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by Daniel P. Sulmasy
Respect for intrinsic human dignity encompasses an acknowledgment that while we human beings are of inestimable value, we are not of infinite value. We are worth more than sparrows but less than the angels. We are made in the image of God, but we are not gods. As the psalmist says, we are made “a little lower than God.”
Thus, while there might be an absolute prohibition on killing, the duty to maintain life is finite. “Extraordinary” means of care are what the Roman tradition has called life-sustaining treatments that go beyond what a finite human being can be obliged to bear. We respect human life, but we do not worship human life. While we cannot make death our aim, we can forgo measures that forestall death, realizing that death will likely follow as a consequence. In fact, in some cases striving to stay alive at all costs can be inconsistent with respect for one’s own dignity—if it is rooted in a refusal to accept the finitude that is characteristic of the kinds of things we are as human beings. What Basil of Caesarea wrote concerning his monks’ use of medicine in the fourth century is instructive:
Whatever requires an undue amount of thought or trouble or involves a large expenditure of effort and causes our whole life to revolve, as it were, around solicitude for the flesh must be avoided by Christians. Consequently, we must take great care to employ this medical art, if it should be necessary, not as making it wholly accountable for our state of health or illness, but as redounding to the glory of God and as a parallel to the care given the soul. In the event medicine should fail to help, we should not place all our hope for the relief of our distress in this art, but we should rest assured that He will not allow us to be tried above that which we are able to bear.
Withholding or withdrawing life-sustaining treatments when they are futile, burdensome, costly, or complicated, or when their use would interfere with our ability to carry out other moral obligations, is perfectly consistent with respect for the intrinsic dignity of the human. Respect for intrinsic dignity implies that we should act in a manner consistent with our true intrinsic value, neither clinging vainly to this life nor denying the intrinsic value of this life.
Daniel P. Sulmasy, OFM holds the Sisters of Charity Chair in Ethics at St. Vincent’s Hospital in Manhattan and serves as professor of medicine and director of the Bioethics Institute of New York Medical College. This excerpt is from his essay in LIVING WELL AND DYING FAITHFULLY: CHRISTIAN PRACTICES FOR END-OF-LIFE CARE edited by John Swinton and Richard Payne (Eerdmans, 2009).