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Assisted dying, the current phrase for active euthanasia, has until recently been a debate between the progressive idea of personal autonomy and the Christian idea of public morality.  But, today there is less talk about the sanctity of life and the moral injury of suicide and more of a focus on notions of “safeguarding” and “informed consent.”  In other words, Christian ethics rooted in the infinite value of human life is rarely a part of the debate.  Let’s explore this issue in light of 21st century morality.

The matter of assisted suicide reached another milestone in Great Britain.  In late November 2024, lawmakers in Britain voted in favor of a proposal to legalize assisted dying for some terminally ill patients in England and Wales.  [The 330 to 275 vote in the House of Commons was not the final say on the matter; the legislation will be scrutinized in parliamentary committees and amendments may be put forward.]  It was the first time in nearly a decade that British lawmakers voted on assisted dying, “a once-taboo practice that has been the subject of increased interest as some Western countries have made it legal in recent years.  It also underscored the growing global momentum for legalizing assisted dying as improved medical treatments help people live longer—including patients with terminal illnesses.  Assisted dying is legal or partly legal in about a dozen countries, according to a July report by the Swedish National Council on Medical Ethics.”

Ali Watkins and Alexandra E. Petri provide a helpful guide on this important legislation in the UK:

1. What does the bill say?  The bill applies to those who are at least 18 years old, have received a terminal diagnosis and have no more than six months to live. Two doctors and a judge are required to give their approval, and fatal drugs would have to be self-administered.  Parliament overwhelmingly rejecteda proposal to allow assisted dying in 2015. But since then, as other European countries have slowly approved assisted suicide, pressure has mounted on British lawmakers to establish their own policy, especially as it has become more common for terminally ill Britons to travel abroad to die on their own terms.  “The debate over assisted dying practices was reignited in December, when the British broadcaster Esther Rantzen said she would consider traveling abroad to end her life, given her diagnosis of terminal lung cancer. Prime Minister Keir Starmer said he promised Ms. Rantzen before the July general election that if his Labour Party won, the government would allow a debate and a vote on the subject.”
2. What is the current law in Britain?  It is illegalto assist someone in the act of killing themselves in Britain.  Still, it is difficult to convict someone in these kinds of cases. According to the Crown Prosecution Service, the public prosecutor for England and Wales, 187 cases of assisted suicide have been referred to courts in the last 15 years; only four have been successfully prosecuted.
3. How does the British public feel about the practice?  In a recent poll, two-thirds of respondents in Britain said they believed assisted dying should be allowed, under certain conditions.  Lynsey Chutel reports that “In Britain, a surveyahead of Parliament’s vote showed that almost two-thirds of people in England and Wales supported the legalization of assisted dying. That reflected Britain becoming more socially liberal, said Bobby Duffy, director of the Policy Institute at King’s College in London, which ran the survey of more than 2,000 adults.  ‘It’s important to remember this isn’t a uniform global trend: There is still very high disapproval in many more religious, more traditional and lower development countries,’ Mr. Duffy said.”
4. What is the status of assisted dying in other countries?  Chutel summarizes the situation:

• Switzerland has allowed assisted dying for over 80 years, with the first documented case occurring in 1985, according to the medical and public health journal Deutsches Ärzteblatt International. The law permits the practice as long as it is not motivated by “selfish” intentions, though in the years since the law was enacted, some restrictions have been introduced.  Doctors and loved ones are not allowed to administer any lethal drugs. The person wishing to die must carry out the final act.
• Countries That Recently Legalized Assisted Dying:

1. In 1997, Colombia’s constitutional court ruledthat a doctor could not be prosecuted for helping terminally ill people who have given informed consent to end their lives. In 2015, at further prompting from the court, Colombia issued regulations to allow assisted death conducted by a medical practitioner, paving the way for what was considered the country’s first legal case. The country widened the practice to include self-administered death and patients with chronic illnesses in the 2020s.
2. The Netherlands, which for decades practiced informal assisted dying, and where doctors have had some form of protection against prosecution since the 1970s, in 2001 became the first European Union country to officially legalize assisted dying. Belgium and Luxembourg followedin 2002 and 2009. Spain and Austria enacted laws in 2021, and Portugal in 2023.
3. Canada introduced medical assistance in dying laws in 2016, a year after its Supreme Court found a ban on the practice unconstitutional. It later amended the lawsto include people who do not have a terminal or fatal condition but are in “an advanced state of irreversible decline.”
4. In New Zealand, a public referendum in 2020 legalized assisted dyingfor terminal patients, allowing doctors or registered nurses to administer the medication.  Belgium, Colombia and the Netherlands allow assisted dying for some minors.

• Where Assisted Dying Is Partly Legalized:  Assisted dying is legal in 10 states across the United States, along with Washington, D.C. Nineteen other states are considering bills that could legalize some form of assisted dying.  Oregon was the first U.S. state to legalize the practice with the 1997 implementation of the Death with Dignity Act. Washington and Montana followed in the late 2000s, and Vermont in 2013. Since 2016, the District of Columbia and six states have legalized assisted dying in some form: California, Colorado, Hawaii, Maine, New Jersey and New Mexico. Regulations differ, with some states limiting the practice to residents only, while others require a waiting period.  Australia experienced a similar legislative wave. After the state of Victoria passed legislation to allow voluntary assisted dying in 2017, the practice is now legal in all six states, with differing regulations on eligibility criteria and the administration of the lethal drugs. Assisted dying is set to take effect in the Capital Territory, home to the country’s capital, Canberra, next November. It remains illegal in the more remote Northern Territory.
• Countries Where Assisted Dying Is in a Legal Gray Area or Under Consideration:  Germany has had a shifting relationship with assisted dying over the last decade. A 2015 law effectively banned it, but the measure was overturned by the Constitutional Court in 2020. Germany has not passed laws clearly regulating the practice, creating some legal confusion for doctors, patients and organizations. In Italy, the situation is similarly complex. The law bans assisted death, but, in 2019, the country’s Constitutional Court decriminalized the practice in certain limited circumstances. In 2022, after a lengthy legal battle, a 44-year-old was granted the right to self-administered death, becoming the first such case in Italy. A handful of other cases have been approved by local health services, and the Constitutional Court has repeatedly called on Parliament to regulate the practice. In 2024, Ecuador’s Supreme Court ruled in favor of a woman with A.L.S., a severe neurological disorder, who wanted to end her life. The ruling decriminalized assisted dying and gave lawmakers the task of drafting legislation to regulate the practice within 12 months.  Other countries, including Cuba, France, Ireland, Mexico, Chile, and others, are considering or have considered proposals on assisted dying in recent years.

How should we think about this growing panacea to embrace assisted dying?  First of all, The Economist summarizes several concerns:

• “If assisted dying becomes common, will old people who require round-the-clock care feel more social pressure to choose death? Many already worry that they are a burden on their children or care givers.  Some may feel additional guilt if continuing to live is seen as an individual choice, rather than the blind workings of fate. This is a genuine concern.
• The trickiest questions arise when an individual’s capacity to make an informed choice is in doubt. Some people with mental disorders have suicidal thoughts that come and go. For them, the bar should be very high. Doctors must be sure they can distinguish between a temporary mental-health crisis and a sustained, considered wish to die. If in doubt, they should offer treatment aimed at helping the patient to live.
• Dementia poses the hardest problem of all. Someone diagnosed with the condition may make a living will, asking for an assisted death when it becomes severe. But they may change their mind. Such a document should never be used to kill someone against their wishes, and if those wishes are unknowable, they should be left to live. Assisted dying should be only for those who can make an informed decision at the time they take the drugs.”

Second, does the Bible speak to this issue of assisted dying, a form of euthanasia?

1. There are two important biblical passages to consider:
   • Exodus 20:13:  You shall not murder (see also Matthew 19:18; Romans 13:9).  Is assisted dying a form of murder?
   • 2 Samuel 1:1-16 (The account of Saul, gravely wounded, begged an Amalekite man from his camp, to kill him).   As Wayne Grudem notes, in this passage we some similarities to modern euthanasia:
     • Saul (the patient) appeared to be terminally injured, with no reasonable hope of recovery.  (He had fallen on his sword in an attempted suicide, 1 Samuel 31:4-5).
     • The patient was in extreme pain and, if he did not die, faced the prospect of even more suffering.
     • The patient clearly requested, even begged, that someone would put him to death.
     • This request, from the head of the government, was ordered by King Saul.
     • David declared that the Amalekite who had killed Saul (carried out euthanasia) was guilty of murder and was worthy of capital punishment.
2. There is a critical difference between killing and letting a person die.
   • Killing is actively doing something to a patient that hastens or causes his/her death (i.e., the cause of death is an action actively taken by another person).
   • “Letting die” is passively allowing someone to die from other causes, without interfering with that process (i.e., the cause of death is the disease, injury or the aging process that has already been occurring in the person who dies).
   • To clarify this however, two points are necessary:  We should intervene and try to help the person recover and not passively allow the person to die, when [1] there is a reasonable human hope of recovery and [2] we are able to help.  If there is no reasonable hope of recovery (a “situation of futility”), and it is the patent’s wish to die (e.g., via a living will) and we are unable to help, then it may be ethically right to allow the person to die.  This could involve not starting a medical life-support system to stopping a life-support system.   It is important to remember that a believer need not fear death (Philippians 1:20-22 and 2 Corinthians 5:8).
3. Additional observations about euthanasia:
   • Euthanasia is a slippery slope which leads to the teaching of an “obligation to die.”  This is now a topic of discussion where the elderly have an obligation to die due to the rising medical care costs and other entitlements, which are becoming too costly for society to bear.
   • Increasingly, we are seeing the horrors of involuntary euthanasia.  In the Netherlands, in 2020, over 7,000 people were euthanized through a mix of sedatives and a lethal dose of a muscle relaxant.
   • Doctor-assisted suicide is the norm in much of Europe and is growing in the US.
   • Infant euthanasia is also a growing practice in Europe (e.g., 2005 the Netherlands announced the intention of expanding its euthanasia program to permit doctors to end the lives of infants with the parents’ consent.  Belgium has also passed a similar law).

A culture of death is growing in western civilization where we see the erosion of the protection of human life, all along the continuum from prenatal life to the elderly.  It is flouting the idea of the sanctity of all human life, so central to God’s Word.  God is not honored by such a development and, at some point, He will vindicate His view of the infinite value of all human life.

See Ali Watkins and Alexandra E. Petri, “British Lawmakers Voted to Legalize Assisted Dying” in the New York Times (29 November 2024);  Lynsey Chutel, “The U.K. Voted to Legalize Assisted Dying. Which Other Countries Allow It?” in the New York Times (5 December 2024); The Economist (13 November 2021), pp. 62-64; James P. Eckman, Christian Ethics, pp.  35-41 ; and Wayne Grudem,  Christian Ethics, pp. 587-605.