Leaders of Christianity, Judaism, and Islam presented a signed declaration to Pope Francis Monday expressing their total opposition to euthanasia and any form of physician-assisted suicide, as well as voicing their support of palliative end-of-life care.

The document was signed at the Vatican Oct. 28 by Archbishop Vincenzo Paglia, head of the Pontifical Academy for Life, along with representatives of the Jewish and Islamic faiths. It was given to Pope Francis during an audience.  

The position paper states that the three Abrahamic religions "oppose any form of euthanasia – that is the direct, deliberate and intentional act of taking life – as well as physician assisted suicide – that is the direct, deliberate and intentional support of committing suicide – because they fundamentally contradict the inalienable value of human life, and therefore are inherently and consequentially morally and religiously wrong, and should be forbidden without exceptions."

The paper also affirms the right of healthcare workers to not be coerced or pressured into directly or indirectly assisting in the intentional death of a patient through assisted suicide or any form of euthanasia, especially when doing so would violate the provider's religious beliefs.

Even if accepted by the local legal system, "moral objections regarding issues of life and death certainly fall into the category of conscientious objection that should be universally respected," the paper declares.

Healthcare providers, it notes, have the responsibility "to provide the best possible cure for disease and maximal care of the sick."

The idea for the declaration came from Rabbi Avraham Steinberg, an Israeli medical ethicist, who proposed it to Pope Francis. The pope entrusted the project to the Pontifical Academy for Life, which organized an interreligious committee to create the document.

In the nearly 2,000-word position paper, it is stated that the Catholic, Jewish, and Islamic faiths "share common goals and are in complete agreement in their approach to end-of-life situations." It also notes that these principles are sometimes in conflict with "current secular humanistic values and practices."

The preamble to the report notes that "the moral, religious, social and legal aspects of the treatment of the dying" are among the most complex and most widely discussed in medicine today.

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The issues surrounding the end of life include "difficult dilemmas," which have increased in recent years, it argues, because of scientific-technological developments, changes in the patient-doctor relationship, cultural changes, and a growing scarcity of resources related to the expense of medical care.

These dilemmas are not primarily medical or scientific, but "social, ethical, religious, legal, and cultural," it declares, adding that human intervention in the form of medical treatment and technologies "are only justified in terms of the help they can provide."

"Therefore, their use requires responsible judgment about when life-sustaining and life-prolonging treatments truly support the goals of human life, and when they have reached their limits," it claims.

The declaration states that "when death is imminent despite the means used, it is justified to make the decision to withhold certain forms of medical treatments that would only prolong a precarious life of suffering."

However, both medical providers and society should respect the wish of a dying patient to prolong or preserve his/her life even for an additional short period of time by clinically appropriate medical measures," it continues.

The Catechism of the Catholic Church teaches that a person may legitimately choose to discontinue medical procedures which are "over-zealous," meaning "burdensome, dangerous, extraordinary, or disproportionate to the expected outcome.."

The position paper defines a "dying patient" as someone who has "a fatal, incurable, and irreversible disease" and is at a stage when their death will likely occur within a few months "as a result of the disease or its directly related complications, despite the best diagnostic and therapeutic efforts."

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The report offers encouragement and support for professional palliative care for everyone, everywhere and to commend laws and policies which protect the dignity of a dying person.

It also declares a commitment to engage with communities on the issue of bioethics, and to raise public awareness about palliative care.

The paper states a belief that society has an obligation to help patients not to feel like a burden and to know the value and dignity of their life, "which deserves care and support until its natural end."

The declaration also calls on policymakers and healthcare providers to familiarize themselves with the perspective and teaching of these religions in order to better provide medical assistance in accord with their patients' beliefs.

"While we applaud medical science for advances to prevent and cure disease, we recognize that every life will ultimately experience death," it states. "Care for the dying is both part of our stewardship of the Divine gift of life when a cure is no longer possible, as well as our human and ethical responsibility toward the dying (and often) suffering patient."