Last Friday, Pope Francis addressed members of the Congregation for the Doctrine of the Faith, who had gathered in Rome to reflect on euthanasia. The Pope noted that many Westerners now regard the “voluntary interruption of human existence [as] a choice of ‘civilisation’”. The “civilised” supporters of euthanasia regard the Church’s condemnation of the practice in all circumstances as naïve – or even cruel. And Catholics are no longer able to appeal to a shared understanding of human worth. “Where life is valid not for its dignity, but for its efficiency and productivity,” Francis said, “[euthanasia] becomes possible. In this scenario it must be reiterated that human life, from conception to its natural end, has a dignity that renders it inviolable.”

Euthanasia – where a doctor directly ends a patient’s life – is not new. It was practised in ancient Greece (with the support of Socrates and Plato) and ancient Rome. But its legalisation across the developed world is relatively recent. The Netherlands became the first country to introduce it in 2002, followed closely by Belgium. They were later joined by Colombia, Luxembourg and Canada. Assisted suicide – where a patient takes their own life with a doctor’s aid – is legal in Switzerland, Germany and a handful of US states.

The Church has had a strong presence in most countries that have legalised euthanasia or assisted suicide and has contributed significantly to local healthcare systems. This presents acute dilemmas: how can the Church protect its institutions from the incursion of an alien ideology? How does it prevent palliative care from being corrupted? And how should it treat suffering Catholics who opt for euthanasia? The situation is fast-moving and the Church is struggling to catch up.

In Belgium, for example, palliative care specialists are reportedly resigning because their job is increasingly being reduced to preparing “patients and their families for lethal injections”. According to Professor Benoit Beuselinck, consultant oncologist at the Catholic University Hospitals of Leuven, palliative care units are being turned into “houses of euthanasia”.

The Vatican is currently locked in conflict with board members of the Belgian Organisation of the Brothers of Charity, a body connected to a religious order specialising in psychiatric care. Board members allow euthanasia to be practised on patients in Brothers of Charity homes, in brazen defiance of Church teaching.

Meanwhile, the Canadian bishops seem at odds over Catholics seeking euthanasia. One bloc, the bishops of Atlantic Canada, argued in 2016 that priests should have wide latitude, in the name of “pastoral accompaniment”, to give the sacraments to those committed to undergoing euthanasia. The bishops of Alberta, in contrast, insisted that priests must clearly inform sufferers that euthanasia is a gravely sinful act and can withhold the Sacrament of the Sick if the patient remains “obstinate”.

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