True Christian Morality on End-of-Life Issues

I. Was Terri Schiavo Murdered?

The first question that needs to be answered is whether it is accurate to say that Terri Schiavo was “murdered,” “killed,” or “starved and dehydrated to death” as some conservative Christians have claimed. Was Mrs. Schiavo’s life actively ended by human intervention, or was it simply allowed to end by natural causes?

A Feeding Tube Is Life Support

To answer this question, we must define artificial life support. Does a feeding tube qualify as medical treatment that keeps a person alive when they would otherwise die a natural death? A common refrain heard from conservatives in the Schiavo case was that only respirators and other types of equipment - not feeding tubes - qualify as “life support” technology. If Mrs. Schiavo had required help with her breathing by means of some kind of respirator or ventilator, they argued, then perhaps it would have been morally acceptable to remove this medical technology and allow her to die. But a feeding tube, in their view, is nothing more than food and water delivered to a person in an unusual way, which they did not see as life support. Because nutrition and hydration were withdrawn when the feeding tube was removed, therefore Mrs. Schiavo was killed according to this line of reasoning, because anyone would die if denied these basic forms of sustenance.

It is surprising that such an argument was made so frequently and often went unchallenged, because it makes no sense. It is based not on logic, but on arbitrary distinctions between different forms of medical technology used to support different systems of the body which are all vital to life. Human beings not only require food and water, but also air, in order to continue living. If Terri Schiavo was “starved to death” when her feeding tube was removed, then a person would be “suffocated to death” when a respirator is removed. So why don’t conservatives argue that respirators are also morally obligatory? That would be logically consistent. A person is put on a respirator when they cannot take air into their lungs on their own - even though if air is delivered into the lungs, their body can still process it and metabolize the oxygen. Similarly, a person is put on a feeding tube when they cannot take food and water into their stomach on their own - even though once in the stomach, the nutrients can be processed and utilized by the body. There is no difference whatsoever. In the case of a respirator, artificial assistance is required for the delivery of air into the lungs because the natural way of breathing (by means of the windpipe, diaphragm, etc.) is not functioning properly, or signals from the brain are absent which would allow a person to inhale and exhale. In the case of a feeding tube, artificial assistance is required for the delivery of food and water into the stomach because the natural way of eating and drinking (by means of the mouth, esophagus, etc.) is not functioning properly, or signals from the brain are absent which would allow a person to chew and swallow.

Until recently, people who lost the ability to eat simply died. This was regarded as a natural death. The bodily function of eating had shut down. Perhaps the stomach and intestines were still working, but the part of the digestive system that transports the food into the stomach was non-functional. Similarly, people who lost the ability to breathe also died. Perhaps the lungs were capable of using oxygen, but the person was not able to take air into the lungs, so the person would die and this was understood to be a natural death. It was only when methods of artificial feeding and ventilation were developed through advancements in medical science, that it became possible to artificially prolong the lives of such people. In the case of the surgically implanted feeding tube used to sustain Terri Schiavo for 15 years after she would have naturally expired, this life-support technique was first developed by Dr. Jeffrey Ponsky at a children’s hospital in Cleveland in 1979. Before then, it simply was impossible to keep people alive in a vegetative state indefinitely, as was done to Mrs. Schiavo.

The Appropriate Use of Life-Supporting Treatments

Once we realize that there is no arbitrary line that can be drawn between different forms of life-support technology, we realize that in all cases, the use or non-use of such medical treatments is an individual judgment call depending on how it benefits the patient. There are a wide variety of types of life support available that allow people to defy natural death and continue living despite problems with organs that would normally be fatal. And this is a good thing. Pacemakers can be implanted to keep the heart beating regularly and prevent fatal arrhythmias. Kidney dialysis machines can filter the blood of people whose kidneys have been damaged or removed. Today there are even electrodes that can be implanted into a person’s brain to prevent severe, uncontrollable epileptic seizures, which would cause death. Some drugs could be considered life-supporting measures, because they extend the life of a person who would otherwise die. The question is not which forms of medical intervention are “life support” and which are not; the real question is when, in what cases, is it morally necessary, optional, or perhaps even morally wrong to make use of the inventions of modern science.

Consider the case of the late actor Christopher Reeve. Mr. Reeve lived for almost ten years as a quadriplegic, totally paralyzed from the neck down and unable to breathe without the assistance of a ventilator. Without this technology, he would have died. Would conservatives argue that it would have been ethical to remove Mr. Reeve from his ventilator, simply because it is a means of artificial respiration, not artificial eating? Certainly not! Christopher Reeve used his ventilator not just to breathe, but to continue living a productive, meaningful life after the horseback riding accident that left him paralyzed. It is because the medical technology was a truly valuable treatment in his case that it was morally right to use it. If Mr. Reeve had been severely brain damaged, the moral picture would have been changed considerably. In that case, perhaps removal of the artificial respirator would have been called for.

Pope John Paul II used a feeding tube during the last weeks of his life, apparently because his long-standing Parkinson’s disease had become so severe that muscle rigidity prevented him from taking food through the esophagus. He chose to do so because he believed he could still be productive, fulfilling his papal duties, if he had the benefit of the feeding tube. When it became clear shortly thereafter that he was in fact dying, he decided to remove his feeding tube and did not even go to the hospital to attempt to be kept alive longer. In other words, the Pope decided it was his time to die, and refused heroic measures of artificial life support when he could no longer continue to live rather than merely exist.

This is somewhat ironic because it was Pope John Paul II himself who proclaimed the doctrine that a feeding tube is not a form of life support that can be legitimately removed, drawing a distinction between a feeding tube and a respirator. In his 1995 encyclical, Evangelium Vitae (“Gospel of Life”), the Pope took a strong stance on end-of-life issues, condemning all forms of assisted suicide and euthanasia, including the removal of life support in many cases. His position was further developed in speeches and Vatican statements in following years, becoming a new philosophy of bioethics that has been criticized by some Catholic scholars and theologians as a departure from long-standing church interpretation of Christian morality. For example, Rev. John Paris, professor of bioethics at Boston College, charged John Paul II with “wholly upending four centuries of consistent Catholic moral analysis.” James J. Walter, a bioethicist at Loyola Marymount University in Los Angeles said, “He’s overshot the mark by drawing a line in the sand on withdrawing nutrition.”

For better or for worse, it was the Pope’s reasoning that inspired much of the argument from conservative Christians in the Terri Schiavo case. But when it came to his own end-of-life decisions, Pope John Paul II decided that quality of life, functionality and productivity are more important than strict doctrine. And who can blame him? One can only imagine what turmoil would have resulted had the pope been sustained indefinitely on some form of life support, his mind clouded or unconscious but his body still biologically alive. The Roman Catholic Church might have broken apart, with some leaders deciding to elect a new pope while hardliners argued that even in a vegetative state, the pope is still the pope until he is technically dead. Similarly, Terri Schiavo’s family did break apart over the question of whether or not to let her go. The result was not good for anyone involved.

This brings us to the crux of the issue: Is medical treatment supposed to be primarily about extending the length of a person’s life regardless of other factors, or should it be to bring about the best possible outcome for patients and their loved ones, even if in some cases that means allowing death to occur? Since we have already established that there is no meaningful distinction between “artificial life support” and any medical treatment that extends a person’s life, the question is very simply whether or not it is morally acceptable for treatment ever to be denied because it is unlikely to produce a benefit. For example, in the Schiavo case, there was a time when Terri Schiavo had a bladder infection several years after she entered a persistent vegetative state. Michael Schiavo considered at that time the option, recommended by doctors, to administer no antibiotics to kill the infection and instead let it end his wife’s hopeless existence. When her parents protested, he opted for treatment. But it might have been a better decision simply to let Mrs. Schiavo die of infection at that point, when it was already clear that she would never regain meaningful brain function to live a real life. There is nothing inherently immoral about such an option, unless one believes it is morally obligatory under all conditions always to use medical treatment to extend life - a position so extreme it is not even held by arch-conservatives of the Christian faith such as Pope John Paul II.

The Moral Uncertainties of Modernity

The main difficulty in the case of Terri Schiavo is the fact that she was unable to tell anyone whether or not she wanted to continue living. It is because of this, and this alone, that it is sensible even to ask the question of whether she was “murdered” or instead “allowed to die.” If for some strange reason she wanted to remain in a persistent vegetative state without the ability to move, talk, eat, or do anything to live a functional life, then perhaps removing her life support was an act of murdering or killing her. But if she did not want to remain in that state, as is much more likely, then forcing her to remain alive would also present serious moral problems - an issue we will return to later in this article. Either way, there is the possibility of doing something immoral. Such is the reality of a world that has advanced to the point of being able to keep people artificially alive with extreme brain damage, a feat unimaginable only a few decades ago.

What we need to understand in the Schiavo case and all cases like it where the patient cannot communicate their wishes, is that nobody can ever be sure what course of action would be going against either the person’s will or God’s will. We can only go on what the person wrote or said before their illness, and when this is in dispute, it is the appropriate role of the courts in a law-abiding society to hear the evidence and decide. Furthermore, we must understand that anything that is done or not done is an act of human will; there is no longer an option of leaving the matter in the hands of God alone. In the past, when advanced, effective medical treatments simply were not available because they had not yet been invented, one could say that God was in control when a person lived or died. That is not the case in today’s world. Doctors “play God” every day, by saving people’s lives with drugs and operations, extending people’s lives through all sorts of advanced methods and treatments, and deciding when the time has come to stop trying to keep a person alive. That is normal business in the 21st century. So it becomes a question not of whether we should take life-and-death decisions out of God’s hands, but whether we accept the fact that they are now already in our hands and how we use this power that science has made possible.

Conservative Christians have argued that removing Terri Schiavo’s feeding tube is an act of human arrogance in defiance of God. However, we need look no further than the Church of Christian Science to realize that not even all Christians can come anywhere close to agreement on what it means to “play God.” Followers of Christian Science believe that virtually all medical treatment is playing God and therefore immoral, because it takes life-or-death decisions out of God’s hands and puts them in the hands of human doctors rather than the Holy Spirit. They argue that we should have faith in God to do His will in our lives, either heal us or cause us to die. Today’s Roman Catholicism, on the other hand, has moved toward the opposite extreme, that refusal of life support systems such as a feeding tube implanted into the stomach would be playing God, because God wills for people to preserve life in all cases. Neither of these extreme viewpoints is consistent with the dictates of basic Christian morality, or common sense. There are a variety of dogmatic positions held by some Christian sects on medical issues. For example, Jehovah’s Witnesses believe in most kinds of medicine but are against blood transfusions and organ transplants. All such theories of black-and-white morality on issues unique to modern times are based not on the Biblical Gospel or ancient Christian teachings, but only on personal interpretations and opinions that have been turned into dogma by Christians who crave rules and shun individual moral decision-making. It is reminiscent of the legalistic spirit of the “gospel of circumcision” which the Apostle Paul criticized in the strongest terms.

In more and more cases, no clear line can be drawn between killing someone versus allowing someone to die a natural death. There is always a gray area in decisions about the proper use of life-saving medicine, because any denial of medical treatment could theoretically be considered killing, or it could instead be considered allowing natural death to occur. It is always a judgment call. Some cases are certainly much easier than others. The Schiavo case was a tough one with strong opinions on both sides, which is why it lasted seven years in the courts and provoked public controversy. But much of the controversy could have been avoided had Christian leaders understood that we are not dealing with a clear-cut issue of moral absolutes.

Murder Is a Matter of Spirit, Not Technicality

Everyone knows that if doctors had simply decided never to insert a feeding tube into Terri Schiavo’s stomach in the first place, she would have died 15 years earlier, and that would have been regarded as a natural death. The tube was inserted to provide time to determine whether or not she could recover from her brain injuries. After many neurological examinations, an EEG showing no activity in the cerebral cortex (the part of the brain responsible for thought), and a CAT scan showing much of this cortex had deteriorated and been replaced by fluid, it became obvious that Mrs. Schiavo was doomed to die or else be kept alive artificially to exist like a vegetable. Just because the feeding tube had been put in, that does not mean that removing it suddenly changes a natural death into murder. Had doctors simply never fed Terri Schiavo by artificial means, there would not ever have been an issue to debate. There is no moral difference between never using a life support technology versus using it for a time and then removing it.

Even for those who do see a significant distinction between those two scenarios - which seems more like a matter of perception rather than anything else - there is little basis in the Bible to argue that “killing” a person in the condition of Terri Schiavo by removing her feeding tube would be morally wrong. One of the Ten Commandments is “You shall not kill.” (Ex. 20:13). However, this has always been understood, both by Jewish and Christian thinkers, to have exceptions where the termination of life is morally acceptable. In war, it is not blameworthy to kill a soldier fighting for the other side on the battlefield; and in law, it is not blameworthy to kill a criminal who has committed certain heinous crimes such as murder. Both of these types of killing are sanctioned as morally legitimate because they are considered beneficial to society - specifically, because they help preserve the lives of others. Similarly, killing someone in a comatose or persistent vegetative condition could be considered to have societal benefit to preserve life, such as by sparing limited resources for the medical care of others who can actually improve with treatments given. We must be very careful when considering possible exceptions to the Biblical prohibition against killing, but it is clear that there are circumstances where ending another person’s life is morally acceptable and does not violate the spirit of God’s commandment.

Regardless, logic and evidence show that Terri Schiavo was not really killed, but was allowed to die a natural death after years of fruitless life support. It is the fact that her life had become a mere existence without quality, purpose or function that made the decision to remove life support morally legitimate. Contrary to the rhetoric of the religious right, it is not immoral, un-Christian, or defiant against God for medical treatments to be curtailed in certain cases, when it is clear that God has made it impossible for the person to continue any kind of meaningful life rather than only a biological existence without human faculties. In such cases, any type of life-supporting technology may be removed - no realistic distinction to be made between a feeding tube, respirator, or anything else - because it is only human choice that has perpetuated the person’s life in a physical body through technological means, not the will of God or nature.

II. Is Refusing Treatment a Form of Suicide?

Now that we have established that Terri Schiavo was not murdered, we need to ask another important question: If, before her brain was irreversibly damaged, she did in fact tell her husband not to keep her alive with artificial life support should she ever be in such a condition, does that mean that Terri Schiavo committed suicide? If so, was her decision - and the choice of others to leave similar verbal instructions, living wills and advance directives - a morally wrong course of action in defiance of God’s will for people to preserve their own life?

This argument was seemingly made in federal court by the lawyers for Terri Schiavo’s parents, who told a judge that according to the Roman Catholic faith she belonged to, Mrs. Schiavo could face eternal damnation if she was allowed to die after her feeding tube had been removed. Since no form of Christian theology teaches that a murder victim goes to hell because of being killed, the only possible explanation for such an argument is that Mrs. Schiavo really did tell her husband she would never want to be kept alive artificially, and therefore, in the view of her parents, that would be an act of suicide which they believed according to Catholic theology would result in damnation.

No Clear Line Between Suicide and Natural Death

There are two issues here. First, would this even be suicide? Second, if it is suicide, is that necessarily wrong and deserving of God’s punishment? On the first issue, we need to realize that suicide is a very hard thing to define. There are some examples that are clearly suicide, such as when a sane, healthy person decides to shoot himself in the head. But when the health of either the brain or body is at issue, there is a huge gray area between what is allowing nature to take its course and what is suicide. When a severely mentally ill person kills himself because the brain went into a pathological self-destruct mode, is that suicide? Is refusing cancer treatment suicide, when there is a chance the treatment could be successful? Is opting against a potentially life-extending operation suicide? Is it suicide to smoke a pack of cigarettes a day or regularly overindulge in high-fat, high-cholesterol foods? Probably everybody has chosen to do or not do something knowing that such will cause a shorter lifespan as a result. So are we all guilty of suicide, in some form or to some degree?

On the specific question of whether refusing medical treatment is suicide, we should consider the arguments made earlier in this article about how no clear line can be drawn between killing and natural death when a person must receive the assistance of modern medicine to remain alive. Similarly, no clear line can be drawn between self-killing and natural death in these cases. Many people throughout history have died because they chose to stop eating. They were old and sick and unable to do anything productive anymore, so they simply decided it was their time to go. That has not usually been considered a morally wrong act of self-killing, known in the Christian tradition by the stigma-bearing term “suicide.” It has been thought by most Christians and churches as an acceptable way to die. Why would it be any different if a person refuses a feeding tube or some other form of medical intervention? Either way, the person is deciding that the quality of life and purpose of extending it further are so low, that it is not worth bothering with.

If a person is very old, it is easier for people to understand how choosing not to extend one’s life could be morally acceptable. This is more difficult in the case of a relatively young person such as Terri Schiavo, who was 26 years old when her brain was first damaged. However, this distinction is only in how it makes us feel about the person’s death - we grieve more when the person dies at a young age - but it has nothing to do with the morality of the type of death. When a young person is reduced to a shell of their former self because of severe, irreversible illness, such as cases of severe brain damage, we feel more sad about it than we would for an elderly person who would normally die soon anyway. But morally, there is no distinction. If a life has ceased to be functional or meaningful and there is no realistic hope of recovery, it does not matter what age the person is when this condition takes hold. Regardless of age, if the person chooses to allow their life to end because it is so irretrievably damaged as to be not worth living, we should not put the harsh label of “suicide” on that person’s death.

Hypocrisy of Popular Christian Views of Suicide

Even if we do say that someone commits suicide when they stop eating, refuse medical treatment, or are allowed to die because of a living will or other prior instructions, does this necessarily mean the person did something morally wrong? It is commonly assumed by Christians that all self-killing is immoral, against God’s desire that life be preserved. However, this is based largely on tradition, not the Bible. It is a fact that no verse in the Bible specifically condemns suicide as morally wrong - none whatsoever. The commandment “You shall not kill” has been interpreted to prohibit all self-killing, but as we have already discussed, there are recognized exceptions to this commandment. In certain cases, suicide could be such an exception.

Christians generally do not like a gray area on the issue of suicide, preferring to call death “suicide” only under very specific conditions to avoid labeling righteous people as suicides. One example of how Christians have deliberately defined suicide with as narrow a definition as possible is the issue of martyrdom. Thousands of Christian radicals, especially in the early church, willingly submitted to horrific forms of death to show the extraordinary strength of their faith. In many of these cases, martyrs could have decided to avoid death without necessarily doing anything to repudiate their religious beliefs - but they actually wanted to die in martyrdom and sought out a suicidal death, because it was considered a noble and glorious way to die, meriting automatic entrance into heaven. Ironically, many Christians believe non-martyr suicides automatically go to hell. Perhaps the truth is that a voluntary death can have various moral dimensions and meanings, depending on the exact individual circumstances. Some acts of martyrdom might just be stupid, a waste of a good life that could have been better used serving Christ on earth for many more years. Some other suicides might be justified because continued life in this world would be pointless or even produce a negative effect. Only God knows, and Christians are not supposed to judge the state of people’s souls.

Let us remember that Christianity was founded by a man who voluntarily chose to die to prove a religious point and fulfill prophecies. Jesus Christ chose to go to the cross when it was entirely possible for him to escape trial and execution and continue his ministry outside Jerusalem, or even in a foreign country if necessary. It was because he believed God wanted him to die on the cross so that he could be resurrected from the dead, to help his disciples be forgiven of their sins and born again in the Spirit, that he decided to submit to martyrdom. As Jesus explained to his disciples, “The reason my Father loves me is that I lay down my life - only to take it up again. No one takes it from me, but I lay it down of my own accord. I have authority to lay it down and authority to take it up again. This command I received from my Father.” (John 10:17-18). Jesus is saying that when he is crucified, nobody actually kills him; he is killing himself, because he believed according to his conscience that God wanted him to die on the cross and would empower him to rise from the dead. No wonder Jesus went to Jerusalem and allowed himself to be arrested, instructed his disciples not to prevent the Roman soldiers from capturing him, and did not speak out in his own defense at trial. Pontius Pilate gave Jesus an opportunity to try to persuade him to let him go free, saying, “Do you refuse to speak to me?... Don’t you realize I have power either to free you or to crucify you?” (John 19:10). Jesus did everything possible to ensure that he would die.

A religion that was founded on an act of voluntary death should not be so quick to argue that everyone who chooses to die is morally wrong. It is more a question of motivation and purpose for living or dying which reveals our moral character, not the way we die in and of itself. How we live while we are still alive matters far more in the final analysis than whether or not we choose to extend our years on earth to their maximum possible length. Certainly in the case of refusing artificial life support, voluntary death would not necessarily be a morally blameworthy act of suicide. Nevertheless, this is what some Christians today argue, that living wills and verbal instructions to loved ones to pull the plug are essentially a form of suicide - assisted suicide - and therefore automatically immoral, both for the one who asked to die and those who allow it to happen.

This point of view derives from the traditionally fierce opposition to suicide in Christian culture rather than Biblical moral philosophy. For centuries, Christians who killed themselves were even denied a Christian funeral and burial, and this strongly judgmental practice continues today in some more conservative churches. This, despite the fact that even murderers are treated more leniently! Murder of another human being is for obvious reasons a sin far worse than taking one’s own life. But there is the popular argument that one cannot repent of suicide because one is dead, and therefore this is the unforgivable sin. However, the only sin mentioned in the Bible as unpardonable “in this age or the age to come” is the blasphemy against the Holy Spirit, which Jesus defined as rejecting good works of the Spirit, such as miracle healings, as a satanic deception (Matt. 12:32). This has nothing to do with suicide. As for repentance, the Bible teaches that “if anyone is in Christ, he is a new creation; the old has gone, the new has come! All this is from God, who reconciled us to Himself through Christ and gave us the ministry of reconciliation: that God was reconciling the world to Himself in Christ, not counting men’s sins against them.” (2 Cor. 5:17-18). If a person is a believer in Christ, it doesn’t matter how one dies; one is already forgiven of all sins. One does not forfeit one’s status as a Christian by suicide, even in cases where it is a morally wrong action. Sin is covered by the sacrifice of Christ on the cross. “In him we have redemption through his blood, the forgiveness of sins, in accordance with the riches of God's grace that He lavished on us with all wisdom and understanding.” (Eph. 1:7).

Apostle Paul on Suicide and the Meaning of Life

Killing oneself is not necessarily sinful anyway, according to the Bible. The Apostle Paul set down an important principle concerning suicide in one of his letters. He tells us that he himself considered suicide when he was in prison, but opted against it because he believed he would still have an opportunity to do good in the world by continuing to live. It was the likelihood of fruitful function that was the moral imperative for continued life rather than choosing death - not, as most Christians claim, the requirement to always choose life itself, regardless of functionality or purpose. Paul says, “I eagerly expect and hope that I will in no way be ashamed, but will have sufficient courage so that now as always Christ will be exalted in my body, whether by life or by death. For to me, to live is Christ and to die is gain. If I am to go on living in the body, this will mean fruitful labor for me. Yet what shall I choose? I do not know! I am torn between the two: I desire to depart and be with Christ, which is better by far; but it is more necessary for you that I remain in the body. Convinced of this, I know that I will remain, and I will continue with all of you for your progress and joy in the faith, so that through my being with you again your joy in Christ Jesus will overflow on account of me.” (Phil. 1:20-26).

Paul’s view of suicide as stated in this passage is that it is a poor moral choice when a person has a chance to continue living a fruitful life that benefits other people, but it could be a legitimate option if a person no longer will be able to do so. Severe incurable illness which takes away one’s basic ability to function would seem to be a case where suicide is morally permissible according to Paul’s philosophy. Other than the functionality issue, we should also notice that Paul did not say anything at all that even hints that suicide would result in condemnation to hell. In fact, he indicates that if he were to die by his own hand, that would be “gain” and he would go to “be with Christ,” a “better” life than a purposeless existence on earth.

These ideas about life and death are contrary to popular Christianity, which stands in complete contradiction on both points, the meaning of life issue and the question of hell. Who are we to believe, the Apostle Paul who saw the resurrected Christ and whose writings became scripture, or other Christians who are merely stating their own opinions without the same level of authority? Clearly, Paul’s view as applied to cases like Terri Schiavo would be that if her stated wish was to die, that would in no way be morally wrong. This would also be true in less extreme cases where most of the ability to live a fruitful life is lost, because the meaning of life is to bear fruit, not merely to exist. If a person chooses to depart this world under such circumstances of fruitless existence, they would go to be with Christ according to Paul - not to hell.

The Moral Value of a Self-Sacrificial Attitude

But what about another statement by Paul that has been used by Christians to promote the idea that suicide is always wrong? Paul said, “none of us lives to himself alone and none of us dies to himself alone. If we live, we live to the Lord; and if we die, we die to the Lord. So, whether we live or die, we belong to the Lord.” (Rom. 14:7-8). It is true that our lives are not our own, but God’s. We are only stewards of our own life. But what Paul is saying is that in either living or dying, we are called to do it in a way that serves God and other people. This is consistent with Paul’s discussion of his own possible suicide: he decided against it because he believed he still had the opportunity to live a life of service. Yet, if this had not been the case, Paul was open to the option of death. That is why he said it was his desire that “Christ will be exalted in my body, whether by life or by death,” and that he hoped he would not be “ashamed” by lack of “courage” to live or die in the way that serves God the most. Clearly, Paul believed sometimes to die is the best form of Christ-like service, although in most cases choosing life would be the better option. Either way, we must make our choices in a way that is not self-serving but in the service of the Lord.

The stewardship argument against suicide does not work in all cases. One can easily conceive of unusual situations in which a steward of someone else’s property might decide the best course of action at a certain point is to return it to the owner. And that is what death is, if we believe in an afterlife as the Christian faith proclaims - not the destruction of life, but simply its return to the spiritual world of God from which it came. We are given life to use for the purposes of our Lord, and He expects us to use it wisely. It can also be used in heaven, not only on earth. If it is no longer useful on earth for the service of God and other people, it could be a morally acceptable choice to return one’s life to heaven where God may make better use of it.

In Jesus’s parable of the talents (Matt. 25:14-30), when a servant buries the Master’s money in the ground instead of investing it, that is said to be a bad decision. What about a case where the property becomes damaged goods and the steward cannot invest it anymore? In that case, there is only the choice of burying it until the Master asks for it back, or else giving it back to the Master immediately. This is analogous to a situation where one’s life in the physical body reaches the point where one can no longer use it and there is no hope that this situation will change. In such a case, good stewardship could actually be returning one’s life to God at that point, for Him hopefully to make better use of it in another dimension of existence, since God has unlimited power. To do otherwise, persisting in extending one’s physical life in a vegetative or severely compromised state when there is nothing to be gained, could perhaps be an example of burying the coin in the ground where it cannot yield anything for the Lord.

But we need not rely on such analogies and the philosophy of Paul to understand that choosing death is not always morally wrong according to Biblical Christianity. Jesus clearly stated, “Greater love has no one than this, that he lay down his life for his friends.” (John 15:13). Traditionally, this has been interpreted to mean only martyrdom, as well as rare cases like falling on a grenade to save one’s buddies in war or accidentally dying in an attempt to rescue someone from imminent death. But such a narrow interpretation conflicts with the overall spirit of New Testament moral teachings, that we should have a self-sacrificial attitude in general, in everything we do. If a person decides to forgo medical treatment that is fruitless or of questionable value, to spare loved ones the suffering of watching a long, painful dying process, or to protect one’s family from the financial ruin that would be incurred by long-term nursing care, that could be understood as a legitimate application of Jesus’s moral principle of showing love by voluntarily laying down one’s life. The important thing to recognize is that such end-of-life choices must always be voluntary when people retain enough mental faculties to decide for themselves. For someone to put pressure on a loved one to die more quickly is immoral, because the person applying pressure would be acting out of self-interest rather than the spirit of self-sacrifice that Jesus taught. In all cases, we are to act in a self-sacrificial spirit, choosing to do with our own life what we honestly believe in our conscience would be best for others, and respecting other people’s equal right to make their own moral choices about life and death issues.

Since self-sacrifice and helping others are virtuous, would it be immoral for a sick person to choose death if this would deny others the opportunity to sacrifice their own interests by caring for one who is unable to care for oneself? Perhaps, although this would only be the case if the sick person could really be helped by somebody’s Christ-like loving care. In the case of Terri Schiavo, no amount of care or attention was able to benefit her, other than to prolong her fruitless existence in this world. Therefore, it would not be morally superior for such a person to choose continued life support under such circumstances, since nobody gains in any way from this. If the caregivers of a person in a vegetative state wish to exercise their spiritual faculty of love and self-sacrifice for other people, they should volunteer to help someone who actually gains from such action. There are plenty of sick and disabled people who need care and can truly be helped, who would benefit tremendously from the kindness of Christian charity.

If our society did not have the option of warehousing the old and sick in nursing homes, out of sight and out of mind, many people would think twice about when it may be appropriate for life to be prolonged or discontinued. Because we now are able to put people in long-term medical facilities, ostensibly with decent care from professionals trained to manage the hopeless lives of the progressively demented, intractably insane, persistently vegetative, and otherwise non-functional and damaged beyond repair, it is easy to say, make them keep living no matter what! After all, we ourselves do not have to see on an everyday basis how hideous these lives really are and do the difficult and depressing work necessary to keep them going. Those who lose the ability to think and make choices on their own may lose the chance to die in a morally responsible way that glorifies God, unless they have left behind explicit, legally authorized written instructions demanding death. For those who still retain some of their faculties, or who are terminally ill and in pain, often it cannot be clearly determined whether or at what point of decline it would be morally acceptable to choose death. In many cases, it is unclear whether continuing to live or voluntary exercising the right to die would be the preferable choice to make from the standpoint of a self-sacrificial Christian attitude, because (among other reasons) it is uncertain whether or not the help of others would be useful or could be better used on someone else in need. That is why people should prayerfully consult their own conscience when faced with terminal or debilitating chronic illness and a future of dependence on the care of others - not feeling obligated either to live or die based on the wishes or biases or anyone else, but only seeking to follow what they believe would be the way of Jesus, listening to the voice of God in their own heart.

In a case where a person has a living will or advance directive about refusing medical treatment, we are morally obligated as Christians to follow their written wishes, because they have a right to decide according to their individual conscience what would be the best way to serve God through life or death. Christians should, in fact, write their own living wills and whatever other legal documents are necessary to enable one to be a responsible steward of one’s life, rather than turning over the responsibility to someone else who might not share the Biblical Christian values of self-sacrifice, service to God, belief in an afterlife and acceptance of physical death. In a case like that of Terri Schiavo, who did not have a living will and had permanently lost the ability to speak on her own behalf, it is appropriate for the legal guardian to make end-of-life decisions in accordance with what he believes were her wishes. Other family members are free to contest such a decision in court and present evidence supporting another course of action, but if they lose their case, they must accept the outcome in a law-abiding society.

III. Moral Implications of Forced Life Support

Now that we have examined and rejected the possibilities that Terri Schiavo was murdered or committed an immoral act of suicide, we are left with the idea that her death by removal of life support was natural and morally acceptable. Her case admittedly falls in somewhat of a gray area created by the inevitable advancement of medical science. But it seems clear that whether or not she really told her husband she would prefer no life support, as long as she didn’t specifically leave instructions asking to be kept alive as long as possible with a feeding tube, it was a legitimate decision to remove it after 15 years of fruitless medical care. In a case where life had permanently lost its ability to bear fruit, Christians can take comfort in their belief in the afterlife, knowing that “killing” Mrs. Schiavo or “letting her die” was in fact liberating her from a non-functional prison of flesh and enabling her to take her place in heaven. We should therefore turn our attention to the question of whether keeping someone like Terri Schiavo alive for years in a persistent vegetative state could actually be a violation of Christian morality.

The Golden Rule

The first consideration of this question must be the Golden Rule. Jesus taught, “in everything, do to others what you would have them do to you, for this sums up the Law and the Prophets.” (Matt. 7:12). In other words, the highest moral prerogative, beyond any specific law or prophetic exhortation in the Bible, is that we are to treat other people as we would wish to be treated. Furthermore, Jesus said, “A new command I give you: Love one another. As I have loved you, so you must love one another.” (John 13:34). And Paul reiterates both of these concepts, saying, “whatever other commandments there may be, are summed up in this one rule: Love your neighbor as yourself.” (Rom. 13:9).

Very few people would want to be kept alive for decades in a state of extreme brain damage - unable to think, move, or communicate - and with no hope of recovery. In fact, polls taken during the Terri Schiavo controversy showed that well over three quarters of Americans would have wanted the feeding tube to be removed if they were in Mrs. Schiavo’s condition. Some polls showed the figure over 90%. In light of this fact, the Bible’s teachings on loving others and treating them as we would want to be treated are unequivocally on the side of removing the tube from Mrs. Schiavo’s stomach - a tube that was an unkind imposition according to most people’s preferences. Conservatives have argued that when in doubt about a person’s wishes, society must always err on the side of life. Not so, according to Biblical Christian morality. The highest moral commandment is the Golden Rule, and this rule when applied to the Schiavo case would argue strongly in favor of allowing her to die and return to God rather than continuing to keep her technically alive in a horribly diminished state of existence. If Christians truly wish to uphold the supreme value of love for others and treating them as we would wish to be treated, the clear moral obligation would be to err on the side of what the vast majority of people regard as a loving act they would themselves desire: removing life support when it has proved to be fruitless. Only if there is a preponderance of evidence that someone like Mrs. Schiavo wanted what most people do not want, should the excessive life support continue to be provided.

Not only is the default mode, according to Biblical moral teachings, to treat people the way most of us would wish to be treated - which in the Schiavo case meant allowing death - but specifically, it was known that Terri Schiavo had a personality that would have been deeply hurt by what was done to her in artificially prolonging her existence. We know that Terri Schiavo was shy, probably suffered from bulimia (which led to the heart failure that damaged her brain), and definitely did not like too much attention and focus on her physical body. She almost certainly would not have wanted the whole world watching her on television reduced to a vegetative state, a caricature bearing little resemblance to her real self, a political football to be kicked around by ideological combatants. She would have been terribly embarrassed that commentators were openly discussing her grossly reduced mental state, her bladder and bowel incontinence, the fact that she could no longer have gynecological examinations because her muscles were too spastic to pry her legs open, and all other manner of intimate personal details. All of this was the direct result of her parents’ relentless effort to keep her connected to a feeding tube because of their wishes, not hers, using political and religious activist groups, websites and print advertisements devoted to their cause, endless legal maneuvering and court appeals, and encouraging the unprecedented involvement of politicians going all the way up to the Congress and President of the United States. Did her parents and their allies stop to think about how this poor woman they loved so much would be remembered after their campaign to preserve her in the flesh? Did they even consider that perhaps, just perhaps, this was not what she would have wanted, and therefore it would be morally wrong according to the teachings of Jesus to turn their beloved Terri into the equivalent of a wax museum piece for the whole world to gawk at?

We cannot judge the motivations of anyone’s heart, and we do not know what was going through the minds of Terri’s family, the Schindlers. But we can be sure they were misguided, and unduly influenced by fanatical pro-life activists who frequently spoke on camera representing the cause to keep Mrs. Schiavo alive, shouting that “an innocent disabled woman” was being “murdered” and “starved to death” in a “barbaric fashion” like what happened in “Nazi Germany” and the “crucifixion of Jesus Christ,” in a way that “you couldn’t even do to a dog without going to jail.” These activists seemed to be ignoring the basic facts of the case: that Mrs. Schiavo was not disabled, but totally non-functional and being kept alive through artificial means with no hope of ever again living a meaningful life; that she was dying in a way that happens normally in hospitals and homes across America, every day, without protest; and that hyperbolic, invalid comparisons only made their argument look ridiculous and devoid of substance. What was even more astounding was that these fanatics were being treated by the media as representative of Christianity. Little philosophical analysis of the moral issues of the case from a Biblical perspective was ever offered. Columnists and commentators who did present “the Christian view” mostly parroted the philosophy of Pope John Paul II on end-of-life issues, which is a new development in Christian thought that derives not so much from the Bible as from that greatly influential pope’s personal choice of emphasis. Where was there talk of the true fundamentals of the faith of Jesus Christ: the glorious promise of the afterlife, the Christian responsibility of living and dying in a self-sacrificial way, and the Golden Rule that requires us to treat others the way we would want to be treated? Rarely were these ideas brought up. But they should have been, and they must be in the future.

The Question of Torture

It is easy enough to see that Terri Schiavo probably did not want the glare of the cameras cast on her vegetative body, even if we discount the court testimony of her husband and two others who were willing to say under oath that Mrs. Schiavo had mentioned her desire not to be kept alive artificially. She probably did not want a federal case made out of her feeding tube, nor was it likely that she even wanted it at all, especially after 15 years. But there is an even deeper moral problem we must look into: the question of torture. All along in the Schiavo case, advocates of the feeding tube argued that Mrs. Schiavo might be somewhat more conscious than most neurologists believed. Instead of a “persistent” or “permanent vegetative state,” some neurologists said she might possibly be in what is known as a “minimally conscious state,” which would mean she had some level of awareness of her surroundings. If this were the case, the pro-tube side argued, then she must be kept alive indefinitely because she had some ability to think, and that fact would make it morally wrong to terminate her life. Many people bought this line of reasoning without understanding its real implications. If, in fact, Terri Schiavo had some thinking ability but was unable to move or communicate for 15 years, then her life must have been a living hell, and those who were keeping the feeding tube in her stomach would be guilty of the grave sin of torture - a sin that may actually be worse than murder under such circumstances.

There is such a thing as mercy, and being merciful is endorsed by the Bible. “Blessed are the merciful, for they will be shown mercy.” (Matt. 5:7). “Be merciful, just as your Father is merciful.” (Luke 6:36). Forcing people to stay alive artificially, unnecessarily, in a hellish condition when virtually everyone would prefer death, is torture and demonstrates a lack of mercy and love. Torturing someone for years would be flouting the Golden Rule and Jesus’s commandment that we “love one another.” To do so for an ideological principle of church doctrine would be to put our own imperfect interpretations and ideas above the most important moral teachings of the Gospel - religious hypocrisy of the worst sort! This is the kind of thing Jesus warned the Pharisees so strongly about, that they were focusing on the lesser aspects of the Law while forgetting the spirit.

If we really love someone, would we make them suffer the agonies of living trapped inside a totally non-functional body for decades, conscious but unable even to communicate their needs to us, when they could die and go to heaven if only we have the courage to put aside our culturally-induced qualms and remove artificial life support? If we have the spirit of Christian mercy, we will recognize that to force a person to endure such a prolonged, frustrating, miserable existence through unnecessary medical technology is not only morally unnecessary, but profoundly morally wrong. Such would be the case for Terri Schiavo, if it were true as her parents argued, that she was minimally conscious rather than in a full-blown vegetative state. If the pro-tube argument on this point was correct, then the rest of their argument for keeping her alive falls apart, at least from the standpoint of Biblical Christian morality. Only if she were totally unconscious could there be a reasonable argument made that artificially sustaining her life for decades is, perhaps, a morally acceptable option.

What About Terri Schiavo’s Soul?

But would it really be morally acceptable to keep Terri Schiavo alive, even if she were in a persistent vegetative state as most doctors testified, and with the added condition that she never told anyone she would have wanted to die, as her parents argued? Even under these conditions - the precise combination of conditions that would seem to allow the greatest moral leeway for the possibility of keeping her alive - there are still serious moral problems with the pro-feeding tube position. One of them is another implication of the Golden Rule, this time in a spiritual dimension.

Research into near-death experiences (NDEs) shows that there are altered states of consciousness between life and death, in which a person’s soul detaches from the body and enters another level of reality. For example, a significant percentage of people revived from cardiac arrest or any brief period of being clinically dead report leaving their body and floating above it, sometimes entering a long tunnel at the end of which is a bright light they believe to be God. More detailed near-death experiences also include meeting dead relatives and friends on the other side, and some of the most amazing stories include information that could only have been perceived if the person’s consciousness was truly outside their physical body. The NDE phenomenon, which has been documented and discussed a great deal in recent years by scientists, doctors, and spiritual leaders, confirms what Christianity has always taught about the reality of life after death: that there is a non-physical soul that can exist separate from the body of physical flesh, and there are other dimensions of existence beyond this earthly plane.

From the evidence that has been gathered of NDEs, it appears that long-term coma or other such extremely reduced mental conditions are an undesirable state for the soul to be in. It is like being stuck in limbo, unable to function either on earth or in the spirit world. The soul might be able to see the glories of heaven that await, but is unable to enter this greater realm until someone is kind enough to remove fruitless life support from the vegetative physical body. Some souls might become confused and have difficulty making a smooth transition to the next world when life support is finally discontinued and they are allowed to die. Is being kept in this condition something we would want done to us, from a spiritual perspective? Nobody has ever come back from a persistent vegetative state such as what Terri Schiavo was in, but comas are similar, and people have come back from comas with NDE testimony - most of which indicates a long-lasting coma is not a desirable situation for the soul. If we are to believe such reports, Terri Schiavo was kept for 15 years in limbo, her soul trapped between two worlds. Whether or not it was a particularly unpleasant time for her we cannot know, but we can be sure her soul would have found a much better abode in heaven rather than the spiritual limbo of a persistent vegetative state. During the time her spirit was artificially tethered to the physical body by man-made technology that afforded her no ability to live a real life on earth, she was prevented from being with her Lord Jesus Christ, her loved ones who had already passed on, and doing the wonderful things that people can do when they cross over to the other side of the grave. This spiritual issue was generally left out of discussions of Terri Schiavo, although it should be of central importance to anyone who believes in the Christian promise of the afterlife and the moral virtue of treating others the way we would wish to be treated.

Gross Inequality Ignored

Another issue that was rarely discussed is the problem of limited resources for medical treatment in society, and how these resources should be comparatively allocated according to moral and ethical considerations. Donated organs are limited in supply, and it is generally considered morally responsible for society to decide who should receive a life-saving organ transplant based on qualitative factors, such as the age and health status of the potential recipient. Similarly, money for medical care is also limited. Many Americans have no health insurance, or insurance which does not cover certain types of treatment. Millions of these uninsured and underinsured citizens are children, some of whom suffer greatly - sometimes even die - because they are denied appropriate medical procedures that would be necessary for their well-being. Is it ethical for society to preserve a functionless existence of a woman in a persistent vegetative state for many years, while some children living in the richest country on the planet cannot even receive basic operations that would allow them to live a fruitful, full life? Not to mention the millions of children around the world who are literally starving, do not have clean water to drink and are exposed to deadly diseases because of lack of sanitation and lack of the most rudimentary preventive care.

Medical costs for Terri Schiavo’s nursing care alone, during the 15 years her existence in a physical body was artificially preserved with a feeding tube, approaches one million dollars. Several million dollars more were spent on legal bills for fighting to keep the tube implanted in her stomach, along with funds raised by political and religious activist groups for advertising and lobbying. After Mrs. Schiavo’s feeding tube was removed, her parents appealed the Florida court decision more than a dozen times to various higher courts, including the U.S. Supreme Court twice - and just filing the legal paperwork for each of these last-minute appeals reportedly cost in the neighborhood of one thousand dollars. Legal experts correctly predicted that none of these repeated appeals had any realistic chance of success, and so an amount of money that would have paid for life-saving surgery for an uninsured person in need, was needlessly thrown away. President Bush unnecessarily chose to fly on Air Force One from his ranch in Crawford, Texas, to Washington, D.C., to sign a Congressional bill authorizing these extra legal appeals in federal court that would not normally have been allowed. The cost of the President’s trip to Washington and back to Texas was over $70,000 - using Air Force One is extremely expensive! - for nothing more than to sign the bill into law a few hours sooner than he could have done had he stayed in Texas, to make a statement about how important he believed the Schiavo case to be. For that amount of money spent on a dramatic political appeal to impress the religious right, the lives of several uninsured children could have been saved if it had been donated for medical treatment which their families were unable to afford.

Jesus taught that charity is one of the most important virtues. Helping the poor and disadvantaged is a moral obligation for Christians who are able to do so. For example, Jesus instructed a rich man to give away all his money to the poor if he wanted to be a true Christian (Luke 18:22). There are countless underprivileged people who needed medical care, food and water much more than Terri Schiavo did. Mrs. Schiavo was being kept alive artificially in an unconscious, non-functional condition with no hope of recovery, mainly because her ultra-conservative Catholic parents wished to follow the teachings of Pope John Paul II on the use of feeding tubes. Other people could have really used the resources extravagantly spent on fighting to preserve Mrs. Schiavo’s fruitless existence, which were denied to them because resources are limited. While a woman who should already have been allowed to die of natural causes was being sustained by medical technology that provided her no benefit, millions around the world were crying, “I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.” (Matt. 25:42-43).

What Was Gained, What Was Lost?

Including medical bills, legal bills, political and media spending, several million dollars were spent keeping Terri Schiavo artificially alive in a persistent vegetative state and fighting to prevent her husband from removing her feeding tube. The total sum of money involved was probably five million, ten million dollars, or even more. What was gained with such a huge expenditure, and what could have been gained instead? One woman was allowed to live either unconscious or minimally conscious in a very unpleasant condition, unable to talk or communicate, get out of bed or move her limbs. She did nothing at all and probably thought nothing at all for seven extra years, because of millions of dollars invested to keep her attached to artificial life support that served no purpose other than to keep her technically alive. After that, she finally was allowed to die the natural death that had been so strenuously prevented. What would have been different if this great sum of money had not been spent and her husband had simply been allowed to remove her feeding tube years earlier, already quite a few years after her brain injury occurred? For Terri Schiavo, nothing would have been lost except seven wasted years of meaningless physical existence during which she could have been enjoying heaven; and for everyone else involved, seven years of grief and emotional turmoil would have been avoided. In other words, nothing was gained from an expenditure of millions of dollars, and the peace of Mrs. Schiavo’s family was lost in the process.

Michael Schiavo and Terri’s family are no longer on speaking terms after having had an excellent relationship in the past. Mr. Schiavo was slandered by fundamentalist religious organizations on the side of the Schindlers along with right-wing political commentators in the news media, despite the fact that during the entire 15 years his wife was on life support, he was vigilant about her care and she never had a bedsore. He even became a registered nurse in order to help take care of her. Michael Schiavo is no saint: Much has been made of the fact that he began seeing another woman and had two children. However, this happened after many years of trying to save his wife from her vegetative condition, and he continued to visit and care for Terri until the very end. Only after all reasonable medical options had been exhausted did he begin fighting for his wife’s right to die with dignity as he believed were her wishes. One of the reasons he refused to get a divorce, as the Schindler family wanted, was precisely because he did not want his wife’s end-of-life wishes to be violated by family members who were driven by a much more ideological religious faith than her own. Unlike her parents, Terri Schiavo was not fundamentalist in her beliefs. Terri’s father, Robert Schindler, was so extreme in his belief in the religious obligation of using life support that he had actually testified in court that he would never consider removing his daughter’s feeding tube under any circumstances, even if all her arms and legs had to be amputated and she were in terrible pain.

Michael Schiavo’s reputation has been tarnished by all sorts of unfounded allegations against his character designed to detract attention from the facts of the case, including the coarsest and most vulgar ad hominem attacks that he had beaten his wife into a vegetative state, that he denied her appropriate care, and that he was only interested in removing her feeding tube to get money from her insurance and a medical malpractice suit. No credible evidence of domestic violence or abuse of any kind was ever produced. In an organized effort to convince the state to take away Mr. Schiavo’s rights as his wife’s legal guardian, 89 complaints of abuse were filed with the Florida Department of Children and Families over a four year period - many of which were based on rumors and innuendo circulating in Internet chat rooms. All were investigated, and all were found to be false. In a public report, the agency wrote, “the spouse has always been courteous and very compassionate toward his wife” and “all her needs being met.” As for the allegation of greed against Mr. Schiavo, the money in question was mostly used up on her treatment, and any that remained he publicly offered to donate to charity. Moreover, he turned down an offer of $10 million and another offer of one million dollars from wealthy conservatives to give custody of his wife to her parents, refusing these extravagant gifts because, as he said over and over again, he believed the right thing to do was to follow his wife’s medical wishes. Regardless of the facts, Mr. Schiavo may never fully regain the good reputation he lost because of repeated, widely broadcast, deliberate acts of slander.

Robert and Mary Schindler spent seven years filled with grief and anger, devoting their lives to preserving Terri’s feeding tube and fighting their son-in-law Michael, instead of accepting the emotional closure that a natural death would bring. A family was torn apart, a man’s name was smeared, and in the end, a whole nation was divided by harsh rhetoric. Money was raised for an intense media campaign from people who would have less to give for genuine charitable purposes as a result, and the coffers of numerous radical organizations were emptied in a quixotic, emotionally fueled bid to prolong the life of one woman in a vegetative state in spite of what the courts ruled were her wishes - a woman who, against her own will, became the symbol of a new ideological movement seeking to redefine the essentials of Christian morality.

As a sad consequence of the Terri Schiavo case, millions of dollars that ideally could have been spent on saving the lives of poor people with a real chance to benefit from medical care they could not afford, instead was wasted. This money could have fed, clothed, sheltered, and educated many hundreds of starving children in a third-world country. Did the Roman Catholic and fundamentalist Christian activists who spent so much and fought so hard to force-feed one nearly brain-dead woman stop to think about what opportunities for Christian charity were squandered, what terrible facts of life in the world were being ignored while they turned the spotlight on Terri Schiavo? The children with their whole lives ahead of them, lacking enough food to live, or the most basic medical services to prevent them from dying of diseases that have been long eradicated from the wealthy West. Refugees in war-torn lands, living in squalor while comfortable Americans have fun shopping at Wal-Mart for consumer products they don’t need - Americans who make impassioned speeches about the supreme moral importance of our “Christian country” keeping a person on artificial life support for many years, while numerous people in less fortunate countries lack the food and water to live at all. Where was the “culture of life” movement for these forgotten people? Was their “sanctity of life” less important than a woman who was already nearly dead anyway, who was being sustained for an unusually long time through artificial means? The religious right decided to gawk at the hopelessly non-functional body of one woman who would have been naturally allowed to die in almost any other country on earth, using her to raise money to promote their own ideology and political agenda, while literally thousands of people in Sudan, Congo, and other troubled nations around the world were allowed to die, though they could have been saved if the funds had been spent on them. These were people who had a chance for a real life, not the life of a vegetable - if only they had been given the most basic financial and medical resources they needed.

So, basically, here is what happened in the Schiavo case: One person lay in bed in a zombie-like state for 15 years, the subject of extraordinary family strife and public debates about how long she should be fed by a tube, fueled by well-organized fundraising campaigns and furious religious finger-wagging by people touting a so-called culture of life, while many starving children whose lives could have been saved were ignored. Is that true Christian morality, or grossly misplaced priorities? As our rancorous American culture war raged under the glare of the cameras and with the hot breath of eager politicians, real people died - unnoticed. What would Terri Schiavo have wanted? As a Christian, would she have wanted her loved ones to fight in courts, in legislatures, and on television, so that millions of dollars were spent on sustaining her inanimate body with a feeding tube that offered no benefit for her health - or, alternatively, would she have preferred that starving children in Africa had been saved, or that the money had been spent on providing life-saving operations for uninsured people in America? I think we all know the answer.

IV. Culture of the Flesh versus Faith of the Spirit

Looking back on the theater of the absurd that was the Terri Schiavo case, it can only be said the Christian religion has chosen a path that, if continued, would soon lead to its disappearance as a coherent moral philosophy and belief system for rational people. Much in the same way as the Roman Catholic Church centuries ago attempted to suppress such cutting-edge thinkers as Galileo, today there is an attempt being made by that same institution, allied with many evangelical Protestant leaders, to promote a stifling doctrine about end-of-life issues that will become impossible to sustain in the face of continued rapid advancement of medicine.

At the beginning of the 21st century, we find ourselves living in a surreal world in which some nations still do not have enough food and basic medical care for all their citizens, while others can debate with a straight face whether 15 years of force-feeding through surgical technology is long enough for a woman who has lost all higher brain function. Strangely, most vocal Christian leaders have taken the side of the absurd prerogatives of the super-rich of this world - medical choices that would be laughable, if not downright offensive to the moral sensibilities of the poor masses who remain a seemingly permanent fixture on planet earth. In doing so, Christianity has drifted into a twilight zone of diminishing relevance to the challenging moral problems of the modern age. How can Christianity, a faith founded on the principles of charity, mercy, self-sacrifice, and courageous acceptance of death with an otherworldly trust in the afterlife, speak convincingly to the concerns of today’s world when it is willing to defy its own most basic principles to compromise with the psychological peculiarities of modern Westerners, the most self-absorbed, death-averse people ever to have lived?

Christianity Adapting to Modern Western Culture

Make no mistake about it, that is what it is: compromise. It is a subtle and pernicious intellectual compromise, not deliberate, but based on a misguided interpretation of the “sanctity of human life” in a time when abortion has been on the increase and the pleasures of life in the material world are greater than ever before. There has been a concerted attempt to develop a new interpretation of Christianity emphasizing the preservation of all human life on earth as the highest good, primarily in an attempt to argue against abortion. Abortion may be morally wrong, but it should not be linked to end-of-life choices. They are different issues, polar opposites in fact. On the one hand, a fetus has the opportunity to live an entire life ahead of it, full of growth and learning and experiences in this world, whereas a person like Terri Schiavo has nothing to look forward to but the blissful release of death. Why deny the fetus a chance at life - and why deny a dying, hopelessly ill, severely brain damaged or permanently vegetative person a chance at death, the life hereafter promised by the glorious resurrection of Jesus Christ? There are some moral gray areas on the issue of abortion in certain cases, but in general, it is easy to see why abortion would usually be wrong whereas removal of life support would usually be the right choice according to Christian moral values.

The hidden reason behind the linkage of abortion with end-of-life issues under an umbrella of a “culture of life” is that people today, especially in the rich and materialistic West, have become excessively uncomfortable with the thought of death and dying - including Christians - to the point where what was once considered a normal part of life, especially for Christians, has become taboo. Many people today almost seem to think of death as optional, something that doesn’t have to happen to you if you have enough resources to fight it. Sex, the old taboo, is now flaunted to excess; whereas death, which was once a common and accepted (though sad) occurrence, has become the thing we refuse to accept and are defiantly angry about, in a cultural milieu when anybody who doesn’t live to be at least 80 years old is seen as having “died young.” It is in such a climate that the Schiavo case was able to captivate our attention, a lurid spectacle of a tragically shattered young woman’s life so many of us simply refused to let go, wishing to preserve her body to the bitter end, by any means necessary, rather than ever give in to the dreaded death. Death has simply become unacceptable to the modern Western mindset, as if to die or allow someone to die is to fail. Therefore, many of us seek to reinterpret our religion in a way that justifies our extraordinarily intense fear of death and fervent desire to remain alive as long as possible in the material world, while at the same time tying it to a legitimate moral concern about the growing prevalence of casual sex and abortion on demand. This is the intellectual compromise that is made through the “sanctity of life” argument: that Christians can simultaneously be on the right side of one important issue of our time, while indulging their un-Christian weakness in the face of death that has become endemic in a society beholden to the desire for long life and the pleasures of the flesh at the expense of focusing on the spiritual life beyond the grave.

Our modern obsession with defying death comes in many forms: the rise of cosmetic surgery, a multi-billion dollar pharmaceutical industry offering pills to give elderly men an erection, the alternative health and vitamin craze, groundbreaking forms of surgery never before thought possible, organ transplants, experiments with cloning and stem cells, and the development of various types of life-support technology up to the point of allowing virtual corpses to remain technically alive indefinitely. Within one generation, wealthy people in wealthy countries such as America might routinely be able to remain alive for well over a hundred years, replacing their organs whenever they wear out, getting bionic implants for parts that cannot be naturally replaced, face transplants and all other manner of amazing enhancements each time they start to look old again, and when all else fails, desperately clinging to life for decades on machines when they are beyond repair and a ward of the state - reveling in a fleshly attitude of total non-acceptance of the inevitable death of the physical body. And of course, as always, there will be the people in underdeveloped countries who will still be starving, living in primitive conditions, dying in childhood from insect bites and other preventable plagues, while Americans worship at the altar of Mammon. Where will Christianity stand as this bizarre future unfolds? What shall be its priorities? Which problems and excesses of modern Western culture will it tackle head on, which will it embrace, and what disturbing features of life in a radically altered world will it conveniently turn aside from and ignore?

The Dangers of Imbalance

As with just about anything else, medicine is good when used within reason, for the right reasons. When used excessively and for irresponsible and immature reasons, it becomes only another thing that may lead us astray from God, and a source of gross inequity and corruption in the world. So too with Christian values such as the sanctity of life. Various values and concerns must be balanced to find a moral and rational framework for how we live and how we die, a framework consistent with our highest responsibilities to God and our fellow man. It is ironic that perhaps the only thing that ever could have helped Terri Schiavo regain a functional, meaningful life of service to the Lord - the promise of embryonic stem cell therapy to re-grow parts of a damaged brain, which might become available in the near future - is opposed by the Catholic Church and the fundamentalist Protestants who wanted her to remain alive in a vegetative state. It is also ironic that the Catholic Church opposes the use of condoms, which would prevent the spread of AIDS in places where it is destroying entire societies and killing millions of innocent children, such as sub-Saharan Africa. If there is to be a “culture of life,” at least let it be philosophically consistent. As it stands, the culture of life movement in Christianity is rife with the worst kind of hypocrisy, as demonstrated by a selective blindness proceeding from doctrinal imbalance.

The biggest danger of the burgeoning overemphasis among Christians on the sanctity of life and so-called culture of life, as presently defined, is that it downplays an overarching Christian moral value: living a heavenly life of spirit rather than a worldly life of flesh. This concept is spoken of repeatedly in the New Testament and can be considered one of the essential themes, a prototypical characteristic of being a true Christian. For example, Jesus said, “The Spirit gives life; the flesh counts for nothing.” (John 6:63). He said, “I am not of this world” (John 8:23) and “My kingdom is not of this world” (John 18:36). Jesus taught in many verses that we are to seek the things of heaven, not focus on materialistic life. The Apostle Peter described Christians as “aliens and strangers in the world.” (1 Peter 2:11). The Apostle John said, “Do not love the world or anything in the world. If anyone loves the world, the love of the Father is not in him.” (1 John 2:15). The Apostle Paul said, “The mind of sinful man (mind set on the flesh) is death, but the mind controlled by the Spirit is life and peace.” (Rom. 8:6). And he warned, “See to it that no one takes you captive through hollow and deceptive philosophy, which depends on human tradition and the basic principles of this world rather than on Christ.” (Col. 2:8). Paul was warning about Christians who focus more on traditional doctrines and the things of this world rather than the spirit. In his day, the concern was Christians promoting circumcision and Jewish dietary laws; today, it is feeding tubes and a “culture of life.”

Let us be clear about one thing: The culture of death was in the past, not today. Before modern medicine, life was cheap. More than half of all people died before ever reaching adulthood. Many who did survive died young, by today’s standards, because men went off to fight in bloody wars and women frequently died in childbirth. Every few generations, plagues ravaged the land and killed people like flies. Execution was the normal punishment for a wide variety of crimes that today would earn only a prison term in Western democracies - and criminals were hanged, beheaded, crucified, fed to wild animals, or drawn and quartered in public spectacles for mass entertainment. Funeral preparations were not conducted by professional businesses, conveniently out of sight, but by the family of the deceased, who themselves washed and dressed the dead bodies of their loved ones and often made their own coffins and dug their own graves. For our ancestors, death was all around, an omnipresent menace that was understood to be a natural occurrence, like their infestations of rats and lice. If not fully accepted, at least death was not treated as a taboo the way we do in the modern developed world. People in the past knew life on earth to be “nasty, brutish, and short,” as the philosopher Thomas Hobbes aptly put it, and people of faith tended to focus on the hopeful promise of the afterlife with their Lord in heaven. Belief in life after death was one of the main reasons why people used to be so deeply religious compared to us today. In light of these facts, how can anyone rationally argue that our modern world is the “culture of death”? If anything, the only people on earth who are more inclined towards death are those suffering in abject poverty, who still live with the problems and values of their forebears. For most Americans, Europeans, and a growing segment of the global population, life in the flesh is good - unbelievably good by the standards of just a few centuries ago.

In the developed world, the conflict between worldly focus on the flesh and true Christian belief in the spirit is fast coming to a head. Life on earth may be becoming too good for our spiritual health, overshadowing man’s real priorities which include an eventual physical death and reunion with God. In another hundred years, it is possible that death of the physical body may literally become a choice, not an inevitability, for those with enough money. When cancer, degenerative diseases, and the genetically programmed aging process itself are conquered; when organs can be grown and harvested from test tubes, animals with altered DNA, and perhaps even specially designed human clones created without brains and sustained by machines until all their organs are used up; when nerve tissue can be re-grown, so that even progressive deterioration of the brain and central nervous system caused by Alzheimer’s, Parkinson’s, ALS, Creuzfeld-Jakob disease, and other dread afflictions no longer spell doom; and when the risk of fatal accidents can be almost completely avoided through a preoccupation with safety, already beginning in our time, the only people who will die will be the poor and those who decide they prefer death and the afterlife over continued life in this world. If Christianity is to remain true to its roots as a faith centered on trust in the divine promise of life after death - a more wonderful life in heaven that is our true home - how will the neo-Christian “culture of life” movement reconcile itself to the fact that death will have become optional for those who can afford to avoid it, allowing people to remain apart from God indefinitely in a world that, according to the Bible, is only supposed to be a short preparation for a much greater life hereafter?

That so many Christian leaders reacted to the Terri Schiavo case without even mentioning issues of the afterlife and the soul, as if these considerations were totally unimportant, is compelling evidence that Christianity is dangerously out of balance today, shifted away from historical orthodoxy and into new territory of subconscious compromise with an era that overemphasizes the life of flesh at the expense of the spirit. In their moral and philosophical discussions of the Schiavo case, it seems that few Christians, at least publicly, believed it necessary to consider that a human being’s ultimate purpose is to meet our Maker after a brief sojourn on this planet, and that artificially preventing a person from doing so when they are no longer able to use their mind and body for purposeful ends is, at the very least, morally questionable and perhaps even in violation of basic Christian principles. The way Terri Schiavo’s parents and their allies among the religious right frantically clung to her physical life - a life that very few people, even sincere Christians, would choose for themselves - makes one wonder whether their own understanding of Christianity was unduly influenced by extreme ideological concerns, unique to the modern drift of Christian thought into moral irrelevance and reactionary fanaticism, rather than the most fundamental and enduring Biblical teaching of the hope of a greater life beyond the grave.

Biblical Christianity emphasizes the glory of the afterlife and repudiates a life focused on fleshly existence. But for some reason, many Christians seem to think imprisoning someone in the flesh and actively preventing them from going to heaven, even though they cannot do anything on earth, is a good idea. They call this part of the culture of life that is supposedly of central importance to Christianity today. It is not a true Christian culture, though. This ideology is a result of the modern materialistic mindset infiltrating into Christianity and changing it from a faith that focuses on the hope of the afterlife to a religion that emphasizes the length of one’s physical life instead. A similar trend can be seen with the prosperity theology movement - also known as “word of faith” or “name it and claim it” - that shifts the focus from spiritual riches in heaven to getting materially rich on earth through prayer and charismatic worship. These modern movements are the polar opposite of early Christian heresies such as Gnosticism, which overemphasized the glory of death and the corruption of the physical body. Neither extreme is truly authentic Christianity.

Final Thoughts on a New Beginning for Christianity

In conclusion, Christianity seems to be moving in the wrong direction as we enter a new century, a time of great change that is introducing new, unprecedented issues and problems into our moral consciousness. The Body of Christ, though diverse and containing a wide variety of different opinions on questions not specifically answered in the Bible, is increasingly seen in the public eye as an extreme and irrational religion unwilling to accept and deal constructively with the realities of life and death in the modern world. Represented primarily by outspoken right-wing fundamentalists and the conservative Roman Catholic Church, the Christian faith is defining itself on the wrong side of the important debate on end-of-life issues in an age of rapidly advancing medical science and technology. If this trend continues, Christianity is in danger of being rejected by most people who would otherwise be receptive to it, as a logically inconsistent, hypocritical, and reactionary religion not suited for the concerns of modern times. Christians need to get back to the basic teachings of Jesus and the Bible, not some strange neo-Christian ideology of a “culture of life” that focuses on clinging to life in the physical flesh as long as possible through artificial life support. That’s not really Christian at all; it’s materialistic and misguided.

The Terri Schiavo case revealed a disturbing nascent ideological change within Christianity. If we reflect on it with thoughtfulness and a willingness to consider the original message of Christ with our own spiritual vision, we will see that supreme Christian values such as the Golden Rule, the moral imperative of self-sacrificial life and death, mercy and love for other people, were largely ignored in favor of a narrow emphasis on secondary doctrinal concerns promoted by latter-day Christian apostles of artificial life support who claimed to speak for God. The original values taught by Jesus, Paul, and the other authors of the New Testament are a timeless philosophical heritage that must be preserved above all else. As Christianity moves forward into the new century, let us return to these core moral values that have defined what it means to be a true Christian throughout history, regardless of the ever-shifting ideological movements that rise and fall within the church in each generation and period of time.