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AID-IN-DYING – Propositions by Hans Küng: The Revd Canon Rosie Harper


Hans Küng. for those of you who are not familiar with his work, is a distinguished Swiss Theologian now an emeritus professor at Tübingen University. They rather rate him there – and he was made an honorary citizen in 2007.

I confess I am quite naturally drawn to him both for his Swiss roots – I’m also Swiss – and for his utter commitment to the truth – even when it gets him into hot water.

An early colleague of Joseph Ratzinger – to become, of course, Pope Benedict – Küng played an important role as a theological advisor in the development of Vatican 2 in the 1960s. Towards the end of that decade he became the first major Catholic theologian for a century to question the doctrine of Papal infallibility -and really from then on he has conducted his career from the naughty step. He has a huge following and received many important international awards for his commitment to peace and reconciliation – and also for his ability to look honestly at Catholic institutions – and call for reform.

Küng began to develop a serious and considered theology around assisted dying many years ago and articulated it in Dying with Dignity, co-written in 1998 with Walter Jens. At that time the subject was generally taboo in religious circles -even though helping someone to die has been legal in specific circumstances in Switzerland since 1940 – and thus quite naturally Christians in that country have been living with the reality and thinking through their pastoral as well as theological response for a long time.

The theses that I’d like to speak about this morning were first written in 2001. With this day on the horizon I got in touch with him and asked if his position had changed in any way. By way of an answer he sent me the most recent version of these propositions. They are in the process of being developed into a book due shortly. So – I think we are up to date!

In these 20 propositions Professor Küng looks at the underlying theology and ethics of assisted dying. He also challenges the received church teaching -including the fear that some theologians experience as the church effectively silences discussion. There is then some exploration of the experience in other countries and the nature of the boundaries and safeguards that would need to be put in place.

Theologically there are three building blocks found in propositions 1, 17 and 18 -I’d like to begin there.

The bedrock is this:

According to Christian belief, human life ultimately is a gift of God

This would certainly frame the debate in Christian circles in this country. Just over a year ago there was a brief debate in General Synod (February 2012) -and this was pretty much the only theological argument against. There were also many reasonable questions about the safeguards around the legislation, but the mood of Synod was that the theology was a given.

Küng proceeds to unpack it this way:

According to Christian belief, human life ultimately is a gift of God. But according to divine guidance, it is also the responsibility of man. We are encouraged and allowed to dispose of life according to our own wishes. The same is true about the last stage of our life – dying. To give support to the dying ultimately is the same as giving support to the living.

This has to be one of the key concepts -Küng is arguing that far from valuing life less, enabling a person who feels they have no quality of life worth living for to have a choice about their end is actually valuing life more. Nowhere, he says, ‘has the good God of creation demanded that human life be reduced to its pure biological-vegetative function. If a person decides to end his life because he feels that he has no quality of life worth living for -this may or may not be justified,’ -but, he implies, it is not an illegitimate question.

Theologically Küng is telling us that although life is a gift from God – it is one that we are invited to collaborate in shaping. This is not a mechanistic God but one who encourages and allows us to dispose of life according to our own wishes. – A very grown up theology which looks at our responsibility in tandem with divine guidance.

The second building block comes in proposition 17 where he looks at the Fifth Commandment.

To discuss this, the words ‘thou shalt not kill’ need to be reframed more accurately as ‘thou shalt not murder.’ This is then not difficult to describe:

(1) The act of ending a life may be called murder if it is enacted by evil motivation and by violence directed against its object.

(2) The act of ending a human life is irresponsible if it is enacted by motivations that are not necessarily mean but superficial and reckless – as, e.g., in the case of a man who abandons his life in its bloom without taking into consideration his wife and children because he is not successful in his job.

(3) The act of ending a life may happen responsibly if it comes in due time.

Catholic tradition itself holds that life is not the highest of all goods – ethics permit the surrender of one’s life for a higher good – as of course in the death of Jesus Christ. Ethics also allow for individual and collective self-defence – even if that involves the death of your aggressor. A hostage-taker can be killed to save the hostages for example.

So it would seem that there is no ultimate theological prohibition on the control of the moment of death.

He goes on the expand this in the last proposition –number 20 –  saying:

If ending the life is done responsibly, one will not call it ‘murder’ or ‘killing’ but ‘assistance-in-dying’ – i.e. help in the process of dying as motivated by mercy and respect of the free will of the patient.

The patient will call it ‘surrender of life’; when the time of dying has come and the patient has been prepared for it, he may encounter it in submission, thankfulness and hopeful expectation.

He will return his life into the hand of his creator, who is a god of mercy and not a cruel tyrant who would strive to see man in the hell of pain and helplessness as long as possible.

This is powerful stuff – and it is aligned with the instinctive feeling of so many of the faithful who experience God as a God of love, compassion and mercy.

The final theological discussion is around eternal life.

Küng says in proposal 18:

If you believe in eternal life in God, you need not fear an eternal prolongation of your life on earth. ‘To everything there is a season, and a time to every purpose under the heaven: A time to be born, and a time to die’ (Ecclesiastes 1, 1s.) – when there is no hope for an extension of life in human dignity.

This is elegant and simple logic – when your belief is in eternity why might you choose to be driven by a fear of dying – of making death the final arbiter, even when all human dignity has been lost and there is no hope for recovery?

I just have to take a little side road here – Küng can’t resist a challenge to orthodox Catholic teaching on contraception at this point:

‘An institution that has condemned ‘artificial’ regulation of birth (the Pill!) as ‘the error of the century’ (without having yet corrected itself), should hesitate to claim the whole truth for itself where end of life issues and assistance in dying is concerned.

It should take care that the moral authority of the church (in which also her critics are interested) is not diminished once again. But like many physicians who are silent and being scared by the sanctions of their professional organizations, some Catholic moral theologians are silent because they are afraid of the ‘Congregation of Faith’ and its proceedings’

It is a little bit like this in the Church of England too. The most recent YouGov poll commissioned to inform last month’s Westminster Faith Debate on this issue, showed that even amongst church goers 70% of respondents were happy to discuss some form of help for those who found their life intolerable and wished for help. But actually I feel pretty vulnerable standing here talking about it openly – not because my own congregation would be unhappy, but because I’m really not on message institutionally.

A substantial proportion of the rest of the document is focused on the way in which moral and ethical safeguards can inform the practical laws that would be needed to be enacted. But in a typical Küng way he also tackles the great taboo of modern German society – hold on to your hats:

He is talking about the most recent change in the law in Holland:

‘Calling the new Dutch attitude towards assistance to dying patients a relapse into barbarianism supports the prejudice that the Germans tend to switch from one extreme to the other; so that mass killing as commanded by the Nazi-State is substituted by repression of self-responsibility in democratic Germany. In Germany, there is a tendency to treat this issue as a taboo. The officials of church, state and professional associations ignore:

 That our population is aware not only of the advantages but also the limits of palliative medicine, and that in Germany, as well as in all developed countries, there is a growing tendency to let people die whose disease is irreversible and who wish to die. 67% of all Germans say that an incurably ill patient should be allowed to choose death and to demand an injection that will help him to die (according to Allensbach March 2001).

 That in several European countries – e.g. in Switzerland – jurisdiction and medical practice are far less restrictive than in Germany.
 That even in the Netherlands there exists no unconditional license to actively assist patients in dying. The license is dependent on the following: terminal illness, the wish to die must be expressed freely and repeatedly by the patient, the diagnosis must be confirmed by a second physician and consent must be obtained from a regional commission of jurists, physicians and ethethists), information from authorities of state that may review the case. No physician can be forced to administer assistance to dying patients.’
The broader ethical argument that Küng makes concerns the difference between the rights and obligations.

Any choice a person might want to make is not based on their diminished humanity in extreme circumstances. He clearly states that ‘Neither incurable disease nor weakness due to old age nor final loss of consciousness deprives a man of still being a whole human being. Man is a human being until the end of his life.’

This is a very helpful clarification – every person is entitled by their sheer humanity ‘to a life of good quality even during a terminal illness and to a humane death.’

However, suggests Küng: The right to live one’s life to the very end does not mean a moral obligation to do so.

The developments in medicine and technology: can prolong the process of dying for hours, months, years or even decades and deny a patient a humane death.

This same denial of the full humanity and dignity of a dying person can be experienced in the uneven power relationship between the patient and their physician, especially in an age of litigation where the physician has far less freedom to act in the generous, compassionate and humane way that many clearly did in the past.

There is a lot more – much of it rather more specific to the German situation than is pertinent here.

I will end with his 16th proposition -the one I think best encapsulates his position – as one might expect from Küng, it values human freedom, including freedom of conscience very highly.

Nobody shall be urged to die; and nobody shall be compelled to live. The decision of conscience is the task of the patient ; no other person nor even the physician should decide whether the patient’s pain is intolerable.

Rosie Harper 13.05.13

This is a talk given by The Revd Canon Rosie Harper, which she has kindly allowed Lay Anglicana to reprint.

You can see her speak here on and here on Out4Marriage.

3 comments on this post:

Matthew Caminer said...

I had mixed feelings when I saw this, even before I had read a word.

It went something like “Oh, Rosie Harper. Again! What’s she banging on about this time?!” She does, after all, have a way of putting the focus on issues that make me feel intensely uncomfortable. That’s not to say she is wrong to do so, and it’s not that I necesarily disagree: it’s more that I am almost always afraid to confront these issues, even though I know that eventually I must do so. And, in common with others who have my admiration by being brave enough to stand on platforms and lobby hard, she does sometimes communicate with such passion, such noise, anger even, that it can act as a distraction rather than drawing me in. At those times, all I hear is the static, not the reasoned argument that lies beneath. Similarly when hyperbole extends to over-egging an argument, then it is those weaknesses that somehow stick in my mind. Silly, petty even, but I’m human!

OK. I got all that off my chest!

On this occasion, I found this an engaging, well reasoned and non-emotional exposition of the emerging argument in favour of assisted dying. I noticed the reference to the humane practices of some doctors in the past, practices, I assume, whereby increasing doses, of morphia perhaps, could do the job quietly, without fuss, ending heart-rending suffering for patient and family alike when the progress of an illness, and the associated suffering, were utterly beyond question. But that was indeed before the scourge of litigation. A scourge it is, because I suspect that that quiet, kindly action is all that would have been required for many of the cases that this is all about.

I don’t have any difficulty with the principle when the situation is obvious, as in those cases. My concern lies at the margins, where the situation is less black and white, where there may be doubts, where there may be the possibility of a new lease of life. Similarly, I have a concern about cases where the suffering may appear to be beyond doubt but where patients are not capable, whether through illness, another incapacity or reduced intellect, of expressing their wishes clearly. For such cases, I didn’t find that these extracts from Kung’s argument really shifted me one way or the other.

On the theeology of it all, I wouldn’t presume to trade texts with Canon Rosie, let alone with Kung. However, the argument that “this is not a mechanistic God but one who encourages and allows us to dispose of life according to our own wishes” did make me very uneasy. Did it lose something in translation perhaps? There is something about the last few words which seems loose, almost trivialising the momentousness of the decision we are discussing. Is it really the will of our loving God to let us completely loose with these decisions? Would a loving parent let a child play with matches? Or, if we are going to get biblical: “Which of you fathers, if your son asks for a fish, will give him a snake instead?”. Yes I know, cherry-picking bible quotations can be a dangerous game, but by the same token is there a risk that we re-invent God in our own image to support our human arguments?

Please: I don’t have the answers so I’ll be fascinated by others’ responses.

Joyce Hackney said...

Matthew, my response is to express the hope (in addition to the one that this time my reply will turn up on the page) that this old argument will soon become outdated. If the next generation of medicines really does turn out to be tailorable to the indivdual and many more times effective,I can forsee the possibility that treatment can alleviate pain and other discomforts sufficiently to render death no longer a preferable alternative.

Matthew Caminer said...

I am sure that is the ideal to which the medical profession would aspire, and may it be soon!

I’m not sure, however, that those who are suffering NOW feel disposed to wait that long, for it may well be generations before some conditions have been sufficiently addressed “to render death no longer a preferably alternative”. I do have a concern that if the law had once been changed, it would be almost impossible to reverse that change. I also suspect that the challenges would not go away, but simply be different. The bar might be raised, but the argument over the principle would remain.

22 May 2013 21:50
22 May 2013 21:18
21 May 2013 00:19

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