Tag Archives: physician-assisted suicide

The clear and present danger of medical martyrdom

Will Catholic doctors who subscribe to the Church’s moral teaching against assisted suicide and abortion ever be forced to take human life? Until recently, such a prospect was unthinkable.

smithIf trends continue, Catholic and other sanctity-of-life-believing doctors will be forced to choose between violating the Sixth Commandment and continuing in good stead in their chosen profession. I call this threat “medical martyrdom” — a potential authoritarianism that looms darkly in the coming decade because of two fundamental mutations in the ethics of medicine.

First, doctors don’t take the Hippocratic Oath anymore and haven’t for decades. The Oath’s ethical proscriptions against participating in abortion and assisted suicide cut against the contemporary moral grain, leading medical schools to dumb it down or dispose of it altogether. Second, “patients’ rights” have become the new mantra in health care where physicians are “service providers” and patients are, in essence, consumers. As such, many among the medical intelligentsia and in bioethics believe that the competent customer is entitled to virtually any legal procedure from “service providers.”

As a consequence, Hippocratic-believing professionals are pressured to practice medicine without regard to their personal faith or conscience beliefs. This moral intolerance is slowly being imbedded into law. In the U.S., such legal controversies have mostly swirled around. Elsewhere, the force of law has — or threatens to — force doctors to be complicit in abortion and euthanasia.

The first such law was passed several years ago in Victoria, Australia, where the local law requires all doctors to perform — or be complicit in — abortion: If a patient requests a legal termination and the doctor has moral qualms, the dissenting physician is required to find a doctor on behalf of the patient known to be willing to do the deed.

Canada is heading rapidly in the same direction regarding euthanasia. Quebec legalized doctor-administered death last year and allows no conscience exemptions. When palliative care centers and hospices balked, the Minister of Health called such resistance “inappropriate and unfortunate” because doctors must “adapt to the patient,” warning darkly that euthanasia “will be offered.”

Meanwhile, Canada’s Supreme Court just legalized euthanasia for those with a diagnosable medical condition that causes “irremediable suffering,” including “psychological pain.” Recognizing that some doctors will have moral qualms about “terminating life,” the Court gave Parliament 12 months to pass enabling legislation, stating that “the rights of patients and physicians will need to be reconciled” by law or left “in the hands of physicians’ colleges.”

That doesn’t bode well for medical conscience rights. Canada’s medical associations have low regard for conscientious objectors. Saskatchewan’s College of Physicians and Surgeons recently published a draft ethics policy that would force doctors to provide “legally permissible and publicly funded health services” — which now include euthanasia as well as abortion — to “make a timely referral to another health provider who is willing and able to … provide the service.” If no other doctor can be found, the dissenting physician will have to do the deed personally, “even in circumstances where the provision of health services conflicts with physicians’ deeply held and considered moral or religious beliefs.” Meanwhile, 79% of Canadian Medical Association delegates at a recent convention voted against a motion that would have supported conscience exemptions from participating in euthanasia.

U.S. doctors cannot be forced to participate in abortion and assisted suicide (in the jurisdictions where it is legal). But these professional safeguards are generally opposed by the medical establishment — at least as they apply to abortion. The American College of Obstetricians and Gynecologists (ACOG) published an ethics-committee opinion in 2007 strikingly similar to the Saskatchewan College’s:

“Conscientious refusals should be limited if they constitute an imposition of religious and moral beliefs on patients. Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they do not feel they can in conscience provide the standard reproductive services that patients request.”

If these trends continue, 20 years from now, those who feel called to a career in health care will face an agonizing dilemma: Either participate in acts of killing or stay out of medicine. Those who stay true to their consciences will be forced into the painful sacrifice of embracing martyrdom for their faith.

WESLEY J. SMITH is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council. He received Legatus’ 2014 Cardinal O’Connor Pro-Life Award for his work against assisted suicide.

The slippery slope of physician-assisted suicide

Patrick Lee writes that physician-assisted suicide takes us in a dangerous direction . . .

Dr. Patrick Lee

Dr. Patrick Lee

Catholics believe human life is intrinsically valuable, and therefore one should never intentionally kill an innocent person, whether oneself or someone else. This is central to our moral convictions. But it is being challenged by a virulent campaign in favor of physician-assisted suicide (PAS).

Why must we refrain from “assisting someone to die” (as it is euphemistically called) if that person is in unbearable suffering or has decided for herself that her life is no longer worthwhile? And even if it is morally wrong, how can we impose our moral belief — so it is objected — on society?

We should first distinguish between the suffering person and the suffering itself. When someone we love suffers grievously, we have a strong emotional response. But our emotional repugnance should be directed to the suffering itself. It’s a different thing altogether to conclude that the best way of helping that person is to help her kill herself. We rightly abhor the pain and suffering, but not the person. It’s right to try to remove the pain and suffering; it is not right intentionally to destroy the person to alleviate her anguish.

PAS proponents argue that a person should be able to decide for herself whether her life is worthwhile. But a person’s life is inherently worthwhile, not something that becomes valuable only because someone decides it is so. Life can never cease to be intrinsically valuable because your life is not your possession. Rather, it is the same as you yourself, and you yourself cannot cease to be worthy of love and care.

Of course, the moral issue does not by itself settle what the law should be. Some argue that we should respect people’s autonomy and so the law should allow PAS. A large degree of autonomy is necessary for people to lead responsible lives, but there are rightful limits to autonomy. The law requires drivers to wear seatbelts and motorcyclists to wear helmets. There are laws against prostitution, dueling, Russian Roulette, and the use of certain addictive drugs. All laws limit liberty (autonomy) to some extent; the question is whether  there is a sufficient public good at stake.

The protection of life is as an essential component of the public good. Especially important is how the culture as a whole — which is profoundly influenced by the law — regards human life. If a culture regards human life as inviolable, that fact protects all of us; if not, then the most vulnerable among us — especially the elderly and the disabled — are in danger. A culture that condones PAS views life as merely contingently valuable and so views the lives of many of the most vulnerable among us as mere burdens.

Consider laws that prohibit physicians from amputating healthy limbs or performing female genital mutilation. Such laws exist precisely because we recognize that physicians should perform surgery only to provide a real medical (or cosmetic) benefit to the patient — or at least not significantly harm her. Rescinding such laws would send the message that these practices are not inherently harmful. In the same way, rescinding the law against PAS would send the message that in many cases a person’s life is simply not worth living and, by implication, is merely a burden on his or her family.

The sense of self-worth among the elderly, dying, and disabled would be profoundly harmed by legalizing physician-assisted suicide, and it would lead many to despair and request suicide out of undue deference to others. A society cannot, then, be neutral with respect to the lives of these people: It will either protect their lives or it will help shape a culture that views them as better off dead.

The logic of de-criminalizing PAS for the terminally ill who are suffering grievously would lead inexorably to allowing (and encouraging) other types of killing. If the rationale for PAS is to respect autonomy, then why limit it to those who are terminally ill? Why privilege the autonomy of those who are terminally ill above those who are suffering chronically? Alternatively, if the rationale for PAS is that a person is in misery or has allegedly lost her dignity — if the law is based on the belief that for some people death is a benefit — then it will be impossible to deny this alleged benefit to other groups who lack decision-making capacity, for example, those who are unconscious, demented, or are children (as the Netherlands has been led to do with the open euthanasia of infants).

Thus, PAS is a denial of the equal and inherent dignity of the elderly, the dying, and the disabled. Respect for human life and genuine compassion and care for all requires that PAS remain illegal.

PATRICK LEE, Ph.D., is the John N. and Jamie D. McAleer Professor of Bioethics and the director of the Institute of Bioethics at Franciscan University of Steubenville.