Cardinal O’Malley: We Can Win the Fight Against Euthanasia

An interview with the archbishop of Boston.

Cardinal Sean O’Malley of Boston is leading a statewide fight to defeat the Death With Dignity Act, a November 2012 ballot measure that would legalize assisted suicide in Massachusetts.

He has outlined the Church’s underlying moral concerns regarding the threat to human dignity and patients' rights posed by assisted suicide in a video homily broadcast at Boston-area Catholic churches. He's also writing a series of columns critiquing the measure, and he has worked with the Massachusetts Catholic Conference to form the Committee Against Physician-Assisted Suicide, a coalition that includes religious, medical and disability groups across the state.

During the final weeks before the November election, the Committee Against Physician-Assisted Suicide will direct a voter-education campaign on television and radio, participating in media debates and funding ads highlighting key concerns. In 2011, the conference released “To Live Each Day With Dignity: A Statement on Assisted Suicide.” In 2000, while serving as the bishop of Fall River, Mass., he issued a pastoral letter on euthanasia titled “For the Love of Life.”

In his interview with Register senior editor Joan Frawley Desmond, he says the Church and its allies in the Committee Against Physician-Assisted Suicide can win this fight, and he asks for financial support during the final weeks before the election.

 

Over the past nine months, you have made the defeat of the Massachusetts ballot measure endorsing the Death With Dignity Act a central mission. What is the goal of that measure, and who is behind it?

The legislation provides that if someone has been diagnosed with just six months to live they can request a lethal drug to end their life.

This group behind the ballot measure is Compassion & Choices, a reincarnation of the Hemlock Society. They got the signatures, and it will be on the ballot in November. They hope to replicate the process that got a similar measure passed in Washington, where it appeared on the 2008 presidential ballot. Massachusetts is a very liberal state and [Compassion & Choices] believes that it might prevail.

 

Have there been high-profile stories about Massachusetts residents who have terminal cancer and have been prevented from ending their suffering through assisted suicide?

When you look at what they are driving at, it’s not so much about pain management, but control and autonomy to end their life.

A campaign-strategy group [for the state coalition opposing the measure, the Committee Against Physician-Assisted Suicide] has done some polling and focus groups to look at voter attitudes about this issue. Their findings are that the majority of people favor this legislation, and most consider themselves secular.

This indicates that it will be an uphill battle, and we know from Oregon [which legalized assisted suicide in 1997] and Washington that the other side will spend millions of dollars in advertising.

Our message is a powerful one, and we’ve argued that the legislation is very flawed. If people help us with the advertising costs, we have a chance to prevail, but it will be an uphill battle.

 

What are your primary concerns about the ballot measure?

This is an encroachment of the culture of death [which contends]: “The autonomous self needs to be in control of every moment of our lives, and if we aren’t in control, the quality of life is such that we would be better off dead.”

Instead of taking care of the terminally ill, we are helping them in a moment when they are most vulnerable to commit suicide. This strikes at the heart of the kind of compassion and mercy that the Church is supposed to be about. The sacredness of human life is cheapened by this kind of behavior.

This sends a terrible message to people in the disability community, and they stand opposed to this with us.

 

Right now, the polls in Massachusetts reflect support for assisted suicide. What is your strategy for reversing that trend?

There are two approaches.

One is a catechesis of our own people by deepening their understanding of Gospel values, the moral teaching of the Church and how precious life is.

When we deal with the larger society, we look for allies with whom we can initiate a dialogue about our values and the sacredness of human life.

Some Jewish groups have joined the coalition opposing assisted suicide. They recognized that if they don’t speak up now, in two months, it will be all over. It’s worth remembering that Hitler used the terminology “mercy killing,” and that brought him into conflict with the Church. He was euthanizing mentally impaired children. You can see why people in the disability community are connecting the dots.

 

What other concerns have been raised about the proposed Death With Dignity Act?

Patients who have been told they have six months or less to live would be able to obtain a prescription for a lethal dose. But physicians who oppose this [ballot initiative] note that it can be hard to predict how long a person is going to live.

There was an interesting column in the Boston Globe with the headline “Kevorkian Is Coming to Town.” The article cited the example of Sen. Edward Kennedy, who was told he would live two to four months, but actually lived with his family and as a legislator for 15 months.

Psychiatric studies indicate that about half of the people dying of cancer become clinically depressed, and depression can lead to suicide. The legislation before the voters in Massachusetts makes no provisions for any kind of psychiatric or psychological evaluation for patients to see if they are in the grip of depression when they ask for this lethal drug.

Further, family members can be witnesses, even though they may be heirs. During a period of heightened concern about elder abuse, which is usually perpetrated by a spouse or children, this proposed law puts people at risk.

Take a look at the website for our state coalition, the Committee Against Physician-Assisted Suicide. It points out the flaws in this legislation and provides an opportunity for people to support our efforts. We are going to have to spend millions of dollars on this message; the other side is expected to spend $4 million-$5 million on advertising to get the message out.

 

Beyond the Church, what other groups oppose this measure?

We have people from the hospice community, a number of Jewish rabbis, and we are counting on orthodox Christians and on black ministers. Our coalition includes many medical groups: The Massachusetts Medical Society took a vote opposing physician-assisted suicide.

 

Why does this measure have support right now?

They talk about pain and expense, but when push comes to shove, they admit that modern medicine can in most instances control the pain and that, really, they just want to control their life.

Unfortunately, people misunderstand the Church’s view on care for the terminally ill. The Church does not say that you must keep people alive by any means; we don’t believe in keeping people alive when they really are dying. But assisted suicide is quite different: This person is dying, so give them poison.

 

What have we learned about the moral or cultural impact of assisted suicide in countries like Holland, where it has received tacit approval since the 1980s and was codified into law in 2002, and U.S. states like Oregon, where the practice was legalized in 1997?

On April 3, The New York Times reported on the latest development on assisted suicide in Holland. It calls for teams to go out to euthanize people. The service would be provided for anyone over 70 years old, irrespective of their physical condition.

I know Americans think it wouldn’t happen here. But doctors in Oregon tell us that now there is a push to force physicians who don’t want to participate to make referrals.

In Oregon, they have a higher rate of suicide overall. Of course, they will say it has nothing to do with the assisted-suicide law. But how can you oppose suicide at the same time that you are providing lethal drugs to the terminally ill?

In these days, when conscience protections are disappearing, how about the pharmacist who is asked to fill a prescription for a lethal dose for a cancer patient? What is he or she supposed to do?

 

You have noted that legalizing assisted suicide made families complicit in the decision to help a terminally ill person commit suicide. So guilt is added to their grief at the death of a loved one?

We can only imagine how horrible the situation must be. I read an article by a physician in Britain, where this issue has also been debated. He wanted to better understand the impact of legalized assisted suicide and went to investigate the situation in Oregon. He learned about the case of one patient who was helped to commit suicide. One of his family members subsequently committed suicide ... so distraught by this process.

Once you legalize this choice, it puts pressure on the terminally ill to make that choice. They begin to think, I’m a burden on my family, and I’m using up their resources; so if this is permitted, I should end my life and save my family this grief.

At the same time, legalizing assisted suicide also suggests that the terminally ill can’t or shouldn’t depend on others.

In our culture, the mentality of complete autonomy is so mistaken. The truth is that we are very dependent on each other, at the beginning and the end of life in particular. We need other human beings to take care of us. And at different points in our life, we are called upon to be the caretaker. That interdependence is part of being a human being. This whole notion of compete autonomy reflects the extreme individualism of our culture.

 

That hyper-individualism is reflected in the embrace of abortion rights and the decline of marriage, seen by some as a social institution that constrains individual choices.

“It’s my body; the institution of marriage doesn’t fit my needs; I want marriage to be redefined”: It’s the culture of death.

Communio is life-giving. Working for the common good is what our mission should be. The rabbis that signed the letter [opposing legalizing assisted suicide] wrote that, for Jews, life is a gift from God; we can’t give it back, and we can’t destroy it. It’s good.

Hopefully, people will see that true compassion and mercy are about protecting life when it is most vulnerable, as Mother Teresa did in the slums of Kolkata, so they can die surrounded by love. That is our mission: not to kill people and allow this kind of unethical practice.

 

Reportedly, the hospice movement, at least in some U.S. states, is shifting to a neutral position on efforts to legalize assisted suicide.

Nationally, the hospice movement is on record as opposed to assisted suicide. They have been supportive of our efforts in Massachusetts.

We want to point out to people that our efforts should be directed to improving care for terminally ill patients with pain management and palliative care. This kind of legislation is a terrible distraction from making those improvements

 

Are you concerned about the law’s impact on the practice of medicine at the end of life?

The law compromises the role of physicians. The medical profession is pledged to protect life and directed to “do no harm.” It’s significant that the Hippocratic Oath mentions specifically that a doctor cannot give lethal drugs to a patient, even if they request it.

Assisted suicide changes the whole nature of medicine. But in Holland they are proposing that medical schools do a better job of killing people. It could provoke a crisis in the medical profession.

 

In the debate leading up to the passage of the Affordable Care Act, there were strong concerns about so-called death panels being used to ration care to the elderly and other vulnerable groups.

All the more reason to oppose a practice that makes it possible to end a person’s life.

A lot of people feel as though this could never happen here. But if you legalize suicide and make it part of medical practice, then you are opening the door for these nightmarish scenarios.

 

Individualism may be driving the push for full control over every part of life, including death, but is secularism also playing a role?

Individualism and secularism go hand in hand.

Our faith calls us to be in relationship with God, our family, society and creation, whereas secularism is much more a pact between individuals who can be seen in competition and conflict with each other.

We have to strive to evangelize the culture. It means a profound conversion of our own people and a deeper understanding of the Gospel message. There should be a greater consistency in the way we live our faith, so that we can fully reflect our values in our day-to-day lives.