- Reading the letter “Samaritanus bonus on the care of persons in the critical and terminal phases of life” recently issued by the Congregation of the Doctrine of the Faith is like breathing in clean fresh air – the much needed fresh air of orthodoxy in moral theology which, in this case, is concerned with end of life issues, in particular, euthanasia and assisted suicide.
- The main purpose of Samaritanus bonus is to clarify the critical notion of accompaniment in the care of the terminally ill. In recent years, this notion of “accompaniment” has become a rather prevalent modus operandi of the Church’s pastoral care of Catholics whose lifestyle and convictions are at variance with the faith they profess. What indeed does it mean to “accompany” Catholics “with special needs”, such as Catholics who are divorce-remarried, Catholics who are pro-choice, or Catholic patients who intend to end their own life by means of assisted-suicide or voluntary euthanasia?
- Does “accompaniment” mean – in the name of mercy – to turn a blind eye and therefore condone the sinful conduct? Or does “accompaniment” mean – in the name of both mercy and truth – to guide and admonish Catholics “with special needs” to conversion, so that their thinking and way of life conform to the Catholic faith? Thus, when employed without any clear specifications, the notion of accompaniment is fraught with ambiguity, and opens the door to moral confusion and disorder. It is for this very reason that the letter Samaritanus bonus – with its precise and concrete guidelines regarding the accompaniment of the terminally ill – is worthy of praise. By means of its letter, the Congregation of the Doctrine of the Faith has provided a great service to the Church and her children. In so doing, the Congregation also actualizes a fundamental task of the Church, that of being the beacon of truth to the world at large.
- Samaritanus bonus is both firmly grounded in Sacred Scripture and in continuity with the teaching of the Magisterium – from the teaching of Pope Pius XII to the teaching in Veritatis splendor, Evangelium vitae, Salvifici doloris, and Spe salvi, as well as the teaching of the Catechism of the Catholic Church and the Code of Canon Law, among others. Thus, the document vigorously reaffirms that human life is a sacred and inviolable gift from God the Creator. This is a foundational anthropological truth, for without life there can be no other activities – in particular, the exercise of one’s freedom or the establishment of human relationships. Thus, to end the life of a terminally ill person at his/her request freedom is to disavow the value of his/her freedom and of human relationships. In what way then, as pointed out in Samaritanus bonus, can euthanasia and assisted suicide qualify as acts of mercy and compassion, or as acts which respect the dignity of the human person?
- In a clear and succinct manner from beginning to end, Samaritanus bonus explains why a correct understanding of accompaniment must necessarily be in conformity with the truth of the natural law which God has inscribed in the human heart. In the context of the care of the terminally ill, the foundational principle of the natural law “do good and avoid evil” is reiterated in the Hippocratic principle, primum non nocere. The care and accompaniment of the terminally ill therefore must take in to account the conditions of the individual patient in question, in order not to fall in extreme – either to hasten death intentionally by means of euthanastic measures or to prolong life at all cost by continuing burdensome extraordinary measures which no longer benefit the patients. In this regard, it is commendable that Samaritanus bonus reiterates the teaching of the Magisterium that:
(i) “It is not lawful to suspend treatments that are required to maintain essential physiological functions, as long as the body can benefit from them (such as hydration, nutrition, thermoregulation, proportionate respiratory support, and the other types of assistance needed to maintain bodily homeostasis and manage systemic and organic pain).” Here, Samaritanus bonus does not mince words in denouncing the rampant practice of euthanastic palliative interventions which “involve the administration of medications that intend to hasten death, as well as the suspension or interruption of hydration and nutrition even when death is not imminent.”
(ii) The possibility of deep palliative sedation at the terminal stage can be morally acceptable, provided that it is clinically motivated, that it is not with the intention to euthanize, and that prior spiritual preparation is given to the patient while he/she is still conscious.
(iii) A fundamental element in the care of the terminally ill is the psychological and spiritual support – a work of love in which family members (or alternatively, hospice workers) are called to play a central role. In the Western world, this dimension is sadly often overlooked. Here, Samaritanus bonus invites us to meditate on the scene of Christ on the Cross, with Blessed Mother and the beloved disciple at the foot of the Cross, so that we may grasp the depth of what it means to “remain” by the side the sick. Indeed, this seemingly insignificant act of “remaining” by the side of the sick, is both “a sign of love and the hope that it contains” and, therefore, a powerful antidote to the irrational solution of euthanasia and assisted suicide
- Just as in wedding of Cana when the best wine is served at the end, the most important teaching of Samaritanus bonus comes at the end, for one needs first to have a correct understanding of the complex and multifaceted issue of the care of the terminally before one can understand what the role of the priest should be in his accompaniment of Catholics who opt for euthanasia or assisted suicide. The crucial issue regards whether or not these Catholics, whose convictions and actions are at variance with the Catholic faith, can receive the last rites, that is, the Sacrament of Reconciliation with absolution, the Anointing, and the Eucharist which is the “viaticum” for eternal life.
To persist in convictions or actions contrary to the Catholic faith constitutes in itself to an explicit declaration that one has no need of the Sacrament of Reconciliation. In other words, it is not the Church who is withholding the Sacraments, but rather the individuals themselves, who by holding fast onto their erroneous convictions or ways of life, make themselves unavailable to receive God’s grace that is communicated through the Sacraments. The reception of the Sacraments entails some sign of repentance. This is why the priest could conditionally administer the sacraments to an unconscious person if he/she had given some sign beforehand, on the basis of which it might be presumed that he/she had repented. 7. The intelligibility of its style, the logical and succinct flow of its argumentation, and the clarity and conciseness of its teaching in defense of human life in its terminal phase – all of these elements contribute to make the letter Samaritanus bonus an outstanding document, one that should be read by every Catholic, and included in the curriculum of moral theology/bioethics in seminaries and Catholic universities.
In closing, the John Paul II Academy for Human Life and the Family would like to express its deepest gratitude to both the Congregation for the Doctrine of the Faith and His Eminence Cardinal Ladaria Ferrer for the timely promulgation of the letter Samaritanus bonus. Doyen Nguyen, OP, M.D., S.T.D. On the Feast Day of St. Michael, the Archangel, 29 Sept 2020