Catholic Medical Quarterly Volume 72 (3) August 2022
Loneliness, Euthanasia and the Wholeness of
Human Personhood: Part II of III:
Loneliness Leading to
Euthanasia
Francis Etheredge
In this second piece, the relationship which leads to euthanasia expresses an inadequate anthropology of the human person.
Loneliness leading to death
‘Former
U.S. Surgeon General Vivek Murthy says the
most common pathology he saw during his years of service “was not heart
disease or diabetes; it was loneliness”’[1].
Carl Jung found that ‘many people were afflicted with hopelessness and anxiety’[2], which he understood to be the emergence of a spiritual problem which ‘coincided with the declining influence that traditional religions, most prominently Christianity, have had on Western societies over the past several centuries’[3]. Indeed, one author found that loneliness began to be a problem in the ‘16th Century, when it signaled the danger created by being too far from other people’[4]. As regards those who want to permit euthanasia, or even seek it themselves, there is the work of Viktor Frankl[5]. Frankl thought there were many layers where illness could arise, and that one of them was due to failure to find meaning in life’[6].
So, as we are religious by nature, what about the spiritual significance of what we suffer and the social situation in which we exist: What about the meaning of our life and our experience of loneliness in the times in which we live?
In Gaudium et Spes, the Church says: ‘They will stand by them as children should when hardships overtake their parents and old age brings its loneliness’ (48).
But what happens when the extended family shrinks to a few children, the nuclear family is uprooted from its “locale” and children, if there were any, were no longer local and are simply overwhelmed by the demands of their own lives, hours of work and the difficulties of finding time to travel or to even be-in-communication virtually, not to mention the decline of village and country side populations or the rising cost of living there because of commuter traffic? Just as isolation seemed to increase when people were housed in flats rather than on the same street, so disrupting the network of kin and neighbourliness in a society may be more significant than we realize. What about the increasing number of undiscovered deaths in Japan, to the point where there is now a commercial work of going in to remove the decayed body? More widely, too, the contraceptive and abortion mentality, even considering people a burden, worthless, lacking a quality of life, parasites or polluters of the planet all indicate that relationships have ceased to be the central human reality and that, in its place, there has arisen a kind of claim that even to live is to be a “carbon footprint” vandal, or a cost-analysis “loser” who has lost out on being kept alive as against bringing about his or her death.
To put it in terms of modern parlance, loneliness is about being “out of the loop”. However, in terms of anecdotal evidence of people who have committed suicide, there was either a presence on social media or a certain “loudness” which seemed to disguise an interior reality that was completely different. When, then, a particular student committed suicide, even those who had known this person from childhood were shocked. In other words, the interior life of a person can be very different to the outward, either virtual or “outgoing” appearance of a person; and, therefore, this seems to indicate a kind of incommunicable, interior “aloneness” – but without the sense of being in a relationship to God.
There is a kind of loneliness, then, which leads to a different kind of death – more a wilting of the very root of life, a draining of the very desire to be in communion with others and a hopelessness in front of the possibility of ever being happy. There may well be a mixture of psychological and spiritual factors involved in this type of loneliness; indeed, it could even be called a “relational deficit” of the kind in which one person is unable communicate who she or he really is: a kind of asphyxiation of interiority owing to it being, for whatever reason, un-communicated.
Loneliness, euthanasia, and the trauma of death
Whatever, then, in the case of those seeking euthanasia, the extreme sufferings that warrant careful and well managed palliative care of the terminally, or extremely ill, there appears to be more than a superficial link between loneliness and dying by the deliberate action of another. Indeed, in a recent study, there was an explicit link between loneliness and euthanasia[7]. Not to mention, in a different piece, a dearth of interest in referring ‘suicidal patients to psychologists’[8]. Or even, in view of the power of persuading vulnerable people to opt for euthanasia, the pressure of argument; hence the following account of why a woman’s husband changed his mind and shocked his wife with the request for euthanasia:
‘She found out that the one nurse in palliative care had spoken to him for two hours in the middle of the night, convincing him that it was the right thing to do”.[9]
In view of the growing prevalence of euthanasia as a response to life’s
experiences, there is also a negative impact on the provision of
palliative care, ranging from the withdrawal of funding because of not
providing euthanasia, the suffering of doctors who collaborate with
euthanasia and the growing recognition that people are opting for
euthanasia because it is the only option and ‘are fearful of being a
burden’[10].
Examining what has been found more closely, both from the
point of view of the doctor administering what is not a treatment but a
method of killing a person and the experience of the person being killed,
there are clearly problems.
On the one hand, ‘up to one half of doctors who participate in an assisted death experience significant psychological and emotional distress (9). Refusals by physicians in Canada to participate in assisted deaths are not based on religious or moral grounds, but because of the emotional burden of enacting a patient’s premature death and awareness of psychological repercussions on themselves and the clinical team (10)’[11].
In other words, in practice, there is a human, almost involuntary, reaction against the deliberate killing of a human being.
On the other hand, it is shocking to see that the whole process is being approached so clinically, as if assisted-dying is not morally problematic and has not already caused significant stress[12] and suffering to doctors, nurses, patients and relatives and involved a kind of euphemistic suggestion that administering death can be so clinically controlled:
‘Shavelson and Parrot have identified which patients are more likely to linger, and can recommend adjustments. People with gastrointestinal cancer, for example, don't absorb the drugs as well. Former opiate users often have resistance to some of the drugs. Young people and athletes tend to have stronger hearts and can survive longer with low respiration rates’[13]. In other words, what are people actually going through to bring about this kind of feedback on bringing about a person’s death is far from a suffering-free death?
Clearly there are immense and important parallels between what is happening to a person who is being euthanazed and a child being terminated, those who are doing it and those affected by it; indeed, how our language hides the reality that somehow we know to exist and does not address it directly; and, in its stark reality, how is it possible not to compare what is going on now, in medical practices throughout the world, with what went on in the death camps of the Second World War? Do we suppose that democracy is an infallible expression of humanity when it allows one group of people to kill another; to discriminate, in other words, against the life of those either completely innocent, suffering or under the misapprehension that dying through the hands of others is a “neutral” choice or an answer to the problem of the meaning of human experience?
‘"We're learning. Hypothesis, data and confirmation. This is what science is," he said. "Our job is to stop the heart; that's what they want us to do’[14].
It is almost as if it is simply a “medical challenge” to bring about an abrupt, unnatural death that, in the process, expresses a willingness to experiment on the living – resulting, in some cases, in hours of trauma. In the brutally honest explanation of what these men are doing, “Our job is to stop the heart”, they inadvertently raise the question of whether or not brain death is death. Indeed, if the whole intention of these men is to find a way to stop a person’s heart, and by definition end that person’s life, are we not in another area as well: that of the controversy surrounding “brain death” as a device for harvesting organs from the living – rather than an actual definition of death? In other words, if these men, who are specializing in bringing about death, consider stopping the heart as the crucial determinant of whether or not a person is dead, then does this not undermine the credibility of brain death as a criterion of death
Doctor or what?
What kind of evidence counts in an ‘evidence-based medicine’[15]?
What we are confronted with is an increasing mentality of disregarding the reality of what a person experiences, how a person dies, what effect drugs have, such as “home abortifacients”[16] and the widespread practices of administering harmful hormonal contraceptives, the actual practice of taking the life of a child in the womb, IVF procedures that join sperm and egg in a glass dish and overlook the act of God giving the gift of life as an interpersonal gift, freezing embryos, discarding[17] or experimenting upon them, surgically altering the gift of a person’s sex, when there is no ambiguity, and the whole program of robbing organs, whether of the nearly dead or the imprisoned.
The original definition of a doctor is that of a teacher, an
instructor, or a guide[18] and a physician is one who is trained in a
‘knowledge of nature’ and the ‘art of healing’[19]. Indeed, St. Thomas
Aquinas said that medicine, like education, is assisting a natural process
– not supplanting it. There is, however, a related root to the word
‘teacher’ which is ‘to show’[20]. All three of these concepts are
accompanied by the tradition of the Hippocratic Oath and its relationship
to the natural law maxim: do good and avoid harm. In other words, it is
perfectly consonant with the origin, history and development of medicine
that it is ‘evidence based’[21] and that the learned show forth what they
have learnt about the knowledge of nature; and, just as it is possible to
see what there is ‘to show’, so it is possible to point back to what is
seen – so that what there is to show is seen by others. Thus a dialogue
with reality as it is must be essential to good medicine as it is the
basis on which real progress is made. A key observation by a doctor
examining my eldest son’s deteriorating hands was the “pooling of blood”;
my son is a university student and tends to sit very still when working,
in a somewhat cold house. And, subsequently, we have suggested a variety
of hand and arm exercises to stimulate the circulation in his hands; but,
as we found when he was at home, holding his hands upright, from time to
time, was a significant help to recovering the skin from splitting and
pussing.
The key word from the doctor, that has made life-changing
sense, was the “pooling” of blood: that the deterioration in my son’s
hands and my legs could be, in addition to other factors, causative of the
skin deteriorating. Thus, due to the blood not changing very effectively
and, as a result, pooling and, because of pooling, an agent or agents in
it attacking the skin. Therefore: A small but significant change can be
lifesaving as in a leg that was going black from clots, poor return valves
and varicose eczema which has, after nearly eleven months of being
periodically elevated vertically, and having gone through the shedding of
many layers of skin, has begun to regain its normal colour – albeit it
they are not completely pink as yet[22]. In other words, after twenty-five
years of deterioration, which neither regular, moderate walking or cycling
prevented, changing the blood in my legs by putting them vertically up
against a wall has radically improved their colour and my general
wellbeing.
What is significant, however, is the “selective focus” of what constitutes evidence and, in the field of loneliness and euthanasia particularly, the poor grasp of the person as a whole: of the psychosomatic whole of being one in body and soul and “from” and “for” relationships – both to God and to each other; indeed, it could even be called a poverty of thought when it comes to an adequate anthropology and, therefore, one wonders where doctors and nurses will encounter, not just an enriched understanding of the human person – but a truly realistic account of the whole of human personhood?
References and notes
- Amelia Worsley, “A History of Loneliness”:
https://theconversation.com/a-history-of-loneliness-91542. - John O’Brien, OFM, The Darkness Shall Be the Light, p. 84, printed in Great Britain by Amazon: https://www.amazon.co.uk/Darkness-Shall-Be-Light-Journey/dp/B09DMXTL9V/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1636043167&sr=1-1.
- John O’Brien, OFM, The Darkness Shall Be the Light, p. 84/
- Amelia Worsley, “A History of Loneliness”:
https://theconversation.com/a-history-of-loneliness-91542. - E.g. His book called: Man’s Search for Meaning.
- P. 100 of a prepublication manuscript by Dr. Ronda Chervin, The Battle for the 20th Century Mind, viewed with permission of the author (St. Luis, MO: En Route Books and Media, possibly 2022).
- “Study Uncovers euthanasia deaths based on loneliness in the Netherlands: Source: Euthanasia Prevention Coalition”: ‘19 of the 53 MGS euthanasia deaths listed loneliness as a primary reason’: https://oneofus.eu/study-uncovers-euthanasia-deaths-based-on-loneliness-in-the-netherlands-source-euthanasia-prevention-coalition/.
- ‘Right To Life UK spokesperson, Catherine Robinson, said: “In
Oregon, if one doctor refuses to partake in euthanasia, the patient is
generally able to “doctor shop” until they find a willing executioner.
There is zero state oversight, and the system relies on self-reporting
by doctors who stand to gain from the business, and rarely
refer their suicidal patients to psychologists”’:
https://www.lifenews.com/2021/08/12/scientists-want-people-fitted-with-euthanasia-chip-that-kills-you-at-first-sign-of-dementia/. - Alex Schadenberg “Is Death Becoming an Industry in Canada?”: https://alexschadenberg.blogspot.com/2021/11/is-death-becoming-industry-in-canada.html.
- “The impact of assisted dying on hospices and palliative care – Dr Claud Regnard”: https://ehospice.com/editorial_posts/the-impact-of-assisted-dying-on-hospices-and-palliative-care/.
- “The impact of assisted dying on hospices and palliative care – Dr Claud Regnard”: references 9 and 10 in this excerpt are to two sources: 9 is : Kelly B, Handley T, Kissane D, et al. “An indelible mark” The response to participation in euthanasia and physician-assisted suicide among doctors: a review of research findings. Palliative and Supportive Care, 2019; 18(1): 82-8. https://doi.org/10.1017/S1478951519000518; and 10 is: Bouthillier M-E, Opatrny L. A qualitative study of physicians’ conscientious objections to medical aid in dying. Palliative Medicine 33(9): 121-20.
- Cf. Nancy Preston, “The Conversation”: “Its stressful to kill somebody” etc: https://theconversation.com/its-stressful-to-kill-somebody-the-healthcare-workers-who-support-assisted-dying-173024: One doctor who was all for euthanasia says “I can’t do it anymore”.
- “Doctors seek life-ending drugs that smooth the way for the
terminally ill” by Lisa M. Krieger:
https://medicalxpress.com/news/2020-09-doctors-life-ending-drugs-smooth-terminally.html;
and cf. also “Is an assisted death 'quick and painless'?” by Michael
Cook:
https://alexschadenberg.blogspot.com/2021/11/is-assisted-death-quick-and-painless.html. - “Doctors seek life-ending drugs that smooth the way for the terminally ill” by Lisa M. Krieger.
- This is referred to in an article on the covid-19 vaccines, by
Lucie Wilk, “Why have we doctors been silent?”:
https://www.conservativewoman.co.uk/why-have-we-doctors-been-silent/. - Cf. “Petition by Caroline Farrow, CitizenGO
- Among the many varieties of ministry that there are is that of burying the early remains of a child, “I can’t begin to tell you how much this means to me. To know that these babies were laid to rest with so much dignity – thank you!’: Sacred Heart Guardians and Shelter laura@sacredheartguardians.org: Email update, Tuesday, 16th November, 2021.
- “doctor”: https://en.wiktionary.org/wiki/doctor.
- “physician”: https://en.wiktionary.org/wiki/physician.
- Daren K. Roberts:
https://www.linkedin.com/feed/update/urn:li:activity:6866378446084337664/. - A recovery of this evidence based work is evident in Humanae Vitae, 50 Years Later: Embracing God’s Vision for Marriage, Love, and Life, edited by Theresa Notare, Washington, DC: The Catholic University of America Press, 2019; and cf.
- Cf. Francis Etheredge, “Legs: On Pain and Healing” in the
forthcoming, Within Reach of You: A Book of Prose and Prayers:
https://enroutebooksandmedia.com/withinreachofyou/.