If anyone were unsure of where the Catholic Church stood on assisted suicide and euthanasia, they can have no doubts now. In a lengthy document titled Samaritanus Bonus (“the good Samaritan”), the Vatican has released a lengthy response to the spread of “assisted dying”.
Assisted suicide or euthanasia or both are permitted in the Netherlands, Belgium, Luxembourg, Canada, Colombia, Switzerland, eight states in the United States plus the District of Columbia, and two states in Australia. A number of other countries are considering legalisation.
The document is clear and emphatic: euthanasia is “an intrinsically evil act, in every situation or circumstance”.
As well, anyone who cooperates is guilty as well, even those who defend legalisation.
“Euthanasia is an act of homicide that no end can justify and that does not tolerate any form of complicity or active or passive collaboration. Those who approve laws of euthanasia and assisted suicide, therefore, become accomplices of a grave sin that others will execute. They are also guilty of scandal because by such laws they contribute to the distortion of conscience, even among the faithful.”
The Church’s opposition is hardly news. More than 50 years ago the Second Vatican Council condemned euthanasia. Long before the Netherlands legalised it in 2002, Pope John Paul II forbade it in an encyclical, Evangelium Vitae (“the Gospel of Life”). However, the disagreeable reality of legalisation presents problems for Catholics – and other Christians who oppose it in theory. Should people who request assisted suicide or euthanasia receive the Church’s last rites? Should they be given a Christian funeral?
Some bishops appeared to lean toward a policy of demonstrating compassion by “accompanying” a person who chooses to die in this way.
Samaritanus Bonus puts the kibosh on this. People who request assisted suicide or euthanasia may not receive the Church’s sacraments. Even membership in an association organising “assisted dying” is forbidden. They “must manifest the intention of cancelling such a registration before receiving the sacraments”.
Whilst this sounds harsh, the document acknowledges that in extremis people may be so distressed that they are not fully responsible for choosing this kind of death. It urges priests to look for “adequate signs of conversion”. But in principle, there should be no cooperation whatsoever:
Those who spiritually assist these persons should avoid any gesture, such as remaining until the euthanasia is performed, that could be interpreted as approval of this action. Such a presence could imply complicity in this act. This principle applies in a particular way, but is not limited to, chaplains in the healthcare systems where euthanasia is practiced, for they must not give scandal by behaving in a manner that makes them complicit in the termination of human life.
Familiar stuff, perhaps, for friends and foes of Catholicism.
What’s different about this document is that it also offers a perceptive bioethical analysis of euthanasia, along with theological prescriptions.
The principal justification for euthanasia is autonomy. It’s my life; I can do what I want with it. Nobody can tell me what to do. We have to respect a patient’s autonomous decision. Choosing the time and place of death is the ultimate affirmation of autonomy, etc. The arguments are nearly always drawn straight from the playbook of the 19th century British philosopher John Stuart Mill.
The philosophy underlying the secular arguments deployed in Samaritanus Bonus is completely different. Instead of departing from the autonomy of the patient, it emphasises the universal experience of vulnerability.
For the fully autonomous man, think of lron Man in the Marvel Universe. Zipping around in his suit of armour, he is invulnerable. But what makes him interesting is the fact that Tony Stark is vulnerable. He suffers from PTSD, narcissism and loneliness. It’s not the strength of Iron Man’s armour that makes him human, but the fragility of Tony Stark’s character.
Which is more or less what the Vatican says:
“The need for medical care is born in the vulnerability of the human condition in its finitude and limitations. Each person’s vulnerability is encoded in our nature as a unity of body and soul: we are materially and temporally finite, and yet we have a longing for the infinite and a destiny that is eternal. As creatures who are by nature finite, yet nonetheless destined for eternity, we depend on material goods and on the mutual support of other persons, and also on our original, deep connection with God.“
Given this vision of what a human being is, the appropriate response to illness is not to kill a patient, but to care for him.
“Our vulnerability forms the basis for an ethics of care, especially in the medical field, which is expressed in concern, dedication, shared participation and responsibility towards the women and men entrusted to us for material and spiritual assistance in their hour of need.“
Furthermore, the document points out that measuring a patient’s dignity by his autonomy leads to the contradiction which has always bedevilled Mill’s theory. How can the highest expression of autonomy be to extinguish it? If that were true, couldn’t we choose to sell ourselves into slavery to settle our debts? No. “Just as we cannot make another person our slave, even if they ask to be, so we cannot directly choose to take the life of another, even if they request it,” it points out.
“Therefore, to end the life of a sick person who requests euthanasia is by no means to acknowledge and respect their autonomy, but on the contrary to disavow the value of both their freedom, now under the sway of suffering and illness, and of their life by excluding any further possibility of human relationship, of sensing the meaning of their existence, or of growth in the theologal life. Moreover, it is to take the place of God in deciding the moment of death.“
The document also makes some very shrewd observations about the implications of pretending that we are Iron Man instead of acknowledging ruefully that underneath we are really Tony Stark.
In fact, if autonomy is the highest value, people whose autonomy is impaired are in trouble.
“Those who find themselves in a state of dependence and unable to realize a perfect autonomy and reciprocity, come to be cared for as a favor to them. The concept of the good is thus reduced to a social accord: each one receives the treatment and assistance that autonomy or social and economic utility make possible or expedient. As a result, interpersonal relationships are impoverished, becoming fragile in the absence of supernatural charity, and of that human solidarity and social support necessary to face the most difficult moments and decisions of life.”
In short, the proper response to Tony Stark’s end-of-life existential crisis is not to end his life, but to lavish care upon him, to treat him as unique and precious (which is what happens in Avengers: Endgame).
An even better parable is the Biblical story of the Good Samaritan. Instead of allowing the Jew on the way to Jericho to die autonomously, the Good Samaritan tenderly cares for him and pays for him to be nursed back to health. The choice of solidarity over solitude is ultimately the message of this splendid meditation on human weakness in the face of death.