On the Encyclical Evangelium Vitae
Gonzalo Herranz, departmentde Bioética, University of Navarra.
Gijón, 7 June 1995.
1. The evangelical character of the EV
3. The joy and dignity of human life
II. My opinion as a professor of medical ethics
Never in my life have I started a lecturewith a more acute awareness of my inability, my inadequacy.
The reason is quite simple: the Encyclical Evangelium vitae (EV) cannot be dealt with in depth in the short deadlineof 45 minutes. It is too little time to describe it, to summarise the many ideas and incitements that the Pope includes in the Introduction, in its four dense chapters, in the conclusion. It is impossible to submit to even a superficial analysis the theological and anthropological instructionson which the Pope bases his message. One could devote oneself to situating the Encyclical in the context of today's world, in the culture of death in which so many of our contemporaries live; or consider EV in its capacity to be a cornerstone of the Culture of Life that the Pope wants to inaugurate with it. The Pope maintains that whenever possible we should begin our reflections and teachings on questions of Ethics with a reference letterto Scripture: he has taken the story of the lacerating experience of Abel's death by Cain to sensitise our conscience, to inoculate us against the risk of over-dramatising the usual, ordinary tragedy of the death of brother by brother, which relentlessly and with degrading repetition, continues to fill the pages of the book of the history of peoples.
And, although we could talk about these things and many more, we will have to decide on one or another so as not to fall into inconcretion or cliché. After giving it a lot of thought, I have decided to speak about the Introduction to the Encyclical. I think that in this way I can help you to start with a good disposition the intentional, tenacious, penetrating reading of the message as simple as bread, joyful as good news, which means gospel, that EV transmits to us.
It's funny: people tend to skip reading prologues and introductions. They prefer to cut to the chase. They think of book introductions as something like the tuning of the orchestra before the concert begins. It serves to set the mood, but it is not something to pay attention to. They think that there is little substance in the introductions, because what is important is in the chapters that make up the body of the book. It is true that some introductions are hollow, or rather, full of banalities. But not all of them are like that: some are not simply trying to win the reader's attention, to get him or her into subject, but to tell what the author's intentions are, what his or her starting points are, his or her way of reasoning, the articles of his or her creed and ideological project, what ideas we have to share with the author in order to accompany him or her throughout the adventure of reading, of this spiritual journey that author and reader are going to make together.
Omitting to read the prologue or the introductory chapter of a book often means missing the author, ignoring him, not understanding him. The consequence is the premature withdrawalof reading a book that could change some aspect of our lives.
EV's introduction is one of those introductions that must be read. And, curiously, there are few of us who have read it. The vast majority of the people to whom the Charter on the value and inviolability of human life is addressed - the lay faithful and all people of good will - have paradoxically been content with the press references, with the hasty and superficial, if not hostile and ridiculously critical, commentaries that have appeared on the news, on the morning radio programmes, on the opinion pages of the newspapers. Correspondents and commentators have gone in search of the conclusions of the document, without the slightest interest in its foundations and reasons. With the one-way mentality of someone who has to prepare a commentary in a few minutes, they have limited themselves to saying and writing that the ideas are the same as always, the impermeability of the Church to progress the usual, the condemnations of abortion and euthanasia absolute and lacking in compassion. Obsessively, they have insisted that the Church is still flirting with the death penalty and has missed an opportunity to condemn it once and for all. At summary: that Wojtyla is still the same old Wojtyla.
Hardly anyone has thought of taking the Encyclical with them for a weekend at least, to a quiet place, and there to read it slowly, to try to understand it in depth, to reflect on it, in order to be able to give an opinion with knowledgeof cause. They skipped the Introduction, went looking for the points of scandal, and closed themselves to the message of the document.
Here we have yet another example of the seed fallen by the wayside, on the hard crust of prejudice, of indifference, where it is impossible for it to germinate. In our society, respect for life is not fashionable. Most people, those who work in the media and those who read or listen to them, probably harbour neither feelings of love nor hatred towards the Pope and the Encyclical, only indifference and estrangement. They live by the day, with an olympic indifference to the timeless, dragged along by what is the news or the problem of each day, of each minute. People today tend to think that everything flows and changes, that everything ceases to be news in a few hours. For many, lacking in faith, the Pope is a paradoxical and incomprehensible man: enviable as a communicator, with dangerously advanced ideas in social doctrine, but fiercely conservative in matters of sexual and family morality.
In general, the dominant idea in our society about the EV is a rickety and partial idea, closed to the transcendent, limited to socio-political coordinates, to circumstantial comments on the confrontation of the Encyclical's norms with the legal norms in force or in preparation. At the end of the day, the idea that people have been left with is that it is a document addressed to a minority, with little political influence.
But we must not be swayed by this mentality. Ronald Knox's words come very much to mind here purpose. I read them to warn us against the risk of overlooking the Encyclical addressed to us, for I suppose we all fall into one of those two categories of recipients of the EV: the faithful and people of good will. Knox tries to understand the phenomenon of insensitivity to Christian doctrine that affects many people today, "those who have left the Church, or those who so often seem closed to every murmur of her teachings. Only God Himself, in His unfathomable wisdom," says Knox, "can read into the secret of these hearts and know what part the accidents of environment and Educationhave played in separating them from the consciousness of their Christian vocation. Perhaps some of them will not be able to evade the responsibility of having disdained the enlightenment they have received, and of having, by long habit of misusing or under-using it, corked their Schoolsappreciation of spiritual matters. More or less consciously, they have corrupted their intellect by a lack of curiosity, involuntary at first, but more conscious as time goes on, about the meaning and purpose of life".
They skipped the Introduction, went looking for the points of scandal, and closed themselves off to the message of the document. There are many Catholics who have not read and re-read the Encyclical, who have not spent time reflecting on it, who have not prayed to God to give them the grace to understand and accept it. They have read what the newspapers said, written by people who think that everything that comes from Rome is wrong. If they had read the Introduction they would not have deceived themselves so grievously.
1. The evangelical character of the EV
The whole argument of the EV is luminously contained in its degree scroll: On the value and inviolability of human life. It is a moral topic, which requires that those who study it understand the basic principles that author and readers must share beforehand in order to understand the problems and their solutions.
In the first line, the Pope tells us which feelings abound in his heart. It is not he who speaks to us: as the Vice-Christ on earth, he wants Jesus to speak for him.
The Gospel of life is at the heart of Jesus' message. Welcomed with love every day by the Church, it is proclaimed with fearless fidelity as good news to people of every age and culture.
These are the first words of the Encyclical. It is worth commenting on them, as they will help us to prepare ourselves to read the whole document, since it deals with a central topicof the Christian message, which demands courage to accept it, tenacity to spread it, joy in the heart to interpret it and make it known to so many good people, of all times and cultures, for it is a universal message, full of moral rectitude and reasonableness, which appeals to so many people who have an innate sense of the dignity of man.
What I want to emphasise at this point is that the doctrine set out is at the heart of the doctrine of Jesus. It comes to us from Him. What does this mean? That we are to receive it as if it came from Christ Himself. If we read the four gospels with a realistic sense, with alert and lively eyes, we discover with force that Jesus taught very firmly. He was, and was called, Teacher. The Sermon on the Mount is not a lyrical poem: it is a moral code, strong and full of cordiality, of strict and exacting standards. No one who has read it will think that divorce or promiscuity, that living comfortably oblivious to the needs of others, that living a morally insincere life or abusing the weak, can be reconciled with being Christian and truly human.
The response Jesus expected from his hearers was one of joyful acceptance. He did not want people by his side who found his doctrine burdensome or restrictive. Once he spoke very loudly in the synagogue in Capernaum, many left his side. He then asked his closest disciples if they too were thinking of leaving him. Peter answered for all of them that He alone had the words of eternal life, that He alone spoke things that were liberating and enlightening to man's life. And they stayed with him.
I do not think I am wasting your time and mine, if I remind you and remind myself that it is a wonderful thing that Christ was Master and that He delegated to His Church, and principally to Peter, His prophetic mission statement. This is a very great fortune, a grace. It is not at all easy for men to find the right answer to many problems. My friends in the field of bioethics tell me - some with envy, others with a mixture of envy and intellectual disdain, but that's just the way it is - how lucky I am to find a guidein Catholic doctrine to get out of many doubts, so as not to spend too much time in confusion. The light of faith is a great and undeserved grace.
And yet, inside and outside the Church, there is now widespread contempt for the moral authority of the Pope's teachings. They say that to be guided by another, even if he is the Vicar of Christ, is to abdicate the responsibility of being a moral adult who decides for himself, that it is to remain infantilised and to allow paternalism to endure. But these same people act in other spheres of life with an astonishing submission to the experts: they allow themselves to be operated on by surgeons, they buy the cars that the brand representatives advise them to buy, they go on holiday wherever the travel agencies tell them to go and they pay attention to the weather forecasts on the television news. Why is it that only moral conduct should fall outside the sphere of those who give advice? Why is there little respect for the teachings of the Church?
The sense of Christ as Master has been lost. Deep down, the good disciple of Christ has the praises of the law-giving God ringing in his heart and head. Psalm 18 is a good psalm to remember when reading the Gospel. Some of its verses go like this:
The law of the Lord is perfect, it gives joy to the soul. The decrees of the Lord are trustworthy; they give wisdom to the simple.
The precepts of the Lord are right, they make the heart glad; his commands are clear, they enlighten the eye.
The fear of the Lord is pure and lasts forever; the judgments of the Lord are true, they are all righteous.
They are more precious than gold, than a heap of fine gold; sweeter than honey from the honeycomb.
These verses of the psalm express the attitude with which we should read the EV, the attitude that the believer should have, but which we painfully cultivate too little. We should foster this attitude of grateful receptivity when we read the Encyclical. Read with simplicity, believe and give thanks with love, with the same simplicity and love with which the Pope has written to us. This is how good children read their parents' letters.
At this point, I think some may wonder if I am not overstepping my bounds. Not only that this is more like a fervour than a lecture. I will give the reason for what I have said.
As soon as the Encyclical was published, on the same day, a journalist from a news agency asked me for my first impressions. Among other things, I told him that the degree scroll, Evangelium vitae, given to the Letter was very strong and bold, because I imagined that the Pope was not writing an apocryphal text, but an authentic and authoritative interpretation of the Gospel. When one reads the EV one sees that the degree scrollis fully justified, that there is no exaggeration or fraud in it.
The Pope's fidelity to the person and doctrine of Christ reaches a peak in Evangelium vitae. He told the journalist that, in the Gospel, Jesus taught everyone firmly and condemned sin with great energy; but, full of tenderness and compassion, he invited everyone to repentance and amendment, and to all he generously granted forgiveness. In Evangelium vitae John Paul II does the same. His teachingis firm, strong, prophetic, because he wants to wake us up from this kind of moral narcotisation in which we are being submerged by welfare and selfishness. The Pope is very courageous and radical in his defence of the weak, the anonymous and the vulnerable. He stands up to the powerful, be they parliamentary majorities, the scientific establishment or the neo-Malthusian catastrophists. It tells them that their idea of man is poor, inhuman, pessimistic. That the morality that is reflected in the laws they pass is accommodating, unsupportive, selfish. At some points, the Pope puts on all the spiritual power that comes to him from Christ through Peter, surrounds himself with the entire episcopal high schoolwith which he has consulted his decision, and, in the most solemn way possible, anathematises the crime of abortion, euthanasia, the lack of respect for nascent human life and the disregard for the dignity of human procreation.
But he immediately opens his compassionate heart to us. And just as Jesus did, he comes in search of us so that, abandoning our errors and sins, we may return to the friendship that God mercifully offers us. Underlying the whole Encyclical is, alongside the vibrant message of love for human life, an infinite understanding of the moral frailty of men and women of flesh and blood, a compassionate call to abandon error and the cruel domination of the strong over the weak, and to ask for forgiveness. Truly, the Pope is the Vice-Christ, he has clothed himself with the strength of the Master, and with his bowels of Christ's mercy. His appeal to the women who have had abortions is moving: he tells them that he understands how abandoned they may have felt, that he realises the harshness of the conditions that have led to their wrongdoing, the pain they must have felt in going through the drama of abortion and the uneasiness that has remained in their souls. But, at the same time, despite the circumstances that may have diminished their subjective guilt, he does not hide from them that they have committed a very serious error, which requires them to open themselves with humility and repentance to God's forgiveness in the sacrament of Reconciliation. He tells them that nothing is lost. With astonishing psychological insight he tells them that peace will come if they ask God for forgiveness and ask forgiveness from the son who now lives in the Lord. He encourages them to become defenders of the right to life, for their painful witness will be particularly eloquent. Just as Jesus sought out sinners and tax collectors, the Holy Father tells these women that they too can be artisans of a new way of looking at human life.
This is how the Gospels tell us that Jesus spoke. This balanced mixture of firm and well-founded doctrine, with this invitation to seek God's forgiveness and hope, is typically evangelical.
3. The joy and dignity of human life
The Introduction is very insistent that the Gospel of Life is joyful. The Encyclical devotes several paragraphs and four points to tell us that it is something to be celebrated, in a spirit of celebration. On the first page, the Pope sets before our eyes the joy of Christmas to exemplify the joy of man's coming into the world, the feast for every child born, which is the condition for new and eternal life.
It tells us that each person has incomparable worth. This, which is at the basis of all human rights declarations, which is a glorious human truth, is constantly contradicted by the conduct of many and by the laws in force in many advanced countries. It is worthwhile to consider for a moment the arguments the Pope offers in favour of the incomparable and unique value of every human being in this temporal life of ours, the life of time.
The EV tells us that it is precisely in man's eternal destiny that the sourceof his supreme dignity lies. Our life in time is a reality final, but transitional; not ultimate, but penultimate: but it is, in its temporality, a sacred reality, for every man is the object of God's love staff. This is the reason for the uniqueness of each one of us: God has created us and loved us one by one, uniquely.
The Pope says that this joyful news, of being uniquely loved by God, has a deep and persuasive echo in the heart of every person, believer or not, because it exceeds all human expectations, but, at the same time, it fulfils them completely. This common denominator of the dignity of every human being is the key that will open the doors to the new culture of life. We must be convinced that, in spite of appearances, every person sincerely open to truth and goodness perceives, with hesitation and uncertainty, with reason and under the mysterious influence of grace, that each person's life is of incalculable value, from its beginning to its end.
Respect for the dignity of every man, whoever he may be, is truly a rational and universal concept. From the roof tiles down and in a human context, we can conclude that each of us is entrusted with an individual destiny, unique and unrepeatable, original and creative. The world, with its wonders and its tragedies, is lived by each human being, and by all, in a core topicstaff , singular, proper and, in a certain way, ineffable. In the interiority, more or less rich, more or less impoverished, of each human being, the world is seen, heard, thought, understood, enjoyed with absolute and exclusive ownership. A song, the taste of a fried egg, the fear that the Racing will have to promote, the recitation of a prayer, a walk along the seashore, everything is lived, felt or statementby each person in an original and unique way.
What makes us unique and valuable beyond measure is not simply having an original and unrepeatable sequence of nucleotides in our DNA endowment, but being human beings, each of us having a body and a soul, an incommunicable life that each of us lives within ourselves, the non-transferable conversation of each of us with ourselves, with others, with God: this is our intrinsic dignity. Each human being is a universe that enriches humanity, that completes the world: this, in my opinion, is the universal reason for the dignity of man, the sourceof respect for each and every human being.
Human dignity is a subject to which we should pay much more attention. Human dignity is an expression that is everywhere: in constitutional texts, in ethical guidelines, in activist slogans for a thousand different things. In EV, thanks to a computer programme, it appears 52 times. But even if the notion of human dignity is subject to inflationary depreciation at the hands of politicians and sociologists, human dignity contains first-rate moral values, full of meaning and operability. reference letterThe word dignity refers to the inherent nobility and value that has always been accorded to man, to the human person, to the incomparable worth of every human being. It is, in the Christian conception, in the joyful news of God's love for man, an essential part of the Gospel of life.
The Genesis account, the creation of man in the image and likeness of God, brings into the world the notion of man's supreme dignity. Man is God's vice-regent in the world; he is crowned with glory and honour. Being imago Dei confers on him exclusively, among all creatures on earth and in spite of the original fall, rationality, self-consciousness and free will, which are participations of divinity, which give him the capacity to transform the world and to educate himself, to be a moral agent managerand free. All men enjoy this supreme and identical dignity.
After giving us this encouraging picture of the dignity of all men, the EV takes a turn: the Pope denounces the new threats to human life. He tells us how much the Church, who feels herself to be the mother of all men and women by Christ's command, is suffering, because in our days the threats to life have multiplied. It is no longer only hunger and disease, violence and war, that are man's enemies. New, cruel and inhuman forms of destruction have appeared in our midst, with enormous and growing lethal potential, making up the culture of death. What is perversely original about this new cultural statusis the justification by broad sectors of society of attacks on life as a manifestation of individual rights and freedoms, as sampleof civic progress, which deserve impunity, approval, and even economic support from the state.
The projectCulture of Life is also typically evangelical.
II. My opinion as a professor of medical ethics
I feel I must not fail to speak out as a professor of medical ethics. I dare to predict that Evangelium vitae will become a classic of Bioethics. No one can deny that it is the most precise and intense synthesis of the Church's perennial doctrine on the value and inviolability of human life. And although the doctrine is perennial, it is said in new words, with an unprecedented intensity, with an appeal to the basics of Christ's doctrine, enriched with a strong supplement of common humanity.
It is a moral antidote to the legalistic intoxication that is suffocating the professional ethics of medicine. EV opens up new perspectives on such basic and constantly debated problems as the role of the doctor as a moral agent, the limits of medical interventions, conscientious objection to health care, right activism in favour of life, respect for declining life, the professional and political survival of the Christian doctor in a world governed by unjust laws.
As a professor of medical ethics, I have to make an appeal to reference letterto the most topical problem of our time: euthanasia. The Encyclical devotes four long points to the drama of euthanasia. We all, but especially doctors, have to thank the Pope for having included in Evangelium vitae a solemn and unequivocal condemnation of euthanasia. The absolute prohibition of putting the sick person to death is a great good for medicine. The reason is obvious: euthanasia soon becomes a deadly passion, it poisons the brain and the heart of the doctor who succumbs to this unfortunate temptation.
When doctors deviate from their duty of utmost respect for human life, which they consider violable, they are swept, as samplethe painful history of legalised euthanasia in the Netherlands, into a whirlwind of violence. We already know a lot about what happens when a society accepts euthanasia and doctors become the arbiters of their patients' lives. We should not ignore what is happening.
Euthanasia becomes a deadly passion. In no other medical statusis the reality of the moral slippery slope so inexorably fulfilled.
It is possible that the dramatic nature of an extreme case may convince the doctor that internshipeuthanasia is acceptable. Anyone can be the victim of a mistake, anyone can succumb in a moment of weakness. But if, having made this regrettable mistake, the doctor does not abjure it, if he continues to believe that his action is morally justifiable, that there are lives so devoid of dignity or so burdened with suffering that they are dispensable, then he will never be able to stop administering to his patients the death that frees them from pain and vital decay.
This happens because in the soul of that doctor there remain dislocated remnants of his professional virtues (of his compassion, his justice, his diligent prevention of pain) that blindly facilitate the action of a now deadly zeal.
The moral drama of euthanasia unfolds in four stages of progressive eclipse of medical respect for life and the person.
1. At first, when the doctor agrees to kill out of compassion, he conceives euthanasia as an exceptional intervention, a last resort resource, justifiable only in extreme situations of torturing pain, refractory to the most energetic treatments, and only authorised in response to a repeated and moving request from a rational and lucid patient. Faced with the poor response to symptomatic remedies and moved by the tragic nature of the clinical status, the doctor surrenders to the idea that only death can free his patient from his unbearable life. In fear and trembling, full of anguish, moved by compassion, the doctor puts his first patient to death. In doing so, he breaks something of inestimable value in his soul: his utmost, virginal respect for life.
If he were to repent and never do it again, he would safeguard his medical vocation. But if he self-justifies his action, if he continues to believe that euthanasia is a professional, exceptional but ethically acceptable action, he will no longer be able to escape the euthanasia cascade.
2. Because the doctor, having apostatised from his faith in the sacredness of life, is drawn into the false faith of the absolutism of quality of life. He comes, more or less quickly, to the pessimistic conclusion that there are lives, which are not in short supply, lives that do not deserve to be lived, so painful and lacking in dignity and vital value. In a few years, in the social environment of permissive legislation or jurisprudence tolerant of euthanasia, with public opinion narcotised by the press and television, mercy killing ceases to be a very exceptional remedy, and becomes an almost ordinary medical resource, a therapeutic option like any other, controversial like so many others that are accepted by some doctors and rejected by others, of which there is much talk in professional journals. Its results are audited and compared with other therapeutic alternatives. Euthanasia gains respectability and prestige, as it turns out to be a quick and painless intervention, demanding skilland good internship, comfortable, aesthetic and economical, and even more compassionate than palliative treatment.
Under this aspect of orthodox and highly professional intervention, euthanasia becomes an ordinary medical act, a priority option for many clinical situations, especially when it is desired and requested by the patient or his or her relatives.
In the statusof permanent scarcity of economic resources in which medicine will live forever, euthanasia will end up being accredited as a very efficient treatment, with an optimal cost/benefit ratio, which enormously lightens the health expense, which gives relief to those involved, and satisfaction to those who ask for it.
3. And also to those who cannot ask for it. Euthanasia in the third stage is an expression of the paternalistic, paternalistic initiative of the doctor. If a doctor considers that euthanasia is a service to which everyone has a right, he cannot refuse it to those who are unable to ask for it. The doctor then assumes, by virtue of his therapeutic privilege, the function of subjective agent of the incapable patient. Faced with the insane, the severely malformed, or the persistent vegetative patient, the doctor, having lost the utmost respect for life, reasons in his heart: "It is horrible to live in these conditions of biological or psychological precariousness. No one in their right mind would want to live like that. Death is preferable to such an impoverished life. If I were you, I would demand a sweet death". The doctor thus acquires discretionary power over the life and death of the incapable.
4. But that is not all: the doctor who considers euthanasia as a virtuous act will end up judging that there are patients whose desire to continue living is irrational and capricious, because he considers that the life they have ahead of them is biologically detestable, an intolerable social burden, an economic waste. His argument goes like this: "Some patients' desire to live is an irrational whim, an economic luxury, a burden on others, an unjust, selfish, unsupportive abuse. To satisfy this merely vitalistic desire to continue living, because that is what the sick or those who represent them demand, is not only an injustice, but also an irrational consumption of economic and human resources. That money and that work effort could be invested in more beneficial and interesting things".
This is, unfortunately, not an imaginary status: Dutch general practitioners state that 10% of the euthanasia acts they perform are on patients who are conscious and capable of deciding, but who, for paternalistic reasons, are not given enquiryabout the euthanasia being performed on them.
The Holy Father's words in point 67 of Evangelium vitae seem harsh to many when he describes as murderers those who arbitrarily and unjustly usurp God's power to decide on the life and death of the sick. The Pope accuses them of allowing themselves to be dominated by a logic of foolishness and selfishness. These words of the Holy Father, like the entire Encyclical, are, beneath their harsh appearance, a heartfelt and compassionate appeal to good moral sense and rectification.
They should serve all of us, first of all, to keep us from engaging in dialogue with the temptation of euthanasia and the medical financial aidto suicide, to make us aware that to take a step in that direction is to go to the bottom, to introduce a false, compassionately destructive or cynically utilitarian zeal into the soul.
If the doctor succumbs to the temptation of euthanasia and does not turn back, it will be very difficult for him to stop killing. Because if he is ethically congruent with himself, and believes he is doing something good, he will be compelled, moved by the remnants of justice and beneficence that remain in his soul, to apply euthanasia to less and less dramatic cases, to lives that he considers, now or a little later, lacking the necessary quality.
Only in absolute respect is it possible to conclude that all human lives are worthy, that none is dispensable or unworthy of being lived. The respectful physician evaluates with humble and realistic lucidity the limited efficacy of the technical means at his disposal, recognises their finiteness, and refrains from using them futilely, obstinately and without judgement. And because he believes in the inestimable value of terminal life, of the mere vegetative life of man, he attends to it with palliative care.
Absolute respect for life is a core value. Even the most upright and honest doctor needs to protect himself against the excesses of his virtues. Euthanasia hurts medicine also as a scientific business. If doctors were to work in an environment in which they knew that they would go unpunished whether they treated or killed certain patients, they would become indifferent towards certain types of patients, and the researchin vast areas of pathology would wither: there would then be no reason to investigate the pathogenic mechanisms of senility, cerebral degeneration, terminal cancerous disease, biochemical or morphological malformations. Euthanasia slows down the progress of medicine.
The obligation to respect and care for all human beings, not to threaten the life of any of them, is part of the professional charism of the physician, a wonderful moral force and an inspiring force of charity and science. We physicians owe a most sincere and profound thanks to the Holy Father for reiterating in the strongest terms the absolute prohibition of euthanasia.