Bioethics in Faith and Practice, Volume 2, Number 1

Bioethics in Faith and Practice ⦁ 2016 ⦁ Volume 2 ⦁ Number 1 9 57 that permits us to forego ‘extraordinary means’ to do so, when such latter means do not “offer a reasonable hope of benefit or entail an excessive burden. ” 38 Directive 58 must be read with the guidance provided in Directives 56 and 57 in mind. The Church counsels us to consider death as a part of life, the logical, unavoidable and ultimate end of our time here on earth. As mentioned in Part Five of ERD5, Catholics face “the reality of death with the confidence of faith. ” 39 We are given stewardship but not ownership of our bodies and remain “accountable to God for the life that has been given to us. ” 40 Life’s true meaning is found in the resurrection of Jesus and hope for the life to come after earthly death . 41 As CST has developed, and as found in Directives 56 and 57 of ERD5, Catholic thinkers have for centuries distinguished between ordinary and extraordinary measures for preserving life. 42 This approach's challenge is chiefly to determine what may, in particular circumstances and for a particular patient, constitute ordinary (proportionate, useful, beneficial or easily borne) care and thus be obligatory and what may, under the same circumstances and for the same patient, constitute extraordinary (disproportionate, useless, harmful or burdensome) care and thus not be obligatory but only permissible. To put the question more simply, as Gerald Kelly does, “How much does God demand that I do in order to preserve this life which belongs to God and of which I am only a steward? ” 43 Where impossibility is encountered, one may be excused from making the effort to sustain one’s life “especially where there is little hope of life, or none at all.” 44 Our duty in the Catholic tradition is limited “to make do with the normal means medicine has to offer. ” 45 The Catholic view is that “Life is a gift of God, and, on the other hand death is unavoidable; it is necessary that we, without in anyway hastening the hour of death, should be able to accept it with full responsibility and dignity. ” 46 To preserve life at all costs would make idolatry out of or create a culture of worship for human life that would not find support in CST. God alone is worthy of worship and to elevate ourselves and our lives to that level would be inappropriate and unwarranted. End of Life: The hotly debated and much discussed issues of forgoing or withdrawing of medical technology in general and the issue of killing or letting die (particularly but not exclusively in the realm of euthanasia, physician- assisted suicide or PAS, or physician aid in dying or PAD) are beyond the scope of this paper, but basing any conclusions of moral permissibility solely on a characterization of a particular behavior as an action rather than an omission is a thin reed upon which to build an ethical foundation. The Catholic teaching forbids euthanasia, regardless of how accomplished, whether by action or omission. Therefore, it is no answer to say that one approach (euthanasia, PAS or PAD) represents an act resulting in death and letting die is only an omission, since the consequences are the same for Raanan Gillon “unless you also can say that makes the moral difference; whatever that something is, it must be different from the bare difference between acts and omissions. ” 47 According to Gillon, there are at least three moral claims that stand behind the Catholic rejection of any simple act-omission test in these circumstances: (1) the omission is morally culpable; (2) outcomes and prior moral obligations, along with the understanding and intent of the actor are all relevant; and (3) certain acts and omissions are always forbidden , such as intentionally ending the life of an innocent. 48 The above claims do not mean that, in an appropriate case, pain relief cannot be applied, even if use of the pain-killing drugs may shorten the life of the patient because the intent is to relieve pain, not cause death. 49 We operate in an area of moral ambiguity worthy of careful thought and review, however, in the case of letting die and in the area of moral prohibition in the case of killing . 50 Killing in this context includes