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The EditorsMarch 04, 2015

‘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.

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William Sippo
9 years 4 months ago
RELIGIOUS FAITH . . . THE OPIUM OF THE MASSES ! Control of pain and suffering is an essential treatment goal in the practice of modern medicine and surgery. As a practicing Physician and Surgeon of 32 years, I have had extensive experience in exposing patients to necessary but sometimes painful procedures and treatments for their ultimate benefit. The appropriate use of opioid medications to blunt the pain of illness and surgery . . . . . . assists patients to tolerate life benefiting and life extending treatments and procedures . . . permits treated patients to rest comfortably and allow nature to perform the healing process . . . encourages patients to actively participate in rehabilitation and improvement of functional performance . . . allows patients to withstand the debilitating ravages of chronic conditions that are incurable So when Carl Marx labels Religion the 'Opium of the Masses' . . . he is spot on. For controling the pain and suffering which we all experience in life through Religious Faith and Prayer, . . . assists people to tolerate the disappointments, injustices, and problems of daily life . . . permits people and families to find solace, rest and healing for their unreconciled losses . . . encourages people to actively rebound from setbacks with hope and vigor . . . allows people to withstand the burden of chronic or progressing physical, emotional, and spiritual suffering Far from degrading the value of Religion, his statement reinforces the natural importance of Faith in human lives. It is good and natural for us to seek solace in the Belief of a loving and assisting Entity beyond ourselves. When people seek to find this Benevelent Force . . . Their revelation is not always the same . . . . . . They may find Him in the Jewish Scriptures and recognize Him as 'I Am - The Unspeakable Name' . . . . . . They may find Him in the Judeo - Christian Scriptures and recognize Him as The Father - Son + Holy Spirit . . . They may find Him in the Muslim Koran and recognize Him as Allah . . . . . . They may find Him in the Buddhist Teachings and recognize Him as The Buddha . . . . . . They may find Him or Her in another Religious Tradition and recognize an Entity to whom they can relate. However, Whomever a person recognizes as their Entity, the result of this relationship is universal . . . . . . They find a source of Peace - Hope - Love and a meaning for their existence . . . situation . . . and struggle. This preamble leads into the discussion of suffering, aging and the inevitable death which we must all face. It has been my experience, that people with a strong, deep seated faith accept their pain, suffering, debilitation and death with greater sense of purpose and hope. This does not mean that they desire to have a rigorous or challenging decline and death, but rather that they extract some meaning to their lives even amidst the natural progression of their decline unto death. It is my proposition that the increase in agnosticism removes the value of our decline and death as part of our natural cycle of life. These people then, seek a quick and simple end to their life before they endure too much suffering or decline because they find no value or future in enduring. As Medical Professionals we need to do a better job of being honest to patients about their decline and death. We must get over our sense of failure when we cannot keep a patient alive and well for ever. We must actively put forth the extra effort to realistically address those issues which we can effect such as pain control, symptom control, and guidance away from futile care employed only to appear to be doing something, at great cost, but for little benefit. We must understand when to offer palliative care and hospice care as a means of supporting appropriate patients toward their natural end with some comfort and dignity. We must encourage patients to stay the course, to seek spiritual guidance, and to continue to discuss those issues which we have not adequately resolved. It is also beneficial for us, as Healthcare Providers, to seek for ourselves a touch of Religious Faith to provide us the patience, strength, and sense of purpose in delivering protracted, less rewarding end of life care. To the Religious, I strongly feel that you need to do a better job of preaching the hard talk amongst a portion of your sermons and counseling. You need to teach your people that it is natural, even in a good persons life, to experience suffering, loss, and the inevitablity of physical, functional, and mental decline. You need to help them find meaning and hope in even the unpleasant aspects of life. This was driven into me in my Catholic School education and is one of the greatest insights that I retain from those days. The understanding that there is true value in accepting and offering up the disappointments and pain that are part of our everyday life. In secular terms, 'If it does not kill you, it could make you stronger' . . . if you offer it up. Religious professionals need to examine their actions to see if they could do a better job in ministering to the sick, suffering and dying. Just as the majority of Physicians prefer to avoid patients whom they cannot cure, in my experience, there is a similar reluctance for religious to visit the incurable especially in secular hospitals. Ironically, these patients and their families are the persons who have the greatest need to reinforce their faith, to find hope in their situation and to remember that the love of God is waiting for them.. If we as Medical Professionals and Clergy do a better job in our ministering to the sick, elderly, declining, disabled and dying . . . and to their families, then there would be less need for patients to actively pursue death. We need to do all we resonably can to address pain, disablity, fear and worry. We need to provide honest answers to their questions, concerns and situation so that patients can control their remaining days. We need to discuss and offer alternative passive pathways to their death such as palliative care, hospice care, and alternatives to futile treatments that prolong existence but do not solve the main problems. William C. Sippo MD, FACS

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