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Answer
The advancement of medical technology has saved lives and improved the quality of life for many individuals. However, it has also raised new questions that previous generations did not encounter. A century ago, there were limited end-of-life options, and death occurred more swiftly without machines to sustain organ function when the brain ceased activity. With modern medicine capable of prolonging vital signs, the mere existence of life is no longer the sole consideration. The focus shifts to the quality of life when we witness loved ones enduring suffering or lingering longer than desired. This situation gives rise to an ethical dilemma: from a biblical perspective, should quality of life factor into end-of-life decisions?
Determining quality of life is a personal choice. Each person should have the autonomy to define what constitutes “quality” for themselves. Some individuals tenaciously hold onto every moment of life, seeking all available medical interventions to extend their earthly existence as much as possible. Conversely, some, particularly Christians, may approach their impending death with acceptance and even express readiness to transition to eternity when called by God. The right to refuse medical intervention should be accessible to every mentally sound adult and can often be formalized through living wills or other written directives. Nevertheless, ethical boundaries may be crossed when end-of-life decisions involve hastening death or assisted suicide. Just as suicide is not deemed a human right, assisted suicide based on a medical prognosis is also not justified.
While each person should have a say in defining their own “quality of life,” humans are not the ultimate arbiters. Life comprises a mix of positive and negative experiences, and there are periods in everyone’s life when the perceived quality is diminished. Instances such as depression, anxiety, heartache, or financial hardship can appear to diminish life quality temporarily. Additionally, injury, illness, or disability can significantly impact the quality of life for an individual.Pain can degrade a person’s quality of life, but that does not imply the right to end that life. God is the determiner of life and death, not our opinion of its quality (Deuteronomy 32:9;Psalm 139:16).
Completing a living will or assigning durable power of attorney to a trusted family member is a great alternative to last-minute decision-making by families trying to determine a patient’s wishes. Withholding certain medications, treatments, or life-saving measures may be in the patient’s best interest, and, if that has been previously discussed, the family is relieved of that moral responsibility. Establishing a trusting relationship with the doctor in charge of a dying patient can also eliminate miscommunication and later regrets. Fortunately, it is still illegal in most countries for physicians to prescribe medications that will actively end a life. The potential for abuse of that option makes it a dangerous one to leave to human discretion. However, palliative care can be increased to the point of allowing the body to die without causing the patient undue pain. When all possibility of cure is gone, increasing palliative medications allows the body to shut down naturally, and death can occur without unnecessarily prolonging the dying process.
Quality of life cannot be defined by external factors. The quality of one’s life is deeply personal and often linked to that person’s relationship with God. Healthy, successful Americans may have a low quality of life due to emotional unrest and poor moral decisions, while a handicapped person in a developing country may live a joy-filled life. Physical sickness also does not determine a person’s quality of life, so trying to evaluate it is not within our power. Our responsibility before God is to provide the best loving care we can for those who are suffering and trust that their Creator will decide when life ends.
