Sermon copyright (c) 2025 Dan Harper. As delivered to First Parish in Cohasset. The text below has not been proofread. The sermon as delivered contained substantial improvisation.
Sermon
This is a sermon that grew out of the concerns and interests of people in First Parish. It began with questions a couple of you have asked me about assisted dying. And then after I announced this topic, quite a few of you sent me articles and other material about assisted dying. Thank you to everyone who sent me those materials, and to everyone who talked with me about the topic.
My goal this morning is not to give you an exhaustive overview of the topic of assisted dying. Instead, what I’d like to do is to consider what it means to make personal choices around assisted dying. As usual, I’m not going to try to give you any final answer; I’m merely going to try to lay out some of the main ethical issues. It will then be up to you to figure out how to address these ethical questions in your own life.
When talking about ethical issues, it often helps to have a concrete case study to consider. For a case study about assisted dying, I’m going to give you the story of the death of Scott Nearing, as told by his wife Helen Nearing. Soctt Nearing was a well-known figure in the twentieth century, though he is mostly forgotten today. He first came to prominence during the First World War, when he was fired from his position as college professor because of his public support of pacifism during that war. (Pacifism was essentially illegal during the First World War; the First Amendment was ignored, and anyone who spoke publicly in favor of pacifism risked job loss, imprisonment, and officially sanctioned harassment.) After the First World War, Nearing became a Socialist, and then during the Great Depression a Communist. Then he and his wife Helen decided that they wanted to live by the efforts of their own hands, first moving to a farm in Vermont. When a ski resort opened next to their farm, they felt they had to move, but rather than sell their land to the ski resort, which would have made them millions of dollars in profit, they gave it to the town as conservation land. They then moved to Maine, where they wrote a book “Living the Good Life” describing how they lived off the land, and how they followed what we would now call a vegan diet. This book became a sort of Bible for the 1960s “Back to the Land” movement, and the Nearings had many visitors who came to their farm to learn how they, too, might live off the land.
I tell you all these details of Scott Nearing’s life to help you understand that he was an independent thinker who was not bound by a conventional religious worldview; he was a freethinker. This will become important later. Now I’ll give you the story of his death, as it was told by Helen Nearing:
“A month or two before Scott died, he was sitting at table with us at a meal. Watching us eat he said, ‘I think I won’t eat anymore.’ ‘All right,’ said I. ‘I understand. I think I would do that too. Animals know when to stop. They go off in a corner and leave off food.’
“So I put Scott on juices: carrot juice, apple juice, banana juice, pineapple, grape — any kind. I kept him full of liquids as often as he was thirsty. He got weaker, of course, and he was as gaunt and thin as Gandhi.
“Came a day he said, ‘I think I’ll go on water. Nothing more.’ From then on, for about ten days, he only had water. He was bed-ridden and had little strength but spoke with me daily. In the morning of August 24, 1983, two weeks after his 100th birthday, when it seemed he was slipping away, I sat beside him on his bed.
“We were quiet together; no interruptions, no doctors or hospitals. I said ‘It’s all right, Scott. Go right along. You’ve lived a good life and are finished with things here. Go on and up — up into the light. We love you and let you go. It’s all right.’
“In a soft voice, with no quiver or pain or disturbance he said ‘All … right,’ and breathed slower and slower and slower till there was no movement anymore and he was gone out of his body as easily as a leaf drops from the tree in autumn, slowly twisting and falling to the ground.
“So he returned to his Maker after a long life, well-lived and devoted to the general welfare. He was principled and dedicated all through. He lived at peace with himself and the world because he was in tune: he practiced what he preached. He lived his beliefs. He could die with a good conscience.” (1)
Thus ends Helen Nearing’s story of how Scott Nearing died. Now let’s consider this story as an ethical case study that might shed some light on assisted dying.
First, let’s ask: Was Scott Nearing’s death suicide? I would say: yes, it was. He starved himself to death. Think about it this way: if Helen Nearing had called 9-1-1, when the EMTs came they would have given him intravenous feeding; that is, a third party would see that Scott Nearing was dying, and they would have done what they could to stop him from dying.
Second, let’s ask: Was this assisted dying? Again, in my opinion the answer is fairly clear: yes, it was. Helen Nearing helped Scott Nearing to die. She assisted him in reducing his food intake, first to juices, then to only water. When Scott Nearing was bed-ridden, she had to care for him, but she did not force him to eat, nor did she take him to the hospital. She assisted him in dying.
This is not the usual way we think about assisted dying, of course. We usually think about assisted dying as a patient asking for the assistance of a doctor or other health care professional in finding a way to end their life. And certainly when a health care professional is involved, that raises other ethical questions for the professional. But assisted dying can also take place at home, without medical supervision or assistance.
Now that we’ve determined that this was assisted dying, let’s consider some of the ethical issues that arise in this case study. And the first issue that has to be considered when considering any form of assisted dying is whether the person dying has given their full consent. When it comes to assisted dying, this is perhaps the trickiest of all ethical considerations. Often, we try to dodge this question, as when we say that assisted dying is acceptable if a doctor determines that the person who wishes to die has only a few months left to live. In such a situation, more people are inclined to say that assisted dying is acceptable; even if someone is unable to give their full consent, perhaps we don’t worry so much about consent because after all the person is going to die soon anyway; and in such cases perhaps assisted dying allows the person to die in dignity, without unbearable suffering and pain.
But Scott Nearing did not have a terminal diagnosis, so in this case study we cannot dodge the issue of consent. I would say in Scott Nearing’s case that yes, he was able to give full consent. Not only that, but he gave consent repeatedly over a period of time: he gave consent every time he chose not to eat. Furthermore, by putting him on a juice diet at first, Helen Nearing gave him the option to revise his decision; he got terribly thin on that juice diet, but he could still have changed his mind and begun eating once again. So in this case, by choosing this method of dying, Scott Nearing gave the fullest possible consent.
Consent is very important for at least two reasons. First, obviously we should be concerned about the possibility of family members pushing someone to commit suicide for reasons of their own — they want the person’s money or property, or whatever less-than-savory motivation that might exist. Second, it turns out that many people change their minds during or after a suicide attempt. Back in 1981, Art Kleiner wrote an article titled “How Not To Commit Suicide.” In that article, he documented how when suicide attempts fail (and they often fail), those who attempted suicide decide afterwards that they really wanted to live. (2) Thus consent cannot arise from a momentary impulse; consent can only arise from a carefully considered decision.
It’s both critically important and quite difficult to determine whether consent has been freely given. Was the person forced into the decision by others? Would the person change their mind if you gave them time to think about it? These are two key questions. In the Scott Nearing case study, we can be about as certain as it’s possible to be that consent was freely given.
Next we have to consider how a decision to die affects all those around the person who is dying. I assume that we are isolated individuals, but rather that each one of us is a part of the interdependent web of existence, and what we do with our lives will have distinct and definite effects on other people. We especially have an effect on those who are closest to us, but when a person dies by suicide they also have an effect on the wider society, especially those who are required by law and custom to investigate such deaths.
In the story of Scott Nearing’s death, he did take into account those around him. In particular, he had to take into account his spouse, Helen Nearing. What would Helen think if Scott decided to die? Helen Nearing tells us that several years before he died, Scott Nearing told an interviewer: “‘I look forward to the possibility of living until I’m 99.’ His blue eyes twinkled. ‘It is a precarious outlook, I assure you. … I have almost nothing left but time. But if I can be of service, I would like to go on living.’” Helen then said that Scott “did more than his share of mental and physical work up to his last years.” Helen implies that it was only when Scott felt unable to contribute as much as he felt he should to their partnership that he decided to die; and that, while she may not have fully agreed with him, she understood and supported his decision; supported it to the point that she was willing to care for him in his last couple of weeks when he was bed-ridden. When we consider how a person’s death affects those around them, this helps us understand the difference between assisted dying and other types of suicide. Assisted dying is a decision made in partnership with others, with full awareness of the emotional toll on others, full awareness of the help that will be needed from others, and full awareness of all the impacts on others.
One should also consider carefully how the means of death will affect others. One brief example: I was on a train once that someone used to die by suicide. When that happens, the train becomes a crime scene, and all of had to stay in the train for a couple of hours. I have a vivid memory of watching the train crew as they walked down the train to talk with the police, of seeing their expressions of pain and shock. You simply do not want to do that to anyone. Then too, there is the impact on the first responders, and all those who will have to investigate. By contrast, Scott Nearing chose a means of assisted dying that was not going to traumatize other people.
In addition, there are other impacts beyond the emotional impacts. For example, there may be financial impacts. Consider the way assisted dying happens in Switzerland. The legal situation around assisted dying in Switzerland is complex — I don’t pretend to understand all the ins and outs — but from a practical standpoint, while assisted dying is allowed, every unnatural death has to be fully investigated. Those organizations that provide assisted dying in Switzerland charge their clients a fee that covers not only the assisted death, but also the investigation that has to happen afterwards. That way, Swiss taxpayers don’t have to pay every time an assisted death is investigated.
And then there are the legal implications of assisted dying. But I don’t have time to go into the complicated question of the subtle differences in assisted dying laws in different jurisdictions. Here in the United States, assisted dying is legal in California, Colorado, Hawai’i, Maine, Montana, New Jersey, Oregon, Vermont, and the District of Columbia; yet each jurisdiction has slightly different laws. In other ocuntries, assisted dying is available in Austria, Belgium, Canada, Colombia, Ecuador, Germany, Italy, Luxembourg, the Netherlands, New Zealand, Portugal, Spain, and Switzerland; in all Australian states except the Northern Territory; and in the United Kingdom in England, Wales, and Scotland. (3) Each of these jurisdictions has significantly different laws for assisted dying, and each set of laws results in different ethical issues, and I don’t have the time or the expertise to talk about these differences. Beyond the legal questions of assisted dying, there are many other ethical issue that arise. We don’t have the time to cover them all, so I’m going to stick to my purpose: trying to consider the personal choices around assisted dying.
Thinking about personal choices raises one last question, and that’s the question of religious ethics. In our case study, Scott Nearing did not have a conventional religious perspective, which may have allowed him to perceive options that would not have been apparent to a more conventional religious worldview. So what religious stand do Unitarian Universalists take on assisted dying? There is no simple answer. Ours is a religion that does not have a creed or dogma to which we all must assent. Instead, we leave ethical matters to a person’s individual conscience, while also acknowledging that a person’s individual conscience only exists as a part of a larger community.
By contrast, many Christians are able to fall back on a simple and straightforward dogma or belief system regarding assisted dying — they would say assisted dying is a sin. Many Buddhists would also feel that assisted dying is unacceptable, since it could affect a person’s next birth. Many Hindus and Jains feel that assisted dying is wrong because it can be seen as a form of violence directed against the self, which goes against the principle of ahimsa, or non-violence. In other words, some religious traditions have firm teachings on assisted dying that are easy to understand and follow.
In some ways, it would be easier if we Unitarian Universalists had a simple and straightforward perspective on assisted dying. But we don’t. From our religious perspective, we can imagine situations in which assisted dying is quite acceptable — when someone is suffering too much, when life has become a burden, and so on. We can also imagine situations in which assisted dying gets ugly — when it looks too much like eugenics, or when it looks too much like an excuse to get rid of people who are old or disabled, and so on.
I would say that most of us Unitarian Universalists feel that some kind of assisted dying should be available to those who want it. And most of us probably agree that there should be some limitations to assisted dying and some protections — and I suspect many of us have known someone who died by suicide when that was probably the wrong thing to do. So we want the possibility of assisted suicide, with appropriate protections in place — protections like ensuring consent, and considering the impact on other people.
Thus we Unitarian Universalists do not have a single straightforward teaching or doctrine that covers assisted dying. Our religious worldview doesn’t force us to find one simple, final answer to every question. Instead, we try to think carefully about difficult ethical questions, to understand our feelings about those difficult questions, and to understand the feelings of those around us. Then we do our best to live out our beliefs, living lives that are in tune with our highest principles, at one with the interdependent web of all existence.
Notes
(1) Helen Nearing, “At the End of a Good Life,” In Context, summer, 1990, p. 20. https://www.context.org/iclib/ic26/nearing/
(2) Art Kleiner, “How Not To Commit Suicide,” CoEvolution Quarterly, summer 1981, pp. 88-109. https://archive.org/details/coevolutionquart00unse_26/page/88/mode/2up
(3) See, e.g., Fergus Walsh, “How assisted dying has spread across the world and how laws differ,” BBC News website, 29 November 2024. https://www.bbc.com/news/articles/c1dpwg1lq9yo — N.B.: since this article was written, assisted dying has been legalized in England, Scotland, and Wales.