When euthanasia or physician-assisted suicide is legalized, "it starts to be regarded as a 'normal death,'" and even as the most desirable way of dying, said a professor from Belgium, where euthanasia has been legal for 20 years.
Chris Gastmans, a professor of biomedical ethics at the Catholic University of Leuven, Belgium, and Bishop Noël Simard of Valleyfield, Quebec, spoke about their countries' experience with legalized euthanasia and medically assisted death on the opening day of a webinar sponsored by the Pontifical Academy for Life.
A few hours before the webinar Feb. 9, Pope Francis had spoken at his weekly general audience about the Christian attitude of accepting, but not provoking death.
The pope also insisted that people have a right to palliative care -- a collection of pain relief, comfort measures and emotional, psychological and spiritual support for a person diagnosed with a serious illness.
"For a Christian," the pope said, "a good death is an experience of the mercy of God, who comes close to us even in that last moment of our life."
But, Gastmans told webinar participants, "the current societal conception of a 'good death'" is not the same as the Christian concept. For more and more people today, he said, a good death is "a planned death, a rapid death and a death without suffering."
"Death by euthanasia is no longer regarded as an exception requiring special justification" and conditions such as the patient is facing imminent death and excessive pain, he said. "Instead, it is regarded as a normal death and a benefit not to be restricted without special justification."
Bishop Simard, a member of the Pontifical Academy for Life, told the conference he believes the acceptance in Canada of medically assisted dying "is based on a strategy" that deliberately tries to convince people it is a form of "care and not an act of killing."
He also said that more and more Canadians, including Catholics, see the issue from the framework of the "quasi absolute autonomy of the person," independent of the wishes and support of the patient's family.
At the same time, he said, the Catholic Church and others have taken steps to ensure greater access to palliative care for people in their homes, in hospitals and in hospice settings. Bishop Simard cited a 2018 study by the Canadian Institute for Health Information, which estimated that "up to 89% of people who die might have benefited from palliative care. However, a substantial proportion of Canadians were neither identified as having palliative needs, nor as having received palliative care in their last year of life."
Unlike hospice care, which provides pain relief and support once treatment has ended, palliative care can -- and, according to the speakers, should -- begin as soon as a diagnosis is made and should continue along with treatment.
Bishop Simard told the conference that to help Canadians understand the resources available, the bishops in November launched "Horizons of Hope: A Toolkit for Catholic Parishes on Palliative Care."
Despite government promises, the availability and affordability of palliative care have not increased while "the clear support of the media and political leaders" for medically assisted dying continues, he said. "No wonder dying people may feel pressured to ask for euthanasia and assisted suicide when quality palliative care is not largely accessible."
Dr. Christoph Ostgathe, chair of palliative medicine at Germany's University Hospital Erlangen and president of the European Association for Palliative Care, said that not only do most people in the world have no access to palliative care, but in a growing number of countries medically assisted suicide is the priority approach to helping a person facing terminal illness.
Education is essential, he said. "When you ask people on the street what is palliative care, they think of dying. But our patients are thinking about living -- without pain and with more time with their families."
Dr. Johan Menten, coordinator of palliative care at the University Hospital of Leuven, said patients diagnosed with a terminal illness "want to be assured they will not be alone and suffering," which is why many of them initially request euthanasia.
In Belgium, he said, 2.5% of all deaths are by euthanasia, but at his hospital, which requires that patients be advised of the palliative care options, only 1% of deaths are medically induced.
In addition, Menten said, when informed about palliative care options, 25% of people who had asked for euthanasia withdraw their request.