Roman Catholicism
According to Catholic teachings, death is contrary to God's plan for humankind. In the Old Testament story of Genesis, when God created human beings, he did not intend for them to die. But when Adam and Eve—the first humans—disobeyed God in the Garden of Eden, physical death was the consequence of their sin. In the New Testament section of the Bible, Jesus Christ was the Son of God who, out of love for humankind, was born into the world and died as a man. God raised Jesus from the dead after his crucifixion to live eternally with him in Heaven, and Jesus promised humankind the same opportunity. According to Christian doctrine, Jesus thus "transformed the curse of death into a blessing" (Catechism of the Catholic Church, Second Edition, English Translation, Doubleday, 1997).
HISTORY
Early Christians believed that God was the giver of life, and therefore he alone could take life away. They viewed euthanasia as usurping that divine right. The early Christian philosopher St. Augustine (circa 354–430) taught that people must accept suffering because it comes from God. According to Augustine, suffering not only helps one grow spiritually but also prepares Christians for the eternal joy that God has in store for them. Moreover, the healthy were exhorted to minister to the sick not for the purpose of helping to permanently end their suffering, but in order to ease their pain.
St. Thomas Aquinas (circa 1225–74), considered one of the greatest Catholic theologians, taught that ending one's suffering by ending one's life was sinful. To help another take his or her life was just as sinful. However, in 1516 Sir Thomas More (circa 1477–1535), an English statesman, humanist, and loyal defender of the Catholic Church, published Utopia, which described an ideal country governed by reason. More argued that if a disease is not only incurable but also causes pain that is hard to control, it is permissible to free the sufferer from his or her painful existence. This was a major departure from the medieval acceptance of suffering and death as the earthly price to be paid for eternal life.
PRINCIPLE OF DOUBLE EFFECT
Catholic moral theologians were said to have developed the ethical principle known as the "Rule of Double Effect." According to this principle, "Effects that would be morally wrong if caused intentionally are permissible if foreseen but unintended." For example, a physician prescribes an increased dosage of the painkiller morphine to ease a patient's pain, not to bring about his or her death. However, it is foreseen that a potent dosage may depress the patient's respiration and hasten death. The Catechism of the Catholic Church states:
The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable.
ON EUTHANASIA
Over the years, Catholic theologians have debated balancing the preservation of God-given life with the moral issue of continuing medical treatments that are of no apparent value to patients. In 1957 Pope Pius XII stated that if a patient is hopelessly ill, physicians may discontinue heroic measures "to permit the patient, already virtually dead, to pass on in peace" ("The Prolongation of Life"). He added that if the patient is unconscious, relatives may request withdrawal of life support under certain conditions.
In Nutrition and Hydration: Moral and Pastoral Reflections the Committee for Pro-Life Activities of the National Conference of Catholic Bishops (Washington, DC: NCCB, 1992) stated:
In the final stage of dying, one is not obligated to prolong the life of a patient by every possible means: "When inevitable death is imminent in spite of the means used, it is permitted in conscience to make the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due the sick person in similar cases is not interrupted."
The Eastern Orthodox Church
The Eastern Orthodox Church resulted from the division between Eastern and Western Christianity during the eleventh century. Differences in doctrines and politics, among other things, caused the separation. The Eastern Orthodox Church does not have a single worldwide leader like the Roman Catholic pope. Instead, national jurisdictions called "Sees" are each governed by a bishop.
Eastern Orthodoxy relies on the Scriptures, tradition, and the decrees of the first seven ecumenical councils to regulate its daily conduct. In matters of present-day morality, such as the debates on end-of-life issues, contemporary Orthodox ethicists explore possible courses of action that are in line with the "sense of the Church." The sense of the Church is deduced from Church laws and dissertations of the Fathers of the Church, as well as previous council decisions. Their recommendations are subject to further review.
"The Stand of the Orthodox Church on Controversial Issues," by the Reverend Stanley Harakas, Th.D. (http://www.goarch.org/en/ourfaith/articles/article7101.asp), states, "The Orthodox Church has a very strong pro-life stand which in part expresses itself in opposition to doctrinaire advocacy of euthanasia." However, the article quotes current Orthodox theology to clarify that "the Church distinguishes between euthanasia and the withholding of extraordinary means to prolong life. It affirms the sanctity of human life and man's God-given responsibility to preserve life. But it rejects an attitude which disregards the inevitability of physical death."
Protestantism
The different denominations of Protestantism have varying positions about euthanasia. While many hold that active euthanasia is morally wrong, they believe that prolonging life by extraordinary measures is not necessary. In other words, though few would condone active euthanasia, many accept passive euthanasia. (Active euthanasia involves the hastening of death through the administration of lethal drugs. Passive euthanasia refers to withdrawing life support or medical interventions necessary to sustain life, such as removing a patient from a ventilator.) Among the Protestant denominations that support the latter view are the Jehovah's Witnesses, the Church of Jesus Christ of Latter-Day Saints (Mormons), the Lutheran Churches, the Reformed Presbyterians, the Presbyterian Church in America, the Christian Life Commission of the Southern Baptist Convention, and the General Association of the General Baptists.
Some denominations have no official policy on active or passive euthanasia. However, many individual ethicists and representatives within these churches agree with other denominations that active euthanasia is morally wrong but that futile life supports serve no purpose. Among these churches are the Seventh Day Adventists, the Episcopal Church, and the United Methodist Church.
Christian Scientists believe that prayer heals all diseases. They claim that illnesses are mental in origin and therefore cannot be cured by outside intervention, such as medical help. Some also believe that seeking medical help while praying diminishes or even cancels the effectiveness of the prayers. Because God can heal even those diseases others see as incurable, euthanasia has no practical significance among Christian Scientists.
The Unitarian Universalist Association, a union of the Unitarian and Universalist Churches, is perhaps the most liberal when it comes to the right to die. The Association believes that "human life has inherent dignity, which may be compromised when life is extended beyond the will or ability of a person to sustain that dignity." Furthermore, "Unitarian Universalists advocate the right to self-determination in dying, and the release from civil or criminal penalties of those who, under proper safeguards, act to honor the right of terminally ill patients to select the time of their own deaths" (http://www.uua.org/actions/health/88die-dignity.html).
Judaism
In the United States there are three main branches of Judaism. The Orthodox tradition adheres strictly to Jewish laws. Conservative Judaism advocates adapting Jewish precepts to a changing world, but all changes must be consistent with Jewish laws and tradition. Reform Judaism, while accepting the ethical laws as coming from God, generally considers the other laws of Judaism as "instructional but not binding."
Like the Roman Catholics, Jews believe that life is precious because it is a gift from God. No one has the right to extinguish life, because one's life is not his or hers in the first place. Generally, rabbis from all branches of Judaism agree that active euthanasia is not morally justified. It is tantamount to murder, which is forbidden by the Torah (the Five Books of Moses). Moreover, Jewish teaching holds that men and women are stewards entrusted with the preservation of God's gift of life and therefore are obliged to hold on to that life as long as possible.
PROLONGING LIFE VERSUS HASTENING DEATH
While Jewish tradition maintains that a devout believer must do everything possible to prolong life, this admonition is subject to interpretation even among Orthodox Jews.
The Torah and the Talmud provide the principles and laws that guide Jews. The Talmud—the definitive rabbinical compilation of Jewish laws, lore, and commentary—has provided continuity to Jewish culture by interpreting the Torah and adapting it to the constantly changing situations of Jewish people.
On the subject of prolonging life versus hastening death, when that life is clearly nearing death, the Talmud narrates a number of situations involving people who are considered "goses" (literally, the death rattle is in the patient's throat, or one whose death is imminent). Scholars often refer to the story of Rabbi Haninah ben Teradyon, who, during the second century, was condemned to be burned to death by the Romans. To prolong his agonizing death, the Romans wrapped him in some wet material. At first the rabbi refused to hasten his own death; however, he later agreed to have the wet material removed, thus bringing about a quicker death.
Some Jews interpret this Talmudic narration to mean that in the final stage of a person's life, it is permissible to remove any hindrance to the dying process. In this modern age of medicine, this may mean implementing a patient's wish, such as the do-not-resuscitate directive or the withdrawal of artificial life support.
Islam
Islam was founded by the prophet Muhammad in the seventh century. The Qur'an (also transliterated as Koran), which is composed of God's revelations to Muhammad, and the Sunnah, Muhammad's teachings and deeds, are the sources of Islamic beliefs and practice. Although there are numerous sects and cultural diversities within the religion, all Muslims (followers of Islam) are bound by a total submission to the will of Allah, or God. The basic doctrines of Allah's revelations were systematized into definitive rules and regulations that now comprise the Shari'ah, or the religious law that governs the life of Muslims.
Muslims look to the Shari'ah for ethical guidance in all aspects of life, including medicine. Sickness and pain are part of life and must be accepted as Allah's will. They should be viewed as a means to atone for one's sins. Death, on the other hand, is simply a passage to another existence in the afterlife. Those who die after leading a righteous life will merit the true life on Judgment Day. The Qur'an (chapter 2, verse 28) states, "How do you disbelieve in God seeing you were dead and He gave you life and then He shall cause you to die, then He shall give you life, then unto Him you shall be returned?"
Islam teaches that life is a gift from Allah; therefore, no one can end it except Allah. The prophet Muhammad said, "Whosoever takes poison and thus kills himself, his poison will be in his hand; he will be tasting it in Hell, always abiding therein, and being accommodated therein forever." While an ailing person does not have the right to choose death, even if he or she is suffering, Muslims heed the following admonition (Islamic Code of Medical Ethics, Kuwait Document, Kuwait Rabi 1, 1401, First International Conference on Islamic Medicine, 1981):
[The] doctor is well advised to realize his limit and not transgress it. If it is scientifically certain that life cannot be restored, then it is futile to diligently [maintain] the vegetative state of the patient by heroic means…. It is the process of life that the doctor aims to maintain and not the process of dying. In any case, the doctor shall not take a positive measure to terminate the patient's life.
Hinduism
The Eastern religious tradition of Hinduism is founded on the principle of reincarnation—the cycle of life, death, and physical rebirth. Hindus believe that death and dying are intricately interwoven with life, and that the individual soul undergoes a series of physical life cycles before uniting with Brahman, or God. "Karma" refers to the ethical consequences of a person's actions during a previous life, which determine the quality of his or her present life. A person can neither change nor escape his or her karma. By conforming to "dharma," the religious and moral law, an individual is able to fulfill obligations from the past life. Life is sacred because it offers one the chance to perform good acts toward the goal of ending the cycle of rebirths.
A believer in Hinduism, therefore, views pain and suffering as personal karma, and serious illness as a consequence of past misdeeds. Death is simply a passage to another rebirth, which brings one closer to God. Artificial medical treatments to sustain life are not recommended, and medical intervention to end life is discouraged. Active euthanasia simply interrupts one's karma and the soul's evolution toward final liberation from reincarnations.
Buddhism
Buddhism, like Hinduism, is based on a cycle of reincarnation. To Buddhists, the goals of every life are emancipation from "samsara," the compulsory cycle of rebirths, and attainment of "nirvana," enlightenment or bliss. Like the Hindus, Buddhists believe that sickness, death, and karma are interrelated. Followers of Siddhartha Gautama, also called Buddha (circa 563–483 BCE), the founder of Buddhism, claim that Buddha advised against taking too strict a position when it comes to issues such as the right to die.
The fourteenth Dalai Lama, Tenzin Gyatso, spiritual leader of Tibetan Buddhism, has commented on the use of mechanical life support when the patient has no chance to recover. Rather than advocating or condemning passive euthanasia, he advised that each case be considered individually (Sogyal Rinpoche, The Tibetan Book of Living and Dying, San Francisco, CA: Harper, 1992):
If there is no such chance for positive thoughts [Buddhists believe that a dying person's final thoughts determine the circumstances of his next life], and in addition a lot of money is being spent by relatives simply in order to keep someone alive, then there seems to be no point. But each case must be dealt with individually; it is very difficult to generalize.
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