Euthanasia and the Sanctity of Life Ethic
25th Sunday in Ordinary Time (Cycle B)

Doug McManaman
Reproduced with Permission

If we pay careful attention to the readings today, we should get a glimpse at just how far we as a culture have drifted from the gospel's fundamental attitude towards the sacredness of human life. Every few years there seems to be an attempt to introduce a private members bill that would allow doctors, who are pledged to heal human life, to intentionally destroy human life. The latest attempt is Bill C-43, which was introduced by MP Francine Lalonde. This Bill, if passed, would ensure that doctors will not face criminal prosecution if they help a person die who is at least 18 years old and who, after being given treatment, or refusing it, continues to "experience severe physical or mental pain without any prospect of relief."

The language used in support of this Bill is worded so as to appear humane, using words like "compassion" or phrases like "medical assistance in dying". This latter is an interesting expression, because the Latin medicor means 'to heal'. To make someone die is hardly a form of medical assistance. It is essentially anti-medical.

There are so many linguistic traps like these that surround the issue, and so what I thought I'd preach on today are 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.

The first thing we need to keep in mind is that over the past 40 years, there has been a subtle change in the way we as a culture regard human life. There are two attitudes or postures that one can take towards human life. The first is the Sanctity of Life Mentality, which at one time dominated the medical profession, and 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, 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 individually, 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 higher 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 usefulness, their productivity, their ability to be of some use to society. They are not valued for their own sake, but for the sake of what they can do for society as a whole.

The Christian world has always rejected this. Every individual person has been created by God, and God created 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. He entrusts human beings to parents, but they belong to God.

Of course God calls us all to serve others, but each person here has been given life for your own sake. And Christ is mysteriously united to every individual person here, because you have been created by God and that same God joined a human nature, like yours, and with that nature he redeemed all of us.

Christ sacrifices himself so that we might have life. But those who belong to the culture of death have the reverse attitude: They believe in sacrificing 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, and of course 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 as well as in the Netherlands.

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, especially 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 someone who asked me to shoot him, that he willed it does not change the fact that I carried out an act with the intent to bring an end to his life. That is murderous.

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.

There are two types of Euthanasia: Active and Passive. Active euthanasia is death by commission. The person is given a lethal injection, for example, or the doctor mixes up a cocktail that the patient drinks, which will kill him.

Passive euthanasia is death by omission. A person dies because a certain medical treatment is omitted or withdrawn.

Active euthanasia 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 be very careful. At this point we need to distinguish between two types of treatment: extraordinary treatment and ordinary treatment.

Extraordinary treatment is any medical treatment that is a serious burden on the patient, physically, psychologically, emotionally, or even financially.

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 lives. But one is not obligated to use extraordinary treatment to preserve human life. Some examples at this point might help.

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 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 you that you have six months to live, but that with a treatment which carries seriously painful side effects, or psychologically repugnant side effects that are serious, you can extend your life for an extra two years or so. A person does not necessarily have an obligation to consent to it. If the treatment is a serious financial burden on you, for example, you do not necessarily have a duty to consent to it.

Again, what the person intends in refusing treatment 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 a burdensome 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 burdensome, but because they couldn't stand to see their daughter in that condition. The tube was removed so that she would die. Her death was intended. This is murder.

We need to 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 chemo therapy, might constitute extraordinary treatment for a 77 year old man whose body may not be able to recover as well as the 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 who has already been resuscitated once before might find the physical side effects of CPR far too burdensome. Her decision in favour of a DNR order is not necessarily suicidal; rather she is accepting her death. She does not intend it, she intends or wills to be delivered from a treatment that she finds seriously burdensome physically. So, she says: "if I am having a heart attack, it's my time to go, so let me go."

That's 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 expression "serious burden". If we look closely at what exactly is the serious burden, however, we see that it is not the medical treatment, but the condition of the patient. It is never justified to intentionally destroy human life in order to relieve one of a burdensome existence. That 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. We may use pain management that may, as an undesirable side effect, shorten a person's life. In this case, we accept that side effect. But we must not eliminate the pain by intentionally eliminating the patient.