Category Archives: End of Life

The Tyranny of the Hopeless

End of Life, Grace, Heaven, Last Things, Virtue, , , , , , ,

Around the year 251, the Roman Empire began to be ravaged by a plague.  Historians estimate that up to 5000 people died per day in Rome alone.  As Eusebius recounts, the pagans of Rome ran, quite literally, for their lives, shunning “any participation or fellowship with death; which yet, with all their precautions, it was not easy for them to escape” (Book VII, Ch. 22).  It was the Christians that stepped forward and were “unsparing in their exceeding love and brotherly kindness. They held fast to each other and visited the sick fearlessly, and ministered to them continually, serving them in Christ. And they died with them most joyfully, taking the affliction of others, and drawing the sickness from their neighbors to themselves and willingly receiving their pains. And many who cared for the sick and gave strength to others died themselves having transferred to themselves their death…Truly the best of our brethren departed from life in this manner, including some presbyters and deacons and those of the people who had the highest reputation; so that this form of death, through the great piety and strong faith it exhibited, seemed to lack nothing of martyrdom” (ibid).  Despite being viewed as the scourge of the Roman Empire, the Christians were the only ones who stepped forward when Rome was scourged.  This event was no historical accident but instead a blueprint for how Christians should respond in a time of plague.  Throughout history, we find similar responses.  Whether it was Justinian’s Plague of the late 6th Century plague in Rome that Pope St. Gregory expelled with some help from St. Michael and friends or the Black Death in which the mortality rate for priests was 47%, the Church has always viewed plagues as a time to let her light shine before men.

One might be quick to dismiss these historical precedents as irrelevant to our own times.  Society is structured such that plagues and their treatment are very different.  Christians are no longer needed to be de facto First Responders.  The State provides those.  Instead Christians should get out of the way and let the professionals do their job.  It is time to put said light under the bushel basket so that the contagion not spread.  But this would be a misreading of the events and a misunderstanding of what it means to be a Christian.

The Christian Response

Playing armchair epidemiologists, we might comment that the Christians probably made the problem worse.  That many of them died along with the sick would naturally support this fact.  And herein lies the problem.  A natural reading of these events reveal them to be failures, but a supernatural reading of them changes everything.  It is precisely in times of calamity that Christians need to become supernatural storytellers, not primarily by their words, but in their actions.

What made the Christians during those catastrophes exemplars was not that they ran to the front lines and tended to the wounded, but that they were beacons of hope.  They were beacons of true hope, not the optimism of only “two more weeks” but the hope that says “death is not the end”.  The light that they shone was Christian hope, a light that enabled everyone in society to realize that dying well is the meaning of life.  They tended to the spiritual wounds, they were really a Field Hospital and they remained open. 

They didn’t just talk about Christian hope, but they showed it by their actions.  The difference between true Christians and those who are not comes down to one thing—fear of death.  It is the fear of death that keeps people trapped within the clutches of the devil.  But it is Christ Who “freed those who through fear of death had been subject to slavery all their life” (Hebrews 2:15).  Each one of the cornerstones upon which the Church has been built did not fear death and each stone that is added to the edifice is free from the same fear.  The Apostles had seen their Teacher and Lord die, but then He was alive.  Freed from death, He promised them the same power.  That was the basis of their hope and it was the source of their freedom to live for the Glory of God and the salvation of souls even if it cost them their lives.

The Cost of Hope

Like the Apostles and Martyrs, sometimes witnessing to hope cost the Christians living in the times of plague their lives.  That too was necessary because it testifies to the fact that the world can offer no fountain of youth, no immortality.  Still its inhabitants remain locked in fear of death.  Only the Christian is truly free from the fear of death and it is this that sets them apart.  But it wasn’t that they “visited the sick fearlessly, and ministered to them continually,” but also that they “held fast to each other.” 

In short, hope was made manifest by the fact that they continued to meet with each other.  They showed no fear of death because spiritual death is far worse.  The danger of spiritual death is ever-present, plague or not.  They met because they needed to constantly feed the hope that was in them.  Only a hopeless lot would give up the Sacraments or treat that only as a life insurance policy. 

You might think they were naïve, but they were far wiser than we; they knew that if Christians were going to rebuild society after the plague, they would need to build up the spiritual strength now.  They knew they would only build as reservoirs of grace, filling up society with the overflow of divine life they received from the Church and her Sacraments.  With greater knowledge they may have taken more precautions, but they would have ultimately thrown caution to the wind because of the value of a single soul. 

Living as we now do under, what Bishop Schneider has dubbed, the “dictatorship of the sanitary” the Church needs to shine forth as a beacon of hope.  What this might look like once prudent precautions are taken isn’t entirely clear, but it has been made abundantly clear both by history and the present moment what it wouldn’t look like.  When the Church responds exactly the same way the world does to a crisis then something is wrong.  The tyranny of the hopeless shuts down everything, the liberality of hope opens wide the doors.  Christians must be witnesses to hope, especially in ages such as we are living.

Augustine and the Culture of Euthanasia

Bioethics, Culture of Life, End of Life, Human Dignity, , ,

Nearly sixteen centuries after its publication, St. Augustine’s City of God remains a seminal text in Christian political philosophy.  With the Fall of Rome as his backdrop, the Doctor of Grace contrasts the forces at work that seek to claim men’s souls.  History, from the Fall of the Angels to the Fall of Rome, has consisted of battle between the City of God and the City of Man.  From the vantage point of over a millennium and a half, one can see how, using the Augustine’s principles, Christendom emerged as the City of God dominated the City of Man.  But we seem to be living in a time where the transition is going in reverse and the weeds of secularism are choking out the wheat of Christendom so that Augustine’s text can serve as a blueprint of sorts for restoring the City of God and rebuilding a Christian society.

Without diving into all of the themes Augustine presents, the focus will be on his opening theme: suffering.  Why, in introducing the two cities, would Augustine choose to focus on suffering?  As he points out, the sack of Rome led to seemingly indiscriminate sufferings; both the good and the bad, the Christian and the Pagan suffered.  Suffering doesn’t seem to distinguish them at all.  But when we look not at the nature of the sufferings, but the response of the sufferer, we find great differences.  He says, “though the sufferings are the same, the sufferers remain different.  Virtue and vice are not the same even if they undergo the same treatment…What matters is the nature of the sufferer not the nature of the sufferings.”  So then suffering becomes like a great identification card enabling us to determine residency in either of the two cities.  

The Two Cities

Why this is so becomes apparent once we grasp that ultimately, the two cities are distinguished by their loves.  The “two cities were created by two kinds of love: the earthly city was created by self-love reaching the point if contempt for God, the Heavenly City by the love of God carried as far as contempt of self…The one city loves its own strength shown in its powerful leaders; the other says to its God ‘I will love You, my Lord, my strength.”  For Augustine suffering is brought about when men love the world more than God, the City of Man more than the City of God.  The good and bad suffer together because even the good (even if to a much lesser degree) love this world rather than despising it.

Both the Christians and non-Christians were equally affected but the sufferings of the Christians have “tended to their moral improvement because they are viewed through the eyes of faith.”   For the residents of the City of God suffering becomes an opportunity for growth in virtue and holiness.  “Viewed through the eyes of faith,” sufferings become necessary because they are the most expedient (i.e. most gentle and most merciful) way that God naturalizes us as residents in the heavenly city.  They may be free from criminal and godless wickedness they still see that they are not so far removed as to not to deserve to suffer temporal ills for them.

The residents of the City of Man see suffering as the greatest of all evils.  Rather than viewing them as opportunities, they see them as something to be avoided at all costs, even to the point of self-inflicted death.  From within this context Augustine visits the question of noble suicide within Roman culture.  Drawing from two historical examples at key turning points in Roman history, Augustine shows why suicide is always wrong.  His first case study is Lucretia.  After becoming a victim of rape she killed herself and Rome celebrated the nobility in doing so.  Augustine asks why should she, who was innocent, have suffered a worse punishment than the offender?  “One does not take vengeance on oneself for another’s crime.”  To suffer some injustice and then commit another injustice, even against oneself, is like killing the innocent.

His second example is Cato who killed himself as a political act, a steady refusal to live in a Rome led by Caesar.   As the prototypical Stoic, he thought happiness was only to be found in escaping the body and not something that was achieved in the soul through the body.

The City of God and the Culture of Euthanasia

But he does more than simply prove the immorality of suicide.  He also shows how one might argue against a suicide culture.  In this way he provides us with a blueprint for overcoming a Culture of Euthanasia.  In both of his case studies Augustine chose to focus on “cold-blooded” suicides.  Both Lucretia and Cato were deliberate suicides, not merely acts of impassioned despair.  Augustine thinks there is nothing noble about killing oneself and a culture that elevates it as such is a culture that bestows victimhood on its members.  He wants to empower men and women so that they can be truly noble in facing their sufferings, even the final ones, head-on.

Augustine’s argument and ours as well depends upon strong Christian witness.  If we are to overcome the Culture of Euthanasia we must preach that the only “sweet death” is one that opens wide the door to eternal life.  We cannot “accompany” someone who chooses to kill themselves because it is accompanying a lie that says that God does not use the death He has chosen for us as a means to bring about life.  Instead we should accompany them in their sufferings by encouraging them to dying with true nobility, the nobility of Christ.  Dying with dignity is dying as conformed to Christ.  We will never overcome the emerging Culture of Euthanasia until we suffer like true Christians and encourage others to do the same.  This was Augustine’s way and it needs to be ours too.   

God’s Choice?

Church, Church Authority, Divine Mercy, End of Life, Fasting, God's Will, History, Magisterium, Pope Francis, Prayer, Sin, Spiritual Warfare, , ,

As criticism continues to mount against Pope Francis amidst this time of ecclesiastical turmoil, a growing number of peacemakers have emerged, who, in an attempt to diffuse the situation, are quick to offer the reminder that “he was chosen by the Holy Spirit.”  One can certainly appreciate the attempt to maintain unity.  Especially because the Pope is the most visible sign of Catholic unity.  But this path to peace is a theological dead end.  The Pope is not “chosen by the Holy Spirit”, at least in the sense that the peacemaker means it.  Cardinal Ratzinger, the future Pope Benedict XVI was once asked whether the Holy Spirit is responsible for the election of a pope to which he replied:

I would not say so, in the sense that the Holy Spirit picks out the Pope. . . . I would say that the Spirit does not exactly take control of the affair, but rather like a good educator, as it were, leaves us much space, much freedom, without entirely abandoning us. Thus the Spirit’s role should be understood in a much more elastic sense, not that he dictates the candidate for whom one must vote. Probably the only assurance he offers is that the thing cannot be totally ruined…There are too many contrary instances of popes the Holy Spirit obviously would not have picked!

In his usual pedagogical succinctness, the Pope Emeritus gives us several important reminders, not only on the election of the Pope, but also on the nature of the Church, especially in times of crises such as we are currently facing.

The Holy Spirit and the Conclave

As Benedict is quick to point out, one need only study history to see that this hypothesis is highly questionable.  History is rife with scoundrels who came to occupy the Chair of Peter.  It is always a good idea to study Church history and remind ourselves of this, especially because most of us have lived under the reign of popes who became saints.  It is only with great intellectual dexterity that we could admit that the Holy Spirit “picked” both these saints and someone like, say, Pope Alexander VI.

One might object that, even if it is a highly informed one, Cardinal Ratzinger was just offering an opinion (“I would say so…”).  The tradition of the Church would suggest otherwise.  Lex orandi, lex credenda—as we worship, so we believe.  The Church, among her various liturgies, has a Mass for the Election of the Pope.   The Church Universal prays that the Conclave will be docile to the promptings of the Holy Spirit.  This implies that they can also operate under the promptings of mixture of other spirits as well.

Free will of the Cardinal electorate then is operative and “anyone” can be chosen.   Yet we are also treading on the horizon of free will and Divine Providence.   The man chosen to be Pope will be God’s choice, but only in the sense that the papal election, like all things, falls under God’s Providence.  We may be certain that the Holy Spirit directly wills the election of a given man as Supreme Pontiff, but through the mystery of Providence will allow another to take his place.

Our Lord told St. Peter that the gates of hell would not prevail against the Church.  What He meant by this was that no matter what, the Church would not fail.  The Barque of Peter may take on water, but it will never sink.  The Holy Spirit will allow the Church to take on water, but will always keep her afloat.  That is the extent of His protection.

This however is not the end of the story because of God’s Providence.  Regardless of whether it is a good Pope or bad, the Church will always get the Pope it needs.  Providence dictates that God will always provide the People of God with what they need.

Reading the Times

There may be a mutiny on the Barque of Peter and the Holy Spirit will pick a strong captain to lead a counter-mutiny, stopping the flow of the water.  Or, He may allow another man who joins the mutiny and ignores the water that continues to flow onto the boat.  Eventually all the compartments are flooded, washing the mutineers overboard.  The end result is the same, the corruption has been washed away and the Church was given exactly what she needed.

In a very real sense then the Pope is always God’s choice but only as an instrument.  As a type of the Church, Israel shows us this.  History continually moved in the direction towards the coming of the Messiah, the only question was whether the king and the people would cooperate.  Israel would flourish, grow fat, play the harlot, be chastised, and continue through the remnant.  This pattern is revealed so that we will come to recognize and expect it in the Church.  Either way history will continue to move towards the Second Coming.

In turbulent times this ought to serve as a great comfort.  The infestation of corruption in the Church is finally coming to a head and God is going to root it out.  He will use Pope Francis as his instrument.  The only question seems to be which type of captain Pope Francis will be.  Either way these scandals should not push us towards despair, but should instill hope into us.  God will not be mocked for sure, but neither will He ever abandon His people. He is always on the lookout for co-redeemers—those people who will pick up the Cross with Jesus and lay down their lives for the Church.  Only acts of reparation will repair the Church and each of us has an obligation to do this.  Every man must come on deck, stem the mutiny and start bailing water or risk being carried overboard.  “Penance, penance, penance!” the Angel of Portugal told us through the children of Fatima.  The time is at hand.  Our Lady of Fatima, pray for us!

A Right to Die

End of Life, Human Dignity, Suffering, , , ,

Ambiguity is the mother of all social ill.  The less clear we are in our social discourse, the easier it is to pull a fast one on society at large.  Many states across the country have fallen victim to this through the “Death with Dignity” movement.  “Right to die” legislation has been either been accepted or introduced into legislation in 28 states in our country.  With this issue being raised with such regularity, it is worth investigating the merit of a so-called “right to die.”

Before we can even approach the question of whether there is a “right to die”, we need to examine what a right is.  Despite all of the talk we hear about rights in our country, few can actually define what a right is.  It is the steady refusal to examine rights philosophically that leads to all the muddle-headed discussion surrounding rights.  A right is the moral power to possess, do, or exact something that is due to the person.  Within this definition we find that there are three components.  First, there is the person who owns the right.  Second, there is the person who has the duty to respect the right.  This can be either passive, as in a duty of non-interference, or active, as in the duty to satisfy the right, or both.  These two are bound together morally by the final component, the thing in question.

One of the great dangers that our culture’s obsession with rights poses is that there are always those who will use the language of rights to mask something far more nefarious than it appears to be.  Nowhere is this more obvious than in the “right to die” or “death with dignity” movement.  This is why having clarity about rights in general can protect many innocent people from suffering at the hands of those who are fighting for our “right to die.”  It will remove any doubt that there is such thing as a “right to die.”

Flatlines

First we can look at the holder of supposed right.  Is death something that is due to a person?  In the strictest sense, no, it is not something that is owed to someone.  Rights flow either directly or indirectly from human nature itself.  Ultimately any rights claim is based upon the assumption that the thing being claimed is a good.  As John Paul II said many times the right to life is the “fundamental right and source of all other rights” (EV, 72).  Even if you look to the foundations of modern liberalism rooted in the works of Hobbes and Locke, you will find that because all rights are given by nature, they assume that we all by nature have a self-interested attachment to our own lives.  In other words, the right to life is inalienable in that it flows from the fact that life is a good by nature.  This becomes clearer when we look at the person whose duty it is to respect the right.  If life is an “inalienable” right then this means that there is a corresponding duty to protect life.  Practically speaking, there is an obligation to protect another’s life when it is in jeopardy.

While this may appear to be quite cut and dry, reality is more complicated than that.  The question of a “right to die” arises not just because autonomy has run amok in the West.  Medical technology has made it so that we now have more control than ever over when and how we die.  Thanks to some medical interventions, patients can be kept alive long after nature would have taken its course.  From within this setting, we have to ask whether a person has a “right to be let to die.”

In essence the “right to be let to die” means that a person has the right to choose not to receive life-sustaining medical treatment.  In order not to interfere with the obligation of others to protect life, the treatment must be excessively burdensome in that its benefits are outweighed by its burdens.  Those responsible for taking care of the person still have the obligation to provide routine attention to the patient by bathing them, keeping them warm, controlling pain and providing food and water.

So while this means no one has the “right to die” per se, it is reasonable to assert that they do have a “right to be let to die.”  The problem at this point is that people who label themselves as “Death with Dignity” advocates have piggybacked onto this legitimate right and wedded it to something else, namely a “right to be made dead.”  By hiding behind a sweet sounding name, Euthanasia (which literally means “good death”), what is being claimed is a right to positive assistance in bringing about death.  This means that what appears on the surface to be a mere personal freedom is really about placing an obligation to kill on another person.  This obviously contradicts one’s obligation to protect life.  This self-contradictory aspect of the “right to be made dead” shows why it is not a true right.  It also helps to reveal what this is really about.

This movement has very little to do with medical technology or terminal illnesses.  What is really being sought is acknowledgment of a right to commit suicide.  Given the will, there are very few people who could stop someone that wanted to kill themselves, so why would we need legislation for a right to commit suicide?  The answer is all about money and power.  First, in the states where it is legal, insurance companies must pay out when someone commits suicide.  This means that previously what was a deterrent, namely the financial well-being of a family, is taken out of the equation.  In fact the family may end up better off financially when their loved one is dead.  One can easily see that there could be familial encouragement to end it all based on a monetary windfall.

Second, this is ultimately about some people having the power to determine who lives and who dies.  If we recognize a “right to be dead” then there is a corresponding “duty to make dead.”  Who is the one who must exercise this duty and when should it be exercised?  Already we can see how the person and the proxies could be compromised, but what if they are not coming around to what is obvious to doctors and other “experts”?  While no one likes slippery slope arguments, this is precisely what has happened in places where a “right to die” has been recognized like the Netherlands.  The emphasis is no longer on the right to die, but the obligation to take the life that has been deemed unworthy of life.

What makes this particularly evil is that it plays into people’s emotions.  No one wants to be a burden to their loved ones, especially when there seems to be a painless way to avoid that.  As usual though, it is not enough to have our hearts in the right place; we must get our heads their too.  Demanding clarity when it comes to rights, especially the “right to die,” is a good place to start the journey from our hearts to our heads.

Pulling the Plug

Bioethics, End of Life

After giving them the entire synopsis of the Gospel for the first eleven chapters of his letter to the Romans, St. Paul tells the Christians to be “transformed by the renewal of your mind” (Romans 12:2).  In essence he is telling them that the Gospel ought to penetrate into every single dimension of their lives.  This is the role of the Church as Teacher—to show us just how deeply the Gospel penetrates all areas of our lives and how we can act as “heirs of God and joint heirs with Christ” (Romans 8:17) in all things.  For converts coming into the Church, it is often the Catholic intellectual tradition that makes the Church herself attractive because it reveals truth as an integrative whole—incorporating not just divine Revelation, but philosophy, science and even psychology all leading us to the One Who is Truth itself.  There may be no single area where this integration is more obvious than in the Church’s teaching on end of life.

Modern medicine is plagued by the problem that there is no strictly scientific way in which to determine when someone has died.  St. John Paul II in an Address to the Eighteenth Meeting of the Transplantation Society in 2000 acknowledged this difficulty when he said:

“…the death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self. It results from the separation of the life-principle (or soul) from the corporal reality of the person. The death of the person, understood in this primary sense, is an event which no scientific technique or empirical method can identify directly.”

In defining death as the separation of the soul from the body, it is obvious that it cannot be determined empirically since the soul is non-material in nature.  Furthermore, as the Holy Father pointed out death is not a process but the definite termination of the life of the person.  What this means is that not all parts of the body die at the same time (fingernails and hair continue to grow for example).  Further complicating this is the fact that through ventilators and heart pumps the person can appear to be alive almost indefinitely.  In summary, it seems at best that medicine can only develop a set of criteria that makes the fact that death has occurred very likely.

Despite the fact that no empirical method can identify when death actually occurs, it is possible to apply Thomistic principles in order to create a criterion for death and leave it to modern medicine to determine what clinical signs may be used to obtain moral certainty that death has occurred.

LifeSupportSlider

To understand these principles, we must first look at the Catholic understanding of the human soul.  Technically speaking the soul is simply the animating principle of each living thing.  In other words, there is no such thing as a living being that does not have a soul.  There are three different types of souls that exist in a nested hierarchy of sorts.  First there is a vegetative soul that has the capacity for growth, assimilate nutrition and reproduction.  A sensitive soul has all the capacities of the vegetative soul plus has the capacity for locomotion and perception.  Finally the intellectual soul has all the capacities of the other two plus the capacity for rational thought.

It is also necessary to examine what we mean when say that “the soul is in the body.”  When a spiritual principle is “in” a material principle it really means that the spiritual principle is operating upon it.  But the human soul does not operate upon each part of the body directly.  When I will to raise my hand, it is not my will that operates directly on my arm, but instead it operates on a “primary organ” through which the soul “moves” or “operates” the body’s other parts.    Although St. Thomas thought this organ was the heart, modern biology tells us that this organ is the brain.  His philosophy was solid, he just lacked the necessary biological knowledge to be more precise.

With this understanding of the human soul and its action upon the human body serving as a foundation, we can now apply this to the practical question of when death occurs.  To say that the soul “has left” the body is to say that the soul is no longer acting upon the body.  Because the union of body and soul is a substantial one, this can only occur when it is no longer able to operate on the body because of a permanent defect in the primary organ (the brain).  This is the basis for the Church’s support of the “neurological criteria” for ascertaining death.

The problem of course is that medically speaking, “neurological criteria” for determining death means different things to different people, but the Church has a very specific understanding of this criteria.  Returning to St. John Paul II’s 200 address, he says, “…in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem).”  This is the so-called “whole brain death.”

To see why this must be so, we can return to St. Thomas’ teachings on the human soul.  The human soul operates in three different capacities—rational, sensitive, and vegetative.  Although we have a single soul, not all these capacities need to be exercised for the soul to be present (think of when we are asleep for example).  Even if the higher capacities can no longer be exercised because of brain damage, the soul is still present and operating in its vegetative capacity.  In other words, when the vegetative capacity can no longer be exercised, we can be morally certain that the soul has left the body and the person may be declared dead.

The person who still has vegetative powers is still in fact alive and loses none of their dignity as a person.  They may be in what is defined medically as a (Permanent) Vegetative State (PVS), but they are still a person and entitled to the care that we afford all people who are incapacitated in some way.  This care includes things such as bathing, warmth, turning them to avoid bedsores, pain relief and most importantly providing food and water.

These basic elements of care are distinct from medical treatments (which are interventions made to return someone to health or cure disease) and are never optional.  There is a tendency within some medical communities to treat those in PVS as if they are already dead and only the body is left.  This leads to the practice of removing nutrition and hydration from them; a practice that was rejected by the CDF in their 2007 document Responses to Certain Questions of the USCCB Concerning Artificial Nutrition and Hydration.  In a very clear manner it was taught that

“The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented. A patient in a ‘permanent vegetative state’ is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.”

This is why the Church so vociferously opposed the ruling in the Terry Schiavo case.  While she was in a PVS and very unlikely to ever regain use of her higher faculties, she was not dying.  Instead her cause of death was dehydration and starvation.  Unfortunately there are cases every single day that do not garner the same national attention, that still require our attention.  All too often when confronted with what appears only to be a medical decision, families defer to unethical doctors.  “Pulling the plug” is always a moral decision and one that we can make well when we value and attempt to see the truth of the Church’s teachings.

Dying with Dignity?

End of Life, Human Dignity

Americans have always been a very practical people.  Proof of this can be seen by examining the number of how-to books that make their way onto the bestseller lists.  One how-to book that is particularly noteworthy, entitled Final Exit, climbed to the top of the New York in September of 1991.  Derek Humphry’s bestseller was unique in that it was a practical guide on “self-deliverance and assisted suicide for the dying.”  Given the book’s popularity, it is not surprising that the demand for assisted suicide has been on the rise in our country.  Physician Assisted Suicide is considered one of the most effective remedies for restraining death.  There are a number of arguments that have been brought forth to defend this practice.  The reasoning ranges over a number of fields including: legal, philosophical, medical, practical, and economic arguments.  With the possibility of the State of California joining Oregon and Washington as states where assisted suicide is legal, it is important that the Church come to the defense of truth.

To begin it is necessary to define what one means when they speak of assisted suicide.  Dr. Timothy Quill, one of the champions of the cause of assisted suicide defines it as “the act of making a means of suicide available to a patient who is otherwise physically incapable of suicide, and who subsequently acts on his or her own.”  Although Dr. Quill and many proponents of assisted suicide differentiate it from euthanasia, the Church for her part views both though the same lens.  Each is an act of the intentional killing of an innocent human person for reasons of mercy.

At the heart of each of the arguments is the notion of the principle of autonomy.  Simply put this principle says that if a person gives free and informed consent then they ought to be in control of their own life and manner of death.

The legal arguments are founded upon this principle of autonomy.  Current American jurisprudence seems to recognize assisted suicide as a liberty interest.  To date, the Supreme Court refused to recognize assisted suicide as a fundamental right.  However in Vacco v. Quill (1997) and Washington v. Glucksberg (1997), the Court ruled that because it was a liberty interest it ought to be left it up to the states to decide.  Currently there are three US states (Oregon, Washington and Montana) in which assisted suicide is legal.

These arguments clearly confuse freedom with license.  In man, his freedom is the most “exceptional sign of his being made in the image of God” (Gaudium et Spes, 17).  However, this freedom does not extend to control over life and death.  That is not freedom but license.  “We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of” (CCC2280).

Assisted-Suicide sign

Although the legal argument sits upon the philosophical principle of personal autonomy, there is another philosophical reason that is often put forth.  This viewpoint involves a functional definition of personhood in which a person has value only insofar as they can be useful to society.  This represents a reduced view of human dignity that is finds its basis in the writings of Thomas Hobbes, who defined dignity as “the public worth of a man, which is a value set on him by the commonwealth.”

The Church for her part places human dignity upon a threefold foundation with a permanent character that cannot be taken away.  Regardless of the extent to which a person suffers diminished spiritual and physical capacities, or even if he commits the most heinous sin, he still retains his human dignity.  This dignity is “manifested in all its radiance when the person’s origin and destiny are considered: created by God in his image and likeness as well as redeemed by the most precious blood of Christ, the person is called to be a ‘child in the Son’ and a living temple of the Spirit, destined for the eternal life of blessed communion with God” (Christifidelis Laici, 37).

In reflecting upon this threefold foundation we find an additional characteristic other than its permanence.  Human dignity is also something which is to be achieved and realized in “communion with God.”  This notion of dignity shows that even when ‘quality of life’ diminishes or perhaps hasn’t been ‘achieved,’ ­dignity can actually increase because of the response of the sick to their suffering.

The economic arguments are perhaps the most straightforward.  Supporters of assisted suicide argue that the economic resources that are spent treating a seriously ill person could be put to better use by the family or society as a whole.  This viewpoint is flawed in that it puts economic resources ahead of the life of a person.  We ought to recognize this and be willing to accept any economic burden that would accompany allowing a person to die in a manner that is commensurate with their inherent dignity.  Mercy consists not in aiding to kill a person, but in shouldering the burden of journeying to death with them.  This often includes not only an emotional burden, but an economic one as well.

The medical arguments usually involve an argument that appeals to the just principle of “treating like patients alike.”  If terminally ill patients with free and informed consent are able to refuse medical treatment that will prolong their deaths, then those who are suffering but are not dependent upon medical treatment to live, ought to be able to hasten death through assisted suicide.

This argument fails to distinguish between refusing an extraordinary measure and being allowed to die and acting with the direct intent of causing death in the patient.  The decision to refuse treatment may be based upon the excessive burden that the treatment places upon the person and not represent a direct choice to die.

From 1990 through 1998, Dr. Jack Kevorkian assisted in the deaths of over 130 people.  While he had in mind the goal of reliving the suffering of the afflicted, his motivation was of a more practical nature.  He argued that “if the patient opts for euthanasia…he or she can save anywhere from five to ten lives.  Now the death becomes definitely positive.”  His argument was that by donating their bodily organs, their death contributed to the good of society as a whole.  He is not alone in arguing for assisted suicide for “practical” reasons.

This is a misapplication of the principle of totality.  In its simplest form, the principle of totality holds that that under certain circumstances it is morally permissible to sacrifice the good of a part for the sake of the whole.  However there is an “essential difference between a physical organism and a moral organism.”  The organs of the body exist solely for the sake of the body while each human person does not exist for the sake of the whole of humanity.  Instead each human person has intrinsic worth and thus cannot be coercively sacrificed for the sake of the whole (Pope Pius XII, “Speech to Leaders and Members of the Italian Association of Cornea Donors and Italian Association for the Blind”).

We see then just how important the distinction between a physical organism and a moral organism is in determining the application of this principle.  A physical organism is one in which there is a unity on the level of essence.  Thus the relationship of part to whole exists if the part by its very nature has no finality outside the whole.  A moral organism however is a group of individuals that are bound together in some unity of action.  Each member of the group has a value that is intrinsically bound up with what (or more accurately who) they are rather than what they contribute to the community.  To kill another person for the sake of harvesting their organs is always morally wrong, regardless of the good that may come from it.

In conclusion, although many argue in favor of assisted suicide using legal, philosophical, medical, practical and economic reasoning, these arguments ultimately are flawed.  It is always contrary to the dignity of the person to directly intend their death by either an act of commission or omission.  Furthermore, we find that in allowing this to occur it only further promotes a culture of death, not just in the killing of the person, but in what it does to those who willingly participate.  As Archbishop Charles Chaput said, “in helping the terminally ill kill themselves we’re colluding not only in their dehumanization but our own.”