EUTHANASIA

What is Euthanasia?
Euthanasia comes from the Greek word "thanatus" which means "easy or happy death." Implicit
in this etymological meaning is the outright rejection and avoidance of the opposite: "a difficult or
sorrowful death," so that the condition of a dying person which is characterized by intense pain and
suffering can be a reason to opt for a willful maneuvering into that which paves the way to an "easy
death." Obviously, "easy death," in this context, means earlier death that is intentionally caused in order
to get rid of a "difficult death." Hence, the Sacred Congregation for the Doctrine of the Faith states:

By Euthanasia is understood an action or omission which, of itself or by intention causes death,

in order that all suffering may in this way be eliminated.

Types of Euthanasia

Below are the two major types of euthanasia gleaned from its definition:
1. Euthanasia by Commission is also called active euthanasia. It refers to the positive act of causing
death that is geared towards termination of pain and suffering. By positive act is meant a
measure necessary to end the life of a suffering person is directly used. Example: a lethal dose is
injected into the terminally ill patient to cause immediate death.
2. Euthanasia by Omission is also called passive euthanasia. It refers to the negative act of causing
death that is geared towards termination of pain and suffering. By negative act is meant a
omitted, withheld or withdrawn. Example: food and water are measure necessary to sustain the
life of a suffering person is withdrawn to bring about the earlier death of a terminally ill patient.

Categories of Euthanasia
In the health care milieu, euthanasia by commission and euthanasia by omission can be
administered taking variety of categories according to the circumstances of a suffering patient, to wit:

1. Voluntary Euthanasia indicates the measure of causing the death of the patient at his willful
consent or request. The consent or request can be verbally expressed, written in the patient's
advance directive as in a living will or durable power of attorney, or given by mere gesture in
case of inability to speak and manage oneself. This category is usually done by means of a
positive act either by the health care personnel as in direct employment of a lethal measure or
by the patient himself as in assisted suicide. In assisted suicide, technically, the patient
administers the fatal means made available by the health care team.
2. Non-Voluntary Euthanasia indicates the measure of causing the death of the patient who is
unable to express his will and make his intentions known as in unconscious or comatose state. In
this category, the decision to end the patient's life is made either by the watchers of the patient,
the health care team, or the society.
 3. Involuntary Euthanasia indicates the measure of causing the death of the patient in defiance of
his expressed will and/or against his consent.

Conditions of the Option for Euthanasia

Advocates of euthanasia may suggest the following conditions and reasons for the acceptability
of the procedure:

1. When the patient is terminally ill or incurably sick. The fundamental medical principle provides
that patients have to be treated and provided with all the appropriate means that car heal
them-with tenderness, love, and care. However, if their medical and pathologic condition is
indicative of a hopeless case which the science of medicine deems to have nothing to do, then,
they can be given the option to get rid of their dreaded situation by their hastened death.
2. When the patient experiences unbearable suffering. Health also to alleviate pain and suffering.
But when the pain and suffering are considered to be intolerably burdening, the alleviation of
pain and suffering may also take the form of causing earlier death.
3. When the patient makes a voluntary decision. Health care personnel should actively get
involved with the healing and caring process the patient undergoes. But when the patient makes
a decision to submit for the termination of his life due to terminal illness or unbearable pain,
nobody can hinder. His decision has to be respected and carried out accordingly in observance of
the so- called principle of autonomy in which the patient has the inherent right to make a choice
without having to be interfered with.
4. When the patient's life is deemed to be not anymore "worth-living." The science of medicine is
aimed to heal, comfort, and bring the patient back to his normal and healthy life. But, when the
patient's condition irreversibly deteriorates to the point of existing as a mere biological organism
in his vegetative existence, with no retrievable consciousness and no sense of self, and the like,
he can be considered to be devoid of qualities proper to a human person whose life is no longer
"worth-living." Thus, euthanasia is opted.

Arguments in favor of Euthanasia

Below are the major arguments invoked by pro-euthanasia activists in the pursuit of their cause:

An Act of Mercy
So far, the strongest argument for the recourse to euthanasia is its being perceived as an act of
mercy. The mercy, in this case, apparently manifests itself in a motive to put an end to the terminal pain
and misery of the person. That is why, it is commonly called "mercy-killing." Indeed, to rid the patient of
humanly demeaning anguish and horrendous agony may appear to be a merciful act. And there is no
other way by which the patient can definitely be freed from such a terrible situation except to cause his
earlier death which simply and necessarily means to kill him. The patient's death is seen as the only
remedy of the problem.
 The main point of justifying the procedure resides in the argument that there is no violation of
the life principle because in rather, they are merely existing as organisms-network of organs most cases,
the people killed are not fully alive as human beings; and cells. It is an act of mercy, a proponent of
mercy killing might dead", have suffered 80 percent brain damage. They will have a plantlike existence,
exhibiting no personality or real human consciousness whatsoever; therefore, it is an act of mercy to end
their existence.
Thus, the motive of mercy for euthanasia is highlighted to initiate and earn societal or public
approval.

Prolonging the Suffering of a Dying Patient is an Act of Cruelty

Flowing from the first argument, to do nothing that will cause the earlier death of a dying patient
is to prolong his unbearable agony. To prolong said agony when there is conspicuously an available
option to terminate it can be understood as an act of cruelty on the part of those attending to him. The
perceived cruelty is characterized by their irresponsible, insensitive, and neglectful regard for the
patient's condition which should be considered to necessitate the hastening of his death. After all, he is
surely going to die and that his death is just expedited so as to be, at once, released from severely
excruciating pain.

A Dignified Death
Since euthanasia is employed to cause a speedy death, the patient no longer has to come to the
point where he loses his sense of humanity and freedom because of the devastating progression of
suffering and agony while staying worthlessly alive. This argument seems to be undisputable in reference
to a long- term enfeebling and disintegrating pathologic condition like cancer.
Likewise, the patient who is to undergo the "mercy-killing" may still be given the chance to make
a choice as to when and how he should die-an act that presupposes the exercise of freedom indicating a
distinctively human and dignified character-an act extreme tip of dying devoid of any sense of self.
Hence, euthanasia that can no longer be performed by a patient who comes to the is considered as a
procedure that gives the dying patient a dignified death.

Euthanasia Serves the Best Interest of the Patient, the Relatives, and the Health Care Personnel
a. The patient is given due recognition of his human dignity by having the last chance to freely
make a decision-a dignifying opportunity in the final moment of his life. Then, he is enabled to
express his love and concern for his loved-ones by letting go of their burden and anxiety their
attending to him may have caused thereby getting away with any guilt feelings stemming there
from. Finally, he will be released and freed from the unspeakably degenerating agony and
anguish he has been experiencing. Thus, the best interest of the patient in this necessarily
inescapable moment is very well served.
b. The procedure of euthanasia gives the relatives a liberating sense of relief from the tremendous
and seemingly unbearable burden they may have been shouldering in attending to their patient.
They are, at last, emancipated from emotional anxiety and apprehension along with financial
difficulties which, if looked at closely, have been appropriated to a meaningless and wasteful
 cause from which the patient reaps definitely nothing but the prolongation of his useless
existence. Thus, the best interest of the relatives is also well served.
c. Opting for euthanasia also unchains the health care personnel from their apparently enslaving
and worthless exercise of responsibilities for a case estimated to be, in and of itself, bereft of any
hope for recovery. Moreover, because of the recourse to euthanasia, they are provided with the
appropriate opportunity to employ and redirect the utility of the medical and health care
resources into a more useful and productive medical endeavor. In effect, the said resources will
be subtly and cleverly used, particularly in their scarcity, for an optimum and successful health
care delivery. Hence, euthanasia serves the best interest not only of the health care practitioners
but most significantly of the health care system.

Euthanasia is in Accordance with the Golden Rule

The euthanasia movement may also argue that "mercy killing" is in keeping with the provision of
golden rule. Just as one would want others to help him rid of his dreadful anguish, so also others would
obviously want him to do the same if they were in his
situation.

Criticisms of the Pro-Euthanasia Arguments

The criticisms cited below expose and destroy the fallacies and reasonable and truthful grounds.
They also offer rational and absurdities of each of the arguments favoring euthanasia with humane
alternatives in addressing specific surrounding issues in lieu of the option for euthanasia, to wit:

1. On Euthanasia as an Act of Mercy

❖ Regarding "Mercy Killing"
To the question: "Can there be mercy in the act of terminating the excruciating pain and
suffering of a person?" the answer would be: Yes, there can be. In fact, it is an expression of
mercy. But, if the termination of pain and suffering takes the form of killing the person, the
motive of mercy is devoid of what it truly is.

Synonymous to mercy is compassion. Taking its root from the Hebrew word rahamin,
compassion expresses the instinctive attachment of one being for another335 which may be
indicative of filial or fraternal intimacy. This sense of intimacy radically manifests itself in one's
willingness, without reservation, to unite and to be one with the other to the extent of feeling,
of experiencing the way the other does particularly in time of tragic misery. From this
perspective of compassion, it follows that when one suffers, the other shares in the suffering and
even wishes to be the one to experience it rather than the former.
Hence, what may be desired for each other is nothing but each other's goodness
ensuring that no harm or pain of every sort is deliberately inflicted upon one or the other.
Now, in the case of euthanasia, the suffering patient is killed. Why is he killed? Because
killing him is the only means by which his intense pain can be put to an end. Eliminating his pain
and suffering is that which, according to euthanasia proponents, constitutes the merciful motive
so that the procedure is called "mercy killing."
 However, what cannot be denied is that the ultimate and even the greatest pain or harm
that can ever be inflicted upon another, here on earth, is to be killed.
Thus, the preposterous irony is that: out of "mercy or compassion" one wants to put an
end to the patient's pain by deliberately killing him which is the greatest form of inflicting pain
no matter how "painless" the employed procedure may measure is painful or painless? Is it the
health care team who appear to be. By the way, who determines whether the lethal administers
it or the patient who experiences it and who can not anymore express how it feels to be killed?
Moreover, by having recourse to euthanasia, the relatives put a stop to what would
rather be an occasion of being one with, sharing in the suffering by their enduring support, and
even wishing to be the ones to suffer rather than their beloved patient as what compassion in its
real sense constitutes. Hence, the "compassion or mercy that is attached to euthanasia is
nothing but ridiculously absurd.
At this juncture, the euthanasia advocates may insist: But after his getting killed, the
patient experiences no more suffering and pain. So, it's still worth the purpose. Well, the
perceived cessation of pain which just follows after death does not and cannot erase the
reality-the greatest pain inflicted-the act of killing.
By the way, how sure are these people that after death there is no more suffering?

❖ Regarding "Less Human Personhood"

It is also contended that suffering patients, particularly those in coma, permanent

vegetative condition, unconscious state, and the like have a diminished personhood so that no
life principle is conspicuously violated if such individuals are put to "permanent rest."
Again, the protection of human persons guaranteed by any rationally civilized state
constitutions is cunningly devised to be not attributable to such patients. Like the in vitro
embryos designed for experimentation, patients in severely degenerative condition are held to
have no possession of qualities proper to a human person. Obviously, the absence of the
referred "qualities" in said patients is described by their lots of inabilities. They cannot walk or
speak, cannot manage themselves and outwardly make use of their rational faculties, have no
consciousness and sense of self, and others.
Putting a not-so-perfect analogy, a human fetus cannot walk faculties, and has no
consciousness and sense of self. Does he or speak, cannot manage himself, cannot use his
rational have a diminished human personhood? (This author would not wonder if euthanasia
advocates turn out to be abortionists too.) The pro-euthanasia argument along this line which
has also been raised to favor early abortion, embryo stem cell research, and I.V.F. has repeatedly
been refuted in this book using scientific and philosophic attestations just the same (refer
properties such as status, human conditions, health and to Chapters 7, 8, & 9 in particular). Once
more, the accidental pathologic circumstances, and the likes do not in any manner, whatsoever
annihilate the substance of the human person as such.
2. On Prolonging the Suffering of a Dying Patient as an Act of Cruelty
If the suffering and agony of the patient are harmfully prolonged because his dying
moments are desperately and unduly being delayed, the act may indeed be cruel. Along this line,
there seems to be no identified point for objection. Even the Church would certainly agree to the
argument. (In fact, the case on prolonging the dying process is legitimately negated in the latter
discussion of dysthanasia.)
Unfortunately, however, the euthanasia proponents make use of the said standpoint to
grandstand their proposed "merciful" method of hastening the death of the patient which, as
such, indicates disputable angle.
Just as it is cruel to prolong the suffering of the patient by delaying his dying process,
more so, it is cruel to eliminate his suffering by hastening his death even if he is surely dying
after all. (For even death convicts, with all the more reason to be put to an earlier death, cannot
be speedily executed just because, after all, they are going to die). As implicated in the previous
discussion. killing as a cruel act in itself can never turn out to be a merciful act just because it is
done with a merciful motive.
To candidly and bluntly put into language the contradicting elements of euthanasia in
terms of its motive and act is something like this: Since I am compassionate with you, I want to
help you rid of your suffering by inflicting on you the ultimate form of suffering (as far as earthly
suffering is concerned). Is this not another face of sadism getting out of the sexual realm in its
most catastrophic feature?-killing the beloved out of love or compassion? How tragic! Then,
what should be done about a case in which the dying moment of the patient should not be
unduly delayed so that his suffering may no longer be unjustly prolonged? This question will be
addressed in the discussion of orthothanasia.

3. On Dignified Death
It is true that a person may have a dignified death if he can still show signs of sense of
humanity and freedom as he can still make a choice in the face of death. However, to hasten his
death for that purpose is to make his dignity work only to be trampled
upon.
To put it simply, killing a human person, whatever is the motive, represents the worst
violation of human dignity. Strictly, human dignity flows not from human freedom but from
human life itself. In short, without human life, there is no human dignity, there is no human
freedom. Thus, human dignity cannot truly be affirmed in the exercise of freedom by taking that
from which it flows.
Moreover, the patient who is subjected to euthanasia is provided with an arbitrarily
designed chance to use his freedom and assert his dignity just in order to be stripped of the
same freedom and even of what could be the greatest exercise of freedom and thus the greatest
affirmation of human dignity-which is to face death as it is naturally occurring, without
intervention, as the culminating part of human existence. (Detail of which is discussed at the last
part of the chapter for the reader to realize how the experience of death without intentionally
taking life may indeed be the ultimate expression of human freedom and recognition of human
dignity in man's earthly existence through hospice care.)
 Finally, contrary to their claim, the euthanasia advocates even grossly disregard and
reject the human dignity of the patient by considering him to have come to the point of being
definitely worthless who deserves to be killed.

4. On Euthanasia as Perceived to Serve the Best Interest of the Patient, the Relatives, and the
Health Care Personnel
a. Does it really serve the best interest of the patient? In reference to the last moment of
the patient's life, what would accord him the best interest can correctly be construed as that
which does not only serve his bodily needs but most
significantly his entire person, body, and spirit.
Primarily, his human dignity must be upheld. To be how and when to die which ends up
in getting killed is to given the last chance of freely making a decision about limit and imprison
the patient's human dignity in the talking, writing, moving, or gesturing so that if the patient
embodiment of that decision-making, as in the act of becomes unable to talk, move or make a
gesture, his human dignity is already crippled.
While the embodiment of human dignity by the exercise of freedom may not anymore
be employed in the case of a dying unconscious patient, this does not mean that the patient
faces an undignified death. Likewise, while the loss of sense of self and distinctive human
character may really be undignifying, prevention of such a loss by means of causing an early
death is just the same. Differently, as the patient moves on and enters into the threshold of
death which is empirically marked, being its indispensable part, by the loss of sense of self, his
death may still be a dignified
one.
To Christians, human dignity is a spiritual character. that belongs to the human person as
an image and child. of God. And as such, it cannot be solely confined within the limits of bodily
faculties, and thus is not essentially conditioned by any pathologically incapacitating
circumstance.
The most important, in the face of death, that rather serves the patient's best interest, is
to uphold human dignity that has bearing upon his eternal destiny in union with His Creator, and
not the ability to freely make a decision whose repercussion may be detrimental to that union.
(Please refer to the moral teachings on suffering and death and on how is it to die with dignity at
the last part of the chapter).
On the other hand, it is true that out of the patient's love for his loved ones, he may
wish to die earlier so as to ease not just his suffering but also his guilt feelings and the burden it
causes his relatives for continuously attending to him. But this wish cannot validly be assumed
even by the relatives to justify euthanasia because, for them who are truly compassionate with
their beloved patient, they can bear even what seems unbearable, endure even what seems
unendurable, and tolerate even what seems intolerable. It sounds absurd but it is the argument
of compassion.
Regarding the patient's release from the unspeakably degenerating agony and anguish
he has been experiencing, please refer to orthothanasia and again, to the moral teachings on
suffering and death.
 b. Deducing from the pro-euthanasia argument, the serving of the best interest of
relatives is defined in terms of the sense of relief from burden, anxiety and financial difficulties
they bear in taking care of their patient. This is again another factor that contributes to the
ambiguity of "mercy killing" which turns out to be at the service of the best interest of the
relatives.
Suffering in its most excruciating degree provides the most appropriate time for the
relatives to express how enduring, no matter how burdensome, are their true love and genuine
compassion for their patient who, in the very face of death, needs them the most. By reason of
the natural bondage of kinship, relatives tend to take care of their suffering patient out of love
that must be greater than even the greatest burden the tending may entail.
Ironically, this is also the very moment the relatives finally give up on their patient simply
because it serves their best interest. Sad to say, human life in its most final moment can be
treated out of utilitarian mentality. Again, how tragic!

c. By administering euthanasia, the health care personnel may be unchained of their

responsibilities for a case that is deemed to be devoid of any hope for recovery. But would it
really unchain them of their great responsibility that proceeds from the very essence of their
existence as health care practitioners which is to ultimately save life as necessary as possible and
never kill? Would it not send the people a signal that doctors and nurses can become exactly the
opposite of what they are perceived to be thereby destroying public trust and confidence both in
their person and profession? Does it not constitute a terrible. contradiction to the nature of their
profession for which they took a public oath to uphold at all times?

It is not a question of "wasting" time for a patient whose case is hopeless but is a matter
of faithfulness to one's profession. Thus, what serves the best interest of health care
practitioners is that which upholds the integrity of their profession and not that which
besmirches it with something vehemently contrary to that for which they have
become who they are.
Likewise, it is not a question of "wasting" the use of scarce health care resources but is a
matter of making said resources serve the one who is in need most at a given time within validly
designed boundaries. What serves the best interest of the health care system is to make it serve
its purpose for which it exists that is the provision of the appropriate and necessary health care
regardless of the favorability of the prognosis.

5. On "The Golden Rule"

Basically, the golden rule is in accordance with natural law. Doing to others what one
would want them to do to him, and avoiding what one would not want others to do to him are
expressions of the fundamental precept of natural law: "do good and avoid evil." As such, the
provision of the golden rule is inherent to human nature which human reason recognizes. And
since human nature is the same in all human beings, the golden rule is universal. Meaning, it is
acceptable to all who have the use of reason regardless of religion, race, life's situations,
 statuses, and so on and so forth. Thus, it is not conditioned neither is it influenced by said
human circumstances.
Now, in the case of euthanasia, the patient is severely suffering. And there is no dispute
whether the patient would want others to release him from pain as what they would do if they
were in his situation. It is in fact, a human tendency to get away with what is perceived as evil or
abnormal because of human nature which is, in and of itself, being ordered to what is good or
normal. Here, the evil or abnormal circumstance perceived is suffering from which the patient
tends to be freed. Again, there is no question about it.
However, focusing on the patient as the subject (who experiences the pain), it is one
thing for him to tend to get away with suffering, and another thing to want to get killed. The
former is a naturally devised motive while the latter is not.

Moreover, wanting to get killed is triggered by abnormal circumstance (suffering). Since,

human nature is in keeping with what is good, it would never tend towards what is evil per se.
Now, wanting to be killed is subjectively seen not as evil but as good in reference to its being as
that which would free the patient from suffering which is the perceived evil to avoid. The clear
point is that the decision is just conditioned or influenced by the abnormal circumstance of
suffering which would definitely not be made under normal circumstance (unless there is indeed
something abnormal
in the person).
In which case, the decision to want to get killed is not inherent to human nature, and as
such is not universally acceptable. It is a great fallacy to label such a decision as in harmony with
golden rule whose provision is not formulated under abnormal circumstance.

Is Euthanasia Moral?
The question as to the moral inadmissibility of euthanasia is still relevantly in place. Aside from
the above-cited criticisms, euthanasia is evil on the following bases:

❖ Violation of the Natural Law and the Decalogue

Euthanasia, by consent or request from a suffering patient invoking the so-called
principle of autonomy, does not eliminate in one way or another the evil attributed to killing.
Besides, contrary to what is claimed by the pro-euthanasia movement, euthanasia destroys the
principle of autonomy which it ironically invokes to justify. This takes place in a form of
destroying human life from which autonomy inherently flows as its indispensable character that
should rightly be employed to make human life grow towards its development, and not to take
it.
In like manner, (assisted) suicide contradicts the natural inclination of the human being
to preserve and perpetuate his life. It is gravely contrary to the just love of self....Suicide is
contrary to love for the living God. 236 Meaning to say, man tends to protect and even do
something for the natural prolongation of his life which stems from his innate love for himself.
And since true love
 as mentioned, the most outrageous form of hurting. Just like love for others, love for
one's self can truly be made manifest in the midst of his intense pain and suffering.
Thus, intense pain and suffering are not valid reasons to lean towards that which is
against love for life. Both in the order of the greatest pain and suffering that may occur so that it
is nature and Christian perspective, human life is greater than even unreasonable and
unchristian to kill one's self just in an effort to
escape from the said pain and suffering.
another person (the patient) to commit suicide and to help him in Thus, for medical
practitioners to concur with the intention of carrying it out through the so called 'assisted
suicide' means to cooperate in, and at times to be the actual perpetrator of, an injustice which
can never be excused even if it is requested an
Moreover, to cause the death of the patient who is unable to express his will and make
his intentions known due to unconscious or comatose state is simply a form of murder. It is an
act of killing the innocent human being which is prohibited both by the dictates of right reason
and the commandments of God stipulated in the Sacred Scriptures: "You shall not kill" (Ex.
20:13) and ...do not put an innocent person to death for I will condemn anyone who does such
an evil thing." (Ex. 23:7)
Much worse is the administration of euthanasia, whether by commission or omission, in
defiance of the patient's expressed will and/or against his consent. The act is outrageously evil
whose victim's blood "cries out to heavens like a voice calling for revenge." (Gen. 4:10)
Summing up, the statement of Pope John Paul II embodied in the encyclical Evangelium
Vitae is candid and straightforward, to wit:
I confirm that euthanasia is a grave violation of the law of God since it is the deliberate
and morally unacceptable killing of a human person. This doctrine is based upon the natural law
and upon the written word of God, is transmitted by the Church's Tradition and taught by the
ordinary and universal magisterium.
In the words of the Sacred Congregation for the Doctrine of the Faith in its Declaration
on Euthanasia,...nothing and no one can in anyway permit the killing of an innocent human
being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from
incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act
of killing, either for himself or herself or for another person entrusted to his or her care, nor can
he or she consent to it, either explicitly or implicitly.action. For it is a question of the violation of
the divine law, an offense Nor can any authority legitimately recommend or permit such an
against the dignity of the human person, a crime against life, and an attack on humanity 2

❖ Contrary to the Ultimate Author of Life

The act of taking life, whether it be that of the self or that of the other, whether it be in
conformity with one's request or much worse, against his will, is a dishonor against the Creator
who has absolute power over life and death.
In other words, intentionally causing one's own death or suicide as wrong as murder;
such an action on the part of the is equally person is to be considered as a rejection of God's
sovereignty and Joving plan.
 The Catechism of the Catholic Church (CCC) clearly states:

Everyone is responsible for his life before God who has given it to him. It is God who
remains the sovereign Master of life. We are obliged to accept life gratefully and
preserve it for His honor and the salvation of our souls. We are stewards, not owners, of
the life God has entrusted to us. It is not ours to dispose of.

Hence, just as abortion dishonors the will of God for one's life at its beginning, so also
euthanasia dishonors the will of God for one's life at its end.

What is Dysthanasia?

Dysthanasia refers to the undue prolongation of life and delay of the occurrence of natural
death which in effect lengthens the suffering of the person.

Undue Prolongation of Life and Delay of Natural Death

Unduly prolonging life indicates the use of artificial and medical means which does not in any
manner truly sustain life but rather delays the occurrence of an irrevocable death.

In the field of medical science, for a medical measure to sustain life, however artificial may be, it
has to contribute to the stimulation of life to be able to manifest itself as an immanent capacity to
integrate movements and functions clinically indicated in the biological and physiological functioning of
organs and systems, and ultimately of the brain stem vital for the patient to continue living his life. This
means that although the patient is connected which he may even die, the patient is still enabled to
manifest the to a life-support system, to a lesser or higher degree and/or without said capacity signifying
a sustained life.

Hence, the employment of life-support system does not necessarily require the patient to be
biologically and organically dependent upon it but to sustain his inherent capacity to show signs of life.

Meaning to say, if the patient is breathing purely because of the respirator and not because of
his immanent capacity to breathe as supported by the said respirator, the medical means employed does
not anymore sustain life. In other words, his breathing is artificially designed, removal of which facilitates
the natural occurrence of death as an irreversible event. Indeed, a very real problem arises when
artificial measures of resuscitation and life- support become death-delaying rather than properly life-
supporting" (see brain death).

Take note that the problem does not reside in the artificiality of the means of care used but in
the artificiality of the "biological signs of life in the patient.
Lengthening of the Person's Suffering

Consequently, the patient's death is unduly delayed causing prolongation of pain and suffering
which, in this case, are already unnecessary.

In its strict sense, the procedure of dysthanasia does not truly prolong life for it is not, in any
way, sustained. Rather, it lengthens the experience of dying which turns out to be a painful one thereby
ending in a regrettable and frustrating moment of death after a thoroughly extended use of a medical
means of care that does not anymore truly serve its purpose.

Means of Medical Care

The means of care is classified into two:

1. Ordinary Means of Care. This refers to a health care which is proportionate to its expected
outcome. There is proportion when the expected result is good to the patient. It is beneficial and
good if the patient's specific needs are satisfactorily addressed. Since, it serves the means of care
provides a reasonable hope of benefits and the purpose for which it is administered and thus
useful, the ordinary means of care is obligatory, appropriate, and/or necessary.

Nutrition, hydration, oxygenation, and medications are typical examples of ordinary

means of care as they are beneficial and good to the patient in terms of meeting his needs such
as food to extinguish hunger, water to quench thirst, oxygen to provide Oxygenation, and
medicines to address certain health problems.

Other Basic Examples

1. Provision of personal hygiene, cleanliness, and warmth
2. Emotional and spiritual care
3. Prevention of complications and bed sores
4. Monitoring and recording of vital and clinical signs
5. And others

Ordinary means of care is significant not only to the preservation and sustenance of life, and to
the provision of responses to certain addressable needs but also to the affirmation of the intrinsic worth
and value of the human person. As such, the ordinary means of care belongs to basic human rights that
should never be alienated from him. And since the patient who is awaiting an irreversible death is a
human person, then, his value and dignity remain. Thus, every patient, regardless of personal
circumstances, living or "dying," is entitled to such a means of care.
Withdrawal of such means of care causing the patient's untimely and early death may constitute
euthanasia by omission.
 2. Extraordinary Means of Care. This refers to a health care which is disproportionate to its
expected outcome. It is disproportionate when the outcome for which the treatment is
employed cannot significantly be attained. Meaning, the means of care does not provide
reasonable hope of benefits and the result does not do any good for the patient's sustenance
thereby inflicting unjust burden and strain on the patient himself, on the family, and on the
health care team. In other words, the real needs of the patient for which the said means of care
is administered are not properly addressed. Thus, extraordinary means of care is wastefully
utilized and is considered useless. As such, it is optional, Inappropriate, and/or unnecessary.

Artificial means of resuscitation that only delays the dying is a typical example of
extraordinary means of care since it is not moments and prolongs the agony of the irreversibly
dying patient this means of care is the one that is employed in the process of beneficial and does
nothing good but harm to the patient. Actually, this means of care is the one that is employed in
the process of dysthanasia.

Can ordinary means of care to one patient be extraordinary to another?

Since, the surrounding pathologic and biological circumstances may vary from one
patient to another, the classification of a means of care to be ordinary or extraordinary may also
vary so that it becomes subjective or is determined by the condition of the subject-the patient.
It is possible, then, for a means of care estimated extraordinary to one patient to be
ordinary to another considering the variety of their clinical circumstances. A respirator which is
extraordinary to the patient whose brain stem has just collapsed and who is irreversibly dying
may take the form of an ordinary means of care to another patient who significantly responds
and shows reasonable hope for recovery.
Hence, it is quite improper to label certain means of care as extraordinary or the other
way around without reference to the patient's medical status.
Likewise, the classically perceived ordinary means of care may also turn out to be not
anymore working as such. Without prejudice to their employment as ordinary means of care
that always represent the natural means of preserving life even when administered artificially,
nutrition and hydration may not anymore be deemed useful during which the patient is actually
experiencing the dying process.

Conditions for the Withdrawal of Nutrition and Hydration

There are two specific conditions that should satisfactorily be met so as to pave the way to the
withdrawal of food and water from the patient who is dying, to wit:
1. The current form of feeding causes significant pain or is contraindicated. Considering the
fundamentality of nutrition for life's sustenance and in an effort to avert the possibility of
causing starvation, the meeting of this condition must accurately be determined. Nutrition as in
stomach or naso-gastric feeding tube should be proven to have inflicted undue pain on the
patient who is currently entering into the threshold of death.
 3. The person is so close to death that further nutrition (and hydration) will do him no good and he
will die naturally before the resultant hunger and thirst cause significant pain.** In which case,
the patient dies not of starvation or dehydration but of a natural death. This further implies that
the patient, though, in his dying moments should be provided with nourishment until he comes
to the very tip of death in which the withdrawal of the same does not cause suffering out of
starvation and thirst because they are overtaken by death.

Is Dysthanasia Moral?
From the moral point of view, dysthanasia is morally questionable because of the following
reasons:

❖ Against Natural Law

By continuing the employment of extraordinary means of care which just unduly prolongs the
dying moments of the patient whose irrevocable death is approaching as part of the nature of his earthly
existence, the procedure patently contradicts the natural law.
Of course, it is a natural tendency for man to preserve his life so that when he is ill, or much
more seriously ill, he tends to submit to the appropriate health care services to retrieve his health and
live normal life again. However, when man comes to the point where he is at the edge of the final
moment of his life as a natural phenomenon from which nobody can escape and about which no amount
of medical intervention can do to alter, right reason dictates that the occurrence of the same be properly
accepted in submission to nature.
Any useless attempt to impede the occurrence of death in its given moment inflicts violence on
nature resulting to the undue suffering and painful dying of the dying thereby contravening the natural
law and the dictates of reason. Fr. Gomez, O.P. says about extraordinary means of care; if it is truly
useless, why should it be used at all. He also quotes the writings of Jorge Manrique, a Poet: Que querer
hombre vivir/ cuando Dios quiere que muera/ es locura (For man to want to live when God wants him
to die is madness).

❖ An Insult to the Sovereign Master of Life and Death

It does not require even a less-moderate degree of contemplation of a patient, with all
the accompanying clinical signs, is a crystal- the reality articulated in nature that an irremediably
dying moment clear manifestation of the will of the Sovereign Master of life and death.

Hence, though death cannot truly be hindered in its irreversible event, the effort exerted
to protract it beyond its naturally designed occurrence is a prominent resistance or opposition to
that will by whose power causes life and death. Despite the non-contestability of said will due to
its omnipotence, still an attempt is done, no matter how futile, to alter the event constituting an
insult.
 In his talk during the 8th Asia Pacific Congress on Love, Life and Family, Fr. Gomez, O.P.
cites Pope John Paul II's remarks:

Both the artificial extension of human life and the hastening of death, although they stem from
different principles, conceal the same assumption-the conviction that life and death are realities
entrusted to human beings to be disposed of at will.

❖ Contrary to Human Dignity

As he is insignificantly sustained by the dysthanasia procedure causing prolonged dying,

the dying patient comes to the extreme point of worthlessly and meaninglessly losing his
distinctive human character and sense of personality in the face of death. This state is uncalled
for, in the first place, which can be averted and hence is not an indispensable part of the dying
moment in its natural occurrences. Consequently, the procedure violates human dignity which
demands of a kind of death that is worth it.
To sum up its morality, just as euthanasia is immoral because of its method of hastening
one's death, so also is dysthanasia because of its method of prolonging a person's death.

What is Orthothanasia?

Orthothanasia refers to the mere allowing and acceptance of natural death in its definitely
inescapable occurrence in due time as the final moment of one's earthly life.

How Should Death be Merely Allowed and Accepted?

First of all, there should be no intervention of any measure to either hasten death before
(euthanasia) or lengthen it after its due time (dysthanasia). To merely allow death is to plainly facilitate in
the event of death, however sooner or later, as an indispensable part of human existence. It means to
discontinue or withhold and put no worthless impediment to the manifestation of nature extraordinary
means of care that are not only disproportionate to the expected result for which they are administered,
but also unjustly prolonging the suffering and the dying moments of the patient and the burden of his
relatives and the health care team. ventually, the patient dies the correct way of dying so that his undue
suffering is averted and his life comes to its end naturally. Indeed, orthothanasia means correct dying

However, the decisions should be made by the patient if he is competent and able or, if not, by
those legally entitled to act for the patient whose reasonable will and legitimate interests must always
be respected. The latter may include the well-informed family members or relatives and the health care
practitioners whose findings and well-founded declarations pertaining to the biological condition of the
patient should be considered.
 Nevertheless, the ordinary means of care which is appropriate to the situation should not be
omitted. Though dying, the patient has still to be cared for according to what can be beneficial and good
in the sense that the care employed addresses certain needs without overlooking the most important
need for spiritual care in preparation for the patient to meet his Creator.

What is the Difference between Euthanasia by Omission and Orthothanasia?

In the case of euthanasia by omission, what are withdrawn or withheld are not only the
extraordinary but most significantly the ordinary means of care from which the patient, though facing an
imminent death, may still benefit in one way or another. This may include, as mentioned, the withdrawal
of food and water so that the patient dies not of his fatal condition for which his death is awaited but of
new causes of death such as starvation and dehydration. Moreover, the death of the patient is directly
caused and willed either as a means or an end.
And if it happens, death is not directly caused and willed as a means are withheld for being futile
but never the ordinary ones. Whereas, in the case of orthethanasia, only the extraordinary means or an
end though foreseen and merely allowed because of its being an irrevocable event.

Is Orthothanasia Moral?

By natural indication and of the principle of stewardship, everyone is morally obliged to nurture
and take care By natural inclination and by reason of the principle of his life even for its prolonged
existence. It is in accordance with the dictates of reason to avoid that which will tarnish the quality of
one's life and that which will shorten his life. As already stated, it does not evoke any awful surprise for
one to seek medical care when life is deemed in danger because of serious and life. threatening health
condition.
Nevertheless, if one's condition is clearly indicative of indubitable death as a reality that
transpires in its naturally designed occasion, right reason again dictates that it has to be merely allowed
and accepted. God determines the time of death of every human being and that it is just as
impermissible to try to extend one's life beyond that time as it is to attempt to end it before that time.

In fact, the bishops of Ireland authoritatively declare that:

...There is clearly no moral obligation to keep a body breathing and biologically alive after
irreversible brain death has occurred. It is not euthanasia to decline the use of such means
(extraordinary) or even to discontinue them when it is clear that they are only death-delaying

What is Brain Death?

To resolve the problem and avoid the immoral procedures of euthanasia and dysthanasia, there
is a need to define when the exact moment of death occurs. The above-cited statement of the Irish
bishops implies that brain death is the go-signal for the acceptance of one's death.
 Furthermore, Pope John Paul II, in his address to the 18th International Congress of the
Transplantation Society last August 29, 2000 defined death in its exact occurrence:

When can a person be considered dead with complete certainty? In this regard, it is helpful to
recall that the death of the person is a single event, consisting in the total disintegration of that
unitary and integrated whole that is the personal self... Specifically, this consists in establishing,
according to clearly determined parameters commonly held by the international scientific
community, the complete and irreversible cessation of all brain activity in the cerebrum,
cerebellum, and brain stem. This is then considered the sign that the individual organism has lost
its integrative capacity,

Brain death is defined as cessation of neurologic functioning by the criteria of deep

unconsciousness without response to painful stimuli, absence of spontaneous breathing, fixed pupils,
spontaneous marked hypothermia, absent reflexes except rarely tendon reflexes, and an isoelectric
electroencephalogram showing no electrical activity over 2 microvolts at maximum gain even with
stimulation by sound, pain, or pressure, recorded for 30 minutes or longer at 24-hour intervals.
Nevertheless, it is possible that with the continuing attachment of the respirator or heart
machine, the heart and lungs may still be functioning despite the fact that the patient is already
pronounced clinically dead or brain dead. At this juncture, there is no moral objection as to the
withdrawal of such medical equipment since the moment of death has already been determined beyond
any clinical doubt and that the patient is just uselessly sustained. It should be crystal clear that said
withdrawal does not cause the patient's death when he is already dead and thus is not euthanasia by
omission. It is rather an act of orthothanasia.

What is Persistent Vegetative State (P.V.S)?

Persistent Vegetative State refers to the comatose condition of a patient showing no evident
sign of self-awareness or of awareness of the environment, with no ability to interact with others and no
reaction to specific stimuli. Yet, it does not reveal significant disintegration of the patient's integrative
capacity as his brain stem is still functioning.

This state or condition may last for weeks, months, or even years with or without technological
support. The comatose patient may awaken after sometime or degenerate further towards his death.
However, with the more sophisticated medical and scientific measures in the treatment of P.V.S., a
prognosts favorable to the patient's recovery may reasonably be foreseen. This goes to show that P.V.S. is
not identical with brain death.
In fact, studies and researches have been conducted revealing a number of recoveries from such
a condition.
One study of 84 people whom physicians considered to be in a "persistent vegetative state"
showed that 41 percent had regained consciousness within 3 years. A second study of 26 children in
consciousness within 6 months and 58 percent had regained eventually regained consciousness. Another
study found that one comes lasting more than 12 weeks found that three-fourths third of the 370
patients in "PVS" for up to one year recovered enough to return to work.
The documented cases of recovery provide implications that there can still be no exact
determining measures as to who, among comatose patients even after several years of comatose study,
will recover or not, and that persistent vegetative state is not to be absolutely considered in itself as fatal
condition. Any health care measure deemed beneficial to the patient, in one way or another, is an
ordinary means of care that is obligatory.

Specific Guidelines for the Withdrawal of Extraordinary Means

The Sacred Congregation for the Doctrine of the Faith in its declaration on euthanasia set some
specific guidelines as to the moral permissibility of the withdrawal of means of care that are wastefully
administered for doing more harm than good to the patient who is just awaiting the event of inevitable
death:54

● It is also permitted, with the patient's consent, to interrupt these means, where the results fall
short of expectations. But for such a decision to be made, account will have to be taken of the
reasonable wishes of the patient and the patient's family, as also of the advice of the doctors
who are especially competent in the matter. The latter may, in particular, judge that the
investment in instruments and personnel is disproportionate to the results foreseen; they may
also judge that the techniques applied impose on the patient strain or suffering out of
proportion with the benefits which he or she may gain from such techniques.
● It is also permissible to make do with the normal (ordinary! means that medicine can offer.
Therefore, one cannot impose on anyone the obligation to have recourse to a technique which is
already in use but which carries a risk or is burdensome. Such a refusal is not the equivalent of
suicide; on the contrary, it should be considered as an acceptance of the human condition, or a
wish to avoid the application of a medical procedure disproportionate to the results that can be
expected, or a desire not to impose excessive expense on the family or the community.
● 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 (ordinary) care due to the sick person in
similar cases is not interrupted. In such circumstances the doctor has no reason to reproach
himself with failing to help the person in danger,

Is it morally permissible to administer a therapy provided by the most advanced medical techniques even
if said therapy is at its experimental stage and is not without certain risk to a seriously ill patient?

It is morally permissible provided that the two conditions set by the Declaration on Euthanasia are met,
namely:

1. There are no other sufficient remedies.

2. The informed consent of the patient must be sought.
By accepting (the therapy), the patient can even show generosity in the service of humanity.

Is it morally allowable to give a dying patient narcotics or pain relievers that will just promote
unconsciousness in the face of death? Yes, provided the three conditions are fulfilled, to wit:

1. The patient is suffering from severe physical pain.

2. The narcotics are not intended to cause earlier death.
3. If the patient is Catholic, he has first to be given the opportunity to receive the last three Sacraments.

If the above conditions are not met, it is morally advisable to leave the patient as conscious as he
ought to be so that he may prepare himself so well in facing his Creator. The dying patient should never
be deprived of the ultimate grace he could receive but of being held unconscious-the grace of salvation
through the Sacraments he ought to receive.

What about narcotics that, in effect shorten the life of the patient?

If no other means exists, and if, in the given circumstances, duties: Yes. In this case of course,
death is in no way intended or this does not prevent the carrying out of other religious and moral
sought, even if the risk of it is reasonably taken; the intention is simply to relieve pain effectively, using
for this purpose painkillers Available to medicine. In this case, the principle of double effect applies.

Moral Teachings on Suffering and Death

On Suffering

In and of itself, suffering is of no value, of no meaning. It is even perceived as evil that causes a
lot of discomfort, grief, hatred, fears, and so on and so forth. Hence, it is always seen as that which has to
be avoided at all cost.
However, as a reality that cannot altogether be eliminated in spite of the tremendously
successful medical measures in its mitigation, suffering can provide great opportunity for one to be
purified, growing in personal maturity and faith in God, and ultimately to gain merits for his salvation.

The Sacred Congregation for the Doctrine of the Faith stated in its declaration on euthanasia:

According to Christian teaching.... suffering, especially suffering during the last moments of life,
has a special place in God's saving plan; it is in fact, a sharing in Christ's passion and a union with the
redeeming sacrifice which He offered in obedience to the Father's will. Therefore, one must not be
surprised if some Christians prefer to moderate their use of painkillers, in order to accept voluntarily at
least a part of their sufferings and thus associate themselves in a conscious way with the sufferings of
Christ crucified (cf. Mt.27:34). Nevertheless, it would be imprudent to impose a heroic way of acting as a
general rule. On the contrary, human and Christian prudence suggests for the majority of sick people the
use of medicines capable of alleviating or suppressing pain, even though these may cause as a secondary
effect semi-consciousness and reduced Jucidity. As for those who are not in a state to express
themselves, one can reasonably presume that they wish to take these painkillers, and have them
administered according to the doctor's advice

On Death

Despite the consideration of suicide, many people do not subscribe to any idea of being desirous
of death. In fact, death is, so tar, the most feared occasion in the life of man. It is considered as the
saddest event from which man in all his interests to live wants to escape. That is why, some people ask:
Why do we have to live just to die after all? Is life not a sort of absurdity if it is only directed towards
death? What is life for if it is overcome by death?
Flowing from the said questions, not a few people have the orientation in life that death is
something that should not be talked about, that should be avoided in every progressive human
discussion. It is all because death is comprehended as an event which puts an end to everything about
life, which inflicts upon buman beings sorrow and bereavement for the loss of their loved ones, and
which puts life in all its endeavors into meaninglessness and nothingness. Ultimately, death is seen as the
most radical negation of life in all its freedom of existence.
Yes, death is the end of human life and everything pertaining to it. But if it is to be understood as
merely a negation of life, as the most patent form of restriction of human freedom, then, with all the
more obvious reasons, death is an event to be avoided as much as possible.

Death as the Ultimate Act of Human Freedom

Nevertheless, death can be an act of freedom, in fact, the ultimate act of human freedom. It can
be so, if death occurs as meaningful as it should be simply because of its being the final moment of one's
life on earth.

A meaningful death proceeds from a meaningful life. A meaningful life is one that has attained a
deep sense of fulfillment of how is it to live human life on earth, of how is it to live human de to the full.
And to live human life to the full is to cultivate all its inner resources and giftedness translated in the
practice of human values not only for one's development but also for others.

To Christians, living one's life to the full is to live the life of of self-emptying as the greatest form
of love that can ever be Christ. And the life of Christ is a life of service, of self-giving and expressed
culminating in the dimension of the Cross. To love, in fact, is the greatest expression of freedom, for it
cannot be what it truly is without freedom. Hence, a life that is lived in the spirit of loving service, of
self-giving and of self-emptying either as a parent or a child, as an employer or an employee, as a
teacher or a student, a politician, a doctor, a nurse, and so on and so forth, is a life in freedom.

With this deep sense of meaning and fulfillment of life in freedom, the one who is in the last
stage of his life finally attains the ultimate act and even the crowning of his human freedom in the face
of death manifested in its full acceptance. (An act of accepting is an act of freedom.) It is unlikely for the
other who has lived his life otherwise to be free to die in full acceptance. The greater the degree of
acceptance of death, the fuller the freedom and the fuller the earthly life lived. The lesser is the other
way around.

From a Christian perspective, the Catechism of the Catholic Church (C.C.C.) quotes these
significant words:
Every action of yours, every thought, should be those of one who expects to die before the day is
out. Death would have no great terrors for you if you have a quiet conscience... Then, why not
keep clear of sin instead of running away from death? If you aren't fit to face death today, it's
very unlikely you will be tomorrow.

Moreover, Christ's acceptance of His death on the Cross was the greatest expression of freedom
particularly for mankind. By the freedom of his will, death is transformed by Christ. Jesus, the Son of
God, also himself suffered the death that is part of the human condition. Yet, despite his anguish as he
faced death, he accepted it in an act and free submission to his Father's will.

With this realization, death is something that should not be feared, for in death, God calls man
to himself. Therefore the Christian can experience a desire for death like St. Paul's: "My desire is to
depart and be with Christ.

Thus, the Declaration on Euthanasia has this to say.

Life is a gift of God, and on the other hand, death is unavoidable, it is necessary, therefore, that
we, without warmth, prevention of complications and bed sores, and regular monitoring of vitals signs,
inputs and outputs, etc.

4. Outpatient and Home Care. This brings greater comfort to his families and his own favorite belongings
around him. The home the patient by allowing him to stay in familiar surroundings with must remain, at
the final stage of one's life, to be the most comfortable place to depart where the patient used to live
happily. No wonder, many old folics return to their native places and houses where they can peacefully
expire.

5. Humanized Inpatient Care. If there is a need for the patient to be placed in an inpatient facility other
than his home, the place must be "home-like" where he can feel at home. Visit by relatives and friends
must be liberally tolerated with no restrictions on age as much as possible so that children can visit their
grandparents. It must be a real hospice house where care and comfort are indeed experienced.

6.Freedom from Financial Worry. Financial concerns should be the least or they should even be set aside
in favor of a needy patient. After all, the essence of existence of a hospice house is not the payment per
se. On the contrary, it can continue to exist because of financial donations and the likes coming from
generous individuals. The most important is the serving of the purpose for which the house exists.
7. Bereavement Counseling and Assistance. At this point, both the dying patient and his relatives receive
counseling and assistance in handling the situation that is very likely a painful one. The respective
specialization of each member of the team is important in counseling. Above all, the mere presence of
everybody that exudes a loving and caring atmosphere making the patient at home even with his own
death is the best counseling approach, so far.

Finally, C.C.C. exhorts:

The dying should be given attention and care to help them live their last moments in dignity and
peace. They will be helped by the prayer of their relatives, who must see to it that the sick receive at the
proper time the sacraments that prepare them to meet the living God.
With the hospice care approach, the dying patient is fully recognized as a human person
dignified in nature and thus worthy of care, love, and respect who is in his "home-coming" to His Father
in Heaven.

Pointers for a Health Care Practitioner

The following pointers are given to health care practitioners for reflection and application in cases where
patient's death is imminent:
1. The terminally ill patient who is on the verge of death needs nothing more than love and
affection from both the relatives and the health care practitioners attending to him. It is very
dignifying to accord him a deep sense of respect and unconditional acceptance of his very
person.
2. When the medical treatment in all its tremendous technological and scientific advances seems
to be a failure in an irreversibly degenerative health condition, it does not mean health care
ceases to function. Ordinary means of care that go beyond any sophisticated medical measures
useless in themselves are at work the most. They can heal not the pathologic condition but the
very being of the patient making him happy in the last moments of his life in preparation for the
eternal happiness he will have with God.
3. When a dying patient asks for the hastening of his death, it does not necessarily imply a desire
for euthanasia but for support, love, and affection. Kindly respond in a more humane way by
your mere presence-touching and sharing in his suffering by just being there, and silently loving
and praying for him full of tenderness and compassion. Indeed, how wonderful it is to become
God's instrument of His love for that dying patient!
4. If the patient is a Catholic, never forget as part of your moral responsibility to call the hospital
chaplain who is a priest to administer the last three Sacraments, namely; Anointing of the Sick,
Penance, and the Holy Viaticum. It's good that the patient is still conscious when he receives the
said Sacraments so he can express sorrow for sins in preparation for his meeting with the
Creator. If he is non- Catholic and is requesting the minister of his religion to come, please
respond positively, in the spirit of ecumenism and inter-religious relationship, without however
compromising your own faith. If there are no available priests, and the patient is in immediate
danger of death, kindly make him aware of God's graces of mercy and forgiveness and tell him to
repeat after you, the act of perfect contrition. Again, how magnificent it is to become God's
instrument for the salvation of souls!