What Should We Think About Euthanasia?

The magisterial definition

Saint John Paul II, in the encyclical Evangelium Vitae, formulates the canonical definition in two closely argued sentences:

"To give a correct moral judgment on euthanasia, the first requirement is to define it clearly. Euthanasia in the strict sense is understood to be an action or omission which of itself and by intention causes death, with the purpose of eliminating all suffering. Euthanasia's terms of reference, therefore, are to be found in the intention of the will and in the methods used." — Saint John Paul II, Evangelium Vitae, 25 March 1995, § 65^[11]

Two elements simultaneously required: (1) intention — death is willed, either as an end or as a means of eliminating suffering; (2) means — one does, by action or omission, what causes death. The typical act is lethal injection, which generally combines a powerful sedative, a barbiturate and, if needed, curare to block breathing.^[12] But a deliberate omission can equally constitute euthanasia: cutting off oxygen, food and hydration to a stabilized patient so that he dies. The Vincent Lambert case is the most discussed example in France — and a disputed one: legally, stopping nutrition and hydration was upheld as refusal of unreasonable obstinacy (Council of State, 24 June 2014; European Court of Human Rights, Grand Chamber, 5 June 2015), whereas Catholic doctrine sees in it euthanasia by omission within the meaning of John Paul II's address of 20 March 2004 on the food and hydration owed to patients in a vegetative state.^[13]

Four adjectives for four situations

The bioethics literature has long distinguished:

One capital fact emerges from this distinction: all serious defenders of euthanasia reject involuntary euthanasia. The debate concerns only the voluntary and non-voluntary forms. This does not remove the need to note that, in the countries that have legalized it, euthanasia without the patient's explicit request reaches worrying proportions: according to a study published in the Canadian Medical Association Journal in June 2010 on 6,927 certified deaths in Flanders, 32% of deaths caused by lethal drugs had taken place without the patient's explicit request, and the decision had not even been discussed with the patient in 77.9% of cases.^[14] A second Belgian survey, published in the New England Journal of Medicine in 2015 using the same population-based survey method independent of official declarations, measures the change over time: the rate of deaths classified as euthanasia in Flanders rose from 1.9% in 2007 to 4.6% in 2013, and the administration of lethal substances without the patient's explicit request still accounted for 1.7% of all deaths that year.^[15]

The decisive distinction: euthanasia versus refusal of overzealous treatment

This is the most painful confusion to dispel, and the trickiest for public debate. Refusing overzealous treatment is not euthanasia. The Catechism states it with definitive clarity:

"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of 'over-zealous' treatment. Here one does not will to cause death; one's inability to impede it is merely accepted." — Catechism of the Catholic Church, § 2278^[16]

The difference is not wordplay: it is ontological. In refusing overzealous treatment, the patient dies of the disease; one simply stops doing everything to fight it when the effort has become disproportionate, futile, painful. In euthanasia, the patient dies of an act inflicted upon him or self-inflicted through calculated neglect.

Evangelium Vitae specifies the criteria for judging a treatment disproportionate: interventions "which are no longer adequate to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. […] To forgo extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death."^[17]

French law itself reflects this distinction. Article R. 4127-38 of the Public Health Code imposes a dual and inseparable obligation on physicians:

"Physicians must accompany the dying up to their last moments, ensure by appropriate care and measures the quality of a life that is ending, safeguard the dignity of the sick and comfort those around them. They have no right deliberately to cause death." — Public Health Code, article R. 4127-38 (article 38 of the Code of Medical Ethics)^[18]

Assisted suicide: another name for the same act

Medically assisted suicide consists, for the physician, in supplying the patient with the means to take his own life — typically a lethal substance to swallow. The boundary with active euthanasia is thin: it is the same death, deliberately sought, with the cooperation of the medical profession. Switzerland made the singular choice of leaving unpunished assisted suicide without selfish motive (art. 115 of the Penal Code, in force since 1942) while prohibiting active euthanasia, punished as "murder at the request of the victim" (art. 114 of the Swiss Penal Code).^[19]

Saint John Paul II does not let himself be trapped by this distinction:

"To concur with the intention of another person to commit suicide and to help in carrying it out through 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." — Saint John Paul II, Evangelium Vitae, § 66^[20]

And the encyclical calls, in support, on a passage of Saint Augustine of astonishing relevance:

"It is never licit to kill another, even if he wished it, and even more if he requested it because, suspended between life and death, he begs to be helped in freeing his soul, which struggles against the bonds of the body and longs to be released; even if the sick person were no longer able to live, this is not licit." — Saint Augustine, quoted in Evangelium Vitae, § 66^[21]

Language that conceals

Countries that want to normalize these practices invent a vocabulary of avoidance. Belgium and France speak of "active aid in dying." Quebec calls euthanasia "care." Pro-euthanasia campaigners claim the right to "die with dignity" — as if a person's dignity could be measured by the tidiness of his end.

Doctors Jean-Marie Gomas and Pascale Favre, who together devoted more than half a century to palliative care, note it precisely:

"The deliberate erasure of the word euthanasia from common discourse and its replacement by the expression 'active aid in dying' distorts our grasp of the reality of the act. The substitute term, deliberately used to reassure, suggests medical accompaniment toward a gentle death, a sort of anaesthesia." — Dr Jean-Marie Gomas and Dr Pascale Favre, Fin de vie, peut-on choisir sa mort ?, Artège, 2023^[22]

The philosopher Rémi Brague reminds us, for his part, that the expression "dying with dignity" is in fact a misunderstanding:

"Every man's death is dignified. It is our gaze upon the dying person that can make it undignified. My own death will not necessarily be pleasant or peaceful. Of course I hope it will not be too painful or anguished. Like all of us, I would like to die cared for, surrounded, accompanied. But my death will be dignified in any case. No one can take my dignity from me. It lies in my being a person, not in the state I am in." — Rémi Brague, Le Figaro, 2014^[23]

The whole rational case against euthanasia holds in one limpid syllogism, which Matthieu Lavagna put back at the centre of French-language debate:^[24]

1. The deliberate killing of an innocent person is immoral and must be illegal.
2. Euthanasia is the deliberate killing of an innocent person.
3. Therefore euthanasia is immoral and must be illegal.

The argument is logically valid: if both premises are true, the conclusion necessarily follows. Premise 2 is guaranteed by the very definition of euthanasia: intentionally causing a patient's death. Everything therefore turns on premise 1. Yet this premise is one of the founding principles of every civilization. Deliberately killing an innocent human being inflicts on him the greatest possible loss: the definitive deprivation of the whole of his being.

The Hippocratic Oath, twenty-five centuries of medicine

Long before Christianity, Greek medicine had defined itself against euthanasia. The Hippocratic Oath (4th century BC) — still sworn today in modernized forms by new physicians in France — contained from the outset an explicit commitment:

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect; similarly, I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art." — Hippocratic Oath, 4th century before Jesus Christ^[25]

The Greek word pharmakon thanasimon — "deadly drug" — designates very precisely the lethal poison requested by a despairing patient. Hippocrates well knew the request would come; he decreed that medicine would never be that. Medicine exists to heal, not to kill. Killing one's patient is not a variant of care: it is its pure negation.

The European Convention and the Penal Code

What medicine refuses, international law proclaims with equal sharpness. Article 2 of the European Convention on Human Rights (1950) provides:

"No one shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law." — European Convention on Human Rights, Article 2, paragraph 1, 4 November 1950^[26]

In French law, article 221-1 of the Penal Code qualifies "the act of deliberately causing the death of another" as murder, and article 221-4 punishes this murder with life imprisonment when committed against "a person whose particular vulnerability, due to age, illness, infirmity, physical or mental deficiency […], is apparent or known to the perpetrator."^[27] Legalizing euthanasia would therefore, strictly speaking, require amending these articles — that is, retracting from the Penal Code a protection the Republic has guaranteed the most vulnerable since its foundation.

Shifting the burden of proof

Lavagna draws a conclusion often forgotten in media debate:

1. Legalizing euthanasia means legalizing murder in certain circumstances.
2. But there is no valid reason to question the illegality of murder.
3. Therefore euthanasia must remain illegal.

The burden of proof lies with the supporters of such an upheaval. Until they have demonstrated that murder must become legal in certain cases — a demonstration none has carried through to this day — the anti-euthanasia position wins by default. This is precisely the opposite of the campaigning rhetoric that presents opposition as a defensive retreat in need of justification.

Three broad families of arguments attempt this reversal: compassion, autonomy, and lost dignity. We shall examine them one by one.

"Euthanasia is an act of compassion: it allows a person to die without unbearable suffering."

No one wants to suffer. No one wants to watch a loved one suffer. Compassion is the most human thing in contemporary sensibility, and it would be monstrous to despise it. But a question immediately arises: does compassion require eliminating the person who suffers, or relieving his suffering?

Palliative care now relieves all pain

Modern medicine no longer, in principle, lets a patient die in suffering. Palliative care has an arsenal of painkillers — morphine and opioids in all their forms, anti-inflammatories, anti-epileptics, antidepressants, local anaesthetics — that relieves physical pain. The National Consultative Ethics Committee (CCNE), a body far from confessional, admitted it in its preparation for the Claeys-Leonetti law:

"Experts agree that all pain can today be relieved by a range of solutions extending to anaesthetic techniques or pain surgery." — National Consultative Ethics Committee, quoted by Henri de Soos, L'impasse de l'euthanasie, Salvator, 2022^[28]

For extreme cases — refractory pain at the end of life — deep and continuous sedation until death plunges the patient into unconsciousness, extinguishing the perception of pain. Legally regulated in France since the Claeys-Leonetti law of 2016, it bears no moral relation to euthanasia. Doctors Favre and Gomas write:

"The purpose of deep sedation is to relieve the refractory suffering of a patient close to the end of life. The intentionality of the act is that relief alone. […] The patient dies from the progression of his disease. By contrast, euthanasia is an act whose objective is the administration of death: to be relieved, the patient is eliminated." — Dr Jean-Marie Gomas and Dr Pascale Favre, Fin de vie, peut-on choisir sa mort ?, Artège, 2023^[29]

The philosopher Jacques Ricot sums it up in a formula now famous:

"Euthanasia does not complete accompaniment, it abolishes it. It does not follow palliative care, it interrupts it. It does not relieve the patient, it eliminates him." — Jacques Ricot, Esprit, August–September 2001^[30]

The following table, synthesized from the clinical work of doctors Gomas and Favre, crystallizes in six dimensions the medical and legal distinction between the two acts:^[31]

This table reveals the emptiness of the argument sometimes advanced to trivialize euthanasia: "deep sedation is the same thing." No: intention, means, procedure, result, timing and legal framework differ on every line.

The principle of double effect

The cornerstone of medical ethics at stake here is the principle of double effect (PDE), formulated in the 16th century in late scholasticism and already implicitly present in Saint Thomas Aquinas (Summa Theologiae, II-II, q. 64, a. 7).^[32] It states that an act with two effects — one good, one bad — is morally licit if four conditions are simultaneously met:

1. The act itself is good or morally neutral (administering a painkiller).
2. The good effect (relief) results directly from the act, not from the bad effect (death).
3. The bad effect is not willed, only foreseen and tolerated as an inevitable consequence.
4. There is a proportionate reason for accepting the bad effect (refractory suffering).

Pius XII, in his address to anaesthetists of 24 February 1957 — the founding text of modern Catholic bioethics — formulated the clinical application with a precision never surpassed:

"If between narcosis and the shortening of life there is no direct causal link, whether willed by those concerned or inherent in the nature of things, and if on the contrary the administration of narcotics produces by itself two distinct effects, first the relief of pain and second the shortening of life, it is licit; but one must still see whether there is a reasonable proportion between these two effects, and whether the advantages of one compensate the drawbacks of the other." — Pius XII, address to anaesthetists, 24 February 1957^[33]

Sedation and pain relief meet these conditions. Euthanasia violates the first three: the act (lethal injection) is not neutral, relief comes precisely through death, and death is directly sought. Believing one can uphold the principle of double effect to justify euthanasia is a conceptual confusion moral philosophy has rejected for four centuries.

"Incurable is never synonymous with untreatable"

The Dicastery for the Doctrine of the Faith, in the letter Samaritanus Bonus published on 22 September 2020, laid down a formula now central:

"This desire always to care for the sick person offers the criterion for evaluating the various actions to be taken in the situation of 'incurable' illness: incurable is never synonymous with 'untreatable.' The contemplative gaze calls for an expansion of the notion of care. The aim of treatment must be directed at the integrity of the person, guaranteeing with appropriate and necessary means physical, psychological, social, family and religious support." — Congregation for the Doctrine of the Faith, Samaritanus Bonus, 14 July 2020 (published 22 September 2020), chapter I^[34]

This brief sentence defuses at a stroke the media argument from compassion: there is always, even when one can no longer cure, something to do to relieve, support, accompany. The letter adds that "experience shows that the application of palliative care considerably reduces the number of persons who request euthanasia."^[35] The observation is confirmed by all palliative care physicians: requests for euthanasia fall as soon as a patient is properly relieved and surrounded.

The false mercy denounced by John Paul II

Saint John Paul II settled the question in a magisterial formulation that remains, thirty years on, the reference:

"Even when not motivated by a selfish refusal to be burdened with the life of someone who is suffering, euthanasia must be called a false mercy, and indeed a disturbing 'perversion' of mercy. True 'compassion' leads to sharing another's pain; it does not kill the person whose suffering we cannot bear." — Saint John Paul II, Evangelium Vitae, § 66^[36]

True compassion, as its etymology indicates (cum-patior, "to suffer with"), is presence, not elimination. Killing the one who suffers is not being with him: it is sparing oneself his suffering by sparing oneself his person. It is precisely the opposite of compassion.

"My body, my choice. Society must respect my freedom to choose my death."

This is the central slogan of campaigning associations — in France, the Association for the Right to Die with Dignity (ADMD) has repeated it for decades. The utilitarian philosopher Peter Singer gave it its academic formulation:

"The principle of respect for autonomy tells us to allow rational agents to live their own lives according to their own autonomous decisions, free from coercion or interference; but if rational agents should autonomously choose to die, then respect for autonomy will lead us to assist them to do as they choose." — Peter Singer, Practical Ethics, Cambridge University Press, 2nd ed., 1993, p. 195^[37]

The argument is powerful because it rests on an authentic value: the freedom of the person. But it collapses as soon as it is pushed to its conclusion.

An autonomy that is never absolute

If bodily autonomy conferred on me an absolute right to dispose of my body, nothing would prevent anyone from asking to be killed for any reason whatever: heartbreak, job loss, gambling debt, existential weariness. Yet even the ADMD shrinks from this conclusion. Its president Jonathan Denis declared it publicly in a March 2023 debate with Jean-Marie Le Méné (president of the Jérôme Lejeune Foundation):

"No country today will say: because you have a broken heart, we will allow you aid in dying." — Jonathan Denis, president of the ADMD, March 2023 debate^[38]

But then the argument falls. If autonomy is not absolute — and it never is — the defender of euthanasia must say where it stops, by what criteria, and why those criteria. None has managed to do so in a non-arbitrary way.

The French State itself recognizes that disposing of one's body is not an absolute right: it prohibits organ trafficking (up to 7 years in prison), penalizes the purchase of sexual services (since 2016), prohibits the consumption of hard drugs (article L.3421-1 of the Public Health Code). If bodily autonomy sufficed, these prohibitions would be illegitimate — and, for consistency's sake, one would have to legalize kidney sales, prostitution and heroin. The ADMD fortunately does not go that far, but it then saws off the branch it sits on.

One cannot divest oneself of fundamental rights

The philosopher David Oderberg (University of Reading) formalized the major objection: certain rights are inalienable, meaning one cannot renounce them by individual choice, even voluntarily.

"Although a man can give up some particular good which he has, he cannot give up his right to property as such. A human being can say: 'I bequeath this part of my goods,' but he cannot say: 'I give up, as a human being, my right to property.'" — David Oderberg, Applied Ethics — A Non-Consequentialist Approach, Blackwell, 2000, p. 56^[39]

The same holds for liberty: no one can sell himself into slavery, even by freely consented contract. No court in the world would ratify such an act. The right to life belongs to the same category: it is inalienable, because it is what grounds all other rights. One cannot renounce what makes every renunciation possible.

Medicine is not the execution of desires

A second objection is more practical still. Even if the patient desires death, the physician is under no obligation to yield to the request. An anorexic patient who asks for reduced nutritional intake because she would "feel better" losing weight must not be obeyed: the request goes against her own health. A patient who asks to be amputated of a healthy arm for psychological reasons (body integrity identity disorder, or BIID, is documented) must not be obeyed. A patient who asks a physician to inject him with heroin to "feel better" must not be obeyed either.

The rule is simple: the purpose of medicine is to heal, not to execute desires. But if a physician refuses to mutilate a patient because it is contrary to his health, a fortiori must he refuse to kill him — an infinitely more radical and irreversible harm.

The incoherence of atheistic materialism

Lavagna notes, in passing, a philosophical irony. The fiercest defenders of absolute "individual liberty" are often atheistic materialists (Peter Singer, Yuval Noah Harari, Raphaël Enthoven). Yet, from the atheistic materialist standpoint, individual liberty itself becomes problematic: if all I am reduces to biochemical processes determined by the laws of physics, in what sense are my choices "free"? Harari admits it bluntly:

"Over the last century, researchers have opened the black box of Sapiens: they discovered that there was in him neither soul, nor free will, nor 'self'; only genes, hormones and neurons obeying the same physical and chemical laws that govern the rest of reality. […] Free will exists only in the imaginary stories men have invented." — Yuval Noah Harari, Homo Deus — Une brève histoire de l'avenir, Albin Michel, 2017, pp. 304–305^[40]

The materialist who invokes liberty to demand euthanasia cannot, without contradiction, maintain that this liberty really exists. The debate ultimately makes sense only within an anthropology that recognizes the transcendence of the person.

"His life is no longer worth living. When there is no quality of life left, it is better to go."

The French actress Line Renaud, a famous ADMD campaigner, summed it up thus: "When there is no quality of life left, it is better to go."^[41] The argument invokes neither suffering nor liberty but an objective judgment on the value of life. Yet as soon as it is examined, it collapses on itself.

No objective criterion exists

On what would this judgment rest? On physical autonomy? Newborns are not autonomous: they would die within hours if abandoned on a hospital bed. Should we conclude they have no value? On social utility? No one in a developed society lives in total self-sufficiency: we all depend on countless others. On mental health? Persons with severe psychiatric conditions would then automatically be candidates for elimination — and Belgium, alas, is already there.

Christopher Kaczor, philosopher at Loyola Marymount University, puts it clearly:

"It is impossible to propose genuinely objective and non-arbitrary criteria for determining the threshold at which a life would suddenly become unworthy of being lived." — Christopher Kaczor, Disputes in Bioethics — Abortion, Euthanasia and Other Controversies, 2020^[42]

The ADMD's bill illustrates this impasse with involuntary clarity. The proposed text retains as eligibility criterion: "unrelievable psychological suffering that she judges unbearable" — that is, it is the patient himself, and he alone, who decides whether his suffering is "unbearable."^[43] There is here no objective medical criterion, no verifiable clinical threshold, no qualified third party to confirm or deny. As a logical consequence, any disabled person suffering from depression could validly request euthanasia, and no physician could legitimately oppose it in the name of an objective criterion. Matthieu Lavagna stresses that this slide is not a malfunction of the law — it is its very principle, assumed from the drafting stage.

Dependence is not indignity

The conjoined twins Jodie and Mary, born on 8 August 2000, shared the same spine and the same cardiopulmonary system; Mary depended entirely on her sister's body to breathe and survive. Must we say Mary had no dignity because she was totally dependent? No court in the world has dared write it.

Henri de Soos, in his book L'impasse de l'euthanasie (Salvator, 2022), sums up the point in a striking formula:

"Why this illusory will for omnipotence, total mastery, total independence, as if depending partly on another were an unacceptable degradation for a human being? This culture of the strong ignores that millions of people live in weakness and vulnerability." — Henri de Soos, L'impasse de l'euthanasie, Salvator, 2022, p. 195^[44]

A decisive thought experiment

Christopher Kaczor proposes a thought experiment that closes the debate. Imagine a woman in a persistent vegetative state, hospitalized, days from death. Suppose a physician enters her room and rapes her while she is unconscious. Everyone will immediately recognize this as rape and that this woman has been gravely assaulted in her dignity. Her being unconscious changes nothing.

But if we admit that this woman retains, despite her extremely degraded physical state, the fundamental right not to be raped, then a fortiori she retains the fundamental right not to be killed — murder being a still more radical assault than rape.^[45] The ontological dignity of the person is never lost. It is not measured by the state of the body: it lies in the identity of the person herself, created in the image of God for the believer, a subject of inalienable rights for the secular philosopher.

The Universal Declaration of Human Rights

This fundamental intuition is carved into the founding stone of modern international law. The Universal Declaration of Human Rights, adopted by the United Nations General Assembly on 10 December 1948, recognizes "the inherent dignity and the equal and inalienable rights of all members of the human family." Its article 3 states: "Everyone has the right to life, liberty and security of person."^[46]

If these formulas are taken seriously, all human beings without exception enjoy an inalienable right to life — that is, a right that can under no circumstances be taken from them. Legalizing euthanasia means splitting humanity into two categories: those whose life is inviolable, and those whose death can be organized. This is a frontal break with 1948. Lavagna formulates the alternative bluntly:

"Supporters of euthanasia face a dilemma: accept the Universal Declaration of Human Rights and reject euthanasia, or accept euthanasia and reject the Universal Declaration of Human Rights. Between human rights and euthanasia, one must choose." — Matthieu Lavagna, L'Euthanasie en débat — Peut-on donner la mort par compassion ?, Salvator^[47]

The moral argument may seem abstract. The facts are not. Twenty-three years after the first Dutch legalization (2001), the data collected by official agencies allow an empirical assessment of what authorizing the killing of patients produces at a country's scale.

Netherlands — from 2,000 to over 10,000 deaths a year

The first country to legalize euthanasia (April 2001, in force 2002), the Netherlands publishes each year a public report of the five Regional Review Committees (RTE). The finding is stark:

• 2002: ~2,000 euthanasia cases (1st year of application)
• 2014: ~5,300
• 2021: ~7,800
• 2023: 9,068 euthanasia cases, or 5.4% of all deaths in the country^[48]
• 2025: 10,341 euthanasia cases, or about 6% of all deaths^[49]

A fivefold increase in twenty-three years. The grounds have slid from terminal-phase cancer toward ever broader indications: chronic diseases, dementia (499 cases in 2025), psychiatric suffering alone (174 cases in 2025), "accumulation of old-age conditions" (475 cases in 2025), even "completed life" for persons with no identified condition.^[50] In 2002, children from age 12 became eligible. In 2023, the Council of Ministers extended the possibility to children under 12, with parental consent; for infants under one year, "with parental consent."^[51]

Theo Boer, professor of ethics at the Protestant Theological University of Groningen, sat from 2005 to 2014 on one of the five Dutch Regional Review Committees (Overijssel-Gelderland-Flevoland-Utrecht region), where he personally examined some 4,000 euthanasia and assisted-suicide files.^[52] He had initially supported the 2002 law. His reversal, expressed in a Le Monde op-ed of 1 December 2022, has become a reference text:

"I supported the law and worked, from 2005 to 2014, for the authorities in charge of reviewing euthanasia cases. I was convinced the Dutch had found the right balance between compassion, respect for human life and the guarantee of individual liberties. However, over the years, certain developments worried me more and more. After an initial period of stabilization, we witnessed a spectacular increase in the number of euthanasia cases, which rose from 2,000 in 2002 to 7,800 in 2021, with a continued increase in 2022. In some places in the Netherlands, up to 15% of deaths result from an administered death. […] The practice has extended to persons suffering from chronic diseases, to disabled persons, to those suffering from psychiatric problems, to non-autonomous adults who had formulated advance directives, and to young children. Currently, we are discussing an extension to elderly persons without medical conditions." — Theo Boer, Le Monde, 1 December 2022^[53]

And he concludes, addressing the French:

"Look at this country and you may see the France of 2040." — Theo Boer, Le Monde, 1 December 2022^[54]

Belgium — toward children, psychiatric patients, prisoners

Belgium, which legalized in May 2002, broadened its law in 2014 to minors with no lower age limit — unique in the world — subject to capacity of discernment and constant unbearable suffering.^[55] The Federal Commission for the Control and Evaluation of Euthanasia (CFCEE) declared 3,423 euthanasia cases in 2023 (or 3.1% of all deaths, versus 2.5% in 2022, +15% in one year), 3,991 in 2024 (or 3.6% of deaths, +16.6% on 2023), then 4,486 in 2025 (or 4% of deaths, +12.4% on 2024).^[56][57][58]

Three recent facts mark the Belgian evolution:

1. Psychiatric suffering alone now justifies euthanasia. The Tine Nys case (38, depression, euthanized in April 2010) even led to a trial of the physicians in 2020 — all were acquitted.
2. Prisoners may resort to it. According to a university study (Vrije Universiteit Brussel, 2019), 23 prisoners requested euthanasia between 2011 and 2017, almost all invoking psychological suffering linked to prolonged detention.^[59]
3. Euthanasia tourism: of 110 foreign patients euthanized in Belgium in 2023, 101 were French residents; in 2024, the CFCEE counts 120 patients residing abroad, including 106 residing in France; in 2025, it counts 123, including 110 French residents.^[60][61][62]

Canada — over seventy-six thousand deaths in nine years

Canada adopted medical assistance in dying (MAID) in June 2016. The trajectory is even more brutal than in the Netherlands:

• 2016 (1st year): ~1,000 MAID deaths
• 2019: 5,631
• 2022: 13,241
• 2023: 15,343 MAID deaths — about 4.7% of all Canadian deaths and +15.8% on 2022^[63]
• 2024: 16,499 MAID deaths — 5.1% of all Canadian deaths^[64]

The cumulative total since 2016 exceeds 76,000 deaths in nine years. The 2024 report notes annual growth slowing (+6.9% between 2023 and 2024), but the order of magnitude is now established: about one Canadian death in twenty goes through medical assistance in dying.^[65] Extending MAID to mental illness alone was scheduled for March 2024; it was postponed to March 2027 under pressure from psychiatric associations, worried about the impossible assessment of "irremediable suffering" in depression.

In a letter addressed to Benedict XVI at a medical congress, Dr Margaret Cottle, a Canadian palliative care physician in Vancouver for over twenty-six years, writes:

"In jurisdictions where euthanasia and assisted suicide have been legalized, we have seen rapid expansion and a complete lack of enforcement of the supposed 'safeguards'. Patients with mental illness, early-stage eye disease, and even tinnitus have been euthanized. Children and dementia patients who cannot provide meaningful 'consent' have also been targeted. […] It is a major violation of human rights to suggest death as an 'answer' to our society's lack of commitment to caring for our vulnerable citizens." — Dr Margaret Cottle, palliative care physician (Vancouver)^[66]

When euthanasia replaces palliative care

This is the most strategic finding. In every legalizing country, palliative care provision stagnates or recedes the moment euthanasia becomes an option. The European Institute of Bioethics and the November 2024 report of the Anscombe Bioethics Centre (Oxford) measured the gap:

Source: David A. Jones, Evidence of Harm — Assessing the Impact of Assisted Dying / Assisted Suicide on Palliative Care, Anscombe Bioethics Centre, November 2024.^[67]

The mechanism is logical. Once euthanasia becomes a "legitimate" option, public and private investment in palliative care loses its urgency. In British Columbia, the provincial government withdrew in February 2021 its annual funding of 1.5 million dollars to the Delta Hospice Society, because it refused to practise euthanasia on its premises.^[68] The French National Consultative Ethics Committee had warned as early as its opinion No. 121:

"Any move toward authorizing active aid in dying could be experienced by vulnerable persons as a risk of no longer being accompanied and treated by medicine if they expressed the desire to pursue their lives to the end." — National Consultative Ethics Committee, opinion No. 121, 2013^[69]

Objection: "Do these figures not merely show better reporting?"

Defenders of legalization often oppose a statistical explanation to these rising curves: the increase would reflect better reporting of cases already practised in the shadows, not a genuine extension of the practice. The objection deserves to be taken seriously — in the very first years following decriminalization, the reporting rate does improve, as physicians familiarize themselves with the procedure and lose the fear of prosecution.

But this explanation is not enough to account for the scale of the Belgian phenomenon. Chambaere's team's surveys do not measure official declarations: using an identical population-based protocol repeated in 2007 and then in 2013, they question a representative sample of all Flanders death certificates, independently of what physicians did or did not declare to the review commission.^[70] Yet this same measuring instrument, insensitive by construction to progress in official reporting, also records the doubling from 1.9% to 4.6%.^[71] A reporting artefact cannot explain a rise measured by a method that precisely does not depend on reporting.

Above all, the objection stumbles on a second fact no under-reporting hypothesis can explain: the qualitative broadening of eligible categories. A physician who poorly reported, yesterday, a euthanasia performed on a terminal-phase cancer patient does not become, by a mere effect of better administrative compliance, the physician who today performs euthanasia for psychiatric suffering alone, for dementia or for old-age polypathology. The extension to minors, to autism, to chronic depression and to "completed life" is an extension of the criteria themselves, documented in successive laws and official reports — not a statistical catch-up.

Theory becomes unbearable when one looks at the names. Here are five cases, among hundreds, that should suffice to stop the French debate of 2026.

Shanti De Corte — euthanized at 23 for attack trauma

Shanti De Corte was 17 on 22 March 2016 when, in the check-in hall of Brussels-Zaventem airport, two Daesh terrorists detonated their belts. She stood metres from the bombers. Physically unharmed, she never psychologically recovered from what she saw. Six years of depression, suicide attempts, hospitalizations. On 7 May 2022, in Antwerp, two psychiatrists approved her euthanasia request for "unbearable psychological suffering." She was killed at 23.^[72]

The case was revealed by RTBF on 5 October 2022. The Belgian State took up arms to defend her against murderers in March 2016. Six years later, it paid its physicians to kill her.

Zoraya ter Beek — euthanized at 29 for autism and depression

Zoraya ter Beek, Dutch, was 28, in a relationship, living in North Brabant. Diagnosed autistic, borderline and depressive since adolescence. Ten years of treatments. More than thirty sessions of electroconvulsive therapy. Her euthanasia request was approved. On 22 May 2024, she was euthanized at 29, in perfect physical health.^[73]

The case travelled the world. A young woman in good physical health, with a partner and two cats, obtained from a European State that it kill her because her psychological suffering was judged "irremediable." No institutional objection prevailed.

Lisa Pauli — euthanasia requested for anorexia

Lisa Pauli, Canadian, 47, 42 kilograms, anorexic since age eight. She publicly declared in 2023 that she wanted to benefit from MAID as soon as the extension to mental illness alone came into force:

"Personally, I'm too tired. I'm not going to change. I don't want to recover, which means putting on weight." — Lisa Pauli, Reuters testimony, July 2023^[74]

The extension being postponed, her request is pending. But the mere scheduled eligibility of a chronic anorexic for medical assistance in dying betrays a civilizational collapse: the medicine of a rich country envisages killing its anorexic patients instead of treating them.

Amir Farsoud — poverty as grounds

Amir Farsoud, Canadian, 54, non-lethal chronic back pain, living in a rented room under threat of eviction. His MAID request was in progress in 2022. He did not want to die; he said publicly: "I know that in my current health condition, I would not survive if I were homeless." A single physician's signature was missing for him to be euthanized. A GoFundMe campaign launched by journalists allowed him to rehouse himself, and he cancelled his request.^[75]

The Canadian State was one signature away from killing a man solely because he could no longer pay his rent. This is exactly the situation Catholic doctrine had foreseen: "the most vulnerable persons can very quickly feel they must ask for death so as not to cost, not to disturb."

Marin Eugen Sabau — euthanized before his trial

Marin Eugen Sabau, a Romanian settled in Spain, had shot and wounded four former colleagues in Tarragona in December 2021. Paraplegic after his arrest, he requested euthanasia. The victims' families asked that his death be postponed until after the trial, so he could answer for his acts. The investigating judge rejected their request. On 23 August 2022, Sabau was euthanized at the Terrassa prison hospital — in pre-trial detention, before his trial.^[76]

For the first time in Europe, the State killed a detainee who was due to stand trial, depriving victims of the right to see the author of their injuries appear in court. Euthanasia thus becomes a judicial exit: it suffices to be suffering enough to escape punishment.

The French debate of 2025–2026 does not come from nowhere. It belongs to a half-century of legislative evolution that must be followed step by step.

From the Leonetti law (2005) to the Claeys-Leonetti law (2016)

Promulgated on 22 April 2005, the Leonetti law had found a clear balance: refusal of overzealous treatment, accompaniment of the dying, relief of pain, prohibition of causing death. Tugdual Derville and many Catholic bioethicists judged it perfectly acceptable.

The Claeys-Leonetti law of 2 February 2016 introduced two novelties:

1. Parenteral feeding and hydration are now qualified as "treatments" (not basic care), which opens the possibility of stopping them as part of refusing overzealous treatment — which, in some cases, amounts to letting a patient die of hunger and thirst.
2. Deep and continuous sedation until death is legalized as a patient's right.

Pope John Paul II, in March 2004, had nevertheless explicitly stated that "the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, therefore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory."^[77] The Claeys-Leonetti law therefore opens, in certain situations, a grey area Catholic doctrine would qualify as euthanasia by omission.

The 2025–2026 bill

The legislative timetable since the favourable opinion of the National Consultative Ethics Committee of September 2022 and Emmanuel Macron's declaration in favour of euthanasia after his re-election:

This turbulent timetable reflects a deep fracture between a National Assembly favourable to the text and a reluctant Senate. Two successive Senate rejections did not suffice to stop the process: the constitutional machinery ended by giving the "last word" to the National Assembly, which finally adopted the text on 15 July 2026 — and the Constitutional Council declared it constitutional on 14 August 2026 (decision No. 2026-910 DC), subject to three interpretive reservations.^[78]

The finally adopted text provides for a "lethal substance" which the person "self-administers" or "has administered" — in other words assisted suicide AND euthanasia depending on the case. Five cumulative criteria are required: being an adult, French or a stable resident, suffering "from a serious and incurable condition with a life-threatening prognosis at an advanced or terminal stage," presenting refractory physical or psychological suffering, and having the capacity to express a free and informed will.^[79] The Constitutional Council judged this scheme constitutional (decision No. 2026-910 DC of 14 August 2026), subject to three interpretive reservations; Law No. 2026-794 of 18 August 2026 entered into force on 20 August 2026.^[80]

Twenty-one departments with no palliative care unit

While the legislator prepares administered death, access to palliative care remains unworthy of a rich country. According to the Court of Accounts report published in July 2023 (2021 data, 2023 Atlas of palliative care):

• 171 palliative care units at the end of 2021, and 21 French departments with no palliative care unit at all (including Ardennes, Gers, Lozère, Pyrénées-Orientales and French Guiana).
• Only 48% of estimated palliative care needs are actually met — needs assessed at about 60% of deaths each year (≈ 365,000 persons in 2017), i.e. some 190,000 persons a year deprived of the accompaniment they would have needed.^[81]

The order in which a civilized country should proceed is reversed. First, guarantee everyone access to palliative care. Then, and only then, debate anything else. Proceeding in reverse order, as France does in 2026, organizes pressure: a poorly relieved patient will more readily request death than a relieved one.

The revolt of caregivers

The medical world, in its very large majority, opposes the project. According to the internal survey of the French Society for Accompaniment and Palliative Care (SFAP, March 2025):

• 85% of palliative care actors oppose intentionally caused death.
• 83% consider that "such an act cannot be regarded as care."
• 22% of palliative care physicians declare they would resign if the text were adopted.
• Only 6% of palliative care physicians would agree to administer the lethal substance.^[82]

The National Order of Physicians spoke out against it, as did almost all medical learned societies. The National Council of the Order demanded, once the text was voted, a strict conscience clause — which the Constitutional Council's decision of 14 August 2026 partly enshrined in its interpretive reservations. Yet — and this is one of the most worrying points — the current version of the text obliges the objecting physician to himself find a colleague willing to kill his patient, which turns conscientious objection into formal cooperation in murder.

"If a physician conscientiously objects to participating in torture or capital punishment, or to force-feeding a prisoner on hunger strike, it would be unscrupulous of him to find someone with fewer scruples to do it in his place. Requiring a conscientious objector to facilitate the performance of the procedure to which he objects constitutes a direct attack on his conscience and moral integrity." — David Albert Jones, Oxford bioethics centre, quoted by Tugdual Derville^[83]

The Conference of Bishops of France, in its statement after the vote of 27 May 2025, spoke of an "anthropological upheaval" and stressed that "deliberately causing death cannot constitute human progress."^[84] On 27 February 2026, after the second adoption in the Assembly, the bishops invited deputies to "debate without haste" in the face of "the absence of broad consensus" on the subject.^[85] After the final adoption of 15 July 2026, Cardinal Jean-Marc Aveline, president of the Conference of Bishops of France, and his two vice-presidents published the very same day a signed statement noting that this vote "marks a grave rupture in the history of our country" and "breaks with the long tradition of care whose vocation is to relieve suffering and accompany each person to the natural end of life," while assuring that "the Catholics of France will continue […] to serve life."^[86]

For the Catholic reader — and for every reader who wants to know the position of the world's oldest and most articulate moral institution on the end of life — here are the decisive doctrinal sources, in their official formulation.

Evangelium Vitae — the solemn declaration of 1995

The encyclical Evangelium Vitae, signed by Saint John Paul II on 25 March 1995 (solemnity of the Annunciation), remains the founding document. The pope explicitly exercises his charism of definitive teaching, in union with all the bishops:

"Given these distinctions, in harmony with the Magisterium of my Predecessors and in communion with the Bishops of the Catholic Church, 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. Depending on the circumstances, this practice involves the malice proper to suicide or murder." — Saint John Paul II, Evangelium Vitae, § 65^[87]

The formula engages the authority of the ordinary and universal Magisterium, and the letter Samaritanus Bonus takes it up as "definitive teaching" — it is this formula, attested by the sources themselves, that must be kept to.

A few paragraphs earlier, the same John Paul II had laid down the general principle of which euthanasia is only an application:

"With the authority which Christ conferred upon Peter and his Successors, in communion with all the Bishops of the Catholic Church, I confirm that the direct and voluntary killing of an innocent human being is always gravely immoral. […] Nothing and no one can in any way 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 an 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. Nor can any authority legitimately recommend or permit such an action." — Saint John Paul II, Evangelium Vitae, § 57^[88]

Samaritanus Bonus — the dicastery letter (2020)

The Congregation for the Doctrine of the Faith (renamed Dicastery in 2022) published on 14 July 2020 a letter entitled Samaritanus Bonus, "on the care of persons in the critical and terminal phases of life." The document, signed by Cardinal Luis F. Ladaria, S.J., and approved by Pope Francis, reaffirms the doctrine as "definitive teaching":

"For these reasons the Church considers it necessary to reaffirm as definitive teaching that euthanasia is a crime against human life because, by this act, man chooses to cause directly the death of another innocent human being. […] Euthanasia, therefore, is an intrinsically evil act, in every situation or circumstance. Any direct cooperation, whether formal or material, in such an act is a grave sin against human life." — Congregation for the Doctrine of the Faith, Samaritanus Bonus, 14 July 2020, chapter V, § 1^[89]

The letter adds, addressing Catholic legislators:

"Those who approve laws on euthanasia and assisted suicide are thus accomplices in the grave sin that others will commit. They are also guilty of scandal, because by such laws they contribute to distorting conscience, even among the faithful." — Samaritanus Bonus, V, § 1^[90]

On the delicate pastoral question of the sacraments administered to a person persisting in the intention of euthanasia, the letter specifies — a point often ignored in the press — that such a person "is in a situation of manifest lack of the proper disposition for the reception of the Sacraments of Penance, with absolution, and Anointing of the Sick, as well as Viaticum. The penitent will be able to receive these sacraments when his willingness to take concrete steps enables the minister to conclude that he has modified his decision."^[91] And — no less important — "it is not admissible on the part of those who spiritually assist these sick persons to carry out any external gesture whatsoever that could be interpreted as approval of euthanasia, such as remaining present at the moment of its realization. Such presence can only be interpreted as complicity."^[92]

The Catechism — the doctrine summarized

The Catechism of the Catholic Church, promulgated by Saint John Paul II in 1992, devotes eight paragraphs (§§ 2276–2283) to respect for life at its end. The two central articles:

"Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgment into which one may have fallen in good faith does not change the nature of this murderous act, which must always be forbidden and excluded." — Catechism of the Catholic Church, § 2277^[93]

"Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged." — Catechism of the Catholic Church, § 2279^[94]

On suicide, the Catechism recalls God's sovereignty over life while yielding nothing on mercy:

"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." — Catechism of the Catholic Church, § 2280^[95]

"We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives." — Catechism of the Catholic Church, § 2283^[96]

The juridical nullity of euthanasic laws

This is one of the most radical points of the teaching, and the least known. Evangelium Vitae teaches not only that euthanasia is immoral: it teaches that the laws legalizing it are juridically null. The pope relies on Saint Thomas Aquinas:

"This is the luminous teaching of Saint Thomas Aquinas, who writes among other things: 'Human law is law only inasmuch as it is in conformity with right reason; and hereby it is clear that it flows from the eternal law. Insofar as it deviates from right reason it is called an unjust law; in such case it is no law at all, but rather an act of violence.' And again: 'Every law framed by man bears the character of law exactly to that extent to which it is derived from the law of nature. But if in any point it differs from the law of nature, it is no longer a law but a perversion of law.'" — Saint Thomas Aquinas, Summa Theologiae, I-II, q. 93, a. 3, ad 2 and q. 95, a. 2, quoted by Evangelium Vitae § 72^[97]

And John Paul II draws the direct consequence:

"Laws which authorize and promote abortion and euthanasia are radically opposed not only to the good of the individual but also to the common good; as such they are completely lacking in authentic juridical validity. […] It follows that, when a civil law legitimizes abortion or euthanasia, by that very fact it ceases to be a true, morally binding civil law." — Saint John Paul II, Evangelium Vitae, § 72^[98]

This is the most demanding juridical position of the contemporary Magisterium. A law authorizing euthanasia is not a law in the full sense of the term. It is, as Saint Thomas says, "a perversion of law." The Catholic citizen — like every person of good will — is morally bound to oppose it by conscientious objection: "it is never licit to cooperate formally in evil" (EV § 74).

Pope Francis confirms

Pope Francis, despite the media image sometimes cultivated of a "more flexible" pontiff, confirmed the position with clarity and constancy. From the general audience of 5 November 2014, he calls euthanasia a "sin against God and against creation."^[99] On the occasion of the World Day of the Sick in February 2024, he recalls:

"Euthanasia and assisted suicide constitute a grave threat to humanity; they are not the right solution to suffering; they are never an option, but they betray the function of medicine, which is to combat suffering, not to eliminate the one who suffers." — Pope Francis, message for the 32nd World Day of the Sick, 11 February 2024^[100]

A few months later, in the address of 14 February 2024 to participants in the Plenary Assembly of the Pontifical Academy for Life, Francis adds that "the true answer cannot be to kill, even when it appears humanitarian, but to embrace and accompany."^[101] The position has been constant since Pius XII: no pope, since 1957, has varied the doctrine by one iota.

No moral theory removes the suffering of the sick, nor the anguish of the families who accompany them. A Catholic encyclopedia cannot stop at principles; in the end, it must give the floor back to those who suffer and those who care for them.

The cry beneath the request

Dr Benoit Beuselinck, oncologist at UCLouvain, practises in a country where euthanasia has been legal since 2002. Over two decades, he collected the real reasons behind requests:

"The most frequent reasons why a person requests euthanasia are the fear of seeing one's state of health deteriorate, of becoming dependent, of being a burden on others, of suffering in the final moments, of no longer being able to do what one did before. It is, by contrast, rather rare for the sick to request euthanasia for acute and unrelievable physical suffering. It is more a matter of metaphysical suffering […]. The much-publicized euthanasia cases in Belgium are the perfect illustration. […] An elderly person in a retirement home, with urinary incontinence and failing sight, if she requests euthanasia, it is not for intolerable physical pain, it is for an underlying psychological suffering. Most often loneliness. Another in the same state, but well surrounded, will not think of it!" — Dr Benoit Beuselinck, oncologist at UCLouvain, quoted in Timothy Devos, Euthanasie, l'envers du décor — Témoignages de soignants, Éditions Mols^[102]

Many euthanasia requests are the expression of a cry for love that one no longer knows how to formulate otherwise. Tugdual Derville reports the words of a Belgian patient persuaded by his family to request euthanasia:

"Doctor, do I have the right to live a little longer?" — Testimony reported by Tugdual Derville, Docteur, ai-je le droit de vivre encore un peu ?, Salvator, 2023^[103]

The book's title says it all: in a society that legalizes administered death, the most fragile come to ask for the right to live.

The testimony of Pozzo di Borgo

On 8 April 2021, before the National Assembly examining the Falorni bill for the first time, Philippe Pozzo di Borgo — tetraplegic since 1993 after a paragliding accident, inspiration for the film The Intouchables, spokesman for the collective Soulager mais pas tuer — delivered his appeal "N'abolissez pas nos vies":

"You do not realize the disaster caused, among persons struggling with difficult lives, by your support for euthanasia or assisted suicide as 'free, dignified and courageous' deaths. Would I have lacked dignity, courage and liberty by staying alive, I the untouchable, 100% dependent on others' help to live in society? More than a quarter-century of tetraplegia, marked — I dare say — by as many joys as real pains, vaccinated me against the trap of the word 'liberty.' In all liberty, after my accident, when I saw no meaning in this life of suffering and immobility, I would have demanded euthanasia had it been offered to me. In all liberty I would have yielded to despair, had I not read, in the gaze of my caregivers and loved ones, a profound respect for my life, in the lamentable state in which I was. Their regard was the light that convinced me my own dignity was intact. It is they — and all those who love me — who gave me the taste for living." — Philippe Pozzo di Borgo, appeal of 8 April 2021^[104]

Mother Teresa and the worst of diseases

"The greatest disease in the West today is not tuberculosis or leprosy, but being unwanted, unloved and neglected. We can cure physical diseases with medicines, but the only cure for loneliness and despair is love. Many die for a piece of bread in the world, but many more die for a little love." — Saint Teresa of Calcutta, Nobel Peace Prize acceptance speech, Oslo, 11 December 1979^[105]

These words, spoken almost half a century before the French debate of 2026, say the essential. The civilization preparing to kill its dying is not making humanist progress: it medically organizes what it can no longer treat spiritually. "The only cure for loneliness and despair is love" — not lethal injection.

Dying surrounded, relieved, accompanied

Marie de Hennezel, palliative care psychologist and author, gave the simplest and truest definition of what "dying with dignity" should be:

"I would like a peaceful death, in my own bed, not in hospital. I would like people around me saying words of love to me, giving me the strength to die, touching me with gentle, calm gestures, letting me slip into death without forcing me to eat if I no longer feel like it. I want to feel life around me, children moving, people talking, and, if I suffer, to be given what I need so I no longer hurt. That is, for me, dying with dignity." — Marie de Hennezel, Nous voulons tous mourir dans la dignité, Robert Laffont, 2013^[106]

No lethal injection in this picture. No "lethal act" organized by the State. Just a presence, relief, life around. That is what palliative care offers; that is what euthanasia abolishes.

The Catholic encyclopedia also feeds on the spiritual wisdom accumulated over the centuries. The Christian end of life is neither a debacle, nor a liberation, nor a mere transition: it is a passage in which, according to tradition, what matters most in a human life is at stake.

Saint Alphonsus Liguori and preparation for death

Saint Alphonsus Liguori (1696–1787), Doctor of the Church, devoted one of his major works to Preparation for Death. Far from the morbid anguish sometimes attributed to him, his book is a practical manual for living death as life's last action — the one demanding the greatest lucidity, the greatest peace and the greatest trust:

"Consider, my brother, that you will die; and consider that you will die but once. If you fail at your death, there will be no way back. See to it, then, that you do it well." — Saint Alphonsus Liguori, Preparation for Death^[107]

Alphonsus's position, like that of the whole Catholic tradition, consists neither in fleeing death through overzealous treatment, nor in hastening it through euthanasia. It consists in preparing to receive it peacefully, relieved of pain, surrounded by one's own, at peace with God — in other words, exactly what palliative care tries to make possible.

Saint Thérèse of Lisieux — trust to the end

Saint Thérèse of the Child Jesus died of tuberculosis on 30 September 1897, aged 24, after months of atrocious suffering (inability to breathe, haemoptysis, intestinal pain). By contemporary criteria, she would have been perfectly "eligible" for euthanasia. She chose something entirely different:

"I am not dying, I am entering life." — Saint Thérèse of Lisieux, words reported by Sister Geneviève^[108]

The sentence is not a denial of suffering. Thérèse wrote in her final weeks lucid notes on the anguish she endured and even on the temptation of suicide that can cross, at certain moments, those who suffer beyond all measure. She describes suffering with medical precision, without disguising it. But she chooses, in that same suffering, trust — not elimination.

Saint John Paul II — the public agony of February–April 2005

Saint John Paul II, who had signed Evangelium Vitae ten years earlier, lived his own end of life under the eyes of the whole world. Struck by Parkinson's disease made public as early as 1991–1992,^[109] progressively paralyzed, operated for a tracheotomy on 24 February 2005, unable to speak in his final days, he refused to be hospitalized a second time and chose to die in his Vatican apartment, surrounded by prayer. He refused every form of passive or active euthanasia and testified — by his mere presence — that a man's dignity is not lost with the collapse of his body.

Six years earlier, in his Letter to the Elderly of 1 October 1999, he had written with premonitory lucidity:

"Despite the mystery that surrounds it, and which is sometimes almost overwhelming, death cannot be for the believer but an experience that sheds light on life: the present life from which he says farewell, the new life looming on the horizon. […] Saint Paul expressed it clearly: 'For to me, to live is Christ, and to die is gain' (Phil 1:21)." — Saint John Paul II, Letter to the Elderly, 1 October 1999, § 16^[110]

According to the testimony of his private secretary, Cardinal Stanisław Dziwisz, his last audible words, spoken in Polish a few hours before his death on 2 April 2005 at 9:37 p.m., were: "Pozwólcie mi odejść do domu Ojca" — "Let me go to the house of the Father."^[111]

His spiritual testament, written by himself between 1979 and 2000 then published on 7 April 2005, confirms his refusal of overzealous treatment as of hastening:

"I thank everyone. I ask forgiveness of everyone. I also ask for prayer, that God's mercy may be greater than my weakness and unworthiness. […] At the end of my life, I look back. […] My thoughts, my heart and my soul turn toward the Mother of Christ." — Saint John Paul II, Testament, final version of 17 March 2000, published 7 April 2005^[112]

The contrast is total with euthanasic logic: a pope who could, at any moment, have requested the stopping of all treatment, chose the patience of going to the end — not from stoicism, but from fidelity to what he had written. His public agony was, as Joaquín Navarro-Valls would write, "Karol Wojtyła's last encyclical."^[113]

This article's central argument holds in one line. Directly causing the death of an innocent person is never care — whatever the motives (compassion, autonomy, dignity), whatever the means (injection, omission), whatever the lexical disguises ("aid in dying," "medical assistance in dying," "assisted death," "care" in Quebec). Euthanasia remains, by magisterial definition and by rational evidence, the deliberate killing of an innocent person.

This position is not a refusal of compassion. It is, on the contrary, its most demanding form: refusing to eliminate the one we can no longer cure. The physician faithful to his vocation will always seek to relieve the sick person's suffering without ever giving him death. Palliative care, where available, now relieves all pain. Deep sedation, framed by the principle of double effect, offers a peaceful outcome to extreme situations. Love, presence and listening do the rest.

The Catholic way is therefore neither overzealous treatment, nor abandonment, nor administered death. It is harder than these three false solutions: it is the patience of accompanying, the rigour of relieving, the humility of loving to the end. It reminds every dechristianizing society that a person's dignity never disappears with health, and that the worst disease of our time is not physical suffering — it is, as Mother Teresa wrote, the feeling of being wanted by no one.

To the France of 2026, which has just crossed before its Parliament a threshold twenty-five centuries of medicine and two thousand years of Christian teaching had forbidden it, and which now awaits the Constitutional Council's judgment, the Church repeats, through John Paul II: "No authority can legitimately impose it, nor even authorize it." And through the Dicastery: "Incurable is never synonymous with untreatable." And through all the saints who made, of dying, the last act of love of an offered life.

• What Should We Think About Abortion? — the other great issue of respect for innocent life, treated by the same encyclical Evangelium Vitae.
• Evil and Suffering — why suffering, in the Christian perspective, never removes the dignity of the person.
• Why Catholicism Is the True Religion — the general framework of Catholic morality and its anthropology.

To read to go deeper

• Saint John Paul II, Evangelium Vitae — encyclical of 25 March 1995, full text on vatican.va.
• Congregation for the Doctrine of the Faith, Samaritanus Bonus, 14 July 2020 — letter on the care of persons in the critical and terminal phases of life, full text on vatican.va.
• Catechism of the Catholic Church, §§ 2276–2283 — paragraphs on euthanasia, suicide, palliative care and double effect.
• Matthieu Lavagna, L'Euthanasie en débat — Peut-on donner la mort par compassion ?, Salvator — the French-language apologetics synthesis of reference on the subject.
• Dr Jean-Marie Gomas and Dr Pascale Favre, Fin de vie, peut-on choisir sa mort ?, Artège, 2023 — the clinical experience of two palliative care physicians.
• Timothy Devos (ed.), Euthanasie, l'envers du décor — Témoignages de soignants, Éditions Mols — twenty testimonies of Belgian caregivers after twenty years of legal euthanasia.
• Tugdual Derville, Docteur, ai-je le droit de vivre encore un peu ?, Salvator, 2023 — the account of abuses observed in legalizing countries.