“Respect for life does not demand that we attempt to prolong life by using medical treatments that are ineffective or unduly burdensome. Nor does it mean we should deprive suffering patients of needed pain medications out of a misplaced or exaggerated fear that they might have the side effect of shortening life…”
At some point, all families face end-of-life care for a loved one. As Catholics attempt to navigate the myriad of medical, ethical, and religious questions that arise, they must also deal with the grief of an impending death: it can become overwhelming.
In an effort to offer assistance, the New York State Catholic Conference has produced a video, Now and at the Hour of Our Death, and a website- www.catholicendoflife.org– that tackles many questions and concerns regarding End-of-Life Decision making.
They also have a helpful guide: the NYS Catholic Guide to End-of-Life Decision Making with Health Care Proxy
ABOUT ASSISTED SUICIDE
One of the principles in Catholic Social Teaching is promoting the dignity of all human life from the moment of conception until natural death. Our social ministry efforts don’t just focus on the beginning of life, or on helping people have a decent quality of life, but in educating and advocating in support of life all the way to natural death. Bills to legalize assisted suicide have been presented in New York State and the NYS Catholic Conference has joined with an alliance of other faith based groups, medical and legal professionals, and disability rights groups to oppose these bills and promote truly compassionate and appropriate end-of-life care. Assisted Suicide is one of three issues chosen for the 2016 Diocesan Public Policy Agenda, and the materials that follow will help you educate parishioners, students, and others to understand what’s at stake and of the crucial need to protect life at the vulnerable end of life stage.
ISSUES IN CARE FOR THE SERIOUSLY ILL AND DYING1
Christ’s redemption and saving grace embrace the whole person, especially in his or her illness, suffering, and death.35 The Catholic health care ministry faces the reality of death with the confidence of faith. In the face of death—for many, a time when hope seems lost—the Church witnesses to her belief that God has created each person for eternal life.36
Above all, as a witness to its faith, a Catholic health care institution will be a community of respect, love, and support to patients or residents and their families as they face the reality of death. What is hardest to face is the process of dying itself, especially the dependency, the helplessness, and the pain that so often accompany terminal illness. One of the primary purposes of medicine in caring for the dying is the relief of pain and the suffering caused by it. Effective management of pain in all its forms is critical in the appropriate care of the dying.
The truth that life is a precious gift from God has profound implications for the question of stewardship over human life. We are not the owners of our lives and, hence, do not have absolute power over life. We have a duty to preserve our life and to use it for the glory of God, but the duty to preserve life is not absolute, for we may reject life-prolonging procedures that are insufficiently beneficial or excessively burdensome. Suicide and euthanasia are never morally acceptable options.
The task of medicine is to care even when it cannot cure. Physicians and their patients must evaluate the use of the technology at their disposal. Reflection on the innate dignity of human life in all its dimensions and on the purpose of medical care is indispensable for 30 formulating a true moral judgment about the use of technology to maintain life. The use of lifesustaining technology is judged in light of the Christian meaning of life, suffering, and death. In this way two extremes are avoided: on the one hand, an insistence on useless or burdensome technology even when a patient may legitimately wish to forgo it and, on the other hand, the withdrawal of technology with the intention of causing death.37
The Church’s teaching authority has addressed the moral issues concerning medically assisted nutrition and hydration. We are guided on this issue by Catholic teaching against euthanasia, which is “an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.”38 While medically assisted nutrition and hydration are not morally obligatory in certain cases, these forms of basic care should in principle be provided to all patients who need them, including patients diagnosed as being in a “persistent vegetative state” (PVS), because even the most severely debilitated and helpless patient retains the full dignity of a human person and must receive ordinary and proportionate care.
55. Catholic health care institutions offering care to persons in danger of death from illness, accident, advanced age, or similar condition should provide them with appropriate opportunities to prepare for death. Persons in danger of death should be provided with whatever information is necessary to help them understand their condition and have the opportunity to discuss their condition with their family members and care providers. They should also be offered the appropriate medical information that would make it possible to address the morally legitimate choices available to them. They should be provided the spiritual support as well as the opportunity to receive the sacraments in order to prepare well for death. 31
56. A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.39
57. A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.
58. In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally. This obligation extends to patients in chronic and presumably irreversible conditions (e.g., the “persistent vegetative state”) who can reasonably be expected to live indefinitely if given such care.40 Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be “excessively burdensome for the patient or [would] cause significant physical discomfort, for example resulting from complications in the use of the means employed.”41 For instance, as a patient draws close to inevitable death from an underlying progressive and fatal condition, certain measures to provide nutrition and hydration may become excessively burdensome and therefore not obligatory in light of their very limited ability to prolong life or provide comfort.
59. The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching. 32
60. Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death.42
61. Patients should be kept as free of pain as possible so that they may die comfortably and with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.
62. The determination of death should be made by the physician or competent medical authority in accordance with responsible and commonly accepted scientific criteria.
63. Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death.
64. Such organs should not be removed until it has been medically determined that the patient has died. In order to prevent any conflict of interest, the physician who determines death should not be a member of the transplant team.
65. The use of tissue or organs from an infant may be permitted after death has been determined and with the informed consent of the parents or guardians. 33
66. Catholic health care institutions should not make use of human tissue obtained by direct abortions even for research and therapeutic purposes.43
FREQUENTLY ASKED QUESTIONS
What is the difference between letting a person die and practicing euthanasia?
How much treatment must be provided to the sick and dying?
Can Catholics have “living wills”?
FOR PARISH LEADERS
Schedule a comprehensive end of life presentation using the Now and at the Hour of Our Death video and booklet from the NYS Catholic Conference. These issues can be confusing and people appreciate the clarity offered in this presentation (especially Catholic teaching on ordinary and extraordinary care, as well as guidance on advance directives). Help us cover every parish in the Diocese. I am also happy to offer resources for your specific purposes. Moreover, I am also available to present on assisted suicide (with the possibility of a disability rights presenter as well) or to include it as part of a comprehensive end of life session. Feel free to contact me at firstname.lastname@example.org or 585.328.3210, ext. 1304.
You can use these materials on Assisted Suicide in various ways – in liturgies (see Prayer Resources at usccb.org/toliveeachday), bulletin inserts, posting on websites and social media, in adult ed programs, faith sharing groups, prayer groups, youth groups, and in other groups and organizations.
Blessings to you as you promote truly compassionate care that supports the dignity of ALL human life!
- Statement from Bishop Matano
- Ethical and Religious Directives for Catholic Health Care Services
- USCCB’s “Assisted Suicide and Euthanasia” page
- National Catholic Bioethics Center
- Memo of Opposition: Physician Assisted Suicide
- Fatal Flaws in NYS Bills
- Life Matters: Doctor-Assisted Death, by William L. Toffler, MD
- The True Face of Assisted Suicide, by Richard Doerflinger
- NYS Catholic.org
- NYS Catholic Conference Action Center
- No Assisted Suicide NY and Videos
- Address to the Participants in the International Congress on Life-Sustaining Treatments and the Vegetative State: Scientific Advances and Ethical Dilemmas, St. John Paul II (March 20, 2004)
- Declaration on Euthanasia, Congregation for the Doctrine of the Faith (May 5, 1980)
- The Prolongation of Life: Address to an International Congress of Anesthesiologists here or here , Pope Pius XII (November 24, 1957).
- Commentary regarding Life Sustaining Treatments and the Vegetative State
- Responses to Certain Questions of the USCCB Concerning Artificial Nutrition and Hydration
- Catholic Bioethics and the Gift of Human Life, Third Edition, by William E. May
- Caring for the Dying with the Help of Your Catholic Faith by Elizabeth Scalia
- Frequently Asked Questions: End of Life Issues by Steven Bozza
- Assisted Suicide Flyer
- Short Articles and Tweets on Assisted Suicide
- Memes for No Assisted Suicide
1 Ethical and Religious Directives for Catholic Health Care Services, Fifth Edition, United States Conference of Catholic Bishops. Pages 29 – 33.