November 11, 2016
This is a rush transcript. This copy may not be in its final form and may be updated.
It’s Friday, November 11, 2016. I’m Albert Mohler and this is The Briefing, a daily analysis of news and events from a Christian worldview.
The Hippocratic Oath and assisted suicide: Will doctors now reject centuries of medical ethics?
The issue of assisted suicide, you remember, was on the ballot on Tuesday in the State of Colorado. And what made that vote so significant was the margin of victory for the forces that were seeking to legalize physician assisted suicide; the measure won by basically a two-to-one margin. That’s massively important, because what it underlines is the fact that when the culture of death and the logic of that culture becomes situated within a society, it spreads. And it not only spreads in terms of its reach, it also turns out it accelerates in terms of its velocity. A two-to-one vote in favor of legalized, physician-assisted suicide in Colorado would’ve been unimaginable just a few years ago. But it was actual, all too real on Tuesday in that state.
But the signal about the change in this culture was also made clear on Saturday in the pages of the New York Times in an article by a physician. The doctor is Haider Javed Warraich, identified as a Fellow in Cardiovascular Medicine at Duke University Medical Center. He’s also the author of the forthcoming book entitled, Modern Death: How Medicine Changed the End of Life. He begins his article by writing,Show Full Transcript
“Out of nowhere, a patient I recently met in my clinic told me, ‘If my heart stops, doctor, just let me go.’
“‘Why?’ I asked him.
“Without hesitating, he replied, ‘Because there are worse states than death.’”
Then the doctor wrote this,
“Advances in medical therapies, in addition to their immense benefits, have changed death to dying — from an instantaneous event to a long, drawn-out process. Death is preceded by years of disability, countless procedures and powerful medications. Only one in five patients is able to die at home. These days many patients fear what it takes to live more than death itself.”
Now we need to look at this very closely, because in that one paragraph we find contained fundamental untruths that have to be known to be untrue by the doctor who wrote the article. It’s certainly not untrue that many people these days die in a hospital or in another medical setting rather than at home. But we also need to note that is itself a matter of choice, and it’s also a reflection of what can only be described as medical progress, medical progress not only at the end of life, but also in every other stage of life. There are many people who are living to an old age who never would’ve lived that long until the development of modern medical therapies, medicines, and other forms of intervention. That’s not a failure, that’s a success of modern medicine. And furthermore, what the doctor wrote in this article is that death has now been changed to dying; he writes this, “from an instantaneous event to a long, drawn-out process.”
Now to concede his point, perhaps the process of dying, or at least the period at the end of life, is more drawn out and more filled with medical procedures than was previously the case in human experience. But note this, it is simply untrue, it is fundamentally untrue to say that somehow only in the modern age has death been changed to dying. He goes on to say, you’ll remember, from an “instantaneous event to a long, drawn out process.” Can he possibly mean what he writes here? Can he possibly mean that prior to modern medicine, everyone simply died in an instant, that there were no long drawn out illnesses, that there was no enduring disability? The fact is that is an absolutely ludicrous statement. And yet not only did the author make it, but the editors of the New York Times allowed it to go into print.
One of the explicit arguments in this article is that advances in medical technology have allowed the extension of life, and that this leads to any number of indignities that come with old age and the loss of capacities, what could be described as disabilities. But we need to understand that that is as old as humanity. That is not a modern development. Old age has always been contrasted with youth precisely because there is a distinction. If you’re wondering about that, just look at the Book of Ecclesiastes, chapter 12. What we face here is an argument for the legalization of physician-assisted suicide that the author recognizes means the necessary overthrow of an entire moral universe, of a complete moral order.
He understands that the acceptance of assisted suicide and the claim that we can somehow have autonomy over the end of our lives requires a redefinition of medical ethics, in particular a rejection or revision of the historic Hippocratic oath undertaken by physicians. In perhaps the most revealing part of this article, he recognizes that the main obstacle to the acceptance of assisted suicide isn’t coming from the general public, but rather from physicians. As he writes,
“Yet even as assisted suicide has generated broader support, the group most vehemently opposed to it hasn’t budged: doctors.”
Now let’s just pause there for a moment. What does that tell us? That doctors themselves are the most resistant of all to taking on the authority to decide who shall live and who shall die. He goes on to explain,
“That resistance is traditionally couched in doctors’ adherence to our understanding of the Hippocratic oath. But it’s becoming harder for us to know what is meant by ‘do no harm.’ With the amount of respirators and other apparatus at our disposal, it is almost impossible for most patients to die unless doctors’ or patients’ families end life support. The withdrawal of treatment, therefore, is now perhaps the most common way critically ill patients die in the hospital.”
Now there is some truth in that, of course. It is the withdrawal of treatment that is perhaps the most common way that, medically speaking, the end-of-life comes about in life’s last stage. But notice the very language reveals something that you might not notice here, and that is this: the end of treatment or the withdrawal of treatment indicates that prior to this, there had been treatment. And one of the things we need to recognize is that virtually no one is arguing that we should simply decide that some people are not worthy of receiving medical treatment. The other thing we need to understand here is that the withdrawal of medical treatment is not and has never been recognized as being the moral equivalent of intentionally bringing about death.
I also have to note at this point the slippery language that is deliberately employed in this article. Not only is there reference to the Hippocratic oath, but rather we are told that, “Resistance is traditionally couched in doctor’s adherence to our understanding of the Hippocratic oath,” as if perhaps there is merely a problem here in interpretation.
The doctor’s point is made abundantly clear as he concludes his article by arguing,
“We need to be able to offer an option for those who desire assisted suicide, so that they can openly take control of their death.”
Now notice again what’s being claimed here is that somehow we should have the right to “openly take control of our death.”
But then he concludes,
“Instead of seeking guidance from ancient edicts, we need to re-evaluate just what patients face in modern times. Even if it is a course we personally wouldn’t recommend, we should consider allowing it for patients suffering from debilitating disease. How we die has changed tremendously over the past few decades — and so must we.”
We need to face squarely what we’re looking at here. Here you have a doctor arguing against the majority in his own profession that patients should have the right to demand assisted suicide and physicians should be authorized to deliver it. But you’ll also note that what he identifies here as what must be overcome is “ancient edicts.” Now in the direct reference to his article that ancient edict first and foremost will be the Hippocratic oath. But we also need to understand that if Western societies are going to accept the culture of death and the demand for assisted suicide, it would require overthrowing another text that could be described as an ancient edict, and that is the Bible. Accepting assisted suicide doesn’t merely require overthrowing the Hippocratic oath, it requires overthrowing the entirety of the Christian worldview.
This article is insidious in other ways as well. In the middle of it he writes,
“While the way people die has changed, the arguments made against assisted suicide have not. We are warned of a slippery slope, implying that legalization of assisted suicide would eventually lead to eugenic sterilization reminiscent of Nazi Germany. But no such drift has been observed in any of the countries where it has been legalized.”
Now at this point I simply have to say that following this issue for decades, I have never once in my entire experience seen anyone warn of what he says doesn’t happen here, and that is that assisted suicide would lead to the legalization of forced sterilization. Those are two completely unrelated issues. In other words, the editors of the New York Times allowed this doctor to set up an absolutely false premise and then knock it down as if it supported his argument. And where this doctor insists that there has been no such moral drift—he says, of course, there hasn’t been a drift towards what he identifies as eugenic sterilization in those countries that have legalized physician-assisted suicide—he doesn’t acknowledge the moral drift that is all too apparent and has been reported, including in the pages of the New York Times. And that is this: there has been a drift away from assisted suicide demanded for those who were in the end stages of what’s diagnosed as a terminal disease towards those who now are being euthanized and offered assisted suicide merely because they are depressed.
He also doesn’t talk about the moral drift that is now well documented in those nations from assisted suicide offered only to adults in that terminal situation to now assisted suicide that is being extended to adolescents and children as well. Accepting assisted suicide doesn’t merely require overthrowing the Hippocratic oath, it requires overthrowing the entirety of the Christian worldview. And it tells us something really important that the majority of physicians in the United States—and that would mean those who are not by any means explicitly Christian—understand that it violates the very nature of their calling to bring about rather than to prevent death.
Labeling arguments against gay marriage "hate speech," Australia's Parliament shuts down public vote
Next, we shift to Australia where we confront another sign of the times. In this case, the headline is this:
“Australia’s Parliament Rejects Public Vote on Gay Marriage.”
That nation is itself very secular in terms of its general contours, and yet Australia at present does not nationally have a law that legalizes same-sex marriage. The current government had a proposal presented to Parliament whereby the question will be put to the Australian public, but Parliament voted it down. And amongst those who voted it down were not opponents of same-sex marriage, but supporters of same-sex marriage. And what’s really important to us is the argument that they employed. As Michelle Innis of the New York Times reported,
“On Monday, a majority of senators from the Greens and from the Labor Party, along with lawmakers from smaller parties, joined together to block the plebiscite, by a vote of 33-29.”
She went on to explain,
“Although the Greens and Labor support legalizing same-sex marriage, they oppose holding a plebiscite, calling it a possible platform for hate speech. Instead, they advocate deciding the issue in Parliament.”
Penny Wong, identified as a Senator from the Labor Party, said,
“We know a plebiscite is divisive. It will give those who oppose equality a multimillion-dollar, taxpayer-funded megaphone to spread a message of intolerance.”
Now at this point we need to note what’s happening. Here you have the Australian Parliament voting down presenting the question of same-sex marriage to the Australian people. There are at least two issues here. First is the fear that the Australian people would vote the measure down. But the other issue is this: the people who voted against this measure that is allowing the public to at least decide the question are open in the fact that they do not believe the question should even be considered in public. In other words, what they’re arguing here is that there is no legitimate case against same-sex marriage, that the only origin of any opposition to same-sex marriage is intolerance and hatred that should not be allowed in terms of public conversation.
This amounts to a shutting down of all public conversation, and what it means is that there is no place, at least in the argument of those who prevailed in this vote, for any argument in which what the society had held and even holds now to be right might be reasonable. The almost totalitarian nature of this kind of impulse is seen in the fact that the law in Australia right now, at least at the federal level, defines the union of a man and a woman alone as marriage. Is that now described as hate speech? Does the law of Australia right now represent only intolerance? Were those who put it into place merely motivated by animus against those who are now described as a sexual minority? Well, Australia has now reached the point that the government could not even prevail in presenting the question to the public. But before we throw stones at Australia, remember that effectively the very same thing happened here in the United States of America when the question was taken up by the United States Supreme Court. In the Obergefell decision legalizing same-sex marriage, as in the Roe v. Wade decision of 1973 legalizing abortion on demand in all 50 states, what we had was a judicial usurpation of politics. But in the United States, at least most politicians were reluctant to make the argument that was openly made in the Australian Parliament. We cannot trust this question to the people and, furthermore, we do not even want this question discussed in polite conversation.
As I said, this tells us a very great deal about where we stand. We’ve now reached the point that in some Western countries it is now almost unspeakable to articulate even the current law, much less the arguments behind it. And any argument against same-sex marriage is here dismissed, any argument at all, as being nothing more and nothing less than hate speech.
British parents fear passing down faith will make their children social outcasts
Finally and along similar lines, an incredibly important story appeared in recent days in The Telegraph of London. The headline of this story,
“Parents fear that religion will make their children outcasts.”
This is one of those articles that demands our very thoughtful attention, and it’s not driven by a headline that has to do only with recent events, even though the headline story has to do with a report recently released by a British think tank known as Theos. Note the reason why we need to linger here is because this is exactly what will be faced by parents in the United States. And what this tells us is a great deal about the distinction between nominal and cultural Christianity on the one hand and authentic Christian faith on the other. Danny Boyle, writing for The Telegraph tells us,
“Almost a quarter of religious parents are not passing on their faith to their children for fear they will be alienated at school.”
This is one of those really interesting questions. It’s about time that someone undertook this kind of study, and this is an issue that is not only of course germane to Great Britain, it’s very relevant here to the United States of America.
We’re being told in this study that a quarter of those who are parents in the United Kingdom who identified as religious—and that’s all we need here is just the fact that they identified as religious—said they were not going to be passing on their religious faith to their children because, after all, that religious faith might cost their children. It might even mean that they will be alienated at school.
There’s so much going on here. First of all, you have the concern on the part of many parents about the most important thing in their children’s lives being whether they are or are not alienated at school. What we see here at least in part is the fact that many parents on both sides of the Atlantic now measure their own success as parents in the relative social status of their children. That tells us a very great deal.
The other thing we see in this article is the fact that there are parents who have decided that it’s just too costly to pass on their religious faith to their children. That is, it will cost their children. If their children identify as Christians in an increasingly secular society, they just might have to pay a cost, they might be considered as outcasts. This is where we have to understand that in previous generations, we expected that people would gain social status—it’s otherwise known as social capital—by identifying with Christianity. But now we have to recognize as the society around us hardens and grows increasingly secular, those who are confessing Christians and who identify with historic biblical orthodox Christianity will pay social capital rather than receive it in terms of that public identification.
The study referenced here in The Telegraph indicated that one in four of those parents in the UK who responded this way indicated that they were worried that their children might be sidelined by friends if they openly identified with the religion of the parents. Now it’s just a fundamental fact that in the vast majority of these cases that religion would be Christianity. And of course what we’ve been seeing in the United Kingdom is the increased marginalization of Christianity in a society that, after all, still has a state church known as the Church of England. In recent days that church has openly acknowledged that it is considering whether or not it can continue to expect weekly services to be held in their churches simply because the numbers are dwindling, and they are falling so fast.
Here we are witnessing the disappearance of cultural Christianity—that is, the disappearance of some form of Christianity that was friendly to the culture and was adopted by people who did not really identify so much as believing Christians, but rather identified with Christianity because it was convenient and because by that identification they gained social status. Well, now in a secular age, that social status comes with a cost rather than a benefit, and here you have many parents who are saying that they’re not going to pass on their religious faith simply because they think it may cost their children in terms of that social status.
But at this point we simply have to interject that whatever faith these parents have chosen not to pass on to their children must not be a faith that means a great deal to their parents. It must not be a faith that is understood to be deeply grounded in truth. It’s not evidently a faith that is understood to come with eternal consequences.
There once was a day when Christian parents understood that it was their responsibility to raise their children to be martyrs if necessary, to die for the faith as well as to live for Christ. Now we’ve reached the point that at least a quarter of those who responded to this study in the United Kingdom, identifying themselves as religious in themselves, had decided not only that they’re unwilling for their children to pay an ultimate price for their faith, they don’t even want them to have to pay in terms of a loss of social status.
The nature of the so-called faith that is here not being passed on by parents to their children is also further described when we are told that just 40% of the parents who responded to the study “had actually spoken to their children about faith, with many respondents citing that the subject ‘never came up in family discussions.’”
Well, once again, to state the matter as plainly as possible, if this is a matter that doesn’t come up in family conversations, then it is really not a part of the family life whatsoever. This probably tells us less about the missing faith of the children more than the missing faith of the parents. But it also tells us a very great deal about where convictional Christians will stand and will be expected to stand in terms of the secular society.
We’re being warned here that parents in the United Kingdom have decided that identifying with biblical Christianity will just be too high a price to pay for their children. Those who have gone so far as to make that open acknowledgment are probably those who have already decided that they’re not willing to pay that price either. And biblical Christians should keep in mind that what this underlines is the fact that indeed our children may and almost certainly will pay a price for identifying with biblical Christianity. But before we defer this merely into the future as a challenge that might be faced by our children, we had better be ready in ourselves to be a people of conviction ready to pay that price not only in the future, but in the present.