End of Life

End of Life

In today’s society, the end of life is seen by many as a time of prolonged suffering that must be shortened as much as possible, without waiting for natural death to occur. Why suffer, if the physical and emotional suffering serves no purpose and has no meaning?

For Christians, on the contrary, the end of life—including the associated suffering—is considered a privileged time during which God wants to fill us with his love.

Indeed, there are many who witness to the blessings this time of life can bring if people accept their own vulnerability, whether they are sick or caregivers. Facing the end of life, a Catholic will ask the following questions: Which forms of end-of-life accompaniment does the Catholic Church recommend? What should I think of euthanasia and assisted suicide?

 

Born of the mystery of Redemption in the Cross of Christ, the Church has to try to meet man in a special way on the path of his suffering.
(Salvifici doloris, 3)

 

Nobody wants to suffer or see his loved ones suffer. Also, news of the illness or death of a friend or family member often surprises us, which brings us to ask serious questions: Why did this person leave us so suddenly? Why so young? Why so much suffering? Where is God in all this? How to go through so much pain and suffering without becoming insane?

These questions offer many opportunities—as long as one tries to answer them— to understand a bit better the mystery of suffering, the Christian meaning of death and life.

Suffering refers to the mystery of the created human being

A vast majority of healthy people forget an essential truth: they have received everything from God! So, illness and suffering force them to admit that they received their life and existence as a gift. But from whom? Christians answer that their life and existence is a gift from God; nobody ever gave himself life, which is a free gift from God, a gift from His unconditional Love for every human being. Such is the great mystery to discover, or meditate on; Christians have known this truth since the first day of their conversion.

God wants to become known and recognized by every human being as the creating and original Love, in order to restore a very intimate relationship with Him.

The original sin: to create one’s own happiness, without reference to God

The original mistake is to “cut” the bridges—the relationship—between God and us, rejecting the fact that our life is not our own creation and comes from Him.

The original mistake is to want to create our own happiness according to our own wishes and preferences, while denying that this happiness depends in any way from God.

The original mistake is to think that, far from making us happy, believing in Him, entrusting our life to Him, going along with His Project for us, will rather make us unhappy and make each of us a puppet that God would use for His own interests.

Rebuilding the bridges

It is this original mistake that estranged God’s creatures from Him. It is this original mistake that broke the love relationship between God and each of His creatures. Because God-Is-Love, He did not accept that this breakup of the relationship should persist; in His infinite mercy, He decided to repair it, restore it—for eternity this time.

It was to achieve this mission that God gave us his only-begotten Son, Jesus Christ.

Through His entire life, His words and miracles, all His acts of love, His passion, death and resurrection, Jesus was the only One who could rebuild the bridges between God and us, to “restore the Covenant” between God and human beings.

By offering us His only-begotten Son, God wanted both to have us rediscover His infinite Love and to give us back the possibility of living it out concretely, even now and for Eternity.

Love as access code to the mystery of suffering

 

Love is also the richest source of the meaning of suffering, which always remains a mystery […]. Christ causes us to enter into the mystery and to discover the "why" of suffering, as far as we are capable of grasping the sublimity of divine love. (SD 13)

 

Saint John Paul II liked to repeat, quoting Gaudium et Spes (a document of the Council) that “Through Christ and in Christ, the riddles of sorrow and death grow meaningful. Apart from His Gospel, they overwhelm us.” (GS 22, 6)

Taking our burdens upon Himself

Christ did not come to suppress suffering, but to take it upon Himself to give it a meaning (God’s love that saves through it) and to help us carry our own (in and by love).
Photo No attribution required 8 or 15

 

Come to me, all you that are weary and are carrying heavy burdens, and I will give you rest. Take my yoke upon you, and learn from me; for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light. (Mt 11:28-30)

 

Evangelization through suffering

When our sufferings are borne through love, united to the love of Jesus, they assume an infinite divine value in the spiritual realm. When we unite them to those of Jesus Christ, our sufferings can thus help rebuild the bridges—the saving relationship—between God and countless people awaiting salvation (redemption). Our offered sufferings, through the mystery of our cooperation with God’s work of salvation, thus contribute to their discovering human and spiritual happiness.

Our suffering, whatever it is, can therefore evangelize the world if we offer it to the Father in Jesus, through the Spirit. Yes, evil—in us—can bring good, in God!

For almighty God. . ., because he is supremely good, would never allow any evil whatsoever to exist in his works if he were not so all-powerful and good as to cause good to emerge from evil itself. (Catechism § 311)

Resources:

Approaching Death in the Company of Christ (Assembly of Quebec Catholic Bishops - AÉCQ)
End-of-Life Care in the Light of God’s Word (A Journey of Reflection in Five Steps -AÉCQ)
Living, Suffering and Dying… what for? (Catholic Organization for Life and Family)
Evangelium Vitae (The Gospel of Life) – Encyclical Letter
Talking with Kids and Teens about Dying and Death

Since the end of life is not discussed before one is confronted with it personally or through loved ones, it is normal to often feel helpless when the time comes to face it.

Of course, our first concern then consists of seeking to alleviate the suffering of the sick person, whether it is a family member, a friend or ourselves. We are quite right not to seek suffering for itself as an end in itself.

Some people, when confronted with (great) end-of-life suffering (their own or someone else’s), will spontaneously think about euthanasia or assisted suicide as the best (quick and effective) solution to put an end to the pain.

Do they know that there is another option to alleviate pain? This option, still too little known, is palliative care, which all Quebecers and Canadians can access (after some administrative procedures).

Also, do these people know that Montreal residents can benefit from rich and vast expertise in palliative care?

What is palliative care?

Palliative care addresses the physical, psychological, social and spiritual needs of the patients (and family members) who face a disease that will soon put an end to their life.

This approach relies on the expertise of different health care professionals and is intended to improve the quality of life of the sick at the end of their lives. It focuses on the prevention and alleviation of suffering, pain and other difficulties these sick people may face.

Death is natural

This comfort care perceives death as a normal and natural process. Therefore, it neither hastens nor delays it.

The sick person’s dignity

Palliative care believes that the inherent dignity of the patient—who is a human person—must always be respected, especially when he/she suffers, is vulnerable, frail, and is losing autonomy.

Palliative care offers the patient at the end of life the opportunity to live unique and (very) precious moments with himself, his family and loved ones, in an environment specially designed to this end. Palliative care seeks to uphold the integral respect of the inalienable dignity of the patient until the very end, by means of physical, psychological, social and spiritual care given by qualified and loving people.

Listen to Archbishop Lépine talking about dignity (bilingual):

 

 

Each person is unique

Palliative care respects both the sacred character of life and the particular values, beliefs and spirituality of the sick person. This approach is based on listening, peace and deep compassion, both for the patient and his family members. The latter, who prepare for the loss of a loved one, also need to benefit from attention, listening and caring to help them through this journey.

Brightening the sick person’s life

The involvement of family and friends helps humanize palliative care even more during this last stage of life. All share the same goal: to brighten the sick person’s life, one day at a time, until the last one.

Dying with dignity: a misused and faulty expression

The primary meaning of the word dignity has been distorted by the proponents of physician-assisted dying and assisted suicide, two forms of euthanasia that are considered to be incompatible with human dignity as defined by the Catholic Church.

Human dignity, for the Church and many schools of philosophy, is the inherent, intrinsic (= inner) value of each human being, which is equal for all and flows from the simple fact of existing. Nothing can suppress or diminish a person’s dignity, whether it be the person’s life situation, good or bad actions, or problems of health or autonomy. In other words, a person at the end of life is NEVER without dignity (as such) just because he/she is sick and impaired.

However, the look cast on another person (or ourselves) can respect this dignity or not, without ever destroying or diminishing it (in itself). Similarly, our actions toward another person may or may not be in accordance with that person’s dignity.

The expression dying with dignity is inaccurate and an abuse of language, in that it would suggest that a person at the end of life has partially or totally lost his/her inherent dignity merely because he/she is severely impaired, depends on others for his/her hygiene and care, etc. No one becomes unworthy at the end of life merely because he/she is severely impaired.

Dying with dignity, for the proponents of euthanasia, amounts to regaining one’s dignity that was lost (because of illness and its various effects) by deciding for oneself the moment and means of one’s death, thus refusing the suffering and deterioration caused by natural death (as well as the care others would have to offer). Again, this expression is inaccurate and is an abuse of language.

Every person keeps his/her inherent dignity when dying, regardless of the manner of death. However, the people who monitor this natural death have the duty to do everything possible for the dignity of the dying person to be respected until the last second.

To better understand palliative care:

Websites
Pontifical Academy for Life - Respect of the Dignity of the Dying
Canadian Virtual Hospice
Canadian Hospice Palliative Care Association

Videos
Do not waste your Deah - Rose DeAngelis - Evening of reflection on euthanasia and end of life
Dr. Balfour Mount, father of palliative care - Making Healing Connections
Dr. Balfour Mount, father of pallicative care - Living as if Everything is a Miracle
Dr. Balfour Mount, father of pallicative care - Death Anxiety and Finding a Healing Path
Salt + Light TV – Toward a Comprehensive Pan-Canadian Palliative Care Strategy

What the Catholic Church teaches about palliative care:

Palliative Care from a Catholic Moral Perspective
Letter to the Pontifical Academy for Life
Characteristics of the PAL-LIFE project (Pontifical Academy of Life)
Approaching Death in the Company of Christ (AECQ)

Resources:

Palliative Care Residences
The Lighthouse – Children and Families

Discussions on euthanasia and assisted suicide always inflame passions. This is absolutely normal: they elicit our greatest fears (such as the fear of suffering and dying), our compassion, our desire to alleviate the suffering of our loved ones, as well as our concerns about respecting the dignity of people at the end of their lives, including their quality of life.

These passionate debates are necessary, given what is at stake.

For many Canadians, including Quebecers, euthanasia and assisted suicide (which is not practiced in Quebec), known in Canada as “physician-assisted dying,” seem to be ways of taking into account both the dignity of suffering people who want to put an end to their suffering and the compassion of the caregivers, who want to see an end to the suffering of their loved ones.

Let us clarify the meaning of words

Physician-assisted dying (according to the Act Respecting End-of-Life Care)
Care consisting of the administration, by a physician, of medications or substances to a person at the end of his/her life, at the patient’s request, in order to relieve their suffering by hastening death.

Euthanasia (according to the Report of the Dying with Dignity Committee, 2012)
An act that involves deliberately causing the death of another person at his or her request, to put an end to that person's suffering.
WARNING: Physician-assisted dying, therefore, is synonymous with euthanasia—a form of it.

Assisted suicide
The act of helping a person to commit suicide by providing him with the means to do so or information on how to proceed, or both.

What about in Quebec?

Euthanasia and assisted suicide are allowed in Canada since a vote held in June 2016 in the House of Commons. This being said, euthanasia had been permitted a few months before in Quebec (December 2015) after a public debate that had not allowed the general population in Quebec to understand all the ins and outs of this set of issues that is, ethically, very complex .

Despite this reality, several members of the political class, whose views are echoed by many obliging media, want the population to believe that this debate was resolved in a social consensus, while the reality is totally different. The truth is that neither euthanasia nor assisted suicide attract a consensus among physicians—who are very divided on this issue—and the population. Also, contrary to what is affirmed too often, not all opponents are Catholic; many citizens invoke other arguments to justify their opposition to both.

To better understand the arguments of those who promote palliative care rather than euthanasia or assisted suicide, please click here and here.

Evolution of the situation in Quebec
Read some testimonies

As Catholics, what should we think?

Catholics, being faithful to Biblical revelation and the teaching of Jesus, believe that human life is a gift from God, a sacred gift which no one (neither the sick person nor the medical staff, even with good intentions) can dispose of, from conception to natural death. Catholics also believe that every human being, regardless of his/her medical condition, has inalienable, inherent dignity that must be respected at all times.

Respect of dignity and human life requires that we take reasonable care of our lives. However, respect does not mean that we should use every possible means to prolong biological life, which would not be reasonable when death is unavoidable or treatments would be too difficult to bear for the patient. This would then be aggressive treatment, which Catholics oppose.

To conclude, some very important clarifications :

The refusal or cessation of a treatment is not euthanasia.

A sick person or his representative can refuse a treatment or ask for cessation of a treatment (if it is being administered), even if this treatment is likely to keep him alive (at least for some time). This grave personal decision is made on the basis of the assessment, by the patient or his representative, of the potential advantages and disadvantages of this treatment.

In this case, it is not euthanasia because the person who refuses a treatment dies naturally from the effects of his disease and not because of the refusal of treatment. In the normal order of nature,  a terminal illness causes the death of the patient.

The refusal of aggressive treatment is NOT euthanasia.

Aggressive treatment is the use of disproportionate or extraordinary treatments to prolong the life of a sick person who has reached the terminal stage of his disease, without any real hope of improvement of his condition. Aggressive treatment, since it does not respect the natural order of things AND the dignity of the person, must therefore be prohibited.

To be clear, refusing aggressive treatment is not a form of euthanasia. On the contrary, it respects the natural order of things and the dignity of the human person.

To better understand euthanasia and assisted suicide :

Euthanasia and Assisted Suicide: Urgent Questions!
Living with Dignity

What the Catholic Church teaches about euthanasia and assisted suicide :

Catechism of the Catholic Church on euthanasia, disproportionate treatment and end of life (2276-2279)
Canadian Conference of Catholic Bishops – Euthanasia and Assisted Suicide
COLF on the legalization of euthanasia and assisted suicide

What the Catholic Church teaches about disproportionate treatment and stopping or refusing a treatment :

What constitutes “extraordinary means” of care? A Catholic Perspective
Can a Catholic refuse medical care?

As Catholics, we believe that our lives and bodies are offered to us by God. Now, we also believe—we know—that the life God gave us He can take back, at the moment and in the way He wants.
 
In the same way, for the sake of the love that unites us, God is asking us to accompany those who suffer and to alleviate their moral and physical sufferings as far as possible. This being said, this assistance also has its limits: as Christians, it is not up to us to choose the method and moment of anyone’s death; this decision belongs to God alone.

It is not easy for anyone, Christian or not, to see a loved one suffer and decline toward death, slowly or not. It is almost normal in these circumstances to feel the temptation to want to hasten his/her natural death through human means (euthanasia), especially as one has the impression that the sick person, whose strength and overall condition are constantly declining, is losing some of his/her dignity. With God’s help (from prayer and sacraments), however, the Christian learns how to accept the situation (over which he has no control at all) with serenity and to remain open to all the blessings and divine graces that God has in store for the relatives and the dying person.

May all Christians proclaim from the rooftops that being there to the end of a loved one’s life is worth (all) the trouble and (all) the efforts! God is there, with His many blessings, and does not forget anyone. For example, accompanying one’s elderly and sick parents to death, despite the difficulties and sorrows, remains one of the greatest opportunities for graces in life.

Human dignity

Human dignity, for the Church and many schools of philosophy, is the inherent, intrinsic (= inner) value of each human being, which is equal for all and flows from the simple fact of existing. Nothing can suppress or diminish a person’s dignity, whether it be the person’s life situation, good or bad actions, or problems of health or autonomy. In other words, a person at the end of life is NEVER without dignity (as such) just because he/she is sick and impaired.


 

 

The Good Samaritan, or how to take care of those who are sick and suffering

A good Samaritan (see the episode in the Gospel according to Saint Luke, 10:25-37), in the tradition of the Church, is any person who feels great compassion (= “suffering with”) for the suffering or distress of another and who, in addition, comes to his assistance to carry his burden and alleviate both his physical pain and moral suffering.

 

“(…) we could say that suffering, which is present under so many different forms in our human world, is also present in order to unleash love in the human person, that unselfish gift of one's "I" on behalf of other people, especially those who suffer.” » (Salvifici doloris, 29, hereunder SD)

 

Since no person can "fully find himself except through a sincere gift of himself" (Gaudium et Spes, 24), everyone is invited to become a Good Samaritan to those who are suffering and sick, that is, a person “capable of such a gift of self.” (SD 28)

Taking good care of those who are suffering and sick is a duty of charity (of love) for every Christian.

To go further:

Canadian Hospice Palliative Care Association
“Do Not Waste Your Death” - Evening of reflection on euthanasia and end of life (nursing section)

Proposals of the Catholic Church:

Approaching Death in the Company of Christ (Assembly of Quebec Catholic Bishops)
Respect of the Dignity of the Dying – Pontifical Academy for Life

Resources for family caregivers:

Association Lavalloise des Personnes Aidantes

No, in all these things we are more than conquerors through him who loved us.  For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation will be able to separate us from the love of God in Christ Jesus our Lord. (Rm 8:37-39)

 

Christians know that life is an invaluable gift from God—the greatest we have received, along with the gift of salvation. God created each of us in His infinite Love, to have us discover this Love and invite us to share it. Indeed, God’s greatest desire for each of His creatures is to share His divine Life with them (through sacraments and prayer) and fill them with His happiness, now and for eternity.

Obviously, this outlook on life is not shared by everyone. Now, it happens that some people, during their lives, go through very great moral or physical trials causing cruel sufferings that push them to the edge of despair. Some of them, after assessing all possible solutions to their problems, consider—wrongly—that suicide is the best option for finding relief and ending their pain.

I am considering suicide

Even if you are under the impression that there is no solution left for your problems and that there will never be an end to your suffering, you are mistaken: the help you need exists; you are not alone.

During a lifetime, every one of us in turn needs help. Asking for help is human, it is normal, and most importantly it is the first step to getting through it. Then, the second step is to accept this help. Even Jesus, who is the Son of God, accepted help in carrying His cross.

To obtain help immediately:

(514) 723-4000 (in Montreal) or 1-866-277-3553 (1-866-APPELLE) or click here.

I am worried about someone

Does someone you know talk more or less openly about suicide? Do you believe you have received cries for help from a person who seems to feel the pain of living, to be discouraged or crushed by trials? Do you want to help that person but do not know how?

Most of the time, people who think about suicide do not want to die; what they want most is for their suffering to end. It is important to be able to decipher their cries for help and to answer them (In French). You could save a life!

 

Bear one another’s burdens, and in this way you will fulfill the law of Christ. (Ga 6:2)

 

For advice or support, please feel free to call (514) 723-4000 or click here or here (in French).

I lost a loved one

Losing someone who is dear to us is one of the greatest sufferings in life. If you lost someone to suicide, you are experiencing a kind of grief that is out of the ordinary. If you want to learn a bit more on the particular aspects of grief related to a suicide, click here (in French).

Please know that you are not alone.

You will find support by calling (514) 723-4000 or click here (in French).

Catholics and suicide

Suicide is always a tragedy, a bomb which has wide and terrible human repercussions. The saddest is that in most cases, it could have been avoided.

The tragedy of suicide, its absurdity, is that a child of God, destined to receive even on earth God’s blessings and infinite Love, failed to recognize in his life the Presence of the Wholly Other, his Creator and Saviour. Because of this lack of understanding, the suicidal person despaired of life, of his life; he thought nothing could alleviate or suppress his deep suffering.

In the end, the person who committed suicide because of the heaviness of his problems stopped believing in the priceless value of life, of his life; it was no longer for him a treasure and a gift, but rather a burden that was too heavy to bear.

“What you do to the least... ”

Suicide, Albert Camus wrote, is the only real philosophical question: is life worth living, or not? Sooner or later, all human beings ask this question, especially when they go through great trials.

Those who have suicidal ideations experience this crisis acutely. They desperately need to meet on their road compassionate people who will become for them channels of light, love and healing.

All Christians are called to make themselves available to the action of the Holy Spirit, who will be able to use us as needed. In fact, through our presence, listening and support, the Holy Spirit can transform the life of a desperate person by making him (re)discover his immense value and restoring his zest for life.

What does the Catholic Church say about suicide?

Although interrupting one’s own life is incompatible with God’s plan of happiness for each of us, the person who commits suicide does so because he is pushed to it by his despair and great suffering; very few are telling God, through their suicide, that they reject in a fully conscious and free way their life—and salvation. Rather, these desperate people kill themselves because they no longer (or do not) see God in their lives.

For this reason, the Catholic Church believes that people who committed suicide will also be able to benefit from God’s infinite mercy:

 

We should not despair of the eternal salvation of persons who have taken their own lives.  By ways known to him alone, God can provide the opportunity for salutary repentance.  The Church prays for persons who have taken their own lives.” (CCC 2283)