Abstract
Is there any meaningful distinction between palliative care and assisted suicide? Is medically assisted suicide merciful? The argument in favor of legalizing this activity, and incorporating it into regular medical practice, assumes there is no morally significant between the two. Furthermore, the argument in favor holds this activity is indeed merciful. However, such an argument presumes a particular understanding of the phenomena of mercy and compassion. This chapter provides a thorough act analysis that explores the fundamental philosophical differences between palliative acts and acts of self-killing. The difference is categorical—there are two very different ways to approach pain, symptoms and fear of future suffering. The difference is not in degrees but difference in kind. From this fundamental distinction, the chapter then explores how each corresponds to traditional concepts of compassion and mercy. Only palliative acts truly express the compassion—the healing ability to share in the suffering of the patient—and mercy—the removal of pain and symptoms—that stand at the heart of authentic humanistic, Christian medical practice. Assisted suicide, while often motivated by pity and right intentions, can only ape the authentic mercy of palliative acts since it eliminates a person to eliminate their suffering.
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Notes
- 1.
For more on the underlying systematic concepts of causality see Bishop (2012). Bishop argues that modern medicine recognizes only two types of causes : material and efficient. This view would be contrasted, for instance, with the Catholic perspective that would also include formal and final causes.
- 2.
This is suicide by placing a plastic bag over the head, especially in combination with inhalation of gases.
- 3.
This is a form of assisted suicide, accomplished by omitting food and water, while managing the symptoms of dehydration and starvation.
- 4.
See, Ganzini (2009). For instance, in their study of family member’s perception as to why patients chose assisted suicide, Ganzini et al. report, “the most important reasons that their loved ones requested PAD [Physician Assisted Death], all with a median score of 4.5 or greater, were wanting to control the circumstances of death and die at home, and worries about loss of dignity and future losses of independence, quality of life , and self-care ability. No physical symptoms at the time of the request were rated higher than a median of 2 in importance. Worries about symptoms and experiences in the future were, in general, more important reasons than symptoms or experiences at the time of the request. According to family members, the least important reasons their loved ones requested PAD included depression , financial concerns, and poor social support” (Ganzini et al. 2008: 154).
- 5.
Cf. Pearlman et al. (2005: 236).
- 6.
This idea is clearly expressed in the Ethical and Religious Directives for Catholic Health Care Services : “The task of medicine is to care even when it cannot cure” (USCCB 2009).
- 7.
Here a distinction must be drawn. Laws like the Oregon “Death with Dignity ” law expressly forbid “mercy killing ”, i.e. active euthanasia (Death with Dignity 2017).
- 8.
Benjamin Wiker, for instance, explores how thinkers in the tradition of Liberalism have constructed this individualistic anthropology and the implications it has for society (Wiker 2013).
- 9.
For discussion on the negative and positive obligations for facilitating and fostering autonomy see Beauchamp and Childress (2009, pp. 103–05).
- 10.
“In keeping with the social nature of man, the good of each individual is necessarily related to the common good , which in turn can be defined only in reference to the human person” ( Catechism of the Catholic Church 2008: n. 1905).
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Bedford, E.L. (2019). Medical Mercy and Its Counterfeit. In: Cataldo, P., O’Brien, D. (eds) Palliative Care and Catholic Health Care . Philosophy and Medicine, vol 130. Springer, Cham. https://doi.org/10.1007/978-3-030-05005-4_15
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