Euthanasia and the sanctity of life

by Deacon Doug McManaman

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Language that has been used in support of a Bill to legalize euthanasia has almost always been worded so as to appear most humane.  Words such as “compassion”, “autonomy”, “dignity”, and expressions like “medical assistance in dying” or “medically recommended course of treatment” often pad the arguments and, unfortunately, deceive the unwary.  Consider the expression: “medical assistance in dying”, or “medically recommended course of treatment”.  The word “medical” comes from the Latin medicor, which means “to heal”.  To make someone die, by lethal injection for example, is not medical at all, despite it being administered by a medical doctor, but is radically anti-medical.  There are many linguistic traps like these, which is why we should become familiar with some of the basic principles of Catholic Life Ethics to help us see through some of the arguments of those who belong to the culture of death.

First, we need to keep in mind that over the past 40 years, there has been a subtle change in the way we as a culture regard human life.  Within this period, we can discern two competing attitudes towards human life; the one is the Sanctity of Life mentality, which at one time dominated the medical profession, the other is the Quality of Life mentality, which seems to be more widespread today.

The Sanctity of Life mentality regards individual human life as holy, sacred, and of immeasurable value, regardless of the physical and/or mental quality of the person.  You can place a price on things, but not on human persons who are created by God and who are called by God, each one, to union with Him in the unimaginable joy of eternal life in heaven.

The Quality of Life mentality does not see individual human life as holy, sacred, of immeasurable value, but actually places a value on individual human life on the basis of its physical and/or mental quality, as we would place a price on a product.  We value computers and automobiles on the basis of their quality, whether they function well, whether they are useful and efficient.  The Quality of Life mentality places a higher value on a human life that is of greater physical and mental quality, and a lesser value on individual human life that is of lesser physical and mental quality.  And so a handicapped child would be of less value than a healthy child.  In this framework, human persons are valued for their productivity, their ability to be of some use to society as a whole, not for their own sake.

The Christian world has always rejected this.  Every individual person has been created by God, each one of us, for Himself, not for our parents, not for the State, but for eternal union with Himself, because He loves us individually, and He loves us as if there is only one of us.  God entrusts children to parents, but first and foremost, they belong to God.

Of course God calls each person to serve the common good of the civil community to the extent of his ability, but each person has been given life for his own sake.  And Christ is mysteriously united to every individual person, because that same God who created us joined a human nature and with it redeemed us all.  Christ sacrifices himself so that we might have life.  But those who belong to the culture of death have the reverse attitude; they believe it is acceptable to sacrifice individual human life in order to make their own temporary lives here more convenient.

This attitude of the culture of death spread rapidly after the legalization of abortion, and many social critics predicted that infanticide would soon follow–which is the deliberate starvation and neglect of handicapped children whose lives are deemed not worth living.  We saw this come to pass in the famous Baby Doe case back in April of 1982 in Bloomington, Indiana.  Infanticide has been happening ever since, here in Canada as well as elsewhere in Europe.

Critics also pointed out that the next target, after infants, will be the terminally ill and the elderly.  To help this along, we have seen a gradual redefining of the terms, in particular “murder”.  The western world has always understood murder to be the intentional killing of another human being.  That the murdered victim wanted to die was and is entirely irrelevant.  If I shoot a student who asked me to end his life, with his own gun, that he willed to die does not change the fact that I carried out an act with the intent to bring an end to his life.  That is murderous.  But what is happening today is that murder is being defined as killing someone against his/her will.

We of course do not accept this.  My will does not alter the value of my life.  Human life itself is sacred, intrinsically good, whether the person is sick, dying, terminally ill, whether he wants to live or not, whether he is mentally ill, depressed, or mentally handicapped, or quadriplegic.

Types of Euthanasia

There are two types of euthanasia, active and passive.  Active euthanasia is death by commission.  A person is given a lethal injection, for example, or the doctor mixes up a lethal cocktail for the patient to drink.  Passive euthanasia is death by omission.  A person dies because a certain medical treatment is omitted or withdrawn.

Active euthanasia is very simple from a moral point of view.  It is never justified, because it always amounts to murder.  It is the intentional destruction of human life, which is intrinsically good and of immeasurable value, regardless of the condition of the patient.  Passive euthanasia, however, can sometimes be justified, depending on the circumstances.  Here is where we have to tread carefully.  At this point we need to distinguish between two types of treatment: extraordinary and ordinary treatment.

Extraordinary treatment is any medical treatment that is a serious burden on the patient either physically, psychologically, emotionally, or even financially, etc.  Ordinary treatment is any medical treatment that is not a serious burden on the patient physically, or psychologically, or emotionally, or financially.

Traditional medical ethics and Catholic teaching have always taught that one is obligated to use ordinary treatment to preserve human life.  But one is not obligated to use extraordinary treatment to preserve human life.  If a treatment is a serious burden on the patient in one of the aforementioned ways and he refuses it because it is seriously burdensome, he is not thereby intending his own death.  He is accepting his death as a side effect of refusing a seriously burdensome treatment.  Suppose a doctor were to tell a person that he has six months to live, but that with a treatment that carries seriously painful or psychologically repugnant side effects, his life can be extended for an extra two years or so.  A person does not necessarily have an obligation to consent to it.  Again, what the person intends is not necessarily the ending of his own life, but the ending or impeding of a medical treatment that is seriously burdensome in some way.  Death is a side effect of removing such treatment, and death is accepted, not intended.

But some people omit ordinary treatment so that the patient will die.  We saw this in Missouri, with the Nancy Cruzan case.  The parents pushed to have the feeding tube removed, not because it was a serious burden, but because they couldn’t stand to see their daughter in a persistent vegetative state.   The tube was removed so that she would die.  Her death was intended, and this is murder.

We need to also be careful of what some call extraordinary treatment.  High tech medical equipment is not necessarily extraordinary treatment.  The definition of extraordinary is such that what is ordinary here in Canada might very well be extraordinary in the United States.  As circumstances change, so too might the status of a medical treatment.  What is ordinary treatment for a young 40-year-old, such as a form of chemotherapy, might constitute extraordinary treatment for a 77-year-old man whose body may not be able to recover as well as that of a younger man.

Performing CPR on a young teenager whose heart has stopped is usually ordinary treatment.  A young man can recover from the injuries to his rib cage resulting from CPR, but an 86-year-old grandmother in a Palliative Care Unit who has already been resuscitated once before might find the physical side effects of CPR far too burdensome.  Her decision in favour of a Do Not Resuscitate Order is not necessarily suicidal.  Rather, she is accepting her own death.  She intends to be delivered from a treatment that she finds seriously burdensome physically.  That, of course, is very different from removing all treatment because one does not wish to live with a disease, or one does not want a child who is disabled.

Those who promote euthanasia will often use the words “serious burden”.  If we look closely at what exactly is the serious burden, however, we see that it is not the medical treatment at all, but the condition of the patient.  It is never justified to intentionally bring an end to human life in order to relieve one of a burdensome existence.  To do so is to do evil to achieve good.  Our obligation is to love our patients, not for our sake, but for theirs, to care for them even when they cannot thank us or when they are not apparently aware of us.  Our duty is to make them as comfortable as possible, to reduce pain as much as possible, even if such pain management has, as an undesirable side effect, the shortening of a person’s life.  In this case, we accept that side effect.  But we must not eliminate the pain by intentionally eliminating the patient.

Individual human life is intrinsically good, holy, created by God and of immeasurable value, and it is to be revered absolutely.  Much of the darkness that covers this world is rooted in our refusal to love individual human life absolutely and for its own sake.  But life will be brighter for all of us when we begin to take concrete steps to reverse this trend.

Doug McManaman is a Deacon and a Religion and Philosophy teacher at Father Michael McGivney Catholic Academy in Markham, Ontario, Canada. He is currently the President of the Canadian Fellowship of Catholic Scholars

Copyright © 2009 Doug McManaman

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