I'm going to venture some comments on the Brittany Maynard case–and related issues. I'd draw a couple of distinctions:
i) You can find fault with someone, but still make allowance for extenuating circumstances.
ii) You can find fault with someone's behavior without necessarily faulting them.
If somebody spikes the punch, resulting in guests losing their inhibitions and indulging in risky behavior, like balancing on the ledge of a fourth-story window, you can fault their actions without faulting them personally. It's precisely because they're in a state of diminished responsibility–through no fault of their own–that they are engaging in risky behavior.
Of course, there's a wonderful opportunity for the church to minister to the desperately ill.
Likewise, you have edifying stories of Christian hospice nurses to care for the dying.
Losing your mind is a paradox. People naturally few losing control. It's frightening to feel your mind slipping away.
But if you truly lose your mind, then by definition it doesn't bother you. Once it's gone, you're in no position to be cognizant of what you lost. And so long as the prospect bothers you, you haven't lost it. If it's absent, you lack the presence of mind to know it.
Another problem is that we really don't know what people who die from brain cancer or dementia experience. Since they don't come back to tell us, we don't know how much they were still aware of at the end.
There are, of course, reported cases of comatose patient's diagnosed in a PVS who wake up and say they heard everything doctors, nurses, and visitors said in their hospital room.
There are certain dilemmas. For instance, the elderly may take drugs which both prolong life and preserve or enhance the quality of life. For instance, a patient may take a blood-thinner to reduce the risk of stroke. The point is not necessarily to extend life, but to reduce the chance of a debilitating stroke. But the effect is to extend life, and extending life often exposes an elderly patient to other debilitating illnesses to which the elderly are prone (like Alzheimer's or Parkinson's).
In the past, many people dodged those bullets by simply dying before the age they become susceptible to these ravaging diseases.
If she was, say, a childless widow with no close relatives, or estranged from her brothers or sisters, then that might be a mitigating factor.
LIkewise, before the age of sedation, where they spend their final days or weeks screaming in pain, that might be an extenuating circumstance.
But when people have loved ones, it's important for their loved ones to follow through to the bitter end. Their loved ones need to have that level of commitment. They need to face death and dying. They need to face the "indignities" of terminal illness or degenerative conditions.
There's some merit to soul-making theodicies. They aren't the whole solution to the problem of evil, but they're an important component.
We're creating a eugenic culture, like those utopian/dystopian SF movies where everyone is terminated at the age of 30 (or whatever) so that no one must face the indignity of physical and mental decline. Everyone is healthy and youthful.
There are several complex issues. Do we have a standing duty to let nature take its course?
To a great extent, medical intervention is about not letting nature take its course. Impeding nature, reversing nature, redirecting nature.
Of course, "nature" is ambiguous in this context. There's "nature" in the sense of letting things happen all by themselves.
Then there's a normative conception of nature. What nature is supposed to be like. Proper function. Restoring nature.
Medical intervention frequently interferes with the letting nature take its course to restore proper function.
So, there's a sense in which medical science does and doesn't let nature take its course.
Is there a duty to die of brain cancer? Is there a duty to go through the whole process? Is there a duty to die of starvation–in the absence of food?
Do we have a duty to hang on? Or is it sometimes okay to let go?
I don't think there's a uniform answer to that question.
For instance, a husband and/father might starve himself to feed his wife and kids.
I'm not sure there's an intrinsic or even general duty to become mentally or physically incapacitated, if that puts you at the mercy of uncaring strangers.
Take elderly Europeans who are being exported to E. Europe and Asia:
You can imagine the abuse many of them will suffer.
Of course, that can be a false dilemma. Choosing between elder abuse and suicide shouldn't be the only two alternatives.
One objection to suicide is that we should just trust God. There is, of course, a sense in which that's always true. However, that can be taken fatalistically. Do nothing. Leave it in God's hands.
Yet medical intervention isn't just a case of trusting God, but doing something about one's condition. Like the famous quip: Trust in God and keep your powder dry.
There's the question of what we can trust God for. We should trust his promises, but what has he promised? What can we expect from him?
Both in Scripture and experience, not every pious life has a happy ending–this side of the grave. Many of the faithful suffer calamity. It's not as though, if you just trust God, things will work out for the best in this life.
Euthanasia raises additional issues that suicide does not.
i) If suicide is wrong, then euthanasia compounds the wrong by implicating a second-party.
ii) Asking a second-party to euthanize you may put unfair pressure on them. It shifts the onus from you onto them.
iii) Once it becomes a patient's "right," then doctors will be required to euthanize patients upon request. Liberals are intolerant of conscience-clauses.
iv) It also changes the doctor/patient dynamic. Instead of trusting your doctor, you may fear telling him your symptoms in case that will be used against you.
I'm not saying suicide or euthanasia is wrong in all cases. Just sketching the ethical complications of euthanasia, above and beyond suicide.
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