towards a judgment for which they are unprepared followed by eternal separation from God in hell (Hebrews 9:27; Revelation 20:15). Thus it may be the worst thing we could ever do for them!

Euthanasia is wrong fundamentally because God has said it is wrong - and when, as Christians, we are tempted to consider it, our response needs to be quite simply 'it is written: you shall not murder' (Matthew 4:4, 7, 10). However, as well as being right, God's laws also make good sense. We can therefore argue effectively against the legalisation of euthanasia in a secular forum even when our opponents don't accept that God exists.

  1. Saunders P. Renewed pressure to change the law must be resisted. Triple Helix 2013; 57:5 (Summer)
  4. Saunders P. Situation ethics is alive and well amongst British evangelicals. Christian Medical Comment 13 Jan
  5. Saunders P. Abortion: time to reconsider. JCMF 1994; 40(4): 12-17
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