Pastoring in an assisted suicide world
Written by James Mildred
Pastoring in an assisted suicide world
The theologian Don Carson has often used the analogy of a General Practitioner (GP) when describing the role of a church leader.
I wonder if you would agree?
Alongside the demands of regular preaching and Bible study, there is the need to nurture the next generation of church leaders, care well for your own family, meet a wide variety of pastoral needs and situations and that’s alongside the incessant administration!
Part of your role also involves ministering to congregants who have a physical illness of some kind or another.
There is no question some of the instances of sickness and ill health are difficult enough to know how best to pastor and care for them. But if you look ahead and think about what it will be like if assisted suicide is ever legalised here, a whole new and disturbing dimension opens up. For example, you might need to respond to a member who is dying
in hospital, and who wants to choose an assisted suicide. How will you respond? If they go ahead, how will you communicate this to other members? How would a congregant choosing an assisted suicide affect your approach to conducting their funeral?
There will also be cases where you are supporting a sick saint and their family are putting them under huge pressure to choose an assisted suicide. You could be placed squarely in the middle.
In your church will be nurses, social care workers, and doctors who will resist this law but suffer as a result. At the same time, there might be doctors who convince themselves to ‘go along with it’.
There will be members who have elderly parents who choose an assisted suicide? What counsel and help will you offer them?
All of this presents a momentous challenge to the church. How can we respond? What should we do?
How then can the church respond?
In Galatians 6:2, the Apostle Paul tells us to carry each other’s burdens and, as we do so, we fulfil the law of Christ. It is a costly privilege to walk alongside a brother or sister in Christ, especially through the valley of sickness and suffering.
This is what real, genuine compassion looks like. Supporters of assisted suicide love to use the word ‘compassion’ and argue that assisted suicide is a ‘compassionate’ response to terminal illness and suffering at the end of life.
But what does the word actually mean? It means to suffer with someone. This is a profoundly Christian response to suffering at any stage of life. Rather
than turning and walking on the other side of the road, like the priest and the Levite in the Parable of the Good Samaritan, we walk with those who are hurting.
When compassion is understood like this, it exposes the lie that assisted suicide can ever be a ‘compassionate’ response to suffering and sickness. In fact, assisted suicide is the very opposite of compassionate. It robs the opportunity to walk with someone in their trial and pain. Both sufferer and companion are denied this time and gift, to be loved and to love.
By showing true compassion we follow the example of the Good Shepherd who does not abandon his sheep, even when they walk through the valley of the shadow of death (Ps 23:4).
It is costly and complex to do this. To carry another’s burden means taking it upon yourself, at least to some degree. As church leaders, you will be doing this for many of your congregants.
When you add in the reality of family life, regular ministry and general tiredness alluded to already, it can be a hugely daunting prospect. Hopefully, there are others in your church family who can help so that you do not have to do everything alone.
I have valued learning from the wisdom of others to help sharpen the church’s response for those who are sick and dying. Here are two main insights I want to share that I have found helpful and I pray and trust you do as well.
“assisted suicide is the very opposite of compassionate. It robs the opportunity to walk with someone in their trial and pain. Both sufferer and companion are denied this time and gift, to be loved and to love.”
Total Pain requires Total Care
We might think a lot of people die in excruciating pain. But the truth is quite the opposite. Pain can be managed through expertise and pain relief drugs. The truth is that the real suffering at the end is more complex than physical pain.
It was Dame Cicely Saunders, the Christian pioneer of the modern hospice movement, who used the phrase ‘total pain’ to describe the experience of those who are dying. This idea emerged from her experience and multi-disciplinary roles as a nurse, medical social worker, doctor and researcher. In particular, she pioneered new pain control methods for the dying poor in Bayswater. Under her care, patients were given continuous pain relief, rather than being forced to wait until their pain returned.1
According to Professor John Wyatt, her most profound insight was that
pain at the end of life is not just physical. It is also psychological, relational and spiritual.2 I think we see a biblical example of this ‘total pain’ concept in the book of Job. Consider his situation after Satan has been allowed to seriously afflict him:
First there is the physical pain: there were the boils that afflicted his skin and left him carving at his own skin with broken pottery. There was emaciation from hunger and thirst along with general malaise and weakness of the body.
But you can also see his psychological pain as he grappled with the mystery of his suffering. There was the relational pain of his three friends and his wife who was not on the same spiritual page as he was and who urged him to curse God and die! There was spiritual pain as well as he wrestled with the mystery of why God would allow this to happen.
What is true for Job will almost certainly be true for those you pastor.
Whilst you will not be able to help them with their physical pain, you can help your members at the level of spiritual, psychological and relational pain.
That being said, it is also important to ask questions to make sure the church member is being looked after physically. Even knowing what sort of pain relief they are receiving can be helpful because it will help you prepare for their level of alertness.
Practically, it is important to never minimise the suffering a member is going through. It is striking that when Elijah wanted to die, God provided physical refreshment first and only after he had eaten and had some water did the Lord speak spiritual truths to him.
Never underestimate the value of simply being present with a member or loved one who is dying. Depending on your work and context, you might need more time during the week to simply spend with members who are in hospital or the hospice.
I think it is also vital to stress, graciously and winsomely, that for the Christian, no suffering is meaningless. Assisted suicide looks to end suffering, but we know that suffering can be used by God for our good and for the good of others. In 2 Corinthians 1, Paul says he received God’s comfort in trials, so that he could comfort and be a blessing to others. Suffering in our lives has purpose which is something our secular world just cannot grasp.
“Never underestimate the value of simply being present with a member or loved one who is dying.”
We need to learn how to die well
Alongside learning about, and responding to, the reality of total pain, there is another act of loving service we can do for those in your church who are especially sick. Through the regular teaching and ministry of the church we can prepare people for sickness and death before they come. In particular, we must help people to die well.
As pastors and under-shepherds, we are on the front line in providing care and support for the sick and dying. Most people are more informed about dying by what they watch on TV or read about on social media than by listening to the words and voices of those who are there when people die.
Therefore, I think it is helpful to correct this misunderstanding and help people to understand the reality of dying. This is where the voice of those who care for people at the end of their lives is so valuable. I commend Christians in Care, for example, as a wonderful group who help us better understand what dying is really like.
As we teach our people about the reality of dying, we can also remind saints that the Christian’s relationship with death has been forever changed thanks to the transforming work of Christ.
Society’s view of death
A French Enlightenment Philosopher once said: “Death, like the sun, should not be stared at.”3
Modern society largely ignores death and minimises it. Theologian Carl Trueman made this pointed observation: “Once, churches stood next to graveyards and the weekly rituals of worship could not be attended without one’s first passing by reminders of our mortality. Today, the death industry is kept at a safe distance except at funerals.”4
In contrast, in Psalm 90:12 we read this: “teach us to number our days so we may gain a heart of wisdom.”
It is a sign of wisdom to prepare for death. In scripture, we discover the help and resources we need to prepare to die well. This starts by understanding how we should view death.
The church’s view of death
Firstly, death is an enemy.
We should rage against death. It is not natural. We see this when Jesus wept outside the tomb of his dear friend Lazarus. He wept tears of rage against the worst consequence of sin. Secondly, death is an opportunity.
It is a chance to put things right. There are so many stories of people finding forgiveness and reconciliation in their final months because death focused the mind and pushed them to do the right thing.
The Scottish Theologian and pastor Thomas Chalmers said it was greatly to be desired that Christians prepare for death. They need to start
disengaging themselves from their life in this world, to ‘withdraw from business’ as it were. If the Bible says our lives are three scores years and ten, then he argued that as we enter our 70s, we need to view that time as like a Sabbath – a season of preparation for heaven.
Dr Martyn Lloyd Jones agreed: “I agree with Chalmers absolutely. We don’t give enough time to death and to going on. It is a very strange thing this. Death is the one certainty and yet we don’t think about it. We are too busy. We just allow life and circumstances to occupy us but we don’t stop and think. Peoples say about sudden death that it is a wonderful way to go, but I have come to the conclusion that this is quite wrong. I think the way we go out of this world is very important. The hope of sudden death is based upon the fear of death. It is the hope of wanting to slip through death rather than to face it.”5 Lloyd Jones went on to say that saints can live victorious lives but then become weak and feeble in the face of death. We must never forget that death is the final enemy and it must be faced. We can triumph, argues Lloyd Jones, but only if we prepare well for it.
So how do we prepare? Firstly, there is spiritual preparation. We must reflect and contemplate the promises of God’s word. We will not be abandoned to the realm of the dead. We will not face the final river alone. We must look beyond death to reaching the glory land and we must mediate on Paul’s famous words: “to live is Christ and to die is gain.”
As pastors and preachers, this means preaching about death and dying. Whether as a one-off sermon, or a series, or engaging with it as you exposit Bible books, keep in mind that this is one application that will apply to everyone in front of you! To illustrate, you could use examples of saints in history who have died well, like Lloyd-Jones.
But we must also prepare practically as well. We must think through what our own preferences are when it comes to the end of our lives. Our people need this practical help as well. We can draw up plans that spell out our preferences around resuscitation at the end of life.
There are legal moves we can make, like granting trusted loved ones lasting power of attorney. There are other financial arrangements we can make too, to ensure our loved ones are provided for. Preparing to die is good for our souls and good for our families as well.
Here is what the Puritan theologian and pastor John Owen said:
In plain terms, I am speaking to dying men who do not know how soon they may die. May God advise my own heart that I should labour and watch so that death might not find me without a sight of eternal things! If it does—if our bellies cleave to the dust and our eyes turn to the ground; if we are filled with other things, and death approaches—do you think it will be an easy thing to gather in your minds and affections to agree to it and welcome it? You will not find it so’.6
Finally, thanks to Jesus, death is a severe mercy.
It is still hard to pass through the final waters. But through Christ, we have new life! The power of the age to come is at work in us already. For the Christian, death becomes a portal to another world. Death has been redeemed and when Jesus returns, it will suffer its final defeat.
Our greatest hope is found in the words of the Apostle Paul in 1 Corinthians 15:57-58:
“When the perishable has been clothed with the imperishable, and the mortal with immortality, then the saying that is written will come true: “Death has been swallowed up in victory.”
“Where, O death, is your victory? Where, O death, is your sting?”
The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ. Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain.”
May God help you to pastor the sick and the dying, meeting total pain with total care and helping people to prepare to die well.
Conclusion
One of the most powerful quotes I have ever read on the issue of assisted suicide comes from a Christian philosopher called Joseph Pieper.
Speaking about love, he said this: “Love is a way of saying to another person, ‘It’s good that you exist; it’s good that you are in this world.’”7
This is the polar opposite to the message of assisted suicide, which says that it would be better if you died and the world would be better off without you.
Christian teaching about death and dying is a better story for society! By saying no to assisted suicide, we are still saying yes to greater palliative care, to walking in true compassion with someone who is sick and dying, to affirming their God-given dignity, and to helping them prepare to die well.
References
1 https://www.kcl.ac.uk/cicelysaunders/about-us/cicely-saunders, accessed 24/02/2026
2 https://www.johnwyatt.com/essay-medical-issues-in-the-care-of-the-dyingperson/, accessed 24/02/2026
3 John Wyatt, Matters of Life and Death, IVP, 2006, p14
4 Ibid
5 https://banneroftruth.org/us/resources/articles/2020/dr-martyn-lloyd-jones-on-preparing-for-death-by-rev-iain-murray/?srsltid=AfmBOopLb0K2tUk_F_0RHhgA085w0gnBi6xKyC4_meaXF_FvsBACYqb7, accessed 02/01/2026
6 https://banneroftruth.org/us/resources/articles/2025/john-owen-on-dying-comfortably/?srsltid=AfmBOopdMqX3kCUM3maWv3XHtj19PwWh_kyJDg79Ux05vuMinurjy0L0, accessed 02/01/2026
7 https://www.johnwyatt.com/ethical-dilemmas-and-compassionate-responses-to-abortion/, accessed 25/02/2025
For further reading
John Wyatt, Dying Well, IVP
Christians in Care: https://www.christiansincare.org/
Also available from CARE:
Dear MP: Your guide to engaging with your local representative
Assisted Suicide: Everything you need to know about the end-of-life debate
Change Begins: Your guide to the next five years of Labour government
These resources and many others are available online at care.org.uk/resources. To request copies free of charge, please use the contact details listed on the next page.
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When he’s not causing mayhem around the office, James oversees rather a lot: comms, church engagement, media, campaigns and events. As a true Scot, he’s a stranger here in London, where he lives with his far more talented wife.
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