The Church and Euthanasia
On Benjamin Crosby’s “Ten Thousand Gentle Killings”: I am an Australian respiratory specialist and have end-of-life discussions with people most days of the week, usually with people dying of lung cancer or emphysema. In my home state euthanasia became legal eight weeks ago. In my health jurisdiction of 1.5 million people, fifteen have been supplied a lethal drug; nine have taken it to date. I would like first to acknowledge the feelings of those who think euthanasia may be appropriate in some situations; they are often influenced by watching a loved one die, one of life’s most upsetting universal experiences.
In Australian opinion polls there is fairly wide support for euthanasia; by next year it will be available in all states. As a doctor I have found that the debate over euthanasia has reflected a very limited understanding of the dying process and the nature and scope of palliative care; here the debate has been driven by activist politicians and right-to-die groups which often sensationalize extreme and uncommon examples of suffering.
Most of these cases do not reflect what I have seen in my twenty-five years as a doctor – I would suggest that few people in Australia die in the extreme pain that is so often given as a reason for legalizing euthanasia. Evidence from other countries suggests most who take the option do so because of loss of independence and fear of being a burden to others. My observation of death is different – when I ring family members to offer condolences on the death of a loved one, they often tell me of a peaceful death and express gratitude for the palliative care and respiratory nurses who made that possible.
Some nurses have told me they support euthanasia because they don’t want to watch people die. I remember hearing something like this in medical school thirty years ago – a psychiatrist noted that often arguments for euthanasia are complicated by families’ fear not only of patients’ dying but of how difficult it is for loved ones to deal with this suffering. To me, this evidence suggests that in choosing euthanasia because they perceive themselves to be a burden to others, patients are suggesting they can’t deal with their loved ones’ suffering as well.
As a Catholic doctor who is opposed to abortion, I assumed my many medical friends who disagree with me on this issue would also disagree with me on euthanasia. However, the majority want nothing to do with it; many atheist doctors are vehemently opposed to euthanasia. We know what good palliative care and end-of-life planning can offer. We know we often get prognoses wrong – I have many patients coming to my clinic who should have been dead years ago. We also know that the great majority of those who took the euthanasia option would have had peaceful deaths with good palliative care. When this does not happen, it is far more likely due to health-care disparities than a lack of euthanasia availability.
I am what some would define as a liberal Christian. I believe in a woman’s control of her body and the right of an individual to end his or her own life when that life is beyond medical recovery. However, I also believe that these are very complex, profound, and personal moral issues that demand respectful exploration and self-examination. This does not happen often in today’s world, and it does not happen at all without people like those writing in Plough pushing us to question and evaluate our values and beliefs.
Benjamin Crosby’s article on Canada’s experiment with euthanasia is a case in point. Plough’s articles on abortion as a method of eugenics is another. In each case, I have had to ponder, reconsider, and change.
My younger brother Jon died of cancer in his early twenties. It was painful to see a healthy, strong twenty-year-old turn into an emaciated skeleton in just eighteen months. I remember, near the end of his life, pleading with God that he would die quickly. It was almost unbearable to see him in pain and feel so helpless. I wondered whether it could be merciful to help someone die gently and sooner, to spare them that pain. Sparing those we love from pain is a natural and good instinct.
But sparing pain is not the only form love takes. Seeing people who have suffered painful things or have been forced to live with a disability, things I would never choose for myself, and yet have grown into compassionate, beautiful people, challenges me to reconsider. I hesitate to pronounce judgment when I am so afraid of pain and disability. But we must consider those who have suffered, and have transformed their pain into compassion; who have found a meaningful, satisfying life with disability, with pain. Not for the sake of argument alone, but to offer an alternative vision of what constitutes a worthy life, a valuable life, and a good life.
Perhaps this is the unique vocation of the church. Not to compel others to live as we think they should, nor condemning them when they don’t, but offering an alternative vision, a better vision of what constitutes a meaningful life through how we value and care for each other. That is the ultimate question underlying euthanasia: What makes a life valuable, or worth living? Our best answer is not argument, but example. A more compelling, more beautiful, more meaningful way to live and value life. An irresistible vision, rather than an irrefutable one.
But what of terminal cases? Part of what compels me toward the Christian vision of life is that it takes death both more seriously, and more lightly. It frees us from the fear of death, and the fear of life. We can heartily affirm the goodness of life and death. To summarize Paul, to live is a joy because we can help others, and to die is to our advantage, because we go home to something even better.
Tolstoy’s “Death of Ivan Ilyich” seems very prescient on this issue and the way a medicalized vision of life and death warps our conception of what it means to live and die. Gerasim, to Ivan’s shock, cares for him in the indignities of illness, saying, “We’ll all be there someday.” This vision isn’t possible when late-life, illness, and death are relegated to the antiseptic rooms of hospitals. The greatest insight I’ve had into holy living and dying has been from caring for my own father, my grandmother, and another elderly woman in my home as they died. Those experiences have convicted me of my own responsibility to care for others in this fundamental human process and the desire to bear my own death when my time comes.
Working as a nurse in ICU, I interact with death and dying frequently. The medical machine rolls on until someone says stop. When a person or family makes the decision to stop (feeding, hydration, ventilation) we assist with medication for pain or anxiety. When we rely on modern medicine but have faith as backup, is it OK to choose not to be resuscitated? Death, childbirth, and old age can be painful; how much should believers rely on the benefits of science rather than accepting discomfort?
Engraved on the Heart
On Lisabeth Button’s “Letters from a Vanishing Friend”: I was moved by Ms. Button’s biography of her improbable friendship with Ellen, the childhood friend eventually afflicted with Alzheimer’s disease.
A detail that struck me was how Ellen might have been considered “lost” only to write a letter that was insightful and poignant.
I serve weekly as a Eucharistic minister to Catholic hospital patients wishing to receive communion.
Recently a note explained that a patient suffered from dementia, so any conversation would not be possible. Indeed, my greeting was received with a blank stare and no evidence of recognition or purpose.
Nonetheless, I decided to proceed and improvise as the spirit led me. As soon as the cadences of that ancient rite began, the old man lit up. His part of every response and prayer was recited perfectly. It was as though this sacred information was engraved on his heart and found a way for him to give it voice one more time.
No Grief without Love
On the PloughCast episode, “C. S. Lewis and the Problem of Pain”: As I wrote in “Another Grief Observed” for Plough several years ago, in my experience, love was the only redeeming force in the midst of grief. Guided by love, friends did what they could and community softened the hardness of grief. Sharing it all, Victoria (my wife) and I love each other all the more. In the context of love, the experiences of profound sorrow, gratitude, and joy are not mutually exclusive. We can love without grief but we do not grieve without love, and I would rather live in a world with grief than in a world without love.
The Empty Hands
On Eduardo Galeano’s “Communion of Empty Hands”: I was moved to tears by your article and artwork of empty hands communion. I lived in Argentina during the dirty war in the seventies; Uruguay was also in the throes of dictatorship, prison, torture, and death. I remembered my friend who was the only survivor of a large group of university students who were tortured and killed. She was spared because the military realized that she was a US citizen.
The empty hands gave me an image of not knowing how to pray or what to pray and I found comfort in just offering my unknowing to the author of life itself, so that the One who does know all can work in the midst of the mystery that makes all things new.
The One Who Helps
On Elise Tegegne’s “Foolish Generosity”: I have worked on the streets of New York City’s poorest neighborhoods for decades. Initially, I was like the author; I always looked away or only gave out money to get rid of a troublesome person. But with the passage of time I realized that nobody is a con. They are the desperate, impoverished, and broken among us who come to us in their need. So what if they ask for food money and then buy a cheap bottle of wine? Those few dollars relieve their pain for an hour or two. To judge the least among us for their desperation because they prefer cash to a pair of socks is kind of missing the message.
Back in the 1970s, I was a homeless teenage runaway from a violent alcoholic family for two years, until I could get legal and get back in the normal world. And I did. Both being homeless and becoming non-homeless were very hard. There are a lot of reasons people end up on the streets, and a lot of reasons people beg for money. To this day, if someone asks me for money, I’ll give it to them. I’d rather be taken for a sucker than be the one who doesn’t help.
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