How Should We Then Die?

Euthanasia makes a lot of sense. At least in our culture at this time, it makes intuitive sense that those who are ill without hope for a cure or those who are in pain without likelihood of relief ought to be able to choose to end their own lives. Our culture assumes there are few higher virtues than autonomy and that an individual’s right to self-government should extend even to matters of life and death. Hence we see the rising acceptance and legalization of euthanasia throughout the West, though it comes in the form of several variations and euphemisms—physician-assisted death, physician assisted-suicide, medical assistance in dying (MAiD), and so on.

Christians, of course, have grave concerns with euthanasia. While we sympathize deeply with those who are ill without hope for a cure and those who are in pain without likelihood of relief, we do not believe that humans have the right to take life—even if that life is their own. It is God alone who has the right to number our days, God alone who has jurisdiction over life and death.

Because euthanasia is on the rise—and an especially precipitous rise here in Canada—we need distinctly Christian responses to it. Ewan Goligher has provided an excellent one in How Should We Then Die?: A Christian Response to Physician-Assisted Suicide. Goligher is an assistant professor of medicine at the University of Toronto and a physician who practices critical-care medicine, specializing in mechanical ventilation. He is, in other words, a man who faces issues of death on a daily basis.

Should doctors help patients end their own life? Is it right and good to cause death (to kill) out of mercy for suffering? Over the last decades, Western society has seen a marked rise in interest and support for the idea that doctors should be allowed (even expected) to facilitate suicide or cause death for their patients under certain conditions. This shift in social values, together with an aging population, means that all of us, whether or not we work in healthcare, will be forced to face this question. Every one of us will eventually face illness, suffering, and death at some point, and we will have to decide whether we would consider seeking and obtaining assistance from a doctor to end our life.

His book is written to help Christians think well about this question. In other words, his book is written to help Christians think distinctly Christianly about whether doctors should help patients end their lives.

He begins by explaining why physician-assisted death has become such a prominent issue and one that is so widely accepted. Having done that, he carefully shows how advocates of euthanasia diminish the intrinsic and innate value of human beings by insisting there are situations in which it is better for people to cease to exist than to continue to exist. “When we say that people matter, we are also saying that it is good that they exist. If people have intrinsic value, then it is always good that they exist. And if we insist that they really matter—that they have deep intrinsic, inherent value—then the cessation of their existence (their death) must always be regarded as a terrible tragedy.” He shows that the acceptance of physician-assisted death depends on a completely different understanding of human life and human worth than any the West has known.

He also shows how euthanasia is an act of secular faith. Euthanasia tends to be offered or accepted where there is the belief that remaining alive is a fate worse than death, and that death is nothing but the absence of life. These claims are said to be grounded in science, yet science cannot prove them, for what comes beyond death is beyond science’s jurisdiction. Hence, lives are ended with faith—secular faith—that what comes beyond death is better than what precedes it. Science may insist that humans have no souls, that we are material and nothing more. But it cannot prove this and therefore cannot prove that souls do not remain when bodies die—a possibility that has terrifying consequences for those whose souls are not prepared for what comes next.

As the book heads toward its close, Goligher addresses the despair of being critically ill and provides a Christian response to it, for he says that Christians “must have something better to offer than death.” And what we can offer is meaning—the kind of meaning that says suffering is not purposeless and not hopeless, but rather a means through which God works his inscrutable will. It is through faith in God that we can pass through suffering with endurance and even with joy. It is through faith that we can escape the despair that so often leads to the conviction that it would be better to just end it all.

For those of us who live in the West, and perhaps especially for those of us who live in Canada (which is leading the charge when it comes to euthanasia), it is becoming increasingly common to know people who have opted to end their own lives. It is also increasingly common for pastors to have to counsel their elderly parishioners away from it and for children to have to plead with their elderly parents not to opt for it. It is widespread and becoming more common, it is accepted and becoming more acceptable. As Christians, we need to be prepared and we need to be able to offer a response. How Should We Then Die? does exactly that and does it well. It prepares and equips us for what is sure to prove one of the defining issues of our time.