Journal: assisted suicide about 'autonomy,' not pain

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TORONTO (BP) -- A report on physician-assisted suicide in Canada appears to support claims by opponents of the practice that it is driven by a desire for personal autonomy rather than pain management.

A study published May 25 in the New England Journal of Medicine (NEJM) found 95 percent of patients to receive medical aid in dying (MAiD) through Toronto's University Health Network between March 2016 and March 2017 cited "loss of autonomy" as a reason for the request to end their lives. No other reason was cited as frequently. The article's seven coauthors wrote that "few patients cited inadequate control of pain or other symptoms."

Southern Baptist Theological Seminary President R. Albert Mohler Jr. said the article "absolutely puts to the lie the argument that's being made by the mainstream proponents of assisted suicide."

"The proponents of assisted suicide have made their case arguing that it's morally necessary to allow persons to escape from unrelenting physical pain ... that cannot otherwise be escaped," Mohler said May 26 on his podcast The Briefing. "But now we know, documented by none other than the New England Journal of Medicine, that … is actually not the case."

The inordinate elevation of personal autonomy, Mohler said, runs contrary to biblical teaching.

"Our satisfaction with the conditions of our life [is] not, biblically speaking, the grounds for our dignity nor for our understanding of life as a gift from the Creator," Mohler said. "... Believers in the Lord Jesus Christ are to find our identity in Christ, never in ourselves."

Legalized by the Canadian Supreme Court in February 2016 and regulated by parliament in June 2016, MAiD is legal for adult residents of Canada with "grievous and irremediable" medical conditions whose "natural death has become reasonably foreseeable," according to Canadian statute.

The Patients Rights Council, a group that opposes assisted suicide, argued the vast majority of Canada's MAiD cases in 2016 technically were "euthanasia" and not "assisted suicide" because a report from the Canadian government indicated 504 of 507 "medically assisted deaths" in "participating jurisdictions" were "clinician-administered" rather than "self-administered."

All patients referenced in the NEJM article as receiving MAiD died by lethal injection. Most patients who inquired about assisted death had cancer diagnoses, though other conditions were reported.

The article noted, "Overall, 26% of the patients (19 of 74) who inquired about MAiD received the intervention. Those who received MAiD tended to be white and relatively affluent and indicated that loss of autonomy was the primary reason for their request. Other common reasons included the wish to avoid burdening others or losing dignity and the intolerability of not being able to enjoy one's life."

Even when assisted death was not carried out, researchers stated, approval for MAiD helped some patients "relieve distress over the loss of autonomy" and "experience a sense of personal control over the circumstances of dying."

Studies in the U.S. and Europe have yielded similar findings, the researchers noted.

Lead author Madeline Li of the University of Toronto told The Washington Post patients sought to end their lives over "what I call existential distress," as with a marathon runner who was confined to bed and a university professor who "didn't want to get to the point of losing control of his own mind."

Li added, "It has been very surprising to me."

Brian Sandifer, pastor of Potomac Heights Baptist Church in Indian Head, Md., called physician-assisted suicide "yet another example of radical individual autonomy."

Physician-assisted suicide "denies that God is the author of life" and presupposes an unbiblical view of suffering, Sandifer wrote in a column forwarded to Baptist Press by the Baptist Convention of Maryland/Delaware.

Suffering, Sandifer wrote, "serves the important purpose of conforming the believer into the image of the Son. Suffering is not pointless. Nor is suffering pointless for the unbeliever. Suffering points to the reality of sin and brokenness and to the need for healing and restoration that are ultimately found in Christ Jesus Himself. There is much to profit from suffering."

True compassion "is not found, as some suppose, in escaping suffering, but true compassion is found in recognizing that the Creator has a purpose for allowing suffering to be part of one's life," Sandifer wrote.

Mohler and Sandifer argued physical pain should be alleviated through palliative care of terminally ill individuals as much as possible.

A 2015 Southern Baptist Convention resolution "on the sanctity of human life" affirmed "the dignity and sanctity of human life at all stages of development, from conception to natural death."

In the U.S., physician-assisted suicide is legal in six states and the District of Columbia.

David Roach is chief national correspondent for Baptist Press, the Southern Baptist Convention's news service. BP reports on missions, ministry and witness advanced through the Cooperative Program and on news related to Southern Baptists' concerns nationally and globally.
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