Putting Heart & Soul in End-of-Life Care
In April 2002, the Netherlands became the first country in the world to legalize assisted death—what we term "euthanasia" and also assisted suicide—under a very specific set of conditions: unbearable pain, incurable illness, and a request made in the patient's "full consciousness."1 Later that year, Belgium followed suit.
In both countries, instances of assisted death have gone up markedly each year. In Belgium, 235 people were killed in 2003. In 2013, there were 1,807 cases, representing an almost eight-fold increase.2 In the year 2016–2017, there were a startling 2,309 cases reported.3
The Belgian and Dutch laws are similar in that both allow doctors who carry out euthanasia and assisted suicides to self-report, which seems to leave the door wide open for abuse—i.e., cases of questionable legality may go unreported. Hence, it is impossible to know how many people really die via euthanasia or assisted suicide each year. One independent study of assisted deaths in the Netherlands, for example, indicated that there were 7,254 such deaths there in 2015, while the country's official report showed only 5,561 deaths—a discrepancy of 1,693.4
Belgium also became the first—and so far, mercifully, only—country to allow the assisted death of a minor. To date, three adolescents have died by this method. Both the Netherlands and Belgium (and many other countries where euthanasia is legal, including Canada) have been wrestling with outcries at the growing numbers.
Two Key Factors
What's going on here? Why are so many people now choosing to end their own lives? There are a couple of relevant, albeit depressing, factors to consider.
First, within these rising numbers is an increase in the number of people dying in nursing homes. While the age of most of those whose death is "assisted" is still over 80, the percentage of younger people dying this way is steadily increasing. For more and more of the elderly, dying swiftly, via a method they can "control," seems better than a long, protracted death in an impersonal setting, such as a nursing home or hospital. Overall, old people are lingering longer, but not as well, increasingly spending their final days in institutions instead of in their own homes with their own families. In the U.S. for instance, according to some estimates, only about 20 percent of people die at home; another 20 percent die in nursing homes, and 60 percent die in acute care hospitals.5 The "birth dearth" in most developed nations also means that there are fewer and fewer young people to care for the elderly.
The second factor that plays into these decisions is the modern world's general abhorrence of suffering and loss of autonomy. Key in the discussion of assisted death in Belgium is the term "polypathology"—a set of conditions or illnesses (blindness, deafness, incontinence, disability) that combine to make life "unbearable" for an individual. In other words, a patient doesn't actually have to be dying to be considered a good candidate for assisted death. Suffering is tacitly regarded as taboo, something to avoid at all costs—even the cost of death—rather than as a part of the human condition, which the grace of God gives us the strength to endure.
In centuries past, there were widely recognized limits on what medicine could do for the feeble and elderly: the technology capable of prolonging life for years via medication and mechanical means didn't yet exist. Moreover, most people died at home, in the arms of their loved ones. Today, we are terrified of suffering because we so rarely see it. Instead of caring for the suffering in our own homes, we send them to nursing homes to be cared for. We don't carefully feed grandma, bathe her, tenderly read the Word to her, or sing hymns to her when she is in pain. Instead, we send her away, and leave it to professionals to see that she dies comfortably.
No wonder grandmas the world over are beginning to take matters into their own hands. Because we don't see suffering in our homes and families, and have not had to devise ways of coping with it, we can't fathom how anyone whose life has been blighted by illness or disability could possibly wish to remain alive. We don't understand how even a suffering individual, someone who has lost autonomy and depends upon others for daily care, may impart great wisdom to a child, or great comfort to an adult.
In turning death out of the home and away from the family, we do both ourselves and our loved ones a great disservice. Part of each individual's divine call is to accept the station he or she has been given, even when that station requires the humility to accept care from others.
Christ has told us we will suffer: "In this world, you will have trouble," he assures us (John 16:33). Yet suffering can be good for the soul, both the soul of the one suffering and the soul of the one caring. It may also sometimes involve great pain, both emotional and physical. But by seeking death as a means to end suffering sooner, we deny both ourselves and others the opportunity to become more Christ-like.
And suffering does not have the final word. "But take heart!" Christ continued. "For I have overcome the world."
1. "Euthanasia and Assisted Suicide Laws Around the World," The Guardian (July 17, 2014): theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world.
2. Madeline Kennedy, "Euthanasia rising in Belgium, including more who are not terminally ill," Reuters (Sept. 15, 2016): reuters.com/article/us-health-euthanasia-belgium-idUSKCN11M03D.
3. Simon Caldwell, "Three children killed under Belgium's euthanasia law," Catholic Herald (July 25, 2018): http://catholicherald.co.uk/news/2018/07/25/three-children-killed-under-belgiums-euthanasia-law.
4. Alex Schadenberg, "Netherlands' 2017 euthanasia deaths increase by another 8%," National Right to Life News Today (March 8, 2018): nationalrighttolifenews.org/news/2018/03/netherlands-2017-euthanasia-deaths-increase-by-another-8.
5. Stanford School of Medicine, "Where Do Americans Die?" (accessed Aug. 29, 2018): https://palliative.stanford.edu/home-hospice-home-care-of-the-dying-patient/where-do-americans-die.
is the managing editor of the Howard Center's quarterly journal, The Family in America: A Journal of Public Policy.This article originally appeared in Salvo, Issue #47, Winter 2018 Copyright © 2019 Salvo | www.salvomag.com https://salvomag.com/article/salvo47/suffering-elderly