In the Carter decision, the Supreme Court of Canada ruled that a competent adult who consents to death, and has a “grievous and irremediable medical condition (including illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition” has a right to physician-assisted dying. The ruling does not restrict physician-assisted dying to those who are terminally ill.
The Court found that a total ban against physician-assisted dying is broader than necessary to achieve its objective of protecting “vulnerable persons from being induced to commit suicide at a time of weakness”. In the view of the Court, the consequences of the prohibition impinge on the individual’s right to life, liberty and security of the person.
In the words of the Court, “the prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear they would be incapable of doing so when they reached the point where suffering was intolerable. The rights to liberty and security of the person, which deal with concerns about autonomy and quality of life, are also engaged. An individual’s response to a grievous and irremediable medical condition is a matter critical to their dignity and autonomy. The prohibition denies people in this situation the right to make decisions concerning their bodily integrity and medical care and thus trenches on their liberty. And by leaving them to endure intolerable suffering, it impinges on their security of the person.”
As I read through the lengthy decision, it was difficult not to let the logic of the Court inform my belief on the matter. It is hard to argue against the individual’s right to autonomy and dignity when I like to make my own decisions, and have no wish to endure suffering, nor watch someone else endure it.
Still, I have issues with physician-assisted dying.
My attitude towards suffering differs from the negative approach towards suffering implied in the term “dying with dignity”, and endorsed in the Carter decision. In my view, the human person is created in the image and likeness of God. This divine stamp on the individual sanctifies every human life, and gives each of us an innate and inviolable dignity.
We operate under a false premise when we equate the suffering arising from disease, illness or disability with a loss of dignity. I have known people to endure each of these with great dignity, allowing their suffering to transform them, and in the process, their relationships and those who cared for them. Rather than losing their dignity, they grew in graciousness.
Archbishop Antonio Mancini of Halifax-Yarmouth, in a homily I happened to hear while visiting Halifax a few days after the Supreme Court decision, addressed our struggle to make sense of suffering. “When there is no meaning to suffering, it is only pain, and of course people are afraid . . . But where there is meaning, where there is love and proper care, where there is community support, suffering can become sacrifice. Sacrifice is not just another word for ‘put up with’. It literally means . . . to make something “sacred”. To take suffering and to transform it with meaning is to make the reality of suffering a manifestation of the holy and the sacred.”
While this view of the relationship between suffering and dignity differs from that of the majority of Canadians and of the Supreme Court, there is the same desire to act compassionately towards those who suffer. From this standpoint, the compassionate response begins with a willingness to share, not to avoid, the suffering of another, and encompasses support and care.
For those who do not applaud this decision as one giant step forward for Canadians, and who seek an alternate response, the Canadian Conference of Catholic Bishops has issued a statement that may be helpful. The bishops recommend that legislators interpret the decision as narrowly as possible so as not to open the door to euthanasia. They urge governments and professional associations to implement policies that will protect the freedom of conscience of healthcare workers who oppose physician assisted dying. And, they renew their call for universal access to quality hospice-palliative care.
Undergirding these action points is an unshakeable belief in the sanctity of human life as a reality that defines the human person, and in the power of love to ease the transition from life to death in even the most difficult of situations.
Louise McEwan is a catechist and former teacher, with degrees in English and Theology.