The Biblical and Christian Worldview
for the 21st Century

End of Life Issues: Dying, Death and Euthanasia

Evangelicals are familiar with Christ’s promise "that (we) might have life, and have it abundantly" (John 10:10b). We associate that promise with the peace, hope, and joy that comes from our reconciliation to God and our obedience to His commandments. Perhaps we are not as familiar with the concept in the first part of that same verse. "The thief comes to steal and destroy," the opposite to Jesus’ work. The false messiah causes discord, despair, and emptiness. Both the positive and the negative sides of this verse are usually associated with spiritual consequences for the believer or the unbeliever. This verse and others, have a clear application to the health of the physical body. We will explore that application as a foundational principle for Christian health professionals, that is, a biblical/medical ethic. The practice of medicine is secondary to a concept of health, as health is determined by a concept of life and death.

The Bible places all issues into two categories that are described as light and darkness, truth and error, good and evil, righteousness and lawlessness, and life and death. Our concern is with life and death. Three texts serve to illustrate this contrast. 1) Through Moses God spoke to the Israelites "See, I have set before you today life and prosperity, and death and adversity… So choose life in order that you may live, you and your descendants" (Dt. 30:15, 19b). 2) Man at his best still fails: "There is a way which seems right to a man, but its end is the way of death" (Prov. 14:12). 3) "Now He is not the God of the dead, but of the living; for all live to Him" (Lk. 20:38).

The dominant worldview within modern medicine ignores God, and is even anti-God. As such, it is death-oriented. Therefore, its fruits have become, in particular instances, the intended death of patients (e.g. abortion and euthanasia). To ignore and despise God will inevitably cause death in one of its forms.

The Bible recognizes only two systems. One is associated with God and life. The other is without God and associated with death. If a Christian does not understand this fundamental incompatibility of the current philosophy withini medicine and biblical life, then he can never make the distinctions necessary to a biblical practice of medicine. By consequence, he cannot provide the most complete approach to health for his patients, and worse, may impart death when he intended life.

"Life" and "death" are used as though they were simple concepts. They are, however, much more complex than is readily apparent. In our approach we will move from the biological to the biblical in order to contrast the ordinary understanding of life and death with a biblical understanding. The Bible, not common or cultural opinion, must be our ultimate source of definitions.

Most simply, life is the absence of death. But, what is it that characterizes an "alive" organism? First, it assimilates material from its environment into itself. Second, this material is used to produce energy and to replace used materials. Third, a period of time exists when this assimilation results in growth in size and complexity. Fourth, this assimilation results in the production of energy. Fifth, the waste products must be eliminated. Sixth, disease or injury must be overcome or healed. Seventh, reproduction must occur or the life of the specie will cease with the present generation. Eighth, the organism reacts to external stimuli.

As I state these criteria, I realize that these characteristics are not present in all living organisms throughout their lifespans. Growth and reproduction are present only at certain periods. The other six characteristics, however, must always be present. When any one or more of these processes ceases, death occurs.

Biblical concepts markedly change these characteristics. First, the spiritual dimension of reality is introduced in addition to the physical. Second, a Living Being (God) is described who is entirely Spirit and who is entirely sufficient within Himself. For Him none of these characteristics of biological life apply. Third, there are other spiritual beings who have none of these characteristics of life. they are of two kinds: good (those who serve God) and evil (those who serve Satan). Fourth, man is composed of a spiritual (non-physical) element as well as the physical.

Fifth, there are four environments where life is determined by the obedience of men and women to certain conditions set forth by this All-sufficient Being. The first environment was a Paradise where man was placed with the condition that he not eat of the tree of knowledge of good and evil (Gen. 2:16-17). After his disobedience, his environment changed as he was discharged from Paradise and placed under a personal curse (Gen. 3:14-16) and an environmental curse (Rom. 8:19-22; 1 Cor. 15:42-58). Therefore, man has an opportunity to be changed through regeneration, the beginning of the reversal of the personal curse. Finally, two future environments exist as the destiny of men, eternal peace and joy or eternal discord and despair, depending upon the presence or absence of regeneration in each person.¹

In essence, life is communion with God. Basically, this communion has two aspects –knowledge and obedience:

If we say that we have fellowship with Him and yet walk in the darkness, we lie and do not practice the truth; but if we walk in the light as He Himself is in the light, we have fellowship with one another, and the blood of Jesus His Son cleanses us from all sin (1 John 1:6,7).

Obviously, one must "know" where to walk and then must obey in order to have fellowship with both God and other men (the same Greek word in the New Testament, koinonia, is translated both communion and fellowship). Right knowledge and right action are ethical concepts. Thus, biblical life is an ethical concept.

A biblical definition of death will correspond to a biblical definition of life. It can be derived from the types of death that are described in the Bible. There are four. (Some applications of these states to euthanasia have been made elsewhere.²) One is biological death (Mt. 9:18; 1 Cor. 15:3, 12-19; 1 Thess. 5:16b). A second is the second death (Rev. 2:11; 20:6, 14; 21:8). This state is the final judgment of Jesus Christ of the unregenerate. A third is the person who dies to his former self and way of life as a result of regeneration (Rom. 6:2-14). The fourth is God’s curse on Adam and Eve after their disobedience in the Garden of Eden (Gen. 2:15-17), under which the unregenerate continue as long as they remain outside of Christ (Rom. 7:24; 1 Cor. 15:22; Eph. 2:1, 5). Thus, with the exception of the Christian’s death to his former way of life, death is a consequence of sin.

Death, biblically understood, is a spiritual change or separation of one’s relationship to God, to other people, to oneself, and to one’s residence. This change may be for the better or for the worse. The central concept here concerns one’s relationship to God in obedience or disobedience. This relationship is ethical, having to do with right and wrong, righteousness and sin. The wrong orientation to God causes a wrong orientation to oneself and to others contrary to what God intended originally in the unity of the human race.

One might wonder why unregenerate men do not fear separation from God since this state is the fullest realization of death. First, they do fear death. Scripture speaks of those who "through fear of death were subject to slavery all their lives" (Heb. 2:15). They "suppress the truth" (Rom. 1:18) and, therefore, this fear is neither conscious in their minds nor in their communication to others. Dr. Rousas Rushdoony is likely correct in his assessment of this suppression of fear:

because the sinner is in revolt against God, he does not experience the fear of death as fear of separation from God, but rather as a fear of separation from life.³

Thus, he is willing to sacrifice everything to prevent his own death. An example is the common expression, "Better red than dead," meaning that it is better to yield to Communism than to fight and die for the cause of freedom.

Man’s disorientation apart from God is apparent. On the one hand, he wants life at all costs. On the other hand, he often seeks death as a solution to the problems of life. These biblical concepts of life and death compel Christians to apply them in medical situations. The critical factor is the addition of ethical criteria that are established by God and that affect both man and his environment. This factor is not substantial (physical or material), but entirely spiritual. A definition of life becomes dependent upon this ethical relationships. Therefore, medicine as the discipline that maintains and assists in the restoration of human lives must define what enhances and what destroys life according to this ethical relationship.

Health, righteousness, and life are closely related concepts, as are sickness, sin, and death. They are not identical because the spiritual takes priority over and at time may supersede physical health. For example, the missionary does not choose the most physically healthy situation for himself and his family by going to some remote region. He is, however, doing that which is most spiritually healthy, because his going results in a more complete communion with God than if he did not go (assuming that he is indeed called to the mission field). Most graphically, martyrs give up physical life entirely for their spiritual health.

Christianity is the only religion⁴ that consistently and in every way promotes life. This reality is seen in the transformation of the Western world where biblical values came to predominate. Thus, once backward and barbaric nations have freedoms that are unparalleled in human history. With that transformation came unprecedented health. Scholars may debate whether there is direct cause and effect here, but the fact that the spread of Christianity and these developments were simultaneous is undeniable. By contrast, what have other religions produced?

In India where Hinduism is dominant, widespread poverty continues. Alongside of malnourished children lacking protein in their diets are cattle that could supply this protein were it not for the religious taboo against eating their meat. Although actual death is not always the immediate consequence, death is present in the retardation of physical and intellectual growth. The poverty of the people in general (infra) is a consequence that closely approximates death. Without sanitation, proper nutrition, and immunization, the death rate, especially for the younger ages, is much higher than in Western countries.

The Muslim religion claims hundreds of millions of followers worldwide. One distinctive of its teaching is fatalism. Whatever happens is "Allah’s will." On the surface, this teaching appears somewhat similar to Calvinism which recognizes that all things are directed by God’s will. However, Calvinism has a strong emphasis on personal and social responsibility. One cannot make the excuse that "God willed it" when a result could have been avoided by following biblical teaching. That Islam stifles personal and social responsibility to prevent and treat disease and death is apparent.

Secular humanism is without question a religion. Even the Supreme Court has ruled that it is, and the Humanist Manifestos I and II clearly present humanism as a religion. Thus, the various aspects of death that are called for in these documents is consistent with their approach to life that excludes, and is even hostile to God. "Freedom" for women to have abortions and for all to have "death with dignity" are examples. There is even an organization call, "The Society for the Right to Die." Its nonsensical name is apparent. All men die regardless of rights! This title is consistent with man’s only choice other than God and the life associated with Him.

As Western man has lost his identity with God, he has also lost his place as the most valuable living organism. Protection for all non-human forms of life is actively sought simultaneously with the death of unborn children by the millions. Death for the physically defective and the elderly receives active lobbying in the legislatures of our land. Elevation of animal life over human life is strangely twisted thinking, but is a consistent application of a philosophy that excludes God.

The epitome of man’s attempt to separate himself from God and the resulting association with death is found in the Enlightenment influence that caused the French Revolution. The movement was consciously a revolt against any supreme, supernatural authority that dared to tell man how he should live. The result of that attempt has become known as the Reign of Terror. Man’s fear is most fully realized when he is most consistently aligned against biblical revelation. Death and destruction are the inevitable result.

We must never lose sight of the fact that ultimately there are only two religions: the one described as Christian theism^5), and the defined without that revelation (the broad category of naturalism). These have been discussed in some detail previously.⁶ Further, Dr. Gary North has extensively demonstrated the similarities of demonism and the occult with humanism.⁷

In medicine a common belief is the association of poverty with an increased incidence and prevalence of disease and death. This belief is only partly true because poverty primarily consists of the ethics of a group, rather than the presence or absence of wealth per se. Of five factors responsible for famine, only weather is a factor beyond man’s control.⁸

The "Protestant work ethic" has been much maligned, but it is a major factor in overcoming the problem of poverty. Certainly, it can be carried to the extreme where responsibilities other than one’s employment are neglected. Short of that extreme, the productive nature of that ethic should be fully appreciated. First, diligence of labor will produce an abundance of food or the money to purchase it. Second, the certainty that the universe is an orderly, predictable system because its Creator and Sustainer has made it so, has resulted in a science that has beeen able to understand something of the spread of disease so that it can be controlled by appropriate sanitation and immunization. Again, the development of this science in the West where Christianity prevails is an association that should not be ignored.

Wealth alone does not produce maximum health. Literally, men and women are killing themselves in the midst of wealth. In the United States there are clearly avoidable causes of disease and death. Lung cancer caused by cigarette smoke is the second leading cause of death in the United States and accounts for one-third of all cancer deaths each year. Cirrhosis of the liver is the third leading cause of death, frequently caused by alcoholism (there are common causes other than this for which a person is not morally responsible). If one surveys the other eight leading causes of death, he will find other avoidable risk factors, such as stress, alcohol, and poor nutrition (the ones already named), and too much food and too little of the right kinds.⁹

The lives of some of the world’s wealthiest me provide graphic examples of the dissociation of the individual possession of wealth and disease and death. For example, we can review the ends of the lives of nine of the world’s richest men in 1923. One died in bankruptcy after living the latter days on borrowed money. One died penniless in a foreign country where he had fled to escape justice. Another died abroad insolvent. Another died insane. Two spent time in prison. Finally, three died by suicide.¹⁰

This "self-destructiveness" clearly reveals that man is death-oriented apart from God. In the United States both the knowledge and the means are available for greater physical health, yet the major killers are "self-indulgence." Without an ethical reorientation man can do little to combat his downhill course.

One foundational principle for a biblical worldview in medicine, then, is that obedience to god’s law and principles produces health and life. The disease and death associated with poverty are overcome by regeneration and re-orientation to God’s world causing a person to become responsible and thus more productive.¹¹ On the other hand, redistribution of wealth in the form of medical care to the poor will not (and has not) overcome their disease. Wealth without orientation to God still produces disease and death. A biblical view of poverty and wealth as it relates to health and disease calls for repentance of both the wealthy and the poor. Health is not available any other way.

At first glance, Sweden and Japan may seem to contradict this dissociation of wealth and a biblical worldview. A closer look, however, minimizes this impression. First, both Japan and Sweden have strong Christian influences at some time in their history. Second, both are building upon the bodies of aborted babies. Third, Sweden’s suicide rate is high, parental authority (e.g. spanking) has been severely eroded (see next section), and they depend on others for national defense.

The family, as the basic unit of society, is a life- and health- promoting institution. When no one else cares, the family is concerned for its own. Even those who are "evil" give good gifts to their children (Mt. 7:9-11). In our society, however, an anti-family bias is clearly present. The violation of the integrity of the family is directly a cause of disease, and not infrequently, an actual cause of death.

Abortion not only causes death of a potential new addition to the family, but complications for the mother that may include sterility, bleeding, perforation of the womb, infection, or "psychological" problems. Millions both fear and experience various forms of sexually transmitted diseases (STD) each year;¹² these are entirely avoidable and could be eradicated almost entirely within one generation simply by obedience to God’s design for sex expression and intimacy only within marriage.

As all birth control methods have side effects, the avoidance of pregnancy has many complications. The intra uterine device (IUD) may perforate the womb or cause serious bleeding and infections. (It is also an abortifacient.) The birth control pill (oral contraception) may cause heart attacks, strokes, blood clots that can damage the lungs, and other side effects that may require medical attention (See chapter 2).

This anti-family bias is seen in the present health emphases of stat and federal governments. Billions are spent to prevent or treat the problem of smoking, alcohol, and drug addiction. At the same time the government supports immoral sexual practices through its provision of birth control measures (including abortion) and the "non-judgmental" treatment of STDs. In any state minor girls can be treated for these problems without parental consent or notification. A double attack on the family exists here. First, the promotion of immoral sexuality is destructive to the commitment necessary to maintain an intact family. Second, that these "medical" practices can be performed without the parents’ consent undermines parental authority and cohesiveness.

It is well known among family physicians and is documented with research that families with interpersonal conflicts and divorce have more real and imagined medical problems than stable families. When these interpersonal conflicts are successfully managed through counseling, visits to the doctor’s office are markedly reduced. Further, there is extensive documentation that the health and longevity of married men and women is much greater than those who are single, regardless of age.¹³

God’s emphasis on the importance of the family unit is seen in His death penalty for sexual immorality in the Mosaic Law.¹⁴ At first glance His punishment seems harsh, but the necessity of the family for a healthy society justifies this penalty, if only at a human level. (On a cosmic level God’s laws are just –simply because He makes them.) If the sanctity of life requires the death penalty when innocent life is taken, then the direct threat to life that results from the violation of the sanctity of the family necessarily requires a similar penalty.

Today, there seems to be an increasing number of instances in which individuals and cultures propose and practice the death of other human beings as a solution to their problems. Such a solution is the clearest illustration of the result of a worldview that is not ethically oriented to God’s revelation.

Materialism, the excessive desire for material possessions, causes death in ways that directly concern the medical profession. In more than ninety-five percent of abortions, the decision is clearly made on the basis of convenience. The pregnancy interferes with the plans and desires of the woman, so her solution is to choose death for the unborn child. Evolution, as one example of a worldview that ignores God, provides a justification for these choices since man is but another animal. Even abortion for the so-called hard cases, rape, incest, and a severly deformed fetus (2-5 percent of pregnancies), is a choice of death over economic, social, and "psychological" cost.

Euthanasia¹⁵ is similarly a solution for a variety of reasons. The problem may be the day-to-day hardship of caring for someone who is severely or chronically ill, a desire to have immediate access to an inheritance, or as a solution to the escalating costs of care for the elderly. Infanticide involves similar choices at the other end of the life spectrum.

Suicide may be interpreted as the ultimate in self-absorption¹⁶ because death is seen as the answer to one’s problems. No one else is considered except as the distorted intention of the suicidal person to free others of the burden he perceives himself to be to them. Materialism, as a response to the loss or indebtedness of large sums of money, is frequently a factor here also. Murder may be less common, but nevertheless, frequent answer to interpersonally problems. The seemingly simple solution is to get rid of the other person rather than spend time, effort, and physical resources to sort out and remedy problems.

Utilitarianism is a dominant philosophy in modern medicine denoted by such terms as "quality of life" and "the good of society." In perhaps the most advanced application of medical practice, eugenics by genetic engineering, death is inherently part of the protocol. First, there seems to be little moral reservation to experiment upon human embryos and then simply flush them down the sink. Second, if mistakes are made, they can similarly be handled, or if the mistake is recognized after implantation into a woman, it can be aborted.

In some political systems the answer is to kill one’s opponent(s) or put them in prison (a form of death). The present government is seen to be ineffective and hopeless, so that a severe corrective action must be taken. That physicians sometimes participate in these regimes demonstrates the link of medical practice to one’s politics.¹⁷

The Sixth Commandment stands as a bulwark against these "solutions." Consistent non-Christians, as one told me personally, see no distinction between allowing a disease to progress naturally to end in death and giving an injection to end the life of a suffering patient. God has not intended killing others as a solution. He has given us all the biblical means with which to solve problems in every area without this option. The Christian can assume that any decision that calls for such death of another person or persons as a solution to a problem situation is in antithesis to the revealed will of God. If we ever contemplate the death of a person or persons as a solution, it should be a red flag of warning that we have not chosen God’s way.

The Bible, however, seems to allow certain exceptions: just war, self-defense, and capital punishment.¹⁸ Actually, killing in such situations is based upon such an elevated view of the sanctity of life that those who threaten or destroy the life of others must forfeit their own lives. "Whoever sheds man’s blood, by man his blood shall be shed, for in the image of God He made man" (Gen. 9:6). Thus, as a last resort in those situations where life has already been taken or is immediately threatened death is prescribed. It should be noted that even here, however, death is not seen as a solution but an act of punishment.¹⁹

Finally, in situations with terminally ill patients where the better course is not to prolong death, death is not a solution, but an inevitable consequence of the disease process. Death is allowed because man is limited in his efforts to prevent death.

Two basics are absent in a non-Christian worldview: the need for regeneration and a willingness to improve one’s own situation and the situation of others. Regeneration (often called "the new birth"), however, is widely misunderstood among Christians. Either term is biblically accurate, but the words "born again" are too loosely applied by both Christians and non-Christians. The change of which the Bible speaks is dramatic: "transformation" (Rom. 12:2, 2 Cor. 3:18), a "change of mind (2 Cor 7:10), "made alive" (Eph. 2:5), "a new creature" (2 Cor. 5:17), and "renewal" (Rom. 12:2, 2 Cor. 4:16, Tit. 3:5). The state of a person changes from darkness and death (Eph. 2:1) to life and life (2 Cor. 3:18).

The entire physical universe is under the sentence of death, having been "subjected to futility" and "corruption" (Rom. 8:19-22). This sentence of death is clearly seen in the Second Law of Thermodynamics that states, "an orderly system always proceeds toward disorder without an input of additional usable energy." "Nature" left to itself can only cause death and destruction as an ultimate end. Correspondingly, the universe will be regenerated when Christ finally comes to reign (Mt. 19:28). It is fascinating that the only times the Greek word for regeneration, palingenesis, is used in the New Testament are: once concerning man (Titus 3:5) and once concerning the physical universe (Mt. 19:28). Other words (as noted above) are used to convey the characteristics of the new birth, but the actual word, regeneration, is only used in these two places.

The definitive character of this change must be realized. It is an ethical re-orientation.²⁰ Whatever source of ethics one has followed until this point is renounced for God’s Word as the basis of one’s ethics. Simply, it is a re-orientation from self-centeredness to God-centeredness. This reorientation amounts to obedience to the Ten Commandments. We have seen several examples where they apply directly to issues of life and death and therefore health and disease.

What conclusions can we draw for the practice of medicine from a biblical concept of life and death?²¹ 1) Christians who work in medicine and medical ethics must increasingly become conscious that only two worldviews exist: that governed by God’s supernatural revelation and that governed by man within himself. It is obvious that humanism, as a medical philosophy, has resulted in many practices that are contrary to the biblical worldview.

2) Life, health and righteousness are the opposites of death, disease, and sin. All diseases and death result indirectly from the sinful state into which Adam and Eve plunged the human race, directly as the result of personal sin or as a part of God’s sovereign plan (job 2:1-6; John 9:1-3). The ultimate death is final separation from God. "Death with dignity" is opposite to the biblical concept of death. The choice of God’s way is not only a choice leading toward spiritual life, but usually toward physical health and life as well. Much, if not most, diseases are avoidable by this "way." God’s promises are mostly spiritual, but they have real physical impact. Perfect health is reserved for heaven, but a maximal degree of health is possible by ethical re-orientation. We who practice medicine are obligated to make this identification. A violation of God’s moral law has severe consequences in a similar way that a violation of natural laws does. For example, the violation of the law of gravity will result in a fall that causes injury or death.

3) A corollary is that medical practice is first and foremost dependent upon a biblical ethic. The Ten Commandments, as they are meant to reflect considerable breadth, summarize a great deal of this necessary ethical re-orientation.²²

4) A great deal of the medical care and cost in the United States is directly related to sin. Modern medicine supports the sins of people by its "non-judgmental" approach.

5) Sanctity of life involves the whole of the biblical ethic. The pro-life movement has become so closely identified with the sanctity of physical life that in some instances it ignores other important values. Perhaps the most apparent is the oversight, and sometimes refusal, to face financial limitations in the provision of medical care. To ignore this wider application and identify this sanctity with only abortion, infanticide, and euthanasia is to restrict its biblical application. Further, spiritual values take precedence over physical health. For example, the missionary who threatens the health of himself and his family when he goes to "regions beyond," believes (rightly) that his proclamation of the gospel takes precedence over that concern.

Other specifics may be found throughout this book. My intent is to help all Christians know what is darkness and what is light within the practice of medicine.

For he who finds me finds life,
And obtains favor from the Lord.
But he who sins against me injures himself;
All those who hate him love death (Proverbs 8:35-36).
 

Notes

1. The definition of regeneration includes sanctification and glorification as a continuation of the same spiritual process.

2. Payne, Biblical/Medical Ethics, 182-3.

3. Rushdoony, Rousas J., Revolt Against Maturity, Fairfax, VA; Thoburn Press, 1977, p. 110.

4. I am aware of the debates whether Christianity is a religion. I believe along with Gordon Clark that no category can be properly labeled "religion." Simply, religion is any personal philosophy held consciously or unconsciously. In our day certain words that are not preferable must be used in order to communicate. "Religion" is still useful for that purpose. The modern debate about the place of "religion" in society and politics, however, urgently mandates clarification of the defintion.

5. Van Til, Cornelius, Christian Theistic Ethics, Phillipsburg: Presbyterian and Reformed Publishing Company, 1980, 13-17.

6. Payne, Biblical/Medical Ethics, 11-26.

7. North, Gary, Unholy Spirits, Ft. Worth, TX: Dominion Press, 1986.

8. The other causes of famine are: the prevention of cultivation or the willful destruction of crops, defective agriculture caused by communistic control of land, governmental interference by regulation or taxation, and currency restrictions, including debasing of the coin (inflation).

9. Payne, Biblical/Medical Ethics, 90-94.

10. Bright, Bill, "Jesus and the Intellectual," Campus Crusade for Christ, Inc., Arrowhead Springs, San Bernadino, CA 92404.

11. Grant, George, Bringing in the Sheaves, Atlanta, GA: American Vision Press, 1985.

12. "Sexually Transmitted diseases" has replaced the term "venereal diseases," probably in an attempt to avoid the stigma of the latter.

13. Lynch, James L., The Broken Heart, New York: Basic Books, Inc., 1979.

14. I am not arguing here for or against the death penalty in modern times for these offenses.

15. The complexities of what euthanasia is and is not is far beyond this book. I am using the term here as it would be used commonly: death brought on by an immediate act in a patient who otherwise would live for a time longer.

16. Adams, Competent to Counsel, 141.

17. Stover, Eric and Elena O. Nightengale, The Breaking of Bodies and Minds, New York: W. H. Freeman and Company, 1985.

18. I am assuming the validity of "just wars" and capital punishment here. Obviously, these options will not exist for those Christians who hold other views. Most Christians will likely agree that killing in self-defense is right.

19. This emphasis on punishment suggests the reason that some studies have apparently demonstrated that the death penalty is not a deterrent, but a punishment to illustrate the value of life.

20. This re-orientation fundamentally concerns truth. Further, the basis of all ethics is some system of truth. However, a consideration of the relationship of truth and ethics here would cloud the issue under discussion.

21. A supplementary and more thorough list of these conclusions has already been developed. Payne, Biblical/Medical Ethics, 95-96.

22. The Larger and Shorter Catechisms of the Westminster Confession of Faith are clear examples of the breadth of the application of the Ten Commandments. The reader who is not familiar with these catechisms should read them. He will be enriched and blessed by their content. I have discussed this broader use of the Commandments elsewhere. Payne, Biblical/Medical Ethics, 67-68