Bioethics

Prairie Messenger October, 1994 Mark Miller, C.Ss.R., Ph.D. On December 15, 1994 a special committee of the Canadian Senate will conclude its hearings on euthanasia and assisted suicide. The committee will have spent the better part of the year gathering information from Canadians about the possibility of changing the present laws prohibiting active euthanasia or assisting someone to commit suicide. The Senate committee will prepare a report for the House of Commons where, likely in 1995, a free vote will be held concerning any changes to the law. A free vote means that the Members of Parliament will vote according to their consciences rather than the discipline of their parties. It is imperative, I believe, that Christians do not stand on the sidelines and simply debate whether this is a good idea or not while parliamentarians make the decision for our society. Part of our love for others, especially the weakest and most vulnerable in our society, involves putting ourselves on the line and being heard as part of our society. As I bioethicist I could spend this column in developing the ethical (rather than strictly Christian) arguments against killing people or helping them kill themselves. Rather I will summarize these counter-arguments for your own reflection and then turn to a Christian perspective on the issue. First, since people seem to demand the right to kill in the face of ‘overwhelming pain and suffering’ (as an act of ‘compassion’), we must be aware that there are alternatives to killing people. The primary alternative is palliative care, that is, care appropriate to the dying. Such care aims at control of pain through medication; but it also seeks to handle the emotional and psychological suffering that many people feel in the face of their mortality, the loss of life and loved ones, and the debilitating effects of illness. Drugs may lessen pain, but caring people help deal with suffering in all its dimensions. Furthermore, no person is obligated to hang on to every second of life; medical treatment which is futile or burdensome or does nothing more than prolong the dying can morally be refused. Second, think of what allowing physicians and nurses to kill people would do to the health care profession. While many doctors, for example, get very frustrated by the ravages of unstoppable disease, when pain can be controlled why would any medical professional want even the choice of killing the patient? There is much evidence in Holland, where doctors have the right to kill patients, that the elderly are afraid to go to hospitals and nursing homes. Is the sacrifice of such trust worth fulfilling somebody’s request for death? Third, think of what would have to go into a decision to kill somebody. The easiest path would be to say, “Well, that is what the patient wanted.” Then the doctor can shrug off any moral responsibility. However, most suicidal persons are depressed; the cause of the depression is what needs to be treated. Can a doctor clearly distinguish the depressed from the competent? And if a competent patient were to ask for death, how would the doctor know that this is ‘good’ for the patient? What criteria would the doctor invoke to accept one request and not another? Furthermore, what kind of protections could be put in place to safeguard against doctors making decisions for the patient? Who would remain to tell? To take this one step further, suppose a doctor were to ask you if it were time to put an end to the life of your mother or father who is now unconscious? Would you even want that as a choice? The Christian believes in the sanctity of every human life. Nowhere in our tradition is there any room for even thinking about killing another innocent human being. Our call is to care for people, especially those who are most vulnerable, those who are least able to take care of themselves. Care may involve all the formidable array of the modern medical arsenal which can do wonders in treating people. However, care must also be seen as the person-to- person intimacy which hi-tech, sanitized modern medicine often overlooks. The Christian call is not to kill people because modern medicine sometimes overlooks the human; our challenge is to join in the kind of caring which comes with holding the hand of a dying person or simply being present so that they are not alone. Compassion in its latin roots means “with the suffering.” Accompanying those who suffer, particularly at the end of life, is one of the great acts of Christian love. It is to be noted that we are speaking here of accompanying those who suffer; I am assuming that bodily pain can be controlled by proper medication (as palliative care physicians have assured me). Christians are not enamoured of either pain or suffering. To reduce the pain of another is part of the love commandment. To reduce another’s suffering is much more difficult; sometimes we have nothing more to offer than ‘com-passion,’ suffering along with the other person. Sometimes presence, or a few words, or a gentle touch, or even a hearty discussion can bring the dying person peace despite all suffering. Such, I believe, is our Christian call. Where the avoidance of suffering becomes an acceptable priority in our society, life itself becomes devalued wherever there is suffering. In the words of George Webster, a bioethicist at St. Michael’s Hospital in Toronto, euthanasia or assisted suicide can be nothing other than the ultimate abandonment of the dying. Death is a mystery. Dying is also a mystery, though a part of the mystery of living! God, I believe, calls us to be sharers in this mystery of living, living with one another, not to make ourselves lords of the moment of death.