From Today’s Christian Doctor – Summer 2011

Hippocrates said it clearly, “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly, I will not give a woman a pessary to cause an abortion.” The Oath has been the primary resource and guide for the ethical practice of medicine for 2,500 years. Only in recent decades have the provisions of the Oath been challenged, even changed. The changes started when the proscription against abortion was turned upside down and continue now with the international debate about euthanasia and physician-assisted suicide (PAS).

We must recognize that the Hippocratic Oath is not holy writ. However, these two prohibitions in this historical professional guide are consistent with a biblical understanding of the sanctity of human life. This understanding translates directly into a biblical prohibition of intentionally ending innocent human life by anyone, including physicians.

The very best argument against legalization of PAS is a positive alternative — strong support for excellent palliative measures along with legitimate concerns about the consequences of legalization.

The technological capabilities of modern medicine have made end-of-life treatment decisions much more complex than they were a generation or more ago. It is appropriate, even laudable, for patients, families, and healthcare professionals to consider limitation of life-prolonging treatment as death approaches and to instead focus on providing excellent comfort care. But the ancient prohibition of any action that intentionally causes death remains outside the bounds of biblical behavior and continues to be clearly prohibited by professional policy (e.g., American Medical Association policy).

Euthanasia has been legalized in a few countries (such as in the Netherlands and Belgium) and assisted suicide in others (the Netherlands and Switzerland). The US Supreme Court has concluded there is no constitutional right to assisted suicide, but has stated that it is up to the states to decide whether to permit PAS. Physician-assisted suicide has been legalized in a few states (Oregon, Washington, and possibly Montana) and is under legislative consideration in several others.

When bills to legalize PAS are introduced into state legislatures, some Christian physicians take the position that, “I wouldn’t do it, but if others want to move in this direction, that is their decision.” That could be a defensible position if the only objection to PAS were theological. And, in all honesty, a theological objection holds little persuasive power in our secularized society. However, there are actually three sets of reasons to oppose legalization of PAS:

• Principle-based reasons – human life is sacred (primarily religious positions)
• Virtue-based reasons – doctors should not kill (professional positions, e.g., Hippocratic Oath, AMA)
• Consequence-based reasons – it will lead to bad results (abuses, expansions, complications)

Consequence-based reasons are generally the strongest arguments on this issue in public debate. Those promoting the legalization of PAS maintain that they have built into the proposals many safeguards to protect against bad results. However, reviewing both euthanasia and physician-assisted suicide where they are now allowed shows clearly that the practice does not match the theory. It is for this reason that the Vermont Alliance for Ethical Healthcare developed the following comparison for use in the public square.