The Bible does not explicitly address the modern concept of “quality of life” in end-of-life decision making. However, there are some principles from Scripture that can provide guidance for Christians thinking through these difficult issues.
The sanctity of human life
The Bible affirms the sanctity and value of human life as created in God’s image (Genesis 1:26-27). Human life is precious to God at all stages and in all conditions. This implies that we should not make end-of-life decisions based solely on perceptions of “quality.” Every life has dignity and worth.
Genesis 1:26-27 – Then God said, “Let us make man in our image, after our likeness. And let them have dominion over the fish of the sea and over the birds of the heavens and over the livestock and over all the earth and over every creeping thing that creeps on the earth.” So God created man in his own image, in the image of God he created him; male and female he created them.
The timing of death is in God’s hands
God is sovereign over the timing of our death. Our lives are in His hands (Psalm 139:16; Job 14:5). This implies we should avoid taking active measures to hasten death in most circumstances. God’s timing is best even when we face suffering.
Psalm 139:16 – Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.
Job 14:5 – Since his days are determined, and the number of his months is with you, and you have appointed his limits that he cannot pass.
The example of Christ
Jesus Christ endured intense physical suffering prior to His death (Mark 15:15-37). He did not seek a hastened death to avoid suffering. His example provides a model for enduring suffering with faith and humility.
Mark 15:15-37 – So Pilate, wishing to satisfy the crowd, released for them Barabbas, and having scourged Jesus, he delivered him to be crucified… And when they had crucified him, they divided his garments among them by casting lots. And it was the third hour when they crucified him. And the inscription of the charge against him read, “The King of the Jews.”
Avoiding suicide
The Bible prohibits murder and suicide (Exodus 20:13). Intentionally taking one’s own life, even for perceived compassionate reasons, goes against God’s commandments. We should avoid rationalizing end-of-life decisions as “compassionate” when they involve deliberate hastening of death.
Exodus 20:13 – You shall not murder.
Avoiding vitalism
While human life has sanctity, the Bible does not teach we must always extend biological life by any means possible. Allowing death can be appropriate when medical interventions become excessively burdensome or offer little benefit (cf. Luke 14:26-33).
Luke 14:26-33 – “If anyone comes to me and does not hate his own father and mother and wife and children and brothers and sisters, yes, and even his own life, he cannot be my disciple. Whoever does not bear his own cross and come after me cannot be my disciple… So therefore, any one of you who does not renounce all that he has cannot be my disciple.
Seeking wisdom and counsel
End-of-life decisions should be made carefully with prayer, wisdom from God’s Word, input from medical professionals, and counsel from mature believers (Proverbs 15:22). These difficult matters should not be faced alone.
Proverbs 15:22 – Without counsel plans fail, but with many advisers they succeed.
Motives matter
As with any decision, our motives are key. God cares about why we choose what we choose (Proverbs 16:2). End-of-life motives should reflect faith in God’s goodness, care for those who will grieve, and testimony to God’s love.
Proverbs 16:2 – All the ways of a man are pure in his own eyes, but the Lord weighs the spirit.
Entrusting our loved ones to God’s care
As believers, we can have hope that God will mercifully receive our loved ones into eternal life when they pass away. This hope can encourage us to avoid unnaturally extending life simply to delay a death (Philippians 1:21-23).
Philippians 1:21-23 – For to me to live is Christ, and to die is gain. If I am to live in the flesh, that means fruitful labor for me. Yet which I shall choose I cannot tell. I am hard pressed between the two. My desire is to depart and be with Christ, for that is far better.
Active euthanasia is wrong
Actively causing someone’s death, even if seemingly motivated by mercy, violates God’s prohibition against murder. We should not rationalize lethal injections or assisted suicide as compassion (Exodus 20:13).
Exodus 20:13 – You shall not murder.
Passive approaches may be appropriate
Allowing the natural dying process through removing burdensome interventions can be permissible when death is imminent. However, any actions with the explicit intent to cause death are morally wrong.
Palliative care is appropriate
Alleviating pain and providing comfort measures for the dying are morally right. Effective palliative care is part of the mandate to love our neighbor (Luke 10:25-37).
Luke 10:25-37 – He answered, “You shall love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind, and your neighbor as yourself.” And he said to him, “You have answered correctly; do this, and you will live.”
Maintain hope and trust God
As believers facing death, we can maintain hope in God’s promise of eternal life (Titus 1:2). While the dying process may be grim, our future with Christ gives hope and comfort amid grief (1 Thessalonians 4:13-18).
Titus 1:2 – in hope of eternal life, which God, who never lies, promised before the ages began.
1 Thessalonians 4:13-18 – But we do not want you to be uninformed, brothers, about those who are asleep, that you may not grieve as others do who have no hope. For since we believe that Jesus died and rose again, even so, through Jesus, God will bring with him those who have fallen asleep…
Making preparations while of sound mind
It can be wise to plan for potential end-of-life dilemmas while of sound mind through advance directives and discussing one’s wishes with loved ones (Proverbs 13:16). This can help guide decision making if one becomes incapacitated.
Proverbs 13:16 – Every prudent man acts with knowledge, but a fool flaunts his folly.
Avoid futile treatment
Extraordinary treatments that only prolong the dying process without offering real benefit may be refused in good conscience (Ecclesiastes 3:1-8). However, basic provision of food, water, and routine care should be maintained.
Ecclesiastes 3:1-8 – For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted…
Don’t delay making things right with God
No one knows when their end will come (Luke 12:16-21). Waiting until old age or sickness to get right with God and others is unwise. We should be ready to meet our Maker at any time (Matthew 24:36-44).
Luke 12:16-21 – And he told them a parable, saying, “The land of a rich man produced plentifully, and he thought to himself, ‘What shall I do, for I have nowhere to store my crops?’ And he said, ‘I will do this: I will tear down my barns and build larger ones, and there I will store all my grain and my goods. And I will say to my soul, “Soul, you have ample goods laid up for many years; relax, eat, drink, be merry.”’ But God said to him, ‘Fool! This night your soul is required of you, and the things you have prepared, whose will they be?’ So is the one who lays up treasure for himself and is not rich toward God.”
Matthew 24:36-44 – “But concerning that day and hour no one knows, not even the angels of heaven, nor the Son, but the Father only…Therefore you also must be ready, for the Son of Man is coming at an hour you do not expect.
Prepare for your death and grieving
Although painful to consider, we can take steps to prepare for our death, such as planning our funeral and making amends in relationships. This provides closure and makes grieving easier for our loved ones (Ecclesiastes 7:1-4).
Ecclesiastes 7:1-4 – A good name is better than precious ointment, and the day of death than the day of birth. It is better to go to the house of mourning than to go to the house of feasting, for this is the end of all mankind, and the living will lay it to heart. Sorrow is better than laughter, for by sadness of face the heart is made glad. The heart of the wise is in the house of mourning, but the heart of fools is in the house of mirth.
Rely on God’s grace in suffering
While facing death’s “sting,” we can draw comfort from God’s promise that His grace is sufficient amid weakness (2 Corinthians 12:7-10). He will enable us to bear suffering with perseverance and hope.
2 Corinthians 12:7-10 – So to keep me from becoming conceited because of the surpassing greatness of the revelations, a thorn was given me in the flesh, a messenger of Satan to harass me, to keep me from becoming conceited. Three times I pleaded with the Lord about this, that it should leave me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.”
Prepare for eternity
The most important preparation we can make for death is trusting in Christ for salvation. Only He can redeem us from sin’s penalty and secure our hope of eternal life beyond the grave (John 3:16; John 14:6).
John 3:16 – “For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.
John 14:6 – Jesus said to him, “I am the way, and the truth, and the life. No one comes to the Father except through me.
In summary, the Bible provides principles that can guide end-of-life decisions: upholding the sanctity of life, avoiding deliberate hastening of death, preparing spiritually, managing pain and suffering, seeking godly counsel, trusting God’s sovereign timing, having hope in eternal life, and making practical preparations. While difficult, facing death through the lens of Scripture allows us to honor God and finish well.