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On the verge of a “Euthanasian” theology?
25 Questions require Answers

By Protopresbyter Constantine Strategopoulos

The issue of organ transplants is a serious one and must be placed within a context of essential theological thought and dialogue, in order for the Church (at a pan-Orthodox level and not simply a local level) to submit its essential opinion.

Man’s concern to date mainly focused on the criterion of brain death. Is the data pertaining to this criterion truly valid, as claimed by Harvard?  So why are there two kinds of death according to the new data, i.e. brain death and clinical death?  Why are the donor’s organs removed prior to clinical death and after brain death? Most people know that organs –except for special exceptions- cannot be taken from a deceased donor, because in most cases, the organs are useless after the heart has stopped. We know for sure, that they are taken from a living organism whose brain has ceased functioning, according to Harvard’s questionable criteria. Who can possibly know the exact time of the soul’s separation from the body? Who can possibly define the mystery of death?  Can the Church advocate in favor of organ removal prior to the definite dissolution of the bond between soul and body?  Shouldn’t the Church take into consideration the reaction of the many scientists –both in Greece as well as overseas- who oppose the Harvard criteria and the imposition of dual death, i.e., brain and clinical?

All of the above pertains to the data of the problematics so far.  We personally cannot accept any intervention for the removal of organs prior to irrevocable death, as it constitutes a removal of life, regardless whether its purpose is the cure of another patient.  The end does not justify the means. The mystery of death will forever remain a mystery. Nobody has the right to decompose it and re-define it according to his personal medical or theological perceptions.

And while this entire research is still moving within the framework of the preceding thoughts, a book has appeared in circulation, which has changed the entire level of solution-finding and will eventually stumble onto the mystery of death.

The book is written by the archmandrite Nicholas Chatzinikolaou and published by the “Center for Bio-ethics and Moral Ethics” with the title “Freed of the Genome”. In the chapter “The spiritual morality and pathology of transplants” (pages 315-345) we find positions that surpass the problematics up to now. We submit them here, in anticipation of the answers to the questions that are posed in this text.

In page 318, the following are mentioned:  “Life is indeed a gift of God, but, it is not a gift that only belongs to the donor. It also belongs to the recipient. It is also mine. It is the unique field in which we practice self-government. It is not granted to us for the purpose of fulfilling our selfishness and our possessiveness; it is offered to us, so that it becomes so much our own, that we can even offer it to others. That is why we love it and protect it more than anything else – with prudence, because it belongs to God and spontaneously, because it is ours. The best way to return it to God is by offering it to our fellow-man. “There is no other way to be saved, except through those near us” (Saint Makarios the Egyptian)”

Question 1. Our life is naturally a practice field for self-government. But if this self-government doesn’t lead us to God, isn’t this offer merely a horizontal one and humanistic?

Question 2.  Does the expression “life is also ours” justify us theologically to do what we want with our life?

Question 3. What is the meaning behind the liturgical phrase: “and our entire life let us appose to Christ the Lord”?

Question 4. Is the author of the book possibly confusing the word “ministering to the saints” (Corinthians II 8:4) with the word “appose”, as in: “in your hands do I appose my spirit” (Luke 23: 46), or even: “they apposed themselves unto the Lord” (Acts 14: 23) and: “they apposed their souls unto the faithful creator…” (Peter II, 4: 19)?

Question 5. How can the passage of Saint Makarios be used so arbitrarily, for purposes that were not in his perspectives when he was alive?

Question 6.
Isn’t the arbitrary and segmental use of Saint Makarios’ words a threat that will open the way to humanistic offers being regarded as a means of de facto salvation, making the mystic life within the Church redundant?   Is it possible, that the equilibrium in the passage of the Apostle Peter in Question 4 above provides a fulfilled answer, without any dangerous, polarizing positions?

Question 7. Since the text is referring to offering and to love, could it be simultaneously conceding  to the fact of organ removal from a living person, because a dead (or, according to others, brain dead) person lacks the self-government required for offering and loving?

Question 8. Could it be, that by using eloquent words, we are trying to convince the people of God to make an offering that is not a proper offering, or, if the donor is alive, are we possibly taking the event of death out of the hands of God, who is the Lord of life and death?

In page 319 we note an outright admission that the removal of organs should be from a living organism, with the phrase:  “How is respect and recognition of the value of life better expressed? Towards the donor, who is irrevocably departing, or towards the recipient, who is enabled to live?”

Question 9. How is the author so sure of what is irrevocable?  Is God unable to intervene in the things we believe to be irrevocable?

Question 10.
Why does the author ask whether more respect is shown towards the donor or the recipient? Does the Church make such distinctions on the measure of respect towards any individual person?

Question 11. The author again concedes to the fact of a living donor, since he speaks of “irrevocable departure”.  Is he therefore accepting the removal of one’s life?  Can the Church collaborate in the removal of a life?  In the same page 319, the author speaks of an “improbable miracle – because that’s what it is all about.”

Question 12. Is there also a denial of the possibility of a miracle?  Aren’t all miracles “improbable” events, by nature?  How can the author predefine God’s free intervention when a miracle is performed? How can God be excluded from a miracle, once and for all?

I’m afraid that Lazarus, the deceased citizen of the city Nain - as well as Jaerus’ daughter – would not have had a chance to be resurrected if they lived in our time, since their organs would have previously been removed, with the blessings of the Church’ shepherds, and justified as “offerings”.

In page 320, we see the phrase:  “Medicine confronts the dilemma and is invited to dare to demonstrate love in the presence of two people who are dying. To two people, of which, the one will be able to rebuild his life on the ruins, the leftovers of the other’s life."

Question 13. What kind of love is it, when it kills one so that another can live?  Is it permissible to kill in the name of love?

Question 14. With all the above, is the way being opened for a “theology” of euthanasia, or even suicide in due course?  

In page 323 we read:  “The ‘conscious consent’ to donate one’s body after death comprises an exceptionally sacred act of self-denial and love, since it means that the donor has the opportunity:

Á. [...]

Æ. Lastly, during moments of blissful sobriety, to cede the right and consequently his trust in the doctors and his own people, so that they might stop the function of his heart when they think is the best time, instead of waiting for the heart to stop functioning on its own, reassuring him of course that they want only what is to his best interest.”

Question 15. Isn’t the text in a somewhat embarrassing notional contradiction, since it initially stresses an “after death”, while afterwards mentioning love?  The question is again posed, as to how someone can love, after death?

Question 16.  Isn’t the author negating himself, when speaking of a blissful sobriety further along?  Does a dead person possess sobriety?

Question 17. Which is that Orthodox definition or thought or tradition that gives someone the right to  request that his heart be stopped,  “instead of waiting for the heart to stop functioning on its own”?  The text is rystal-clear. The Church is being asked to give its blessing, to intervene in a living organism.  Who will bear such a responsibility?  What kind of “theology” will ever attune itself to these un-theological absurdities?

In page 331 the text is absolutely clear:  “Then there is the case where respect towards a person signifies not only that we allow him, but that we even facilitate him, to die.”

Question 18.  Where exactly did this author learn in the realm of the orthodox church on the issue of “facilitating” someone’s death?  

In his attempt to give an orthodox streak to his unprecedented and inadmissible “theology”, the author invokes the “benediction for a departing soul” from the Minor Benedictions book. He actually invokes the phrase: “Release Your servant from this unbearable suffering and the bitter ailment that has overcome him, and repose him, where the spirits of the righteous are”.

Question 19. What kind of a comparison can there be, between a benediction that beseeches the “release from suffering” and the actual procedure of removing organs, which, if the organism is still alive according to the preceding thoughts of the author, will cause unbearable pain to the body and will make the event of death even more painful?

Question 20.  Isn’t the violent intervention for removal of organs from a living donor a negation of the prayer that asks for “peaceful ends to our lives”?  How can the church pray for peaceful ends and simultaneously condone violent ends?

The contradictions of this text are obvious, even at its “finest moments”. In page 330, it says:  “We only intervene therapeutically on the body.  Every movement that supports its deterioration also offends the soul and is sinful. This is why the process of deterioration should be entirely natural, and never forced.”  And in page 329 we read: “In no way should death be accelerated. We have no right to take anything from the body, nor to interrupt the link between the soul and the body, or deduct a certain moment from the time of psycho-physical union. “

Question 21. The author needs to clarify the purpose of these statements about “not accelerating death” and the “natural and never forced process of deterioration”, since he was speaking of “facilitating” death, only just a while ago. The author has clear very positions, which seem to annul themselves with these last words. Is it possible that attempts are being made to disorient people, with the use of correct theological thoughts?

Question 22. With the phrase “we have no right to take anything from the body”, is the author refusing the transplantation of double organs from a living donor to a living recipient? Is he also against the transplanting of bone marrow? And finally, is he refusing blood transfusion also?

In page 325,he mentions: “Transplantation doesn’t have as much value for the recipient –it offers only biological life – as it does for the donor; while the donor may offer organs, he nevertheless receives the juices of spiritual life”.

Question 23.  If transplants don’t have that much value for the recipients, then why is there so much talk of love and offering?  Is it because we want the donor to benefit spiritually?

Question 24. What is the meaning of the phrase “the donor receives the juices of spiritual life”? Are we looking at a new kind of ascetic teaching of the Church?  We normally attain spiritual life through ascesis, within the realm of the Grace of the Holy Spirit. Are we to understand that from now on, man will attain spiritual life when he offers his organs while still alive?  Does he become a spiritual person at the moment of his death?

In Page 335, we read:   “The Lord Himself, during the Last Supper, presented to His Apostles as the ultimate expression of love the offering of one’s very life for their fellow-man: ‘no-one has a love greater than this – such that he would lay down his life for his friends” (John 5 : 13).  But the Apostle John in his first Epistle also says something even more powerful : “In this do we recognize love; in that He laid down His life for us. And we too are obliged to lay down our lives for our brethren” (John Epistle A, 3:16).

Question 25. Is it permissible to use such passages, in order to serve our own theological demands?  

When interpreting the words “and my soul I lay down, for the sake of my sheep» (John 10:15) Sain John the Chrysostom writes: “He says this repeatedly, to declare that he is not a deceiver” (EPE 14, 121).

In the text of John’s gospel (10: 17-18) “for I lay down my life, so that I shall receive it again, and nobody takes it from me, but I lay it down of my own accord.  I have the authority to lay it down and I have the authority to take it back again”, Saint John the Chrysostom writes:

Let us therefore pay attention with our full attention to the words “I have the power to sacrifice my life” he says. And who does not have the power to sacrifice his life? Because every person who wants to, can bring death upon himself.  But not like that, he says. Well, how? I have such power to sacrifice my life, so that nobody else can do it if I do not wish it, which is something that man cannot do, because we do not have the power to sacrifice our life in any other way other than by killing ourselves only.  If however we happen to encounter people who scheme against us and who could murder us, then we do not have the power to sacrifice or not sacrifice our life, but without our wanting this, they take away our life.  In the case of the Lord however, things are not like that; instead, although they were scheming against Him, He still governed over the decision to not sacrifice His life. So, after He said that “nobody can take it from Me”, He added: “I have the power to sacrifice My own life”, which means: “Only I have the authority to sacrifice it, which is something that you (=people) do not have, because there are many others who dominate over you and can take away your life from you”.  However, He did not say these things from the very beginning, (nor would His word have been convincing), but it was only after He had attained testimony from the events themselves, and after He had been schemed against many times without being arrested (as He had escaped from their hands thousands of times), that He finally said: “Nobody (else) can take my life”. So, if this is true, then it can be safely surmised that equally true is the fact that whenever He so wishes, He can take it back again; for, if His death was far superior to the death of people, do not doubt that either. Because the fact that He alone has authority to sacrifice His life shows that He is master by His own authority to sacrifice it.  Do you see how, from the first point He has proven the second, and how, from death He has made the resurrection indubitable?” (EPE 14, 125-127).

To the words “lay down our lives for our brethren”, Saint John replies with the following: “I say this to you, so that you may love each other; in other words, I am not saying this to accuse you, as though I am the one who is sacrificing his life or that I first sought to become acquainted with you, but in order to lead you all into friendship.

Then, because persecution by many and accusations were something terrible and unbearable and capable of humbling the loftiest soul, for this reason, after foretelling them so many things, then Christ mentioned this: in other words, after preparing their soul, then He comes to them and shows bounteously that these were said for them…” (EPE 14, 481)

We cannot convince the body of Church faithful with theological acrobatics or skirmishes. The responsibility is huge, and no-one should provoke matters with their contradictory positions, or with the acceptance of a fact which, if not handled with theological prudence, could lead the Orthodox stance to a difficult moment with regard to the respect towards every person and towards the mystery of death.


SOURCE: Magazine «Trust», Issue No. 22 : Jan.-Feb. 2002


Translation by A. N.

Greek Text

Article published in English on: 7-11-2005.

Last update: 7-11-2005.