Church Teaching on End-of-Life Issues
The following is a compilation of Church teaching on End-of-Life issues to further facilitate understanding of the issues involved in end-of-life treatment.
"Dignity of the Dying” | Appropriate Medical Treatment | To Physicians |
Modern Society and Technology | Conclusion
It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an eldery person, one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly. Nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity. [i]
"Dignity of the Dying”
"The dignity of the dying" is rooted in the fact that they are created by God and personally called to eternal life. This hope-filled vision transfigures the destruction of our mortal body. "When the perishable puts on the imperishable, and the mortal puts on immortality, then shall come to pass the saying that is written: "Death is swallowed up in victory" (1 Cor 15:54; cf. 2 Cor 5:1). [ii]
The approach to the gravely ill and the dying must therefore be inspired by the respect for the life and the dignity of the person. It should pursue the aim of making proportionate treatment available but without engaging in any form of "overzealous treatment" (cf. CCC, n. 2278). One should accept the patient's wishes when it is a matter of extraordinary or risky therapy which he is not morally obliged to accept. One must always provide ordinary care (including artificial nutrition and hydration), palliative treatment, especially the proper therapy for pain, in a dialogue with the patient which keeps him informed. [iii]
The Church knows that the moment of death is always accompanied by particularly intense human sentiments: an earthly life is ending; the emotional, generational and social ties that are part of the person's inner self are dissolving; people who are dying and those who assist them are aware of the conflict between hope in immortality and the unknown which troubles even the most enlightened minds. The Church raises her voice so that the dying are not offended but are given every loving care and are not left alone as they prepare to cross the threshold of time to enter eternity. [iv]
Thus in defending the sacredness of life, even that of the dying, the Church is not in some way absolutizing physical life, but is teaching respect for the true dignity of the person, a creature of God, and is helping him to accept death serenely when his physical powers can no longer be sustained. [v]
Appropriate Medical Treatment as Proportionate to the Prospects for Improvement: the Distinction between Euthanasia and the Decision to Forego Aggressive or Overzealous Medical Treatment
The Church teaches that "intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator (Catechism, 2324).” Euthanasia that is directed at "putting an end to the lives of handicapped, sick, or dying persons is also morally unacceptable (Catechism, 2277).”
However, the Church makes the distinction between euthanasia and "over-zealous” treatment—"medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome. Here one does not will to cause death; one’s inability to impede it is merely accepted. (Catechism, 2278).”
Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. [vi]
At the approach of death, which appears inevitable, "it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life" (cf. Declaration on Euthanasia, part IV) because there is a major ethical difference between "procuring death" and "permitting death": the former attitude rejects and denies life, while the latter accepts its natural conclusion. [vii]
Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death. [iix]
If there are no other sufficient remedies, it is permitted, with the patient's consent, to have recourse to the means provided by the most advanced medical techniques, even if these means are still at the experimental stage and are not without a certain risk. By accepting them, the patient can even show generosity in the service of humanity.[ix]
It is also permitted, with the patient's consent, to interrupt these means, where the results fall short of expectations. But for such a decision to be made, account will have to be taken of the reasonable wishes of the patient and the patient's family, as also of the advice of the doctors who are specially competent in the matter. The latter may in particular judge that the investment in instruments and personnel is disproportionate to the results foreseen; they may also judge that the techniques applied impose on the patient strain or suffering out of proportion with the benefits which he or she may gain from such techniques.[x]
Therefore one cannot impose on anyone the obligation to have recourse to a technique which is already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an acceptance of the human condition, or a wish to avoid the application of a medical procedure disproportionate to the results that can be expected, or a desire not to impose excessive expense on the family or the community.[xi]
To Physicians
When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the 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. [xii]
As for those who work in the medical profession, they ought to neglect no means of making all their skill available to the sick and dying; but they should also remember how much more necessary it is to provide them with the comfort of boundless kindness and heartfelt charity. Such service to people is also service to Christ the Lord, who said: "As you did it to one of the least of these my brethren, you did it to me" (Mt. 25:40). [xiii]
Role of Modern Society and Technology in End-of-Life Decisions In modern society, people are increasingly experiencing a new need for meaning. "Man will always yearn to know, at least in an obscure way, what is the meaning of his life, of his activity, of his death”[1206]. It is difficult to meet the demands of building the future in a new context of an even more complex and interdependent international relations that are also less and less ordered and peaceful. Life and death seem to be solely in the hands of a scientific and technological progress that is moving faster than man's ability to establish its ultimate goals and evaluate its costs. [xiv]
When he denies or neglects his fundamental relationship to God, man thinks he is his own rule and measure, with the right to demand that society should guarantee him the ways and means of deciding what to do with his life in full and complete autonomy. It is especially people in the developed countries who act in this way: they feel encouraged to do so also by the constant progress of medicine and its ever more advanced techniques. By using highly sophisticated systems and equipment, science and medical practice today are able not only to attend to cases formerly considered untreatable and to reduce or eliminate pain, but also to sustain and prolong life even in situations of extreme frailty, to resuscitate artificially patients whose basic biological functions have undergone sudden collapse, and to use special procedures to make organs available for transplanting. [xv]
Conclusion
Life is a gift of God, and on the other hand death is unavoidable; it is necessary, therefore, that we, without in any way hastening the hour of death, should be able to accept it with full responsibility and dignity. It is true that death marks the end of our earthly existence, but at the same time it opens the door to eternal life. Therefore, all must prepare themselves for this event in the light of human values, and Christians even more so in the light of faith. [xvi]
Our times call for the mobilization of all the forces of Christian charity and human solidarity. Indeed, we must meet the new challenge of the legalization of euthanasia and assisted suicide. To this end it is not enough to oppose this deadly trend in public opinion and parliament, but society and the Church's own structures must also be involved in providing dignified care for the dying. [xvii]
Statements of Bishops
End-of-life Decisions Require Respect for Human LifeBishop Gregory Aymond, Diocese of Austin April 15, 2007
Public Testimony & LettersAdvance Directives; CSSB 439 Letter to the State House of Representatives Texas Catholic Conference and the Catholic Health Association May 7, 2007
FAQs
What does the Church teach on euthanasia?
What does the Church teach about end-of-life-issues? Is it ever right to stop treatment? Click here to visit our FAQ page
ResourcesClick here to learn about Archbishop Gomez's book: A Will to Live: Clear Answers on End of Life Issues, a great resource on Catholic Teaching for end-of-life issues. Should I Have a Living Will or Designate a ‘Health Care Proxy’
By Rev. Tadeusz Pacholczyk, Ph.D. National Catholic Bioethics Center Medical Power of Attorney Form created by the National Catholic Bioethics Center Catholic Health AssociationThe Catholic Health Association of Texas advocates health-related issues that ensure access to high quality health care for all Texans. National Catholic Bioethics CenterThe NCBC conducts research, consultation, publishing and education to promote human dignity in health care and the life sciences, and derives its message directly from the teachings of the Catholic Church .
[i] SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
DECLARATION ON EUTHANASIA, May 5, 1980 Click here
[ii] ADDRESS OF JOHN PAUL II TO THE MEMBERS OF THE PONTIFICAL ACADEMY FOR LIFE
[iv] ADDRESS OF JOHN PAUL II TO THE MEMBERS OF THE PONTIFICAL ACADEMY FOR LIFE
Saturday, 27 February 1999 Click here
[v] ADDRESS OF JOHN PAUL II TO THE MEMBERS OF THE PONTIFICAL ACADEMY FOR LIFE
Saturday, 27 February 1999 Click here
vi. EVANGELIUM VITAE, March 25, 1995
[viii] EVANGELIUM VITAE, March 25, 1995Click here
SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
;[x] SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
DECLARATION ON EUTHANASIA, May 5, 1980 Click here
xi SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
DECLARATION ON EUTHANASIA, May 5, 1980 Click here
[xii] SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
[xiii] SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
DECLARATION ON EUTHANASIA, May 5, 1980 Click here
[xiv] COMPENDIUM OF THE SOCIAL DOCTRINE OF THE CHURCH, April 2005
Click here
[xvi] SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH
DECLARATION ON EUTHANASIA, May 5, 1980 Click here
[xvii] ADDRESS OF JOHN PAUL II TO THE MEMBERS OF THE PONTIFICAL ACADEMY FOR LIFE
Saturday, 27 February 1999
Click here
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end of life issues
