HBC Big Ideas Night: Euthanasia

Back in 2018, my church ran one of their Big Ideas Nights on the topic of euthanasia and assisted suicide. I gave a presentation at that meeting discussing my background and some thoughts I had on the idea of suffering and euthanasia drawing from my own experience. Below is the transcript, and slides, from that presentation.

So I thought I’d start off by giving you a bit of my background. So I grew up in Sydney, ended up doing medicine at Sydney Uni, then after a few years of working there, we moved up to Newcastle where I started anaesthetic training, which I completed in 2013.

(1ST SLIDE: Family)

This is me and my family at about that time. And over the years of my medical career, I had worked in emergency departments, general wards, palliative care wards, intensive care units and of course operating theatres. Not surprisingly, I’d seen a fair bit of pain, suffering, dying and death over that time, and had had lots of conversations with patients and families about those topics. But then in late 2013, it all became very personal.

I drove myself to John Hunter thinking I may have had kidney stones, and as part of the workup for that I ended up having a chest x-ray:

(NEXT SLIDE: Chest X-Ray)

I’m sure there are a number of med students and doctors here, who can probably see the issue here, but to make it a bit clearer I’ve circled it in red

(NEXT SLIDE: Chest x-ray with red circles)

…things in my lung that shouldn’t be there!

Things snowballed quickly, and the issues on the next two slides should be obvious to everyone, not just those with medical training!

NEXT SLIDE (1st Brain MRI) NEXT SLIDE (2nd Brain MRI)

To cut a long story short, I was diagnosed with melanoma, and I was told the median survival for this kind of presentation was about 3-4 months. That meant that if 100 people presented with what I did, then within 4 months, at least 50 of them would be dead.

There weren’t many treatment options available to me and those that were, were only palliative in intent, but I ended up having neurosurgery and whole-brain radiotherapy, but I then developed a bowel obstruction which required having half my colon removed.

But then, a month or so later a clinical trial of immunotherapy became available, and as a last roll of the dice, I enrolled in it.

However, shortly after starting it, I developed another bowel obstruction requiring further surgery, and that, combined with side effects from the new drugs. meant I went from this:

(NEXT SLIDE: Family photo again)

to this,

(NEXT SLIDE: Double photo: Jets & at home)

over the course of only a few months…

but, at this point, the new drugs appeared to be working and the melanoma was shrinking. But that was when the genuine suffering really began…

(NEXT SLIDE: Greying hair and proverbs)

…when the drugs also started making my hair go grey! Though I do now have a new favourite Proverb!

“Gray hair is a crown of splendour; it is attained in the way of righteousness.”

But, in all seriousness, as you can imagine, I’ve been through quite a bit of pain and suffering over the last 4 years or so, both physical and mental. And it is ongoing. I am still on the immunotherapy, and it’s working, but it’s also generating some pretty nasty side effects, and there is still some residual melanoma remaining. But despite my background in healthcare as I described before, I found that I was “surprised” by this suffering, and I think that this is becoming quite a common experience.

And Tim Keller has this to say on it: (NEXT SLIDE: Time Keller quote)

“We live in a unique culture. Every other society before ours has been more reconciled to the reality that life is full of sorrow. If you read the journals of people who lived before us, it is obvious they understood this, and that they were never surprised by suffering. We are the first culture to be surprised by suffering. When Paul writes to the people of his day, “We do not lose heart, though outwardly we are wasting away,” he speaks of suffering as a given”

We have come so far over the last 50 years or so in terms of medical science, technology, engineering etc that it is now quite possible for someone like me to get well into their 30s, or even much older, without having to face any deep, existential, physical or emotional suffering. Of course, this is not everybody’s experience, but it was certainly mine. I had a pretty “privileged” upbringing with a loving family. We weren’t rich but certainly not in poverty. I was healthy and I got a good education. Even though I was exposed to other peoples suffering in my job, it was almost a job requirement to try not to let it affect you too much, though it wasn’t always easy to do that.

In any case, I was surprised by suffering when it rudely interrupted my rather comfortable life just over 4 years ago. Now don’t get me wrong. These improvements in recent times are a genuine blessing from God, and I don’t think that being “unsurprised” by suffering makes it any more bearable or less painful. But like all of God’s gifts, our sinful hearts have used and abused these improvements, and I think it’s resulted in a very unhelpful approach to suffering, that is becoming more prevalent in our society today.

First of all, we can be tempted to think that because we are not used to experiencing suffering, we believe that it serves no purpose. We just put it down to an unfortunate outcome of evolution and/or due to man’s sinfulness, and therefore it has no purpose, so no good can possibly come from it.

Probably related to this is a second issue which is that because we aren’t used to it, and also see no purpose in it, we can also end up seeing life’s primary goal as being to avoid it…no matter what the cost.

And while these views on suffering might be becoming more common today, they are by no means new. In fact, it probably goes right back to the Greek philosopher Epicurus?

Here’s one quote from him: (NEXT SLIDE: Epicurus quote)

“when we speak of pleasure or happiness as the chief good, we mean the freedom of the body from pain and the freedom of the soul from confusion.“

So this is from 300BC, but it seems the idea is coming back into vogue, & perhaps not surprisingly it’s happened over the similar time period in which we have been increasingly surprised by suffering.

(NEXT SLIDE: Humanist Manifesto III)

 

It was in 1933 that the first Humanist manifesto was written and it has evolved over time but here is the heading from one of seven sections in version 3 from 2003:

“Working to benefit society maximises individual happiness”

And a quote from the “Secular Humanist Declaration” in 1980

“As secular humanists we believe in the central importance of the value of human happiness here and now.”

And if that didn’t make it obvious enough (NEXT SLIDE: The Happy Human)

they’ve called their official logo “The Happy Human”, and it’s interesting this version appears to be made of gold, conjuring up images from Exodus!

(NEXT SLIDE: Atheist bus campaign)

And the message is further reinforced by public campaigns by the likes of Richard Dawkins who you can see here.

This is the atheist bus campaign from a number of years ago.

“Stop worrying and your enjoy life!”

Simples!

But to be fair to humanists and atheists, I think we as Christians can sometimes be guilty of the same thinking and behaviour, even if we don’t express it as explicitly as they might. We sometimes think of God as an Epicurean, whose job it is to ensure our worldly happiness, as defined by us.

And this desire, by both Christians and non-Christians, to pursue happiness & avoid pain and suffering at all costs means that we will often look for quick fixes or distractions when we are confronted with even minor or transient inconveniences that may not even qualify as genuine suffering.

“1st world problems” has become a running joke. We don’t have any real problems so we complain and whinge about trivial things. And we turn to things like alcohol, Netflix, video games, sex, drugs or whatever we can find to avoid it. To the point where we even avoid situations that might cause suffering, and we look away when we see others suffering because we don’t like to be reminded of our own mortality and potential to suffer.

But this means that when it does inevitably come our way, and of course it will sooner or later, we are ill-equipped to deal with it. We haven’t developed a framework or appropriate coping strategies, or the psychological resilience required to prevent it from bringing our world tumbling down around us. We have become so used to fleeing suffering, or going to great lengths to avoid it in the first place, that we don’t know how to cope when backed into a corner.

And one of the concerns I have about euthanasia is that it will just perpetuate this problem. As euthanasia increases worldwide with more and more countries legalising it, and expanding access to include people without a terminal illness, and even to children, then the rest of society will have fewer and fewer examples of “how to suffer well” & can continue to turn a blind eye to it. This will mean their own strategies on how to deal with it will be inadequate and kids will grow up in a society where they see their loved ones take the euthanasia option when things get tough, so when their turn comes to suffer, for whatever reason, it might be seen as the only “good” option.

And it will also muddy the waters on suicide more generally. There’s been a lot of recent discussion about mental health & suicide, and how to prevent it. I’ve seen it particularly in medicine where there has been a big increase in suicide amongst doctors. Up until recently the universal message in Australia has been that “No matter how bad things get, it’s not ok to end your life. There’s always something more we can do to help.”

But now it’s become “If you live in Victoria, have a particular diagnosis & a level of suffering above “X”, then, not only is it ok to end your life, but we will help you do it.”

And I can already imagine the future advertising campaigns for “Euthanasia Equality” & “Suffering is Suffering”, and accusations of discrimination against those with mental illnesses by not allowing them access to services provided for those with physical illnesses, and so on and so forth. This will be exacerbated by the fact that pain and suffering are essentially subjective by definition, so it will be difficult to draw the line anywhere.

And in my day job in the world of anaesthetics and Human Factors, we talk about the concept of “complex socio-technical systems”, & modern western society is a good example of such a system. And in these systems, even small, well-intentioned changes, that may seem small on the surface & only affect a small number of individuals, can resonate through the system and have unintended consequences for the system as a whole. As they say, “No man is an island.” I think there is a risk that euthanasia could do this in our society.

So what’s the alternative? If Epicurus can’t give us an answer, can Christianity? I think it can. Because I think Jesus is, in some sense, a humanist!

(NEXT SLIDE: John 10:10) As we read in John

“I have come that they may have life, and have it to the full.”

He is certainly human, but because He is also God, He cares deeply about us who are made in His image. He wants us to have life to the full. But His view of what life to the full is is vastly different from that of the humanists. So what does the bible say about the meaning of life, if it’s not “individual human happiness”?

Well, fortunately, some people way smarter than me have looked into it and come up with a short, snappy summary of what “life to full” is, that I agree with…

(NEXT SLIDE: Westminster catechism)

You may or may not have heard of the Westminster catechisms, but they are basically a set of Frequently Asked Questions on Christian doctrine and faith. And the very first questions asked is:

Q. 1. What is the chief end of man?
A. Man’s chief end is to glorify God and to enjoy him forever.

So life is about God’s glory, which then flows into our “enjoyment”. Both here and now, but also on into eternity. The secular humanist view leaves out both God and eternity.

How does suffering fit into this? Contrary to what Epicurus and the humanists say, can suffering have a purpose? And is there an alternative to avoiding it at all costs? I think the bible is pretty clear that the answer to both questions is yes.

The obvious example of suffering having a purpose is Jesus. In 1 Peter 2:24 we read:

“He himself bore our sins” in his body on the cross, so that we might die to sins and live for righteousness; “by his wounds you have been healed.”

So Jesus suffering achieves something. His wounds have healed us. By extrapolation our own suffering can achieve things, and Paul says as much in Romans 5:3-5

“Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because Godʼs love has been poured out into our hearts through the Holy Spirit, who has been given to us.” Romans 5:3-5

I remember at one point in the midst of all this, praying to God and asking him to give me perseverance because I was really struggling with suffering. But I subsequently realised that the way God gives this good gift of perseverance is by actually making you persevere through something!

So, if we are paying whatever cost is required to try & avoid that first step of suffering, then we will never develop perseverance. If we don’t develop perseverance then we will also miss out on the character & hope that flows on from it.

And this hope, as Dave McDonald’s book title puts it so nicely, is a hope beyond cure. It is a hope beyond death. Yes, suffering sucks! Yes, we should try and minimise it! But no, we shouldn’t avoid it at any cost!

So I’ll finish up now with another quote from Tim Keller:

“Don’t just accept suffering—because God doesn’t want it.
Don’t just avoid suffering—because God can use it.

Don’t just embrace suffering—because it is evil.

Instead, enjoy the hope that suffering is going to be engulfed, swallowed up. The evil that hurts us now will be the eventual servant of our joy and glory eternally.”

Thank you.

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