Busted Halo
feature: politics & culture
November 11th, 2011

Pulling the Plug: Letting Go of Misconceptions


In response to a Massachusetts ballot question that would legalize physician-assisted suicide, Boston’s Cardinal Seán O’Malley has encouraged the Catholic legal community to uphold a “gospel of life.” In the past month, Cardinal O’Malley’s remarks have sparked discussion of this issue among laypeople. Some of this discussion has caught my attention, and it’s pretty clear that there are some serious widespread misconceptions — some of which I once held myself — both about physician-assisted suicide and about the nuances of the Catholic Church’s position.

In the minds of lay people, physician-assisted suicide often becomes conflated with “pulling the plug.” Because the Church is misrepresented as being opposed to “pulling the plug,” many people perceive it as heartless and unreasonable, and are needlessly and tragically alienated from her.

Make no mistake; the Church does oppose physician-assisted suicide — that is, any act “which of itself or by intention causes death, in order that all suffering may in this way be eliminated.” (National Conference of Catholic Bishops (1984). Guidelines for Legislation on Life-Sustaining Treatment, 2.) Examples of this would be the administration of a lethal drug with the intended effect of ending a life, or the withholding of food or water with the intended effect of ending a life. As with all moral issues, this one comes down to intention.

But the Church, the champion of Natural Law, does not expect individuals to go to extraordinary or disproportionate measures to preserve life. Even though we’re expected to take reasonable measures to care for ourselves (like taking medicine that will aid in recovery) we’re not obliged to rely on medical procedures that will prolong life with no hope of recovery or that cause extreme suffering. The woman unable to breathe her own need not subsist on an artificial respirator; the man with Stage IV cancer can choose to refuse chemotherapy.

Of course, such decisions should be made with the help of a doctor. Artificial respirators are sometimes necessary as a temporary treatment; cancer caught early enough is often curable.

The moral dilemma

Make no mistake; the Church does oppose physician-assisted suicide… but the Church, the champion of Natural Law, does not expect individuals to go to extraordinary or disproportionate measures to preserve life.

The moral dilemma arises when an artificial respirator is used and the hoped-for recovery fails, or when it is used with the intent of postponing death, but the patient eventually becomes at peace with death. When the only thing standing between an individual and death is an extraordinary medical measure that may even be causing her extreme discomfort, it is okay to stop that treatment and put the situation in God’s hands.

Dr. Charles Camosy, assistant professor of Christian ethics at Fordham University and Catholic Moral Theology contributor, stresses that “you cannot be aiming at death — that’s always going to be wrong. You need to be aiming at something else (removing burdensome treatment), while foreseeing but not intending that death is likely.” Such decisions should not be made lightly. Camosy adds, “You need a proportionate reason to do it. And because it involves death — a very serious matter — you need a very serious reason.”

If the cessation of that treatment causes discomfort, the U.S. Bishops say “it is permissible… to use painkillers, which carry the risk of shortening life, so long as the intent is to relieve pain effectively rather than to cause death.” (Ibid.)

Just as the intentional ending of someone’s life violates her dignity, the perpetuation of someone’s life when God is calling her home can also challenge dignity, even though it is well intentioned. Families and patients in this position should be given love and support as they struggle with this issue.

The questions that arise when dealing with end-of-life issues are complex, and there are no easy answers. What’s touched on here should be considered through the lens of the teaching authority of the Church. The United States Bishops’ website on end of life issues can be extremely useful in informing your conscience during a spiritually trying time.

It takes time to accept the reality of death, to trust God, and to say goodbye. The desire to postpone death is human. Jesus himself, overcome with grief, resuscitated his friend Lazarus because of this very human instinct. But the willingness to put a situation in God’s hands and the trust that death is only the beginning are beautiful things. They shouldn’t be discouraged because of a misunderstanding of Church teaching. It’s not okay to kill. It is okay to let go.

The Author : Helen Lee
Helen is a former Busted Halo intern and recent graduate of Fordham University, where she studied Theology and Communications.
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  • Ann Turner

    This is a difficult and complex situation requiring discernment and prayer, I believe, as well as paying good attention to “the seamless garment of life.” Having been present with friends and family for several deaths, my take is that people are most afraid of losing control and dying in incurable pain. My Dad’s doctor assured him that his pain from spreading cancer would be controlled–that he would not be suffering needlessly–and that he would slimply slip away at the end. I realize not everyone’s death is as “easy” as that, but if the doctors and hospice people (heroes!) can control pain adequately, doesn’t that answer one of peoples’ deepest fears? I could never request an artificial end for myself nor recommend it for a loved one. It just seems deeply wrong to me.

  • Gina Santonas

    That is a very good article and I am glad that the church is loosening it’s rules on it. Just as you can say God has given us the talents to cure people, he probably gave us the means to end suffering as well. It is just such a difficult decision when to do that. That decisions should be made between that person and his or her creator and not the government.

  • John

    The desire on a person’s part to put a stop to suffering doesn’t strike me as a matter of being tied to tangible things. Hospice care is only as effective as the people who work in it. My only real point here is that people should have this choice. Most faithful Catholics will not embrace that choice, I would imagine, but there will be instances for which the choice should be legally available. A one size fits all rule will almost certainly result in unfortunate results.

  • Jill

    John – a slow death may be beyond our control (to the extent that we as Catholics allow God to determine the day and hour that He calls us home) but there is no death that has to be painful, either physically or psychologically. For those who have an incurable illness, whether it be heart failure or cancer or ALS, hospice is an appropriate and effective way of handing those concerning issues. The inevitable truth for all of us is that we will die one day. Does that mean we should not live in the meantime? Euthanasia is not an act of mercy, it is the horrific result of a culture that preaches your worth as a human is tied to tangible things.

  • John

    If death is only the beginning, it is not clear to me why the Church would insist on prolonging life here. It is easy to state in theory that one is not required to undergo extraordinary measures to preserve life here or that painkillers may be used to ease dying, but the reality of a slow death is not nearly so painless and efficient. Unless the Church intends to hold on to a perverse notion that a miserable death is somehow a noble or necessary one, euthanasia is an act of mercy, and it does not deny God’s power over life and death. It is simply a means to accept the inevitable — God’s will– without pointlessly extending pain. Or does the Church suppose that God wills painful,miserable deaths?

  • Jason Thomas

    Really well put. Thank you for opening up what can be a delicate issue, to say the least. I did a report for my nursing program on this very issue some months ago and found the Church’s teaching on this matter to be generally well informed and thoughtful. One life-sustaining measure that you have not mentioned–and that those in the medical community are often at odds with– is the use of supplemental/artificial nutrition for individuals in a persistent vegetative state. The Church teaches that administering of nutrition and hydration for an individual in this type of situation is NOT considered an extraordinary measure, unless this treatment causes more harm (in the really great Q&A from the USCCB they use the example of stomach cancer and infection from the feeding tube).

    I realize this might be beyond the scope of a webpage post, but I would like to know what the Church considers “death”, which seems to be at odds with what many in the medical community would consider death, or at least “beyond recovery”.

    Either way, thank you again for the article.

  • James Leo Oliver

    You have made this important distinction very clear. God bless us all.

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