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
The sanctity of life
Religious people often refer to the sanctity of life, or say that human life is sacred. They usually mean something like this:
God gives people life, so only God has the right to take it away.
You can look at that sentence in several ways. Here are three:
- God gave us our lives
- We owe our lives to God
- God is the final authority over our lives
- We must not interfere in the ending of our lives
- God is intimately involved in our lives
- God was intimately involved in our births
- God will be intimately involved in our deaths
- It would be wrong to try and shut God out of our dying
- We should not interfere in the way God has chosen for our lives to end
- God gave us our lives
- We are only stewards of our bodies, and are responsible to God for them
- We must use our bodies as God intended us to
- We must allow our lives (our stewardship) to end at the time and in the way God wants
Euthanasia and Islam
Human Life
The sanctity of human life is a basic value as decreed by God even before the
times of Moses, Jesus and Mohammad. Commenting on the killing of Abel by his
brother Caine (the two sons of Adam), God says in the Quran: "On that account
We ordained for the children of Israel that if anyone slay a person -unless
it be for murder or spreading mischief in the land- it would be as if he slew
the whole people. And if anyone saved a life, it would be as if he saved the
life of the whole people" (Quran 5:32). The Quran also says: "Take not life
which Allah made sacred otherwise than in the course of justice" (Quran
6:151 and 17:33). The Shari'a went into great detail in defining the
conditions where taking life is permissible whether in war or in peace (as an
item of the criminal law), with rigorous prerequisites and precautions to
minimize that event.
Is there a Right to Suicide?
Not in Islam. Since we did not create ourselves we do not own our bodies. We
are entrusted with them for care, nurture and safekeeping. God is the owner
and giver of life and His rights in giving and in taking are not to be
violated. Attempting to kill oneself is a crime in Islam as well as a grave
sin. The Quran says: "Do not kill (or destroy) yourselves, for verily Allah
has been to you most Merciful" (Quran 4:29). To warn against suicide Prophet
Mohammad said: "Whoever kills himself with an iron instrument will be
carrying it forever in hell. Whoever takes poison and kills himself will
forever keep sipping that poison in hell. Whoever jumps off a mountain and
kills himself will forever keep falling down in the depths of hell."
Euthanasia - Mercy Killing
The Shari'a listed and specified the indications for taking life (ie. the
exceptions to the general rule of sanctity of human life), and they do not
include mercy killing or make allowance for it. Human life per se is a value
to be respected unconditionally, irrespective of other circumstances. The
concept of a life not worthy of living does not exist in Islam.
Justification of taking life to escape suffering is not acceptable in Islam.
Prophet Mohammad taught: "There was a man in older times who had an
infliction that taxed his patience, so he took a knife, cut his wrist and
bled to death. Upon this God said: My subject hastened his end, I deny him
paradise." During one of the military campaigns one of the Muslims was killed
and the companions of the prophet kept praising his gallantry and efficiency
in fighting, but, to their surprise, the Prophet commented, "His lot is
hell." Upon inquiry, the companions found out that the man had been seriously
injured so he supported the handle of his sword on the ground and plunged his
chest onto its tip, committing suicide. The Islamic Code of Medical Ethics
endorsed by the First International Conference on Islamic Medicine (Islamic
Organization of Medical Sciences, Kuwait, 1981, p.65) includes: "Mercy
killing, like suicide, finds no support except in the atheistic way of
thinking that believes that our life on this earth is followed by void. The
claim of killing for painful hopeless illness is also refuted, for there is
no human pain that cannot be largely conquered by medication or by suitable
neurosurgery...”
There is still another dimension to the question of pain and suffering.
Patience and endurance are highly regarded and highly rewarded values in
Islam. "Those who patiently preserve will truly receive a reward without
measure" (Quran 39:10). "And bear in patience whatever (ill) may befall you:
this, behold, is something to set one's heart upon" (Quran 31:17). Prophet
Mohammad taught "When the believer is afflicted with pain, even that of a
prick of a thorn or more, God forgives his sins, and his wrongdoings are
discarded as a tree sheds off its leaves." When means of preventing or
alleviating pain fall short, this spiritual dimension can be very effectively
called upon to support the patient who believes that accepting and standing
unavoidable pain will be to his/her credit in the hereafter, the real and
enduring life. To a person who does not believe in a hereafter this might
sound like nonsense, but to one who does, euthanasia is certainly nonsense.
The Financial Factor
There is no disagreement that the financial cost of maintaining the incurably
ill and the senile is a growing concern, so much so that some groups have
gone beyond the concept of the "right to die" to that of the "duty to die".
They claim that when the human machine has outlived its productive span its
maintenance is an unacceptable burden on the productive stratum of society,
and it should be disposed of, and rather abruptly than allowing it to
deteriorate gradually (Jacques Atalli: La medicine en accusation - in Michel
Solomon 'L' avenir de la vie', Coll. Les visages de L'avenir. Ed. Seghers,
Paris, 1981, p. 273-275). This logic is completely alien to Islam. Values
take priority over prices. The care for the weak, old and helpless is a value
in itself for which people are willing to sacrifice time, effort and money,
and this starts, naturally with one's own parents "Your Lord decreed that you
worship none but Him, and that you be kind to your parents. Whether one or
both of them attain old age in your life, say not to them a word of contempt
but address them in terms of honor. And lower to them the wing of humility
out of compassion, and say: my Lord, bestow on them Your mercy even as they
cherished me in childhood" (Quran 17:25- 25). Because such caring is a virtue
ordained and rewarded by God in this world and in the hereafter, the
believers don't take it as a debit but as an investment. In a materialistic
dollar- centric community this logic is meaningless, but not so in the
value-oriented God heeding community of the faithful.
When individual means cannot cover the needed care, it becomes, according to
Islam, the collective responsibility of society, and financial priorities are
reshuffled so that values take priority over pleasures, and people derive
more pleasure from heeding values than from pursuing other pleasantries. A
prerequisite of course is a complete moral and spiritual re-orientation of a
society that does not hold to these premises.
Clinical Situations
In an Islamic setting the question of euthanasia usually does not arise, and
if it does, it is dismissed as religiously unlawful. The patient should
receive every possible psychological support and compassion from family and
friends, including the patient's spiritual (religious) resources. The doctor
also participates in this, as well, and provides the therapeutic measures for
the relief of pain. A dilemma arises when the dose of the pain killer
necessary to alleviate pain approximates or overlaps with the lethal dose
that might bring about the patient's death. Ingenuity on the part of the
doctor is called upon to avoid this situation, but from a religious point of
view the critical issue is the doctor's intention: is it to kill or to
alleviate? Intention is beyond verification by the law but according to Islam
it cannot escape he ever watchful eye of God Who according to the Quran
"knows the treachery of the eyes, and all that hearts conceal" (Quran 40:19).
Sins that do not fulfil the criteria of a legal crime are beyond the domain
of the judge but remain answerable to God.
The Islamic Code of Medical Ethics (1981 p.67), states: "In his/her defense
of life, however, the Doctor is well advised to realize his limit and not
transgress it. If it is scientifically certain that life cannot be restored,
then it is futile to diligently keep the patient in a vegetative state by
heroic means or to preserve the patient by deep freezing or other artificial
methods. It is the process of life that the doctor aims to maintain and not
the process of dying. In any case, the doctor shall not take a positive
measure to terminate the patient's life".
The seeking of medical treatment from illness is mandatory in Islam,
according to two sayings of the prophet: "Seek treatment, subjects of God,
for to every illness God has made a cure", and "Your body has a right on
you." But when the treatment holds no promise it ceases to be mandatory. This
applies both to surgical and/or pharmaceutical measures, and, according to a
majority of scholars, to artificial animation equipment. Ordinary life needs
which are the right of every living person and which are not categorized as
"treatment" are regarded differently. These include food and drink and
ordinary nursing care, and they are not to be withheld as long as the patient
lives.
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 meant 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 arguments 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 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
-
Euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person.Pope John Paul II, Evangelium Vitae, 1995
- The Roman Catholic church regards euthanasia as morally wrong. It has always taught the absolute and unchanging value of the commandment "You shall not kill".
- The church has said that:
- nothing and no one can in any way permit the killing of an innocent human being, whether a foetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.
- Pope John Paul II has spoken out against what he calls a 'culture of death' in modern society, and said that human beings should always prefer the way of life to the way of death.
- The church regards any law permitting euthanasia as an intrinsically unjust law.
- The value of life
- Life is a thing of value in itself; it's value doesn't depend on the extent that it brings pleasure and well-being.
- This means that suffering and pain do not stop life being valuable, and are not a reason for ending life.
- The church believes that each person should enter the dying process with all its mysteries with trust in God and in solidarity with their fellow human beings; they should die with the dignity of letting themselves be loved unconditionally.
-
As Catholic leaders and moral teachers, we believe that life is the most basic gift of a loving God--a gift over which we have stewardship but not absolute dominion.National Conference of Catholic Bishops (USA), 1991
- 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.
- Refusing aggressive medical treatment
- The church regards it as morally acceptable to refuse extraordinary and aggressive medical means to preserve life. Refusing such treatment is not euthanasia but a proper acceptance of the human condition in the face of death.
- Assisting suicide
- Since it is morally wrong to commit suicide it is morally wrong to help someone commit suicide.
-
True compassion leads to sharing another's pain; it does not kill the person whose suffering we cannot bear. Pope John Paul II, Evangelium Vitae, 1995
Euthanasia may not be in the best interests of the patient
A serious problem for supporters of euthanasia are the number of cases in which a patient may ask for euthanasia, or feel obliged to ask for it, when it isn't in their best interest. Some examples are listed below:
- the diagnosis is wrong and the patient is not terminally ill
- the prognosis (the doctor's prediction as to how the disease will progress) is wrong and the patient is not going to die soon
- the patient is getting bad medical care and their suffering could be relieved by other means
- the doctor is unaware of all the non-fatal options that could be offered to the patient
- the patient's request for euthanasia is actually a 'cry for help', implying that life is not worth living now but could be worth living if various symptoms or fears were managed
- the patient is depressed and so believes things are much worse than they are
- the patient is confused and unable to make sensible judgements
- the patient has an unrealistic fear of the pain and suffering that lies ahead
- the patient is feeling vulnerable
- the patient feels that they are a worthless burden on others
- the patient feels that their sickness is causing unbearable anguish to their family
- the patient is under pressure from other people to feel that they are a burden
- the patient is under pressure because of a shortage of resources to care for them
- the patient requests euthanasia because of a passing phase of their disease, but is likely to feel much better in a while
Supporters of euthanasia say that most of these problems can be prevented by assessing the patient properly, and, if necessary, discriminating against the opinions of people who are particularly vulnerable.
Chochinov and colleagues found that fleeting or occasional thoughts of a desire for death were common in a study of people who were terminally ill, but few patients expressed a genuine desire for death.
They also found that the will to live fluctuates substantially in dying patients, particularly in relation to depression, anxiety, shortness of breath, and their sense of wellbeing.
References
Chochinov HM, Tataryn D, Clinch JJ, Dudgeon D. Will to live in the terminally ill. Lancet 1999; 354: 816-819
Other people have rights too
Euthanasia is usually viewed from the viewpoint of the person who wants to die, but it effects other people too, and their rights should be considered.
- family and friends
- medical and other carers
- other people in a similar situation who may feel pressured by the decision of this patient
- society in general
- Euthanasia puts pressure on the vulnerable
- This is another of those arguments that says that euthanasia should not be allowed because it will be abused.
- The fear is that if euthanasia is allowed, vulnerable people will be put under pressure to end their lives. It would be difficult, and possibly impossible, to stop people using persuasion or coercion to get people to request euthanasia when they don't really want it.
- I have seen . . . AIDS patients who have been totally abandoned by their parents, brothers and sisters and by their lovers.
- In a state of total isolation, cut off from every source of life and affection, they would see death as the only liberation open to them.
- In those circumstances, subtle pressure could bring people to request immediate, rapid, painless death, when what they want is close and powerful support and love.
- evidence to the Canadian Senate Committee on Euthanasia and Assisted Suicide
- The pressure of feeling a burden
- People who are ill and dependent can often feel worthless and an undue burden on those who love and care for them. They may actually be a burden, but those who love them may be happy to bear that burden.
- Nonetheless, if euthanasia is available, the sick person may pressure themselves into asking for euthanasia.
- Pressure from family and others
- Family or others involved with the sick person may regard them as a burden that they don't wish to carry, and may put pressure (which may be very subtle) on the sick person to ask for euthanasia.
- Increasing numbers of examples of the abuse or neglect of elderly people by their families makes this an important issue to consider.
- Financial pressure
- The last few months of a patient's life are often the most expensive in terms of medical and other care. Shortening this period through euthanasia could be seen as a way of relieving pressure on scarce medical resources, or family finances.
- It's worth noting that cost of the lethal medication required for euthanasia is less than £50, which is much cheaper than continuing treatment for many medical conditions.
- Some people argue that refusing patients drugs because they are too expensive is a form of euthanasia, and that while this produces public anger at present, legal euthanasia provides a less obvious solution to drug costs.
- If there was 'ageism' in health services, and certain types of care were denied to those over a certain age, euthanasia could be seen as a logical extension of this practice
