(Dr. Leonard Bernstein, MD, MPH is a retired orthodontist and former Professor of Orthodontics at Boston University. After retiring, he returned to school and obtained an MPH from Boston University. He is a prolific author and lecturer on both professional and non-professional subjects. He and his wife live in Brookline, Massachusetts, and in Port of Spain, Trinidad.
This is the first of a two-part post on how world religions view aid in dying.)
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Personal autonomy
The ethical and philosophical basis for a person making the decision to end their life is the concept of autonomy. In medical practice, autonomy is usually expressed as the right of competent adults to make informed decisions about their own medical care. The principle underlies the requirement to seek the consent or informed agreement of the patient before any investigation or treatment takes place.
Personal autonomy is an important term worthy of discussion. It is an important consideration when discussing the right to die and/or dying with dignity. The question being is to the right that a person has over their own life. The annual Oregon Death with Dignity Act survey shows that loss of autonomy, by far, is the most important concern of those who choose to exit.
There is a long history on the development of autonomy concept relative to dying with dignity as exemplified by Seneca, a Roman stoic philosopher who lived from 4 BCE to 65 CE. Seneca wrote, “I will not escape by death from disease so long as it may be healed and leaves my mind unimpaired; I will not raise my hand.”
Religious groups and end-of-life choices
The Pew Charitable Trust has investigated religious groups’ views on end-of-life (EOL) issues. In the following summaries, religious leaders, scholars, and ethicists from 16 major American religious groups explain how their faith traditions’ teachings address Medical Aid in Dying (MAiD), euthanasia, and other end-of-life questions. While most religious bodies are generally opposed to most EOL options, there are exceptions.
In reviewing the summaries, the observation can be made that while being opposed, most groups are not immune to reality and offer what may be described as an “escape clause” which can be interpreted as, “we are opposed; however …”
- Assemblies of God
The country’s largest Pentecostal denomination opposes MAiD, suicide, and euthanasia. They teach that life is a sacred gift, and only God should determine when it ends.
At the same time, the church allows that life need not be sustained at all costs when there is no hope for recovery. It leaves room for people to reject artificial means of life support. Also, the church does not frown on the use of pain medication to alleviate suffering, even in cases where it might contribute to hastening death.
- Buddhism
Buddhists generally oppose assisted suicide and euthanasia, believing it is morally wrong to destroy human life, including one’s own, even if the intention is to end suffering. Buddhists are taught to have a great respect for life, even if it is not being lived in optimal physical and mental health.
However, Buddhists also believe that life need not be preserved at all costs and that one does not need to go to extraordinary lengths to preserve a dying person’s time. This infers that while someone who is terminally ill should not be denied basic care, they could refuse treatment that might prove to be futile or unduly burdensome. The inference is that so long as there is no intention to take life, no moral problem arises.
- Catholicism
The Roman Catholic Church strongly opposes MAiD and euthanasia, teaching that life should not be prematurely shortened because it is a gift from God and that it is the Creator’s decision.
On the other hand, the church recognizes that a dying person has the moral option to refuse extraordinary treatments that only minimally prolong life. This means patients can legitimately forgo treatment that doesn’t give a reasonable hope of physical or spiritual benefit, such as resuscitating someone who is at the very end. However, a 2021 Susquehanna poll reported that 66 percent of Catholic voters support MAiD legislation.
- Church of Jesus Christ of Latter-day Saints (Mormons)
The Church opposes physician-assisted dying and euthanasia, believing that taking one’s own life or another’s violates God’s commandments and His plan for each person.
However, the church teaches that when someone is dying, it is acceptable to forgo excessive or extraordinary therapies. “The church does not believe that allowing a person to die from natural causes – removing a patient from artificial life support, for example – falls within the definition of euthanasia and that families should not feel obligated to extend life by unreasonable means.”
- Evangelical Lutheran Church in America
The ELCA opposes efforts by medical professionals to speed a patient’s death. Destroying life created in God’s image is contrary to core church teachings and that life is a gift from God, to be received with thanksgiving, and there is an integrity of the life process that should be respected.
At the same time, the church teaches that there is no requirement to take extraordinary steps to keep a dying person alive a little longer, and that allowing something to happen is different than actively hastening death.
- Episcopal Church
Episcopalians are against aid in dying and forms of active euthanasia, believing it is morally wrong and unacceptable to take human life to relieve suffering caused by incurable illness. Still, there is a sense within the church that hard-and-fast rules on EOL issues may not fit every circumstance. Although they have a clear moral norm against the taking of human life, there may be cases that stand beyond judgment.
The church also teaches that it is justified to stop medical treatment, including artificial nutrition and hydration, when that treatment brings significantly more burdens than benefits to someone. Such decisions also should be informed by the moral norm against taking life and that the dividing line is the difference between the intent to take life and withdrawing of treatment.
- Hinduism
While there is no formal Hindu teaching on Medical Aid in Dying or euthanasia, there is a general concern that prematurely ending someone’s life could negatively impact their karma. The concept of karma centers around the belief that good and bad occurrences are caused by actions taken in past lives, since Hindus believe in reincarnation. The act of delaying suffering may further increase bad karma in the next life.
At the same time, some Hindus believe there are circumstances to justify hastening death. If you have reached a stage when you can no longer worship properly [due to illness or infirmity], then you are justified in asking your doctor to speed your death, although most Hindus would probably not subscribe to this view.
- Islam
Islamic teachings oppose physician-assisted dying and euthanasia. Muslims believe that life is sacred and comes from God; therefore, it is a sin to take it. Islam also teaches that God alone decides how long someone will live and when they will die.
Islam’s views also are influenced by the belief that suffering and other difficulties might be beneficial, that you should go through some kind of difficulty that tests your faith. End-of-life suffering is seen as a way to purify previous sins so that by the time you meet God, you do so in a more pure state.
While Islamic thinkers oppose hastening death, they also generally believe that the terminally ill need not employ extraordinary means and technologies to delay dying. Basically, talking about the difference between a conscious decision to end life, which is wrong, and life ending by itself, is not always clearly defined.
(To be continued next week …)
(Please scroll down to comment.)
Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
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Thank you, Leonard. This is very insightful.
Jim schultz
I’ll be anxious to read what you see as Judaism’s views. In my (Jewish) opinion, they are quite varied. I think that Orthodox Jews will never endorse MAID but many Reconstructionist are close to endorsing and Reformed are often not far behind the Reconstructionists. As you probably know, it’s all based on Torah interpretations. Over the centuries, we have twisted Torah to say pretty much whatever we need it to say and I’m convinced we can find something in there that we can interpret as MAID being okay. All it will take is one courageous Rabbi to start that ball rolling. That’s my opinion. I’m looking forward to yours. Also, to you intend to include Unitarian-Universalism in the article? They have endorsed MAID, starting with a 1988 resolution supporting a person’s right to die with dignity and have even encouraged their members to work for legislation supporting that right.
Ron, Here are two blog posts on that topic: https://www.thegooddeathsocietyblog.net/2022/05/29/im-a-rabbi-and-i-helped-my-father-end-his-life/ and https://www.thegooddeathsocietyblog.net/2023/08/27/a-jewish-interpretation-of-death-with-dignity-seven-teachings/
Also, both Judaism and the UU are included in part two.
You accurately depict the formal doctrine of the mainline Protestant denominations but, fortunately, the clergy leadership of both the ELCA and Episcopal churches are much more nuanced in their approach to MAiD as they walk with parishioners experiencing suffering at the end of life. Yes, I do wish the formal statements would change, but I am heartened to see that the “boots on the ground” are stepping with more compassion for EOL suffering and supporting all options.
It interests me that religions consistently decry messing with natural life-span to SHORTEN it (“it’s all in God’s hands”) while having no qualms whatsoever about using medical technology to artificially LENGTHEN life-span. If the span of our life is determined by God, why is it okay to use man-made technology to lengthen it beyond what God intended for that person, but not okay to hasten impending death by a few weeks or months? This seems internally inconsistent and has always bothered me.