Catholic Medical Quarterly

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Catholic Medical Quarterly Volume 72 (3) August 2022

Papers

Towards a More Human Society – “NO” to euthanasia and assisted suicide

Fr James McTavish, FMVD

“Today we are a more human, fairer and freer country."[1] With these words, the Spanish Prime Minister Pedro Sanchez welcomed the decision to allow doctors in Spain to kill their patients. Spain thus joined the growing list of European countries where euthanasia is legal, including the Netherlands, Luxembourg, and Belgium. In Switzerland, assisted suicide is permitted and Austria looks like the next country to follow suit. Are euthanasia and assisted suicide, really the way to a more human society?

1. Brief Situationer

Let us look more closely at what is happening in these countries.

Looking at Europe

The Netherlands was the first country in the world to legalise euthanasia and physician-assisted suicide. There were 6361 cases of euthanasia in 2019. Euthanasia is on the increase accounting for just under 2% of all deaths in 2002, to just over 4% in 2019.

Belgium: From 2002 to 2020, over 24 thousand people have been officially euthanized in Belgium. In 2020, 2,444 people underwent what can be called assisted suicide in Belgium. In 2014, the Belgian Senate extended the law on euthanasia to terminally ill children.

In Switzerland, there were approximately 2000 “accompanied suicides” from 2010 to 2020. Cancer, neurological conditions, and cardiovascular disease were the most common medical issues involved. In the “Dignitas” clinic, with its cringe- worthy motto of “To live with dignity – to die with dignity,” it costs around £8,000 for each assisted suicide. Patients have come from 134 different countries since 1998 to avail of its services, with most coming from France (13%), United Kingdom (16%) and Germany (46%). In July 2009, the renowned British conductor Sir Edward Thomas Downes, CBE, ended his life there at the age of 85. He had travelled to the Dignitas clinic with his 74-year-old wife Joan, who was terminally ill. Their family said in a statement the couple "died peacefully, and under circumstances of their own choosing." [2]

In the United Kingdom, both euthanasia and assisted suicide are illegal under current English law. Of some concern is the recent decision of the British Medical Association (BMA) to change their position on assisted dying. On 14 September 2021 the BMA voted in favour of a motion changing their policy from opposition to a change in the law on assisted dying, to a position of neutrality. This means that the BMA will neither support nor oppose attempts to change the law. This is a significant back pedaling from the Doctors’ association. For so long, doctors have been vehemently opposed to directly killing their patients, and against helping them to commit suicide. But the times seem to be changing.

The Slippery Slope

One grave concern regarding euthanasia and assisted suicide is the so-called “slippery slope.” In a succinct way, Dr J. Pereira nicely summarises the slipperiness of this slope.

In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and “tired of living.” Dutch euthanasia protocols have also moved from conscious patients providing explicit consent, to unconscious patients unable to provide consent. [3]

Glancing Globally

For Australia, in Victoria and Western Australia, Voluntary assisted dying (VAD) is in operation. In the USA, physician-assisted suicide is legal in: Oregon, Washington, Vermont, California, Colorado, Hawaii, New Jersey, Maine and the District of Columbia
In Canada, Medical Assistance in Dying (MAiD) is permitted.
In Colombia, voluntary euthanasia is legal for terminally ill people.

2. Relevant Aspects of Catholic Church Teaching

In the Church’s “Declaration on Euthanasia” from 1980, euthanasia is defined as “an action or omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated." [4]

The Catechism of the Catholic Church teaches:

Direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons. 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 and person and the respect due to the living God, his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. [5]

Assisted suicide, physician assisted suicide, medical assistance in dying, accompanied suicide – whatever the terms (often used to sugar coat the bitter pill of reality) helping another to kill themselves is wrong.

Saint Pope John Paul II spoke clearly about the wrongs of suicide in Evangelium Vitae (1995) stating,

Suicide is always as morally objectionable as murder. The Church's tradition has always rejected it as a gravely evil choice. Even though a certain psychological, cultural and social conditioning may induce a person to carry out an action which so radically contradicts the innate inclination to life, thus lessening or removing subjective responsibility, suicide, when viewed objectively, is a gravely immoral act.[6]

If suicide is wrong,[7] then in no way can helping another to end their life be somehow right as Church teaching clearly explains:

Intentionally causing one's own death, or suicide, is therefore equally as wrong as murder; such an action on the part of a person is to be considered as a rejection of God's sovereignty and loving plan. Furthermore, suicide is also often a refusal of love for self, the denial of a natural instinct to live, a flight from the duties of justice and charity owed to one's neighbor, to various communities or to the whole of society - although, as is generally recognized, at times there are psychological factors present that can diminish responsibility or even completely remove it. However, one must clearly distinguish suicide from that sacrifice of one's life whereby for a higher cause, such as God's glory, the salvation of souls or the service of one's brethren, a person offers his or her own life or puts it in danger (cf. Jn. 15:14). [8]

The new Vatican charter for Healthcare workers (2017), strongly denounces euthanasia as a defeat, a crime, a backward step, and a homicidal act which no end can justify.  [9] It further teaches that “one’s attitude toward the sick person in the terminal stage of his illness is a test of the professionalism and ethical responsibilities of health care workers.”

The charter also underlines that euthanasia and assisted suicide are always a wrong choice.

The medical personnel and other health care workers - faithful to their task of ‘always being at the service of life and assisting it to the end’ - cannot lend themselves to any act of euthanasia, not even at the request of the interested party, much less of his relatives. Indeed, there is no right to dispose arbitrarily of one’s own life, and for this reason no health care worker can become the executor of a nonexistent right. [11]

For this reason, “euthanasia and assisted suicide are a defeat for those who theorize about them, who decide upon them, or who practice them.” [12]

Samaritanus bonus (Good Samaritan), is a recent document arising from the Congregation for the Doctrine of the Faith (CDF) on the care of persons in the critical and terminal phases of life. Discussing care for one’s neighbor in the spirit of the good Samaritan who takes responsibility for the wounded patient, the document notes that “every individual who cares for the sick (physician, nurse, relative, volunteer, pastor) has the moral responsibility to apprehend the fundamental and inalienable good that is the human person. They should adhere to the highest standards of self-respect and respect for others by embracing, safeguarding and promoting human life until natural death.” [13]

An important part of Christian witness is not to abandon the sick at their most vulnerable, but to be with them.

Those who assist persons with chronic illnesses or in the terminal stages of life must be able to ‘know how to stay’, to keep vigil, with those who suffer the anguish of death, ‘to console’ them, to be with them in their loneliness, to be an abiding with that can instill hope. By means of the faith and charity expressed in the intimacy of the soul, the caregiver can experience the pain of another, can be open to a personal relationship with the weak that expands the horizons of life beyond death, and thus can become a presence full of hope.

3. My personal response

There comes a time when we have to take a stance. We cannot sit forever on a hypothetical fence of neutrality. How can we be neutral, like the BMA, in front of evil? It is like announcing that in front of genocide, or human trafficking, my response is neutrality! The core issue at stake is whether we see killing another as right or wrong, as humane (according to the Spanish Prime Minister) or as a “murderous act.”
[14]

Some proponents of euthanasia and physician assisted suicide like Dr Philip Nitschke are very vocal. When he was suspended from the medical register for helping a 45-year-old man to die he said, “It will make no difference to what I do.” He is fully committed to his deathly ministry! There is really a need to announce Life, in a loud voice to the world of today.“Today this proclamation is especially pressing because of the extraordinary increase and gravity of threats to the life of indi- viduals and peoples, especially where life is weak and defenceless.” [15]

In this challenging task we can be so encouraged by the example of Cardinal Von Galen, the so- called “Lion of Münster.” During World War II, the Nazis began a program of euthanasia, for elderly, handicapped, and mentally impaired indi- viduals whom they termed “unproductives.” The crouching lion sprang into action. He preached 3 public homilies, at great risk to his own safety, to denounce this murderous campaign. On Sunday 3rd August 1941 in St. Lambert's Church, Münster, Germany he preached on the Sunday Gospel taken from chapter 19 of St Luke, where surveying the happenings, Jesus weeps (Luke 19:42ff ).

“These numerous unexpected deaths of the mentally ill are not the result of natural causes, but are deliberately brought about; that in these cases that doctrine is being followed, that one can put an end to so-called 'worthless life,' that is, can kill innocent persons, if one believes that their life is of no more value to the people and the state; a horrible doctrine, that would justify the murder of the innocent, that gives a funda- mental license for the violent killing of those in- valids, cripples, incurable sick, and weak old persons who are no longer able to work!

… Once it is granted that people have the right to kill "unproductive” fellow human beings - even if at the moment it affects only the poor defenceless mentally ill - then in principle the right has been given to murder all unproductive people: the incurably ill, the cripples who are unable to work, those who have become incapacitated because of work or war; then the right has been given to murder all of us, once we become weak with age and therefore unproductive.

… Who will then be able to trust his doctor? Perhaps he will report the patient as unproductive” and receive the order to kill him. It is unthinkable what degeneration of morals, what universal mistrust will find its way even into the family, if this frightening doctrine is tolerated, taken up, and followed. Woe to humanity, woe to our German people, if the holy commandment of God, “Thou shalt not kill," which the Lord gave on Sinai amid thun- der and lightning, which God the Creator wrote into the conscience of man from the beginning, is not only broken, but if this breach is tolerated and taken up as a regular practice without punishment! [16]”

“The lion has roared - who will not fear? The Sovereign Lord has spoken - who can but speak out?” (Amos 3:8). We pray for the intercession of Blessed Cardinal von Galen, the Lion of Münster. Perhaps we cannot quite roar like him, but collec- tively we can all raise our voices even slightly. Our prophetic duty urges us to say a louder “no” to euthanasia and assisted suicide, and in this way help do our part to build a more human society.

References

1. https://twitter.com/euronews/status/1372609044809154560?lang=en-gb
2. Cf. BBC News. “Conductor dies in aided suicide.” 14 July 2009.
   http://news.bbc.co.uk/1/hi/entertainment/arts_and_culture/8149166.stm
3. J. Pereira MB ChB MSc,“Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls,” Current Oncology - Volume 18, Number 2, April 2011, E38-E45, E38.
4. Sacred Congregation for the Doctrine of the Faith. “Declaration on Euthanasia,” Pt II Euthanasia. May 5, 1980.
5. Catechism of the Catholic Church, n. 2277.
6. Saint Pope John Paul II. Evangelium Vitae, n. 66.
7. Suicide is always a wrong choice. It is wrong be- cause it is an offence against oneself – an offence against the dignity and respect we should treat ourselves with. It is an offence against our family, who have to suffer afterwards. It is a wrong against society and ultimately an offence against God, the giver of life.
8. Sacred Congregation for the Doctrine of the Faith. “Declaration on Euthanasia,” I.3.
9. See Pontifical Council for Pastoral Assistance to Health Care Workers, 2017. New Charter for Health Care Workers. National Catholic Bioethics Center, Philadelphia, USA Viewable at
   https://www.scribd.com/document/431501363/The-New-Charter-for-Health-Care-Workers
10. Ibid., n. 145.
11. Ibid., n. 169.
12. Ibid., n. 170.
13. Congregation for the Doctrine of the Faith. “Samaritanus Bonus on the care of persons in the critical and terminal phases of life.” 14 July 2020. I. Care for One’s Neighbor.  Available at
    https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20200714_samaritanus-bonus_en.html#.
14. See endnote 5.
15. Saint Pope John Paul II. Evangelium Vitae, n. 3.
16. The excerpts are taken from the book of Fr Daniel Utrecht, The Lion of Münster. The Bishop Who Roared Against the Nazis (North Carolina: TAN books, 2016), pages 238 and 241-242.