LEICESTER, United Kingdom – Catholic bioethicists have welcomed the Vatican’s clear statement that euthanasia is incompatible with palliative care.
The document Samaritanus Bonus (“The Good Samaritan”) was released on Tuesday by the Congregation for the Doctrine of the Faith, and discussed various aspects surrounding the euthanasia debate and end-of-life care.
“A key message of this document is that euthanasia is incompatible with palliative care. It points to the corruption of palliative care by euthanasia, calling it ‘a socially irresponsible threat to many people, including a growing number of vulnerable persons who needed only to be better cared for and comforted but are instead being led to choose euthanasia and suicide’,” said David Albert Jones, the director of the Oxford-based Anscombe Bioethics Centre, the leading Catholic bioethics institution in the United Kingdom.
“Whereas authentic palliative care offers both relief of symptoms and emotional solidarity with those who are suffering, euthanasia is effectively an admission of hopelessness. How could this not undermine the relationship of care, especially for someone in a vulnerable and fragile state?” Jones continued.
“We see this from the real-life experience of countries where palliative care has been undermined and hospices have no longer been able to reassure patients that their role is to support people to live well in the last phase of their life, not to end that life prematurely. In Belgium, and now also in Canada, healthcare professionals and charitable institutions are effectively being required to facilitate euthanasia and assisted suicide both for people with physical and with mental illnesses, and both for those who are dying and for those who are disabled,” he said.
Helen Watt, the Anscombe Centre’s senior research fellow, said the CDF document is “a moving reminder to all of us that respecting the dignity of those who are ill and disabled includes valuing their lives, even if respect goes far beyond that.”
“This is not simply an abstract point,” she told Crux.
“When euthanasia is accepted by some, it sends a message to others in a similar situation that their lives may no longer be valuable because of their condition. Life is always an aspect of human well-being and there is no ‘life unworthy of life’. There are other aspects of human well-being that need devoted attention, and in healthcare and especially palliative care, we need an integrated approach so that physical, emotional and spiritual needs can be scrupulously addressed. This is what the document calls for. Terminating lives, however, can never respect the dignity of patients and is the very reverse of healthcare,” Watt said.
The Vatican document came out as medically assisted dying is gaining steam across the world: Euthanasia – the direct killing of a patient by medical personnel is legal in the Netherlands, Belgium, Colombia, Luxembourg, Canada and the state of Western Australia; physician-assisted suicide – where medical personnel prescribe a lethal dose, but the patient administers the drug – is legal in Switzerland, Germany, the Australian state of Victoria and in the U.S. states of Washington, Oregon, Colorado, Hawaii, Vermont, Maine, New Jersey, California, and the District of Columbia.
Next month New Zealanders will go to the polls to vote on a euthanasia referendum and Spain’s government is seeking to legalize the practice. In Ireland, a private member’s bill to legalize physician-assisted suicide was introduced into parliament last week.
Speaking specifically about the Irish proposal, Watt said “extreme skepticism” is needed about reassurances that it would only affect “a small number of people.”
She said these promises “do not sit well” with the bill’s “short waiting periods and the extremely broad definition of what counts as a qualifying terminal illness.”
“Other alarming features include the low bar required for capacity to make this irrevocable decision, which may lead to those with cognitive impairments being euthanized, and the unprincipled requirement that unwilling doctors must refer patients on so that suicide drugs can be obtained,” she said.
The CDF document also clarified that pastoral care of those contemplating receiving euthanasia or any other form of suicide can’t include reception of the sacraments, including confession and absolution.
The passage was seen by many as a mild rebuke of Italian Archbishop Vincenzo Paglia, the head of the Vatican’s Pontifical Academy for Life, who in December said he would “hold the hand of someone” who was dying from medically-assisted suicide.
“A priest cannot grant absolution or perform the anointing of the sick on a person who has not repented from the intention to take their own life,” said Joseph Meaney, the president of the Philadelphia-based National Catholic Bioethics Center.
Meaney told Crux he was “very pleased” the CDF cleared up “any pastoral confusion” regarding the reception of sacraments for those who freely choose euthanasia and physician-assisted suicide.
“There is a worrying trend of more countries passing laws to allow these practices and for people to be confused about the morality of euthanasia and assisted suicide. Regrettably, many people equate what is legal with what is moral,” he continued.
“This lack of clarity has extended to some members of the clergy who thought they could administer the sacraments to persons with the firm intention of being euthanized or killing themselves. God always forgives if we repent of our sins and affirm that we reject this path in the future. It is simply not possible to grant absolution of sin to a person who is determined to continue with a sin. That is why a priest could never anoint a person just before euthanasia or committing suicide,” Meaney told Crux.
Michael Wee, the Education and Research Officer of the Anscombe Bioethics Centre and a member of the Pontifical Academy for Life, said the refusal of absolution is not a denial of the sacrament, but a “delay.”
Wee told Crux this is “not a condemnation, but a medicinal act, intended to encourage conversion of heart.”
“The document even calls it a necessity to remain close to such a person in order to help facilitate a path back to the sacraments via true repentance and a revival of hope. At the same time, it cautions against being complicit in euthanasia, such as by remaining with the person until the euthanasia is performed, which may imply approval. Chaplains and others providing spiritual assistance will need to keep these principles in mind as they work through what is inevitably a delicate situation,” Wee added.
Both Meaney and Wee highlighted the Vatican’s insistence that Catholic institutions cannot collaborate with euthanasia or any other form of assisted suicide.
“It states that Catholic health care workers and hospitals have a clear duty to conscientious objection against euthanasia and assisted suicide and governments must respect this duty and right. It goes on pointedly to say that it is not morally acceptable for Catholic institutions to cooperate with these evils and makes it clear they can lose their designation as a Catholic health care ministry if they do so,” Meaney said.
Wee notes the Vatican also calls on governments to recognize the right to conscientious objection, as well as reminding Catholic institutions of their moral obligations.
“These are important statements, particularly in places where it is more difficult for institutions, as opposed to individuals, to exercise the freedom to refuse euthanasia within their premises,” he told Crux.
Wee also pointed out that the CDF document also warns against the “other extreme” of end-of-life medical decisions: “Not accepting the limits of medicine, and aggressively trying to avoid death, which may result in robbing someone of a serene remainder of their life as it comes to a close.”
“Yes, life always has intrinsic value, and it should not be discarded via euthanasia or wrongful withdrawals of treatment. But that doesn’t mean life must be preserved at all costs, and prolonging life with overzealous treatment actively harms the person and offends their dignity,” he told Crux.
“The document goes so far as to criticize the way aggressive treatments might deprive ‘death of its true dignity’, and this perspective is certainly worth reflecting on, After all, wherein does the dignity of death lie?” Wee continued.
“It is not just about being comfortable but, above all, about meeting God the Savior after one’s earthly life. Seen in this light, aggressive treatment may in fact hinder one from preparing spiritually for this encounter. That is why palliative care, as the document makes clear, should include spiritual assistance to patients. To give someone the resources of prayer and the sacraments when close to death is a supreme act of charity,” he said.
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