Physician-Assisted Suicide:
What is the Role of the Pastoral Caregiver?
by Kathleen Krug, LPC
Cecile, a woman in her mid-70's extremely distraught, comes into your office. She has been diagnosed with Parkinson's. Her movement is shaky, her gait unstable and she's having some cognitive impairment. The medication she's taking has various side effects, some of which seem more disturbing than the disease, she says. She sees the future as bleak and hopeless. A widow, she's on a fixed income and doesn't want to burden her two children who live in other states. She wants to end her life with the aid of Dr. Kevorkian, and wants your professional counsel.
In another part of town, Henry comes to his pastoral caregiver because of the terminal condition of his 53 year old wife. She's suffering from amyotrophic lateral sclerosis ("Lou Gehrig's disease") and wants a merciful end to her despair. Even though she can't communicate, he "knows" she would want him to help her out of her misery. He would like to administer an overdose of her sleeping medication and wonders what you would advise. What would you say to Henry? to Cecile?
This subject of physician-assisted suicide or euthanasia is ever before us, as recent issues of Time, The Harvard Mental Health Letter and The New York Times have addressed. It will continue to be debated in the next century because of a burgeoning senior citizen population, and an ever-increasing belief in the right of self-determination.
A distinction is made between physician-assisted suicide, where the doctor gives the patient the means to die, and euthanasia, in which the doctor terminates life at the patient's request. In either case, there is a manipulation of the death process.
Most people acknowledge these to be the conditions for such a procedure - the patient is suffering, the situation is hopeless and death is imminent. These factors are important for pastoral caregivers in thinking about their advice. Even Dr. Kevorkian, who has assisted in many deaths, states that patients wishing to die be examined by a psychiatrist to determine if they are of sound mind. Should the decision rest solely with the psychiatrist? Why not the pastor? or priest? or pastoral counselor?
Another consideration for caregivers is what is legal, ethical, and moral. Assisted suicides are still illegal in the U.S., but New York and California are moving closer to legalizing them. They are also illegal in the Netherlands. But there, cases are on the rise as in the U.S., and supportive citizens carry "Euthanasia passports." Perhaps a question to keep in mind is what is incurable vs. what is terminal. Suicide, also, does not seem to have the stigma that it used to. For so long it was considered "sin" to take one's own life. Now perhaps we begin to think in terms of quality or sanctity of life.
Then there are theological issues. We pastoral caregivers will be called upon to search our hearts as to how we think God operates in this world. What would God sanction or bless in cases like Cecile's and Henry's, and thousands yet to come? We must be able to comfort those deeply troubled, at the same time helping them trust that what they choose God will affirm.
Perhaps, just the knowledge that dying people know they have some means to die is freedom enough. In Greek, euthanasia means "good death." Is it?
Read Erna Dennis's response to this article entitled: What Does it Mean to Die Well.
Reprinted with permission from the Spring,, 1997 edition of PPImprints, the Journal of The Professional Pastoral-Counseling Institute, Inc. To be notified when PPImprints is published, please register.
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