Legitimising state killing by assisted suicide

Simultaneous attempts to legalise assisted suicide appear to be being made in several countries in Europe. In the UK, Baroness Meacher’s private member’s Bill is due to have its second reading in the House of Lords on Friday, 22 October. The Bill would allow terminally ill persons to receive assisted dying if approved by two independent doctors and a High Court judge. The individual seeking to die would be prescribed lethal medication, which they would take themselves. An attempt to introduce similar legislation in Scotland is also ongoing. But perhaps, most significantly to demonstrate the decline of once Christian Europe, the parliamentary leaders’ conference in Rome has also announced that on 25 October the Chamber will examine a new Bill on euthanasia. The text of the proposal, adopted by the committees as the base text under the title “Refusal of medical treatment and the legality of euthanasia”, appears chilling to say the least. We asked Fabio Fuiano, President of the Students for Life in Italy, to explain the proposal and its implications, who shared the following observations on each of the articles of the Bill.

Article 1 defines the purpose of the law, which is to regulate the ability of a person “suffering from an irreversible pathology or with a terminal prognosis to request medical assistance in order to voluntarily and autonomously put an end to his life”. [emphasis added] The first logical contradiction implies that a person in the stated condition can “autonomously” end his own life, whilst however requesting “medical assistance” to this end. The doctor is therefore constrained to kill the patient (conscientious objection is not even mentioned), but the patient’s act remains “autonomous”.

The contradiction is further confirmed in Article 2, where an attempt is made at a clumsy definition of “medically assisted voluntary death” (the standard euphemism for killing a patient) as “a passing occasioned by an autonomous act with which [ …] one puts an end to one’s own life in a voluntary, dignified, and deliberate way, with the support and supervision of the SSN [Italian NHS]”. All this is envisaged to take place at taxpayers’ expense, as with abortion and in vitro fertilisation, forcing all citizens to be involuntary cooperators in what is in effect a crime.

Article 3 describes the so-called “hurdles” to be put in place for access to euthanasia, which are expected to be removed step by step by rulings of the Constitutional Court. Even as it stands, however, these expressed “conditions” are just for show. To make the request one only needs to be undergoing “physical or psychological suffering considered intolerable”. The verb “considered” indicates that the authors of the Bill intend to completely subjectivise the degree of suffering. It would be impossible to guarantee that a healthy person who “considers” himself a victim of psychological distress that (for him) is intolerable would not be killed.

The article also states that the person must be “suffering from an irreversible pathology or a terminal prognosis or one that involves an irreversible clinical condition”. But it is not clarified whether the authors of the Bill consider irreversibility something permanent, or is it subject to technological and medical progress.

Finally, it claims that such a person must be “kept alive with life-sustaining treatments”. This phrase implies that artificially administered nutrition, fluids and oxygen have the power to keep someone alive “even if he is one step away from death”. The text of this Bill thus covertly tries to classify such support as “aggressive treatment”, without ever mentioning this explicitly, by virtue of their presumed power. However, it is obvious that one can die even when this vital support is being administered.

Article 4 defines the requirements and form of the request for euthanasia. It is stated that the request can be revoked at any time by the patient “by any means suitable for making his intention known”. Since many could legitimately ask themselves how a patient in a serious condition (e.g. in a coma) can unequivocally express this intention, the article makes an awkward claim that: “In the event the patient’s condition does not allow it, the request can be expressed and documented with any suitable device that allows him to communicate and unequivocally manifest his intention”.

The authors of the Bill probably had in mind those ALS patients who are able to communicate through devices that convert eye movement into words in spite of total muscle paralysis. Nevertheless there are very many situations, completely ignored by the present text, in which the patient’s intention cannot be expressed and is therefore presumably fixed in the more or less distant past (for example through an advance treatment directive).

Article 5 defines the “modalities” of the so-called “act of passing” (a new category of human acts). Apart from everything else it is interesting to note that this law provides for the establishment of an ad hoc committee called the “Committee for clinical ethics”, which “within seven days of receiving the patient’s request must express a judgement on the existence of the conditions and requirements in support of the request for medically assisted voluntary death”. In this article we see one of the greatest contradictions of the case for euthanasia: it seems to be based on “free will”, on the patient’s self-determination, but ultimately it is the state (in this case a committee set up by the state) that decides who can and cannot access euthanasia. In fact, even if it were to define the possibility of access for X patients suffering from N diseases, there will always be a patient with another disease, not included in the legislation, seeking to exercise their “self-determination” by requesting to die. This is why euthanasia rhetoric finds itself at a crossroads: one must admit either that we are confronted with true murder by the state, which is far from the “freedom” of individuals, or that the time will come when the faculty of requesting euthanasia will be extended to all, regardless of the actual individual condition.

Paragraph 8 of article 5 deserves a special mention: it candidly explains that medically assisted death (that is, the murder of the consenting person) is in every way like passing from natural causes. We would have to reconsider all the verdicts of Nuremberg! According to this logic, the Nazi Aktion T4 was simply a “natural cause” that resulted in many deaths.

Article 7 serves to exclude any person who facilitates or cooperates in the act of euthanasia from liability according to articles 580 (incitement to suicide) and 593 (failure to provide assistance). This exclusion even has a retroactive effect for all those who have been convicted of such crimes in the past! Article 8 simply defines the “duties” of the Ministry of Health in implementing these legal provisions.

Mr Fuiano concluded that we are confronted with the definitive legitimisation of state murder, amid the general silence of those who should have tenaciously opposed it.

Where assisted dying is legal, we have seen that offering people the choice to end their lives creates pressure for them to choose death. Especially many vulnerable people, disabled and elderly, feel pressured into taking their own lives, because they do not wish to be a “burden”. Indeed, 34% of Canadians killed by assisted suicide said they feared being a burden on family and carers. In Oregon in 2020, a majority (53%) of people killed by assisted suicide cited a fear of being a “burden on family, friends/caregivers” as a reason to end their lives.[1] In Washington State in 2018, 51% of people who were killed by assisted suicide said that being a burden on family, friends and caregivers was a reason to end their lives.[2] And a third of over-50s Scots already feel they are a “burden”.

A society where the right to life at whatever stage is protected merely by choice sinks deeper and deeper into injustice that ultimately will threaten all its members. Thus moving further and further away from God, there may soon come a point where such a society itself faces an irreversible pathology, a fatal diagnosis. Recognising the value and sanctity of every human life created in the image and likeness of God is the first basic step to abandon barbarism and restore a Christian society. Let us hope that the legislators debating the bills on assisted dying and euthanasia will take this basic step.

[1] Oregon Death with Dignity Act 2020 Data Summary

[2]  2018 Death with Dignity Act Report (July 2019)