‘A moral seduction.” That is how our late friend and columnist John F. Kavanaugh, S.J., described the debate around physician-assisted suicide in 1997.
“We have succumbed before,” Father Kavanaugh wrote, “in our always justifiable wars, in the treacherous bargain with capital punishment, in the 1973 Roe v. Wade decision to dehumanize unborn children. But now the stakes are higher. The ‘slippery slope’ of diminished human value is in deep descent.”
What would Father Kavanaugh say today, with several states considering bills to legalize assisted suicide? Oregon led the way in 1994, and now California and New York are following suit, prompted by the very public death of 29-year-old Brittany Maynard last year. Ms. Maynard decided after being diagnosed with cancer to end her life and moved to Oregon for this purpose. The “right to die” movement had been largely moribund, at least in the United States, but sometimes all it takes is a single episode to rekindle a seduction.
A ballot initiative proposing the legalization of assisted suicide failed in Massachusetts in 2012, but the question will not go away. It cuts to the heart of many issues that are important to our society: the rising costs of health care; personal liberty; questions of human dignity. As more baby boomers enter their elder years, and fewer turn to religion for consolation and guidance, more states will begin to consider assisted suicide as a legitimate path for those who suffer.
Is this the solution? The medical community places the utmost importance on individual agency. Decisions made by a patient or proxy on questions of nutrition, pain management and resuscitation are accorded full authority under the law. Why should it not be so for the ultimate decision, when to end our lives?
Marcia Angell, a respected Harvard physician and former editor of The New England Journal of Medicine, speaks for many when she argues in favor of legalizing assisted suicide “for terminally ill patients whose suffering cannot be relieved in any other way.” Some of the most ardent supporters of assisted suicide laws are those who work with people who have ALS, who face a painful physical decline. These are people who care deeply for patients under their watch. It is people like these the church must address when it makes the case for caring for patients until their natural death.
The focus, for ALS patients and others in distress, should be on alleviating suffering. Much can be accomplished with proper treatment. Consider the late work of the historian Tony Judt, who died of ALS. As Dr. Michael J. Brescia, the executive medical director of Calvary Hospital in New York, a widely respected palliative care facility, says in a new video produced by the New York State Catholic Conference (catholicendoflife.org): “The physical aspects of suffering are the easiest to control; the hard part is the emotional suffering.”
Here lies the primary danger with expanding legal assisted suicide. Patients, not wishing to be a burden on their friends and family, may seek to end their lives out of a sense of loneliness or desperation. Safeguards can be set up, as they have been in Oregon, to make sure patients are making the decision for the “right reasons.” But they are an insufficient solution to what remains a much larger problem.
Our society must re-evaluate its notion of personal freedom and how far it extends. Do we not have obligations beyond ourselves? What if we began to think about death not as a moment to assert our personal autonomy to its fullest extent, but as a moment to teach our sons and daughters, our nieces and nephews, about what it means to suffer and, finally, to die with dignity? As Ronald Rolheiser, O.M.I., writes in his book Sacred Fire, this is the final challenge we face as Christians. We cannot shy away from it.
But what is dignity? The term is widely misused, as evidenced by the title of Oregon’s Death With Dignity Act. In our secular culture, dignity means living as you would want to live, being seen as you wish to be seen, not in a degraded state and certainly not in diapers. But this is the moral seduction: to think we can avoid suffering, or at least limit it—to control our lives to the very last moment.
We believe that dignity is deeper than that. Viktor E. Frankl, a Holocaust survivor, wrote, “Every human person constitutes something unique; each situation in life occurs only once…a man’s life retains its meaning up to the last—until he draws his last breath.” This is our starting point as believers. It is why Catholic health care workers excel at palliative care, and why they must continue to model this service to the whole medical community. Who knows when moments of grace may come for us and our families? Our job is to care for one another, at all moments of our lives, and trust that our loving God will shelter us in the end.