ST. BONIFACE — Rev. Mark Miller, CSsR, is concerned about end-of-life issues, is concerned about what is happening in Canada with respect to laws that will permit physician-assisted deaths. He was in Winnipeg May 12 to speak at St. Timothy’s Parish to a capacity crowd as part of the tri-diocesan National Week for Life and the Family.
Miller was the clinical bioethicist at St. Paul’s Hospital in Saskatoon for 16 years. Following his appointment as provincial for the English-speaking Redemptorists of Canada and his move to Toronto, he continues to work part-time at the Centre for Clinical Ethics at St. Joseph’s and St. Michael’s hospitals.
End of life is “a sacred or a holy time,” noted Miller, but it can also be a time of pain and a feeling of being abandoned. In his practice, Miller would often hear patients say, “I want to get this over with.” The issue, then, was the control of pain. “When the pain was controlled and when they knew they would be cared for, they wanted to live. They needed to know they would not be abandoned,” Miller emphasized.
End-of-life care takes place in programs of palliative care or in a hospice. Miller points out that this is the “most holistic form of medicine we have today.” Its primary goal is to “help you live while you are dying.” It has “a very simple philosophy,” he said, “and it’s we don’t hasten death and we don’t prolong the dying.” Yet, in Canada, only 30 per cent of Canadians have access to palliative care.
Miller spoke to the often confusing matter of what interventions that we, as Catholics, need to accept as we approach the end of life. “Whatever you are going through, you get to weigh the potential benefits against the burdens,” Miller said. “If you feel the burdens are too great for you, you can say no to the treatment. It is perfectly ethical to say, ‘I don’t want this treatment any more.’ ’’ The burdens a patient considers could be physical, financial or family concerns. It is for the patient to decide. And, if they decide against treatment, palliative care is an alternative to be considered.
Miller spoke, as well, to the current legislation that was recently passed in the House of Commons: Bill C14, an Act to Permit Medical Assistance in Dying. He questioned how the medical profession could be involved in the practice and offered this caution: “There is this myth that this is a decision being made by the patient himself or herself. Maybe occasionally that does happen, but I want you to think for a moment, how often our decisions are based on what we feel, what we hear from others.” A family member might say, “You know, Mom, we see you suffering a lot. If you want to get it over with, we’ll support you.” “What does that sound like?” questioned Miller. What would Mom feel or think she should say?
Miller also addressed the matter of Advanced Health Care Directives which “only take effect if you cannot make your own decisions.” He underscored the importance for everyone to have such directives regarding their health care and to have conversations in families regarding our desires at the end-of-life care.
Examples of Advanced Health Care Directives can be seen at the St. Paul’s Hospital website, Patient and Family Services section at http://www.stpaulshospital.org/patient/index.php?page=39. These documents were designed by Miller when he was at St. Paul’s Hospital in Saskatoon.