As my family cares for my 94-year-old father who is suffering from advanced Alzheimer’s and other effects of aging, we wrestle with the questions and worries that confront all of us as we face our human mortality. How should we care for our critically ill or dying loved ones? The ongoing pain and suffering, soaring medical expenses, our desire to maintain control and dignity and the desire not to be burdens upon our families all become concerns that are difficult and troubling.
Amid these challenges, we should support our loved ones with genuine compassion and not with the misguided compassion of physician assisted suicide (PAS), often euphemistically packaged as “aid in dying.” There is an excellent, effective and ethical alternative to PAS: namely, palliative or comfort care.
There is an old adage in medicine, “Cure sometimes, relieve occasionally, but care, always.” The central principle of medical ethics, enshrined in the Oath of Hippocrates and taken by physicians is “first, do no harm.” We seek medical care when we are ill, and we expect our doctors to exercise the great power of medicine to restore us to health, if possible, and, at the minimum, to ease our suffering when we cannot be restored to full health.
Today we have incredible medical tools. As we marshal these powerful tools, we must also ask whether we need to use them in all circumstances. When can we say that, “Enough is enough?”
Dedicated, caring physicians and nurses know medical care is a dynamic process. As a patient’s condition changes, certain interventions and treatments shift from basic or ordinary means of care to heroic or extraordinary means of care. The goals of medical care move from full restoration of health to comfort care, or palliative care. The purpose of palliative care is to provide as much comfort as possible to enable the patient to face his or her inevitable transition from life to death. Such care is an expression of faithful presence, not abandonment of the patient.
Hospice care is also an integral part of a comprehensive palliative-care protocol. These specialists provide invaluable medical, emotional, spiritual and social support for terminally ill patients and their families. Physicians and members of the medical team who provide this supportive care honor the noblest tradition of medicine as a healing art. PAS, which enlists physicians as accomplices in the tragedy of suicide, corrupts the medical profession at its core.
As a Catholic priest and moral theologian, I encourage us to ponder part of the excellent statement by the United States Conference of Catholic Bishops, “To Live Each Day with Dignity: A Statement on Physician-Assisted Suicide,” which says, in part:
“Respect for life does not demand that we attempt to prolong life by using artificial treatments that are ineffective or unduly burdensome. Nor does it mean we should deprive suffering patients of needed pain medications out of a misplaced or exaggerated fear that they might have the side effect of shortening life. … In fact, severe pain can shorten life, while effective palliative care can enhance the length as well as the quality of a person’s life. It can even alleviate the fears and problems that lead some patients to the desperation of considering suicide. … (It) also allows patients to devote their attention to the unfinished business of their lives, to arrive at a sense of peace with God, with loved ones, and with themselves. … ”
We may fear the prospect of an excruciating, painful death. But today, we have excellent pain medications and pain-management strategies to help us confront our final days. PAS short-circuits the much-needed conversation we must have as a society to strengthen these effective, proven pain management resources, including hospice care. Palliative care is the solution we all deserve, not the destructive and misguided compassion of PAS.