I have always been disturbed by Canada’s (and much of Europe’s), ease in making medical assisted dying the law of the land. The original bill (C-14) that legalized MAD did garner some attention. Still, the pushback from Canadian Churches was at best, weak, and at worst, incoherent. Recently, bill (C-7) that now allows an expansion to whom is eligible to seek MAD from a doctor was quickly passed by parliamentarians without any public notice. I’m sure it doesn’t help that everyone is preoccupied with the Corona Virus pandemic. Still, it saddens me that this bill, considering its impact on all of us, has passed under the radar of society in general and, especially, the Church. Nevertheless, clergy like myself cannot avoid dealing with this issue pastorally whether we want to or not. Therefore, it is incumbent upon me to give a response.
In my opinion, MAD conflicts with the heart of Christian teaching, in particular, the doctrines of Creation, Incarnation, and, most importantly, Atonement. Now before I move on to argue my thesis, let me be clear on one important pastoral point. Although I am fundamentally against MAD (or what I prefer to call, euthanasia) I will always pastorally care for anyone no matter what they decide to do at their end of life. If I based my pastoral presence on people believing what I believe, I’m not sure I would have anyone left to care for. Nevertheless, it is precisely because out Christ’s love, I pastorally care for people that I must discourage anyone considering MAD.
How have we arrived at this juncture in the Canadian political landscape where MAD is so easily accepted? I could write a whole book about how this has happened, but I will not bore you with the details. Briefly, the ease with which MAD (and sexual identity politics for that matter, but that is for another essay), is accepted by many Canadians comes from the modern notion of the self. This self is totally self-sufficient, self-guided, and resistant to any outside influences, most especially religious ones. Today, it’s commonly believed that no one can tell anyone else what to believe, know, or do. Coupled with this liberal mindset is the assumption that human dignity can only be maintained when society upholds the freedom of each person to exercise their human right of self-determination. Consequently, accepting MAD as a human right is a natural outcome, especially when debilitating effects of chronic and degenerative deceases, fear of losing control of life, and the burden it has on loved ones is assumed to undermine human dignity. Who are we to tell someone who is suffering, they can’t kill themselves? And, besides, what harm does it do? And, surely, if you truly love your family, why would you want them to experience watching you suffer?
So that is the argument for MAD. Let us now turn to the Christian notion of self, dignity, and rights and then deal with the weak assumptions of the pro-MAD argument. The Christian view of what it means to be human is based on a completely different ‘ontology’ (big word for ‘view of reality’). From the Christian perspective there is no such person who is a complete, independent self that can be conceived independent of God and a human community. Why? Because God created all that there is, including you and me ex nihilo, out of nothing. Furthermore, God created us in His image. Therefore, becoming one’s true self, and thus fully human, is about realizing this image of God in us. The modern, liberal notion that we can decide who we want to be (here I am not talking about whether you decide to be a doctor or a carpenter!) and do whatever you want to do is contrary to how God has made us and thus the way things are. Of course, we are free to do whatever we wish. Nevertheless, it is like a fish deciding it no longer wants to swim in water, but instead walk on land. It can try, but it will just flop around because it is going against what it is made to be and do.
Consequently, the doctrine of Creation teaches us that our body is not our own. It belongs to God because it is a gift of God. What we do with it, including whether our life ends or not, is for God to decide, not us. It is when we decide to do as we wish with our bodies, irrespective of what God says we should do, that we have problems both in our lives and in the world. I will suggest what those problems are later. The doctrine of Creation also teaches that human life is inherently good and, therefore, of utmost value. Since God is pure goodness, and we were created in His image, human life is inherently good. That does not mean, as a result of our sinful turning away from God, that human suffering, evil, sin, and death is good (and I’ll also deal with how God addresses this in a moment). But whatever is good in us must be encouraged, which includes life itself. Lastly, because we are made in the image of God, and thus inherently, good, no matter what chronic or degenerative decease is impacting someone, that person has as much dignity and value as does the physical and mentally healthy person. A person’s dignity and value does not rest in what we think it is, but in what God believes it to be.
The full realization of what it means to be human has come in the incarnation of Christ. In Him, we see what it means to be truly human because Jesus is the perfect human. He became one of us, so we can become, eventually, like Him. What does Jesus teach us about being human? First, He shows us that if we want to be truly human, we must be servants. Although fully God, He humbled Himself and lived the life of a servant. Just as Jesus lived the life of service, so too must we to be human. Therefore, the purpose of the human live is not to serve one’s own desires, needs, and demands. The truly human person is a de-centered person, who orients one’s life completely around Christ in trust and thus, others. Just as Jesus put his life, including what happens to his body in the Father’s hands, so must we.
I have not yet addressed how the Christian deals with human pain and suffering, especially when it is prolonged. The doctrine of Atonement (big world for what happened in the death of Christ on the Cross), answers this question. The suffering and death of Jesus on the Cross shows us two things; one, that our suffering need not be meaningless, and two, we need not be alone in our suffering.
First, suffering is not meaningless. Imagine what the disciples, friends, and Jesus’ mother, Mary thought as their lord suffered and died in the horrific way He did? To what end? We gave up everything to follow you. We pinned all our hopes on you. What reason can there be for you to die, and not just die, but die in such a way? Alas we say the same thing today about the suffering of our family and friends. What is the point of suffering? Just let a doctor give you an injection and get it over with. But that is not what the disciples, Jesus’ family, and Mary thought after the Resurrection of Jesus. Despite appearances, they then realized that Jesus did not suffer and die for nothing. He suffered and died for yours, mine, and all of humankind’s salvation. Therefore, insofar as Christ’s suffering and death have meaning so does ours. How so?
The decision to seek MAD is actually a selfish one. I know you do not want to hear this. But if you are honest with yourself, you will agree. You say, I want to end it early so my family and friends do not have to suffer? Is that really true? As a priest I’ve been with many people dying along with their families. The impact of someone I have witnessed dying who is assured of God’s love and the hope of the resurrection has always been a positive experience for the family, friends, and myself. In other words, when a Christian sees their dying as an opportunity to witness to the Gospel, it always benefits both the dying and their family.
Furthermore, when someone decides to have a doctor end their life, they take away the opportunity for their friends and family to realize their own humanity. As I said before, created in God’s image, we are made to be servants of one another, most especially when we are dying. But if the opportunity to care for their dying loved one is taken away from them, they are robbed of their human calling, to serve them as Christ serves us. The patient also forgoes the opportunity to experience Christ’s presence in their suffering which He promises us in Matthew 28. How is He present with us in our suffering? In and through the caring presence of dying person’s family, friends, and priest.
The argument can be made, ‘What about those who have no family, friends, or a Church to be with them while they are dying?’ But surely the solution cannot be to make the situation even more hopeless by allowing MAD? That solution does not deal with the real problem! The real problem is why are their people in the first place who die alone? What is it about our culture and society that allows this to happen? What is the Church doing so this does not happen? Do your remember Mother Theresa? What was her ministry? It was to make sure the rejected and lonely of society did not die alone. MAD just sweeps the real problem under the rug.
I have outlined the argument for and against MAD. Let us now consider the underlying assumptions of those who argue for MAD. First, pro-MAD people assume the decision of the person who wishes MAD does not impacting anyone else, at least not negatively. As I have already hinted at, that is simply absurd. Its impact is multi-levelled and far reaching. First, it puts incredible responsibility and strain on doctors, nurses, and others in the medical field. Why should anyone assume doctors and nurses are prepared to carry out a patient’s wish? What if a doctor, for religious reasons, cannot agree to this procedure? ‘The doctor can simply refer the case to another doctor,’ you say. But that is easier said than done. What impact will that decision have on the doctor’s career? How will others in the medical system view them? What about the cultural pressure that says, if you are paid by the state, you should do what the state tells you to do? Second, how can we be sure doctors know when a patient is of right mind when requesting MAD? Most doctors do not have the psychological/spiritual training to make this determination. And who is to say, ‘what does it mean to be of right mind?’ Most patients are struggling with depression and anxiety when they are dying. What level of depression/anxiety is acceptable before a doctor can say it is debilitating?
Besides the ramifications MAD has on the medical system, what about on society as a whole? We need not look far to see the pandora’s box MAD opens up. For instance, in European countries such as Holland, Germany, and Switzerland, the right to seek MAD is now extended to teenagers and in some case, even children. How can we accept, as a society, even a 16-year-old teenager is emotionally, mentally, and mature enough to ask for MAD? It is one thing for a teenager after deciding to have a sex change to later reverse the procedure (although, in some cases the original procedures are irreversible). You cannot decide to reverse your decision for MAD. Yet, younger and younger people are given the power to make this decision in Europe and it will not be long before it can happen here in Canada.
My intention in writing this essay is pastoral. It is because I care for you and thus, do not want you to miss out on what Christ is offering you, yes even in your suffering and death, that I have written this piece. If you have considered MAD, I pray this essay will give you cause to rethink your position. If you already are against MAD, I pray this essay has provided you with the tools to lovingly argue your case with others. Lastly, if you are left with questions that need answers, I pray you will not hesitate to speak with me.