Alfie’s lesson to us all

The sorrow caused by the early departure – for impending causes and tragic circumstances, that are not unrelated to human action – of a young son that we feel also ours, a son of God and of the Church in whose faith he was baptised, makes it hard to put together words and overwhelming, overlapping thoughts. Yet after having stood in silence, gathered in prayer for Alfie and for his parents marked by unyielding courage and hope, something needs to be said, for the love of the Truth that this child now contemplates in the Heavens, before having had the possibility of knowing it on Earth, and to pay homage to his “spiritual will”, that was not written in ink but was carved in his flesh.

First of all, there is a twofold truth highlighted by Pope Francis on April 18, at the end of the general audience, remembering Afie and Vincent, the French quadriplegic man in a minimum conscious state object of a request to be taken off life-sustaining treatment. “The only master of life – from its beginning to natural end – is God, said the Holy Father, and our duty is to do everything to safeguard life” that He has given to every man and every woman, child and adult, whether healthy or sick. This is the bedrock, these are the cornerstones of the code of ethics of medicine, politics and society.

Whoever claims the (non-existing) right to be the master of his own life or of someone else’s life, for whichever reason, is denying the right of God, the Father of humankind and the Bestower of what is good.

Whoever – while having the possibility of acting independently or delegating to others who offered to act in his place – fails to administer to the protection of the life of those entrusted to their care until the natural end owing to their state of indigence, weakness or diseases, did not do this for Jesus, as He said: “Whatever you did not do for one of the least of these, you did not do for me.” (Cf. Mt 25: 45).

In every civilization, the touchstone of human justice (in ancient times, that of the king and his delegates, in modern democratic systems that of judges), consists in the in the ability to defend the vulnerable from the abuse of power, to give a voice to those without voice when faced with someone with greater power. This duty is exemplified in the Bible, when referring to the protection of the rights of the widow, of the orphaned child, and of the foreigner (Cf. Dt 26:12-13; 27: 19). The fundamental right of every human being is the right to life, in whichever season or condition of human existence.

In some circumstances this right to life encompasses reception into a welcoming country, distant from endemic poverty and endless violence, in others it encompasses the recovery of peace and the end of bombings and warfare, in others still it represents the medical supply of life-sustaining treatment to a sick human body.

As Pope Francis said, “may every sick person be always respected in their dignity, and cared for in a way suited to their condition with the consent of family members and loved ones, of the doctors and of other healthcare workers, with great respect for life” (Regina Coeli, April 15 2018)

Finally, we cannot forget the decisive role of the legislative framework of a State, called to safeguard and protect the life of its citizens. Laws on the so-called “end-of-life” are being adopted throughout Europe and beyond. One such law was approved December last. The medical-jurisdictional story of Alfie highlighted the fact that

The most sensitive and decisive aspect of these laws – and, notably, of their implementation – revolves around the thin blade separating so-called “futile medical care” and “omissive euthanasia.”

This blade passes through the fundamental clinical, anthropological, ethical and juridical distinction between “therapy”, that can be interrupted in case it proves to be futile for the improvement or the stabilization of the patient’s medical condition, and “treatment” (namely, “support of vital functions” essential for life), that must never be interrupted until it keeps the body alive.  The failure of a Country’s legal system to acknowledge this difference leaves room for the repetition of tragic situations similar to Alfie’s. In order to avoid it, it is necessary to review the regulations that make therapy and treatment operatively equivalent, ensuring that incurable patients are never suspended the treatment indispensable to live until the last hour that God will give them, never intentionally shortening their life.

(*) Professor at the Faculty of Medicine at the Catholic University of the Sacred Heart in Rome.