The advance of modern medical technology can be both a blessing and a burden for any society. Medical technology provides a blessing to society because it has the means to correct our bodies from the effects of the fall (Genesis 3:17). However, this same technology can create a burden. With such technology, we now have the ability to take life through medical means. We call this euthanasia and physician assisted suicide.
Euthanasia is a hotly debated topic. Should medical professionals be able to take life? Some proponents of euthanasia claim that actively killing someone through medical means is no different than withholding or withdrawing medical treatment at the end of life.
In other words, some Christians already affirm that if a person is on life support and no other medical technology has the ability to heal, then it is acceptable to withdraw life support and allow the person to die. Many advocates for euthanasia believe that the act of withdrawing life support is analogous to giving a lethal dose of morphine to the patient.
How do Christians respond to a society that seeks to legalize euthanasia and physician assisted suicide? Is euthanasia the same as withdrawing life support, or is there a difference?
The purpose of this post is to help you understand that our intentions matter in the debate between euthanasia and withholding or withdrawing treatment. Pastors have the responsibility to help believers understand that their biblical worldview supports a distinction between killing someone and allowing someone to die.
Why Intentions Matter
Our intentions matter when it comes to decisions being made at the end of life. This is especially true in regard to individuals whom Gilbert Meilaender labels as “irretrievably dying.” If a patient is irretrievably dying, then no modern medical technology can help the patient recover from the dying process.
Withdrawing or withholding medical treatment from a patient who is irretrievably dying does not fit in the same moral category as euthanasia. John Heywood Thomas’ affirms this idea as he writes,
It is essential, for instance, to distinguish very carefully between euthanasia in the proper sense of the term as now used—the deliberate termination of life, the active ‘mercy killing’—and a wide variety of treatments that allow a patient to die rather than prolong life artificially.
The key, then, to distinguishing between euthanasia and “letting die” is intent or motivation. Let’s explore this idea further.
Our intentions do have a role in determining a distinction between euthanasia and withholding or withdrawing treatment.
David W. Jones explains,
Within the Protestant tradition most ethicists have engaged in moral evaluation by considering conduct, character, and goals. 
In other words, a moral decision involves three parts — the person’s conduct, the person’s character (or intention) and the person’s goals. A decision to withdraw or withhold life support from an irretrievably dying patient would not usually have a negative intention attached to it; the intent is not to actively kill a person. Instead, the intentions involve removing life-sustaining treatment in order to allow the person to die from natural causes.
However, not all decisions for withdrawing or withholding treatment are acceptable. Take the case of Baby Doe that occurred in Indiana in 1892. The baby in this case was born with tracheoesophageal fistula and Down’s syndrome. The parents withheld treatment to surgically repair the esophagus because of the potential future life the baby and parents would have to endure if surgery was successful. This would be a case of a bad intention for withdrawing treatment because the decision to withhold treatment was not for an irretrievably dying baby. Rather, the intention was for a better life for the parents and a perceived unprofitable life for the baby if the surgery was executed.
God’s Appraisal of Intentions
We should note that God takes into consideration our intentions, too. For example, in Numbers 35:9–34, intention has a role in determining if someone should be put to death as a murder or should flee to a city of refuge as a manslayer. How does this passage determine if a person that kills another person is a murder or a manslayer? The passage says,
These six cities shall be for refuge for the people of Israel, and for the stranger and for the sojourner among them, that anyone who kills any person without intent may flee there. (Numbers 35:15, emphasis added).
God weighs our actions by looking also at the intention of a person’s heart. A murderer is someone who intentionally kills another person, but a manslayer is someone who kills by accident or unintentionally. The law in the United States of America distinguishes between intent and unintentional also. The penal code holds to a differentiation between degrees of murder and manslaughter, and the penal code affirms with Scripture that intentions do matter.
What This Means for the Euthanasia Debate
Intention matters in other moral acts, and it certainly matters in the euthanasia debate. The intention of withdrawing or withholding treatment for a patient who is irretrievably dying is vastly different from intentionally killing someone through medical means. In other words, removing life support from a patient that is irretrievably dying does not mean that an individual is actively killing that person. David VanDrunen explains,
Actively bringing about a person’s death—by drowning, lethal injection, or whatever—is quite simply not the same thing as deciding not to intervene when something else is bringing death upon a person.
Typically, this something else is some type of disease that is killing the person.
Understanding this distinction between killing and letting die has significant weight for the euthanasia debate. You can engage public policy by addressing the intentions between killing and letting die. This moral distinction is only one aspect of the debate, but by understanding intention, you can be better prepared to discuss the euthanasia debate from a biblical worldview.
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 Currently, California, Oregon, Vermont, and Washington have passed laws allowing for physician-assisted suicide, and Montana will allow for physician-assisted suicide dependent upon a court ruling.
 Gilbert Meilaender, Bioethics: A Primer for Christians, 3d ed. (Grand Rapids: Eerdmans, 2013), 72.
 John Heywood Thomas, Theology and Issues of Life and Death, ed. Susan F. Parsons (Cambridge: James Clarke & Co., 2014), 48.
 David Jones, An Introduction to Biblical Ethics, ed. Daniel R. Heimbach (Nashville: B&H, 2013), 21.
 David VanDrunen, Bioethics and the Christian Life: A Guide to Making Difficult Decisions (Wheaton: Crossway Books, 2009), 209.