On 27 November 2023, the Australian Catholic Bishops Conference (ACBC) released a document called To Witness and to Accompany with Christian Hope. It guides priests, chaplains and pastoral workers in how to pastorally support and accompany Catholics who might be considering euthanasia.
Archbishop of Melbourne Peter A Comensoli, chair of the Bishops Commission for Life, Family and Public Engagement, said the release of this document is ‘particularly timely’ given the number of requests for something of its kind.
With euthanasia available in every Australian state, ‘It is vital that chaplains and pastoral workers have the information to confidently respond to the realities that are facing them as they minister to Catholics in hospitals, in aged care and in their own homes,’ he said.
The bishops worked alongside medical professionals, theologians, ethicists, liturgists and the Dicastery for the Doctrine of the Faith to develop the document, which is offered as a pastoral response in the face of a challenging reality. Here are five takeaways from To Witness and to Accompany with Christian Hope.
1. A continuation of Jesus’ ministry
The bishops point to Jesus as offering the supreme example of what Christians mean when they talk about ‘accompaniment’. They especially highlight the story of Zacchaeus the tax collector (Luke 19:1–10), who, moved by Jesus’ willingness to come and stay with him, promises to give away half of his property and repay anyone he has cheated.
‘Jesus looks beyond Zacchaeus’ past to see the person in need of love and companionship, in keeping with his mission to “seek out and save what was lost”,’ the bishops write (§1).
Christian accompaniment is a ‘continuation’ of Jesus’ own ministry. While never condoning or approving of evil, Jesus nevertheless calls people to conversion and the fullness of life in him.
‘Jesus provides a template for us to affirm life without compromising truth,’ the document says (§2).
Christian accompaniment means reflecting this in our own pastoral work. It means ‘not abandoning the patients’ but coming close like Jesus did, motivated by concern for the whole person, to listen, understand and guide them into a fuller appreciation of the truth (§15).
Jesus provides a template for us to affirm life without compromising truth.
It involves ‘a commitment to walk with a patient and their family on a journey without necessarily knowing how that journey will unfold … It requires a type of listening that provides the patient with a companion to whom they can express their deepest hopes, fear and questions’ (§16).
2. Dignity can never be lost
Although throughout Australia the term ‘voluntary assisted dying’ (VAD) is used, the document points out how misleading this term is, since ‘VAD actually involves the intentional ending of a human life’ (§3).
While there is a technical distinction to be made between ‘assisted suicide’ (wherein the doctor prescribes a lethal substance for the patient to consume) and ‘euthanasia’ (wherein the healthcare professional administers the dose), the document refers to both of these as euthanasia because in both cases there is an intentional ending of human life.
Not only does euthanasia contradict the Fifth Commandment—‘You shall not kill’—but it also ‘contradicts the goodness and dignity of each person, created in the image of God,’ the bishops write.
‘This dignity can never be lost, no matter how “undignified” a patient may feel when affected by the frailty of illness and old age. Just as we begin our lives as fragile babies, totally dependent on others, we commonly end our lives more or less dependent on others.
‘What matters is the person we become in the intervening years: the relationships we have formed, the virtues we have developed and the faith in God that we have nurtured.
‘When the last phase of earthly life arrives, with trust in God, the giver of all life, we can pass the weeks or days that remain to us in the best possible ways while preparing for the gift of eternal life,’ they say (§6).
3. The Christian response to suffering
Fundamental to the ‘Good News’ celebrated and shared by the Church is the conviction that by entering into the world’s suffering, Christ ‘transfigures suffering and makes it redemptive’ (§9).
On the cross, Jesus experienced the deepest suffering and the complete loss of human ‘autonomy’, but in the face of this, he ‘handed his suffering over to his Heavenly Father’ and ‘offered [it] for the good of the world’.
‘We believe that we can unite our own sufferings with Jesus’ and thus participate in his redemptive plan for the good of all humanity,’ the document says (§10).
The Christian understanding is that ‘Suffering never diminishes the fact that our lives are always worth living and that we can see the best in human beings in times of suffering. Even in times of suffering near the end of life, there is still so much for which to live’ (§11).
We are also called to help the terminally ill ‘to appreciate the medical care that is available to relieve their symptoms and distress’ (§18)—in other words, palliative care.
Suffering never diminishes the fact that our lives are always worth living and that we can see the best in human beings in times of suffering.
‘The Church continues to advocate strongly’ for a more equal distribution of palliative care resources to ensure that patients’ symptoms are effectively managed and that they can spend their final days with the support and in the environment that will most benefit them (§20), pointing out that when it is made available, there is much that palliative care can do to ease the suffering of terminally ill patients.
The document notes that palliative care professionals often speak of patients finding that they want to continue living ‘once their symptoms have been managed’ (§19).
4. Assessing responsibility
The document also provides guidance for family members, health care professionals and pastoral workers on how to navigate difficult moral questions of personal complicity.
For example, the bishops affirm that ‘we should and do wish to support and accompany the people we love and care for, even when we cannot support the actions they are taking. This is our Christian duty—but how are we to do this without being complicit in the act of euthanasia?’ (§26).
One question that is discussed, for instance, is whether family members are permitted to be present when the lethal dose is administered, despite being personally opposed to euthanasia.
Drawing upon Pope John Paul II’s teaching that we must evaluate the ‘acting subject’—the goals and purpose of the person undertaking an action—the bishops offer a number of principles and examples to guide people in assessing situations for themselves and understanding their own obligations (§§23–36).
5. Guidance for priests
An especially important aspect of this discussion is the guidance offered to priests in relation to administering the sacraments.
Christian accompaniment means being able to assess whether the person considering euthanasia is in the right state to worthily receive the sacraments, including Penance, Anointing of the Sick or the Eucharist received as Viaticum—‘food for the final journey’ from life to eternal life (§37).
The bishops offer principles and practical advice on what conversations to have and with whom, and on what needs to be made clear. They also provide examples of how conflicts of conscience might occur for the patient and how priests can help resolve these inner conflicts (§§45–50).
They also outline the situations in which it is not permissible for sacraments to be administered (§51) and what the norms are for funeral rites (§§52–54).
You can read To Witness and to Accompany with Christian Hope here.
