A Christian view of suicide and assisted suicide

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Recently a debate on 'Assisted Dying' took place in Westminster Hall in response to a petition to Parliament (e-petition 653593). The wording of this petition was as follows:

'This petition calls for the Government to allocate Parliamentary time for assisted dying to be fully debated in the House of Commons and to give MPs a vote on the issue. Terminally ill people who are mentally sound and near the end of their lives should not suffer unbearably against their will.

'We believe dying people in the UK should have the option of requesting medical assistance to end their lives with dignity, through a safe and compassionate system with strict eligibility criteria and safeguards. Without this, too many are taking matters into their own hands with tragic consequences. The Daily Express and Dignity in Dying support Dame Esther Rantzen's call for a free vote. The time has come to Give Us Our Last Rights.'

Although the debate did not end with a vote and the current government is neutral on whether there should be a change in the current law on the matter the fact that the debate was held is indicative of the continuing pressure on the UK to follow other jurisdictions such as the Netherlands, Belgium and Canada in legalising the practice of 'assisted dying.'

In thinking about the proposal to legalise 'assisted dying' from a Christian perspective there are two preliminary points that need to be noted.

The first is that the term 'assisted dying' is a misnomer. This is a point that is helpfully made by Nigel Biggar in his book What's Wrong with Rights?. Commenting on the language of 'physician assisted dying' used by the Canadian Supreme Court, Biggar writes that this language:

'....obscures the fact that what is under discussion is the legal permissibility of medical patients being given assistance to bring an end to their suffering by intentionally killing themselves or by having someone else kill them upon request. Intentional self-killing is what we call 'suicide' and intentional killing 'homicide,' because that is what the words literally mean. Whether or not assistance in killing oneself and killing someone else upon request are morally right, they are distinct from assistance in passive dying. Otherwise known as palliative care, that is where a patient is given comfort and pain relief in the process of dying.'

As Biggar further notes:

'It is true that there are cases where palliative treatment can increase the probability of dying, and so has the effect of hastening death. Nevertheless, it is a common place of human experience that we cause things we do not intend. And sometimes at least there is an important moral and legal distinction between effects that we cause intentionally, effects we risk but do not intend, and effects we cause accidentally. It matters whether I intended to kill you, or merely risked your life, or killed you by accident. The presence or absence of intention alone might not finally decide the moral or legal status of my action, but it is nevertheless an important factor. This is obscured by the choice to describe assistance in intentionally killing oneself and being killed upon request as 'assistance in dying.' The question before the court was not simply about the legal permissibility of giving help to the dying, but rather about whether or not to enshrine in law the obligation of healthcare professionals to assist patients to commit suicide or to kill them at their request.'

What Biggar says in these two quotes highlights the fact that we need to abandon the language of legalising 'assisted dying.' Assisting someone to die as painlessly and peacefully as possible is not a crime and never has been (or else the whole hospice movement would have been illegal). What we are talking about is intentionally killing someone. This might be done legally but without their agreement (as happened in Nazi Germany) in which case we are talking about execution (even if, like the Nazis, we talk about euthanasia). Alternatively, it might be done with their agreement, in which case we are talking about suicide, since it is a case of someone requesting help to kill themselves.

Since, fortunately, we have not reached the stage where anyone is arguing for those who are considered unfit to live to be executed (even if they are innocent of any wrongdoing) what we are talking about is legalising the assisting of suicide.

The second preliminary point that needs to be noted is that the argument that is now most used against legalising assisted suicide is the 'slippery slope' argument that it will put pressure on vulnerable people to end their lives when they would not otherwise have done so.

This point is stressed by the disabled actress and disability rights campaigner Liz Carr in her new documentary Better Off Dead in which she argues against a change in the current law. As the BBC news website explains: 'Carr is afraid that changing the law for terminally ill people could eventually result in those who are poor, disabled or mentally ill being allowed to have an assisted death in the UK - or even feeling compelled to do so.'

The actress says the possibility is 'terrifying.'

She points to Canada where the law was changed in 2016 to allow those whose death was 'reasonably foreseeable' to have an assisted death, and then changed again in 2021 to include those with a medical condition who were 'suffering unbearably.'

The article also quotes the words of the palliative care specialist Dr Katherine Sleeman who, it says, 'is concerned for people who may feel they are a burden to their families.'

'Patients will say to me: "I don't want to go to a care home really, but I know my family want me to do it and I know it will be easier for them, so I think I'm going to say yes,"' Dr Sleeman explains.

'Substitute the words "go to a care home" with "have an assisted death" and I think it's a completely different picture.'

The specialist believes no assisted dying law can be completely safe, and that some people who do not really want to die will always 'slip through the net.'

These points made by Carr and Sleeman are very powerful and are supported by the experience of all the countries in which assisted suicide has been legalised, not simply Canada. The evidence suggests that a 'slippery slope' is not only a possibility, but practically inevitable.

However, let's assume, hypothetically, that a law was introduced in this country to legalise assisted suicide but was so framed and enforced that a 'slippery slope' was avoided, and the only people who died were people who truly and freely wanted to die. Would such a law be acceptable from a Christian point of view?

I would argue that the answer still has to be 'no.' This is because suicide as such is morally impermissible, even if it is freely chosen. As the Catechism of the Catholic Church explains, this is because suicide contravenes the love that one ought to have for God as one's creator, for oneself as God's creation and for one's neighbours by breaking the commandment 'Thou shalt not kill' (Exodus 20:13). To quote the Catechism:

'Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honour and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.

'Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbour because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.'

The consequence, argues the Catechism, is that '... an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded' (Para 2277).

The position taken by the Catechism may seem a very hard line, but it is the position that the Christian Church as a whole has taken throughout its history. Thus, Augustine writes in The City of God that 'we take the command "You shall not kill" as applying to human beings, that is, other persons and oneself. For to kill oneself is to kill a human being.' This position also makes good theological sense. God has given our life on this earth as a gift to us and through us to our neighbours. It is not morally right to reject this gift. As the Catechism says, contrary to the modern secular idea that 'my life is my own', this means that our life 'is not ours to dispose of.'

Because assisted suicide must thus be regarded as a breach of the sixth commandment, Christians are under an obligation to refuse to engage in it themselves, and to refuse to help other people to perform it, in the same way that they would refuse to engage in other acts of unjustified killing. In addition, they must do what they can to prevent it taking place, which means not simply declaring that it is wrong, or trying to ensure that it remains illegal, but compassionately helping people tempted to engage in it to understand that it is not necessary because God's command to go on living, however hard it may subjectively seem, is a better alternative. As human beings we are never in a position in which we can rightly second guess God.