Euthanasia can be divided into 4 categories for purpose of
1. Suicide – Carried out by oneself, this is not illegal.
2. Voluntary Euthanasia – Carried out on someone who has
requested death, but is not able to do so alone, either at the
time or in advance of disability.
3. Involuntary Euthanasia – Carried out on someone who has
the ability to ask for it to avoid continued suffering, but who
hasn't asked. It is done for the recipient's “own good,” but
maybe against his wishes.
4. Non-voluntary Euthanasia – Carried out on someone who
isn't in the position to ask to live or die.
Active euthanasia is taking an action to end life. Passive
euthanasia is allowing someone to die by withholding
Coma: Stedman’s defines coma as “a state of profound unconsciousness
from which one cannot be roused”. Following a traumatic injury,
unconscious patients are said to be in a coma.
Persistent (Permanent) Vegetative State: [Many physicians find the
original term “persistent” to be potentially misleading, as it suggests
irreversibility. Thus, over the last thirty years or so, many health workers
have opted to use instead the diagnosis of “vegetative state.”] Persons
diagnosed in a vegetative state show no behavioral evidence of
awareness of self or environment. There is brain damage, usually of a
known cause, consistent with the diagnosis. In order for a person to be
diagnosed in a “permanent” vegetative state, there should be no reversible
causes present, and at least six months should have passed since the
Brain Death: Brain death (sometimes called whole-brain death) occurs when
the entire brain—including the brain stem—is irreversibly damaged. In
1968, an ad hoc committee at the Harvard Medical School formulated a
set of criteria for diagnosing brain death, which included
unresponsiveness, absence of spontaneous respiration, and loss of
brainstem reflex activity. All brain functions have ceased. There are no
sleep-wake cycles. The President’s Commission (1981) proposed an
updated version of the Harvard criteria, and as such, these modified
criteria are gaining acceptance for determining brain death.
“Locked-In” Syndrome (or Midbrain Death): A person with locked-in
syndrome shares many similarities to a PVS patient, since the person is
almost completely paralyzed. But there is a major difference. Locked-in
patients are aware of their surroundings, and frequently can move their
eyes purposefully. They are conscious, and can communicate with those
around them. Sadly, however, they are “locked-in” to a body that does not
allow them to move.
Advance Directive (Living Wills, DNR Orders): An advance directive is a
document with two parts: The first allows a person to appoint a health-care
agent to make medical decisions for them when they become unable to do
so. The second, which often is called a living will, allows people to state
specifically what care they do or do not want to receive at the end of their
life. Contrary to popular opinion, most state laws regarding living wills do
not allow an individual to avoid pain and suffering from an illness. Do not
resuscitate (DNR) orders are directives placed in the medical chart to
prevent heroic measures and allow patients to die as a result of disease or
Artificial Feeding (Tube Feeding): This procedure provides patients with
artificial nutrition through a tube. This artificial enteral feeding takes place
primarily by three different methods. The first is via a tube that is inserted
through the nose (“NG” tube). The second is a gastrostomy tube (G-tube).
The most common of these are the percutaneous endoscopic gastrostomy
tube (PEG tube) or a surgically placed feeding button. These require a
safe, fairly routine surgical procedure to implant the tube directly into the
stomach. Most PEG patients are elderly, while feeding buttons are more
common in pediatric patients. The third is a jejunal tube. During a
jejunostomy, a tube is inserted surgically through the abdominal wall into
the small intestine.
Glasgow Coma Scale: A standardized system physicians use to assess the
degree of brain impairment in order to determine the seriousness of injury
in relation to an expected outcome. The Glasgow Coma Scale involves
three determinants: (1) eye opening; (2) verbal responses; and (3) motor
response (movement). Each determinant is evaluated separately,
according to a numerical value that indicates the level of consciousness
and the degree of dysfunction. Scores run from a high of 15 to a low of 3.
Persons are considered to have experienced a “mild” brain injury when
their score is 13 to 15. A score of between 9 and 12 is considered to be
indicative of “moderate” brain injury, and a score of 8 or less reflects
“severe” brain injury.
Case #1: Chantal Sebire
PARIS — A woman who suffered from a painful facial tumor and had drawn
headlines across France with her quest for doctor-assisted suicide was
found dead Wednesday, an official said. Chantal Sebire, a former
schoolteacher and mother of three, was found at her home in the eastern
French town of Plombieres-les-Dijon. The circumstances of her death were
not immediately clear. Sebire, 52, was diagnosed nearly eight years ago with
esthesioneuroblastoma, a rare form of cancer. The illness left her blind, and
with no sense of smell or taste, her lawyer said. She could not use morphine
to ease the intense eye pain because
of the side effects. The tumor had
burrowed through her sinuses and
nasal cavities, causing her nose to
swell to several times its original size,
and pushing one of her eyes out of
Case #2: Tony Bland
Great Britain — (Due to a riot at a football game)..he suffered crushed ribs and two
punctured lungs, causing an interruption in the supply of oxygen to his brain. As a
result, he sustained catastrophic and irreversible damage to the higher centres of
the brain, which had left him in a Persistent Vegetative State (PVS). He was
transferred to the care of Dr J. G. Howe FRCP., a consultant geriatrician (and
neurologist) at the Airedale General Hospital. Dr Howe had some experience in
treating those with PVS. Several attempts were made by Dr Howe and his team,
along with Bland's father, sister and mother, to try to elicit some response from him
and for some signs of interaction. However, all attempts failed. He showed no sign
of being aware of anything that took place around him. EEG and CT scans
revealed that whilst the brain stem remained intact, there was no cortical activity.
Indeed, scans subsequently shown to the court showed far more 'space than
substance in the relevant part of Anthony Bland's brain'. His body was being kept
alive by artificial nutrition and hydration and excellent nursing. But to all intents and
purposes the person who was Anthony Bland was gone and there was no
reasonable possibility of recovery.
Case #3: Karen Ann Quinlin
New Jersey - Karen Ann Quinlan (March 29, 1954 – June 11, 1985) was an
important person in the history of the right to die controversy in the United States.
When she was 21, Quinlan became unconscious after coming home from a party.
She had consumed diazepam, dextropropoxyphene,
and alcohol. After she collapsed and stopped breathing
twice for 15 minutes or more, the paramedics arrived
and took Karen Ann to the hospital, where she lapsed
into a persistent vegetative state.
After she was kept alive on a ventilator for several months without improvement, her
parents requested the hospital discontinue active care and allow her to die. The
hospital refused, and the subsequent legal battles made newspaper headlines and
set significant precedents. The tribunal eventually ruled in her parents's favor.
Although Quinlan was removed from mechanical ventilation during 1976, she lived
on in a persistent vegetative state for almost a decade until her death from
pneumonia in 1985.
Case #4: Claire Conroy
New Jersey - Claire Conroy was an 84 year-old nursing home patient suffering from
"serious and irreversible mental and physical impairments with a limited life
expectancy." In March 1984 her nephew (her guardian and only living relative)
petitioned for removal of her nasogastric feeding tube. Conroy's guardian ad litem,
appointed by the court, opposed the petition. The Superior Court approved the
nephew's request, and the guardian ad litem appealed.
Conroy suffered from heart disease, hypertension, and diabetes. She also had a
gangrenous leg, bedsores, and an eye problem that required irrigation. She lacked
bowel control, could not speak, and had a limited swallowing ability. In the appeals
trial, one medical expert testified that Conroy, although awake, was seriously
demented. Another doctor testified that "although she was confused and unaware,
she responds somehow.'"
Both experts were not sure if the patient could feel pain, although she had moaned
when subjected to painful stimuli. They agreed, though, that if the nasogastric tube
were removed, Conroy would die a painful death.
Conroy's nephew testified that his aunt would never have wanted to be maintained
in this manner. She feared doctors and had avoided them all her life. Claire Conroy
died with the nasogastric tube in place while the appeal was pending.
Case #5: Terri Schiavo
New Jersey - On the morning of February 25, 1990, at approximately 4:30 a.m. EST,
Terri collapsed in a hallway of her St. Petersburg apartment. Firefighters and
paramedics arriving in response to Michael's 911 call found her face-down and
unconscious, not breathing and had no pulse. They attempted to resuscitate her and
she was transported to the Humana Northside Hospital. There she was intubated,
ventilated, and eventually given a tracheotomy. In 1993, Terri's husband, Michael,
had entered a DNR order for her but was convinced by the nursing home staff to have
it rescinded; in 1998 he petitioned to remove her feeding tube, but was opposed by
Terri's parents, Robert and Mary Schindler, who argued that Terri was conscious.
Michael later transferred his authority over the matter to the court, which determined
that Terri would not wish to continue life-prolonging measures.
On April 24, 2001 Schiavo's feeding tube was removed for the first time and then
reinserted several days later as legal decisions were made. The local court's decision
to disconnect Schiavo from life support was carried out on March 18, 2005, and
Schiavo died at a Pinellas Park hospice on March 31.
Case #6: Nicholas Coke
Pueblo, Colorado - Nicholas Coke, a baby boy from Pueblo is a living miracle. He was born with no brain. He can’t see,
hear, crawl or suck, but still managed to make a history. This week he has completed his one year’s tough fight for
The disease Nicholas was born with is called Anencephaly. It’s a genetic disorder in which a person has no brain, just a
brain stem. Anencephaly is a defect in the closure of the neural tube during development in the womb. The neural tube
is a narrow channel that folds and closes between the third and fourth weeks of pregnancy, forming the brain and the
spinal cord. In rare cases, one end of the neural tube does not close. This results in the absence of a major part of the
brain, skull, and scalp.
Anencephaly occurs in about 1 out of 10,000 births, although the exact number is not known because many of these
pregnancies result in a miscarriage, according to the National Institute of Neurological Disorders and Stroke.
The cause of anencephaly is unknown, although the mother’s diet, including an insufficient intake of folic acid, may play
a role. Most scientists, however, believe many other factors are also involved.
Nicholas, the miracle child has survived without doctors, or tubes. Her mother Sheena told that he even showed sign of
emotion. It was his first smile that brings solace to her poor mother.
They are celebrating every moment as they didn’t know when that fateful moment would come and they had to witness
their child breathing his last breath..
Anencephaly is a disorder that results from a neural tube defect that occurs when the cephalic (head) end of
the neural tube fails to close, usually between the 23rd and 26th day of pregnancy, resulting in the absence of a
major portion of the brain, skull, and scalp. Children with this disorder are born without a forebrain, the largest
part of the brain consisting mainly of the cerebral hemispheres (which include the neocortex, which is
responsible for higher-level cognition, i.e., thinking). The remaining brain tissue is often exposed—not covered
by bone or skin
There is no cure or standard treatment for anencephaly and the
prognosis is poor. Most anencephalic babies do not survive
birth, accounting for 55% of non-aborted cases. If the infant is
not stillborn, then he or she will usually die within a few hours or
days after birth from cardiorespiratory arrest.
In almost all cases, anencephalic infants are not aggressively
resuscitated since there is no chance of the infant ever
achieving a conscious existence. Instead, the usual clinical
practice is to offer hydration, nutrition and comfort measures and
to "let nature take its course". Artificial ventilation, surgery, and
drug therapy are usually regarded as futile efforts. Clinicians and
medical ethicists may view the provision of nutrition and
hydration as medically futile.
In the United States, approximately 1 out of 150,000 to 200,000
babies are born with anencephaly each year. Research has
suggested that, overall, female babies are more likely to be
affected by the disorder
WHAT DOES THE BIBLE SAY?
The Bible does not specifically forbid or condone euthanasia. It does refer to several instances of
suicide, and reveals several principles which we may apply to this issue. We must let the Bible aid us to
"discern both good and evil" - He 5:14.
Specifically, life comes from God, to take it is murder. As such He has the sole right to dispose of it
- Ac 17:25,28. Human life is sacred because we are made in His image - Gen 9:5-6. Suicide, in general, is
an act of murder which is immoral - Exo 20:13
Our bodies belong to God, not us. This is especially true of Christians – 1 Co 6:19-20. We no
longer live for ourselves, but for God - Ro 14:7-8; 2 Co 5:15. We might prefer death, but the Lord may have
a different plan - Php 1:21-24
Every example of suicide in the Bible was by a sinful man: Abimelech, assisted by armor bearer -
Judg 9:50-54; Saul, who gravely wounded fell on his own sword – 1 Sa 31:3-4; Ahithophel, who hanged
himself – 2 Sa 17:23; Zimri, who burned himself alive – 1 Ki 16:18-19; Judas, who hanged himself - Mt 27:5.
Men of God chose to endure pain rather than end life prematurely: Job, who longed for death, but
would not kill himself – Job 6:8-9. Jeremiah, who suffered with those who had sinned - Lam 3:38-41. Jesus,
who suffered for all who sinned - 1Pe 3:18
The early Christians saw value in suffering: For the character and hope it produced - Ro 5:3-4; For
the maturity and patience it produced - Ja 1:2-4; For the opportunity to honor and glorify Christ - 1Pe 1:6-7;
Paul was willing to endure suffering for the benefit of others. He preferred death, but considered
the needs of others – Ph 1:21-24; He endured suffering to demonstrate the power of Christ in him – 2 Co
4:8-12; He viewed affliction as an opportunity to provide an example – 2 Co 1:6-11. How we die may be our
last opportunity to magnify the Lord and help others.
Voluntary euthanasia (suicide), even when one is suffering, can be viewed as an act of
ingratitude toward God who gives us both life and suffering for our good. As a violation of our duty to
serve God all the days of our lives. A misguided effort to escape an aspect of life that God intends
for us to experience. A selfish act that hurts those closest to us, depriving them of our example and
How can we hasten our death, just to avoid suffering? When we do not know what the
future holds (a cure, remission, answer to prayer)? When our suffering may be allowed for our
benefit and those around us?
This is not to say we cannot try to alleviate suffering via pain killers short of taking a life. But
our lives belong to God, and we must trust in Him and His promises...
No temptation has overtaken you except such as is common to man; but God is faithful, who
will not allow you to be tempted beyond what you are able, but with the temptation will also make the
way of escape, that you may be able to bear it. - 1 Co 10:13
Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of
all comfort, who comforts us in all our tribulation, that we may be able to comfort those who are in
any trouble, with the comfort with which we ourselves are comforted by God. For as the sufferings of
Christ abound in us, so our consolation also abounds through Christ. - 2 Co 1:3-5