Lesson 6b: Gospel of Life: Euthanasia
Chapter III of EV treats Euthanasia in nn.64-67. As with the prior lesson, there is a prior Declaration of the Congregation of the Doctrine of the Faith that must be studied because it is quoted throughout -- CDF, Declaration on Euthanasia (5/5/80) nn.I-IV. The companion piece in the Catechism ##2276-2279 also quotes the CDF Declaration of 1980 but oddly does not cite it in footnotes.
EV, 64 outlines how the Culture of Death prepares for and promotes Euthanasia -- the shift (EV, 23) from a criterion of personal dignity (requiring respect, generosity and service) to the criterion of efficiency, functionality and usefulness. This is complicated by the temptation to take 'control' of death before its time, recalling the misguided autonomy rejected in the beginning of the encyclical since many moderns seem to think they own their life the way they own a BIC pen. Here too, life is a gift we have from God on trust, for a while, then we go back to God. God has absolute dominion over life; we have, at best, useful dominion, a responsible stewardship -- we are not the landlords of our own existence.
Euthanasia is defined in EV, 65 as an ACTION or OMISSION which of ITSELF or by INTENTION causes death (CCC#2277; Ethical and Religious Directives 60, 61; Charter for Health Care Workers, n.147). Thus, the terms of reference can be found in the intention of the will and in the methods used.
This is to be distinguished from aggressive or extraordinary treatment which it is legitimate to refuse.
Since the distinction between ORDINARY and EXTRAORDINARY is crucial here, we should attempt to define it. Ordinary and Extraordinary means are calculated in relations to the patient's real conditions and actual circumstances. Thus, all medicines, treatments and operations that: (1) offer a reasonable hope of benefit to the patient; (2) without a serious danger of death; and, (3) without excessive pain, hardship, burden, expense are 'Ordinary' means for that patient.
Morally, all are bound to use ORDINARY MEANS to preserve their life, health and bodily integrity (Ordinary = Obligatory); usually, one is not bound to use EXTRAORDINARY MEANS but is free to do so, if one chooses (Extraordinary = Optional).
There are certain basics that are always presupposed in a correct understanding of 'ordinary means:' basic hygiene and supportive measures -- food, water, bed-rest, room temperature and personal hygiene. Some call these 'minimal means'! The basis for this distinction is the difference between a negative prohibition that is absolute (not directly kill the innocent) and the positive duty to take care of health and life within reasonable and proportionate limits. Even the notion of 'minimal means' allows that their mechanical delivery, in unusual circumstances, might, by exception, qualify as 'extraordinary' but that can only be determined on a case by case basis. For good guidance consult the NCCB's "Nutrition and Hydration: Moral and Pastoral Reflections" Origins 21:44 (April 9, 1992) pp.705-712; also, Charter for Health Care Workers (1995) n.120.
It is, perhaps, in the area of omissions that the most confusion arises. Some even advocate the terminology "active" and "passive" euthanasia as if the former is prohibited and the latter is acceptable. This is highly misleading. One can kill by omission; not every omission to be sure -- but the term "passive euthanasia" is inherently ambiguous until and unless one determines in a given case what is being 'passively' omitted, withdrawn or withheld.
The omission of Ordinary Means is euthanasia (ERD #56); whereas the omission of Extraordinary Means is not euthanasia and should not be so called (ERD #57).
Similarly, one should not equate cure with care. Cure is not always available; care is always appropriate and required. Quoting the Declaration of 1980, EV 65 is explicit -- when inevitable death is morally imminent one can in conscience: "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted" (EV, 65). Some authors, even textbooks, omit the second half of that quote which is dangerous and misleading. "Methods of palliative care" are here recommended (EV, 65; also 88) as does the Catechism: "Palliative care is a special form of disinterested charity. As such it should be encouraged" (CCC #2279).
As above, one can read with profit the specifics and examples in the Charter for Health Care Workers (1995) III 'Death' nn.114-138.
As twice before in EV (n.57 re direct killing of the innocent; n.62 re direct abortion) the Pope again proclaims a formal infallible truth. In harmony with the Magisterium of my Predecessors (largely 20th Century due to the formulation of this question; cf. footnote #81 of EV) in communion with the Bishops of the Catholic Church: "I confirm that euthanasia is a grave violation of the law of God since it is the deliberate and morally unacceptable killing of a human person" (EV, 65). The doctrine is based on natural law, divine positive law, sacred Tradition and the ordinary and universal Magisterium of the Church. "Depending on circumstances, this practice involves the malice proper to suicide or murder" (EV, 65)(Latin: "homicidium" in AAS 87, 1995, p.477).
Further, suicide and assisted suicide are similarly condemned in EV 66. It is perhaps, assisted suicide that presents the next lethal and legal step into the Culture of Death -- oddly a pattern more developed in the so-called First World than in the Third World. In essence, this is not a poor people's campaign, but the poor may be the first 'beneficiaries' of this unwanted 'favor' under the guise of reimbursement schemes, that is, the denial of reimbursement for ordinary care and treatments.
Quite properly, EV 66 calls euthanasia what it is -- a "false mercy". It will march under the banner of 'compassion'; but it is, of course, not compassion at all. "Compassion" (cum passio) means sharing another's pain or burden: "it does not kill the person whose suffering we cannot bear" (EV, 66). Murder is no less murder simply because the recipient requested it.
EV 67 cites John Paul's Apostolic Letter, Salvifici Doloris (2/11/84) which treats of the Christian understanding of suffering. That apostolic letter should be read in its entirety; failure to do so leaves Catholics ill equipped to resist the euthanasia movement.
A final section of Chapter III of EV nn.68-74 treats at length of the relationship between civil and moral law. While it is true that the CDF Instruction Donum Vitae (2/22/87) did approach this subject in n.III, the treatment in DV is minuscule compared to the much fuller exposition in EV nn.68-74. It should be read and studied with the greatest care.