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St Raphael's Notebooks no. 2

By Dr. Jean Pierre Dickès, M.D.

The question of euthanasia can be summed up very simply. Does mankind have the right to dispose of his life; or does he think that it is a gift given by God who has loaned it to him? My basic experience as a doctor dictates to me a very simple reality, and most of my colleagues have gone through the same process I have. It can be summarized in two very simple items.

The first one is the following. We know perfectly well that man does not have eternal life here below; his existence on this earth will at one time will be finished. When one of our patients is coming to the end of his life, we know perfectly well that a moment will come when it is not possible to struggle anymore against illness and death. We just have to stop our useless treatments. Our duty is to obtain for them as quiet a death as possible.

First of all, our patient has to put himself right towards God and men. When that is done, we have to help to prepare him to a peaceful death, with as little suffering as possible. We are not obliged to use extraordinary treatments and our patient has perfectly the right to refuse to be submitted to useless and painful treatments which prolong his life and his sufferings in vain. Some people call this passive euthanasia, but it is not euthanasia. It is simply taking note that life is coming to its end. Then, humanization of death is necessary. Most of our work will be to provide nursing and treatments against any kind of pain. It is what we call palliative treatments.

Why are supporters of euthanasia asserting that it is euthanasia? Simply to convince people that most of the physicians commonly use euthanasia, and from there to make people accept active euthanasia which consists in directly killing the patient with a mortal injection.

Letting a dying man die of starvation and thirst in bed cannot be compared to euthanasia; but rather to a sadistic practice; or also to a refusal of assistance to a person in peril of death.

Lethal injection with potassium, curares, high dosage of morphine, or psychotropes and lytic cocktails used with increasing dosages can all be considered as premeditated murders.

But we have the duty of relieving the sufferings of our patients. Some of them - it is in fact very rare - declare that they cannot get rid of their sufferings in spite of their treatments. Then it is necessary to increase the dosage of the sedatives even, explains Pope Pius XII, if the practitioner is conscious that the life of his patient will be shortened for a few hours or days. The Pope's exact words are: “ If no other means exist, and if, in the given circumstance, this does not prevent the carrying out of other religious and moral duties." (Sept. 9, 1958). Important dosages of morphine can be lethal. Normally a good use may avoid that kind of situation. The intention is what is important. With the same dosage of morphine the first intention may be to end the life of the patient: it is impossible to agree with that. But if the intention is simply to get rid of sufferings, it is fair. The use of indirect voluntary must be used here. The pope is very clear about that. It is not forbidden, and morally obligatory. This is the second item concerning euthanasia.

But effectively, the patient may want to be united to the sufferings of Jesus on the Holy Cross. However, the Church does not strictly require it.

Writing about this, it is impossible not to be reminded of the death of my own son. He was suffering from muscular dystrophy. He suffered in agony as did many of the saints, and died after three weeks. During his last moments he pronounced the words of Jesus Christ on the cross. He entered into death in full consciousness, without receiving any sedative. His last words were really shouted although with his poor strengths: I will soon cry victory.
He had overcome his sufferings and defeated death.
He was only 18 years old.

Dr. Jean-Pierre Dickès
Président de l¹ACIM

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