Catholic, Jewish, and Muslim leaders sign declaration against euthanasia, physician-assisted suicide

By Hannah Brockhaus
Vatican City, Oct 28, 2019 / 12:15 pm (CNA).

Leaders of Christianity, Judaism, and Islam presented a signed declaration to Pope Francis Monday expressing their total opposition to euthanasia and any form of physician-assisted suicide, as well as voicing their support of palliative end-of-life care.

The document was signed at the Vatican Oct. 28 by Archbishop Vincenzo Paglia, head of the Pontifical Academy for Life, along with representatives of the Jewish and Islamic faiths. It was given to Pope Francis during an audience.  

The position paper states that the three Abrahamic religions “oppose any form of euthanasia – that is the direct, deliberate and intentional act of taking life – as well as physician assisted suicide – that is the direct, deliberate and intentional support of committing suicide – because they fundamentally contradict the inalienable value of human life, and therefore are inherently and consequentially morally and religiously wrong, and should be forbidden without exceptions.”

The paper also affirms the right of healthcare workers to not be coerced or pressured into directly or indirectly assisting in the intentional death of a patient through assisted suicide or any form of euthanasia, especially when doing so would violate the provider’s religious beliefs.

Even if accepted by the local legal system, “moral objections regarding issues of life and death certainly fall into the category of conscientious objection that should be universally respected,” the paper declares.

Healthcare providers, it notes, have the responsibility “to provide the best possible cure for disease and maximal care of the sick.”

The idea for the declaration came from Rabbi Avraham Steinberg, an Israeli medical ethicist, who proposed it to Pope Francis. The pope entrusted the project to the Pontifical Academy for Life, which organized an interreligious committee to create the document.

In the nearly 2,000-word position paper, it is stated that the Catholic, Jewish, and Islamic faiths “share common goals and are in complete agreement in their approach to end-of-life situations.” It also notes that these principles are sometimes in conflict with “current secular humanistic values and practices.”

The preamble to the report notes that “the moral, religious, social and legal aspects of the treatment of the dying” are among the most complex and most widely discussed in medicine today.

The issues surrounding the end of life include “difficult dilemmas,” which have increased in recent years, it argues, because of scientific-technological developments, changes in the patient-doctor relationship, cultural changes, and a growing scarcity of resources related to the expense of medical care.

These dilemmas are not primarily medical or scientific, but “social, ethical, religious, legal, and cultural,” it declares, adding that human intervention in the form of medical treatment and technologies “are only justified in terms of the help they can provide.”

“Therefore, their use requires responsible judgment about when life-sustaining and life-prolonging treatments truly support the goals of human life, and when they have reached their limits,” it claims.

The declaration states that “when death is imminent despite the means used, it is justified to make the decision to withhold certain forms of medical treatments that would only prolong a precarious life of suffering.”

However, both medical providers and society should respect the wish of a dying patient to prolong or preserve his/her life even for an additional short period of time by clinically appropriate medical measures,” it continues.

The Catechism of the Catholic Church teaches that a person may legitimately choose to discontinue medical procedures which are “over-zealous,” meaning “burdensome, dangerous, extraordinary, or disproportionate to the expected outcome..”

The position paper defines a “dying patient” as someone who has “a fatal, incurable, and irreversible disease” and is at a stage when their death will likely occur within a few months “as a result of the disease or its directly related complications, despite the best diagnostic and therapeutic efforts.”

The report offers encouragement and support for professional palliative care for everyone, everywhere and to commend laws and policies which protect the dignity of a dying person.

It also declares a commitment to engage with communities on the issue of bioethics, and to raise public awareness about palliative care.

The paper states a belief that society has an obligation to help patients not to feel like a burden and to know the value and dignity of their life, “which deserves care and support until its natural end.”

The declaration also calls on policymakers and healthcare providers to familiarize themselves with the perspective and teaching of these religions in order to better provide medical assistance in accord with their patients’ beliefs.

“While we applaud medical science for advances to prevent and cure disease, we recognize that every life will ultimately experience death,” it states. “Care for the dying is both part of our stewardship of the Divine gift of life when a cure is no longer possible, as well as our human and ethical responsibility toward the dying (and often) suffering patient.”

h/t to CNA

Organ donation and euthanasia make a good team in Ontario

h/t to BioEdge by Michael Cook | 20 Oct 2019 | 

There is a startling statistic tucked away in Ontario’s September quarter euthanasia statistics. A total of 519 people were euthanised from July 1 to September 30.

Nothing too surprising.

But of the total euthanised, it appears, from government’s sketchy summary, 30 donated organs. In other words, somehow the euthanising doctor and the transplant surgeons coordinated their efforts so that these people could give their organs to others. The time period is unclear. 

Presumably the donation was not the cause of death, as this is illegal under Canada’s euthanasia legislation. But there is pressure from doctors to change this. A year ago two Ontario physicians and Robert Truog, a bioethicist from Harvard Medical School, published an article in the New England Journal of Medicine listing all the advantages of “organ donor euthanasia”.

It would be necessary to do away with the dead donor rule – that a patient must be dead before donating. In Canada a euthanasia death must be caused by the administration of a “substance”, not by organ retrieval. The law would have to be amended to take account of this medical and ethical development.

This has been bitterly criticised, of course. Last month Dr E. Wesley Ely, of Vanderbilt University, published an opinion piece in the journal Intensive Care Medicine. He argued: “When physicians are participating in a procedure designed to take a person’s life, will patients feel 100% certain that their physician is firmly on the side of healing? What message does it send about the value of every human life when physicians endorse the exchange of one life for another? What effect has it already had on physicians complicit in such death-causing procedures?”

Michael Cook is editor of BioEdge

Bioethicists defend euthanasia for mentally ill

by Xavier Symons | 9 Oct 2019 | h/t Bioedge

A new edition of the American Journal of Bioethics explores the theme of euthanasia for mentally ill persons. Several well-known commentators on euthanasia argue that in principle euthanasia should not be prohibited for people suffering from severe psychiatric disorders. 

The journal discussion is built around a target article by Brent Kious and Marget Battin from the University of Utah. Battin is a long-time proponent of voluntary euthanasia, while Kious is a psychiatrist who specialises in severe and persistent mental illness. The authors argue that euthanasia for the mentally ill is morally indistinct from euthanasia for physical terminal illness: 

“We think it is clear that the suffering associated with mental illnesses can sometimes be as severe, intractable, and prolonged as the suffering due to physical illnesses. Accordingly, it seems to us that if severe suffering can justify [physician assisted dying] for some persons with terminal physical illnesses, it should justify [physician assisted dying] for some persons with mental illnesses, too. Call this the parity argument.” 

To resist the parity argument, some scholars claim that terminality (i.e., the presence of a terminal illness) is morally relevant as patients who request euthanasia are dying already. Yet Kious and Battin argue that suffering, not terminality, is the ultimate justification that motives lawmakers to legalise euthanasia: “Terminality is...merely a safeguard, and not a rationale, for [physician assisted dying]”.

Other scholars argue that persons with mental illness lack the capacity to make decisions about ending their own life. Kious and Battin acknowledge that severe mental illness can greatly affect capacity, but they suggest that this does not rule out the possibility that some persons with severe psychiatric disorders are capable of making an autonomous decision to end their life. Indeed, in some cases we may be denying competent persons the right to a humane death:  

“by forbidding [physician assisted death] in [cases of] mental illness we could [be denying] much-needed succor to a person who is suffering severely and whose request for death is reasonable and made with full capacity”.

While several of the open peer commentaries are supportive of Kious and Battin’s basic proposal, a commentary by Charles Foster (University of Oxford) takes the parity argument in the opposite direction. Foster argues that the parity argument is in fact a reason to prohibit euthanasia all together: 

“Kious and Battin are right to assert that there is no distinction of substance between physical and psychiatric suffering, and that the presence of psychiatric suffering does not necessarily connote incapacity (although in practice it often will)...[yet the authors] have reached precisely the wrong conclusion using, in part, precisely the right reasoning. The right conclusion is not that the ambit of legally sanctioned physician-assisted suicide (PAS) should be widened, but that it should be narrowed: Indeed, PAS should be unlawful”.