Statement on euthanasia by the Congregation for the Doctrine of the Faith

Foundation: Congregation for the Doctrine of the Faith.
source : Holy See.
language original: Latin.
Copyright the Latin original: No.
English translation: Holy See.
Copyright of the Spanish translation: No.
Date: 5 May 1980.
Checked on 8 August 2018.

Introduction

The rights and values inherent in the human person occupy an important place in contemporary issues. In this respect, the Second Vatican Ecumenical Council solemnly reaffirmed the excellent dignity of the human person and in particular his or her right to life. It has therefore denounced crimes against life, such as "murder of any kind class, genocide, abortion, euthanasia and even deliberate suicide"(Gaudium et spes, 27).

The Sacred Congregation for the Doctrine of the Faith, which has recently recalled the Catholic doctrine on procured abortion1 , now deems it appropriate to propose the Church's teaching on the problem of euthanasia.

Indeed, even if the principles enunciated in this field by recent Popes2 remain valid, medical progress in recent years has brought to light new aspects of the problem of euthanasia that need to be further clarified in terms of their ethical content.

In today's society, in which the very fundamental values of human life are not infrequently called into question, changes in culture are influencing the way in which suffering and death are viewed; medicine has increased its capacity to cure and prolong life under certain conditions which sometimes pose problems of a moral nature. People living in such an environment are therefore anxious about the meaning of prolonged old age and death, and consequently ask themselves whether they have the right to obtain for themselves or for their fellow human beings the "sweet death" which would serve to shorten the pain and would, in their opinion, be more in keeping with human dignity.

Various Bishops' Conferences have asked the Sacred Congregation for the Doctrine of the Faith about this issue. After having consulted order , the Congregation, after having obtained the opinion of experts on the various aspects of euthanasia, wishes to respond to the requests of the Bishops with this Declaration, in order to help them to give the faithful a correct orientation and to offer them elements for reflection which they can present to the civil authorities at purpose on this very serious problem.

The subject proposal in this document concerns above all those who place their faith and hope in Christ, who by his life, death and resurrection has given a new meaning to the existence and especially to the death of the Christian, according to the words of St. Paul: "For if we live, we live unto the Lord; and if we die, we die unto the Lord. Whether we live or die, we are the Lord's" (Rom. 14:8; Phil. 1:20).

As for those who profess other religions, many will agree with us that faith - if they share it - in a Creator, Provident God and Lord of life confers an eminent value on every human person and guarantees respect for him or her.

We trust, however, that this Declaration will reflect the consensus of so many people of good will who, over and above philosophical or ideological differences, have a lively awareness of the rights of the human person. Such rights, moreover, have often been proclaimed in recent years in declarations of international congresses3 ; and since they are fundamental rights of every human person, it is obvious that one cannot resort to arguments based on political pluralism or religious freedom to deny them universal value.

I. Value of human life

Human life is the foundation of all goods, the source and the necessary condition of all human activity and of all social coexistence. While most people believe that life has a sacred character and that no one can dispose of it at will, believers see in it a gift of God's love, which they are called upon to preserve and make fruitful. The following consequences flow from this last consideration:

1. No one can attempt against the life of an innocent man without opposing God's love for him, without violating a fundamental, inalienable and inalienable right, without committing a crime of extreme gravity4 .

2. It is the duty of every human being to conform his life to God's plan. It has been entrusted to him as a good which must bear fruit already here on earth, but which finds its full perfection only in eternal life.

3. Voluntary death, i.e. suicide, is therefore as unacceptable as homicide; such an action constitutes, in fact, on the part of man, a rejection of God's sovereignty and of his loving plan. Moreover, suicide is often a rejection of love for oneself, a denial of the natural aspiration to life, a Withdrawal in the face of the duties of justice and charity towards one's neighbour, towards the various communities and towards society as a whole, even if sometimes psychological factors intervene, as we know, which can attenuate or even remove responsibility.

However, it is important to distinguish from suicide that sacrifice by which, for a higher cause - such as the glory of God, the salvation of souls or the service of one's brothers and sisters - one's own life is offered or endangered.

II. Euthanasia

In order to deal adequately with the problem of euthanasia, it is first of all necessary to clarify the vocabulary.

Etymologically, the word euthanasia in ancient times meant a gentle death without excruciating suffering. Today we do not so much refer to the original meaning of the term, but rather to medical intervention aimed at alleviating the pain of illness and agony, sometimes even at the risk of premature termination of life. The term is also used, in a narrower sense, with the meaning of "causing mercy killing", in order to radically eliminate the last sufferings or to spare subnormal children, the mentally ill or the incurable the prolongation of an unhappy life, perhaps for many years, which could impose too heavy a burden on families or society.

It is therefore necessary to state clearly in what sense the term is taken in this document.

Euthanasia means an action or omission that by its nature, or in intention, causes death, in order to eliminate any pain. Euthanasia is therefore at the level of intentions or methods used.

Now, it must be firmly reaffirmed that nothing and no one can authorise the death of an innocent human being, whether foetus or embryo, child or adult, elderly, incurably ill or dying. Moreover, no one can ask for this homicidal act for himself or for others entrusted to his responsibility, nor can he consent to it explicitly or implicitly. No authority can legitimately impose it or permit it. It is in fact a violation of divine law, an offence against the dignity of the human person, a crime against life, an attack on humanity.

It could also be verified that prolonged and unbearable pain, reasons of affective subject or other diverse motives, induce someone to think that he can legitimately ask for death or procure it for others. Although in such cases the responsibility staff may be diminished or even non-existent, nevertheless the error of judgement of conscience - even if even in good faith - does not alter the nature of the homicidal act, which in itself remains always inadmissible. The pleas of the very seriously ill who sometimes invoke death should not be understood as an expression of a true desire for euthanasia; they are in fact almost always anguished requests for attendance and affection. In addition to medical care, what the sick person needs is love, human and supernatural warmth, with which all those who are close to him, parents and children, doctors and nurses, can and must surround him.

III. The Christian in the face of suffering and the use of painkillers

Death does not always come in dramatic conditions, at the end of unbearable suffering. It should not be thought of only in extreme cases. Numerous concordant testimonies suggest that nature itself facilitates at the moment of death a separation that would be terribly painful for a man in full health. Thus a prolonged illness, advanced old age, a status of loneliness and withdrawal, can determine such psychological conditions that facilitate the acceptance of death.

However, it must be recognised that death, often preceded or accompanied by atrocious and prolonged suffering, is an event that naturally distresses the human heart.

Physical pain is certainly an unavoidable element of the human condition, at the biological level, it constitutes a sign whose usefulness is undeniable; but since it concerns the psychological life of man, it often exceeds its biological usefulness and can therefore assume such a dimension as to arouse the desire to eliminate it at any price.

However, according to Christian doctrine, pain, especially that of the last moments of life, assumes a particular significance in God's saving plan; it is, in fact, a participation in the passion of Christ and a union with the redemptive sacrifice which He offered in obedience to the will of the Father. It is not surprising, therefore, if some Christians wish to moderate the use of painkillers, in order to accept voluntarily at least a part of their sufferings and thus consciously associate themselves with the sufferings of Christ crucified (cf. Mt 27:34). It would not, however, be prudent to impose a particular heroic behaviour as a general rule . On the contrary, human and Christian prudence suggests for the majority of sick people the use of medicines that are suitable to alleviate or suppress pain, even if this results, as side effects, in dullness or reduced alertness. As for those who are unable to express themselves, it may reasonably be presumed that they wish to take such painkillers, and they should be given them according to the advice of the physician.

Exempt However, the intensive use of painkillers is not without its difficulties, as the phenomenon of getting used to them generally makes it necessary to increase the dose in order to maintain their efficacy. It is worth recalling a statement by Pius XII which is still valid today. A group of doctors had put this question to him: "Is the suppression of pain and conscience by means of narcotics ... permitted to the doctor and the patient by religion and morality (even when death is approaching or when it is foreseen that the use of narcotics will shorten life)?" The Pope replied: "If there are no other means and if, in such circumstances, this does not prevent the fulfilment of other religious and moral duties: Yes "5. In this case, in fact, it is clear that death is not wanted or sought in any way, even if the risk is taken for a reasonable cause: it is simply an attempt to mitigate the pain effectively, using for this purpose the analgesics available to medicine.

Analgesics which cause a loss of consciousness in the sick, on the other hand, deserve special consideration. It is extremely important, in fact, that men should not only be able to satisfy their moral duties and family obligations, but also and above all that they should be able to prepare themselves in full consciousness for meeting with Christ. For this reason, Pius XII warns that "it is not licit to deprive the dying man of his conscience without grave reason "6.

IV. The proportionate use of therapeutic means

It is very important today to protect, at the moment of death, the dignity of the human person and the Christian conception of life against a technicality that risks becoming abusive. In fact, some speak of the "right to die", an expression which does not designate the right to seek or have one's death as one wishes, but the right to die in all serenity, with human and Christian dignity. From this point of view, the use of therapeutic means can sometimes pose certain problems.

In many cases, the complexity of situations may be such as to raise doubts about how to apply moral principles. Decision-making will ultimately be a matter for the conscience of the patient or those qualified to speak on his or her behalf, or even of physicians, in the light of moral obligations and the various aspects of the case.

It is the duty of everyone to cure himself and to be cured. Those who have the care of the sick must serve them with all diligence and provide them with the remedies they deem necessary or useful.

But should every possible remedy be resorted to in all circumstances class ?

Until now, moralists have replied that one is never obliged to use "extraordinary" means. Today, on the other hand, such an answer, always valid in principle, may seem less clear, both because of the imprecision of the term and because of the rapid progress in therapy. For this reason, some prefer to speak of "proportionate" and "disproportionate" means. In each case, the means can be assessed by comparing the subject of therapy, the Degree difficulty and risk involved, the necessary expenses and the possibilities of application with the result that can be expected, taking into account the conditions of the patient and his or her physical and moral strength.

To facilitate the application of these general principles, the following points can be added:

- In the absence of other remedies, it is lawful to have recourse, with the consent of the sick person, to the means made available by the most advanced medicine, even if they are still at an experimental stage and are not free from all risk. By accepting them, the sick person can thus set an example of generosity for the good of mankind.

- It is also lawful to discontinue the application of such means when the results disappoint the hopes placed in them. But in making such a decision, the just wishes of the patient and his relatives should be taken into account, as well as the opinion of truly competent physicians; they will certainly be able to judge better than anyone else whether the employment of instruments and staff is disproportionate to the foreseeable results, and whether the techniques employed impose greater suffering and discomfort on the patient than the benefits to be derived from them.

It is always lawful to be content with the normal means that medicine can offer. It is therefore not possible to impose on anyone the obligation to have recourse to a cure subject which, although already in use, is not yet free of danger or is too costly. Its refusal is not tantamount to suicide: it means rather either a simple acceptance of the human condition, or a desire to avoid putting on internship a medical device disproportionate to the results that could be expected, or a desire not to impose excessively heavy costs on the family or the community.

- Faced with the imminence of inevitable death, despite the means employed, it is permissible in conscience to decide to forego treatment that would only prolong life in a precarious and painful way, without, however, interrupting the normal treatment due to the patient in similar cases. For this reason, the doctor has no cause for anguish, as if he had not given attendance to a person in danger.

Conclusion

The norms contained in this Declaration are inspired by a deep desire to serve man according to the plan of the Creator. If on the one hand life is a gift of God, on the other hand death is unavoidable; it is therefore necessary that we, without in any way anticipating the hour of death, should know how to accept it with full awareness of our responsibility and in all dignity. It is true that death puts an end to our earthly existence, but at the same time it opens the way to immortal life. This is why all people must prepare themselves for this event in the light of human values, and Christians even more so in the light of their faith.

Let those who devote themselves to the care of public health omit nothing, so that they may put their whole skill at the service of the sick and dying; and let them also remember to give them the still more necessary consolation of immense kindness and ardent charity. Such a service rendered to men is also a service rendered to the Lord Himself, who said: "...As you did it to one of the least of these my brethren, you did it to me" (Mt 25:40).

The Supreme Pontiff John Paul II, in the course of an audience granted to the undersigned Cardinal Prefect, has C this Declaration, decided in meeting ordinary of this Sacred Congregation, and has ordered its publication.

Rome, from the Offices of the Sacred Congregation for the Doctrine of the Faith, 5 May 1980.

Cardinal Franjo SEPER
Prefect

Jerôme HAMER,
Titular Archbishop of Lorium,
Secretary

Notes

(1) Statement on Procured Abortion, 18 November 1974, (AAS 66, 1974, pp. 730-747)

(2) Pius XII, speech to the congressmen of the International Union of Catholic Women's Leagues, 11 September 1947 (AAS 39, 1947 p. 483); Allocution to the Italian Catholic Union of Midwives, 29 October 1951 (AAS 43, 1951, pp. 835-854); speech to the members of the International Bureau of Documentation of Military Medicine, 19 October 1953 (AAS 45, 1953, pp. 744-754); speech to the participants in the IX congress of the Italian Society of Anaesthesiology, 24 February 1957 (AAS 49, 1957, p. 146); cf. Allocution on "Resuscitation", 24 November 1957 (AAS 49, 1957, pp. 1027-1033). Paul VI, speech to the members of the United Nations Special committee for the "Apartheid" question, 22 May 1974 (AAS 66, 1974, p. 346). John Paul II, Allocution to the Bishops of the United States of America, 5 October 1979 (AAS 71, 1979, p. 1225).

(3) Recall in particular recommendation 779 (1976), concerning the rights of the sick and dying, of the Parliamentary Assembly of committee of Europe at its 27th ordinary session. Cf. Sipeca, No. 1, March 1977, pp. 14-15.

(4) The issues of the death penalty and war, which would require specific considerations outside the scope of topic of this Declaration, are completely left aside.

(5) Pius XII, speech, 24 February 1957 (AAS 49, 1957, p. 147).

(6) Pius XII, speech, 24 February 1957 (AAS 49, 1957, p. 145, cf. Allocution, 9 September 1958 (AAS 50, 1958, p. 694).