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Newlywed Brittany Maynard started the New Year off with a bang: The
agonizing headaches she was having were caused by a malignant brain tumor.
Initially, doctors estimated she could live up to 10 years, but in April, her
condition had worsened. The new prognosis? Six months to live. None of the treatment
options available could save her life, and the side effects would destroy her
quality of life as she knew it.So Maynard began to research "death with dignity," and learned that most states do not allow terminally ill patients to end their lives. But Oregon had enacted a law in 1997 permitting physicians to prescribe lethal doses of barbituates capable of ending the suffering of a patient who has no hope of recovery. Since then, 1,173 people in that state have requested such prescriptions, of whom 752, as of 2013, have actually used the drugs to die. Some who found comfort in knowing they had a choice in the manner of their death discovered that they were able to manage their pain through palliative care, so in the end did not ingest the medication.
Maynard and her husband, Dan Diaz, decided to move from San Francisco to Portland to establish her eligibility for the medication. Making such a drastic move at a time when she is getting sicker involved great sacrifice and difficulty for her and her family. She told People magazine, "There's tons of Americans who don't have time or the ability or finances, and I don't think that's right or fair."
She selected November 1 as the day she plans to die surrounded by family and her best friend. She and her husband say they feel relief, peace and comfort knowing that she has this option available to her. Diaz said in a video, "Death with dignity allows for people who are in the predicament of facing a lot of suffering [to] decide when enough is enough."
Americans are divided on the issue, with most wanting some control over how they die, as long as it involves ending life "by some painless means" rather than by "committing suicide." A New England Journal of Medicine poll conducted last year revealed that about 67 percent of the 1,712 medical experts surveyed in the U.S. were against physician-assisted suicide.
As for Maynard, she stated: "I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms .... Who has the right to tell me that I don't deserve this choice? That I deserve to suffer for weeks or months in tremendous amounts of physical and emotional pain? Why should anyone have the right to make that choice for me?"
Maynard hopes more states will adopt legislation to allow terminally ill residents who are judged by two physicians not to be depressed or incompetent to request and receive prescription drugs that would hasten their deaths. Physicians would not administer the drugs; the decision whether or not to take them and when would remain in the hands of the patients. She has volunteered her time with Compassion & Choices, which according to its website is "a nonprofit organization committed to helping everyone have the best death possible," to advocate for death-with-dignity laws in other states.
Awaiting the inevitable day of her demise, Maynard reflected, "I hope to enjoy however many days I have left … I hope to pass in peace … The reason to consider life and what's of value is to make sure you're not missing out … seize the day … what's important to you, what do you care about, what matters. Pursue that. Forget the rest." She added, "When my suffering becomes too great, I can say to all those I love, 'I love you; come be by my side, and come say goodbye as I pass into whatever's next.'"
Although most media reporting on Maynard's planned suicide has been supportive and even encouraging of others, there is a dark side to euthanasia that is often downplayed or ignored. Where euthanasia is legal, it's possible for it to become an "easy out" for people facing temporary problems, and helps them avoid dealing not only with the fear of death, but with other emotional concerns. It is now well established in the Netherlands (the first Western country to legalize euthanasia) that suicide is a legitimate medical "treatment" for someone depressed about a tragedy in one's life.
More on this story can be found at these links:
Cancer Patient Brittany Maynard, 29, has scheduled her death for Nov. 1. The Washington Post
Compassion & Choices
My Right to Death with Dignity at 29. CNN Opinion
Bioethicist: Why Brittany Maynard Changes the Right-to-Die Debate. NBC
Dying Young: Why Brittany Maynard's Story Resonates. CNN
Lessons From the Dutch Experience. New Zealand Life
The Big Questions
1. In your view, is physician-assisted suicide acceptable? Why or why not? If so, under what conditions should it be permitted? How does your Christian faith inform your response? Is there a difference between "physician-assisted suicide" and "death with dignity"? If so, how would you distinguish between the two?
2. If you were the spouse, parent or friend of someone in Brittany Maynard's situation, would you try to advise her in a certain direction or not? How would you respond to her decision? Do family members have the right to have any say in a matter like this? Do family members have the right to have any say in any other matters in an individual's life?
3. Modern society urges us to avoid death at all costs. But as Christians, is death the worst thing that can happen to us? If you could know what date you would die, would you want that information? Why or why not? What would you do with that information if you had it?
4. If physician-assisted suicide is acceptable when someone is faced with an excruciatingly painful death, is it also acceptable for a person with Alzheimer's or chronic depression who may not be experiencing physical pain, but instead feels extreme psychic pain or the loss of mental capacity and social awareness? Do "death with dignity" laws lead us down a "slippery slope" that will open the door to various abuses? What about people who may want the pills for the wrong reasons? What safeguards should be in place to prevent misapplication of a death with dignity law?
5. Should it make a difference that we are able to extend life so much more due to advances in medical knowledge and pharmaceuticals? When are we "dead"? Does the commandment "Thou shalt not kill" apply when our quality of life is almost non-existent and we become a burden to others? On the other hand, how do we ensure that people are not choosing assisted suicide prematurely? In whose hands should life-and-death decisions rest?
6. As a pastor, caregiver, health professional or caring friend, you may have given advice to someone which you knew would necessarily shorten the life of a loved one without actively terminating that life (such as choosing to dispense with medications, treatments or the insertion of feeding tubes). For the sufferer, is this different from suicide? Is extending life a virtue or goodness that trumps all other considerations? Is it easier or more difficult to share advice with others compared to choosing such a course of action for your own loved ones?
Confronting the News With Scripture and Hope
Here are some Bible verses to guide your discussion:
Ecclesiastes 8:5-8
... the wise mind will know the time and way. For every matter has its time and way, although the troubles of mortals lie heavy upon them. Indeed, they do not know what is to be, for who can tell them how it will be? No one has power over the wind to restrain the wind, or power over the day of death; there is no discharge from the battle, nor does wickedness deliver those who practice it. (For context, read 8:2-8.)
The author of this section also penned the familiar words in chapter 3:1-3: "For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; ... a time to kill, and a time to heal ...." In Genesis 27:1-2, blind Isaac, aware that death could come at any time, tells his son Esau, "See, I am old; I do not know the day of my death."
Questions: Is it possible to be wise enough to know when is the right time and way to die? When "the troubles of mortals lie heavy upon them," is it easier or harder to gain such wisdom? In what sense is it true that "no one has ... power over the day of death"? In what sense might that not always be true? How can we know when it might be the season for death, the time to die, or even to kill (oneself)?
Define what in your mind is a biblical definition of a "good death." What constitutes a "bad death"? Are there circumstances where choosing to extend life at whatever expense to well-being, quality of life or finances begins to seem wasteful or absurd? Does your denomination or church have end-of-life statements or counsel?
Job 3:20-23, 25
Why is light given to one in misery, and life to the bitter in soul, who long for death, but it does not come, and dig for it more than for hidden treasures; who rejoice exceedingly, and are glad when they find the grave? Why is light given to one who cannot see the way, whom God has fenced in? ... Truly the thing that I fear comes upon me, and what I dread befalls me. (For context, read 3:1-3, 20-26; see also Job 7:14-16 and Revelation 9:6.)
In anguish because of multiple catastrophic losses, including the death of all 10 of his children, the theft or destruction of all his property and sudden onslaught of chronic and acute physical pain, Job curses the day he was born, wishing he were dead.
Questions: Can you imagine a situation so bad, when you are so miserable and your soul is so bitter that you might long for death and yet not find it? Have you ever felt "fenced in" by God, as though you had no good choices available to you? In such a situation, what is the thing that you would fear most? What might help you overcome your fear?
Job's situation is different from some situations that involve medically assisted suicide. The Oregon law requires examination by two physicians and a waiting period so that one does not take one's life just because one is depressed. Indeed, most people who qualify for the prescription fill it but never use it. They just prefer to have control over their passing, and often palliative care makes the suicide unnecessary.
1 Samuel 31:3-4
The battle pressed hard upon Saul; the archers found him, and he was badly wounded by them. Then Saul said to his armor-bearer, "Draw your sword and thrust me through with it, so that these uncircumcised may not come and thrust me through, and make sport of me." But his armor-bearer was unwilling; for he was terrified. So Saul took his own sword and fell upon it. (For context, see 31:1-5; see also 2 Samuel 1:1-16.)
During his final battle with the Philistines, King Saul was so badly wounded that he felt he had no chance of escape or recovery. The prospect of falling into the hands of the enemy seemed worse to him than death by the hand of his armor-bearer or by his own hand. When his armor-bearer would not acquiesce to his request that he assist him in his death, Saul took his own life.
Later, an Amalekite falsely reported to David that he had seen Saul in agony and obeyed Saul's command to kill him. David inquired, "Were you not afraid to lift your hand to destroy the LORD's anointed?" Then David had the Amalekite killed because he confessed to killing the king, something David himself had refused to do even though Saul tried to kill him more than once. It's not clear whether David would have been particularly concerned if the Amalekite had killed any dying soldier on the battlefield, but he was disturbed that he lifted his hand against the man set apart by the Lord to be king.
Questions: Kenneth Goodman, founder and director of the University of Miami Bioethics Program, said about the Brittany Maynard situation that "these decisions are among the most exquisitely difficult decisions in the history of civilization. ... we agree ... that life is precious ... so is liberty .... It's good to have misgivings." What kind of misgivings should we have when facing these kinds of ethical dilemmas?
John 11:3-4
So the sisters sent a message to Jesus, "Lord, he whom you love is ill." But when Jesus heard it, he said, "This illness does not lead to death; rather it is for God's glory, so that the Son of God may be glorified through it." (For context, see 11:1-44.)
When Jesus' friend Lazarus became sick and died, Jesus knew that God and he himself would be glorified through it when Jesus raised Lazarus from the dead. Such extraordinary miracles astound us because they are not part of our normative experience.
Questions: Is it easier for you to accept negative things that happen in your life as means by which you can glorify God, or do you tend to cling to the hope that God will glorify himself by replacing those negatives with positives? Could God have been glorified if Lazarus had not died? If he had not been raised from the grave? Explain.
Philippians 1:20-24
It is my eager expectation and hope that I will not be put to shame in any way, but that by my speaking with all boldness, Christ will be exalted now as always in my body, whether by life or by death. For to me, living is Christ and dying is gain. If I am to live in the flesh, that means fruitful labor for me; and I do not know which I prefer. I am hard pressed between the two: my desire is to depart and be with Christ, for that is far better; but to remain in the flesh is more necessary for you. (For context, read 1:12-14 and 20-26; cf. Romans 14:7-9 and 1 Corinthians 3:21-23.)
Paul, writing from prison, expresses his inner conflict over whether he would rather remain on earth (and help the believers) or "depart and be with Christ," which for the believer is "gain." In Romans 14, Paul says "whether we live or die, we are the Lord's" and that "Christ died and lived again, so that he might be Lord of both the dead and the living."
Questions: What are the ramifications of Paul's statements in Romans 14 regarding the physician-assisted suicide or death with dignity debate? Are there circumstances in which the death of a Christ-follower might actually be more beneficial for other believers than for them to remain on earth? Can you think of a Christian whose death profoundly blessed you and built up your faith in a way that their life here on earth did not?
For Further Discussion
1. Read the comments following the article entitled "'It's Selfish to Die Just Because You're Scared to Live': Blaze Readers React ..." (TheBlaze.com). Using the comments as a starting point, have group participants debate the issue of physician-assisted suicide.
2. A member of the TWW team recalled the controversy over Terri Schiavo, the 27-year-old woman who had a heart attack that rendered her so brain-damaged that she was in a coma for years. Her husband wanted to remove the feeding tube that kept her body alive, but her parents did not. Faith groups weighed in on both sides of the question, some arguing that using artificial means of life support was an attempt to "play God" in determining whether a person lives or dies, and others holding that removing life support was the equivalent of "playing God" and no better than murder. The court decided in favor of the husband, and an autopsy revealed that there was no hope of recovery. What are the theological strengths and weaknesses of each position in such a case?
3. Discuss this story shared by TWW team member Frank Ramirez from his book Job: The Bootleg Commentary: After struggling to make life and death decisions regarding which children should receive powdered milk during the Spanish Civil War, relief worker Dan West birthed the ministry of Heifer International to provide live, pregnant animals to families in devastated cities in Europe following World War II. Decades later, when West learned he had ALS and would eventually choke to death, he spent the holidays with his family before stepping out into a raging snowstorm three times the night of January 4, 1971, wearing only his pajamas, boots and an overcoat. The staff at the nursing home where he resided had instructions not to try to stop him. When he contracted pneumonia, he declined to use an oxygen tent, writing on a piece of toilet paper, "My life is not worth this cost." He died three days later.
4. Consider how Jesus faced death: "not my will, Father, but your will" in Gethsemane. What motivated Jesus to willingly accept death? How might his motivation be similar or different from a person who desires physician-assisted suicide?
5. What would you say to Job that would be different from what you might say to the young woman who is the subject of this lesson? Is there a difference between her situation and Job's? Job came to see life from a different perspective and to repent. How important is time in determining if one is truly in a situation that may justify medically assisted suicide?
Responding to the News
If you have not already drafted Advance Directives to inform your loved ones of your desires should you become incapacitated and unable to make your own decisions regarding your health and medical treatment, you may want to set up appointments to discuss your options with your physician and pastor, and to share your wishes with your family and close friends.
Closing Prayer
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