Window view of the Armenian Church, Vol. 3, No. 3 & 4, 1993

WHAT IS GOOD DEATH?
Issues Related to Death and Dying

by Hratch Tchilingirian

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Euthanasia (Greek for "good death"), in general, means "the
causing of an easy or painless death to the patient who is
dying of a terminal illness. Death can be induced by the
patient himself without the knowledge or cooperation of any
other persons. Or it can be effected by others at the request or
with the consent of the patient. In all these cases it is called
voluntary euthanasia. If death is induced against the will or
without the knowledge of the patient, [it is called]
involuntary euthanasia.1
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In 1991 when the Hemlock Society published the best seller
Final Exit by Derek Humphry, a wave of controversies and
debates emerged and once again, euthanasia became a topic
of public discussion. Meanwhile, an Armenian doctor in
Michigan, named Jack Kevorkian, was assisting terminally ill
or potentially terminal patients to commit suicide.
Kevorkian became "famous" in 1990 when he chose to help
Janet Adkins commit suicide in the early stages of her
Alzheimer's disease. In the beginning, "despite some
criticism by a few psychologists and ethicists, there was
tremendous public support evidenced for his compassion,"2
Humphry writes. However, as the number of his assisted
suicides increased, Kevorkian's "public support" turned into
public outrage.

Why did this initial support decline to an eventual
disapproval? Kevorkian - or Dr. Death as he became known
in the press - was acting "as god" in the eyes of society, i.e.,
determining the end of life or when life should end "for the
sake of his patients." While the initial cases of assisted
suicides by Kevorkian were seen as compassionate relief
from ongoing physical pain and discomfort, eventually, his
method became a major public issue when it went "too far."
As Nancy Gibbs in her cover story in Time magazine wrote,
Kevorkian, in his determination to fight for the rights of his
patients, told the State of Michigan "to go to hell."3 By
placing himself above any authority except the will of the
dying person, Kevorkian negated the basic ethical questions
surrounding life and death. He was satisfied with his own
answer.

The Social Debate

Questions such as whether an individual has the "right to die"
or whether life should be prolonged or whether life should be
ended to prevent pain are discerned through social dialogue,
where the social, moral, political, philosophical and
theological implications of such issues are discussed on
various levels. Who decides the length of life? Who
determines the value of life? What is death? Is it a matter of
personal choice? What is the responsibility of society? In a
pluralistic society such as ours, when faced with these
complicated ethical questions, we find ourselves divided
over the fundamentals of life and death.

The ethical and theological problem over death and dying is
further complicated today by the fact that modern medicine
and clinical technology has succeeded in prolonging the life
span of human beings - whether by stretching out the length
of an illness or using artificial means of sustenance. Today,
euthanasia is discussed within the context of this social
dilemma. While on the one hand technology has made many
miracles possible, it has also legitimized the illusion that
"man is the center of the universe" and therefore controls his
own destiny. On the contrary, as M. Gorbachev underlines,
"technology has not only failed to ease the conflict between
man and nature, it has aggravated that conflict.... The crisis
of civilization that we see today is a crisis of the naive belief
in the omnipotence of humanity."4

Technological advances without corresponding moral
discussion and determination create an ethical vacuum in
society. Obviously, many resort to euthanasia out of fear of
machines and hospitals where human beings are treated as
"lab subjects." The medical industry has not clarified its
boundaries and the parameters of its function in society. As
such, the gap in the trust between patients and doctors has
increasingly grown wider.

What is Death?

Biologically, the death of any living organism is viewed as
the "inevitable and critical moment when an organism ceases
to function as a specific, unified, homeostatic system and
becomes disorganized into a mere collection of
heterogeneous chemical substance." The process of death is
the tangible unraveling of the biological system; death is the
cessation of systemic functioning. "Hence, the essential
point about determining human death is not to decide
whether any life is present, but whether human life in the
most radical sense of a unified human person is still
present."5 And yet, who determines whether this "unified
person" is present? Is it the doctor? Is it the patient? Is it the
family? If the person is "not present," do we have the right to
extinguish this life? When is life no longer of value? Today,
in a market-driven society, human life is viewed from a
materialist perspective and life is often valued for its
productive capacity or for its adequacy to seek and
experience pleasure. Thus death, while feared, is preferred
over a non-productive or painful existence.

Nevertheless, unlike other organisms, "human death has a
mystery about it, because at death we lose touch irrevocably
with a person who previously was able to communicate and
to share our human community of thought, of love, of
freedom, and of creativity. Human death is not merely a
decay of an organism, it is the departure of a member of the
human community."6 It is this interdependence between the
individual and the community that sets the "climate" of the
dialogue concerning community and societal issues, e.g.,
euthanasia. On the other hand, in Western societies, the loss
of a member of the human community is viewed as evil - "an
evil which is resented, fought against and battled, even
though it is seen as inevitable. Death is darkness. It is the
end of life on earth as we know it. It is the conclusion of our
efforts, our hopes, our dreams, our expectations, our
existence as earth-borne beings."7

An Orthodox Perspective

Ultimately, any ethical position or contemplation in life takes
place in a specific context. And that context is defined by
one's religious belief or values by which she lives. A person's
understanding of life is based on her values, her upbringing,
her experience in life, her religious faith and practice and
many other variables. As Armenian Christians, we have the
rich theological tradition of the Armenian Church which
defines that context.

The Armenian Church understands death in the context of
life, i.e., dying and living in Christ. This understanding is
reiterated throughout the liturgical tradition of the Armenian
Church, (e.g., Baptism, Divine Liturgy, Funeral Service,
etc.). In fact, in the New Testament "the dominant lines of
[God's] revelation converge toward the mystery of Christ's
death. There all of human history appears like some gigantic
drama of life and death; until the coming of Christ, and
without Him, there is only the kingdom of death. Christ
comes, and by His death triumphs over death itself; from that
instant, death takes on a new meaning for the new humanity
which dies with Christ in order to live with Him eternally."8

In a broader sense, dying should be viewed as a process and
death as an event. The Christian, through Baptism, dies in
his "old life" and lives anew in Christ. The entire life process
is a process of "dying," and "reliving" in Christ through love
in the Holy Spirit. Death, for the Christian, is merely the
event by which one leaves this world to become a part of
another. There may be pain and suffering in the process and
that is understood through the purifying and salvific suffering
of Christ.

According to the Armenian Church, suicide - i.e., those who
separate or cut off themselves from the church community -
constitutes the deliberate taking of human life and as such is
to be condemned as murder.9 The Church, however,
"distinguishes between euthanasia and the withholding of
extraordinary means to prolong life unable to sustain itself.
It affirms the sanctity of human life and man's God-given
responsibility to preserve life. But it rejects an attitude
which disregards the inevitability of physical death. The
only "good death" for the Orthodox Christian is the peaceful
acceptance of the end of his or her earthly life with faith and
trust in God and the promise of Resurrection."10

Thus, the meaning of life is not determined by an individuals
productivity, or her comfort or his pleasure or her desire to
live, but by the individual's faith in God. Death is not an
ending, but a beginning. Death is not a condition to be
induced or avoided; it is the culmination of this life and the
preparation of a new life in Christ. The circumstances of
death are always difficult - for those who die, as well as
those who remain behind - but ultimately, human life and
condition are to be entrusted to God and His mercy. It is not
a matter of personal control. As the Psalmist writes, "The
Lord redeems the soul of his servants: and none of them that
trust in Him shall be desolate," (Ps. 34:22).

Notes:

1. Andrew C. Varga, The Main Issues in Bioethics, (New
York: Paulist Press, 1984), pp. 267-68.

2. Derek Humphry, Final Exit: The Practicalities of Self-
Deliverance and Assisted Suicide for the Dying, (The
Hemlock Society, 1991), p. 18.

3. Time, May 31, 1993, p. 35.

4. Time, September 6, 1993, p. 53. M. Gorbachev is
currently President of International Green Cross.

5. ibid., p. 366.

6. Benedict M. Ashley and Kevin D. O'Rourke, Health Care
Ethics: A Theological Analysis, (St. Louis: The Catholic
Health Association of the United States, 1982), pp. 364-65.

7. Stanley S. Harakas, Contemporary Moral Issues Facing
the Orthodox Christians. (Minneapolis: Light and Life
Publishing Co., 1982), p. 166.

8. Xavier Leon-Dufour, Dictionary of Biblical Theology.
(New York: The Seabury Press, 1973), p. 117.

9. Canon 11 and 28 of St. Athanasius of Alexandria. cf. op.
cit. Harakas, p. 174. For other related canons of the
Armenian Church see Vazken Hagopian, Canon Book of
Armenians [in Armenian], Vol. I and II, (Yerevan: Armenian
Academy of Sciences, 1964/1971).

10. op. cit. Harakas, p. 176.