SASKATOON — End-of-life issues, the formation of conscience, and the pastoral implications of the legalization of euthanasia and assisted suicide were explored by Bishop Noël Simard of the Diocese of Valleyfield, Quebec at a provincial workshop held Dec. 1 at the Cathedral of the Holy Family in Saskatoon.
Organized by the Catholic bishops of Saskatchewan, the day of reflection and discussion also featured presentations by well-known ethicist Rev. Mark Miller, CSsR (see related article).
Simard, who has a doctorate in moral theology from the Gregorian University in Rome, has served as an ethicist and moral theologian in a variety of capacities. He was appointed auxiliary bishop of the Diocese of Sault Ste. Marie in Ontario in 2008, and bishop of Valleyfield in December 2011. Simard is a member of the Pontifical Academy for Life and former chair of the Catholic Organization for Life and Family.
“Disease, suffering and death are existential realities we cannot escape. They are fundamental realities. But today we are living in a culture of death,” said Simard. “Euthanasia and assisted suicide bring another view on death and dying. “
The new reality in Canada presents a lot of pastoral challenges, with the Supreme Court decision on the Carter Case and Bill 52 in Quebec legalizing euthanasia and assisted suicide, which have been euphemistically dubbed medical aid in dying (MAID) or physician-assisted death.
“There is a lot of confusion in our people — even our Catholic people — because they will say that ‘medical aid in dying’ is a good thing, it is ‘part of health care’ . . . they don’t see that it is killing,” he said. “It is a language misunderstood and misinterpreted.”
Arguments for euthanasia emphasize the autonomy of the individual (“my life, my choice, my right”) but stand against a responsibility to the community, the common good and solidarity, Simard asserted.
“The true autonomous conscience is not self-centred but oriented towards others, in solidarity with others. I cannot fulfil my life without opening myself to the other. So I am not an island, (but am) living in relationship with others, in solidarity with others,” he said.
The first half of Simard’s presentation considered the nature of conscience in detail, as well as tackling freedom of conscience, the formation of conscience, and moral error.
“What is legally permitted is not necessarily morally justified. The moral obligation comes first from the moral conscience . . . and what is lived or admitted by the majority is not necessarily a moral good. The number of similar opinions upon an issue does not determine the moral truth of an action . . . Because the majority — 75 per cent — agree with medical aid in dying, that is not a reason to say that medical aid in dying is OK,” he said.
“When we form our conscience, we need to look at our intention. But good intention does not make an action good. The means must also be good and the circumstances must be taken into consideration.”
In considering end-of-life issues and the formation of conscience, it is necessary to take into consideration the realities of suffering and death, to clarify terms, to reflect on the right use of medication and relief of suffering, he said. “We have to rediscover the moral wisdom of the church teaching. We have to build up the community and the common good. And we have to base our action on the three calls: the call to respect the dignity of human person and the sanctity of life, the call to foster trust and compassion, and the call to promote social justice and good care for all.”
It is necessary to make a distinction between euthanasia (the killing of a patient) and stopping aggressive treatment and accepting death as a natural consequence, he noted. Many mistakenly believe that the church requires that all means must be taken to keep a person alive — but this is not true, said Simard. “When there is no reasonable hope, we have to just let our lives (go) into God’s house.”
Palliative care is the appropriate answer to suffering and death, a true and compassionate alternative to euthanasia, Simard asserted.
Pastoral care must focus on the needs of the dying person: physiological, psychological, emotional, social, economic, spiritual and religious, listed Simard. Guiding principles include dignity, respect, quality of life, autonomy, respect for life, life as a responsibility, justice and equity, and especially solidarity, he said.
“And finally, accompanying the dying person — what does it mean? Humanity: attention to, and respect for, the full human particularity of the dying person. The dying person is not a number. She is a unique person with a unique biology, individualized needs, weakness, strengths, and life plans.”
To accompany the person who asks for euthanasia is problematic for a Catholic pastoral minister, Simard said.
The response could involve “first of all, receiving the request of presence — listening to the cry for help, developing a dialogue with the person on the meaning of his or her request, and trying to discern the real motives and reasons,” he said, as well as “offering spiritual help as prayer and proposing the Christian meaning to suffering and death.”
The pastoral minister may have to explain why it is not possible to be present at the moment of the lethal injection, Simard acknowledged. However, he also described the experience of one woman, who stayed with her brother and held his hand at the moment of euthanasia, even though she strongly disagreed with his decision.
“How can we express our disagreement and at the same time express mercy?” challenged Simard. “Truth and mercy. Pope Francis speaks a lot about mercy, and he quoted Pope Benedict: ‘mercy is truth.’ When you are merciful you are right in Jesus’ way of behaving and acting.”
As a general statement, pastoral ministers should make every effort to “permit the seriously ill to meet the Lord in the sacraments, and to have access to the forgiveness of sins, the anointing of the sick and the eucharist,” said Simard.
At the same time, the request for the anointing of the sick by someone who is asking for euthanasia is “very problematic,” Simard said. “The canon 978.1 can be evoked, reminding the priest that ‘he is at once both judge and healer,’ and that he is constituted by God as a minister of both divine justice and divine mercy.”
Guidelines produced by the bishops of Alberta and the Northwest Territories earlier this year state: “This implies the duty to implore the sick person with gentle firmness to turn away from this determination (asking for euthanasia) in repentance and trust. If the person, however, remains obstinate, the anointing cannot be celebrated.”
Simard expressed it another way: “The anointing is for the living and aimed to bring healing and life. Euthanasia or assisted suicide which brings or causes death contradicts the meaning and the purpose of the sacrament or anointing.” At the same time, it may happen that a particular situation could arise that might permit the sacrament, he said.
“When we are facing a complex situation, there is no black and white. There is a lot of grey zone, and it is where mercy can be expressed — in the grey zone. And I think we are called to express the mercy of God.”
He summarized: “I am not too much in favour of giving the sacrament of the sick to people asking for euthanasia, because there is a contradiction. But when I look at a person’s situation, I may reconsider, I may express my attitude and approach and my decision in a different way, based on mercy.”
As for requests for funeral rites for someone who has died by euthanasia or physician-assisted suicide, Simard again recommended a pastoral approach.
“It is a pastoral request which has theological implications, but a pastoral approach which must take into consideration these elements: first, the meaning of the request: who is asking for the funeral, for what reasons . . . secondly, the meaning of the funeral rites: is it the celebration of the life of someone or the celebration of our Christian hope? For whom the funeral is held? Is it for only the deceased person or for all family and friends and community members?” Another consideration is the church’s evolving attitude toward suicide, which makes a distinction between “rational suicide” and suicide caused by depression or mental illness.
He pointed to Pope Francis’ call to discern, accompany and integrate frailty into difficult pastoral situations. “I think that we need to be very close to people, (bringing) a message of proximity and compassion.”