The primary end of healthcare is treating illnesses and injuries so that the human person, body, mind, and soul, can live a rich and vibrant life. Healthcare, in other words, is that discipline which helps the human person to flourish by restoring the full potential of their physical, mental and spiritual capacities. Now there is also a secondary, legitimate and important purpose of healthcare, which is the relief of unnecessary suffering. Most of the time, this relief occurs in conjunction with efforts of medical personnel to heal a person. But in certain cases where death is inevitable and imminent, the best that healthcare professionals can do is to keep the person as comfortable as possible for their remaining time of life. In such cases, this “palliative care” is an act of mercy.
While palliative care is appropriate and helpful, however, it is not the primary purpose of healthcare. In fact, if palliative care becomes the primary purpose of healthcare, it is no longer appropriate or helpful, but inappropriate and damaging. Why would this be? Very simply, because the role of the doctor is to heal and restore the person to fullness of health. If a doctor abdicates that responsibility in a circumstance when there is a reasonable hope that the person can be healed, then the doctor is facilitating the death of the patient by omission. This is what is referred to as passive euthanasia. The patient dies because of the failure of the doctor to take the appropriate medical action that would save his or her life.
There is currently a movement in this country to expand the prevalence and influence of palliative care. This movement finds legislative expression in HR 1676, a bill which requires the Department of Health and Human Services (HHS) to provide broad support to palliative care and hospice education centers. This support takes the form of training medical professionals in palliative care, as well as financing the expansion of palliative care. HHS would also need to engage in a national awareness campaign about the benefits of palliative care.
In the first place, we must ask why this is necessary. According to the National Hospice and Palliative Care Organization, in 2016 there were 4,382 certified hospices in operation across the United States, providing pain management and support in the last stages of life. Given the prevalence and accessibility of this type of healthcare, why create more public funding for what already exists in abundance? It would make far more sense for HHS to spend these funds on cancer research, finding cures and treatments for auto-immune diseases, promoting cardiovascular health, or any number of others areasthat promise to advance the central purpose of medicine, which is restoring the health of the whole person. In truth, we must say that HR 1676 is a diversion of healthcare resources into a secondary area of healthcare, palliative care, that can never fulfill the essential purpose of medicine to heal the person.
Secondly, we should look at the risks posed by this bill. As previously mentioned, it diverts funds and non-material resources from the central purpose of healthcare. While palliative care already accompanies many curative treatments, the governmental funding and prioritization of this type of healthcare threatens to displace the proper emphasis of healthcare professionals on curing the patient. It suggests that palliative care is at least equally important to the practice of medicine as curative treatment. It also encourages medical providers to make subjective judgments about quality of life and allow those judgments to impact how they practice medicine. If a doctor believes that a patient has a low quality of life, he may elect to relegate his “treatment” to palliative care. Few Americans would choose to die unnecessarily, and they expect their doctor to use the fullness of his or her training to heal them, instead of simply making them comfortable while they die. In fact, if the doctor refuses to try and heal a person who wants to be healed, they will come to distrust their doctor and look for another doctor who can help them to live. It is then no exaggeration to say that this bill threatens to undermine the nature of the doctor-patient relationship by putting doubt in the mind of the patient of their doctor’s intention to heal them. Put more bluntly, this bill has the likely potential of funding passive euthanasia. Anyone who doubts this should consider that Compassion & Choices, one of the pro-euthanasia organizations that stem from the Hemlock Society, is supporting HR 1676.
For the above stated reasons, the pro-life community should reject HR 1676- The Palliative Care and Hospice Education and Training Act. This bills threatens to undermine the integrity of the medical profession through the promotion of passive euthanasia and is certain to divert funds and resources that should be spent on the treatment of illnesses and injuries.
MICHAEL VACCA is a devotee of the Sacred Heart of Jesus and St. Therese of Lisieux. He graduated from Hillsdale College with a B.A. in English and Political Science, holds a J.D. from Ave Maria School of Law, and is a licensed attorney in Michigan. He currently serves as Director of Ministry, Bioethics, and Member Experience for Christ Medicus Foundation CURO. He worked for the Pontifical Council of the Family in Rome, where he advised the Church on pro-life and pro-family issues and advanced Catholic social teaching throughout the world. Michael is the Managing Editor of the International Center on Law, Life, Faith, and Family, which produces and provides resources on these issues, www.icolf.org. He is a founding board member of Sidewalk Advocates for Life, and currently serves on the board of the Casa Vitae Foundation. He is author and coauthor of various articles on bioethics and law, including: Michael Vacca, A Reexamination of Conscience Protections in Healthcare, 62 MEDICINA E MORALE 78 (2013) ; Jane Adolphe & Michael Vacca, Best Practices: Laws Protecting Human Life and the Family Around the Globe, 2 AVE MARIE INT’L L. J. 1 (2012); Michael Vacca, Talk About a Human Rights Violation: How Heterologous Assisted Reproduction Harms Children and Violates International Human Rights Law, 7 AVE MARIE INT’L L. J. 53 (2018); Michael Vacca, Natural Law as Guardian of the Human Person, 4 BAKU ST. UNIV. L. REV. 149 (2018); and Michael Vacca, Education and Religious Freedom in the Toledo Guiding Principles: A Comparative Analysis Between the Holy See and the United States 36 ARIZONA JOURNAL OF INTERNATIONAL AND COMPARATIVE LAW 2 (2019). He is also a co-editor of two published books, ST. PAUL, THE NATURAL LAW, AND CONTEMPORARY LEGAL THEORY (2012) and EQUALITY AND NON-DISCRIMINATION CATHOLIC ROOTS, CURRENT CHALLENGES (2019). More than anything, Michael is grateful to know the love of Jesus Christ and for his beautiful and holy wife Sarah.