Me Before You and Physician-Assisted Suicide

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When an idea or concept needs a push in popular culture, Hollywood often makes a movie about it. With the power of emotional drama and a film score designed to tug at the heart, Hollywood has the power to advance ideas that we would otherwise reject on moral grounds. Its most recent attempt uses the book-to-movie love story Me Before You to create sympathy for and acceptance of euthanasia and Physician-Assisted Suicide (PAS).

Based on the 2012 novel by Jojo Moyes, Me Before You has earned more than $180 million worldwide. It received the Heartland Film award in 2016 and the 2017 People’s Choice Award for Favorite Dramatic Movie as well as three other nominations. It’s a touching love story, but so much more, as it presents the idea that humans should have the right to choose how and when they will die.

The concept and agenda isn’t new. In 2004, the Clint Eastwood film Million Dollar Baby—which won four Academy Awards, two Golden Globes, and fourteen other awards worldwide— promoted a similar agenda. In both films, young adults who have been paralyzed in accidents choose to die because they feel that their lives are no longer worth living.

When Million Dollar Baby hit the theatres twelve years prior to Me Before You, assisted suicide was, for the most part, illegal in the U.S. and most of the world. Only Oregon had legalized PAS in the U.S., and worldwide, only Switzerland, The Netherlands, and Belgium allowed it. In the years since, Luxembourg and the U.S. states of Washington, Montana, Vermont, California, and New Mexico have followed suit. The Swiss, Belgians, and Dutch have also legalized euthanasia.

PAS allows doctors to supply the information and means (lethal dose of medication) to patients wishing to die, but requires patients to administer the dose themselves. In cases of euthanasia, the doctor actually takes action that causes a patient’s death. While euthanasia is not yet legal in the U.S., there is deep concern that the one will eventually lead to the other.

In 1997, the U.S. Supreme Court unanimously ruled that there was no right to die under the U.S. Constitution. While they did not make PAS illegal, they refused to lift the ban on it in all states. This ruling hasn’t changed, although states continue to battle for the right to PAS.

Outside Hollywood, a real-life, high-profile case concerning Brittany Maynard captured the nation’s attention. Brittany was a twenty-nine-year-old California woman who opted to die instead of letting a terminal illness destroy and eventually kill her. She moved to Oregon to receive PAS in 2014.

Moyes, in an interview in the back of her novel, shared why she chose this subject matter. “The novel was really spurred by a story I heard about a young rugby player who was left quadriplegic after an accident and who persuaded his parents to take him to Dignitas” (an actual Swiss clinic for euthanasia also featured in the novel). She said, “I couldn’t believe any parent would agree to do that—and yet the more I read up on his story, the more I realized the issue was not as clear-cut as I would have liked to believe.”[1]

In other words, perhaps there should be room for the possibility of allowing people to choose their own death? While one may be able to understand the desire to end one’s emotional and/or physical pain, is this the best option?

These movies and real-life stories make PAS a serious social concern. As it becomes a more sought-after option state by state, Christians must prepare a loving, biblical response.

The Bible contains strong reasons to reject PAS and euthanasia. The sanctity of human life created in God’s image (Gen. 1:26-17) is one. God’s authority and sovereignty over life and death (Deut. 32:39) is another. Finally, God’s prohibition of murder, which would logically seem to include murder of self or suicide (Ex. 20:13), gives us ample reason to oppose this dangerous agenda.

Even Congress, when ratifying the Fourteenth Amendment, which gives us a “right to liberty,” did not see this liberty as including a right to die. As noted earlier, in 1997, the Supreme Court ruled that against a right to die within the Constitution.[2] The American Medical Association’s official position continues to be against PAS, since first addressing it in 1885 as something “fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”[3] Even further back in history, the Hippocratic (Doctor’s) Oath originally stated, “I will give no deadly medicine to any one if asked, nor suggest any such counsel.”[4]

Finally, there is a deep and rightful concern that the legalization of PAS will lead to euthanasia. Historically, as happened in Nazi Germany, this included involuntarily ending lives deemed no longer worth living or able to speak for themselves—such as the mentally handicapped, infirm, and elderly. A recent disturbing trend in the Netherlands and Belgium underlines this concern, with increasing rates of euthanasia and an ever-widening range of conditions that qualify for such requests.[5] A similar progression may also be happening closer to home. In at least one case an insurance company has refused to pay for medical treatment but was willing to pay for PAS.[6]

While safeguards have been put into place to supposedly keep people from dying against their wishes, perhaps the U.S. Supreme Court has provided the most wisdom by observing that “legal physician-assisted suicide could make it more difficult for the state to protect depressed or mentally ill persons, or those who are suffering from untreated pain, from suicidal impulses.”[7]

As Christians, we must continue to maintain that human life is created in the image of God. As his creation, we are primarily subject to his divine authority, not solely our human autonomy, for life-and-death decision making. If this is not enough to be convincing, the warnings issued by the American Medical Association and Supreme Court should heighten our sense of caution. They should cause us to pause and deeply consider what we as a society might be getting ourselves into if we continue to allow physician-assisted suicide.

Resources

[1] “An Interview with Jojo Moyes” in Me Before You: A Novel (2012; repr., New York: Penguin, 2016), 384.

[2] See the unofficial remarks to this effect by Judge Antonin Scalia in Jan Crawford Greenburg, “Supreme Court to Decide: Is There a ‘Right’ to Die?” Chicago Tribune, January 6, 1997. For the official opinion of the Supreme Court, see Washington v. Glucksberg, 521 U.S. 702 (1997), available at https://www.law.cornell.edu/supct/html/96-110.ZO.html#FNSRC18.

[3] American Medical Association, “Chapter 5: Opinions on Caring for Patients at the End of Life,” in AMA Principles of Medical Ethics (2016), 8, https://www.ama-assn.org/sites/default/files/media-browser/code-of-medical-ethics-chapter-5.pdf. The entire AMA Code of Medical Ethics can be found here: https://www.ama-assn.org/about-us/code-medical-ethics.  

[4] Ludwig Edelstein, trans. The Hippocratic Oath: Text, Translation, and Interpretation (Baltimore: John Hopkins, 1943), in “Hippocratic Oath,” Sheridan Libraries & University Museums, http://guides.library.jhu.edu/c.php?g=202502&p=1335752. This site provides a translation of the Oath.  

[5] Barron Lerner and Art Caplan, “Euthanasia in Belgium and the Netherlands: On a Slippery Slope?” JAMA Internal Medicine 175, no. 10 (2015): 1640–1641, doi:10.1001/jamainternmed.2015.4086.

[6] See, for example, the case of Stephanie Packer documented in Compassion and Choice DENIED by The Center for Bioethics and Culture at http://www.cbc-network.org/denied/?mc_cid=fbad63e2ca&mc_eid=c915f72787.

[7] See “Excepts from Decision That Assisted Suicide Bans Are Constitutional,” New York Times, June 27, 1997, http://www.nytimes.com/books/97/07/20/reviews/scotus-suicide-text.html. This particular quotation is from Chief Justice Rehnquist.