mercoledì, settembre 30, 2020

New Vatican document sets out clearly the case against assisted suicide

Last week, the Congregation for the Doctrine of Faith, published ‘The Good Samaritan’, a letter approved by the Pope decrying euthanasia. It is very timely from the point of view of the assisted suicide bill currently before the Dáil. Some form of it could be passed within the next 12-18 months.

The document describes euthanasia as “an intrinsically evil act, in every situation or circumstance”, as it directly causes the death of an innocent human being.

It says assisted suicide makes the act of suicide even worse by involving another person in it, namely the health workers and anyone else involved in the decision. This could include family members.

The document refers to legislators as well. It states: “Those who approve laws of euthanasia and assisted suicide … become accomplices of a grave sin that others will execute”. It reminds Catholic hospitals that they must never cooperate with assisted suicide or euthanasia.

It reaffirms that life is a fundamental good, necessary of every other good. “Just as we cannot make another person our slave, even if they ask to be, so we cannot directly choose to take the life of another, even if they request it.”

But the Church also makes clear that while you must never directly kill a patient, it is morally lawful to suspend futile treatments when death is imminent and those treatments would only extend the pain with no real benefit for the patient. But, even when futile treatments are suspended, the therapeutic care continues and the essential physiological functions have to be maintained.

Similarly, deep sedation in the terminal stage is morally licit, when the direct purpose is not kill the patient but to mitigate unbearable pain.

The Vatican letter presents three cultural obstacles that obscure the sacred value of every human life. First, the use of the misleading use of the term “dignified death” as measured by a person’s “quality of life”. Second, a false understanding of compassion. Third, a growing individualism within personal relationships.

In contemporary culture, human life is no longer recognised as a value in itself but, instead, it is considered worthwhile only when it has an acceptable degree of quality. The presence of physical or psychological discomfort, according to this point of view, impoverishes the quality of life and makes it not worthy of continuation.

A false sense of compassion claims that it is better to die than to suffer but, the document states, “human compassion consists not in causing death, but in embracing the sick, in supporting them in their difficulties, in offering them affection, attention, and the means to alleviate the suffering”.

The third obstacle to appreciate the value of human life is individualism. Those who become dependent on others are not able to exercise perfect autonomy, so choosing one’s own death becomes the ultimate act of self-affirmation.

The document reminds readers that the doctor “is never a mere executor of the will of patients, but retains the right and obligation to withdraw from any course of action contrary to the moral good discerned by conscience”.

A significant portion of the letter is devoted to conscientious objection. “Laws exist, not to cause death, but to protect life. … It is therefore never morally lawful to collaborate with such immoral actions or to imply collusion in word, action or omission”. This is the case for individuals and also for institutions, such as hospitals or nursing homes. When conscientious objection is not legally recognized, “one may be confronted with the obligation to disobey human law”.

Catholic healthcare institutions cannot cooperate with gravely immoral laws. This also means “Institutional collaboration with other hospital systems is not morally permissible when it involves referrals for persons who request euthanasia”, as this would be a form of participation.

Episcopal conferences, local churches and Catholic institutions should “adopt a clear and unified position to safeguard the right of conscientious objection in regulatory contexts where euthanasia and suicide are sanctioned”.

The Vatican document also says that while chaplains are allowed to assist spiritually those who expressly wish to legally end their lives, they should avoid doing anything that could be interpreted as approval of such an act. If the patients are determined in their intent, they cannot be given absolution during Confession. This is intended not to condemn but to the lead the sinner to conversion.

This document deserves careful reading and urgent dissemination by the Irish Church.

martedì, settembre 29, 2020


 Conoscete Franco Farinelli? E' un geografo. Io l'ho scoperto solo tre giorni fa e da allora non riesco a smettere di guardare i suoi video. Interessantissimo.

mercoledì, settembre 23, 2020

A quarter of Catholics may not return to Mass post-Covid

How many Catholics were attending Mass before the pandemic began? How many have returned in the meantime? How many will come back when this is all over? These were some of the vital questions asked in a new Iona Institute poll conducted by Amarach Research.

Here are the main findings:

  • 27pc of Catholics were attending Mass regularly before the pandemic began
  • 36pc of those attending before the pandemic have come back in the meantime
  • 19pc of those who are attending before don’t know if they will come back
  • 4pc said they won’t come back.

This is the first poll of its kind conducted in Ireland. You can download the results of this very important survey here

The poll also found that a large majority of those who have not returned to regular attendance said it is due to fear of the virus (45pc) or because of the limits on numbers permitted to attend (22pc).

The findings should act as a further wake-up call for the Church. On the positive side, 36pc of people are back at Mass which is probably close to the maximum because of current restrictions. It is also good that big a majority of those who were attending Mass before the outbreak want to return when all this is over. But the fact that 19pc of Catholics who attended Mass regularly before Covid don’t know if they will came back, and another 4pc say they won’t come back, is obviously deeply worrying. The Church is clearly going to have to organise a big parish-by-parish effort and invite them back. The Church is nothing if it is not a community. We can’t be Christians on our own.

previous poll commissioned by The Iona Institute and conducted in mid-April, found that 27pc of respondents had tuned into religious services online, which is comparable to the numbers attending Mass regularly before lockdown began. It also found that 18pc of people were praying more than usual.

domenica, settembre 20, 2020

Porta Pia 

Un bellissimo articolo dell'amico Paolo Gulisano sulla breccia di Porta Pia.

mercoledì, settembre 16, 2020

martedì, settembre 15, 2020

Assisted Suicide Bill introduced in the Dail today is fatally flawed

A Private Members’ Bill permitting Assisted Suicide has been introduced to the Dail today by Gino Kenny TD. Some media reports say the Bill has strong safeguards and is limited in scope. This is totally false. Its definition of ‘terminal illness’ is incredibly broad, a person does not have to be within a few months of death to avail of the proposed law, and doctors will be forced to facilitate assisted suicide.

The proposal is obviously wrong in principle but, even allowing for that, the Bill is incredibly far-reaching. Let’s go through some of the main provisions.


Terminal illness

The Bill defines ‘terminal illness’ as follows:

“A person is terminally ill if that person has been diagnosed by a registered medical practitioner as having an incurable and progressive illness which cannot be reversed by treatment, and the person is likely to die as a result of that illness or complications relating thereto”.

This is so broad it could include heart disease, dementia, MS, Parkinson’s and Motor Neurone disease in addition to many other conditions.

The definition merely says, ‘likely to die’. What does ‘likely’ mean? Does it mean a 51pc chance? It appears the condition does not have to be advanced or imminently life-threatening at all.

The Bill would permit doctors to help the suicide of anyone suffering of an incurable illness, at any stage, even if they are not at the end of their life.


No time limit set


People suffering from incurable and progressive diseases can live for many years but the Bill would permit someone diagnosed with, for instance, early stage dementia or Parkinson’s, to immediately apply for assisted suicide and once two doctors agree to the request, be given a lethal drug 14 days later.

(Some legislations permitting assisted suicide require that the patient is expected to die within 6 months or less. This is the case in Oregon, or in Victoria, Australia).


No proper protection for conscience rights


The Bill also obliges those health professionals (physicians, nurses, pharmacists) who have a conscientious objection to assisted suicide, to make “arrangements for the transfer of care of the qualifying person”, which is a form of participation. This would go against conscience rights.

It amounts to a wholesale assault on the hospice movement which was set up specifically to care for people nearing the end of their lives but without the intention of ever deliberately killing a patient. Doctors working in hospices would become the very people most often forced by law to refer their patients to other doctors willing to give them a deadly poison, which can never be a part of medicine.


Few safeguards


In the Australian State of Victoria, a person must request assisted suicide three times before it is granted. Here there is only a requirement to do this once. In addition, the Victoria law requires that a person is six months from the end of their life, or 12 months in the case of a neuro-disease, before they can access assisted suicide. Of course, the Victoria law is wrong in principle, but the Gino Kenny Bill is even more permissive than it.


What will happen to the Bill?


The Government has been largely silent about the Bill. Sinn Fein has indicated support for it in principle as has Labour and several Green TDs.

If there is a free vote, a version of this Bill could pass in a matter of months. Fortunately, the voices of palliative care doctors and geriatricians opposed to assisted suicide are starting to be heard. 

venerdì, settembre 11, 2020

Why leading doctors oppose assisted suicide


A Private Members’ Bill seeking to permit assisted suicide will be debated in the Dáil next week. It is proposed by Socialist TD, Gino Kenny. The last time when this issue was discussed in Leinster House, three years ago, some of the strongest opposition came from the members of the medical profession and disability advocacy groups. It’s worth recalling what they said because it is still completely relevant.

The Joint Committee on Justice and Equality heard from two doctors, Regina Mc Quillan, speaking on behalf of the Irish Association of Palliative Care, and Des O’Neill, professor of Medical Gerontology at Trinity College Dublin. (Here is the final report of the Committee).

Dr Mc Quillan made five main points: “1. A change in the law would put vulnerable people at risk. 2. It is not possible to put adequate safeguards in place. 3. The drive to improve the care of people with life-limiting illnesses by education, service development and research may be compromised. 4. Personal autonomy is not absolute and we are part of a society. 5. Allowing assisted suicide or euthanasia for some populations for example the terminally ill or the disabled, devalues the lives of those compared to those targeted in suicide prevention campaigns.”

Dr Mc Quillan cited research by The National Safeguarding Committee revealing that half of the population has witnessed abuse of an adult, and so she maintained that it is “not prudent to assume vulnerable people can be protected in the context of assisted suicide and euthanasia.“

People are already at risk, even with laws and regulations, and “changing the law to allow assisted suicide and euthanasia will endanger the lives of many”, despite suggestions that abuses of this type of legislation can be prevented.

She referred to research showing failures in the countries where medically assisted killing has been introduced. Even where restrictions were in places, there is evidence that euthanasia was offered to those who were not terminally ill or were suffering from psychiatric problems.

Dr Mc Quillan explained which areas within palliative care need development. She said: “the acceptance of assisted suicide and euthanasia could lead to an underinvestment in palliative care research and service delivery, as assisted suicide and euthanasia may be promoted as cheaper options than appropriate health care provision.”

Doctors who everyday deal with suffering and end of life decisions are rarely heard in public debates on these issues, which tend to concentrate on dramatic, high-profile cases. The experience and the concerns of those who offer palliative care are particularly meaningful as they offer a view that is an alternative to common emotional appeals.

“We do not currently have equitable access to palliative care, disability services, psychiatric or psychological support services and my concern and that of many working in health care is that to move in the direction of euthanasia would be to move away from investment in the appropriate services.”, Dr Mc Quillan said.

She also highlighted that, as women are more likely to live longer with greater disability and more likely to have less social support, they will suffer more if euthanasia or assisted suicide is introduced. Women, she claimed, “are more likely to be a victim of ‘mercy killing’ by a male family member in cases which have come to the criminal courts in different countries.”

Professor Des O’Neill was another firm opponent of medically assisted killing. He told the Oireachtas Committee: “That there might be two forms of suicide – one which is clearly upsetting and worthy of strenuous societal efforts to prevent, and one which might be tolerated and given the support and protection of law – is a deeply challenging and contradictory premise. … The decriminalisation of suicide was a humane initiative, aimed at avoiding stigma and further hurt in terms of both completed suicide and attempted suicide, and emphasising the need for help and support for people in this situation, an impulse that holds true for those seeking assisted suicide as well. It was certainly never seen to be an expression of a societal desire to extend access to suicide as a human right, or to position suicide as an act that equality legislation might facilitate”.

Prof. O’Neill criticised the idea of unlimited choice, based on the assumption “that all patients are independent and autonomous, even at moments of high vulnerability”. Instead, we should remember that decisions are often led by the “potency of prejudice against ageing and disability.”

He said that all the major UK advocacy groups for disability have rejected assisted suicide.

To those proposing ‘death with dignity’ he replied: “Human dignity is not a thing that can be lost through disability, disease, dependency, or suffering, although insensitive treatment or attitudes to those so affected can constitute undignified care.”

The promotion of dignified care, instead, is the best way to contrast assisted suicide. In this respect, health care professionals play a pivotal role. Their opposition to deliberately killing, or facilitating self-killing, is something rarely appreciated and highlighted in the current public debates about the end of life decisions.

Prof. O’Neill expresses this perspective clearly: “Public and private discussion with regard to assisted suicide should be seen to represent concerns over adequacy of treatment and support as well as existential concerns relating to the future: these need to be proactively addressed.

“To ask doctors to run counter to this by killing patients short-circuits and undermines our impetus to care, comfort and support and damages our framework of care. Current and future patients need to be reassured that the response of the healthcare professions to distress and pain is one of compassion and care, addressing the needs at a range of levels – biological, psychological, social and spiritual – while respecting wishes to the greatest extent possible.”

(Many of Prof. O’Neill’s points were reiterated in this recent radio interview: )

martedì, settembre 08, 2020


Ho comparato un nuovo microfono per i miei podcast e per fare lezione.

giovedì, settembre 03, 2020

Countries with liberal legislation have higher rate of abortion for unexpected pregnancies

A new study has found that 70% of unintended pregnancies end in abortion in countries where it is broadly legal, while in countries where abortion is restricted, this happens only in 50% of the cases.

A new multi-authored study published by The Lancet medical journal investigated the occurrence of abortion in unintended pregnancies world-wide. Unintended was defined as pregnancies that occurred sooner than desired or were not wanted.

The researchers developed a new statistical model that jointly estimates unintended pregnancies and abortion.

It should be highlighted that four of the eight authors of the article are from the Guttmacher Institute, historically associated to the US abortion provider Planned Parenthood. Funding was provided by organisations such as the Bill and Melinda Gates Foundation which support abortion.

Nonetheless, the study provides evidence for what pro-life groups has always claimed: more restrictive laws contribute to reduce the incidence of abortion.

The study divides all the countries in the world in two categories: where abortion is restricted and where it is “broadly legal”. By restricted they mean that it is prohibited, permitted to save the life of the woman or to preserve physical and mental health. By broadly legal is intended where abortion is available on request or on broad socio-economic grounds.

Interestingly, Ireland is listed among those countries where abortion is available on request while the United Kingdom is among those where it is permitted on socioeconomic grounds.

Two results are particularly significant: in the period 2015-19, in countries where abortion is broadly legal, the abortion rate per 1,000 women aged 15-49 was 40. The rate was 36 in countries where abortion is restricted.

In that period, 70% of unintended pregnancies ended in abortion in countries where it is broadly legal, while in countries where it is restricted, this happens only in 50% of the cases.

Those two results prove that where more restrictive laws are in place, both the abortion rate and the number of unintended pregnancies ending in abortion are lower, compared to countries with more liberal abortion regimes.

There is no simple cause and effect between legislation and those two rates, as they are determined by a complex number of factors (socioeconomic conditions, quality of the health system, culture, etc.), but the association is clear.

The study also divided countries into three groups, according to their income as calculated by the World Bank, and found that the annual unintended pregnancy rate is 34 per 1,000 women aged 15-39 in high-income countries, 66 in middle-income countries, and 93 in low-income countries

It is not a surprise that unintended pregnancies are inversely proportional to the country income.  Nonetheless, both the abortion rate and the proportion of unintended pregnancies ending in abortion is higher in middle-income countries, than in low or high-income countries.

In other words, while there are more unintended pregnancies in poor countries, those pregnancies don’t end in abortion at the same rate as they do in middle-income countries.

The limit of this world-wide studies is that they group dozens of countries that might have one element in common (abortion legislation, in this case) but too many other factors that cannot be taken into consideration.

In the study the authors make some claims that are contradicted by their own results. For instance, they say: “We found no evidence that abortion rates were lower where abortion was restricted”.

In saying this, they refer not to the figures that I have quoted above. Instead, they have to exclude India and China, so that abortion rate in countries where abortion is legal decreases from 40 per 1,000 women to 26 per 1,000 women.

But why should those countries be excluded? Because they “skew” the results and the authors of the study are not happy with that?

In a quite unreasonable explanation they say: “We found that China and India, which comprised 62% of women who were at reproductive age in countries where abortion was broadly legal, skewed the averages in countries was broadly legal. Averaging among all other countries where abortion is broadly legal, abortion rates were higher among countries where abortion was restricted.”

That is quite astonishing. Of course, if you exclude 62% of the population, the results will be different but that is not a good reason to do it. Sample should not be manipulated to achieve a preferred result.

The conclusion remains that this new study – from pro-choice researchers – confirms that abortion rates are lower where abortion is more restricted, unless you want to ignore the two most populated countries in the world.

mercoledì, settembre 02, 2020

martedì, settembre 01, 2020

Assisted suicide is incompatible with human dignity


The debate about assisted suicide is heating up in Ireland again with a Private Member’s Bill due to come before the Dail that seeks to permit the procedure under certain circumstances. At the core of this debate is the very dangerous assumption that death by a form of suicide is compatible with human dignity.

Dignity is the intrinsic value of a person that requires respect and reverence.

Suffering, physical or mental, is a terrible but there is profound dignity when someone faces the most difficult circumstances with courage and strength.

Associating this great human value with self-killing is detrimental. The more astute campaigners for assisted suicide will use more acceptable expressions such as “assisted dying” or “end of life options”, as they are well aware of the contradictions of their own perspective.  But behind those euphemisms there is the dark reality that assisted suicide is a form of suicide and endorsing it, even in limited circumstances, sends the wrong message to those who struggle.

Those who are vulnerable deserve more protections, particularly protection from despair or a sense of abandonment. They don’t need a “dignified” exit option, precisely because there is no real dignity in suicide.

Among the strongest opponents of assisted suicide are health care professionals. For instance, the World Medical Association has recently reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide.

“The WMA reiterates its strong commitment to the principles of medical ethics and that utmost respect has to be maintained for human life. Therefore, the WMA is firmly opposed to euthanasia and physician-assisted suicide”, they stated at their 2019 annual conference, “No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end.”

Their pledge also refers to dignity twice: “… I will respect the autonomy and dignity of my patient; … I will practise my profession with conscience and dignity …”

Once we agree with the false notion that killing ourselves, with the help of others if needed, is a more dignified death than other alternatives, it becomes harder to restrict it.

It would become more difficult, for instance, to refuse a ‘dignified’ death to a young person who felt clinical depression (say) was making their life ‘unbearable’.

Involuntary euthanasia also becomes harder to resist. If we decide deliberate killing is compatible with ‘dignity’, then the way is paved to authorising the death of people suffering from severe dementia, are seriously ill in other ways, and cannot make a decision for themselves.

There is an almost natural step from “this is a good option” to “this is the good option”.

In vulnerable minds, – because this is precisely what we are discussing here – once assisted suicide becomes socially acceptable it also becomes the expected “choice”.

The experience of the few countries that have introduced assisted suicide – which is still banned almost everywhere – tells us two things: with time those laws become less restrictive and the number of people who kill themselves grows, together with the number of abuses of the legislation.

It is not surprising that soon or later the initial restrictions are lifted because if “dying with dignity” is preferable to alternatives, there is no compelling reason why it should be restricted at all. Also, it is not surprising that what is initially presented as a “choice” becomes a social norm. Legalisation means normalisation.

I am not saying that the proposal to allow a limited form of assisted suicide is bad because it could escalate. I am arguing that it is always wrong and it is impossible to make a distinction between bad and good suicides.

It is wrong in itself and it is much easier to see why when we consider all the necessary and logical consequences of accepting a principle that initially is limited to restricted circumstances.

Let’s be clear, there is no dignity in suicide and those who perpetuate this notion are spreading a very dangerous idea.