Paglia on end of life care: The greatest remedy is closeness

By Christopher Wells

The question is not primarily about euthanasia – because when put like that, the issue is ‘too dry, too frigid’. The problem, instead, ‘is how to accompany, how to make this passage as painless as possible and, at the same time, less desperate’.

Archbishop Vincenzo Paglia, speaking with journalists at the headquarters of the Pontifical Academy for Life, reflected at length on the theme of end-of-life care. In a few days, he will leave for North America, travelling first to the United States and later to Toronto, Canada, at the invitation of the local bishops, where he will participate in a symposium on palliative care.

Archbishop Paglia says his main concern and commitment is to provide context for a subject that is sometimes diminished or levelled by legislation. Instead, he maintains, ‘every death is different from every other and therefore should be accompanied in a personal way’.

Read the full interview below: 

Archbishop Paglia, how are you preparing for this symposium?

The visit to Canada represents a special moment for me precisely because, in a culture like the western one, the theme of the last stages of life must acquire a relevance that it does not yet have today. There is a risk of producing legislation that basically wants to exclude the problem through laws that are frigid, that tend to unite very different cases, laws that may be somewhat like ‘washing one’s hands’. Instead, I believe it is an issue that we must address very carefully. The term ‘palliative care’ needs to be explained very carefully. If I could use another word, I would say ‘accompaniment’, which removes, for example, the drama of loneliness, which is not a physical pain, but a kind of inner tragedy that must be cured.

Cured in what way?

With closeness, with affection, with interest, with love. The subject of physical pain, then, can be dramatic; and we must fight it. And in my opinion, here we should urge governments to further also the scientific and research aspects of these treatments that accompany the end of life. We should urge the Churches to rediscover the importance of accompaniment for an effective ‘good death’, which for us believers is the passage to life with Jesus.

We should also help all other religions or men of good will, because at that final moment, each of us needs to physically feel closeness. Here, in this sense, it seems important to me that the reflection is not just ‘euthanasia yes [or] euthanasia no’: it is too dry, too frigid. The problem is how to accompany, how to make this transition as painless as possible and, at the same time, less desperate. That is why there is a great challenge ahead of us concerning the very meaning of life.

There is also a path to be charted that looks to the future...

Yes, it is also an important discussion for the generations to come. Reflecting on the end of life means, first of all, understanding this: Is it really the end of life? Quantum philosophy tells us no, because, if anything, we remain energy. Christian Revelation tells us that death is a passage, it is not the end, we could say the end of this earthly life in a certain way, but we know from the Creed that after death human life continues, even if it is resurrected—and unfortunately, this dimension is hardly emphasised in sermons any more, whereas we should rediscover it.

This is why I believe that this reflection around palliative care or the end of life is a huge issue that concerns all the components of society, from medical to scientific and pedagogical, from humanistic to philosophical, theological and psychological.

Pope Francis has said that we must accompany people at the end of life but not provoke death or facilitate assisted suicide. How is this possible?

The Pontifical Academy for Life published a study a few years ago at the end of an international congress on exactly this topic, where we outlined ten points that describe the meaning of palliative care.

Life is a gift and it is a gift that God entrusts to us. So life is also our own, yes, but it is not ours alone. The Lord has given us life with a great gift, for us to multiply it for ourselves and for others. Indeed, if we multiply it for others we will also multiply it for ourselves. That is why Pope Francis also urges us to understand that accompanying each other in this last moment enriches everyone. Even when we cannot heal, we can always provide care, we must always provide. And even when we no longer have the means to block the path of death, which comes for everyone, there is being present. There is no longer acting, but holding hands, there is being present to show that love is stronger than the pain of death, that friendship is stronger even than death, which wants to break ties. What happened on Calvary can in a way be an example of this.

How so?

That Jesus had His mother and young disciple at His side was certainly a comfort to Him, and that mother and young disciple heard from the one who was dying: She is your mother and he is your son. It was love that continued. The Resurrection begins there, because the death that wanted to silence Jesus was actually a death that began to generate a new solidarity, a new fraternity. After all, closeness is experienced even at the beginning of life: When a mother gives birth to a child, there are those who welcome him or her, those who cut the umbilical cord, those who care for the child and bring the child up together. So, as together we are born, together we must die.

How can the Church, and the Pontifical Academy for Life in particular, deal constructively with even the most critical views on these issues?

We must continue to reflect and talk to everyone because these perspectives are humanist perspectives. Faith illuminates them, but reason understands them. That is why the Church's task is to try to ‘de-ideologise’ these topics, which are often contaminated precisely by ideologies and not by actual accompaniment. It would only take a little reason to understand that each death is different from the other and should therefore be accompanied in a personal manner. Therefore, each needs its own words, its own gestures, its own presence. And this is what we must make understood. Of course, then there are millions of laws, because if there are no laws, the risk is that a barbarianism will take over.

All this is indispensable, perhaps, but even more indispensable is a culture that unites believers and non-believers, because being born and dying is not a Catholic issue, it is everyone's issue. And so finding an alliance, an understanding that is as broad and as common as possible, is at the very least indispensable, which is why I believe that one of the tasks of the Pontifical Academy for Life is precisely this: to make it credible, to make it reasonable, even that extra gear that we may have on issues that in reality concern everyone, starting precisely from the reasonable dimension.