Window Quarterly Vol. 3, No. 3 & 4, 1993 Copyright 1993 [Permission is granted to use, print, reproduce this article provided the following acknowledgment is given: From Window Quarterly 3, 3/4 (1993); ACRAG c. 1993. *** WHAT IS GOOD DEATH? Issues Related to Death and Dying by Hratch Tchilingirian ------------------------------------------------ Euthanasia (Greek for "good death"), in general, means "the causing of an easy or painless death to the patient who is dying of a terminal illness. Death can be induced by the patient himself without the knowledge or cooperation of any other persons. Or it can be effected by others at the request or with the consent of the patient. In all these cases it is called voluntary euthanasia. If death is induced against the will or without the knowledge of the patient, [it is called] involuntary euthanasia.1 ------------------------------------------------ In 1991 when the Hemlock Society published the best seller Final Exit by Derek Humphry, a wave of controversies and debates emerged and once again, euthanasia became a topic of public discussion. Meanwhile, an Armenian doctor in Michigan, named Jack Kevorkian, was assisting terminally ill or potentially terminal patients to commit suicide. Kevorkian became "famous" in 1990 when he chose to help Janet Adkins commit suicide in the early stages of her Alzheimer's disease. In the beginning, "despite some criticism by a few psychologists and ethicists, there was tremendous public support evidenced for his compassion,"2 Humphry writes. However, as the number of his assisted suicides increased, Kevorkian's "public support" turned into public outrage. Why did this initial support decline to an eventual disapproval? Kevorkian - or Dr. Death as he became known in the press - was acting "as god" in the eyes of society, i.e., determining the end of life or when life should end "for the sake of his patients." While the initial cases of assisted suicides by Kevorkian were seen as compassionate relief from ongoing physical pain and discomfort, eventually, his method became a major public issue when it went "too far." As Nancy Gibbs in her cover story in Time magazine wrote, Kevorkian, in his determination to fight for the rights of his patients, told the State of Michigan "to go to hell."3 By placing himself above any authority except the will of the dying person, Kevorkian negated the basic ethical questions surrounding life and death. He was satisfied with his own answer. The Social Debate Questions such as whether an individual has the "right to die" or whether life should be prolonged or whether life should be ended to prevent pain are discerned through social dialogue, where the social, moral, political, philosophical and theological implications of such issues are discussed on various levels. Who decides the length of life? Who determines the value of life? What is death? Is it a matter of personal choice? What is the responsibility of society? In a pluralistic society such as ours, when faced with these complicated ethical questions, we find ourselves divided over the fundamentals of life and death. The ethical and theological problem over death and dying is further complicated today by the fact that modern medicine and clinical technology has succeeded in prolonging the life span of human beings - whether by stretching out the length of an illness or using artificial means of sustenance. Today, euthanasia is discussed within the context of this social dilemma. While on the one hand technology has made many miracles possible, it has also legitimized the illusion that "man is the center of the universe" and therefore controls his own destiny. On the contrary, as M. Gorbachev underlines, "technology has not only failed to ease the conflict between man and nature, it has aggravated that conflict.... The crisis of civilization that we see today is a crisis of the naive belief in the omnipotence of humanity."4 Technological advances without corresponding moral discussion and determination create an ethical vacuum in society. Obviously, many resort to euthanasia out of fear of machines and hospitals where human beings are treated as "lab subjects." The medical industry has not clarified its boundaries and the parameters of its function in society. As such, the gap in the trust between patients and doctors has increasingly grown wider. What is Death? Biologically, the death of any living organism is viewed as the "inevitable and critical moment when an organism ceases to function as a specific, unified, homeostatic system and becomes disorganized into a mere collection of heterogeneous chemical substance." The process of death is the tangible unraveling of the biological system; death is the cessation of systemic functioning. "Hence, the essential point about determining human death is not to decide whether any life is present, but whether human life in the most radical sense of a unified human person is still present."5 And yet, who determines whether this "unified person" is present? Is it the doctor? Is it the patient? Is it the family? If the person is "not present," do we have the right to extinguish this life? When is life no longer of value? Today, in a market-driven society, human life is viewed from a materialist perspective and life is often valued for its productive capacity or for its adequacy to seek and experience pleasure. Thus death, while feared, is preferred over a non-productive or painful existence. Nevertheless, unlike other organisms, "human death has a mystery about it, because at death we lose touch irrevocably with a person who previously was able to communicate and to share our human community of thought, of love, of freedom, and of creativity. Human death is not merely a decay of an organism, it is the departure of a member of the human community."6 It is this interdependence between the individual and the community that sets the "climate" of the dialogue concerning community and societal issues, e.g., euthanasia. On the other hand, in Western societies, the loss of a member of the human community is viewed as evil - "an evil which is resented, fought against and battled, even though it is seen as inevitable. Death is darkness. It is the end of life on earth as we know it. It is the conclusion of our efforts, our hopes, our dreams, our expectations, our existence as earth-borne beings."7 An Orthodox Perspective Ultimately, any ethical position or contemplation in life takes place in a specific context. And that context is defined by one's religious belief or values by which she lives. A person's understanding of life is based on her values, her upbringing, her experience in life, her religious faith and practice and many other variables. As Armenian Christians, we have the rich theological tradition of the Armenian Church which defines that context. The Armenian Church understands death in the context of life, i.e., dying and living in Christ. This understanding is reiterated throughout the liturgical tradition of the Armenian Church, (e.g., Baptism, Divine Liturgy, Funeral Service, etc.). In fact, in the New Testament "the dominant lines of [God's] revelation converge toward the mystery of Christ's death. There all of human history appears like some gigantic drama of life and death; until the coming of Christ, and without Him, there is only the kingdom of death. Christ comes, and by His death triumphs over death itself; from that instant, death takes on a new meaning for the new humanity which dies with Christ in order to live with Him eternally."8 In a broader sense, dying should be viewed as a process and death as an event. The Christian, through Baptism, dies in his "old life" and lives anew in Christ. The entire life process is a process of "dying," and "reliving" in Christ through love in the Holy Spirit. Death, for the Christian, is merely the event by which one leaves this world to become a part of another. There may be pain and suffering in the process and that is understood through the purifying and salvific suffering of Christ. According to the Armenian Church, suicide - i.e., those who separate or cut off themselves from the church community - constitutes the deliberate taking of human life and as such is to be condemned as murder.9 The Church, however, "distinguishes between euthanasia and the withholding of extraordinary means to prolong life unable to sustain itself. 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. The only "good death" for the Orthodox Christian is the peaceful acceptance of the end of his or her earthly life with faith and trust in God and the promise of Resurrection."10 Thus, the meaning of life is not determined by an individuals productivity, or her comfort or his pleasure or her desire to live, but by the individual's faith in God. Death is not an ending, but a beginning. Death is not a condition to be induced or avoided; it is the culmination of this life and the preparation of a new life in Christ. The circumstances of death are always difficult - for those who die, as well as those who remain behind - but ultimately, human life and condition are to be entrusted to God and His mercy. It is not a matter of personal control. As the Psalmist writes, "The Lord redeems the soul of his servants: and none of them that trust in Him shall be desolate," (Ps. 34:22). Notes: 1. Andrew C. Varga, The Main Issues in Bioethics, (New York: Paulist Press, 1984), pp. 267-68. 2. Derek Humphry, Final Exit: The Practicalities of Self- Deliverance and Assisted Suicide for the Dying, (The Hemlock Society, 1991), p. 18. 3. Time, May 31, 1993, p. 35. 4. Time, September 6, 1993, p. 53. M. Gorbachev is currently President of International Green Cross. 5. ibid., p. 366. 6. Benedict M. Ashley and Kevin D. O'Rourke, Health Care Ethics: A Theological Analysis, (St. Louis: The Catholic Health Association of the United States, 1982), pp. 364-65. 7. Stanley S. Harakas, Contemporary Moral Issues Facing the Orthodox Christians. (Minneapolis: Light and Life Publishing Co., 1982), p. 166. 8. Xavier Leon-Dufour, Dictionary of Biblical Theology. (New York: The Seabury Press, 1973), p. 117. 9. Canon 11 and 28 of St. Athanasius of Alexandria. cf. op. cit. Harakas, p. 174. For other related canons of the Armenian Church see Vazken Hagopian, Canon Book of Armenians [in Armenian], Vol. I and II, (Yerevan: Armenian Academy of Sciences, 1964/1971). 10. op. cit. Harakas, p. 176. *** =================================================== _ _ _ _ _ |_| ___ _| | ___ _ _ _ | | | | | | _ / _ \ / _ | / _ \ | | | | | | | |_| |_| || |_ | | | || |_| || |_| || |_| |_| | \_________/\___||_| |_| \___/ \___/ \_________/ View Of The Armenian Church ===================================================