Faithful Responses to Suffering When Medical Assistance in Dying (euthanasia/assisted suicide) is Legal: A Canadian Catholic Health Care Experience
Christopher De Bono, PhD, Vice-President of Mission, People and Ethics at Providence Health Care
Approximately 1 in 10 people who receive palliative care, which is a clinical approach aimed at improving quality of life through the management of pain and suffering (1), (2), ask about euthanasia (i.e. an action directly taken to end another’s life) or assisted suicide (i.e. helping another to intentionally end their life) to alleviate suffering (3).
Three years ago, Canada’s Supreme Court struck down a law against assisted suicide (2), (4) (also known as Medical Assistance in Dying or MAiD). This ruling meant eligible Canadians gained the legal ability to request and receive MAiD. As of June 2018, more than 3,700 Canadians have died with MAiD (5). While many requests for MAiD are received from patients in Catholic health care settings, none of these assisted deaths have actually occurred at any Canadian Catholic health site.
Assisted deaths do not take place in Catholic health care sites because Catholic moral teaching calls for the respect for the dignity of every human person and respect for all human life, until the natural end (6), (7). This respect for dignity and life means suicide and euthanasia are never morally acceptable options in a Catholic health system. Thus, Catholic health care organizations have faced considerable complexities; one of which is how to navigate paths of compassionate responses for individuals in their care who request MAiD, and when and how to transfer care for eligible persons who persistently seek MAiD.
At its core, the question becomes, how can a person’s legal rights related to MAiD be balanced with the core values of a faith-based organization that never intentionally ends a human life? These fundamentally different views exist concurrently in a diverse and publically-funded health system like Canada’s, where care is progressively more coordinated and collaborative between the secular and faith-based providers (8). These partnerships raise an important practical question too: How close to MAiD can a Catholic health care organization get?
This session tells the story of Providence Health Care, a large Canadian Catholic health care organization located in a region where MAiD statistics are twice the national average, representing approximately 2% of all deaths. The session shows how Providence responded to the legalisation of MAiD.
The audience will be engaged around four of our core experiential learnings: (1) the legal framework which allows faith-based organizations to opt out of MAiD provision; (2) a compassionate, faithful and morally licit approach to MAiD, which accounts for the bio- psychological spiritual aspects of a person when responding to requests; (3) our collaborative and licitly cooperative engagement with non-faith-based organizations; and, (4) what it means when patients remain in our care while deliberating their MAiD request.
This presentation will be of interest to front line clinicians, and middle and senior leaders in Catholic and faith-based organizations who want to better understand the challenges of compassionate and faithful responses to requests for MAiD, in an era where it is increasingly being legalized.
References
1. World Health Organization (2018). Definition of Palliative Care. http://www.who.int/cancer/palliative/definition/en/
2. Kenny, N. (2015). Health Decisions and Care at the End of Life: A Catholic Perspective. Health Catholic Health Alliance of Canada. Novalis, Toronto, ON.
3. Dees, M. Vernooij-Dassen, M., Dekkers, W., Vissers, K., & van Weel, C. (2011). ‘Unbearable suffering’:
A qualitative study on the perspectives of patients who request assistance in dying. Journal of Medical
Ethics, 37(12), 727-734.
4. Government of Canada. (2018). Medical assistance in dying. https://www.canada.ca/en/health-
canada/services/medical-assistance-dying.html
5. Health Canada. (2018). Third Interim Report on Medical Assistance in Dying in Canada. Available
online: https://www.canada.ca/content/dam/hc-sc/documents/services/publications/health-system-
services/medical-assistance-dying-interim-report-june-2018/medical-assistance-dying-interim-report-june-
2018-eng.pdf
6. Catholic Health Alliance of Canada (2012). Health Ethics Guide (3rd ed.).
7. United States Conference of Catholic Bishops (2018). Ethical and Religious Directives for Catholic Health Care Services (6th ed.). Washington, DC Catholic Church. (1994).
8. De Bono, C. (2017). Faith-based care and medical assistance in dying.
http://policyoptions.irpp.org/magazines/december-2017/faith-based-care-and-medical-assistance-in-
Three years ago, Canada’s Supreme Court struck down a law against assisted suicide (2), (4) (also known as Medical Assistance in Dying or MAiD). This ruling meant eligible Canadians gained the legal ability to request and receive MAiD. As of June 2018, more than 3,700 Canadians have died with MAiD (5). While many requests for MAiD are received from patients in Catholic health care settings, none of these assisted deaths have actually occurred at any Canadian Catholic health site.
Assisted deaths do not take place in Catholic health care sites because Catholic moral teaching calls for the respect for the dignity of every human person and respect for all human life, until the natural end (6), (7). This respect for dignity and life means suicide and euthanasia are never morally acceptable options in a Catholic health system. Thus, Catholic health care organizations have faced considerable complexities; one of which is how to navigate paths of compassionate responses for individuals in their care who request MAiD, and when and how to transfer care for eligible persons who persistently seek MAiD.
At its core, the question becomes, how can a person’s legal rights related to MAiD be balanced with the core values of a faith-based organization that never intentionally ends a human life? These fundamentally different views exist concurrently in a diverse and publically-funded health system like Canada’s, where care is progressively more coordinated and collaborative between the secular and faith-based providers (8). These partnerships raise an important practical question too: How close to MAiD can a Catholic health care organization get?
This session tells the story of Providence Health Care, a large Canadian Catholic health care organization located in a region where MAiD statistics are twice the national average, representing approximately 2% of all deaths. The session shows how Providence responded to the legalisation of MAiD.
The audience will be engaged around four of our core experiential learnings: (1) the legal framework which allows faith-based organizations to opt out of MAiD provision; (2) a compassionate, faithful and morally licit approach to MAiD, which accounts for the bio- psychological spiritual aspects of a person when responding to requests; (3) our collaborative and licitly cooperative engagement with non-faith-based organizations; and, (4) what it means when patients remain in our care while deliberating their MAiD request.
This presentation will be of interest to front line clinicians, and middle and senior leaders in Catholic and faith-based organizations who want to better understand the challenges of compassionate and faithful responses to requests for MAiD, in an era where it is increasingly being legalized.
References
1. World Health Organization (2018). Definition of Palliative Care. http://www.who.int/cancer/palliative/definition/en/
2. Kenny, N. (2015). Health Decisions and Care at the End of Life: A Catholic Perspective. Health Catholic Health Alliance of Canada. Novalis, Toronto, ON.
3. Dees, M. Vernooij-Dassen, M., Dekkers, W., Vissers, K., & van Weel, C. (2011). ‘Unbearable suffering’:
A qualitative study on the perspectives of patients who request assistance in dying. Journal of Medical
Ethics, 37(12), 727-734.
4. Government of Canada. (2018). Medical assistance in dying. https://www.canada.ca/en/health-
canada/services/medical-assistance-dying.html
5. Health Canada. (2018). Third Interim Report on Medical Assistance in Dying in Canada. Available
online: https://www.canada.ca/content/dam/hc-sc/documents/services/publications/health-system-
services/medical-assistance-dying-interim-report-june-2018/medical-assistance-dying-interim-report-june-
2018-eng.pdf
6. Catholic Health Alliance of Canada (2012). Health Ethics Guide (3rd ed.).
7. United States Conference of Catholic Bishops (2018). Ethical and Religious Directives for Catholic Health Care Services (6th ed.). Washington, DC Catholic Church. (1994).
8. De Bono, C. (2017). Faith-based care and medical assistance in dying.
http://policyoptions.irpp.org/magazines/december-2017/faith-based-care-and-medical-assistance-in-