Editor’s Note: This essay is paired with another essay which will appear tomorrow. The first is from the context of Canada; the second from the United Kingdom. Both authors are Anglican bishops.
I recently observed the tenth anniversary of my father’s death. He died in October 2014 of a massive stroke. My brother and I, along with our spouses, were able to fly down to be with him and my mom as he lingered in Kerrville, Texas, for a little less than a week. When we arrived, we found him largely unresponsive, though his lips moved when we recited the Lord’s Prayer.
We talked to the doctor about not making any extraordinary efforts at keeping him alive. He had signed a life directive saying he didn’t want any heroic measures taken. But it was a real question for us, about the degree to which his suffering was something we should seek to alleviate by withdrawing the means of life support. We considered the possibility that a hastened death would make it easier on my mom, and then there was the matter of the medical resources he was using that might have been deployed on others with a better prognosis.
And just as we were discussing this, I watched his two sisters fuss over him. One was his bossy older sister, the other a needy younger sister. My dad had a complicated relationship with them growing up and into adulthood, but he had been good to them both. And now it was their turn to be good to him. There one of his sisters stroked his head and read psalms to him. There another sister massaged his bare feet with lotion in what reminded me of a biblical story. And it struck me that here, by virtue of his incapacity, in his discomfort and dependency, my dad was offering a final gift to his family. He was presenting us with a last opportunity to care for him.
My memory of my father’s final hours often comes to mind in the current debate in Canada of what is euphemistically called “medical assistance in dying” (MAiD). I know it is dangerous to frame an ethical approach to voluntary euthanasia through one’s encounter with the suffering and death of others, but is it really possible to discuss this issue in an entirely abstract manner? In my conversations with others, there is very little moral reasoning, but everyone has a story or an imagined scenario in which they are sympathetic to those who want to “die with dignity.” Indeed, in my reading on this subject, nearly every one of the serious works addressing the morality of euthanasia, both pro and con, features firsthand accounts of people contemplating or attempting suicide, and many of them are told quite personally.
In Canada, there are 200 suicide attempts every day. It is the second leading cause of death among our youth. Those most at risk are men and boys, the incarcerated, and those who have lost a close friend or relative to suicide. In the Indigenous, Métis, and Inuit communities, it is often regarded as an epidemic, and is commonly associated with church- and government-run residential schools.
The federal government cites these statistics with alarm, so it seems odd that our courts and lawmakers appeare bent on making suicide readily available to a population that will soon include minors and those with a mental illness. In the “world’s fastest-growing assisted-dying program,” recent studies suggest that MAiD will eventually become a factor in 10 percent of all deaths in Canada.
It is challenging for Christians who want to engage a secular culture in debate on physician-assisted suicide. At the root of our convictions are theological commitments that many outside the church do not share. St. Augustine’s teaching that the taking of one’s life removes the opportunity for repentance, and is ultimately an expression of despair in the mercy of God, can be translated into an appeal not to foreclose the possibility that some good may come in a difficult circumstance. But when he concludes that trials of life “school us for eternity” (City of God, 1.29), this is heard as a fantasy that does nothing to dull pain. Similarly, when Thomas Aquinas explains that suicide violates the commands of love for God and self, the response from an agnostic and self-entitled generation is often derision or even indignation.
Thomas cites another reason why it is wrong to end one’s life prematurely: because of the command to love our neighbor. He writes, “Now every man is part of the community, and so, as such, he belongs to the community. Hence, by killing himself he injures the community” (Summa II.II.64.5). St. Paul declares, “You do not belong to yourselves” (1 Cor. 6:19). Christians understand that we all belong to God, but there is a real sense in which all human beings belong to one another, too.
And this is a generative talking point for those who support physician-assisted suicide. How will sanctioned suicide affect one’s family and friends? What are the consequences for the wider community of which a suffering person is a part? John Donne, who wrote a book on suicide that sought to refute Augustine, also wrote the poem “No Man Is An Island,” which includes the line, “Any man’s death diminishes me, / Because I am involved in mankind.”
Every human being is caught up in a web of interdependence, and we owe our daily survival to relationships ranging from the intimate to the anonymous. It is often said that the protection and care a society offers to the suffering and the vulnerable is a measure of how it values its humanity. Indeed, as Stanley Hauerwas has written about people with disabilities, they “remind us of the insecurity hidden in our false sense of self-possession.”
In one way of thinking, death may be regarded as a solitary event. But this is not the same as saying that one undergoes it alone. Even in their adversity and incapacity, those who suffer have a claim on the compassion of others, a compassion that cannot be given them when they are dead.
The Rt. Rev. Dr. Stephen Andrews is the principal and Helliwell Professor of Biblical Interpretation at Wycliffe College, University of Toronto.