CONTEMPORARY HEALTH CARE and the CHOICE for LIFE

I have set before you life and death . . . choose life!
— Deuteronomy 30:19

The choice that Moses set before the Israelites as they prepared to pass into the Promised Land is a choice that is set before us today in a variety of ways. The exhortation to choose life applies to the decisions we make to serve the Lord of life and treat others with the justice that human dignity demands. It applies to the choices we make in political life to secure the rights of the needy and defend the unborn, aged, infirmed, and disabled. We are called to choose life. We are to protect, nurture, and sustain our own lives and the lives of others, acting as faithful stewards of God, who is the Lord and giver of life.

We are not, however, to sustain bodily life at all costs. Consider the Passion of Christ and the death of the martyrs. Jesus and his faithful witnesses gave up their lives willingly, not by choosing to cause their own deaths, but by choosing that which is greater that bodily life: faithfulness, truth, the salvation of the world, eternal life in God’s kingdom. For Christians, suicide and martyrdom are opposites. Suicide is the choice to cause one’s own death. Martyrdom is the choice to allow one’s death to be caused by others for the sake of greater life.

Most of us will not have the opportunity to die as martyrs. Many of us will, however, confront challenging circumstances that require us to distinguish between choosing to cause death and choosing to allow death to occur naturally for the sake of a greater good.

This dilemma occurs frequently in the world of contemporary health care. Medical technology has given us better methods for both preserving and destroying human life. People with terminal diseases have more ways of keeping themselves alive and more ways of hastening their deaths. Pregnant women have greater means at their disposal both to save the lives of their unborn children and to end them. How can these people know when allowing death is morally right? How can they distinguish between permitting of death as an unfortunate side effect and choosing death in an act of killing?

The Catholic Church has the resources with which to answer these questions. The Church’s moral tradition distinguishes between ordinary and extraordinary means of preserving life. It identifies the conditions according to which an evil result can be permitted as a side-effect of a good action. Often these principles can be applied easily and straightforwardly to the situation at hand. Sometimes applying such principles correctly is difficult and complicated. In every case, however, arriving at the right answer begins with asking the right question.

The right question is not the question of life or death: Should I live or should I die? Is life worth living or not? Does that person’s life have any value? These are questions we have already answered in responding to the exhortation of Moses. We choose life! We choose to value, uphold and defend the dignity of all human life. We reject the choice to cause death. God is the master or life and death. We are not. Our task is to protect, nurture and sustain our lives as long as God’s providence permits.

The question that is ours to ask and answer is not whether life is worthwhile; it is whether or this or that procedure, treatment, or intervention is worthwhile. We know that life is always good. Our question is whether this or that lifesaving measure is good or whether it is evil, overly burdensome, or otherwise unreasonable. It is to this question, not the question of life or death, that we apply the resources of the Church’s moral tradition.

We start by choosing life, affirming its value and God-given dignity. We choose to protect, nurture and sustain life and never to make death our aim. If we are firm in this life-affirming choice and rely on the guidance of Catholic teaching we can be confident that, even when we decide to allow the natural process of death to occur and entrust our loved ones to mercy of God, we remain faithful to the exhortation of Moses:

I have set before you life and death . . . choose life!