The Theologic Ethics of Euthanasia

The Theologic Ethics of Euthanasia As Easter approached, the contrast of the two pronouncements kept going through my mind: I injected the morphine intravenously...within seconds her breathing slowed to a normal rate. Her eyes closed and her features softened. She seemed restful at last. The older woman stroked the hair of the now-sleeping patient. I waited for the inevitable next effect of depressing the respiratory drive...the breathing slowed...became irregular, then ceased. It's over, Debbie.(1) The strife is o'er, the battle done, the victory o'er death is won. The song of triumph has begun. Hallelujah(2)! Debbie's was one of those epochal cases that seem to engage our whole society in an issue that troubles everyone to the very core of his being. Current practices in Holland and political initiatives in the United States suggest an urgency to debate on euthanasia with implications spanning personal, professional, and legal concerns. How shall we personally meet a good death? How shall physicians act in the face of terminal illness and imminent death? What policy, if any, shall our society promulgate? A Transcendant Ethic The questions of deliberate death and euthanasia present issues that move our reflection beyond the customary modes of ethical analysis. We are no longer faced with the gruesome stipulates of an "ecological ethic" of weeding out the old and the weak. Here also we move beyond the philosophic ethic that speaks of a "right to die," a professional ethic that affirms a "duty to preserve life," and the legal ethic that proscribes acts of medical murder, even if the victim is a pleading patient and the perpetrator a compassionate physician. At times such as this, what is called for is an ethic transcending both reason and convention, an ethic rooted in patient plight and the ultimate ground of being. For here we touch the mysteries of life and death, and face the human impulses of risk, guilt, and sacrifice. In these moments, and "borderline situations," other parameters of ethics do not fit. Yet the radical and "different" ethic required is also traditional, in that its elements are imbedded in particular cultures. The dominant moral ethos in America is Christian, commingled with Judaism and secular humanism. Our religiomoral ethos is anchored in beliefs of radical ethical freedom, the sacred origin and destiny of the human soul, persistent sin, and the drama of suffering, death, and transfiguration as a decisional paradigm for difficult choices. It is grounded in belief in the sacredness of the human being in vitality and in frailty, and in the ultimacy of grace and forgiveness. These convictions should profoundly influence our perspectives on euthanasia. When a situation or moral decision is viewed theologically in this manner, three new ethical perspectives are disclosed. First, when God is acknowledged as the giver, sustainer, and receiver of life, we see and evaluate that life with awe and wonder: responses of quick dispatch or highly principled withdrawal are no longer possible. We also view death as transparent and nonfinal. Though death is feared because life is celebrated, this fear is transformed by belief in the reality of life hereafter. Finally, we are prompted to give "intensive" care and companionship to the dying. What implications does this system of theological ethics hold for the issue of euthanasia? Types of Euthanasia Let us begin with the most easily justifiable class of cases, passive euthanasia, in which death occurs in the course of treating a terminally ill person by forgoing potentially life-prolonging measures. It is not considered obligatory to initiate CPR, antimicrobial therapy, mechanical ventilation, or artificial nutrition and hydration when it is futile or only marginally helpful. Patients are not obliged to accept surgery, organ transplantation, or mechanical organs when hearts or kidneys fail. …