Suicide And Euthanasia
By Rev.G.J. MacGillivray M.A.
London Catholic Truth Society No.s0131 (1966)
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WHAT EUTHANASIA MEANS
"Look, at this wretched man, suffering from cancer, or some other painful and incurable disease. He has nothing to look forward to but months of suffering, ending in inevitable death. Why should he not be allowed to end it all now swiftly and painlessly? If a dog or a cat were hopelessly diseased and in pain, you would consider it cruel to let it go on suffering. You would put it out of its misery. Then why is it not cruel to let a human being linger on in pain? Why be more merciful to a dog than to a man?"
Questions of this kind are becoming increasingly common. And they are being asked, not merely by a few erratic individuals, but by distinguished doctors and surgeons, ministers of religion, and other people in responsible positions.
There was a case of a woman whose husband was afflicted with some painful and incurable malady, and who poisoned first him and then herself. The coroner instructed the jury that, if they were satisfied that the woman intended to kill her husband and actually did so, they were bound to bring in a verdict of murder. He suggested that at some future time it might be lawful to put such sufferers painlessly to death, but that it was not so now, and in any case it would have to be done by properly constituted authority, and not permitted to private individuals. The jury did as they were told, and brought in a verdict of murder and suicide while of unsound mind, but the foreman added that they regretted having to do so, because they regarded the woman's action as a brave and merciful deed. It is not clear how a brave and merciful deed is consistent with being of unsound mind, but that little contradiction did not seem to worry them.
But things have gone so far that a society has been formed called the Voluntary Euthanasia Legislation Society, the object of which is to promote legislation which would make it lawful for a doctor, at the patient's request, after fulfilling certain conditions and obtaining a permit from a "Euthanasia Referee" appointed by the Ministry of Health, to terminate by a swift and painless death the life of a person suffering from a painful and incurable disease. The first president of this society was Lord Moynihan, quite an array of prominent names appearing as vice presidents, many distinguished physicians and surgeons being its Consultative Medical Council, and a number of well known ministers of religion, including a Dean of St. Paul's, the Dean of Canterbury, the then Regius Professor of Divinity at Cambridge and some prominent Nonconformists, gave their assent to its proposals, saying that in their opinion "voluntary euthanasia, i.e. painless death for persons desiring it, who are suffering from incurable, fatal, and painful disease... should not be regarded as contrary to the teaching of Christ or to the principles of Christianity."
The secretary of this society, Dr. C. Killick Millard, wrote a little book in which the principles of the society are set forth. It has a preface by Sir Arbuthnot Lane and an appendix "containing expressions of opinion from Medical Men, Clergymen and Others". The book is an interesting study in modern methods of propaganda. It professes to be an appeal to "the enlightened conscience of mankind" against "the old spirit of prejudice and intolerance." But in fact it is almost entirely an appeal to sentiment, with hardly any attempt at reasoning or discussion of fundamental principles. The whole contents of the book might be summed up thus: "Picture to yourself the dreadful sufferings of these poor people. Why let them suffer? Why be more merciful to a dog than to a human being? Many pagans approved of suicide. Then came Christianity, and Christians have always condemned it - at least until recently.
But now we live in a more enlightened age, and it is time to get rid of these old prejudices." A pretty appeal, no doubt, to those who pride themselves on being more enlightened than their fathers - and that is a powerful appeal in these days - but it is not rational argument.
Dr. Millard's curious method of reasoning may be illustrated by a few of his statements. He says that the "fundamental distinction between legalized voluntary euthanasia and what is ordinarily understood by suicide" consists "in the fact that the one is legalized and approved, whilst the other is illegal and condemned." In other words, there is no difference between right and wrong except what the law of the land Cows or for bids. Right and wrong are created by Parliament. So, if an Act of Parliament were passed making it lawful to put to death by slow torture all members of the V.E.L.S., it would be quite right to do so! Again, he says: "My own feeling about the ethics of suicide is that it depends almost entirely upon the motive prompting the act." But suppose that someone, regarding Dr. Millard's teaching as detestable and injurious to society, were to "feel" that the community would be better without him, and were to take upon himself to murder Dr. Millard, would he not be acting from a high and unselfish motive? But would Dr. Millard approve the act as "rational, courageous, and highly altruistic"?
To take just one other example, Dr. Milliard tells us that the "fundamental difference" between suicide and murder is "that in murder we commit a grievous wrong against another, in that we rob him of his most precious possession, his life; whereas in suicide we are only destroying that which, humanly speaking, is our own." What does he mean by "humanly speaking"? He can only mean ignoring God. But the whole case against suicide is that we must not ignore God, and that our life is not our own, but belongs to God. He tries to prove his case by ignoring, not attempting to disprove, the whole basis of his opponent's argument. Once more, this is not rational discussion.
It is amusing, by the way, to notice that the V.E.L.S. actually issued a leaflet in which an attempt is made to claim the authority of St. Thomas More for their doctrine, on the ground that he describes the inhabitants of Utopia as practicing euthanasia. The writer of the leaflet evidently thinks that St. Thomas means to approve of everything that he describes as taking place in that "Land of Nowhere," whereas in the book itself St. Thomas makes it perfectly clear that he does not. The writer of the leaflet himself describes the Utopia as a "jeu d'esprit," and that is exactly what it is, a half serious and half jesting description of an imaginary country, in which there are some things of which the author approves and many of which he strongly disapproves.
But it is clear that these proposals of the V.E.L.S. will not satisfy the more extreme supporters of the euthanasia movement. They will regard them as only an installment. For example, Dr. Alexis Carrel, a distinguished American doctor, was quoted in the press as saying: "The question is one of great importance. Sentimental prejudice should not stand in the way of civilization. It is my opinion that not only incurables, but kidnappers, murderers, habitual criminals of all kinds, as well as the hopelessly insane, should be quietly and painlessly disposed of." (Notice how guilty and innocent people are lumped together without distinction). Dr. Emmanuel N. Josephson is said to have stated that "Physicians know that those born hopelessly deformed live in absolute misery. They should be gently put out of that misery as a saving and safeguard to the state." And Dr. Frederick Bancroft is quoted as saying. "I do not see why we should not give humans the same treatment that we accord animals."
It is. clear, therefore, that this question of euthanasia is an urgently practical one, and it is of great importance that Catholics should be ready with an answer to the arguments of those who advocate it. But first we must get clear the meaning of the term euthanasia. It is a Greek word, and means literally a "good death." What Catholics understand by a good death we shall consider later. But euthanasia is always used as meaning an easy, painless death. But this is still ambiguous. It might mean the administration of drugs merely to alleviate pain, and so make the passage out of this world as easy as possible, without attempting to hasten it. This is a perfectly lawful thing to do.
But to-day euthanasia has come to be used as the technical name of a much more drastic process. It means definitely killing, by using drugs or other means which put an end quickly to the patient's life, instead of allowing him to live until he dies of his disease. Some advocate doing this only with the consent of the patient, while others, as we have seen, would do it in certain cases without his consent. It is in this sense, therefore, that the term will be used in this pamphlet. And we couple it with suicide, because the principles involved are the same. The questions are whether it is ever lawful for a person to kill himself, or for one person to kW another, and if so, in what cases.
OBVIOUS OBJECTIONS
There are some very obvious objections to euthanasia. One is that doctors are not always right in their diagnosis. In fact they are often wrong. Consequently there would be a great risk of killing people who might have recovered and lived happily for many years. Everybody with much experience of sick folk has come across cases in which doctors have pronounced their patients to be incurable, and they have afterwards been restored to health. Indeed a distinguished Scottish physician, Dr. Thomas Colvin, has stated that the term "incurable disease" should never be in the vocabulary of any true physician or true surgeon.
He pointed out that diseases which were considered incurable half, or even a quarter, of a century ago are curable to-day. He declared that euthanasia would be an admission on the part of the medical profession that they were bankrupt in medical research, and added, very truly, that the prime and sole duty of the doctor is to cure, not to kill. He also asserted that the safeguards in the Bill promoted by the V.E.L.S. are purely theoretical, since "unscrupulous doctors and unscrupulous lawyers could play ducks and drakes with them," and there would be "a temptation for unscrupulous persons to insure heavily their relatives and then magnify their minor ailments as qualifying them as candidates for the lethal chamber." Again, as Dr. Colvin very truly says, the legalization of euthanasia would destroy that confidence of patients in their medical advisers which is so essential to recovery. "What patient," he asks, "could have confidence in a medical attendant who had the legal power to kill him? And how few patients would consent to go to a hospital for necessary treatment of their ailments? For they would read that it was only a half-way house to the lethal chamber."
Indeed, if the Bill became law, I can imagine many patients, especially among those who are treated free in hospitals, saying: "Now, I suppose, when the doctor gets fed up with my case, and cannot be bothered with me any longer, he will say I am incurable, and when I am in great pain, and not able to think clearly, he will persuade me to sign some paper authorising him to kill me. No, thank you, no more of those hospitals for me." And to this it may be added that there is a strong suspicion in the minds of many people that some doctors praxes euthanasia now, quietly terminating the lives of patients whom they regard as incurable, with or without their consent. In Dr. Millard's book, Dr. Percy Dearmer is quoted as saying that "a certain amount goes on at present," and Dr. Millard prints this without denial or other comment. At any rate it is true that many people suspect it, and if it were legalised, with whatever theoretical safeguards, these suspicions would be enormously increased. It would be a terrible blow to the prestige of the medical profession going a long way towards destroying that confidence and respect which have hitherto been given to it.
Another obvious objection is that people suffering from incurable diseases very seldom wish to die. Dr. Halliday Sutherland, in one of his books, says: "It is the everyday experience of doctors and nurses that patients, even in the last stage of cancer or tuberculosis, cling to life. Only once have I known a patient who asked for an overdose of morphia.... It is not physical pain, but mental anguish that drives men and women to suicide." And Dr. Colvin quotes Dr. R. A. Fleming as stating that not one of his patients in the Royal Edinburgh Hospital for Incurables has a desire to die.
FUNDAMENTAL PRINCIPLES
But these are far from being the most serious objections to euthanasia, serious as they are. We must now get down to fundamental principles. The difficulty, however, in a discussion of this kind is that usually we and our opponents start from entirely different first principles. Or, more often, we start from certain first principles, and our opponents have none at all, but are guided merely by considerations of expediency and sentiment. It seems best, therefore, in a pamphlet like this, to begin by stating clearly the first principles from which the Catholic argument proceeds, that is to say our beliefs about God, our relation to God, and the meaning and purpose of life. Then we proceed to show the logical conclusions on these questions of suicide and euthanasia which necessarily follow. Finally we shall try to see how the advocates of suicide and euthanasia have gone astray.
We begin, then, by stating very clearly that we believe in God, the Creator of all things. This sounds elementary, but we must start here, because it is on this fundamental belief that our whole argument depends, and we may have to push our opponents back to the plain question : Do you believe in God? For it is chiefly by ignoring God and His claims that people go astray in questions of this kind. They go on talking about the cruelty of allowing unnecessary suffering, the uselessness of prolonging a miserable life, the rights of the individual, the feelings of his relatives, the good of society, and so forth. But all this is a beating of the air unless they first state clearly on what first principles their arguments are based. We must push them back to that and ask them bluntly: "Do you believe in God?" If they do not, further discussion is useless, because we have no common basis. And in fact the words that they use, such as "ought" and "ought not," "duty," "right" and "wrong," are meaningless. If there is no God to whom we are accountable, there is no such thing as right and wrong. But if, on the other hand, our opponents admit a belief in God, then we can go on to a rational discussion, and we can proceed to set forth our arguments. We believe, then, in God, the one eternal. self-existent Being, who is infinite in power, wisdom, goodness, justice, love, and all other perfections. And we believe that this God is the Creator of all things, including ourselves. He created us, and from this it follows that we belong to Him. If we had created ourselves, we should belong to ourselves. But we did not. We were created by God. We owe our being to Him. Therefore we do not belong to ourselves, we belong to God. We are His property absolutely. Therefore we have not the right to dispose of ourselves as we please. We exist, not for our own pleasure, but for God, to give Him the service, worship, and glory which He made us to give Him.
But, further, we believe that it was out of infinite love that God created us. He created us to give service, worship, and glory to Him, but He willed that in giving glory to Him we should find perfect happiness. The act of creation was an act of goodness and love. God created because He is good, and goodness is diffusive of itself. Good always seeks to spread itself. So God desired to have creatures upon whom He could pour out something of His own infinite treasure of goodness and happiness. God created us because He loved us. He loved us before ever we existed. He loved the creatures whom He intended to create. And now He loves us because He created us.
Consequently we are bound, not only to serve and give glory to God, but to love Him and to give Him a willing and loving service. And it is only in doing so that we can ultimately find perfect happiness. To attempt to go our own way and please ourselves can only end in disaster. The only possible way for us to attain lasting happiness is to go in the way that God has marked out for us.
But it is not in this world that we reach our end. We believe that our souls are immortal. This life is only the beginning. We live here for a few years and we die. That is to say that the body dies, but the soul leaves it and lives on eternally. And even the body does not end in the grave, for some day it will rise again. It will be transformed, no doubt, in a way that as yet we cannot imagine. But it will rise and be restored to the soul, and the whole man, soul and body, will live eternally.
We are, then, merely passing through this world on the way to eternity. It is not in this life that God intends us to find lasting happiness, but in the next. Moreover, our eternal happiness hereafter is the reward of faithful service here, and there is the awful alternative that, if we fail to serve God faithfully here, we shall miss the end for which God destined us, and find ourselves cast off from Him in eternal misery.
It is from the fact of our creation by God that there arises duty. If there were no God there would be no such thing as duty. Duty means something that we owe to another. If vie had created ourselves, we should owe nothing to anyone. But since God created us, we owe everything to Him. We owe it to God to give our whole lives to Him, to love, worship, obey, and serve Him. But from that it follows that we have a duty to ourselves and a duty to our neighbour.
It is our duty to take care of God's property entrusted to our charge - our souls and bodies. They belong, not to us, but to God. We must therefore take such care of soul and body that we may be able to serve God, do the work which He has given us to do, and go on doing it as long as it pleases Him to leave us here, and so attain to that future life in which we shall be perfectly united to God, and find perfect happiness in giving to Him the glory that is due to Him to all eternity. That is our duty to ourselves.
We also have a duty to our neighbour. Since God has created him and destined him for a certain end, he has a right to enjoy all the means necessary for attaining that end, and it is our duty not to interfere with him or hinder him, but on the contrary to give him the help he needs. We must respect his rights. And first of all these rights is the right to live so long as it pleases God to leave him in this world. God has given him his life, and he has a right to live it.
WHEN IS IT LAWFUL TO KILL?
Certainly there are limits to these rights, for men must not pursue their rights in such a way as to violate the rights of others. They may therefore be justly restrained from such actions as to violate the rights of others, and may justly be punished if they commit them. And from this it follows that in certain cases it is even lawful to kill. The cases in which it is lawful are three.
The first is that of the unjust aggressor. If I am unlawfully attacked, I am justified in defending myself, and if the only way of saying my own life is by killing the aggressor, it is lawful for me to do so. Similarly it is lawful to kill the unjust aggressor against another, in defence of his life. And it is generally held that this applies also to the defence of very valuable property. A woman also may kill a man in defence of her chastity, if she is unable otherwise to repel him.
The second case in which it is lawful to kill is that of capital punishment, ordered by lawful authority. The public authority in any state has a certain power, delegated to it from God, over the lives of the citizens. It may never, indeed, put to death an innocent person, because every man has the right to live until he has forfeited that right by a gross violation of the rights of others. But the state has the right and duty of punishing such violation, and there are certain crimes which are appropriately punished by death. There are crimes which are so injurious to the community that the offender deserves to be cut off from it altogether. In the present law of England, death is still the penalty for murder and High Treason. In the Mosaic Law, which had divine authority, it was also decreed for such crimes as idolatry and adultery.
The third case is that of a just war. Fighting among private individuals is forbidden, because there is a superior authority to which they can appeal for justice. But a state may have no means of defending itself or vindicating its rights except by war. If that is so, the nation is justified in making war, and its soldiers are justified in fighting, and therefore of course in killing, if they can, the enemy's soldiers. It is evident, of course, that in every war one state must be right and the other wrong. Therefore, if it is a just war for the one, it must be an unjust war for the other. But everyone who is satisfied that his own country is in the right must regard it as a just war on his side, and is therefore justified in fighting. On the other hand, if anyone is convinced that his country is in the wrong, he must refuse to fight, whatever the consequences of refusal may be.
It should, however, be added that the causes of war are often so complicated that ordinarily the individual soldier has not the means of forming an accurate judgment, and therefore does well to assume that his own country is in the right, unless the contrary is very clear to him. The responsibility lies mainly upon those in authority.
These are the only cases in which it is lawful directly to kill another man. It is never lawful for anyone directly to kill an innocent person. Of course in the case of unjust aggressors it makes no difference whether they are morally guilty or not so long as the act of aggression is in itself unjust. Thus, if I am attacked by a madman, I may certainly kill him in self-defence, although he is not morally accountable for his action. And so in war I may kill the enemy's soldier, although he may think that he is only doing his duty and is therefore personally guiltless, so long as I am convinced that the war in which he is taking part is unjust on his country's side and just on mine, and that he is therefore taking part in an unjust aggression.
PRINCIPLE OF THE DOUBLE EFFECT
I have used the phrase "directly to kill," because there is an important principle in morals called the principle of the "double effect." It may be stated thus : It is lawful to perform an action which is in itself good, or at least indifferent, which will have two effects, of which one is good and the other bad, provided that the good effect is immediate, that the intention is good, and that there is a proportionately grave cause. In other words, I may perform an action, which is in itself good or indifferent, if the direct effect of it (and the effect which I intend) is good, even if it has another effect which is bad, provided that the good to be obtained is sufficiently great to justify the permission of the bad; for in that case I am doing a good action for a good purpose, and I do not intend the bad effect, but merely, with sufficient reason, permit it. It is important to notice that the action must be in itself good, or at least indifferent, because in spite of what our slanderers say, we Catholics - Jesuits or otherwise - do not hold that the end justifies the means. It is never allowable to do an action which in itself is wrong, however much good may be likely to result. It is never lawful to do evil that good may come. Thus it is always wrong directly to kill an unborn child in order to save its mother's life, because that is directly doing a bad action that good may come.
It is quite lawful, however, if the mother is suffering from some grave disease, likely to prove fatal, to give her medicine to cure that disease, even if you foresee that this may, incidentally, result in the death of the child, provided, of course, that there is no other way of curing her ; for here the action itself, the administering of the medicine, is good and the direct effect, the curing of the mother, is also good, while the evil effect, the death of the child, is merely permitted. So too in war, it is unlawful directly and intentionally to kill non-combatants. But it is lawful to bombard a fortified town, even if it is morally certain that some noncombatants will incidentally be killed. Their death is not intended, but merely permitted.
THE DUTY TO PRESERVE OUR OWN LIFE
From these principles it follows that in no case is a man justified in killing himself, because he cannot be called upon to defend himself against himself. He cannot be an unjust aggressor against himself. The only conceivable case in which it would be lawful for a man to kill himself would be if, having committed a crime, he were appointed by lawful authority his own executioner. Thus Socrates., if he had been really guilty of the crimes charged against him, might have been justified in drinking the cup of hemlock offered to him. But that is the only possible exception to the law that a man may not kill himself.
But not only are we forbidden to kill ourselves, we are also bound to take all reasonable care, and to adopt all ordinary means to preserve our life. Consequently it is wrong to expose oneself to grave danger without a good and sufficiently grave reason. Thus, if a man were to perform very dangerous "stunts" in an aeroplane merely out of vanity, in order to "show off," he would be committing an unlawful act. On the other hand, a soldier is quite right in exposing himself to very grave danger, as he obviously must do, in fighting for his country. He may even expose himself to the certainty of death, as when a number of soldiers, overpowered by the enemy, refuse to surrender, knowing that they will be shot down to the last man. The good effect which their courage will have justifies them in doing so. Nothing could justify them in killing themselves, but they may in these circumstances allow themselves to be killed.
Similarly a fireman quite lawfully and commendably runs a great risk in order to rescue someone from a burning building. A missionary quite rightly risks his life by living in an unhealthy climate. A doctor, or nurse, or priest quite properly runs similar risks in attending to persons suffering from infectious diseases.
It is quite clear that on these principles it is also unlawful, without a good and grave reason, to pursue any course of action which is morally certain to shorten one's life. But it is lawful for a good and sufficient reason. It would, for example, be lawful for a man to engage in some work which was certain to shorten his life if he had no other means of supporting his family, or if the work was of vital importance to society.
It has been said above that we are bound to employ all ordinary means to preserve our life. But we are not bound to employ extraordinary means. Thus, if a man is seriously W, he is bound in duty, unless he knows how to treat himself, to call in medical aid, and use such ordinary remedies as may be prescribed. But, if he is told that the only means of saying his life is to undergo a serious operation, or at great expense and inconvenience to migrate to a more suitable climate, he is not obliged to do so.
THE VALUE OF SUFFERING
Another important principle that has to be borne in mind is that of the value of suffering. The very idea that there can be any value in suffering is repugnant to the modern world. The fashion of the day is to consider suffering as the one great evil to be escaped as far as possible. Those who are selfish concentrate their efforts on avoiding it themselves. The unselfish devote themselves to alleviating the sufferings of others.
We know, however, from God's revelation that suffering is not the one great evil. The one absolute evil is sin. Suffering is only an evil in a secondary sense, and it may be so used as to become the means of great good.
Suffering, in the first place, is the penalty of sin. It was not God's intention, when He created man, that there should be any suffering in the world. It was His gracious and loving will that men should live for a short time of probation in this world, and that, if they continued to obey His laws, they should pass through it without any pain or suffering of any kind, and without that violent separation of body and soul which we call death, into the eternal la of perfect friendship and union with God in heaven. To make this possible He gave to our first parents, Adam and Eve, certain supernatural gifts. First there was a gift of what is called "grace," which is nothing less than a participation in the eternal We of God Himself - a gift which makes possible that perfect union with God for which He destined us. Then there were the gifts of impassibility, immortality, and integrity. The first two of these, if Adam had kept them and so been able to transmit them to us, would have supernaturally preserved us from suffering and death, while the third would have given us the power easily to control C our passions, and keep them in subjection to the will and to right reason.
But Adam disobeyed, and the penalty of disobedience was that he lost all these gifts. So he and his descendants became liable to suffering and death. Moreover, having lost the gift of integrity, our passions are difficult to control, so that, left to ourselves, it is morally impossible for us to avoid falling into sin. Consequently, unless God had provided a remedy, the whole human race would have drifted further and further from God into eternal separation from Him, and into that eternal suffering in hell which is the final penalty of sin.
But God, in Ms mercy, has provided a remedy. "God so loved the world as to give His only-begotten Son, that whosoever believeth in Him may not perish, but may have life everlasting." God the Son became man to make satisfaction for the sin of the world and reconcile the world to God. He did so by willingly accepting the penalty of sin, which is suffering and death, and offering His life and death of perfect obedience to the Eternal Father. That life and death of His were so infinitely pleasing to the Father that they counterbalanced, and far more than counterbalanced, all the sins of men from the beginning to the end of time. He merited forgiveness and a restoration of the divine life of grace to all who would accept Him and follow the way of life that He taught.
Now, in view of all these facts, we are able to get a right understanding of the place of suffering in human life. In the first place, it is the penalty of sin, so it remains, and as such it must be accepted. That is God's just decree. But with God mercy always tempers justice. And so, while decreeing that suffering should follow on sin, He also provided the means of alleviating it. Therefore it is right to use these means. Our Lord Himself was moved with pity towards the sick, and often miraculously healed them. And so ever since Ms followers have devoted themselves to the relief of suffering in every form. Indeed compassion for the suffering and organised efforts to relieve it are among the most striking characteristics of the Christian religion. It was the Catholic Church that first taught the world practical compassion and care for the afflicted, and whatever is done in that matter to-day is due to the continued influence of the Church even amongst those who have abandoned her faith. And if it is right to relieve the sufferings of others, it is permissible also for everyone to adopt means for the alleviation of his own suffering.
But God has done more than provide means to alleviate suffering. He has not, indeed, made it possible for anyone to escape it altogether, for it must remain as the penalty of sin. But He has done something better, He has taught us how to make use of suffering, and to turn it from an evil into a good. Such is the power of Christ's passion that it not only makes satisfaction for sin and merits grace, as has been explained above, but it gives the same power to every suffering offered to God in union with it. All who receive Christ and are united to Him by grace, through the means provided by Him in His Church, partake of His power. Consequently, if they accept willingly whatever suffering comes upon them, and offer it to God in union with Christ's passion, they can effect wonders. They make satisfaction for their own sins, and for the sins of others, they gain more grace for themselves, and therefore an increase of glory in heaven, and they may gain innumerable graces for others, grace for sinners to repent, for the heathen to be converted, and for the faithful to make progress in virtue.
So suffering, from being the mere penalty of sin, becomes an instrument for obtaining great good. And therefore, although it is perfectly lawful to seek relief from suffering, it is better to endure it. That is why there are heroic souls who refuse all drugs that would alleviate their pain, for they wish to make the fullest use of all that comes to them They desire to suffer as much as they can bear, in order to be made more like to Christ, who suffered for us. and to co-operate more effectually with Him for the salvation of souls. Saints, indeed, learn to rejoice in suffering, and desire only to suffer more and more.
Another fact to be borne in mind is that death is not necessarily the end of suffering, as so many people assume. God has revealed to us that after death He will "render to every man according to his works." For those who have sinned gravely, and so made themselves the enemies of God, and who have obstinately refused to repent of their sin up to the last moment, there is the eternal suffering of hell. And even for those who have sinned, but repented of their sin and made use of the appropriate means provided by God to have their sin forgiven, there is still some temporal suffering to be endured, for just satisfaction must be made for all sin. The satisfaction may be made in this world. Every good work that we do, and every suffering that we accept willingly and offer to God in union with the passion of Christ, helps to make satisfaction for past sin. But if we have not made complete satisfaction before death, it remains to be made after death in Purgatory.
[Also see "The Relief of Pain", Allocution of Pope Pius XII concerning the Relation of Catholic Doctrine to Anaesthesia. C.T.S. Do 298]
APPLICATION OF THESE PRINCIPLES
Such are the leading principles which Catholics have learnt from God's revelation. It remains to see the application of them to these questions of suicide and euthanasia. But indeed once the principles are grasped, their application to these matters is obvious.
It is quite right to use drugs to alleviate pain. A doctor may reasonably assume that his patient desires to be spared as much suffering as possible, and he rightly acts on that assumption, unless the patient gives him to understand that such is not the case. The patient may also rightly desire to be spared as much pain as possible, provided he is willing to accept patiently what cannot be escaped. On the other hand his behaviour will be more heroic if he accepts all that comes without using means to alleviate it.
Moreover, in the case of very severe pain, it is lawful to use drugs to alleviate it, even though it be foreseen that they may cause some slight shortening of life, provided that the alleviation of pain, and not the shortening of life, is the purpose for which the drugs are administered, and is the primary effect of the drugs, and that there is no other way of relieving the pain.
In that case the shortening of life is an indirect effect, which is permitted for a grave reason, and that this is lawful has been explained above in the section on the "Principle of the Double Effect." In a debate in the House of Lords on the Voluntary Euthanasia Legislation Bill, Lord Dawson of Penn (as reported in Hansard) seized upon a statement of this principle, and tried to show that, if this is held by Catholics, they should not object to euthanasia. "That," he said, "is what we feel would be the right attitude of mind. We have not in mind to set to work to kill anybody at all... We should see to it... that the passage takes place more easily and more rapidly than otherwise it would have done." I have italicised "more rapidly" because these words indicate the fundamental difference between Lord Dawson's opinion and the Divine Law. It is quite right to make the passage more easy, and the means used for this purpose may have the indirect and unintended effect of causing it to take place more rapidly. But to do anything with the intention of making death take place more rapidly is willful murder.
In no case is it lawful for a person to kill himself, or to do any act the immediate purpose of which is to terminate or shorten life. That rules out suicide and "voluntary euthanasia." For it is clear that if a person asks a doctor to put him to death, that is equivalent to suicide. Indeed, it is worse, for such a person is guilty of two crimes. He is guilty of suicide, and by inciting the doctor to commit murder he is responsible for that sin also.
We have also seen that in no case can it be lawful to put an innocent person to death. And so that rules out all cases of deliberately killing anyone in order to shorten his sufferings, or because the continuance of his life seems useless, or for any similar reason. That is simply murder, and it is equally murder whether the person wishes it or not. Indeed if the person wishes it, the crime is greater, because in that case you are certainly killing a person who is in a state of mortal sin, giving him no time to repent, and so killing not only his body but his soul also.
You are doing your very best to send him to hell. You are by no means ending his suffering. You are sending him from the temporary and comparatively light suffering of this world to the eternal suffering of hell.
And here it should be noted that, even in the administration of drugs to case pain, care should be taken not to hinder the patient from doing what is necessary for the salvation of his soul. And he may be so hindered if drugs are repeatedly administered in such a way that he is kept asleep for a long time and never fully regains consciousness before he dies. Special care should be taken to avoid this in the case of a patient who has, to all appearance, been living in a state of mortal sin, and has hitherto shown no signs of repentance. At all cost he must be given the opportunity to make his peace with God. And even in the case of one who appears to be in excellent dispositions, at peace with God, and ready to die, such continuous sleep should be avoided, if possible. If the pain is very great, he may be put to sleep for a time, and even repeatedly, but, if possible, he should be allowed at least to have lucid intervals, so that he may have the opportunity of resigning himself more completely to God, making renewed acts of contrition, charity and so forth, and thus gaining great merit.
WHAT IS A "GOOD DEATH"?
In contrast to the advocates of suicide and murder, it may be well to say a few words about the Christian idea of a "good death." It has been explained above that if a person has committed grave sin, and has not repented of it and used the appropriate means to have it forgiven, he is in a state of enmity against God. That is what we call a state of mortal sin. And if a person dies in that state, he will go straight to the eternal pain of hell. The first essential, therefore, for a good death is to make sure that one's sins are forgiven, and that one is at peace with God. For this the Catholic Church provides a simple and easy means. It is the sacrament of Penance, commonly called Confession. If any person makes a good confession, with sincere sorrow for all his sins, he is absolved, and through absolution his sins are forgiven, and he is reconciled to God. If for any reason confession is impossible, there are two other ways in which the same result may be obtained. One is through the sacrament of Extreme Unction. By this also sin is forgiven provided the person is sincerely sorry. And then there is what is called an act of Perfect Contrition. This means that if a person has the best kind of sorrow for his sin, namely, that sorrow which arises purely from the love of God, his sin is forgiven without either of these sacraments.
To have one's sins forgiven, in one or other of these ways, is an absolute essential for a good death. There are others, which indeed I am presupposing. I of course presuppose that the person has faith and has been baptized, for without these nothing else is of any use, as Our Lord said: "He that believeth and is baptized shall be saved." I also presuppose that he has some love of God and hope in Him, and some measure of resignation to His will, for at least a minimum of these is indispensable. But besides these essentials there is more that is highly desirable, for it is clear that, when one is about to go through the great crisis of death and pass out of this world to God, one ought to be as well prepared as possible. Now, these dispositions mentioned above - faith, love of God, hope, and resignation His will - may be more or less perfect, and the more perfect they are the better. It will be a really good death if the dying person has a very lively faith, a very firm trust and confidence in God, a very fervent love of Him, and a perfect resignation to His will. And it must not be forgotten that, as death approaches, the devil makes his last attack, tempting the dying person to rebellion or to despair. And his last attack is likely to be very violent, for he knows that it is his last chance to get that soul into his clutches.
To help the sick person to overcome these attacks and to practise the appropriate virtues, the Church provides other helps. The sacrament of Extreme Unction, mentioned above. not only forgives sin, but brings great strength and comfort to the soul. And then there is Holy Communion, or the Holy Viaticum, as it is called in these circumstances, the power of which is unlimited, for it is nothing less than Our Lord Himself entering into the sick man's body and soul, giving Himself to him, taking him into His loving embrace, and pouring His own divine strength into his soul.
These are the inestimably precious means of help for the dying which God has provided in His Church. But of course the sick person must try to do what he can to respond to these graces, so far as his weakness will let him. He should try to make repeated acts of contrition, faith, hope, love, and resignation, and his friends should help him to do so. Thus he will deepen his sorrow for past sin, rouse himself to a more lively faith and firmer hope, a more fervent love of God, and a more perfect resignation to His holy will. All this will be most pleasing to God, and by these acts the dying person will make fuller satisfaction for his past sins and gain great merit, which means that he will have less to suffer in Purgatory, and greater glory in heaven. And, what is most important of all, he will give greater glory to God. And so he will be ready, when the Master calls, to answer the call with loving confidence, and even with joy. That is a really "good death" - a true euthanasia.
HOW THE MODERNS HAVE GONE WRONG
The Catholic attitude to suicide and euthanasia, which has been explained above, follows quite logically, as I hope I have made clear, from those fundamental truths and laws which are known partly by reason and partly by God's revelation. How have the moderns gone wrong? They have gone wrong by leaving those fundamental truths and laws out of account, neglecting reason, and letting themselves be guided by sentiment and expediency. There are some who deny these truths altogether, even to the existence of God, the immortality of the soul, and the obligation of an eternal moral law. For them there can be no objection to euthanasia. If there is no God and no moral law, there can be no such thing as right or wrong. If men are just beasts, they may as well be treated like beasts. With people like that we cannot argue. We have no common ground.
But what of those other supporters of euthanasia, who still retain a belief in God and even in some modified form of Christianity? How are we to account for their extraordinary attitude? The only possible explanation is that they have not sufficiently thought out their own first principles and their logical consequences. They had allowed themselves to drift with the tide, and to be guided by sentiment and feeling. To them we may hope to appeal. All we ask of them is to get back to fundamentals and be guided by reason. Let them ask themselves such questions as these: What are the rights of an omnipotent, all-wise, and all-loving Creator? What is the purpose and end of human life? What is the way to attain that end? What is the place of suffering in life? What is the origin and nature of the moral law? It is to fundamental questions of that kind that they must get back.