Sister Elizabeth John of the Dolgellau Carmel concludes her study of the rise in support for assisted suicide
Status of Assisted Suicide
The status of medically assisted dying has changed dramatically in the last twenty-six years. Switzerland permitted it before 1997. As of October 2022, it is legal in ten countries and parts of the USA: Switzerland (since 1942, but mostly from the 1980s), the Netherlands and Belgium (2002), Luxembourg (2009), Colombia (2014), Canada (2016), Austria, New Zealand, and Spain (2021), Australia (2022), plus twenty-two states or districts in the US. In 2023, medically-assisted dying was legalised in Portugal, but assisted suicide and euthanasia remain illegal. It is still being debated in Germany, France and Scotland.
Passive euthanasia, where a patient simply
requests critical life support to be withdrawn, is permitted in at least nine
countries (the Czech Republic, Denmark, France, Germany, Hungary, Italy,
Norway, Sweden and the UK), ‘and probably quietly practised in rather
more’.[23]
The 2021–22 Session of the UK
Parliament was prorogued before the ‘Assisted Dying Bill’ made much progress.
However, Sir Keir Starmer, in a phone call to Dame Esther Rantzen in March
2024, pledged a vote on ‘assisted dying’ in the next Parliament if Labour won
the election, saying, “I’m personally in favour of changing the law … I think
we need to make time. We will make the commitment. Esther, I can give you that
commitment right now”.[24]
A Private Member’s Bill,
‘Terminally Ill Adults (End of Life)’, which applies to England and Wales, has
had its first reading. The Bill will be debated in the Commons on 29th November
(the second reading) and MPs will have another vote as to whether the
Bill should proceed further.
Slippery Slope
Canada has been cited as evidence of a
‘slippery slope’:[25]
MAID was introduced in 2016 for
adults whose death was reasonably foreseeable, expected within six months. It
was extended in 2021 to those with severe chronic but not terminal physical
ailments. It was also to have been made available in 2023 to those with severe
chronic mental conditions. However, the law was postponed for a year, and has
now been shelved again until March 2027.[26]
Currently under consideration
is the possibility of advance directives for people falling into conditions
like dementia that will remove their decision-making ability. MAID, in 2021, accounted for 3.4% of all
deaths in Canada (10,064 people).[27]
There is concern that health
professionals may feel pressurised into approving people for assisted suicide
and/or carrying out the procedure. Since 2021, the British Medical Association
has adopted a neutral position on PAD (previously they opposed it); members
have “a right to decline to carry out activities directly related to assisted
dying, for any reason”.[28]
A Culture of Death
Pope John Paul II writes of a
‘culture of death’ In Evangelium Vitae several times:
“…the
emergence of a culture which denies solidarity and, in many cases, takes the
form of a veritable ‘culture of death’. This culture is actively fostered by
powerful cultural, economic, and political currents which encourage an idea of
society excessively concerned with efficiency…
“While
it is true that the taking of life not yet born OR in its final stages is
sometimes marked by a mistaken sense of altruism and human compassion, it
cannot be denied that such a ‘culture of death’, taken as a whole, betrays a
completely individualistic concept of freedom, which ends up by becoming the
freedom of the strong against the weak who have no choice but to submit.”[29]
The word dignity has
unfortunately become associated with death, for example, in the
‘Campaign for Dignity in Dying’ in the UK, ‘Dying with Dignity in Canada’, and
‘Dignitas’ in Switzerland, there is an implication that other deaths are
not dignified.
‘Dignitas’ styles itself as being the
‘Swiss self-determination, autonomy and dignity group’. They are a
not-for-profit members’ society which “advocates, educates and supports for
improving care and choice in life and at life’s end…we are the spearhead for
the worldwide implementation of ‘the last human right’.” They claim, “Citizens
are not the property of the state. … They are the bearers of human dignity and
this is characterised most strongly when a person decides his or her own fate.”[30]
The British conductor, Sir Edward Downes, and his wife Joan, travelled in 2009
to Switzerland to commit suicide together at the ‘Dignitas’ Clinic. Joan had
terminal cancer but Edward, although he had poor eyesight and deteriorating
hearing, was not terminally ill. Sir Edward asserted, “This is a form of
evolution of humanity.”[31]
Esther Rantzen, who has stage four lung cancer, joined ‘Dignitas’ in
2023. She said that, if her latest treatment did not work, “I might buzz off to
Zurich”.[32]
As a contrast, in March 2024,
the Vatican published the Declaration Dignitas Infinita, which views
euthanasia and assisted suicide as a violation of human dignity, utilising “a
mistaken understanding of human dignity to turn the concept of dignity against
life itself.”[33]
Another word, choice,
has also become associated with death (such as the pro-choice abortion
lobby). A quotation on the Dignity in Dying home page reads: “I have
only months left and I want to be able to choose how and when I die.”[34]
Well, it is in God’s hands: you might not necessarily die from your illness!
One can only live in the present moment, as it is impossible to be certain what
will happen from one second to the next. “Watch therefore, for you know neither
the day nor the hour.” (Matt 25:13)
As an antidote, The Centre for
the Art of Dying Well at St Mary’s (Catholic) University, London, helps people
to live and die well and sees dying as a journey.[35]
A Sister was dying of cancer in our local hospital. She firmly told the doctor
on her final day, that “No”, she did not want anything to make her
more comfortable and told us to “stop the prayers for the dying” as she had
“only just started to die”. Later in the day, the four of us who were with her
all sensed that she was indicating that the right time for the prayers had
come; she peacefully took her last breath shortly afterwards.
Death is more remote now, at
least in our Western, sanitised, society, compared with the time when people
usually died at home. Maybe there is a greater fear of it in countries where
religion is becoming increasingly marginalised with the consequence that more
people believe that death is the end, rather than a beginning.[36]
Worthless Lives?
Who has the right to calculate the relative value of a
person’s life? I read of a gentleman in my home town who had Wolf-Hirschhorn
Syndrome and was not expected to survive until adulthood but celebrated his
fiftieth birthday last year. His mother said, “…we love having him. He’s taught
us all something.”[37]
I also knew a lady who developed a brain tumour quite early in her marriage,
but her husband – a humanist – continued to care for her lovingly for some
forty years. Consider Professor Stephen Hawking or Jean-Dominique Bauby, who
had Locked-in Syndrome and dictated his books The Diving-Bell and
The Butterfly by blinking an eyelid. We had a wonderful parlour with a
retired priest who was confined to a wheelchair after an error in a medical
procedure; he was so grateful for what he could do. It is amazing how the loss
of one sense can lead to heightened sensory awareness elsewhere.
The UN Special Rapporteur on The
Rights of People with Disabilities cautioned in a 2020 report:
“…If assisted dying is made available for
persons with health conditions or impairments but who are not terminally ill, a
social assumption could be made that it is better to be dead than to live with
a disability… People have the right to live and to die with dignity, but we
cannot accept that people choose to end their lives because of social stigma,
isolation, or lack of access to personal assistance, or disability-related
services.”[38]
People may feel that they have
a duty to die.[39]
Who knows what is going through
the minds of dementia patients? An Anscombe Bioethics Centre report has the
title, Dignity in Living: Addressing Euthanasia by Affirming Patient
Personhood in Dementia[40]
Are their lives of no value? One day, I was visiting one of our sisters in a
care home and she was being rather difficult but she suddenly started saying
the rosary. She had a very peaceful death with no medication, just gradually
fading over a few days. Another Sister who is in a nursing home can be very
unresponsive, keeping her eyes closed.
However, she senses when she is being prepared to receive Communion and
stops grinding her teeth, and she still joins in when we sing hymns.
What
about the comatose? A friend of mine died of cancer a few years ago and I
received reports that just before she died, she moved her crucifix over her
heart.
The Catechism of the Catholic Church on Suicide
The Catechism emphasises our
duty of care as follows: “We are stewards, not owners, of the life God has
entrusted to us. It is not ours to dispose of” (§2280), and points out that suicide is
contrary to love of self, love of neighbour and love of God. (§2281). “Voluntary co-operation in
suicide is contrary to the moral law.” (§2282) However,
there is an understanding of situations where there might be diminished
responsibility (§2282) and we should pray for those who have
taken their own lives, not despairing of their eternal salvation. (§2283)
Monotheistic Religions: beliefs on the end of life[41]
A Position Paper of the Abrahamic religions including Christians, Muslims, and Jews shows that we have the same core values on this subject, as a few excerpts will show:
“We
oppose any form of euthanasia … as well as physician-assisted suicide …
because they fundamentally contradict the inalienable value of human life and
therefore are inherently and consequentially morally and religiously wrong, and
should be forbidden without exceptions...”
“…We, as a society, must assure that patients’ desire not to
be a financial burden does not tempt them to choose death rather than receiving
the care and support that could enable them to live their remaining lifetime in
comfort and tranquillity...”
“Any dying patient should
receive the best possible comprehensive palliative care – physical, emotional,
social, religious, and spiritual.”
The
Anscombe Bioethics Centre in Oxford has conducted valuable research on
euthanasia and assisted suicide.[42]
Some important lessons, for instance, can be learned from a report on
euthanasia case-studies from Belgium, which include difficulties in life
expectancy estimates, and problems related to euthanasia’s causing confusion
and distrust in palliative care. Major life-events can result in patients
living longer than expected. Accepting a
natural death can bring peace to the family and caring for a loved one need not
be seen as a burden. A lady who requested euthanasia, in one touching case, was
initially moved from intensive care to palliative care, where she found rest,
gradually recovered, returned home, and lived for a further three years in good
health before dying naturally.[43]
Suffering[44]
‘…Most of these [days of our life] are emptiness and pain.
They pass swiftly and we are gone.’ (Ps. 89:10)
Jesus did not come to end
suffering but he is with us in our sufferings. “God is faithful, and he
will not let you be tempted beyond your strength.” (1 Cor. 10:13) There should be greater
understanding of the word compassion: “com–passion” means suffering
with. Suffering can be a lesson in patience and acceptance for the person
suffering and incentive toward greater selflessness for those helping them.
Consider the spiritual benefits of redemptive suffering. Dignitas Infinita
states:
“It
must be strongly reiterated that suffering does not cause the sick to lose
their dignity, which is intrinsically and inalienably their own. Instead,
suffering can become an opportunity to strengthen the bonds of mutual belonging
and gain greater awareness of the precious value of each person to the whole
human family.”[45]
It is not unknown for religious
to commit or to be tempted to commit suicide. St Thérèse suffered greatly
during her final months (as well as receiving graces), and had suicidal
thoughts:
“What a
grace it is to have faith! If I had not had any faith, I would have committed
suicide without an instant’s hesitation...” (Yellow
Notebook,
22nd September 1897, no. 6)
“Watch carefully, Mother, when
you will have patients a prey to violent pains, don’t leave near them any
medicines that are poisonous. I assure you, it needs only a second when one
suffers intensely to lose one’s reason. Then one would easily poison oneself.” (Conversation with Mother
Agnes of Jesus, a:46, 23rd Aug. 1897)
The use of ‘Do Not Resuscitate’
(DNR) notices are intended to relate to cardiopulmonary resuscitation (CPR),
but poor Robert Murray choked to death because he had a DNR notice on his care
home file, so the paramedics were stood down.[46]
Another
grey area is where people continue to seek additional medical opinions because
they insist that someone’s life should continue, rather than receiving
palliative care.
Conclusion
This
article was a series of considerations, rather than arguments leading to a
conclusion. One can only pray that assisted suicide will not become legal in
the UK, that Esther Rantzen may yet become a champion for palliative care, and
that appropriate palliative care guidelines be put in place.
“If I should walk in the valley of darkness
no evil would I
fear.
You are there
with your crook and your staff,
with these you give me
comfort….” (Ps 22)
On a positive note: If a phrase containing the word ‘suicide’ is Googled, a ‘help is available’ message appears with a link to the Samaritans.
ENDNOTES
[23]
Wittenberg-Cox, “Designed Death”.
[24]
See, e.g. the Independent, 13 March
2024
<https://www.independent.co.uk/news/uk/politics/keir-starmer-pledge-assisted-dying-vote-b2511370.html>.
Esther Rantzen is well-known for her charitable work and defending the rights
of consumers, so she has gained people’s trust.
[25]
Avivah Wittenberg-Cox and Tim Hollins, “Slippery Slope Or Wise Demise? The Pros
and Cons Of Medically Assisted Dying”, Forbes
Magazine, 1 November 2022 <https://www.forbes.com/sites/avivahwittenbergcox/2022/11/01/slippery-slope-or-wise-demise-the-pros-and-cons-of-medically-assisted-dying/?sh=3515cbc318c9>.
[26]
<https://www.dyingwithdignity.ca/end-of-life-support/get-the-facts-on-maid/>.
[27]
Wittenberg-Cox and Hollins, “Slippery Slope”.
[29]
Pope John Paul II, Evangelium vitae
(On the Value and Inviolability of Human Life), 25 March 1995, §12 and §19
respectively.
[30]
See Dignitas: Home Page and Dignitas: Principles / Philosophy respectively,
<http://www.dignitas.ch>.
[31]
Written evidence submitted by Dignitas to the Health and Social Care
Committee’s Assisted Dying / Assisted Suicide Inquiry, January 2023
<https://committees.parliament.uk/writtenevidence/116663/html/>.
[32]
“Esther Rantzen Says She’s Joined Assisted Dying Clinic”, BBC News, 19 December
2023 <https://www.bbc.co.uk/news/uk-67756506>.
[33] Dicastery for the Doctrine of the Faith,
Declaration Dignitas Infinita (On Human Dignity), 25 March 2024,
§51.
[36]
In the 2021 Census, only 46% of the population identified as Christian (in 2011
it was 59.3%) <https://www.ons.gov.uk>.
[37]
“Happy Soul: Matthew Carter”, Derby
Telegraph, 3 February 2023 <https://www.derbytelegraph.co.uk/news/local-news/happy-soul-matthew-carter-who-8101652>.
[38] A/HRC/43/41: “Lives
Worth Living: Fighting Ableism and the Devaluation of the Lives of Persons with
Disabilities”
<https://documents.un.org/doc/undoc/gen/g19/346/54/pdf/g1934654.pdf>.
[39]
See, e.g., the Archbishop of Canterbury’s statement on assisted suicide made on
16 October 2024 <https://www.archbishopofcanterbury.org/about/meet-justin-welby/archbishop-justins-priorities/archbishop-canterbury-warns-against>.
[40]
Dr Pia Matthews, “Dignity in Living: Addressing Euthanasia by Affirming Patient
Personhood in Dementia”, Anscombe Bioethics Centre, Oxford, 2021 <www.bioethics.org.uk>.
[41]
Position Paper of the Abrahamic Monotheistic Religions on Matters Concerning
the End of Life, Vatican City, 28 October 2019
<https://www.academyforlife.va/content/pav/en/pallife/position-paper.html>.
[43]
Professor Benoit Beuselinck, “Euthanasia Case Studies Fatherom Belgium:
Concerns About Legislation and Hope for Palliative Care”, Anscombe Bioethics
Centre, Oxford, 2021 <www.bioethics.org.uk/research/euthanasia-assisted-suicide-papers/>.
[44]
See also the reports on the 2023 IFM in the October 2023 issue of Cor Unum.
[45] Dignitas Infinita, §51.
[46] “Do Not Resuscitate: Man Choked to Death after
Paramedics Stood Down”, BBC News, 16 May 2023 <https://www.bbc.co.uk/news/uk-65597888>
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