Session 3: "Where sickness and sorrow are no more . . ." - Euthanasia

"A Christian ending to our life, painless, blameless, and peaceful . . . let us ask of the Lord.”

— Litany of the Prosthesis

Aim: There are several important issues that are dealt with in this session. The basic question of "why do bad things happen to good people?" rises immediately. How could a good and loving God allow suffering? How should we respond to suffering? The saints, and in particular the martyrs have gone ahead of us and shown us the way of enduring suffering. They show us that suffering can transform lives for the better when offered to Christ.

Therefore this session looks at the meaning of suffering and “death with dignity,” by comparing euthanasia and assisted suicide to the martyrdom of the saints, who endured immense suffering for the glory of God. We will discuss how they knew that the suffering of this life was nothing in comparison to the glory that awaited them in the Kingdom, and how this assurance led them to do remarkable achievements.

As Christians, we must cultivate a remembrance of death and live our lives as a preparation for death. We also pray at every liturgy for a "painless and blameless death." Euthanasia may provide a “painless” death, but is it blameless? To die with dignity does not necessarily mean to die without suffering or pain, but approaching death in humility and hope of the Resurrection. Many people find it easy to dismiss the moral implications of euthanasia. This session challenges the participants to come to term with these implications and explore the meaning of suffering.

Objectives: By the end of this session, students should be able to

1. Define Euthanasia, both passive and voluntary, and distinguish it from physician-assisted suicide.

2. Articulate the Church's teaching on Euthanasia.

3. Explain the meaning of the Unction service.

4. Pray for those who suffer.

Useful texts:

Revelation 21:4;

2 Tim 2:11-13,

2 Tim 4:6-8;

2 Corinthians 4:6-12;

Matthew 24:13

1 Corinthians 1:18;

Materials:

  • Art supplies for get-well prayer cards:
  • Orthodox Clip art, Icons prints,
  • paints, glitter, fabric, beads,
  • parchment, tissue paper

Procedure:

I. Opening Prayer

II. Check-In and Review

III. Activity #1: The Holy 40 Martyrs of Sebaste

IV: Activity #2: What is Euthanasia anyway?

V. Activity #3: Prayers for Healing

VI. Session Conclusions

VII. Closing Prayer

I. Opening Prayer


II. Check-In: Have each person say their name (if necessary) and how they are doing. Ask them to give an answer to the following question: "What have I given up on in my life?" Explain one time when you have quit or given up on something.

Review:

What are some ways we Orthodox pray for those who have passed on?

What do we hope for when we pray for those who have passed? Why do we pray?

III. Activity #1: The Lives of the 40 Martyrs of Sebaste

Time: 15 minutes

This is a directed study of the story of the 40 martyrs. The story of these martyrs touches on some of the key issues of this unit. They illustrate, from a Christian perspective, what it means to die with dignity, for the glory of God. This story also shows what happens when someone gives up or quits-- their suffering is made meaningless and they do not share in dignity, but in shame. There is also a certain ambivalence here. After all, didn't they ask the judges to kill them? Stories of martyrs challenge us on many levels, just as the question of euthanasia. By reading this story and talking about it, participants have a chance to start thinking about suffering in a way that directs them towards God

Pass out copies of the The Forty Holy Martyrs of Sebaste sheet at the end of this session. Read through it together.

This story is about life and death choices. This story shows us what it means to suffer with honor, and dying with dignity. Tradition also has that the traitor who jumped into the hot Roman baths after being in icy water immediately died from the shock of the hot water. His death came without honor or dignity. Have participants get into small groups to answer the following questions. You may want to have a copy of the above story available for each group.

Why were the forty martyrs put to death? [For being Christian, for refusing to renounce Christ, etc.]

Why do you think 39 of the 40 accepted their suffering and stayed in the lake? [They knew they would be saved and receive the kingdom of heaven.]

What does this story say about trust, hope, and not giving up? [Great rewards come to those who endure; We should trust in God even in suffering; etc.]

Do you think that there is dignity in their death? Why or why not?

To be a martyr means to literally be a 'witness'. Their actions are a testimony to their faith in God and their belief that the kingdom of heaven was worth the pain. The dignity in their death should not be seen as simple honor or pride, but the glory of God revealed in His saints.


IV. Activity #2: What is Euthanasia?

Time: 10-15 minutes.

This is a discussion designed to clarify the issues and provide important definitions for the participants. The term euthanasia is misunderstood by many. There is for instance, a difference between physician assisted suicide and voluntary euthanasia are two different things and two different legal issues. Both result in the death of the patient. But they are morally quite different from a situation in which life support is ended because of a patient's wishes or even a family's wishes (in the case of brain death, for instance)-- this is called passive euthanasia.

Begin by writing the word "EUTHANASIA" on the board and ask, "What does this word mean to you?" [Terminal Illness, Dr. Jack Kevorkian, right to die, etc.] Write down their responses around the word. There will likely be a variety of ideas expressed, if they are familiar with the word at all.

The Webster's dictionary definition of euthanasia is "the act or practice of killing or permitting death of hopelessly sick or injured individuals in a relatively painless way for reasons of mercy." Euthanatos in the Greek literally means "easy death." We can also break down euthanasia into three different "practices":

Active Euthanasia: a physician performs the act which leads to death, such as administering a lethal dose of a drug to kill a person.

Physician Assisted Suicide: a physician provides a patient with the means to terminate their own life but does not administer it directly.

Psssive Euthanasia/Removal of Life Support: a physician, at the wishes of the patient or if the patient is unable to make a decision (such as in the case of brain death), the family, removes whatever artificial means are being employed to keep someone alive. The patient then expires 'naturally.'

In each case, the patient dies. In each case, the physician ceases to attempt to keep the patient alive. However, they are not all completely the same.


What do you think are the differences between these three methods? [In the first two death is caused by our will and actions, the last one lets death happen without our will to say it will or won't. The first two use drugs to bring death sooner. The first two seem less painful.]

Which of these do you think is acceptable and which are unacceptable ways of dealing with suffering and death? Why? [Removal of Life Support can be acceptable-- when we accept to be humble and accept death and do not try to play 'God' with our medicine by forcing a body to live. However, it is still questionable in practice — some physicians might suggest removal of life support even when there is a chance for survival after a period of healing, in order to cut down on medical costs.]

It is very easy for us to make quick judgments about what is morally superior. Many of those who choose Euthanasia and suicide as a way out of suffering are guided by an experience of suffering and pain that most of us will hopefully never know. Unlike the 40 Martyrs, most of them have to face that pain alone. We need to be compassionate always to their suffering. After all, we pray for a painless and blameless death at each liturgy.

But there is something very important missing from someone when they make the decision to commit (Voluntary) Euthanasia or Assisted suicide. What do you think that could be? [Hope in God's mercy, humility to accept death in the way it comes, trust in Christ's Resurrection.]

The Bible tells us in many ways and many places what we should do in the face of death and suffering. It was on this basis that the Forty Martyrs could put Christ before whatever sufferings they might encounter. Ask each group to look up one of the pairs of Scripture passages used in the service of Holy Unction. Each group should have the passage corresponding to one of the seven priests, including an epistle and a Gospel. Give each group their pair of readings individually from the following list.

Epistle: James 5:10-17 “Is any sick among you?”

Gospel : Luke 10:25-38 The Good Samaritan

Epistle: Romans 15:1-8 “Receive one another”

Gospel Luke 19:1-11 Salvation comes to the house of Zaccheus

Epistle 1 Cor 12:27-13:18 “Do all have gifts of healing?”

Gospel Matt 10:1,5-9 “He gave them power”

Epistle 2 Cor 6:16-7:1 “You are the temple of the living God”

Gospel Matt 8:14-24 Christ heals Peter’s mother

Epistle 2 Cor 1:8-12 “He will still deliver us”

Gospel Matt 25:1-14 The Foolish and the Wise Virgins

Epistle Gal 5:22-6:1-2 “Bear one another’s burdens”

Gospel Matt 14:21-29 Christ heals the daughter of the Canaanite woman

Epistle 1 Thess 5:14-24 “Comfort the faint-hearted”

Gospel Matt 9:9-14 “Those who are well have no need of a physician”

Each one of these passages says something about healing and suffering. Some of these may seem puzzling at first — that is okay, sometimes Scripture appears as a riddle.

In your group, talk about what each passage means and relate it to suffering, healing, and the choice of to commit euthanasia. Come up with one or two sentences to apply the Bible to this problem. In a few minutes, we will come together and share our insights. Take about five minute, then discuss. Some of these passages are more straightforward. Feel free to add your own selections that are relevant to the topic.

How did your epistle and gospel reading relate to each other?

How would you connect the readings to healing and suffering?

How would you apply these passages to a situation where a person was thinking of asking for euthanasia or assisted suicide?

Based on the Church's teaching through the Bible and the Saints, we can conclude that there is something definitely wrong with euthanasia and physician assisted suicide. To give in to this temptation is like an athlete failing to finish the race, taking a short cut and expecting to gain the award of those who follow the rules. How can we dare to number ourselves amongst the Forty Martyrs if we decide the icy water is not for us and we'd rather take a nice hot bath?

V. Activity #3: The meaning of Unction

Time: 10 minutes.

This is an introductory look at the Church service of Holy Unction or Anointing. In many parishes, Unction services have all but disappeared from liturgical life and are often now confused with the “last rites”. The fact is, Unction is a service of bodily and spiritual healing that can be performed for any Orthodox Christians. By looking at the service in this session, participants can get a sense of how the Church approaches dying, suffering, healing. The Unction service teaches us to look past our illnesses to what is really and eternally important: the Kingdom of Heaven. In doing so, it does not provide an "opiate" or distraction from death and suffering, but rather directs us to a life of repentance so that our suffering will be made a meaningful part of our life. To say the least, it is a very different approach than that which dominates in the West today.

What do priests do when they come to the bed of a person in the hospital? What are they there for? [To reconcile the person to God, hear their confession, commune them, give them “last rites,” often confused with holy unction, which is also done.]

Did you know that there are several special prayer services for ill people that our Church has? What are some special needs that you think might have their own prayers? [Pregnancy, miscarriage, before surgery, for recovery from illness, for healing of soul and body, for the departing of the soul from the body. Look at the Book of Needs for examples.]

Many of our special needs have prayers established for them. The simplest prayer is “Lord have mercy.” Perhaps the most elaborate prayer of healing is a sacrament of the Church known as Holy Unction. Priests are often called to give Holy Unction when they visit the sick in hospitals. Some times it is confused with “last rites,” or prayers said upon the departure of the soul from the body.

During Holy Unction, the priest anoints the ill person with oil. What is the basis for this action? [James 5:14, also the parable of the Good Samaritan] The oil itself is blessed through a special prayer.

Besides anointing, Holy Unction involves the reading of Scriptures over the afflicted. The readings and the prayers speak of healing the soul and the body. Who then is able to receive Holy Unction? [Any Orthodox Christians — we all suffer from sin both bodily and spiritually.]

Several of the Scripture readings we looked at above are part of the Unction service. In a full Unction service there are seven priests, who each read seven passages from the Gospels and the Epistles, followed by a prayer for healing to be said over the afflicted. There are several variations on how the service is being performed, depending on how many priests are serving it and if it is for just one person or a whole parish.

Looking at the Scripture readings of the Holy Unction service, what can we learn about healing and suffering? [Healing is not just about physical health, but includes spiritual well-being. Repentance is the key medicine for the soul and has bodily effects as well. When we think about healing, we must always look at a person holistically: soul, body, spirit.]

The anointing of a person is done in cross-wise manner. Why do you think we are anointed in the shape of the cross? [We are healed through what Christ did (by dying) on the Cross.]

The priest anoints the forehead, below the nose, below the lips, the cheeks below the eyes, the heart, and the hands on both sides, and sometimes the feet. Show on the body where it is done.

What do you think is the meaning of this anointing? Why are these places on the body anointed? [Our senses (through the eyes, nose, mouth, ears) are healed, for through them temptation comes; our hands and feet are anointed as Christ’s were pierced by nails; our hearts are healed so that they might receive Christ, etc.]

Today, Holy Unction is a spiritual medicine for us that can heal soul and body. After all, we describe Christ, after his own words in Matthew 9:12, the ‘physician’ of our souls and bodies.

There is a lesson about our Church in this: that we do not suffer alone, that all of us together need healing from sin, the source of death. A follow-up activity to this would be to accompany the priest to a hospital for ministry to the sick and to assist him with prayers and services there. That can really make an impression.

VI. Activity #4: Get Well Prayer cards

Time: 10-15 minutes.

Participants will design get-well cards for the sick and the suffering. One of the greatest factors in leading the terminally ill to choose suicide is the lack of loving, prayerful support. They may have caring families, but the families are unable to see the spiritual danger of euthanasia. This activity also emphasizes a key idea of the unit, that the first part of a solution to life and death problems is prayer.

Begin by sharing some prayers for the sick from the Book of Needs (prayers mostly to be done by priests) and prayer books. Have each person design a prayer card or small prayer book for someone suffering from an illness, be it physical, mental, or spiritual. Ask your priest for names of parishioners in need of prayers who might be sick or especially in the hospital.

When they have written their prayers, using the Church’s prayers as models and guidelines, have them put them together in a creative fashion as get-well cards. Use icons, flowers, and art supplies to create uplifting cards that they can give to the ill person directly or through the priest or hospital ministry. Just knowing that someone cares enough to take notice often profoundly improves a person’s ability to recover. Make this activity part of the regular youth ministry of the Church and help save lives!

An example of a prayer for the sick:

O Holy Father, heavenly Physician of our souls and bodies, who has sent thine Only begotten Son our Lord Jesus Christ to heal all our ailments and deliver us from death: do Thou visit and heal thy servants, (N.) Granting them release from pain and restoration to health and vigor, that they may give thanks unto Thee and bless Thy holy name, of the Father, and of the Son, and of the Holy Spirit: now and ever and unto ages of ages. Amen.

VII. Session Conclusions

Review:

What is euthanasia and what forms are there?

What should we do when faced with suffering and pain?

What can we do for others who are faced with suffering and pain?

Orthodox Christians were among the first people to invent hospitals as we understand them. They first developed them in ancient Byzantium, the late Eastern Roman Empire that became Christian in the fourth century. Throughout the middle ages, they had some of the most advanced medical procedures of the time. They faithfully followed the Hippocratic Oath which forbade doctors from practicing euthanasia. Today’s doctors are no longer bound by that ancient tradition.

Part of success of Byzantine hospitals was that they knew the soul and the body were intimately tied, and that our spiritual and physical being are inseparable. Very often, hospitals were built as an outreach of monasteries first. Treatment was free and supported by the donations of the faithful.

VIII. Closing Prayer Include a general prayer for the sick and the suffering. Just as at the end of Session 2, you might want to lead a brief prayer circle using the Church’s prayers for the sick. Let each person who has someone to pray for speak their name at the appropriate time.

The Forty Holy Martyrs of Sebaste from the Prologue- March 9th

These were all soldiers in the Roman army, but believed firmly in the Lord Jesus. When a persecution arose in the time of Licinius, they were all taken for trial before the commander, who threatened to strip them of their military status. To this one of them, St. Candidus, replied: "Do not take only our military status, but also our bodies; nothing is dearer or greater honor to us than Christ our God." Then the commander ordered his servants threw the stones at the Christians, the stones turned back and fell on themselves, causing them grievous injuries. One stone fell on the commander's face and smashed his teeth.

The torturers, in bestial fury, bound the holy martyrs and threw them into a lake, setting a watch all round it to prevent any of them escaping. There was a terrible frost, and the lake froze around the bodies of the martyrs. To make the torture worse, the torturers built and lit baths by the lake, in the sight of the freezing sufferers, with the idea that one of them might deny Christ and acknowledge the idols of Rome. In fact, one of them did abjure, came out of the water and went into the baths. But lo, during the night a strange light appeared from heaven, which heated the water in the lake and the bodies of the martyrs, and with that light there descended from heaven thirty-nine wreaths for their heads. One of the sentries on the shore saw this, confessed the name of Christ and went into the lake to be worthy of the fortieth wreath in place of the traitor. And the fortieth wreath was seen to descend upon him.

The next day, the whole town was amazed to see the martyrs still alive. Then the wicked judges commanded that their legs be broken and their bodies thrown into the water, so that the Christians should not be able to find them. On the third day, the martyrs appeared to the local bishop, Peter, and told him to search beneath the water and bring out their relics.

The bishop went out on a dark night with his clergy, and saw where the martyrs' relics were glowing in the water. Every bone which had been broken off from their bodies rose to the surface and burned there like a candle. They gathered them, and gave them burial, and the souls of these martyrs went to him who was martyred for us all and rose with glory, the Lord Jesus. They suffered with honor and were crowned with unfading glory in 320.

Tropar to the Forty Holy Martyrs (Tone 1)

We beseech Thee, O Lord of mankind
To accept in supplication
The suffering which the Saints endured for Thy Sake, O Lord,
And Heal all our infirmities