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Applying Worldviews to Bioethics, Part 2: Dealing with Death
In the second article of his four-part series on bioethics, David J. Hill takes an introductory look at euthanasia. Operating from the grid he introduced last time, Hill explores how four different worldviews approach this culturally divisive issue.
A Life in Equilibrium
In my part one of this series, I introduced a worldview grid that showed the intersection of two factors: 1) God vs. Nature, and 2) Reason vs. Aesthetics. The first factor deals with what we are and the second with how we think. I put forth the charge that a Christian worldview demands that we "abide in the paradox" of these dichotomies. That means we acknowledge both the spiritual and natural components within us and appeal to both our reason and sense of aesthetics in our search for truth.
This is much easier said than done.
Abiding in the paradox is challenging because we must balance aspects of ourselves that are not well integrated. We must balance that part of us that is physical, consisting of matter and energy, and our spiritual, eternal part. This is the vertical axis of the grid.
The dichotomy here is that we are made in God's image, with His breath inside us, and still we are nothing but dust. We mustn't think too highly of ourselves, lest we become prideful. Yet we mustn't think too lowly of ourselves, lest we make a mockery of the fact that God made us in His image.
If that were not enough, we must also seek equilibrium between our minds and souls. This means that as much as we have an obligation to rational thinking, we also must bring our sense of aesthetics to the table. This is the horizontal axis of the grid.
When it comes to the issues of our day, exercising reason alone dehumanizes everyone involved. On the other hand, a worldview based only on aesthetics walks a dangerous line between an entirely relativistic worldview and an utterly self-serving one. Again, achieving an equilibrium between reason and aesthetics is the pathway toward truth.
Euthanasia: A Case Study in Worldview Application
In order to gain a perspective on how worldviews affect positions in bioethics, I want to focus on an issue that has received a fair amount of attention over the past few decades: euthanasia.
Euthanasia is the act of terminating the life of an individual who is suffering. It is sometimes called mercy killing. There are those who would add conditions to this definition — i.e. the individual must be suffering from an incurable illness, or the means of termination must only involve suspending medical treatment. But, for the sake of this article, I will invoke the broader definition.
According to our definition then, there are at least two parties involved: the individual who will be terminated and the individual or individuals who will be doing the terminating or allowing the termination to proceed.1 Furthermore, the individual to be terminated must be suffering to a certain degree. Our definition implies that the degree of suffering involved in dying will somehow be less than the suffering involved in living; otherwise, there is not even the appearance of mercy, only killing.
Moral Justification?
Now that we have examined what euthanasia is, we turn to the question the public has been debating for some time: Is euthanasia morally justified under any circumstance?2 If the individual to be euthanized is unable to choose life or death (as Terri Schiavo was unable to do in 2005), or if the individual doing the euthanizing is of a questionable mental state (as some might argue is the case with Dr. Jack Kevorkian)3, then the morality of euthanasia ought to be immediately suspect, regardless of one's worldview.
But in terms of how euthanasia is morally assessed from a particular worldview, much of the debate comes down to two issues: the mind/body problem and the morality of suffering.
The Mind/Body Problem
Underlying any position a person might have on euthanasia is their belief about the mind/body problem. This is a classic question about what humans consist of — whether the soul and body are two separate components of a human being (dualism), or if they are one and the same (monism).4
The Vertical Axis: Nature. Some make no distinction between the soul and the body. For them, death is utterly terminal — when one's body dies, so does whatever is referred to as the soul. This would be true if all things are explainable by natural phenomenon (the lower half, or "Nature" part of the grid).
It would also be true if anything inside us that we consider "spiritual" is actually just energy or genes or something else that ultimately has a physical basis. In this case, people may very well feel that life is beautiful and should not be extinguished on a whim. But in this context, the value they place on life is completely arbitrary — they are only concerning themselves with the morality of terminating a complex arrangement of matter and energy. From this point of view (especially if holding to the tenets of evolution), whether that matter and energy is human or not isn't truly relevant.
So, in general, if people adopt either a naturalistic or pantheistic worldview, they focus their moral judgment on whether or not it is wrong to stop or inhibit natural processes that would otherwise promote life. In the naturalist's or pantheist's mind, this would apply not only to euthanasia, but global climate change and species extinction as well.
The Vertical Axis: God. Imagine now that we were in the upper part of the grid, among the worldviews of platonism and mysticism. These worldviews assert that human beings have a soul separate from the body. This begs the question, "Does the way a person dies affect their soul?" Many would argue that the body and soul are two very separate things and therefore, death of the temporal body doesn't affect the eternal soul. In other words, the body is like a temporary storage container for the soul and can be shed or replaced when necessary.
Others say that the soul, while it is a separate entity from the body, is still affected to some degree by what happens to the body on Earth. If this is so, it would mean that, a person's soul can be affected by how the person's body dies — either from cancer, murder, suicide, abortion, or euthanasia.
Evaluating this from a human point of view is almost impossible, since we know so little about spiritual reality. Ultimately, if we adopt a platonistic or a mystical worldview, we will wrestle with the morality of whether actions against the body affect the soul, and if so, to what degree.
The Morality of Suffering
The other issue that affects our worldview stance on euthanasia is our attitude toward suffering. Most people recognize that suffering happens, and many feel that at least certain kinds of suffering are unjust.
This is an issue related to how we think about suffering more than what suffering actually is. Certainly, some argue that pain is not real, but just something in your mind. However, that doesn't necessarily make the pain go away. Our perception of suffering-induced pain has more to do with the way we think about the pain, and less to do with whether the pain is actually there.
The Horizontal Axis: Reason. If we adopt worldviews on the left, or the "Reason" side of the grid, suffering is inevitable because, in all probability, an individual sometime in their life will want something they can't have. In this sense, suffering is simply desiring something and being denied it. For instance, starving children want food, but they are being denied it, so they suffer. Likewise, children who want a toy from the store but are denied it suffer as well. What must be evaluated, then, is the degree of suffering on some kind of absolute scale. Those leaning toward the "Reason" side of the grid assume that those who are candidates for euthanasia are at the high end of the suffering scale.
In euthanasia, a person making the choice to die desires to be rid of the pain their illness is causing them. Dying seems to them like a reasonable option, because it would eliminate the illness, and therefore the suffering. A platonist or a naturalist making this sort of moral judgment is concerned with two things: 1) the means by which an individual achieves what they want, and 2) the degree to which that individual is suffering.
The Horizontal Axis: Aesthetics. On the right side of the grid, that is, "Aesthetics," where mysticism and pantheism reside, one could argue that suffering is an aesthetic injustice. The aesthetic component of life focuses on universals such as beauty, love, hope, and happiness. Whether or not our emotions related to these universals come from the soul or from complex chemical processes in our brains is irrelevant. They would say these universals are part of who we are, not just something that can be turned off or on at will. Suffering, then, is the denial of one or more of these universals — the denial of what makes someone human.
As this logic goes, an individual suffers an aesthetic injustice at the point that their suffering dehumanizes them. A person with a terminal illness cannot find the same hope they would find in a healthy state — they are "not themselves." Worldviews polarized toward the aesthetic are prone to think that euthanasia provides a way for these "dehumanized" individuals to regain their human dignity.
What is the Christian Perspective on Euthanasia?
C O F F E E S H O PDo you agree with Hill's take on how these different worldviews would approach euthanasia?
Join the discussion!
Considering all the factors that go into the bioethics of euthanasia, how does someone adhering to a Christian worldview abide in the paradox? What is the biblical view of the mind/body problem? How are we supposed to view suffering? In part three of this series, we will strive to reach the middle of our grid.
- We must assess suffering on the individual level because, although pain may be universal to humans, perception of pain is not. For instance, it would not be moral to euthanize all cancer patients since not all would state that they are suffering "beyond hope." Because of this, the definition is restricted to only individuals being euthanized and not groups of people. Back^
- The morality of euthanasia ultimately must be justifiable by everyone involved: the patient, the doctor, the medical staff, the family, companies that manufacture chemicals used for euthanasia, and so on. Although the nature of the moral conflict might be slightly different for each of these parties, no one can be completely exempt from moral responsibility. Back^
- Take, for instance, this quote about Dr. Kevorkian by Boston University school of medicine professor George Annas, from a 1992 TIME article entitled "Mercy's Friend of Foe?"*: "He's more like a serial killer than a physician." Back^
- Without getting too deep into the philosophy of this issue, here we will use mind and soul interchangeably. Back^
*(Note: Referrals to Web sites not produced by Focus on the Family are for informational purposes only and do not necessarily constitute an endorsement of the sites' content.)
David J. Hill is a freelance writer in science education and a copyeditor in medical education. His interests include cultural and Christian perspectives on science and technology. In his spare time, he can be found obsessing about why the Book of Job is not talked about more on Sunday mornings and whether or not he should start a book on the lives of 18th-century scientists entitled, Alchemy Rules!: When Turning Stuff into Gold Was the Topic at the Water Cooler. He attended graduate school in chemistry at the University of Illinois and did his undergraduate work at Point Loma Nazarene University. He and his wife, Angel, have three children.
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