Brittany Maynard will die on Saturday by her own choice.
The 29-year-old American is suffering from terminal brain cancer and has become a campaigner for the right to assisted dying. She and her family have moved to Oregon, where it is legal, and she will swallow a prescribed cocktail of lethal drugs. Her decision has divided public opinion and Christians are on both sides. So what are are some of the issues raised by her case, and how should we think them through?
1. Prayer should come first. It's really sad that someone of her age should be facing death at all. The first reaction of Christians should be to pray for her and her family, not to condemn her. This should not be about winning an argument, but respecting a person.
2. Respect for the individual is central.The arguments for and against assisted dying are often polarised, but they are both based on wanting to protect the vulnerable. All too often people who are opposed to it are caricatured as heartless dogmatists who don't care about suffering, while people in favour of it are caricatured as heartless merchants of death. Both have hearts.
3. Leave it to God? Some people argue that Brittany Maynard shouldn't be allowed to choose her time of death because people sometimes get better after being diagnosed with terminal diseases, or because legalising assisted dying puts pressure on people to die who don't want to and it's impossible to protect them from that. Very few people would just argue that it's up to God when we die and we shouldn't take the choice out of his hands.
4. The dignity argument. Other people argue that people should be allowed to choose death when life becomes unendurable because they are in too much pain, they have lost their dignity and there is no hope of recovery. They point to hard cases like that of Tony Nicklinson, who was totally paralysed but unable to die even though he wanted to.
5. The Killing is Kind argument. Some say that it's cruel to keep people alive when they feel their life is done and they genuinely wish it to be over: a common saying is, "If an animal were suffering like that you'd shoot it". The usual answer is, "Yes, but the point is that we aren't animals."
6. The slippery slope argument. Many would argue that assisted dying is a step down a very dangerous path to involuntary euthanasia, where people's lives are terminated without their consent because they are in a persistent vegetative state after an accident, for instance, or because an infant is born with severe disabilities. People who resist assisted dying legislation argue that this is morally wrong.
7. The fear of a 'Culture of death'. Many people are troubled by what they see as the growth of a 'culture of death' in which the old and sick are regarded as disposable. They argue that the right to die inevitably becomes a duty to die when someone sees themselves as a burden to the state or to their family. If someone knows that the inheritance they planned to leave their children is going to be eaten away by expensive nursing home fees, they might choose death even if they could have years of life ahead of them.
8. Palliative care is very effective... Some campaigners say that choosing to die is just unnecessary and what's needed is more investment in helping people manage pain.
9. ...But it isn't the answer to everything. Maybe in rich Western nations it is, but not in most parts of the world. It's easy to lay down rules about assisted dying when you have access to first-world medicine; the problem looks very different when your nearest anaesthetics are 200 miles away.
10. We need to be careful about our motivations: it's possible to think we are talking about relieving someone else's pain, when really we're talking about relieving our own. We can have intense feelings of sympathy for someone who's suffering, and just want them to be out of pain and distress. We also have to cope with the expense and the disruption of someone else's illness, too, which can be exhausting. Death after much suffering can be a relief to the family as well as the one who dies, but it's the person who's ill that matters most.
11. Some suffering can be a blessing... Some would say that the campaign for assisted dying reflects very modern, Western approaches to suffering: you try and fix or escape it rather than seeing it as something to learn from and that helps you to grow. There's a long spiritual tradition which is in danger of being forgotten. Some suffering can be a blessing.
12. ... But not all suffering is a blessing. Some is just destructive. Christians need to be very wary of encouraging people like Brittany Maynard, who are enduring unimaginable pain, to see any good in their suffering. It usually just seems smug and insensitive.
13. Mind your language. People who argue that assisted suicide should not be legal can come across as harsh and judgmental because they don't adequately acknowledge that they are dealing with really hard situations. Everything Christians say on this subject should be said in compassion, with real cases in mind, and preferably by people with real pastoral experience of the issues.
14. The law is a very blunt instrument. One of the slogans in the campaign for assisted dying is that 'It's my right to choose.' But everyone's personal choices will be limited by the responsibilities owed to the weak and vulnerable. Both people who campaign for the right to die and people who oppose it need to honour the motives of their opponents and respect their integrity. And both need to realise that the law won't always get it right.
15. Anyone who thinks this is simple is almost certainly wrong. There are passionate feelings and strong arguments on both sides. Whichever side you're on, your opponents are probably not bad people. Prayer, self-examination and humility are essential in whatever we say or do.
