May Christian Doctors Help Patients Die If the Law Permits?
00:00:00.000 | A podcast listener named Marna writes in, "Hello Pastor John, I'm a physician in Canada
00:00:10.000 | that would soon face requests from my patients regarding assisted dying for possibly the
00:00:15.760 | elderly, the chronically ill, or for cancer patients.
00:00:20.480 | Legislation would soon be approved.
00:00:22.480 | How do I have such a conversation with patients and family given the fact that it is not God's
00:00:27.440 | perfect will and not Christ or gospel-centered?
00:00:31.200 | What is your view on this, Pastor John?"
00:00:33.720 | You know, the first thing that comes to my mind right now as we're talking, which hadn't
00:00:39.040 | come to mind before as I was thinking about this kind of issue, is that the phrase she
00:00:43.520 | used, "assisted dying," that's a tricky phrase.
00:00:49.720 | Instead of assisted suicide, assisted dying.
00:00:53.200 | Nobody's going to have a problem with assisted dying if assisted dying means, "Give me a
00:00:58.360 | drug please to help the pain not be so great as I'm dying."
00:01:02.840 | So that phrase is one of those slippery, it just kind of galls me that when we invent
00:01:09.080 | phrases that are okay in one sense and not okay in another, and then we use them to talk
00:01:16.240 | about what's not okay and thus muddy the water.
00:01:19.200 | Well anyway, that just came to my mind as I was hearing you ask me the question afresh.
00:01:25.040 | But here I have a whole lot of thoughts about this, and it seems to me we should start with
00:01:30.040 | some clear things and then end with some ambiguous things, because I really, really sympathize
00:01:36.560 | with the ambiguities that doctors especially and family members face in these moments.
00:01:42.340 | But establishing what's clear will help us with the ambiguities, I think.
00:01:47.160 | Number one, it seems clear to me that Christian conviction is the dominant control of the
00:01:55.120 | behavior of a Christian, rather than any laws passed by governments.
00:02:00.680 | We submit to laws as Christians, but not if they contradict clear biblical convictions.
00:02:06.800 | So no law concerning physician-assisted suicide should be the guide for a Christian doctor
00:02:15.360 | in what he or she is willing to do.
00:02:17.640 | That's clear thing number one.
00:02:19.560 | Number two, God wants us to obey him even if we can't see all the good fruit that will
00:02:29.560 | come or that he designs to come from our obedience.
00:02:33.920 | God usually gives some of his reasons for his commands, but leaves many of those reasons
00:02:41.360 | for us to discover long after the act of obedience, even decades or centuries after.
00:02:48.940 | Sometimes God commands us to do something, and only much later do we or the world discover
00:02:56.800 | how many good effects come from obeying God and/or would have come if we had obeyed God.
00:03:04.440 | So that's the second clear thing.
00:03:06.600 | God wants obedience even if we can't see all the good that will come.
00:03:11.280 | Third clear thing is that both Old and New Testament command us not to murder—that
00:03:20.240 | is, not to take the life of an innocent person who doesn't deserve to be put to death.
00:03:25.720 | Romans 13:9, for example.
00:03:28.840 | The Bible underscores this command repeatedly by using various phrases, and one dominant
00:03:35.360 | one is "Don't shed innocent blood," 19 times in the Bible, telling us to cleanse
00:03:43.440 | our land from the shedding of innocent blood, which is a circumlocution of "Don't take
00:03:52.040 | the life of a person who doesn't deserve to have his life taken away."
00:03:56.820 | Number four, the fourth clear thing that it seems to me stands out in this discussion.
00:04:05.900 | Human life, which is distinct from all other earthly life in being created in the image
00:04:11.400 | of God and designed to exist forever, is the gift of God, and He owns it and may do with
00:04:19.980 | it as He pleases, take it any time He pleases, without wronging anyone, and this is His unique
00:04:28.340 | prerogative.
00:04:29.340 | 1 Timothy 6:13, "He gives life to all things," or Deuteronomy 32:39, "See, now I, even
00:04:39.700 | I am He, and there is no God besides Me.
00:04:42.180 | I take life, and I make alive.
00:04:45.860 | I wound, and I heal.
00:04:47.780 | There is none that can deliver out of My hand," or 1 Samuel 2:6, "The Lord takes
00:04:54.740 | life and brings to life.
00:04:57.360 | He brings down to Sheol and raises up," or James 4:15, "Instead, you ought to say,
00:05:03.640 | if the Lord wills, we will live and do this or that."
00:05:08.460 | Now, it seems to me that all those passages from the Bible teach that giving and taking
00:05:16.180 | life is ultimately God's right.
00:05:20.580 | Human life, in its fullest sense, is a miracle that only He can create and only He has the
00:05:28.820 | right to take, unless He has given the state the right to use the sword in various settings
00:05:37.740 | to take life.
00:05:39.360 | But as far as medical things are concerned, I think it is clear God's rights are at
00:05:45.060 | stake here, and we dare not intrude on what He alone has the right to do.
00:05:51.780 | A fifth clear thing is the truth that physicians historically have been life-givers and life-sustainers,
00:06:02.100 | not life-takers.
00:06:03.820 | The Hippocratic Oath that goes back four or five centuries before Christ has guided physicians
00:06:10.420 | for centuries, and it's got a sentence in it like this, "Nor shall any man's entreaty
00:06:17.140 | prevail upon me to administer poison to anyone, neither will I counsel any man to do so.
00:06:25.420 | Moreover, I will give no sort of medicine to any pregnant woman with a view to destroy
00:06:32.460 | the child."
00:06:33.460 | That's the Hippocratic Oath for babies in the womb and old people outside the womb.
00:06:40.660 | And so it's just a clear thing historically.
00:06:43.000 | This is what doctors do.
00:06:44.580 | They've pledged themselves not to use their remarkable gifting to take life.
00:06:51.900 | A sixth clear thing is that suffering, human suffering, is horrible beyond words in some
00:06:59.940 | cases, and it is right and loving for physicians to use whatever medicines they have at their
00:07:06.620 | disposal if the patient wants it, to minimize the pain of their patients.
00:07:12.540 | Nothing I say should be considered to contradict that, and I think it could be shown from Scripture
00:07:18.300 | that the fall of man into all the miseries that we have doesn't justify the refusal
00:07:25.700 | to help men avoid being in pain.
00:07:30.100 | And a seventh truth is that suffering is not viewed in the Bible as the worst thing.
00:07:37.160 | The Bible describes how God often uses it for good and wise and loving purposes, and
00:07:44.060 | therefore suffering never becomes such an evil, so great that it justifies disobedience
00:07:53.540 | to one of the commands of God, like the command not to take innocent life.
00:07:59.140 | So you can see where those, what, seven things lead.
00:08:04.380 | I don't think a Christian physician will use his or her skill to take a person's life or
00:08:11.940 | help someone else take it.
00:08:13.660 | Now here's what remains ambiguous.
00:08:17.820 | The line between taking life and not unduly sustaining life is not always clear.
00:08:26.340 | That's the rub.
00:08:27.340 | Yes, and I am admitting, I am saying that there are times when death should be allowed
00:08:35.480 | to run its course or to arrive naturally without any extraordinary efforts to keep a person
00:08:42.860 | alive.
00:08:45.020 | Clearly death comes to all of us.
00:08:47.340 | The wills that it come, discerning that time is not easy in these modern, remarkably wonderful
00:08:58.740 | medical days in which we live, which have created new possibilities for sustaining life
00:09:04.900 | beyond all ordinary means of life.
00:09:10.260 | And so I'm just admitting great ambiguity here.
00:09:14.100 | The will of the patient to live is one key factor.
00:09:18.860 | Yes, strives to sustain life for a patient who desires life, but the will of a patient
00:09:27.600 | to die is not a decisive word for the simple reason that many patients in the crisis of
00:09:36.480 | depression have attempted suicide, been rescued, and gone on to be thankful for the rest of
00:09:42.900 | their lives that someone contradicted their dark desires at that moment.
00:09:48.940 | And there are other reasons.
00:09:50.180 | So my conclusion is that we do not have the right to help a patient take his own life
00:09:58.140 | or the right to take it ourselves.
00:10:01.560 | The laws that put such things into our hands are bad laws and should not constrain Christian
00:10:08.340 | physicians to act against their convictions, even if they have to lose their job in the
00:10:14.140 | process.
00:10:15.140 | The ambiguities of end-of-life decisions regarding what is fitting life support and what blocks
00:10:23.500 | a timely, natural death, those decisions remain very, very difficult.
00:10:29.980 | Pastor John, thank you for addressing the ambiguities and for holding this unswerving
00:10:35.860 | position on the preciousness of life for so many years.
00:10:39.900 | And Marta, thank you for the excellent question.
00:10:41.780 | These are the tricky pastoral questions that we address on the podcast five times a week.
00:10:45.740 | And for more information and to download our apps and to search our archive of over 800
00:10:50.740 | past episodes, you can find us online at desiringgod.org/askpastorjohn.
00:10:56.340 | Well tomorrow we're going to call Don Carson again, and if he's available, we'll have him
00:10:59.460 | explain the doctrine of creation and how those first two chapters in Genesis correspond to
00:11:05.660 | really everything else in theology.
00:11:07.620 | I'm your host Tony Reinke, and I'll see you tomorrow on the Ask Pastor John podcast.
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