Euthanasia: Can Death Be Friendly?

Death by Choice, by Daniel C. Maguire (Doubleday, 1974, 224 pp., $6.95), Death by Decision, by Jerry B. Wilson (Westminster, 1975, 208 pp., $7.50), Freedom to Die, by O. Ruth Russell (Human Sciences, 1975, 352 pp., $14.95), Beneficent Euthanasia, edited by Marvin Kohl (Prometheus, 1975, 255 pp., $4.95 pb), and The Morality of Killing, by Marvin Kohl (Humanities, 1974, 122 pp., $9.75), are reviewed by Sid Macaulay, Southeast regional director, Christian Medical Society, Decatur, Georgia.

In late January, 1975, Dr. and Mrs. Henry Pitney Van Dusen, elderly members of the Euthanasia Society, took an overdose of sleeping pills to carry out a suicide pact. He had been the president of Union Seminary in New York from 1945 to 1963 and was one of the founders of the World Council of Churches. For the last five years of his life, Dr. Van Dusen was severely debilitated; a stroke had left him unable to speak or write. His wife, who suffered from severe arthritis, died from the overdose; Van Dusen vomited up the pills but died two weeks later of a heart ailment.

Ethicist John C. Bennett, a long-time friend of the Van Dusens, wrote, “There was no doubt in my mind that they sincerely believed that in this act they were doing the will of God for them.”

C. S. Lewis describes our Lord’s dilemma in contemplating his sufferings: “Hence the Perfect Man brought to Gethsemane a will, and a strong will, to escape suffering and death if such escape were compatible with the Father’s will, combined with a readiness for perfect obedience if it were not.” Can we know the will of God on hastening our own death? And who among us will realize a redemptive purpose in his or her suffering? Euthanasia is a complex issue that reaches into almost all ethical categories. The Bible does not resolve the situation, and if it did, modern medical techniques would pose an indefatigable challenge.

The consensus of these writers is that we must have some kind of euthanasia legislation and that 1975 is already late. I am still unconvinced. To say the least, if the problems of suicide and suffering could be resolved, many things would fall into place. Voluntary euthanasia is, in a sense, assisting in the suicide of one who is undergoing an unbearable or meaningless suffering.

If there is anything more effective than reading five books on euthanasia to spoil one’s summer, it is to find that one of the writers has ink in his veins as well as in his pen. I am thinking of Marvin Kohl’s cool dissection of the Morality of Killing. In his treatment of abortion, however, his ethics and logic falter (there is some blood there!).

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I must confess that I can now clearly understand, thanks to Kohl, how euthanasia is an expression of mercy and kindness in certain instances, even though it is a type of killing. We can justify killing in some war, in capital punishment, and for a number of proper motives, including self-defense. Kohl sees euthanasia as a moral alternative for the patient suffering irremediable pain.

He rarely indicates a good grasp of Christian theology or concerns, and asserts that “theology and ethics are logically independent.” Little is accomplished in his dealings with euthanasia from the hinterland of linguistic analysis.

Kohl also edited Beneficent Euthanasia, essays stacked on the side of the legalization of suicide, assistance in suicide, direct and indirect euthanasia. I could not find anyone who favors strict involuntary euthanasia, but the term non-voluntary (not in involuntary) is supported for those who lack the capacity of consciousness and consent, where no dissent is actual or implied. Color this category gray.

Bishop Joseph Sullivan, one of the contributors, still follows the conservative position of the Roman Catholic Church magisterium, which is that no innocent life can ever be taken. He considers scriptural material in his essay, but to very little consequence. In fact, these essays in general show the point of view of persons who claim there is an abyss between biblical studies and Christian ethics.

Since beneficent euthanasia means mercy-killing, Harvard professor Arthur Dyck, another contributor, coins benemortasia as an alternative. He observes, “Whereas the former would deliberately induce death, the latter, as a last resort after making every effort to save and repair life, mercifully retreats in the face of death’s inevitability.” Dyck stands out from the crowd with his declaration that “every life has some worth” and his conviction that “humans require restraint.”

Call Joseph Fletcher what you will, his contribution, “The Right to Live and the Right to Die,” is cogent and communicates without obfuscation. His logic may be simplistic reductionism, but he forces you to think from a Christian position. While most of the essayists try to do away with the “wedge” argument, Fletcher extends its life brutally. “Why is fetal euthanasia all right, but not terminal euthanasia?” he asks.

Freedom to Die by O. Ruth Russell is a textbook or reference handbook, replete with documentation. It is the work of a Canadian psychologist who points to the logic and moral suasion of the opinions and arguments advanced by others. Every imaginable bit of information, including legislative proposals and a massive bibliography, is included. Dr. Russell’s amassed evidence is a necessity for anyone working on the legislative or historical level. Her book is not dispassionate; she clearly supports the legalization of euthanasia. Since she is not trained in theology, there is not a serious evaluation of theological principles that bear on the subject. Her book, unlike the other four, is indexed, which makes it a useful reference resource.

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Death by Choice and Death by Decision are similar in purpose and content. Both seek to integrate the medical, moral, and legislative aspects of euthanasia in order to give a comprehensive appraisal. They both conclude that more human freedom will be gained than lost by a good law allowing doctors to do what they are, on occasion, now doing furtively with terminal patients (yet without any real legal punishment).

Both authors want some type of committee to monitor the decision-making, but neither considers the thorny issue of who will be the “executioner,” to use Dr. Duncan Vere’s word. Wilson comes down hard on the patient’s right to determine the direction of treatment at every possible turn.

Although Wilson allegedly works from a theocentric perspective, Christian thinking amounts to little more than a theological overlay. If “theocentric love … begins with the concrete needs of patients as persons,” as he claims, where could anthropocentric love possibly begin? Why is the “imago dei” not even considered here? One wishes for a more articulate explanation of “response to the redeeming love of God” than that the “dying can confront death without anxiety or despair.” It sounds like a baptized stoicism.

Daniel Maguire does not try to maintain a theological tenor; he writes as the warm-blooded ethicist that he is. Yet he does recognize that “for a Christian and for anyone who believes in an afterlife, to ‘terminate life’ is … to move on to a new life.” Sandwiched in the middle of Maguire’s book is an excellent minicourse in ethics. I consider it worthy of independent publication as an ethics primer.

Wilson’s work, unlike Maguire’s, is too abstract. But it is an excellent contribution, especially in its objective appraisal of the dilemmas and professional pitfalls of physicians. He identifies four distinct levels of moral discourse: emotional, moral, ethical, and metaphysical. He totally avoids the emotional and offers no real help on the metaphysical or theological. Maguire is thoroughly sensitive to the area of feelings, which is a sine qua non for a proper evaluation of the euthanasia problem. He employs the German term, Gemüt to denote intuition or knowing that comes from the heart.

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Both of these authors deal seriously and adequately with the contributions of Princeton professor Paul Ramsey. On this delicate subject, as on other ethical issues, Ramsey can be counted on to shore up the weak places in the ethical dam. He has done Christendom a great service by skillfully pointing to the “indignity” of death from a biblical perspective (see Hastings Center Studies, May, 1974).

We are at a social apex for this problem of caring for the dying. This is the “gerontological era,” says Maguire, and he cites a forceful statistic: “It has been estimated that one quarter of all human beings who have ever reached age 65 are alive today.” Since 1900 their number has increased 500 per cent in the United States alone. While a lot of attention is being grabbed by the sensational issue of euthanasia, the more common problem of the quality of life for the aged is more important and is significant for conceiving of death as an enemy or a friend. Ruth Russell and Maguire both reflect a deep concern for the care and quality of institutions for the elderly.

The case for voluntary euthanasia is gaining an approving consensus among Christian moralists. The best arguments, against it seem to be on the level of Gemüt, where the practical application of death-dealing techniques will be. Most ethical, philosophical, and legal discourse will disqualify feelings as having any authority in the arbitration of this issue. I am not sure that is right.

Those who want a consistent opposing view will find it among these authors: Yale Kamisar, Duncan Vere, and Cicely Saunders (the latter two are British).

Maguire’s book is more easily read than the other four. I recommend it for those who want to enter or keep up with discussions on euthanasia. His thesis is that “death should be presumed an enemy until it presents itself as a friend.”

What’S In A Name?

The Naming of Persons, by Paul Tournier (Harper & Row, 1975, 118 pp. $5.95), is reviewed by Michael H. Macdonald, associate professor of German and philosophy, Seattle Pacific College, Seattle, Washington.

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Paul Tournier’s latest work focuses on the human person and its inestimable value. Dr. Tournier seeks to rediscover the spiritual communion between doctor and patient, teacher and student, person and person, I and thou, which is still beyond the frontiers of objective scientific knowledge. Man belongs to two worlds, the impersonal world of nature and the spiritual world of the person. The basic problem of our time is that too much importance is attached to things and not enough to persons. This book, like Tournier’s others, presupposes that the source of life and human consciousness lies in God and that man’s universal and supreme need is to find him.

The Naming of Persons explores the meaning and implications of names and shows that their role in our lives is larger than we might suspect. Names are not the result of chance. In his perceptive manner, Tournier probes into the significance of signatures, nicknames, name-changes; he discusses why names are chosen, why children name teddy-bears, and when first names should be used. God gave man the right to name, enabling him to personalize the world. God calls man to share “in the creation of the spiritual world, of this world of persons which is the people of God.”

Man is also charged with the responsibility of giving names to the beasts of the earth and the birds of the air. Herein Tournier sees animals, plants, and even inanimate things endowed with the quality of the spiritual realm. (Does not the Bible allude to fellowship with these spheres in First Kings 4:33?)

Tournier’s call is for a mature dialogue between God and man, man and man, man and world. This is the very basis of the idea of the person.

Tournier argues that the child in some way comes into existence when it is named. It is no longer a “bundle of cells” but the indivisible whole that is a person. The name is “not only the symbol of the person; it is the person itself.” Naming the child implies the parents’ responsibility before God to bring the child up as a person in accordance with God’s will. A child is not a thing to be possessed but a person who should be respected.

In an excellent chapter on possessiveness Tournier stresses that parents “must avoid all those commands and threats that have no other aim than to test out the child’s docility, to break his will and force him to capitulate.” Even love, devotion, and kindness can turn the child into a slave as well as spoil him, for “the purest love and the most dangerous possessiveness are inextricably bound up together.” Dependence must diminish or it will become an obstacle to personal development. It is important that the child acquire his own tastes, aspirations, beliefs, and ideas. This, of course, includes the choice of activities, studies, dress, hair-style, friends, and career.

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Harmful effects in blocking the development of the child can last a lifetime. The roots of possessiveness are deep within the human heart. Liberation is really possible only as God himself intervenes in our lives, making us new creatures in Christ.

With warm, personal anecdotes the author emphasizes the interrelationship of medicine, psychology, and religion. He is honest; he admits that we see only “through a glass, darkly.” In places he might be somewhat frustrating to the person only searching for clear, distinct ideas and answers. But this is how it must be, for Tournier is no system-builder. This is not an analytic and detailed exposition; Tournier here evokes a way of life. At its center is the potential for a unique God-given attitude, universally available yet almost totally neglected. I find that he gets to the heart of the matter in a way that none of the more analytic philosophers and psychologists have been able to do.

Biblical Authority

Holy Scripture, by G. C. Berkouwer (Eerdmans, 1975, 377 pp. $8.95), is reviewed by Geoffrey Bromiley, professor of church history and historical theology, Fuller Theological Seminary, Pasadena, California.

The Christian world owes a great debt to the Dutch scholar G. C. Berkouwer for his series of studies in dogmatics in which over the years he has offered a fresh treatment of most of the central theological themes. Now the latest volume in the series has now been made available in an excellent translation.

Predictably, Berkouwer does a thorough, painstaking job. He covers not only questions of inspiration, authority, and reliability but all the traditional aspects of a theology of Scripture, including the canon, interpretation, clarity, sufficiency, and the relation to preaching. He manifests a wide acquaintance with Scripture itself and quotes and discusses writers both ancient and modern. As in all Berkouwer’s works, the extensive interaction with Dutch theology is a particularly useful feature for those who have not had direct acquaintance with this nourishing root.

From many angles Berkouwer’s theology of Holy Scripture will commend itself as an informed and convincing presentation of the orthodox Reformation position in the changed world of the twentieth century. The discussion of the testimony of the Spirit in chapter two is particularly balanced and helpful. Another good chapter follows in which Berkouwer deals with the canon. The substitution of the more literally biblical “God-breathed character” for “inspiration,” which is in line with Warfield’s argument, also calls for commendation, and the chapter on the “servant form” of Scripture is an innovative feature that adds depth and stature to the understanding of the theme.

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Good things may be found, too in the chapter on sufficiency, both in relation to the role of tradition and also existentially in relation to the perplexities of life and thought in the modern age. Along similar lines the treatment of the relation between Scripture and preaching, while perhaps not as comprehensive or profound as it might have been, responds to a critical question in modern ministry with the cogent declaration that preaching achieves true relevance when it sets forth the biblical message of salvation without reorientation or rearrangement to suit what might seem to be more pressing contemporary issues.

One must be grateful to Berkouwer, then, for the powerful help he brings in these important matters. Nevertheless, some uneasiness cannot be avoided at the way he deals with certain particularly sensitive areas. Among these, I wish to consider three: first, fundamentalism; second, inerrancy; and third, the relation of Scripture to time and culture.

In his first chapter Berkouwer engages in a brief criticism of fundamentalism that can hardly be described as either illuminating or helpful. For one thing, he recognizes that fundamentalism is a complex phenomenon, and yet he goes on to attack the whole in terms of the part. To be sure, he accurately pinpoints some problems in fundamentalism, especially its tendency to be pushed into an either/or. Yet he himself will not let it break out of this.

Regarding the divine and human roles in producing Scripture he argues that Burgon’s rejection of mechanical inspiration cannot on its own premises be taken seriously. Burgon has to give an account of the method of inspiration and is forced to ignore “the fact that God’s Word has passed through humanity.” Three points may be made in this regard. (1) It has always been a weakness of Berkouwer in theological evaluation to say what others must do, or cannot do, on their own presuppositions. (2) It is by no means self-evident that emphasis on the divine authorship precludes a nonautomatic use of human means. This is for God, not Berkouwer, to decide. (3) Pressing the alternative on fundamentalism carries with it the danger that on the other side, in fact if not in intention, the reality of the divine authorship will be, implicitly at least, left out of the reckoning. Something of this may be seen in the author’s own work.

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As Berkouwer sees it, a serious fault of the fundamentalist stress on the divine origin of Scripture is that it entails a “leveling down” whereby every statement has the same weight and in practice interpretation is superfluous. This leveling down seems to be identified at one point with the presence of propositional truth-communication in Scripture. Here, of course, we have in the first instance a generalization that cannot stand up to analysis. Dispensationalists can hardly be accused of a leveling down that obliterates all nuances and involves no interpretation. Similarly the Reformed conservatives whom Berkouwer quotes, e.g., Warfield and Packer, obviously are not going to offer Passover lambs on the ground that the Old Testament command has the same force as the new commandment of Jesus. As regards propositional statements, it has been increasingly appreciated that the antithesis between the propositional and the existential has been much exaggerated and that no either/or need exist here. Berkouwer makes some good points in this section, but his barely veiled hostility to an amorphous fundamentalism, which presumably includes Packer, D. B. Knox, and Warfield, since these are the only names he gives, can hardly be described as informal or illuminating.

My disquiet increases when in chapter six, “The God-Breathed Character Continuity,” Berkouwer discusses inerrancy. Again he begins with two incisive and helpful comments. First, he agrees with Bavinck that the authors of Scripture “spoke in the language of daily experience.” Hence they did not need a special knowledge of topics such as zoology, and there is no reason for technical prevision in what they say about such matters, which are not in any case the subject of their message. Second, he points out that the real concern about the Bible is with erring rather than errancy, i.e., with swerving or diverting from the truth rather than with limited or even defective knowledge of secular topics. Lying is what Scripture associates with error, and Scripture itself is certainly not be be identified with deception in this sense. In relation to God and his truth it will never lead into error, and to that extent it is inerrant.

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This is all true, but unfortunately Berkouwer cannot leave well enough alone. To be sure, he does not explicitly say that there is factual misinformation in the Bible. But he does say that in the view of inerrancy that has developed in our time “we meet with a serious formalization of erring … which cannot later be related to truth in the biblical sense.” If the naturalness of the authors’ speech leads to what might be technically called errors, this makes no difference to the basic reliability of God’s Word, and even enhances it, whereas earnestness for a “miraculous correctness” “in the end will damage reverence for Scripture more than it will further it.”

The precise position of Berkouwer in all this is difficult to determine. He operates with the principles of everyday speech and time-bound cosmology without clearly saying what the coincidence of the two involves or, indeed, how they interrelate in matters of inerrancy. He confuses, matter by adducing our Lord’s “not knowing” and yet apparently saying that he, of course, could not be charged with error (or is he quoting someone else here?). He confounds confusion by equating inerrancy with the extreme form in which it means the miraculous anticipation of every true scientific discovery. The problem, perhaps, is not that Berkouwer leaves us with a Bible that is unreliable in some areas but that he fails to present the matter in a coherent way. He advances some useful principles but so obscures their application that in some respects the trustworthiness of the biblical record is left in suspense.

A few concrete examples might have brought some clarification. For instance, is the historical witness to the empty tomb historically reliable, so that we can be sure that things did in fact happen as the records say they did? In this case Paul apparently thinks that should there be error in the accounts, the apostles are false witnesses who are leading people astray. Unfortunately, however, Berkouwer remains in the realm of ambivalent generality, the more distressing here because in another connection he sees that the apostolic records must be historically reliable and can even say that a stand for inerrancy might be necessary.

The third and possibly the chief reason for uneasiness is the way Berkouwer handles the time-boundness of Scripture in connection with inerrancy. The issue, of course, is not the fact that the Word of God is given in specific times and cultures. This is a truism. The real issue is the inferences drawn from this fact. Haunted by the fear that the statements of Scripture might be reduced to timeless truths, Berkouwer sees an implication of contingency and tries to avoid the dangers of this approach by a distinction between the scope or intent of Scripture, which is for all ages, and its timebound expression, which is simply the way of presenting it in a given situation and by a given author. As he sees it, Paul offers apt illustrations in First Corinthians 7 and 11, where the detailed injunctions are culturally related and have only historical authority but their intent, which has to be discerned, has in contrast an authority that is normative. One may thus obey God’s Word here while ignoring the specific commands that the apostle gives.

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The problems in all this are obvious. First, why should not the scope or intent be culture-bound as well? Why should anything in Scripture be relevant to this age and place when all of it was written for other ages and places? Berkouwer’s efforts to deal with this difficulty are lengthy but carry little conviction.

Second, distinguishing between intent and time-bound statement may be easy in some cases where Scripture itself tells us why a command is given (as Paul does in First Corinthians 7), but in other cases it is extremely difficult. The resurrection narratives are given in order that we might believe, but believe in what? Are the narratives simple records of real events, so that we are to believe in Jesus Christ as the Son of God whom the Father has raised from the dead? Or are they time-bound ways of expressing something else, so that perhaps we are to believe in Jesus as the Eternal One in whom we may have ongoing life after death? Berkouwer himself naturally takes the former view, but the principle of contingent time-boundness can just as easily lead to the latter.

Third, there seems to be no way that Berkouwer can prevent others from using his distinction along the lines of Harnack’s husk-and-kernel procedure or Bultmann’s demythologizing. Certainly Berkouwer himself sees important differences, emphasizing especially (1) the fact that he seeks from Scripture itself its true intent within its expression and (2) the fact that Scripture intends to present historical and not timeless or existential truth.

But both Harnack and Bultmann would agree on the first point, and as regards the second, Harnack can easily argue that the historical approach of Scripture is itself culturally related, while Bultmann maintains that the eschatological act of God is the true theme of Scripture, so that authentic historicity is not jettisoned.

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The root of the problem seems to be that Berkouwer imposes on himself and others an either/or of timeless truth and contingency when there is in fact a third possibility, namely, particularity: the fact that God has himself chosen the times and cultures and so forth in which to speak his Word. Berkouwer briefly mentions this but immediately discards it because he seems to be caught by the false principle that emphasis on the divine authorship must inevitably weaken the humanity of Scripture. Particularity, however, opens up a wholly different view of the relation of Scripture both to its own and also to other languages, times, and cultures. It also makes possible a more serious reckoning with verbal inspiration than Berkouwer achieves. It brings a more precise biblical control than Berkouwer can establish over the “translation” of Christianity into other linguistic and cultural forms. It answers many of the real questions that Berkouwer raises without exposure to the dangers that inevitably arise—especially the danger of uncontrolled relativism—with his own acceptance of contingency.

All in all, Berkouwer offers a solid contribution to the discussion of the doctrine of Scripture.

It would do him a serious injustice to say that he personally espouses a compromising view. The problem remains, however, that his presentation opens up unhappy possibilities that his many imprecise or ambivalent statements in no way exclude. His reactions to some forms of fundamentalism, his lack of coherence in treating inerrancy, and his misdirected approach to time-relatedness weaken the total impact of what is for the most part a strong and positive statement concerning Scripture.

They do this, unfortunately, at a time when the normativity of Scripture seems to be dissolving in a sea of relativism and the distinctiveness of the Christian “transforming” of life and thought is apparently being lost in the blur of secular “conforming.” Berkouwer himself believes that in the long run his understanding will strengthen the authority of Scripture.

I hope that he is right but gravely fear that he is wrong.

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