When can we die?

There has been a lot of comment recently about the right to die, highlighted by the recent suicides of Britons in Switzerland, and Debbie Purdy’s campaign for clarity on UK laws about assisted suicide. The writer Terry Pratchett weighed in with a typically passionate and disarming plea for the right to choose when and how he dies, i.e. before his Alzheimer's disease becomes unbearable. I want to refer to him throughout this article as he states powerfully the case for the right to die.

He makes two principle points:

“I live in hope - hope that before the disease in my brain finally wipes it clean, I can jump before I am pushed and drag my evil Nemesis to its doom, like Sherlock Holmes and Moriarty locked in combat as they go over the waterfall. In any case, such thinking bestows a wonderful feeling of power; the enemy might win but it won't triumph.”

“I am certain no one sets out to be cruel, but our treatment of the elderly ill seems to have no philosophy to it.”

Where to start?

What to think, to say, to do? Clearly this is a subject with areas of deep grey, but there must also be black and white truths to identify the grey. So my starting point would be described best by the Bible, “The Lord gave, and the Lord has taken away; blessed be the name of the Lord.” (Job 1:21) Here we find God’s sovereignty both acknowledged and celebrated, despite Job’s acute suffering.

Applying this principle – that God is the giver and taker of life – gets complicated when we consider the possibilities of medical intervention. Setting aside the reality that God heals miraculously today, He has also created us with bodies that can heal and that are comprehensible to us so that we can help them heal. The Bible affirms this, with Paul giving medical advice to his protégé Timothy, and the writer of large portion of the New Testament, Luke, being referred to as “the beloved physician”. This contradicts the tragic foolishness of a couple in America who have been found guilty of killing their sick daughter by praying for her healing and not allowing her to receive medical attention.

Where does it leave us who seek to know God’s will? Uncertain, I should think.

To add yet another factor, I’ve seen that some chronically ill people (the elderly especially) seem to reach a point where the struggle to stay alive seems too much and they are said to ‘choose to go’. I know of one lady currently in such circumstances who has prepared herself and her family for what she knows will come soon. My own grandmother was able to pass on surrounded by her children, a peaceful exit after a long struggle. These are surely instances of God's grace, including medical care. They seem to me to be a privilege, I don’t believe I could demand such an end for myself or a loved one as a right.

Pratchett rages against his illness, as do many others. I turn to Job again, who was encouraged by his wife to curse God because of all his sorrows but refused: "You speak as one of the foolish women would speak. Shall we receive good from God, and shall we not receive evil?” (Job 2:10) It should also be noted, though, that he, in the manner of many of the Psalms, did pour out his agonised and grieving heart to God.

The God-factor
Of course Job and I believe in God, whereas Pratchett does not. Is there any reason to live in suffering if you don’t believe in a Creator and Judge? Self-confessed “angry agnostic” Bryan Appleyard makes a good case, concluding, “Once we accept that our existence belongs wholly to ourselves, then we must also accept that others are not obliged to care for us. That, unquestionably, is the road to hell paved, as ever, with good intentions.”

Legal changes?
In the UK at the present time we find ourselves in a typical legal ‘fudge’. It is illegal to help someone commit suicide but there have been no prosecutions forthcoming from the 115 British assisted suicides that have occurred in Switzerland. The same can be said for our medical communities, where there are varying degrees of ambivalence about whether stopping helping someone to live is the same as helping them to die, and what lies either side of a line of right actions - if indeed such a line can be said to exist. To frame impersonal laws to find a way through such variable circumstances seems fraught with difficulty, though I would again state my preference for the purpose of legislation to be the protection of the vulnerable.

Can any good come from dying?
What about the Christian’s own life and death? Firstly, Job teaches me that it is less mine and more God’s. Secondly, we are called to follow the One who was “obedient to death” (Philippians 2:8). The context of this quotation is Christ’s exemplary humility – seen in His humiliation on the cross. The pressure group who campaign for “patient choice at the end of life” are called Dignity in dying. Christ’s death was not dignified. But it was victorious. This leads me to wonder: if I die slowly, painfully, and embarrassingly, will that not remind me and those around me that I am but a poor creature in this life, marred by sin and dependent on God alone? Might it help me to know Christ in His sufferings (Philippians 3:9-10)? And will not the first step I take in my new, imperishable body (1 Corinthians 15:42-43) feel all the more glorious?

Those are compelling arguments, admittedly stated from my current situation of youthful good health. Nevertheless, my hope for the end of my life is not that I might die without pain, though of course I would prefer that, but Christ. Pratchett wrote of the "power" he would feel if he could choose to die, and the “victory” this would be. There is only way to triumph over death, and that is to be united with the One whom death could not hold…

“Behold! I tell you a mystery. We shall not all sleep [meaning to die before Christ returns], but we shall all be changed, in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we shall be changed. For this perishable body must put on the imperishable, and this mortal body must put on immortality. When the perishable puts on the imperishable, and the mortal puts on immortality, then shall come to pass the saying that is written: ‘Death is swallowed up in victory. O death, where is your victory? O death, where is your sting?’ The sting of death is sin, and the power of sin is the law. But thanks be to God, who gives us the victory through our Lord Jesus Christ. Therefore, my beloved brothers, be steadfast, immovable, always abounding in the word of the Lord, knowing that in the Lord your labour is not in vain.” (1 Corinthians 15:50-58, emphasis mine)