Chapter 6. Euthanasia
Human life is a "trust" and not a personal "possession" over which we have full control. No one can claim total mastery over one's own life or another's life. Every innocent human being is absolutely equal to all others. This equality is the basis of all authentic social relationships and can only be founded on truth and justice, recognizing and protecting every man and woman as a person and not as an object to be used.[44]
God alone has sovereignty over life and death. The taking of one's life is not a human right and intentionally causing death is a rejection of God's sovereignty over life.
Explaining euthanasia
The Euthanasia Society of America defines euthanasia as "the termination of human life by painless means for the purpose of ending severe physical suffering."[45] Webster's New World Dictionary defines euthanasia as "an early and painless death; act or method of causing death painlessly, so as to end suffering; advocated by some as a way to deal with victims of incurable diseases."[46] The Catechism of the Catholic Church says, "whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus, an act or omission which, of itself or by intention causes death in order to eliminate suffering, constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator."[47]There are six recognized types of euthanasia:
- Voluntary Active Euthanasia: A deliberate intervention by someone other than the person whose life is at stake, solely intended to end the life of the competent, terminally ill patient who makes a fully voluntary and persistent request for aid in dying.[48]
- Physician-Assisted Euthanasia: The physician helps to bring on the death of the patient by providing the means to do it, or by giving the necessary information on how to do it, but the patient performs the lethal act on himself or herself.[49]
- Involuntary Active Euthanasia: Intentionally administering medications or other interventions to cause the patient's death when the patient was competent but without the patient's explicit request and/or full informed consent; e.g., the patient may not have been asked.[50]
- Nonvoluntary Active Euthanasia: Intentionally administering medications or otherwise intervening to cause the patient's death when the patient was incompetent and mentally incapable of explicitly requesting it; e.g., the patient may have been in a coma.[51]
- Indirect Euthanasia: Administering narcotics or other medications to relieve pain with incidental consequence of causing sufficient respiratory depression to result in the patient's death.[52]
- Terminating Life-Sustaining Treatments (Passive Euthanasia): Withholding or withdrawing life-sustaining medical treatments from the patient to let him or her die.[53]
The legal position
Active euthanasia is technically illegal throughout the world. In practice, however, euthanasia is permitted in The Netherlands with certain guidelines: The patient must request euthanasia repeatedly both consciously and freely; the patient must be experiencing suffering which cannot be relieved except by death; the physician must consult with another physician who agrees that euthanasia is acceptable in this particular case.Euthanasia has become legal in Colombia, South America, and Japan. On May 20, 1997, Colombia's Constitutional Court ruled that terminally ill patients, in extreme pain, suffering from cancer, AIDS, or kidney or liver failure can give authorization to terminate their lives. No one, according to the ruling, can authorize euthanasia for degenerative diseases, such as Lou Gehrig's, Parkinson's, or Alzheimer's diseases.
In May 1995, Japan's Yokohama District Court ruled that euthanasia was legal for terminally ill patients who have no other alternative treatments available and have clearly asked to terminate their lives.
In the United States, active euthanasia is a serious crime punishable by life imprisonment. State law, however, decides whether a patient is allowed to die and allows the physician in charge to suggest options of death to the patient's relatives, especially if the patient is brain dead.[54]
In 1990, the U.S. Supreme Court ruled that patients have a right to passive euthanasia. They can express their wishes in documents called living wills or by granting durable powers of attorney. A living will allows patients in a terminal condition or a permanently unconscious state to state their wishes concerning the withdrawal and withholding of medical intervention by a physician. The physician will provide care to relieve pain and keep patients comfortable, permitting them to die naturally. The durable power of attorney allows patients to name one or more persons as their agents to make decisions about their medical care should they become terminally ill or be in a permanently unconscious state. These documents are signed and witnessed with patients who are capable of making these decisions.
The preparing of a living will and the naming of a durable power of attorney are morally acceptable within the Catholic Church. These documents, advance directives, should reflect the teachings and traditions of the Catholic faith.
Only one state, Oregon, has narrowly passed a measure that allows physician-assisted suicide for those who are terminally ill with six months or less to live. (It must be noted that estimates of this sort are ultimately under God's jurisdiction.) It is stipulated that they have to make three separate requests that are witnessed by two people, who would attest that these requests were voluntarily made by the patient. There is no requirement that the patient receive an expert psychiatric evaluation for clinical depression, the most common reason people commit suicide.[55] A referendum to appeal this measure was placed on the November, 1997 ballot. It was soundly defeated, and the measure stands.
The Church's position
The fifth commandment states that "thou shall not kill." It is a specific command intended to protect the dignity and sanctity of human life, and indeed the whole of God's law protects human life. The Church states that no one has the right to terminate the life of another person at any stage or circumstance of life. "No one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. Nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity."[56] "God alone is the Lord of life from its beginning until its end."[57] Euthanasia is a murderous act which must always be forbidden and excluded. It is morally unacceptable.The Catholic principle of sanctity of life affirms that life is a basic good, but it is not an absolute good to be preserved at all costs.[58] The discontinuing of medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "overzealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The patient should make this decision when he is competent and able, or, if he is not, by those legally entitled to act for the patient.
Euthanasia is the intent to kill the patient. It is a false "mercy" in that people bypass the need to help their brothers and sisters by sharing their pain and suffering, showing compassion for their fellow man. Killing the person who is suffering because we cannot bear it is somehow a perverted form of mercy. In today's world, there seems to be a "conspiracy against life."[59] We must bring ourselves to the point of remembering the seriousness and holiness of our calling as Christians. A truer understanding of what human freedom means is needed -- people do not have a right to take their own lives but to understand the meaning of the sanctity of life and what it entails. We have the right to the "use" of human life, not dominion over it.
Impact on the individual, family and community
"For the government to allow the devaluing of human life in any form is a great evil; for the government to promote it can lead to nothing less than the assisted suicide of all the values which we as a society cherish."[60]Euthanasia is a social decision. Individualism and selfinterest outweigh the value of the common good in today's society, which allows the debate on euthanasia to continue. Individualism asserts that independence, not interdependence, is the key to human dignity. We, as a society, have to travel beyond this individualism and decipher the impact euthanasia has on the welfare of our community. The collective good is more important than the good of any one individual. Individuals will flourish only insofar as society as a whole flourishes.
Euthanasia defenders try to turn this into a private issue, but it must be considered as a social issue that affects the heart of the community. Euthanasia involves the one to be killed, the one doing the killing, and a compliant society to make it acceptable. "To resort to euthanasia is to fail to embody the trust that sustains life and the commitment to be companions to one another, especially those who are helpless or those who are unable to contribute to the community."[61] Euthanasia causes a breakdown of ethics and values regarding life.
If euthanasia is legalized, a chain reaction, the "slippery slope," will follow. Euthanasia is not based on good moral principles, which means that it can be used to advance constantly expanding and controversial situations. If euthanasia is used for terminally ill patients, why not for debilitating diseases, cardiovascular disorders, senility, comatose patients, irreversible mental illness, or those who are crippled or bedridden? Legalizing euthanasia would undermine compassionate and humane care of the terminally ill. Physicians might find it easier and more efficient to use euthanasia for the suffering than the constant attention necessary for symptom control and counseling. Legalization can also pressure patients to consider euthanasia to relieve families of financial and emotional strain, particularly affecting the poor, elderly, disabled, and minorities. It is claimed that once death is recognized as more beneficial than a life of pain and suffering, it could lead to the attitude that death is more beneficial than a life devoid of consciousness or higher mental functioning.[62]
Alternatives to euthanasia
We, as a community of caring and loving individuals, can be of immense help to the sick, suffering, and terminally ill. We need to be committed to one another as partners who sustain each other through trust, mercy, and care. Through the development of social structures and skills, we can, as a community, be present to those who are suffering. An interdependence among people is formed, and those who are suffering and terminally ill do not feel abandoned or forgotten as a result of our commitment to serve them in love.The Church, through prayer, community presence, and physical care, accompanies the sick or dying person by exercising joint stewardship with that person for the life that belongs to God. The Sacraments (Anointing of the Sick, Eucharist, and Reconciliation) heal the sick and help them with their struggle. Reconciliation can repair broken relationships, heal the soul, bring the person back into the community of faith, and help the person to feel forgiven, which is often needed to face the tragedy of dying. Pastoral caregivers can be the companions who enable the dying to reach into their own experiences of life and into their tradition of faith to find comfort and meaning for the remainder of their lives.
We, as individuals, care for the sick and dying by persistent presence, careful listening, and a willingness to enter deeply into another person's life to help carry the burden that that person feels.20 We need to help them understand that death is not just a termination of life but a completion of life. We have to help people in their struggle against anger, doubt, loss, or abandonment and help them to understand the meaning of it all and gain some peace. The dying person should be treated as a patient with symptoms, and as a person who needs love and who is seeking a sense of significance.
As a patient becomes more ill or debilitated, the more he/she becomes distrusting, depressed, or despondent. Emotions and thoughts regress, and it becomes more difficult to think clearly, much less assert one's claims to care. At this point physicians play an important role in the lives of a terminally ill patient. The physician talks with patients and families about the diagnosis, treatment options, and likely outcomes, and provides the best medical management possible. At the point when treatment becomes burdensome and futile, the doctor recommends the discontinuance of that treatment and provides the best physical comfort possible. At the same time, the physician is a friend. A patient can share his or her feelings, concerns, doubts, and what he is suffering, and the physician can offer some ray of hope for relief. The physician has the ability to preserve the dying patient's dignity and humanity.
Hospice care is the treatment of the terminally ill which focuses on relieving patients' physical symptoms and providing psychological and social support for patients and their families. Hospice prepares the individuals to "die with dignity," or more precisely to "live with dignity"21 to the end of their lives. It is an environment where one maintains quality of life while dying peacefully without actively prolonging life or hastening death. Hospice care provides comfort rather than a cure. It prevents pain before it begins rather than giving pain relief when needed.
Hospice extends support and relief to the families and caregivers. Without such relief, euthanasia can edge its way into the thinking of all involved. Hospice support allows the families and the caregivers to take care of their own personal affairs, receive information on what services provide financial support, and provide temporary housing, if necessary, so that families can stay together and remain close to their loved ones. Dying is a part of life, and a person matters as much at the end of life as at the beginning.
As the number of families helped by hospices grows, so the education of the public about end-of-life issues, optimal care, and hospice services grows as well. With a new awareness and knowledge of the issues, care, and services already available, euthanasia and assisted suicide may become non-issues.
Conclusion
Euthanasia is the termination of human life for the purpose of ending severe physical suffering. From the legal standpoint, the United States does not condone active euthanasia. It is a serious crime punishable by life imprisonment. The Church states that euthanasia is a murderous act that must always be forbidden and excluded. It is morally unacceptable. The euthanasia debate is fundamentally about the nature and meaning of human life. We, as a society, have a choice to make. Do we become more and more an individualistic, self-interested society, or a society that respects and values the meaning of God's gift to us?Resources
Concerned organizations
Opposes physician-assisted suicide and euthanasia:American Life League (ALL)
Center for the Rights of the Terminally Ill
Human Life International (HLI)
National Catholic Bioethics Center
National Hospice Organization
National Right To Life
Opposes physician-assisted suicide:
American Medical Association (AMA)
Takes no position but acts as a forum for discussion of issues such as euthanasia:
American Society of Law, Medicine, & Ethics
Lobbies against euthanasia:
Americans United for Life (AUL)
Prayers
Please add your own prayers to these.In you, O Lord, I take refuge;
let me never be put to shame.
In your justice rescue me, incline your ear to me,
make haste to deliver me!
Be my rock of refuge, a stronghold to give
me safety.
You are my rock and my fortress;
for your name's sake you will lead me and
guide me.
But my trust is in you, O Lord;
I say, "You are my God."
In your hands is my destiny;
rescue me from the clutches of my enemies
and my persecutors.
Let your face shine upon your servant;
save me in your kindness.
Once I said in my anguish, "I am cut off from
your sight";
yet you heard the sound of my pleading
when I cried out to you.
Love the Lord, all you his faithful ones!
The Lord keeps those who are constant,
but more than requites those who act proudly.
Take courage and be stouthearted, all you who hope
in the Lord.
Psalm 31:2-4,15-17,23-25
Prayer for Those Who Are Terminally Ill
| Lord Jesus, you healed so many people during your public ministry. I bring before you now, in prayer, all those who are terminally ill -- those afflicted with cancer, AIDS, and other illnesses. |
| Look lovingly and compassionately upon them. Let them feel the strength of your consolation. Help them and their families to accept this cross they are asked to carry. |
| Let them see you carrying their cross with them, at their side, as you once carried yours to Calvary. May Mary be there, too, to comfort them. |
| Lord Jesus, I know and believe that, if it is your will, you can cure those I pray for (especially N.). I place my trust in you. I pray with faith, but I also pray as you did in Gethsemane: your will be done. |
| Bless us, Lord, and hear my prayer. Amen. |
| Reprinted from "Queen of Apostles Prayerbook" with permission of copyright holder, Pauline Books & Media, Boston, MA, 02130. |
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