|His Grace, J. Michael Miller, CSB|
Archbishop of Vancouver
Dear Health Care Professionals:
As shepherd of over 400,000 Catholics in Greater Vancouver and the Lower Mainland, and in view of the Supreme Court of Canada decision of February 6, 2015, and the recent legislation enacted by Parliament concerning euthanasia and assisted suicide, now termed MAiD, I am writing to offer some clarity concerning the Catholic Church’s teaching in this matter.
- We maintain as a fundamental principle that any action or omission which of itself or by intention causes or hastens death is a grave violation of the Commandment: “You shall not kill.”
- Consequently, no one may be pressured or coerced to accept any such action or omission; nor may any health care practitioner be pressured or coerced to cooperate in such an action or omission.
- We hold equally firmly that, while every person has a fundamental right to normal care and treatment, he or she has also the right to refuse procedures or treatments considered “extraordinary” or “disproportionate”; that is, overly burdensome, painful, or of dubious effectiveness in restoring health. Likewise, the individual has the right to discontinue treatment under the same conditions. (Now, read carefully the following nuanced passages!) Occasionally there is the false impression that the Catholic Church teaches that one must sustain and prolong life under all circumstances and at any cost. Just as respect for the human person demands the utmost care of the sick, so the same respect urges avoiding the imposition of treatments that are overly burdensome, unnecessary or futile. As a general principle, if a person’s condition was such that it was legitimate to not administer a particular treatment, it would be equally legitimate to discontinue the treatment when it is judged to be futile, even when it is foreseen that death will follow.
- Nutrition and hydration are to be considered “ordinary” treatment; they can be discontinued only when the body is no longer able to receive or process food and water. To allow a person to die of starvation or dehydration, rather than of his/her illness, would be a form of euthanasia.
- For those in the final stages of a terminal illness the Church is a strong advocate for palliative care. We applaud the progress that has been made in the field of pain alleviation and management. While acknowledging the human and redemptive value of suffering, we also recognize our common human responsibility to bring relief to suffering wherever possible. Thus, in palliative care it is always legitimate to administer medication in doses adequate to control the pain, even if it is foreseen that death will be hastened, so long as the intent is to alleviate the pain, and not to hasten death.
- The conscience of caregivers, physicians, nurses and support staff must always be respected. No one may be subjected to discrimination because of conscientious objection either to MAiD or to effective direct referral.
Euthanasia2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.2277 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. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged.
2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God.2282 If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal. Voluntary co-operation in suicide is contrary to the moral law.Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.2283 We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.