The one thing that proponents and opponents of euthanasia both agree on is that no one should have to die in pain.
In formulating its teaching on care at the end of life the Catholic tradition takes into account the absolute importance of effective pain relief and also makes a clear moral distinction between 'direct killing' and 'allowing to die'. At the core of these issues is intention.
Direct killing is any action or omission that intends the death of another i.e. the cause of death is the human intervention or omission. By contrast, withholding or withdrawing futile or overly burdensome treatment is judged as 'allowing to die' i.e. the disease or fatal condition overtaking the person is ultimately the cause of death. This is not euthanasia.
Administering pain relief is an action that can have the foreseen effect of shortening a person’s life. If a health professional directly intends the death of the patient, then the provision of such medication (at a dose level that is greater than what is needed to relieve the patient's pain) is wrong and is considered to be an act of killing, regardless of how well-meaning the person’s actions may be.
If, however, the health professional's sole intention is the relief of pain, the fact that the administration of the pain medication has more than one outcome – one positive (relief of pain) and one negative (earlier death) – does not make their action wrong; it is not act of 'direct killing' because, while an earlier death may be foreseen, it is an unintended consequence. Once again, this is not euthanasia and it is misleading and confusing to refer to such actions as “passive euthanasia” as some do.
When medicine can no longer provide a cure for persons at the end of life the proper management of a patient’s pain and other physical symptoms is vital if the spiritual and relational aspects of the person are to be addressed. All those who are dying should have the opportunity to proper health care and pain relief based on a universal and unconditional respect for the fundamental equality of all persons.
John Kleinsman
The Nathaniel Centre
Really.
Very good entry. Looking forward to the next.
I am an Aged Care nurse, who has a massive problem with the ethical standards of some Medical Doctors in Aged Care. Unfortunately, it is my observance that unprotected elder people, generally speaking, are easy prey for the so called medical "profession" and the disadvantage is often taken as far as priority - or even the inconvenience of turning up for the doctor is concerned. Recently at our facility, a non-eating Resident was not admitted to hospital - so she died. A local 90 year old farmer had his angina medication discontinued - they had to admit him with vascular congestion leading to heart failure and he is so weak now that he will probably not come back. Apparently he was terrified when they carted him off to hospital - Do you know what angina feels like? A pending heart attack - and if you do not know what is happening, the feeling is that you could die of a heart attack. You do not have adequate blood oxygen levels to reduce blood viscosity and ease the thicker blood flow - because some muscular problem has reduced the ability to breathe. We need a good blood/oxygen level to naturally make us feel like drinking water! Unfortunately in my experience most Medical Practitioners are money centered - rather than patient centered. And that is the main reason that I have observed that most MD's are in the business - rather than life saving - otherwise the majority of doctors I have observed would do all in their power for their patients - but only a very few will bend over backwards for their people.
If a doctor operates on a person to relieve chronic back pain the doctor's actions in giving an anaesthetic and cutting the person open creates a risk that the person might die in the process of obtaining relief from pain. The risk is accepted because the purpose is to relieve the person's pain. Is this a parallel situation to the giving of pain relief even though it creates a risk of earlier death which John Kleinsman talks about?
John, This is a great article. i appreciate the distinction you make and it is helpful. Regards - Patrick
What youre saying is completely true. I know that everybody must say the same thing, but I just think that you put it in a way that everyone can understand. I also love the images you put in here. They fit so well with what youre trying to say. Im sure youll reach so many people with what youve got to say.