Discussion: End-of-Life Decisions


This work will consider the case of the stage concerning the decision of a man with an incurable disease – amyotrophic lateral sclerosis (ALS). This paper will take into account the Christian worldview of the patient. First of all, his perception of illness as punishment for his sins and the opportunity to get closer to God will be considered. Next, the value of the life of a seriously ill person for himself and others will be considered. After that, the author’s opinion will be expressed against euthanasia and palliative care.

Suffering in Light of the Christian Narrative

Emphasis on the Fallenness of the World

Christianity teaches that every person, including George, is born damaged by sin. The damage is very serious and affects all sides of nature. The human heart, mind, will, conscience and even the body itself are infected with sin. If it were not for Christ, the human situation would be desperately hopeless. According to the Holy Scriptures, the main fruit of sin is eternal death. However, many others can be distinguished: fears, cataclysms, crises of social and political relations, or a serious illness like amyotrophic lateral sclerosis (ALS), which was diagnosed in George.

The first and main cause of suffering is undoubtedly personal sins. The way to get rid of suffering for one’s sins is repentance, and the power of repentance should be commensurate with the degree of sin. Repentance reconciles a person with God, and if there is not sufficient awareness of sin and deep repentance, then it is necessary to accept the sufferings sent with humility. Therefore, with an emphasis on the fallenness of the world, George will interpret his suffering in light of the Christian narrative as fruits for his sins (Ethical and Spiritual Decision Making, 2022). For example, since he is a lawyer by profession, George may interpret them as the result of dishonest execution

Another cause of suffering for George may be getting rid of the sin of pride and acquiring humility. It is natural for a person to overestimate his achievements, which is a sin, and God, with the help of suffering, reminds a person that he is still not perfect. For example, George could be a respected lawyer, which gave rise to his excessive self-confidence, which is considered a sin in the Christian worldview.

Emphasis on the Hope of Resurrection

With an emphasis on the hope of resurrection, George will interpret his suffering in light of the Christian narrative as a way to get closer to God with the goal of gaining eternal life. A seriously ill Christian will seek a living connection with God, he will not be satisfied with a formal confession of his guilt and sinfulness. Wanting to understand the meaning of his sufferings, a person will turn to God more often.

Innocently enduring grief and suffering from an incurable disease, George learns the suffering that Christ will have to endure for the salvation of people. Then George realizes that God is not just sending him suffering without guilt, but God Himself suffered for George. This will allow the patient to approach eternal life, as he will be able to look at his sufferings differently and see in them a spiritual, irrational meaning.

Through a serious illness, God helps George to avoid eternal death. A person with amyotrophic lateral sclerosis (ALS) gets very close to God in prayer in the hope of healing and slowing down the disease since medicine is practically powerless (Ethical and Spiritual Decision Making, 2022). This helps the patient to fully establish himself in God and in faith in Christ, become His follower and be able to inherit the salvation that the incarnate Son of God brought. However, not every suffering and seriously ill person finds salvation. Only on condition that George repents for his sins and recognizes his torments as just, he, like the innocent sufferer of Christ, will ascend to heaven during the resurrection.

Value of Life

The meaning of Christian life is to live according to Divine laws that bestow the highest good to the man himself and to the whole world. By connecting graciously with God, a believer strives for the main goal of the Christian life – to gain immortal existence, to enter into the unimaginable joy and fullness of Divine eternity. By purifying through suffering and getting closer to God during the progression of his amyotrophic lateral sclerosis (ALS), George’s Christian worldview will increase the value of his life as a person.

In earthly life, each person, by thought, word and deed, creates an invisible and at the same time, quite real spiritual building of his eternal being. The Christian way calls for prudently, for the benefit of oneself and humanity, to fulfill the saving will of God, transforming the world around us with the creativity of holiness, goodness and love (Ethical and Spiritual Decision Making, 2022). Experiencing material and spiritual trials, George is not only himself in the process of finding salvation of the soul.

George also gives his loved ones the opportunity to share his sufferings and, thanks to this, to know the joy of eternal life with God. The Christian life is built on a simple and clear principle – to constantly listen and hear God, in practice embodying His holy saving will. Therefore, the value of George’s life according to the Christian worldview is high because he fulfills the will of God. In the pursuit of knowledge and implementation of Divine laws during illness, he carries out the path to salvation of the soul and the attainment of eternity; therefore, the value of his life during the struggle with progressive amyotrophic lateral sclerosis increases.

Opting for Euthanasia

The Christian Church, while remaining faithful to the observance of the commandment of God to not to kill, cannot recognize as morally acceptable the attempts now common in secular society to legalize so-called euthanasia, that is, the deliberate killing of the terminally ill, including at their request. Suffering is always useful for the salvation of George’s soul: by showing patience, humility and hope, he approaches eternal life. In addition, by condemning his neighbor to suffer, he also gives them a chance to approach eternal life. Thus, the values and considerations on which George will focus converge to the fact that he should not for euthanasia.

The patient will come to this conclusion, considering the value of suffering and human life and taking into consideration the possibility of approaching the eternal life of himself and his relatives. For a believer and a Christian, life is a sacred gift, which is an indisputable and supreme value (Ethical and Spiritual Decision Making, 2022). Mercy killing in order to end the suffering of the terminally ill George is by no means merciful. It pursues a completely utilitarian goal: getting rid of the burden, extracting obvious benefits from this for a modern society devoid of traditional values, including genuine compassion for each other. Therefore, George should not opt for euthanasia.

Morally Justified Options

In the Christian worldview for George, it will be morally justified not to opt for euthanasia but to accept suffering and illness with humility. From a moral point of view, it is quite justified and even necessary to use drugs to relieve pain when providing palliative care to suffering patients. A person cannot decide for themselves when to die. It is the attitude of a person to his death that determines whether they will fall into a state of despair or, on the contrary, inner freedom.

A person has a choice: to become a victim or to find meaning in what is happening, to learn something. Accepting the challenge of suffering, a person undoubtedly grows into a completely new dimension and a completely new greatness. They are able to face suffering and grief and remain completely human and still grow into a greater measure of compassion, understanding and courage (Ethical and Spiritual Decision Making, 2022). From a moral point of view, seriously ill George will really become a heavy burden for loved ones and society as a whole.

However, the opportunity to serve people who need help is a blessing — everything that is done for them is done for the Lord himself. Being among healthy people seriously ill George encourages his loved ones to abandon a false system of values and beliefs based on the desire for comfort at any cost — and accept another based on mutual love and care. Refusing to euthanize George will allow his loved ones to learn to appreciate people, not things or pleasures, and open up to a much more dignified and happy life, and more importantly, eternal salvation.

My Decision

Based on my worldview, if I was in George’s situation, I would not opt for euthanasia. At the same time, I would have turned to palliative care and refused artificial lung ventilation. In cases where active therapeutic care is untenable, it should be replaced by palliative care, including anesthesia, care, social and psychological support. In addition, according to my worldview, such assistance should include a conversation with the pastor, with the aim of creating a truly peaceful human ending of life, filled with love and mercy. The care of terminal patients belongs to the field of spiritual tasks, and those who devote themselves to this noble service fill in the gaps where the medical staff with their means is powerless and is a positive and real alternative way of caring for the dying.

According to my worldview, the prolongation of life by artificial means, in which only individual organs actually act, cannot be considered as a mandatory and in all cases desirable task of medicine. Delaying the hour of death sometimes only prolongs the sufferings of the patient, depriving a person of the right to a dignified, shameless and peaceful death, which Christians ask God for during divine service. In my opinion, when active therapy becomes impossible, palliative care should take its place, consisting of anesthesia, care, social and psychological support, as well as pastoral care. All this aims to provide a truly human end to life, warmed by mercy and love.


Ethical and Spiritual Decision Making. (2022). Case study: End of life decisions. 

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