End-of-Life Choice, Palliative Care and Counseling

Dogma v Dignity

Catholic Political Operatives Follow the Bishops

As I wrote last week, Compassion & Choices welcomes the affirmation by the United States Council of Catholic Bishops (USCCB) that religious objection is the foundation of their opposition to aid in dying. The bishops’ battle against the medical practice of aid in dying has been vigorous in the past, though cloaked in secular arguments about protecting the vulnerable or promoting palliative care. The statement the USCCB adopted last week asserts “suffering accepted in love can bring us closer to the mystery of Christ’s sacrifice for the salvation of others.” It’s refreshing and important to see that theological rationale established at the forefront of political opposition to aid in dying.

Never would I intrude in another person’s expression of religious faith and belief. I have no desire to interfere with those who wish to emulate the Passion of Christ on their death bed. Thomas Lynch wrote eloquently about his mother embracing this framework for her suffering in his delightful book, The Undertaking: Life Studies from the Dismal Trade. His deeply respectful and loving description is enormously moving.

The Conference of Bishops was already clear in its opposition to aid in dying. So one wonders about the purpose of this new statement. As LifeSiteNews reported:

During a 2004 meeting of the bishops of the United States an agreement was made to sanction Catholic politicians who support abortion.  At a press conference today at the 2011 Spring General Assembly of the U.S. Conference of Catholic Bishops (USCCB), LifeSiteNews asked if those same sanctions would apply to Catholic politicians who support assisted suicide.

Cardinal Daniel DiNardo of Galveston-Houston, chairman of the USCCB Committee on Pro-Life Activities replied that the question of sanctions has not “been completely addressed internally.”  He did, however, stress that once approved, the new policy statement on assisted suicide – which is to be voted on by the bishops Thursday – would be made known in the public square, “and the political square as well.”

As soon as the Bishops voted, lower level operatives went to work in “the political square.” It got personal. “AID IN DYING” CROWD LOVES ABORTION wrote Catholic League president Bill Donohue, characterizing our supporters as “those who delight in helping people die,” and slandering some – by name – with epithets like “gay phenom” and “notorious.” No facts accompanied these accusations. Donohue falsely calls me “a champion of abortion rights,” when I’ve taken no public position on access to abortion. I can think of no reason to link me and other aid-in-dying supporters to abortion except to tap into a ready-made pool of anger, hate and violence.

The policy statement itself claims, “Leaders of the ‘aid in dying’ movement in our country have also voiced support for ending the lives of people who never asked for death, whose lives they see as meaningless or as a costly burden on the community.”

This kind of reckless, unsubstantiated accusation, and demagogic attacks on the character and loyalty of political adversaries is what we call McCarthyism. If it alarms you to see the Catholic Bishops playing this kind of slanderous hardball, consider what happened next.

Five days after the bishops spoke, Patrick Reilly, in Crisis Magazine, named five aid-in-dying sympathizers within the Church: theologians, bioethicists and law professors on the faculty at Jesuit universities. Because their views conflict with the bishops’ on end-of-life choice, Reilly says “they violate the mission of a Catholic university” and recommends censorship. Do such accusations of impurity in thought not echo our nation’s darkest history of blacklisting intellectuals? Will tenure track interviewers soon inquire, “Are you now, or have you ever been, a member of any organization that supports aid in dying?”

Many religious scholars believe Catholic teaching derives not only from the Bishops, but also from the wisdom of the faithful (sensus fidelium), and the wisdom of theologians. “Real people bear both the grace and the burden of thinking,” wrote John J. Hardt in America, The National Catholic Weekly, “as the church does about the meaning of living and dying.” Or as Lisa Fullam has written in Commonweal Magazine,

[O]ur tradition has been enlivened time and time again by dissenters who voiced positions in tension with that of current magisterial teaching. I’m not referring to mere cranks, but informed and faithful dissent which serves to call the Church to reexamine itself on matters of importance.

Dismissing all dissent within the Church as immature and unbalanced hardly contributes to our reputation as a tradition of fearless inquiry. Rather, we are seen as people who think in mindless lockstep. Why should people outside the Church engage in dialogue with a magisterium which disallows dialogue and respectful disagreement internally?

Some, however, see such dissent as disloyalty. Mr. Reilly, whose Crisis article named names, is president of the Cardinal Newman Society, “a national organization to advocate and support the renewal of genuine Catholic higher education.” “Genuine” I gather means “without dissent.”

Unsubstantiated character assassination. Lists of disloyalists. These are the tactics that in the ‘50s led Americans to wonder, as Army attorney Joseph Welch asked aloud of Joe McCarthy, “Have you no sense of decency, sir? At long last, have you left no sense of decency?”

Dogma vs. Dignity

Compassion & Choices works to improve care and expand choice at the end of life. We dream of a time when all can live and die as free people — in dignity according to their own values and beliefs.

It’s an interesting circumstance that the United States Conference of Catholic Bishops (USCCB) met in Washington to adopt its first formal teaching on life-ending medication as an end-of-life choice. While this is a new attack, the Catholic hierarchy has a long, well-documented history of opposition to patient autonomy at the end of life. In 2008 Washington citizens passed a Death with Dignity Act by large margins. The Catholic Church’s political arms were principal funders of the opposing campaign. Support for aid in dying is strong in every corner of the state, and Compassion & Choices of Washington is a highly respected partner with healthcare providers, churches and other institutions to improve end-of-life care, increase hospice utilization, and ensure access to and compliance with the Death with Dignity Act.

We are proponents of comprehensive end-of-life choices and defend our advocacy as compassionate, moral and just. Most Americans believe a mentally competent, terminally ill person should be able to obtain medication for peaceful dying from their physician. The Gallup organization has polled this question since 1947 and never found less than a solid majority in favor. Like the bishops meeting in Seattle today, we oppose assisting suicides, because suicide is the self-destructive impulse of a mentally ill person. Assisting a suicide is a felony in Washington and Oregon, and the Oregon legislature is expanding that felony to include mailing suicide kits into the state. A bright and wide line separates the crime of assisting a suicide from the medical practice of aid in dying. Blurring that line, or pretending it doesn’t exist, does a tremendous disservice to terminally ill patients and to a society struggling to perfect end-of-life care.

The Catholic Conference’s battle against the medical practice of aid in dying has been vigorous, and it promotes an error of logic by lumping it together with the crime. Their position is not new, but we welcome – and are deeply grateful for – today’s clarity and affirmation that religious objection is the foundation of opposition to the medical practice of aid in dying.

In 1994 Oregon’s then-Archbishop Levada was the first and most vocal opponent of the Oregon movement for Death with Dignity, and everyone understood opposition arose from a particular set of religious beliefs. In subsequent campaigns, religious arguments faded into the background. From 1995 – 2011 opponents concentrated on secular arguments. But 14 years of practice, volumes of medical research and diligent state oversight in Oregon and Washington have disproven every secular argument. No credible claim remains that aid in dying compromises end-of-life care, weakens hospices, threatens people with disabilities, discriminates against women, elders or vulnerable populations, or in fact harms anyone. So we are back to 1994. Only the arguments based on religious teaching remain intact, and the USCCB reinforces those teachings today.

We respect the role of the Conference of Bishops in affirming Catholic doctrine and guiding those of the Catholic faith. But we cannot accept that the instruction of one religious authority would overrule the most personal decisions of individuals of every faith; not in a religiously diverse society. The choice of how to address suffering in a terminal illness must be the province of dying individuals themselves in consultation with their doctors, families, clergy and conscience. Our government has no place policing religious doctrine at the bedside of dying Americans.

The hierarchy of the Catholic Church uses its political and lobbying force across this nation to shape the law, limit patient choice and impose its teachings on all Americans. This year they led the campaign to overturn the Montana Supreme Court’s decision affirming aid in dying for terminally ill Montanans. The policy statements adopted here by the bishops have practical consequences for every American. Their teachings govern Catholic healthcare providers and restrict the choices of all patients – Catholic or non-Catholic – who purchase Catholic health plans or enter Catholic institutions.

The Conference makes special note of the words in the name of our organization, which reflect our values. I’d like to set the record straight.

The Conference’s statements say our compassion focuses on eliminating patients, not suffering. No, our compassion focuses on providing comfort and peace of mind to individuals who fear they will suffer unbearably in their dying. Comfort and peace of mind come from obtaining, or knowing they could obtain, medication to bring about a peaceful death. Patients need not ingest the medication to achieve peace of mind. Every year, one in six dying Oregonians inquires about the Death with Dignity law. Only one in one-thousand die under its provisions. Few use the law, but many are comforted by it. The purpose of prescriptions written under the law is to provide comfort.

The Conference’s statements also say Death with Dignity laws restrict choice. This claim defies logic. Simply adding a healthcare choice in no way pressures people to exercise that choice. People feel comforted, not pressured; and safeguards in the law guarantee it remains this way.

Human choice – the right to make important life decisions – is a part of the liberty and dignity that follow us all our lives, to our deaths. The government in a civilized society, one that protects religious freedom, owes its people no less than that liberty and dignity.


Take Action: Sign our Open Letter to the U.S. Conference of Catholic Bishops now, and affirm your personal belief that no one – and no institution – should have the power to dictate your choice at the end of your life. www.CompassionAndChoices.org/openletter