Euthanasia, Dying and the Dignity of the Human Person – Keynote Address – 2 August 2021
Good evening everyone and thank you for joining us this evening as we reflect together on such an important issue which, in fact, touches us at that moment at which we are most vulnerable – the moment of death itself.
Or course, my priestly life has made me no stranger to death. As a young monk, one of my first responsibilities was nursing the older, sick members of the community through to their death. It was one of the most formative experiences of my life. Then, later, as chaplain at St Vincent’s Hospital in Melbourne in the late 90s, I recall in the space of one week alone attending 24 deaths. This experience has inevitably given me a familiarity with death. Yet, one of the things that would strike me – in hospital chaplaincy, particularly – is that those unfamiliar with death would understandably struggle with its natural processes. “Why does my mother have to suffer like this?” they would ask in anguish. Or with the same anguish, they might declare, “no one should have to suffer like this!” when, in fact, the person they loved was simply going through the natural process of the body shutting down, even quite peacefully.
Ignorance of death can make us fearful of it. Indeed, we have largely removed death from our daily lives, often relegating it to the medical context rather than integrating it into our family circle. The overwhelming majority of people now die in hospital. Gone are the days when someone may have died in the same bed in which they were born – which wonderfully was the experience of the father of a friend of mine. Many of us may not have the experience of being with someone dying until well into our own life, if at all. Many of us rarely see death, if at all.
Our experience of death is also situated within a wider cultural framework, and I wish to explore this a little because it provides the context of how such issues as Voluntary Assisted Dying rise to the surface of social life.
We do live in one of the most exciting times in human history. Never have we had as much access to our past. Never have the possibilities for our future been as extensive. This remarkable possibility, however, does not present with cohesion and focus. With the eclipse by the middle of the 20th century of the philosophical project we call modernity, we enter the future without a unifying narrative. Everything now claims attention for legitimacy; every claim is regarded with value, even though experience demonstrates that where everything is tolerated, intolerance bounds. This is what we might call the paradox of postmodernity.
Within this context, the Canadian philosopher of religion, Charles Taylor, especially, has highlighted for us the way in which meaning today is derived almost entirely from personal experience.[1] The individual ‘self’ has now become regarded as the repository of truth. Further, it is how I feel that determines the rightness of something. Unless I feel something has value, it has none. This we might label ‘the tyranny of affect’, and it is particularly endemic in the way that most of us think and speak today. Most of us may not be aware of it. However, if we listen for it, we hear it everywhere.
The outcome of this evolution in consciousness, particularly in the West, is that Truth becomes entirely internal, something wholly subjective. The idea that Truth exists outside of ourselves, that it is something objective, something we receive, and to which we are accountable, has become increasingly foreign. It is not the collective wisdom forged through the Tradition of a people to which I am now accountable, but that which I have determined to be personally authentic, according to how I feel.
The loss of the Transcendent in a secular society exacerbates this self-reference. We live in a society in which the orientation to the Transcendent no longer exists and the sense of accountability to something other than me is no longer apparent. In this context, life is not a Mystery to be served but rather a right to be exercised.
The secular itself is something about which we should not be afraid: it is the domain of civil and political life created on the principles of sound reason. However, a secularist agenda, which is something different from the secular sphere itself, seeks to banish any reference to the Transcendent in life, in favour of that which is entirely empirical and immediate. It cannot admit of the religious word, the religious gesture, or the religious symbol – all of which it regards as an affront to what is rational, even though the most beautiful moments in human history have most often been inspired in the flourishing of the religious imagination. And above all, the secularist agenda cannot admit of the religious conscience. It asserts the demands of moral responsibility as a higher category of discernment than that of the religious conscience.
The religious imagination has been replaced by the technological. We cannot but marvel at the possibilities of technology across so many aspects of our existence. And yet, we can also be unwittingly seduced into a fantasy by technology – the fantasy that everything is possible. And if it is possible, why can’t we do it? And so, possibility and prosecution become thought of as without distinction. If something is possible, I have a right to pursue it, if I feel that it is good to do so. However, with the banishment of the Transcendent from social consideration, this appeal to rights takes on an absolute character. It is not human rights as such to which we appeal. It is ‘my’ rights that we demand. I have a right to choose; I have a right to decide. I have a right to do anything that I feel to be right for me, so long as it does not adversely affect anyone in a way that is immediately visible. This primacy of personal rights, as distinct from a community’s rights, erodes our sense of a social conscience – that something should be followed not because it might be good for me, but because it might be good for the community at large.
There is a second fantasy into which we can be seduced by technology. This is the illusion that we are in control, and that life itself can be controlled. It translates into what we might call an antiseptic mentality which cannot engage the inevitable reality of human suffering, and which seeks to sedate difficulty and hardship – all that is perceived as negative in life. Worst, and in line with what we have outlined earlier, life is evaluated primarily through the pleasure principle, through the “feel-good” syndrome. If something does not feel good, then something must be defective, inadequate, wrong. Suffering is not to be redeemed; it must be anaesthetized, literally – as we see in the demand for the right to end one’s life neatly, and with complete control.
And this brings us back then to the issue at hand.
I recall an ABC TV ‘Q and A’ exchange that highlighted this vividly. A woman from the audience – clearly a very educated and articulate woman – made a passionate appeal for her right to determine when she might die. One did not get the sense that she was currently suffering from a terminal disease, and she did not intimate that she was. It was for the principle of the right to die at the time of her choosing for which she was passionate. Faced with the prospect of a lingering death, requiring the services of many other people, surely, she should have the right to die with dignity? Why should she suffer the indignity of having to be cared for in every respect, to be fed by others, to be toileted by others? The prospect of being so dependent on others was an affront to her dignity. Surely it was her right as an individual to make a choice to preserve her dignity. As an individual, entirely responsible for herself, she should be able to make such a choice with the assistance of others that did not implicate those assisting negatively.
The argument presents so reasonably, so clearly. Yes, surely as mature, responsible individuals we should have such rights, and so avoid the prospect of suffering. Why prolong suffering? Why should anyone suffer, in fact, when the outcome of death is obvious – particularly when the means are there to remove the suffering in a controlled, humane manner? A person is to die in any event. Why not control the time of death to limit the possibility of suffering of the one who is terminally ill, and the suffering of others who will be drawn into the experience as they watch and wait?
However, beneath the argument we hear the premise of the individualism that marks our time in which the self, and nothing other, has become the arbiter of what is right and what is true. However, are we as individual as we think we might be? Are we as wrapped up in individual autonomy as we have been led to think? More authentically, we are our relationships, and it is only through our relationships that we have our very life. We discover who we are only in and through our relationships. And where does this radical definition of ourselves as human find its greatest transparency but in the care we exercise with and for one another? When we are prepared to forget ourselves and suffer with another, then we show with greatest clarity who we are truly. A love that is prepared to enter the suffering of another, a love that is prepared to forget oneself in care of another, and a love that is prepared to receive that care, gives us back the truth of ourselves. It is precisely in that mutuality that a beauty of humanity rises in the midst of the darkness and shines forth to so transform it.
The question of suffering is at the heart of our human experience. How are we to approach the unavoidable reality of suffering in our life? Surely, we are to limit and overcome suffering, neither to seek it, nor to intensify it? How can we stand by and let someone we love suffer? Of course, no one wants to see someone suffer, especially someone they love. For those who argue most for the right to die at the time of their own choosing, there is, often, an incredibly sad story of watching someone they love die. It is understandable when we hear them say that they would not want anyone to go through that they have experienced – even if the appeal to their personal experience renders it with a legitimacy that is, in fact, entirely subjective, though delivered with uncontestable authority. Yet, when we base our decisions exclusively on our subjective experiences to what social cohesion are we accountable?
What demonstrates our humanity is our readiness to enter the suffering of one another. In suffering there is, in fact, a light to be discovered that the darkness cannot extinguish – a light that, in fact, overwhelms the darkness, transforming it by the exercise of an altogether different logic. This is genuine compassion. Compassion means suffering with. It is a love that holds the suffering of another, that journeys into the suffering of another, a love that is prepared to enter the suffering of another so that their suffering becomes mine. However, as the Canadian philosopher, Charlies Taylor, observes, we have reduced compassion to the therapeutic, to the ‘feel-good.’ Then, compassion becomes merely a shadow of itself, a justification to limit the intrusion of the negative, of the painful, in our experience. Compassion, then, is about the restoration to feeling good, rather than about living with questions that are raw and relentless, questions that undo us and recreate us.
Do we really want a society in which the beauty of human compassion has been so hollowed out, and in which our suffering is terminated with the coldness of an isolated decision, and with technological precision? Assisted dying is a failure of humanity, and it is a failure of society itself. It promises a certain redemption in the form of deliverance, but it robs us of that which makes us most deeply and fully human which can only be received in the experience of a depth of care for another to the very limits. Neat, clean, controlled, euthanasia short circuits the deepest possibility that lies in what it means to be human – and not only human, but also divine: the mystery of life is disclosed in a self-emptying become a self-giving. For a society to go down the track of assisted dying is for it ultimately to wash its hands clean of the radical responsibility of care by which alone we are humanized and given our dignity as persons.
Do we want a therapeutic society? Or do we want a loving society? Do we want a technologically determined society? Or do we want a human society? Do we want a society that is altogether neat and controlled? Or do we want a society that retains the full unpredictability and messiness of life itself? Which society reflects to us our truth? Which society makes us more human, not less?
As followers of Jesus, we celebrate life. We celebrate a life that we do not own, but that we have been given, that we have received to nurture and to protect until the One who has given us life withdraws it into its Mystery once again. For us baptized into the story of the life of the Resurrection, the termination of life for any reason is abhorrent. It is the fundamental usurpation of an authority not our own, and, therefore of the rightful order between creature and Creator. How we receive life, nurture life, and protect it demonstrates to us the acknowledgement, or otherwise of this radical relationship that is the ground of all others.
However, at the same time, we are not expected to prolong life using extraordinary means. There comes a point where we no longer need to resist the forces of diminishment, and when we can let go. There have been a not a few instances in which I have worked with people who have come to the faith-filled decision not to pursue a course of treatment for which the benefit seemed futile, and who have decided to surrender their life. These have been moments of remarkable faith and hope. I will never forget one of these people. She was a woman in her late 60s, afflicted by the paralyzing Guillain-Barré syndrome. She had been in intensive care for many months, and all the treatment afforded her was having no effect. She came to the decision not to pursue the treatment, with the expectation that when the life support was withdrawn, she would die shortly after. I recall the morning the breathing apparatus was removed. We expected to be with her in prayer as nature took its course. Nature did take its course, but in a way that no one had imagined. From the moment medical treatment ceased, she started to get well. In a most curious way, the treatment had been preventing her body from resisting the disease. Six weeks later the lady walked out of the hospital. The most extraordinary dimension of this experience for me was the paradox that in her very readiness to die, the woman was given back her life.
Without doubt, for some, though, the experience of death can be traumatic, not only psychologically but also physically. This can be one of the most awful experiences to witness. However, with the enormous advances in palliative care such situations today are not common. We recognize that the treatment of pain, especially through opioids such as morphine, can, on occasions, seem to hasten the event of death. There have been times at which I have been present with someone dying when it was clear the next injection of morphine would so suppress their breathing that respiratory function would cease. However, neither the decision to cease extraordinary medical intervention either for ourselves, or for those we love who are incapable of making their own decision, nor the administration of pain relief, even with the inevitable outcome of death, is euthanasia. Euthanasia is the deliberate primary intention of someone to terminate life.
We have so much to celebrate in our world. We also have much to confront: the primacy of individual rights in opposition to the rights of a community; the assertion of the self and its perceived rights as the arbiter of truth and rightness without attention to the social wisdom of centuries experience; the dissolution of the Transcendent into the technological illusion of limitless possibility; the assumption that the ‘feel-good’ determines the value of our experience.
Most importantly, all this means we are not only confronting specific issues such as voluntary assisted dying. We are also having to confront much deeper, more pervasive, more ingrained ways of thinking. And this is what is most difficult, and why it is especially challenging to have our voice heard in the increasing chatter around us. From the perspective of our Christian faith, and from the perspective of our long 2000-year Catholic Tradition of rational reflection, we cannot, however, but resist those trends which we consider rob us of our humanity which we proudly propose is not simply discovered in how we feel personally, but how we relate as a community. The Christian is not interested in what is good for them individually; the Christian is passionately concerned with the world and the type of society which might promote genuine human flourishing, or otherwise.
We should be under no illusion. To listen deeply to the Spirit of God, to be accountable to a vision of life that we have received from a reality outside ourselves, to be drawn into a field of meaning that we ourselves have not determined, is to set ourselves up for estrangement in a climate that determines the rightness of something from how I feel about it, and which cannot entertain the objectivity of meaning beyond reference to my own personal experience of something. For this reason, the religious voice is considered obsolete in the discussion of social issues. It is deemed as having nothing to offer. Subsequently, we experience the attempt to marginalisze completely the religious voice from public debate, even though it is preposterous arrogance to think that 2,000 years of rational, philosophical reflection has nothing to offer trends which are hardly fifty years old.
We are essentially talking about here the way of the Cross. At our baptism, we were immersed into the mystery of this Cross: the life, death, and resurrection of Jesus. We were not baptiszed into something that felt good. We were not baptiszed into something that we control, something from which we can pick and choose to make our own. We were not baptiszed into a narrative without definition, and which is inclusive of every position without boundaries. We were not baptiszed into a feel-good mythology in which love is reduced to being nice to everyone, and in which the tortuous project of compassion is reduced to acceptance of everything. We were baptiszed into a story of renunciation, a story of sacrificial love, a story of resistance. We were baptiszed into a life that resists everything that would truncate us of our humanity and draw us from the truth of ourselves. Incorporated into the life of Christ, we were made with him kings, priests, and prophets.
This is our time to be the prophets we have been baptiszed to become. As another great Catholic thinker of the 20th century, Jacques Maritain, wrote,
“Too long, in modern times, ‘has the Christian world obeyed two opposing rhythms, a Christian rhythm in matters of worship and religion, and, at least among better men, in things of the interior life; and a naturalistic rhythm in things of the profane life, the social, economic and political life . . .’ Today, at least for Christians who have ears to hear, this dualism is past.[2]
. . . we must not only act as Christians and as Christians as such, as living members of Christ, on the spiritual plane; we must also act as Christians, as living members of Christ’s body, on the temporal one.”[3]
And yet, if we are to be true and faithful to the story into which we have baptizsed, we must act not simply according to what feels right to us. To do so is to abandon our accountability to the Mystery which has called us into itself, and not which we have called into ourselves. This Mystery alone can be the genuine means of discernment in respect to the position that we might adopt about the current questions before us if we are to remain Christian not only in name – and not only in feeling – but by our baptismal responsibility and obligation.
Now is the time to make a choice in respect to our baptism – and yes, to accept the price, or otherwise. Yes, our long Tradition into which we have been baptiszed does celebrate a defined perspective about life. This framework has not changed. As Chesterton once quipped, “The Church is the only democracy where the dead have a vote.” In other words, what we consider to be right is not just about what our generation might consider to be so. We must pitch our opinion against something larger than ourselves – the experience and witness of countless disciples of Jesus that have lived before us in an unbroken perception of what is true.
[1] See Charles Taylor’s two magisterial works, Sources of the Self: The Making of the Modern Identity (Harvard University Press, 1989), and A Secular Age (Harvard University Press, 2007).
[2] Jacques Maritain, Scholasticism and Politics, translated and edited by Mortimer J Adler (New York: The Macmillan Company, 1940), 201.
[3] Jacques Maritain, True Humanism, translated by M.R. Adamson, (Westport, Connecticut: Greenwood Press Publishers, 1941), 292.