Inter-religious statement on euthanasia, in Portugal

Care, with compassion, until the end

Inter-religious statement on euthanasia

The debate currently underway in Portugal about what has been labelled “assisted death” invites all of us to reflect and offer their contribution to enrich a process of dialogue which requires the intervention of all social agents. The religious traditions bear a message about the life and death of man, as well as the model of society we build, and it is both legitimate and necessary that they present this message with freedom and humility.

At a time when Parliament debates and prepares to vote on proposals for a possible law on euthanasia, we, the undersigned religious communities present in Portugal, having gathered to discuss and reflect together, and aware that we are living moments of great importance for our time collective future, do declare:

1. The dignity of those who suffer

We believe that each human being is unique and, as such, irreplaceable and necessary to the society of which he or she is a part, bestowed with an intrinsic dignity which is prior to any criteria of quality of life or usefulness, until the time of natural death. Not only does life not lose its dignity as it draws to its end, but the vulnerability with which it is clothed in this stage is, rather, a badge of special dignity which requires proximity and care. We do believe that suffering should be avoided if possible and, therefore, we give thanks for the fact that medical and pharmacological sciences have developed to such an extent that they allow for an effective relief of pain and promotion of well-being. However, we do not ignore the dramatic nature of suffering and the difficulty in finding meaning in continued life. We are aware that religion offers the possibility of meaning to those who believe, but we also know, from experience in accompanying so many who are not religious, that belief is not a necessary condition to finding meaning in one’s own suffering. With these our brothers we learn, indeed, that this task represents one of the greatest achievements of personal dignity. One’s dignity does not depend on anything other than existence as a person and personal autonomy cannot be emptied of its social meaning.

2. For a merciful and compassionate society

The suffering at the end of life is a spiritual challenge for each individual and an ethical challenge for society as a whole. Principles such as mercy and compassion are common to the different religious traditions and, over the history of civilization, have given rise to social models capable of creating, in each period, precise ways of accompanying and caring for the most fragile members of society. Today, human death is one of the areas which challenges us. What is asked of us is not that we give up on those living their final stages of life, by offering them the legal possibility of death, which can be the result of suffering without adequate care. It is this suffering which is truly unbearable and which gives rise to the will to die. It is the fruit of a society which abandons, which loses its humanity and becomes indifferent. Our beliefs in this respect are confirmed by our experience that people who are properly accompanied neither despair nor ask to die. What is asked of us, therefore, is that we commit ourselves more deeply to those who are living through this stage, taking upon ourselves the necessity of offering them a humane and accompanied death.  

3. Palliative Care, a necessity which cannot be delayed

We believe that palliative care is the most complete expression of this service which the state is obliged to give, since it results from the highest technical and scientific skill and competence in compassion, both of which are needed when dealing with people in the final stage of life. True compassion does not insist on futile treatment in an attempt to prolong life, but helps people to experience their own death as humanely as possible, recognising that it is only natural. Palliative care values a person until their natural end, alleviating their suffering, fighting off loneliness through the presence of family and other loved ones. We ask Portuguese society to rise up to this challenge, which can no longer be postponed, of making palliative care available to all, and we take upon ourselves the task of doing all that we possibly can to participate in this national effort. We cannot help but to ask if this current debate, preceding as it does an investment in proper palliative care, does not betray a lack of truth.

Religious traditions profess that life is a precious gift, with Abrahamic religions stressing that it is a gift from God and, as such, sacred in nature; but this only confirms its natural dignity, from whence stem its inherent inviolability and unavailability which, therefore, do not rest on religious foundations. But religion does give life a meaning, a hope and other possibilities of transcendence. Societies need this vision of man to stand alongside all the others which exist.

We, the religious communities present in Portugal, believe that life is inviolable until natural death and we share the belief in a compassionate model of society. For this reason, in the name of humanity and the future of the human community, we feel called to take part in the current debate on assisted death, to express our opposition to its legalisation under any of its forms, be it assisted suicide or euthanasia. Therefore we put our names to this common statement.

Lisbon, May 16^th, 2018

Portuguese Evangelical Alliance -  Pastor Jorge Humberto, representing the president Pedro Calaim

Portuguese Hindu Community – Mr Kiritkumar Bachu

Islamic Community of Lisbon – Sheikh David Munir

Israeli Community of Lisbon – Rabbi Natan Peres

Catholic Church – Cardinal Patriarch D. Manuel Clemente

Ecumenical Patriarchate of Constantinople – Archpriest Ivan Moody

Portuguese Buddhist Union – Diogo Lopes

Portuguese Union of Seventh Day Adventists – Pastor António Carvalho, representing the president, pastor António Amorim

Thoughts on the Alfie Evans case

A few thoughts on this case which many of us have been following closely.

#1 – Aflie is not Charlie

Despite many comparisons, Alfie’s case is not the same as Charlie Gard’s, the similarities notwithstanding.

The main difference is that Charlie was, according to his doctors, suffering and in pain. The cause of his pain was not so much his disease, as the invasive medical equipment which was keeping him alive. In short, the cost of keeping Charlie alive was to keep him in pain and in suffering.

Charlie’s parents had their hopes set on treatment in America. But when the actual facts came out, it turned out that the treatment they had been offered was a farce. There was no indication it would help him in any way, it had never even been tested on mice and there was not even any guarantee that it wouldn’t make him worse.

Alfie, on the other hand, does not seem to be in pain, at least that is not what the hospital and courts have been saying, so far as I can make out. The problem does not seem to be that he will suffer if kept alive, the problem – again, as far as I can make out based on the press – is that doctors and judge consider that to keep him alive is futile. This is a not so subtle way of saying that his life is not worth living.

Alfie’s parents do not have their hopes set on some maverick doctor providing a miracle treatment, they just want him to live as long as he can, cared for and as comfortable as possible. They understand that he will not live as long as a healthy little boy, but they refuse to accept that this means he is not worth being cared for. The way his life has moved countless people would seem to prove beyond doubt that even a life that is materially unproductive is not futile.

#2 – The doctors are not psychopaths

A lot of the rhetoric from people defending Alfie and his parents is disturbing. I don’t believe the doctors have anything but Alfie’s best interest at heart. Of course, that does not mean that their idea of his best interest coincides with mine or is even correct.

This happened with Charlie Gard as well. Some of the things said about the health professionals was absolutely disgraceful. In that case I had a personal stake in the issue, since at the age of 10 I was admitted to Great Ormond Street and was treated with spectacular care and attention. I have nothing but the warmest memories. I have no personal connection to Alder Hey, but find it unlikely that its staff is composed of zombies and cold blooded killers. The hateful rhetoric helps no one.

However, that being said, there are some disturbing indications coming out from Alder Hey. In my experience doctors already have a natural tendency towards arrogance, especially when dealing with people who have little or no medical knowledge. 

One paragraph struck me in the Guardian’s coverage of the hearing on Tuesday. “The clinician, who cannot be named but who was one of the team treating Alfie on Monday night, said the hostile atmosphere had created a ‘genuine fear’ among fellow doctors and that there would have to be ‘a sea change’ in their relationship with the family before they could consider letting him go home.”

What?! This sounds a lot like “hey, change your attitude and then maybe we will think of lending you this little boy you say is your son, but who is actually our property”. Are they mad?

This arrogance seems to confirm what we, outside Britain, hear about State and health worker’s attitudes towards families. I know of several non-British residents in London who will avoid taking their children to hospital at all costs, for fear of raising suspicions of abuse. Even if this is an exaggeration, the fact that people feel that way is in itself cause for alarm.

#3 – Whose children are they?

The crucial question here is, does the State have the right to override parents decisions regarding their own children? In short, yes, it does. If it did not, then there would be no safeguards against child abuse. You can’t get your five year old drunk on Vodka every two days and say you’re his dad so that’s ok.

However, if there is any situation in which the state should exercise its power in the most conservative way possible, it’s this one. A parent’s connection to his child is a sacred bond, it should not be severed lightly.

So yes, it is possible for a judge to rule against the parents in a case like this, but that doesn’t mean that the state is always right in doing so. When the state is wrong in these cases, it is oh so very, very, very wrong, and the injustices caused should make all involved shudder.

#4 – The people are rebelling…

Regardless of who is in the right in this or that particular case, there can be no doubt that we are heading down a path where life is seen, more and more, through the lens of utility rather than inherent value.

Euthanasia, which is gaining ground in so many countries despite the alarming signs coming out of Belgium and Holland, is another way of saying that our life loses value when we cease to be productive and that dignity is something we define ourselves, rather than being inherent.

So it is not surprising that doctors, judges and others will increasingly begin to look at cases like Alfie’s and just think “why bother?” It may not be about money, although that can be a worrying factor, it’s just about not seeing the point.

And this is not exclusive to Britain. Friends of mine who have a child with a rare cognitive and physical condition which essentially renders him completely dependent, have spoken about their despair at going to the hospital and feeling, even if it wasn’t said out loud, that the doctors didn’t understand why they didn’t just let their child die.

So it is interesting to see – and probably shocking for many – that in cases like Alfie’s, where the parents fight back, people are backing them up. They are taking to the streets, they are organizing prayer vigils, they are protesting on social media. Maybe not always in the best way, maybe not in the best terms, but they are rebelling.

The de-dignification of human life runs counter to what we are. We know, deep down, that we are more than what we produce, than what we feel, than the pleasure we enjoy or the suffering we endure. When we see an old and ill person saying they just want it all to end, then maybe we keep silent out of supposed respect for their autonomy, but when we see a man climbing on to a ledge our instinct is still to talk him back down and when we see doctors saying, or seemingly saying, that a baby’s life is not worth the effort, we lash out.

Let this be a warning. Let those who make our laws and policies take heed. Let their arrogance not be their undoing.