Friday, November 25, 2016

What I Would Say to a Hollywood Executive

 * Covenant Eyes recently had a write-in contest.  They encouraged people to respond to the following (in 500 words or less)-“If you are at the Movieguide Gala sitting with one of the top 300 influencers of Hollywood, what would you say to that person?”  Below is my entry (which didn't win!):


“As a Christian could I mention a couple things to you?  The first thing I want to say is that we in the Christian community have not always done well in interacting with and responding to Hollywood.  I’m not an official spokesman or anything like that but I would offer my apologies for some of our behavior.  We haven’t always appreciated true artistic beauty.  Even when our moral instincts about certain movies have been correct we have not always responded in a reasoned and effective manner.  We serve and worship a God of infinite creativity but we, as His people, are sometimes close-minded and dull.  We are getting better, I think, at engaging with the cinematic media and some in the Christian community are even trying their hand at movie making but we have more work to do.

“Second, I hope that Hollywood will not pander to the Christian community.  There can be a temptation to think that Christians only enjoy Bible-centered stories or moralistic tales where everyone has a happy ending.  The irony is that movies attempting to capture a biblical narrative rarely work well.  The reason is that we see the Bible as God’s revelation to us and it functions in profoundly shaping ways in our communities.  There is both a theological and existential engagement with the text of Scripture among most Christians so our expectations are already very high when we go see a movie centered on a biblical story or character.  To be honest, we are often disappointed by the dissonance we experience when we see how Hollywood treats our sacred text.  Also, we need more than trite morality plays.  I say this not to demean you or your profession but, rather, to encourage you to challenge us, the Christian community.  Our recent forays into movie making are often of the moralistic-everything-ends-fine type.  We need to be challenged to something deeper. 

“If I had to put the challenge we need into words it might be adequately expressed this way: Give us that which is True, Good, and Beautiful.  There are movies that debase the viewer and there are movies that enliven and ennoble.  This doesn’t always mean that the ending is happy.  We need to see the truth of a broken world—the Bible doesn’t shy away from this reality.  This doesn’t mean there won’t be violence but there are movies that glorify and perpetuate violence and there are movies that, although they depict violence, render the viewer moved to morally stand opposed to injustice.  By “beautiful” I don’t mean only sunsets and daisies.  There can be a stark beauty in a barren landscape artfully filmed to produce in the viewer a sense of abandonment or aching breathlessness.  We need truth, goodness, and beauty.  I submit that all of humanity needs such virtues displayed and enacted in front of them.  Give us what we need—not simply what we want.”


Monday, November 21, 2016

The American Flag in the Worship Service

* I was part of a church in which there was some controversy generated by the decision to remove the American flag from the worship area of the church.  I wrote the following to give my perspective.  Hopefully its reasoning and use of Scripture may be of help to others. (Note: The picture below was not from our church.)




1.     How will this controversy serve the cause of the gospel of Jesus Christ?  After the discussions and decisions, will we love Jesus more?  Will we be more excited about the trans-national kingdom of God which is bigger than any one nation?  Will we have a greater commitment to unity and peace in the body of Christ?  Will we have a greater zeal for the lost who do not know Christ Jesus and are, therefore, under the wrath of God?  If controversy causes us to dig deeper into Scripture and to reason in a way that is more gospel-centered and Spirit-filled, then the controversy will be worth it.  If not, then we will have wasted this controversy—wherever the flags are placed.

2.     There are many things God wants us to do in worship: read the Scriptures, preach the Word, pray, confess our sins, sing, affirm our faith, bless one another with benedictions, give to one another for physical needs, participate in the Lord’s Table with purity and unity… these things we do in the name of the risen Savior, Jesus Christ.  Therefore, our worship services are Christian in nature—whatever flags may be present or not present.

3.     We are not given a specific pattern for a worship service or are we given specifics as to what the surrounding environment should look like in a worship service.  Therefore, there seems to be some freedom as what the surroundings can look like.  If we have the choice to decorate our surroundings for worship (and not all have this luxury) our decisions should be made on the basis of biblical principles.  Does the architecture and environment “speak of the gospel?”  For example, we should not purposefully adorned the walls of the sanctuary with a Nike “swoosh” logo—not because there is a specific verse that says not to do this.  Rather, such a logo would send the wrong message for those who are gathered for worship—we are gathered to worship Jesus as the church and not as a marketing demographic.  We do adorn the sanctuary with a cross because this is one of the central symbols of the love of God displayed in Jesus Christ.  We want to follow in Paul’s footsteps and “boast in the cross of our Lord Jesus Christ” (Galatians 6.14).

4.     Architectural space is not simply neutral.  The Reformers recognized this.  The following is from Presbyterian theologian Bryan Chapell in his book Christ-Centered Worship:

Structures tell stories.  Martin Luther knew this when he designed the first Protestant church in Torgau, Germany.  Prior to the construction of this chapel for the castle of Luther’s protector, the Elector John Frederick I, Protestant services were held mainly in churches that were formerly Roman Catholic  The main architectural change that occurred when Protestants took control of such churches was the replacement of a cross on the spire of the church with a rooster, symbol of the new dawn of the Reformation.  And it was not rare in the competing tides of Reformation times that if Roman Catholic forces returned to power, they would replace the rooster with another cross.

Each faith movement signaled its control by the changed “hood ornament” most obvious to all in the town or region, but the basic architecture of the church changed little.  Thus, when Luther had the opportunity to design a church that would reflect the new perspectives of the Reformation, he made sure that the basic structure of the church would convey the gospel story he wanted to tell.  No structural change would have been more obvious to sixteenth-century worshippers than the placement of the pulpit. In deliberate contrast with the Roman Catholic practice of placing the pulpit at the front of the congregation, Luther arranged for the pastor to preach among the people.  The pulpit was at the center of the long wall of the worship sanctuary.  In addition, the altar, while still located at the front of the church, was no longer separated from the people by screens that had designated sacred space for clergy alone.

Luther preached “the priesthood of believers,” and his structures conveyed the same message.  The placement of the pulpit silently explained that the preacher was not more holy than the people.  He ministered among them because all were fulfilling holy callings as they served God in their occupations for which he had gifted them.  The architecture of the altar “said” there was no need for priestly intercession or separation, since everyone had equal and immediate access to God.  The early Calvinistic churches of the French Reformation pushed the idea further by putting the pulpit in the center of a circled congregation.  This structure not only symbolized the priesthood of believers, but also asserted the centrality of the Word in Christian worship.

I do not mention these architectural details in order to mandate designs for church architecture.  In fact, the various ways in which the Reformers expressed their views can also argue for the liberties in church architecture that modern Christians have obviously exercised.  But such freedom is best applied when we have some sense of the story we are trying to tell, and this requires understanding our place in God’s unfolding plan for his Church.[1]

Again, the issue, as Chapell states, is not slavishly following Luther or Calvin but, rather, to consider what elements of the gospel-story are we attempting to communicate with our architectural space.  What are we saying with the presence of the American flag?  What are we communicating by its absence?  Does the gospel message shape our practice?  What biblical principles are we attempting to use in our decision-making process.

5.     Reformed Pastor Douglas Wilson writes:

If the church places an American flag in the front of the sanctuary, this becomes part of our sacred architecture, and therefore says something.  It becomes a shaping influence.  Important questions should come immediately to mind: What is this saying?  And is it scriptural?  It should not be too much to ask for some kind of scriptural agreement with what we are saying before we say it.  Placing a flag in the sanctuary has many possible implications.  It could convey the idea that we claim some sort of ‘favored nation’ status.  It could imply we believe that the claims of Caesar extend into every space, including sacred spaces.  It could imply that our version of Christianity is similar to some kind of syncretistic ‘God and country’ religion, where patriotism and religion are one and the same.[2]

What is the biblical or theological argument for including the American flag in a worship service space?  What biblical principles are being upheld by the presence of the American flag?

6.     One of God’s goals in Christ Jesus is to transcend ethnic, cultural, and national distinctions.  Consider Ephesians 2.14-16

For he himself [Christ] is our peace, who made both groups into one and broke down the barrier of the dividing wall, by abolishing in his flesh the enmity, which is the law of commandments contained in ordinances, so that in himself he might make the two into one new man, thus establishing peace, and might reconcile them both in one body to God through the cross, by it having put to death the enmity.

Consider Colossians 3.11 which speaks of the renewal in Christ Jesus, “a renewal in which there is no distinction between Greek and Jew, circumcised and uncircumcised, barbarian, Scythian, slave and freeman, but Christ is all, and in all.”  One Bible commentator has written of this verse:

In contrast to these artificial, earthly distinctions, Paul said, “Christ is all, and in all” (3:11b).  The new distinction is Christian/non-Christian, rather than nationality, race, religious background, or economic distinctions.[3]

7.     The Old Testament as well speaks to this issue of the eventual blessings of the nations—all of them—as they participate in the reign and rule of God (Genesis 12.3; Psalm 22.27; 117.1-2; Isaiah 2.1-4).  Isaiah 19.24-25 is an especially clear passage which speaks of how the people of God will no longer be just Israel but will also encompass even Israel’s enemies (Egypt and Assyria) on equal footing.  Christopher Wright, an evangelical Old Testament scholar, has written:

The identity of Israel will be merged with that of Egypt and Assyria.  In case the implications of verse 24 was not clear enough, the prophet makes is unambiguous (not to mention scandalous) by applying to Egypt and Assyria descriptions that hitherto could only have been said about Israel…The shock of reading ‘Egypt’ immediately after ‘my people’ (instead of the expected Israel) and of putting Israel third on the list is palpable.  Yet there it is.  The archenemies of Israel will be absorbed into the identity, titles, and privileges of Israel and share in the Abrahamic blessing of the living God, YHWH.[4]


8.     Another Old Testament passage to consider is Isaiah 56.7

Even those I will bring to my holy mountain and make them joyful in my house of prayer.  Their burnt offerings and their sacrifices will be acceptable on my altar; for my house will be called a house of prayer for all the peoples.

The context of this prophecy is about the inclusion of “foreigners” (Isaiah 56.3, 6) in the people of God.  Even those formerly excluded from the worship of God from among the “peoples” will be granted access.  Jesus takes this passage very seriously.  He quotes this passage when he is clearing out the temple (Mark 11.17).  So in the New Covenant where is the “house” of the Lord?  The church is God’s temple, God’s building (1 Corinthians 3.9; Ephesians 3.19-23; 1 Peter 2.5).  The gathered church in the New Covenant should reflect this universal reality of God’s kingdom.  His people are not isolated to one nation—his kingdom is trans-cultural and includes all the peoples.  He still desires that his house be a house of prayer for all the peoples.

9.     New Testament scholar Greg Beale writes regarding the heavenly worship scenes in Revelation chapters 4 and 5:

John intended the readers to see what is told of in the vision [Rev. 4-5] as a heavenly pattern that the Church is to reflect in its worship rather than the other way around (just as the heavenly pattern of the tabernacle shown to Moses on the mountain was to be copied by Israel in the construction of their own tabernacle)[5]

It is good to remember that this heavenly vision of worship stresses the international character of God’s people who have been purchased by the blood of the Lamb

Worthy are you to take the book and to break its seals; for you were slain, and purchased for God with your blood men from every tribe and tongue and people and nation.  (Revelation 5.9)

10. In light of all this above our worship space ought to reflect and not contradict this international focus of the people of God. To enter into the sanctuary without the American flag symbolizes that we worship as the trans-national Church—the international people of God bought by the blood of Jesus.  Our worship space does not send mixed signals in this regard.  Rather, our architectural space devoted specifically for corporate worship conveys a significant gospel-truth in this regard—the church of Jesus is universal, for all peoples. 

11. However much we may love our country and its flag, our allegiance and love for our Savior, Jesus Christ should so far exceed it that our love for Jesus makes all other loves pale in comparison.  Consider how Paul speaks of his nationality and upbringing in Philippians 3.5-6.  He can point to a proud heritage as being of the nation of Israel and especially of the tribe of Benjamin.  He was a “Hebrew of Hebrews”; a Pharisee full of zeal.  And yet when Paul begins to consider Jesus Christ is speaks of the “surpassing value of knowing Christ Jesus my Lord” and counts everything else as “rubbish.”[6]  Paul did not hesitate to use his Roman citizenship when it helped further the gospel message (Acts 16.36-40; 22.25-29).  He would even use his background as a Pharisee as credentials to further the gospel (Acts 23.6-9).  But over all these allegiances Paul’s first allegiance and love was to Christ.  This should be our first allegiance and love.

12. Good Christian men and women can disagree on the issue of placing the American flag in a worship sanctuary.  This disagreement, however, should not disrupt the unity in the body of Christ.  Ephesians 4.1-3 is still the Word of God and ought to be heeded as we seek to put on its commanded virtues:

Therefore I, the prisoner of the Lord, implore you to walk in a manner worthy of the calling with which you have been called, with all humility and gentleness, with patience, showing tolerance for one another in love, being diligent to preserve the unity of the Spirit in the bond of peace.

13. Differences of opinion on matters such as these should be placed in the category of Romans 14.  In Romans 14 the issue was one of eating meat or not eating meat.  Also, there were those upholding special religious days and others treated all days equally.  Paul’s counsel is instructive for us:

            One person regards one day above another, another regards every day alike. Each person must be fully convinced in his own mind.
            He who observes the day, observes it for the Lord, and he who eats, does so for the Lord, for he gives thanks to God; and he who eats not, for the Lord he does not eat, and gives thanks to God.
                    For not one of us lives for himself, and not one dies for himself; for if we live, we live for the Lord, or if we die, we die for the Lord; therefore whether we live or die, we are the Lord’s.
             For to this end Christ died and lived again, that He might be Lord both of the dead and of the living.
             But you, why do you judge your brother? Or you again, why do you regard your brother with contempt? For we will all stand before the judgment seat of God.
                                     For it is written,
As I live, says the Lord, every knee shall bow to Me,
And every tongue shall give praise to God.”
                                     So then each one of us will give an account of himself to God.

In Romans 14.17 Paul reminds us what are some of the central values that should characterize our lives:

…for the kingdom of God is not eating and drinking, but righteousness and peace and joy in the Holy Spirit.

14. We should always keep in mind the distinction between God’s word and human tradition.  Human tradition is not necessarily bad or inappropriate.  But it becomes a stumbling block to truth when it is elevated to the position of equality with God’s word.  This was part of the failure of the Pharisees of Jesus’ time.  Mark 7.1-13 is crucial reading in this regard.  I want to write very carefully here so as not to be misunderstood.  I am not saying that those who want to have an American flag in the sanctuary are evil Pharisees.  I am saying that the presence of an American flag in a worship sanctuary is a tradition—there is no specific command to have such a flag in our worship service.  It may be a good tradition that serves biblical purposes—even if that has yet to be established or articulated.  But allegiance to this tradition should not over-ride the very clear commands of Scripture to love one another and pursue unity in the body of Christ.  When our allegiance to human traditions—even good ones—trumps the Word of God then that human tradition rightly falls under the censure of Jesus’ words in Mark 7.8—“neglecting the commandment of God, you hold to the tradition of men.”




     [1] Bryan Chapell, Christ-Centered Worship: Letting the Gospel Shape Our Practice (Grand Rapids, Mich.: Baker, 2009), 15-16—bold-face added.
     [2] Christianity Today July 5, 2012.
     [3] Richard R. Melick, Jr. Philippians, Colossians, Philemon (NAC; Nashville, Tenn.: Broadman Pess, 1991), 298.
     [4] Christopher J. H. Wright, The Mission of God: Unlocking the Bible’s Grand Narrative (Downers Grove, Ill.: Intervarsity Press, 2006), 493.  Wright adds: “It is very possible that his triple expression of the inclusion of the Gentiles within the identity and titles of Israel (as coheirs, a co-body, and cosharers with Israel) in Ephesians 3:6 owes something to this verse in Isaiah.”
     [5] Quoted in Jeffrey J. Meyers, The Lord’s Service: The Grace of Covenant Renewal Worship (Moscow, Idaho: Canon Press, 2003), 134.
     [6] The Greek word translated “rubbish” in the NASB is a very graphic word.  “This is harsh language.  [Skubala] means ‘excrement’ or in some contexts refers to the parts of the carcass of an animal that are unusable.” Jerry L. Sumney, Philippians: A Greek Student’s Intermediate Reader (Peabody, Mass.: Hendrickson, 2007), 78-79.

Monday, November 14, 2016

Problems in Oregon and Washington's Physician-Assisted Suicide Laws

* I've been teaching on end-of-life issues (physician-assisted suicide, euthanasia, etc.) for a Sunday School class--see HERE for details.  I put together this brief sheet as part of that series.


Euthanasia

Problems and Concerns with the Physician-assisted Death Statutes in Oregon and Washington:

The claim is made that there are “adequate controls” in place to hinder abuse of the system.

In Oregon and Washington the following problems are evident:

1.     The doctor who prescribes a lethal overdose self-reports the incident.  There is no oversight from another source.

2.     The doctor who prescribes the lethal overdose selects the doctor who is to give the “second opinion” on the case.

3.     The doctor who prescribes the lethal overdose is the one who decides whether the person needs psychological counseling.

4.     The doctor is not required to give any notification to family members.

5.     The doctor often works in conjunction with pro-suicide groups.

6.     The doctor does not need to be present when the person dies.

7.     The doctor signs the death certificate.  The statement of cause of death is not physician-assisted death but, rather, the underlying medical condition.


Bibliography

Richard M. Doerflinger, “Don’t Let Assisted Suicide Come to the Nation’s Capital,” Public Discourse (November 14, 2016).  Online: http://www.thepublicdiscourse.com/2016/11/18224/

“Some Oregon Assisted Suicide Abuses and Complications” Not Dead Yet Washington.  Online: https://dredf.org/assisted_suicide/18_Oregon_abuses.pdf

“Assisted Suicide Laws in Oregon and Washington: What Safeguards?” Secretariat of Pro-Life Activities (September 22, 2016).  Online: http://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-each-day/upload/Oregon-and-Washing-euthanasia-2013.pdf

Friday, November 4, 2016

Life, Death, & Growing Old (part six): End of Life Issues


* The following is part of a teaching series done for a Sunday School class.

Life, Death & Growing Old

·      End of life issues: terminating life support, physician-assisted suicide, and euthanasia

1.     Biblical Principles on Death: Important points to remember and factor into our thinking when discussing these topics

a.     Timing and manner of death belong ultimately to God: Deuteronomy 32.39; Matthew 10.28; Revelation 1.18

§  We are not autonomous!  We live under the sovereign lordship of God.

b.     Death was not part of God’s design.  It is an alien intruder into God’s good creation; an enemy: 1 Corinthians 15.26

c.      Death is “normal” now due to the state of sinfulness in the world—“The way of all the earth” as a metaphor for death: Joshua 23.14; 1 Kings 2.1

d.     Death is both “normal” and an enemy (b. and c. above)

e.     Life is to be sought after—all of Scripture teaches this as its default setting: Proverbs 24.11-12; Galatians 6.10; 1 Thessalonians 5.15

f.      This earthly life is not the highest good: Romans 14.7-8; 1 Corinthians 10.31; 2 Corinthians 5.9-10

g.     God can and does use human suffering for good: 2 Corinthians 12.7-10; 1 Peter 2.21-24; 4.12-17

2.     Definitions

a.     Termination of life support (TLS)

                                               i.     Used to be called “passive euthanasia”

                                              ii.     Nothing “passive” about it—deliberate act

                                            iii.     Usually withdrawing ventilator support for breathing or withholding CPR for patients whom it would be futile.

b.     Physician-assisted suicide (PAS)

                                               i.     Physician more actively serves as a causal agent in the patient’s death.

                                              ii.     Physician provides medicine and knowledge of how to use it to bring about death.

                                            iii.     Death is directly caused by medication and not by underlying disease.

c.      Euthanasia (sometimes called “mercy killing”)

·      Note: euthanasia comes from the Greek word “eu-thanatos” meaning “good death”

·      Sometimes the term “euthanasia” is used broadly to cover all the categories including TLS and PAS.

                                               i.     Refers to the direct and intentional efforts of a physician or other medical professional to help a dying patient die.

                                              ii.     Usually accomplished by administering a lethal injection of drugs into the patient.

                                            iii.     The patient is actually killed by the direct action of the physician.

·      Note: The main difference between physician-assisted suicide and euthanasia is the direct involvement of the physician in the patient’s death.


·      Distinctions we have been discussing…








·      The “slippery slope” in arguing for physician-assisted death:




·      “Even if, for the sake of argument, we grant the legitimacy of assisted suicide, that's only "necessary" in a fraction of cases (i.e. incapacitating accidents). Yet euthanasia is applied far more broadly. And notice how quickly it goes from voluntary to involuntary euthanasia. 

The real reason is that assisted suicide is a pretext for government to expand its authority to kill people. It uses the guise of "compassion" and "death with dignity" and "mercy killing" as an excuse to assume the role of public executioner, become the arbiter of life and death. It's really about the absolute power of the state. And not coincidentally, this dovetails with nationalized healthcare. The apotheosis of the state. Physicians as public employees who kill at the behest of the state.

There's also something undeniably diabolical behind it all. The devil hates humans. The devil is a murderer for the beginning (Jn 8:44). The devil is the unseen architect of genocide. How else do we account for self-loathing humanism?”[1]   --Steve Hays  


3.     Important for Christians to think about these things

a.     “For the church, physician-assisted suicide and euthanasia is a very pressing issue, and the big debates loom just over the horizon.  We must affirm to our churches what it means not only to have a good life but a good death.  A good death is able to minimize suffering when possible, and it affirms the inherent dignity of the person.  In a profound, true sense, one cannot evade all forms of human suffering.  I am not arguing, of course, that people should simply accept every kind of suffering.  However, the opposite position that one must intervene to alleviate all suffering, or even intervene before the suffering begins, is an extreme one.  Suffering was not part of God’s original design for his creation.  It is the result of the fall, just like death.  However, God can use these to accomplish his greater purposes in the world.  The notion of suffering and its ability to produce character and make possible a deeper experience with God is littered throughout Scripture.  This is a point that opponents to our position will not be fond of, yet it is one that Christian tradition and Scripture stand upon and must not forfeit.  The Christian church would do well to recover a robust ars moriendi [art of dying] and stand ready to articulate their position on assisted dying, lest culture attempt to redefine it for us.”[2]

b.     “Five states—California, Oregon, Washington, Montana, and Vermont—have legalized physician-assisted suicide in some form. PAS remains illegal by statute in Montana, but a 2009 Montana Supreme Court decision shields doctors from prosecution so long as they have the patient's request in writing. New Mexico's statutes continue to list assisted suicide as a fourth-degree felony, but the courts briefly made the practice legal in 2014 before the New Mexico Court of Appeals ruled against it.”[3]

4.     Distinctions: Important for how we reason about these issues and how to respond to unbiblical views

a.     Withholding vs. Withdrawing Treatment

                                               i.     Definitions:

1.     Withholding: treat not started

2.     Withdrawing: stop a treatment already begun

                                              ii.     Emotionally: more difficult to stop a treatment

                                            iii.     Ethically: there is not a relevant difference between the two[4]

                                            iv.     “When one begins a treatment, the implicit promise (and thus, patient expectation) only involves using that treatment until a point is reached when it becomes pointless and excessively burdensome.”[5]

b.     Voluntary, Nonvoluntary, and Involuntary

“Voluntary euthanasia occurs whenever a competent, informed patient autonomously requests it. Nonvoluntary euthanasia occurs whenever a person is incapable of forming a judgment or expressing a wish in the matter (e.g., a defective newborn or a comatose adult). Involuntary euthanasia occurs when the person expresses a wish to live but is nevertheless killed or allowed to die.”[6]

c.      Ordinary/Extraordinary distinction

                                               i.     Ordinary means: “all medicines, treatments, and operations that offer a reasonable hope of benefit without placing undue burdens on a patient (e.g., pain or other serious inconvenience).”[7]

                                              ii.     Extraordinary means: “those that are not ordinary; that is, those that involve excessive burdens on the patient and that do not offer reasonable hope of benefit.”[8]

                                            iii.     Important qualifications:

1.     Distinction is relative to the changes that happen in medicine.  What was excessive 50 years ago may be ordinary today.

2.     Distinction should be applied to kinds of treatments for specific persons in specific situations.  Same treatment may more or less burdensome or painful for differing patients.

3.     “The line between ordinary and extraordinary treatment is not always easy to draw, and such judgments should be made on a case by case basis and should involve the patient, the family, and the attending physician.”[9]

4.     Because of these points the terms more in use today are obligatory and optional.  This takes into account the role that different circumstances play in determining which treatments are morally required and which ones are not.

d.     Motives, Intentions, and Means

§  1 Samuel 16.7 “…for God sees not as man sees, for man looks at the outward appearance, but the Lord looks at the heart.”

§  Hebrews 4.12 “For the word of God is living and active and sharper than any two-edged sword, and piercing as far as the division of soul and spirit, of both joints and marrow, and able to judge the thoughts and intentions of the heart.”

                                               i.     Motives: Why one acts.

                                              ii.     Intentions: What one intends on doing.

                                            iii.     Means: How one acts.

§  Evaluating the morality of an action requires that we need to determine if an immoral means was used to accomplish a moral/good end.

§  “The ends do not justify the means.”

                                            iv.     Illustration: “Suppose that Patty, Sally, and Beth each have a grandmother who will leave behind a large inheritance.  Each visits her grandmother on a Saturday afternoon and brings a cherry pie to her.  Patty, motivated by respect for a relative, intends to love her grandmother by means of being with her for the afternoon and by giving her a cherry pie.  Sally, motivated by greed, intends to secure a place in the will by means of being with her grandmother for the afternoon and by giving her a cherry pie.  Beth, motivated by hate for her grandmother, intends to secure a place in the will by means of giving her grandmother a cherry pie with poison in it.”[10]


Patty
Sally
Beth
Motive
Good motive: respect for relative.
Bad motive: greed.
Bad motive: hate.
Intention
Good intention: love grandmother.
Bad intention: selfishly securing place in will.
Bad intention: selfishly securing place in will.
Means
Good means: spend time; give pie.
Good means: spend time; give pie.
Bad means: killing grandmother with poisoned pie.


5.     The Distinction between “killing” and “letting and die”

a.     There are some who say this is a distinction without a difference.

b.     Important to maintain this distinction

c.      Intentions and results

                                               i.     Killing: aiming at death as the goal

                                              ii.     Letting die: not necessarily (and usually not) aiming at death as the goal

                                            iii.     “To kill—that is, actively to take someone’s life—is by definition to choose death, whether this be done out of wicked or merciful motives.  To let an ill person die (ourselves or another), however, may well be to choose not death but one form of life over another.  A person’s choice to forgo an additional round of chemotherapy when her cancer is evidently a terminal case is probably not a choice to die.  The fact of death has already been decided, apart from the cancer victim’s will.  Instead, the choice to forgo more chemotherapy may be a decision to live a somewhat shorter life than the chemotherapy might make possible, but a shorter life that is free from the debilitating burden of chemotherapy and that enables the person to enjoy her remaining life more—to finish projects, to spend time with loved ones, and to get her house in order.  It is not necessarily a choice between life and death, therefore, but a choice between one kind of life and another kind of life.”[11]

                                            iv.     “One more example is needed to unpack the implications of our distinction between an act’s aim and its result.  A patient in the last stages of terminal illness, who is suffering greatly, may request and receive increasingly large doses of morphine to control his pain.  We know that increasingly large doses of narcotic drug may bring death more quickly by suppressing respiration.  That is one possible result of this treatment, and of course one could aim at that result by giving a dosage large enough to cause death.  But a carefully calibrated increase in the amount of medication is aimed at controlling pain, not at bringing a quicker death than would otherwise have happened, though that is hard to know.  The intent, however, is to provide the best care possible in these difficult circumstances.  Neither the patient who requests the morphine nor the doctor who authorizes it is necessarily choosing death in so doing.”[12]

d.     We do not always need to do everything possible to avoid death.

“Nevertheless, the fact that we ought not to aim at death for ourself or another does not mean that we must always do everything possible to oppose it.  Life is not our god, but a gift of God; death is a great evil, but not the ultimate evil.  There may come a time, then, when it is proper to acknowledge death and cease to oppose it.  Our aim in such circumstances is to care for the dying person as best we can—which now, we judge, means withdrawing rather than imposing treatment.”[13]

e.     Guidelines used to determine when to refuse treatment

                                               i.     A treatment can be refused if is useless. 

·      Sometimes continued treatments in an attempt to cure a patient only impose needless difficulty and may well get in the way of the effort to care for the person.

                                              ii.     A treatment can be refused if it excessively burdensome.

·      “Because life is not our god, we need not accept all burdens—no matter how great—in order to stay alive.  We need to recognize clearly what this means.  It means that we rightly refuse even useful treatment that would prolong our life for a significant period of time if that treatment really does carry with its significant burdens.”[14]

6.     Difficulties in applying God’s standards to difficult cases

It is also the case, as we mentioned before, that many issues of the modern day are not specifically discussed in scripture. If we cannot fax the apostles to learn their view of baptism, much less can we determine directly what they would say about nuclear weaponry, the government role in welfare, the medical use of life-support equipment. Here too, there are biblical principles which apply; but the argument can be complicated. It is not as if the apostles were readily available for interviews.

In facing our epistemological disadvantages, the first thing to be said is that God understands. He is the Lord of history. His providence has planned and controlled it. It is no accident that we are in the present epistemological situation. That situation, uncomfortable as it may be at times, suits God’s purposes perfectly, and we must be thankful for it. We should not murmur or complain, as Israel in the wilderness. When someone calls and asks me a hard question, say, about whether they should remove life support systems from a dying relative, I usually begin by saying that these are, after all, hard questions, and that God understands how hard they are for us. We cannot fax the apostles, but He doesn’t expect us to. He has left us with Scripture and the Spirit’s illumination, and He has determined that that is enough. We may fumble around in searching for answers. We may make decisions which we regret later on, because we hadn’t at first considered all the relevant principles and facts. But God understands that! He doesn’t expect us to be perfect theologians. He is not waiting up in heaven with a club to hit us over the head when we make an exegetical mistake.

In such situations, it is helpful to remember that we are justified by faith, not by works, nor, therefore, by ethical accuracy. That comfort does not, of course, excuse us from hard thinking. If God has justified us, we will want to please him, and we will make intellectual and other efforts to do what he wants. But the sincerity of such efforts is not measured by the perfection of the results. We may try very hard to apply biblical principles and come up with an answer that later proves inadequate. Yet God will still honor the attempt. He knows the heart, and he takes into consideration the obstacles (including epistemological) that we must overcome.[15]

7.     What are the primary arguments given in support of physician-assisted suicide/euthanasia?  How would you respond to each one?

a.     Argument from mercy: merciful to relieve the suffering of the terminally ill

                                               i.     Most cases of pain can be controlled and managed through medication

·      A report by the National Institute of Health notes that in published studies, pain is not a dominant motivating factor in patients seeking PAS. The reasons for seeking to die are usually depression, hopelessness, issues of dependency, and loss of control or autonomy.”[16]

                                              ii.     Acceptable for patients to “go to sleep” through medication before they die

                                            iii.     Even if pain relief control slows down heartbeat and breathing this is justified under “double effect”

§  “Double effect”: an unintended but foreseen negative consequence of a specific action does not necessarily make that action immoral

b.     Argument from utility: it’s a “win-win” situation—benefits the suffering patient, family, high cost of medical care is avoided, medical staff can get on with helping others.

                                               i.     Such calculations need to include the impact on the public at large over the long term as well as the short term.

                                              ii.     Do the actions produce a balance of good consequences in society in general, especially as it relates to future terminally ill patients who might be coerced into consenting to active euthanasia.

                                            iii.     This utilitarian reasoning assumes the adequacy of utilitarian moral reasoning.  There are also deontological arguments that need to be considered (i.e., the sanctity of life and the prohibition of killing innocent people.

c.      Argument from autonomy: timing and manner of one’s death are personal and private decision protected by the right to privacy.

                                               i.     Personal autonomy is not absolute.  Some things we cannot do with our bodies (i.e., illegal drugs, prostitution).

                                              ii.     When there has been a conflict of personal autonomy and the rights of others, the rights of others usually takes precedence.

1.     Opening the door to euthanasia threatens the lives of others at the end of their lives—Dutch experience strongly suggests that some euthanasia is being administered against people’s will.

                                            iii.     If autonomy is used then autonomy is a “universal right” and thus physician-assisted suicide cannot be limited to terminal patients.  It must be available to all regardless of age or illness.

                                            iv.     Christian worldview: theologically it is not the case that people have the right to choose the time of their death.  God is the one to decide when one dies.

d.     Argument that euthanasia is not a violation of the Hippocratic Oath: (1) HO also outlaws abortion but we allow that today; (2) HO is less a moral requirement than a quaint piece of history not taken seriously today; (3) if Hippocrates had known of chronic diseases he would have understood the need for physician-assisted suicide.

                                               i.     If Hippocrates had known of the pain management medicines he would have been able to uphold his standard of not taking life.

                                              ii.     We don’t think that abortion should be allowed.

e.     No morally relevant difference between killing and letting die: uses James Rachels’ argument—nephew in bathtub and uncle who stands to inherit money if boy dies: (1) active killing by drowning and (2) allowing a fallen nephew who is passed out under water to die by refusing to help.

                                               i.     Rachels’ analogy is overblown—has a masking or “sledge-hammer effect.”  The two cases given by Rachels are both so morally atrocious that they fail to take into account other features of their situation (killing versus letting die) that are morally determinative.

                                              ii.     Main problem: inadequate analysis of the human moral act.  Merely looks at overt behavior but does not take account of intentionality.

1.     “A human act, moral or otherwise, is a composite whole that contains various parts among which are these two: (1) the object, end, or intention of the act, and (2) the means-to-the-end of the act.”[17]

2.     Rachels leaves out the intentionality of the agent from his analysis.

3.     If actions and intentions are linked then Rachels’ argument fails.  If actions and intentions are de-coupled then actions cannot reveal intentions (which most ethicists deny).

                                            iii.     Cause of death is different in both cases.  In one (letting die) the disease is allowed to take its course.  In the other (killing) the physician administers the lethal action—his or her action is the immediate cause of death.



Bibliography

Ryan T. Anderson, “Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality” Backgrounder (The Heritage Foundation: March 24, 2015). Online: http://thf_media.s3.amazonaws.com/2015/pdf/BG3004.pdf.

Joe Carter, “Nine Things You Should Know About Physician-Assisted Suicide” Gospel Coalition Website (June 21, 2016). Online: https://www.thegospelcoalition.org/article/9-things-you-should-know-about-physician-assisted-suicide.

Daniel J. Hurst, “Physician-Assisted Suicide and Euthanasia: A Slippery Slope Indeed” Canon & Culture (July 29, 2015).  Online: http://www.canonandculture.com/physician-assisted-suicide-and-euthanasia-a-slippery-slope-indeed/.

Gilbert Meilaender, Bioethics: A Primer for Christians. Grand Rapids, Mich.: Eerdmans, 1996.

J. P. Moreland, “The Euthanasia Debate: Understanding the Issues” Christian Research Journal (Winter, 1992).  Online: http://www.equip.org/PDF/DE197-1.pdf.

J. P. Moreland, “The Euthanasia Debate: Assessing the Options” Christian Research Journal (Spring, 1993).  Online: http://www.equip.org/PDF/DE197-2.pdf. 

Scott B. Rae, Moral Choices: An Introduction to Ethics 3rd ed. Grand Rapids, Mich.: Zondervan, 2009. Chapter 8—“Physician-Assisted Suicide and Euthanasia”.


David VanDrunen, Bioethics and the Christian: A Guide to Making Difficult Decisions. Wheaton, Ill.: Crossway, 2009. Especially chapters 7-9.


State of Arizona Attorney General’s “Life Care Planning” page:
·      Contains the following:
o   Durable Health Care Power of Attorney
o   Durable Mental Health Care Power of Attorney
o   Living Will (End of Life Care)
o   Pre-Hospital Medical Directive (Do Not Resuscitate)


     [1] Steve Hays, “Assisted Suicide,” Triablogue (November 1, 2016).  Online: http://triablogue.blogspot.com/2016/11/assisted-suicide.html.
     [2] Daniel J. Hurst, “Physician-Assisted Suicide and Euthanasia: A Slippery Slope Indeed” Canon & Culture (July 29, 2015).  Online: http://www.canonandculture.com/physician-assisted-suicide-and-euthanasia-a-slippery-slope-indeed/.
     [3] Joe Carter, “Nine Things You Should Know About Physician-Assisted Suicide” Gospel Coalition (June 21, 2016). Online: https://www.thegospelcoalition.org/article/9-things-you-should-know-about-physician-assisted-suicide.
     [4] J. P. Moreland, “The Euthanasia Debate: Understanding the Issues” Christian Research Journal (Winter, 1992), 6—note: page numbers are to online edition: http://www.equip.org/PDF/DE197-1.pdf.
     [5] Moreland, “The Euthanasia Debate: Understanding the Issues,” 6.
     [6] Moreland, “The Euthanasia Debate: Understanding the Issues,” 6.
     [7] Moreland, “The Euthanasia Debate: Understanding the Issues,” 6.
     [8] Moreland, “The Euthanasia Debate: Understanding the Issues,” 6.
     [9] Moreland, “The Euthanasia Debate: Understanding the Issues,” 7.
     [10] Moreland, “The Euthanasia Debate: Understanding the Issues,” 8.
     [11] David VanDrunen, Bioethics and the Christian: A Guide to Making Difficult Decisions (Wheaton, Ill.: Crossway, 2009), 210-211—bold-face added.
     [12] Gilbert Meilaender, Bioethics: A Primer for Christians (Grand Rapids, Mich.: Eerdmans, 1996), 70-71.
     [13] Gilbert Meilaender, Bioethics: A Primer for Christians (Grand Rapids, Mich.: Eerdmans, 1996), 71.
     [14] Gilbert Meilaender, Bioethics: A Primer for Christians (Grand Rapids, Mich.: Eerdmans, 1996), 74.
     [15] John Frame, “Between the Apostles and the Parousia: Bearing the Burdens of Change and of Knowledge” (May 16, 2012).  Online: http://frame-poythress.org/between-the-apostles-and-the-parousia-bearing-the-burdens-of-change-and-of-knowledge/.
     [16] Joe Carter, “Nine Things You Should Know About Physician-Assisted Suicide” Gospel Coalition Website (June 21, 2016).  Online: https://www.thegospelcoalition.org/article/9-things-you-should-know-about-physician-assisted-suicide.
     [17] J. P. Moreland, “James Rachels and the Active Euthanasia Debate,” JETS 31.1 (1988), 89.