Assisted suicide — calling evil “good”

In his play Good, C P Taylor tells the fictional tale of John Halder, a professor of literature in 1930s Germany.1 Weighed down by domestic responsibilities, especially the demands of caring for his elderly, bedridden mother, Harder writes a novel about euthanasia that brings him to the attention of the Nazi government. The action then follows Halder’s gradual descent into the culture of death — from cooperation to complicity and finally active participation in crimes against humanity. Taylor’s point is that at each step of the way, Halder’s motives are good — his road to Hell is paved with good intentions. 

While variations on this proverb are often rendered along the lines of “the road to Hell is paved with the skulls of bishops”, its attribution to one or other of the Church Fathers appears to be apocryphal. Nevertheless, its current popularity may reflect the level of concern with which the laity views the leadership of the Church. The recent remarks of the President of the Pontificia Accademia per la Vita (PAV), on assisted suicide will only deepen such concerns. On 19 April 2023, during a discussion on “the last journey” (towards the end of life) at the Perugia Journalism Festival, Archbishop Vincenzo Paglia was reported to say:

“In this context, it cannot be ruled out that in our society a legal mediation is practicable that would allow assistance to suicide under the conditions specified by Sentence 242/2019 of the Constitutional Court: the person must be “kept alive by life-support treatments and affected by an irreversible pathology, source of physical and psychological suffering that they consider intolerable, but is fully capable of making free and conscious decisions”… Personally, I would not perform suicide assistance, but I understand that legal mediation may be the greatest common good actually possible in our present living conditions”.2

The reaction to the comments was predictable. While the front page of the left-wing Italian daily, Il Reformista, proclaimed: ”Bishop Paglia is open to the assisted suicide law”, faithful Catholics and the pro-life movement expressed their anger and dismay that the President of the Pontifical Academy for Life had, once again, undermined the magisterium on the inviolability of innocent life.3 Almost immediately the PAV issued a statement explaining that Archbishop Paglia rejects assisted suicide in a moral sense but supports its decriminalisation.4 There are two critical problems with this position.

While a case can be made for lifting the threat of criminal prosecution from people who have survived a suicide attempt, there is evidence that criminalisation of suicide in very highly developed countries, such as Italy, is associated with lower suicide rates, particularly in men.5,6 On the other hand, removing criminal penalties for helping another person take his or her life would effectively legitimise it. Laws against homicide deter murder primarily by the threat of criminal prosecution and punishment upon conviction. But when prosecution becomes an empty threat, the deterrent effect disappears. Euthanasia was widely established in the Netherlands long before it was finally legalised in 2001 because the courts refused to impose the penalties set out in Article 293 of the Dutch criminal code. Although decriminalisation is presented as less radical than outright legalisation, it “hides profound social and political processes that usually precede juridical reform”.7

The second, and arguably even more disturbing aspect of Archbishop Paglia’s defence of his remarks is the apparent belief that law can be separated from morality. This positivist understanding of the law is the antithesis of the natural law philosophy on which the Church’s moral teaching is founded. The principle that an unjust law is not truly a law was recognised by pre-Christian thinkers such as Cicero (104–43 BC) but was restated by St Augustine and then by St Thomas Aquinas. It has remained central to Catholic teaching ever since. Archbishop Paglia’s suggestion that the decriminalisation of assisted suicide “may be the greatest common good actually possible in our present living conditions” is a direct contradiction of the Catholic understanding of God and Creation. 

According to St Thomas, existence is the fundamental good, so fundamental that he regards the two terms as virtually interchangeable. Existence, however, precedes the good, a point highlighted in Exodus 3:14 when God identifies Himself with existence — “He who is”.8 Later in Exodus, the negation of the good of existence through the killing of the innocent is prohibited by the Fifth Commandment.9 Of course, this injunction applies even to our own lives. This is why St Thomas places the duty to preserve human life as the first of his five precepts.10

In modern legal terms, this duty is also recognised in its corollary as the right to life, the fundamental and inalienable human right. This right, like freedom from slavery, is such an integral aspect of human dignity that it cannot be renounced. The decriminalisation of the killing of certain human beings even with their consent means that the protection of life provided by the law is no longer unconditional. Contrary to Archbishop Paglia’s claims, the decriminalisation of assisted suicide is not a common good but an evil that degrades us all. His comments will, however, send the message that the Church is no longer prepared to resist the advance of the culture of death, further demoralising Catholic politicians.

Just three weeks after Archbishop Paglia backed decriminalisation, the governing Council in the Veneto Region of Italy voted to guarantee “help” to die for anyone who requested it. Perhaps the most depressing feature of this episode was the near-total collapse of opposition. The initiative passed by 32 votes with two against and six abstentions.11

Then, on 12 May, the Portuguese Parliament passed a Bill to introduce assisted suicide. It was the fifth time the measure had been approved, but this time, it won sufficient support (129 votes to 81) to override the veto of conservative President Marcelo Rebelo de Sousa. Ironically, the Portuguese Communist Party (PCP) opposed the Bill. In a statement, the Party leader Paulo Raimundo said:

“Individual autonomy is something that must be respected, but an organised society is not a mere sum of individual autonomies. One cannot assume a legislative option on people’s life and death without taking into account the circumstances and social consequences of that option…

“The Portuguese State cannot continue to deny many of its citizens the health care they need, particularly in times of greatest suffering. The creation of a palliative care network with a universal character must be an absolute priority. Nobody understands euthanasia as a substitute for palliative care and for the PCP there is an issue that is unavoidable: a country should not create legal instruments to anticipate death and help die when it does not guarantee material conditions to help live.”12

Sadly, Raimundo’s remarks express greater moral insight regarding the evil of assisted suicide than those of the President of the PAV. Experience — especially the experience of Nazi Germany — shows that, regardless of the motivation, once legalised killing is introduced, it cannot be contained and will lead to the deaths of thousands of people. This is a danger that even secular commentators can understand. But for Catholics, the deliberate killing of even one innocent individual is evil in itself regardless of the potential consequences.

In response to events in Portugal, Pope Francis said, “I am very sad today. It is another step on the long list of countries with euthanasia,” which he described as “a grave sin against the sacredness of life.” And yet, Francis is responsible for the direction taken by the PAV following its restructuring in 2017 under Archbishop Paglia’s leadership. Since then, its members were no longer required to adhere to Catholic teaching on the sanctity of human life. On 28 April, the John Paul II Academy for Life and the Family, established to continue the legacy of the late Pope’s teaching, issued an open letter calling for Archbishop Paglia to be dismissed.

“In order to avoid complicity and in the light of the above absence of an unequivocal correction and apology for this scandalous betrayal of vulnerable patients, the remaining pro-life members of the PAV must ask Pope Francis to dismiss Archbishop Paglia, replacing him with a President who, with courage, unequivocally proclaims the perennial teachings of the Church and Saint John Paul both on life and on its legal protection.

“Failing this, these pro-life members should themselves resign from this discredited Vatican institution.”13

There is of course little likelihood that this will happen but, while he allows Paglia to remain, the Pope’s professions of sadness as the world descends deeper into the culture of death will seem little more than crocodile tears. 


  1. Cecil Philip Taylor, (1929–81), Good: A Tragedy. First staged by the Royal Shakespeare Company in 1981. It has recently seen a revival in the London West End.
  2. Tommaso Scandroglio, “Assisted suicide: Paglia’s OK destroys Magisterium”, New Daily Compass, 23 April 2023. https://newdailycompass.com/en/assisted-suicide-paglias-ok-destroys-magisterium#.ZEZNw9XufH8.twitter
  3. See: “Pontifical Academy attacks Catholic doctrine on human life”, Voice of the Family, 7 September 2022. https://voiceofthefamily.com/pontifical-academy-attacks-catholic-doctrine-on-human-life/ 
  4. “End-of-Life. Statement of the Pontifical Academy for Life”, 24 April 2023. https://www.academyforlife.va/content/pav/en/news/2023/paglia-end-of-life-statement.html
  5. Kevin Chien-Chang Wu et al, “Criminalisation of suicide and suicide rates: an ecological study of 171 countries in the world”, BMJ Open 2022,12, p 4.
  6. The association is even stronger with regard to weekly religious observance and lower rates of divorce. See Steven Stack “Religion and Suicide: A Reanalysis”, (1980) Social Psychiatry 15, 65–70 and “Regularly attending religious services associated with lower risk of deaths of despair”, Harvard — TH Chan School of Public Health, 6 May 2020. https://www.hsph.harvard.edu/news/press-releases/regularly-attending-religious-services-associated-with-lower-risk-of-deaths-of-despair/
  7. Justus Uitermark and Peter Cohen, “Decriminalisation: A short description, and the social process behind it” in Encyclopaedia of Law and Society (Sage, 2005). See http://www.cedro-uva.org/lib/uitermark.decriminalisation.html 
  8. “God said to Moses: I AM WHO AM. He said: Thus shalt thou say to the children of Israel: HE WHO IS, hath sent me to you.”
  9. Exodus 20:13.
  10. For St Thomas, a principle is a source or starting point while a precept is a rule that must be followed. He considers the following to be primary precepts required for our actions to accord with our human nature: 1. Self-preservation/preservation of the innocent; 2. Continuation of the species through reproduction; 3. Education of children; 4. To live in society; 5. To worship God.
  11. Paolo Gulisano, “Fine vita, così il Veneto tradisce elettori e malati” in La Nuova Bussola Quotidiana, 8 Mai 2023 https://lanuovabq.it/it/fine-vita-cosi-il-veneto-tradisce-elettori-e-malati
  12. Michael Cook, “Portugal on the brink of legalising euthanasia” in Bioedge, 16 May 2023. https://bioedge.org/end-of-life-issues/portugal-on-the-brink-of-legalizing-euthanasia/
  13. John Paul II Academy for Life and the Family, “AN OPEN LETTER to His Excellency, The Most Reverend Archbishop Vincenzo Paglia, President of the Pontifical Academy for Life and Members of the Pontifical Academy for Life”, 28 April 2023. https://www.jahlf.org/english-he-who-is-silent-is-taken-to-agree/