What is the Church’s position on controversial end of life issues?
Firstly the Church is often at pains to point out that human life is by its very nature sacred, that is, it is intrinsically good and deserves respect and protection. Secondly, the Church and many thoughtful people are aware that suffering can be redemptive: through suffering we can grow spiritually and in other ways. Indeed, it could be that proponents of euthanasia or physician-assisted suicide do not have a deep understanding of the purpose of suffering.
Active euthanasia and physician-assisted suicide is forbidden by the Orthodox Church. The word “euthanasia” comes from Greek words and literally means “good death.” Fr Stanley Harakas declares, “The only ‘good death’ for the Orthodox Christian is the peaceful acceptance of the end of his or her earthly life with faith and trust in God and the promise of the Resurrection.” Active euthanasia then, is clearly rejected by the Church; only God can decide when life is to end. What is more difficult to be clear about is the issue of not treating someone with an incurable illness. This needs thoughtful and prayerful consideration on a case-by-case basis.
At one end of the spectrum is someone in the very late stages of an incurable disease who develops some superadded medical problem. The question comes up as to whether this other medical problem should be treated. If such a person truly is in the late stages of an irreversible disease, then it would be best “to respect the dying process” (as expressed by the Orthodox writer, Fr John Breck). In other words, he would recommend not to treat, and especially not to use extreme measures such as life support machines. Fr Breck says there is a fundamental difference between “killing” and “letting die.”
The purpose of life is not to live on this earth forever, but to get to Heaven. In such a situation there is a need to emphasise dignity, the spiritual care of this person, to call the priest (and not leave this too late), and involve palliative care services. At the other end of the spectrum is cases that many of us have witnessed. They also have an incurable disease, but are not in the late phase. They or their proxy accept some medical treatment, and because of this they improve and live several more months. In those months they achieve a lot, much more than they achieved in years. They seek reconciliation with family members and friends, and reconciliation with God through a very good Confession, they may give valuable advice to loved ones, etc. What is very difficult is cases that fall in between the two extremes we just mentioned.
This author feels he should present it as follows: we do need to respect the wishes of the patient or their health-care proxy, otherwise we risk lapsing into a form of “paternalism”, (though some limited paternalism may be appropriate in some situations). In trying to make this difficult decision we do have to consider the pre-existing situation of the patient. For example, for a very long time they may have been fully dependent due to severe dementia, and now they have developed severe pneumonia. If after careful consideration we still find it difficult to decide whether or not to treat, then, “opt for life”, though not necessarily by using extreme measures.
† Fr D. K.
Source: Lychnos July-August 2019