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The Montana Supreme Court recently heard oral arguments regarding a lower court decision stating that Montanans have a constitutional right to physician assisted suicide (PAS). This is perhaps the most important case the Court has decided in the past several decades, maybe longer.
Our Catholic teaching calls us to respect life from conception to natural death. However, this is a very complex and complicated issue, and over the next several months you will hear conflicting statements that will be very confusing and emotional. Bishop George Leo Thomas and Bishop Michael W. Warfel submitted a brief under the banner of the Montana Catholic Conference opposing PAS. In their brief they made three main points to help us understand some of the troubling aspects. A summary of their brief follows.
1. Helping People Commit Suicide is Not a Reasonable or Compassionate Response to Their Pain and Suffering
The reasonable and compassionate response to any human problem is to address the problem, not to end the life of the person who has the problem. An appropriate response to a person in pain is to relieve his or her pain, not to help destroy his or her life. Pain can be controlled in even the most severe situations.
This is not to say that doctors always manage pain as they should. The answer to that problem is to better educate and encourage physicians to manage pain, not to kill the patient. In addition, providing an option for suicide can discourage development of palliative care and pain management practices.
It has been shown that while palliative care has developed rapidly in English-speaking countries where assisted suicide is illegal, whereas the acceptance of assisted suicide in the Netherlands stifled the development of hospice and palliative care practices in that country. Oregon is similar. Since physician assisted suicide was introduced in that state, pain levels for those in the final stages of life has increased. Studies have shown that Oregon residents in the latter period were “approximately twice as likely to be reported to be in moderate or severe pain or distress during the last week of their lives.”
2. Suicide is Rarely, If Ever, the “Informed,” “Voluntary,” “Competent,” and “Uncoerced” Decision That Proponents of Assisted Suicide Claim
The district court’s decision gives terminally ill patients who are “competent” a right to assisted suicide. Whether one is “competent” to commit suicide is a standard that has no clear meaning or criteria in modern psychology and ignores what the medical literature tells us about persons who act out suicidal thoughts. “Those who attempt suicide – terminally ill or not – often suffer from depression or other mental disorders” leading many health practitioners to conclude that rational suicide is an oxymoronic statement.
In most cases when the depression of a suicidal person is treated, his or her suicidal wishes usually disappear. Such patients are usually “grateful that no one facilitated their suicide while they were temporarily depressed....”
In addition, when a patient enters a psychiatrist’s office with the sole intention of securing a certification that he or she is “fit” to commit suicide, it subverts the therapeutic process that might otherwise have successfully treated the depression underlying her suicide request.
Furthermore, since only those counselors without moral or ethical objections will presumably participate in this regulatory scheme, they will presumably be those who believe that suicidal thoughts are “rational” when the patient is terminally ill. Thus, the deck will be stacked in favor of assisted suicide.
Expressions of a wish to commit suicide – whether voiced by a depressed elderly person, a middle-aged person in poor health, or a discouraged adolescent – should be seen for what they are: a cry for help. As citizens and fellow human beings, we respond compassionately and reasonably to depression, poor health, and discouragement by addressing these problems and their causes, not by acquiescing in a despondent wish to end life.
3. Predicting Length of A Terminal Illness is Notoriously Difficult
The district court’s opinion permits assisted suicide when one is predicted to have six months to live.
The opinion does not distinguish between persons who will die within six months with treatment and those who will die in six months without treatment. As a consequence, the “terminally ill” population envisioned by the court’s ruling can include persons with such readily treatable diseases as diabetes, and others who with treatment can live relatively symptom-free for many years. Thus, the 18-year-old who incurs a spinal cord injury, the 25 year old with insulin-dependent diabetes, and the 35-year-old with a chronic progressive disease – all of these could be swept up into the court’s definition of “terminally ill” even though they have treatable conditions and, with treatment, can live for years comfortably and happily.
Even if there were a workable definition of terminal illness, diagnoses of terminal illness and predictions of life expectancy are notoriously inaccurate.
There are far more questions than answers with legalized PAS. Many who voted for passage in Oregon and Washington did not understand the full implications of the laws they passed. We need to work hard to make sure that does not happen in Montana. There is a multitude of good information available through the Montana Catholic Conference and the USCCB. Please contact us with your questions or requests for more information.
The complete brief is on the following websites, montanacc.org, diocesehelena.org, dioceseofgfb.org
Download the PDF of this article.
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