One of the most poignant suicide notes I’ve read was written by Gillian Bennett. A brilliant and articulate woman, and a trained psychotherapist, she was diagnosed with dementia and began to experience the resulting limitations, weakness, and frailty.
She decided to end her own life to avoid experiencing further decline. She wrote about her decision on a dedicated website. The story of her death and her reasons for choosing it were widely discussed in the media. Her words help us to understand the perspective of a patient seeking physician-assisted death:
I will take my life today around noon. It is time. Dementia is taking its toll and I have nearly lost myself. I have nearly lost me. . . .
Understand that I am giving up nothing that I want by committing suicide. All I lose is an indefinite number of years of being a vegetable in a hospital setting, eating up the country’s money but having not the faintest idea of who I am.
Each of us is born uniquely and dies uniquely. I think of dying as a final adventure with a predictably abrupt end. I know when it’s time to leave and I do not find it scary.
According to the website, Gillian Bennett died at 11 a.m. on August 18, 2014, in the presence of her husband. News of her death, and her poignant declaration of her reasons for ending her life, contributed to the growing public support for physician-assisted death. Within a year of her death, the Supreme Court of Canada struck down the criminal code prohibiting physician-assisted death. By 2022, 4.1 percent of all deaths in Canada were physician-assisted.
How do we respond to people like Gillian who find no reason to go on, who want life to be over, and who want to control the manner and timing of their deaths? Given this “why,” which seems so intuitive and plausible in our present social milieu, is there a reasonable “why not”?
Wealthy, White, Nonreligious Suicides
A consistent finding from studies of patients who seek euthanasia is that they’re generally from a specific group in society: wealthy, white, nonreligious people.
This observation is sometimes cited in support of physician-assisted death because it’s taken to mean these patients aren’t from so-called vulnerable or marginalized populations. They aren’t being taken advantage of or forced to obtain physician-assisted death. They aren’t vulnerable to coercion. Nobody is making them choose this path.
But are we failing to understand the true nature of vulnerability? What if vulnerability to physician-assisted death arises from within rather than from external social forces? What if people lack the resources offered by spiritual beliefs and community to make sense out of suffering and to transcend it? What if vulnerability isn’t social but rather psychological and spiritual?
The fact that a specific group of people is predisposed to seek physician-assisted death raises the distinct possibility that existential, philosophical, and spiritual concerns—problems of meaning and significance in the face of suffering and loss—are key factors that help explain why people seek death from a doctor.
Decide Your Own Value
Proponents of physician-assisted death claim to care greatly about human value. They insist that physician-assisted death is a matter of respect for intrinsic value and autonomy. Intrinsic value rises from the thing itself. By regarding a person as the source of his or her own value, the person appears to be accorded deep significance and importance. After all, isn’t this “value from inside”?
On the contrary, physician-assisted death doesn’t affirm the intrinsic value of humanity, because it’s based on a sense of value conditional on someone’s self-regard. In fact, it requires viewing humans as having extrinsic value, which comes from the valuer’s opinion. When we treat ourselves as the foundation of our own value, we force ourselves to bear an unbearable weight. If we’re in a situation where we’re unable or unwilling to value ourselves, then we lose our value. If we’re of no use to ourselves, then we really are useless. If I feel my existence is bad for me, then it really is bad to exist.
By contrast, if I had intrinsic value, I’d be obligated as “valuer” to value myself. But if I don’t have such intrinsic value, then I’m under no obligation to value myself, and I’m free to do with myself as I please, no matter how self-destructive my choices might be.
True Value
We’re too weak, too frail, too vulnerable to circumstances for our self-regard to be a firm foundation for our value and significance. And this is a burden we need not bear, for God tells us how valuable we are over and over (Ps. 139; Isa. 43:4; Matt. 6:26; 10:29–31; John 3:16). Yet the tragedy of the human condition is that we’re prone to forget how much we matter.
We’re too weak, too frail, too vulnerable to circumstances to be a firm foundation for our value and significance.
One important way we remember our intrinsic value is through community. When others treat us as if we’re deeply valuable (e.g., kind wishes from friends and family on our birthday), we feel ourselves to be valuable. If we’re ignored, neglected, or forgotten, we quickly doubt our value. Unless we enjoy respect and dignified treatment from others, we’re inclined to feel worthless.
This is the essence of loving community, seen so clearly in the local church. It’s a web of value in action.
Solution to Despair
Physician-assisted death is held up as a solution to the problem of suffering; at bottom, it’s a solution to despair. And the solution is to end the person who’s in despair.
We know a better way.
The gospel offers us deep, durable meaning—powerful enough to sustain us through life and through suffering and dying. Our story becomes part of God’s grand story, the story behind all stories. It’s the story in which our suffering is shown to be for good, to be meaningful, to matter, to be worth it.
And it’s a happily-ever-after story, a too-good-to-be-true story, a story of faith, hope, and love that culminates in eternal life and everlasting communion with the One who made us for himself. In the kingdom, we discover that God himself is our highest good. In the kingdom, we discover a meaning for our suffering that makes it all worth it. In the kingdom, our suffering isn’t useless. In the kingdom, there’s no despair.
The gospel offers us deep, durable meaning—powerful enough to sustain us through life and through suffering and dying.
So how should we respond? The church can head off physician-assisted death in our congregations by discipling Christians to suffer well. We must equip believers with the theological, philosophical, and spiritual resources to face suffering, to endure hardness. Our teaching should anticipate suffering, illness, and death.
Those of us privileged to live in democratic societies must ask our elected officials to oppose this practice and to uphold freedom of conscience for healthcare professionals who refuse to participate.
A nation’s laws are a teacher. Legalizing physician-assisted death teaches our society to doubt human value and to see it as merely extrinsic and conditional. Prohibiting this practice reminds us of the true depth of human value. Protecting freedom of conscience allows professionals in healthcare facilities to provide safety for those living with disabilities or chronic illness who see themselves as vulnerable to the suggestion of death.
The Gospel Coalition