Preparing for a good death
Catholic Standard September Editorial
The introduction of a bill in parliament proposing assisted suicide has caused Tasmanians to reflect on the question of what constitutes a “good death”. Proponents of the bill would see a good death as one in which a person can decide how and when they are to die. The catch phrase, “My life, my choice”, encapsulates the idea that each person should be free to choose how they die.
This phrase endorses a very dangerous view – that anyone should be free to end their life. It sends out all the wrong messages to people who are going through a dark or difficult time in their life. It fails to recognise that none of us are “islands” – our life and our death has an effect on others.
The intense sadness felt by loved ones when someone chooses to take their life reminds us that we are as human beings interdependent. Even if a person feels that their life has no value, others close to them see it in the opposite way.
However, it can equally be true that we do not want to extend life unnecessarily. The Book of Ecclesiasticus (3:2) speaks of a “time to be born and a time to die”. There is a time to die when life ebbs out of us. The Christian understands that we have to allow the dying process to take its natural course, but we want to do all we can to support and accompany the person. We want to surround the dying person with love and faith.
As a society we must ensure that those suffering a terminal illness are provided with the best palliative possible. They need to have access to all the necessary treatment required to relieve pain and other symptoms they experience. It is unacceptable that those suffering terminal illness be left in intolerable physical pain or mental, emotional or spiritual distress.
Pain relief and sedative medications are appropriate for symptom control in end of life care. Evidence suggests if these medications are only introduced where necessary, and the dose is increased gradually and only to the level needed for symptom relief, they do not hasten a patient’s death.
People may fear being kept alive by machines or dying slowly in a high dependency ward attached to drips and leads. There is, however, no requirement in Catholic moral teaching to continue burdensome and futile treatment to preserve the life of a person when they have entered the dying process. Patients have the moral and legal right to refuse treatment in these circumstances even if death may come sooner as a result of this choice. Doctors and nursed involved in this process are therefore not choosing or causing the death of their patient. They are merely making prudent medical decisions in the best interest of the particular patient.
Therefore in Catholic teaching, the practice of palliative care that seeks to alleviate the symptoms of pain or distress with morphine or sedatives to the level required for relief, is not the equivalent of euthanasia or assisted suicide. Neither is refusing burdensome or futile treatment. In both cases the intention is not cause death.
Underpinning the practice of both euthanasia and assisted suicide is the lack of any concern or intention to treat the symptoms caused by the underlying illness, rather the intention is to bring about death of a patient. The direct taking of life, by oneself or another, is fundamentally opposed to the human good, and God’s moral law.
The Catholic Church understands the role of medical care and indeed the basis of all medical ethics is to do no harm. Any direct intervention to end a person’s life is opposed to very purpose of medical care.
The dying process is a profoundly human process which engages the person not only physically, but also psychologically, emotionally and spiritually. When best practice palliative care is available this should be a relatively peaceful process. It should not be traumatic. It is important that people are better informed about what palliative care is able to do. Much of the support from the public for euthanasia or assisted suicide comes from not understanding the holistic approach to end of life challenges available through palliative care.
A person of faith knows that as life draws to a close God awaits to receive us. Thus the dying process is an act of surrender and an entrustment of one’s life into the hands of God. It is a process that is peaceful and grace-filled. As the Book of Wisdom declares: “Because grace and mercy are with his holy ones”.
Archbishop Julian Porteous
September 13, 2020