A rhetorical question?
Preacher: Revd Dr Donald MacEwan
Readings: 2 Kings 5:1-14; 2 Timothy 2:8-15
Am I God, to give death or life?
So says the king of Israel in the midst of the story we heard earlier. An Aramean soldier called Naaman has come to him with a letter from the king of Aram. The letter asks the king of Israel to cure Naaman, standing before him, of his leprosy – a serious condition affecting the skin and much more besides. The king tears his clothes – he may be king but does not have this power, and so he asks, Am I God, to give death or life? All the same, Naaman is healed when he follows the instructions of the prophet Elisha, the man of God, and washes in the River Jordan seven times.
When I read this passage in the lectionary for this week, I could not get past the king’s rhetorical question. It just seemed so relevant to so many issues we face in contemporary life. And the area I’ve been thinking about lately is the end of life, questions about illness and dying, medical care and moral questions around euthanasia. And indeed it’s a question Scotland has been facing. There is a new bill which the MSP for Orkney Liam McArthur hopes to introduce to the Scottish Parliament soon to give a right to assisted death for mentally competent adults with a terminal illness. Just last month, responses to a public consultation were released. If it becomes law, Scotland will join Switzerland, the Netherlands, Belgium, Canada and parts of the USA in legalising certain forms of euthanasia.
These may seem strange issues to focus on in a University Chapel with most worshippers thinking more about studies, beginning a career, and with questions about embarking on family life some distance down the line. And yet we are all touched by issues of age and illness – in our families, and among the communities we call home. We are aware that old age in much of the world is lengthening, and that many people have years of increasing dependence on others, with or without the effects of dementia, often Alzheimer’s.
But today I want to reflect on those people who have terminal conditions, which could be cancer, motor neurone disease, and others which, towards the end, may involve significant pain, distress for them and others, and the need for help with bodily functions, usually very private. For such people, treatment of the condition often gives way to treatment for the symptoms, reducing suffering by something we call palliative care. At home, at hospital, and in specialist spaces for palliative care called hospices, people at the end of life are treated with strong medications for pain, helped to be as comfortable as possible, and family and friends are encouraged to share what time is left with their loved one. Chaplains and others may spend time with the dying, helping them face the future with peace. This chimes with the introit sung by the choir: words of peace spoken by Jesus offering comfort in the face of death.
Now there are times when there is a decision to be made whether to continue certain treatments which may be prolonging life, but also prolonging the time of pain and suffering. In general, the law allows the withdrawal of such treatment when it is no longer beneficial, and most Christian voices agree. Life at all costs is no part of Christian faith: sometimes the human costs mean that treatment is the wrong way forward.
But the bill to come before the Scottish Parliament is about assisted dying, not the removal of treatment. It’s about allowing people to be helped in taking their own life when they feel their pain is intolerable – helped by doctors. Assisting in suicide is currently illegal. This bill wishes to change that in specific cases of terminal illness. And it’s questions around assisted dying (which some call assisted suicide) I want to focus on.
These questions seemed more pertinent than ever during the pandemic. I supported a number of people and their families during the pandemic who had terminal cancer. Pre-Covid, they may well have died in a hospice, with skilled nurses on hand round the clock, and open visiting from loved ones. But while the hospice beds were largely available during the pandemic, families were often not allowed to visit. This left awful dilemmas. The people I knew chose to die at home, so that their families could be with them, but it meant that the medical and nursing care was much more patchy. It meant, for some, more pain and distress. Hearing their stories, when preparing for the funeral, I could quite understand if they had said – if I could have given her a pill to make it end, I would have done so.
What would we say to such a thought? What would we do ourselves? Well, this meditation is part of a service of worship, in responding to the words of scripture. How should Christians think about these questions? Let me suggest some principles.
First, Am I God, to give death or life? No, I am not and none of us are. God is God, Creator of the world and giver of life. Christians see life as a gift, given freely to all. We don’t own our lives – we might say they are lent to us, or given us in trust. There’s a parallel with nature as a whole – we don’t own creation, and when we think we do, we invariably spoil the environment.
Second, there is a time to be born and a time to die, as the Bible tells us.
As we sang earlier, Frail as summer’s flower we flourish;
Blows the wind and it is gone.
Sometimes, when someone we love continues living but with no apparent quality of life, we may even feel anger at God that life continues. I have prayed for a parishioner to die, and I’ve reassured loved ones that’s it’s okay to do so. Sometimes death, as much as life, is a gift of God.
A third Christian principle is the dignity of all human beings regardless of wealth, social status, disability or quality of life. That means we have a deep responsibility to all, especially the vulnerable. Here’s another rhetorical question from the Bible: Am I my brother’s keeper? The answer must surely be yes.
Fourth, Christians believe that Jesus was God in human being, and experienced the end of life, in pain, humiliation, and loss of dignity, before entering the darkness of death. Jesus prayed to be spared this suffering, but nevertheless endured this fundamentally human phenomenon.
A final principle is that Jesus was raised from death. Christians believe in a destiny beyond death, without pain or crying or sorrow, in perfect light and love with God in the new creation. That is Paul’s hope which we heard in his letter to Timothy earlier: If we have died with him, we will also live with him. When we sang Be still, my soul, we sang of that hope which encourages us to bear patiently the cross of grief and pain, because God is with us.
These principles are common to nearly all Christians. And yet they can lead us in different directions, and that is okay. There are different faithfully Christian ways of approaching moral issues. But in the last few minutes of this sermon, I’d like to share my own view – and is my own, not the University’s, nor even the Chaplaincy’s. It’s informed by my own experiences: as a grandson and son, minister and chaplain over these past 20 years, and interwoven by my Christian faith.
Things came to a head last year when I read an article in the London Review of Books by Stephen Sedley called “A Decent Death.” Sedley, a retired judge from the Court of Appeal, argued that people should be allowed to follow through on a rational choice to end their life if their life has become intolerable. Now, I have subscribed to the twice-monthly LRB for over 20 years, loving its approach to books and ideas, its preferred style of prose, even its typeface – I am a bit of a fan. But something about this article got my goat. It may have been when Sedley referred to God as a capricious deity. Anyway, after 20 years of non-interactive consumption of the paper in bed, in the bath and across the world, I wrote a letter. Which they published in this red-letter edition!
Here is the gist of what I said. I can think of many people who might rationally choose assisted suicide for themselves. On the whole they’re well-educated people who know their own minds and are used to making decisions without being coerced. But the law doesn’t only exist for the sort of people who graduate from St Andrews University, it exists for everyone. It exists for the poor, those with little education, those who are usually acted upon by others. When I was a minister in St Monans and Largoward, two villages with a really varied mix of social classes, I learned to recognise how most people typically approached medical issues. Doctors were the experts. People didn’t want to make choices about their health. And, over and over, they told me they didn’t want to be a burden. I would worry that in places like St Monans, assisted dying will be a choice offered to people who don’t have the confidence to refuse.
And so I am not in favour of a change in the law. What I am in favour of follows from all those principles – that life and death are God’s gifts, that all lives are of deep value, that God loved the world so much he lived, died and was raised in human flesh. And so what I’m in favour of is improved treatments for pain and discomfort, the investment of resources into care for the terminally ill such as hospices and nurses who come to the home, and increasing collective responsibility for the vulnerable, disabled people, the aged and people with dementia.
Are we God to give death or life? It may look like a rhetorical question. But in reality, it’s one that all of us, in our own way, may need to answer.
END