Euthanasia and assisted suicide

Abstract der Rede von Willem Jacobus Eijk, dem Erzbischof von Utrecht (Niederlande) zum Thema Sterbehilfe auf dem JuraHealth Congress am 14. und 15. Mai in der Berliner Urania

The Dutch law on reviewing termination of life at request and assisted suicide does not imply a legalization of euthanasia and assisted suicide. However, these acts, though remaining crimes, are not penal if committed by a physician, who has implemented a series of requirements of due caution. According to the Belgian law euthanasia, but not assisted suicide, has been legalized. Notwithstanding this and some other differences, both laws recognize a certain autonomy to dispose of one’s life, albeit not without limits.

What can be said about autonomy regarding life and death? In the first place one may wonder whether a human being under stress is really autonomous? For people requesting euthanasia or assistance in suicide do so because they are confronted with an incurable disease or another kind of suffering deemed unbearable.

More fundamentally, we are facing the question whether a human being has the right to dispose of his life and death. The prevailing view of man in present secularized society, the ‘Identity Theory of Man’, identifying the human person with his mind, considers the human body and hence human physical life as an extrinsic and thus only instrumental value: it would only have the value, the person in question attributes to it. This view of man implies however an untenable dualism. The body is an intrinsic value and therefore remains a value, even if affected and tarnished by diseases of handicaps. This is enforced within the framework of Christian anthropology, viewing the human person as being created in God’s image and likeness, not only in his spiritual but also in his physical dimension. He is therefore a manifestation of God in this world, notwithstanding his spiritual or physical condition. Physical life may therefore not be sacrificed in order to end suffering.

A human and Christian duty

Human life, though an intrinsic value, is not a absolute value. No duty exists to preserve it at any cost. If the ratio between the chance of preserving life and health on the one hand, and collateral effects, complications and the burden for the patient on the other hand is not proportionate, one may renounce therapy or disrupt treatment already started. Obviously, one will take into account the suffering which treatment in itself may cause to the patient and the quality of life, which may be expected after treatment. Establishing whether suffering is bearable or not, remains founded in the end on a subjective evaluation. In this respect medical experts also frequently turn out do differ from opinion. An evaluation of the degree of suffering may have a role in deciding whether or not to apply or continue life preserving treatment, but not when one considers to terminate life at the request of the person involved, because this is an irreversible decision.

It is a human and Christian duty to assist people who are suffering from an incurable disease, to persist living and to relieve their suffering by reducing it to bearable proportions. The drop of the annual numbers of cases of euthanasia and assisted suicide and of requests for euthanasia and assistance in suicide in The Netherlands in recent years has partly been attributed to a extended offer of adequate palliative care.