The Good Samaritan and the "good death": Catholic reflections on euthanasia.

• Author: Doerflinger, Richard M.

Once a lawyer stood up, trying to test Jesus with a question, `Teacher, what am I to do to inherit eternal life?' Jesus said to him, `What is written in the Law? How do you read it?' He said in reply, `You must love the Lord your God with all your heart, with all your soul, with all your might, and with all your mind; and you must love your neighbor as yourself.' Jesus then said to. him, `You have answered correctly; do this and you shall live.'

But the lawyer was anxious to justify himself; so he said to Jesus, `But who is my neighbor?' Jesus took him up and said to him, `A certain man was traveling down from Jerusalem to Jericho, when he fell in with robbers. They stripped him, beat him, and went off leaving him half-dead. Now by coincidence a priest was going down that same road; when he saw the man, he passed by on the other side. Similarly, a Levite also came upon that place, saw him, and passed by on the other side. But a Samaritan who was on a journey came up and bandaged his wounds, pouring olive oil and wine over them. He set him on his own mount, led him to a public inn, and made provision for him there. The next day he took out two pieces of silver, gave them to the innkeeper, and said, "Provide for him, and on my way back I shall reimburse you for whatever you spend over and above this." Which of these three seems to you to have been neighbor to the man who fell into the hands of the robbers?' He answered, `The one who showed him kindness.' So Jesus said to him, `Go and do the same yourself.'(1)

The story of the Good Samaritan has inspired centuries of Christian commitment to health care as a ministry and given its name to our secular "Good Samaritan" laws, which encourage physicians to help accident victims in emergencies. The parable retains its power even today, and certain features are worth noting for their similarity to situations and problems of our own time.

The mugging victim lies "half-dead" by the side of the road, and two of his fellow countrymen, a priest and a Levite, pass by without stopping. Why? Most likely they fear the ritual defilement of touching what may well be a dead body--a taint that would make them unfit for their duties in the Temple. In today's more secularized times we have far more fear of social or physical defilement, such as the stigma or risk of infection from treating a patient who may be HIV-positive. In one recent study, twenty-three percent of American medical residents said they would not care for persons with AIDS if they had a choice; nineteen percent of them said a patient of theirs had been refused care by a specialist, and thirty-nine percent had a patient who had been refused care by a surgeon.(2) Today a total stranger found lying on the ground with open wounds would be a perfect candidate for such discrimination.

Other possibilities: The priest and the Levite may be hurrying by because they know there are robbers in the area, and they are afraid they too will be robbed if they linger. This is a common fear among physicians at accident scenes today as well--except that the robbers now are known as malpractice attorneys. In our litigious society, many physicians are hesitant to stop at accident scenes or respond to the call of "Is there a doctor in the house?" for fear that any mistake made in a sudden emergency can make them the targets of lawsuits.(3)

It is precisely to alleviate this fear that Good Samaritan statutes have been enacted in every state, beginning with California in 1959. These laws typically protect physicians and others from legal liability for providing care to strangers in emergencies, unless they are clearly guilty of "gross negligence."(4)

Finally, of course, the priest and the Levite may just feel that their other responsibilities demand their attention, and it would be futile to expend time and energy on someone who is at least half-dead and probably beyond help.

Our own health care cost crisis has prompted many physicians and hospitals to entertain various policies on the denial of "futile" care.(5) In a society that has accepted the concept of brain death, today's half-dead patients at risk of being denied care are the half-brained (that is, lacking higher-brain functions while continuing to breathe spontaneously, such as patients in a "persistent vegetative state").(6) Today even some prominent Catholic priests (as well as the lay ethicists who are today's Levites) have articulated their own theological version of a "futile care" standard, arguing that all efforts to support life are futile when provided to a patient who no longer has the potential to pursue the spiritual purposes to which human life is ordered. In their view a person diagnosed as having lost this potential is maintaining only "mere physiological function," which has no intrinsic value for the patient because such functioning cannot be put to use in pursuing higher spiritual ends. Such a person, it is argued, can no longer relate to us, or even to God, as a neighbor.(7)

But the parable of the Good Samaritan seems to issue a warning against pursuing this line of argument. For when the lawyer asks, "Who is my neighbor?" in an attempt to justify himself--that is, in an effort to define certain limits to the classes of persons to whom he has an obligation of care-Jesus turns the tables on him. He asks which person in the story acted like a neighbor to the half-dead, helpless man. And when the lawyer says the Samaritan did, he simply orders him: "Go and do the same yourself."

The parallel question posed to us might be this: When we make these distinctions between meaningful and meaningless human lives in order to limit the scope of people to whom we owe lifesaving care, are we perhaps stalling our own...