In medical ethics, a genuine right to die is a right to be allowed to die when one is dying. Those who are dying should be given all necessary comfort and not have their dying unnecessarily prolonged or impeded. This is the role of palliative care. This is not euthanasia. Euthanasia is not a right to die a natural death, but a ‘right’ to be killed.[1]

We all know it is wrong, always wrong, to kill innocent human beings. This is because all human beings have an inherent and equal ‘worth’ or ‘value’, regardless of their physical, emotional or psychological condition.

Society has a responsibility in justice to protect all innocent lives, especially those of the most vulnerable. The legal system simply cannot accommodate the killing of innocent human beings because it would require a judgement that a life is no longer worth living – that the person’s life is no longer of any value[2] – and it would make us complicit in the killing.

This should come as no surprise because every civil liberty or human right is an extension of the primary right to life. It is contradictory to claim as a civil liberty an act that would not protect, but rather undermine the right to life.

But what about suffering? Unfortunately, we cannot entirely eliminate suffering from our lives, although there is a great deal we can and should do to lessen it.

What about loss of dignity? It is not the helpless who have lost their dignity, it is we who have lost sight of it.

What about personal autonomy? This derives from, and reflects, our intrinsic value as human beings. Personal autonomy cannot support the killing of the person it is designed to serve.

Note on End of Life Care

One of the most difficult areas of end of life care is when to cease medical treatment while continuing to provide basic health care such as nutrition, hydration, cleanliness, warmth, the prevention of complications related to confinement to bed, etc.,[3] and palliative care providing relief from the symptoms, pain, physical and mental stress of a terminal illness.

The moral and legal principle is that medical treatment can be refused if it (i.e. the treatment) would be burdensome or futile (referred to as ‘extraordinary’ or ‘disproportionate’ treatments). In making this judgment the patient can take into account their physical, psychological and other resources (e.g. those with terminal illness or who are very frail indicating not to resuscitate in the event of a cardiac or respiratory arrest).[4]

Morally, if not legally, the administration of food and water is a natural means of preserving life, and is not medical treatment, even if it is given via tube.[5]

Nonetheless, when the body itself can no longer assimilate the food and water (futile), or if tube feeding is problematic (burdensome), it should be refused.

Medical treatments that generally provide reasonable benefits without any undue burden (referred to as ‘ordinary’ or ‘proportionate’ treatments), such as antibiotics, flu vaccinations, oxygen, clearing a blocked airway after a person has choked on food, stopping bleeding from cuts, placing limbs in casts if fractured, etc. should continue.[6]

There is flexibility to address the complexities of real-life medical circumstances but, disturbingly, as a result of a lack of legal and ethical clarity, there are instances of euthanasia through the withholding of ordinary medical treatment, or by sedation and demand feeding, including for newborns with abnormalities or who have survived attempted abortions (infanticide).[7]

Note on Fear

Ilora Finlay, Professor of Palliative Medicine, says that when “we are unfamiliar with something, we fear it; and what we fear we seek to control”. Death is something we all fear, and the argument for control over the timing of death is prominent in the ‘assisted dying’ campaign. Good palliative care reduces fear around the process and timing of natural death.[8]

Sources

[1] “The Lethal Corruption of Euthanasia” by David van Gend, Quadrant July-August 2019, https://quadrant.org.au/magazine/2019/07/the-lethal-corruption-of-euthanasia/

[2],[6] Catholic Bioethics and the Gift of Human Life by William E. May, Our Sunday Visitor Publishing Division, Huntington, IN, 2000, p.258, 256

[3],[5] Address of John Paul II to the Participants in The International Congress On “Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas”, 20 March 2004, para 4, http://w2.vatican.va/content/john-paul-ii/en/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc.html ; Letter “Samaritanus bonus” of the Congregation for the Doctrine of the Faith on the care of persons in the critical and terminal phases of life, 22 September 2020, https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2020/09/22/200922a.html

[4],[7] About Bioethics – Volume 2: Caring for People who are Sick or Dying by Nicholas Tonti-Filippini, Connor Court Publishing, Ballan, VIC, 2012, p. 78, 109-110

[8] “International expert emphasizes palliative care” by Warwick D’Silva, News Weekly 25 August 2018, http://www.newsweekly.com.au/article.php?id=58216

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Policy Statement – Euthanasia is provided under the Creative Commons Attribution 4.0 International (CC BY 4.0) license.