On February 15, the Christian nonprofit on Capitol Hill ministering to congressional staff, Faith & Law, hosted Kimberly Kuo and her presentation on assisted suicide and euthanasia. As someone who has thought about end-of-life issues before, I was familiar with the basic concepts and had already formulated opinions about them.
Nevertheless, the event gave me a new awareness of how pressing the problem of assisted suicide and euthanasia legislation really is. It convinced me that, because of their denial of human dignity and the public health issues they pose, these practices are not just morally problematic but constitute a serious threat to public justice. Kuo’s presentation encouraged me to be conscientious of legalization attempts and more determined to do what I can to prevent them.
A Personal Matter
From the beginning of her presentation, Kuo made it clear that end-of-life issues are, and always will be, deeply personal in nature. Her husband David was formerly the Deputy Director of the Office of Faith-Based and Community Initiatives and a Special Assistant to President George W. Bush. In 2003, he was diagnosed with terminal brain cancer and given six months to live. Amazingly, he lived on for another 10 years before he died.
After that difficult decade, the Kuo family witnessed Brittany Maynard, a young woman who also had brain cancer, call for the legalization of assisted suicide throughout the country. Maynard’s promotion of “death with dignity” as the “compassionate choice” was received positively by the media and American society at large. All of this caused serious pain for the Kuos, who felt that David’s struggle to live was being characterized as cowardly.
After looking back on the experience of her husband’s illness, Kimberly Kuo was adamant that self-inflicted death is never the right choice. She asserted that there is no such thing as purposeless existence, because each moment that someone is alive, he or she can influence others for the better. David was a perfect example of this. During the tenure of his illness, he had two children, evangelized other hospital patients, strengthened the faith of all those around him and was able to spend precious moments every day with his son. He was also was the inspiration for a ministry that provides cancer treatment to the homeless.
David’s example shows that humans are not isolated individuals whose choices exist in a vacuum. On the contrary, individual decisions can impact and call one another to create communities and organizations of shared purpose. Nonprofits and faith-based ministries, like the one David inspired, are just a few examples of what interpersonal connections can motivate us to do. None of what David accomplished while he was dying, either directly or indirectly, would have been possible if he had ended his life during his original “last six months.”
Of course, on the surface, few people’s dying years seem as overtly rewarding as his. But this does not mean that they are any less meaningful. From a Christian perspective, every human being is made in the image and likeness of God, an important detail made clear in the creation narrative (Gen. 1:26-27). Consequently, every human life has inherent value which cannot be lost or diminished by physical ailments. Kuo’s point still holds, even in cases that are not as remarkable as David’s was. In her presentation, she pointed to Job, who embodies this principle when he refuses to seek God’s destruction, even when he has lost everything:
Then his wife said to him [Job], “Do you still persist in your integrity? Curse God and die.” But he said to her, “You speak as any foolish woman would speak. Shall we receive the good at the hand of God, and not receive the bad?” In all this Job did not sin with his lips.
(NRSV, Job 2:9-10)
All this is not to say that the 10 years David spent in horrendous pain were easy or somehow enjoyable. Kuo recalled them as genuinely unbearable at times. Nevertheless, they convinced her that true compassion means entering into others’ suffering and bearing it with them — not ending their lives to minimize the misery of all parties.
A Policy Matter
According to Kuo, end-of-life issues are deeply personal, but they also have serious public consequences and therefore constitute a matter of public policy. In states where assisted suicide is legal, insurance companies are beginning to deny cancer patients coverage for non-lethal (i.e. more expensive) treatments, and state legislatures are incentivized along similar lines because it is more convenient for their budgets.
Moreover, there is essentially no accountability regarding where prescribed drugs end up – whether patients keep them or give them to someone else. And doctors’ life expectancy predictions are often incorrect, meaning people sometimes take their lives based on a vast underestimate of how much time they have left. It is terribly dangerous when doctors are allowed to determine who should live and who should die, both for doctors and patients. After all, Kuo asked, what was the original sin if not the desire to play God, to take on more responsibility than humans are meant to have?
Assisted suicide may be a fringe issue right now, but Kuo explained how it could end up affecting nearly everyone in the country. In assisted suicide, one’s doctor prescribes lethal drugs to be self-administered. In euthanasia, on the other hand, the drugs are administered directly by the doctor. In European nations where both practices have been legalized, any semblance of guardrails has disappeared, and a genuine culture of death has become the norm. In the Netherlands, almost 5% of all deaths are from euthanasia. In Belgium, children can request lethal measures (there are no age limits) simply for depression, and perhaps even more frightening, a study found that over 30% of euthanasia cases in one region had no record of patient consent. These statistics show just how slippery of a slope this issue is.
A Public Justice Matter
Kuo’s underlying reasoning and principles are directly in line with principles of public justice, which seek to uphold the right roles and responsibilities of government and civil society for the good of all citizens. In a public justice framework, “Government’s responsibility for the political community begins with the protection of a) the lives of its citizens and b) the life-generating, life-sustaining institutions of marriage and family.”
These affirmations of life run contrary to the association of “death with dignity” and compassion that characterizes the assisted suicide movement. Kuo’s emphasis on the value of every individual and the interdependence of all citizens also reflects the public justice principle that issues relating to life and the family almost always have implications for public policy, and vice versa. As public justice guidelines state, “government [is] responsible, as a public matter, for the protection of life and for the authorization of [all] decisions that take life.”
In addition, public justice recognizes, with Kuo, that we can work together as citizens to provide palliative care for the dying. Natural death is an expression of God’s expansive will, and it is not always necessary, or even right, to take extraordinary measures to extend life. For example, there is no reason to keep a dying woman on invasive, artificial life support if she does not desire it. However, there are ways to alleviate pain and care for the dying that do not involve prematurely ending a life. Through institutions of civil society and, in a special way, faith-based nonprofits like the one David inspired, communities can alleviate pain and bring emotional support to those in need. As Kuo pointed out in her presentation, modern hospice care and associated services are remarkably effective at making terminal illness bearable and, unlike assisted suicide and euthanasia, do not deny the inherent dignity of the human person.
An Uncertain Future
Kuo held out hope that we can prevent assisted suicide’s spread, but not necessarily optimism, and I share her views. The practice raises serious ethical concerns. Furthermore, it seems to be causing serious public health problems, and statistics from European nations show that these could increase, especially if euthanasia is introduced. Therefore, I hope that citizens can rally to make assisted suicide illegal in as many states as possible, perhaps relying on the American Medical Association – which is generally opposed to the practice – for help.
Unfortunately, as Kuo pointed out, so few politicians have thought about end-of-life issues or formulated opinions about them that advocates who present assisted suicide as the “compassionate choice” may easily convince them. Most Americans have already been convinced. Seventy-three percent of those polled support legalization of not only assisted suicide, but euthanasia as well. Moreover, Kuo criticized almost all Christian intellectuals, aside from some Catholics, for failing to raise the issue. Those of us who want legal limits must become more vocal about the dangers of assisted suicide and euthanasia; otherwise, they may be normalized before we realize it.