Cherishing Life, the Bishops’ 2004 document on the moral and spiritual well-being of the human person in society, offers clear definitions of subjects concerned with the dignity of life from conception to natural death.
Human life is under threat in our contemporary society both at the beginning and at the end of life. This can be seen in shifting attitudes to suicide and euthanasia. Suicide is a deliberate act or omission by which a person aims to bring about his or her own death. Such self-destructive action contradicts the proper love of life. It is also a form of rejection or abandonment of family and society. It is hard to live if we feel that we are a burden to others, but suicide leaves those left behind with a far greater burden. To add to their grief, in many cases they feel that they have been unable to help and that they failed to provide sufficient reason for the loved one to go on living. Suicide is the ultimate inability to accept the gift of life.
Suicide should never be romanticised, promoted or encouraged. On the other hand, attempting suicide is typically the act of a desperate person and it should be greeted with compassion rather than with blame. It is for this reason that the Suicide Act 1961 decriminalised suicide. The aim of the new law was not to encourage suicide and assisting suicide remained a serious crime. Suicide was thought of as a terrible act, but the help that suicidal people needed was seen as more easily given if those who survived the attempt were not treated like criminals. Most of all, those who contemplate ending their lives need to be given a sense of hope in life.
The Church is increasingly aware of the pressures that bring people to attempt suicide and which reduce the moral culpability of their actions. Therefore, the Church publicly expresses hope for their eternal salvation. ‘We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.’ (Catechism of the Catholic Church, paragraph 2283)
In recent years voices have been heard in favour of legalising euthanasia and assisted suicide. Sometimes it is said that people have a right to ‘die with dignity’, by which is meant, a right to be killed on request. Euthanasia is worse than suicide, for it involves the intentional killing of someone else, albeit someone who may have asked to be killed. Those who take someone else’s life take to themselves the power of life and death and decide that another person’s life is without value. If someone is suicidal, pushing him or her over the brink is not helping, it is harming. This is obvious when young and healthy people attempt suicide. Since, however, elderly, sick and disabled people may succumb more easily to doubts about the worth or value of their continued existence, it is even more important to affirm the inherent dignity of their lives.
Respecting the dignity of people who are dying must involve respecting their lives, for without life there is no dignity. Furthermore, legalising euthanasia rep resents a grave danger for many vulnerable people. This was clearly recognised by the House of Lords Select Committee on Medical Ethics which reported in 1994. Having heard the arguments for legalisation at length, it unanimously concluded that legalising voluntary euthanasia would be wrong in principle and dangerous in practice, not least for the vulnerable. What is needed most of all is adequate support for those who need long term care and for the disabled. Greater knowledge of palliative medicine within the medical profession and an expansion of the work of the hospice movement are also essential, so that those who are near death can be confident of proper care and respect right up until the end.
There is a basic level of nursing care that is demanded by human solidarity. We all recognise that leaving a patient cold, unclean, in pain or without human contact for significant periods of time would fall below a decent standard of care. Within the health service, great efforts are made to maintain high standards in this area, despite the pressure of resources and limited staff. In general, providing food and fluids should also be considered basic care. However, when patients are in the final phase of dying they should not be troubled by intrusive treatment and efforts to place or replace a feeding tube may well be excessive or burdensome. What is not morally acceptable is to withdraw tube-feeding, or other life sustaining treatment, precisely in order to end a patient’s life. This would cross the line from reasonable withdrawal of inappropriate treatment into the realm of passive euthanasia.
As life is given by God, so we should be ready to meet God in death when the time comes. For Christians this is a time in which fear and sadness are mixed with hope and love. It is an occasion to surrender ourselves into the hands of God. It is wrong for us to anticipate God’s command and bring about our own deaths, but one may forgo excessively burdensome treatment. In 1980 the Congregation for the Doctrine of the Faith produced a clear statement concerning these questions: A Declaration on Euthanasia.
It is important to emphasise that the alleviation of pain is a worthy aim even when the treatment itself carries the risk of shortening life. In such cases there need be no intention of seeking death. It should also be noted that high doses of painkillers do not shorten life in all cases. If the dose is increased gradually over some time the patient will develop a level of tolerance. Nevertheless, in cases where it is foreseen that high doses of painkillers will shorten someone’s life, it may still be reasonable to use them to counter the pain. The Church’s Declaration on Euthanasia is clear: ‘In this case, of course, death is in no way intended or sought, even if the risk of it is reasonably taken; the intention is simply to relieve pain effectively.’ On the other hand, what is not acceptable is the deliberate use of painkillers as a means to euthanasia.