by Father David Q. Liptak

The United States Supreme Court has ruled, in two unanimous decisions handed down June 26th, that Assisted Suicide is not a Constitutional right. On the contrary, states may continue to prohibit the practice. The two decisions were given in reply to constitutional challenges of laws in New York and Washington barring physician-assisted suicide.

The Court left open the question as to whether in the future at least some terminally ill individuals experiencing intractable pain might claim a Constitutional right to a physician's help (in Justice Sandra Day O'Connor's words) "in controlling the circumstances of his or her emminent death."

The reasoning offered by Chief Justice William H. Rehnquist, specifically with respect to the Washington law, warrants emphasis. Five basic considerations are set forth, the first of which is that the State has an "unqualified interest in the preservation of human life."

Second, suicide is really "a serious health problem, especially among persons in otherwise vulnerable groups." Thus, the state "has an interest in preventing suicide and in studying, identifying and treating its causes.." (The fact is that those who consider suicide are frequently suffering from depression or some other mental or emotional problem; hence, they are confused, ambivalent, fearful.) Justice Rehnquist states that physician-assisted suicide could "make it more difficult for the State to protect" persons with mental or emotional deficits or who are in especially severe pain.

Third - this is quite significant - the state has an interest "in protecting the integrity and ethics of the medical profession." Indeed the American Medical Association has declared that Physician Assisted Suicide "is fundamentally incompatible with the physician's role as healer." There is a faith patients invest in their physician, a faith expressed in the past by the Hippocratic Oath (unrevised version, one must add). The Court cautioned here against "blurring the time-honored line between healing and harming." That "line" derives its validity not from its ancient observance, but from ethical norms which transcend and, consequently, govern the art and science of medicine. One of these norms is fundamental to a physician's practice; namely, Primum, non nocere. (First, do no harm). (I would have liked to have seen this explicitly stressed in the court's decision.)

Fourth - this is quite interesting - Judge Rehnquist's opinion formerly grants "an interest in protecting vulnerable groups, including the poor, the elderly and disabled persons from abuse, neglect and mistakes." Whereas, a lower court had dismissed the State's concern that the disadvantaged might be pressured into physician aided suicide as "ludicrous on its face," the Supreme Court ruling acknowledged the "real risk of subtle coercion and undue influence" in end-of-life circumstances.

Last, the Court granted that the consequences of allowing as Constitutional doctor-assisted suicide could mean that "every man and woman in the United States must enjoy it." Thus, the "slippery slope" of an unethical judgment would be magnified many times.

The existentialist philosopher Albert Camus averted that very first philosophical question is: "Should I or should I not commit suicide?" Yet, as philosopher Ralph McInerny has responded, "To discuss it (this question) is already to answer it in the negative." In other words, knowing the answer is more important than dispatching oneself and one's ability to ask.

When Socrates, one of the world's truly original thinkers, was advised to thwart the executioner and take his own life, he retorted that he did not own himself; on the contrary, he was of God. Life was for him a gift from God; hence his power over life was restricted. Socrates was a pagan who lived three centuries before the Incarnation.

"Pagans," McInerny argues, "as well as believers, have seen the ultimate point of life as beyond the present one. Returning the gift (of life) on this view does not restore one to the status quo ante, that is nothingless, but is rather rushing to a judgment that might prove more exacting than the pain felt" ("The Ethics of Suicide" in Pope John Paul II's "Lecture Series Bioethics," Holy Apostles College and Seminary, 1991).

Analyzing the nature of suicide leads to an immediate recognition of its absurdity. To argue - as those who are drawn to physician-aided self-destruction do - that one who takes his own life only desires a pain-free life, is to defend as mindless proposition. It is mindless because it defacto negates what one desires: specifically, to be, albeit without pain. One's ceasing to be can hardly be viewed as desirable. Can it be a moral choice?

The answer is that it cannot. Those who are dying in great pain need all the help available. Fortunately, advances in the science and art of palliative care have been substantial in recent years, not only in pain control but also in the treatment of emotional and mental disorders. These are the areas in which physicians should be competent and expert, not in removing patients from our midst. To view a dying person in pain as one would a horse with a broken leg is tragic. As Aristotle commented, such an attitude demands punishment, not instruction.

Father David Q. Liptak is Pastor of St. Catherine's Parish, Broad Brook, CT and Censor Librorum for the Archdiocese of Hartford. His column Faith Perspectives appears monthly in the Catholic Transcript published by the Archdiocese of Hartford

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