The neighborhood around the hospice facility was densely packed. Houses stacked upon houses, and the facility loomed over the neighborhood. As I pulled into the parking lot and walked through the front door, I was filled with anxiety. I was a new pastor on my first hospice visit, and I had no idea what to expect. Winding through the labyrinthine corridors, I was wrestling with what to say. A handful of verses rolled through my mind as I contemplated the question: “What does someone on their deathbed need to hear?”
An elevator ride led to more corridors, and I finally found the room. As I walked through the door, I saw my congregant lying in bed. She looked weak and frail. Her family members were attending to her. I approached the bed, and as I leaned over to speak with my dear sister, I realized that I needed to hear from her more than she needed to hear from me. She had been walking with Jesus for decades, and though her body was failing, she was alive with hope in the promise of seeing Jesus face to face. We talked about the gospel of peace and the forgiveness of sins, and we prayed. I stood up and turned to speak with her family, who were wrestling with whether to withhold medications. In that moment, I was confronted with their question: What is the difference between hospice and assisted suicide? Is refusing medication the same thing as suicide?
Walking into the room, I expected to need words of encouragement for the woman who was dying, but instead, I was faced with the moral dilemma in the heart of the family: what does the Sixth Commandment mean? Does “thou shalt not kill” mean that we must do everything possible to preserve life? In this brief article, I am going to expound the practical significance of the Sixth Commandment in the life of the believer. I will begin by briefly expounding the Sixth Commandment, and then I will address several issues facing every believer.
“Thou Shalt Not Kill”
My grandparents’ living room had a tin engraved with the Ten Commandments. I used to lie on their floral-patterned davenport1 and stare at the golden engraving. Because of that engraving, I learned the Ten Commandments in King James English, and as a boy, I always pondered the meaning of “Thou shalt not kill.” Did it mean, “Thou shalt not kill anything?” as I heard the savory hiss of the freshly butchered chicken frying on my grandmother’s stove. Did it mean, “Thou shalt not kill another human?” Did it mean, “Thou shalt not kill another human in any circumstance?”
1. That is what my grandparents always called their sofa.
As I delved deeper into the Bible, I found the nuance I was seeking; the rest of the Torah puts flesh on the skeleton of the Ten Commandments. In Genesis 9:3, the Lord gives the animals of the earth as food for Noah and his descendants, and at the same time, the Lord prohibits killing other human beings. The Lord tells Noah, “And for your lifeblood I will require a reckoning: from every beast I will require it and from man. From his fellow man I will require a reckoning for the life of man. ‘Whoever sheds the blood of man, by man shall his blood be shed, for God made man in his own image’” (Gen. 9:5–6). Because human beings are created in the image of God, anyone who sheds the blood of man will face a penalty, but notice, the penalty for the perpetrator is that his blood will be shed by man. In this one verse, we have two kinds of killing. One is wicked and liable to punishment; the other is sanctioned by justice itself (see also Rom. 13:4).
Clarity ensues. The Sixth Commandment is specifically addressing the issue of murder: the wicked, unjustified taking of human life. Throughout the Law, the Lord stipulates distinctions between murder (Deut. 19:11–13), unintentional killing (Deut. 19:4–6), self-defense (Exod. 22:2), and justified judicial killing (i.e., meting out of legal penalties [e.g., Exod. 21:12–17] and war [e.g., Deut. 7:16]). Minimally, the Sixth Commandment prohibits murder, but as with every commandment, it is not merely a prohibition. The apostle Paul teaches that the law is fulfilled in obedience to the positive command, “You shall love your neighbor as yourself” (Gal. 5:14). Thus, alongside the negation of murder, the Lord of life is simultaneously inculcating a love for the life of your neighbor.
To summarize: “Thou shalt not kill” prohibits the malicious, unjustified taking of human life and at the same time, the Sixth Commandment positively instructs the Christian to love and preserve the life of his neighbor. So, the next question: how does this work out in the life of the believer? I will examine two significant issues: euthanasia and abortion.
Euthanasia
Euthanasia, or medically assisted suicide, has become a pressing topic in modern society, and this topic was the pressing concern for the family in the opening story. Is there a difference between refusing end-of-life care and participating in euthanasia? To begin thinking through this topic, we must first define terms. Euthanasia can be defined as the intentional act of ending a person’s life to alleviate suffering. Whether the drugs are self-administered or administered by a physician at the patient’s request, it is the active decision of the patient to end his or her own life. Thus, euthanasia requires the agency of the individual to take a direct action with the goal of willfully causing his or her own death.2 In this sense, euthanasia is suicide or self-murder, and as murder is prohibited by the Sixth Commandment, self-murder is likewise prohibited; thus, euthanasia is morally impermissible.
2. In this article, I am not addressing the administration of euthanasia by medical professionals or families without the consent of the individual. Such cases simply constitute murder.
End-of-life care, by contrast, is more complex. Every life has a “natural” end. Because of the fall of Adam into sin, death entered the world, and death spread to all men (Rom. 5:12). However, because of modern medical technology, we have the ability to extend that “natural” end through technological intervention. But does the mere existence of a technology require its use?
Refusing medical intervention and permitting disease to run its course is a distinctly different action than administering drugs to take one’s own life. For instance, one hundred years ago, cancer was a death sentence, and someone suffering from a form of cancer knew that the disease would run its course and consume the body. Today, we can extend life through various treatments. Those treatments extend life, but they can exact a tremendous toll. Thus, the individual with terminal cancer faces a horrible dilemma: do I embrace quality of life, or do I embrace quantity of life? The goal of the one who embraces medical intervention is to extend life, and the goal of the one who rejects medical intervention might be to preserve the quality of life. In either scenario, whether the individual embraces quality or quantity, the cause of death will read: cancer.
When considering end-of-life and terminal illness, Christians must recognize the goodness and beauty of life even in the midst of deep suffering, and Christians must wrestle with the reality that death is our enemy. On the one hand, if a Christian embraces medical technology and the extension of life, he or she must recognize that this cannot confer eternal life. Our fundamental hope is the glory of resurrection. On the other hand, if a Christian refuses technological intervention, he or she must not do so simply with the hope of dying. The goal for the Christian can never be death for death’s sake, as our hope in the gospel is eternal life.
Euthanasia and the refusal of medical intervention are distinct, and euthanasia is never permissible for the Christian because it constitutes murder. Furthermore, as Christians are commanded to love and support the lives of their neighbors, we are duty-bound to oppose the proliferation of murderous medical technologies and practices. This opposition comes through helping our neighbors understand the God-givenness and beauty of life. But our love must extend to the legislative process as we consider candidates and the various legislation proposed with respect to euthanasia and medically assisted suicide. In this regard, Christians must vote in accordance with the Sixth Commandment and uphold the preservation and goodness of life.
Abortion
In the cosmic irony of our age, advances in medical technology have enabled us to both preserve life and end it. To deepen the irony, this reality plays out at the end of life and at the beginning. Modern medical advances have pushed the threshold of viability earlier, opening the door of life for babies once impossible to save. And on the other hand, modern medical advances have made abortions as accessible as the threshold of your own home with pills available to be shipped to every mailbox—no clinic or physician required. Alongside euthanasia, abortion stands as another important consideration for the Christian’s relationship to the Sixth Commandment.
Abortion is the intentional termination of a pregnancy with the goal of the procedure being the death of the child.3 Christians must settle in their minds that abortion is murder. Debates about heartbeats and viability have unnecessarily shifted the conversation away from the nature of the baby in the womb. From the moment of conception, the life inside of the womb is a human life distinct from the mother. Furthermore, that life is a distinct human person. In Psalm 139, David rejoices in the wondrous work of procreation, declaring the mystery of the Lord’s power: “For you formed my inward parts; you knitted me together in my mother’s womb” (Ps. 139:13). David self-identifies with the life in his mother’s womb. That rapidly expanding life was not a person-less clump of cells, nor was it a cancerous growth. That life was David in the embryonic stage of his life. The life inside of a mother’s womb is not only a human life; it is a human person. Therefore, per the Sixth Commandment, that human person must be preserved and protected. Abortion is murder; therefore, abortion is morally unconscionable for the Christian.
3. Throughout this section, “abortion” does not refer to medically necessary lifesaving intervention on behalf of the mother (e.g., ectopic pregnancies). In such cases, the goal of the medical intervention is not directed at terminating the pregnancy. Rather, the goal is to save the life of the mother, and the termination of the pregnancy is the tragic result. Neither am I referring to miscarriage management, which treats the mother, whose child died from natural causes.
Furthermore, abortion poses another set of questions as it has been enshrined in American law as a legal form of murder. Mothers are permitted the “right” to murder their own children as long as those children are still in utero.4 As the Sixth Commandment enjoins the Christian to love the lives of their neighbors, Christians must not only utterly reject abortion as a personal option, but they must also actively oppose pro-abortion legislation and seek to elect officials who will uphold and fight for the right to life for every human being. Working to preserve and uphold the life of your neighbor must extend to preserving and upholding the lives of our pre-born neighbors. Failure to do so is a failure to uphold the positive side of the Sixth Commandment—to love our [unborn] neighbors.
4. This so-called right is applied differently depending on the state in which the mother resides.
Conclusion
Our age is fraught with ethically questionable practices, and deep Christian reflection on the Ten Commandments will assist the Christian in making personal decisions. But as we saw with the Sixth Commandment, Christian ethical thinking extends beyond the piety of the individual as we are called to love, uphold, and preserve the lives of our neighbors. As two examples, we examined the viability of euthanasia and abortion for personal Christian ethics, and we saw they were beyond the pale. But at the same time, we saw that the Sixth Commandment offers clear guidance for legislative and political issues. As Christians seek to bring all of life into subjection to Jesus Christ, we must be known as those who love and cherish life.
