Voluntary Assisted Dying – Dr Paul Mercer

The world is saying ‘no’ to fake news, including fake news about palliative care


From Luke’s Journal 2021 | Dying & Palliative Care | Vol.26 No.2

Christians participate in the voluntary assisted dying conversation in the truth that is in Jesus. A truth that is both particular and wide open.

We participate as people putting off an old lifestyle and now putting on Christ. 

It is a life of transformation, not moral rehabilitation.

We are good news people, news that in love, God sent His Son to live and die on a Roman cross in Israel 2000 years ago. According to the apostle Paul, Jesus was Israel’s long-promised Messiah. His coming deals with the problem of human sin and initiates the Kingship of God in the world, working like yeast in bread. Life as we know it, is irrevocably changing because of Jesus Christ. The door of history has been opened by God’s grace. In this in-between time, the apostle Paul urges us to imitate God; as God’s children, to ‘live a life of love’. Daily we pray, ‘Your kingdom come on earth as it is in heaven”. 

“Today” is one of these in-between days, when we pull aside to consider the proposal to permit euthanasia in our community. Many in our community see the passage of euthanasia bills as good news. Death on individual terms, without facing intolerable suffering. How do we confront this as the “good news” people?

I am a local Christian general practitioner, who has served the sick and dying in my community over 33 years. Euthanasia is a conversation which requires of us full attention to grace and truth. A conversation which requires we live and act from the embrace of the love of God. A conversation where we are promised the personal presence of the Holy Spirit.

“Death on individual terms, without facing intolerable suffering. How do we confront this as the ‘good news’ people?”

Human rights are historically grounded in the Christian truth story. Yet we live in interesting times when God’s rule and His love are effectively blindsided in public conversation. The rise in autonomy and choice as ways of living, leave ethical decisions down to a pragmatic sense of good.

Yet, the world God made is good, and this goodness is part of the Christian good news. 

Yes, the future of God’s world will be a good future – sorrow and sighing will flee away. This again, is part of Christian good news. There will be trees whose leaves will be for the healing of not just individuals but nations as well. It will be the resurrection life. Life overflowing in joy and peace. Life lived out in faith, hope and love is good news come full circle. It is life’s ‘pilot study’ mode now. 

Many people have considered deeply the significance of death and its meaning and challenge to our lives. My role is not to go through ethical argument points. Although I could. The resurrection of Jesus promises to destroy death, and the resultant flourishing implies eternal life in the emerging new heavens and new earth. 

So how does the Christian good news inform good ethical choices now?

Paul identifies three broad responses in 1 Corinthians. Some people consider the good news as “foolishness”. It should be dismissed. They are failing to recognise that real change is emerging in our world. Christian arguments are not persuasive for them.

Some, it seems, found in the good news of Jesus, of God initiating an earthly kingdom, a stumbling block. New life, new creation was beyond their imagination. Such a particular vision of life is unacceptable in our liberal, pluralistic society.

Photo Luis Quintero Pexels

Paul says a third group hears the gospel, the good news and believe it. Now we who do this, discover a transforming power in our own lives and indeed, all of creation. These responses recur as the good news is announced through the ages. 

Because it is centred in love, the good news is life-affirming news. So, what is my experience of ‘life’ in our Bayside district where I work?

Many people genuinely enjoy life in Bayside. In God’s providence, most of the ingredients for a flourishing life are accessible right where we live. Waterfront access, accessible work and recreation opportunities, good schools, shopping facilities and churches.

However, the picture is not uniform. Some of us struggle without work or a stable home. Some have very limited experiences of love and dignity. There is sickness, sorrow, suffering and at times despair. For some, life bumps along close to intolerably. 

In the patchwork, there are many beautiful days. Days of delight. There are many services and individuals who bring compassion, love and hope to our lives. Transport, Meals on Wheels, community visitors, community nursing, libraries, schools and so on. Our churches mirror these rhythms. We are called to both celebrate and be patient in the power of God’s love. None of us seek an agonising death.

As I have described, there are many resources in our community, and most people with good psycho-social-spiritual-physical and medical care die with peacefulness. Some don’t, a minority. 

“By removing the possibility of physician-induced deaths, the Hippocratic tradition restored public trust in doctors, and this has been sustained now for 2,500 years.”

Our community is blessed with palliative care and other care resources. Political will has not been able to extend this to all Australian communities. This feeds a sense of restlessness about the pathway to death in the broader community.

What our world is saying these days is ‘no’ to fake news, including fake news about palliative care. We must not overstate our case.

My experience as a GP committed to whole-of-life generalist care, including palliative care, is also both positive and negative. Some people in their family contexts embrace death. They die well and mostly surrounded by love. Some find dying distressing, they suffer and are unprepared. Some are angry and frustrated that good plans, good friendships must end. My experience replicated by other palliative care physicians, is that with good help, much distress can be alleviated. We call this palliative care. 

So why am I committed to a palliative approach?

  1. Hippocratic medicine arose in the context of involuntary assisted dying. Greek physicians responded to inadequacy and the impossibility of therapeutic interventions by prescribing a poison to end suffering and also protect their reputation. This resulted in distrust and avoidance
    by people needing health care.
    By removing the possibility of physician-induced deaths, the Hippocratic tradition restored public trust in doctors, and this has been sustained now for 2,500 years.
  2. A Christian pro-life worldview merged easily with the Hippocratic approach and also introduced social justice perspectives.
  3. Over the past 32 years I have contributed to the care of nearly 1,000 people in the Wynnum/Manly community who have died. While death was both inevitable and often complex for these people, few died a “horrible death”.
  4. The rise of the palliative approach in the modern context has witnessed major advances in the relief of both physical and existential suffering. Science can continue to inform better approaches. So should theology.
  5. Life-long learning principles support community GPs to stay with the best practice approach to palliation.
  6. The rise of community-based team care and specialist palliative services and hospice facilities have also been very positive developments.
  7. To a great extent, we are the stories we tell. Dying is a phase of life to reminisce, to laugh, to heal wounds, to tell each other that we are lovers. In a world of autonomy, our self remains intrinsically communal. Palliative care harnesses the communal reality of life so that death can become a gift to those we leave behind. Palliative care shows there is a better way than the ‘Scottish’ “blue pill” or Facebook “unfriending” in the context of suffering. GP palliative care enters seamlessly into our story telling worlds.

I return to my primary argument. Intellectually, we recognise the good news, gospel news is pro-life. Life is a gift, a glorious gift.

Intellectually, we can recognise a tension when the good news reaches out to the terminally ill, the despondent and marginalised with its pro-life calling. 

Is this resolvable?

Christians can start to respond by being the good news: “They will know we are Christians by our love” are Jesus’ words. Christians will love their neighbours as themselves. We will enter our community with respect, compassion, patience and hope. Many cry out: “Send somebody to love me!” As we love, we will kindly remind our neighbours of the good news. The incentive for serving needy neighbours is that this is both the way to follow Christ but also a way to encounter Christ himself. The text of Matthew 24 encourages such a vision. A challenge remains.

Will we be willing to love if neighbours choose Voluntary Assisted Dying (VAD)? Will we respectfully maintain a cruciform presence in the context of such despair? God’s entry into the life of the world in Jesus, extended to his voluntary surrender to death on the cross – it was love at full stretch.

Today is a time to speak the truth and be the truth – good news truth in love. Life is a wonderful gift to be entered into, as a creation-forming partner with God. 

Tomorrow, our calling may be to go the extra mile of love, with neighbours who embrace the prospect of VAD. We will need to adapt with grace in such a world. We can embrace such neighbours, knowing the future of death is secure. It is good news that the sting of death is settled in Christ and death’s power is being withdrawn as the kingdom comes. 

Christ humbled himself as a servant. Our calling is to follow in his steps, to live in Christ – indeed daily dying and living with Jesus. Let us be ethically robust ‘good news’ people, and let us love radically as ‘good news’ people. 

(The content of this paper was presented at a public Australian Christian Lobby event in Brisbane, August 2019.)

Dr Paul Mercer
Dr Paul Mercer is a Brisbane GP and former editor of Luke’s Journal.

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