By: Carolyn Chau
Euthanasia and physician-assisted suicide have been in the national discourse with increasing regularity as legislation on medically assisted dying (Bill 52) was recently passed (June 9, 2014) by the Quebec provincial government and as private member’s bills are put forward at the federal level to legalize physician-assisted suicide.
Bill 52, which allows for “medical aid in dying,” has been under discussion over the past two years. The new law endorses both terminal palliative sedation and “medical aid in dying;” patients in Quebec may now request aid in dying by lethal injection. Careful to avoid the term euthanasia, a concern of the federal government, the legislation treats this aid as health care, a matter of provincial jurisdiction.
The federal government has thus far expressed clear opposition to changing the law against euthanasia and will likely appeal the Quebec decision to the Supreme Court, arguing that Bill 52 is a criminal matter (as euthanasia is currently defined) and subject to federal jurisdiction. The Carter case in British Columbia (see Mark Miller’s Forum, December 2012), claiming that prohibitions against PAS are unconstitutional, is scheduled for October 2014 and will add something from the judiciary on the state of PAS.
Interestingly, the Canadian Medical Association, which includes the Catholic Health Alliance of Canada among its members, issued a call to the federal government for a national palliative care strategy immediately after the passing of Bill 52; and Catholic health networks have voiced the importance and value of palliative care as well as to have earmarked funds for this type of end of life health care.
The Assembly of Quebec Catholic Bishops have urged pastors across the country to publish their June 6 message in parish bulletins and to speak about this development in Quebec. Others too, from bloggers to the Catholic Organization for Life and the Family, have been working on these life issues. However, given the ambivalence many Catholics in Canada feel about the wrongness of medical aid in dying, it is arguable that the Church has been insufficiently engaged on the ground to help people beyond those already committed to the cause to live according to conscience, intellect, and moral formation. The need for effective Catholic moral formation is apparent and increasingly urgent. Catholic teaching on euthanasia must make transparent to all Canadian Catholics that the intentional taking of life or hastening of death, even of one who is experiencing great pain, is wrong. Suffering may be transformed by loving accompaniment, even as pain relief may require permissible palliative care. The sanctity of and respect for life are deeply held values of the Catholic tradition, without arguing thereby any kind of defense of vitalism.
Moreover, despite arguments that Bill 52 is less concerning than at first glance with its stipulations to thwart abuse, physicians were not adequately consulted about the law nor was there full consensus during the consultative process. The passing of this law reveals, then, not only a challenge for ecclesial response and action but a challenge of how to address the increasing weakness and vulnerability of democratic political process, a challenge pertinent to all people.
All too often, competing voices in debates about euthanasia root their arguments in the criterion of compassion for the preservation of human dignity while various sides claim to have a better understanding of what constitutes that dignity. With high profile cases, such as pro-PAS Dr. Donald Low regarding his own dying, arguments must move beyond the emotional sway of individuals making a case for or against legalization. In contrast, we might ask how the Church’s teaching, and its traditions of social ethics and virtue ethics, could be brought to bear on an issue so often defined by the language of individual rights.
Rather than entitlements, perhaps the focus can be turned to the ways religious, social, medical, political, and legislative bodies can explore the content of “dying well” and can offer help to individuals, families, and physicians as they face decision-making in health-critical end-of-life care. Unfortunately, in the face of dying, secular culture upholds autonomy as the highest good. Alternately, the acceptance of human vulnerability and a community’s and society’s support in living well even while dying may offer another more human and humane way to conceive the good. In the meantime, current developments such as the vote by the Canadian Medical Association for a national palliative care strategy give reason for hope that Canada will embrace this alternative.