Suicide Tourism

On March 2nd of this year, the PBS program Frontline invited the public to witness the assisted suicide of Craig Ewert, a 59 year-old sufferer of ALS (amyotrophic lateral sclerosis, or “Lou Gehrig’s Disease”). Viewers followed Ewert through the last phases of his life—a life he intentionally ended through the ministrations of the Swiss non-profit organization ironically named “Dignitas.” The program’s title, “Suicide Tourism,” refers to the fact that Dignitas allows persons from outside of Switzerland to travel to their center in order to die by physician-assisted suicide (PAS). The banality of that title was in stark contrast to the public display of a man struggling (successfully) to kill himself.

ALS is a terrible, totally debilitating disease that leads progressively to paralysis of the entire body. It is characterized by the degeneration of neurons in the brain stem and spinal cord. It’s an irreversible condition that involves months if not years of acute emotional and physical suffering. Those afflicted with it normally remain conscious until the very end, often tortured by the prospect of dying by suffocation. Under these conditions, loved ones—especially those who provide regular care to the patient—experience their own emotional pain and distress, frequently compounded by guilt for wishing the patient could or would finally die. The disease is a powerful poster child for proponents of PAS and euthanasia.

The comments that appeared on the Frontline website were as poignant and disturbing as the video itself. They represented just what one would expect. The majority praised the family and the network for raising the issue, and for their “caring sensitivity,” as Craig Ewert ended his life in the Zürich apartment Dignitas had rented as the venue for their program of assisted suicide. “I don’t know if I could do it myslef [sic],” wrote one woman, “but nothing would scare me more than a diagnosis of ALS… It must be a true nightmare. My heart goes out to all concerned.” Many evoked their personal experience with dying family members, cases of “needless suffering” endured for months before death finally ended the pain. One man declared, “There should be dignity with death and religion should stay out of it.” In this same vein, others pointed out that the Bible does not forbid or condemn suicide, even though the Catholic and Orthodox Churches formally insist that only God has the “right” or authority to determine the time and manner of our death. (Suicide seems approved, in fact, in cases such as king Saul’s; and the commandment “Thou shalt not kill” refers only to the murder of one Israelite by another.)

Those who voiced concern—even anger and revulsion—over the presentation did so for reasons often expressed by Christian and other ethicists. They evoked, for example, the danger of the slippery slope (if PAS becomes universally acceptable, pressure will be put increasingly on the sick and elderly to end their lives). Others argued that the matter could and should be resolved not by PAS, but by improving hospice programs and techniques for palliative care. Finally, one man made a comment that especially struck me, because it pointed directly to what I found to be the most tragic aspect of Ewert’s death and the program about it. He noted simply: “the setting in that apartment was so clinical and technical and rushed.”

An innocuous statement, perhaps, but one that underscored more clearly than any of the others the sad reality of that death and all that surrounded it.

It would be possible to respond to this event by rehearsing all the reasons the Church’s theologians have proposed as to why PAS, like euthanasia, is considered to be immoral, sinful. There is above all the sovereignty of God over all life, including our own, that makes any personal decision to end that life arbitrarily and “before its time” a violation of our most basic stewardship. “Do you not know that your body is a temple of the Holy Spirit within you, which you have from God, and that you are not your own?” (1 Cor 6:19f). And the apostle adds, “you were bought with a price; therefore glorify God in your body.”

But to this and to so many other arguments, one can raise counter-arguments that point to the intolerable suffering of the great many people who face a long yet painful dying process. If we compassionately “put down” dying pets, why can’t we do the same for our loved-ones? It’s a perfectly reasonable question. More to the point, though, is the fact that the setting in that Dignitas apartment was “clinical, technical and rushed.”

Craig Ewert held no particular religious beliefs and had no real hope in any form of afterlife. Although his wife wished him “a safe journey” and added something about seeing him again, the entire scene was one of final and ultimate closure, a true “dead end.” From an Orthodox perspective, everything was turned upside down and backwards. Life was perceived by Craig and his family—as by the vast majority of people today—as the only “real reality” we are presented with. Maybe there actually is something after death; in any case, we can hope so. But we live, and we die, as if there were not. Whatever may lie ahead, if not just wishful thinking, is so nebulous that it’s hardly worth considering, even when death is staring us in the face.

The “real reality,” in fact, is precisely the opposite. This biological life of ours is a preface, a needful but ephemeral beginning to what “life” is all about. Christian hope is not wishful thinking. It is the certainty that death marks not an end but a beginning. Death is a passage, a stage in an eternal process that leads from “this vale of tears” into a form of existence that thought can barely grasp and words cannot express. From this mortal existence into life beyond, we are being “transformed from one degree of glory to another,” St Paul declares. “So we do not lose heart. Even though our outer nature is wasting away, our inner nature is being renewed day by day. For this slight momentary affliction [from terminal disease to martyrdom] is preparing us for an eternal weight of glory beyond all measure…” (2 Cor 3-4).

This is why we within the Body of Christ surround the bed of a dying person with psalms, hymns, prayer, and the loving presence of the community of the faithful. This is why we do all possible to offer them the grace and blessing of a final confession and Holy Communion.

In that austere room in Zürich there was no awareness of God’s presence, of death as a passage, or of hope of any sort. Or so it certainly seemed. Had there been, that would not at all have justified what occurred there. The point is that there are reasonable, successful and blessed alternatives to physician-assisted suicide, just as there are to euthanasia. Hospice and palliative care are important elements in any such alternatives. But vastly more important is the Church’s act of placing the ill person in the hands of God, and seeking there needed comfort, together with ever-growing assurance that in Christ, suffering and death can truly be transfigured from glory to glory.

The memorial plaque for Craig Ewert gives his name, together with his dates of birth and death. Then it reads, “To the last breath… for knowledge and freedom.” This expresses a sad, even cruel paradox. For the only true knowledge is of Christ: tortured, crucified and risen. And the only true freedom is to be found, not in the death brought on by a clinical and rushed act of suicide, but in the ineffable joy, peace and beauty of the life beyond.