Abstract Roman Catholic healthcare institutions in the United States face a number of threats to the integrity of their missions, including the increasing religious and moral pluralism of society and the financial crisis many organizations face. These organizations in the United States often have fought fervently to avoid being obligated to provide interventions they deem intrinsically immoral, such as abortion. Such institutions no doubt have made numerous accommodations and changes in how they operate in response to the growing pluralism of our society, but they have resisted crossing certain lines and providing particular interventions deemed objectively wrong. Catholic hospitals in Belgium have responded differently to pluralism. In response to a growing diversity of moral views and to the Belgian Act of Euthanasia of 2002, Catholic hospitals in Belgium now engage in euthanasia. This essay examines a defense that has been offered of this practice of euthanasia in Catholic hospitals and argues that it is misguided.
Extract There are other flaws with Bill C-407, but this is not the place to present them in detail. However, there is one serious flaw that is appropriately considered in this forum, and that is the fact that the Bill is a partial measure at best. It deals only with assisted suicide, not euthanasia. It would not help those who, although competent, could not perform the final act themselves because they are disabled. . . .As well, the Bill ignores those who have never been competent and never will be. Their rights would still be less than those of other persons: they would be condemned to suffer when a competent person would not. An appropriately crafted suicide and euthanasia Bill would change that situation.
Kluge E-H. Assisted Suicide & Euthanasia: a Proposal for Restructuring the Criminal Code of Canada. Humanist Perspectives Online Supplement. 2005;38(4):1-5
Oswaldo Castro, Frederic A Lombardo, Victor R Gordeuk
New England Journal of Medicine
Extract Real medical care and services always respect human life. No one should be forced to collaborate in abortion (even when it is achieved through the prevention of implantation), lethal research on embryos, euthanasia, or assisted suicide.
Extract . . . In medical and legal opinion, Terri Schiavo’s cognizance of her self and her life ended in 1990, when she suffered a cardiac arrhythmia and massive cerebral cortical encephalopathy that left her in a persistent vegetative state. Her facial expressions, along with a seemingly “normal” sleep–wake cycle, constituted but one dimension of the cruelty of this condition. . .
. . .More than one commentator has viewed the “right- to-life” fight to prolong Schiavo’s pitiable existence as an anti-abortion campaign “by other means.” . . .
. . . there seems little doubt that, in North America, ideology and religion have begun to seriously distort the type of consensus-building that is the proper business of democratic politics . . .
Where do physicians find themselves in such debates? Medicine is a secular and scientific profession that, for all that, must still contend with the sacred matters of birth, life and death. In practice, physicians must set aside their own beliefs in deference to the moral autonomy of each patient — or else transfer that patient’s care to someone who can meet this secular ethic. . .
. . .The emotionalism and rancour that swirled around the Schiavo case underscores a wider societal duty borne by the medical and scientific community. This is to remain alert to political and legislative tendencies that impose imprecise moral generalizations on the majority, at the expense of reason, scientific understanding and, not infrequently, compassion.
Extract Inspired by Nazi ideology and implemented by its apostles, eugenics and euthanasia in the late 1930s and early 1940s served no social necessity and had no scientific justification. Like a poison, they ultimately contaminated all intellectual activity in Germany. But the doctors were the precursors. How can we explain their betrayal? What made them forget or eclipse the Hippocratic Oath? What gagged their conscience? What happened to their humanity?
Wiesel E. Without Conscience. N Engl J Med.. 2005 Apr 14;352(15):1511-1513.
Israeli Journal of Psychiatry and Related Sciences
Abstract Between 1939 and 1945, 180,000 psychiatric patients were killed in Nazi Germany. This paper opens with a brief discussion of the reasons for addressing this issue today; it is followed by the details of the so-called euthanasia program that entailed killing of patients by gas in special hospitals in the years 1939-1941, and in psychiatric hospitals in the years 1942-1945. In this latter period, patients were killed with lethal injections and through the introduction of a starvation diet. The fate of the Jewish patients and forced laborers, as well as the experiments conducted on the patients, are mentioned. Finally, some thoughts are presented to answer the question of why this could have happened. To me, the giving up of individual responsibility in an authoritarian system leads to the loss of the individual conscience and soul, including those of a psychiatrist.
Cranach MV. The Killing of Psychiatric Patients in Nazi-Germany between 1939-1945. Israeli J Psych & Related Sciences. 2003;40(1):8-18
A presentation by the same title with a similar abstract was presented at a meeting of the Israel Psychiatric Association, Jerusalem, 6th of December 2001.
Abstract In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to ‘‘organize” a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. . .I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed.
Extract In this article, I will first describe the argumentative way in which the major Christian churches in the Netherlands and Belgium have dealt with what they considered the challenge of the demand to legalize euthanasia in their respective countries. Given the important differences between the courses of events in both countries, the part on the interventions in the Netherlands will be considerably longer than the one on Belgium. No doubt, the most important reason for this difference is the fact that the public discussion on euthanasia together with efforts to change the penal law prohibiting it, took shape in the Netherlands already from 1968 on. Next to this, the fact that the major Christian churches in the Netherlands were not in agreement on the proper approach also contributes to a more differentiated picture. In the third part of this article, I will present some comments and a moral theological evaluation of the core of the argumentation forwarded by the Christian churches.
Extract In the first part of this article the input of palliative care organisations in the Dutch euthanasia debate is described and explained by situating it in its broader context. First opinions on euthanasia of a variety of palliative care organisations are described. Secondly the Dutch debate on palliative care and euthanasia is analysed and evaluated. In a second part of this article a brief introduction to Belgian palliative care is given. This introduction is followed by an overview of the way organised palliative care has been active in the Belgian euthanasia debate. Attention too is given to the Belgian discussion on palliative sedation, sedation being presented by some as the palliative alternative to euthanasia but seen by others as nothing but euthanasia in disguise
(Flanders Palliative Care Federation Advocates A Palliative Filter in the Euthanasia Procedure)
Bert Broeckaert
Ethische Perspectieven
Abstract Op 20 maart 2001 werd het euthanasiewetsvoorstel van de meerderheidspartijen, samen met een wetsvoorstel over palliatieve zorg, goedgekeurd door de Verenigde Commissies voor Justitie en Sociale Aangelegenheden. Op initiatief van de Senaatsvoorzitter werd het euthanasiewetsvoorstel intussen doorgestuurd naar de Raad Van State, voor een spoedadvies. In zijn advies (2 juli 2001) stelt de Raad Van State uitdrukkelijk dat het euthanasiewetsvoorstel niet in strijd is met artikel 2 van het Europees Verdrag over de Rechten van de Mens (EVRM) en artikel 6 van het Internationaal Verdrag inzake Burgerlijke en Politieke Rechten (IVBPR), artikels die handelen over het door de wet beschermde recht op leven. Wat betreft het euthanasievoorstel beperkt de Raad van State zich tot detailkritiek.
In de bespreking van het wetsvoorstel over palliatieve zorg is de toon heel anders: hier toont de Raad Van State zich bijzonder kritisch. Vragen worden onder meer gesteld bij de vaagheid van de term palliatieve zorg, bij gecontroleerde sedatie en bij de federale bevoegdheid wat betreft de palliatieve zorg. Na het zomerreces is het nu (van 23 tot 25 oktober 2001) aan de plenaire vergadering van de Senaat om zich over het euthanasiewetsvoorstel uit te spreken.
Met de onderstaande tekst (26 september 2001) wil de Federatie Palliatieve Zorg Vlaanderen haar voorstel om in de euthanasieprocedure een palliatieve filter in te bouwen nogmaals onder de aandacht van de Senatoren brengen.
[Translation] On March 20, 2001, the euthanasia bill proposed by the majority parties, along with a bill on palliative care, was approved by the United Committees on Justice and Social Affairs. At the initiative of the Senate President, the euthanasia bill has now been forwarded to the Council of State for urgent advice. In its advice (July 2, 2001), the Council of State expressly states that the euthanasia bill does not conflict with Article 2 of the European Convention on Human Rights (ECHR) and Article 6 of the International Covenant on Civil and Political Rights ( ICCPR), articles dealing with the right to life protected by law. With regard to the euthanasia proposal, the Council of State restricts itself to detailed criticism.
In the discussion of the bill on palliative care, the tone is very different: the Council of State is particularly critical here. Questions are asked about the vagueness of the term palliative care, about controlled sedation and about the federal competence with regard to palliative care. After the summer recess, it is now (from 23 to 25 October 2001) up to the plenary session of the Senate to pronounce on the euthanasia bill.
With the text below (September 26, 2001), the Federation Palliative Care Flanders wants to bring its proposal to include a palliative filter in the euthanasia procedure once again to the attention of the Senators.
