DECLARATION ON EUTHANASIACongregation for the Doctrine of the Faith
May 5, 1980
CONTENTS
Introduction
The Value of Human Life
Euthanasia
The Meaning of Suffering for Christians and the Use of
Painkillers
Due Proportion in the Use of Remedies
Conclusion
INTRODUCTION
The rights and values pertaining to the human person occupy an important
place among the questions discussed today. In this regard, the Second Vatican
Ecumenical Council solemnly reaffirmed the lofty dignity of the human person,
and in a special way his or her right to life. The Council therefore condemned
crimes against life "such as any type of murder, genocide, abortion, euthanasia,
or willful suicide" (Pastoral Constitution
Gaudium et spes, no. 27).
More recently, the Sacred Congregation for the Doctrine of the Faith has
reminded all the faithful of Catholic teaching on procured abortion.(1)
The Congregation now considers it opportune to set forth the Church's teaching
on euthanasia.
It is indeed true that, in this sphere of teaching, the recent Popes have
explained the principles, and these retain their full force (2);
but the progress of medical science in recent years has brought to the fore new
aspects of the question of euthanasia, and these aspects call for further
elucidation on the ethical level.
In modern society, in which even the fundamental values of human life are
often called into question, cultural change exercises an influence upon the way
of looking at suffering and death; moreover, medicine has increased its capacity
to cure and to prolong life in particular circumstances, which sometimes give
rise to moral problems. Thus people living in this situation experience no
little anxiety about the meaning of advanced old age and death. They also begin
to wonder whether they have the right to obtain for themselves or their
fellowmen an "easy death," which would shorten suffering and which seems to them
more in harmony with human dignity.
A number of Episcopal Conferences have raised questions on this subject with
the Sacred Congregation for the Doctrine of the Faith. The Congregation, having
sought the opinion of experts on the various aspects of euthanasia, now wishes
to respond to the Bishops' questions with the present Declaration, in order to
help them to give correct teaching to the faithful entrusted to their care, and
to offer them elements for reflection that they can present to the civil
authorities with regard to this very serious matter.
The considerations set forth in the present document concern in the first
place all those who place their faith and hope in Christ, who, through His life,
death and resurrection, has given a new meaning to existence and especially to
the death of the Christian, as St. Paul says: "If we live, we live to the Lord,
and if we die, we die to the Lord" (Rom. 14:8; cf. Phil.1:20).
As for those who profess other religions, many will agree with us that faith
in God the Creator, Provider and Lord of life -- if they share this belief --
confers a lofty dignity upon every human person and guarantees respect for him
or her.
It is hoped that this Declaration will meet with the approval of many people
of good will, who, philosophical or ideological differences notwithstanding,
have nevertheless a lively awareness of the rights of the human person. These
rights have often, in fact, been proclaimed in recent years through declarations
issued by International Congresses (3); and since it is a
question here of fundamental rights inherent in every human person, it is
obviously wrong to have recourse to arguments from political pluralism or
religious freedom in order to deny the universal value of those rights.
THE VALUE OF HUMAN LIFE
Human life is the basis of all goods and is the necessary source and
condition of every human activity and of all society. Most people regard life as
something sacred and hold that no one may dispose of it at will, but believers
see in life something greater, namely, a gift of God's love, which they are
called upon to preserve and make fruitful. And it is this latter consideration
that gives rise to the following consequences:
1. No one can make an attempt on the life of an innocent person without
opposing God's love for that person, without violating a fundamental right, and
therefore without committing a crime of the utmost gravity. (4)
2. Everyone has the duty to lead his or her life in accordance with God's
plan. That life is entrusted to the individual as a good that must bear fruit
already here on earth, but that finds its full perfection only in eternal life.
3. Intentionally causing one's own death, or suicide, is therefore equally as
wrong as murder; such an action on the part of a person is to be considered as a
rejection of God's sovereignty and loving plan. Furthermore, suicide is also
often a refusal of love for self, the denial of the natural instinct to live, a
flight from the duties of justice and charity owed to one's neighbor, to various
communities or to the whole of society -- although, as is generally recognized,
at times there are psychological factors present that can diminish
responsibility or even completely remove it.
However, one must clearly distinguish suicide from that sacrifice of one's
life whereby for a higher cause, such as God's glory, the salvation of souls or
the service of one's brethren, a person offers his or her own life or puts it in
danger (cf. Jn. 15:14).
EUTHANASIA
In order that the question of euthanasia can be properly dealt with, it is
first necessary to define the words used.
Etymologically speaking, in ancient times euthanasia meant an easy death
without severe suffering. Today one no longer thinks of this original meaning of
the word, but rather of some intervention of medicine whereby the suffering of
sickness or of 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.
It is, therefore, necessary to state clearly in what sense the word is used
in the present document.
By euthanasia is understood an action or an omission which of itself or by
intention causes death, in order that all suffering may in this way be
eliminated. Euthanasia's terms of reference, therefore, are to be found in the
intention of the will and in the methods used.
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 old person, or 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.
It may happen that, by reason of prolonged and barely tolerable pain, for
deeply personal or other reasons, people may be led to believe that they can
legitimately ask for death or obtain it for others. Although in these cases the
guilt of the individual may be reduced or completely absent, nevertheless the
error of judgment into which the conscience falls, perhaps in good faith, does
not change the nature of this act of killing, which will always be in itself
something to be rejected. The pleas of gravely ill people who sometimes ask for
death are not to be understood as implying a true desire for euthanasia; in
fact, it is almost always a case of an anguished plea for help and love. What a
sick person needs, besides medical care, is love, the human and supernatural
warmth with which the sick person can and ought to be surrounded by all those
close to him or her, parents and children, doctors and nurses.
THE MEANING OF SUFFERING FOR CHRISTIANS AND THE USE
OF PAINKILLERS
Death does not always come in dramatic circumstances after barely tolerable
sufferings. Nor do we have to think only of extreme cases. Numerous testimonies
which confirm one another lead one to the conclusion that nature itself has made
provision to render more bearable at the moment of death separations that would
be terribly painful to a person in full health. Hence it is that a prolonged
illness, advanced old age, or a state of loneliness or neglect can bring about
psychological conditions that facilitate the acceptance of death.
Nevertheless the fact remains that death, often preceded or accompanied by
severe and prolonged suffering, is something which naturally causes people
anguish.
Physical suffering is certainly an unavoidable element of the human
condition; on the biological level, it constitutes a warning of which no one
denies the usefulness; but, since it affects the human psychological makeup, it
often exceeds its own biological usefulness and so can become so severe as to
cause the desire to remove it at any cost.
According to Christian teaching, however, suffering, especially suffering
during the last moments of life, has a special place in God's saving plan; it is
in fact a sharing in Christ's passion and a union with the redeeming sacrifice
which He offered in obedience to the Father's will. Therefore, one must not be
surprised if some Christians prefer to moderate their use of painkillers, in
order to accept voluntarily at least a part of their sufferings and thus
associate themselves in a conscious way with the sufferings of Christ crucified
(cf. Mt. 27:34). Nevertheless it would be imprudent to impose a heroic way of
acting as a general rule. On the contrary, human and Christian prudence suggest
for the majority of sick people the use of medicines capable of alleviating or
suppressing pain, even though these may cause as a secondary effect
semi-consciousness and reduced lucidity. As for those who are not in a state to
express themselves, one can reasonably presume that they wish to take these
painkillers, and have them administered according to the doctor's advice.
But the intensive use of painkillers is not without difficulties, because the
phenomenon of habituation generally makes it necessary to increase their dosage
in order to maintain their efficacy. At this point it is fitting to recall a
declaration by Pius XII, which retains its full force; in answer to a group of
doctors who had put the question: "Is the suppression of pain and consciousness
by the use of narcotics...permitted by religion and morality to the doctor and
the patient (even at the approach of death and if one foresees that the use of
narcotics will shorten life)?" the Pope said: "If no other means exist, and if,
in the given circumstances, this does not prevent the carrying out of other
religious and moral duties: Yes." (5) In this case, of course,
death is in no way intended or sought, even if the risk of it is reasonably
taken; the intention is simply to relieve pain effectively, using for this
purpose painkillers available to medicine.
However, painkillers that cause unconsciousness need special consideration.
For a person not only has to be able to satisfy his or her moral duties and
family obligations; he or she also has to prepare himself or herself with full
consciousness for meeting Christ. Thus Pius XII warns: "It is not right to
deprive the dying person of consciousness without a serious reason."
(6)
DUE PROPORTION IN THE USE OF REMEDIES
Today it is very important to protect, at the moment of death, both the
dignity of the human person and the Christian concept of life, against a
technological attitude that threatens to become an abuse. Thus some people speak
of a "right to die," which is an expression that does not mean the right to
procure death either by one's own hand or by means of someone else, as one
pleases, but rather the right to die peacefully with human and Christian
dignity. From this point of view, the use of therapeutic means can sometimes
pose problems.
In numerous cases, the complexity of the situation can be such as to cause
doubts about the way ethical principles should be applied. In the final
analysis, it pertains to the conscience either of the sick person, or of those
qualified to speak in the sick person's name, or of the doctors, to decide, in
the light of moral obligations and of the various aspects of the case.
Everyone has the duty to care for his or her own health or to seek such care
from others. Those whose task it is to care for the sick must do so
conscientiously and administer the remedies that seem necessary or useful.
However, is it necessary in all circumstances to have recourse to all
possible remedies?
In the past, moralists replied that one is never obliged to use
"extraordinary" means. This reply, which as a principle still holds good, is
perhaps less clear today, by reason of the imprecision of the term and the rapid
progress made in the treatment of sickness. Thus some people prefer to speak of
"proportionate" and "disproportionate" means. In any case, it will be possible
to make a correct judgment as to the means by studying the type of treatment to
be used, its degree of complexity or risk, its cost and the possibilities of
using it, and comparing these elements with the result that can be expected,
taking into account the state of the sick person and his or her physical and
moral resources.
In order to facilitate the application of these general principles, the
following clarifications can be added:
-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.
-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.
-It is also permissible to make do with the normal means that medicine can
offer. 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.
-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.
CONCLUSION
The norms contained in the present Declaration are inspired by a profound
desire to serve people in accordance with the plan of the Creator. 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 immortal 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.
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 the 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).
At the audience granted to the undersigned Prefect, His Holiness Pope John
Paul II approved this Declaration, adopted at the ordinary meeting of the Sacred
Congregation for the Doctrine of the Faith, and ordered its publication.
Rome, the Sacred Congregation for the Doctrine of the Faith, May 5, 1980.
F. Cardinal Seper
Prefect
Jerome Hamer, O.P.
Tit. Archbishop of Lorium
Secretary
NOTES
- Declaration On Procured Abortion
, 18 November 1974:
AAS 66 (1974), pp. 730-747.
- Pius XII, Address to those attending the Congress of
the International Union of Catholic Women's Leagues, 11 September 1947:
AAS 39 (1947), p. 483; Address to the Italian Catholic Union of
Midwives, 29 October 1951:
AAS 43 (1951), p. 835-854; Speech to the members of the
International Office of military medicine documentation, 19 October
1953: AAS 45 (1953), pp. 744-754; Address to those taking part in
the IXth Congress of the Italian Anaesthesiological Society, 24 February
1957: AAS 49 (1957), P. 146; cf. also Address on "reanimation"
24 November 1957: AAS 49 (1957), pp. 1027-1033; Paul VI, Address
to the members of the United Nations Special Committee on Apartheid, 22
May 1974: AAS 66 (1974), p. 346; John Paul II: Address to the
Bishops of the United States of America, 5 October 1979: AAS 71
(1979), p. 1225.
- One thinks especially of Recommendation 779 (1976) on the
rights of the sick and dying, of the Parliamentary Assembly of the Council
of Europe at its XXVth Ordinary Session; cf. Sipeca, No. 1 March 1977, pp.
14-15.
- We leave aside completely the problems of the death
penalty and of war, which involve specific considerations that do not
concern the present subject.
- Pius XII, Address of 24 February 1957: AAS
49 (1957), p. 147.
- Pius XII, ibid., p. 145; cf. Address of 9
September 1958: AAS
50 (1958), p. 694.
Teachings of the
Magisterium on Abortion
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