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Why the Church Opposes Assisted Suicide

by Wilton D. Gregory, S.L.D.

In addition to the ancient scourges of poverty, hunger and war, new crimes against life have emerged. In some ways these crimes are more urgent because they are falsely or erroneously justified in the name of freedom and seek authorization by the state.

In the midst of a culture that often denies the value of human life, I want to present the teaching of the Church in regard to the issue of physician-assisted suicide. Not only has there been a sharp increase in the publicity surrounding national and local incidents of active physician-assisted suicide, but there is a nationwide effort to legalize the practice, state by state.

The emerging debate surrounding physician-assisted suicide forces all the members of society to pause. It clarifies the shared assumptions about life and death that our laws are meant to protect. The Church has a rightful place in this public discussion because the issues surrounding death are not only medical and legal, but they are religious and moral as well.

The light of faith

As Christians, our faith shapes our attitude toward sickness and death in three important ways. First, we believe that human life is good. Human life is a gift from God to be cherished and respected because every human being is created in the image and likeness of God (Gn 1:26). Our Church teaches that we are stewards of life and in heeding God—s command, "Thou shall not kill" (Ex 20:13), we recognize that we cannot dispose of life as we please.

Second, we believe that the Son of God became man to reconcile us with the Father and to be our model of holiness (Mt 11:29). His sacrifice of himself is the model of the new law, "Love one another as I have loved you" (Jn 15:12). By living among us, Jesus has created a new communion or solidarity among us (1 Cor 12:26-27), making everyone a neighbor worthy of our charity and care (Lk 10:25-36).

Third, we believe that we are redeemed by Christ and called to share eternal life with him. The Christian vision of death is expressed in the funeral liturgy when we pray: "Lord, for your faithful people life is changed, not ended. When the body of our earthly dwelling lies in death we gain an everlasting dwelling place in heaven" (Preface for Christian Death I).

As Christians, we face death with the confidence of our faith in him who has conquered death by his resurrection (Rom 6:3-9; Phil 3:10-11). Christians live in the world knowing that although the advantages that science and technology provide enrich our lives, they will never exempt us from our own personal encounter with the mystery of death. Christ has overcome death. He has rendered death—s dividend barren. Still, each one of us must follow the Lord in his triumphant passage to life. Our faith does not dispense us from this encounter with the vanquished foe that we call death.

These convictions guide the Church—s teaching and practice with regard to euthanasia and physician-assisted suicide. In the recently revised Catechism of the Catholic Church, the Church condemns absolutely "an act or omission which, of itself or by intention, causes death in order to eliminate suffering" (#2277). The meaning of this statement can be made clear by two examples.

     1) Active euthanasia occurs when a doctor or medical staff person administers a lethal dose of medication with the intention of killing the patient.

     2) Assisted suicide occurs when a doctor or medical staff person prescribes a lethal amount of medication with the intent of helping a person commit suicide. The patient then takes the dose or turns the switch. In both active euthanasia and assisted suicide, death is induced before its time.

Facing our own deaths

The discussions that are going on in our society about physician-assisted suicide represent, in part, our anticipation and fear of the circumstances of our own deaths. What we may fear first of all is being given too much technology—dying not at peace but in a wild frenzy of efforts to give us a little more time to live. Second, we may fear that, despite all the marvelous successes of medicine and technology, they will not be able to help us recover our health but merely entrap us in the dying process longer than we can endure.

To help guide the decisions that we may face about medical treatments for ourselves or for others and to give us some control in the dying process, the Church draws a distinction between ordinary and extraordinary means of preserving life. When we use these terms, we often focus on the level of sophistication of the technologies that are at our disposal to maintain human life. Unfortunately, trying to categorize treatments this way reduces the distinction to the difference between customary and unusual treatment.

To avoid this misunderstanding, the Church has recently used the terms of proportionate and disproportionate means of treatment. This more appropriate terminology aims to show that the use of technology is at the service of the total well-being of the person. Treatments cannot be evaluated without reference to the patient receiving them.

As stewards of life, we are obligated to use only proportionate means of treatment to maintain life; they are those means that offer a reasonable hope of benefit and do not involve an excessive burden.

We are not obligated to use disproportionate means to maintain life; they are those means that do not offer us a reasonable hope of benefit or impose on us an excessive burden. To forgo disproportionate means of treatment is not the same as suicide or euthanasia; rather, it signals the acceptance of the inevitability of death as part of human life.

With these distinctions, the Church helps guide us in making a prudential treatment decision. In assessing the burdens and benefits of the medical options that are available to us, we should inquire whether the treatment offers any hope for recovery, whether the procedure may be painful or dangerous, or whether the treatment will impose on us or on others considerable hardships, such as when it may be excessively expensive.

Help in dying

Facing death can be a time of isolation, anguish and despair; it can also be a time of extraordinary spiritual growth and fulfillment. Each of us will long for the saving touch of Christ through the sacraments. The Church offers us in our infirmity the comforting grace of the Anointing of the Sick and the Eucharist as the sacrament of passing over from death to life, from this world to the Father (Jn 13:1). This ancient practice of receiving the Eucharist near the time of death is known as Viaticum, which literally means "food for the journey."

Each of us, too, will long for the warmth of a human touch in the form of being accompanied through the final mystery of life. None of us wants to die deserted and isolated from human love. When faced with death, a person should be given an opportunity to say good-bye to family and friends.

As fearful as it might be, we should be willing to take the risk to walk selflessly with those who experience in their illness the limitations and fragility of the human condition. We must keep company with the dying in order to affirm their dignity in every phase of life. No amount of medical intervention can replace the compassion and love that the person needs and deserves in the hour of death.

This deep love for the sick and dying has given rise to a long and outstanding history of charity. All of us in the Church can be particularly grateful to the many women religious, doctors, medical staffs and pastoral-care ministers who, through their leadership in the health-care ministry, present an eloquent example of Christ—s compassion toward the sick.

Managing pain effectively

The contemporary discussion in which we are involved also goes to the heart of the purpose of the medical profession. Physicians and other caregivers have the obligation to maintain life and to relieve pain. These two duties, however, may come into conflict when caring for someone who is dying.

Proponents of physician-assisted suicide at times argue that their initiatives are the only way to protect the dying from severe and intractable pain. It is true, too, that public opinion polls reveal that many people who favor assisted suicide do so because they do not want to endure a physically painful death. Quite understandably, people want to make the last steps in life without pain.

It is important to point out that the effective treatment of pain guarantees that no one will suffer a painful death. Health-care providers must make every effort to ensure that the available medications to eliminate or control pain are provided to a patient.

From a moral perspective, a physician may responsibly administer medications to control or alleviate pain even when doing so may hasten death. The physician—s intention is not to kill the patient but to relieve pain effectively with the medicines available.

Much of the debate in this matter fails to distinguish between pain and suffering. The distinction is far more than academic for a person of faith. Pain most frequently refers to the physical experience of discomfort.

Suffering is more profound than the endurance of physical pain. It may well be present even in the absence of pain. Suffering can also be an expression of one—s faith and love. Suffering endured out of love is redemptive. Our suffering, from apostolic times, has also been a way that each one of us identifies with and shares in the salvific work of Christ himself (Col 1:24 and 1 Pt 4:13).

Church and society

As a people of faith, we have an important role in the public discussion about physician-assisted suicide. In this public conversation our position must not only be stated clearly and confidently, but our opposition to assisted suicide must be backed up with compassionate action.

Our opposition to physician-assisted suicide is not to hinder freedom but to protect the right to die with human and Christian dignity. Between the two extremes of active euthanasia or assisted suicide and the use of every possible means to prolong life at all costs, the Church offers a third alternative of action that can help to guide the public discussion.

The Church recognizes a person—s right to refuse disproportionate medical treatment. What we must safeguard in our society is that a person—s informed treatment decisions are respected.

The Church also recognizes the need for the proper management of pain. In this regard, we must ensure in the clinical setting that a person need not seek death in order to escape pain.

Finally, the Church recognizes the importance of the interpersonal aspects of human suffering and death. As members of the Church, we offer to the sick and dying our service of charity as a resplendent sign that "God has visited his people" (Lk 7:16).

It will be our compassion toward the sick and dying that will ultimately make our teaching on assisted suicide effective and credible enough to shape and guide the public agenda.

In the midst of the final looming controversy over his own fate, Jesus uttered the words of faith that continue to inspire and to guide the Church—s teaching in this mystery of Christian death: "This is why the Father loves me, because I lay down my life in order to take it up again" (Jn 10:17).

 

Wilton D. Gregory, S.L.D., is bishop of the Diocese of Belleville. He was born in Chicago, Illinois, and served as a priest and auxiliary bishop of the Archdiocese of Chicago before his 1993 appointment to Belleville, Illinois.

Widely published photographer Don Doll, S.J., is professor of fine arts at Creighton University, Omaha, Nebraska. The photographs in this Update are of his mother and family before she died of terminal illness.

 


Critical Questions

Why shouldn—t assisted suicide be legalized? To sanction the taking of innocent human life is to contradict a primary purpose of law in an ordered society. A law or court decision allowing assisted suicide would demean the lives of vulnerable patients and expose them to exploitation by those who feel they are better off dead. Such a policy would corrupt the medical profession, whose ethical code calls on physicians to serve life and never to kill. The voiceless or marginalized in our society—the poor, the frail elderly, racial minorities, millions of people who lack health insurance—would be the first to feel pressure to die.

How does cost enter into this issue? In an era of cost control and managed care, patients with lingering illnesses may be branded an economic liability, and decisions to encourage death can be driven by cost. As Acting U.S. Solicitor General Walter Dellinger warned in urging the Supreme Court to allow states to ban assisted suicide: "The least costly treatment for any illness is lethal medication.

" Why are people with disabilities worried about assisted suicide? Many people with disabilities have long experience with prejudicial attitudes on the part of able-bodied people, including physicians, who say they would "rather be dead than disabled." Such prejudices could easily lead families, physicians and society to encourage death for people who are depressed and emotionally vulnerable as they adjust to life with a serious illness or disability. To speak here of a "free choice" for suicide is a dangerously misguided abstraction.

What is the view of the medical profession? The American Medical Association holds that "physician-assisted suicide is fundamentally incompatible with the physician—s role as healer." The AMA, along with the American Nurses Association, American Psychiatric Association and dozens of other medical groups, has urged the Supreme Court to uphold laws against assisted suicide, arguing that the power to assist in taking patients— lives is "a power that most health-care professionals do not want and could not control.

"What about competent, terminally ill people who say they really want assisted suicide? Suicidal wishes among the terminally ill are no less due to treatable depression than the same wishes among the able-bodied. When their pain, depression and other problems are addressed, there is generally no more talk of suicide. Courtesy of U.S. Catholic Conference (#257)

 


Key Terms

Active euthanasia: A doctor or medical staff person administers a lethal dose of medication with the intention of killing the patient.

Assisted suicide: A doctor or medical staff person prescribes a lethal amount of medication with the intent of helping a person commit suicide. The patient then takes the dose or turns the switch.

Proportionate means: medical treatments that offer a reasonable hope of benefit and do not involve an excessive burden.

Disproportionate means: medical treatment that either does not offer a reasonable hope of benefit or imposes an excessive burden. We are not obligated to use disproportionate means to maintain life. To forgo them is to accept natural death.

 

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