It is important to carefully define what euthanasia and assisted suicide are so that those discussing it can be clear and knowledgeable about the subject and so participate constructively in the conversation.
Pro-euthanasia advocates commonly blur all distinctions of definitions in order to confuse the issue and then redefine it according to their objectives and agenda. In addition, it is important to know the distinction between which treatments or actions are euthanasia and assisted suicide, and those that are morally permissible.
The following definitions are an important tool for understanding the rhetoric around euthanasia and assisted suicide debates, and end of life care.
The use of euphemisms is common practice by pro-euthanasia advocates. This is done in an attempt to sanitise what is really being proposed and appeal to people’s emotions.
A clear example of this tactic is the title of New Zealand’s End of Life Choice Act.
By clouding the discussion with nice sounding words, proponents steer people’s minds away from reasoned arguments and instead appeal to the emotions.
A favourite euphemism of the moment is “assisted dying.” Assisted dying is a term those speaking against euthanasia and assisted suicide would be wise to avoid. The phrase attempts to sanitise what is really State-sanctioned suicide and the killing of another human being.
The following are some euphemisms commonly employed by euthanasia and assisted suicide advocates:
- medically assisted dying
- choice in dying
- values of autonomy
- assisted dying
- right to die
- end of life choice
- aid in dying
- mercy killing
It is important to call euthanasia and assisted suicide out for what it is – the intentional and direct killing of another human being, or assisting them to commit suicide.
Remember that verbal engineering always precedes social engineering.
Where does the word euthanasia come from?
The origin of the word euthanasia is from two Greek words “eu” (good or easy), and “thantos” (death), so “good death”. It originally meant an easy death without suffering.
A closely related Greek work “epivalothanasia (e-PIV-a-LOW-than-asia) means imposed death.
- Imposed death on the unborn is abortion.
- Imposed death on a newborn or young child is infanticide.
- Imposed death on the adult is murder.
What is euthanasia?
Euthanasia is the intentional killing by act or omission of a dependent human being for his or her alleged benefit. The key word here is intentional. If death is not intended, it is not an act of euthanasia.
What is voluntary euthanasia?
Voluntary euthanasia describes the case where the person killed had requested to be killed.
What is non-voluntary euthanasia?
Non-voluntary euthanasia is the case where the person who is killed made no request and gave no consent to be killed.
What is assisted suicide?
Assisted suicide is the case where a person assists an individual to take their own life by providing information, guidance, and/or the means for doing so. The person knows that the individual will act on the help given.
When a doctor helps a patient to kill themselves it is called Physician Assisted Suicide (PAS).
What is NOT euthanasia or assisted suicide in end of life care?
In end of life care, it is important to know what is ethically appropriate to do given the circumstances, and what is not.
It is important to remember that it is the intention of the action, or non-action which determines whether it is ethical.
Euthanasia and assisted suicide both depend on the intention to kill.
If death was not intended by what was done or not done, it is not euthanasia. Therefore, some medical actions or procedures that are often labelled passive euthanasia are not forms of euthanasia, since the intention to take life is lacking. These procedures include:
- choosing not to commence a course of treatment which would not provide any long term benefit to the patient;
- withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted;
- administering high doses of pain-killers, when these are medically necessary, even though they may shorten life.
What is meant by ordinary and extraordinary means?
When discussing end of life care options in particular situations, it is important to make distinctions between what are ordinary and extraordinary means of treatment. Treatments and care that are ordinary must never be forgone, and are morally obligatory. However, there are times, as stated above, where treatments, procedures, or care, may be overly burdensome, or futile. This is considered extraordinary means. In these situations one is not morally obliged to consent.
Ordinary means are procedures whereby hydration and nutrition (food and water), protection from elements (excessive heat and cold), rest medicines, protection from exposure, treatments which offer a reasonable hope of medical benefit and recover and which can be obtained and used without excessive pain or other inconvenience.
Extraordinary means are treatments which are gravely burdensome to the patient, and which cannot be obtained or used without excessive pain, or other inconvenience, or which if used would not offer a reasonable hope of recover to the patient. Life support or chemotherapy are such treatments, where these do not offer hope of recovery.
What does the Catholic Church teach about ordinary and extraordinary means?
The Catholic Church has always taught that it is never morally permissible to directly (intentionally) bring about one’s death, even when to relieve pain and suffering. To do so would be to go against the natural law and the Fifth Commandment, “Thou shall not kill” (Deuteronomy 5:17)
Pope Pius XII, in an address to anesthesiologists in 1957, explained the moral duty for one to be held only to ordinary means. “That is to say” he said, “means that do not involve any grave burden for oneself or another.” He pointed out that no one is obliged to undertake extraordinary means, which “would be too burdensome for most people.” Importantly, the Pontiff noted that decisions must be ordered toward attaining “the higher, more important good,” which is the spiritual.
Deciding whether particular medical treatments or procedures in individual situations are ordinary means, and therefore obligatory, or extraordinary means that can be forgone, can at times be difficult to discern.
Where uncertainty exists about the morality of any course of action in medical or end-of-life care, it is important to seek advice from others. In times of doubt, Catholic patients and their families should to turn to the Church for direction regarding the morality of any decisions made.