Death, dignity, and end-of-life care

If you are thinking about ending your life, please reach out now. In the United States, call or text 988 to reach the 988 Suicide & Crisis Lifeline. It is free and confidential, and someone answers at any hour. In other countries, findahelpline.com lists free helplines near you. If you are in immediate danger, call your local emergency number.

Christians believe that their lives and their deaths belong to God, and that God’s love holds them all the way through. Perhaps someone you love is dying, and the doctors have begun to speak of comfort care. Perhaps you have received a hard diagnosis yourself and are wondering what faith asks of you. The mainline churches have thought carefully about these questions, and their answers begin with the same promise: you are the Lord’s, and you will not face the end alone.

What is medical aid in dying?

In the United States, medical aid in dying (also called “death with dignity” by supporters and “physician-assisted suicide” by many critics) means that a doctor may prescribe medication that a terminally ill adult may choose to take to end his or her life. Oregon’s voters approved the first such law in 1994, and it took effect in 1997. A growing number of states now permit the practice, and the laws generally require that the person be expected to die within six months, be mentally capable of the decision, and take the medication themselves.

Medical aid in dying is a separate question from suicide that comes from depression, crisis, or despair. People in that kind of pain are often far from death, and help can bring them back to hope. The church meets them with urgent care and the assurance that their lives are precious (see suicide and the Christian faith). The debate about medical aid in dying concerns people who are already dying and how their last days should be lived.

What does the Bible say about death and dying?

The Bible does not speak about modern medicine, ventilators, or prescriptions, and Christians have to think about these new questions with the wisdom Scripture gives them. Its deepest word about death is that it does not separate us from God:

For none of us lives to himself, and none dies to himself. For if we live, we live to the Lord. Or if we die, we die to the Lord. If therefore we live or die, we are the Lord’s.

Romans 14:7–8

The Presbyterian Church (U.S.A.)’s Brief Statement of Faith begins with the same confidence: “In life and in death we belong to God.” The psalmist prays, “My times are in your hand” (Psalm 31:15), and the Teacher in Ecclesiastes knows that there is “a time to be born, and a time to die” (Ecclesiastes 3:2). Christians have drawn two lessons from these words. Life is a gift to be received and guarded, and death, when its time comes, need not be fought at every cost.

The best-loved psalm walks with the dying:

The LORD is my shepherd; I shall lack nothing. He makes me lie down in green pastures. He leads me beside still waters. He restores my soul. He guides me in the paths of righteousness for his name’s sake. Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me. Your rod and your staff, they comfort me.

Psalm 23:1–4

Is it wrong to stop treatment or choose hospice?

The mainline churches agree that there is no duty to prolong dying by every possible means. The ELCA’s 1992 message on end-of-life decisions says, “Patients have a right to refuse unduly burdensome treatments which are disproportionate to the expected benefits,” and that it may be morally responsible to withhold or withdraw such treatments “and allow death to occur.” It adds, “This decision does not mean that family and friends are abandoning their loved one.” The Episcopal Church’s General Convention resolved in 1991 that “there is no moral obligation to prolong the act of dying by extraordinary means and at all costs,” and that the decision should ultimately rest with the patient.

The modern hospice movement, with its palliative care (medical care focused on comfort and relief of pain), began with a Christian. Dame Cicely Saunders, a nurse, social worker, and physician whose Christian faith shaped her work, founded St Christopher’s Hospice in London in 1967. She told her patients, “You matter because you are you, and you matter to the end of your life.” Choosing hospice for someone you love is a way of loving them to the end.

What do the mainline churches teach about medical aid in dying?

The mainline churches have reached different conclusions about medical aid in dying. The ELCA’s 1992 message, adopted by the ELCA Church Council, opposes legalizing physician-assisted death and states that “deliberately destroying life created in the image of God is contrary to our Christian conscience.” The Social Principles of the United Methodist Church say that the conviction “that life is a sacred gift” leads the church “to oppose both euthanasia and suicide,” and in the same passage the church rejects “attempts to deny the ministries and service of the church to those who die by euthanasia or suicide.” The Episcopal Church’s General Convention resolved in 1991 that “it is morally wrong and unacceptable to take a human life in order to relieve the suffering caused by incurable illness.”

Other churches have been more open. The Presbyterian Church (U.S.A.) has not taken a definite position on assisted dying, according to a 2013 Pew Research Center survey of church teachings. The United Church of Christ places great weight on individual conscience, and in 2017 a General Synod resolution supporting medical aid in dying legislation won about 65 percent of the delegates’ votes, twelve votes short of the two-thirds it needed.

Members and clergy in every one of these churches hold a range of views. Christians who support medical aid in dying speak of mercy for those who suffer and of trust in the conscience of the dying. Christians who oppose it speak of life as God’s gift and worry that elderly, disabled, or poor people may come to feel that they are a burden. Both sides want the dying to be cared for with love.

How can I care for someone who is dying?

Jesus counts care for the sick as care for himself: “I was sick and you visited me” (Matthew 25:36). Being present matters more than finding the right words. Hold a hand, read a psalm aloud, sing an old hymn, and let silence be enough. Ask your pastor or a hospital chaplain to come, to pray, and to bring Holy Communion to the bedside. Ask the doctors about pain relief, and ask the hard questions about what treatment can and cannot do.

If you have already faced one of these decisions for someone you love, whatever you chose in grief and love, you can entrust it to God, from whose love nothing can separate us, “neither death, nor life” (Romans 8:38–39; see grief and the Christian hope, what happens when you die, and seeing loved ones in heaven).

The church has long prayed the song of the old man Simeon at the close of the day and at the end of life:

Now you are releasing your servant, Master, according to your word, in peace; for my eyes have seen your salvation, which you have prepared before the face of all peoples; a light for revelation to the nations, and the glory of your people Israel.

Luke 2:29–32

If you are struggling with thoughts of ending your own life, you are not alone. Call or text 988 in the United States, or visit findahelpline.com for help in your country.