The death of
Eluana Englaro in Italy on February 9 echoed around the world. After a car accident
in 1992 she lived for 17 years in a deep coma in a Catholic nursing
home. Her father, however, thought that she would be better off dead.
After years of legal battles, he won. Italy’s highest court allowed
him to withdraw food and water and his daughter died after three
days.

The case was
incredibly controversial and politically divisive. Here a Catholic
theologian in Rome answers questions about its significance.

How
should we approach the debate over Eluana Englaro?

When
a sick person capable of thinking and wanting -- or his or her
relatives or guardian -- refuses medical treatment or ordinary care
(feeding, hygiene, etc), this decision has ethical, deontological,
legal and political consequences. It
is not morally neutral. The choice
made on behalf of Eluana Englaro can only be just or unjust –
although I must stress that I do not want to pass judgement on
particular persons.

Two important
things occur to me: 

(a) It is not true
that a choice made freely and in good faith is necessarily correct.
Nor is it true that it is necessarily wrong. Sincere and free choices
can be right or wrong from an ethical point of view. Denying this is
simply denying the existence of ethics itself.

(b) We must not
assume that those who have opposed the choice made on Eluana’s
behalf have pre-judged the case and are harsh, negative and even
cruel. The dispute is not over who made decisions.

But how can you
deny someone freedom of choice?

First of all, we
are all free to refuse burdensome medical treatment. Everybody agrees
that there is no sense insisting on futile treatment in the face of
the inevitable death of a sick person. We must alleviate suffering
and support patients so that his or her last moments can be lived in
the best way possible.

Second, the notion
of self-determination in relation to medical treatment must be
considered in light of the Italian legal system which prohibits
suicide and assisting suicide.

So, for example, if
a young person with serious diabetes were to refuse to take insulin,
we would regard this as tantamount to suicide. No doctor could do
that, at least without consulting. The same criteria should hold for
a healthy person or a clinically-stable patient (eg, a quadriplegic
or a someone in a vegetative state), who cannot feed himself. Without
judging people’s intentions or using harsh words like murder or
homicide, withdrawal of nutrition and medicine must somehow conflict
with the law. The actual or presumed will of the person concerned is
irrelevant because the application of the law does not depend on the
intentions of the person concerned.

Do we have to
rethink the commandment “Thou shalt not kill”?

This is the crux of
the problem. There are two fundamental positions:

Some maintain that
a living in a clinically-stable situation can be negative and
senseless. Intentionally taking away the life of a person in such
state is a good and legal action. The life of the sick person is
deemed so bad that it justifies the abrogation of the
universally-accepted juridical principle “Thou shalt not kill
(oneself or another person)” or (“Thou shalt not intentionally
take away the life of anyone” or “Thou shalt not program an
action or an omission that will cause the death of somebody”).

Others maintain
that “Thou shalt not kill” is always and everywhere valid, even
if in some painful situations it is not necessary to prolong life
with burdensome treatment.

The reason why the
case of Eluana Englaro has been so controversial is that the legal
system has now set down as a juridical principle that there are
exceptions to “Thou shalt not kill”.

For centuries,
despite terrible wars, civilisation has been based on the notion that
a just resolution of whatever type of conflict has a limit that can
never be crossed and that limit is: “Thou shalt not kill”. This
has been considered universally valid, always and everywhere, even in
extreme conflicts. If the legal system accepts that this principle
has exceptions, then other universally accepted principles can also
have exceptions, which would vary throughout history.

Where the legal
possibility of taking away a person’s life is admitted for those
who ask for it in extreme cases, slowly but surely even the lives of
those who have not asked for it are taken away. This is a documented
fact which is not worth debating here. If situations exist which
justify exceptions to this absolute prohibition, every government
could create its own ideology.

The
person who pursued the decision on Eluana’s behalf has been hailed
as an honest man who has tenaciously pursued his case through the
legal system. I insist that I am not being critical of individuals. I
am just noting the failure of a universally accepted juridical
principle.

Will
there be political consquences?

I
believe so. The modern state is based on the idea that men surrender
their own capacity for self-defence and their unfettered
self-interest to a government which assumes a monopoly of authority.
They believe that in this way, their lives, their freedom and their
property are better protected. Governments were created to guarantee
life, liberty, equality and health and not to administer death,
sickness, or slavery.

In
every society there will be murderers. But this sad reality has
always been considered contrary to the law. The government and its
health system must not offer services which lead to the grave.
Exceptional and desperate cases must be considered individually.
Certain things cannot be asked from the health system, from doctors
or from tribunals of justice.

But
isn’t this a case of the Catholic Church interfering?

Invoking
the question of secularity of the State just confuses things. The
late secular Italian philosopher Norberto Bobbio, who understood the
foundation of modern political life, once wrote: “I am stupefied
that secularists leave to believers the privilege and honour of
affirming that one must not kill”.

Isn’t choosing
death the ultimate freedom?

Invoking
freedom and right of self-determination is likewise confusing.
The modern state exists to defend life and freedom and it cannot
admit the freedom to kill or the freedom to be killed. For that
matter, neither can it admit a freedom to rob or to rape. A life that
is free is the highest form of life that can be enjoyed here on
earth. If freedom turns out to be against human life, it contradicts
itself, and ceases to be a fundamental principle of social and
political life.

Angel
Rodríguez Luño is the head of the
Faculty of Theology in the Pontifical University of the Holy Cross in
Rome. Translated and adapted by Dean Johnpaul Menchavez y Dumlao, a
free-lance journalist currently based in Rome.