The Debate on Euthanasia in the Context of the Dialogue between Christianity and Secular Humanism

by Bishop Hilarion Alfeyev.

The recent debate on euthanasia is impossible to examine apart from the main problems in the dialogue between the religious world-view and Western secular humanism over the values which should lie at the foundation of the ‘new world order.’ In our opinion, these arguments demonstrate the anti-human essence of atheistic humanism, which lays claims to being a universal ideology and openly opposes itself to the traditional notions of life and death.

In the debate on euthanasia humanists systematically insist on the ‘right to die’ for the terminally ill. The most radical humanists go even further and maintain that the right to die should belong to all people, including the healthy, and that everybody who desires to part with life may do so either by committing suicide or by asking doctors for help in this. In many Western countries there are societies which propagate euthanasia and suicide. In France there is the ‘Association for the Right to Die with Dignity,’ in Japan the ‘Society for Death with Dignity.’ In America the ‘Hemlock Society,’ whose motto is ‘good life, good death,’ has been active for almost 25 years and counts approximately 25 thousand members. Its founder, Derek Humphry, is the author of the Final Exit, a kind of suicide manual. The book contains many tips on how to end one’s life by oneself or help others to do so, includes tables with indications of lethal doses of various substances, discusses the positive features of potassium cyanide and suggests methods for those who wish to suffocate – from plastic bags to exhaust fumes. Humphry confirmed his ideas in practice by helping his wife, his brother and his father-in-law commit suicide: his wife and her father took sleeping pills according to Humphry’s dosage, while his brother was helped to die when Humphry broke his life-sustaining apparatus.

Modern protagonists of euthanasia reject any connection between their ideas and the events that took place in Nazi Germany. But it was there that the first theory of euthanasia was developed, and it was there that this theory was first put into practice. In 1936 Helmut Unger published the story of a doctor who helped his wife, who suffered from advanced sclerosis, to die. A film based on this story was shot, which generated widespread public sympathy for the idea of a ‘merciful death.’ Soon thereafter the father of an incurably ill child asked Hitler to allow doctors to take his child’s life. Hitler handed this case over to his personal doctor, Karl Brandt, who fulfilled the request. In 1939 Hitler entrusted Reichsleiter Bouhler and Dr Brandt with the task of giving permission to doctors for the ‘granting of a merciful death to patients who, according to human estimation, are incurably ill.’ Soon in Germany appeared the first ‘Hungerhaus’ (‘house of hunger’) – such was the name given to medical institutions where babies with incurable diseases and elderly were starved to death. From 1939 until 1941 euthanasia became a routine phenomenon: the terminally ill, cripples and the mentally retarded were systematically murdered in gas chambers by the orders of doctors. During these years around 70,000 people were killed by the ‘euthanasia program,’ while by the end of World War II the total number of the programme’s victims, according to the Nürnberg Tribunal, comprised 275,000. At the Nürnberg process Dr Brandt stated:

The underlying motive was the desire to help individuals who could not help themselves and were thus prolonging their lives in torment... To quote Hippocrates today is to proclaim that invalids and persons in great pain should never be given poison. But any modern doctor who makes so rhetorical a declaration without qualification is either a liar or a hypocrite... I never intended anything more than or believed I was doing anything but abbreviating the tortured existence of such unhappy creatures (P. J. King, ‘Lessons from History: Euthanasia in Nazi Germany’. For more information on the Nazi euthanasia program cf. ‘Holocaust Encyclopedia: Euthanasia Programme’.)

The same argumentation is at the basis of the philosophy of modern proponents of euthanasia, who are finding more and more supporters among European legislators. After the war euthanasia was prohibited in all European countries. It still remains illegal in the majority of Western countries, although in reality it is being put into practice ever more frequently. The gradual change in public opinion in favour of euthanasia has led to the approval of euthanasia laws in two European countries – the Netherlands and Belgium. According to these laws, adopted in 2002, doctors who help the terminally ill to commit suicide are exempt from criminal responsibility. It seems that similar norms will soon be introduced in other European countries and may enter the legislation of the European Union. In the Council of Europe a resolution is already being discussed on the necessity of bringing legal norms into harmony with existing practices and on the legalization of ‘active euthanasia,’ i.e. the right of doctors to ‘terminate the life of the patient at his or her persistent, voluntary and well-considered request’ (Parliamentary Assembly of the Council of Europe, document No. 9898 of 10 September 2003). For the time being we are not yet dealing with a programme for the systematic destruction of the incurably ill, similar to that which was put into practice by Hitler’s Germany, but do we have any guarantee that European legislators, after abolishing one prohibition, will not want to lift other bans as well – exclusively with ‘humane’ aims, of course?

Today representatives of traditional Churches, including the Catholic and Orthodox, oppose the legalization of euthanasia. The cardinal difference in views on euthanasia and suicide between the Christian tradition and secular liberal humanism is based on the difference in fundamental notions of life and death. In liberal humanism both questions are viewed first and foremost in the context of human rights: everybody is the master of his own life, and therefore if somebody is tired of life he has the right to end it. In the Christian tradition, however, God is recognized as the master of life and death. Therefore the Orthodox Church considers suicide a severe sin and equates euthanasia with suicide or murder (The Bases of the Social Conception of the Russian Orthodox Church XII, 8). The Orthodox Church ‘cannot recognize the current widespread attempts in society to legalize so-called euthanasia, i.e. the intentional killing of the hopelessly ill (including cases in which they are put to death according to their wishes), as morally acceptable. The requests of the ill to accelerate death are sometimes conditioned by a state of depression, which deprives them of the possibility of correctly appraising their condition’ (Ibid. XII, 8). The Catholic Church also considers euthanasia ‘morally unacceptable,’ calling it ‘murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator’ (Catechism of the Catholic Church 2277).

The liberal approach views human life as an absolute value, and illness and death as evil. In the Christian tradition earthly life is not thought of as having absolute value, since Christians base their understanding on the perspective of eternal existence, viewing illness as a trial which can bring spiritual benefit, and death as the passage into another world. The irreligious person who does not believe in life after death tries to live on this earth as long as possible: hence the attempts to prolong life by artificial means after the natural functions of the human organism cease. The Church holds to another view, since it believes that the ‘prolonging of life by artificial means, by which only some organs continue to function, cannot be viewed as the necessary and desired goal of medicine in all cases’ (The Bases of the Social Conception of the Russian Orthodox Church XII, 8). The Church allows for the discontinuation of medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome, since in such cases ‘one does not will to cause death; one’s inability to impede it is merely accepted.’ (Catechism of the Catholic Church 2278).

The irreligious person fears death, the thought of death, preparation for it as well as its throes: hence the widespread view of sudden death as the most desirable end. Christians, on the contrary, pray to be delivered from sudden death, considering the possibility of preparing themselves for the end of their earthly lives to be a good thing, since death is viewed as a spiritually significant transition in one’s life. Surrounded by Christian care, the dying person is capable of experiencing a grace-filled change of heart, along with a new understanding of the path he has walked and the penitent standing before eternity during the last days of earthly existence (The Bases of the Social Conception of the Russian Orthodox Church XII, 8). Those who commit suicide as well as those who undergo euthanasia are deprived of this.

The problem of euthanasia carries in itself a whole array of other moral questions which are closely linked with the main problems in the debate over traditional and liberal values. One of these questions deals with the function and role of the doctor. According to the religious idea steeped in centuries-long tradition, the task of the doctor is to cure illnesses and maintain the life of the sick, and by no means to put an end to life. The Hippocratic oath reads: ‘I will not give a drug that is deadly to anyone, even if asked for it.’ Doctors who render assistance in the killing of an ill person, even if this takes place with the approval or by the request of the latter, take upon themselves the function of an executioner. The moral criterion, which made the medical profession so honoured over the ages and thanks to which the patient could entrust his life to the doctor, disappears. The legalization of euthanasia will make such trust impossible. Moreover, it will open the door for the transformation of doctors into serial killers. A frightful example of this is the American Jack Kevorkian, called ‘Doctor Death’: while actively propagating euthanasia, he ‘helped’ 130 patients end their lives. At court he attempted to prove that he did so exclusively from humane considerations, in order to lessen the suffering of the terminally ill. Another serial killer in a medical coat was the Englishman Harold Shipman, who hung himself in his prison cell in 2004. An investigation found him guilty of the murder of 352 patients, whom he murdered over the course of many years of his medical practice. If doctors receive an official ‘license to kill,’ what will protect patients from new Shipmans and Kevorkyans? What will protect the doctors themselves from the appearance of serial killers in their midst?

Another moral problem indirectly linked with euthanasia concerns the gradual changes in the correlation between the youth and the elderly in Western countries. According to a UN report compiled in 2002, the aging of the population in the modern world is a process without precedent in the history of humankind. The increase in the proportion of elderly people (60 years of age and older) is accompanied by the decline in the proportion of young people (15 years of age and younger). By 2050 the number of elderly in the world will outnumber the number of young for the first time in human history. The aging process is occurring with the greatest speed in developed Western countries, where it is caused by both the sharp decrease in the birth rate and the increase in life expectancy. It is a well-known fact that the higher the average age of a country’s population, the heavier the financial burden on every young person in the country, since they will have to pay more and more taxes to support the ever-increasing army of old people. In this situation euthanasia may turn out to be in special demand as an easy means of ridding oneself of the necessity of spending money on the support of the elderly. The latter will be ever more often reminded of their ‘right to death’ and the possibility of ‘dying with dignity.’

Sometimes it seems that we are living in a world turned upside down. In a world in which the system of values has been overturned, where good is called evil and evil good; life called death, and death life. Values based on the religious moral ideal, which continue to remain traditional for the majority of people on the planet, are undergoing systematic desecration, while new moral norms which are not rooted in tradition and contradict the very nature of humans are being inculcated into the masses. Millions of unborn children are being deprived of life, while the elderly and the terminally ill are being offered the ‘right to die’. The ideals of family, marriage, marital fidelity and childbearing are being ridiculed and spat upon, while sexual deviations and ‘free love’ are being actively propagated and endorsed. The plague of militant atheism and liberalism has struck millions of people in the West: it has taken the lives of some, deprived others of the possibility of being born and granted others the right to ‘die with dignity.’ The humanists and atheists rub their hands with satisfaction, declaring that the problem of population growth in the developed countries of Europe and North America has been successfully solved (Humanist Manifesto 2000, chapter II). They prefer not to notice that the universal reappraisal of values has already cast Western civilization into a demographic abyss and now threatens to bring about a global, inter-civilizational conflict, should the epidemic of liberalism seize other regions of the world.

Today every believer in the West should think seriously about his future and the future of his children, country and civilization. Religious people must realize the special responsibility that rests with them and engage in dialogue with the secular worldview. If such dialogue is not possible, they should openly resist this system of values.

Believers should remind Western civilization of the moral choice on which its future directly depends. The essence of this choice was best expressed by Moses while addressing the people of Israel: ‘See, I have set before thee this day life and good, and death and evil; In that I command thee this day to love the Lord thy God, to walk in his ways, and to keep his commandments… that thou mayest live and multiply: and the Lord thy God shall bless thee... But if thine heart turn away, so that thou wilt not hear, but shalt be drawn away… I denounce unto you this day, that ye shall surely perish, and that ye shall not prolong your days upon the land… I call heaven and earth to record this day against you, that I have set before you life and death, blessing and cursing: therefore choose life, that both thou and thy seed may live’ (Deut. 30:15-19).