Lord, teach us to pray:
(To be read by the Leader)
“God created humanity in His image and likeness, in His divine image He created him; male and female He created them….God looked at everything He had made, and He found it very good, (Gen. 1, 27, 31)”
Brothers, we have discussed the tangled web of Euthanasia and assisted Suicide these past months and I am not sure if anyone ever feels totally at peace with their understanding of these controversial, painful and morally wrong perspectives on God’s gift of life. So I have summarized what I believe are key points about the practical realities of addressing the very real possibilities of having to address these matters when we find ourselves with a family member or loved one who is at the end stages of their lives.
1. In “Guidelines for the Celebration of the Sacraments with Persons & Families Considering or Opting for Death by Assisted Suicide or
Euthanasia” promulgated by the Catholic Bishops of Alberta and the Northwest Territories on Sept 14, 2016, the following introduction is offered. “Death by assisted suicide and euthanasia has been made legal in Canada. These grievous affronts to the dignity of human life from beginning to natural end are never morally justified. The legal permission now granted to these practices does not change the moral law.” The teaching of the Catholic Church on these matters is clear. “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons. It is morally unacceptable” (CCC 2277).
2. What is Euthanasia? “Euthanasia is the deliberate killing of someone, with or without that person’s consent, in order to eliminate all suffering. The individual who commits euthanasia must, therefore intend to kill the person and must cause the death for example, by lethal injection.”
For clarity: It is not euthanasia when we respect a loved one’s refusal of a particular treatment or their request to discontinue a particular treatment. It is not euthanasia when we allow a loved one to “die naturally by withdrawing or withholding medical treatment when its burdens outweigh its benefits.”
3. It is not euthanasia “when the administration of drugs appropriate for the relief of pain and suffering, even if some anticipate that the unintended effect might be the shortening of life.” It is a medical reality that in some cases the amount of a particular pain killer may have a detrimental effect on the life of the individual receiving the drug. The term used here is “comfort care.” This is the case when recovery does not appear to be possible and so the goal becomes to make sure the individual is as comfortable as possible during their remaining time here in the world. The medical profession has made great advances in palliative and comfort care within the areas of pain management.
4. What is Assisted Suicide? “In cases of assisted suicide, a ‘third person’ (a legal term meaning a disinterested party) provides the means for the person to kill him or herself, (e.g. information, lethal substances [pills], or a weapon.” In short, assisted suicide occurs when for instance a medical professional (knowingly) is involved in administering the lethal concoction of drugs that would terminate a person’s life. Assisted suicide occurs when the individual whose life is at stake collaborates with another, (medical person or otherwise) in bringing their life to an end. Euthanasia can be understood as the same person whose life is at stake being brought to death without their own collaboration. In other words, someone else has made the decision for them. Please remember, respecting your loved one’s refusal of a treatment or request for withdrawal of treatment, (assuming sound mind of the individual) is not euthanasia nor is it assisted suicide. Also, recognizing that administration of some drugs in the appropriate amount to manage pain well may have the unintended effect of shortening one’s life. This is neither euthanasia nor assisted suicide.
5. As Catholics, our guiding principles are the intrinsic value and sanctity of human life.
6. To deny our brothers and sisters this opportunity, (which belongs to them and them alone) would be perpetuating a grave injustice. We cannot take our sister and brothers right to life from them. It is not ours to take.
7. “Although a legal distinction is made between euthanasia and assisted suicide, there is no ethical difference. The moral responsibility remains the same whether a third party provides the pills or gives an injection.” As Catholics, we believe that life itself is a gift of God’s love for us. We do not have absolute dominion over this profound gift. We are the stewards of this gift of life, not the owners. The conclusion is pretty straightforward. “Consequently, the time and circumstances of our birth and death are not ours to choose.” Nor are they anyone else’s for that matter.
8. “I confirm that euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person. The act of euthanasia appears all the more perverse if it is carried out by those, like relatives, who are supposed to treat a family member with patience and love, or by those such as doctors, who by virtue of their specific profession are supposed to care for the sick person even in the most painful terminal stages…The choice of euthanasia becomes more serious when it takes the form of a murder committed by others on a person who has in no way requested it and who has never consented to it. The height of arbitrariness and injustice is reached when certain people, such as physicians or legislators, arrogate to themselves the power to decide who ought to live and who out to die, (St. John Paul II, Evangelium Vitae, # 65-66), March 1995.”
9. So the question that arises out of this medical, ethical, moral quagmire. 1. What are our obligations to the dying person? What are we to do? How can we know what is appropriate and proper. This is perhaps one of our biggest concerns. Am I doing the right thing and am I doing enough or too much for my loved one? In “Life Matters” our point of reference published by the Catholic Organization for Life and Family, (COLF) we are offered the following guidelines for walking with our loved ones who are preparing to meet the Lord. “Persons who are dying should be provided with care, compassion and comfort, including:
• Appropriate medical care capable of providing comfort;
• Pain and symptom management;
• Social, emotional, spiritual and religious support;
• Full information about their condition;
• The opportunity to freely discuss their desires with health care personnel
• Full disclosure to any family member or any person authorized by the dying person to receive information; and
• A degree of privacy that ensures death with dignity and peace.”
We only want the best for our loved ones. Brothers, these are good moral and ethical guidelines to assist us in walking with our loved ones through the inevitable and necessary doors of death to the eternal life made possible for us through the death and resurrection of our Lord.
10. Yes, we do have a moral and ethical obligation to ensure that a dying person is ensured good quality end of life care, with appropriate medical, social, emotional, spiritual and religious support that will ensure a death with dignity and peace. The principal to be used when exploring treatment options from a Catholic perspective is this. “We are to seek measures that offer a reasonable hope of benefit and that can be obtained and used without excessive pain, excessive expense or other serious inconvenience.”
There must be a reasonable hope of benefit for a treatment to be considered. “Persons receiving care are not obliged to seek treatment when it is of no benefit, or when the burdens resulting from treatment are clearly disproportionate to the benefits hoped for or obtained. Similarly, there is no obligation to provide or to continue providing a treatment whose burdens are disproportionate to the
expected or obtained benefits. This would amount to overtreatment-an unacceptable option.” So, common sense needs to be part of the equation. In other words brothers, treatment at all costs and all situations is not the answer. The hoped for outcome of the treatment has to make sense for the afflicted individual and for those providing the treatment. In some cases it makes much more sense to acknowledge that our loved ones are going to die and to make them as comfortable as possible during their final days or weeks.
11. “Is there a real difference between euthanasia and the withdrawing or withholding of burdensome treatment?” Yes, absolutely. When extraordinary or excessive treatment is withdrawn, the intent is to allow our loved ones to die peacefully and naturally. Euthanasia is expressly for the purpose of causing death. Our loved one does not die naturally but before their time. There is a great difference between allowing someone to die and killing them. Our intentions (our intent) are a key element when it comes to distinguishing between end of life decisions and euthanasia. “Distinctions based on intent are important, and in fact form the basis of our criminal law. While factually the distinction may, at times, be difficult to draw, legally it is clear.” (Justice Sopinka ruling on the Sue Rodrigues case in 1993). If our intent is based on love and guided by God’s natural law, we will not go wrong. God gave us our lives out of His love for us. He will decide when our lives will end in order for us to be with Him forever in the heavenly kingdom.
12. Some people choose to indicate in advance what treatment they do or do not want should the situation arise where they become unable to be their own advocates at a particular moment in time. “This can be done through an instructional directive (often called a
living will) or a proxy directive (often called a durable power of attorney of mandate).” A ‘living will’ indicates in advance what level and even what type of treatment a person may desire should they become incapacitated by illness or injury. Some experts feel that ‘living wills’ can be a risky business because it is very difficult to anticipate all possible situations that one might encounter. They are also challenging because they are open to the misinterpretation of the health professionals who are treating us. Though their intention is good, they do not know the particular moral values of the individual they are treating.
13. “A proxy directive is a more reliable way to ensure that our end of life decisions are respected.” A proxy directive is a notarized or witnessed legal document where an individual family member or friend who knows us and our value system is entrusted with making
appropriate decisions on our behalf and in our best interests should we become ill, incapacitated, injured and unable to advocate for ourselves. Brothers, if in doubt, put a competent loved one in charge of our health and treatment options, but do it in writing with witnesses so that they have legal standing to make decisions on our behalf. These individuals we have entrusted with our treatment decisions are referred to as “health care proxies.”
14. “It is best to avoid making a blanket statement rejecting certain types of care in all circumstances-unless death is imminent or treatment futile-and to leave enough latitude for our agent or doctor to offer appropriate care for our condition.” We need to be clear in the language we are using and to ensure that our “health care proxy” know what we mean and what we want. We also need to make
sure key people in our lives know we have a written directive.
15. Some might say that euthanasia and assisted suicide are personal decisions that others have no right to intervene in. The reality is that either of these methods of killing always implicates a third party such as a physician, pharmacist, other medical professionals or even family members and friends. There is nothing victimless about euthanasia or assisted suicide.
16. “A liberalized euthanasia and assisted suicide law would obviously jeopardize the role of the medical profession, which is the safeguarding of life, and would seriously undermine the trust that must exist between patients and doctors.” Presently we place our
very livelihood and well-being in the hands of our family doctors and the medical profession. The legalization of killing either by euthanasia or assisted suicide would dramatically affect the relationship we have with the health profession because there would
always be the question in our mind about where they stood in regard to end of life issues and care. “The legal prohibition of killing is foundational to a society; it protects everyone equally and is essential to the basic trust necessary for people to live together in
17. So what does the Catholic Church say about the inevitable potential for and reality of the suffering and discomfort that can arise when an individual is very ill. “The Church does not consider suffering good in and of itself and we need to do everything in our power to eradicate or alleviate it.” There is no doubt that prolonged or severe suffering can have a very challenging effect on our human psyche and on our general outlook on life itself.
18. You may ask; what about the person whose pain cannot be controlled, or perhaps those whose pain could be alleviated but they cannot face or deal with the loss of their perceived dignity? “Experts in palliative care state that only a very small proportion of people suffer from intractable pain and even then there are means to keep them comfortable.” Regarding a perceived loss of dignity, our dignity does not come from what we do or our particular status in life. Dignity is afforded to all of humanity by virtue of their membership in the human race. The extension of this brother is that as we have been created in God’s image and likeness, this is what affords us the dignity of the human person.
19. So, what are some realistic alternatives to simply ending it all with assisted suicide and euthanasia? “The alternative is to provide people of all ages, particularly those who are seriously ill or disabled, including those in terminal phase, with the utmost personal attention.” We can accomplish this with quality palliative care offered in the home, care center or hospital setting. This high quality personal attention coupled with the best pain control and alleviation of suffering possible is what will allow an individual to “die with dignity.” Top quality health care, pain management; and as important as all these, your quiet presence, walking with them on their final journey in this temporal world. This type of care and attention keeps a person who is very ill from feeling abandoned and left to seek desperate measures to deal with their health challenges and loneliness at a very difficult time.
20. Brothers, death is a door that we will all enter through. How we pass through that door, how we accompany those who are at the end of their lives is a wonderful opportunity to witness as disciples of Jesus Christ who cared always for the poor and the marginalized. As His disciples you and I have been afforded a beautiful gift in being able to walk with the sick and the dying children of God. It is what they need from us and it will serve them well on their journey, it will strengthen and inspire us for our own journeys. (2622)
“God created humanity in His image and likeness, in His divine image He created him; Male and female He created them….God looked at everything He had made, and He found it very good, (Gen. 1, 27, 31)”
(The Leader now invites the members to spend a few moments in silent reflection, as the above text is not meant to be a ready-made answer but a starter for personal reflection on the theme.)
(The leader now invites the members to share with their Brother Knights any relevant thoughts that came to them during the meditation period.)
(Recited by all)
Let us pray:
“Almighty ever-living God, grant that we may always conform our will to yours and serve your majesty in sincerity of heart. Through our Lord Jesus Christ, your Son, who lives and reigns with You and the Holy Spirit, one God, forever and ever. Amen.”