THE WORD EUTHANASIA comes from two Greek words, ‘eu’ and ‘thanatos’ which literally means good death. Etymologically speaking, euthanasia should even be seen as the natural desire of every person. Everyone wants a good death and we even pray for a good and happy death. But today no one uses the word in this sense anymore. Today it refers to an action by which a person is put to death painlessly, usually to avoid further suffering.

The Webster’s New International Dictionary defines euthanasia as, "A mode or act of inducing death painlessly as a relief from pain." Black’s Law Dictionary defines euthanasia as, "The act or practice of painlessly putting to death persons suffering from incurable and distressing disease as an act of mercy."

The Sacred Congregation for the Doctrine of the Faith (SCDF, now simply CDF) describes euthanasia to be commonly understood as: "…some intervention of medicine whereby the suffering of sickness or the final agony are reduced, sometimes also with the danger of suppressing life prematurely. Ultimately the word ‘euthanasia’ is used in a more particular sense to mean, ‘mercy killing’ for the purpose of putting an end to extreme suffering or saving abnormal babies, the mentally ill or the incurably sick from the prolongation, perhaps for many years of a miserable life which could impose too heavy a burden on their families or on society." (Declaration on Euthanasia, May 5, 1980).

There are other descriptions of euthanasia but all agree that it is an act of putting someone to death so that suffering will cease. Note must be taken that definitions must not be seen as endorsement of the practice of euthanasia.

The two ethical considerations when discussing euthanasia are the degree of consent and the manner in which it is carried out. The degree of consent refers to voluntary or involuntary while the manner refers to whether it is active or passive. It is true that these two terms "passive" and "active" in connection to euthanasia, are hardly used today. Nevertheless it is good to look at these terms because they contribute to a better understanding of the dynamics involved in the act of euthanasia.

Euthanasia is active and voluntary when a person explicitly requests help to die, for example by lethal injection. It is active and involuntary when the act is directed towards persons incapable of requesting for such a procedure as in infants, the unconscious, retarded persons and so on. The former is suicide and the latter is assisted suicide and even killing.

The church in Gaudium et Spes (‘Pastoral Constitution on the Church in the Modern World’) and again in SCDF Declaration on Euthanasia clearly condemns crimes against life, "such as any type of murder, genocide, abortion, euthanasia, or wilful suicide". Suicide is the deliberate and intentional taking of one’s own life. It is self-destruction. Assisted suicide is helping someone to take his or her life and morally it amounts to killing. For example, a doctor kills his patient if he gives him a lethal injection, withholds or withdraws treatment that should be given, provided that it is not reasonable to do so.

But killing does not apply to the act of withholding or withdrawing treatment that is futile and unreasonable because it is burdensome and no longer beneficial to the patient. This course of action is often termed "Allowing to Die". Some refer to this as passive euthanasia. (The term, ‘passive euthanasia’ is hardly used today as it creates confusion and gives the impression that some forms of euthanasia are allowed). It basically refers to stopping treatment which offers no reasonable hope of recovery so that death is not directly caused by an active intervention but by the patient’s fatal pathology.

This distinction is important because it differentiates deaths for which we are morally responsible and those we are not. This distinction also protects the overall respect for life because it recognizes that human beings are limited in their ability to control the ultimate progression of a fatal disease.

It also preserves the dignity of the medical profession as one being committed to caring and curing instead of destroying.

Pope John Paul II has clearly taught that a person may be beyond treatment but no one is beyond care. Many moral theologians are of the opinion that nutrition and hydration even when they are given intravenously does not constitute treatment but care. Whatever their condition may be, appropriate care should be provided for them.

In Christian understanding,
human life is the most fundamental of goods but concretely bodily existence is not the highest of values. Life is a relative good and so the church taking this position adopts the "middle path" between
what ethicists call "medical vitalism" and "medical pessimism". The former wants to preserve life at all cost while the latter destroys life when it becomes frustrating or burdensome.

Some have wrongly interpreted the church’s teachings as tending towards medical vitalism. The church teaches that benefits and burdens must be weighed in the choice of available treatment. This choice in traditional moral theology is referred to as Ordinary and Extraordinary Means. The principle of Ordinary and Extraordinary Means simply states that there is an obligation to use ordinary means but no strict obligation to use extraordinary means. On this issue, perhaps the teaching of Pope Pius XII is the clearest.

In his address to the International Congress of Anesthesiologists on Nov 24, 1957, he taught: One is normally held to use only ordinary means according to circumstances of persons, places, times and culture – that is to say, means that do not involve any grave burden for oneself or for others. A more strict obligation would be too burdensome for most men and would render the attainment of the higher, more important good, too difficult. Life, death and all temporal activities are in fact subordinated to spiritual ends.

This teaching is echoed again in the Declaration on Euthanasia when it teaches: When inevitable death is imminent in spite of the means used, it is permitted in conscience to take decision to 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. In such circumstances, the doctor has no
reason to reproach himself with failing to help the person in danger.

The above tries to show the difference between direct euthanasia which is a grave evil and morally wrong and not wanting certain types of treatment and allowing one’s disease to run its own course which is simply termed, "Allowing to Die".

Since euthanasia is totally non-therapeutic and does not benefit the patient in any way, we have the duty to find the required therapy for those suffering in pain. If this pain could somehow be alleviated, it would offer to dying patients who are in pain, an alternative to euthanasia. It is a fact that most people fear the pain and suffering of a prolonged illness more than death itself.

According to the Catholic Health Association of the United States, 75 percent of patients in pain are inadequately helped. Sixty to 70 percent of terminally ill patients experienced severe to moderate pain and 25 percent of cancer patients die with severe unrelieved pain. Physical pain is usually the easiest type of pain to control and yet it is often left untreated. There are helps and strategies for relieving pain because there is no such thing as intractable pain. Pain can be reduced or even removed in several ways.

For example if a tumour is pressing against a nerve and causing pain, it is possible to reduce the size of the tumour by radiation, chemotherapy, surgery or by laser. When the compression of the nerve is eliminated, the pain is reduced.

If the above procedure is not practical, there are other methods to block the sensory nerves. Every sensory nerve passes from the periphery of the body to the brain through the spinal cord and then to the cortex. At various steps along the way, the nerve can be blocked by anesthetic procedures or can be chemically destroyed. Many patients who have been given such pain relief procedures had gone home and died happy at home in the bosom of their family.

There are other strategies such as raising the pain threshold by the use of drugs, pharmacologically, sedatives and anti-depressant.

Other ways like massage, acupuncture, meditation and of course care, love and friendship have shown to help bring comfort to those who are suffering.

Proponents of euthanasia speak about the quality of life. They ask the question, "When is life considered no longer worth living?" The term, "Quality of life" is complex and it has different connotations. There have been attempts to define it from the social, economic, psychological and philosophical point of view. Hiltler for example, saw the quality of life in a person as intricately related to his or her usefulness in society. Such persons take the position that if someone is no longer "economically viable", that is, when he or she cannot make any useful contribution to the economy, the person is a burden to others and to the state. They conclude then that it would be better for this person not to continue living and be a burden to others and to the state.

The church condemns such a utilitarian perception of a human person. The church teaches that every person has an intrinsic and equal value regardless of age, perfection or the condition of that life. Human life is sacred by the very fact of its existence. Its value does not depend upon certain perfection of that life. Human life also has equal value. This means that we cannot decide whose life is of lesser value and be arbitrarily terminated. The value of a human life is intrinsic. It is not conferred by government or society. As such, government or society has no right to authorize anyone to take life.

It has been shown that countries that have legislated the living will (or Advance Medical Directive) eventually progress to legislate euthanasia. At the time of legislating living will, many of these countries have indicated that euthanasia is morally wrong and that it will not be legalized. These very countries have gone on to legalize euthanasia eventually. In legalizing euthanasia, certain so-called "strict guidelines" were adopted for its execution. Given the truth of the slippery slope argument, who can be certain that these "strict guidelines" will not be disregarded or changed from ending the life of terminally ill persons to ending the lives of the handicapped, the mentally retarded, comatose, Persistent Vegetative State (PVS) patients and all who are deemed idiots? The slippery slope argument has been shown to be truer than true. One’s conscience can become so desensitized that an immoral action can eventually become acceptable.

The Catholic Church joins the adherents of all other respectable religions and even those who do not have any religious affiliation to oppose the taking of an innocent life. The weakest in society are the ones who need our care and protection most. This is the most fundamental humanity we owe to ourselves.

This article ends with a quotation from the Catechism of the Catholic Church, number 2277 which states: Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering, constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. - By Rev Father James Yeo

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