Tuesday, July 22, 2008

Why Terri Schiavo Still Matters

A few years ago, the world was abuzz with the legal and medical issues surrounding Terri Schiavo. Mrs. Schiavo was brain-damaged but not dying, at least she was not dying until she was starved and dehydrated by order of a court at the request of her husband. This highly emotional case made national and even worldwide news. But before there was ever a Terri Schiavo, there was the case of Hanna Heyt, of whom you probably have never heard.

Hanna Heyt was a beautiful and talented woman who was married to a successful, young physician. Not long after the wedding of Dr. Thomas Heyt to his bride Hanna, they discovered that she had multiple sclerosis. Over the next number of weeks and months the MS started to take its toll on her body. And although she was not immediately terminal—in fact, she probably would have lived for many more years—Hanna concluded that if she couldn't have a full, vital life, she didn't want any life at all. So she asked her husband to kill her. She said, "I want to remain your Hanna till the very end; I don't want to become somebody else who is deaf, blind, and idiotic. I wouldn't endure that. Thomas, if you really love me, promise that you will deliver me from this beforehand."

At first, he refused. But as Hanna's condition worsened, Dr. Heyt finally decided to inject her with an overdose of sedatives, and she died.

The young couple's maid was horrified. She went to the police, who came and arrested Dr. Heyt. He said, "Yes, I confess: I did kill my incurably ill wife, but it was at her request." In fact, according to the police report, Dr. Heyt testified that his wife died happily. Nevertheless, Dr. Heyt was formally charged with the murder of his wife.

During the first part of the trial, things were not looking good for Thomas Heyt. The prosecution was presenting its case against him in a clear, comprehensive manner. It looked like an open-and-shut case. So Dr. Heyt decided to take the stand in his own defense. And in one of the most dramatic testimonies ever given in a court of law, Dr. Heyt turned the tables on those who would chastise him. Pointing to each member of the prosecution in turn, he yelled, "You accuse me? I accuse you!" He accused them of prolonging the suffering of those who cannot be saved. Finally the case was handed over to the jury.

The case of Dr. Heyt illustrates something that is more and more common these days: End-of-life issues. With all the advances of the medical industry, end-of-life issues are becoming more complex. For those of us who are Christians, we want to follow God's way. Here are some common questions we face:

  • Is it unbiblical for me to ask for a "do not resuscitate" status?
  • May I as a Christian decline to be hooked up to some machine since I am soon going to die anyway?
  • May a family in good conscience before God ask that our comatose relative's pacemaker or other device be turned off since it is the only thing that is keeping him alive?
  • What does God allow me to do to deal with the intensifying physical pain I am suffering?
  • What is the right thing to do?

Scripture gives us guidelines for these issues. As medical doctor Donn Ketcham wrote, "It is important to have certain guidelines laid down ahead of time—guidelines to which you can cling and hold firmly enough that they weather the storm of emotions in time of crisis. This is a matter in which your convictions must be hammered out on the anvil of Scripture and moral principles before it is necessary to apply them in time of stress. They must be settled in the quietness of the study lest the maelstrom of the actual crisis cause you to be swayed and you find yourself with situationally determined standards."

Although every medical situation has its own unique set of factors, you can make good, God-honoring decisions that are consistent with biblical teachings. The Bible is the Word of God, and it directs our thinking and actions concerning all the questions of life, including euthanasia. Second Tim. 3:16-17 says, "All Scripture is inspired by God and profitable for teaching, for reproof, for correction, for training in righteousness, so that the man of God may be adequate, equipped for every good work."

What does the Bible say about life and death?

The Bible teaches that human life is sacred.

All persons, from the moment of conception to the moment of death, are made in the image of God.

Gen. 1:26-27 (HCSB) – "Then God said, 'Let Us make man in Our image, according to Our likeness. They will rule the fish of the sea, the birds of the sky, the animals, all the earth, and the creatures that crawl on the earth.' So God created man in His own image; He created him in the image of God; He created them male and female."

Your life is sacred. You are special to God. Nothing in all of God's creation is made in His image but humans.

Opposed to the view that human life is sacred is the humanistic secularist view called "the quality of life." This view says that if a person's quality of life is low or declining, he should be exterminated, regardless of whether death is imminent and unavoidable. The "quality of life" ethic grants a decision-maker the right to determine the value of another person's life and to kill individuals whose lives don't have "enough" value.

George Orwell's novel Animal Farm illustrates the "quality of life" idea. Boxer is the slow-witted but hardworking cart-horse, and he gives his every fiber of strength and energy to the animal farm. As he exerts himself over the years he grows weaker. He marks off the days to his promised retirement. However, as retirement approaches, Napoleon and Squealer, the dictator pigs, realize that Boxer's value to the farm has lessened and that his upkeep will be expensive. The solution is to send him to the slaughterhouse under the guise of a trip to the veterinarian hospital.

A part of the euthanasia movement's philosophy is to use the "quality of life" arguments to rid society of the old, the weak, the mentally handicapped, and the unwanted. As followers of Christ, we must reject any philosophical ethic that regards "quality of life" as the standard by which people are cared for and allowed to live. The Bible clearly teaches the sanctity of all human life.

The Bible explicitly condemns homicide.

Exodus 20:13 (KJV) says, "Thou shalt not kill." Why did God give this command not to kill? Because of the image of God in us. To destroy what is made in the image of God is tantamount to an assault against God Himself. That's why God requires the ultimate punishment for murder. In Gen. 9:6 (HCSB), He says, "Whoever sheds man's blood, his blood will be shed by man, for God made man in His image." Since God alone is the Creator of human life, only He has the right to take human life. (There are, however, two instances in which God extends to us His authority to take life: capital punishment and war.)

When Commandment #6 says, "Thou shalt not kill," the word 'kill' refers not only to murder, but to all kinds of homicide. Homicide is the taking of life outside the parameters laid down by God (those parameters again being capital punishment and war). The following are examples of homicide, all of which are forbidden by God:

  • Murder – To kill someone intentionally
  • Manslaughter – To kill someone unintentionally. Even an accidental death is an affront to God. Numbers 35 speaks to the difference in punishment between murder and manslaughter. In OT Israel, a murderer was to be put to death, while someone causing the unintentional death of a person would be banished from his land, his community, and his family. He would not be able to worship with the rest of Israel at the central sanctuary. He would go to live in a designated city of refuge, and he had to remain there until the high priest died. The net result of this law was that Israelites were very careful not to do anything that would cause the death of another person. Listen to Deut. 22:8 (HCSB): "If you build a new house, make a railing around your roof, so that you don't bring bloodguilt on your house if someone falls from it."
  • Suicide – To kill oneself. Suicide is really self-murder, and murder is against God's Law. It is not your right to destroy the image of God in someone, even in yourself. God alone is the Creator of life, and He alone decides when life ends. Suicide is a completely selfish and egotistical act. The person who commits suicide thinks only of himself and not of his relationship to God or others.
  • Euthanasia.

What is euthanasia? The term 'euthanasia' literally means "good death." In its original context, it referred to the process by which a person eases into death without unnecessary pain and suffering. Originally, the focus was on easing pain as death occurred naturally.

However, in 1869 euthanasia was redefined by British historian W. E. H. Lecky. He used the term "to signify the act of taking the life of a person who is hopelessly ill and doing so for reasons of mercy" (Keith H. Essex, "Euthanasia," in Master's Seminary Journal, Vol. 11 [201]). Following Lecky's lead, a common modern definition of euthanasia is: "Any act or deliberate omission undertaken by oneself and/or others that intends to cause and does cause the death of a person, whereby the parties involved act upon a conviction that the death caused will be good for the person being killed" (Ibid.). As it is commonly understood today, euthanasia is not just the relieving of pain; it is the relieving of pain by causing death.

Even passive euthanasia intends death by withholding, withdrawing, or refusing medical treatment that clearly could enable a person to live significantly longer. Euthanasia means to hasten death. In contrast, letting a person die naturally is not euthanasia

Euthanasia is homicide, the killing of one human being by another or by oneself. I agree with Mark Blocher, who wrote, "To use the word killing is technically correct since both action and neglect in particular contexts result in a death that is intended. Euthanasia is allegedly killing for merciful reasons, for reasons of compassion… The absence of malice associated with the acts of euthanasia tends to soften our reaction to it. We are less inclined to label these acts 'killing'. Yet they are" (Right to Die? Caring Alternatives to Euthanasia, p. 77).

To withhold useless treatment is not euthanasia (and therefore not wrong). When death is imminent even with treatment, it is not wrong to withhold the treatment. But if a suffering individual is able to live significantly longer with treatment—as in the case of Terri Schiavo—to cause death is a form of homicide.

The proper way to show compassion to the suffering and the dying is to relieve their pain, not kill them.

People in the medical field are familiar with the principles of 'beneficence' and 'nonmaleficence'. 'Beneficence' means that doctors are obligated to do good for their patients. 'Nonmaleficence' obligates doctors to avoid harming their patients. Doing good for the patient means that when medical technologies can no longer prevent death, the doctor withholds or withdraws all life-prolonging and life-sustaining technologies. This is not euthanasia. This is letting die.

When no medical cures exist, the patient is given "palliative care," which eases discomfort. Many terminal patients receive "hospice," which usually includes pain management, social interaction, and spiritual care.

It is okay to let a terminally ill patient die naturally, but it is not okay to cause or hasten the death of someone in any way.

In the final scene of Shakespeare's tragedy Julius Caesar, Brutus is defeated and intends to kill himself. He pleads for his longtime friend Volumnius to hold a sword while Brutus runs through it. Volumnius refuses and replies, "That's not an office for a friend, my lord." I would add that actively taking the life of a loved one is not the office of a Christian.

How, then, should we face the end of life?

If you understand what the Bible teaches about death, then you will understand how to face the end of life. In the article referenced above, Keith Essex summarizes the biblical teachings about death:

The Bible teaches that death is inevitable.

Ecclesiastes 3:2 (HCSB) says, "[There is] a time to give birth and a time to die."
Since death is inevitable, then you should make preparations for it. There are at least 3 things you should do prepare for death:

  • First, you should give your life to Christ. He died on the cross to pay for your sins, and He rose from the grave to give you eternal life. The Bible says, "If you confess with your mouth, 'Jesus is Lord,' and believe in your heart that God raised Him from the dead, you will be saved" (Rom. 10:9; HCSB). Since the death rate remains at 100% and shows no signs of lowering in the immediate future, you should consider getting your eternal destiny settled.
  • Second, you should have a will. You can't take your possessions with you to heaven, so determine what you want done with the temporal blessings God has given you. Remember to take care of your family and, if possible, leave some of your possessions to continue God's work on earth.
  • Third, you should have a "Will to Live." A Will to Live is like a living will, but better. Unlike most living wills, a Will to Live has a strong presumption in favor of life. It instructs your physician to do what is necessary to preserve your life "without discrimination based on your age or physical or mental disability or the 'quality' or your life;" and it rejects "any action or omission that is intended to cause or hasten death." A Will to Live is a pro-life, anti-euthanasia alternative to a living will. You can learn more about having a Will to Live by clicking the link at the beginning of this paragraph.

The Bible teaches that death is an enemy.

The Bible says, "[Jesus] must reign until He puts all His enemies under His feet. The last enemy to be abolished is death" (1 Cor. 15:25-26; HCSB).

Since death is an enemy, you should always hope for recovery so you can continue to serve the Lord. If medical treatment is a realistic possibility, you should take advantage of it.

The Bible teaches that dying is a process.

Hebrews 11 talks about the heroes of the Bible: "By faith Jacob, when he was dying, blessed each of the sons of Joseph, and, he worshiped, leaning on the top of his staff. By faith Joseph, as he was nearing the end of his life, mentioned the exodus of the sons of Israel and gave instructions concerning his bones" (Heb. 11:21-22; HCSB).

Since death is a process, sometimes we will be aware when death is near. If death is near a loved one, we should remember that it is our Christian duty to show compassion to the dying. Ps. 119:156 (HCSB) says, "Your compassions are many, Lord; give me life, according to Your judgments." And Jesus said, "Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me" (Matt. 25:34-36; NASB).

If a patient's disease is incurable and terminal, you should do whatever you can to control physical pain, to provide food and water, to give regular hygienic care, and to ensure personal interaction, including spiritual care.

The Bible teaches that suffering is a part of our experience.

1 Pet. 5:10 (HCSB) says, "Now the God of all grace…will personally restore, establish, strengthen, and support you after you have suffered a little." When we who are Christians experience pain, even the pains of the end of life, we should patiently endure it. Pain is not the reason to commit the unbiblical act of euthanasia.

Perhaps the best example in the Bible of a person who dealt properly with pain, suffering, death, and thoughts of suicide is Job. Job was a wealthy man, a man of political power and social prominence. He was an old man with a wife and ten grown children of whom God said, "He is blameless and upright, a man who fears God and shuns evil" (Job 1:1).

And then Job lost it all. On one day he lost his wealth, social and political status, and servants. All ten children were killed when a house collapsed. A short time later, Job was stricken with a painful disease. Scholars have cataloged the symptoms: "anorexia, undernourishment, high fever, severe and chronic depression, uncontrolled weeping, sleeplessness, nightmares, chronic halitosis, failing vision, and rotting teeth." He was the very image of death.

Job wished for God to take his life. His wife couldn't stand his misery any longer and begged him to curse God and ensure his immediate death. If you would describe these conditions to one of today's advocates for euthanasia, Job certainly would be described as someone with very little quality of life.

But Job never concluded that he should take an active role in ending his own life, nor did any of his four friends suggest such a thing. Job used the circumstances of his pain and suffering to contemplate the meaning of life and death and his relationship to God.

Your suffering may have a spiritual purpose. Through your suffering people around you will see that you trust in the Lord for all things, and you place your very life in His hands. Some of the Lord's greatest witnesses are those believers who are in the midst of great suffering.

The Bible teaches that to die well, we must trust God.

It is not euthanasia that is the good death. The good death occurs when a Christian maintains his faith strong in the Lord, even unto death, and leaves this life with joy. That's why Ps. 116:15 (HCSB) says, "The death of His faithful ones is valuable in the Lord's sight."

Jesus showed us what attitude we should have when facing death when He prayed in the Garden of Gethsemane, "Father, if You are willing, take this cup from me; yet not my will, but Yours be done" (Lk. 22:42; NASB).

The Bible says that death is not the end.

Death is not extinction. Death is separation. Physical death is the separation of your spirit from your body. Spiritual death is the separation of your spirit from God. Sometimes the Bible calls hell "the second death."

We must remember that this body of sickness and sin is not the final outcome of our existence. We will be given a new and glorified body when we're resurrected from the dead.

If we fail to view death from the perspective of God's Word, we might end up like Hanna Heyt, who was killed by her own husband at her own request. So whatever happened to Dr. Thomas Heyt, who took the stand in his own defense and yelled out, "You accuse me? I accuse you!" Did the jury find him guilty or innocent? Were the jurists convinced that a person with a low quality of life should be killed to end their suffering?

Well, I don't know what happened to him. In fact, no one does. You see, the story of Dr. Thomas Heyt and his wife Hanna is a fictional one. It was a movie called "I Accuse," and the movie ends without a judgment. You have to decide for yourself.

But I do want to show you who produced this movie.

Someone might say, "Oh, the terrible things that happened under Nazi Germany could never happen here." But the only people who think that are those who don't know history.

In 1920's Germany, abortion, although illegal, was widespread; pornography was becoming more popular; and violence was on the rise. (Parallels, anyone?) All of these should have served as warning signs of a society that does not view life as sacred.

Then, beginning in 1933, the eugenics program that Adolf Hitler described in his book Mein Kampf became a reality with the legalization of involuntary sterilization and abortion.

In 1938, the first known case of euthanasia in Germany was performed on "baby Knauer." The father of the child submitted a request directly to Hitler asking that his son be allowed to die. The reason given to Hitler was that the child was retarded, blind, and missing both an arm and a leg. Hitler turned the case over to his personal physician, Dr. Karl Brandt. The request was granted and the infant was killed.

In October 1939, Hitler himself initiated a decree that allowed the widespread practice of euthanasia. Physicians were empowered to grant a "mercy death" to "patients considered incurable according to the best available human judgment of their state of health." These Germans that were killed were either handicapped children, psychiatric patients, or just those deemed "undesirable." The key to the "success" of Hitler's program was that no law was ever passed. Hitler just left it in the hands of doctors. Physicians were not ordered to participate, but merely allowed to do so if they wished. It was considered to be "a private matter between the doctor and his patient." Germany's euthanasia program was not the creation of Hitler; it was the creation of physicians. At first Hitler simply allowed it, and then he used it in even more sinister ways.

In 1940, in an attempt to sway the German populace to embrace the worthiness of killing the worthless, the movie "I Accuse" was produced and then viewed by over 18 million Germans.

And throughout the early 1940's, Hitler continued to put to death those people he considered "undesirables:" incurable mental patients, homosexuals, bed-wetters, children with misshapen ears, Jews, and anyone else who was not German. The mass killing of 11-13 million people continued to be orchestrated by the army, but under the supervision of physicians.

One doctor wrote, "If killing a hemophiliac infant has no adverse effect on others, it would be right to kill him." Which doctor said that? Hitler's personal physician? Another Nazi physician? No. It was Dr. Peter Singer, who is today a leading professor of bioethics at Princeton University.

What a difference a few decades makes: Hitler's personal physician was hanged after the Nuremberg Trials. But our schools give tenure to a professor with the same view of life.

Can it happen here? It happened over 60 years ago to baby Knauer in Germany. And it happened here to Terri Schiavo. And it's happening more often than you know, not in concentration camps and mass graves, but quietly in hospitals and nursing homes; and with the approval of doctors, judges, and family members.

The question is not whether it can happen today. It already is. The question is what will we do? Who will speak for those who can't? Who will defend the defenseless? Who will protect the innocents?

  • You can speak up to your government. We need to remember that we are a nation of the people. And "when the foundations are destroyed, what can the righteous do?" Supreme Court Justice Antonin Scalia said, "A Christian should not support a government that suppresses the faith or one that sanctions the taking of an innocent human life."
  • You can choose life for yourself. Three thousand years ago, the Bible told us, "I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live."
  • Fill out a "Will to Live." A Will to Live is a legal document that you can sign which (1) names someone to make health care decisions for you if you develop a condition that makes it impossible for you to speak for yourself, and (2) makes clear what medical treatment you would want if you can no longer speak for yourself. Unlike some "living wills," a Will to Live is designed to lessen the real and growing danger that you may be starved or denied necessary medical treatment when you cannot speak for yourself. You can find a document designed for the state in which you live by clicking here.

Whatever else you do, don't be confused about the difference between euthanasia and letting die. According to a biblical worldview, the former is homicide and the latter is an act of God.

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