Orthodox America

  Matters of Life and Death

by Father Alexey Young


    Carl and Gerda Lerner were opinion makers in our society. Gerda, a professor at Sarah Lawrence, had written novels, books of history, and film scripts. Carl, a noted Hollywood film-editor, was a political activist. Together they moved in a well-traveled circle of media people.

    In 1972 Carl was diagnosed as terminally ill with cancer of the brain, Her book, A Death of One’s Own, is Gerda's memoir of her husband's illness and death (Simon and Schuster, 1978). Carl's illness lasted 18 months. Seizures, impaired hearing and vision, spreading paralysis, and loss of memory and the ability to speak clearly--all of these symptoms came and went in a relentlessly random way. Neither drugs nor surgery could help.

    The doctors advised against telling Carl the truth about his disease, In fact,it seemed to Gerda that Carl himself didn't want to know. But she had reasons of her own for keeping silent. Since neither of them believed in life after death, she was afraid that "once he knew the full truth, he might decide to end his life.'

    But finally the day came when Carl "knew," without having been told. He now wanted to die quickly and avoid further suffering for himself and his family. Gerda refused to help him commit suicide. She explained that the only way was for him to refuse the massive doses of life-sustaining medication he had been receiving.

    Carl was admitted to a hospital for withdrawal from his drugs. The doctors and staff quietly agreed not to interfere. His final hours were agonizing. They had expected he would just slip into a coma; instead, there was "no loss of consciousness, no coma." Gerda says that her husband's death was a nightmare"—and it was. She had supposed his death would be a dignified and peaceful passing because "he had made up his mind to die and he had made his decision rationally, freely." Why then was his death so terrible? Because, she writes, "nature is cruel and indifferent. Death is a random, inevitable disaster...untidy, mixed up, tormented."

    Devoid of all religious beliefs and all hope, Gerda wrote her book in order to deliver what she calls her "optimistic testimonial" to the American people. What is this testimonial"? Only this: we must accept that "death is not heroic, it is not kind." At best death is a meaningless tragedy and we must fight it off, fearlessly, "while we can."

    There is no need to say how profoundly depressing such a book is. But this book and its basically non-Christian ideas does not exist in isolation. Of course a great deal of the unhappiness experienced by the Lerners is because they are not believers. But Carl and Gerda Lerner did not think up these ideas about suffering and dying by themselves. These ideas are "in the air," and more and more people who are cut off from some kind of Christian concept of life and death are embracing these same attitudes.

    There is a growing awareness that there are ultimate questions in need of answers , questions about illness and suffering, about dying, about infanticide for those with birth defects, about abortion, and about suicide. Is death just a meaningless accident, as Gerda Lerner believes? Is euthanasia ever permissible? Is there any justification for suicide?

     A controversial booklet will be published in London this fall titled A Guide to Self Deliverence. it has been described as the "world's first do-it-yourself handbook on suicide." Many fear that it will help to make suicide a "casual matter" and that 'by helping to sanction suicide, [it] will intensify pressure on the old and infirm to do away with themselves so as not to be a burden to family or society" ("Time," July 7, '80).

    We must remember that these debates for the most part are not taking place in a religious atmosphere or in a vacuum; they are taking place in a society which has already sanctioned abortion (an average of one million, two hundred thousand every year), and where more and more pediatricians are finding themselves at an infant's bedside saying: "His life isn't worth living. Put a sign on the bed saying that he's to be given 'nothing by mouth.'" [According to the New England Journal of Medicine, 14% of deaths in neonatal intensive care units are intentional]. Can there be any doubt what the outcome of these discussions about euthanasia will be?

    All of this would have been shocking and unthinkable less than a generation ago. But now Orthodox Christians, together with other Christians, are compelled to say a word about these urgent questions.

    A recent interview with Dr. C. Everett Koop, Surgeon in Chief of the Children's Hospital of Philadelphia ("The Domino Effect,'' in New Wine, July-August, 1960) is worthy of special note. Dr. Koop says that it used to be that one profession above all-the medical profession--was dedicated completely to life, regardless of the circumstances. (And, indeed, there are still many, many physicians that fall into this category.) But now something different is happening. Is the physician that aborts a baby a healer or a killer? Is the physician that allows a defective baby to starve to death a healer or a killer? Even "the old person in the nursing home today can't be certain whether the approaching physician is coming in the form of a healer or in the form of a killer."

    Dr. Koop says that our society has become very sick. We have a spiritual disease whose symptoms are many, but whose cause is single: "The illness in our society is that we have tossed overboard the consensus that was our heritage from our Judeo-Christian background .... The basic issue was that people viewed human life as unique--something to be protected and loved because each individual was made in the image of God."

    What a long way we have come, from the loving and cherishing outlook Dr. Koop describes, to this statement made by Nobel prize-winner Francis Crick in 1978; "No new-born should be declared human until it has passed certain tests regarding its genetic endowment, and if it fails these tests, it forfeits the right to live."

    Dr. Koop says that doctors are now being asked to solve the social problems of our times. Anyone identified as a "nuisance" (whether unwanted children, babies with defects, or criminals on death-row)is being handed over to the medical profession to be dealt with. And now this also includes the aged, and those suffering from terminal illnesses. Dr. Koop explains:

    "The elderly become a cramping nuisance in today's hedonistic society which looks upon any life but their own as expendable. Physicians are asked to hasten these old folks out of life since they no longer have any 'meaningful' existence .... What we are asked to do with folks who are aged, infirm, senile or retarded is to decide that they have lives not worth living and to at least withhold from them what the euthanasia proponents like to call 'heroic measures.' If we cannot at this moment bring ourselves to practice active euthanasia, at least practice 'passive' euthanasia, they say."

    However, Dr. Koop explains that there is an important difference between prolonging the life of a patient, and prolonging his act of dying. "I would give one word of caution," he continues: "when a physician practices medicine in the realm of trust with his patient, and helps that patient die when he is dying, don't confuse that in any way with what the proponents of euthanasia would like you to believe; 'he is practicing passive euthanasia'.'' It is not the same thing. To allow a patient to die when he is dying, to refuse to increase his pain or prolong his suffering-this is not euthanasia of any kind. Euthanasia (whether "passive" or "active") has to do with ending a life that might otherwise go on for an indefinite period. This is a very important distinction.

     Another area that alarms Dr. Koopis that of the "test-tube baby," which he considers an extraordinarily important matter because it means that "the basic thing that holds the family together, which is the procreation of children in monogamous marriage, will be gone from our society."

     Dr. Koopis afraid of what our society is becoming. He is concerned that there is no outcry, that few people see this as "a repetition, in our culture, of what we saw happening in Germany before the Second World War .... When the corruption of medicine met the corruption of law in the 1930s in Germany and the prelude to the Holocaust was begun, there was no outcry from the rest of the medical and legal professions; there was no outcry from the churches; there was no outcry from the public. Don't let that happen


    We should be grateful that such courageous Christian physicians as Dr. Koop are beginning to make their voices heard; we must pray that God will inspire many more to follow his example. Even more, we should be asking ourselves: where are our voices? What is our response as Orthodox Christians?

    First, our voices are necessarily silent so long as we do not realize that the unique treasure of Orthodox spirituality, which is its otherworldly orientation, must be lived and applied in every aspect of our lives . This means that we must see each day of our life in relation to the life after death; we must strive to view this world and its problems in the light of the world which is to come. If we begin to do this, we will immediately see that each human life--whether that of a defective baby, a terminally ill person, or an elderly and infirm man or woman--has a special purpose, precious in the sight of God. The fact that we do not often understand that special purpose is our lack, not the fault of God or a "trick" of nature.

    St. Basil the Great writes: "We place our hopes upon the things which are beyond, and in preparation for life eternal we do all the things that we do." Accordingly, the closer we draw to the Kingdom of God, the more obvious it will be that not only does every life have a unique meaning, but also every single death, and every moment of suffering and infirmity--for we follow a God Who has won our salvation precisely by means of suffering and death, a Saviour Who has commanded us to pick up our cross of suffering and difficulty and follow Him into the glory of His Resurrection. 

    We welcome further comment and information from our readers concerning these "Matters of Life and Death," and hope that the pages of "Orthodox America" can be a sounding-board for a sound Orthodox discussion. 

“Brethren: I would not have you to be ignorant concerning them which are asleep, that ye sorrow not, even as others which have no hope. (1 Thess. 4:13)