The Movement toward Physician-Assisted Suicide: A Step in the Wrong Direction

Paul John II Evangelium vitae, nos. 65–66.

C.f., Miller F. “Regulating Physician-Assisted Death,” New England Journal of Medicine 331 (1994) : 119–23; T. Quill, C. Cassel, and D. Meier, “Care of the Hopelessly Ill: Proposed Clinical Criteria for Physician-Assisted Suicide,” New England Journal of Medicine 327 (1992): 1380–84; H. Brody, “Assisted Death — A Compassionate Response to a Medical Failure,” New England Journal of Medicine 327 (1992): 1384–88; R. Weir, “The Morality of Physician-Assisted Suicide,” Law Medicine and Health Care 20 (1992): 116–26; D. Orentlicher, “Physician Participation in Assisted Suicide,” Journal of the American Medical Association 262 (1989): 1844–45; and M. Simons, “Dutch Doctors to Tighten Rules on Mercy Killings,” New York Times (Sept. 11, 1995), A3.

Voters passed Measure 16 by a slim margin. Recently, a U.S. District Court in Oregon issued an opinion that the Oregon Death with Dignity Act was unconstitutional.

Congregation for the Doctrine of the Faith, “Declaration on Euthanasia,” (May 5, 1980).

Washington Initiative 119 failed in November, 1991. California Proposition 161 failed in November 1992. Both propositions lost by a 54%–46% margin.

Gomez C. Regulating Death (New York: Free Press, 1991).

Brody H. “Assisted Death,” 1386.

Simons M. “Dutch Doctors to Tighten Rules on Mercy Killings,” A3.

O'Donnell See T. Medicine and Christian Morality (New York: Alba House, 1976), 31–35. C.f., C. McFadden “Assistance at Immoral Operations,” Linacre Quarterly 37 (November, 1970): 243–51.

Weir R. “The Morality of Physician-Assisted Suicide,” 122.

Paul John II Evangelium vitae, nos. 64–66.

Cathechism of the Catholic Church, nos. 2276–2282.

Gula R. Euthanasia and Assisted Suicide: Positioning the Debate (St. Louis: Catholic Health Association, 1994), 3.

Kass L. “Physician Aids in Suicide,” Chicago Tribune (June 6, 1990), Al.

Some authors recognize a further type of cooperation, implicit formal cooperation. Implicit formal and immediate material cooperation involve a sharing of the same moral object by the wrongdoer and the cooperator. However, the authors indicate that implicit formal cooperation occurs when no explanation can distinguish the cooperator's moral object from the wrongdoer's. In such cases one cannot meaningfully say that one is doing the evil deed but does not share the evil intention (c.f., NCCB, Ethical and Religious Directives for Catholic Health Care Services (Washington, DC: USCC, 1995), 29; R. Smith “Formal and Material Cooperation,” Ethics & Medics 20 (June, 1995): 1–2; and Keenan J. , and Kopfensteiner T. “The Principle of Cooperation: Theologians Explain Material and Formal Cooperation,” Health Progress 76 (April, 1995): 23–27). The Directives point out that in the absence of duress, immediate material cooperation is equivalent to implicit formal cooperation. Other authors use the term implicit formal cooperation interchangeably with immediate cooperation, (c.f., W. Smith, “Catholic Hospitals and Sterilization,” Linacre Quarterly 44 (May, 1977): 109–110, n. 6). I personally find the use of the term “implicit formal cooperation” problematic because if one has the genus of cooperation, it seems problematic to separate them into the species of formal and material yet at the same time indicate that a type of formal cooperation is equivalent to a type of material cooperation. Unfortunately, the principle of cooperation is one of the more convoluted ones in the history of moral theology and it still seeks a clear and coherent explanation.

Mchugh J. , and Callan C. Moral Theology: A Complete Course, vol. 1 (New York: Joseph Wagner, Inc., 1958), 627–28. The authors indicate that there may be very rare cases of acceptable immediate cooperation when the cooperator does not share the same moral object as the agent. The classical example is the person who cooperates with a robber if his life is in danger. In such a case, a reasonable owner would be willing to have the cooperator assist with the robbery rather than risk death. Consequently, the moral object of the cooperator is no longer theft because that involves taking property against the reasonable will of the owner. The moral object of the wrongdoer remains theft. However, they indicate that immediate cooperation is always unlawful when the cooperator's moral object is intrinsically evil. The new Ethical and Religious Directives for Catholic Health Care Services in its Appendix on cooperation has indicated that immediate cooperation is always wrong “except in some instances of duress.” Unfortunately, the Directives in this regard are incomplete and fail to make a critical distinction with regard to immediate cooperation when the moral object of the cooperator is intrinsically evil. That is, external circumstances like duress (or intention for that matter) cannot justify the commission of an action by a cooperator whose moral object along with the wrongdoer is intrinscially evil. A failure to understand this directive may tempt people to justify actions like contraceptive sterilizations in Catholic facilities because of market forces which create duress on the facility. However, the moral object in performing a contraceptive sterilization is to render a person sterile for the purpose of preventing pregnancy. Thus, the moral object of the cooperator is intrinsically evil and may not be done.

NCCB, Ethical and Religious Directives, no. 53.

C.f., NCCB, Commentary on Reply of the Sacred Congregation for the Doctrine of the Faith on Sterilization in Catholic Hospitals (Washington, DC: USCC, 1977), 7.

NCCB, Ethical and Religious Directives, no. 45.

The wrongdoer's remote intention would be to relieve suffering. The physician's remote intention would be to maintain his or her medical practice.

Paul John II Veritatis splendor, nos. 75–82.

McHugh J. , and Callan C. Moral Theology, 633.

Paul John II Evangelium vitae, no. 88.