Pain suffering and death lie at the heart of the Christian story and for Christians the fundamental question with regards to PAS is what does life in Jesus Christ the one who hang on the cross, suffered and died a not so dignified death enable and require? Identifying with Christ in turn leads to questions of biblical authority and interpretation of Christianity. Jesus does not die a good death since for may a good death comes after many years of a fulfilling life in old age but Jesus dies tragically young, A good death is by way of natural causes but Jesus dies at the hands of people who hate him, a good death is easy and painless but Jesus dies a painful death.
Christians know that since the particulars of Christ death may not necessarily apply to them, the central question has to do with the witness Christ calls them to make and as Christians encounter pain suffering and death in their own lives and the lives of others they need to examine the entire biblical witness which culminates in Christ and the communities’ witness to him. Therefore, being faced with pressure to succumb to proponents of PAS it would be prudent to examine the biblical perspectives of pain, suffering and death in order to draw conclusions on whether PAS is right or wrong from the biblical perspective.
Scripture presents several different strands of thinking about pain, suffering and death and each stand in relation to the other. These stand in some tension which each other but Christian identity rest not in the selection of one or the other but in living faithfully in the tension they create.
There is an account of reported voluntary euthanasia involving King Saul and an Amalekite. The unnamed Amalekite tells King David that he killed Saul at Saul’s request, as Saul was wounded in battle. David’s response is to have the Amalekite killed for touching Gods anointed. If indeed euthanasia and by extension PAS was beneficial, David would have rewarded the Amalekite and not sentenced him to death. The biblical hermeneutics would have several approaches to this passage and its meaning however it sets an attitude of restrain and disapproval against deliberate acts of terminating a life on the basis of “mercy.” Pain, suffering and death is also a consequence the fall and Paul also states the all humanity inherits and continues the history of sin and suffers death though only in Christ , the new Adam, is pain, suffering and death brought to an end . Pain and suffering is also a mystery as seen in the book of Job where he argues he has not sinned and if he had, the pain and suffering are disproportionately great, the psalmist also protest against undeserved pain and suffering he asserts his innocence and demands the God vindicates him, indeed we also see Jesus cry “ my God my God why have you forsaken me?” This cry of anguish can be a faithful act. In demanding the God listen one expresses confidence that God is ultimately present in pain and suffering and the duty of the community is to stand with those who protest and to bear their burden as their own and not to complain it away. Pain, suffering and death is also redemptive as Paul reminds us that suffering can deepen our faith and trials and temptations become opportunities to learn endurance and to refine and purify faith. Ultimately also for the Christian, Christ has proclaimed victory over sin through his suffering, death and resurrection and the Christians encouragement therefore is this process leads to victory over the devil.
In an attempt to apply the teachings of the holy scriptures, the Christian will not fear death and is encouraged to be present to the dying making all attempts to make one’s physical condition as comfortable as possible and will not seek to prolong ones’ dying, proclaiming the new life in Jesus and entrusting the dying to his care. On the other hand, they must remember that God may be acting redemptively either for the dying’s sake or on behalf of others. They will therefore refrain from actions that hasten death and be open to ways that God may be teaching them about trust, love and surrender to God. It is for this reason that traditionally Christians draw a distinction between active euthanasia and allowing one to die. They can support the withholding or withdrawing of treatment when death is imminent and medical intervention cannot reverse the dying process. Though this distinction is imperfect and indeed ethicists have argued that the intent is the same i.e hasten death.
As concerns unrelieved pain and suffering we see Job crying out against the meaningless of the pain and suffering and his protest becomes an act of faith even in his attempt to seek meaning of this pain and suffering. Christians therefore should not despair when pain and suffering is meaningless but the community should instead be present and show solidarity and bear each other’s burdens and support each other as we are enabled e.g. provide adequate healthcare (especially pain control), bring together, inform adequately and empower all parties involved in end of life decisions as well as help parties involved deal with the emotional and spiritual suffering that makes continuing to live difficult. Indeed, this is compassion in action as in its absence euthanasia and PAS becomes an easier choice to take. Compassion is therefore the hallmark of good end of life care.
The challenge to the Christian is to address these bioethical issues to those of different religions, the agnostic as well as the atheists among others. A unique group is the intellectuals whose main contrary world view is that of scientism and the most prevalent antichristian position is privatized therapeutic syncretism.
That practicing scientism avoid the question of eternity and the significance of finitude. They refuse to acknowledge the real implication of life being infinitely insignificant. The question the evangelicals must ask themselves when dealing with those of such a worldview is : Can there be basis of for common discussion and at least common conclusions on bioethical issues? The answer is in the social contract which requires the acceptance of the concept that all human beings are endowed with fundamental worth and have a right to life that cannot be reduced.
The social contract is an agreement for the moment and not for eternity. It therefore depends on persons having biological life and protects the individual from the state and other individuals including corporations. The social contract requires that one be deemed a person: a human being. Utilitarianism acknowledges that for majority to be happy sometimes the individual forgoes his/her happiness. This agrees with the concept of sacrifice in Christianity where the good of the others is placed ahead of ones own good. Such a sacrifice would be judged as morally good in utilitarianism even though it results in pain to the minority.
Through scripture we note that God has nothing against happiness if this happiness is in conformity to His word e,g as depicted in the beatitudes. If the Christian then believes that their desire to be happy is God given then happiness itself can be related to goodness and the Christian will have a point of confluence when the utilitarian refers to happiness as intrinsically good. Christianity postulates that all are equal before God . This agrees with the utilitarian perspective of treating individuals and others with a degree of equality when determining what is morally right or wrong.
Although utilitarianism rejects faith as a sufficient basis for ethics, it does not necessarily leave God out of the picture. Theistic utilitarianism simply argues that we need to understand how God communicates his will to us i.e. God teaches us through our senses. Christian utilitarianism says that proper observation of the world should tell us what God expects from us since the universe is God’s creation. We are created to be happy and the result od doing what God intends is happiness. “If it be true that God desires the happiness of His creatures, and this was his purpose in their creation, utility is not only not a godless doctrine but more profoundly religious that any other.”
Classical utilitarianism is empirical stemming from an understanding that we as human beings desire pleasure and seek to avoid pain and human beings are seen as pleasure/pain organisms and bundles of experiences. In such a view a person has no value to herself or to others except for the satisfaction of experiences. Such a view leaves no room for the Christian understanding of human beings as made in the image of God with intrinsic rights. Our value as people is derived from God, who created us in his own image.
The principle of utility seems to conflict with the teachings of Jesus. Christ invited the believer to join him in suffering, always to place others first, to turn the other cheek and to forgive. He also teaches that real happiness comes through the service of others ;a kind of happiness that cannot be measured or predicted in utilitarian terms.
Utilitarianism does not consider motives and character as important, only the results and consequences. However to the Christian, character and motives(heart) rather than individual acts are key to moral good. To the Christian virtues like love ,joy, peace, kindness, goodness, faithfulness, gentleness and self-control, are the parameters through which right and wrong are assessed.
Finally, utilitarianism assumes that truth comes through our senses and does not need to rely on a source. This is fundamentally in conflict with the Christian view as the latter derives truth from a source revealed to us through the scriptures. Jesus says “ I am the way the and the truth and the life . No one comes to the father except though me.” It is through accepting Christ and walking in Him that the truth in all things is manifest and clearly this point of view is not accepted by utilitarianism as its heavily reliant on faith rather that senses and empirical evidence.
The “right to die” and “dying with dignity” are common slogans for the advancement of a narrative that supports PAS. The mature Christian should use this to shape their involvement and contribution to good end of life care. Faced with aggressive and innovative use of medical technology to sustain biological life often in the name of sanctity of life , the church must protect the right to die with human and Christian dignity cognizant that the meaning of a dignified death is given a deeper meaning than simply the ability die by one’s own choosing but rather, protecting a dignified death means that the dying need to be assured that their lives will not be arbitrarily shortened, that they will not have to suffer needlessly, that they will not be subjected to unreasonable and burdensome therapies, that medical technology will be applied judiciously, that free, informed and quality consent will be respected and that they will not be abused or abandoned by the community in their dying. This then means that excellent palliative care as a counter measure to PAS needs to be pursued more aggressively with the Christian fully engaged.