Wednesday, May 11, 2016

Let's Talk About Euthanasia

Well, judging from the 'Most Popular Posts' thingy on the right margin of the blog, my new series on 'Gnarly Questions' has immediately proven to be a hit, at least by the standards of this small blog. So let's carry on with it, and talk about one of the gnarliest of the gnarly questions of our day, euthanasia.

So what I have to say today builds on last week's blog post on the morality of suicide. If suicide itself is not understood to be a grave moral wrong, of course none of the Church's specific teaching on euthanasia makes any sense. If it is morally right to kill ourselves in other circumstances, there is no possible reason why it would be morally wrong to ask a doctor to give us a lethal injection.

I cannot possibly give the full and very nuanced Church teaching on this matter in one blog post. The Church's Declaration on Euthanasia from 1980 is still the authoritative teaching on the matter.

Essentially, we must take no direct action to end a person's life due to their being in a condition of terminal illness or chronic suffering. If the person asks us to do so and we comply, we are formally cooperating in the sin of suicide; if they have not asked us to do it and we do it nonetheless, we have committed the sin of murder.

There are nuances in this teaching that are important and have direct application to the real on-the-ground situations any one of us can come across in our lives. The Church does not hold to the ethic of vitalism, that is, the idea that life is to be preserved and prolonged for as long as possible, no matter what the cost to the person.

This makes no sense in the context of our larger vision of human life, in which this world and state of being is not our final goal. We must not take any step that would directly kill ourselves or another, but we are under no obligation to fight death to the last possible moment.

And so it is not euthanasia, not remotely, to decide to suspend medical treatments in certain circumstances. The Church currently uses the language of benefit vs. burden as a useful metric in making these decisions. If a treatment being proposed will yield little benefit for a person but is highly burdensome, then it is a perfectly moral decision for the person, or whoever they have delegated to make such decisions for them if they are incapacitated, to refuse that treatment. I am loathe to start going into specific examples, as this is an area where each situation has to be evaluated on its own merits and there are very few blanket statements that can be made.

It is also not euthanasia in any way, shape, or form, to give a person adequate pain medication to reduce their suffering. This is the case even when the dose of pain medication being given will indeed shorten the person's life by, say, compromising their respiratory system. The intent is what counts in these things--what is intended is to manage the person's pain, not to end their life. The proof of that intent would be that if there was some other way to manage the pain without the life-shortening effect, that method would be taken.

It is not euthanasia to remove artificial respiration when it has become clear that the person is not going to recover from, say, a massive aneurysm or other catastrophic event that has prevented them from even breathing on their own. That is allowing someone to die when that is what in fact they are doing; it is not deliberately causing their death by a positive action.

It is not euthanasia, even, in certain and very specific terminal conditions, to cease giving a person food and water. There is a point in the dying process when the body itself becomes unable to metabolize food and even, at the very end, hydration. At that point to force nutrition into a person is not actually 'feeding' them (since their body cannot absorb the nutrients), and in fact increases their suffering. On the other hand, to withdraw food and water in other circumstances is most definitely euthanasia, since the person has not yet entered that terminal phase of their illness, and their body does indeed want and can absorb food and water.

I go into all these things because it is confusing, otherwise. And in that confusion, the actual euthanasia--actually giving the person a lethal injection intended to kill them--can look like some of these other things. But it is radically different, and we must keep it clear. Choosing to let death happen when a person is actually dying is an entirely different thing than killing the person directly. One is a moral and humane thing to do; the other is a grave evil to be rejected.

Any questions? Fire away in the comments or on my Facebook page, and I will do my best to answer them.


  1. If you're talking about advance directives, they seem to be pretty popular. I have one. They certainly can lead to life ending action on the part of medical professionals. I have no desire to linger on, utilizing medical life support measures, no matter my cognitive state. You certainly can if you want. Break a leg. lol.

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  3. Fr Denis, I cannot tell you what your post has meant to me. I was recently faced with having to make a decision regarding my husband's end of life. I have since suffered wondering if in fact I and the medical staff at the hospital actively killed him. I now know that we did not, that we in fact allowed God's will to be done in letting my husband go. Thank you, Fr Denis, for being an instrument of peace for me. God bless you and what you do.

    1. And I cannot tell you what your comment means to me. It makes all my blogging worth while to know that I have helped bring peace to you in this matter. God bless you and console you in your time of grief.

  4. "Illness, suffering, and death are a part of life.There comes a point when we must accept their hold on us and our own inevitable decline.We believe that the Easter mystery proclaims victory over death.We believe that in our vulnerability we encounter Christ. Illness can be a time of grace. Faith lets us glimpse meaning in our decline. Faith tells us that God is present in the midst of illness, suffering, and death. There is no place where God will not go to be with us."
    This is from a document that the Daughters of Charity wrote about making end of life decisions.
    It is no easy thing to stand by one you love in their grave illness. Sometimes it feels as if the depth of love might cloud rather than inform decision making. Sometimes it feels as if -especially in the great advances of medical science- we have some ability to change the course of true death - which we do not.
    But God is present in all of it....and your words are steeped in oils of Catholic compassion.
    How we need such light and clarity...Bless you.

    1. Thanks, Catherine - it means a lot, coming from you, given your professional experience in these matters. Yes, compassion is everything in this matter, compassion and truth.


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