Physician-Assisted Suicide

Shouldn’t someone who faces a painful and certain death be allowed to end their life on their terms? A physician-assisted suicide measure is up for a vote in my state, and I think supporting it would be the compassionate thing to do. (Maybe that term is outdated. I’ve read other words to describe the topic: dignity in death, right to die, voluntary assisted dying, physician-assisted death, and medical aid in dying — MAiD). Here’s the bottom line for me: Why should people who suffer from a terminal illness — people without any hope for a cure or a decent quality of life — be kept alive against their will?

Many people share your thoughts. And your question leads to a lot of others. Unfortunately, none are as easy to resolve as they might seem.

For example, you refer to terminal patients as “being kept alive against their will.” Yet, everyone has the right to refuse treatment and die a natural death. Mentally competent adults can refuse or stop life-prolonging treatment. And a medical decision-maker for a non-competent adult can also make that decision.

So before we go any further, it’s important to understand what physician-assisted suicide is. We’ll then talk about the other aspects listed below.

Table of Contents

• What is physician-assisted suicide?
• Why do some people choose physician-assisted suicide?
• Potential for abuse in physician-assisted suicide
• How PAS functions in profit-driven healthcare systems
• Moral and ethical implications of physician-assisted suicide
• Life and death belong to God
• Where to find more information about a Christian view of PAS

What is physician-assisted suicide?

Physician-assisted suicide (PAS), sometimes referred to simply as assisted suicide, is an intentional act designed to speed up death using lethal prescription drugs.

PAS is not the same thing as simply stopping life-saving measures. As such, it represents an alarming and dangerous shift in the ethics of our medical community.

There are several states where a person does not have to be a physician to carry out assisted suicide. In these jurisdictions, certain mid-level practitioners (nurse practitioners and sometimes physician assistants) are allowed to prescribe medications for the purpose of causing death. Although these are not technically “physician-assisted” suicides, the term and its acronym (PAS) are still common and will be used here.

It’s also crucial to note up front that the terms for PAS you mentioned in your question are all euphemisms designed to mislead. For instance, Medical Aid in Dying (MAiD), a favored term in Canada and most states where PAS is allowed, takes terminology that describes what doctors have been humanely doing for centuries (providing medical assistance to people who are dying) and uses it to paper over the practice of taking one’s life with help from a doctor.

In fact, most pro-PAS activists refuse to use the word “suicide” at all, advocating for the term “assisted dying.” While some pro-life advocates would opt for a blunt but more accurate term such as “medical killing,” we’ll stick with PAS.

Why do some people choose physician-assisted suicide?

What compels the average patient to pursue doctor-prescribed death? You rightfully suggest that pain is a major factor. However, it doesn’t necessarily follow to say that anyone facing pain will naturally want to end their life as soon as possible.

Statistics gathered in Oregon show that pain is not the top concern for patients seeking PAS in that state. What ranks higher? Loss of autonomy, loss of dignity, and inability to engage in enjoyable activities.

But no matter the concern, premature death of the patient by suicide is not the only way to address it.

The role of pain in choosing PAS

For most patients, pain and other physical symptoms of disease and the dying process can be controlled. In fact, pain and symptom management are widely available, thanks to the expansion of hospice and palliative care. (Hospice and palliative care address the patient’s — and their family’s — physical, psychological, emotional, and spiritual needs.)

Palliative care specialist Dr. Dan Maison says, “One phrase that gets under my skin and breaks my heart is when someone says, ‘There is nothing more we can do.’  There is always more that we can do.” Rita Marker, former executive director of the Patients Rights Council, underscores this fact:

If a patient is in excruciating pain, that doctor does not know what he or she is doing. A patient in pain doesn’t have the energy to go around picking a new doctor. They need family and friends who will be courteous but firm and say, “We want a pain-control specialist.” (Different Pathways)

Depression as a factor in PAS

Suicide is never an acceptable solution for someone who is depressed. Depression can and should be treated, but often it’s not.

A 2008 study published in the British Medical Journal stated that one in four Oregon patients who seek PAS are suffering solely or primarily from depression. Yet in 2024, only three such patients in Oregon (of the 376 people who died from lethal doses of suicide medications) were referred for psychological evaluation under its doctor-prescribed suicide law.

Author and speaker Alan Shlemon tells of a doctor he knows “who works with terminally ill patients, many of whom request PAS (PAS is legal in Oregon).” He writes:

What [the doctor has] found is that when people are connected to their family, friends, and other community resources (churches, support groups, etc.) in significant ways, their depression subsides. When they have loved ones walking with them through their illness, their desire for PAS diminishes.

If their doctor can also identify the source of the pain and help them understand it, then that helps them too. In other words, when people close to a patient are loving, caring, supporting, and sharing the person’s burden, that patient’s desire for PAS is diminished. (Compassion Means to Suffer With, paragraph breaks added)

Potential for abuse in physician-assisted suicide

Elder abuse is a growing and documented problem. So seniors — especially those who suffer from terminal diseases — easily become vulnerable to the impulses or schemes of family members, caregivers, or others. (This is particularly true if someone might gain financially from the patient’s death.)

Even worse, existing laws in states where PAS is legal don’t require the patient’s consent at the time of death. The patient only consents to get the lethal prescription. In other words, there is no provision for medical oversight after the lethal drugs leave the pharmacy. Witnesses don’t need to be present when those drugs are administered, and family notification isn’t required in advance.

It’s not hard to imagine what this might mean. Once the drugs are released from the pharmacy, there is no way to know if the patient takes them voluntarily or if they’re slipped into food or drink by someone else.

The situation is ripe for abuse, as indicated by the finding that, in 2024, the median age of Oregonian patients seeking PAS was 75, more than 40 percent of whom cited “being a burden on others” as a reason for committing suicide. When it comes right down to it, there is no protected “choice” to die, as PAS proponents claim.

How PAS functions in profit-driven healthcare systems

Suicide drugs are far less expensive than effective treatment or palliative care. With escalating healthcare costs and demands to “manage” medical expenses, terminal patients may very possibly be “encouraged” to choose PAS as the cheapest option. That suggestion will carry extra weight with those already worried that they are “burdening” loved ones.

Coverage providers will also have something to say in the matter: At least two patients receiving medical care under the state-funded Oregon Health Plan have reported being denied treatment and offered PAS instead. Eventually the “right to die” could become a “duty to die.”

In addition, doctor-prescribed suicide places the government in the role of approving some suicides while discouraging others. This confusing and inconsistent message (along with the example set by patients who choose PAS) strongly implies that some lives aren’t worth living. And that has a dangerous psychological impact on individuals who struggle with disappointment, depression, or disease in any form.

Along that line, how can society legitimately tell young people struggling with mental health issues like depression that they should not end their own lives while we promote PAS?

When suicide is legitimized, it becomes more common, which recent research seems to suggest. And at that point, it’s no longer a private, personal affair. When my “choice” to die causes someone else to take their own life, we move beyond the realm of “individual rights.” Legalizing physician-assisted suicide is like putting fire into a paper bag: It can’t be contained.

This leads to the most important question: What are the moral and ethical implications of physician-assisted suicide?

Moral and ethical implications of physician-assisted suicide

Do we have the moral authority to end our own lives? Does anyone else — doctors included — have the authority to end them for us— even at our request? We say without hesitation, no.

How can we be so confident?

Because we believe God created human beings in His image. Every person, from conception to natural death, possesses inherent dignity and immeasurable worth. And as a Christian organization that exists to spread the Gospel of Jesus Christ, Focus on the Family is called to defend, protect, and value all human life — regardless of circumstances.

Moral implications of PAS: What it means to have the image of God

PAS spreads the lie that people are not inherently valuable.

However, we know that all people are made in God’s image. That affects our understanding of our Creator and our relationship with Him. It also sets the stage for understanding and defending the sanctity of all human life:

Every single human being, no matter how much the image of God is marred by sin, or illness, or weakness, or age, or any other disability, still has the status of being in God’s image and therefore must be treated with the dignity and respect that is due to God’s image-bearer.

This has profound implications for our conduct toward others. It means that people of every race deserve equal dignity and rights. It means that elderly people … and children yet unborn deserve full protection and honor as human beings.” (Systematic Theology, p. 450, paragraph spacing added).

“If humans are not endowed with value by God,” writes Alan Shlemon, “then what determines human worth?” He explains:

According to societal standards, human worth is based on what people can do: create art, raise children, work at a job, contribute to society, etc. But the moment humans lose the ability to do those things is the precise moment they lose their value. That’s why in a culture that rejects the concept of being made in God’s image, the strong prevail and the weak are discarded.

This is most obviously seen when we dispose of bona fide human beings at the early stages of life (abortion), the late stages of life (physician-assisted suicide), and those who are disabled (euthanasia). Devaluing them is tantamount to the most unjust and heinous discrimination possible.

But if human worth is not determined by what they can do, but rather by who they are (image bearers of God), then the unborn, elderly, and disabled are as valuable as everyone else. (The Imago Dei in Man, paragraph breaks and emphasis added)

Ethical implications of PAS: What it means to “do no harm”

Ironic as it may seem, laws that implement physician-assisted suicide deny terminally ill patients “death with dignity.” That’s because, as we explored above, true human dignity comes from God alone. And that dignity is affirmed by those who care for us during our final days.

If those same people dismiss the value of our continued existence, what’s left to us? If physicians trample on the Hippocratic principle “to do no harm” by prescribing lethal drugs, there can be no trust between doctor and patient.

Kathryn Butler, a trauma surgeon, writes in Can Death Ever Be Good, “Such trends [of physician-assisted suicide] hint at an increasingly prevalent viewpoint that death, rather than a terrible consequence of the fall, is a reasonable option to escape suffering.” She continues:

According to this thinking, death can be “good” if it provides relief from pain. What is more, the movement reflects a culture that upholds self-determination as an ultimate good; we live for ourselves, rather than for God.

Dear friend, when you encounter such ideas, remember that Scripture refers to death not as a phase to celebrate, but as the last enemy (1 Corinthians 15:26). Death comes to us all, and God can and does work through even this for good to those who love him (Romans 8:28), but never lull yourself into the lie that death itself is anything but the terrible wages of our sin, from which we desperately need salvation (Romans 6:23). (Can Death Ever Be Good?)

Life and death belong to God

We don’t deny that suffering is a strong possibility as death approaches. And the idea of such suffering, or the reality of enduring it, can be terrifying. Yet, the finality of suicide rules out the “what ifs” that are such a common element of human life:

What if a doctor’s diagnosis or prognosis turns out to be wrong? What if a new treatment is in the pipeline? What if there’s a chance that a patient will be suddenly cured of his disease?

We’ve all heard of such cases. Some of us even know people who were miraculously healed of a terminal disease. Physician-assisted suicide removes these possibilities. Even beyond that, however, we hold to the truth that suffering isn’t meaningless.

Pastor and author John Piper points to the biblical truth in 2 Corinthians 4:17 that suffering prepares those who have put their trust in Jesus for an eternity with Him. Such anguish is not in vain.

And the grieving spouses and mothers and fathers and brothers and sisters and sons and daughters are not merely watching. They are serving, caring, loving. Yes, suicide spares them the pain of watching. But it also denies them the privilege of serving. There are moments in the tireless care of the dying beloved that are so intense with self-giving love that they would not be traded for any death. (We Are Not Our Own)

Where to find more information about a Christian view of PAS

We don’t know if a personal situation prompted your thoughts about a vote in favor of legalizing physician-assisted suicide. Regardless, we’d welcome the chance to help you keep thinking through such a complicated and sensitive topic.

Call our professional and pastoral counselors for a free consultation at 1-855-771-HELP (4357). They would gladly listen to your firsthand experiences and offer biblical and practical wisdom. In the meantime, we encourage you to dig into the resources listed below.