“Even to your old age I am he, and to gray hairs I will carry you.
I have made, and will bear, I will carry and will save.”  Isaiah 46:4 (ESV)

Among the important “Aging and End-of-Life Issues” presently being confronted in both the church and in our North American secular culture is euthanasia. A recent article in the Washington Post Newspaper stated that the number of Americans over the age of 65 continues to be rising quickly.  “In the past century, it’s grown five times the rate of the rest of the population and is now approaching 60 million people.”  While this is welcome and good news for people who are enjoying happy, healthy golden years, for many others the “golden years” are not so golden.

Providing care and the costs of care for an aging population are often overwhelming issues for seniors, their children and society in general.  One’s view of euthanasia is a faith issue impacting a variety of aging, quality of life and end-of-life decisions.

The biomedical evolution has touched the lives of all of us, and this means that as the end of our life or that of our loved one approaches, increasing numbers of us will be called upon to apply the principles of our faith and God’s Word in making decisions about the meaning of life. Being a church that believes in the sanctity of life, how can we facilitate helpful conversation and provide guidance in decision-making that often involves complex issues and requires theological and spiritual integrity? 

Writing about euthanasia as members of The North American Lutheran Church Life Ministries Team, our purpose is to lift up God’s gift of life across the entire span of human life from conception in the womb to the end of life and all circumstances in between. Our Lutheran understanding about aging, illness and end-of-life decisions pivots around two central points: Upholding the sanctity of life because life is a gift from God to be received and lived with thanksgiving; and providing hope and meaning as the end-of-life approaches.  Such hope and assurance are possible even in times of suffering, and death itself: Truth powerfully proclaimed in the resurrection faith of the church.

So, what is euthanasia and how do Christians who believe in the sanctity of life respond?

“Euthanasia,” in its proper sense, is derived from two Greek words meaning “a good death.”  Euthanasia is something we do or fail to do that causes, or is intended to cause death.  For some, the word “euthanasia” is a synonym for “mercy killing.”

Surrounded by a culture of death, which chants, “My body, my life, my choice,” what is our Christian response?

Many of us who are pro-life hold that there is a difference between “active” and “passive” euthanasia.  Christians in North America face strong forces contending for “mercy killing” and assisted suicide.  We must lay a sound foundation for our own understanding of what it really means to provide care at the end of life and then work together to oppose the terribly-distorted image of care that is projected by “mercy killing.” Active euthanasia refers to an action one takes to end a life, such as a lethal injection.  Passive euthanasia refers to an omission, such as failing to intervene at a life-threatening crisis or failing to provide nourishment.

It is important to not confuse passive euthanasia with the morally legitimate decision to withhold medical treatment that is not morally necessary, and respects that God alone is author of life and of all our days.  When the God-given powers of the body to sustain its own life can no longer function and doctors in their professional judgment conclude that there is no real hope for recovery even with life-support measures, a Christian may in good conscience “Let nature take its course.”  At such times medical interventions are no longer effective expressions of Christian care but instead involve burdensome prolongation of a person’s dying.

Does a person have the right to refuse medical treatments, or must one always use every possible medicine and medical technology available to keep ourselves or another person alive who is dying? 

Believing that life is a gift from God, “Lutherans for Life” opposes physician-assisted suicide and other efforts by individuals and medical professionals to take life or speed a person’s death through so-called “mercy killing.”  Destroying life created in God’s image is contrary to core Biblical teaching about the sanctity of life.  Scripture tells us that even our suffering entrusted to God will not be in vain and can bring glory to God (Romans 8:18-28).  Our last days can witness our faith to family and others, deepen our relationship with Jesus, bring reconciliation with loved ones, and see dying in Christ as a good part of life.

Lastly, it is important to be honest with each other that in making end-of-life decisions, pastors, family and medical professionals who are committed Christians can disagree.  Deliberate and prayerful conversation needs to continue regarding the meaning and definition of passive euthanasia. As Creator, God alone knows with certainty whether an illness or an injury is incurable.

Our disagreements may remind us that Martin Luther once said that there are times we “sin boldly” knowing even our best efforts may lead to error; yet, we are forever covered by God’s “Word of Grace and Forgiveness” through the Gospel of Jesus Christ.  We move forward boldly living by Grace, pondering God’s guidance, and seeking ethical and lawful ways to bring God’s love to each other and our neighbors in promoting a culture of life.  Life is not ours to give, nor is it ours to take.  Respecting the sanctity of life God assures us that even in our old age with gray hairs, he will bear us, carry us and he will save.

The Rev. Dr. Alden W. Towberman,

The North American Lutheran Church Life Ministries Team

Imagine a scenario where a loved one is suffering from an incurable condition and unimaginable pain.  And yet, antiquated laws have prevented her from finding peace once and for all. Shouldn’t they be changed to allow a medical professional to compassionately put her out of her misery?

This is the argument posed by physician-assisted suicide (PAS) advocates, and it has successfully changed numerous laws in the United States. But is death the only way to end pain? And do laws which allow PAS affect others in unexpected ways as well? Furthermore, could the legalization of PAS be abused?

First, let’s examine the facts. PAS is legal in many westernized countries today, such as Canada, the U.K., and Japan. But the country with the most PAS data is the Netherlands–one of the first countries to legalize the practice. Shockingly, PAS accounts for over four percent of all deaths in the Netherlands today, and the percentage is probably larger, since many such deaths go unreported. Furthermore, many euthanized were either unaware or incompetent to make this decision for themselves. Even children as young as twelve can be euthanized under the law. People can also be euthanized for depression in the Netherlands; eighty-three people were put to death for psychiatric conditions in 2017. Because of these facts, many Dutch citizens worry about being euthanized against their wishes. In fact, it is estimated that 10,000 Dutch citizens carry a “do not euthanize me” card just in case they become incapacitated.

Sadly, the United States is following in Holland’s footsteps. Already ten states and the District of Columbia have legalized the practice of PAS and the number of states which will legalize PAS in the future is expected to grow.

But what are the risks of legalizing PAS? Physician bias is always an issue. One only needs to find one doctor who is willing to approve nearly any request for euthanasia, and numerous unneeded deaths will be the result. Furthermore, as the price of health care increases, the possibility for coercion grows. Families will decide, often for economic reasons, that it’s best to end a loved one’s life rather than pay for long-term treatments which might result in financial collapse.

Is PAS even needed to control pain? One of the positive movements in recent decades has been the growth of the hospice movement and its effort to provide palliative pain care. The truth is that most pain conditions caused by life-threatening diseases can be alleviated using analgesic medications, including opioids. Indeed, proper hospice care has been able to extend life in many cases, even above the expected longevity of undergoing additional treatment.

Ultimately, as Christians, we need to understand how PAS does, or does not, fit into God’s plan for our lives. And as with any moral issue, Gods’ Word has to be our final guide.

One of the problems with today’s society is that there is no perceived value in suffering. Everything is solved with a pill. But God’s Word tells us otherwise. In 2 Corinthians 12:9-10, Paul reflects on how the Lord told him that, “My grace is sufficient for you, for power is perfected in weakness.” Paul writes, “Most gladly, therefore, I will rather boast about my weaknesses, so that the power of Christ may dwell in me. Therefore, I am well content with weaknesses, with insults, with distresses, with persecutions, with difficulties, for Christ’s sake; for when I am weak, then I am strong.” Our illnesses teach us about the kind of humility we need in order to have an honest relationship with the living God.

We must leave the power of life and death in the Lord’s hands. After his entire family was killed, Job wrote, “The Lord gave and the Lord has taken away; may the name of the Lord be praised.” We need to leave our mortality in the hands of God because we have a bright and shining future waiting for us – even after we die. At the end of time, “[God] will wipe away every tear from [our] eyes; and there will no longer be any death; there will no longer be any mourning, or crying, or pain; the first things have passed away” (Rev. 21:4).

Rev. Dr. Dennis Di Mauro is pastor of Trinity Lutheran Church (NALC) in Warrenton, VA. He also teaches at St. Paul Lutheran Seminary and the North American Lutheran Seminary.