The Magisterium of the Church on euthanasia

By Amedeo Lomonaco

In its Greek etymology, the word “euthanasia” is related to the concept of a “good death” (εὐθάνατος). This term came to be associated, even in antiquity, with death without suffering. The aim of the doctor was, as far as possible, to ensure that the final moments of life were painless. This form of “euthanasia” was not inconsistent with the Hippocratic oath: “I will not administer, even on request, a deadly drug, nor will I suggest such advice; likewise. I will not give to any woman a medical abortifacient.”

Today, however, the term “euthanasia” no longer bears its original meaning. Instead, sadly, it signifies an action aimed at deliberately bringing about the death of a person with a serious ailment in order to end their suffering.

The rejection of euthanasia and “over-zealous” treatment

In its two-thousand-year history, the Catholic Church has always affirmed that human life must be defended from conception until natural death. Thus, according to the Catechism of the Catholic Church, “Intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator” (CCC 2324)

Technological progress has given rise to new ethical questions. The development of medicine has made it possible to improve health and prolong life in a way that had never occurred in the past and could never be have been imagined. In this regard, 65 years ago, on 24 November 1957, Pope Pius XII gave a speech to a group of anaesthetists and resuscitators that Pope Francis has described as “memorable.”

Reaffirming the illicitness of euthanasia, Pope Pius XII nevertheless affirmed that there is no obligation to always employ all therapeutic means potentially available; and that, in well-defined cases, it is lawful to abstain from them: this is the first indication of the principle of what might be called “over-zealous” treatment, defining as morally permissible, in some cases, the decision to refrain from or suspend the use of therapeutic measures when their use does not correspond to the criterion of “proportionality of treatment.”

John XXIII, Paul VI, and Vatican II

In the encyclical Mater et Magistra, Pope John XXIII emphasized, “Human life is sacred—all men must recognize that fact. From its very inception it reveals the creating hand of God.” And in the encyclical Pacem in terris, the same Pope, speaking of human rights, mentioned the right of all human beings to live, a right that “involves the duty to preserve one's life.”

The conciliar Constitution Gaudium et spes includes euthanasia in its list of “infamies” that are “opposed to life itself”:

“Whatever is opposed to life itself, such as any type of murder, genocide, abortion, euthanasia or wilful self-destruction, whatever violates the integrity of the human person, such as mutilation, torments inflicted on body or mind, attempts to coerce the will itself; whatever insults human dignity, such as subhuman living conditions, arbitrary imprisonment, deportation, slavery, prostitution, the selling of women and children; as well as disgraceful working conditions, where men are treated as mere tools for profit, rather than as free and responsible persons; all these things and others of their like are infamies indeed (GS 27).”

Later, Pope Paul VI, in an address to the United Nations Special Committee on the Question of Apartheid, compared questions about the end of life to racial issues, as he stressed the equality of all human beings, and the need to protect the rights of minorities as well as the rights of “the handicapped, the incurably ill and all those who live at the margin of society and are without voice.”

“Above all the precious right to life — that most fundamental of all human rights — must be affirmed anew, together with the condemnation of that massive aberration which is the destruction of innocent human life, at whatever stage it may be, through the heinous crimes of abortion or euthanasia.”

John Paul II: Euthanasia and the culture of death

Already in his 1995 encyclical Evangelium vitae, Pope John Paul II lamented that euthanasia, “disguised and surreptitious, or practised openly and even legally,” was becoming more widespread. “As well as for reasons of a misguided pity at the sight of the patient's suffering,” he wrote, “euthanasia is sometimes justified by the utilitarian motive of avoiding costs which bring no return and which weigh heavily on society.” Thus, he continued, “it is proposed to eliminate malformed babies, the severely handicapped, the disabled, the elderly, especially when they are not self-sufficient, and the terminally ill.”

The Polish pope noted, “The temptation grows to have recourse to euthanasia, that is, to take control of death and bring it about before its time, ‘gently’ ending one's own life or the life of others.” In fact, he said, “what might seem logical and humane, when looked at more closely is seen to be senseless and inhumane.” He concluded forcefully: “Here we are faced with one of the more alarming symptoms of the ‘culture of death’.”

Benedict XVI: Caring for the dying with love and accompaniment

Pope Benedict XVI, for his part, posed the questions, “does a human being who moves toward a rather precarious condition due to age and sickness still have a reason to exist? Why continue to defend life when the challenge of illness becomes dramatic, and why not instead accept euthanasia as a liberation?” In an address to health care workers in 2007, he responded, “The person called to accompany the aged sick must confront these questions, especially when there seems to be no possibility of healing.” At the same time, he noted, “Today's efficiency mentality often tends to marginalize our suffering brothers and sisters, as if they were only a ‘burden’ and ‘a problem’ for society.” He explained that those with “a sense of human dignity knows that they are to respect and sustain them while they face serious difficulties linked to their condition,” adding, “Indeed, recourse to the use of palliative care when necessary is correct, which, even though it cannot heal, can relieve the pain caused by illness.” However, he said, “alongside the indispensable clinical treatment, it is always necessary to show a concrete capacity to love, because the sick need understanding, comfort, and constant encouragement and accompaniment.” 

Pope Francis: Reject the culture of waste

Today, the prevailing opinion, which Pope Francis has denounced as a “culture of waste,” of rejection or casting aside,” at times proposes a “false compassion which holds that it is a benefit to women to promote abortion; an act of dignity to perform euthanasia; a scientific breakthrough to ‘produce’ a child, considered as a right rather than a gift to be welcomed; or to using human lives as laboratory animals, allegedly in order to save others.” On the contrary, he said in his address to Italian doctors, “the compassion of the Gospel is what accompanies us in times of need, that compassion of the Good Samaritan, who ‘sees,’ ‘has compassion,’ draws near and provides concrete help (cf. Lk 10:33).”

The Pope underlined the point in 2017, in a Message to members of the World Medical Association: “It is clear that not adopting, or else suspending, disproportionate measures, means avoiding overzealous treatment; from an ethical standpoint, it is completely different from euthanasia, which is always wrong, in that the intent of euthanasia is to end life and cause death.” And he recalled the teaching of the Catechism of the Catholic Church (2278), “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one's inability to impede it is merely accepted.” 

Incurable does not mean a refusal of care

In the Letter Samaritanus bonus, approved by Pope Francis and published in September 2020, the Congregation for the Doctine of the Faith affirms, “The judgement that an illness is incurable cannot mean that care has come at an end.” Those who are suffering from a terminal illness, as well as babies born with a limited expectation of survival have the right to be welcomed, cared for, and surrounded by affection. The Church does not countenance “over-zealous” or overly aggressive treatment; but nonetheless “reaffirms as definitive teaching that euthanasia is a crime against human life.”