A Christian Worldview: Debility and Euthanasia

Shakespeare said it back in 1600: “Last scene of all, that ends this strange eventful history, is second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything.”

Solomon’s description in Ecclesiastes 12 is even more graphic: the keepers of the house trembling, the grinders ceasing because they are few, fears arising and desires failing (Eccl 12:1-7), until finally the wheel is broken and the body returns to dust.

The majority of believers do not fear death; but most fear debility and dementia. They fear this “second childishness” with its “mere oblivion” and loss of all that makes life enjoyable and worthwhile. To be reduced to helplessness; to be dependent on others for the most basic necessities of life; to be unable to appreciate the ones we love and the spiritual things which have been our life, is something no one desires. Along with the poignant and piercing cry that accompanies the death of someone who is young, the mystery of why God allows believers to age and to descend into states of dementia ranks as one of the great questions we confront.

Society is slowly, but inevitably moving toward its own answer: that human life of this quality has no value and should be allowed to die, or even to be assisted in dying.  In some parts of our world, euthanasia is already viewed as a humane act. Assisted suicide is now permitted in some places in North America. A society which recklessly pursues happiness and fun, which measures everything by appearance and accomplishment, sees absolutely no value in such a person continuing to be cared for and remaining alive. Currently, surveys indicate that about 1/3 of those polled feel that the elderly are a burden to society. It is doubtful that this poll was conducted in a senior-citizen home or an over-55 community. As governments increasingly pay for this type of end-of-life care, and hard decisions are made about the use of shrinking tax bases, it is almost inevitable that such individuals will be viewed as social and economic “burdens” that are expendable.

Please do not misunderstand the scenario being presented. This is not about individuals who are terminally ill being maintained endlessly on a life-support apparatus, or about individuals with incurable illnesses being brought back from the brink of death, only to face death again in a few hours. We are addressing the thousands upon thousands who are being cared for in nursing homes, in the homes of their children, or in their own homes by caring and loving family members. We are speaking of those in declining years and those who have entered that seventh stage of life of which Shakespeare wrote over 400 years ago and which Solomon described in his memorial caricature of old age.

But all this does not begin to answer the question of “Why?” the debilitated and the demented are allowed to remain. What value can there be to them to merely exist in that state? They are not able to profit spiritually; there is no possibility of growth. Haven’t we been taught that the Lord allows trials, including illness, for our spiritual development? These believers are past the ability to profit from their circumstances. They certainly are not among those who “bring forth fruit in old age” (Psa 92:14). Why, then, does the Lord in His sovereign wisdom, allow this? Why not just take them home?

The Value of the Aged

No one would debate the value of aged believers who are mentally alert and able to share the wealth of their experiences with others. Their value is inestimable. They lend character and stability to assemblies, and are able to pass on to a coming generation the knowledge they have gained of God through many years and trials. All of us can look back to older saints who were a tremendous help to us in younger years. We hate to think of what our Christian lives would have been without their valuable input. We readily rise up before the “hoary head” and give it all the honor that we are able to give (Lev 19:32; Prov 16:31).

But now, that once vibrant and valuable senior saint has descended into the night of confusion and disorientation. Communication becomes virtually impossible and, worse still and most to be feared, there has been a total change in personality so that words and behaviors which were once foreign to the saintly life suddenly appear. And the inevitable anguish “Why?” echoes through the moral universe. Would it not be a great release for them to be home in heaven? Wouldn’t death be a mercy? Would the “killing angels” really be doing them a disservice by releasing them from the chains of their dementia?

There are no easy answers to moral dilemmas such as this. Pat answers are to be eschewed. We are dealing with some of the most difficult ethical issues, calling into question for many the wisdom and love of God. So we must tread carefully and with sensitivity. Likely there are some reading this who have the burden of the care of believers with these afflictions. To them, stock theological answers will ring hollow. They are faced with the daily challenge of care; they are worn down by the investing of their efforts without the satisfaction of seeing improvement in their patients. They give of themselves daily with no appreciation from those they serve.

One issue is clear: since these circumstances cannot be for the profit of the believer so afflicted, they must be for our profit. With this in mind, a few suggestions can be made as to the purposes of God.

The Sacredness of Life

Our view of life is put to the test. Is life sacred? As those who affirm the value of the Word of God to guide us in all ethical and moral questions, we must affirm the sacredness of life. It is so sacred that God instructed Noah that whoever takes a life has forfeited his own life because, “For in the image of God made He man” (Gen 9:6).  Life has value because man is made in the image of God. Throughout the Old Testament are numerous prohibitions against taking life (Exo 20:13; Deut 5:17). God, the giver of life, is the only One Who has the moral right to say when a life should be taken.

Man was created distinct from, and to have dominion over, the rest of nature. Made in the image of God, he bears the stamp of divine dignity, though he be the worst of sinners. Life is indeed sacred.

Euthanasia is far different than withholding futile medical efforts to prolong life. Euthanasia is the active assistance in bringing about a death prematurely. In the eyes of many, it is mercy killing, sparing a person needless suffering and pain, disability and helplessness. Since hastening anyone’s death is Scripturally wrong, we have to say that any active assistance hastening a death is morally wrong.

That does not answer the question which looms before us and challenges our theology. Why would God allow saints to descend into dementia, into a state where their appreciation for spiritual things is blunted and their potential for growth through the experience is non-existent?

The Reality of Death

Death is the end for each of us apart from the Lord’s coming. We have prepared for death spiritually, but should also do so in terms of living wills and directives. This will help guide others as to desires in the event of disability. Death is an enemy, and it still has a sting connected with it. The truth of 1 Corinthians 15:55 will not be known until the last enemy is destroyed. If it is an enemy, then there is no reason we should not resist it if there is the possibility of returning to meaningful life, and not just to await the next needed cardiac resuscitation. That means there is nothing wrong with, or unscriptural about, utilizing medical knowledge and life-saving technology.

What about when it is a state of dementia? In a society which sees absolutely no value in suffering or disability, which measures everything by either a financial ruler or by convenience, we must affirm the value of life, but also affirm the acceptance of death in its own time. We do not “rage against the dying of the light” as Dylan Thomas posited, but we allow God to determine the time of our death.

The Value of these Saints

As already intimated, if the value of the trial of disability and dementia is not for their benefit, then it must be for ours. Are these believers valuable because of who they are or because of Whose they are? Is their value linked to their productivity and usefulness to society? Are they no longer a person because of their impaired mental capacity? Have they become, at this end of life, what those who favor abortion term as merely, “products of conception” and no longer persons?

Or do we treasure them as His sheep to be cared for in all kinds of circumstances? We are affirming the sacredness and value of human life as we care for those who are not able to appreciate or profit from their experience. We are testifying to the value of life as given by God.

As well, here is a unique opportunity for believers. Here is the time to show God-like love and care for those who cannot return it. Every day, God causes His sun to shine on the evil and the good, and His rain to fall on the just and the unjust (Matt 5:45). God daily blesses humanity, and the vast majority of that humanity do not even thank Him. In reality, the majority of mankind blasphemes that worthy Name. And yet God continues to bless without interruption. I watched today as people got their food at a restaurant and rapidly began eating, without even a moments thought that the goodness of God had provided all they had. And yet, God continues to provide day by day without a word of thanks being offered to Him.

Those who care for older saints in the bonds of dementia or severe physical disability express care and love to those who cannot appreciate it or return that love. They are giving unilateral, unconditional love to others. It may well be that they never resemble God-like activity as much in any other display of care and love. To love and receive nothing in return, to provide care and not be appreciated, is a test of godly character.

Witness a husband as he tenderly ministers to a wife who no longer knows his name or recognizes him. She speaks of her mother and father, her mind flooded with childhood memories. Yet he continues to meet her every need with patience and love. Or conversely, the devoted wife who cares for her stroke-ridden husband who can longer speak or feed himself. In each instance, selfless love is being displayed. Each “giving” partner is experiencing and learning something of the heart of God.

Multiple times in the Word of God, we are reminded of the need to treat all men justly and fairly. Psalm 72, relating to a future time when a King will reign in righteousness, emphasizes the “poor and needy.” Would moral justice be served by putting to death those who are demented and debilitated? Have they done anything to warrant death? Would it be just? God has a care for those who are innocent, helpless, and weak. God is the God of the vulnerable. He will avenge all who take advantage of such. At the beginning of life, abortion violates this standard. At the end of life, euthanasia does likewise.

None of us would look forward to being mentally incapacitated, nor to be called upon to care for someone in that state for many years. Let us, however, recognize the value of all believers, and seek, with divine help, to show them God-like love and care. We must categorically reject any attempt to lessen the personhood of any individual “made in the likeness of God.”