‘Hey Father,’ some states have “dying with dignity” laws. Can you please explain the Church’s teaching on physician assisted suicide?

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Today, the questions and difficulties that arise in healthcare ethics are becoming increasingly existential in nature. In other words, they touch upon the very meaning of what it is to be human. Until recent times, the Judeo-Christian understanding of human nature was assumed in the larger society. While there were certainly disagreements about how healthcare should be provided in general and what should be done in particular cases, there was a general consensus about what human nature is, and what constitutes human well-being or flourishing. Today, however, these foundational principles can no longer be taken for granted. In fact, they are the subject of constant questioning, debate, and redefinition. As a result, the Church today is tasked with much more than just understanding and explaining to others how existing moral principles apply to new cases and types of treatment. She must first convince people of the very reality and importance of the principles themselves.

Perhaps the greatest struggle today is that moral relativism or subjectivism have led to the hyper-inflating of personal autonomy, to the detriment or ignoring of the other ethical principles needed to be considered in making a moral decision. This hyper-inflation of the importance of individual autonomy is on full display in the majority statement from the 1992 Planned Parenthood vs. Casey case, which stated, “At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life.” The disproportionate value given to autonomy has dramatic and, frequently, catastrophic consequences for our society’s understanding and practice of healthcare. These consequences are particularly evident when it comes to end-of-life issues.

The Church’s approach to end of life issues, like her approach to all questions, is informed and guided by fundamental truths about God and human beings. First, every human person has intrinsic dignity because he or she is created in the image and likeness of God (Gen 1:27, CCC, 1700) and moreover, because God “desires all men to be saved and to come to the knowledge of the truth” (1 Tim 2:4). Second, Jesus Christ has forever changed the meaning of human suffering and death through his Paschal Mystery, that is, his passion, death, and resurrection.

The Second Vatican Council taught that, “Christ . . . fully reveals man to man himself and makes his supreme calling clear” (Gaudium et spes, 22). This “supreme calling” of man is made abundantly clear in Christ’s resurrection, which proves to us that God’s love extends to the furthest limit of sin and God-forsakenness, even beyond what appears to be final destruction in death. If Jesus Christ had not been raised from the dead, then our attempts to understand suffering and death would be hopelessly confined to this life alone

Without our belief in the resurrection from the dead and our “supreme calling” to live with God forever, the reality of suffering and death in this life would strike us as utterly non-sensical. Without the hope of resurrection and eternal life, death would loom before us as an insurmountable obstacle, a contradiction to the idea that life has any ultimate meaning.  Sadly, sympathy for physician-assisted suicide and even euthanasia is steadily increasing in many places in the world today. This negative trend is due primarily to what is called a “quality of life” ethics. This “quality of life” approach attempts to establish objective criteria to determine whether a person’s life is still “worth” living. This is a deeply problematic judgment to attempt. First, the idea that the difficult circumstances of physical or psychological suffering can actually change the value or worth of a person’s life presupposes that joy and meaning in life are incompatible with suffering. However, we know from both personal experience and our faith that this not true. The suffering of Jesus Christ was unimaginably difficult for him (consider his “agony in the garden”) but also charged with infinite meaning. One could say that as Christians our faith is founded on the idea that, when entrusted to God, suffering can be supremely valuable and redemptive.

A second problem with trying to define objective criteria for a person’s “quality of life” is that it is impossible to enter into other people’s subjective experience of suffering, or to understand what they believe about the value of their suffering. This is especially true when they are not fully conscious or able to express themselves. In the end, to deny the meaning of suffering means to deny the meaning of life, because suffering is an inevitable part our existence. Therefore, true compassion for the dying and even suffering people who request to die involves entering into their suffering and accompanying them in empathy. To actively kill or assist in killing a suffering person, or to allow him to end his own life is not an act mercy or compassion. It is rather a failure to endure the discomfort and even pain sometimes involved in affirming the dignity of the human person, a fact that remains even when he or she is suffering greatly. Indeed, if we treat suffering as an evil to be avoided at all costs, we end up denying the dignity of suffering people. Our actions effectively send the message, “The value of your life is less significant than the burden your suffering creates for you and everyone else.”

The meaning and value of human life is objective, but it is something that God establishes––it is cannot be determined or decided by others, nor is it based on our personal gifts or talents, ability to contribute to society, or level of dependence on others. The value of human life is not a conditional reality that is lessened or destroyed by circumstances of pain and suffering. Suffering, with the disability, dependence, and sorrow it frequently brings, can be like a veil that makes it difficult to perceive the dignity of very ill or dying people. However, this veil does not erase or change the image of God that all people possess by nature. As Christians, we must therefore strive, out of love for God and every person He created with dignity and purpose, to accept and respond to all suffering in light of His plan of salvation in Christ and the common eternal destiny of all human beings.

The Christian tradition, especially in this country, of establishing hospitals, training health-care professionals, and caring for the sick and suffering is borne out of a two-fold belief that cannot be fragmented:  Christ’s command to care for the sick, and in doing so to witness to their objective dignity.  It is right to address suffering and try to alleviate pain, but that cannot be confused with the elimination of the suffering person!

Today, however, many people fear suffering and the dying process. They are afraid of being kept alive past life’s natural limits by burdensome medical technology. They fear experiencing intolerable pain and suffering, losing control over bodily functions, or becoming a burden to others.  These fears are addressed with proper pain management and sharing with and in the life of the suffering brother or sister, not eliminating him.  St. John Paul taught us: “The request which arises from the human heart in the supreme confrontation with suffering and death, especially when faced with the temptation to give up in utter desperation, is above all a request for companionship, sympathy and support in the time of trial. It is a plea for help to keep on hoping when all human hopes fail” (Evangleium vitae, 67).

As the USCCB document “To Live each day with Dignity” points out: “People who request death are vulnerable. They need care and protection. To offer them lethal drugs is a victory not for freedom but for the worst form of neglect. Such abandonment is especially irresponsible when society is increasingly aware of elder abuse and other forms of mistreatment and exploitation of vulnerable persons.”

“Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of” (CCC, 2280).

This answer was co-authored by Father Peter Harman, who is holds a Doctorate in Moral Theology from the Catholic University of America and is rector of the Pontifical North American College in Rome and Deacon Chris Trummer of Neoga.