Assisted suicideis in the news and on lawmakers' agendas. Supporters call it
"aid in dying" and claim it is just another option for ending intolerable pain
as part of end-of-life care. But assisted suicide is radically different from end-of-life
care and the practice of palliative care, the healing art of relieving pain and other
distressing symptoms for patients who are seriously ill. In
fact, these two agendas are at war with each other.
Drugs, Different Results
properly prescribed for the pain of serious illness, powerful pain medications like morphine and other
opioids are safe and effective. Patients can have their pain well-controlled without
risk to life, and generally stay alert as well.
suicide is very different. Where it has been legalized, doctors can prescribe a
lethal overdose of pills to patients whom they think will die within six
months, so they can kill themselves. The patient then
intentionally swallows a massive overdose of barbiturates to cause
unconsciousness and death.
The Importance of Intent
suicide is radically different from end-of-life care and the practice of
having opposite results, these two approaches express different intentions.
pain medication is generally safe under medical supervision, it may have side-effects.
example, barbiturates may be used in rare instances to sedate an agitated
patient in the final stage of dying if other pain control methods are
inadequate, though this poses some risk of shortening life.
In such cases, the doctor and patient must assess the good they intend
and proceed only if this good outweighs the unintended adverse effects. As
risk cannot always be eliminated, modern medicine would be impossible without
this "principle of double effect." The key is that no one involved intends the
bad effects, especially the bad effect of killing the patient.
Assisted suicide, by contrast, directly intends the patient's
death, which is never morally permissible. The doctor prescribes an
intentionally lethal overdose, with instructions on how to use the pills to
cause death. (Interestingly,
there is no record that any patient accidentally surviving the overdose has
ever tried it again.1)
organizations like the American Medical Association and the American College of
Physicians oppose doctor-assisted suicide, in part because it destroys this
essential distinction between intended and unintended effects of treatment. Patients
need to be able to trust their doctors to always care for their lives and never
deliberately cause death.
Problem, Not the Patient
care also addresses symptoms beyond physical pain, in ways that go beyond
medication. Patients facing serious illness may feel hopeless and depressed, as
though their lives have lost meaning. Addressing psychological, emotional, and
spiritual problems is essential to palliative care. Assisted suicide
alleviates none of these problems, but gives in to them. Consider that about
half of patients who had requested assisted suicide under the Oregon law in its
first three years changed their minds when the doctor provided palliative care.2
Yet in Oregon,
almost none of the patients receiving lethal drugs are evaluated to assess
whether their wish for death arises from treatable depression—and over half say
they requested the drugs partly because they feel they are becoming a "burden"
on others.3 Offering assisted
suicide can only confirm and strengthen that feeling. It ignores the underlying
problems, instead abandoning and eliminating the patient who has the problems.
Assisted Suicide Undermines
suicide is detrimental not only for individual patients, but also for patient
care on a large scale. In countries like the Netherlands, where assisted
suicide has been accepted for many years, progress in palliative care has
stagnated.4 In Oregon, legalization was followed by an
increase in severe untreated pain among terminally ill patients. During a
period when 1,832 hospices opened in other states, only five opened in Oregon. In
other states legalizing assisted suicide, use of hospice care has fallen below
the national average.5 By
contrast, when states pass new laws forbidding assisted suicide, while
affirming that doctors may use drugs like morphine for effective pain control,
use of these medications has increased—indicating progress in pain management
The reason is
obvious. Optimum palliative care requires years of training and experience, as
well as a commitment to the patient as someone with inherent dignity who
deserves excellent care. Assisted suicide avoids the need for this hard work
and erodes this commitment. It provides a "quick and easy," as well as cheap,
answer to terminal illness. Once death is accepted as a solution, why bother to
devote resources to more expensive medical progress?
Assisted suicide does
not enhance medicine. As noted by a doctor specializing in palliative and
hospice care in the Netherlands, killing "becomes a substitute for learning how
to relieve the suffering of dying patients."7
True Love and
Do we see people as
the problem, such that our responsibility begins and ends with helping patients
kill themselves? Or, do we see seriously ill patients as fellow human beings
who deserve our love and solutions for their problems? Will
we succumb to the "false mercy" of assisted suicide, or will we endorse what
Pope St. John Paul II called "the way of love and true mercy"?8 Will we dedicate ourselves to providing
genuinely compassionate care, as a society and for our own loved ones? Our
answer today determines the care available now and for years to come.
 Doerflinger, Richard M., M.A.
"Oregon's Assisted Suicides: The Up-to-Date Reality in 2017." On
Point, no. 21 (March 2018): 5. https://lozierinstitute.org/wp-content/uploads/2018/03/Oregon-Assisted-Suicide-The-Up-To-Date-Reality-2017.pdf.
 Ganzini, Linda, M.D., Heidi D.
Nelson, M.D., M.P.H., Terri A. Schmidt, M.D., Dale F. Kraemer, Ph.D., Molly A.
Delorit, B.A., and Melinda A. Lee, M.D. "Physicians' Experiences with the
Oregon Death with Dignity Act." The New England Journal of
Medicine, no. 342 (February 24, 2000): 557-63.
Assisted Suicide Laws in Oregon and
Washington: What Safeguards? PDF.
Washington, D.C.: United States Conference of Catholic Bishops, February 22,
2018: 2,5. https://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-each-day/upload/suicideoregonfeb2018.pdf
 Physician-Assisted Suicide: Threat
to Improved Palliative Care. PDF. Washington, D.C.: United States
Conference of Catholic Bishops, March 4, 2017: 2-3. https://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-each-day/upload/suicide_palliative_care-2.pdf
 Doerflinger, Richard M., M.A. "The
Effect of Legalizing Assisted Suicide on Palliative Care and Suicide Rates: A
Response to Compassion and Choices." On
Point, no. 13 (March 2017): 3. https://lozierinstitute.org/wp-content/uploads/2017/03/The-Effect-of-Legalization-of-Assisted-Suicide.pdf
 Brief Amici Curiae for the United States Conference of Catholic Bishops,
California Catholic Conference, Oregon Catholic Conference, Washington State
Catholic Conference; Catholic Health Association of the United States, and
Lutheran Church-Missouri Synod as Amici Curiae in Support of Petitioners, Alberto
R. Gonzales, U.S. Attorney General, et al. v. Oregon, et al., No 04-623, *18-22 (filed May 9, 2005). https://www.usccb.org/about/general-counsel/amicus-briefs/upload/amicus-sct-gonzales-v-oregon-2005-05.pdf
 Zylicz, Zbigniew, M.D.
"Palliative Care and Euthanasia in the Netherlands." In The
Case Against Assisted Suicide, 142. Baltimore and London: Johns Hopkins
 John Paul II, Evangelium vitae (Gospel of Life) (Vatican City: Libreria
Editrice Vaticana, 1995), no. 66-67.
This article was updated and shortened from a 1998
Respect Life Program article by the same name. Excerpts from Evangelium
vitae, © 1995 Libreria Editrice Vaticana, Vatican City. Used with
permission. All rights reserved. Copyright © 2018, United States Conference of
Catholic Bishops, Washington, D.C. All rights reserved.