In Canadian society, the role of physician-assisted suicide (PAS)* continues to grow. Federal legislation was passed in 2016 to legalize PAS in accordance with the Supreme Court decision in 2015 in Carter v. Canada. Recently, the Council of Canadian Academies has presented a report to the government to further examine PAS in minors, those with solely mental illnesses, and the role of advance directives. The question of death is one that every person must face, and Christians must be prepared to think deeply about this issue and how to engage it. Suicide is an active, intentional means to ending one’s own life. This act harms one who is made in the image of God and disregards his right over life and death. The accounts of those who commit suicide in the Bible, like Saul (1 Samuel 31:4-6) and Judas (Matthew 27:3-5), are largely negative. Christians generally understand that suicide is wrong, but our society has an entirely different approach to death. We must understand the secular worldview to engage the contemporary problem of PAS.
Why is PAS gaining ground in Canadian society?
We live today in the wake of the existential philosophers who placed the primacy of life’s value on personal existence. This movement inherited a heavy emphasis on emotion (as opposed to reason) that grew out of the Romantic movement. As it has evolved today, this worldview affirms no God and sees the external world as a chaotic place devoid of any significance. Subsequently, meaning and purpose must come not from without but within. What this means fundamentally is that there are no higher aspirations in life than to exist as oneself fully. There is nothing else to live for. Personal experiences and their accompanying emotions are the greatest goods. This translates into our modern ideas of self-actualization, living life to the fullest, YOLO, and so on. Understanding this backdrop sheds light on why PAS has increased in popularity. Those who request PAS are often in predicaments where their physical bodies are ailing. If life’s worth consists only of generating experiences to affirm the goodness of my own existence, potentially debilitating disease removes my ability to create the same experiences that provide purpose and value to my life. The contemporary rhetoric of “carpe diem” undercuts the value of human life. No longer are people inherently valuable and made in the Image of God. We are simply repositories of experiences, and when such experiences no longer attain the degree of emotionality that I seek, my life becomes meaningless. This approach to life is not only mistaken but deeply harmful. Idols never deliver, and they devastate their followers along the way. People cannot thrive when they insist they must create their own meaning yet still look over their shoulders to see if people affirm them. Nor can they escape the absurdity and nausea of realizing that all is a vapour when confronted with the inescapable question of nothingness. These are symptoms that existentialists like Sartre and Camus recognized. In caring for others, we must challenge the folly of their worldviews and provide the true alternative. Christians have the most powerful ideological response to contemporary existentialism. We believe in the goodness of emotions and experiences as they pertain to reality, but they can never trump what we know to be unwaveringly true (Matthew 7:24-25). Only if God exists and he created a structured, good world can it be possible that there is more to life than personal experiences.
So, how do we love people who seek PAS?
Increasingly we will find ourselves confronted with the question of PAS at a personal level. Whether it is through working in a healthcare profession or through friends, church, and family, we must love people who seek PAS. There are a number of reasons people consider PAS, but two important categories for Christians to recognize are those who are despairing and those who intend to plan ahead to a time when they believe their lives will no longer be of value and hence should be actively ended. Broadly we must recognize that all worldviews provide their adherents with particular resources to engage with death and suffering. A secular culture steeped in self-fulfilment alongside the modern impulse to technological mastery has virtually no answer to suffering except escape and avoidance. There is no category for suffering as a means to produce perseverance or prepare us for glory. Suffering is, as the philosopher Peter Kreeft says, a scandal, because it is an affront to our ability to determine our own destinies.
First, we must come alongside those who are contemplating PAS and enter into their despair and fear of death and debilitation. I recall the experience of one patient contemplating suicide whose mind was changed simply by the presence of a Christian nurse who provided friendship and presence. Loneliness is a powerful motivator for suicide and a breeding ground for despair. As Christians, our faith is founded on the God who enters into our suffering. He did not stand at a distance but humbled himself (Philippians 2:4-8). We must likewise enter into the hardships of others with true com-passion (“with-suffering”).
Practically this means ongoing presence and support. It means recognizing that days in the hospital can be lonely and isolating. Particularly for chronic diagnoses, the timeline can be years long, and hopelessness can present when we least expect it. We come alongside others for not just a few moments but a journey with many ups and downs. In doing this we communicate the love of God, which casts out not only fear but also despair. We furthermore embody Christian community. When we collectively care for those who feel their lives are meaningless or worthless, we challenge the existential worldview in a way far more powerful than any intellectual manoeuvre. The truth that all lives are valuable becomes incarnational and not solely theoretical. Our support and care provide a practical vision of the greatest gift that can be given to anyone, and that is Christ. In our presence we can confront the false gospel of the existentialist lifestyle with Good News that ultimately proves to be experientially more satisfying because it is true to how God created us.
In our secular society, we must be ready to engage with people discussing or personally contemplating PAS. We have the ultimate hope, and we must apply this hope to a people whose meaning is only found in experience. We must recognize the idols of our society and show how the gospel meets the deepest desires and needs of those who want to die.
*I use the term PAS instead of the euphemism MAiD (Medical Aid in Dying), which is the popular term currently applied. I choose PAS because language is important, and MAiD is not only vague but misleading. Palliative care, which Christians should support so long as PAS is not wholly absorbed into its practice, consists of medical aid in symptom control when people are dying, (i.e. MAiD). This must be distinguished from PAS.