Monday, April 13, 2009

Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 1)

The explosion of ideas generated during the scientific revolution has created vast changes and seemingly limitless potential for innovation in the different fields and practices of science and technology. In the field of medicine, advances in technology and medical knowledge have occurred so rapidly that health care possibilities have outgrown their moral and ethical mores. The appearance of near limitless possibilities and capabilities of medicine and technology have created a conundrum of knowing how and when to set limits to that which seems to be limitless. Many patients expect doctors to do everything possible to cure their ailments; doctors (often out of fear of litigation) oblige this expectation by utilizing every possible medical and technological means available; yet, they endure blame when they fail and complaints by those who accuse them of going to far. In some cases these "heroic" efforts are genuinely therapeutic and life-extending, whereas at other times they simply prolong the process of dying. The result is that the lines between preserving life and prolonging death have become blurred, which has created a "host of complex issues for society, the medical profession, and the dying individual and his family."[1]

The practice of euthanasia has been heralded by right-to-die advocates as a legitimate and humane means for dealing with these new problems. However, it has engendered much scrutiny and debate because of its radical digression from traditional views of life and death. The autonomy of the self and the necessity of mercy are the championed axioms that are replacing the traditional values of the intrinsic value and inviolability of life and society's duty to protect human life.[2] To make the situation even more difficult, there is debate even among right-to-die advocates about how euthanasia should be understood and what practices should be allowed.[3] I have decided to provide a series of posts that will argue that euthanasia should not become an acceptable means for dealing with these difficult end-of-life dilemmas, for rather than promoting death with dignity, it will provide a license for killing with impunity.

However, before I begin, let me put my cards on the table concerning my approach. As a confessionally Reformed Presbyterian, my ultimate reasons for rejecting euthanasia is for biblical, for as the answer to Q.3 of the Westminster Larger Catechism states, "The holy Scriptures of the Old and New Testament are the Word of God, the only rule of faith and obedience."[4] However, given that everyone does not live in light of biblical authority, I am approaching this conversation on euthanasia from a natural law perspective, and I do so for two reasons. First, I desire to attempt to better communicate with my neighbor who does not accept biblical authority as I do. I realize that not everybody accepts biblical authority as I do. I do not desire for this to cut off communication, so utilizing natural law argumentation seems the best way to keep the communication channels open. Peter J. Bernardi states my concern well, "Ultimately, the religious conviction that life is a gift from God that we are not free to end on our own terms is the most effective motive for remaining opposed to doctor-assisted self-killing. But what effect would that argument have on someone who does not believe in God?".[5] With an issue like euthanasia, it is imperative to open lines of communication with which persons from throughout the community will engage no matter their religious convictions.

A second reason I have decided to attempt a natural law argument instead of an explicit biblical argument comes from my understanding of the nature of biblical ethics. The ethical commands of scripture seem to be directed to the covenant community and not towards those outside the covenant community. For example, when one reads the Decalogue in Exodus 2o.1-17, one finds an indicative-imperative structure to the commandments. The commandments are built upon the foundation of the prologue that God has saved his people from bondage in Egypt. God's salvific action on behalf of his people provide the necessary foundation upon which his ethical demands for his people are founded. When one seeks to place those ethical demands on those outside the covenant, who have not been the recipients of God's salvific "indicative," then it would appear that one is using scripture in a way not intended by God. The ethical commands in scripture do not seem to be designed for the world at large. Rather, the purpose of scripture's ethical commands seems to be to regulate and define the lifestyle of God's redeemed covenant people.

Natural law, however, does provide a common ground for those in the covenant community to engage in dialogue over public issues with the unredeemed (those who are members ob both the city of God and the city of man interacting with those who are only members of the city of man). David VanDrunen writes,
Natural law is God's common moral revelation given to all people of whatever religious conviction. A common moral realm, in which all of created humanity enjoys membership, is rightly governed by a common moral standard that is revealed to all of crated humanity. The civil kingdom is for human beings insofar as they are created and sustained by God; natural law morally obligates human beings insofar as they are created and sustained by God.[6]
This understanding of natural law is not built upon the false notion of human autonomy but is grounded in God's own nature and the creation of human beings in the divine image, so that it is ultimately grounded on the authority of God the Creator. In fact, as VanDrunen argues, "natural law is taught in Scripture,"[7] and the scripture actually teaches that when those in the covenant of grace are dealing culturally with those not in the covenant of grace, that natural law rather than special revelation is the basis for moral reasoning.[8]

By making my case according to a natural law argument, I am not jettisoning God's authority or even his communication, rather, I am making my case with two proper, God-centered presuppositions: he is there and he is not silent. His communication is not just found in the scripture, however, but also in his created order; there is a place for general revelation in addition to special revelation. My attempt at a natural law argument is grounded in God's general revelation. Now I acknowledge that my understanding of general revelation has surely been shaped by my study of God's special revelation (the Bible). Yet, I am not making a case for how I have come to my beliefs on this subject as shaped by the Bible; I am attempting to make a case that reflects my beliefs as they are found in general revelation, or natural law, since that is the common language for the sphere of the city of man. Let me be clear, I am not arguing for a common ground or neutral ground of knowledge, but a common ground of communication. I hope to appeal to the law that is written on man's heart because he is created in God's image, which he suppresses in unrighteousness (Rom 1.18), yet which he does not suppress completely.

With an issue as important and controversial as euthanasia, we must engage in the conversation by doing more than simply talking to ourselves (or preaching to the choir). If natural man will not receive the indicatives of the gospel, why do we think we can hoist upon him the imperatives and get a better outcome?

In this series of posts I will be arguing against euthanasia on natural law grounds: legalizing it will have a negative effect on society by creating a culture of death in which death will become the accepted means for dealing with life's difficulties, it will lead to abuses that will endanger the weak and elderly, and it will result in other forms of euthanasia (such as nonvoluntary and involuntary) that can endanger everyone. Euthanasia should not become an acceptable means for dealing with these difficult end-of-life dilemmas, for rather than promoting death with dignity, it will provide a license for killing with impunity.

(Part 2)

[1] John Jerfferson Davis, Evangelical Ethics, 3rd ed. (Phillipsburg, NJ: Presbyterian & Reformed Publishing, 2004), 183.

[2] And as will be discussed in more detail in a later post, the intrinsic equality of all persons is also being replaced with elitist notions of equality that are based on "quality of life."

[3] For the purpose of this series of posts, I will be discussing euthanasia with specific reference to the practices of active-voluntary euthanasia and physician-assisted suicide. Since both actions involve intentional acts of killing an innocent being, I understand them to be morally equal, and hence, I deal with the two of them the same way and at the same time. I realize that not everyone agrees with this moral equation, but for the practical considerations of these posts it is expedient.

[4] For fine discussions of euthanasia from a biblical perspective see Davis, Evangelical Ethics; John S. Feinberg and Paul D. Feinberg, Ethics for a Brave New World(Wheaton, IL: Crossway Books, 1993); Millard J. Erickson and Ines E. Bowers, "Euthanasia and Christian Ethics" Journal of the Evangelical Theological Society 19 (1976): 15-24.

[5] Peter J. Bernardi, "Dr. Death's Dreadful Sermon: From Roe to Final Exit, there really is a slippery slope," Christianity Today, 15 August 1994, 30-32. [emphasis mine]

[6] David VanDrunen, A Biblical Case for Natural Law(Grand Rapids: Acton Institute, 2006), 38.

[7] Ibid., 2.

[8] Ibid., 37-54. For further arguments in favor of the biblical case for natural law and its use in public moral discourse, see Stephen J. Grabill, Rediscovering the Natural Law in Reformed Theological Ethics (Emory University Studies in Law and Religion)(Grand Rapids: Eerdmans, 2006); Markus Bockmuehl, Jewish Law in Gentile Churches: Halakhah and the Beginning of Christian Public Ethics(Grand Rapids: Baker, 2003); David Novak, Natural Law in Judaism (Cambridge: Cambridge University Press, 1998); and John Barton, "Natural Law and Poetic Justice in the Old Testament," Journal of Theological Studies, N.S. 30 (April 1979): 1-14.


  1. David,

    Van Til, I think correctly, argues that all mankind was included in the covenant with Adam. Thus, all mankind, created in the image of God, are covenant breakers in Adam and by actual transgressions. There is the point of contact! To speak from the presupposition of faith (the Reformed faith)the creation ordinances to men, then, is to set before them the Creator God whom they know (in Adam), yet the knowledge of whom they suppress in unrighteousness. The wrath of God is revealed against all their ungodliness; and in the light of such manifestation of wrath, the ungodly are to be called to repent and to embrace the gospel of Christ, the Second Adam, freely offered in the gospel. Van Drunen speaks of natural law; so does C. S. Lewis. Would it not be more to the point to speak of God-ordained creation ordinances, i. e., covenant of works ordinances? Thus, the call to respect life ought to be nothing less than a call to the world (covenant-breakers) to repent of their rebellion against the Creator God and to embrace the grace freely given in Christ in whom we believe.

    If I hear you correctly, that is the direction I think you are leaning.


  2. Hey Dan! I would give a hearty amen to what you say in your comment; yet, I would also submit that the apologetical task you describe is not the only type of encounter I have with my unbelieving neighbor. I also share a community with them and participate in ethical conversations for how the community should function.

    When I (and VanDrunen et. al.) refer to "natural law," I am referring to the God revealed moral law that he has built into creation and implanted in all mankind when he created man in his image (ala Calvin's sensus divintatus). By referring to natural law, I'm simply referring to Calvin's lex naturalis.

    If Van Til is right, and I believe he was, then although natural man suppresses the lex naturalis in unrighteousness, he does not suppress it completely, and as Van Til teaches, he lives on borrowed Christian capital. Why not make an appeal to my neighbor to hold to an ethical position based on the Christian capital he is already borrowing?

    In this series of posts I am assuming this Christian capital in order to help persons put it to action--I am not calling them to respect life--I am presupposing that they already do, and hoping to encourage them to do so consistently.