In its decision in the Carter vs. Canada case, the Supreme Court has given Canadians the right to die, and an answer for the perennial problem of pain and suffering.
But the Carter decision is about more than the right to die. It reflects shifting national values about the nature of human suffering. This has a lot to do with the rejection of religion in general, but more specifically with the rejection of the Judeo-Christian tradition that shaped our nation.
Some of the values of that tradition conflict with the values that the Carter decision expresses. The tradition looks to God’s plan to guide human behaviour. The Supreme Court’s ruling relies on personal autonomy and choice. And whereas the Judeo-Christian tradition searches for a redemptive value in suffering, the court’s ruling rejects suffering.
While people have historically struggled with the reality of suffering, we have also recognized and accepted suffering as part of the mystery of being human. In the past, people were perhaps more willing to grapple with suffering and its meaning. Today, we are much more likely to view suffering (summarized in the Carter decision as illness, disability or disease) as an affront to our dignity and a threat to our ‘quality of life.’
I spoke with Sister Nuala Kenny about the Carter decision and the thorny reality of human suffering. Kenny, of the Sisters of Charity of Halifax, is a pediatrician and the founder of the Department of Bioethics at Dalhousie University. She was a member of the Provincial-Territorial Expert Advisory Group on Physician Assisted Dying, which released its recommendations at the end of November 2015. She is strongly opposed to physician-assisted suicide.
In Kenny’s view, the Carter ruling “goes far beyond the media valorization of the person who is in intractable pain and suffering.”
She zones in on two major problems:
The Carter ruling “is an extreme honouring of individual autonomy, but an autonomy that then requires a reciprocal obligation on the part of others.” It places an obligation on physicians to respond positively to a patient’s request for death.
As a physician, Kenny sees this obligation as a betrayal of the Hippocratic tradition. We have a “huge obligation to provide support for the physical symptoms, that is compassion in itself, and that allows the person who is terminally ill or dying to deal with the spiritual and emotional and psychological challenges.” As a Catholic, she says the focus on individual autonomy expresses a lack of trust in God’s plan for the individual and the community.
The court’s ruling turns suffering, which is a metaphysical reality, into a medical problem, Kenny says. To explain the “medicalization of suffering,” Kenny points to why people request physician-assisted suicide. These include a sense of a loss of dignity and independence, worries about becoming a burden to others, uncertainty about the future, and fears of isolation and a lack of care.
“Those are issues of human suffering. The medicalization of suffering uses death as a treatment for suffering, because there is no prescription for suffering.”
In the Christian tradition, when a person suffers, he or she metaphorically shares in the suffering, death and resurrection of Jesus. Kenny points out that for Christians, the notion that physician-assisted suicide is a compassionate and merciful response to suffering “repudiates the suffering of Jesus” and “flies in the face of the mystery of suffering.”
While this may appear ludicrous to non-Christians, for those of us who profess the Christian faith, it should inform our attitude to suffering and shape our response to the Supreme Court decision.
In about four months, even if no regulations are in place, physician-assisted suicide will be legal in Canada, based on the court’s ruling. And while the time for debating the pros and cons of physician-assisted suicide has past, it is not too late to minimize the potential harms of the ruling’s overly broad and permissive criteria.
One of the most productive responses for those of us who have grievous concerns about physician-assisted suicide centres on palliative care. Canadians need quality, accessible palliative/hospice care. This holistic care tends to the complex needs of the suffering body and soul, neither hastening death nor prolonging life.
Physician-assisted death is coming soon to your community. Isn’t it time for optimal palliative/hospice care to do the same?
Louise McEwan has degrees in English and Theology. She has a background in education and faith formation.