Friends, I'm revising a new book now. It's titled Why You Shouldn't Kill Yourself: Five Tricks of the Heart About Assisted Suicide (to be published by Cascade Books, perhaps in 2017 yet?). This is more Theology of the Body related than you think! But obviously other theological matters are at play as well. I'll excerpt different sections as I work on them and will be requesting beta readers in October...but would appreciate any comments or feedback now, if you have it. This is the introduction for theologians and pastors. (There is a second, shorter introduction for the general reader).
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Introduction for theologians and pastors
Nothing would seem more common, more inflexible, more
historically stable than the experience of death—our own deaths, or the death
of a loved one. And yet, how we perceive
and approach death has changed dramatically (both medically and culturally) in
the physician assisted past few decades.
The culmination of these changes is found in increasing public support
for physician assisted suicide. This
book tries to present the challenge of physician assisted suicide as a misguided
contemporary quest for “safe passage.”
Phillippe Ariès (1914-1984), a historian of family and
daily life, argues that in centuries past human beings
died “a tame death.” That is, dying was
a known process that was expected and folded into the realities of everyday
life. People died at home, of course, because there were few hospitals. Medical care was largely palliative care,
focused on keeping the person comfortable.
The person dying was usually in the center of known ways of family life
until the very end…a bed brought into a living area, for example, and receiving
visitors: family, friends, doctors, a priest.
Although dying could be physically and emotionally difficult, there was
a reassuring sense of place in it.
Death, indeed, was part of life, along with birth, love, grief, joy,
pleasure, and sadness.[1]
But with the rise of modern medicine, Aries says our
perspective on the place of death has tilted. Now, we perceive death as
inherently wild, and something that we need to domesticate through medical
care. The “wild death” is marked by an uncertainty throughout the experience of
dying: at the hospital or at home? Will this cure work, or not? How long should I fight? This looks like the
end--but wait, we have other options. Time
in an ICU, away from most family and friends, and surrounded by beeping
monitors, is likely. Aries argues that
modern medicine’s quest to cure—in itself a good thing—does unfortunately
result in a kind of “technological brinkmanship,” that results in people
actively fighting the disease or injury up to hours before they actually
die. People dying never leave fight
mode.
Because doctors and patients never leave fight mode, a
lack of cure is a perceived, by some, as a failure…as if death is not our common
end.
Great work has been accomplished in the nascent hospice
movement—a movement that has called for people to have a relatively comfortable
experience of dying, ideally at home, with pain issues addressed, and family or
friends around. But most people, at this
point, do not know how to be around someone who is dying. We don’t know how to die at home. The only dying ritual we know is the one
defined by fighting and control. Hospice is quite the counter culture to many,
and those who find themselves facing the dying process may not see why anyone
would not choose to fight for
control.
The contemporary experience of dying, the “wild
death,” has become, more and more, a human quest for safe pasage. But most people translate that understandable quest into a desire
for absolute control. They see that the only way to not hurt, to avoid pain, is
to maintain control. And physician
assisted suicide is the most intense formula for maintaining absolute control.
Not
a moral treatment, but written to the spiritually lost
As you can surmise, my approach to this topic is not,
in the first place, moral. I do think assisted suicide is gravely wrong, and
certainly moral questions are addressed in this text. (Although physician assisted suicide opens a
whole host of moral side issues that I do not touch on much at all: conscience
protections for doctors, nurses, and hospices, the voice of family members in
decision making, the influence of money--or lack of it--in decision making, the
rights of people living with disabilities, and so forth. But these are being addressed in many venues.[2]) People know suicide is wrong. It takes a lot
of mental effort to intentionally end one’s own life: healthy people act to
preserve their lives. We actively try to prevent suicide in any other case. The
reason increasing numbers of people find physician assisted suicide attractive
is that people are spiritually lost.
I do not mean that in any accusatory manner. When you get down to it, we're all a little more lost that we think. But increasingly people have actively chosen not to have a spiritual home, and we know this
through the increasing number of surveys that indicate a sharply rising
increase in the “nones”—the segment of the population that does not identify
with a religion. Sometimes they
self-identify as “spiritual, not religious.”
Sometimes they bear this bumper sticker on their cars: “all who wander
are not lost.” I will be candid: many religions in the United States bear
responsibility for this. I can understand why people could say they believe in
God, but not fully trust religious institutions. We’ve made trust harder than it should
be.
But…this move to “spiritual, not religious” is clearly
not all about institutional
trustworthiness.[3]
I know quite a few of these people—you do, too—and often they say that their
limited experience with a religious home was fine. Just not essential, and couldn’t compete
against the allure of the open road, the freedom of wandering and finding your
own way. We are a country of self-made
men and women—or we like to think so—and that is increasingly including our own
religion.
So what’s wrong with that? Well, let’s begin with dying, and begin with
a story. One of the most poignant books
I have ever read is a memoir called My
Own Country by Abraham Verghese,[4] an Indian-American
infectious diseases doctor working in the mountains of East Tennessee during
the beginning of the AIDS epidemic. The
book is about how medical doctors came to learn to diagnose and treat that
disease when all was mystery and fear--but even more so, the book is about
home. Verghese began noticing that all
these initial AIDS patients—mostly homosexual--were from big cities (New York,
San Francisco, Chicago). They were
dying, and they knew it. When they were
dying, he realized—all they wanted to do was to come home. Not even certain that they would be accepted,
seeking out a “foreigner doctor” for treatment, not even admitting publicly
what they were dying from—they just wanted to come home. That struck him, and me, as deeply poignant. In the end, when we are weak, and in some
pain, and maybe afraid—that is, dying--we all just want to go home.
The problem with “all who wander are not lost” is that
when illness and mortality appear, they want to go home—but do not know how to
do so. When you have dedicated your life
to exploring, you probably don’t know where home is. So people increasingly are attracted to
treating dying in the same way that they have treated living—with a focus on
freedom, making choices, and being in control of the exploration. With physician assisted suicide, they are
“crafting an end.” When you have no
home, you build your own house, while you still can. We are self-made women and men. We take care of ourselves. Right?
Of course, as Christians, we say there is a home: and that
home is God the Father. Jesus Christ is
our guide and mediator, and the Holy Spirit our advocate. But acknowledging that home, through our
Church, requires hanging up the traveling shoes and spending time at “with the
family.” Ultimately, it means allowing
God to take care of us rather than create our own end.
This book is written to the traveler, to the
spiritually disoriented. I want to tell them about their journey, and to tell
them about home. The only key to
understanding the journey and the homeland is the human heart.
As Christians, we are well aware of the scripture “O
that today you would listen to his voice! Do not harden your hearts” (Ps
95:7-8). Learning you have limited time
to live is undeniably God’s voice.
Hardening your hearts is being closed to God’s revelation in your life:
not just about your end of this life, but about the good news of the life to
come. The good news that God is not
finished with your life and loves you beyond all knowing, and has the power to
turn this difficult time to good.
This book is trying to speak to the human heart,
encouraging it to be open to the good news that a natural death will be
challenging, but it can also be beautiful.
There is no reason to be afraid, take absolute control, and try to
“create an end.” A natural death is, ultimately, safe, and can lead you into
God’s life and your destined home.
Physician assisted suicide and euthanasia are realities
that must be addressed through the human heart.
[1] Phillippe
Ariès’ work is referenced a great deal in Daniel Callahan’s popular book The Troubled Dream of Life: In Search of a
Peaceful Death (New York: Simon and Schuster, 1993), 26-27. Ariès’ most relevant work is translated in English as The Hour of our Death.
[2] An
extremely useful compendium of concerns worldwide regarding assisted suicide
and euthanasia can be found in David Albert Jones’ “Assisted Suicide and
Euthanasia: A Guide to the Evidence,” Anscombe Bioethics Centre, Oxford
University. http://www.bioethics.org.uk/evidenceguide.pdf
[3] Michael
Lipka, “Why America’s ‘Nones’ Left Religion Behind,” Fact Tank: News in the Numbers blog of The Pew Research Center, http://www.pewresearch.org/fact-tank/2016/08/24/why-americas-nones-left-religion-behind/
[4] Abraham
Verghese, My Own Country: A Doctor’s
Story (Vintage Books, 1995).
