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Don’t let throwaway culture corrupt end-of-life care

Life is a fundamental gift from God. Is it always worth living?
Catholic Voices

Catholics believe in care for the sick and the dying. Few moral teachings could be less controversial. The most easily offered prayers are for those we know who are ill and in danger of death. We encounter many everyday instances where people drop everything to care for a sick child or to be with a parent who is at the end of life—and, thankfully, in many of these cases, the community rallies in support. My mother passed away in late 2021, and I cherish the all-too-brief time we spent with her in her final illness. A few years prior, my mother spent years caring for my father when he became too weak from emphysema to go out, ensuring that we had more time with him and that he could spend his final years in the comfort of their home.

The importance of such care is imperiled by a growing movement toward laws that permit physician-assisted suicide. The practice is currently permitted in 10 states and the District of Columbia, but this year, bills have been introduced in nearly 20 more states trying to legalize it. Canada legalized physician-assisted suicide in 2016. In the year 2022 alone, more than 13,000 people died under the law’s provisions.

While most people recognize the Catholic Church’s opposition to physician-assisted suicide, the reasons for this opposition may be less understood. Sometimes, people suggest the problem with the practice is that we are “playing God.” But this reasoning suggests a kind of fatalism, as if we just let health events take their course. No one would suggest that improving emergency response times or getting screened for cancer is “playing God,” but these clearly intervene in cases that might otherwise result in death. Catholics are not fatalists.

Rather, Catholics believe that life is a good, a fundamental gift from God. No one should ever make a choice against life. Such a conviction obviously animates Catholic opposition to abortion and the death penalty; abortion terminates a gift to the world of a lifetime of possibility, and the death penalty (among its other problems) makes us believe that somehow a life taken in revenge satisfies some kind of justice. Instead, Catholics think these lives are worth living.

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But what if we think our own life is no longer worth living? It is this question that differentiates physician-assisted suicide. Hence, the typical argument for “death with dignity” is fundamentally a quality-of-life argument. A life that will end in a few months filled with suffering, or a life that will slowly but surely decline into a limbo of dementia—these lives, to some, seem not worth living. And the lack of worth is really about the failure of certain capacities that we deem as essential to a worthwhile life.

But is there really any life that is “not worth living”? Advocates for those with disabilities recognize how ominous quality-of-life claims are. People with disabilities often live lives with chronic suffering, and of course, some with cognitive disabilities face lifelong challenges comparable to those suffering from Alzheimer’s disease. Any quality-of-life argument raises exactly these difficulties for any person or group that might fall “below” whatever standards are set. In the Netherlands, dozens of people seek physician-assisted suicide due to the suffering and loneliness of intellectual disabilities, and in Canada, one mother reported that doctors made such a recommendation within earshot of her disabled daughter.

The instability and dangers of the quality-of-life argument tend to push supporters of physician-assisted suicide to a different argument, simply based on individual autonomy. As Brittany Maynard voiced in 2014 when she became a public advocate for physician-assisted suicide after her brain cancer diagnosis, “Who has the right to tell me that I don’t deserve this choice? That I deserve to suffer for weeks or months in tremendous amounts of physical and emotional pain? Why should anyone have the right to make that choice for me?”

The argument sidesteps any questions about objective “quality” in favor of a subjective conviction that one’s life is no longer worthwhile. But as has been seen in the Netherlands, where assisted suicide has been legal for decades, the threshold for requests keeps getting lower and lower. Life seems “not worth living” for people dealing with failures of many sorts: Children as young as 12 may request assisted suicide with parental consent, and a 16-year-old may choose it even without such consent. The autonomy argument is challenging to apply for those suffering from long-term mental health struggles. Are they really making a free choice?

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Thus, both a “quality-of-life” argument and an “autonomy” argument allow for many cases of physician-assisted suicide that seem unpalatable to almost everyone. Why does the push for physician-assisted suicide remain appealing? The answer remains the target case: a simple expedient to erase several months of “pointless” suffering, or, in the case of mental decline, many years of “pointless” incapacity.

But is this time really so pointless? As most recently articulated in Pope Francis’ 2020 message Samaritanus Bonus (On the Care of Persons in the Critical and Terminal Phases of Life), the Catholic tradition has always accepted that patients need not undertake extraordinary (and often painful and expensive) treatments when the end of life draws near. They can instead be made comfortable through palliative care and prioritize time with loved ones.

This suffering only becomes “pointless” when the living abandon those who suffer. Pope Benedict poignantly wrote, “One of the deepest forms of poverty a person can experience is isolation. If we look closely at other kinds of poverty, including material forms, we see that they are born from isolation.”

The real call for justice and dignity for the dying is a matter of compassionate presence, of accompaniment, of overcoming the terrible loneliness that infects our society. It is not sufficient to oppose legislation; we must also take seriously Francis’ critique of our “throwaway culture,” in which elderly and incapacitated people are the human beings we are willing to discard, like an appliance that no longer works and can’t be fixed. While we should avoid romanticizing a hard reality, there are many inspiring stories of the tender care offered to spouses and relatives suffering from mental decline.

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Praying for the sick is not enough. The practice of visiting the sick begins with our loved ones, but it cannot end there. We need a culture in which our dependence on others is something we ultimately cherish rather than something we flee from. If we truly believe in “death with dignity,” what we must do is show more love, not pass legislation that Pope Francis has called a “law to kill.” 


This article also appears in the June 2024 issue of U.S. Catholic (Vol. 89, No. 6, pages 40-41). Click here to subscribe to the magazine.

Image: Pixabay/truthseeker08

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About the author

David Cloutier

David Cloutier is an associate professor of theology at the Catholic University of America and editor of catholicmoraltheology.com.

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