Latest / The Speak Life Podcast / Responding to Peter Singer on Euthanasia || SLP518

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Responding to Peter Singer on Euthanasia || SLP518 · The Speak Life Podcast

• 0:06
  SPEAKER_01: Hi, I'm Glenn from Speak Life.
• 0:08
  SPEAKER_01: We'd like to see all things through the lens of Jesus, including the issue of life and death.
• 0:13
  SPEAKER_01: Uh just two weeks ago, Peter Singer, an Australian ethicist, came on to Unheard to discuss some of his more controversial views, including his views on euthanasia.
• 0:22
  SPEAKER_01: They touched in the discussion on the experience in Canada, and instantly I thought I want to get to talk to somebody in Canada who knows about medical assistance in dying and who can think through these issues with us from a Christian point of view.
• 0:34
  SPEAKER_01: And I'm very glad that we've actually got Dr.
• 0:36
  SPEAKER_01: Ewan Golliger on the line.
• 0:38
  SPEAKER_01: Dr.
• 0:38
  SPEAKER_01: Golliger, thank you so much for joining us.
• 0:40
  SPEAKER_00: Hi, thank you so much, Glenn, for having me.
• 0:42
  SPEAKER_00: It's my pleasure to be here.
• 0:43
  SPEAKER_00: So can you introduce yourself to us?
• 0:44
  SPEAKER_00: I'm an assistant professor of medicine at the University of Toronto.
• 0:49
  SPEAKER_00: I practice intensive care medicine, and in the course of working in the intensive care unit, care for a lot of patients who are and their families who are working through end-of-life care issues.
• 1:01
  SPEAKER_00: I'm also a physician scientist.
• 1:04
  SPEAKER_00: I run a research program, and uh I also write and speak on issues around end-of-life care ethics, especially to help the Christian community think about these issues.
• 1:14
  SPEAKER_01: You're also the author of a book called How Should We Then Die.
• 1:18
  SPEAKER_01: Um tell us the origin of that book and and what you hope for that book.
• 1:22
  SPEAKER_00: Yeah, I started uh working on that book several years ago.
• 1:27
  SPEAKER_00: It's the fruit of a lot of thought and discussion with others about the issue of physician assisted death.
• 1:35
  SPEAKER_00: I didn't really spend too much mental effort on medical ethics, to be honest with you, aside from that, those issues that arose in the course of my practice until uh assisted death was um legalized in Canada about about 10 years ago.
• 1:51
  SPEAKER_00: And then it became very clear that those of us who oppose the practice would have to be able to give an account of why we were against it.
• 1:59
  SPEAKER_00: And so the book is basically the result of you know years of reflection and and a concerted effort to develop a kind of approach and and to find the right language to explain to people why in killing and uh intentionally killing an innocent person is wrong, what are some of the flawed assumptions behind this practice, why we should oppose it, and and ultimately how to wrestle with the questions about meaning and value that that really underpin the whole conversation.
• 2:32
  SPEAKER_00: And so what I'm hoping for the book is that it equips people to talk to their neighbors, their friends about the issue in a way that's informed and thoughtful and really gets to the root issues, the the questions about what makes life worth living even when we when we have to suffer.
• 2:47
  SPEAKER_00: I think fundamentally that's the question that we have to wrestle with uh when we think about this issue of assisted death.
• 2:54
  SPEAKER_01: Now, as a Christian, uh you're used to thinking in um moral terms and and gospel terms about life and death and ethics in that regard.
• 3:04
  SPEAKER_01: But in your training, uh was there a lot, uh was that was there a lot of time given to medical ethics?
• 3:11
  SPEAKER_00: Well, I wouldn't say there was a lot of time given to it.
• 3:13
  SPEAKER_00: It was certainly part of the core medical school curriculum, so at intervals we would discuss and address different issues.
• 3:21
  SPEAKER_00: Uh traditionally, medical ethics over the last few decades, anyways, has been characterized by uh a kind of principle-based approach where there are four basic principles that we're taught to follow, but really there's no underlying coherent framework for the basis of these principles and so on.
• 3:39
  SPEAKER_00: So, you know, as physicians in training, we, you know, we're drinking in everything that we uh we're hearing, and um, and those principles come to really form and shape the practice, and in many ways they're good principles.
• 3:52
  SPEAKER_00: But I never really had to grapple with sort of the underlying questions of why until those principles started to seem to lead in directions that uh were very concerning to me.
• 4:02
  SPEAKER_00: So, for example, many people will cite the principle of respect for autonomy as the basis for uh the appropriateness of causing a patient's death upon their voluntary request.
• 4:12
  SPEAKER_00: And so uh, you know, I was forced to really grapple with the underlying why of of ethics in in healthcare and and more generally.
• 4:21
  SPEAKER_01: So, what are those four principles?
• 4:22
  SPEAKER_01: Does respect for autonomy is one of them?
• 4:24
  SPEAKER_00: Yeah, the first and really has become the foremost is respect for autonomy.
• 4:30
  SPEAKER_00: Uh, there's also the principle of non-maleficence or first do no harm that many people will have heard of.
• 4:35
  SPEAKER_00: There's thirdly the principle of beneficence, which is the des you know, the principle that we ought to do good for the patient.
• 4:42
  SPEAKER_00: And then finally, uh the principle of justice, which is that we in making decisions about healthcare have to consider um principles of fairness in society as well.
• 4:53
  SPEAKER_00: And you know, the one of the challenges in the practice of medicine is balancing these principles.
• 4:59
  SPEAKER_00: And I would say that over time the principle of autonomy has come to be kind of the basis for all of the other principles and uh is increasingly seen as the kind of foundational principle in the practice of medicine.
• 5:12
  SPEAKER_01: And we'll think about that uh uh in regard to Peter Singer as uh an ethicist who uh was from Melbourne and has been at Harvard for many decades and has been at the leading edge of all sorts of ethical questions.
• 5:27
  SPEAKER_01: I think he would describe himself perhaps as a utilitarian, um, but from that utilitarian basis has forwarded all sorts of views, uh and perhaps for the Christian, these impinge on questions of sanctity of life at the beginning and at the end.
• 5:42
  SPEAKER_01: And uh I was watching this interview that he gave uh just a couple of weeks ago on the Unheard channel, and I just thought I'd like to get your reflection on some of it.
• 5:52
  SPEAKER_01: But um you and you you've sort of come across Peter Singer and some of his views before.
• 5:57
  SPEAKER_00: Yeah, I mean Peter Singer has been described as as the most influential uh living philosopher, which is you know a lofty title, but probably appropriate, is pretty striking.
• 6:09
  SPEAKER_00: I would say over the last several decades, society has shifted uh significantly in terms of its kind of mores and values in ways that align more and more with views that he's been articulating for the last uh many decades.
• 6:23
  SPEAKER_00: Um there's no question that anytime you start wrestling with issues around and of life care ethics, never mind everything else, Singer is uh a significant voice that you have to wrestle with.
• 6:34
  SPEAKER_00: And I think one of Singer's great strengths, I would say, is that A, he's incredibly accessible.
• 6:41
  SPEAKER_00: So he he writes for a broad audience, so he's easy to read.
• 6:45
  SPEAKER_00: Um he's also very transparent and honest, and allows his conclusions to lead him to places that many other people would not be willing to go.
• 6:54
  SPEAKER_00: Questions like infanticide and so on.
• 6:57
  SPEAKER_00: So um I think for that reason he's been an effective and influential voice and and really has to be um taken very seriously when we come to grapple with ethical issues.
• 7:09
  SPEAKER_01: Well, Freddie Sayers here is um speaking about some of the controversies that Peter Singer has been famous for, but actually saying that over the last 50 years, um society in some ways has been catching up to Peter Singer's views.
• 7:23
  SPEAKER_01: Uh here's the way that Freddie Sayers speaks about it, and here's how Peter Singer responds.
• 7:28
  SPEAKER_02: When you first published those books in the 70s and the 80s, and some of the arguments around the case for abortion, up to and beyond term limits, the case for assisted dying, those things were considered very out there and controversial.
• 7:46
  SPEAKER_02: Um do you feel that the world has come closer to you over that during that period?
• 7:52
  SPEAKER_03: Yes, I think definitely on these uh right to life or sanctity of life issues, life and death decisions in healthcare, um I think the world has moved quite perceptibly closer.
• 8:04
  SPEAKER_03: Because at the time when I started writing about them, there was nowhere in the world where voluntary euthanasia was legal.
• 8:12
  SPEAKER_03: Um and also, you know, voluntary assisted dying, if you want to distinguish that, the idea that the physician can prescribe you a drug but not actually administer you a lethal injection to end your life.
• 8:23
  SPEAKER_03: Um that also was not legal.
• 8:25
  SPEAKER_01: Can you um help us with that distinction between voluntary euthanasia and voluntary assisted dying?
• 8:30
  SPEAKER_00: Yeah, so this is a challenging area for many people because uh there's a bit of a word salad around all of the terminology.
• 8:36
  SPEAKER_00: I I actually don't think Singer used the quite the correct terminology.
• 8:41
  SPEAKER_00: I think what he meant to distinguish was voluntary euthanasia from voluntary assisted suicide.
• 8:46
  SPEAKER_00: So in voluntary euthanasia, the healthcare practitioner directly administers the lethal drug to the patient intravenously.
• 8:54
  SPEAKER_00: And in voluntary assisted suicide, the uh practitioner prescribes a lethal drug that the uh loved one or or that the patient, sorry, then uh actually ingests for themselves.
• 9:07
  SPEAKER_00: So they're committing suicide with the assistance of uh of the healthcare practitioner.
• 9:14
  SPEAKER_00: Morally and from ethically speaking, I there's no real significant moral difference, and and I think that's kind of universally agreed.
• 9:23
  SPEAKER_00: But from a practical point of view, because um uh many people are sort of more comfortable having a lethal injection administered to them than actually ingesting a lethal substance.
• 9:35
  SPEAKER_00: Uh in jurisdictions where both are legal, euthanasia is far more popular.
• 9:40
  SPEAKER_00: And if only assisted suicide is legalized, then the practice tends not to grow as widely or as rapidly as as euthanasia does.
• 9:48
  SPEAKER_00: So there's a practical distinction, although not really a moral distinction.
• 9:51
  SPEAKER_01: Aaron Powell Because the patient is much more reticent to give themselves the lethal injection than to have somebody else do that.
• 9:58
  SPEAKER_01: Is that when it comes down to it, it it becomes much more difficult to do the act themselves.
• 10:02
  SPEAKER_00: Aaron Powell Yeah, I that seems to be the case.
• 10:04
  SPEAKER_00: I I don't have data to say exactly uh uh why, you know, the underlying psychology, etc., but clearly uh people vastly prefer euthanasia over assisted suicide.
• 10:15
  SPEAKER_01: Aaron Powell Interesting.
• 10:16
  SPEAKER_01: Well, Singer goes on to say both practices have expanded uh much further than he had thought they would uh back in the 1970s.
• 10:24
  SPEAKER_03: Now it's legal in many countries and increasingly um in the United States.
• 10:30
  SPEAKER_03: It's more states.
• 10:31
  SPEAKER_03: I think it's probably up to about 15 states of the US now, including California.
• 10:36
  SPEAKER_03: Uh you know, formerly Catholic countries like Spain and Portugal, so it's not only the Netherlands uh and uh all of Canada, pretty much all of Australia now.
• 10:48
  SPEAKER_03: Uh I'm rather surprised that it isn't legal in the United Kingdom yet.
• 10:52
  SPEAKER_03: I'm not quite sure what's uh holding that discussion back.
• 10:56
  SPEAKER_03: But uh I was just in France, it's being discussed in France.
• 10:59
  SPEAKER_03: Again, I don't really know what will happen.
• 11:01
  SPEAKER_03: So on that issue, yes, uh the world has moved much closer.
• 11:04
  SPEAKER_01: It has been discussed very often in the United Kingdom.
• 11:07
  SPEAKER_01: It's it's been sort of rejected uh consistently up until now, and it seems like uh Keir Starmer and Labour will get in at the next election, and it seems likely that uh legislation around euthanasia will again be presented to Parliament.
• 11:23
  SPEAKER_01: Um you and you're from outside the the UK.
• 11:26
  SPEAKER_01: I I'm an Australian and and not uh a Brit myself, but uh do you do you have any views on on why the UK might be holding out against this particular tide?
• 11:35
  SPEAKER_00: Well, I I I've actually wondered that myself because I've watched with admiration as the as the UK has held the line on this issue.
• 11:44
  SPEAKER_00: I think one of the factors for sure is that uh the UK has been a world leader in palliative care.
• 11:51
  SPEAKER_00: In fact, the palliative care movement was was started by Dame Cicely Saunders in working in London, I believe, in in the 60s.
• 11:59
  SPEAKER_00: And so I I think the strength of of that movement in in the United Kingdom and the understanding that the process of dying can be an opportunity to flourish and not just a season of of suffering, um, I think has sort of fortified uh many in in in Britain against against the practice.
• 12:22
  SPEAKER_00: I I'm sure there may be other factors as well, but I think it's a really interesting question to to to consider.
• 12:29
  SPEAKER_01: That's very interesting.
• 12:30
  SPEAKER_01: I mean euthanasia is just a word that means good death.
• 12:33
  SPEAKER_01: And I guess if you've got an alternative that really is uh as regards palliative care, uh a good alternative, then it's then it starts to to to be uh easier to say no, I guess.
• 12:45
  SPEAKER_01: I was I was very struck in your book by the analogy you use.
• 12:48
  SPEAKER_01: Um that if you're walking along a cliff top and you you see somebody sort of hanging on by their fingernails, and you know, if if they say, you know, just inject me so that I'll let go, um, and you refuse to do that, um, it is probably morally incumbent on you to alternatively do something else.
• 13:06
  SPEAKER_01: Like if you if you're not going to help them um go off the cliff, you probably should help them in the despair that they're in.
• 13:14
  SPEAKER_01: And and it sort of makes me ask the question if we're going to say no to euthanasia as the church and as society, what sort of church and what sort of society do we need to be in order to say no to that and say yes to something else?
• 13:30
  SPEAKER_00: Yeah, that is such an important point.
• 13:32
  SPEAKER_00: I I think one of the uh reasons that the public embraces euthanasia is because they're genuinely afraid of the dying process.
• 13:41
  SPEAKER_00: And and in medicine, I don't think we've done a terrifically good job of educating people about the options that they have uh for the control of pain and and symptoms as they journey towards death and how just how effective good palliative medicine can be.
• 13:56
  SPEAKER_00: So I think the first thing to do is to reinforce uh the ability of palliative care to ensure that patients live to the fullest even through the dying process.
• 14:06
  SPEAKER_00: And I think it's really important to highlight that most people who are seeking assisted death do so not because of uncontrolled physical pain or discomfort, but rather really because of more existential reasons around loss of autonomy, feeling like a burden, a sense of worthlessness, and just seeing no point in going on with life given that you're in steady decline.
• 14:27
  SPEAKER_00: And those are a fundamentally different set of problems than, say, the kinds of problems that people are afraid of around physical suffering.
• 14:35
  SPEAKER_00: So, what kind of church and what kind of society do we need to be to care for people well through the dying process?
• 14:41
  SPEAKER_00: Well, we need to first of all make sure that good medical care is widely available to people in the dying process.
• 14:48
  SPEAKER_00: And secondly, we need to be communities that gather around people so that they can see how much they matter to themselves.
• 14:55
  SPEAKER_00: I think the temptation for the dying, particularly those for who are living in relative isolation, is to doubt their own worth and significance and to see life as pointless.
• 15:04
  SPEAKER_00: And so our task really becomes to remind them just how much we matter by our words and deeds toward them.
• 15:09
  SPEAKER_00: And I think that's a particularly important task for the church.
• 15:13
  SPEAKER_01: That's a beautiful word because yeah, what is the alternative to autonomy and independence?
• 15:18
  SPEAKER_01: I guess it's kind of interdependence and care.
• 15:20
  SPEAKER_01: Um so yeah, how could how can we be churches like that?
• 15:23
  SPEAKER_01: How can we be societies like that?
• 15:25
  SPEAKER_01: So uh Peter Singer has said okay, uh euthanasia has kind of um increased in certain parts of Europe, in uh fifteen states, I think he said, in uh the United States, uh all across Canada, in certain states in Australia.
• 15:40
  SPEAKER_01: Um what does he say next?
• 15:42
  SPEAKER_03: On uh essentially the idea that uh abortion um is a woman's choice is something that has been much more widely accepted as well.
• 15:51
  SPEAKER_02: I mean if we just take the assisted dying case, it's also whilst it's becoming more accepted in law, it's also become much more of a political argument, hasn't it?
• 16:02
  SPEAKER_02: That it feels like there's been the beginnings of a backlash against it.
• 16:06
  SPEAKER_02: Certainly in Canada, for example, there's there's it's become very controversial, and a lot of people point to the experience in Canada as problematic, worrying, that it's taken.
• 16:20
  SPEAKER_02: I don't really agree with that.
• 16:21
  SPEAKER_03: Um my reading of Canada is uh that they had a somewhat conservative law um allowing physicianists to dying in case of people patients who are terminally ill.
• 16:34
  SPEAKER_03: They've broadened that out to include people who are incurably ill rather than just terminally ill.
• 16:40
  SPEAKER_03: And they're now contemplating, which would be in advance of anywhere else, the idea that if, for example, you have early onset Alzheimer's, um, you could say that you don't want to die now, um, but you would like to die when you reach a certain point.
• 16:56
  SPEAKER_03: Uh and that generally is not legal elsewhere.
• 17:00
  SPEAKER_01: So, what is the Canadian experience?
• 17:02
  SPEAKER_01: When when did medical assistance in dying come in?
• 17:04
  SPEAKER_01: Was it controversial at the time?
• 17:06
  SPEAKER_01: And and has there been a backlash?
• 17:08
  SPEAKER_00: So assisted death was legalized uh technically by the government in 2016.
• 17:15
  SPEAKER_00: There was a Supreme Court case that was decided in 2015 when the criminal uh law prohibition on physician assisted death was struck down, and the government was ordered to pass legislation to legalize it the following year, which they did.
• 17:30
  SPEAKER_00: So since 2016, uh the practice has grown steadily in in Canada.
• 17:36
  SPEAKER_00: I think in the first year it was legalized, there were about 1,300 deaths by assisted death.
• 17:42
  SPEAKER_00: And uh last year or 2022, the last year for which we have official numbers, I think the number was something like 13,000.
• 17:50
  SPEAKER_00: So in terms of acceptance and uptake and growth in the practice, it's really grown quite dramatically.
• 17:57
  SPEAKER_00: As Singer said, when it was first uh legalized, it was restricted to those for whom death was reasonably foreseeable.
• 18:04
  SPEAKER_00: Now that was already a pretty subjective and and sort of uh debatable matter of judgment just when death became reasonably foreseeable.
• 18:12
  SPEAKER_00: But then in 2021, the law was changed to remove that requirement.
• 18:16
  SPEAKER_00: So now people who were grievously and irremediably suffering, but not necessarily facing or dealing with a terminal illness, say for example, chronic disability, could seek assisted death.
• 18:29
  SPEAKER_00: And that I think was uh a significant game changer because up to that point the public's perception was that this was relatively well controlled and limited.
• 18:42
  SPEAKER_00: And uh after that was legalized, the you know, in some sense, the floodgates opened, not in terms of you know when was that change?
• 18:51
  SPEAKER_01: When did that change happen?
• 18:52
  SPEAKER_00: This was 2021.
• 18:54
  SPEAKER_00: Right.
• 18:54
  SPEAKER_00: And and since then, um that's when we've started to hear uh stories in the media about people living in poverty or with significant disability and no other options, seeking assisted death.
• 19:04
  SPEAKER_00: And and and those are some of the stories that have made their way around the world and news headlines to raise concerns about what what is happening in Canada.
• 19:13
  SPEAKER_00: So uh, you know, I would I think it's some I would emphasize that uh those cases are still a small minority of the total number of assisted deaths.
• 19:22
  SPEAKER_00: But one of the challenges in the Canadian conversation has been just how far are we willing to go to permit this?
• 19:29
  SPEAKER_00: Will we permit this for people with mental illness?
• 19:31
  SPEAKER_00: Will we permit this uh if people want to make an advanced directive?
• 19:35
  SPEAKER_00: Will we permit it for mature minors?
• 19:38
  SPEAKER_00: And the trouble is that once you accept the idea that death can be good for suffering, that it's a kind of effective treatment for suffering, well, you know, all kinds of people become eligible potentially for death.
• 19:50
  SPEAKER_00: And so it's very hard to contain once you let the horse out of the barn, so to speak.
• 19:55
  SPEAKER_01: And especially if suffering, if you if we don't have a category for meaningful suffering either, um which uh in the utilitarian calculus is is pretty much the assumption that's that's where you begin that that suffering is as bad as bad can be, really.
• 20:11
  SPEAKER_01: And and you know, pleasure is as good as good can be, and to eliminate all suffering means that at times eliminating sufferers unless we can have a a category for meaningful pain, meaningful suffering.
• 20:24
  SPEAKER_01: Uh but it seems like we don't we don't really have that anymore.
• 20:27
  SPEAKER_00: Yeah, I I think the idea that a life lived with chronic, grievous, and irremediable suffering could still be a life that's worth living seems like almost an absurdity to many people in society now.
• 20:43
  SPEAKER_00: It's very hard for them to to make sense of how such a life could be worthwhile or or significant.
• 20:50
  SPEAKER_00: And I think in the book I I try to draw out the fact that this reflects an underlying or deeper problem that we think we're responsible for finding our own meaning.
• 21:00
  SPEAKER_00: That meaning is not something that's given to us, it's something that we have to create for ourselves.
• 21:04
  SPEAKER_00: And as soon as suffering comes along and and makes us unable to create meaning for ourselves, well, we find ourselves feeling utterly meaningless and therefore uh see no point in going on with life.
• 21:17
  SPEAKER_00: So, really, this this desire, demand for assisted death reflects, I think, a kind of broader crisis of meaning in in in the West, the challenge of making sense of what makes life worth living in the first place.
• 21:30
  SPEAKER_01: And it seems to me to raise the question of how we identify the marginalized, the weak victims.
• 21:38
  SPEAKER_01: Um because I I think from a Christian point of view and from a post-Christian point of view, identifying the truly marginalized, the truly weak and supporting them and being the kind of society that looks after its weakest members um isn't is a virtue.
• 21:55
  SPEAKER_01: I think that's a that's a virtue in in a Christian worldview, I think it's a virtue in a post-Christian world.
• 22:00
  SPEAKER_01: worldview but I guess the big question becomes how do you identify those weak, those poor, those marginalized?
• 22:08
  SPEAKER_01: And I think in the UK, um the the story of of the pro-euthanasian side, they've been very good at um bringing forth those stories of unyielding, unremitting pain and suffering.
• 22:25
  SPEAKER_01: And and it's often a story that's spoken by um someone of that we deeply respect, Terry Pratchett, let's say.
• 22:33
  SPEAKER_01: Um just a wonderful author.
• 22:35
  SPEAKER_01: I I I devoured Terry Pratchett novels as a teenager.
• 22:38
  SPEAKER_01: And we all love Terry Pratchett and we all hate Alzheimer's and and we hate that degenerative condition and what it's doing to Terry Pratchett and and he comes forth as um as a a very worthy um object of our compassion and our care.
• 22:57
  SPEAKER_01: And how do we make sure that you know that Terry Pratchett is in charge of you know the his life and his death and that's kind of forwarded as the the the compassion story that that really does win hearts and minds and sways people.
• 23:12
  SPEAKER_01: How can we tell a better story as Christians about who some of the other vulnerable people are when it comes to euthanasia?
• 23:23
  SPEAKER_00: Well I I think that the first thing that we have to do is to get a lot more clarity on the question of whether ending someone is a way to show respect for them.
• 23:34
  SPEAKER_00: There there is no question that everyone agrees whether we're for assist to death or against assist to death that suffering is tragic that people matter and that we ought to respond to their suffering and and um and their situations with care, concern and and real solutions.
• 23:54
  SPEAKER_00: The question I think is whether death presents itself as the compassionate solution or not and what we're often told is that by ending people you're um rendering them better off.
• 24:06
  SPEAKER_00: You're giving them what you want what they want and you're empowering them and that's how we're expressing value towards them.
• 24:13
  SPEAKER_00: And I think the first thing we have to see that in fact when you choose to end someone what you're actually saying is that they don't matter anymore.
• 24:20
  SPEAKER_00: Their existence doesn't matter anymore and therefore they don't matter anymore and we no longer need them with us.
• 24:27
  SPEAKER_00: So in Assisted death's effort to show dignity and respect for those who are suffering it actually profoundly devalues them because it's a statement that's saying your existence no longer matters.
• 24:40
  SPEAKER_00: It's no longer good that you're here.
• 24:42
  SPEAKER_00: So we need to understand the way in which ending someone actually devalues them.
• 24:47
  SPEAKER_00: And so it essentially takes that option off the table.
• 24:50
  SPEAKER_00: Yes we agree we need to show compassion for those who are suffering for those who are marginalized those who are weak but is is causing their death actually a way to do that and um I think that the other the other thing I would say is that we need to really get clear in the nature of vulnerability here because not only is um are people vulnerable to assisted death when they have external circumstances that make life very difficult for them poverty disability and sickness but I think people are also vulnerable in the sense that if they don't have the resources to find life meaningful when they start to suffer and death seems like the best option, that's a different kind of vulnerability.
• 25:33
  SPEAKER_00: I'd call it a kind of internal or spiritual vulnerability.
• 25:36
  SPEAKER_00: And so I think all these different forms of vulnerability need to be addressed social circumstances, marginalization, especially in our churches looking out for those who are lonely or those who are disabled to ensure that we find ways whether through hospitality and various ministries that we ensure that we show them how much they matter that they're not alone and that they're valued.
• 25:58
  SPEAKER_00: But also just recognizing that our our society has become profoundly vulnerable to the temptation to seek death because we struggle to see how much we matter and because we struggle to make sense of a life worth living in the face of suffering like we said we don't have the spiritual resources to live with suffering.
• 26:17
  SPEAKER_00: So let's say there's many layers of vulnerability to think about but at the end of the day the critical thing is to recognize that causing someone's death is not actually a way to express value, to show them their value.
• 26:29
  SPEAKER_00: It's not an act of love.
• 26:31
  SPEAKER_01: Right, right.
• 26:33
  SPEAKER_01: Let's get back to Peter and uh he's discussing uh the experience of Canada.
• 26:38
  SPEAKER_03: My reading of the controversy in Canada is about how far this should go um and it's not there's not a serious likelihood of it being wound back as I see it.
• 26:49
  SPEAKER_01: Aaron Powell would you agree with that Ewan that's um having brought made in and having expanded um the the scenarios in which euthanasia is applied is there any way of getting the genie back into the bottle?
• 27:02
  SPEAKER_00: Well I I think the first thing is is for people to recover the uh or uh recognize the significance of calling into question the the sanctity of life and or and another way of putting that is to help people recover and understanding that people are intrinsically valuable rather than merely extrinsically valuable.
• 27:22
  SPEAKER_00: But I think it's going to take a kind of paradigm shift for a society because it once you once you accept as I said earlier once you accept the notion that death is good for for suffering then it's very difficult to sort of retrace these lines and and put and recover limits on the practice.
• 27:43
  SPEAKER_00: I think it it you know one could imagine political movements that curtail the practice to some extent that say we've gone too far and we need to redraw some lines but I think there are two challenges to that first of all that ultimately every assisted death is a kind of tragedy and it's not just um you know cases uh where people are ended who are who were you know because they're they were in poverty or marginalized.
• 28:11
  SPEAKER_00: Those are especially tragic cases but we need to see every case of assisted death as a tragedy and and uh secondly you know people have drawn the connection between um the desire for death and the right to death and once this becomes perceived as a right and putting limits and curtailing the practice you're you're curtailing people's rights uh becomes a very challenging social and political conversation.
• 28:37
  SPEAKER_00: So I to be honest with you I it's hard for me to see the way forward and in the absence of a dramatic social shift recovering a vision for the intrinsic value of human persons.
• 28:49
  SPEAKER_01: You've mentioned the difference between intrinsic value and extrinsic value.
• 28:52
  SPEAKER_01: Can you just elucidate on that?
• 28:54
  SPEAKER_00: Yeah so this is a really critical conceptual um set of categories to have when we're thinking about the ethics of assisted death.
• 29:03
  SPEAKER_00: So when we say that people are intrinsically valuable it means that they matter not by virtue of what they can do or not by virtue of their utility or usefulness but simply because of who and what they are.
• 29:14
  SPEAKER_00: They are to be treated and recognized to be an end in themselves.
• 29:20
  SPEAKER_00: Whereas if something has extrinsic value we value it because of its utility, its usefulness and one of the important differences between intrinsic and extrinsic value is that if you have extrinsic value only then you can lose your value because if you become useless or you no longer have utility well then you've lost your value and so things that have extrinsic value their value is contingent dependent variable and essentially what I'm arguing in the book is that assisted death views people as if they have extrinsic value only.
• 29:58
  SPEAKER_00: It treats them as if their value is contingent and variable and once they've lost their value then it's appropriate for us to end them.
• 30:05
  SPEAKER_00: Now it seeks to make themselves the person themselves the arbiter of their own value so it tries to respect autonomy in that sense.
• 30:12
  SPEAKER_00: But ultimately what we see are people being invited to treat themselves as if they have extrinsic value and forgetting that in fact they have intrinsic, unchanging unconditional value that always ought to be respected.
• 30:25
  SPEAKER_00: And so I I like to put it this way that you can't call into question the value of a person's existence without calling into question the value of the person themselves.
• 30:35
  SPEAKER_00: There's this deep connection between respect for someone's life and respect for the person themselves.
• 30:39
  SPEAKER_00: And by permitting assisted death really what we're saying is people don't have intrinsic value they just have extrinsic value and if they lose their value then it's okay to end them.
• 30:50
  SPEAKER_00: So the practice has this kind of built-in devaluation.
• 30:54
  SPEAKER_01: Right and it puts everyone on a dimmer switch rather than on an on-off switch.
• 30:59
  SPEAKER_01: You know a dimmer switch can be dimmer or brighter.
• 31:01
  SPEAKER_01: On off is 100% or zero percent and I guess from um a more faith-based tradition the sanctity of life is is trying to do justice to that kind of concept it's a discrete on-off not continuous dimmer switch.
• 31:15
  SPEAKER_01: Um you in the book um speaking in terms of the difference between the the intrinsic and the extrinsic it's interesting that um uh Peter Singer in this interview actually talks about uh when I talk about abortion and euthanasia stuff I'm talking about the sanctity of lifetime issues and and I guess Peter Singer says that the on-off switch the the a hundred percent um value that's equal uh that intrinsically resides in in every human being is a faith based it is a a a holy thing it's a it's a it's a sanctity issue um and I just I just wonder whether uh he's actually right about that to some degree that it is the Bible that's given us this view.
• 32:02
  SPEAKER_01: You know that it's the Imago day it's the image of God in all people that's been secularized and you can use more religious sounding language like sanctity and you can use more natural law type uh language like intrinsic value but at the end of the day we we get this from scripture more than from logic is is my hunch.
• 32:22
  SPEAKER_01: What do you think about that?
• 32:23
  SPEAKER_00: Yeah this is such an interesting question that I've wrestled with a lot myself you know I would say Singer would really agree with you about that.
• 32:32
  SPEAKER_00: One of the things that he's done really um kind of clearly in his work is draw out the implications of shifting from a Christian vision of human origins and value to a Darwinian vision of human origins and value where you know and by Darwinian I'm talking about kind of naturalistic interpretations of evolutionary theory where people are seen as purely the consequence of an undirected unguided random process of evolution over time where where God is not involved or in the picture at all.
• 33:06
  SPEAKER_00: And he he he would argue that that cancels out any concept or possibility of the image of God and then concludes that for that reason there's no fundamental difference between humans and and other animals in terms of their value, moral significance, etc So he he sort of he calls that a Copernican revolution in ethics and really tries to emphasize the significance of rejecting the image of God concept you know in my own reflections on this on this I would say I would distinguish between knowing that people matter and knowing why they matter I would say that you will be hard pressed to find someone who doesn't know that people matter who at least doesn't know that they themselves matter that they ought to be treated with respect and fairness.
• 34:00
  SPEAKER_00: And I think there's a biblical case to be made that this kind of knowledge is something that's granted to us but it's you know when I talk to my colleagues and my friends and even in the assisted death movement itself we see that desire to show respect for human value even if they reach the wrong conclusions in their attempts to do so.
• 34:20
  SPEAKER_00: So I think we can say that people we know that people matter but then the question becomes well why do they matter?
• 34:25
  SPEAKER_00: Where does this intrinsic value come from?
• 34:27
  SPEAKER_00: And I think you can know that people have intrinsic value without actually knowing why they have intrinsic value and the significance of this of scripture the image of God concept and the gospel is that it gives us the explanation for why people matter and therefore helps us to get to see even more clearly just how much they matter.
• 34:46
  SPEAKER_00: So obviously the question of whether people matter and why they matter are very tightly linked together but one's an epistemological question or a question of knowledge and the other is an ontological question or a question of the being or foundation of value.
• 35:01
  SPEAKER_00: And I I think that it's appropriate for us functioning in the public square to draw on what I think is natural knowledge or the you know what other Christians have called the light of nature.
• 35:13
  SPEAKER_00: We can leverage that to our advantage and but of course then it raises the question well where could this value possibly come from and that's where we can be faithful Christian witnesses and pointing to the fact that we're created in God's image and loved by God so greatly that he sent his own son to redeem us.
• 35:31
  SPEAKER_00: Those those become very powerful um Christian beliefs that help us to sustain and and and clearly envision just how much we matter.
• 35:41
  SPEAKER_01: Yes yeah I mean I I would say yes we can we all have a sense that we all matter the idea that we all matter equally um I I just wonder looking around the world doing sort of comparative anthropology you know the the first manual of midwifery in the first century this Roman manual of midwifery you know section one is on how to identify the the offspring that is worth raising and and you know a Aristotle himself would think that you know me men are more valuable than women and and masters are more valuable than slaves and and citizens are more valuable than barbarians etc etc just how just how natural it is and and whether we are repaganizing actually the the a a post-Christian society that starts putting everybody on the dimmer switch um is is repaganizing but doing it for also Christian ish motivations, you know, out of compassion and healthcare and all these sorts of things which is quite a quite a dystopian um vision.
• 36:45
  SPEAKER_01: Tell me as a doctor how does it change your profession?
• 36:50
  SPEAKER_01: How does it change your role?
• 36:52
  SPEAKER_01: How does it change your calling to now be somebody um who you know first do no harm and you probably didn't take the Hippocratic oath but at least the Hippocratic oath kind of forbids things like this and then all of a sudden this is now an expected part of your role?
• 37:09
  SPEAKER_01: I mean what what does it do to the profession?
• 37:12
  SPEAKER_00: Yeah well you know we took the Hippocratic oath when we graduated from medical school.
• 37:16
  SPEAKER_00: Okay you did but it was heavily modified heavily attenuated version of it obviously um I you know I think that that this represents the way it sort of signifies the way that medicine is shifting from um uh a profession that is focused on on the good of healing and and the moral value of caring for the body and the and and recognizing and predicated on the goodness of the body to one that basically sees its role as one of empower of personal empowerment.
• 37:51
  SPEAKER_00: Others have uh written about this contrasting what you might call kind of traditional medical practice oriented towards healing versus the provider services model where physicians are seen almost like technicians and the patient walks in, tells you what's good for them and then asks for specific services and then you act accordingly.
• 38:15
  SPEAKER_00: So there's a tremendous loss of um professional moral judgment because it's no longer really my place to tell the patient whether death is good for them or not.
• 38:27
  SPEAKER_00: Really my place is only to tell them whether they're eligible for it under the law and if they are eligible for it to make sure that it's accessible to them.
• 38:36
  SPEAKER_00: And so it really changes the role you move away from being a professional to being much more of a a technician.
• 38:44
  SPEAKER_00: And you know I think that that creates challenges throughout all of medicine.
• 38:52
  SPEAKER_00: This is not the only area where there's a tension between what doctors think is good for patients and and and the the need or an expectation to absolutely respect patient autonomy.
• 39:02
  SPEAKER_00: This shows up in other kinds of end-of-life issues as well never mind other parts of medicine.
• 39:07
  SPEAKER_00: And so it really does shift the conversation and I think one of the tasks of those of us in medicine who continue to want to practice in accordance with the intrinsic value of persons have tremendous work cut out for us to sustain a traditional ethic of medicine.
• 39:24
  SPEAKER_00: I think there are efforts to do so but I think that patients going to see their doctor can anticipate questions them being asked sort of what they just what they want in a way that perhaps 30 4 years ago would not would not have happened.
• 39:40
  SPEAKER_00: And in some respects it it's a bit of a pendulum because perhaps in the past medicine was too paternalistic too tempted to make decisions for patients without involving them in in decisions in their own care.
• 39:52
  SPEAKER_00: And now the pendulum is swung extreme to the other side where sort of seeing the patient as the one who directs all their care without the doctor having any sense of what's actually good for the person per se.
• 40:05
  SPEAKER_01: And we might get into financial issues as well because um both the the experience of the NHS here but also in Canada if you've got a national kind of health service all sorts of financial pressures happen um at the the the national level let alone financial pressures on the individual patients as well and that's kind of where Freddie Sayers goes as well and asks Peter Singer are there troubling aspects is there anything that would trouble you uh about the Canadian experience?
• 40:35
  SPEAKER_02: What limits would you put on it then on that example?
• 40:38
  SPEAKER_03: We did a study uh here at Unheard and I think 4.1% of all deaths in uh 2022 were assisted dying in Canada It's not surprising right I mean what what percentage of deaths are due to cancer right um it's much larger and it's not surprising that many people who are dying from cancer and whose quality of life has fallen to a point where they don't regard it as positive don't want to go on to the very end.
• 41:09
  SPEAKER_03: You know it happened to my my brother-in-law uh sadly my wife's brother um and you know he was probably fairly close to dying um but it certainly you know his death would be counted as assisted suicide he used the legislation he he took the drug with his family around him um maybe he would have had another week or two of life um but you know it it wasn't it was already not good at that point.
• 41:31
  SPEAKER_02: So there's no there's no quantity there's no volume of uptake that you would consider intrinsically worrying if it if it turned out it was 10% or 20% of deaths would you start thinking uh oh it's going too far or is no I wouldn't um you know I I I I would want to look at the number of people who are dying from conditions that are distressing in their last week or two.
• 41:53
  SPEAKER_03: Um I would also want to know what the diagnosis what the prognosis was for people right um if there were people who had lots of life left then that would be disturbing not necessarily that the law was wrong but that we couldn't make their living conditions good enough for them to want to live right out to the end.
• 42:14
  SPEAKER_03: Trevor Burrus And there have been cases of that haven't there younger people um with mental health issues or or depression who are seeking to choose that option is that something you that Well I think depression is a is a difficult case because obviously when people have mental illness you might say well are they really making a considered judgment when they're in a suitable frame of mind to make that judgment you know if i if the depression were a temporary one then you I would certainly not want them to be able to make that decision.
• 42:44
  SPEAKER_03: But if as in maybe one of the cases you're thinking of is um a woman in Belgium who had had clinical depression for 20 years and had been trying to get it treated, you know many treatments had been tried and failed and she said her life was just agonizing um because of that.
• 43:05
  SPEAKER_03: I I'm not I you know I wouldn't say that was not her decision to make.
• 43:09
  SPEAKER_03: You again I'd regret that she couldn't find a cure or a way of living better but in the end I think if you're trying for 20 years that is your decision to make.
• 43:18
  SPEAKER_01: We'll get to the financial pressure in a in a second but um we've spoken already about we fail to have a category for meaningful suffering that is ongoing and stubborn and and will only increase until death.
• 43:35
  SPEAKER_01: We and and at that stage the disability commun community I think can rightly feel you know shocked and aggrieved that uh we're we're valuing them less.
• 43:46
  SPEAKER_01: So there there's one community the the the disability community but then there's also mental health issues.
• 43:52
  SPEAKER_01: And if we foreground autonomy when actually precisely the the issue is that Mentally I'm not in a good headspace to make decisions about my life.
• 44:05
  SPEAKER_01: Um are we kind of casting them adrift and and handing them over to their own choices which are not not very good for them?
• 44:14
  SPEAKER_01: Um what what does it do um to uh to open up the scope of euthanasia to um mental health issues as well?
• 44:24
  SPEAKER_00: Well, it really creates uh uh uh a a profound dilemma for the people who are assessing uh patients for assisted death.
• 44:37
  SPEAKER_00: You know, one of the interesting things is that psychiatrists are often called upon to evaluate whether uh mental illness may be contributing to a person's desire for death and whether they're competent to make uh medical decisions uh of that sort.
• 44:54
  SPEAKER_00: And I think for psychiatrists it creates a huge challenge because for a long time we've taken it for granted that the very desire for death is sort of uh implies, necessarily implies some type of mental illness.
• 45:09
  SPEAKER_00: And once you accept the idea that the choice to die can be completely rational, then it becomes very difficult to sort out just to what extent a mental illness is affecting a person's judgment versus um uh them making a rational choice.
• 45:26
  SPEAKER_00: And I'm sure there'll be many border cases where it it becomes a matter of almost personal judgment with a lot of differences from psychiatrist to psychiatrist about whether someone's in in an appropriate state of mind to make a decision like this.
• 45:40
  SPEAKER_00: And so many in the Canadian psychiatric community were sort of very opposed to making it legal just just for this reason that it would be so hard to decide who actually had the capacity to make such a decision.
• 45:54
  SPEAKER_00: Never mind the fact that mental illness can often be variable, that it can often recover in unexpected ways.
• 46:03
  SPEAKER_00: And so, you know, we're at where ending someone's life obviously forecloses those possibilities.
• 46:09
  SPEAKER_00: So it's um yeah, it's been it's been a significant challenge.
• 46:13
  SPEAKER_00: At the same time, you can see how once you buy into the notion that death is an effective remedy for suffering, it becomes very tempting to offer it to people who are genuinely and very seriously suffering uh from a mental illness.
• 46:27
  SPEAKER_00: This is these are deep uh forms of anguish and suffering that we need to take very seriously and show real compassion toward.
• 46:34
  SPEAKER_01: Yeah, yeah.
• 46:36
  SPEAKER_01: So Freddie raises the the issue of mental health, and and Peter Singer is is fairly unmoved by that, but the conversation goes on.
• 46:44
  SPEAKER_02: So I I suppose to flip it around, what would be the signs of what would it take for you to be worried then?
• 46:51
  SPEAKER_02: What what what sort of scenarios would you start to feel like this is now indefensible or we should, even if someone wants it, not allow it?
• 47:00
  SPEAKER_03: So I think it would depend on the on the people who were asking for it.
• 47:03
  SPEAKER_03: If if they were people who generally were from the poorer strata of society and you felt maybe they were not getting sufficient support, they were maybe not getting good health care, um, or perhaps they were trying to save their family money because to get decent health care they had to spend money that the family did not really have, or um uh that would trouble me.
• 47:25
  SPEAKER_03: Um but in fact the the where we have the statistics, it seems like it's generally the more educated and better off part of the population that is using the legislation um and and not disadvantaged minorities.
• 47:39
  SPEAKER_03: So that's why I don't think that that is in fact a problem, but but that would be one thing that that worried me.
• 47:44
  SPEAKER_01: Aaron Powell So how how do financial pressures play into this at the individual level, the family level, but but also a kind of a nationwide level if you've got like a national health service?
• 47:54
  SPEAKER_00: Aaron Powell Yeah, I uh this is a this is a fear that financial pressures could, you know, at a health system level could drive um the provision of euthanasia.
• 48:04
  SPEAKER_00: And there's no question that there seems to be certain specific uh reported cases where people are turning to euthanasia because they really have no other options in terms of social support, being able to afford clean environments where their um chronic illnesses would be better controlled, or people just living in poverty and and having enough of it and turning to assisted death.
• 48:27
  SPEAKER_00: Those cases have been reported.
• 48:29
  SPEAKER_00: And the thing, and even though that's certainly not the majority of cases, you know, the available data suggests that the vast majority of people seeking assisted death are um, you know, wealthy uh white uh patients who um you know don't fit into our typical uh conception of what a visit a visible or marginalized minority looks like.
• 48:54
  SPEAKER_00: But nevertheless, the question I'd love to pose to Peter Singer is just how many of these marginalized cases need to occur in order to say that the practice as a whole is uh unacceptable or you know impermissible?
• 49:08
  SPEAKER_00: You know, is you know, is one out of ten thousand a year too many?
• 49:13
  SPEAKER_00: Is two out of ten thousand too many?
• 49:16
  SPEAKER_00: You know, just where do you draw the line on this?
• 49:18
  SPEAKER_00: And so you know, clearly he admits that that kind of you know pressure and and marginalization would would make it very concerning, but just where is he and he and other advocates for the practice actually prepared to draw the line?
• 49:32
  SPEAKER_00: I think it it would be interesting to hear what he would have to say about that.
• 49:34
  SPEAKER_01: Aaron Powell There's a similar parallel and interesting to think through about uh the death penalty.
• 49:39
  SPEAKER_01: And you and you I I do wonder, you know, how many people are against the death penalty for precisely what you just say, because there might just be one innocent person put to death, and it doesn't matter if 499 um have been guilty, um, just the possibility that one innocent person's life is taken is enough for a lot of people to be in a blanket way against the death penalty.
• 50:03
  SPEAKER_01: But that for some reason that logic doesn't really seem to carry over to the euthanasia debate.
• 50:07
  SPEAKER_00: Yeah, that's such a that's such a great point and such an interesting parallel.
• 50:12
  SPEAKER_00: And um I I again I think it's you know, at bottom it's because once people accept that, you know, this is a compassionate way to respond to suffering and an appropriate way to respond to suffering, it becomes the focus becomes all about finding a way to make sure it's safe and effective and so on.
• 50:30
  SPEAKER_00: And the challenge in Canada, uh, you know, and elsewhere has really become how do you make sure that that these vulnerable patients uh don't suffer as a consequence?
• 50:40
  SPEAKER_00: And um and it's and it's very challenging.
• 50:43
  SPEAKER_00: So I I think your your point is really well taken.
• 50:46
  SPEAKER_01: I just wonder if we need to get better at unmasking the what is compassionate, the the slogan of compassion.
• 50:56
  SPEAKER_01: Unmasking it and and trying to forward uh a a more rounded, rounded, engaged, sacrificial vision for for compassion.
• 51:06
  SPEAKER_01: You see it at the other end of life with with abortion.
• 51:08
  SPEAKER_01: I mean in a post-Christian society, how else is abortion going to be forwarded except as it's health care, it's about bodily autonomy, it's about gender equality, um, and it's compassionate, you know, which are all incredibly Christian-ish kind of um virtues that the the issue is kind of closed in.
• 51:30
  SPEAKER_01: And even even those who kind of forward a practice um that is not Christian cannot help but do so in language that that uses the Christian-ish language of compassion, but uses it as a slogan rather than a kind of a virtue to be um uh to be forwarded.
• 51:47
  SPEAKER_01: So do we just own the fact that the stance against euthanasia might sound cruel, but it's cruel to be kind.
• 51:54
  SPEAKER_01: Um or do we somehow redeem the language of of um compassion and and arrest it and tell better stories?
• 52:01
  SPEAKER_01: I don't know.
• 52:01
  SPEAKER_01: How do how yeah, how do we speak about this?
• 52:05
  SPEAKER_00: Yeah, I think so.
• 52:06
  SPEAKER_00: I think the first thing to do is to unmask the way in which euthanasia actually devalues people rather than showing value.
• 52:14
  SPEAKER_00: I think the desire, the kind of logic behind it is that this is the way we show people that they matter, and this is the way we respect their autonomy, we respond to their moral significance.
• 52:27
  SPEAKER_00: And what I tried to do in the book was to show that this practice actually treats people as if they only have extrinsic value, not intrinsic value.
• 52:35
  SPEAKER_00: It doesn't treat them as if they have intrinsic value.
• 52:38
  SPEAKER_00: But if they have intrinsic value, then it's always good that they're here.
• 52:42
  SPEAKER_00: And so we will be forced to find ways to respond to their suffering that are actually more difficult and challenging for ourselves.
• 52:49
  SPEAKER_00: And I think the word that you use there, sacrificial, is crucial because it's easy to go in.
• 52:55
  SPEAKER_00: I as a physician, it's very easy for me to go into someone's room and end them.
• 52:59
  SPEAKER_00: Like it takes relatively little training and medical skill and and and not that much time.
• 53:06
  SPEAKER_00: Um whereas to journey with them through their illness to be continuously available to respond to their symptoms, that takes work, it takes time, it takes sacrifice.
• 53:17
  SPEAKER_00: And I'd say that's true more generally for those of us who have people who live with chronic suffering and disability in our lives.
• 53:24
  SPEAKER_00: There's a measure of sacrifice that's called upon.
• 53:27
  SPEAKER_00: But in the end, it becomes beautiful because in responding to their value in this way, in journeying with them, which is really what compassion is really about to suffer with, um, we we remind ourselves of the beauty and significance of being human and even in the face of difficulty and tragedy.
• 53:47
  SPEAKER_00: So I think, to be honest with you, I think palliative care is such a good example of what genuine compassion looks like and and the way in which some measure of sacrifice um is necessary in order to genuinely dignify the human condition.
• 54:03
  SPEAKER_01: That's that's beautiful.
• 54:04
  SPEAKER_01: And and you get to a beautiful spot towards the end of the book about casting a Christian vision um for these issues about what is life, what is death, what is human value, what is the good life.
• 54:16
  SPEAKER_01: Um just as we finish, Johan, can you just paint us a picture?
• 54:20
  SPEAKER_01: You're a Christian as well as a doctor.
• 54:23
  SPEAKER_01: Paint us a picture of how the gospel makes us see life and death and value and sacrifice and hope in a different light.
• 54:33
  SPEAKER_00: You know, the gospel's so rich because it just speaks to these issues in so many different ways.
• 54:38
  SPEAKER_00: I mean, what could um help us to see the value of humanity more clearly than the fact that we were created in God's image, that God gave his own son to redeem us from our brokenness and rebellion, and that we will spend eternity and glory with God.
• 54:57
  SPEAKER_00: Um these are these are this is a genuinely exalted vision of what it means to be human.
• 55:04
  SPEAKER_00: And additionally, it sort of equips us to cope with suffering because it gives us the theological and spiritual resources and equipment that we need to suffer well.
• 55:15
  SPEAKER_00: And in the book, I particularly emphasize what are sometimes traditionally called the theological virtues of faith, hope, and love.
• 55:22
  SPEAKER_00: And if we're able to approach suffering with a strong confidence or faith that God's purposes and power are at work and hope that we will not always be left suffering, but that our suffering will ultimately be ended and that we'll be raised bodily to enjoy health in the future to come.
• 55:42
  SPEAKER_00: And finally, that we are love, that God is always with us even in our suffering, and that we were ultimately created to know Him, to love Him, to serve Him, and to worship Him.
• 55:51
  SPEAKER_00: And suffering can't rob us of any of those purposes.
• 55:54
  SPEAKER_00: Well, it um it equips us to be able to transcend suffering and to suffer well and to suffer with those around us who are our suffering uh to the glory of God.
• 56:05
  SPEAKER_00: So I think the gospel, you know, and that's just a brief summary, in so many ways, the gospel um equips us to uh to face this issue in a really effective and transformative way.
• 56:17
  SPEAKER_01: I love it.
• 56:17
  SPEAKER_01: You've been uh very generous with your time, Dr.
• 56:20
  SPEAKER_01: Gallagher.
• 56:21
  SPEAKER_01: Uh the book is called How Should We Then Die.
• 56:24
  SPEAKER_01: It's such a refreshing read, and I think it will be very useful for us, especially in the UK, as we face some of these uh questions here.
• 56:32
  SPEAKER_01: Dr.
• 56:32
  SPEAKER_01: Ewan Gallagher, thank you so much.
• 56:34
  SPEAKER_01: Thank you for having me.