SASKATOON — With the legalization of assisted suicide and euthanasia in Canada, it is vital to reaffirm Catholic health care and what it means, ethicist Rev. Mark Miller, CSsR, told priests, ministry leaders and spiritual care providers from across the province Dec. 1 in Saskatoon.
“We need to stand up for what we believe in; we need to support our Catholic facilities in looking after patients,” he said.
“There are two principles that we operate from. One is that we don’t kill people, but the other one is that we don’t abandon people.”
Miller was a keynote speaker at a conference organized by the bishops of Saskatchewan to address the challenges of providing pastoral care in an era of euthanasia and physician-assisted suicide. Bishop Noël Simard of the Diocese of Valleyview, Quebec, also spoke during the one-day workshop at the Cathedral of the Holy Family in Saskatoon, exploring end of life issues and formation of conscience (see related article).
Born in Edmonton, Miller completed his doctorate in moral theology at the University of Notre Dame in South Bend, Indiana, and then spent 16 years as a clinical bioethicist working at St. Paul’s Hospital in Saskatoon. Presently serving as the provincial of the English-speaking Redemptorists of Canada, Miller also works at the centre for clinical ethics at St. Joseph and St. Michael hospitals in Toronto.
“When the Supreme Court of Canada decided it was OK for physicians to kill patients at the end of life it was a huge tragedy for our country,” Miller asserted, before providing an overview of end-of-life issues, the importance of palliative care, and the new reality in Canada.
In effect, the legalization of assisted suicide and euthanasia says that some lives are not worth living, Miller said. “I think that is to put the dying into a category that is destructive — not just to the dying but to all of us as human beings.”
The aftermath of permitting physician-assisted suicide and euthanasia for those with “irremediable suffering” will be ever-expanding boundaries, Miller predicted. “We have changed the definition of health care. Health care becomes to a great extent what you want.” Other societal changes will follow, he suggested, pointing to suggestions from some commentators that only those willing to kill patients now be accepted into medical school.
Miller pointed to palliative care and the Catholic spiritual tradition as strengths that must be emphasized and shared as alternatives to euthanasia. “We have alternatives in which there is not over-treatment, there is not under-treatment, but there is proper care for people. That’s what needs to be supported,” he said.
When it comes to the end of life, there are two great fears, Miller said, the fear of pain and the fear of abandonment. “What I mean by abandonment is that people feel that they are not worth being looked after.”
There is an attitude in this society that says no one should be dependent, and another that denies the reality of death, he noted.
“We live as if we are not going to die. Then all of a sudden we are facing dying and death and it’s like a panic reaction: let’s just get it over with. But dying is a part of living. And it is extremely important for us in our Catholic faith to understand that when you are talking about people who are dying, we are talking about our brothers and sisters going through one part of the journey of life. And the questions that we always need to ask ourselves are the questions of how can we make that journey a life-giving journey.”
For many in our pragmatic, self-serving, efficiency-obsessed culture, that seems contradictory, Miller said.
“But I’ll tell you what I have seen in palliative care and care for the dying. I have seen family relationships grow — and grow stronger . . . I have also seen reconciliations,” he said. “It’s our job to support those things.” Even when someone is in a coma, transformation can happen in families and relationships, he said. “Things take place because Mom isn’t ready to go yet, something still needs to be done.”
Rather than capitulating to the culture’s values, Catholics must live their own values boldly and clearly, Miller said. “If we don’t have a sense of what we are trying to offer our people at the end of life, then they will get their values from our society, and it will never occur to them that it might be wrong to end their lives if they think they are going to be in pain or if they think they are going to be a burden.”
“We also need to understand our own ethics at the end of life,” he said. “If the burdens outweigh the benefits, you can refuse the treatment, even a life-saving treatment.” Refusing treatment is not suicide or euthanasia, Miller stressed. “They are making a decision about treatment and taking the consequences.”
He called for more discussions in parishes, communities and families about end-of-life issues, about how to care for those who are suffering, and about political action needed to ensure good palliative and hospice care is available.
“Palliative care in Canada offers the opportunity for good, holistic care at the end of life, in which patients will be freed from pain, or at least unbearable pain,” said Miller. “Palliative care is about living while you are dying. In the midst of that, it is about living to the best of your ability with the support that you need,” he said. “This is where we need to make it clear to our brothers and sisters who are dying: you have lots of opportunities to live and we will do what we can to support you.”
The Christian understanding of the dying process has much to offer, he added. For instance, the loss of human strengths and abilities can be an important part of a person’s spiritual journey. “In our human weakness we begin to find God’s strength... to get up on the cross with Christ is a journey sometimes of faith and redemption,” he said.
“You do have to be careful about not dumping that on a dying person — ‘oh well, carry the cross like Jesus’ — that’s not for me to say to another person. But it’s important to understand that this journey is a journey of faith, and somehow in that journey, the Lord’s strength will prevail,” Miller suggested.
He also stressed the importance of community. “A lot of people today see death as an individual experience, isolated from everyone else — ‘it’s my decision’ — and it is kind of reinforcing this individualism of our society. Not for us as Christians. We are a community . . . as a community, the question that we have to face is: what are we doing to support the dying?”
Miller challenged priests to think about how they might respond if a parishioner says in the midst of suffering that they just want to get it over with. “Don’t panic,” said Miller, saying that it is not a time to act as a “moral policeman” but rather, it is a call to engage in listening and dialogue with the person considering euthanasia or assisted suicide.
Great challenges and criticisms are facing Catholic health care institutions, said Miller. “As Catholics, and in our Catholic facilities, we are not going to kill people. That’s the bottom line. That is what we are defending. But what I also want you to understand is that we are going to take care of them. We are going to look after them in whatever way we can,” he said.
“There is going to be a crossroads in our facilities and it has already been put in the press in a couple of places,” he said, pointing to news reports about the transfer of a patient when a Catholic hospital in Vancouver refused to participate in euthanasia. “You read, ‘Oh those Catholic hospitals, they have no compassion.’ These are the hospitals where for 25 years they have been in the forefront of providing palliative care, but now, because we won’t kill people, we are not compassionate,” he said.
“What you have to say in the face of that is: there are different forms of compassion,” Miller said. “In fact, when you actually kill people, you don’t need compassion... as far as I am concerned, it is to say that your life isn’t worth living.”
Instead, the call “for followers of Christ is to support our brothers and sisters so that they know that their lives, until they are called home, are worthwhile. They are part of us and we are part of them and this is a journey we can make, and that we can make it in such a way that it is often a journey of faith and peace and hope.”