Tag Archives: assisted suicide

Assisted suicide – taking stock of where we are

As the push to legalize assisted suicide— euphemistically termed “medical aid in dying”— continues across the United States, it is helpful to step back periodically and reassess where we are. As of January 2019, seven jurisdictions have legalized assisted suicide: Hawaii (2018), the District of Columbia (2017), Colorado (2016), California (2015), Vermont (2013), Washington state (2008), and Oregon (1994). Montana (2009) has not legalized assisted suicide legislatively, but it is permitted through a state supreme court ruling in Baxter v. Montana.  

While much of the media focus is on jurisdictions that have legalized assisted suicide, it is important to recognize the many that have not. In 2018 alone, assisted suicide bills were proposed in Alaska, Arizona, Connecticut, Delaware, Indiana, Iowa, Maine, Massachusetts, Minnesota, Nebraska, New Hampshire, New York, Oklahoma, Rhode Island, Utah, and Wisconsin. None were signed into law. In fact, the Patient’s Rights Council reports that since 1994, more than 240 legislative proposals to legalize assisted suicide have been introduced, and subsequently turned down, in 38 states.

So where are the battlegrounds moving forward? The biggest prize is likely New Jersey. First introduced in 2012, the “Aid in Dying for the Terminally Ill Act” (A-1504) was twice passed by the state Assembly but never made it out of the Senate, likely because then-Republican Governor Chris Christie had vowed to veto it. Now with Democrat Phil Murphy in the governor’s office, assisted suicide supporters believe they can get the bill passed and signed into law. Interestingly, Governor Murphy has not indicated whether he would sign the measure if it comes to his desk, but Compassion and Choices has a $1 million digital advertising campaign aimed at passage. Action on the bill is expected in early 2019.

Another battleground state is New Mexico, where the “End of Life Options Act” (HB-90/SB-153) has been introduced in the state legislature. If the bill becomes law, assisted suicide will no longer be considered a crime under New Mexico state law; instead, it will become “medical treatment.” The bill will also allow practitioners (expanded to include physician assistants and nurse practitioners) to make determinations of “eligibility” for assisted suicide through tele-medicine, without ever seeing or examining the patient in person. Finally, the bill will change the time frame of terminal illness. Generally, the term refers to an incurable or irreversible illness for which death is expected within six months. The “new” definition changes this time frame and refers to an illness where death will result “within the foreseeable future.” Contrary to some media reports, the proposed bill does not allow non-residents to travel to New Mexico to commit suicide. 

Other states that are expected to take up assisted suicide legislation in 2019 include Nevada, Virginia, and Delaware. In Nevada, an assisted suicide bill (SB-261) passed the state Senate in 2017 but died in the Health and Human Services Committee of the state Assembly. Supporters have vowed to reintroduce it in the 2019 legislative term. In Virginia, the “Death with Dignity Act” (HB-2713) was introduced on January 14, 2019. This is the first time the state will consider an assisted suicide bill. In Delaware, assisted suicide bills were introduced in the 2015-16 and 2017-18 legislative sessions, but never advanced to full votes. The legislator who sponsored the two bills has stated he will reintroduce the measure in this legislative session. Opponents are particularly concerned with the new Delaware bill because it specifically links assisted suicide to “additional palliative care options” for terminally ill patients.

Vigilance, prayer, and engaged effort are needed.

JOZEF ZALOT, PH.D., is a staff ethicist with the National Catholic Bioethics Center in Philadelphia. He earned his Ph.D. at Marquette University, and has worked in Catholic higher education and health care.

When is it okay to withhold food and water?

Making decisions about assisted nutrition and hydration can be challenging. We are blessed with the gift of the Catholic Church’s clear moral teachings to guide us. While assisted suicide and euthanasia – seeking to eliminate the sufferer as a means of removing suffering – are always immoral, there are nonetheless times when there is no moral obligation for a patient to receive food and water. Here’s a quick primer on when and why.

John A. Di Camillo, Ph.D., Be.L

Food and water may be withheld when the facts of the situation prove ineffective or harmful, not when someone simply decides “it’s Grandma’s time to go.” There are several critical distinctions at play.

Most importantly, nutrition and hydration are distinct from medical treatment. This establishes a general obligation to provide food and water, even by medically assisted means, when the patient cannot take food orally. They are basic human care that every person deserves, regardless of health condition or life expectancy, and so the default action should always be to provide, with medical assistance if necessary. That said, there are three exceptions to this norm based on three additional distinctions.

First, food and water may at times be distinct from nutrition and hydration. That is, they sometimes fail to achieve their finality of nourishment and hydration. There is no duty to provide food and water by oral or by medically assisted means when the body cannot assimilate them.

Second, serious burdens associated with the effects of food and water on the body, or with the assisted means of delivering them, are morally distinct from the minor inconveniences typical of simple and safe administration. Food and water may therefore be withheld when there is moral certitude of serious harms, complications, or discomfort connected with their use, even if they are still able to nourish and hydrate.

Third, imminence of death based on a specific, identifiable cause is distinct from generally declining health or vague expectations about death. Food and water may be withheld if death is imminent, but imminent must not be confused with inevitable. For example, assisted nourishment and hydration may be withdrawn if death is expected within hours or a day due to an advancing cancer, but should not be stopped based solely on a doctor’s prognosis that the person will inevitably die “any day now.”

In sum, food and water must be provided when they actually nourish and hydrate, unless they entail a serious burden or death is imminent. It would be euthanasia to “let Dad die naturally” by withdrawing food and water when he is able to absorb them without significant harm or discomfort. It might be legitimate, however, to withdraw medically assisted nutrition and hydration if Mom is bloating from hydration her body cannot absorb, if Grandpa is experiencing serious issues with recurring infection at the surgical insertion site of a tube, or if Dad is in his final hours with a metastasized cancer.

There are various pitfalls to watch out for in applying these teachings. First, life itself, no matter the person’s health condition, can never be invoked as a “burden” to justify withholding food and water. Similarly, the fact that food and water will not enable a patient to recover from illness or regain lost function is not evidence for “futility.” Food and water can only be assessed as effective or ineffective with reference to their proper finality: nourishing and hydrating. Finally, death is inevitable for us all, but imminence is very narrowly defined and difficult to establish.

In today’s technological and bureaucratic health care context, families are bombarded with all sorts of pressures and confusion. So let us carefully reflect on these key distinctions in the Church’s moral tradition, which can equip us to defend human dignity and advance the culture of life in concrete decision-making.

JOHN A. DI CAMILLO, PH.D., BE.L., is a staff ethicist at The National Catholic Bioethics Center in Philadelphia. He earned his bioethics doctorate and licentiate degrees at the Pontifical Athenaeum Regina Apostolorum in Rome. He lives in Narvon, PA with his lovely wife Serena and their four children.

Ready, set, kill

Tom Crean has been fighting greed, corruption and the Culture of Death in Canada for decades.


Tom Crean

A member of Legatus’ Vancouver Chapter, Crean and other pro-life activists are sounding the alarm as Canada’s parliament, responding to a Supreme Court ruling last year, is poised to legalize euthanasia and assisted suicide.

“Are we actually going to empower the state to make it legal to kill people? To make it legal for our kids to kill us? This is the point my country has gotten to,” said Crean, whose family for three generations has owned Kearney Funeral Services in Vancouver.

Death care

From his perspective in the “death care profession,” Crean said he has seen Canadian society become desensitized to, even being in denial of, death. Many now consider death to be an inconvenience when it touches their lives — even when relatives become sick or infirm, he said.

The gravity of the situation facing Canada is part of the reason why Crean has a strong interest in media education and getting the word out to citizens and members of parliament as to why they should be concerned about the latest threat to life.

crean-1“The government’s worst nightmare is an intelligent citizen, just as a corporation’s worst nightmare is an intelligent consumer,” Crean said. “We the people need to understand that to provide a future for our kids, it’s going to be in total opposition to the powers that exist, not in cooperation with them.”

In February 2015, the Supreme Court of Canada issued a 9-0 decision to remove all restrictions on state-sanctioned suicide, ruling that the previous prohibition violated the country’s Charter of Rights and Freedoms, which makes up the first portion of Canada’s Constitution.

The high court ordered parliament to pass a new law by June 5 liberalizing assisted suicide and making an accommodation for euthanasia when someone is unable to self-administer the lethal dose or injection.

In February, a special parliamentary committee delivered a report with 21 recommendations to reform the law. The report included some troubling recommendations, such as permitting euthanasia for children and those with mental illness. The report also stated that all medical professionals have a legal obligation either to provide “medical assistance in dying” or to refer a patient to someone who will help end their lives.

On April 14, Prime Minister Justin Trudeau’s government unveiled Bill C-14, legislation that would amend the country’s criminal code to permit euthanasia and assisted suicide. While considered to be more moderate than the committee report, the bill would still create a regime that critics say will pave the way for wide-open euthanasia.

Alarm bells

“At a time when our priority should be fostering a culture of love and enhancing resources for those suffering and facing death, assisted suicide leads us down a dark path,” Cardinal Thomas Collins, the archbishop of Toronto, said in a statement. He encouraged all those troubled by the prospect of assisted suicide to contact their members of parliament.

“At first sight, it may seem an attractive option, a quick and merciful escape from the suffering that can be experienced in life, but fuller reflection reveals its grim implications — not only for the individual but for our society and especially for those who are most vulnerable.”

Jim Hughes

Jim Hughes

However, that message has not gotten through the vast majority of Canadian citizens, said Jim Hughes, president of Campaign Life Coalition, Canada’s oldest and largest pro-life organization.

“Everybody I talk to says, ‘This can’t be happening here,’ but the problem is that 99% of the people are still ignorant of what all this means,” said Hughes, an At-Large member of Legatus.

Hughes, considered by many to be the father of Canada’s pro-life movement, said fighting against the Culture of Death’s advances in Canada is as like repeatedly “getting kicked in the stomach,” adding that even Supreme Court justices appointed by conservative prime ministers have turned out to be activist judges.

In 1988, the Canada’s Supreme Court effectively removed all restrictions on abortion when it struck down a 1969 law that first liberalized Canadian abortion laws. The ruling made Canada one of a small number of countries without a law restricting abortion, treating it like any other medical procedure.

Hughes said Bill C-14 is “so loosely worded, it’s ridiculous.” He said the law would open the door for widespread euthanasia and has no conscience protections for Catholic and other religiously affiliated medical facilities and physicians.

“People in the United States need to be informed on these issues before it’s too late and they’re ramming it down your throats there,” Hughes said.

Cover for murder

Alex Schadenberg

Alex Schadenberg

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, which is based in London, Ontario, said the movement to legalize euthanasia in Canada has turned the concept of mercy upside down.

“It’s now considered merciful for me to kill you,” Schadenberg said. “Compassion is a lethal injection. That is a very dangerous concept.”

Schadenberg said Bill C-14 mirrors other countries’ assisted suicide regimes in that the law lacks adequate oversight. No government representatives or neutral third parties are required to monitor whether a patient has a “serious or incurable illness” that has brought them “enduring physical or psychological suffering.”

In fact, Schadenberg said, the law even permits anyone — not just a physician or nurse practitioner — to carry out the act.

“The bill provides a perfect cover for acts of murder,” Schadenberg said. “It shows you just how bad my country is going.”

Crean has seen that trend since the late 1970s when he started building an interfaith alliance to stop a large funeral home conglomerate from acquiring Vancouver’s only public cemetery. He helped organize dozens of different churches and ethnic groups that marched on city hall and declared that their heritage was not for sale.

“And the most astonishing thing happened,” Crean said. “We won.”

In 1978, at age 21, Crean took the helm of the family business, which his grandfather, Thomas James Kearney, started more than 100 years ago. Kearney Funeral Services has since been able to operate and thrive in Greater Vancouver where large conglomerates control much of the industry.

Crean said he is committed to fighting the Culture of Death in the trenches, adding that he’s involved in initiatives to build hospice and medical facilities — and to establish a cooperative community cemetery that he said will revolutionize the death care profession.

“The great thing about a journey of faith,” Crean said, “is that you don’t always have an idea of where you’re going.”

BRIAN FRAGA is a Legatus magazine staff writer.

Learn more: kearneyfs.com

Belgium’s deadly cough

Roger Kiska contends child euthanasia in Belgium is bad law and may be contagious . . .

Roger Kiska

Roger Kiska

When Europe coughs, America catches a cold. The legal, political and cultural landscape in the U.S. is fertile for the importation of bad legislation like a new law in Belgium that legalizes child euthanasia.

History has shown that once adopted, doctor-prescribed death escapes regulation — and the circumstances in which it is allowed grow rapidly and exponentially. In 1984, the Netherlands was the first nation to lift criminal penalties for assisted suicide. The Dutch model allowed for it only at the explicit request of the patient and to put an end to “unbearable suffering.” Despite guidelines laid down in the law and by the Royal Dutch Medical Association, abuse has been rampant.

A recent government-sponsored survey showed that more than 80% of cases went unreported — a breach of the medical guidelines — and were certified as deaths stemming from natural causes. Verifiable statistics also show the shocking reality that shortly after the decriminalization of assisted suicide in the Netherlands, the practice of involuntary euthanasia commenced. In 1990, at least 1,000 patients were given lethal injections without express consent, amounting to nearly 1% of all deaths caused that year in that country. An astonishing 0.4% of the deaths in the Netherlands as recently as 2005 were attributed to involuntary euthanasia.

The Dutch courts have also allowed for the killing of an estimated 15 to 20 newborns per year. “Dutch doctors have gone from euthanizing the terminally ill to the chronically ill, to people with serious disabilities, to the emotionally and mentally ill” (Wesley Smith, National Review, 2011). Belgium has followed this exact radical trajectory and, like the Netherlands, has moved on to minors.

Belgium legalized doctor-prescribed death in 2002. Abuse has now become epidemic, with statistics suggesting that the rate of involuntary euthanasia deaths in Belgium is three times higher than in the Netherlands. In the decade since Belgium legalized euthanasia, there has been a 500% increase in euthanasia deaths.

A recent study found that in one region of Belgium, 66 of 208 “euthanasia” deaths occurred in the absence of a request or consent. The reasons for the lack of consent included that the patient was unconscious or had dementia, or because the physicians felt that euthanasia was “clearly in the patient’s best interest” and discussing it with the patient would have been “harmful” for the patient.

Other jurisdictions which allow euthanasia have equally startling statistics. Switzerland released a report on assisted-suicide deaths for the first time in 2009; they revealed a shocking 700% rise in cases from 1998-2009. Moreover, these stats only relate to Swiss residents. Five facilities in Switzerland annually allow 550-600 people to kill themselves.

Despite the fact that intergovernmental bodies like the U.N. and the Council of Europe have sharply criticized the practice of euthanasia in Europe, it continues to grow at an epidemic rate.

In the U.S., assisted suicide is legal in Washington, Oregon, Montana, and Vermont. Time will tell if those states will follow the same pattern of abuse prevalent in Europe. One thing is certain: The same cultural paradigms are at play in both Europe and the U.S., redefining human dignity to take on a philosophically utilitarian meaning — that death goes hand-in-hand with personal autonomy and quality of life. This misguided approach is certainly nothing new and has become the public motto for the culture of death.

A 2006 Royal College of Physicians study shows the clear correlation between the desire for assisted suicide and depression. The study also reports that, with the proper medical and psychiatric treatment, more than 98% of these patients would withdraw their request for assisted suicide. Clearly, doctor-prescribed death is not about care, compassion or personal autonomy. It’s a practice that plagues the most vulnerable in society under the false idol of “choice” when, in reality, choice is often withheld.

The U.S. Supreme Court and many state supreme courts have looked to international jurisprudence for guidance. Worryingly, the instances of “rights” being created from the bench by courts citing foreign precedent has been on the rise since the Supreme Court struck down sodomy laws in Lawrence v. Texas — a case in which the high court cited European Court of Human Rights case law.

The expansion of doctor-prescribed death to children in Belgium is the loudest and most brutal cough to come out of Europe in some time. If America stands too close, its children risk catching something far more deadly than a cold.

ROGER KISKA is senior legal counsel at the Vienna, Austria, office of Alliance Defending Freedom, an alliance-building, non-profit legal organization that defends religious freedom, the sanctity of life, marriage and the family.

Death in Massachusetts

Ballot Question 2 presents Bay State voters with a life or death decision in November . . .

Dr. Kenneth Stevens has been fighting doctor-assisted suicide for more than 30 years. The Oregon oncologist regularly has patients request it. He has steadfastly refused.

Euthanasia first reared its ugly head in Stevens’ life in 1982 — 12 years before Oregon legalized doctor-assisted suicide — when he brought his terminally ill wife to her doctor. Her lymphoma had spread to her brain, spine and bones. There was nothing more curatively that could be done.

“As we were about to leave, the doctor said, subtly, that he could write a prescription for an extra large dose of pain medication,” Stevens recalls. “We said no, that we had sufficient pain medication. Then as we got into the car, my wife said, ‘He wanted me to kill myself.’

“It devastated her and devastated me that her trusted doctor would say such a thing. Though she had had a lot of suffering, that experience — that her doctor would feel that her life was no longer of any value — was the greatest suffering.”

Human dignity

Next month, Massachusetts voters will decide whether or not to legalize doctor-assisted suicide on Ballot Question 2. Stevens has joined a coalition fighting on the side of life in the Bay State. The coalition includes disability rights groups, physicians groups, and religious organizations. They want this Pandora’s Box nailed shut because they know its negative consequences.

While most people think assisted suicide would only be used for people with terminal conditions, this has not been the case in places where it’s legal — Oregon, Montana, Washington state, Holland, Belgium and Luxembourg.

Dr. Kenneth Stevens

“Assisted suicide is being sold as something for people near death,” Stevens said. “But that’s not what’s happening. They aren’t choosing this because of pain. They choose it because they don’t want to be dependent.”

The Death with Dignity Act (Oregon’s assisted suicide law) 2011 Annual Report shows that the top five reasons for requesting assisted suicide were “loss of autonomy” (88.7%), “less able to engage in activities” (90.1%), and “loss of dignity” (74.6%).

Amy Hasbruck, board chairman of the disability rights group Not Dead Yet, calls these “disability issues,” which shouldn’t require assisted suicide. She said it reflects the insulting notion that the disabled somehow lack dignity.

Another serious issue is treatment rationing for the elderly and the terminally ill.

“We fought hard against ObamaCare because it will cause rationing, which applies to people at the end of their life,” said Robin Loughman, chair of Massachusetts Alliance Against Doctor-Prescribed Suicide. “The last six months of life are the most expensive. When there are limited resources, a dying person is a sitting duck.”

In Oregon, health care companies regularly refuse to pay for treatment, while offering assisted-suicide coverage.

“Barbara Wagner was a 64-year-old grandmother four years ago,” Stevens explains. “She had lung cancer which went away, then came back. The Oregon Health Plan sent her a letter which said it wouldn’t cover Tarceva — a pill which would slow the cancer down — but it would cover palliative care, which included doctor-assisted suicide.”

Wagner immediately contacted the press, launching a public complaint that the state would pay for her to die, but not to live. Tarceva’s manufacturer finally decided to pay for her medication for a year.

Randy Strope, another Oregonian, was in the fight of his life with prostate cancer in 2008. Oregon Health Plan sent him a letter denying coverage for treatment, offering doctor-assisted suicide instead. Strope fought back publicly, forcing Oregon Health Plan to reverse its decision.

Ballot measure

The Massachusetts ballot on assisted suicide, like Oregon, would not require doctors to seek psychiatric evaluations for patients who request it. Ray Flynn, former Boston mayor and former U.S. ambassador to the Holy See, is concerned.

“When I was mayor, I used to do a lot of work with the homeless and depressed,” he explained. “I saw so many people despondent and in pain, and sometimes they took their own life. I look at them as precious citizens. We should be helping them get the proper care, not play into their depression. If this becomes our new policy, it’s a collapse of our value system.”

Question 2 also specifies that doctor-assisted suicide is only for those who have six months left to live. Yet most doctors will admit that a terminal diagnosis is never exact.

Deacon Steven Marcus

“I owned a hospice and a nursing home, which allowed people to die with dignity,” said Deacon Steven Marcus, a member of Legatus’ Western Massachusetts Chapter who has organized a grassroots campaign against assisted suicide.

“Many times people were given a diagnosis that they had six months to live, and they would live much, much longer — even years,” he said.

The disability-rights community is especially off ended by assisted-suicide legislation because they say it discriminates against the disabled and the elderly.

“If you look at the assisted suicide issue, it doesn’t seem bad at first,” said Hasbruck of Not Dead Yet. “But on second thought, if you look at the profit-driven health-care system — and the family pressure — then you see that the choice is not free. Supposedly it’s about people with terminal illnesses, but it includes those with chronic disabilities, too.”

When a person becomes disabled, she explained, they go through the five stages of grief.

“With assisted suicide, instead of letting them go through the stages, they tell them to give up,” said Hasbruck, herself disabled. “People are afraid of the physical nature of our humanity. They think they’d rather be dead than be like us. People think it’s undignified to be incontinent.”

One of the biggest arguments for assisted suicide is that no one should have to suffer pain. “They witness someone who dies without adequate pain relief,” she said, “but we know that doctors make mistakes. People need to push for better care.”

In fact, in countries and states that have assisted suicide, doctors who take part in it are often deficient in pain management as well as basic medical care. The lack of good pain management has been well-documented in Holland, a nation with only two hospices. According to the Remmelink Report, one-third of the 3,340 people euthanized in Holland in 1990 were killed without their permission. Hospice was not available at the time.

Also troubling: Massachusetts’ Question 2 has no safeguards for elder abuse. A provision allows an heir or potentially abusive caregiver to serve as a witness when a patient signs up for the lethal dose of drugs, yet no witnesses are required when the patient takes the prescription.

The diversity of groups opposed to Question 2 is telling: the Massachusetts Medical Society, the American Medical Association, Doctors Against Suicide, a network of hospices, nurses and doctors, and various disability rights groups. These groups have little funding compared to the right-to-die organizations, who have backers like George Soros.

“I didn’t go into medicine to kill people,” said Stevens. “And there’s no place for a doctor in causing death.”

Sabrina Arena Ferrisi is Legatus magazine’s senior staff writer.


Martha and Mary Ministries

When Oregon legalized doctor-assisted suicide in 1994, a group of Catholic nurses, clergy and concerned citizens in Portland, Ore., got together to formulate a response. In 2010, they founded a hospice called Martha and Mary Ministries.

“We had a sense that the world was changing and asked, ‘What can we do to convince the world that this isn’t needed?’” said Patricia Cary, executive director of Martha and Mary Ministries. A family who had raised 12 children in their house donated the building to the organization. The ministry transformed it into a home which cares for five residents at a time. Nurses and volunteers work with residents around the clock.

Elder care in people’s own homes can be a strain on family members’ time and resources. As a result, our culture tends to demean the elderly by sending the signal that they aren’t worth the effort, Cary said.

“What we want is for this home to be a symbol of how to take care of people at the end of their lives,” she said. “There is a sense of peace and brightness here. We want this place to be an example. We want to convince people that they are worthwhile.”

Martha and Mary volunteers cook, garden, and act as “compassionate companions” who spend time with the residents throughout the day. Three members of Legatus’ Portland Chapter are members of the Martha and Mary board.

“The mission is to promote dignity at the end of life through compassionate care and presence, spiritual support and education,” said Legate Tricia Heffernan, a Martha and Mary board member. “We were named for the sisters who were friends of Jesus. So we are an active and contemplative ministry.”

Martha and Mary Ministries’ supporters say Oregon’s assisted suicide law is the wrong approach. Heffernan says there are many grace-filled moments before people are called home to heaven — moments that would be violated by assisted suicide.

“Martha and Mary Ministries is a light in the darkness,” she said. “Nobody here dies alone. They have dignity and hope at the end of life.”

— Sabrina Arena Ferrisi


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Is euthanasia the same as murder?

Fr. John Trigilio explains why assisted suicide is contrary to Church teaching . . .

Reverend John Trigilio Jr.

Euthanasia — from the Greek eu thanatos meaning good death — is the intentional and deliberate ending of a human life either by withholding necessary, viable and ordinary treatment (passive euthanasia) or by introducing a substance or procedure that directly causes death (active euthanasia).

Both passive and active euthanasia are considered gravely evil and immoral and in the same moral category as abortion — that is, murder. Murder is the deliberate killing of an innocent person. The fifth commandment actually uses the word “murder,” which is rasah (Hebrew), phoneuo (Greek), and occides (Latin) as found in the original Biblical manuscripts. This means that the commandment literally says, “Thou shalt not murder” and not “Thou shalt not kill.”

Murder can be premeditated, a spontaneous but deliberate deadly assault, or it can be an unlawful killing of a human being without malice. These are all forbidden by the fifth commandment. Equivalent acts would also include any and all unjust killing, such as abortion or euthanasia where death is directly intended and achieved — regardless of the motive or consequences.

Patients are never obligated to endure painful procedures which are worse than their current condition and which do not have a reasonable hope of success. During the Civil War, many soldiers died not from war injuries but from the results of medical procedures like infections from botched amputations. In such cases, refusal of these “extraordinary means” would not be considered euthanasia. Today, however, with the progress of medicine, technology, and rehabilitative treatment, drastic procedures like amputation can be done, and survivors usually live and adapt to their disability.

Dying patients are allowed to be given as much pain medication as their bodies can tolerate as long as the dosage itself does not directly cause death. Too much morphine can stop breathing, whereas monitored amounts can keep a person relaxed and comfortable.

So-called “mercy killing” and the efforts of the Hemlock Society and the late Dr. Jack Kevorkian to make euthanasia socially acceptable are condemned by the Church. God alone should decide when someone leaves this earth — not the patient, doctor, or caretaker. Keeping the dying patient pain-free, comfortable, clean, nourished, and hydrated — and just allowing the natural death process to take its course — is how human beings die with dignity.

Use of a feeding tube or insertion of a tracheotomy are also considered ordinary means and both were administered to Blessed Pope John Paul II a month before his death and one year after he issued a statement clarifying that ordinary means and ordinary medical care (shelter, warmth, and dignified respect) must be given to all patients — even those in a persistent vegetative condition. Ordinary does not mean just what is natural, but includes all modern medical procedures which are typically, routinely and successfully  performed.

Reprinted with permission from “The Catholicism Answer Book: The 300 Most Frequently Asked Questions” by Rev. John Trigilio Jr. and Rev. Kenneth D. Brighenti (Sourcebooks, 2007).

Catechism 101

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.

Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate.

Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged.

Catechism of the Catholic Church, #2277-2279

Assisted suicide: why now?

Al Pacino sympathetically portrayed Dr. Jack Kevorkian in a recent HBO movie . . .

Wesley J. Smith

Since 1988, when euthanasia advocates failed to qualify for a legalization initiative on the California ballot, the assisted suicide movement in the United States has gone from a barely noticed fringe movement to a well-funded political machine that threatens Hippocratic medical values and the sanctity/equality of human life.

Consider the disturbing history: In 1994, Oregon legalized assisted suicide (by a 51-49% vote), with the law going into effect in 1997. The movement had a setback in 1997 when the U.S. Supreme Court ruled, in a rare unanimous decision, that there is no constitutional right to assisted suicide. But in 2008, Washington State legalized Oregon-style assisted suicide by a lopsided 58-42%. Then, last year, Montana’s Supreme Court ruled that assisted suicide was not against the state’s “public policy.”

The euthanasia movement is not resting on its recent laurels. Advocates have filed a lawsuit in Connecticut to legalize assisted suicide by redefinition — on the dubious theory that a doctor who lethally prescribes drugs for use by a terminally ill patient is merely performing “aid in dying,” rather than the legally proscribed assisted suicide. Meanwhile, legislative legalization efforts have been initiated in Hawaii, Arizona, Wisconsin, Vermont, New Hampshire and Connecticut — all without success.

A question amidst all of this Sturm und Drang naturally arises: Why now? After all, 100 years ago when people did die in agony from such illnesses as a burst appendix, there was little talk of legalizing euthanasia. But now, when pain and other forms of suffering are readily alleviated and the hospice movement has created truly compassionate methods to care for the dying, suddenly we hear the battle cry “death with dignity” as “the ultimate civil liberty.”

In fighting assisted suicide since 1993, I have often pondered the “why now” question. I’ve found two answers: First, the perceived overriding purpose of society has shifted to the benefit of assisted suicide advocacy, and second, our public policies are driven and defined by a media increasingly addicted to slinging emotional narratives rather than reporting about rational discourse and engaging in principled analysis. Add in a popular culture enamored with social outlaws, and the potential exists for a perfect euthanasia storm.

Social commentator Yuval Levin, a protégé of ethicist Leon Kass, described the new societal zeitgeist in his recent book Imagining the Future: Science and American Democracy. While not about assisted suicide per se, Levin hit the nail on the head when he described society as no longer being concerned primarily with helping citizens to lead “the virtuous life.” Rather, he wrote, “relief and preservation from disease and pain, from misery and necessity” have “become the defining ends of human action, and therefore of human societies.” In other words, preventing suffering and virtually all difficulty is now paramount. In such a cultural milieu, eliminating suffering easily mutates into eliminating the sufferer.

The prevent-suffering-at-all-costs agenda is harnessed by assisted suicide advocates through publicizing heart-rending stories of seriously ill or disabled patients who want to die. Illustrating how potent this emotional narrative has become, even the ghoulish Jack Kevorkian is being remade into a big softy concerned solely with relieving suffering. Indeed, none other than Al Pacino sympathetically portrayed Kevorkian in the recent HBO movie, You Don’t Know Jack.

Ignored by the script writers and the media, the real Kevorkian was the mirror opposite of compassionate. In his 1993 book Prescription Medicide: The Goodness of Planned Death, Kevorkian made his ultimate purpose chillingly clear, calling assisted suicide “a first step, an early distasteful professional obligation” toward obtaining a license to engage in human experimentation.

Writing further: “What I find most satisfying is the prospect of making possible the performance of invaluable experiments or other beneficial acts under conditions that this first unpleasant step can help establish — in a word, obitiatry — as defined earlier.” (“Obitiatry” is the word Kevorkian coined to describe experimenting on people as part of the practice of human euthanasia.) That the media depict Kevorkian as caring rather than self serving tells us how far awry we have been pushed by the collective desperation to avoid suffering by whatever means necessary.

Still, there is good news in spite of the darkening sky: Principle and virtue are not dead. To the consternation of assisted suicide advocates, the sanctity-of-life principle has not yet completely lost its vitality. The vast majority of doctors in Oregon do not assist patient suicides; most of such deaths are facilitated by the advocacy group Compassion and Choices. In Washington, physicians and health corporations — such as the Providence Hospitals — have pushed back against the new law by stating publicly that they will not participate. And despite millions of dollars spent promoting the agenda (financed by the likes of George Soros), assisted suicide has not broken into the mainstream of American law and medical practice.

But they will keep trying. Successful resistance does not require giving up vital principles. Opponents, however, will have to tailor their message of true compassion and care in ways that resonate within the current cultural milieu. Just saying that killing is wrong is no longer enough.

Wesley J. Smith is a senior fellow in bioethics and human rights at the Discovery Institute and a lawyer/consultant for the International Task Force on Euthanasia and Assisted Suicide. He is a special consultant to the Center for Bioethics and Culture.