Message from Bishop Schol | New Law

The United Methodist Church opposes assisted suicide and euthanasia.We believe that suicide is not the way a human life should end. Often suicide is the result of untreated depression, or untreated pain and suffering. The church has an obligation to see that all persons have access to needed pastoral and medical care and therapy in those circumstances that lead to loss of self-worth, suicidal despair, and/or the desire to seek physician-assisted suicide.

Historically, the Christian tradition has drawn a distinction between the cessation of treatment and the use of active measures by the patient or caregiver which aim to bring about death.

As human interventions, medical technologies are only justified by the help that they can give. Their use requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits. There is no moral or religious obligation to use them when the burdens they impose outweigh the benefits they offer, or when the use of medical technology only extends the process of dying. Therefore, families should have the liberty to discontinue treatments when they cease to be of benefit to the dying person. However, the withholding or withdrawing of life sustaining interventions should not be confused with abandoning the dying or ceasing to provide care.

If death is deliberately sought as the means to relieve suffering, that must be understood as direct and intentional taking of life … The United Methodist tradition opposes the taking of life as an offense against God’s sole dominion over life, and an abandonment of hope and humility before God.

Yet, even as we oppose the deliberate ending of life, we continue to affirm that nothing, including suicide, separates us from God’s love and grace (Romans 8:38-39). Those whose pain and suffering compel them to commit suicide should not be condemned, nor should their surviving family and friends suffer from the stigma around suicide. Our role as faith communities is to surround with love and care those who are at risk, those who have survived a suicide attempt, and those who have lost loved ones. Read more.

Theological Statement
As Christians, we live between the certainty of death and the promise of resurrection. Jesus proclaims this paradox in John’s Gospel: “I am the resurrection and the life. Whoever believes in me will live, even though they die. Everyone who lives and believes in me will never die” (John 11:25-26). In the face of loss, we pray that God may help us “to live as those who are prepared to die, and when our days here are accomplished, enable us to die as those who go forth to live, so that living or dying, our life may be in you, and that nothing in life or in death will be able to separate us from your great love in Christ Jesus our Lord” (United Methodist Hymnal, A Service of Death and Resurrection, p. 871). All Christians therefore have a ministry of faithful care for persons suffering and dying. As we minister to others we minister to Christ (Matthew 25:34-40). We exercise that ministry when we care for those who are closest to us as well as to those who are strangers. We exercise that ministry in a number of important ways.

Preparation for Our Own Death and Resurrection
Our ministry to persons who are suffering and dying necessarily includes ourselves. Recognizing that death faces each of us, we are called to prepare for our own death and resurrection. That includes affirming and exercising our relationship with God in Christ. It includes reconciliation with others. It includes making wills—the legal preparation for others to take on the stewardship of the material goods which God has entrusted to us. It includes obtaining social and health insurance when it is available to us so that we minimize the burden we place on others. And it includes preparation for times of illness when we are not able to speak for ourselves. Living wills and instructions provide not only clarity and guidance to care providers and loved ones, but immeasurable relief from the burden of their decision making on our behalf in times of great stress.

Assisting Others Who Face Suffering and Dying
Care for others is the calling of the whole community of faith, not only pastors and chaplains. Because Christian faith is relevant to every aspect of life, no one should be expected to cope with life’s pain, suffering, and ultimate death without the help of God through other people. In care, God’s help and presence are revealed. When we as the church offer care, we empathize with suffering patients and share in the wounds of their lives. When we listen as patients express their feelings of guilt, fear, doubt, loneliness, hurt, and anger we offer them a connection with others and God. When we listen as patients tell their stories of both the extraordinary and the everyday, we help them to make connections between their experiences and God’s joy. We provide resources for reconciliation and wholeness and assist persons in reactivating broken or idle relationships with God and with others. We provide comfort by pointing to sources of strength, hope, and wholeness, especially Scriptures and prayer. Family and friends as well as those who are suffering and dying need care. Those who are grieving need the assurance that their feelings are normal human responses and need not cause embarrassment or guilt. Health-care workers—doctors and others who have intimate contact with dying persons—also need care.Pastoral Care by Pastors and Chaplains
We exercise our ministry for persons suffering and dying as we support those in specialized ministries. Pastors and chaplains sustain the spiritual growth of patients, families, and health-care personnel. They bear witness to God’s grace with words of comfort and salvation. They provide nurture by reading the Scriptures with patients and loved ones, by Holy Communion, by the laying on of hands, and by prayers of praise, petition, repentance, reconciliation, and intercession. They provide comfort and grace with prayer or anointing after a death. They conduct rituals in connection with a terminal illness, of welcome into the care of hospice or a nursing center, or of return to a local congregation by persons who have been absent.Pastoral caregivers not only offer comfort and counsel, but help patients understand their illness. They can assist families in understanding and coming to grips with information provided by medical personnel. Pastoral caregivers are especially needed when illness is terminal and patients and family members have difficulty discussing this reality freely.Medical Care
As human interventions, medical technologies are only justified by the help that they can give. Their use requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits. There is no moral or religious obligation to use them when the burdens they impose outweigh the benefits they offer, or when the use of medical technology only extends the process of dying. Therefore, families should have the liberty to discontinue treatments when they cease to be of benefit to the dying person.Palliative Care
The World Health Organization has described palliative care as care that improves the quality of life of patients and their families through the prevention and relief of suffering. It provides relief from pain; it intends to neither hasten nor postpone death; it integrates the psychological and spiritual aspects of patient care. It provides support both to patient and family. It is applicable early in the course of illness, may accompany treatment, and while its intent is simply relief from distressing symptoms, it may positively influence the course of illness. Ministering to the needs of the suffering and dying includes affirming the need for palliative care, as well as the need for comfort, encouragement, and companionship. Those who are very ill and the dying especially express their needs as they confront fear and grief and loneliness.

When there is no reasonable hope that health will improve, and the rationale for treatment may diminish or cease, palliative care becomes the dominant ministry. Hospital care may be of no benefit and the family can be encouraged to take the loved one home so that the loved one can die surrounded by family and in familiar circumstances.

Patient Rights
We exercise the ministry of faithful care as we support the rights of patients. As Christians, we have a duty to provide counsel, and patients have a right to receive it. Decisions can be complex and not easily made.

We affirm that:
a. Patients deserve to be told the truth.
b. Patients are entitled to a share of decision-making both before and during their illness.
c. Patients have a right to refuse nourishment and medical care.
d. Decisions are best made within a family of faith.

The complexity of treatment options and requests by physicians for patient and family involvement in life-prolonging decisions require good communication. Pastoral caregivers can bring insights rooted in Christian convictions and Christian hope into the decision-making process. When advance directives for treatment, often called “living wills” or “durable powers of attorney,” are being interpreted, the pastoral caregivers can offer support and guidance to those involved in decision-making. They can facilitate discussion of treatment and palliative options, including home and hospice care.

Decisions concerning faithful care for the suffering and the dying are always made in a social context that includes laws, policies, and practices of legislative bodies, public agencies and institutions, and the social consensus that supports them. The social and theological context of dying affects individual decisions concerning treatment and care and even the acceptance of death. Therefore, pastoral caregivers must be attentive to the social situations and policies that affect the care of the suffering and dying and must interpret these to patients and family members in the context of Christian affirmations of faithful care.

Affirming Life
We exercise that ministry as we affirm both life and death. In providing counsel, we affirm the Christian tradition that has drawn a distinction between the cessation of treatment and the use of active measures by the patient or caregiver which aim to bring about death. Patients and those who act on their behalf have a right to cease nourishment and treatment when it is clear that God is calling the patient home. By contrast, however, we understand as a direct and intentional taking of life the use of active measures by the patient or caregiver that aim to bring about death. This United Methodist tradition opposes the taking of life as an offense against God’s sole dominion over life, and an abandonment of hope and humility before God. The absence of affordable, available comfort care can increase the pressure on families to consider unacceptable means to end the suffering of the dying.

The withholding or withdrawing of life-sustaining interventions should not be confused with abandoning the dying or ceasing to provide care. Even when staving off death seems futile or unreasonably burdensome to continue, we must continue to offer comfort care: effective pain relief, companionship, and support for the patient in the hard and sacred work of preparing for death.

Health Delivery Reform
We exercise our ministry as we advocate for the reform of structures and institutions. As Christians, we have a duty to advocate.

We advocate for patient rights, which are easily neglected, especially when patients cannot speak for themselves, and when families are overwhelmed by the stress and confusion of difficult news. This is a reason that preparation is so important.

The duty to care for the sick calls us to reform the structures and institutions by which health and spiritual care are delivered when they fail to provide the comprehensive physical, social, emotional, and spiritual care needed by those facing grave illness and death.

We advocate for health coverage for all globally. In the world today, many nations do not have universal health care and many millions of people have either no health insurance or grossly inadequate coverage, leaving them without reliable access to medical treatment. Even when basic access is provided, good quality comfort care—including effective pain relief, social and emotional support, and spiritual counsel—is often not available.

Absence of comfort care can leave people with a distorted choice between enduring unrelieved suffering and isolation, and choosing death. This choice undermines rather than enhances our humanity. We as a society must assure that patients’ desire not to be a financial burden does not tempt them to choose death rather than receiving the care and support that could enable them to live out their remaining time in comfort and peace.

We charge the General Board of Church and Society to advocate, identify, and address instances where proper care for the suffering and dying is unavailable due to scarcity of resources, unhealthy ideologies, and oppressive conditions.

Proclaiming the Good News
We exercise our ministry as we teach the Christian good news in the context of suffering and dying. We call upon the General Boards of Discipleship and Higher Education and Ministry to develop and promote resources and training for clergy and laity globally that:

Governor Phil Murphy signed the “Medical Aid in Dying for the Terminally Ill Act” (the “Act”) into law on April 12, 2019. The Act affirms the rights of qualified terminally ill patients to obtain and self-administer medication to bring about their own humane and dignified death. The Act takes effect Aug. 1, 2019.

Medical Aid in Dying Requirements for Qualified Terminally Ill Patients
The Act permits “qualified terminally ill patients” to request a prescription for medication that they may choose to self-administer. Qualified terminally ill patients are defined as capable,[1] adult  residents of New Jersey who are terminally ill. The Act defines “terminally ill” patients as those “in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six (6) months or less.” This prognosis must be confirmed by both an attending physician[2] and a consulting physician.[3]

I. Patient Responsibilities
To obtain a prescription for medication, qualified terminally ill patients must:

The written request must be witnessed by at least two individuals in the patient’s presence who can attest the patient: (1) is capable; and (2) is acting voluntarily when executing the request. Attending physicians may not serve as a witness to the written request.

One of the witnesses must be a person who is not:

The Act provides model forms to use for the written request and witness declarations. Patients may rescind the request at any time and in any manner, regardless of mental state.

Patients must designate a person who is responsible for the lawful disposal of the medication. If a patient chooses not to self-administer any dispensed medication, the patient must dispose of the medication consistent with state and federal guidelines or surrender the medication at a prescription medication drop-off receptacle.

The Act makes it clear that no other person – including a guardian, conservator, healthcare representative or patient representative – may make a request for medication on behalf of the patient. They may only communicate a patient’s healthcare decision to a provider at the request and direction of the patient.

II. Physician Responsibilities
A. Attending Physicians
Prior to writing a prescription for medication, the attending physician must:

Once the attending physician determines that all requirements have been met, the attending physician may write a prescription for the medication if: (1) 15 days have elapsed between the initial oral request and the writing of the prescription and (2) at least 48 hours has elapsed between receipt of the patient’s written request and the writing of the prescription.

The attending physician may dispense the medication including ancillary medication intended to minimize patient discomfort directly to the patient if the physician is authorized by law to do so and has a current DEA certificate of registration. The attending physician may also contact a pharmacist to dispense the medication, inform the pharmacist about the prescription and transmit the prescription (personally, by mail or permissible electronic transmission). The medication may not be dispensed by mail or via courier.

B. Consulting Physicians
Pursuant to the Act, the consulting physician must:

If the consulting physician refers a patient to a mental healthcare professional, the consulting physician must provide written notice of the referral to the attending physician.

C. Voluntary Participation
The Act clarifies that healthcare professionals must voluntarily participate in the process. If a healthcare professional is unable or unwilling to assist with a patient’s request, the healthcare professional has a duty to transfer a copy of the patient’s relevant records to the new healthcare professional or healthcare facility.

D. Medical Record Documentation
Attending physicians are required to ensure the patient’s medical record includes:

III. Healthcare Facility Responsibilities
The Act provides that the healthcare facility’s participation in the medical aid in dying process must be voluntary. The Act further notes that the facility’s existing policies and procedures govern the actions of healthcare professionals while on premises owned by or under direct control of the facility. Finally, the Act provides that healthcare facilities are not subject to N.J. Department of Health (“DOH”) licensure enforcement procedures for any actions taken in compliance with the Act.IV. Reporting Requirements
The following information must be reported to the DOH by the attending physician or pharmacist on a form that will be issued by the Commissioner of Health:

Pursuant to the Act, the DOH is required to coordinate the process for reporting information with the Prescription Monitoring Program (“PMP”).  The information collected will be reported in an annual statistical report available on the department’s website. Any information that could be used to identify a patient or healthcare professional will not be included in materials available for public inspection.

V. Liability
The Act does not authorize a physician or any other person to end a patient’s life by lethal injection, active euthanasia, mercy killing, or any other act that constitutes assisted suicide under the laws of New Jersey. Moreover, the Act does not lower any applicable standard of care that is provided by a healthcare professional who participates in this process.

Absent acts of gross negligence, recklessness, or willful misconduct, the Act shields all individuals from civil and criminal liability, professional disciplinary action, censure, discipline, suspension, or loss of any licensure, certification, privileges, or membership, for any action taken in compliance with the Act including being present when the medication is self-administered.

The Act further provides that actions taken under the Act will not constitute patient abuse, neglect, suicide, assisted suicide, mercy killing, euthanasia, or homicide under New Jersey law.

The Act does not limit liability for civil damages resulting from negligence or intentional misconduct of any person. Additionally, government entities that incur costs because a patient self-administers medication in a public place have the right to make a claim against the patient’s estate for costs and attorney’s fees.
The Act provides for criminal charges under certain circumstances:

VI. Issuance of Proposed Regulations
The Act requires DOH; the Director, Division of Consumer Affairs, Department of Law and Public Safety and the state boards of Medical Examiners, Pharmacy, Psychological Examiners, Social Work Examiners to adopt rules and regulations regarding the responsibilities of physicians, pharmacists, healthcare professionals, healthcare facilities and long-term care facilities.