Bishops’ Statement on End of Life Care: “Freedom to Live Fully, Until Death Comes”

The following pastoral letter Freedom to Live Fully, Until Death Comes has been published by the Irish Catholic Bishops’ Conference to inform people of faith and goodwill who wish to protect and support human life with dignity and compassion, especially in the last weeks of terminal illness.

 “Every human person possesses an infinite dignity, inalienably grounded in his or her very being, which prevails in and beyond every circumstance, state, or situation the person may ever encounter.”[1] With that in mind, the Bishops of Ireland wish to invite people to consider once again some of the essential elements of the Church’s teaching on care at the end of life.
 
Palliative and pastoral care focus on the needs of the whole person
As pastors, we are well aware of the impact that critical or terminal illness has, not only on the person who is ill, but also on his or her family and friends.  In his Letter to the Romans, Saint Paul writes: “The life and death of each of us has its influence on others; if we live, we live for the Lord; and if we die, we die for the Lord, so that alive or dead we belong to the Lord” (Rom. 14:7).  We believe that every person who is seriously ill, together with all those who are concerned with his or her care, however difficult the circumstances, is held in the unconditional love of God.
 
“Despite our best efforts, it is hard to recognise the profound value of human life when we see it in its weakness and fragility.”[2] It is our experience however that, in the final weeks of terminal illness, many people can be helped to experience human and spiritual growth.  Faced with the reality of their own mortality, they can and do come to understand themselves better, and to experience the love of family members and friends. This can be a time when old hurts are healed and people find inner peace.[3] This process is supported through palliative and pastoral care, which places the focus on the needs of the whole person.
 
“Assisted suicide” would undermine confidence of terminally ill
It is argued by some that the provision of “assisted suicide” is simply about respecting the autonomy of the individual over his or her own life. Once life is taken away, however, autonomy is also taken away. The Church does not and never has insisted on the use of extraordinary means to prolong life. Nor is there any moral obligation on a sick person to accept treatment which they feel is unduly burdensome. A decision to end life prematurely, however, cuts off any prospect of growth or healing and represents a failure of hope. It is surely far better when a person’s freedom to live is affirmed and supported by a compassionate community of care. Even leaving aside the vision of faith, individual autonomy is not absolute, and consideration must be given to the impact of legislation on the common good, as well as on the individual. By legislating for assisted suicide or euthanasia, the State would contribute to undermining the confidence of people who are terminally ill, who want to be cared for and want to live life as fully as possible until death naturally comes.
 
People who are dying are entitled to be accompanied in a holistic way. We believe that palliative care services need to be more widely available, in hospitals and hospices and in the community. Pope Francis says: “We must accompany people towards death, but not provoke death or facilitate any form of suicide”.[4]   “Care for life is therefore the first responsibility that guides the physician in the encounter with the sick” and the duty of care applies “not only when the restoration to health is a realistic outcome, but even when a cure is unlikely or impossible.”[5] It is often very difficult to accompany those who are suffering near the end of life. All the more reason, then, for Society to make sufficient resources available for the integral care of the dying, so that no one is made to feel that either suffering, or caring, is unbearable.
 
We reject legislation that would facilitate assisted suicide or euthanasia
We have read the “Final Report of the Joint Committee on Assisted Dying”.[6] The first recommendation of that report is “that the government introduces legislation allowing for assisted dying, in certain restricted circumstances as set out in the recommendations of the report”.[7] We totally reject that recommendation because, whatever the circumstances, the deliberate taking of human life, especially by those whose vocation is to care for it, undermines a fundamental principle of civilised society, namely that no person can lawfully take the life of another.
 
People with intellectual disabilities would be particularly vulnerable
We are aware, of course, that the “Final Report” proposes various “restrictions” regarding who might have access to assisted suicide and under what circumstances.[8] We have little confidence that those proposed restrictions would offer any real protection. Taking into account what has happened in many other jurisdictions, and indeed, what is already happening in Ireland with regard to the law on abortion, we believe that it would be only a matter of time before proposals would be on the table again to extend the availability of assisted suicide to those in our society who are most vulnerable, including people with intellectual disabilites.
 
Acting in Freedom and Truth
Assisted suicide requires the active participation of healthcare professionals in taking the lives of the sick. We specifically reject the Recommendation in the Final Report which requires that, “if assisted dying is legislated for, a doctor or nurse practitioner be present” and “must account to the responsible authority.”[9] Similarly, the Final Report proposes that, when a healthcare professional refuses to participate in ending the life of a patient, he or she would then be required to refer that same patient on to a “participating healthcare professional”.[10] Requirements such as these would radically undermine the ethos of healthcare.
 
Conscience is our “inner sanctuary” that sacred place where we come face to face with the truth and that includes the truth about the inherent dignity of the human person. Doctors and nurses are obliged, like everyone else, to seek the truth and to be faithful to it in the way they care for their patients. The Good Samaritan does not ‘pass by on the other side’ as if he didn’t see (Lk.10:31). Whenever we place healthcare professionals under pressure to participate, either directly or by referral, in an act that they themselves believe to be fundamentally immoral, we treat them as mindless functionaries. This does untold damage to the integrity of healthcare in Ireland and removes the human as its primary focus. In our culture, we rightly hold doctors and nurses in high esteem because they are presumed always to be at the service of life, for as long as their patient lives. We call on Catholics to stand firmly in support of nurses and doctors who stand for life. One day it may be your life.
 
ENDS

Personal testimonies may be accessed on a video entitled Through The Valley at the following link:

www.councilforlife.ie/through-the-valley/