Few issues are more difficult and controversial at the same time than the ethical issues around the end of life, particularly assisted suicide. Dealing with the inevitable losses and suffering that come at the end of life are often what motivates a request for assisted suicide. Yet there can be ways of dealing with suffering without eliminating the sufferer. Join Scott and Sean in part one of their interview pro-life advocate Stephanie Gray in a conversation about suffering and the end of life.

More About Our Guest

Portrait of Stephanie Gray

Stephanie Gray is a seasoned and international speaker who began presenting at the age of 18. She has given over 900 pro-life presentations across North America as well as in Scotland, England, Ireland, Austria, Latvia, Guatemala, and Costa Rica. She has spoken at many post-secondary institutions such as Yale University, George Washington University, and the University of California, Berkeley. In 2017, Stephanie was a presenter for the series "Talks at Google," speaking on abortion at Google headquarters in Mountain View, California. Stephanie is author of Love Unleashes Life: Abortion & the Art of Communicating Truth as well as A Physician’s Guide to Discussing Abortion. She holds a Bachelor of Arts in Political Science from UBC in Vancouver, and a Certification, with Distinction, in Health Care Ethics, from the NCBC in Philadelphia.

Episode Transcript

Scott Rae: Welcome to the podcast, Think Biblically Conversations On Faith And Culture. I'm your host, Scott Rae, Dean of Faculty and Professor of Christian Ethics Talbot School of Theology here at Biola University.

Sean McDowell: I'm your co-host Sean McDowell, Professor of Christian Apologetics at Talbot School of Theology, Biola University.

Scott Rae: We're here today to talk with our friend Stephanie Gray who is a very well known international speaker on in the pro-life movement to talk to her about her latest book. Where she's branched out a bit from the issues of abortion to those of assisted suicide. I think it's fair to say that assisted suicide is one of the most difficult gut wrenching issues that we face as a culture today. Stephanie I'm very grateful that you've decided to tackle this and have written some great stuff in your new book entitled Suicide To Assist Or Not? A Life Affirming Reflection On The Universal Experience Of Suffering. So Stephanie, thanks for being with us and for being willing to talk about this. This is a tough subject for a lot of people.

Stephanie Gray: Yes, yes. Thanks for having me on because it's so important that we talk about this issue, which is increasingly affecting so many.

Scott Rae: So, you've spent most of your professional life in the last two decades addressing issues around abortion in the beginning of life. You've given almost a thousand lectures around the world. You've debated physicians, abortion providers, professors, activists of all stripe. Why have you decided to move into this area of assisted suicide? It seems to be a bit of a departure professionally for you.

Stephanie Gray: Well, it started with my own experience as a Canadian. In around 2015 there was a challenge to our existing laws in Canada against assisted suicide. And the Supreme Court of Canada decided that those laws needed to change. And so in 2016 the elected politicians created a law that began to legalize assisted suicide. And so as a result of seeing this happening in my own backyard and knowing it had already been happening in other countries, even in America, you've got Washington, you've got Oregon and other States, but Oregon for quite a while now.

Scott Rae: Not to mention California.

Stephanie Gray: Yes. Right? So, it had been happening other places of course. Europe, you look at Holland and so on and so forth. But as it was starting to happen very intentionally in my own backyard, I thought, I need to speak to this issue from an apologetics perspective because that was my skill.

And so I thought that skill that I've applied to abortion, I can now apply and helping others speak at this other end of life.

Sean McDowell: When I got in your book, one of the things that surprised me and it made perfect sense as I got through it, is that you spend more time dealing with suffering, so to speak, than just assisted suicide. Tell us why you frame it that way and kind of the correlation between the two.

Stephanie Gray: So, what actually my speaking on abortion has taught me is whenever people say something, there's always something behind the words they're communicating and that something is going to be discovered by us asking questions and digging a little deeper. And so as I was doing more and more research on the topic of assisted suicide, I was discovering at the heart of this desire for a premature death is really what people are expressing is I'm hurting, I'm suffering in some way, but this suffering is worse than the normal human experience of suffering.

It's so overwhelming that continuing to live does not seem reasonable in my mind and I'd rather die. And so it is this overwhelming amount of suffering that makes life feel not worth living that I thought was really what was at the heart of the issue. And so if we can address that, if we can understand how we ought to respond to suffering, then I think the effect will be we can lead people to the conclusion that assisted suicide ought to be rejected.

Sean McDowell: By the way, I think this is the power of your approach on pro-life and with euthanasia is that this is not just an issue. What's the heart of the issue behind it? Putting those two together, I think what makes it so powerful.

Stephanie Gray: And experience and prayer, what the Lord has really taught me is we humans are like icebergs. When you first meet someone, you just see what's on the surface. But there is so much more underneath and that is what we have to become more skilled at is discovering what is underneath because then we really address things at the root.

Scott Rae: Yeah, and that's not to say that the logic and the apologetic and our reason doesn't matter, but that there's, there's more to it than that in many cases.

Stephanie Gray: Not either or. It's both and. So, there can be this tendency to just be super logical academic or this other extreme of just being, it's all about just the heart and sitting with someone and never challenging them to rise from where they are to something else. It's not either or. We have to bring both of those things together and it's just the discernment is at what point do I draw on which. Am I drawing more on the emotions in the heart right now or am I drawing more, I want to challenge you to change your views, I want to challenge you to think differently. And that's where prayer and discernment really matters. Which strategy am I drawing on? But I need to be equipped to draw on both.

Scott Rae: Now, Stephanie, you've got quite a bit of your own personal vulnerability that comes out of this book. In fact, I was actually a little surprised when I read that, but you had your own experience where you said out loud, I think to maybe more people than just yourself, I want to die. Tell us a little bit about that.

Stephanie Gray: Yes. So, in 2015 my 35th year on this Earth, I had a dream come true. I got engaged, I had fallen in love and I've been in various relationships before where I was always the one breaking it off and I was like, what's wrong with me? Why can't I fall in love? And then I finally fell in love and I was like, there was nothing wrong with me, it wasn't the right time, it wasn't the right person. And so I finally fell in love and I've heard it said like when you fall in love, it's like going from seeing everything in black and white to life in color and just everything was brighter and everything was better and life was beautiful. And I got engaged and bought my dress and planning everything. And then the engagement ended. And that day when it was suddenly all over was emotionally devastating to me in a way I can't describe other than to say, my reaction was to call my sister and my cousin.

And I remember being so overwhelmed at what felt like a death in my life at this destructive explosion of the loss of my dream and the loss of my love. I remember calling my sister and my cousin and distinctly I said to them, I don't want to live. I want to die. And those words captured this. I honestly thought, I cannot fathom continuing to live on this Earth. And thank God that was not an emotion that was lasting. And I realized for some people suicidal ideation is something that they really struggle with. And I was graced to not have any type of longterm struggle with that emotion. But I remember those words captured what I felt in that moment. And that little glimpse of that has given me just a small sense of what it must be like for people who suffer in all kinds of ways.

It might be physical, it might be emotional, it might be spiritual, but that feeling that you don't want to keep living on this earth.

Sean McDowell: So, connect the dots exactly why you started your book with that story. So, that experience then gives insight into what do we do when someone expresses that. Whatever their reason for expressing it, what do we do when they say I don't want to live, I want to die, I want assisted suicide. And so through my experience, what I found brought me out of despair, what brought me out of distress is what can bring other people out of despair and out of distress. And really that is communion. That's connection, that's support of others. That's prayer. All kinds of things. But we need to find out what is so overwhelming to someone and then work to correct things at the root and find out what leads to human flourishing for that person.

Scott Rae: Stephanie, you move from your own really deeply personal experience and I appreciate you sharing that with us and with our audience. But you move in pretty quickly into some big picture things about how the culture views suicide and you point out, I think it really insightful, the level of ambivalence that we have as a culture about suicide. Spell out a little bit more what you, what you mean by that?

Stephanie Gray: So, you know people who support assisted suicide don't even typically use that phraseology. In Canada, we call it MAID, the acronym is M-A-I-D, medical assistance in dying. It sounds so sanitized. And that-

Scott Rae: The California bill was called the California Aid In Dying Bill.

Stephanie Gray: Right, right. So suicide, that term is not used. Why? Why is it not used? Because suicide itself has a negative connotation. When someone commits suicide, our natural reaction is to grieve, is to advertise helplines for people who are considering suicide so that they don't do that. So, I think it's important therefore to use the language of assisted suicide in order to show that if suicide is wrong, then throwing the word assisted in front of it doesn't make it right. In fact, I would say it makes it more wrong because then we're not helping someone in the very moment when they're crying out for help.

Scott Rae: How do you account for that difference. Because I'd say for most people who are not elderly and who are not sick, if they express a suicidal thought, we immediately put them into suicide prevention, but something changes in the way people think about this to where if you are, say maybe over the age of 75, if you have a terminal illness, you know if you're physically debilitated, if you're experiencing various forms of dementia, anything like that, all of a sudden suicide sounds like this great deliverance, not something we ought to prevent, but something we are to assist someone in. What accounts for that difference?

Stephanie Gray: I think the average person is in that moment perhaps thinking, well, there seems there's no way out to this suffering and they're really close to death anyways. That's often what people are thinking, but when you, when you take them through some basic questioning, you help them see the error in their thought process. And so I think for example of a question that my friends Jonathan van Marin and Blaze Elaine have raised, which is what I cite in my book, they've written also a great book on assisted suicide and they really distill it down to this one question, who gets suicide assistance and who gets suicide prevention? And they make the point that people often say, "Well, it's about choice." It's all about respecting people's choice. If they want suicide assistance, we give it to them. And anyone who would say that, I would say, "Okay, well imagine you've got someone who's about to jump off the golden gate bridge because they are choosing that they no longer want to live because they're 21 and they just had a heartbreak from a broken relationship."

Would you give them suicide assistance? Would you push them off the bridge and that the person who supports assisted suicide would say, "No, of course not. I'm like, I would try to talk them down. I would get them to come back over the railing. I would do everything I could to help them." And then I would say, "Okay, but what if it's not someone about to jump off the bridge? What if it is that 80 year old grandma whose cancer treatments are no longer working? She's got six months left to live. She thinks, what's the point is those six months, let's just end my life now you would support assisted suicide?" And they say, yes, and then I say, "Okay, well wait a minute. If your reason for supporting assisted suicide truly is because it's all about the person's choice, then if you're going to give that 80 year old grandma suicide assistance, then you should give that 21 year old person with heartbreak about to jump off the bridge suicide assistance as well."

And the very fact that you're giving suicide prevention to that individual, but suicide assistance to the other individual is actually proof your real motivation is not choice. It's actually judgment. You're making the judgment that 21 year olds life is worth saving. But you are making the judgment that 80 year olds life isn't worth saving. So, you think you're motivated by choice but thinking it through helps us realize you're actually motivated by judgment and who are we to judge that's a life worth saving but that's not a life worth saving? And so the whole point is to get people to think through the fact that if we believe in human equality, then all humans should equally get suicide prevention rather than us judging you're worth saving but you're not worth saving.

Scott Rae: So, it sounds like this is discrimination based on productivity or lack of it.

Stephanie Gray: Mm-hmm (affirmative).

Scott Rae: We would say the person who is elderly, terminally ill is a net drain on the resources of the culture. And because as a friend of mine put it, there's nothing cheaper than dead. We ought not allow this person to utilize all these resources. Whereas the 21 year old has got lots of productive years ahead of himself or herself is a net contributor. So, would that be fair to say we're discriminating based on productivity or lack of it?

Stephanie Gray: I would say, but what I would say is people don't realize that and it takes talking through these scenarios to help people see, "Wait, you might not realize this is what you're doing, but this is what it sounds like." It sounds like we're no longer valuing humans by virtue of being image bearers, by virtue of being members of the human family. But instead we're saying, "Well, are you contributing? How well are you contributing? Is there a hope that you will eventually contribute again? Is there not?" And then we make decisions based on that and that's goes against the nature of a civil society, which values humans for who they are, not what they do.

Sean McDowell: One of the parts of the book that I just stopped and paused that is when you ask the question, why is suicide wrong? I pause because my first instinct is what's obviously wrong.

And then I thought, have I really taken the time to articulate in my own mind why I think it's wrong? Your definition was really compelling. So, I think when we get a clear definition on that, then we can start to see why it applies across age and different scenarios. So, although it seems like an obvious question, why is suicide wrong?

Stephanie Gray: Well, suicide is wrong because it ends the life of an image bearer and we've been given the gift of life and we have a responsibility to steward that life until it comes to its natural end. And when we take it upon ourselves to end that life, we're, we're almost throwing back in the face of God who created us and delights in the gift of our life and saying, "I'm no longer going to reverence this thing that you've given me." And then we turn ourselves into the arbiters of life rather than creature who is a recipient of life.

Sean McDowell: Now that makes perfect sense. Can you make a case against it without appealing to image bearer, creation, creator? What would that look like? I realized in a sense, ultimately you can't perfectly make that case. If something goes, "I don't believe in God, why suicide wrong?" How would you appeal to them to realize, "No, you really do believe and you really know this."

Stephanie Gray: So, I would say first of all, if we believe all humans are equal and that humans have the right to life, then we have a responsibility to respect each other. Even if someone doesn't believe in God, they will say generally they believe in human rights doctrines that say all humans are equal, that we have the right to life, we have the right to liberty. And so if we have a culture where we start to say, you can end your life for whatever reason you want to pick, then we're going to start to choose death as the solution to people's problems, which is just going to result in mass chaos as opposed to getting creative about affirming life and doing ...

You know, what comes to mind is something that Dr. Victor Frankel spoke about in his book Man's Search For Meaning, which he wrote really from two perspectives. He wrote from the perspective of being a Holocaust survivor and the perspective of being a psychiatrist, having endured profound suffering and observed other people's suffering. He said that despair is suffering without meaning. And despair really is what leads someone to suicide. And so if we live in a culture where people embrace suicide, then we're actually stopping our search for meaning. And the reality is because suffering is a part of the human experience, we can't really escape suffering. Even the beauty of birth and having children is preceded by the intensity of the pains of labor. So, because suffering is part of the human experience, Frankl would say that what's important that we find meaning in our suffering.

And if we teach people to find meaning, they won't despair. And so our option is to just support suicide where you're going to have people continually dying and then the effects of the absence of others and the effect that can lead to more suicides or you can have a world that's going to just continually affirm life and say, how can I find meaning in this? How can I be bring good out of the suffering. And he gives an example of a teenager in Texas who was in a car accident. She became a quadriplegic and he said, this is how she spent her day. She'd watched the news and read the news. And whenever she came across a story of someone who was going through suffering or hard times that she'd read about or heard about, she would ask an assistant to come to her, put a stick in her mouth because she couldn't move her limbs.

And she would use the stick to pound out keys on a keyboard to write notes of encouragement to the people that she'd read about. And that is a demonstration of in her suffering, she found meaning. I have an ability, she's thinking to herself to encourage a suffering person in a way, someone who hasn't suffered like me could reach them. I have a special way and that gave her meaning. So, in a world that embraces suicide, her approach doesn't happen. In a world that embraces suicide, we just continually have death and more death and more death. But in a world that rejects suicide, whether assisted or whether or not we're constantly getting creative and looking for meaning and building relationships of love and union and communion.

Scott Rae: Stephanie, you point out lots of places in the book you have stories of people who respond differently to suffering, you have lots of stories of people who respond well, like the person you just mentioned, but you have other stories of people who don't respond so well and they do end up despairing. You'd cite particularly the story of the two English rugby players who were both injured playing rugby but to really different paths from that point on.

Stephanie Gray: Right. Those are the stories of Dan James and Matt Hampson and it's remarkable because both these guys have a lot of similarities both being from England, both in rugby and both of them when they were in their ... it was either late teens or early twenties independent of each other, playing two separate games, both of them became paralyzed. Matt became paralyzed from the neck down and Dan became paralyzed from the chest down. Matt's paralysis was so severe he requires the use of a ventilator. So, those are their similarities, but yes, this divergent ... this big difference is that Dan ultimately traveled from England to Switzerland where he was killed at a euthanasia clinic. And Matt, on the other hand is thriving. He's given a TED talk. He created this whole rehabilitation center for people who have acquired serious sports injuries. He's a motivational speaker, he's a writer, he's doing all these things.

He volunteers with kids at their physiotherapy sessions and it does all kinds of things. And so one of the points that I want to get across in the book is people can choose both ways. The story of Dan and Matt are proof that it's technically possible to choose the suicide path and it's technically possible to not choose the suicide path. These are technically possible. But the question is not what can I do, what is possible? The question should be, what ought I do? What is the best way to go? And I think the fact that Matt like that teenager in Texas has found meaning in his suffering, gives all of us inspiration that when we suffer we can find meaning, too. And I think the question to ask ourselves is what does each story lead to? Dan's story could lead to other people also committing assisted suicide.

Matt story leads other people when they go through hardship to say, "Hey, how can I bring good out of my situation?" And in fact another story I use in the book is of a guy also from England named Henry Fraser. And the Henry also became quadriplegic. In his case, he just dived into the ocean and the sand was too shallow and it was terrible. But he talks about Matt Hampson because what happened to him happened after Matt Hampson. And so Matt Hampson is now an inspiration to him. So, when we choose the path of life, it bears more life. When we choose the path of death, it produces more death. So, we get fruit either way. But what fruit do we want? Do we want bad fruit? Do we want good fruit?

Sean McDowell: So, let me be the skeptic and just see how you would come back with this. You're saying we have the right to choose, could choose A or could choose B, but should the government force that we choose A as opposed to somebody having the option to choose B? Isn't that the nature of being beings who can make a choice?

Stephanie Gray: Okay, good question. So, I would first correct and say, I'm not saying we have the right to choose, but that we have the ability to choose and I think there is an important difference there because we don't have the right to do what is wrong, but we have the ability to do that. And I would say that in society, the difference between let's say laws on assisted suicide and someone saying, "Hey, we're just going to, as a society make it legal and people can choose whether to do it or not" is you're implicating other individuals with suicide itself.

You're killing yourself on your own. With assisted suicide, we're now involving, bizarrely to me, medical professionals who are in the business of saving lives.

Sean McDowell: That is bizarre.

Stephanie Gray: It's so interesting. Like, why haven't we created a new career path? I've just called like ... Basically because it would be an executioner and it wouldn't be a popular job because I don't think prison executioner is a popular job. So, why would it be for patient executioner? But so first of all, we're implicating the medical professional that has an effect on vulnerable persons in society. Can they truly tell their doctor I want to die and trust that their doctor will get to the root of why they want to die? Or if they vulnerably express, I want to die, will that mean their doctor's going to say, "Oh, that's an assisted suicide request. Oh, well we have a process for that. Here's this paperwork to fill out." Before you know it, you're going down a path you didn't possibly intend to really go down.

So, there's broader implications by legalizing this, we're just giving people choice. No, it's implicating others. And even some people will be guilted into asking for assisted suicide. You might have an old lady who's living on her own and her neighbor maybe committed, assisted suicide. So, maybe she's going to ask for assisted suicide not because she really wants it, but because she feels like she's a burden on others or that she doesn't have support. And instead of voicing that, she just remembers, "Oh, my neighbor did this and they're not a burden, so maybe I'll ask for it too." And so she will even act as though it's a genuine desire, but she's actually influenced by the example of others. And I think that's a key point in all of this. No man is an island. We are influenced by other people. And by legalizing the assistance with someone's killing that is going to influence others around them.

Scott Rae: Well, I think one thing to think about in that regard, I think it's a really good observation is in Europe, they're now starting to make explicit the connection. They're connecting the dots and the way we haven't done in the US yet. They're making explicit that connection between the demographic landslide that's coming and it's really already here and the need to legalize assisted suicide. You know, in the next decade or so, we're going to have a record number of people over the age of 65 in most of the countries in the West, and increasingly we are not going to be able to afford all the healthcare that they need. In fact, the average person will spend roughly half of all their healthcare expenditures in the last 12 months of their life. When arguably it does them the least amount of good and under the guise that there's nothing cheaper than dead, it's not hard to envision that what, what begins as something true, truly and genuinely voluntary could go down a slope and end up being pressured, coerced may be a little bit strong, but being encouraged. We know in the US now some insurance companies are denying end stage cancer treatments, but agreeing to pay for assisted suicide medication. So, how do you respond to that given that you know in some parts of the world is considered irresponsible not to legalize assisted suicide to deal with this demographic landslide that's coming?

Stephanie Gray: Well, I think the first step is to acknowledge that is a very real problem and I think for example, my friends at the Euthanasia Prevention Coalition have done a couple of documentaries on assisted suicide and they've gone over to Europe and they've interviewed people in Belgium and in Holland and been able to show that what seems like, "Oh, it's just people choosing it because they want to die" is going to lead to this slippery slope that that we should be concerned about. Of course, even if it didn't go all the way to that, it would still be wrong, but we have to be very aware of the fact that's the natural progression. And I would say that this is the natural fruit also of a culture of death that when you have taught a generation through abortion, which is what is as pointed out, is primarily what I've historically been educating people on. You've taught a generation that when a needy, vulnerable family member, namely the pre-born child, gets in the way of your life and your plans, that you can kill that individual.

Well, when the individuals of that generation who aren't killed grow up and they have on the other end of life, needy, vulnerable individuals who are family members, they've been taught a message their whole life. Well, those are the people that we kill.

Scott Rae: They're disposable.

Stephanie Gray: They're disposable. And so that the mentality of abortion is now logically leading to a mentality that that embraces euthanasia. And that's where I think the church needs to rise up and be very intentional about creating community where it's lacking because we don't have the family support people once had where you have five or six or ... I mean, my dad's from a family of eight. My mom's from a family of 11. That's a lot of siblings to care for aging parents.

But if you're from a family of one or two kids. So, in my family is actually my sister and I that there you can get caregiver fatigue. Now, we ourselves aren't in a situation where we're caring for our parents because they don't need that particular care right now. But my sister and I are both very committed to providing as two siblings, whatever care our parents need. But where you have just one or two people caring for their loved ones, it can be overwhelming. And so that's where the church needs to step in and we make it a part of our ministry to provide support for people who need breaks when they're caring for a parent with dementia or who needs support if they don't even have anyone caring for them. How many elders are living alone and they don't have children and grandchildren caring for them, but they are coming to our churches?

Scott Rae: I'd venture to say this may be one of the primary areas that the church will be involved in in the next decade incredibly meaningfully. And one of the maybe may actually be one of the primary ways that we serve the gospel, by providing this care. Stephanie, this has been incredibly insightful. We've got a lot more to talk about, so we want to encourage our listeners to join us next time for part two when we continue this discussion with our friend Stephanie Gray on assisted suicide and suffering as experienced at the end of life.

This has been an episode of the podcast, Think Biblically Conversations On Faith And Culture. Listen in next time as we invite Stephanie Gray back to continue this important discussion on assisted suicide and the suffering that's experienced by many people at the end of life. To learn more about us and to find more episodes, go to biola.edu/thinkbiblically. That's biola.edu/thinkbiblically. If enjoy today's conversation. Give us a rating on your podcast app and be sure to share it with a friend. Thanks so much for listening and remember, think biblically about everything.