Introduction
In
this chapter, I will present a variety of views across Christian traditions on the
issues of suicide and assisted suicide.
The chapter concludes with a few resources to those interested in
pursuing the subjects from a Christian perspective and practice in ministry. One of the grave problems with the ‘independent
church’ movement is that such churches lack ecclesiastical guidance and directives
on significant issues. Churches need to have
set in place the wisdom of the Church throughout Church history, not only in Holy
Scripture, when it comes to issues like suicide and euthanasia—issues not directly
addressed in Scripture.
The Orthodox Church: For Example, The Canonical
Orthodox Bishops in the Americas
The Orthodox
Church is comprised of various jurisdictional groups that have some doctrinal
differences. The Ecumenical Patriarch of
Constantinople holds a position of first among equals among the other
jurisdictions. To answer questions on suicide,
the Standing Conference of the Canonical Orthodox Bishops in the Americas
(SCOBA)[1]
produced the following ‘Pastoral Letter on Suicide’ adopted on May 23, 2007 at
St. Vladimir’s Seminary in Crestwood, New York.[2]
A Pastoral
Letter on Suicide
5/23/07
The tragedy of suicide has been a part of the human story from very
early on, and it continues to affect the lives of our faithful today. As
Hierarchs of the Standing Conference of Canonical Orthodox Bishops in the
Americas, we are asked frequently to clarify the Church’s teachings on this
critical issue. Our desire is to offer a pastoral perspective that is
consistent with both the Tradition of our Orthodox Church and our improved
understanding of the medical and psychological factors that might lead one to
take his or her life.
The Sacredness of Life
As Orthodox Christians, we believe that life is a gift from God. The
All-Holy and Life-Giving Trinity created all things and granted life to all
living creatures. Out of His love, God made us, human beings, in His own divine
image and likeness, entrusting us as stewards – not owners – of our lives,
blessing us with the capacity of freedom, and calling us to a life of loving
communion.
Our ancestors’ original rebellion against God was a misuse of
freedom, which ushered in the reality of both spiritual and physical death.
Throughout history, God has acted to redeem the fallen race and to restore the
communion and life that had been forfeited. Indeed, our Lord Jesus Christ
identifies the very purpose of His incarnation and earthly mission with the
gift of life, proclaiming, “I came that they may have life, and have it
abundantly” (John 10:10). Remaining faithful to the Lord’s Gospel, the Orthodox
Church invites all human beings to enter into the living body of Christ, to be
sustained through the life-giving sacraments, and to preserve and perpetuate
both spiritual and physical life.
Suicide and the Orthodox Tradition
While a precise and unproblematic definition of “suicide” is
difficult to articulate, we can say that the type of suicide here being
addressed pertains to the intentional causing of one’s own physical death
through a decisive act. Understood in this way, suicide is regarded generally
within the Orthodox Tradition as a rejection of God’s gift of physical life, a
failure of stewardship, an act of despair, and a transgression of the sixth
commandment, “You shall not kill” (Exodus 20:13).
Historically, the Church was called upon to address the issue of
suicide from the outset. When the Gospel was first being preached,
philosophical and religious teachings prevalent in the Greco-Roman world tended
both to disparage the body and to endorse suicide in circumstances of severe
hardship. The Cynics, Epicureans, Stoics, and Gnostics, for example, all
endorsed voluntary death for reasons consistent with each group’s broader
ethical vision. The early Church’s condemnation of suicide, as reflected in the
teachings of Clement of Alexandria, Lactantius, St. Augustine, and others, thus
served to affirm teachings that were sharply different from those of the
broader culture: the sacredness of each human being, the holiness of our bodies
as Temples of the Holy Spirit, and, especially, the call for each one of us to
maintain faith and hope even in the midst of extreme adversity. While these
core teachings provided a Christian witness to Greco-Roman society, they also
were reflected internally, to the members of the early Church, through the
condemnation of all attempts to hasten one’s entry into the Kingdom by
self-sought martyrdom. Clement of Alexandria, for instance, condemns both
suicide and such martyrdom when he writes, “He who presents himself before the
judgment-seat becomes guilty of his own death. And such is also the case with
him who does not avoid persecution, but out of daring presents himself for
capture. Such a person…becomes an accomplice in the crime of the persecutor” (Stromateis 4.77.1).
Notwithstanding its strong general stance against the moral
permissibility of suicide, the Church, historically, has offered a balanced
teaching on this issue. On the one hand, the Church has maintained the
normative position described above by condemning acts of suicide and by
declining to offer a funeral service and burial to suicide victims. This
dimension of the Church’s teaching has underscored the sacredness of physical
life and the responsibility of human beings to express proper self-love,
gratitude, and hope. This dimension has also served as an intended deterrent
for those suffering suicidal thoughts.
On the other hand, in her wisdom, the Church has acknowledged the
complex etiology and emotionally charged character of a suicide. The corruption
of human nature, brought about by the ancestral sin, carried profound
implications for both the spiritual and physical dimensions of the human
person. While human freedom was not annihilated in the fall, both spiritual
factors, like acedia (spiritual torpor), and physical factors, like depression,
can severely compromise a person’s ability to reason clearly and act freely. In
regard to suicide, the Church has taken very seriously such spiritual and
physical factors, and has responded pastorally by offering a funeral service
and burial to suicide victims whose capacities for judgment and action were
found to be significantly diminished. Thus, Canon 14 of Timothy of Alexandria
states that liturgical services should be offered, “if a man having no control
of himself lays violent hands on himself or hurls himself to destruction.” And
the patristic interpretation of this teaching states that services should be
offered when a suicide victim “is not of sound mind, whether it be as a result
of a demon or of an ailment of some sort.” Question XIV of the 18 Canons of
Timothy, Archbishop of Alexandria. Pedalion,
p. 898.
Suicide and Science
Through advances in science we now have a better understanding of
the relationship between suicide and depression, as well as a more accurate
account of the causes of depression. Depression is an illness caused by both
medical and psychological factors. It is characterized by feelings of marked
worthlessness and hopelessness and is often accompanied by physical changes
such as loss of appetite, weight loss, or in some cases, weight gain. Both
insomnia and hypersomnia are common symptoms.
Current medical knowledge helps us to understand that all
depressions are multi-factorial. Genetic, hormonal, neurochemical,
environmental, and psychological contributions can combine to create a
depressive picture. Furthermore, depression can present as the only expression
of an underlying physical illness such as occult cancers, thyroid dysfunction,
and drug reactions.
Sometimes depressions are very severe and psychotic in nature. These
can be accompanied by delusions, hallucinations, and an altered sense of
reality. In most instances, the depressed person is less impaired. Nonetheless,
in all cases, depression is determined by non-rational psychological and
physical internal events. Even an apparently rational and clear-thinking person
may have his or her outlook and choices strongly affected by those non-rational
internal events.
Pastoral Recommendation
In light of the above theological and scientific reflections, it is
clear that the articulation of a proper Orthodox response to the tragedy of
suicide is both acutely needed and particularly challenging. We are sensitive
to the difficulty of maintaining a balance between the call of every human
person to responsible stewardship of his or her physical life and the call of
the Church to consider how advances in medical knowledge impact Orthodox
pastoral ministry. Conscious of this need for discernment, we offer the
following guidelines for ministering in the wake of a suicide.
First, we must remain mindful that the primary focus of the Church
and its pastoral ministry in cases where a suicide has taken place is on the
living, the family and friends of the deceased. We should maintain a certain
humility while remembering that the state of the suicide victim is and must
remain in the hands of God. Those left behind carry a great burden – of hurt,
guilt, and often shame – with the realization that their loved one has taken
his or her own life. They look to the Church and, especially, to the parish
family, for strength and hope regarding the deceased, and for the support and
love they themselves so urgently need. In addition to their personal pastoral
response, clergy should direct grief-stricken family and friends to crisis
counseling resources in the area, which can complement the healing ministry of
the Church.
Second, as we have studied this issue, it has become clear to us
that far more cases of suicide than have previously been recognized involve
spiritual and/or physiological factors that significantly compromise a person’s
rationality and freedom. While not removing moral culpability from all suicide
cases or changing our general stance against suicide’s moral permissibility, we
affirm the deep relationship between physical and spiritual factors in human
agency and we acknowledge that, in most instances, the complex web of causes
contributing to a suicide lies beyond our full understanding.
Finally, because of the complexity of suicide, both in terms of
determining causes and in terms of ministering to those most affected, the
parish priest should always consult with his diocesan hierarch in order to
discern the proper course of action, the general pastoral recommendation being
that a church burial and memorial services could be granted unless there were
an absence of significantly diminished capacities.
CONCLUSION
In his beautiful description of the Church as the “body of Christ,”
St. Paul writes, “If one member suffers, all suffer together; if one member is
honored, all rejoice together.” (1 Cor 12:26) The suicide of an Orthodox
Christian is a tragedy that is suffered by the entire Church. As hierarchs of
the Orthodox Church, we are acutely mindful of the need to maintain a
perspective on suicide that is consistent with our identity and mission as the
unified body of Christ. We believe that the perspective outlined in this
statement, which reflects our common mind, accomplishes this purpose by drawing
from our Holy Tradition as well as our deepened understanding of suicide’s
causes.
We extend our fervent prayers for the victims of suicide and for all
whose lives and faith have been shaken by the suicide of a loved one.
Furthermore, as Orthodox bishops and members of SCOBA, we affirm that we will
work together rigorously in order both to prevent suicides from occurring and
to provide a unified pastoral response when they do, one characterized by the
faith, hope, and love made possible by God, in Whom “we live and move and have
our being.” (Acts 17:28).
Roman Catholic Catechism:[3]
The
Catholic Church’s ethics is typically framed in terms of natural law and virtue
ethics, stemming from St. Thomas Aquinas.
The 1994 Roman Catholic Catechism represents a change of view on the
subject of suicide. It does not say that
it is a mortal sin and accepts that responsibility for ending one’s life is
diminished in cases of ‘psychological disturbances, anguish, or grave fear of
hardship, suffering, or torture’ (cf. 2282, below). Paragraph 2281 presents a natural law
argument against suicide: we are wired to want to preserve our lives. Natural relationships lay obligations upon us
that we should not sever. The Catechism
says that ‘God can provide the opportunity for salutary repentance’ and that
‘the Church prays for persons who have taken their own lives’ (2283). This is all a far cry from the practice in
times past of not allowing a funeral for a person taking his or her own life
and not allowing burial in the church cemetery.
2280 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 honor 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.
2281 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 neighbor 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.
2282 If suicide is committed with the intention of setting an example,
especially to the young, it also takes on the gravity of scandal. Voluntary
cooperation in suicide is contrary to the moral law. Grave psychological
disturbances, anguish, or grave fear of hardship, suffering, or torture can
diminish the responsibility of the one committing suicide.
2283 We should not despair of the eternal salvation of persons who
have taken their own lives. By ways known to him alone, God can provide the
opportunity for salutary repentance. The Church prays for persons who have
taken their own lives.
Pope John-Paul
II warned of a developing ‘culture of death’ in his 1995 encyclical, Evangelium Vitae.[4] In it, he analyses how the contemporary,
Western world has come to affirm abortion, suicide, and euthanasia. We might note the difference between Roman
culture and this contemporary culture.
Suicide considered a courageous act by one who did what was expected and
necessary did not involve a dignifying of assisted suicide, which would lessen
the heroism of the suicide. In
contemporary culture, suicide is by and large a tragedy, but assisted suicide
is a noble act done to alleviate suffering.
John-Paul II’s
encyclical states that a culture of death
is actively fostered by powerful cultural, economic and political
currents which encourage an idea of society excessively concerned with
efficiency. Looking at the situation from this point of view, it is possible to
speak in a certain sense of a war of the powerful against the weak: a life
which would require greater acceptance, love and care is considered useless, or
held to be an intolerable burden, and is therefore rejected in one way or
another. A person who, because of illness, handicap or, more simply, just by
existing, compromises the well-being or life-style of those who are more
favoured tends to be looked upon as an enemy to be resisted or eliminated. In
this way a kind of "conspiracy against life" is unleashed. This
conspiracy involves not only individuals in their personal, family or group
relationships, but goes far beyond, to the point of damaging and distorting, at
the international level, relations between peoples and States (12).
The encyclical
warns that, alongside the development of technology that attacks human dignity,
a new cultural climate is developing and taking hold, which gives
crimes against life a new and-if possible-even more sinister character, giving
rise to further grave concern: broad sectors of public opinion justify certain
crimes against life in the name of the rights of individual freedom, and on
this basis they claim not only exemption from punishment but even authorization
by the State, so that these things can be done with total freedom and indeed
with the free assistance of health-care systems (4).[5]
This would apply
to government-approved and enabling of assisted suicide, which has only
increased in the West since the encyclical was written decades ago. Thus,
Threats which are no less serious hang over the incurably ill and
the dying. In a social and cultural context which makes it more difficult to
face and accept suffering, the temptation becomes all the greater to resolve
the problem of suffering by eliminating it at the root, by hastening death so
that it occurs at the moment considered most suitable (15).
The culture of
death understands prolonged suffering of the sick, their anguish, discomfort,
and desperation as just cause to end life.
The individual is overwhelmed by his own frailty, while the family is
moved by compassion to end suffering.
These views, combined with those of the death culture that all suffering
is evil and that costs should not be laid upon society as a whole to care for
those who are not self-sufficient, the ‘right’ decision becomes assisted suicide. This culture sees individuals and society as
controlling life and death for ‘malformed babies, the severely handicapped, the
disabled, the elderly, ... and the terminally ill (15). It also insidiously interprets its ‘crimes
against life as legitimate expressions of individual freedom, to be
acknowledged and protected as actual rights’ (18). Thus, the ‘right to life’ is undermined by
this ‘right to choose’ notion of autonomy (freedom and self-sufficiency), which
results in the rejection of the ‘weak and needy, or elderly, or those who have
just been conceived’ (18). Wealthier
countries, with diminishing birth rates, impose on underdeveloped countries
prohibitions against procreation if they are to receive aid (18). This autonomous notion of freedom is heard in
Cain’s question to God after slaying his brother, ‘Am I my brother’s keeper?’
(Genesis 4.9) (19). It is made even
worse in a culture that denies truth and views good and evil as subjective
opinions or selfish interests (19). The
autonomy of individuals from each other becomes an anti-social society:
The State is no longer the "common home" where all can
live together on the basis of principles of fundamental equality, but is
transformed into a tyrant State, which arrogates to itself the right to dispose
of the life of the weakest and most defenceless members, from the unborn child
to the elderly, in the name of a public interest which is really nothing but
the interest of one part’ (20).
This form of
freedom becomes an exercise of power over the weaker in society:
To claim the right to abortion, infanticide and euthanasia, and to
recognize that right in law, means to attribute to human freedom a perverse and
evil significance: that of an absolute power over others and against others.
This is the death of true freedom ... (20).
Beyond
discussion of the meaning of freedom, the culture of death is characterised by
a loss of any sense of God and consequently of what might be held true of man’s
dignity and life (21). Man and the life
he has are mere ‘things’. The life man
possesses as a thing he controls, and it is not revered as a gift from God or
sacred trust (22). A materialistic
culture harms ‘women, children, the sick or suffering, and the elderly’, and
the criterion of personal dignity-which demands respect, generosity
and service-is replaced by the criterion of efficiency, functionality and
usefulness: others are considered not for what they "are", but for
what they "have, do and produce" (23).
Christians, on
the other hand, affirm the dignity of every human being. Often this point is suggested by theologians first
in terms of being created in the image of God, but John-Paul II turns first to
the cross to make the point. The value
of human life is seen in the precious blood of Christ (1 Peter 1.18-19; John
316; 13.1) (25). Later, he turns to the
image of God. Humans are qualitatively
distinct from the rest of the animals in this regard (Genesis 1.26-27; Psalm
8.6) (34-36). John’s Gospel,
furthermore, speaks of Jesus Christ giving eternal life (1.12-13; 3.15; 6.40,
68-69; 8.12; 17.3) (37). Thus, ‘Man's
life comes from God; it is his gift, his image and imprint, a sharing in his
breath of life. God therefore is the sole Lord of this life: man cannot do with
it as he wills’ (38).
Returning to the subject of suicide some sections later, John-Paul
II addresses how we are to approach old age and sickness. He quotes Psalm 116.10: ‘I believed, even when I spoke: I am greatly
afflicted’ (ESV) (46). He discusses
healing, too, and concludes: ‘No one, however, can arbitrarily choose whether
to live or die; the absolute master of such a decision is the Creator alone, in
whom "we live and move and have our being" (Acts 17:28)’ (47). Later, he writes: ‘to kill a human being, in
whom the image of God is present, is a particularly serious sin. Only God is
the master of life!’ (55). He quotes an
earlier declaration on euthanasia in 1980 (57):
Nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. Nor can any authority legitimately recommend or permit such an action.[6]
Having addressed killing human life at its
very beginning—in the womb (58-63)—John Paul II turns to discuss suicide and
assisted suicide (64). He quotes Pope
Pius XII, saying that it is
affirmed that it is licit to relieve pain by narcotics, even when
the result is decreased consciousness and a shortening of life, "if no
other means exist, and if, in the given circumstances, this does not prevent
the carrying out of other religious and moral duties (65).[7]
However, Pius
XII further states,
it is not right to deprive the dying person of consciousness without
a serious reason (Evangelium Vitae
65).[8]
Pope John Paul II continues, ‘Suicide is always as morally objectionable as murder’ (66). He accepts that subjective responsibility might be removed or lessened due to psychological, cultural, or social conditioning, but it is objectively a ‘gravely immoral act’ (66). The further grounds for this claim are that it is a rejection of self-love and of justice and charity to neighbours, communities, and society overall (66). Quoting Augustine (Ep. 204-5), he further states that assisted suicide is never acceptable. A particularly poignant text that he references is Romans 14.7-8: ‘For none of us lives to himself, and none of us dies to himself. 8 For if we live, we live to the Lord, and if we die, we die to the Lord. So then, whether we live or whether we die, we are the Lord’s’ (ESV) (67). Another argument he advances is that suffering can become a source of good, as in Jesus’ death or otherwise (Philippians 3.10; 1 Peter 2.21; Colossians 1.24) (67).
John Paul II notes that the Christian view of suicide and euthanasia faces two opposing views in contemporary society. On the one hand, people claim an absolute freedom of choice while, on the other, they argue for following the dictates of civil law and the public square apart from conscience (69). Both are relativistic arguments (70). However, the State or democracy or the majority view is only good so far as it advances ‘essential and innate human and moral values’ (71).
Noting the
long-held view that God’s eternal law establishes natural law and that any
human laws must not oppose them,[9]
the encyclical states:
Now the first and most immediate application of this teaching
concerns a human law which disregards the fundamental right and source of all
other rights which is the right to life, a right belonging to every individual.
Consequently, laws which legitimize the direct killing of innocent human beings
through abortion or euthanasia are in complete opposition to the inviolable
right to life proper to every individual; they thus deny the equality of everyone
before the law (72).
A state
sanctioned euthanasia unequally sets some people apart from its protection of
every innocent life. Such a law is
established without regard to nature.
The encyclical cites Aquinas:
Every law made
by man can be called a law insofar as it derives from the natural law. But if
it is somehow opposed to the natural law, then it is not really a law but
rather a corruption of the law (Summa
Theologiae I-II, q. 95, a. 2).
Noting instances in Scripture where
God’s people resisted unjust laws, the encyclical avers that, ‘In the case of an intrinsically unjust law, such as a law
permitting abortion or euthanasia, it is therefore never licit to obey it, or
to "take part in a propaganda campaign in favour of such a law, or vote
for it"’ (73).[10] Morally upright people should not take part
in any actions stipulated by an immoral law, such as offering counsel,
preparing, or executing it (74). The
negative law, ‘You shall not kill’ sets a minimal standard for the command to
love others. We are ‘entrusted to one another’
and reflect in our Christian community the Trinity’s mutual self-giving and
receiving (76). Thus,
It is therefore a service of love which we are all committed to ensure to our neighbour, that his or her life may be always defended and promoted, especially when it is weak or threatened. It is not only a personal but a social concern which we must all foster: a concern to make unconditional respect for human life the foundation of a renewed society (77).
This new society we form promotes a culture of life. This entails evangelistic proclamation and witness of the Gospel of life (78-82). We are also called to celebrate this Gospel of life and to do works of charity (83-86). This involves an attitude that one for whom we care is one for whom God has made us responsible (87), and we are to be neighbours to all and help the needy. Charity also
finds the most appropriate means for enabling the elderly,
especially those who can no longer look after themselves, and the terminally
ill to enjoy genuinely humane assistance and to receive an adequate response to
their needs, in particular their anxiety and their loneliness. In these cases
the role of families is indispensable; yet families can receive much help from
social welfare agencies and, if necessary, from recourse to palliative care,
taking advantage of suitable medical and social services available in public
institutions or in the home (88).
No medical practitioner, furthermore, should manipulate life or cause death (89). The family is the community of life and love that has responsibility for its members (92). As Christians, we need to build a culture of life together. This involves forming consciences in regard to the ‘incomparable and inviolable worth of every human life’ (96). Also, life and freedom are united:
These are inseparable goods: where one is violated, the other also
ends up being violated. There is no true freedom where life is not welcomed and
loved; and there is no fullness of life except in freedom. Both realities have
something inherent and specific which links them inextricably: the vocation to
love. Love, as a sincere gift of self, 125 is what gives the life and freedom of the
person their truest meaning (96).
Conscience is further formed in recovery of the link between freedom and truth. The encyclical says,
when freedom is detached from objective truth it becomes impossible
to establish personal rights on a firm rational basis; and the ground is laid
for society to be at the mercy of the unrestrained will of individuals or the
oppressive totalitarianism of public authority (96).
In addition to
the formation of a conscience, education is important. Educating people about the value of human
life is especially important (97). Our
lives include suffering and death. Pope
John Paul II writes, ‘Even pain and suffering have meaning and value when they
are experienced in close connection with love received and given. In this
regard, I have called for the yearly celebration of the World Day of the Sick,
emphasizing "the salvific nature of the offering up of suffering which,
experienced in communion with Christ, belongs to the very essence of the
Redemption" (97).[11]
This encyclical’s call to transform our
culture of death by our Gospel of Life involves valuing people over things
(98). Christians are a ‘people of life
and for life’ (101). This concludes my overview
of the Evangelium Vitae encyclical of
John-Paul II.
Independence of the
individual, enshrined in the value of freedom, is problematic for Christian ethics
that looks not simply at acts but also at character and community. This point is taken up by Monsignor Vincenzo
Paglia, the President of the Pontifical Academy for Life, who brings together
issues of doctrine, freedom, human identity, and accompaniment when discussing
suicide.[12] He stated on 20 April, 2023 at the Perugia
Journalism Festival at Vatican City that that doctrine in general is not like a
package of truths but evolves over time in a dialogue between the Magisterium,
the experience of God’s people, and culture.
He begins with
an understanding of freedom, since
the issue has to do with a person’s choice to end his or her life. Since a person’s identity is in relation to
others, we are responsible towards others in the decisions we make, that is,
the freedom one exercises is not a purely independent freedom. A person must exercise relational and
responsible autonomy, not self-autonomy that disregards culture and concrete
circumstances. When a society turns to
giving individuals their independence to make their own decisions, the
permissibility to make a free decision regarding suicide actually turns to pressuring
people with compromised decision-making capabilities, such as psychiatric
patients, children, and the cognitively impaired elderly.
Paglia’s proposal is to consider accompaniment instead of autonomy in our consideration of suicide. Being with a person at the end of life will, he notes, involve listening to questions and being confronted with existential questions oneself: the meaning of life, suffering, dignity, loneliness, and fear of being abandoned. With better palliative care, requests for suicide decrease. The wider society, he avers, may allow assisted suicide under conditions set by the Constitutional Court’s Sentence 242/2019, which stipulated that life-sustaining treatment must be given except when a person who is capable of making free and conscious decisions faces an irreversible pathology involving intolerable physical or psychological suffering objects. This allowance may be where the Institute is criticised for not simply teaching Catholic doctrine but for becoming more of an interdisciplinary scientific institute for dialogue.[13]
The Lutheran Tradition: For Example, The Lutheran
Church—Missouri Synod
Of the various
Lutheran groups, I have chosen a conservative synod’s perspective. The Lutheran Church—Missouri Synod produced a
document Christian Care at Life’s End
(1973).[14]
The statement
rejects the position that suicide is compassionate, a way of relieving people
of suffering. Rather, ‘Christians aim always to care, never to kill’ (italics
theirs). The statement presents 12
principles (with various case studies) over 25 pages. To quote:
Principle
1: Euthanasia, in its proper sense, is a synonym for mercy killing, which
involves suicide and/or murder. It is, therefore, contrary to God’s Law.
Principle 2: As Creator, God alone knows with certainty whether a
disease or an injury is incurable.
Principle 3: When the God-given powers of the body to sustain its
own life can no longer function and doctors in their professional judgment
conclude that there is no real hope for recovery even with life-support
instruments, a Christian may in good conscience “let nature take its course.”
Principle 4: Administering pain-killing medications, even at the
risk of shortening life, is permissible, since this does not entail the choice
of death as either a means or an end.
Principle 5: It is good ethical procedure for the doctor to request
and receive a statement signed by the patient, if competent to consent, or by
the nearest of kin, agreeing to the uselessness of further “heroic efforts” and
consenting to termination of treatments.
Principle 6: Each person, no matter how infirm and socially useless
he or she may appear to be, deserves to be accepted as a being created in the
image of God.
Principle 7: While suffering is an intrusion into life, it provides
the opportunity for Christian witness and service.
Principle 8: Often the time prior to death is so wrapped in mystery
that no one ought forcibly to interrupt the movement of a man’s spirit as it
may be communicating through God’s Spirit with his Creator and Redeemer by way
of responding in trust and inner yearning.
Principle 9: Death is not merely a physical but a crucial spiritual
event for each person.
Principle 10: Any decisions made in this highly complex area, and
any actions taken that may later appear to have been wrong, have been redeemed
by that forgiveness which is available to all who put their trust in the work
and merits of mankind’s Savior and Redeemer.
Principle
11: The spiritual and moral questions raised by the issue of euthanasia are of
such a nature that their evaluation is an enterprise touching on the very
survival of the basic principles which undergird the integrity of our Christian
faith and the survival of our cultural heritage. They constitute the primary
spiritual and moral crucible of this age. Principle 12: Christians are
obligated to make their position known, by whatever means possible, as a way of
helping to shape public opinion on the question of euthanasia.
The Reformed Tradition: For Examples, The Presbyterian
Church in America and The Reformed Church in America
The Reformed
tradition is represented especially by Presbyterians originating from the
Scottish Reformation and by the Dutch Reformed.
An example of the latter in America is the Reformed Church in America,
which has a position statement by General Synod from 1994 (reaffirmed in 1995,
1996, and 1998) on assisted suicide.[15] It reads:
In 1994, the Commission on Christian Action reported to the
General Synod about physician-assisted suicide. They concluded:
What Christians say about issues of morality ought to be and usually
is a reflection of their fundamental faith convictions. There are at least
three of these convictions that appear especially relevant to the question of
whether it is acceptable for Christians to seek a physician’s assistance in committing
suicide in the midst of extreme suffering.
A fundamental conviction Christians have is that they do not belong
to themselves. Life, despite its circumstances, is a gift from God, and each
individual is its steward ... Contemporary arguments for the “right” to
assistance to commit suicide are based on ideas of each individual’s autonomy
over his or her life. Christians cannot claim such autonomy; Christians
acknowledge that they belong to God…Christians yield their personal autonomy
and accept a special obligation, as the first answer of the Heidelberg
Catechism invites people to confess: ‘I am not my own, but belong—body and
soul, in life and in death—to my faithful Savior, Jesus Christ’ (Heidelberg
Catechism, Q&A 1)… A decision to take one’s own life thus appears to be a
denial that one belongs to God.
A second conviction is that God does not abandon people in times of
suffering …Christians express their faith in God’s love by trusting in God’s
care for them. A decision to end one’s life would appear to be a cessation of
that trust…Suffering calls upon people to trust God even in the valley of the
shadow of death. It calls on people to let God, and not suffering, determine
the agenda of their life and their death.
A third conviction is that in the community of God’s people, caring
for those who are dying is a burden Christians are willing to share. Both
living and dying should occur within a caring community, and in the context of
death, Christian discipleship takes the form of caring for those who are dying.
This is an era when many people find legislating morality a
questionable practice. Should Christians promote legislation which embodies
their conclusions about the morality of physician-assisted suicide?…If
Christians are to be involved in debating laws regulating assisted suicide, it
will be out of a concern for the health and well-being of society…As a society,
there is no common understanding that gives any universal meaning to
“detrimental.” In humility, Christians can simply acknowledge this, and
proceed…to share our own unique perspectives, inviting others to consider them
and the faith that gives them meaning. (MGS 1994: 70-71, 74-75).
The Presbyterian
Church of America (PCA) received a report from the Heroic Measures Committee at
their 16th General Assembly in 1988.[16] The question asked was ‘when is it right to
pursue heroic measures in medical treatment and when is it acceptable or right
to withhold such measures?’[17] Heroic measures are those medical procedures
used to prolong days and, in our technological age, that may do so more but
with significant discomfort and expense.
The committee
suggested consideration of two Biblical principles. First, the purpose of life is to be
weighed. We are to live for fruitful
service to God and others (cf. Philippians 1.19-26). Second, we should not abandon life on account
of suffering. Jesus told Peter that,
when he would be old, he would lose his independence, self-determination, and
mobility, and then, in his death, he would glorify God. He was to follow Christ in all this (John
21.20-21; 1 Peter 2.21). Third, when one
knows that death is inevitable and near, one should face it with realism and
readiness (cf. Genesis 49.1-33; 50.24-26).
Thus, ‘Technological intervention in the
process of dying could very easily undermine important ministerial functions of
the terminally ill in a misguided zeal for prolonging length of days.’
A key question
is whether a heroic measure might bring healing or relieve suffering, or
whether it is one that prolongs dying.
Ineffective or minimally effective treatments should be avoided, as also
those with significant side effects.
One—or a family or any others—should be guided by the rules of Jesus to
do to others as one would do for oneself (Luke 6.31) and to love one’s
neighbour as oneself (Romans 13.9; Galatians 5.14). Yet relief from suffering should not include
intending the death of the person:
Euthanasia,
or "mercy-killing" of a patient by a physician or by anyone else,
including the patient himself (suicide) is murder (III.9).
Medical expense
needs to be considered, such as when the dying person wishes to leave an
inheritance or when the family has no funds for the heroic treatment. Decisions in certain cases need to be made
prayerfully and with the church possibly engaged. The report avers that ‘Our response to babies
and young children in distress is greater than that to older people’, yet it
also states that one life is not more valuable than another’s. Consideration of survivability or health may
be weighed against the age of the suffering person. Another consideration is one’s spiritual
life, and sharing the Gospel with someone yet to receive Christ is more
important than medical treatment. Also,
a dying person may have unfinished business to bring healing to his
relationships.
The report
rejects living wills, which bring the state into decisions that should be made
first by a surviving spouse and second by the family, with the physicians’ and
church elders possibly also consulted.
Medical equipment and processes may be helpful but also might leave one
alone and dying without family present.
If one has an incurable disease, a ‘Do not Resuscitate’ plan is
appropriate. A dying Christian may
prefer a Christian or Christians close to him or her over family. The key point being made here is to give the
dying person personal and wanted presence with those close to him or her. The final section of the report covers
practical ways to be prepared for end of life and medical ‘heroic measures’.
The Anglican Tradition: For Example, The Church of
England
The United
Kingdom has been considering an assisted suicide bill. One thousand and fifty three Anglican clergy
signed an open letter in opposition to the bill on 27 November, 2024. The letter states that ‘the Christian faith
offers a defence of the dignity of life and a call to improve the quality of
life for all those living including those who are dying.’[18] Its arguments include:
·
Bills introduced to ease the
terminally ill are almost always widened to include others: non-terminally ill sufferers (as in Oregon),
the mentally ill (Canada, effective in 2027), children (Belgium). Such widening of the law also means a
broadening of social acceptability of ‘assisted dying’
·
Such legislation puts the
already vulnerable at risk: ‘the elderly, poor, mentally unwell, the long-term
sick, the lonely and isolated’
The letter says
that society must resist a ‘culture of death’ by instead improving the quality
of life for all people. It states:
To reduce the value of human life to physical and mental capacity
and wellbeing has sinister implications for how we as a society view those who
experience severe physical or mental issues, and risks that those undergoing
such suffering come to see their life as of less value than others. Once
legislation is made, society itself risks coming to see these lives as of less
value, too.
Currently,
Anglican canon law states that burial of suicides is a matter under the
bishop’s discretion (Part VI: Ecclesiastical Rites, Principle 79.4).[19]
The Pentecostal Tradition: For Example, The Assemblies
of God:[20]
The Assemblies
of God’s position on assisted suicide begins by noting that, in the United
States, the decision to permit abortion in 1973 had the effect of disvaluing
human life. While some basis for
advocating suicide arises from human reliance on life-sustaining technologies
and pain relief for the dying, the more potent force driving the right-to-die
movement is the devaluing of suffering people.
The statement says that, ‘the Church must (1) proclaim humankind’s
dignity as God’s sovereign creation, (2) reassert God’s authority over life
from conception to death, and (3) affirm meaning and hope for suffering
humanity.’ The dignity or value of human
life is argued from the creation story’s ‘image of God’ over against a
materialist view that finds human life relative and incidental. Also, human life is valuable because Christ
died for us, and by this He has purchased our bodies (1 Corinthians 6.19-20). Murder is condemned (Genesis 9.6; Deuteronomy 5.17),
and suicide is not supported in Scripture.
Furthermore, death is the result of sin, but God gives us victory over
this enemy through Jesus Christ (1 Corinthians 15.55-57). The statement says, ‘Abortion steals from the
womb a life yet to be started; suicide hastens to the grave a life yet to be
completed.’
The next section
of the statement discusses suffering, beginning with Job. For all his suffering, he rejects suicide
(Job 2.7: ‘Curse God and die’) and says instead, ‘I know that my Redeemer lives,
and that in the end he will stand upon the earth. And after my skin has been
destroyed, yet in my flesh I will see God’ (Job 19:25, 26). With reference to Isaiah 53.3-4, the
statement says, ‘Christ identifies with suffering humanity, affirms suffering humanity,
and heals suffering humanity.’ Also
human life is not conditional, and assisted suicide for one reason may open the
door for other reasons, such as the chronically ill, demented, disabled, etc.,
as in fascist Germany. These may be
reasons not only for suicide but also for putting people to death against their
will.
The statement
then offers ways to put these convictions into action. It concludes with a word about how to regard
those who take their own life for psychological reasons:
... one who is clinically depressed or emotionally unbalanced is not
normally regarded as fully responsible. Therefore, questions that deal with
eternal destiny cannot be decided by the survivors. They must be left in the
hands of God who is all knowing, all loving, and forever merciful and just.
Recognizing the limits of human knowledge and the gracious nature of the Lord,
the church can minister effectively in the midst of brokenness and pain.’
The Baptistic Churches: For Example, The Southern
Baptist Convention:[21]
The Southern Baptist
Convention produced resolutions on euthanasia and suicide in 1992, which state:
WHEREAS,
The Bible teaches that God created all human life in His own image and declares
human life to be sacred from conception until death; and
WHEREAS,
Southern Baptists have historically affirmed biblical teaching regarding the
sanctity of human life; and
WHEREAS,
A growing “quality of life” ethic has led to increasing acceptance of
euthanasia and assisted suicide in the United States.
Therefore,
Be it RESOLVED, That we the messengers to the Southern Baptist Convention,
meeting in Indianapolis, Indiana, June 9-11, 1992, affirm the biblical
prohibition against the taking of innocent human life by another person, or
oneself, through euthanasia or assisted suicide; and
Be
it further RESOLVED, That in light of the fact that the end of life may be
painful, we urge scientists and physicians to continue their research into more
effective pain management; and
Be
it further RESOLVED, That we encourage hospitals, nursing care facilities, and
hospices to increase their efforts to keep dying persons as comfortable as possible
and call on Christians to help provide companionship and appropriate physical
and spiritual ministry to persons who are dying; and
Be
it further RESOLVED, That we oppose efforts to designate food and water as
“extraordinary treatment,” and urge that nutrition and hydration continue to be
viewed as compassionate and ordinary medical care and humane treatment; and
Be
it further RESOLVED, That we reject as appropriate any action which, of itself
or by intention, causes a person’s death; and
Be
it finally RESOLVED, That we call upon federal, state, and local governments to
prosecute under the law physicians or others who practice euthanasia or assist
patients to commit suicide.
Some Further Resources
Some further
resources for those ministering to persons in crisis situations and even facing
the question of suicide might be mentioned in conclusion to this overview of
Church positions. Karen Mason addresses
the role that the church might play, given tools at its disposal, in the
prevention, intervention, and ‘postvention’ of suicide.[22] Tools for prevention include: guidance about
a life worth living, teaching people to manage their suffering with practices
of the faith, strengthening people’s moral resolve against suicide and for
life, and delivering life-affirming messages in the life of the church,
including its worship.[23] As the church directly addresses the subject
of suicide, it should also provide ways to help those who need it.
Stephens
Ministry trains ministers in a congregation to ‘provide high-quality,
one-to-one, Christ-centered care in the congregation and the community
experiencing life difficulties’.[24] A Stephen Minister typically has one care
receiver at a time and meets with that person once a week for about an
hour. Such ministers can provide the companionship that might prevent or
identify people at risk of suicide and direct them to others who could bring
help.
Hospice offers bereavement support groups
and may have material dealing with suicide.
In addition to
the more in-depth and focussed study by Karen Mason, further resources for
those helping others in crisis and suicide will be found in:
Kieran Beville, Dying to Kill: A Christian Perspective on
Euthanasia and Assisted Suicide (Christian Publishing House, 2014).
Bill Davis, Departing in Peace: Biblical Decision-Making
at the End of Life (P&R Publishing, 2017).
Wayne Grudem, Christian Ethics: Living a Life that is Pleasing
to God (Wheaton, IL: Crossway, 2024). Chapter 22, Euthanasia. Chapter 23, Suicide.
John H. Hewitt, After Suicide (Louisville, KY:
Westminster/John Knox Press, 1980).
John Hindley, Suffering and Singing: Knowing God’s Love in
the Pain and Despair (10Publishing, 2015).
[This is a reflection on Psalm 44.]
Seymour Perlin, A Handbook for the Study of Suicide (London:
Oxford University Press 1975).
Bruce Ray, Help! My Friend is Suicidal (Shepherd
Press, 2014).
Bruce Ray, Help! Someone I Love Died by Suicide (Shepherd
Press, 2019).
Scott Floyd, Crisis Counseling: A Guide for Pastors and
Professionals (Kregel Ministry, 2008).
Steven R. Tracy
and Celestia G. Tracy, Mending the Soul:
Understanding and Healing Abuse, 2nd ed. (Grand Rapids, MI: Zondervan,
2023).
Also, the Journal of Biblical Counseling is online
and may be of use: CCEF.org.
Christian Concern has a number of articles, videos, testimonies, and key legal cases about suicide and assisted suicide. It also offers the booklet online titled Euthanasia and Assisted Suicide. Go to: CC-Resource-Booklet-Euthanasia-and-Assisted-Suicide-200828.pdf.
[1] This body since 2010 is the Assembly of Canonical Orthodox Bishops
of North and Central America.
[2] Peter Michael Preble, ‘Orthodoxy and Suicide’, Pravmir.com (14 August, 2014); online: Orthodoxy and Suicide (5
February, 2025).
[3] Catechism of the Catholic
Church, 2nd ed. (Libraria Editrice Vaticana, 1994); online: Catechism of the
Catholic Church (accessed 26 December, 2024).
[4] Accessed online: https://www.vatican.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae.html#-3L
(30 January, 2026).
[5] Online: Evangelium
Vitae (25 March 1995) | John Paul II (accessed 30 January, 2025).
[6] 'Congregation for the Doctrine of the Faith, ‘Declaration
on Euthanasia,’ Iura et Bona (5 May 1980), II: AAS 72 (1980),
546.
[7] Pius XII, ‘Address to an International
Group of Physicians’ (24 February 1957), III: AAS 49 (1957),
147; cf. Congregation for the Doctrine of the Faith, ‘Declaration on Euthanasia,’ Iura
et Bona, III: AAS 72 (1980), 547-548.
[8] Ibid.
[9] The encyclical references Thomas Aquinas, but I might note that
this is also the teaching of Cicero in the 1st c. BC (On the Laws). Cf. Cicero, The Nature of the Gods, Divination, Fate, the Republic, Laws, Etc.
(London: W. Clowes and Sons, n.d.); online: https://archive.org/details/treatisesofcicer00ciceuoft/page/n9/mode/2up?view=theater&q=zeno
(accessed 31 May, 2025). Cicero says,
‘nature herself is the foundation of justice’ (Laws XII) or ‘fountain of justice’ (XIII).
[10] The quotation is from Congregation for the Doctrine
of the Faith, Declaration on Procured Abortion (18 November
1974), No. 22: AAS 66 (1974), p. 744.
[11] The reference is to:
‘Letter establishing the World Day
of the Sick (13 May 1992),’ No. 2: Insegnamenti XV, 1 (1992),
1410.
[12] The talk is available through the Pontifical Academy for Life in
Italian. Cf. Paglia
end-of-life statement (accessed 29 May, 2025).
[13] So Elise Ann Allen, ‘Pope appoints controversial Pontifical Academy for Life’s chancellor as new head,’ Catholic Herald (May 29, 2025); online: Pope appoints controversial Pontifical Academy for Life’s chancellor as new head - Catholic Herald (accessed 29 May, 2025).
[14] Available online: LCMS-CTCR-Report-Christian-Care-at-Life-s-End
(2).pdf (accessed 5 February, 2025).
[15] Available online: Statements of General
Synod | Reformed Church in America (accessed 5 February, 2025).
[16] ‘Report of the Heroic Measures Committee Presbyterian Church of
America,’ 16th General Assembly (1988); online: https://pcahistory.org/pca/studies/2-378.html
(accessed 6 February, 2025).
[17] This question is explored by Bill Davis in his Departing in Peace: Biblical Decision-Making at the End of Life (Phillipsburg,
NJ: P&R Publishing, 2017).
[18] Daily Telegraph (27
November, 2024), posted on the Diocese of London’s website at Bishop
of London joins over one thousand clergy to warn of dangers of assisted suicide
legislation | Diocese of London (accessed 4 February, 2025).
[19] The Principles of Canon Law
Common to the Churches of the Anglican Communion, 2nd ed.
(London: The Anglican Consultative Council, 2022); online: Canon
Law 2.indd (accessed 5 February, 2025).
[20]
‘Sanctity of Human Life: Suicide, Physician-Assisted Suicide, and
Euthanasia,’ General Presbytery (August 9-11, 2010); online: Assemblies of God (USA) Official Web
Site | Suicide: Assisted Suicide (Official A/G Position Paper) (accessed 26 December,
2024).
[21] ‘Resolution On Euthanasia And Assisted Suicide’, : online: Resolution On Euthanasia And Assisted Suicide - SBC.net (accessed 25 December, 2024).
[22] Karen
Mason, The Essentials of Suicide
Prevention: A Blueprint for Churches (Eugene, OR: Cascade Books, 2023). Also see her book, Preventing Suicide: A Handbook for Pastors, Chaplains and Pastoral
Counselors (Downers Grove, IL: IVP, 2014); Scott M. Gibson and Karen Mason,
Preaching Hope in Darkness: Help for
Pastors in Addressing Suicide from the Pulpit (Bellingham, WA: Lexham
Press, 2020).
[23] Ibid., p. 4.
[24] For their homepage, see: Stephen Ministries
(accessed 24 January, 2025).
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