Tuesday, August 4, 2009

Euthanasia in different kinds of Religion

Buddhism,

Buddhists are not unanimous in their view of euthanasia, and the teachings of the Buddha don't explicitly deal with it.

Most Buddhists (like almost everyone else) are against involuntary euthanasia. Their position on voluntary euthanasia is less clear.

States of mind

The most common position is that voluntary euthanasia is wrong, because it demonstrates that one's mind is in a bad state and that one has allowed physical suffering to cause mental suffering.

Meditation and the proper use of pain killing drugs should enable a person to attain a state where they are not in mental pain, and so no longer contemplate euthanasia or suicide.

Buddhists might also argue that helping to end someone's life is likely to put the helper into a bad mental state, and this too should be avoided.

Avoiding harm

Buddhism places great stress on non-harm, and on avoiding the ending of life. The reference is to life - any life - so the intentional ending of life seems against Buddhist teaching and voluntary euthanasia should be forbidden. Certain codes of Buddhist monastic law explicitly forbid it.

Lay-people do not have a code of Buddhist law, so the strongest that can be said of a lay person who takes part in euthanasia is that they have made an error of judgement.

Karma

Buddhists regard death as a transition. The deceased person will be reborn to a new life, whose quality will be the result of their karma.

This produces two problems. We don't know what the next life is going to be like. If the next life is going to be even worse than the life that the sick person is presently enduring it would clearly be wrong on a utilitarian basis to permit euthanasia, as that shortens the present bad state of affairs in favour of an even worse one.

The second problem is that shortening life interferes with the working out of karma, and alters the karmic balance resulting from the shortened life.

Euthanasia as suicide

Another difficulty comes if we look at voluntary euthanasia as a form of suicide.

The Buddha himself showed tolerance of suicide by monks in two cases. The Japanese Buddhist tradition includes many stories of suicide by monks, and suicide was used as a political weapon by Buddhist monks during the Vietnam war.

But these were monks, and that makes a difference. In Buddhism, the way life ends has a profound impact on the way the new life will begin.

So a person's state of mind at the time of death is important - their thoughts should be selfless and enlightened, free of anger, hate or fear.

This suggests that suicide (and so euthanasia) is only approved for people who have achieved enlightenment and that the rest of us should avoid it.

Euthanasia - the Christian view

Christians are mostly against euthanasia. The arguments are usually based on the beliefs that life is given by God, and that human beings are made in God's image. Some churches also emphasise the importance of not interfering with the natural process of death.

Life is a gift from God

  • all life is God-given
  • birth and death are part of the life processes which God has created, so we should respect them
  • therefore no human being has the authority to take the life of any innocent person, even if that person wants to die

Human beings are valuable because they are made in God's image

  • human life possesses an intrinsic dignity and value because it is created by God in his own image for the distinctive destiny of sharing in God's own life
    • saying that God created humankind in his own image doesn't mean that people actually look like God, but that people have a unique capacity for rational existence that enables them to see what is good and to want what is good
    • as people develop these abilities they live a life that is as close as possible to God's life of love
    • this is a good thing, and life should be preserved so that people can go on doing this
  • to propose euthanasia for an individual is to judge that the current life of that individual is not worthwhile
  • such a judgement is incompatible with recognising the worth and dignity of the person to be killed
  • therefore arguements based on the quality of life are completely irrelevant
  • nor should anyone ask for euthanasia for themselves because no-one has the right to value anyone, even themselves, as worthless

The process of dying is spiritually important, and should not be disrupted

  • Many churches believe that the period just before death is a profoundly spiritual time
  • They think it is wrong to interfere with the process of dying, as this would interrupt the process of the spirit moving towards God

All human lives are equally valuable

Christians believe that the intrinsic dignity and value of human lives means that the value of each human life is identical. They don't think that human dignity and value are measured by mobility, intelligence, or any achievements in life.

Valuing human beings as equal just because they are human beings has clear implications for thinking about euthanasia:

  • patients in a persistent vegetative state, although seriously damaged, remain living human beings, and so their intrinsic value remains the same as anyone else's
  • so it would be wrong to treat their lives as worthless and to conclude that they 'would be better off dead'
  • patients who are old or sick, and who are near the end of earthly life have the same value as any other human being
  • people who have mental or physical handicaps have the same value as any other human being

Exceptions and omissions

Some features of Christianity suggest that there are some obligations that go against the general view that euthanasia is a bad thing:

  • Christianity requires us to respect every human being
  • If we respect a person we should respect their decisions about the end of their life
  • We should accept their rational decisions to refuse burdensome and futile treatment
  • Perhaps we should accept their rational decision to refuse excessively burdensome treatment even if it may provide several weeks more of life

End of life care

The Christian faith leads those who follow it to some clear-cut views about the way terminally ill patients should be treated:

  • the community should care for people who are dying, and for those who are close to them
  • the community should provide the best possible palliative care
  • the community should face death and dying with honesty and support
  • the community should recognise that when people suffer death on earth they entrust their future to the risen Christ
  • religious people, both lay and professional, should help the terminally ill to prepare for death
  • they should be open to their hopes and fears
  • they should be open to discussion

The right to die

The Roman Catholic church does not accept that human beings have a right to die.

Human beings are free agents, but their freedom does not extend to the ending of their own lives. Euthanasia and suicide are both a rejection of God's absolute sovereignty over life and death.

The church believes that each human life is a manifestation of God in the world, a sign of his presence, a trace of his glory. "The life which God offers to man is a gift by which God shares something of himself with his creature."

A human being who insists that they have the 'right to die' is denying the truth of their fundamental relationship with God.

HINDUISM

Euthanasia and suicide

There are several Hindu points of view on euthanasia.

Most Hindus would say that a doctor should not accept a patient's request for euthanasia since this will cause the soul and body to be separated at an unnatural time. The result will damage the karma of both doctor and patient.

Other Hindus believe that euthanasia cannot be allowed because it breaches the teaching of ahimsa (doing no harm).

However, some Hindus say that by helping to end a painful life a person is performing a good deed and so fulfilling their moral obligations.

Background

Hinduism is less interested than western philosophers in abstract ideas of right or wrong. Rather it focuses on the consequences of our actions.

For Hindus, culture and faith are inextricable. So although many moral decisions taken by Hindus seem more influenced by their particular culture than by the ideas of their faith, this distinction may not be as clear as it seems.

Karma: Hindus believe in the reincarnation of the soul (or atman) through many lives - not necessarily all human. The ultimate aim of life is to achieve moksha, liberation from the cycle of death and rebirth.

A soul's next life is decided by karma, as the consequence of its own good or bad actions in previous lives. You could regard a soul's karma as somehow representing the net worth of its good and bad actions.

A soul cannot achieve moksha without good karma.

Non-violence: Another important principle is ahimsa, not being violent or causing harm to other beings.

Dharma: Hindus live their lives according to their dharma - their moral duties and responsibilities.

The dharma requires a Hindu to take care of the older members of their community.

Killing

Killing (euthanasia, murder, suicide) interferes with the killed soul's progress towards liberation. It also brings bad karma to the killer, because of the violation of the principle of non-violence.

When the soul is reincarnated in another physical body it will suffer as it did before because the same karma is still present.

Death: The doctrine of karma means that a Hindu tries to get their life in a good state before they die, making sure that there is no unfinished business, or unhappinesses. They try to enter the state of a sannyasin - one who has renounced everything.

The ideal death is a conscious death, and this means that palliative treatments will be a problem if they reduce mental alertness.

The state of mind that leads a person to choose euthanasia may affect the process of reincarnation, since one's final thoughts are relevant to the process.

Euthanasia

There are two Hindu views on euthanasia:

  • By helping to end a painful life a person is performing a good deed and so fulfilling their moral obligations
  • By helping to end a life, even one filled with suffering, a person is disturbing the timing of the cycle of death and rebirth. This is a bad thing to do, and those involved in the euthanasia will take on the remaining karma of the patient.
  • The same argument suggests that keeping a person artificially alive on a life-support machines would also be a bad thing to do
  • However the use of a life-support machine as part of a temporary attempt at healing would not be a bad thing

Suicide

Prayopavesa, or fasting to death, is an acceptable way for a Hindu to end their life in certain circumstances.

Prayopavesa is very different from what most people mean by suicide:

  • it's non-violent and uses natural means;
  • it's only used when it's the right time for this life to end - when this body has served its purpose and become a burden;
  • unlike the suddenness of suicide, prayopavesa is a gradual process, giving ample time for the patient to prepare himself and those around him for his death;
  • while suicide is often associated with feelings of frustration, depression, or anger, prayopavesa is associated with feelings of serenity

Prayopavesa is only for people who are fulfilled, who have no desire or ambition left, and no responsibilities remaining in this life. It is really only suitable for elderly ascetics.

Euthanasia and suicide in Islam

Muslims are against euthanasia. They believe that all human life is sacred because it is given by Allah, and that Allah chooses how long each person will live. Human beings should not interfere in this.

Life is sacred

Euthanasia and suicide are not included among the reasons allowed for killing in Islam.

Do not take life, which Allah made sacred, other than in the course of justice.Qur'an 17:33

If anyone kills a person - unless it be for murder or spreading mischief in the land - it would be as if he killed the whole people.Qur'an 5:32

Allah decides how long each of us will live

When their time comes they cannot delay it for a single hour nor can they bring it forward by a single hour.Qur'an 16:61

And no person can ever die except by Allah's leave and at an appointed term.Qur'an 3:145

Suicide and euthanasia are explicitly forbidden

Destroy not yourselves. Surely Allah is ever merciful to you.Qur'an 4:29

The Prophet said: "Amongst the nations before you there was a man who got a wound, and growing impatient (with its pain), he took a knife and cut his hand with it and the blood did not stop till he died. Allah said, 'My Slave hurried to bring death upon himself so I have forbidden him (to enter) Paradise.' "Sahih Bukhari 4.56.669

JUDAISM

The Jewish tradition regards the preservation of human life as one of its supreme moral values and forbids doing anything that might shorten life. However, it does not require doctors to make dying last longer than it naturally would.

  • Jewish law and tradition regard human life as sacred, and say that it is wrong for anyone to shorten a human life
    • this is because our lives are not ours to dispose of as we feel like
  • all life is of infinite value, regardless of its duration or quality, because all human beings are made in the image of God
  • saving someone from pain is not a reason to kill them
  • nor is it lawful to kill oneself to save oneself from pain
  • but there is a limit to the duty to keep people alive
    • if someone's life is ending and they are in serious pain, doctors have no duty to make that person suffer more by artificially extending their dying moments
  • it is also acceptable to ask God in prayer to remove a person from their pain and suffering

Active euthanasia

Jewish law forbids active euthanasia and regards it as murder. There are no exceptions to this rule and it makes no difference if the person concerned wants to die.

Shortening life

It is wrong to shorten a life even if it would end very soon, because every moment of human life is considered equal in value to many years of life.

The value of human life is infinite and beyond measure, so that any part of life - even if only an hour or a second - is of precisely the same worth as seventy years of it, just as any fraction of infinity, being indivisible, remains infinite.Lord Jakobovits, former UK Chief Rabbi

So even if a person is a goses (this word means someone who has started to die and will die within 72 hours), any action that might hasten their death - for example closing the eyes or moving a limb - is prohibited.

Passive euthanasia

Jewish law says that doctors (and patients) have a duty to preserve life, and a doctor must do everything he/she can to save a patient's life - even if the patient doesn't want them to.

But this isn't the end of it. There is some freedom for doctors in cases where a patient is terminally ill.

Although a doctor cannot do anything that hastens death, "if there is something which is preventing the soul from departing" a doctor can remove whatever is preventing the dying person's soul from departing.

In more modern language this means that if something is an impediment to the natural process of death and the patient only survives because of it, it is permitted under Jewish law to withdraw that thing.

So if a patient is certain to die, and is only being kept alive by a ventilator, it is permissable to switch off the ventilator since it is impeding the natural process of death.

The relevance of pain

Rabbi Moshe Feinstein and Rabbi Shlomo Zalman Auerbach have ruled that a dying patient should not be kept alive by artificial means where the treatment does not cure the illness but merely prolongs the patient's life temporarily and the patient is suffering great pain.

Pain relief medicine can be given even though it may hasten death, as long as the dose is not certain to kill, and the intention is not to kill but to relieve pain.

Hastening one's own death

Human beings don't have the right to kill themselves, so someone who is terminally ill and in great pain cannot take action to speed their own death. Even if they are mentally fit to make that choice, the rule that life is sacred prevents them from shortening their life.

A passage in the Talmud tells the story of Rabbi Chanina ben Teradion, who was being burned alive by the Romans. His pupils urged him to end his suffering quickly by opening his mouth and inhaling the flames. He replied, "It is better that He who gave [me my soul] should take it rather than I should cause injury to myself."

It's also against Jewish law to help someone to kill themselves, since one is not allowed to enable another person to break Jewish law.

Does the rule ban treatment that may kill?

Doctors are commanded to do their best to heal the sick and prevent suffering. So it's OK for a doctor to put a patient through life-endangering treatment if that is likely to extend the patient's life or reduce their pain.

Biblical precedents

The first example of Jewish euthanasia comes in the Bible:

And a certain woman threw an upper millstone upon Abim'elech's head, and crushed his skull.

Then he called hastily to the young man his armor-bearer, and said to him, "Draw your sword and kill me, lest men say of me, 'A woman killed him.'" And his young man thrust him through, and he died.

Judges 9:53-54

There's a more famous case at the start of 2 Samuel, where the seriously injured King Saul orders a young soldier to kill him, rather than let him be captured alive. When King David heard what the young soldier had done, he had him executed; to show that euthanasia was equivalent to murder, and that the defense of superior orders was valueless.

SIKHISM

Euthanasia

Sikhs have a high respect for life which they see as a gift from God. Most Sikhs are against euthanasia, as they believe that the timing of birth and death should be left in God's hands.

The Sikh Gurus rejected suicide (and by extension, euthanasia) as an interference in God's plan. Suffering, they said, was part of the operation of karma, and human beings should not only accept it without complaint but act so as to make the best of the situation that karma has given them.

This is not absolute. Sikhism (as already said) believes that life is a gift from God, but it also teaches that we have a duty to use life in a responsible way.

Therefore Sikhs contemplating euthanasia for themselves or others should look at the whole picture, and make appropriate distinctions between ending life, and not artificially prolonging a terminal state.

Care for others

Much of Sikh moral teaching is devoted to caring for others who are less fortunate.

This suggests that the Sikh reaction to situations where people think about euthanasia would be to provide such good care that euthanasia became an unattractive option.

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