Sermon, "Hot Topics: Assisted Death," September 2, 2018

Fifteenth Sunday After Pentecost
Rev. Ingrid Brown

This Sunday is the fourth and final Sunday in our "Hot Topics" sermon series. This week's topic is Assisted Death.

‘When the Son of Man comes in his glory, and all the angels with him, then he will sit on the throne of his glory... Then the king will say to those at his right hand, “Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.” Then the righteous will answer him, “Lord, when was it that we saw you hungry and gave you food, or thirsty and gave you something to drink? And when was it that we saw you a stranger and welcomed you, or naked and gave you clothing? And when was it that we saw you sick or in prison and visited you?” And the king will answer them, “Truly I tell you, just as you did it to one of the least of these who are members of my family,* you did it to me.”
— Matthew 25 (NRSV)
We do not live to ourselves, and we do not die to ourselves. If we live, we live to the Lord, and if we die, we die to the Lord; so then, whether we live or whether we die, we are the Lord’s. For to this end Christ died and lived again, so that he might be Lord of both the dead and the living.
— Romans 14: 7-9 (NRSV)

Last week Rev. Ryan spoke about suffering, and if you weren’t here, I would recommend you go online and have a read or a listen or ask me after worship and ill print you off a copy.  It is a beautiful and thoughtful and faithful exploration.

This week he tasked me with the Hot Topic of Assisted Death.  This is not an easy topic to do justice to in 20 minutes.  Perhaps I should’ve asked to switch and discuss the easer topic of suffering.  I will admit, this wasn’t an easy sermon to prepare for or write, and it isn’t an easy one to share with you.  And, as we are all human and have faced the realities of death, might touch on some tender points.  If you need to talk after, or pray after, let me or someone nearby know.

I have wrestled with and studied this topic for many years and I could likely speak well on a panel about it or give a lecture – even teach a course.  But that isn’t what we do here.  A sermon isn’t about my opinion.  Not exactly.  These precious minutes that we carve out each week are about coming together in community to hear the words of Scripture spoken and interpreted for this unique group of people gathered on this day and to give space for the Holy Spirit to move within and amongst us – as we do this, the space we imagine between us and God shrinks, and we become aware of the presence of God – and that presence might call us to greater understanding and lead us and guide us into more faithful discipleship.

And so, all these things I know or think about assisted death, all of my opinions that I have tidily researched and debated, that have become somewhat unravelled this past week, don’t matter.  Not really, because this isn’t a lecture hall.  Or a community panel.  This is church.  And we are here to listen for Gods’ word for us.  God’s Good News.

Of course, I will talk about assisted death, but first, I want to share with you a personal experience that got me started on this path of learning.

I was 20 years old when I meet Todd, the man who would later become my spouse.  We started dating when I was 21 and we soon fell in love – I knew this was my person, even in the fickleness of my youth, I knew.  Shortly thereafter, Todd’s mom Penny was diagnosed with cancer.  And not just a spot, not early stage.  She had lung cancer that had already metastasized to her brain.  On further investigation the cancer had also moved into her bones, was showing up on her skin…you get the picture.  And I journeyed with Penny and Todd and his sister and brother-in-law and their children through it.  We laugh cried as we shaved Penny’s and Todd’s heads, so she wouldn’t lose clumps of hair during the treatments.  I made countless trips to take out restaurants picking up Penny’s favorite foods for us all to share (we ate a lot of fish and chips during that time).  We cleaned out and sold her house and car and moved her into Todd’s sisters home.   We sat in the hospital for hours.  And hours.  And hours.  My niece and nephew sat in rapt attention at the stories she created as the tumour pressed more and more into her brain, releasing a vividness of imagination no one had seen before.  We walked with her and one another through each new decline in her health and wheeled her through the doors of hospice when her care required more than any of us could give.  And we sat on her bed on what was to be her last day listening to the gurgles of her breath, as her lungs filled with fluid.  The doctor offered, and administered, at the family’s request, a compassionate dose of narcotics that both eased her suffering and likely hurried up her death.  His intent, our intent, was not to end her life but to alleviate her suffering through good palliative pain management.  And a consequence was a slight drawing closer of her last breath.

 

This was over ten years ago, long before the Medical Assistance in Dying legislation had made its way through the court systems in Canada, but was, as I have heard in many stories through the years, not an uncommon practice in end of life care. 

 

Now I don’t think I can talk about assisted dying without first addressing death itself.  Our culture’s response to death is, at best, confused.  There are two main responses at play right now: obsession or concealment.  Obsession is evident in the big-budget movies and video games filled with violence and death, making use of ever more technologically sophisticated means of killing and ever more visually graphic depictions of bodies torn asunder. Or in the popularity of vampires and zombies.  Perhaps those are not a part of your everyday, but even the CBC News nightly tallies up the dead locally and lost in far-off wars.  The other side of this coin is the way we press death to the edges of society.  The dying exist only in institutions where they are tidily kept out of our line of sight, and death is spoken of only in euphemisms of loved ones having “passed on”, with their bodies made up to look as though they are merely asleep.[1]

The truth is, we are, and have always been, afraid of death. 

 

A rational response might suggest that we are to accept death as a natural part of the cycle of life – but that isn’t quite it either, is it?  Because we are more than simply biological organisms.  Truly, neither the psalmists nor Jesus understood death as simply a fact of life. 

 

Christianity is, at its very heart, oriented towards life – this comes from our Jewish roots.  A people who powerfully, throughout history, in the face of astonishing suffering at the hands of others manage to manifest an intense and jubilant commitment to life – who raise their glasses with the ancient words, l’chaim – to life.  We as followers of that Jewish leader and reformer Jesus, have been grafted onto, adopted into this community of faith and, have carried on with this understanding of death as the last enemy (Rev. 21:4).

 

Which brings us to the cross – we cannot talk here about death without the cross.  Golgotha – Calvary – the place of Jesus’ crucifixion, is not a place of veneration, not a place where we learn to glorify death.  It is a courageous facing of, and a confrontation with death, that is, with our enemy. Here God, in Jesus, confronts the great enemy and oppressor of life by facing, undergoing, and entering into death so that it may be challenged, defeated.[2]  The cross does not camouflage the reality of death but calls the thing what it actually is.[3]  And that thing is not sleep or rest or the big garden in the sky.  It is death, and death is real.

 

Now, the great objection of the Bible is not death in and of itself, but rather it is the power of death over life; our own human anxious preoccupation with death that detracts from our capacity to enter fully and joyfully into life.   We are, in a sense, in bondage to death because it remains repressed within us, BUT through Christ’s confrontation of death, we are set free from the power – or as the Apostle Paul puts it, the ‘sting of death’ (1 Cor. 15:55).

 

So then what about MAiD?  Medical assistance in dying.  There are two chief arguments by those who are in favour of it: autonomy and compassion. The autonomy piece argues that each individual is free to set their own life direction, free to dispose of themselves as they see fit, and society should, therefore, respect a competent person’s wish to terminate their life, especially if that person is terminally ill and suffering greatly. This raises the question, are we really autonomous beings?  The appeal to compassion relies on a certain understanding of how we should respond to human suffering, that is, work to eliminate it. But that assumes that suffering does not have some value within it – and who decides what is and isn’t suffering?  Those on the other side of the aisle tend to speak of the preciousness and sanctity of life – that our being is but a gift not to be squandered – as well as the potential dangers of mis-use with regards to people with severe disabilities and serious mental health challenges.

There are countless essays, articles, books, blogs, interviews on both sides of this argument – and while I have read very many of them, I have likely only scratched the surface. 

 

Last year the United Church of Canada adopted and released an official statement reading in part as follows, “We are not opposed in principle to the legislation allowing assistance in dying and to such assistance being the informed, free choice of terminally ill patients. There are occasions where unrelenting suffering and what we know about the effect of pain on the human body can make Medical Assistance in Dying a preferable option. However, we urge a cautious approach …and advocate community-focused and theologically robust discernment on a case-by-case basis that also ensures the protection and care of those potentially made vulnerable by this new law and others like it.”[4]

 

I also appreciate the take of the Anglican church of Canada who have produced much material, some of which reads, “Theologically we continue to assert that human persons, being in the image of God, are the bearers of an inalienable dignity that calls us to treat each person not merely with respect, but with love, care, and compassion. This calling, being a reflection of God’s free grace, is in no way qualified by the circumstances that an individual may face, no matter how tragic. Neither is that inherent dignity diminished nor heightened by the decisions they make in those circumstances, even if they differ from the decisions”[5] we may make for ourselves.

 

As I mentioned at the beginning, I hesitate to share my own views here, so I will instead turn to our Scriptural words for the day. 

The connection to the Gospel reading from Matthew is perhaps obvious – our call, as Christians, as disciples of Jesus, is to be with the sick, the dying.  Not to follow the culture in the pressing of suffering to the edges of society, but to enter into that place along-with.  One cannot tend to the physical, emotional, and spiritual needs of the dying from afar – it requires being present and in relationship.  And there is this key that separates the work we do from the work of other service clubs, which is that when we sit alongside the dying, we are sitting alongside Christ himself.  And the fullness of our Scriptural story tells us that when we come face to face with God, as Moses, as Jacob, we are changed. And how could we not be?  In entering into life with one who is sick and dying we come face to face with our own humanity, our own mortality.  Face to face with that great enemy – our fear of death.  You see, as we avoid the sick and dying we give in to that great enemy, that power of death over life, that which keeps us from entering fully and joyfully into life.  Our fears keep us from God.

 

But in Romans, Paul reminds us that, “we do not live to ourselves, we do not die to ourselves If we live, we live to the Lord and if we die, we die to the Lord. In life and death, we belong to God.” (Rom. 14:7-8)

 

Therefore, I suppose my ultimate point here is that it doesn’t matter what I think about Assisted Death.  And frankly, it doesn’t matter what you think about it either. What matters is that we are called by God to confront the reality of our own mortality in the context of the cross which tells us that death is not something to be feared, or even necessarily to be controlled, because there is one who has ultimately overcome death and liberated us all from its bondage. What matters is that we are called to suffer with those who are dying – to be with them and allow the beauty of their death, in whatever form it takes, to reveal something about Christ to us, so that we might be further transformed in his likeness.  And that in all of it, in every precious, beautiful, excruciating moment, we belong to God, no matter what.

 

In life, in death, in life beyond death, God is with us, we are not alone.

Amen.

 

[1] Many of my thoughts in this sermon have come from “Chapter Twenty-One: Death and Its (In)dignity,” 1027-1078 and “Chapter Twenty-Two: Choosing Death,” 1079-104 in On Moral Medicine: Theological Perspectives in Medical Ethics, 3rd ed. M. Therese Lysaught, editor (Grand Rapids: Eerdmans, 2012).

[2] This line of thinking was sparked by the writing of Douglas John Hall, The Cross in Our Context: Jesus and the Suffering World (Minneapolis: Augsburg Fortress, 2003).

[3] Heidelberg disputation, thesis 21, 1518.

[4] See https://www.united-church.ca/news/medical-assistance-dying for more details.

[5] The General Synod of the Anglican Church of Canada: Faith Worship and Ministry Task Force on Physician Assisted Dying, “In Sure and Cetain Hope: Resources to Assist Pastoral and theological Approaches to Physician Assisted Dying,” 2016, 6.

[6] The United Church of Canada, A New Creed.