Position Paper of the Abrahamic Monotheistic Religions on Matters Concerning the End of Life

The position of Abrahamic religions on end of life and palliative care

News Release

Dicastery for Promoting Integral Human Development

Yesterday 28 October at the Casina PIo IV in the Vatican, 40 representatives of the Jewish, Muslim and Christian faiths signed the joint Position Paper of the Abrahamic monotheistic religions on matters concerning the end of life.

Invited by the Pontifical Academy for Life, presided over by His Excellency Archbishop Vincenzo Paglia, the religious, including the Prefect of the Dicastery for Promoting Integral Human Development Peter K. A. Turkson, have committed themselves in 12 points to stating that euthanasia and assisted suicide are morally and intrinsically wrong and should be prohibited without exception. Any pressure and action on patients to end their lives is categorically rejected.

A very important point for the mission of the Dicastery is that concerning  Health Care Workers that states that no health care worker should be forced or subjected to pressure to witness directly or indirectly the deliberate and intentional death of a patient through assisted suicide or any form of euthanasia, especially when such practices go against the health care worker’s religious beliefs, because there should be always respect for conscientious objection to acts that conflict with a person’s ethical values. This remains valid, continues the Paper, even if such acts have been declared legal at a local level or by categories of persons.

Very significant, the joint declaration also addresses the spiritual and material accompaniment of the terminally ill and their families, as well as the use of medical technology at the end of life and the promotion of palliative care.

Palliative care nurses quit ‘houses of euthanasia’

Catholic Herald

Simon Caldwell

Belgian nurses and social workers who specialise in treating dying patients are quitting their jobs because palliative care units are being turned into “houses of euthanasia”, a senior doctor has alleged.

Increasing numbers of hospital staff employed in the palliative care sector are abandoning their posts because they did not wish to be reduced to preparing “patients and their families for lethal injections”, according to Professor Benoit Beuselinck, a consultant oncologist of the Catholic University Hospitals of Leuven.

He said that after more than 15 years of legal euthanasia in Belgium “palliative care units are … at risk of becoming ‘houses of euthanasia’, which is the opposite of what they were meant to be”. . . [Full Text]

Involvement of palliative care in euthanasia practice in a context of legalized euthanasia: A population-based mortality follow-back study

Sigrid Dierickx, Luc Deliens, Joachim Cohen, Kenneth Chambaere

Abstract

Involvement of palliative care in euthanasia practice in a context of legalized euthanasia: A population-based mortality follow-back study

Background: In the international debate about assisted dying, it is commonly stated that euthanasia is incompatible with palliative care. In Belgium, where euthanasia was legalized in 2002, the Federation for Palliative Care Flanders has endorsed the viewpoint that euthanasia can be embedded in palliative care.

Aim: To examine the involvement of palliative care services in euthanasia practice in a context of legalized euthanasia.

Design: Population-based mortality follow-back survey.

Setting/participants: Physicians attending a random sample of 6871 deaths in Flanders, Belgium, in 2013.

Results: People requesting euthanasia were more likely to have received palliative care (70.9%) than other people dying non-suddenly (45.2%) (odds ratio = 2.1 (95% confidence interval, 1.5–2.9)). The most frequently indicated reasons for non-referral to a palliative care service in those requesting euthanasia were that existing care already sufficiently addressed the patient’s palliative and supportive care needs (56.5%) and that the patient did not want to be referred (26.1%). The likelihood of a request being granted did not differ between cases with or without palliative care involvement. Palliative care professionals were involved in the decision-making process and/or performance of euthanasia in 59.8% of all euthanasia deaths; this involvement was higher in hospitals (76.0%) than at home (47.0%) or in nursing homes (49.5%).

Conclusion: In Flanders, in a context of legalized euthanasia, euthanasia and palliative care do not seem to be contradictory practices. A substantial proportion of people who make a euthanasia request are seen by palliative care services, and for a majority of these, the request is granted.


Dierickx S, Deliens L, Cohen J, Chambaere K. Involvement of palliative care in euthanasia practice in a context of legalized euthanasia: A population-based mortality follow-back study. Palliat Med. 2018 Jan;32(1):114-122. doi: 10.1177/0269216317727158. Epub 2017 Aug 29.

Is there any difference between euthanasia and palliated starvation?

BioEdge

Xavier Symons

While euthanasia and assisted suicide are currently illegal in most countries, the practice of voluntarily stopping eating and drinking (VSED) is seen by some as an ethically and legally permissible alternative. VSED refers to seriously-ill patients refusing to eat and drink for a sustained period of time with the intention of bringing about their own death.

Yet a new paper published in BMC Medicine argues that VSED is ethically indistinguishable from assisted suicide, and should be subject to the same legal regulations as more salient cases of assistance in dying.

The paper, lead-authored by Ralf J. Jox of the Institute for Ethics, History and Theory of Medicine at the University of Munich, argues that “supporting patients who embark on VSED amounts to assistance in suicide, at least in some instances, depending on the kind of support and its relation to the patient’s intention”.

While VSED does not involve an invasive or aggressive act like many other means of suicide, the authors write that “VSED should [nevertheless] be considered as a form of suicide, as there is both an intention to bring about death and an omission that directly causes this effect”. Doctors who assist patients in VSED — by encouraging them, or promising pain-relief if VSED is undertaken — are potentially instrumental in the deaths of the patients, as the suicide would not occur without them, and they share the patient’s intention of inducing death.

The authors of the paper conclude that the same legal prescriptions or regulations that apply to physician assisted suicide should also apply to VSED.

“[We] maintain… that future ethical discussions on assisted suicide require consideration of medically supported VSED, and vice versa…Thus, the widely held position by palliative care societies, professional bodies of physicians, legal scholars, and ethicists to disapprove of assisted suicide but approve of and even promote medically supported VSED appears inconsistent”.


Is there any difference between euthanasia and palliated starvation?This article is published by Xavier Symons and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees.

 

Accessed 2017-08-11

 

Assisted killing still part of Ontario’s palliative care plan

Catholic Register

Michael Swan

The agency responsible for expanding Ontario’s network of hospice care wants hospice patients to have the option of assisted suicide, even if most hospices and the majority of doctors oppose it.

“The OPCN (Ontario Palliative Care Network) promotes early and equitable access to hospice palliative care for all patients with a life-limiting illness, including individuals who have requested medical assistance in dying,” a spokesperson for the Ontario Palliative Care Network told The Catholic Register in an email.

The provincially-funded OPCN, a sub-agency of Cancer Care Ontario, “recognizes that there may be an intersection between palliative care and medical assistance in dying (MAID). Both medical assistance in dying and palliative care are health care services that exist within the health care system,” wrote Cancer Care Ontario communications advisor Jayani Perera. “However, the focus and mandate of the Ontario Palliative Care Network is advancing palliative care in the province.”

A year into legalized killing in Canada, the big question is how palliative care and hospice beds will be expanded, said bioethicist Bob Parke. Will governments fund hospices that refuse to perform or refer for assisted dying? . . [Full text]