“Making Physician-Assisted Suicide Unthinkable”

“Christ came that we might have ‘life (zōē) and have it abundantly.’” 

John 10:10 

by Benjamin Parviz, PhD (candidate),

excerpted from    

"Making Physician-Assisted Suicide Unthinkable," Intersections, May 12, 2026, www.cbhd.org/intersections

Physician-assisted suicide (PAS) is now legally available in 13 U.S. states and Washington, DC, and to the more than 100 million residents of those jurisdictions. Following the removal of residency requirements from eligibility criteria in Oregon and Vermont in 2023, anyone who has the means to travel to those states can potentially receive PAS. More pointedly, all of your parishioners or fellow congregation members who could qualify can now receive PAS, regardless of which state your church is in. Till now, Christians have resisted PAS by working to keep it illegal or to slow its political and legal advance. Christians must reconsider what continued Christian resistance to PAS looks like.

One of the problems presented by the legalization of PAS is that it makes PAS thinkable. [1] When PAS is a legally available option, it forces us to justify the continuation of our existence. This observation has been made by J. David Velleman [2] and Martha Minow, [3] and it is a common argument against PAS from those within the disability community. [4] When PAS is not an option, then no one ever has to explain or justify their desire to continue to live. The desire to live is simply taken for granted. When PAS is an option, however, then every day anyone who can qualify must consider whether or not her continued living merits the medical, economic, physical, and emotional burden that her continued living carries or that it imposes on others. ...

The burden of having to justify one’s desire to continue to live is unequally borne by those who are sick, disabled, or dying. Someday I may bear this burden, as many already do. The story of a human life is one that is always proceeding towards illness and disability. Unless I die suddenly in some tragic accident, it is inevitable that both my body and my mind will decline and cease to function as they once did, that doctor appointments will more frequently fill my schedule, and that the medical costs of my life will increase. This is called aging, and I will be blessed if I get to enjoy it. Whether by aging, disease, or accident, we are all likely to find ourselves in a condition of life where our continued living carries and imposes burdens that will make PAS thinkable. To continue to resist PAS, we have to make it unthinkable again.

I. Why People Choose PAS

Pain and other difficult physical symptoms are not really the reasons that push people to choose PAS. [5] Oregon collects data on the reasons for which patients choose “Death with Dignity,” as it is called in Oregon state law. [6] Since it was first practiced in Oregon in 1998, a minority of patients who have chosen PAS have done so out of concerns about pain and symptom management. Only about 30 percent of all patients who have died by PAS in Oregon chose to do so out of a concern about “inadequate pain control at the end of life.” Forty-five percent cited a concern about “the loss of control of bodily functions, such as incontinence or vomiting.” Palliative care and hospice are very good at responding appropriately to pain and other symptoms in order to manage them well, and these reports reflect that a majority of people trust that medicine has the means and ability to keep them comfortable as they die.

There is another reason why we can conclude that pain and other symptoms are not really the reason why people choose PAS. People have great ability to endure pain and physical suffering when they have a clear purpose for doing so. Viktor Frankl makes this point in his book Man’s Search for Meaning, which is in part a memoir of his time as a Jewish prisoner of the Nazis during W.W. II. ... [7]. The concerns that make PAS thinkable are spiritual and existential: The patient has lost grasp of the why for his continued existence. PAS is made thinkable by a loss of meaning, purpose, and hope. In order to make PAS unthinkable again, we need to take a page from Viktor Frankl and help one another to have a firm grasp of the why.

II. Receiving Love Is Giving Love

Participation in relationships of love in which one still has something to offer can be one source of the kind of meaning, purpose, and hope that make PAS unthinkable. Receiving love and care from others provides an important sense of why one’s life is worth living. However, a sense of an imbalanced relationship in which one is always receiving and never giving can create an uncomfortable sense of unfairness or injustice. This presents an expecially difficult challenge to people who experience significant changes in their bodies and modes of living, such that they cannot give love in the ways to which they have normally been accustomed throughout their lives. There is one very important sense in which ill, disabled, and dying people are able to give love. ... being completely vulnerable to others in order to receive their love and care is a form of giving love. [8] ...

III. A Congregational Culture and Life That Makes PAS Unthinkable

The idea that receiving love is giving love seems paradoxical and unfamiliar because it is so contrary to the dominant culture of our contemporary American society, which values and emphasizes autonomy, individuality, self-sufficiency, strength, youth, and vitality. In order to make sense of the idea that receiving love is giving love, we have to pursue and elevate other values: interdependency, communality, fidelity, fragility, weakness. To resist PAS and to make it unthinkable, Christian congregations need to pursue and establish a culture in which those who are weak, sick, disabled, dependent, and dying are valued, welcomed, and loved as important members of the community. ...

Christian churches cannot allow illness, disability, and aging to isolate a church member from the congregation. The church is a gathering. To be part of the church is to be one with the assembly of the people of God. Illness, disability, and aging present real obstacles to an individual's ability to physically gather with the assembly. Of special concern are shut-ins, for whom isolation from the church appears permanent. Isolation breeds loneliness, which can be a great motivator to PAS. ... Congregation members should visit those who cannot join the assembly due to sickness or disability. Visitors should pray and worship with them. They should enjoy the opportunity to participate with them in a relationship of love. ... However the time together is spent, what matters most is presence and togetherness nourished by mutual Christian love. Such visits should not merely be a responsibility of the pastor or of some particular members of the congregation. Ideally, all members of the congregation would develop and delight in this habit. ...

Developing this habit will help [young, able-bodied] to understand sickness, disability, and dying as normal parts of human life that they will be ready to accept when their own lives enter these stages. ... A congregation can love its dying member by being with them through these final hours at the bedside or in the hospital room. As the person dies, the congregation ought to keep vigil by praying, singing, and worshipping Jesus for the gift of resurrection and eternal victory over death. ... it recognizes the dying person’s inherent dignity and responds to it with honor, gratitude, and love.

IV. Conclusion

Visiting the sick and shut-ins, ensuring the accessibility of church buildings, and being with dying members ... demonstrate that the community values the contributions of these members, ... of presence and of giving love by receiving love. If, by the grace of God, congregations succeed in establishing a culture and a congregational life that values and incorporates the participation of those who are sick, disabled, aging, and dying, then such people will be given a why by which they will know how to endure the very real challenges that they experience on a daily basis. They will be freed from having to think about the option of PAS; they will be free to continue to desire to live and enjoy their relationships of love.

References

1] There are many more problems with PAS than this. Because I do not have the space to engage them in this essay, I must presume that the reader knows both the secular and Christian arguments against PAS, which I take for granted. Christians have no choice but to be opposed to PAS. It is intrinsically contrary to Biblical morality and it is irreconcilable with Christian faith. This is among the most important ethical issues facing Christians today, and churches and pastors have a responsibility to be discussing PAS with their congregation members. Two books that present valuable arguments against PAS and that can helpfully inspire faithful discussion and reflection on the topic are Ewan Goligher’s How Should We Then Die? A Christian Response to Physician-Assisted Death (Lexham Press, 2024) and Charles Camosy’s Living and Dying Well: A Catholic Plan for Resisting Physician-Assisted Killing (Our Sunday Visitor, 2025). Goligher presented his arguments against PAS during a plenary address given at the 2025 conference of The Center for Bioethics and Human Dignity, which can be viewed on YouTube: Ewan Goligher, “How Should We Then Die? A Christian Response to Physician-Assisted Death” (plenary address, The Center for Bioethics & Human Dignity’s 32^nd Annual Conference, Living in the Biotech Century: The First 25 Years, Deerfield, IL, June 28, 2025), https://www.youtube.com/live/XdJa0L5VWjA.

[2] J. David Velleman, “Against the Right to Die,” The Journal of Medicine and Philosophy 17, no. 6 (1992): 665–81, https://doi.org/10.1093/jmp/17.6.665.

[3] Martha Minow, “Which Question? Which Lie? Reflections on the Physician-Assisted Suicide Cases,” The Supreme Court Review 1997 (1997): 1–30, https://www.jstor.org/stable/3109738.

[4] For example, Paul K. Longmore, “Policy, Prejudice, and Reality: Two Case Studies of Physician-Assisted Suicide,” Journal of Disability Policy Studies 16, no. 1 (2005): 38–45, https://doi.org/10.1177/10442073050160010601.

[5] Goligher and Camosy both make this same point.

[6] The reasons here reported are the prescribing physician’s beliefs about the reasons that motivated the patient’s choice to die by “death with dignity.” Oregon Health Authority, Public Health Division, Center for Health Statistics, “2024 Oregon Death with Dignity Act Data Summary,” Oregon Health Authority, March 27, 2025, https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year27.pdf.

[7] Viktor Frankl, Man’s Search for Meaning (Washington Square Press, 1984), 97 (emphases original).

[8] Annette Geoffrion Brownlee, “The Dark Night of Hope,” Journal of Religion & Aging 1, no. 2 (1985): 9–25, https://doi.org/10.1300/J491v01n02_02.

*More references are listed with the original essay on the website of Center for Bioethics and Human Dignity, www.cbhd.org/intersections/making-physician-assisted-suicide-unthinkable.

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