Physician Assisted Suicide: From Dominion over Human Procreation to the “Right to Die”

Forty-six years ago this July, Pope Paul VI issued his most controversial and, as it turned out, his last, yet most enduring encyclical.  I believe that Humanae vitae is a priceless gift to the (post) modern world. In it, Venerable Paul VI, as we know, reaffirmed the 2,000-years-old Catholic teaching on the immorality of contraception. The Pope taught that conjugal love, and indeed “each and every marital act” must remain open “to the procreation of human life” (11).

But many might well ask: “What does an encyclical upholding the traditional understanding of married love, procreation, and sexuality have to do with our current battles over physician-assisted suicide and its legalization?”

elderlyI would argue that both contraception and physician-assisted suicide involve a radical disrespect for the inherent dignity of human life – even if it’s more obvious with the latter practice. Contraception says No to new human life in its “entry,” while physician-assisted suicide says No to human life in its “exit.” If one is willing to act against God’s plan for how a new life comes into the world, then there is nothing to stop one from acting against God’s plan for how a life leaves this world.

Hence, I do not think it a mere coincidence that just one year before the promulgation of Humanae vitae, we had the beginnings of the first so-called “right to die” documents, such as the “Living Will,” sponsored by the Euthanasia Society of America.

Although the modern world likes to separate our beliefs and practices with respect to the “beginning-of-life” from those at the “end-of-life,” there is, in fact, as with love and procreation, an “inseparable connection” (cf. Humanae vitae, 12). One’s attitudes and actions with respect to life in its earliest stages are often a good barometer of one’s attitudes and actions with respect to life in its later and final stages.

If individuals have a “right” to control whether they procreate and then accept new human life, so too (following this logic) must they have a “right” to control how and when they die. Indeed, federal court decisions supporting assisted suicide, such as the Ninth Circuit’s majority opinion in Compassion in Dying v. State of Washington, a 1996 case, have cited the reasoning of Roe v. Wade’s affirmation of a women’s “right” to procure an abortion. “[W]e believe the cases from Pierce through Roe provide strong general support for our conclusion that a liberty interest in controlling the time and manner of one’s death is protected by the Due Process Clause of the Fourteenth Amendment.”

Thus, both issues force us to confront the nature and limits of our dominion over human life. For just as the task of transmitting human life is invested with both objective values and personal choices (cf. Humanae Vitae, 10), so too is the task of caring for life in-its-transition from this life to the next life.

However, as Pope Paul VI reminded us in Humanae vitae, man does not have absolute dominion over either his procreative capacities or over his body as a whole (cf. 13). As stewards of the life that God has given each of us, our claims to do whatever we want with our own lives – whether in generation or in geriatrics – are limited. Yet, in the push for euthanasia and physician-assisted suicide, our desire for absolute dominion is, sadly, all too evident.

We are faced with two contrasting (and competing) “ethics” or “anthropologies,” as the philosophers like to say. Those in the “right to die” movement view human bodily life as something I possess, to do with as I see fit when my life becomes a “burden” due to defect or disease. Thus, they speak of a person’s “quality of life.”

Those of us who oppose physician-assisted suicide – call us the “people of life” movement – view human bodily life as something that shares in my dignity as a person; it is an integral aspect of who I am. This dignity can never be lessened or lost, even in the face of defect or disease.  Nor must it ever be intentionally harmed in any way. Thus, we speak of the “sanctity of human life.”

Although President Ronald Reagan was addressing the abortion crisis, the question he posed in 1983 on the tenth anniversary of Roe v. Wade in his Abortion and the Conscience of the Nation, can easily be applied to our present day assisted-suicide crisis. He argued that the question is no longer “when human life begins” – no, modern embryology took care of that! – but “What is the value of human life?

Unfortunately, our society has not been attributing much value to either end of the life-span. Of course, even to use the language of “attributing” or “assigning” value to human life, as many moral philosophers do (e.g., Peter Singer), is to deny that every human being has an intrinsic and inestimable value as an “image of God” in the world. That is, it is to substitute a “quality of life” ethic for a “sanctity of life” ethic.

In my speaking on physician-assisted suicide over the years, especially in a debate with Geoffrey Fieger, the former attorney for the late assisted-suicide “doctor,” Jack Kevorkian, I have seen these two “ethics” or “anthropologies” confront each other head-on, however much might they remain unarticulated, “below the radar” so to speak.

I have also seen how the “sanctity of human life” ethic has often been caricatured beyond recognition. In general, this is usually done by falsely reducing this ethic to “religious dogma.” Catholics or other Christians need not, however, rely solely on our religion to argue in sound fashion against assisted-suicide. This is true because we can show that the direct taking of innocent human life is a violation of the natural law, in addition to being a violation of God’s law against killing, e.g., the 5th Commandment of the Decalogue.

Here are four specific “caricatures” that I have encountered, along with my brief responses to them. There are many others, but these are some of the most common it seems.

  1. The Catholic Church denies the rightful autonomy of human persons to make end-of-life decisions.  False. Autonomy or self-determination is an important value, as St. Pope John Paul II makes clear in the encyclical Veritatis splendor (cf. 35-41), but when taken out of context or absolutized, it denies the fact that my life is a gift from God and a gift for others, to be lived in “free obedience to God.” (cf. Veritatis splendor, 41) Thus, while I have the right and duty to make decisions that affect my health care, I do not have the right to take my own life. Contrary to the radical individualists, we own neither our lives nor the lives of others. Therefore, neither can we directly take our lives nor the innocent lives of others.
  2. The Church says that the seriously ill who are in pain must suffer without the use of painkillers. False, again. In fact, the Church has long permitted and promoted the use of pain-relieving drugs for those enduring the pain of a serious illness – even if, as a side effect, such drugs render the patient unconscious or shorten his or her life (see more here). Moreover, modern medical advances in pain management and in hospice care have made it possible to treat virtually all of the pain that may accompany a serious illness (see more here).
  3. There is no moral difference between intentionally killing patients and letting them die, since the end result is the same: a dead body. This too is false. The key factor here is intention.  Thus, killing and letting die might be morally indistinguishable if in both cases the intention of the doctor and/or patient is to kill. But it need not be. As the Archdiocese of Los Angeles’s Commission for Catholic Life Issues noted some years ago, “If death is merely foreseen as an undesirable but unavoidable side effect of [an] omission, such an omission is not at all the same as one in which death is directly sought.”
  4. Patients must undergo “heroic” medical measures to keep themselves alive at all cost.  Once again, false.  Patients are not required to use heroic or “extraordinary” measures to preserve life. These are measures which involve burdens that are disproportionate to their hoped for benefits; thus they are non-obligatory. However, patients are obliged to accept “ordinary” or non-burdensome life-sustaining measures. No hard and fast rules can be applied to say that a form of treatment is always ordinary (obligatory) or extraordinary (non-obligatory, optional). “Rather the moral evaluation,” argues the Commission for Catholic Life Issues, “must be highly individualized, taking into account the benefits and burdens of that particular treatment [not the patient’s life!] in the context of that particular patient’s illness, prognosis, finances, social and familial obligations, and state of soul.

Despite these persistent caricatures, authentic Christian teaching on euthanasia and assisted-suicide stands up well against the secular and religious proponents of the “culture of death.” It does so, I believe, because it is grounded in both sound reason and authentic religion.

One of the tasks at hand for Catholics, especially those in secularized countries, is to spread the message about why we believe good health care is rooted in the following maxim – one drawn from Christianity and common morality: “Always to care, but never to kill.” This principle is central to what Pope John Paul II called, in his encyclical Evangelium vitae, the “culture of life.”

By working against laws that would legalize euthanasia and physician-assisted suicide, we will help build what a previous pope called the “civilization of love.” It is no coincidence that the Pope who coined this expression (and who will be beatified this October) was the same pope who wrote Humanae vitae, an encyclical that Saint John Paul II made key to his own pontificate. This was a pontificate best described as a vigorous defense of the “civilization of love” and its “culture of life.”

Mark S. Latkovic, S.T.D. is a Professor of Moral Theology at Sacred Heart Major Seminary (Detroit, MI), where he has taught for over 23 years. He is co-editor of St. Thomas Aquinas and the Natural Law Tradition: Contemporary Perspectives (The Catholic University of America Press, 2004), as well as author of What’s a Person to Do? Everyday Decisions that Matter (Our Sunday Visitor, 2013) and numerous articles in scholarly and popular journals.
Articles by Mark:

  • Valerie Foltz

    Dear Mr. Latkovic,
    I am glad you brought Quality of Life and Sanctity of Life concepts into your argument. I think it is also important to break down Quality of Life further. I have had many families say to me things like the following:” What good is their life?” or “How is this quality?” or even worse “If my mother was a dog I would of done the compassionate thing and put her to sleep.” Despair mixed with fear are the primary motivators in the family or person who asks about euthanasia in my experience as a hospice nurse.
    I have had family members make the above statements about a terminally ill person who has good pain control, and continues to interact although minimally. I often compare the value of the end of life to the value of beginning … the child or infant . This can help move a person beyond despair about their loved one and beyond thoughts of “why not euthanasia”. Make no mistake it is despair that first motivates most people when the ask questions about how to ” speed things up”. However feeding that despair is the way a persons “value” is wrapped up in achievement, as well as intellectual and physical ability and not in the sanctity of each person as a child of God, who is valuable in and of themselves. Until the full sanctity of life of each human person is recognized we will continue to fight this fight.
    Beyond the concerns of quality and sanctity of life is the problem of suffering and sacrifice. We need to reclaim the value of both in order to move past the tragic desire to be in control and end things neatly and quickly. Frankly the issue of suffering today reaches beyond that of patient suffering to family suffering and grief. Our culture sees suffering as a waste and grief as something to get past as fast as possible. Many families feel that even though their loved one is not suffering, they are, because they are worn out with caregiving. When people are involved in the ongoing sacrifice of caring for the loved one, without enough support, it is then when despair again opens the door to asking questions about euthanasia.
    In order to move past despair we need to reclaim the value of the person who suffers. We need to recognize that people suffer from not just pain but the ongoing loss of health, independence, and understanding. While the family suffers great grief at the loss of the healthy person. They also sacrifice their time, love, and energy. Often no or minimal worth is attached to the sick person and their primary care giver as they face a terminal illness with courage. I can tell you that they have great worth, they have great courage and virtue but it is a hard message to get across. I tell them that caring for someone well at the end of life is an act of great love and mercy and they will tell me “well I never wanted to try for sainthood.”
    The focus before a patient enters hospice had been on fighting the illness. When a person becomes terminal instead of seeing the dying process and finally death as the doorway to heaven that will open in God’s time. The secularized American family looks at death as failure. Since they have not been able to beat death, people facing a terminal diagnosis are frightened and often just want to “get it over with”. The also want control of their death the idea of surrender is terrifying to the person without a faith. Because of fear and desire for control the door to despair can be opened.
    Those of us with faith need to be there to help people move past the despair and fear that brings the terminally ill and their families to the thought of euthanasia. We need to help them understand that there is great virtue in allowing death to come in its own time with good care, pain control and support of the caregiver it can even be a “good death.”

    • Mark Latkovic

      Dear Ms. Foltz,
      Many thanks for these excellent comments. I take them to heart. Your response is really an article of its own! Many good insights.
      God bless,

      • Valerie Foltz

        Thank you Mr Latkovic, I am really glad to see these issues brought up and addressed.
        It is really important as our frail elderly population continues to grow we will need to develop strong arguments to defend them. Thank you for being a defender of life!
        Valerie Foltz

        • Mark Latkovic

          You’re most welcome! And keep up your good work!

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  • pescher

    Since secularists accept that we can determine who can ‘enter’ life and also who should ‘exit’ life -before its natural end- then the next logical step would be to determine what type/kind of life should be permitted to exist. Pro-euthansiasts argue that as a society we ‘put down’ animals who suffer and cull animals from the herd in order to eliminate the diseased and weak, so then they will argue that we should be able to ‘cull’ from the human herd those whom we deem unfit for the survival of the human species? Thus the Brave New World of fiction will easily become a reality with almost no debate.

    • Mark Latkovic

      I’m afraid you’re right, pescher!

    • PalaceGuard

      Margaret Sanger was ahead of you on this, and advocated for the abortion of “human weeds”.

      • pescher

        Yes but I’m also warning that with the acceptance of assisted suicide -in its various forms- there will be pressure on hospitals to euthanize patients who have not requested aid-in-dying but share a similar decline in their state of health as others who have requested it. Thus they will be denied medical treatment and given no nourishment under some vague psuedo-medical terminology as “medical aid in dying” or “cost effective medical treatment”, etc., thereby removing even the right to refuse some procedures or insiist on others. Even scarier is the expanding drive for tissue/organs which makes this a plausible scenario.

  • Crimini Reaper

    I think it’s like muslims in non-sharia countries. Compliance with your sanctity perspective can be a sign of a person’s honest, uncoerced ‘free obedience of God’. That’s why normal people hate the impositions of theocrats, though personally I understand their impositions in context of the original imposition….

    The fundamental question for me isn’t about value, but ‘is god our benefactor’. he is the only one who had perfectly free will, as he was under no obligation to create, and still doesn’t need us! So all our suffering is for nothing. Well, his entertainment. You guys should look up your Gnostic buddies and ask them about the sick demiurge who runs this place! Contraception, euthanasia, nihilism in general are beautiful things, in an ugly universe made for ugly nonreasons by an ugly god. Beautiful because unlike the universe, they show evidence of moral assessment and considerate ratiocination. As long as you never dismiss the sufferings of others (i.e solipsism) you are probably more moral than god as we know him.We certainly can’t expect justice from him, so let him do his worst. I mean, I never wanted this life, would never have dreamed of asking for it, and I still got it. Incidentally, I don’t believe in god, but I am one fo those ‘There Is No God And I Hate Him’ atheists. I mean, this is underachievement writ omnipotent! Live in eternity, with the douchebag who made this place? To quote WIlliam Murderface, I’d rather die than go to heaven.