Hospice Palliative Care

The Window of the Ark column of the Catholic Times has an article on physician-assisted suicide and hospice palliative care by a professor at the Graduate School of Life Sciences of the Catholic University of Korea.

What image comes to mind when we think of family or household? We would probably first picture a family of three or four consisting of a mother, a father, and children. This image of a family is commonly referred to as the traditional family model. However, some refer to the emphasis on such a family model as the so-called "normal family ideology". The basis of their argument is that the proportion of 3- to 4-person households, which corresponds to the so-called normal family, is currently very low in Korean society, for the proportion of single-person households now exceeds 40%. However, the increase in the proportion of single-person households cannot be unrelated to the voices advocating for the legalization of physician-assisted suicide or euthanasia. The rise in single-person households ultimately implies the absence of someone to care for oneself, which can make euthanasia appear to be the only solution when one falls ill. In Korean society, where the issue of care is considered so important, if physician-assisted suicide is legalized, hospice and palliative care would decrease. 

Cicely Saunders, who established the first modern hospice center in 1967, was clearly opposed to assisted suicide and euthanasia, and made great efforts to develop hospice as a moral alternative to such practices. However, in the Netherlands, where assisted suicide was legal for several years, hospice palliative care did not develop properly, and in Oregon, USA, where physician-assisted suicide was first legalized, cases of inadequate pain management for terminally ill patients increased. While 1,832 hospice facilities were opened in other U.S. states over the same period, only 5 were opened in Oregon. The legalization of assisted suicide brings about changes in people's mindsets. This can be confirmed in the United States, where many medical organizations, including the Hospice and Palliative Care Society, maintain a neutral stance toward physician-assisted suicide. Considering that hospice care originally began in opposition to euthanasia and physician-assisted suicide, this neutral perspective indicates that many hospice workers no longer hold the view that assisted suicide is morally unacceptable. An important role of hospice or palliative care is not only to reduce the patient's suffering and pain, but, above all, to provide others with the opportunity to share in the patient's suffering. Hospice teams, families, and caregivers caring for terminally ill patients are given the opportunity to experience suffering alongside them. While giving someone the opportunity to suffer may sound negative, sharing in the patient's pain means participating with them in the discovery of not only the meaning of their life but also the meaning inherent in their suffering. In doing so, we can realize true solidarity with others, and such an attitude serves as the criterion for determining whether this society is truly humane. Pope Benedict XVI stated the following in the encyclical *Saved by Hope*, paragraph 38. 

The true measure of humanity is essentially determined in relationship to suffering and to the sufferer. This holds true both for the individual and for society. A society unable to accept its suffering members and incapable of helping to share their suffering and to bear it inwardly through “com-passion” is a cruel and inhuman society. Yet society cannot accept its suffering members and support them in their trials unless individuals are capable of doing so themselves; moreover, the individual cannot accept another's suffering unless he personally is able to find meaning in suffering, a path of purification and growth in maturity, a journey of hope. Indeed, to accept the “other” who suffers means that I take up his suffering in such a way that it becomes mine also. Because it has now become a shared suffering, though, in which another person is present, this suffering is penetrated by the light of love. The Latin word con-solatio, “consolation”, expresses this beautifully. It suggests being with the other in his solitude, so that it ceases to be solitude. Furthermore, the capacity to accept suffering for the sake of goodness, truth, and justice is an essential criterion of humanity, because if my own well-being and safety are ultimately more important than truth and justice, then the power of the stronger prevails, then violence and untruth reign supreme. Truth and justice must stand above my comfort and physical well-being, or else my life itself becomes a lie. In the end, even the “yes” to love is a source of suffering, because love always requires expropriations of my “I”, in which I allow myself to be pruned and wounded. Love simply cannot exist without this painful renunciation of myself, for otherwise it becomes pure selfishness and thereby ceases to be love.

We will need to ask ourselves what kind of society do we truly want.