|A Statement of Consensus on Care for the Dying
For people whose lives are guided
by the Bible, the reality of death is acknowledged as part of the current
human condition, affected by sin (Genesis 2:17; Romans 5; Hebrews 9:27).
There is "a time to be born, and a time to die" (Ecclesiastes 3:2).
Although eternal life is a gift that is granted to all who accept salvation
through Jesus Christ, faithful Christians await the second coming of Jesus
for complete realization of their immortality (John 3:36; Romans 6:23; 1
Corinthians 15:51-54). While waiting for Jesus to come again, Christians
may be called upon to care for the dying and to face personally their own
Pain and suffering afflict every
human life. Physical, mental, and emotional traumas are universal. However,
human suffering has no expiatory or meritorious value. The Bible teaches
that no amount or intensity of human suffering can atone for sin. The suffering
of Jesus Christ alone is sufficient. Scripture calls Christians not to despair
in afflictions, urging them to learn obedience (Hebrews 5:7-8), patience
(James 1:2-4), and endurance in tribulations (Romans 5:3). The Bible also
testifies to the overcoming power of Jesus Christ (John 16:33) and teaches
that ministry to human suffering is an important Christian duty (Matthew
25:34-40). This was the example and teaching of Jesus (Matthew 9:35; Luke
10:34-36), and this is His will for us (Luke 10:37). Christians look in anticipation
to a new day when God will end suffering forever (Revelation 21:4).
Developments in modern medicine
have added to the complexity of decisions about care for the dying. In times
past, little could be done to extend human life. But the power of today's
medicine to forestall death has generated difficult moral and ethical questions.
What constraints does Christian faith place upon the use of such power? When
should the goal of postponing the moment of death give way to the goal of
alleviating pain at the end of life? Who may appropriately make these decisions?
What limits, if any, should Christian love place on actions designed to end
It has become common to discuss
such questions under the heading of euthanasia. Much confusion exists with
regard to this expression. The original and literal meaning of this term
was "good death." Now the term is used in two significantly different
ways. Often euthanasia refers to "mercy killing," or intentionally
taking the life of a patient in order to avoid painful dying or in order
to alleviate burdens for a patient's family or society. (This is so called
active euthanasia.) However, euthanasia is also used, inappropriately in
the Seventh-day Adventist view, to refer to the withholding or withdrawal
of medical interventions that artificially extend human life, thus allowing
a person to die naturally. (This is so called passive euthanasia.) Seventh-day
Adventists believe that allowing a patient to die by foregoing medical interventions
that only prolong suffering and postpone the moment of death is morally different
from actions that have as their primary intention the direct taking of a
Seventh-day Adventists seek to address
the ethical issues at the end of life in ways that demonstrate their faith
in God as the Creator and Redeemer of life and that reveal how God's grace
has empowered them for acts of neighbor love. Seventh-day Adventists affirm
God's creation of human life, a wonderful gift worthy of being protected
and sustained (Genesis 1-2). They also affirm God's wonderful gift of redemption
that provides eternal life for those who believe (John 3:15; 17:3). Thus
they support the use of modern medicine to extend human life in this world.
However, this power should be used in compassionate ways that reveal God's
grace by minimizing suffering. Since we have God's promise of eternal life
in the earth made new, Christians need not cling anxiously to the last vestiges
of life on this earth. Nor is it necessary to accept or offer all possible
medical treatments that merely prolong the process of dying.
Because of their commitment to care
for the whole person, Seventh-day Adventists are concerned about the physical,
emotional, and spiritual care of the dying. To this end, they offer the following
biblically based principles:
1) A person who is approaching the
end of life, and is capable of understanding, deserves to know the truth
about his or her condition, the treatment choices and the possible outcomes.
The truth should not be withheld but shared with Christian love and with
sensitivity to the patient's personal and cultural circumstances (Ephesians
2) God has given human beings freedom
of choice and asks them to use their freedom responsibly. Seventh-day Adventists
believe that this freedom extends to decisions about medical care. After
seeking divine guidance and considering the interests of those affected by
the decision (Romans 14:7) as well as medical advice, a person who is capable
of deciding should determine whether to accept or reject life-extending medical
interventions. Such persons should not be forced to submit to medical treatment
that they find unacceptable.
3) God's plan is for people to be
nourished within a family and a faith community. Decisions about human life
are best made within the context of healthy family relationships after considering
medical advice (Genesis 2:18; Mark 10:6-9; Exodus 20:12; Ephesians 5-6).
When a dying person is unable to give consent or express preferences regarding
medical intervention, such decisions should be made by someone chosen by
the dying person. If no one has been chosen, someone close to the dying person
should make the determination. Except in extraordinary circumstances, medical
or legal professionals should defer decisions about medical interventions
for a dying person to those closest to that individual. Wishes or decisions
of the individual are best made in writing and should be in agreement with
existing legal requirements.
4) Christian love is practical and
responsible (Romans 13:8-10; 1 Corinthians 13; James 1:27; 2:14-17). Such
love does not deny faith nor obligate us to offer or to accept medical interventions
whose burdens outweigh the probable benefits. For example, when medical care
merely preserves bodily functions, without hope of returning a patient to
mental awareness, it is futile and may, in good conscience, be withheld or
withdrawn. Similarly, life-extending medical treatments may be omitted or
stopped if they only add to the patient's suffering or needlessly prolong
the process of dying. Any action taken should be in harmony with legal mandates.
5) While Christian love may lead
to the withholding or withdrawing of medical interventions that only increase
suffering or prolong dying, Seventh-day Adventists do not practice "mercy
killing" or assist in suicide (Genesis 9:5- 6; Exodus 20:13; 23:7).
They are opposed to active euthanasia, the intentional taking of the life
of a suffering or dying person.
6) Christian compassion calls for
the alleviation of suffering (Matthew 25:34-40; Luke 10:29-37). In caring
for the dying, it is a Christian responsibility to relieve pain and suffering,
to the fullest extent possible, not to include active euthanasia. When it
is clear that medical intervention will not cure a patient, the primary goal
of care should shift to relief from suffering.
7) The biblical principle of justice
prescribes that added care be given the needs of those who are defenseless
and dependent (Psalm 82:3- 4; Proverbs 24:11-12; Isaiah 1:1-18; Micah 6:8;
Luke 1:52-54). Because of their vulnerable condition, special care should
be taken to ensure that dying persons are treated with respect for their
dignity and without unfair discrimination. Care for the dying should be based
on their spiritual and medical needs and their expressed choices rather than
on perceptions of their social worthiness (James 2:1-9).
As Seventh-day Adventists seek to
apply these principles, they take hope and courage from the fact that God
answers the prayers of His children and is able to work miraculously for
their well-being (Psalm 103:1-5; James 5:13-16). Following Jesus' example,
they also pray to accept the will of God in all things (Matthew 26:39). They
are confident that they can call on God's power to aid them in caring for
the physical and spiritual needs of suffering and dying individuals. They
know that the grace of God is sufficient to enable them to endure adversity
(Psalm 50:14-15). They believe that eternal life for all who have faith in
Jesus is secure in the triumph of God's love.
This consensus statement was
approved and voted by the General Conference of Seventh-day Adventists
Executive Committee at the Annual Council session in Silver Spring, Maryland,
October 9, 1992.