.

"144. For the health care worker, to serve life means to respect it and care for it until its natural conclusion.  Man is not the master and arbiter of life, but its faithful steward...."

"145....One's attitude toward the sick person in the terminal stage of his illness is a test of the professionalism and ethical responsibilities of health care workers.269"

"146. The dying process...always deserves care and assistance....When conditions permit it, and if requested directly by the patient or his relatives, the dying person must have the option of returning to his own home or to a suitable environment...."

"147....palliative care...with care for his physical, psychological, and spiritual needs, tends to create a loving presence...."

"148....The highest form of humanizing the dying process that health care and pastoral workers can offer is providing a faith-and hope filled presence."


Dying with Dignity
"149....Preserving the dignity of dying means respecting the sick person in the final stage of his life, refusing to hasten death (euthanasia) 275 and to prolong it through therapeutic obstinacy.276...."

"150....the principle... of the proportionality of treatment...can be defined as follows: 'When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted.'279....
The physician is not a mere executor...he keeps the right and the duty not to carry out wishes that conflict with his own conscience."


Civil laws and conscientious objection
"151. No health care worker...can become the defender of a non-existant right, even if euthanasia were requested...."

[In a June 9, 2005 letter, the president of the Pontifical Academy for Life reviewed "The principle of licit cooperation in evil":


"The first fundamental distinction to be made is that between formal and material cooperation. Formal cooperation is carried out when the moral agent cooperates with the immoral action of another person, sharing in the latter's evil intention. On the other hand, when a moral agent cooperates with the immoral action of another person, without sharing his/her evil intention, it is a case of material cooperation.

Material cooperation can be further divided into categories of immediate (direct) and mediate (indirect), depending on whether the cooperation is in the execution of the sinful action per se, or whether the agent acts by fulfilling the conditions - either by providing instruments or products - which make it possible to commit the immoral act.

Furthermore, forms of proximate cooperation and remote cooperation can be distinguished, in relation to the "distance" (be it in terms of temporal space or material connection) between the act of cooperation and the sinful act committed by someone else. Immediate material cooperation is always proximate, while mediate material cooperation can be either proximate or remote.

Formal cooperation is always morally illicit because it represents a form of direct and intentional participation in the sinful action of another person.¹⁰ Material cooperation can sometimes be illicit (depending on the conditions of the "double effect" or "indirect voluntary" action), but when immediate material cooperation concerns grave attacks on human life, it is always to be considered illicit, given the precious nature of the value in question¹¹.

A further distinction made in classical morality is that between active (or positive) cooperation in evil and passive (or negative) cooperation in evil, the former referring to the performance of an act of cooperation in a sinful action that is carried out by another person, while the latter refers to the omission of an act of denunciation or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted¹².

Passive cooperation can also be formal or material, immediate or mediate, proximate or remote. Obviously, every type of formal passive cooperation is to be considered illicit, but even passive material cooperation should generally be avoided, although it is admitted (by many authors) that there is not a rigorous obligation to avoid it in a case in which it would be greatly difficult to do so."

Nutrition and hydration
"152....'The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented.'286"

The use of analgesics in the terminal stage
"153....Pain in the final moments of life can take on a spiritual significance for a sick person and, in particular for a Christian, can be accepted as 'participation in the passion' and union with the redemptive sacrifice of Christ' (cf. Col 1:24)....Proper human and Christian care allows the use of drugs that are designed to alleviate or eliminate pain as necessary in treatment, even though they may result in torpor or diminished lucidity."

"154....'The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable.'[290 includes a quote from 2279 of the Catechism]"

"155....'it is not right to deprive the dying person of consciousness without a serious reason'294....Palliative sedation...must not involve the discontinuation of basic care."


Telling the truth to the dying person
"156. A person has the right to be informed about his own state of health.  This right does not lapse, even in the case of an unfavorable diagnosis and prognosis, and it implies that the physician has a duty to respectfully communicate the patient's conditions....[With the prospect of advising a patient of his impending death,] These are important responsibilities associated with this information that cannot be delegated...." 

"157. The duty of telling a patient the truth in the terminal stage requires the discernment and tact of health care personnel....The truth must not be withheld, but neither must it be simply announced...."

"158....The important thing is not just the accuracy of what is said, but the relation of solidarity with the sick person.  It is not merely a matter of transmitting clinical facts, but of communicating significant truths...."

Religious care of the dying person
"159. The spiritual crisis evoked as death draws near prompts the Church to become for the dying person and his family the bearer of the light of hope, which only faith can shine on the mystery of death...."

"160. It is necessary...to give an evangelical meaning to death: proclaiming the Gospel to the dying person.  This is a pastoral duty of the ecclesial community in all its members....The expressive forms of the proclamation of the Gospel to the dying person are charity, prayer, and the sacraments."

"161. Charity means the giving, welcoming presence....Charity sees in him, in a unique way, the face of the suffering and dying Christ who calls us to love...."

"162. Charity opens the dying person's relation to prayer...."

"163. A privileged moment of prayer with the terminally ill person is the celebration of the sacraments.... 'Penance, the Anointing of the Sick and the Eucharist as viaticum constitute at the end of Christian life "the sacraments that prepare for our heavenly homeland" or the sacraments that complete the earthly pilgrimage.'296"

"164.In this faith, which is full of charity, human powerlessness before the mystery of death is not experienced as distressing and paralyzing.  A Christian can find hope, and in it the possibility, despite everything, of living out rather than merely being subjected to death."

Destroying life
"165. The inviolability of human life means and implies, ultimately, the unlawfulness of any act directly aimed at destroying it...."

"166....'no one may make an attempt on the life of an innocent person without opposing God's love for that person, without violating a fundamental right'301...."

"167. As 'minsters of life and never agents of death,'304 it is up to health care workers 'to safeguard life, to be watchful over its evolution and development throughout its whole existence, respecting the plan drawn up by the Creator.'305
This vigilant ministry of safeguarding human life rejects homicide..., and it opposes voluntary death, suicide....
this ministry must be particularly vigilant [against abortion and euthanasia] and in a certain way prophetic, because of the legislative context, which is very often insensitive, if not outright favorable, to their spread."

Euthanasia
"168. The pity aroused by the pain and suffering of terminally ill patients, children with disabilities, the mentally ill, and the elderly can be the context in which the temptation to commit euthanasia becomes increasingly strong....what might seem logical and humane proves to be absurd and inhumane when examined more closely....Euthanasia...is a homicidal act, which no end can justify.311"

"169....there is no right to dispose arbitrarily of one's own life, and for this reason no health care worker can become the executor of a nonexistent right."

"170. 'The pleas of gravely ill people who sometimes ask for death are not to be understood as implying a true desire for euthanasia; in fact, it is almost always a case of an anguished plea for help and love. What a sick person needs, besides medical care, is love, the human and supernatural warmth with which the sick person can and ought to be surrounded by all those close to him or her, parents and children, doctors and nurses.'313...."

"171. Euthanasia is a crime in which health care worker, who are always and only guardians of life, can in no way cooperate.314...."

 [ 

"In California, Jahi McMath is legally dead. In New Jersey, she is legally alive....In 2013, the then thirteen-year-old girl suffered a cardiac arrest after undergoing throat surgery. Jahi’s brain was deprived of oxygen, and her doctors at the highly respected Children’s Hospital Oakland declared brain death and pushed to have all life-sustaining medical treatment terminated. Jahi’s mother....sued to keep her daughter’s life support maintained....

"there are expert medical opinions supporting...[the position that Jali is NOT dead], most notably from the respected neurologist Dr. Alan Shewmon. Shewmon, professor emeritus in pediatrics and neurology at UCLA, has testified that Jahi’s condition does not currently meet the criteria for brain death. From his testimony (my emphasis):


Upon transfer to St. Peter’s Hospital in New Jersey, she received the tracheostomy and gastronomy feeding tube that were refused in Oakland. She received the enteral feedings that her gut was supposedly unable to handle and that would only be deleterious.With proper nutrition and other treatments for a patient requiring intensive care, her intestines healed, her skin torgor and pulmonary status recovered to normal, and she regained spontaneous maintenance of blood pressure without pressor medications.She still requires blankets to maintain temperature, but for the past 3+ years she has remained remarkably healthy, apart from being severely neurologically disabled.

Disabled isn’t dead. In short, the very medical benefits that California doctors believed could not succeed based on Jahi’s loss of all brain function instead proved physically efficacious.

Shewmon also reviewed forty-nine videos taken by [the mother]..., most of which appear to show Jahi responding to her mother’s requests to move different parts of her body. He testifies that some of the movements could be caused by spinal cord impulses—but not all....Given that tests have shown that these videos have not been doctored, these images should raise all our eyebrows....

Shewmon certainly is an expert. After reviewing Jahi’s medical condition and history, the tapes, and other data, he testified:


Jahi McMath is a living, severely disabled young lady, who currently fulfills neither the standard diagnostic Guidelines for brain death nor California’s statutory definition of death. At the very least, in the matter of life versus death, the compelling evidence [in videos] of responsiveness to commands and of puberty warrants giving life the benefit of the doubt.

....I am stunned that the medical and bioethics communities generally show such a pronounced lack of curiosity about Jahi’s situation....

Perhaps it is just a case of 'experts' not wanting to know—because if Jahi isn’t dead, it would have epochal legal, social, medical, and scientific ramifications. But so what? Jahi deserves justice. If alive, she is a full and equal member of the moral community...." (Wesley J. Smith, First Things, 9/15/17)]