Rev. Jason Forbes
In October of this year, the Voluntary Assisted Dying Bill 2021 (in reference to euthanasia practices), came before the NSW Parliament only to have the vote delayed until 2022. While the delay may come as a reprieve to opponents of euthanasia, it marks a significant shift in the way human life is perceived and valued. This has detrimental consequences for the most vulnerable in our community regardless of one’s faith.
Before discussing these consequences, it’s important to be clear on what is meant by the term “euthanasia”. It refers to the intention to end a person’s life by means of the administration of lethal drugs to avoid suffering. This is quite apart from the withdrawal of treatment that would allow the disease or medical condition to take its natural course ending the person’s life. It needs to be acknowledged that medical technology has the capability to significantly prolong a person’s life and therefore his or her suffering. To prolong a person’s life in this manner would be wrong. I witnessed my mother’s breathing support being switched off and her death a few hours later. I have no qualms about the withdrawal of my mother’s treatment. What I do have qualms with is the legalisation of proactively ending a person’s life prematurely. Not only is this wrong, but it is also jeopardises the life and value of people with disabilities.
It cannot be said that people with disabilities were in mind when the proposed bill was drafted. So, malice towards people with disabilities cannot be assumed by the creators of the proposed bill. The concern of the proposed bill is people with a terminal illness which will result in death in the next 12 months. However, one of the criteria for granting a person’s request for euthanasia is the experience of “physical incapacity” as a result of the terminal illness. Whether the creators of the proposed bill realise it or not, they have just described disability. This bill inadvertently devalues lives where physical incapacity is experienced. Granted that this physical incapacity is in the context of terminal illness that is expected to end the life of a person, but there is very little to suggest that this safeguard will remain. More concerning still is the subjectivity of the physical incapacity. Physical incapacity is not subject to a medical assessment. Rather, all that is required is for the person to consider his or her physical incapacity to be unacceptable.
Another difficulty concerns the expression of consent to request euthanasia. While the proposed bill recognises that not every applicant will be able to sign the required documents, the alternative of an audio-visual recording of the person’s consent is less than satisfactory. People can be left unable to speak due to a number of medical conditions. While such people can communicate through body language, a personal relationship with such persons is required to understand their expressions. This would make it extremely difficult for a review board to determine whether consent had been given. The will of another could easily be imposed on a patient. Aside from this, it needs to be questioned whether anybody has the capacity to make a decision about death when suffering the duress of terminal illness. Are they in a state to give due consideration to the options available to them in palliative care? Further, is the health system adequately supported so it can provide quality levels of palliative care? Spiritual, social and cultural perceptions of incapacity also need to be considered and not just the incapacity itself. All these can influence a person’s decision to consent to euthanasia.
There are also concerns with the review board. While the medical profession is well represented on the board, there is no representation from vulnerable groups such as the aged or people with disabilities. This means there is no formal opportunity to critique euthanasia cases from the point of view of vulnerable peoples.
These issues provide for the right conditions for “concept creep”, such as what has occurred in the Netherlands. While euthanasia laws in 2002 were initially applied only to those with terminal illness, there were soon demands to allow euthanasia for existential reasons such as age. In 2007, there was an increase in allowing euthanasia in instances of mental illness, and in 2013-14 there were discussions in the media concerning the application of euthanasia for conditions that weren’t life-threatening. While the proposed NSW bill differs from the legislation in the Netherlands in the provision that the illness will end in the person’s death in the next 12 months, the proposal is to review this legislation five years from its commencement. This means that the legislation can be changed, and there’s little reason to think it won’t.
Concept creep will depend on the view of what it means to be human. The arguments for euthanasia by advocates reveal a view of being human that has utility and agency as its essence. In simple terms, if the person is unable to contribute and exercise choice, that life loses its value. This is a very dangerous view as it is most likely that all of us will experience times in our lives when we are unable to contribute and exercise choice. For some of us, that is a daily experience. The inevitable consequence of such a view of humanity is that some lives are more valuable than others, and few will benefit from such a view, and the benefit will be fleeting. Ultimately, such a view devalues us all.
The alternative is to embrace the biblical view that humanity is made in the image of God whose purpose it is to reflect God’s being. Christians are recognised as those who have put on the new self which is being renewed in the knowledge of the image of God (Col 3:10). In the light of this, Christians are told to put on compassionate hearts, kindness, humility, meekness, forbearance, forgiveness and love (Col.3:12–14). From this, we can see that the essence of bearing God’s image is not about ability, It’s about character. For this reason, there is no justification for euthanasia based on incapacity. Not only do we, as Christians, need to oppose legislation such as the proposed Voluntary Assisted Dying Bill, but also to take seriously the biblical model that every human bears the image of God, and so is valued accordingly.