New legal ramifications coming into effect with the legalization of assisted suicide in Canada will have consequences not only for medical staff but also for the clergy.
The Special Joint Committee of the Government of Canada on Physician-Assisted Dying released its report, Medical Assistance in Dying: A Patient-Centred Approach, on Feb. 25. The report recommended a broad approach to legally mandated physician-assisted death.
In their pastoral statement Feb. 26 in response to the committee’s report, the Canadian bishops said, “The teaching of the Catholic Church and the stance of the Catholic bishops of Canada are clear. Suicide is not part of health care. Killing the mentally and physically ill, whether young or aged, is contrary to caring for and loving one’s brother and sister.” The bishops disagreed that the report’s recommendations are “patient-centred.”
Dr. Vivian Walker, co-director of palliative care at St. Paul’s Hospital in Saskatoon, commented in the March 16 PM: “The seismic shift in our culture toward physician-hastened or physician-assisted death is big, especially in the context of what we know to be poorly accessible palliative care services nationwide.”
This seismic shift is creating new pastoral dilemmas for clergy and pastoral workers.
What should a hospital chaplain do if a patient expresses a determination to use assisted suicide? Can anointing of the sick be given to such a patient? How do pastors decide whether a person who carried out an assisted suicide should receive a Catholic funeral?
These are questions bishops, priests and health care providers are beginning to struggle with. They are new dilemmas. Some guidelines are beginning to emerge.
Archbishop Terrence Prendergast of Ottawa did not specifically address the pastoral implications of assisted suicide in a letter read at all masses in the archdiocese March 5 - 6. But he said, “From not only a Catholic perspective but any rational perspective, the intentional, willful act of killing oneself or another human being is clearly morally wrong.”
He quoted the Catechism of the Catholic Church, which says, “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons. It is morally unacceptable.”
In an interview with Canadian Catholic News, Prendergast said those who choose to participate in assisted suicide do not have “the proper disposition for the anointing of the sick.” The rite is “for people who are gravely ill or labour under the burden of years, and it contains the forgiveness of sins as part of the rite,” he added. “But we cannot be forgiven pre-emptively for something we are going to do, like ask for assisted suicide when suicide is a grave sin.”
The Code of Canon Law says anointing of the sick “is not to be conferred upon those who persevere obstinately in manifest grave sin.” But the 1983 code dropped a norm from the 1917 code that had denied a Catholic funeral to those “who killed themselves by deliberate counsel.”
Sister Carol Keehan, a Daughter of Charity who is president and CEO of the American Catholic Health Association, isn’t so sure the answer is clear cut. “At this point in time, you really can’t give an answer,” she told Catholic News Service.
“If someone confessed or told a priest about their individual situation, their individual culpability about the decision remains between the person and God, and the priest cannot talk about it,” she added. “I don’t think we ought to ever decide what should happen in the internal forum between the mercy of God and a priest working with someone.”
Marie T. Hilliard, director of bioethics and public policy at the National Catholic Bioethics Centre in Philadelphia, also said the question is not a matter of ethics but of “the governance of the church in terms of access to sacraments.”
“The denial of absolution is not at all our call at the NCBC, nor the call of any one ethicist, but the judgment of the confessor at the time, considering the intention of the penitent to reform,” she said.
As medical and religious leaders ponder these new questions, Catholics need to be clear about what the church now teaches about end-of-life decisions. There is no obligation to undergo “massive amounts of intrusive but futile care” at the end of life, Keehan said. “We are finding over and over again that there are misunderstandings about dying and that the church’s teaching gets misrepresented and misunderstood,” she said.
“People need to understand that when they are “fully in control” of their thought processes and their faculties, their wishes and autonomy are going to be respected, she said. “Dying patients have a right to make those choices” or designate someone to make those decisions for them.
“The church does not advocate prolonging life at any cost,” Prendergast noted. “Rather, the church is guided by the principle of the quality of life that considers the whole person and not simply keeping the body going no matter what.”
Assisted suicide will soon be legal. We have to deal with how to handle it morally.