It seems that moral decline is continuing at pace in the Republic of Ireland. Having dismissed the dignity of the unborn child in the womb and equated same sex relationships with marriage it should not take us by surprise that elected representatives now have their sights set on legislation which would allow for euthanasia and assisted suicide to be given the status of a right for those who choose it. So, those who are bringing forward this debate are calling now for a right to die, and pushing aside definitively with their thought, vocabulary and argument a right to life.
So, on this Day for Life Sunday, which also coincides with our Bethlehem Cistercian Family Retreat Sunday, I thought it might be good to try to present again just why this move on the part of Irish parliamentarians is so abhorrent to any right minded individual who values human life, at all its stages, in all its manifestations, be it seen in the strong or weak, those who are in their right mind or considered not to be, and those who enjoy, for the moment, the gift of the fullness of physical and mental health or those who are living with illness and pain, even be it almost too much to bear or terminal.
Perhaps even more shocking than the audacity of those in the Irish Parliament who are driving this bill is the deafening silence from others who have a duty to speak out in defense of life in all its stages. What is perhaps pitiful to note today on this Day for Life is the brief messages which are being broadcast and which, while laudable in focusing on life in its initial moments, say nothing about life in its other most fragile and vulnerable moments, when critical or terminal phases of illness become the defining aspect of the human person’s life. This seems to be even more disappointing when the Church herself, through the Congregation for the Doctrine of the Faith, has only most recently (22nd September, 2020) issued a letter – Samaritanus Bonus, or The Good Samaritan – providing a clear and strong statement of the Church’s constant and person-centered teaching concerning euthanasia and assisted suicide. It is from this letter that I wish to draw some support and food for reflection and prayer today. I invite you to do likewise, and with these few selections take time to read the full, very powerful document here:
“Whatever their physical or psychological condition, human persons always retain their original dignity as created in the image of God. They can live and grow in the divine splendor because they are called to exist in “the image and glory of God” (1 Cor11:7; 2 Cor 3:18). Their dignity lies in this vocation. God became man to save us, and he promises us salvation and calls us to communion with Him: here lies the ultimate foundation of human dignity.”
The Church has always maintained that the principle for the sustaining and support of human life and the inviolable respect which is due to the person are rooted in the recognition of the person’s being created in God’s image and likeness. In this way, the human person is already a creature set apart from the rest of creation, with his and her own origin, vocation and end in the divine life in which he already shares but which will be given him, through cooperation with grace and the radical acceptance of salvation won by Christ in life after death. Immediately arising from this is the innate demand that the human person, at every moment of their existence, must be given the fullest possible respect, which arises not from any outward or accidental characteristic, but is rooted in the person’s very nature.
This image and likeness persists from the moment of conception right until natural death. Indeed, one of the most deplorable aspects of society’s reaction to conditions and diseases such as dementia and Alzheimer’s – no longer, of course, the domain only of those who are chronologically old, but possible in early onset forms – is the often heard comment that the person who is suffering is “no longer themselves”, or that “they were no longer my mother, or brother, or sister” when the illness appeared to take hold and, for example, self-cognition or recognition of others seems to be impaired. Such a subjective approach implies that the person has, in some way, ceased to be the person that God created. On the contrary, however, even the most severe and apparently person-altering illnesses cannot cloud, obscure or destroy the mystery of God’s purpose in that person’s life. Simply because we cannot perceive it continuing to be achieved does not mean that God has ceased to bring to some fulfillment his plan for that person and indeed, through that person, his plan for us and for creation.
“It is proper for the Church to accompany with mercy the weakest in their journey of suffering, to preserve them the theological life, and to guide them to salvation. The Church of the Good Samaritan regards “the service to the sick as an integral part of its mission”. When understood in the perspective of communion and solidarity among human persons, the Church’s salvific mediation helps to surmount reductionist and individualistic tendencies.”
Here the letter focuses our attention clearly on the place that all persons have in the Church and in society, and especially those who, through suffering, continue to live the pilgrimage of life. In a special way the sick stand at the heart of the Church, and we must have, in the first place, particular regard for the most vulnerable, the sick and the needy. Their fragility and frailty are a reminder to us that we are all, in some way, dependent upon one another, and all are in need of the Good Samaritan’s care.
The matter of accompaniment is crucial here – illness demands that we accompany, and accompaniment is the gift and promise of hope. To withdraw such accompaniment is already an admission of despair and futility, and communicates the pointlessness of suffering, and our inability to be present with the other who is suffering. While compassion is always demanding, and never seeks to say that I feel fully what another feels, still compassion is the presence of communion of one person with another, a solidarity which transcends purely medical or clinical aid and support and which , at its very deepest level, may be called truly human and interpersonal.
“The Church affirms that the positive meaning of human life is something already knowable by right reason, and in the light of faith is confirmed and understood in its inalienable dignity. This criterion is neither subjective nor arbitrary but is founded on a natural inviolable dignity. Life is the first good because it is the basis for the enjoyment of every other good including the transcendent vocation to share the trinitarian love of the living God to which every human being is called: “The special love of the Creator for each human being ‘confers upon him or her an infinite dignity’. The uninfringeable value of life is a fundamental principle of the natural moral law and an essential foundation of the legal order. Just as we cannot make another person our slave, even if they ask to be, so we cannot directly choose to take the life of another, even if they request it. Therefore, to end the life of a sick person who requests euthanasia is by no means to acknowledge and respect their autonomy, but on the contrary to disavow the value of both their freedom, now under the sway of suffering and illness, and of their life by excluding any further possibility of human relationship, of sensing the meaning of their existence, or of growth in the theological life. Moreover, it is to take the place of God in deciding the moment of death. For this reason, “abortion, euthanasia and willful self-destruction (…) poison human society, but they do more harm to those who practice them than those who suffer from the injury. Moreover, they are a supreme dishonour to the Creator”.
This very weighty paragraph draws out a number of central ideas, indispensable to our understanding of the offence of euthanistic interventions and assisted suicide. Above all it brings forward that the gift of life is the primary good upon which all other goods are founded. If we remove that, if we devalue life, then all other goods become arbitrary.
At the heart of these statements is a fundamental recognition that positive law, issued by states and nations, can only be founded on a natural moral law, written into the very nature of the human person, and without which law becomes subjective and a matter for constant emendation and change according to the changing whims and demands of those who frame such laws. In this sense, law becomes a matter of complete instability because it forgets that it has any objective and always true foundation. Objective moral law recognises in the first place that there are truths which are always and everywhere true, and the first of these is the inviolable dignity of the human person, which must be promoted and protected in all circumstances. For a society, effectively, to set this aside is tantamount to the removal of a fundamental good without which society ceases to be human, because it ceases to place the good of the human person at the center of all that it wishes to achieve.
This said, it seems almost inevitable that a society which forgets God and ceases to find in the search for God a guiding principle will eventually forget the dignity of the human person – when God is written out it quickly follows that the human person is also written out. A society which allows itself to be shaped by atheistic principles will see the human person as eventually disposable, since atheism rejects, fundamentally, the existence of and a call to the transcendent, and the human person, by their very nature, is called to a transcendent goal and fulfillment.
“Among the obstacles that diminish our sense of the profound intrinsic value of every human life, the first lies in the notion of “dignified death” as measured by the standard of the “quality of life,” which a utilitarian anthropological perspective sees in terms “primarily related to economic means, to ‘well-being,’ to the beauty and enjoyment of physical life, forgetting the other, more profound, interpersonal, spiritual and religious dimensions of existence”
This is possibly the most common phrase in (current) circulation which is used by advocates to justify the right to euthanasia and assisted suicide – “quality of life”, and its apparent loss or even diminishment. What such a phrase does is create a set of criteria – for the most part, entirely subjective and indeterminate – which are used to justify a point at which a human life, because of a perceived quality measured against apparently positive characteristics, can be deemed less than adequate and so in a place where a humanly decided end can be brought about. But the human person is entirely above determination by subjective criteria. The person’s life is always good in itself; it is always possessed of a unique quality, whether this is demonstrably measurable or not; it cannot be, in any circumstance, subjected to humanly defined criteria which seek to establish the point at which it can be directly and intentionally ended. In fact, at this point, without specifying it, the document leads us towards a consideration of the mystery of the moment of death, and of death itself, which, like life, is tied up in the mystery of God’s plan for each of us, and for our common and shared humanity. Those who are concerned with the care of patients at that most distressing moment – the period leading to death, insofar as this may be experienced as part of a critical or terminal phase – and of death itself have both the privilege and the duty to accompany the one who is dying, in all that this implies and brings with it – clinically, emotionally, humanly, spiritually, psychologically, and in all the varied ways which such a situation manifests to those present, and for each of them according to their specific competence and professional qualification. In this way death is not simply a moment which can be posited – it is a moment which approaches, and always concealing from us its precise moment, but which co-involves all those who accompany. As such, it speaks about the deep reality of the human person – precisely anthropology in that broad sense – both in themselves and always in relation to others.
“A second obstacle that obscures our recognition of the sacredness of human life is a false understanding of “compassion”. In the face of seemingly “unbearable” suffering, the termination of a patient’s life is justified in the name of “compassion”. This so-called “compassionate” euthanasia holds that it is better to die than to suffer, and that it would be compassionate to help a patient to die by means of euthanasia or assisted suicide. In reality, human compassion consists not in causing death, but in embracing the sick, in supporting them in their difficulties, in offering them affection, attention, and the means to alleviate the suffering.”
Here the letter touches upon a common and deliberate misunderstanding and misuse of the term “compassion”. At its very core this term means simply, and yet profoundly, to suffer with another. Compassion, therefore, in itself, demands the burden of accompaniment by others of the one who is suffering, even if they cannot themselves understand or come to know in the same way the suffering of the one whom they accompany. In this sense, the notion of vocation overriding simple profession comes to the fore – it is not a matter merely of doing a job but rather of living a way of life which compassion emphasises. Indeed, so many of those who work in the caring professions, in all its many and varied forms and expressions, do just this already – they invest themselves, personally and as completely as they can, in the care of their patients. To do otherwise, and to take away from them this accompaniment by introducing the commonality of euthanasia or assisted suicide as a way to “solve” a situation of severe or critical or terminal suffering, is to rob their vocations of their essential expression and substance.
It should also be noted at this point that the term “compassion” is often erroneously linked with that other abhorrent phrase, “mercy killing”. There is nothing merciful about the direct and intentional killing of any person. Indeed, to deprive another of life is precisely a contradiction of the mercy which we come to know as a name of God, whose purpose for each of us is communicated in his mercy given for each.
“Euthanasia, therefore, is an intrinsically evil act, in every situation or circumstance. In the past the Church has already affirmed in a definitive way “that euthanasia is a grave violation of the Law of God, since it is the deliberate and morally unacceptable killing of a human person. This doctrine is based upon the natural law and upon the written Word of God, is transmitted by the Church’s Tradition and taught by the ordinary and universal Magisterium. Depending on the circumstances, this practice involves the malice proper to suicide or murder”. Any formal or immediate material cooperation in such an act is a grave sin against human life: “No authority can 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”. Therefore, euthanasia is an act of homicide that no end can justify and that does not tolerate any form of complicity or active or passive collaboration. Those who approve laws of euthanasia and assisted suicide, therefore, become accomplices of a grave sin that others will execute. They are also guilty of scandal because by such laws they contribute to the distortion of conscience, even among the faithful.”
Very directly the Church challenges the reality and project of euthanasia. The language of this paragraph is entirely clear and logical. It speaks to the contradictory nature of euthanistic acts and legislation and calls it out for what it is – the violation of the divine law, an offense against the dignity of the person, a crime against life, an attack on humanity.
We might note at this point – the acquiring of the right to end life, or the demand that one be given the right to end life, even one’s own, is to demand that God not be God, and that the human person, or human legislature, replace Him. Again, it stands to be said that such creation of a false right in place of the divine will is characteristic of an atheistic society, which eventually has as its goal the demeaning of the human person and abuse, both implicit and explicit, of the fundamental rights which belong to the human person by their very nature. One of the characteristics of our society today is precisely this – the demand for “rights” to be created and acquired which in fact do not reinforce the dignity of the human person, but demean. Such rights are never, in fact, reflective of the essential nature of the person, but by and large are based on the subjective demand for wants to be fulfilled here and now, as they arise. By and large these rights are claimed also as absolutes and demand absolute exercise, when in fact no right, except those rights which are intrinsically knitted into the fabric of the human person, can demand absolute exercise, since they invariably infringe on the rights of another or others.
“Each life has the same value and dignity for everyone: the respect of the life of another is the same as the respect owed to one’s own life. One who chooses with full liberty to take one’s own life breaks one’s relationship with God and with others, and renounces oneself as a moral subject. Assisted suicide aggravates the gravity of this act because it implicates another in one’s own despair. Another person is led to turn his will from the mystery of God in the theological virtue of hope and thus to repudiate the authentic value of life and to break the covenant that establishes the human family. Assisting in a suicide is an unjustified collaboration in an unlawful act that contradicts the theological relationship with God and the moral relationship that unites us with others who share the gift of life and the meaning of existence.”
“When a request for euthanasia rises from anguish and despair, “although in these cases the guilt of the individual may be reduced, or completely absent, nevertheless the error of judgment into which the conscience falls, perhaps in good faith, does not change the nature of this act of killing, which will always be in itself something to be rejected”. The same applies to assisted suicide. Such actions are never a real service to the patient, but a help to die.
“Euthanasia and assisted suicide are always the wrong choice: “the medical personnel and the other health care workers – faithful to the task ‘always to be at the service of life and to assist it up until the very end’ – cannot give themselves to any euthanistic practice, neither at the request of the interested party, and much less that of the family. In fact, since there is no right to dispose of one’s life arbitrarily, no health care worker can be compelled to execute a non-existent right”.
“This is why euthanasia and assisted suicide are a defeat for those who theorize about them, who decide upon them, or who practice them.”
There should be no doubt that the demand for euthanasia and assisted suicide arise from the most painful human experiences, both for those who are patients in these moments, and for those who accompany them. The Church is aware of this, and also the communitarian aspect of suffering during illness and the care which is given, especially in the clinical sphere. These moments bring about a real co-involvement of personnel, which expresses a deep level of humanity and communion, both concrete and transcendent, whether the latter is felt or not. It is therefore gravely wrong to co-involve others in such decisions, and worse, in their implementation. To legislate for such circumstances is to provide the grounds for the most demeaning and morally inexcusable actions on behalf of those whose first duty is to care for those under their watch.
“A fundamental and inescapable principle of the assistance of the critically or terminally ill person is the continuity of care for the essential physiological functions. In particular, required basic care for each person includes the administration of the nourishment and fluids needed to maintain bodily homeostasis, insofar as and until this demonstrably attains the purpose of providing hydration and nutrition for the patient.
“Continuity of care is part of the enduring responsibility to appreciate the needs of the sick person: care needs, pain relief, and affective and spiritual needs. As demonstrated by vast clinical experience, palliative medicine constitutes a precious and crucial instrument in the care of patients during the most painful, agonizing, chronic and terminal stages of illness. Palliative care is an authentic expression of the human and Christian activity of providing care, the tangible symbol of the compassionate “remaining” at the side of the suffering person. Its goal is “to alleviate suffering in the final stages of illness and at the same time to ensure the patient appropriate human accompaniment” improving quality of life and overall well-being as much as possible and in a dignified manner. Experience teaches us that the employment of palliative care reduces considerably the number of persons who request euthanasia. To this end, a resolute commitment is desirable to extend palliative treatments to those who need them, within the limits of what is fiscally possible, and to assist them in the terminal stages of life, but as an integrated approach to the care of existing chronic or degenerative pathologies involving a complex prognosis that is unfavorable and painful for the patient and family.”
The Church here, as in other places in the document, recognises that the care which is given to the critically and terminally ill is of such a kind that it should continue until natural death. It is an essential part of the accompaniment which we can provide to those who are dying, and which we might expect in our own last illness. Indeed, it might be said that, at the stroke of a pen, legislation which establishes the possibility of euthanasia and assisted suicide does away with the reality and value which is lived daily by those who work in the palliative care and hospice services. Above all, in these humanly exceptional vocations, the dignity of the person in the last stages of this earthly life can be seen to be esteemed and valued. At no stage does palliative care admit of the kind of qualitative assessment which would underpin a euthanistic philosophy or practice. It might be good, then, to look again at some of the life-affirming teaching around the reality of palliative care in our society in Ireland by visiting the site of the All Ireland Hospice and Palliative Care movement:
“Christian witness demonstrates that hope is always possible, even within a “throwaway culture”. “The eloquence of the parable of the Good Samaritan and of the whole Gospel is especially this: every individual must feel as if called personally to bear witness to love in suffering”.
“The Church learns from the Good Samaritan how to care for the terminally ill, and likewise obeys the commandment linked to the gift of life: “respect, defend, love and serve life, every human life!”. The gospel of life is a gospel of compassion and mercy directed to actual persons, weak and sinful, to relieve their suffering, to support them in the life of grace, and if possible to heal them from their wounds.
“It is not enough, however, to share their pain; one needs to immerse oneself in the fruits of the Paschal Mystery of Christ who conquers sin and death, with the will “to dispel the misery of another, as if it were his own”. The greatest misery consists in the loss of hope in the face of death. This hope is proclaimed by the Christian witness, which, to be effective, must be lived in faith and encompass everyone—families, nurses, and physicians. It must engage the pastoral resources of the diocese and of Catholic healthcare centers, which are called to live with faith the duty to accompany the sick in all of the stages of illness, and in particular in the critical and terminal stages of life as defined in this letter.”
This powerful letter ends by noting again that euthanasia and assisted suicide contribute to the notion that we live in a “throw away” culture and that we have reached the point at which the human person herself is entirely disposable. We too, like so much that we buy and possess and which is identified as commodity, are reduced to such a status by the reality of euthanasia legalised in our society. A society, whether it experiences a sense of the transcendent or the divine or not, whether it is capable of both valuing the individual human person and providing the means for their dignified living of life and acceptance of natural death when it comes, can be measured by how it places, again and again, the inviolable dignity of human personhood at the centre of all that it decides and enacts. Establishing euthanasia and assisted suicide as expressions of a society’s way of life do just the contrary – the person is made subject to the overriding power of the State, and so is robbed, at that last and most fragile of moments, of the mystery of personhood which defines them.
-Part of our ‘Retreat Sunday’ series-