One pleasant surprise at the Harvard Medical School annual bioethics conference, this year on prescribed suicide, was the discussion between doctors Lachlann Forrow and Tim Quill. Originally this segment was supposed to have Diane Meier, a Hemlock Society member from way back; instead, Forrow opposes PAS and has testified against its legalization.  We were treated to a real discussion.

Quill was surprisingly restrictive about physician-assisted suicide (PAS) and palliative sedation for voluntary stopping eating and drinking (VSED).  Based on his presentations, he advocated for these options only for people who are actively dying and physically suffering—like my mother when she stopped receiving transfusions, said her good-byes to her care team, and went home to die.  This is quite unlike Thaddeus Pope, a lawyer who advocated for people to make liberal use of VSED as a universally legal option for euthanasia.  (Therein lies the problem of getting lawyers and politicians involved…) 

Still, Quill cannot be blind to the abuses that are occurring as a result of legalization.  Although he reminds us all that PAS is “rarely” used, he says patients who want it cannot be “held hostage” by those put at risk. I disagree just on sheet numbers alone, never mind the various other very good reasons.

Forrow is not morally opposed to PAS or euthanasia. Instead, his argument was that unless we have a health system in which everyone has equal access, we have high quality palliative care available to everyone, and vulnerable populations have protection, then we cannot legalize PAS.  Later he admits that we could never achieve that “utopian” healthcare system, but we must at least approximate it.

This, to me, is a philosophical argument that reflects a transcending spiritual reality—we are created by God and now have a fallen human nature. Because of this, God revealed his divine law to us in through the Old Law and Jesus Christ as expressed in the teachings of the Catholic Church so that anyone can easily know them.  Fallen human nature may know that killing the innocent is wrong in general, but we can believe and be convinced (deceived) that there are exceptions, as we see with abortion and euthanasia.

Even though at least some of the participants are godless “humanists” (based on the many foyer conversations of both presenters and attendees), they cannot deny human nature.  That is why we can never achieve Forrow’s utopian healthcare system. They have this idea that we humans just haven’t done it right yet, that if we tweak this massive system we can have a perfect world where anyone who wants to kill themselves can without any sort of social influences, that no discrimination will occur, and that people will only choose “reasonable” care and always forego “futile” care.  And those who believe we can create this will be the ones to define just what all those things mean according to what they think is socially just.

Human nature is rational, social, and creative, in the image and likeness of God, and so capable of achieving much good. God revealed the Divine Law to us so we would not convince ourselves that we can achieve anything, and to always keep in mind our eternal destination.

We can never create a perfect healthcare system, so we can never allow PAS.  We could have arrived at this conclusion much sooner and easier through if we weren’t stubbornly trying to always keep faith out of the conversation.

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