END OF LIFE ETHICAL ISSUES

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GodsGrace

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The CC has changed its position on end of life care.
It had believed that suspending food and water was equivalent of causing a person's life.
It now states that if a person is given food and water - and who could not otherwise ingest normally,
the medical treatment can be considered aggressive and thereby makes suspension of food and water acceptable
in a moral and ethical sense.

Anyone care to comment?




The Vatican’s Academy for Life has issued a new text on a series of bioethical issues, including the provision of food and hydration for patients in a vegetative state. It marks a modest departure from the Vatican’s previously held position on the issue, while the Church’s stance against euthanasia remains steadfast.

Published 8 August by the Pontifical Academy for Life (PAV), the volume is titled, “Small Lexicon on End of Life”, and covers a variety of bioethical issues.

According to an introduction by Italian Archbishop Vincenzo Paglia, president of the PAV, the volume has the aim of “reducing at least that component of disagreement that depends on an imprecise use of the notions implied in speech”.

Namely, Paglia referred to “the statements that are sometimes attributed to believers and which are not rarely the result of cliches that have not been adequately scrutinised”.

Among other things, the 88-page text reaffirms a blanket “no” to euthanasia and assisted suicide, but it also shifts toward a new openness from the Vatican when it comes to so-called “aggressive treatment”, specifically the requirement to provide food and hydration to patients in a vegetative state.

In section 13 of the volume, which deals with this issue of food and hydration, a reference is made to the recently published declaration of human dignity from the Vatican’s Dicastery for the Doctrine of the Faith (DDF), Dignitas Infinita.

In Dignitas Infinita, the DDF reiterated the need to avoid “every aggressive therapy or disproportionate intervention” in the treatment of patients with serious illnesses.

Likewise, the PAV’s new volume also invoked the July 2020 letter Samaritanus Bonus, which among other things mentioned “the moral obligation to exclude aggressive therapy” treatment plans.

The volume noted that the food and hydration prepared for vegetative patients are prepared in a laboratory and administered through technology, and thus do not amount to “simple care procedures”.

Doctors, the text said, are “required to respect the will of the patient who refuses them with a conscious and informed decision, even expressed in advance in anticipation of the possible loss of the ability express oneself and choose”.

They noted that for patients in a vegetative state, there are some who argue that when food and hydration are suspended, death is not caused by the illness but rather by those who suspend them.


This argument, the PAV said, “is the victim of a reductive conception of disease, which is understood as an alteration of a particular function of the organism, losing sight of the totality of the person”.

“This reductive way of interpreting disease then leads to an equally reductive concept of care, which ends up focusing on individual functions of the organism rather than the overall good of the person,” the volume says.

To this end, it quoted from a November 2017 speech from Pope Francis to members of the PAV in which he said that technical interventions on the body “can support biological functions that have become insufficient, or even replace them, but this is not equivalent to promoting health”.

“Therefore, an extra dose of wisdom is needed, because today the temptation to insist on treatments that produce powerful effects on the body, but which sometimes do not benefit the integral good of the person, is more insidious,” the text said, continuing the quotation of Pope Francis.

The PAV insisted that this position does not conflict with the position previously taken by the DDF on the issue of food and hydration, which was issued in 2007 in response to bishops in the United States on the moral obligation to provide food and water to patients in a vegetative state, even through artificial means.

In their brief response, the then-Congregation for the Doctrine of the Faith held that even in a situation where there’s moral certainty that a patient will never recover, it was not permissible to withdraw food and water, as doing so would effectively allow the person to die of dehydration or starvation.

The position taken in the PAV’s new document, however, would seem to mark a potential shift toward a new openness from this position. However, PAV insists their stance does not mark a departure from the 2007 decision and, to this end, cited “ethnically legitimate” reasons for suspending treatment included in the then-CDF’s response.

Among other things, PAV noted that the then-CDF said it was possible to suspend treatment when it was no longer seen as “effective from a clinical point of view”, meaning when bodily tissues are “no longer able to absorb the administered substances”, and when it causes the patient “an excessive burden or significant physical discomfort linked, for example, to complications in the use of instrumental aids”.

In a bid to illustrate continuity in the Vatican’s position on the topic, the PAV volume said this last point from the 2007 response refers to the question of proportionality in the administration of treatments, and it argued that the DDF’s new document Dignitas Infinita, published in April, “moves along the same lines”.

The PAV’s new “lexicon” suggested that Dignitas Infinita be interpreted in a “long-term and broad-based perspective”, and it notes that the DDF text “does not elaborate an overall reflection on the relationship between ethics and the legal sphere”.

On this point, “the space therefore remains open for the search for mediations on the legislative level, according to the principle of ‘imperfect laws,’” PAV said.

In terms of legal mediation on the issue, PAV said, “In addressing the issues evoked by individual words, this lexicon takes into account the pluralistic and democratic context of the societies in which the debate takes place, especially when it enters the legal field”.

“The different moral languages are not at all incommunicable and untranslatable, as some claim,” PAV said, insisting that dialogue is possible among those with differing views of the issue.

By allowing the space to be kept open for research on legislative mediation on the topic, “in this way” –as Paglia notes in his introduction – “believers assume their responsibility to explain to everyone the universal (ethical) sense disclosed in the Christian faith”.

source: Vatican clarifies stance on patients in vegetative state; stays firm against euthanasia - Catholic Herald
 

JohnDB

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*sigh*

I have always admired the Catholics stance on life....granted it seems draconian to many but it was simple and clear.

No birth control or abortion of any sort and no euthanasia.
From an opinion of "Always err on the side of life". Fairly simplistic and probably overly so....but everyone understood it.

Now I'm becoming troubled by their trying to keep up.
 
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GodsGrace

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*sigh*

I have always admired the Catholics stance on life....granted it seems draconian to many but it was simple and clear.

No birth control or abortion of any sort and no euthanasia.
From an opinion of "Always err on the side of life". Fairly simplistic and probably overly so....but everyone understood it.

Now I'm becoming troubled by their trying to keep up.
You're right John.
The above isn't so bad.
Sometimes force-feeding a person is detrimental to their health, instead of the other way around.

But on other matters, which I have on a different thread re this Pope,
he is liberal and has changed doctrine/disciplines and is, as you've put it, trying to keep up.
 
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JohnDB

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You're right John.
The above isn't so bad.
Sometimes force-feeding a person is detrimental to their health, instead of the other way around.

But on other matters, which I have on a different thread re this Pope,
he is liberal and has changed doctrine/disciplines and is, as you've put it, trying to keep up.
Faced feeding tube situation myself from my mother's passing. She got Sepsis and they gave her a feeding tube. It was uncomfortable for her but extended her life. But the overriding condition that caused her Sepsis (disintegrating digestive/bowel tract) to begin with was of course not going to repair itself ever. And feeding her this way was only extending her misery for an inevitable outcome. Same with blood transfusions. They too extended her life for an inevitable outcome.

Of course we valued her life...of course we value all life. Living wills are actually very very problematic when facing end of life care. And geriatric spouses make poor decisions when not ready to face losing a spouse of over 50 years....they can be strong armed into the exact wrong decision because the doctor, nursing homes, hospitals and etc do not ever want to lose any patients ever...and will pass them off to avoid liability quickly.

Just saying....
 
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Wrangler

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Anyone care to comment?
Putting aside the CC change, abortion and euthanasia have been ethical issues since antiquity.

I know I’m in the minority and reject the ‘slippery slope’ fallacy of being in favor of EOL care. Not gratuitous suicide but driven to minimize suffering.

IMO, every medical treatment ‘plays God’ in altering the natural trajectory of injury, illness and disease.
 

GodsGrace

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Faced feeding tube situation myself from my mother's passing. She got Sepsis and they gave her a feeding tube. It was uncomfortable for her but extended her life. But the overriding condition that caused her Sepsis (disintegrating digestive/bowel tract) to begin with was of course not going to repair itself ever. And feeding her this way was only extending her misery for an inevitable outcome. Same with blood transfusions. They too extended her life for an inevitable outcome.

Of course we valued her life...of course we value all life. Living wills are actually very very problematic when facing end of life care. And geriatric spouses make poor decisions when not ready to face losing a spouse of over 50 years....they can be strong armed into the exact wrong decision because the doctor, nursing homes, hospitals and etc do not ever want to lose any patients ever...and will pass them off to avoid liability quickly.

Just saying....
Right, there's a lot of politics in this too - just like everything else.
I, OTOH, refused some treatment for both my father and my husband....
Definitly for my father who had alzhiemers. Had to make decisions for him and happily for him
I was here and he didn't suffer as much as he would have had the medical profession had their way.

My husband and I were agreed on methods.
When a person cannot eat anymore and is full of pain, there's no sense in prolonging life.
It's sufficient to stop treatment at that point.

This is why I agree (for once) with something the Pope did.
In some ways I believe we have to go along with nature and allow the dying process to happen.
Some persons want to put this off at all costs, even at the suffering of their loved one.
But, you know how it is:
One person's perception of suffering,
is another person's prolongation of life.
 
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GodsGrace

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Putting aside the CC change, abortion and euthanasia have been ethical issues since antiquity.

I know I’m in the minority and reject the ‘slippery slope’ fallacy of being in favor of EOL care. Not gratuitous suicide but driven to minimize suffering.

IMO, every medical treatment ‘plays God’ in altering the natural trajectory of injury, illness and disease.
Not sure what you mean Wrangler.
EVERY medical treatment?

You mean if a child falls and gets hurt you aren't going to medicate the area?
If you need an appendectomy you're going to refuse it?

I hope you mean something different.
 

Wrangler

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Not sure what you mean Wrangler.
EVERY medical treatment?

You mean if a child falls and gets hurt you aren't going to medicate the area?
If you need an appendectomy you're going to refuse it?

I hope you mean something different.
Nope! That's exactly what I mean. It's Black and White. Either we "play God" with everything or we do not with anything.

As a kid I got severe strep throat many times. I have no doubt if not for modern medicines, I would have died then. Preventing death is playing God just as much as EOL is for the power of yes is the power of no. Who are we to stop someone from dying, opposing God's will in letting nature take its course?

Those who oppose euthanasia want it both ways; the power of life and death and the ability to use that power only on one side of the equation. Getting back to my strep throat, the solution was to cause death - of the strep bacteria. Why is that OK? When one examines the answer, the reason is because we value some things more than life, itself.
  1. In some cases, we value freedom over life.
  2. In other cases, we value human life over other life forms.
  3. In some cases (self-defense and war), we value some human life over other human life. (Take life to save more lives).
  4. And in EOL, we value mercy, stopping the suffering over life.
Is that not so? For those who oppose euthanasia, your position is fickle; life is values less than other things except at EOL.
 

Wrangler

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if a child falls and gets hurt you aren't going to medicate the area?
If you need an appendectomy you're going to refuse it?
If you want to be consistent in opposing euthanasia, yes. An injury could lead to infection, which could lead to death. Why are you advocating we "play God" in one instance but oppose it in another instance?
 

Wrangler

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Definitly for my father who had alzhiemers. Had to make decisions for him and happily for him
I was here and he didn't suffer as much as he would have had the medical profession had their way.
Bless you. I'm sure that was a difficult time for you.

I decided when the time came, if my grandfather asked, I would act to end his EOL suffering no matter what the legal consequences were. It did not come to that.
 

GodsGrace

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Nope! That's exactly what I mean. It's Black and White. Either we "play God" with everything or we do not with anything.

As a kid I got severe strep throat many times. I have no doubt if not for modern medicines, I would have died then. Preventing death is playing God just as much as EOL is for the power of yes is the power of no. Who are we to stop someone from dying, opposing God's will in letting nature take its course?

Those who oppose euthanasia want it both ways; the power of life and death and the ability to use that power only on one side of the equation. Getting back to my strep throat, the solution was to cause death - of the strep bacteria. Why is that OK? When one examines the answer, the reason is because we value some things more than life, itself.
  1. In some cases, we value freedom over life.
  2. In other cases, we value human life over other life forms.
  3. In some cases (self-defense and war), we value some human life over other human life. (Take life to save more lives).
  4. And in EOL, we value mercy, stopping the suffering over life.
Is that not so? For those who oppose euthanasia, your position is fickle; life is values less than other things except at EOL.
That's a very extreme view Wrangler.
It's all very ideological.
What about the practical side?
Do you have children?
Or even for yourself....
You didn't really answer my question.
If you get a pain on your side and require an operation to perform
an appendectomy....
You're going to refuse it?

The rest of your post is all ideology...
and ideology works very well until we're faced with the reality.
 

GodsGrace

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Bless you. I'm sure that was a difficult time for you.

I decided when the time came, if my grandfather asked, I would act to end his EOL suffering no matter what the legal consequences were. It did not come to that.
Your stance is really confusing to me....
 

MA2444

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Putting aside the CC change, abortion and euthanasia have been ethical issues since antiquity.

I know I’m in the minority and reject the ‘slippery slope’ fallacy of being in favor of EOL care. Not gratuitous suicide but driven to minimize suffering.

IMO, every medical treatment ‘plays God’ in altering the natural trajectory of injury, illness and disease.

I think you're right Brother. It's all based on witchcraft & Sorcery..

The Witch Doctors took over the world. It's the largest industry in the world.
 

Wrangler

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That's a very extreme view Wrangler.

Yup. The truth is extreme. Right is extreme.

Do you have children?
Yes.
If you get a pain on your side and require an operation to perform
an appendectomy....
You're going to refuse it?
No. Not sure where you are going with this.
The rest of your post is all ideology...
and ideology works very well until we're faced with the reality.
Hmmm. I have a fully developed philosophy of life. This means I've thought things through to the fundamentals. Regarding your apparent dichotomy between ideology and practical application in the face of reality:
  • although there is a right to abortion, one is not required to have an abortion with every pregnancy.
  • although I am armed and have a right to shoot an intruder, I still welcome people into my home.
I think you get the point. Having an option does not mean one is required to exercise that option. The purpose of education is to know what your options are. Usually, it's simple to tell to what the best options. Simple does not mean emotionally easy.

While I was going through the divorce with my first wife, our dog had problems adjusting. He begin crapping in the house, no matter whose house he was staying with. My soon to be ex-wife made an executive decision to euthanize our beloved dog without giving me the option to keep him. Honestly, I did not see that coming. The dog was emotionally struggling (as I was) not physically suffering. Facing reality.
 

VictoryinJesus

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The CC has changed its position on end of life care.
It had believed that suspending food and water was equivalent of causing a person's life.
It now states that if a person is given food and water - and who could not otherwise ingest normally,
the medical treatment can be considered aggressive and thereby makes suspension of food and water acceptable
in a moral and ethical sense.

Anyone care to comment?




The Vatican’s Academy for Life has issued a new text on a series of bioethical issues, including the provision of food and hydration for patients in a vegetative state. It marks a modest departure from the Vatican’s previously held position on the issue, while the Church’s stance against euthanasia remains steadfast.

Published 8 August by the Pontifical Academy for Life (PAV), the volume is titled, “Small Lexicon on End of Life”, and covers a variety of bioethical issues.

According to an introduction by Italian Archbishop Vincenzo Paglia, president of the PAV, the volume has the aim of “reducing at least that component of disagreement that depends on an imprecise use of the notions implied in speech”.

Namely, Paglia referred to “the statements that are sometimes attributed to believers and which are not rarely the result of cliches that have not been adequately scrutinised”.

Among other things, the 88-page text reaffirms a blanket “no” to euthanasia and assisted suicide, but it also shifts toward a new openness from the Vatican when it comes to so-called “aggressive treatment”, specifically the requirement to provide food and hydration to patients in a vegetative state.

In section 13 of the volume, which deals with this issue of food and hydration, a reference is made to the recently published declaration of human dignity from the Vatican’s Dicastery for the Doctrine of the Faith (DDF), Dignitas Infinita.

In Dignitas Infinita, the DDF reiterated the need to avoid “every aggressive therapy or disproportionate intervention” in the treatment of patients with serious illnesses.

Likewise, the PAV’s new volume also invoked the July 2020 letter Samaritanus Bonus, which among other things mentioned “the moral obligation to exclude aggressive therapy” treatment plans.

The volume noted that the food and hydration prepared for vegetative patients are prepared in a laboratory and administered through technology, and thus do not amount to “simple care procedures”.

Doctors, the text said, are “required to respect the will of the patient who refuses them with a conscious and informed decision, even expressed in advance in anticipation of the possible loss of the ability express oneself and choose”.

They noted that for patients in a vegetative state, there are some who argue that when food and hydration are suspended, death is not caused by the illness but rather by those who suspend them.


This argument, the PAV said, “is the victim of a reductive conception of disease, which is understood as an alteration of a particular function of the organism, losing sight of the totality of the person”.

“This reductive way of interpreting disease then leads to an equally reductive concept of care, which ends up focusing on individual functions of the organism rather than the overall good of the person,” the volume says.

To this end, it quoted from a November 2017 speech from Pope Francis to members of the PAV in which he said that technical interventions on the body “can support biological functions that have become insufficient, or even replace them, but this is not equivalent to promoting health”.

“Therefore, an extra dose of wisdom is needed, because today the temptation to insist on treatments that produce powerful effects on the body, but which sometimes do not benefit the integral good of the person, is more insidious,” the text said, continuing the quotation of Pope Francis.

The PAV insisted that this position does not conflict with the position previously taken by the DDF on the issue of food and hydration, which was issued in 2007 in response to bishops in the United States on the moral obligation to provide food and water to patients in a vegetative state, even through artificial means.

In their brief response, the then-Congregation for the Doctrine of the Faith held that even in a situation where there’s moral certainty that a patient will never recover, it was not permissible to withdraw food and water, as doing so would effectively allow the person to die of dehydration or starvation.

The position taken in the PAV’s new document, however, would seem to mark a potential shift toward a new openness from this position. However, PAV insists their stance does not mark a departure from the 2007 decision and, to this end, cited “ethnically legitimate” reasons for suspending treatment included in the then-CDF’s response.

Among other things, PAV noted that the then-CDF said it was possible to suspend treatment when it was no longer seen as “effective from a clinical point of view”, meaning when bodily tissues are “no longer able to absorb the administered substances”, and when it causes the patient “an excessive burden or significant physical discomfort linked, for example, to complications in the use of instrumental aids”.

In a bid to illustrate continuity in the Vatican’s position on the topic, the PAV volume said this last point from the 2007 response refers to the question of proportionality in the administration of treatments, and it argued that the DDF’s new document Dignitas Infinita, published in April, “moves along the same lines”.

The PAV’s new “lexicon” suggested that Dignitas Infinita be interpreted in a “long-term and broad-based perspective”, and it notes that the DDF text “does not elaborate an overall reflection on the relationship between ethics and the legal sphere”.

On this point, “the space therefore remains open for the search for mediations on the legislative level, according to the principle of ‘imperfect laws,’” PAV said.

In terms of legal mediation on the issue, PAV said, “In addressing the issues evoked by individual words, this lexicon takes into account the pluralistic and democratic context of the societies in which the debate takes place, especially when it enters the legal field”.

“The different moral languages are not at all incommunicable and untranslatable, as some claim,” PAV said, insisting that dialogue is possible among those with differing views of the issue.

By allowing the space to be kept open for research on legislative mediation on the topic, “in this way” –as Paglia notes in his introduction – “believers assume their responsibility to explain to everyone the universal (ethical) sense disclosed in the Christian faith”.

source: Vatican clarifies stance on patients in vegetative state; stays firm against euthanasia - Catholic Herald
It reminds me of Do not resuscitate.
Or when a person asks not to be put on life support where it is only the machines keeping them alive. same with a family having to decide if it’s time to turn off the life support. It’s a hard decision for the family. I’ve had to be apart of making this decision but I don’t get how they said it’s not the disease but the choice to not intervene any longer that caused the death. I know of one who voiced no feeding tube be inserted and that was their wishes for their family to follow. So I’m confusedwhy the Vatican is the one making the decision of what is allowed when it happens already within families with someone passing? The family in discussion of what course to take. “They noted that for patients in a vegetative state, there are some who argue that when food and hydration are suspended, death is not caused by the illness but rather by those who suspend them.”

I’ve heard but I haven’t experienced it yet…that cancer is often not what kills a persons but that they stop eating. when a person is close to death the biggest sign is they stop eating. I don’t know if any of that helps. But it does seem to be a natural thing that happens even in people who are not in a vegetative state …no longer taking in food or drinking as the dying process happens.
 
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Wrangler

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"Stopping treatment" is called passive euthanasia.

No.
Stopping treatment is letting nature take its course.

Isn't this what you believe to be correct??
LOL. Semantics. My position is consistent in us "playing God" by even having a medical profession whose entire mission is NOT to "let nature take its course."

What I think is correct is to act on our God-given knowledge of Good and Evil. This includes active and passive euthanasia as a subset of medicine. I can hardly think of anything more evil than to force people to suffer.

You are not delving into the fundamentals of the issue, dealing with the practical reality. Let me say it again, the entire purpose of the medical profession is to <NOT let nature take its course>.
Why is it OK to <NOT let nature take its course> by taking aspirin when one has a headache but
NOT OK to <NOT let nature take its course> by invoking active euthanasia?
 

GodsGrace

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Yup. The truth is extreme. Right is extreme.


Yes.

No. Not sure where you are going with this.

Hmmm. I have a fully developed philosophy of life. This means I've thought things through to the fundamentals. Regarding your apparent dichotomy between ideology and practical application in the face of reality:
  • although there is a right to abortion, one is not required to have an abortion with every pregnancy.
  • although I am armed and have a right to shoot an intruder, I still welcome people into my home.
I think you get the point. Having an option does not mean one is required to exercise that option. The purpose of education is to know what your options are. Usually, it's simple to tell to what the best options. Simple does not mean emotionally easy.

While I was going through the divorce with my first wife, our dog had problems adjusting. He begin crapping in the house, no matter whose house he was staying with. My soon to be ex-wife made an executive decision to euthanize our beloved dog without giving me the option to keep him. Honestly, I did not see that coming. The dog was emotionally struggling (as I was) not physically suffering. Facing reality.
Your fully developed philosophy of life is unable to answer my simple question:

IF YOU REQUIRED AN APPENDECTOMY....
TO SAVE YOUR LIFE....
WOULD YOU REFUSE IT....
in support of your philosophy that NOTHING should be done medically because it would be PLAYING GOD.

Simple question requires a simple answer.

We'll discuss philosophy right after you prove you believe in your philosophical concepts.
 

GodsGrace

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LOL. Semantics. My position is consistent in us "playing God" by even having a medical profession whose entire mission is NOT to "let nature take its course."

What I think is correct is to act on our God-given knowledge of Good and Evil. This includes active and passive euthanasia as a subset of medicine. I can hardly think of anything more evil than to force people to suffer.

You are not delving into the fundamentals of the issue, dealing with the practical reality. Let me say it again, the entire purpose of the medical profession is to <NOT let nature take its course>.
Why is it OK to <NOT let nature take its course> by taking aspirin when one has a headache but
NOT OK to <NOT let nature take its course> by invoking active euthanasia?
I didn't know we were discussing the medical profession.
That is NOT what this thread is about.

I'm not even really discussing euthanasia.

You're reading into this thread your own problems with the medical profession - maybe.