From the Jan/Feb 2003 Issue of Lay Witness Magazine
ISSUE: What is euthanasia? Why does the Church forbid its practice?
RESPONSE: The glossary in the Catechism of the Catholic Church defines euthanasia as “an act or omission which, of itself or by intention, causes the death of handicapped, sick, or dying persons—sometimes with an attempt to justify the act as a means of eliminating suffering.”
Euthanasia is a form of murder and thus is prohibited by the Fifth Commandment. It is a grave offense against the dignity of the human person and also against God, the Author of human life. While motives and circumstances can mitigate one’s culpability, they do not change the nature of this murderous act, which must be forbidden (Catechism, no. 2277).
The Church affirms the right to life of all persons, from conception to natural death. The Church encourages those with terminal illness to unite their sufferings with those of Jesus Christ, for the sake of His body, the Church (cf. Col. 1:24). The Church also encourages caregivers and family members to treat sick or handicapped persons with “special respect” (Catechism, no. 2276).
DISCUSSION: Death is part of the human condition. While everyone is well aware of this reality, the presence of terminal or severe illness requires us to look more closely at this reality. As we approach death, we confront our own beliefs about the meaning of life, the value of suffering, and the prospect of life after death. In other words, the experience of our own mortality is a pivotal moment in our pilgrimage of faith (cf. Catechism, no. 1501). How we approach death is of utmost importance to the individual and to society. Further, the way we treat those in need, the least of our brethren (cf. Mt. 25:31-46), speaks volumes about who we are as a people.
In his encyclical letter on the “Gospel of Life” (Evangelium Vitae, “EV”), Pope John Paul II identifies several cultural factors that have contributed to the spread of euthanasia. He says that in today’s society we are increasingly unable to face and accept suffering, so we are increasingly tempted to eliminate it at the root by hastening the moment of death (cf. EV, no. 15). This points to the “crisis of faith” in the West, where the physical evil of suffering is considered to be “the epitome of evil, to be eliminated at all costs” (ibid.). The Pope points out several other factors, including modern man’s desire to control life and death and an assessment of human value based on medical costs, self-sufficiency, and societal “burden.”
We saw in the 20th century how Planned Parenthood and the little-known radical views of its founder, Margaret Sanger, subtly imposed its contraceptive, anti-natalist, racist, and eugenic agenda on the world. The result has been that conduct once considered unspeakably evil—the killing of unborn or even partially born children—is not only accepted but enshrined as an inalienable right. Less people, however, are aware that a similar effort is well under way to legitimize the killing of our elderly and sick citizens.
In 1938, Dr. Foster Kennedy, president of the Euthanasia Society of America (ESA), announced his organization’s support of legislation to legalize the killing of “defective” or “incurable” human beings—with or without their consent. Back then, such legislation was utterly intolerable to most people, so the ESA took a more strategic, incremental approach, employing deceptive language such as “death with dignity” and building upon the utilitarianism (“quality of life”) and radical autonomy (“right to choose”) championed by secular society and, unfortunately, the U.S. Supreme Court. Many now see euthanasia as a topic of political discussion, not an abomination.
God’s Timeless and Timely Word
It would not be realistic to expect Sacred Scripture to address contemporary issues regarding care for the dying. Even so, the biblical message—amplified by Church Tradition and definitively expounded by the Magisterium—is firmly and unequivocally on the side of life. Some relevant biblical themes include:
The value and dignity of human life.
The Bible begins with the creation narrative, which provides that man has been specially created in the image and likeness of God (cf. Gen. 1:26-27). The rest of the Bible is the story of God’s fatherly plan to draw all people to Himself. This plan culminates in the Incarnation of Christ. By becoming one like us, God amazingly demonstrates His solidarity with the human family and affirms the value and dignity of human life. Pope John Paul II connects the dots for us, telling us that a rejection of human life is really a rejection of Christ (EV, no. 104).
Prohibition of murder.
The Fifth Commandment expressly forbids taking another’s life (cf. Ex. 20:13). Jesus not only affirms the necessity of this commandment for eternal life (cf. Mt. 19:16-22), but actually tightens its requirements (cf. Mt. 5:21-26). He also roots the commandment in the positive requirement to love one’s neighbor “as one’s self” (cf. Mt. 22:34-40). This positive command presupposes a legitimate love of self that would exclude the rejection of the fundamental gift of life.
Respect for advanced age.
Throughout Scripture, old age is characterized by dignity and surrounded with reverence. Just one example of the dignity of the elderly can be found in the story of Eleazar, who accepted torture and martyrdom rather than violate God’s law. His heroic action is described as “worthy of his years and the dignity of his old age” (2 Mac. 6:23).
Jesus’ love for the sick.
The Gospels are replete with accounts of Jesus tending to the needs of the sick, handicapped, and dying. Jesus healed the sick and instructed His disciples to do the same (cf. Mt. 10:8). Caring for the sick has always been considered a “corporal work of mercy,” based on Our Lord’s own words in Matthew 25. And in the parable of the Good Samaritan (cf. Lk. 10:29-39), we see the Christian’s obligation to tend to the needs of our “neighbor” despite any perceived inconvenience or cultural bias.
Earthly life is not an absolute.
Scripture says we weren’t created simply for this life but for eternity (cf. Wis. 2:23). We are advised to be concerned most of all about threats to our eternal souls (cf. Mt. 10:28), realizing that while our “outer self” is wasting away, our “inner self” is being renewed each day (cf. 2 Cor. 4:12-5:1).
Trust God in life and death.
Life is a gift from God, and whether we live or die is in His hands (cf. Ps. 16:15). The just man is depicted not as seeking deliverance from the burdens of old age, but as putting his trust in God’s loving providence. The Bible does not teach a mere fatalism or resignation, but elicits faith in God and trust in His mercy and promises.
Salvific value of suffering.
Through dying on the Cross for us, Jesus Christ reveals the life-giving value of suffering. Christ’s sacrifice redeemed the whole world, but in appropriating this redemption for ourselves, we are instructed to follow Jesus’ example and carry our own crosses, laying down our lives for others. All our thoughts, words, and actions, but particularly our sufferings, have salvific value when united with Christ’s sacrifice.
Here we have to understand the distinction between martyrdom, which involves accepting suffering and even death out of love for Christ, and suicide, which involves seeking death for its own sake, i.e., rejecting the good of human life. St. Jerome, a 4th-century Doctor of the Church, expressed the distinction this way: “It is not ours to lay hold of death; but we freely accept it when it is inflicted by others.”
For 2,000 years, the Church’s Tradition has consistently taught the absolute and unchanging value of the commandment, “Thou shall not kill.” Pope John Paul II cites the Didache, the most ancient non-biblical Christian writing, which condemns crimes against human life as being part of the “way of death” that Christians must reject (EV, no. 54).
St. Augustine, writing in the fifth century, made several statements that support the Church’s constant teaching on euthanasia, such as his assertion “that no man should put an end to this life to obtain that better life we look for after death, for those who die by their own hand have no better life after death” (City of God, I, 26).
The Catholic Church has firmly and explicitly confirmed its condemnation of euthanasia in recent decades. Notably, at the Second Vatican Council (1962-65), the universal Church taught:
The varieties of crime are numerous: all offenses against life itself, such as murder, genocide, abortion, euthanasia, and willful suicide . . . are criminal: they poison civilization, and they debase the perpetrators more than the victims and militate against the honor of the Creator (Gaudium et Spes, no. 27, emphasis added).
Even more recently, in response to what he calls the “culture of death,” Pope John Paul II definitively reiterated the Church’s perennial teaching:
In harmony with the Magisterium of my predecessors and in communion with the bishops of the Catholic Church, I confirm that euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person. This doctrine is based upon the natural law and upon the written Word of God, is transmitted by the Church’s Tradition, and taught by the ordinary and universal Magisterium (EV, no. 65).
Guilt by Association?
The patient who requests euthanasia in effect commits suicide, which the Church has always considered a “gravely evil choice” (ibid., no. 66). While suicide in all its forms is an objective violation of the Fifth Commandment, we must recognize that psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the person who commits suicide (Catechism, no 2282). We cannot know the eternal fate of such a person: “We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives” (Catechism, no. 2283).
Then there is the physician and others who help to bring about the patient’s death, including those who provide lethal drugs or other means of enabling a patient to commit the form of euthanasia commonly known as “assisted suicide.” All those who knowingly and willingly perform or assist in carrying out the act of terminating the patient’s life have committed murder (cf. Catechism, no. 2277). While there may be mitigating factors in a particular case, especially when it comes to family members who are coping with a loved one’s catastrophic illness, the act nonetheless is seriously wrong, even when the patient requests it. “True ‘compassion’ leads to sharing another’s pain; it does not kill the person whose suffering we cannot bear” (EV, no. 66).
Finally, there are those public officials who pass laws legalizing euthanasia in their jurisdiction. A law that tolerates—or even requires—the killing of the innocent is unjust, non-binding, and brings about the obligation to oppose it by means of conscientious objection (ibid., no. 73). The fact that civil laws allow an evil or that there is a diversity of views on the subject does not alter this requirement, which the Holy Father summarizes:
In the case of an intrinsically unjust law, such as a law permitting abortion or euthanasia, it is therefore never licit to obey it, or to take part in a propaganda campaign in favor of such a law, or vote for it (ibid.).
The Problem of Pain
In discussing the topic of euthanasia, some further distinctions need to be made. First, the Church recognizes the legitimacy of palliative care, which involves making suffering more bearable in the final stage of illness and ensuring that the patient is supported and accompanied throughout his or her ordeal (cf. EV, no. 65).
Surely, Christians are called to find in their suffering and pain a unique opportunity to participate in Our Lord’s Passion. Excessive pain, however, brings the prospect of draining a patient’s moral resources, interfering with his spiritual well-being, and even tempting him to consider euthanasia. Therefore, the patient’s request for pain relief should be respected; those who cannot express their wishes can generally be assured to want such relief.
In treating some serious illnesses such as cancer or AIDS, the doses of narcotics needed to effect adequate pain management can bring about a foreseeable risk of shortening the patient’s life. Pope Pius XII taught in a 1957 address that it is permitted to relieve pain with narcotics, even when the result is decreased consciousness and a shortening of life, “if no other means exist, and if, in the given circumstances, this does not prevent the carrying out of other religious and moral duties.”
The Church has subsequently reaffirmed the moral liceity of authentic palliative care, so long as the medicines are not taken or prescribed with the intention of bringing about the patient’s death. The Catechism calls palliative care a special form of charity which should be encouraged (no. 2279).
It Is Finished
A second issue arises as to what measures must be taken to preserve life. Patients, family members, and health care providers are not morally obligated to pursue every possible avenue of extending human life. Instead, “it needs to be determined whether the means of available treatment are objectively proportionate to the prospects for improvement” (EV, no. 65).
The Church has distinguished between “extraordinary” and “ordinary” care, with only the latter being morally obligatory:
Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted (Catechism, no. 2278).
Even when death is considered imminent, patients by virtue of their human dignity should continue to receive “ordinary” care. The Charter for Health Care Workers (Pontifical Council for Pastoral Assistance for Health Care Workers, 1995) says that such care includes nursing care, hygiene, and palliative care. It also involves nutrition and hydration, orally or with artificial assistance (i.e., a feeding tube), if this will support the patient’s life without imposing serious burdens on the patient.
Allowing the patient to die a natural death with dignity is not euthanasia. While it is not permissible and indeed reprehensible to cause a patient’s death through starvation or dehydration, in the case of a patient in the final stages of the dying process, where providing him with food or water would cause greater hardship than relief, those tending to the patient may forego such care (cf. National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, no. 58).
In both the case of palliative care and the case of foregoing “over-zealous” treatment, the goal is not to terminate the life of the patient, but on the contrary to treat the patient with dignity and respect. The patient’s death is accepted without being willed or deliberately accelerated. And in both cases we see the principle of double effect in action. Some forms of treatment may have two effects, one good (e.g. pain relief) and one evil (shortening of patient’s life). In appropriate circumstances, the treatment may be provided because of the intended good effect, despite the possibility of the foreseeable but unintended bad effect (cf. Catechism, no. 1737). The pivotal issue is what one is trying to accomplish through a given medical decision. If the intention is to kill or shorten the patient’s life, then it is not morally justifiable.
Our Lord says, “Blessed are those who mourn, they shall be comforted” (Mt. 5:4). Modern man tends to resist mourning, to resist embracing the reality of human suffering and death, opting instead for a cosmetic, shallow, and ultimately disposable existence. Our Lord does not say that He will take away our temporal pain and anguish, but He does promise to “comfort” us, which literally means that He will be strong with us, through the power of His Holy Spirit.
He also tells us that when we care for the sick, the marginalized, and the dying, we are truly caring for Him, such that the late Mother Teresa would often say that she was serving the “hidden Jesus” in the poorest of the poor in Calcutta.
We affirm the Gospel of Life, and in particular the value and dignity of the elderly and ill in our midst, when we tend to their physical, psychological, and spiritual needs. This could involve just sitting with them, offering them reassurance, or making the sacraments available to them—particularly Confession and Anointing of the Sick, the underappreciated “Sacraments of Healing”—as well as the Eucharist, which is called “viaticum” when received in anticipation of passing over to eternal life (cf. Catechism, no. 1517). Thus by our actions as well as by our words, we must be ambassadors of God’s mercy and compassion to those who are dying.
Holy Bible (Catholic edition)
Catechism of the Catholic Church
Vatican II Documents
Pope John Paul II, Evangelium Vitae
Sacred Congregation for the Doctrine of the Faith, Declaration on Euthanasia
Russell Shaw, ed., Our Sunday Visitor’s Encyclopedia of Catholic Doctrine
William Brennan, Dehumanizing the Vulnerable
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Last edited: 11/13/2002
 Richard Doerflinger, “Care of the Dying,” taken from Russell Shaw, ed., Encyclopedia of Catholic Doctrine (Huntington, IN: Our Sunday Visitor, 1997),
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