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All of us must be aware of the arguments and counter arguments about the issues surrounding the subject of assisted suicide and so-called "mercy killing" that have been raging in many countries, particularly in England over the last two years, where certain high-profile cases have forced the courts and prosecution authorities to not only clarify interpretation of the law but also to give "guidance" as to what circumstances would result in an offender not being prosecuted.
My purpose is not to address the contentious issue of whether the Director of Public Prosecutions should have issued such guidelines about assisted suicide, but to explore the moral issues underlying this debate in relation to Church doctrine. Even though the teachings of the Catholic magisterium have been clearly stated in many documents and in many lectures and sermons over a long period of time, there is the danger that many Catholics, who because of their own natural concern about a person's suffering at the time of an incurable illness, can be swayed by those arguments that place relief of suffering as the only consideration when the question of suicide arises. I, personally, have not been immune from such arguments, having witnessed such suffering at first hand, both in a family context and in the experiences of my time as a police officer. These arguments can be very persuasive because they appeal to a very human desire of alleviating suffering, especially that of a loved one. Indeed, many advocates of suicide and assisted suicide are genuine caring persons, who have no agenda other than to end the suffering of those terminally or acutely ill. There are those, of course, who have other agendas, who wish to have a complete autonomy over life and death without what they see as interference from the State or censure from the Church. It could be said that because the teachings and guidance of the magisterium have been consistent in their opposition to any form of euthanasia or assisted suicide, then nothing more needs to be said. However, there are two main reasons why there is a need to continue to place Christian teaching at the heart of the debate within society.
First, there is the inescapable fact that many Catholics do not read the documents or books which contain the Christian teachings on "end of life" moral issues. Unless they are made aware by other means, for example through preaching amd talks, they find it impossible or certainly difficult to be informed Christians who are able to promote such teachings in their homes, work places and social gatherings.
Second, and this follows on from the first, the arguments of those who advocate individual autonomy over life are industrious in getting their views across through the communications media. This has the effect of a constant "chipping away" at the moral fibre of those Christians who, because of their lack of knowledge and understanding Christian moral teaching, are vunerable to those persuasive yet erroneous arguments.
My intention in this catechetical letter is to tease out the central moral teachings:from what can be seen by many as an impenetrable "forest" of detailed moral reasoning (though important and necessary) in much of the literature on this subject. Perhaps then we are more able to "be ready to make your defence to anyone".
Brian Pointer BA(Div) MA(Th)
Adult Faith Formation
The notion of value, of worth, of what is "good" or "bad" in relation to our continued existence is at the starting point of all moral choices. In the context of the debate on "end of life" issues, however, and equally fundamental issue relates to the question of autonomy. Is a "life", in its fullest human manifestation, a possession to be disposed of as we see fit, or is it a creation of God whereby life's value and disposal has to be seen in relation to the Creator ? In other words, can we simply treat our lives as purely belonging to us and therefore we can decide to end it at any time or place, or are we only "stewards" of that life which God maintains as his own ? In finding an answer to those questions, Christians find themselves in a fortunate position. Through God's self-communication in word and deed, definitively in his Son, Jesus Christ, we have been given truths about mankind and all creation, about the meaning and purpose of human life. Mankind's strivings for understanding the significance of life has been given the direction which leads us to our human fulfilment. It is only in the light of God's revelation in and through his Son and through the gracious gift of their Spirit that we come to know that the true meaning of life and death is in relationship to our triune God. Therefore, Christians have truths which provide the first principles upon which their God-given powers of reasoning can rely upon.
It is in our recognition and acceptance of this relationship of human life with the life of the divine Trinity that we can talk of the concept of the "sanctity (holiness) of life". This term, which often is simply used as an isolated saying without really an explanation as to what it signifies, has become the rallying cry for those opposed to the argument for euthanasia and assisted suicide. As Christians, we come to know that human life is "holy" because it is always in relation to the life of God, even though we as bodily beings are experiencing the effects, such as bodily death, of that original fall from full communion with God. Our resurrection through Christ will put that right. In the meantime, even though we are required to be masters of how we live, that is the moral dimension, we are not masters of life itself but care for it the best we can with God's help.
Some may say that because we control individual births we have the right to control individual deaths. When I was teaching for a short while, I remember this point being raised by the students. "We create a baby's life, don't we ?" was the cry. I put it to them that although it requires a man and a woman to produce a child, in fact the potency for new life is already in the man and woman. Their act brings that potency for new life into fruition. In a sense, they co-operate with the creative will that is already in being in the egg and sperm. The creation of a new human person is always the work of God brought to fruition through human co-operation with the Creator. This is why the term "procreation" is used exclusively in this context. We cannot claim to have autonomy over the beginning and end of life because we are not the only ones involved ! The creative will of God "our Father" is paramount in any life-giying relationship.
The modern use of the term "euthanasia" to describe the action of what is in fact intentional killing of a human being, whether self-killing (suicide) or the killing of another (homicide), is an attempt to put such killing into a more acceptable form, and therefore a justifiable "good". The God-given precept "Thou shall not kill (murder)" has been replaced by man's precept that homicide and suicide are good if those actions are done in the name of "mercy". Therefore, "mercy killing" becomes, a good for the individual and society under the all-embracing umbrella of man's autonomy in life and death matters.
The Christian, however, has a different perspective on life and death. The precept "Thou shall not kill" is not merely a negative law, as though God is like the pagan gods who arbitrarily decide to restrict human activity to satisfy themselves. God's laws are born of love for mankind, and in this case it protects his gift of life from those who seek to abuse that gift in the act of murder. As a result, there is not a simple right to life but rather a right not to be murdered.
Human life, a unity of spirit and flesh, although imperfect through sin, exists only because it is held in being as God's activity of love. In the willed act of mercy killing or assisted suicide we are placing ourselves in opposition to God's love and as such are putting at risk our own human fulfilment The divine law is for a positive purpose, the eventual fulfilment of all human life. Opposition to God's sovereignty over all life prevents that from happening. Our freedom to choose is always protected by God, for it is his gift to us, but his laws guide that freedom to our eventual fulfilment.
Those that close their minds to this truth deceive themselves in thinking that the true value of life lies in self-determination in life and death. Pope John Paul II makes this point very clear in his encyclical "Evangelium vitae" (The Gospel of Life) "Furthermore, when he denies or neglects his fundamental relationship to God, man thinks he is his own rule and measure, with the right to demand that society should guarantee him the ways and means of deciding what to do with his life in full and complete autonomy." (64) God, in his wisdom, knows what is good for each of us and for all mankind. Euthanasia will always be wrong in whatever guise for it rejects God's sovereignty in Creation, and fails to acknowledge that God has set the value of life in relation to his own and not only in relation of man to man.
.In the recent high-profile cases concerning assisted suicide, the arguments are not only raging around this question of the right to decide the time of death but also on the value of life in qualitative terms. Much of the present controversy in the care of the dying or incurably ill is concerned about the "quality of life" in such an individual person. The question that seems to underpin these debates is the one that asks "Is the quality of life more important than the preservation of life itself?" This is not a new question by any means. For some considerable time now, the notion of the possible existence of "higher goods" than life itself has been prominent in the arguments of those in favour of mercy-killing. In other words, if we say that life itself is a "good", are there higher "goods" for which life can be sacrificed ?
For example, can we say that if death is the only way to achieve the "good" of relieving suffering in a particular person, is that not a higher good than that of preservation of that life ? If we reply in the affirmative then we are saying that life itself is only a biological basis for those "higher goods" such as the ability to love, to seek justice, to have compassion and mercy, to seek God. In other words, human life can only be measured in biological terms, and as such is only there to support those higher goods.
However, once these higher goods are not attainable through some kind of illness, physical or mental, then this "life" is of no value to the suffering person or to others. This separation of human life into basic "goods", such as life itself, and higher "goods", for example the ability to relate to others, is in contrast to the Christian view of human life in its integral nature. There is no part of human nature which can be taken away from the sovereignty of God. Man's stewardship of that life is not only in relation to his spiritual side but also his bodily nature in the integrity of the whole person. One does not function without the other; the spirit of man animates, gives life to the biological body only in the integrity of the human person.
The theologian William May sees this sacrificing of life for quality of life argument as undermining the essential value of life itself. He says that the different "goods" of life cannot be compared with one another, weighed one against the other, a choice be made in preference to the other. This ethic of the "proportionate good", one to be disposed of against the other, is the master principle in the defence of mercy-killing and suicide.(cf. "Human Existence, Medicine and Ethics" p. 149)
Human qualities or virtues, as "goods", such as compassion and mercy, are an integral part, albeit in some people still only in potential, of the total good of human life.
Much of the present controversy iri the medical care of the dying concerns the decisions of doctors and families as to the means to be employed in preserving "quality of life" in the patient. These judgements are based mostly on what is good for the patient, but in some countries the criteria for these judgements are being extended to include the quality of life for the patient's family, the medical staff and hospital, and finally society in general. So far, as far as we can be aware, this has not happened in the United Kingdom. However, if what has happened in the Netherlands and some states in the USA is anything to go by, together with the recent decisions in the UK, the danger of such an extension is very real.
In the not too distant past, there have been significant changes in the laws of US states and the Netherlands, to allow terminally ill patients to decide for themselves as to the time and manner of their "physician assisted" deaths. Once that door was opened, the next step, non-voluntary euthanasia, became easier. For example, in the USA in 1996, two federal appeal courts effectively supported "assisted suicide" by holding as unconstitutional state prohibitions against aiding or abetting suicide. In one of those decisions (Compassion in Dying v. State of Washington) a long footnote redefined voluntary euthanasia to encompass "non-voluntary euthanasia performed with proper authorization."
In 1997, in her study of the US and Netherlands, Cathleen Kavenny noted that in the Dutch guidelines on physician assisted deaths, the reasons for it can include not only unbearable pain but "psychic suffering" and the "potential disfigurement of personality". In the official Remmelink report, the most frequently cited reasons for ending the lives of patients without their knowledge or consent were "low quality of life", "no prospect for improvement", and that "the family couldn't take it any more".
Whatever the situation is in those countries at the present time, the examples illustrate what could happen once we open the door to such evaluation of human life. What value is life when death becomes a means to another's quality of life ?
In the concept of "allowing" a dying person to die, confusion over terminology has become a factor in the debate. The terms "active" and "passive" euthanasia are applied to those situations where either the death is directly willed (active) or to allowing the terminally ill person to die by not starting or discontinuing life-supporting treatment (passive). On the face of it, so-called passive euthanasia would seem to be a moral action which is compatible with the Christian approach to care of the dying. However, there are some instances of "allowing to die" that are morally equivalent to killing and some where it is morally acceptable.
This is where we come up against further technical terms such as "ordinary means" and "extraordinary means". These terms are used in medical ethics when consideration is given to determining whether there are sufficient reasons, or a proportionate good, for allowing death to happen. There are no absolutes in this decision making process. There are not means to keep a dying person alive which are always ordinary or means which are always extraordinary. They have to be proportionate to the condition and circumstances of the person.
Pope John Paul II , in "Evangelium vitae" emphasised the distinction between euthanasia and care of the dying when he wrote, "Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment". (65) It is absolutely imperative to separate the practice of euthanasia from the morally good practice of allowing a dying person to die, "In such situations, when death is clearly imminent and inevitable, one can in conscience refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted," (65) The provision of food and water is not "treatment" but is integral to normal human care.
If treatment, ordinary or extraordinary, is stopped or not started in order to cause the death of the person, then this is euthanasia. The death is brought about by the lack of treatment, not a terminal illness; the intention is to end the life of the person. In euthanasia the intention is always to directly or indirectly cause the death of the person whether it is an act of compassion or otherwise. In withdrawing or not starting extraordinary means which are only delaying an inevitable death and are burdensome and abusive and prevent the dying person from dying "peacefully and with Christian dignity" ("Jura et bona" S C.D.F (1980), then it is not the act of killing, for that is done by the biological forces of the disease.
The "slippery slope" of moral degeneration has already been created and many are sliding down it in their attempt to have complete control over life and death. We as Catholic Christians have clear and strong guidance through God's word, in the person and teachings of his Son, our Lord Jesus Christ, as continually understood and expressed in his Church. It is a bastion of truth against an untruth which poses an enormous threat to the sanctity of life and the goodness of our society.
Quote of the month
"(Even when not motivated by a selfish refusal to be burdened with life of someone who is suffering, euthanasia must be called a 'false mercy", and indeed a disturbing perversion of mercy, True "compassion" leads to sharing another's pain; it does not kill the person whose suffering we cannot bear." Pope John Paul II "Evangelium vitae" (66)