Congregation for the Doctrine of the Faith, Declaration on Euthanasia

Congregation for the Doctrine of the Faith, Declaration on Euthanasia

(Washington, D.C.: United States Catholic Conference, 1980).

DECLARATION ON
EUTHANASIA

Prepared by the Sacred Congregation for the
Doctrine of the Faith

May 5, 1980


INTRODUCTION

The rights and values pertaining to the human person occupy an
important place among the questions discussed today. In this regard,
the Second Vatican Ecumenical Council solemnly reaffirmed the lofty
dignity of the human person, and in a special way his or her right to
life. The Council therefore condemned crimes against life "such as any
type of murder, genocide, abortion, euthanasia, or willful suicide"
(Pastoral Constitution GAUDIUM ET SPES, no. 27).
More recently, the Sacred Congregation for the Doctrine of the
Faith has reminded all the faithful of Catholic teaching on procured
abortion.[1] The Congregation now considers it opportune to set forth
the Church's teaching on euthanasia.
It is indeed true that, in this sphere of teaching, the recent
Popes have explained the principles, and these retain their full
force[2]; but the progress of medical science in recent years has
brought to the fore new aspects of the question of euthanasia, and
these aspects call for further elucidation on the ethical level.
In modern society, in which even the fundamental values of human
life are often called into question, cultural change exercises an
influence upon the way of looking at suffering and death; moreover,
medicine has increased its capacity to cure and to prolong life in
particular circumstances, which sometime give rise to moral problems.
Thus people living in this situation experience no little anxiety about
the meaning of advanced old age and death. They also begin to wonder
whether they have the right to obtain for themselves or their fellowmen
an "easy death," which would shorten suffering and which seems to them
more in harmony with human dignity.
A number of Episcopal Conferences have raised questions on this
subject with the Sacred Congregation for the Doctrine of the Faith.
The Congregation, having sought the opinion of experts on the various
aspects of euthanasia, now wishes to respond to the Bishops' questions
with the present Declaration, in order to help them to give correct
teaching to the faithful entrusted to their care, and to offer them
elements for reflection that they can present to the civil authorities
with regard to this very serious matter.
The considerations set forth in the present document concern in
the first place all those who place their faith and hope in Christ,
who, through His life, death and resurrection, has given a new meaning
to existence and especially to the death of the Christian, as St. Paul
says: "If we live, we live to the Lord, and if we die, we die to the
Lord" (Rom. 14:8; cf. Phil. 1:20).
As for those who profess other religions, many will agree with us
that faith in God the Creator, Provider and Lord of life--if they share
this belief--confers a lofty dignity upon every human person and
guarantees respect for him or her.
It is hoped that this Declaration will meet with the approval of
many people of good will, who, philosophical or ideological differences
notwithstanding, have nevertheless a lively awareness of the rights of
the human person. These rights have often, in fact, been proclaimed
in recent years through declarations issued by International
Congresses[3]; and since it is a question here of fundamental rights
inherent in every human person, it is obviously wrong to have recourse
to arguments from political pluralism or religious freedom in order to
deny the universal value of those rights.


I. THE VALUE OF HUMAN LIFE

Human life is the basis of all goods, and is the necessary source
and condition of every human activity and of all society. Most people
regard life as something sacred and hold that no one may dispose of it
at will, but believers see in life something greater, namely, a gift of
God's love, which they are called upon to preserve and make fruitful.
And it is this latter consideration that gives rise to the following
consequences:
1. No one can make an attempt on the life of an innocent person
without opposing God's love for that person, without violating a
fundamental right, and therefore without committing a crime of the
utmost gravity.[4]
2. Everyone has the duty to lead his or her life in accordance
with God's plan. That life is entrusted to the individual as a good
that must bear fruit already here on earth, but that finds its full
perfection only in eternal life.
3. Intentionally causing one's own death, or suicide, is
therefore equally as wrong as murder; such an action on the part of a
person is to be considered as a rejection of God's sovereignty and
loving plan. Furthermore, suicide is also often a refusal of love for
self, the denial of a natural instinct to live, a flight from the
duties of justice and charity owed to one's neighbor, to various
communities or to the whole of society--although, as is generally
recognized, at times there are psychological factors present that can
diminish responsibility or even completely remove it.
However, one must clearly distinguish suicide from that sacrifice
of one's life whereby for a higher cause, such as God's glory, the
salvation of souls or the service of one's brethren, a person offers
his or her own life or puts it in danger (cf. Jn. 15:14).


II. EUTHANASIA

In order that the question of euthanasia can be properly dealt
with, it is first necessary to define the words used.
Etymologically speaking, in ancient times EUTHANASIA meant an EASY
DEATH without severe suffering. Today one no longer thinks of this
original meaning of the word, but rather of some intervention of
medicine whereby the suffering of sickness or of the final agony are
reduced, sometimes also with the danger of suppressing life
prematurely. Ultimately, the word EUTHANASIA is used in a more
particular sense to mean "mercy killing," for the purpose of putting an
end to extreme suffering, or having abnormal babies, the mentally ill
or the incurably sick from the prolongation, perhaps for many years of
a miserable life, which could impose too heavy a burden on their
families or on society.
It is, therefore, necessary to state clearly in what sense the
word is used in the present document.
By euthanasia is understood an action or an omission which of
itself or by intention causes death, in order that all suffering may in
this way be eliminated. Euthanasia's terms of reference, therefore,
are to be found in the intention of the will and in the methods used.
It is necessary to state firmly once more that nothing and no one
can in any way permit the killing of an innocent human being, whether a
fetus or an embryo, an infant or an adult, an old person, or one
suffering from an incurable disease, or a person who is dying.
Furthermore, no one is permitted to ask for this act of killing, either
for himself or herself or for another person entrusted to his or her
care, nor can he or she consent to it, either explicitly or implicitly.
nor can any authority legitimately recommend or permit such an action.
For it is a question of the violation of the divine law, an offense
against the dignity of the human person, a crime against life, and an
attack on humanity.
It may happen that, by reason of prolonged and barely tolerable
pain, for deeply personal or other reasons, people may be led to
believe that they can legitimately ask for death or obtain it for
others. Although in these cases the guilt of the individual may be
reduced or completely absent, nevertheless the error of judgment into
which the conscience falls, perhaps in good faith, does not change the
nature of this act of killing, which will always be in itself something
to be rejected. The please of gravely ill people who sometimes ask for
death are not to be understood as implying a true desire for
euthanasia; in fact, it is almost always a case of an anguished plea
for help and love. What a sick person needs, besides medical care, is
love, the human and supernatural warmth with which the sick person can
and ought to be surrounded by all those close to him or her, parents
and children, doctors and nurses.


III. THE MEANING OF SUFFERING FOR CHRISTIANS
AND THE USE OF PAINKILLERS

Death does not always come in dramatic circumstances after barely
tolerable sufferings. Nor do we have to think only of extreme cases.
Numerous testimonies which confirm one another lead one to the
conclusion that nature itself has made provision to render more
bearable at the moment of death separations that would be terribly
painful to a person in full health. Hence it is that a prolonged
illness, advanced old age, or a state of loneliness or neglect can
bring about psychological conditions that facilitate the acceptance of
death.
Nevertheless the fact remains that death, often preceded or
accompanied by severe and prolonged suffering, is something which
naturally causes people anguish.
Physical suffering is certainly an unavoidable element of the
human condition; on the biological level, it constitutes a warning of
which no one denies the usefulness; but, since it affects the human
psychological makeup, it often exceeds its own biological usefulness
and so can become so severe as to cause the desire to remove it at any
cost.
According to Christian teaching, however, suffering, especially
suffering during the last moments of life, has a special place in God's
saving plan; it is in fact a sharing in Christ's passion and a union
with the redeeming sacrifice which He offered in obedience to the
Father's will. Therefore, one must not be surprised if some Christians
prefer to moderate their use of painkillers, in order to accept
voluntarily at least a part of their sufferings and thus associate
themselves in a conscious way with the sufferings of Christ crucified
(cf. Mt. 27:34). Nevertheless it would be imprudent to impose a heroic
way of acting as a general rule. On the contrary, human and Christian
prudence suggest for the majority of sick people the use of medicines
capable of alleviating or suppressing pain, even though these may cause
as a secondary effect semiconsciousness and reduced lucidity. As for
those who are not in a state to express themselves, one can reasonably
presume that they wish to take these painkillers, and have them
administered according to the doctor's advice.
But the intensive use of painkillers is not without difficulties,
because the phenomenon of habituation generally makes it necessary to
increase their dosage in order to maintain their efficacy. At this
point it is fitting to recall a declaration by Pius XII, which retains
its full force; in answer to a group of doctors who had put the
question: "Is the suppression of pain and consciousness by the use of
narcotics ... permitted by religion and morality to the doctor and the
patient (even at the approach of death and if one foresees that the use
of narcotics will shorten life)?" the Pope said: "If no other means
exist, and if, in the given circumstances, this does not prevent the
carrying out of other religious and moral duties: Yes."[5] In this
case, of course, death is in no way intended or sought, even if the
risk of it is reasonably taken; the intention is simply to relieve pain
effectively, using for this purpose painkillers available to medicine.
However, painkillers that cause unconsciousness need special
consideration. For a person not only has to be able to satisfy his or
her moral duties and family obligations; he or she also has to prepare
himself or herself with full consciousness for meeting Christ. Thus
Pius XII warns: "It is not right to deprive the dying person of
consciousness without a serious reason."[6]


IV. DUE PROPORTION IN THE USE OF REMEDIES

Today it is very important to protect, at the moment of death,
both the dignity of the human person and the Christian concept of life,
against a technological attitude that threatens to become an abuse.
Thus some people speak of a "right to die," which is an expression that
does not mean the right to procure death either by one's own hand or by
means of someone else, as one pleases, but rather the right to die
peacefully with human and Christian dignity. From this point of view,
the use of therapeutic means can sometimes pose problems.
In numerous cases, the complexity of the situation can be such as
to cause doubts about the way ethical principles should be applied. In
the final analysis, it pertains to the conscience either of the sick
person, or of those qualified to speak in the sick person's name, or of
the doctors, to decide, in the light of moral obligations and of the
various aspects of the case.
Everyone has the duty to care for his or he own health or to seek
such care from others. Those whose task it is to care for the sick
must do so conscientiously and administer the remedies that seem
necessary or useful.
However, is it necessary in all circumstances to have recourse to
all possible remedies?
In the past, moralists replied that one is never obliged to use
"extraordinary" means. This reply, which as a principle still holds
good, is perhaps less clear today, by reason of the imprecision of the
term and the rapid progress made in the treatment of sickness. Thus
some people prefer to speak of "proportionate" and "disproportionate"
means. In any case, it will be possible to make a correct judgment as
to the means by studying the type of treatment to be used, its degree
of complexity or risk, its cost and the possibilities of using it, and
comparing these elements with the result that can be expected, taking
into account the state of the sick person and his or her physical and
moral resources.
In order to facilitate the application of these general
principles, the following clarifications can be added:
--If there are no other sufficient remedies, it is permitted, with
the patient's consent, to have recourse to the means provided by the
most advanced medical techniques, even if these means are still at the
experimental stage and are not without a certain risk. By accepting
them, the patient can even show generosity in the service of humanity.
--It is also permitted, with the patient's consent, to interrupt
these means, where the results fall short of expectations. But for
such a decision to be made, account will have to be taken of the
reasonable wishes of the patient and the patient's family, as also of
the advice of the doctors who are specially competent in the matter.
The latter may in particular judge that the investment in instruments
and personnel is disproportionate to the results foreseen; they may
also judge that the techniques applied impose on the patient strain or
suffering out of proportion with the benefits which he or she may gain
from such techniques.
--It is also permissible to make do with the normal means that
medicine can offer. Therefore one cannot impose on anyone the
obligation to have recourse to a technique which is already in use but
which carries a risk or is burdensome. Such a refusal is not the
equivalent of suicide; on the contrary, it should be considered as an
acceptance of the human condition, or a wish to avoid the application
of a medical procedure disproportionate to the results that can be
expected, or a desire not to impose excessive expense on the family or
the community.
--When inevitable death is imminent in spite of the means used, it
is permitted in conscience to take the decision to refuse forms of
treatment that would only secure a precarious and burdensome
prolongation of life, so long as the normal care due to the sick person
in similar cases is not interrupted. In such circumstances the doctor
has no reason to reproach himself with failing to help the person in
danger.


CONCLUSION

The norms contained in the present Declaration are inspired by a
profound desire to service people in accordance with the plan of the
Creator. Life is a gift of God, and on the other hand death is
unavoidable; it is necessary, therefore, that we, without in any way
hastening the hour of death, should be able to accept it with full
responsibility and dignity. It is true that death marks the end of our
earthly existence, but at the same time it opens the door to immortal
life. Therefore, all must prepare themselves for this event in the
light of human values, and Christians even more so in the light of
faith.
As for those who work in the medical profession, they ought to
neglect no means of making all their skill available to the sick and
dying; but they should also remember how much more necessary it is to
provide them with the comfort of boundless kindness and heartfelt
charity. Such service to people is also service to Christ the Lord,
who said: "As you did it to one of the least of these my brethren, you
did it to me" (Mt. 25:40).


AT THE AUDIENCE GRANTED TO THE UNDERSIGNED PREFECT, HIS HOLINESS
POPE JOHN PAUL II APPROVED THIS DECLARATION, ADOPTED AT THE ORDINARY
MEETING OF THE SACRED CONGREGATION FOR THE DOCTRINE OF THE FAITH, AND
ORDERED ITS PUBLICATION.
Rome, the Sacred Congregation for the Doctrine of the Faith, May
5, 1980.

Franjo Cardinal Seper
PREFECT

+ Jerome Hamer, O.P.
TIT. ARCHBISHOP OF LORIUM
SECRETARY



FOOTNOTES

[1] DECLARATION ON PROCURED ABORTION, November 18, 1974: AAS 66
(1974), pp. 730-747.
[2] Pius XII, ADDRESS TO THOSE ATTENDING THE CONGRESS OF THE
INTERNATIONAL UNION OF CATHOLIC WOMEN'S LEAGUES, September 11, 1947:
AAS 39 (1947), p. 483; ADDRESS TO THE ITALIAN CATHOLIC UNION OF
MIDWIVES, October 29, 1951: AAS 43 (1951), pp. 835-854; SPEECH TO THE
MEMBERS OF THE INTERNATIONAL OFFICE OF MILITARY MEDICINE DOCUMENTATION,
October 19, 1953: AAS 45 (1953), pp. 744-754; ADDRESS TO THOSE TAKING
PART IN THE IXth CONGRESS OF THE ITALIAN ANAESTHESIOLOGICAL SOCIETY,
February 24, 1957: AAS 49 (1957), p. 146; cf. also ADDRESS ON
"REANIMATION," November 24, 1957: AAS 49 (1957), pp. 1027-1033; Paul
VI, ADDRESS TO THE MEMBERS OF THE UNITED NATIONAL SPECIAL COMMITTEE ON
APARTHEID, May 22, 1974: AAS 66 (1974), p. 346; John Paul II: ADDRESS
TO THE BISHOPS OF THE UNITED STATES OF AMERICA, October 5, 1979: AAS
71 (1979), p. 1225.
[3] One thinks especially of Recommendation 779 (1976) on the
rights of the sick and dying, of the Parliamentary Assembly of the
Council of Europe at its XXVIIth Ordinary Session; cf. Sipeca, no. 1,
March 1977, pp. 14-15.
[4] We leave aside completely the problems of the death penalty
and of war, which involve specific considerations that do not concern
the present subject.
[5] Pius XII, ADDRESS of February 24, 1957: AAS 49 (1957),
p. 147.
[6] Pius XII, Ibid., p. 145; cf. ADDRESS of September 9, 1958:
AAS 50 (1958), p. 694.