Canada’s Pastoral Challenge: Ministering Faithfully in a Culture of Doctor-Assisted Death

Some Canadian bishops have adopted differing approaches, as they grapple collectively with their nation’s recent legalization of euthanasia and doctor-assisted death.

(photo: Unsplash)

EDMONTON, Canada — It’s a nationwide pastoral challenge for Canada’s Catholic bishops: Canadian doctors and nurse practitioners have had the legal right to kill patients for six months now, since the Canadian government, at the direction of the country’s Supreme Court, passed a law legalizing euthanasia and assisted suicide.

But two of the nation’s assemblies of regional bishops have released strikingly different pastoral guidelines addressing Canada’s new legal reality, which directly contradicts Church teaching regarding the grave immorality of suicide.

The Atlantic Canadian bishops released a short statement at the end of November that invited criticism from some Catholic commentators for implying that reception of the sacraments and a Church funeral might be broadly available to Catholics who choose to kill themselves with the assistance of doctors.

In contrast, the bishops of Alberta and the Northwest Territories earlier published a far more detailed document that explained why such a pastoral response might be precluded, while exploring in depth an extensive range of other responses that priests could apply as warranted.

Canada’s Catholic bishops, in the lead-up to the bill’s passage, were very vocal in opposing the change, appearing before government panels to warn against the perils of state-sanctioned killing and urging parliamentarians to vote against it, to no avail. Now that assisted suicide is legal, and a fully funded part of Canada’s socialized health care system, the bishops are grappling with the fallout.

A 2014 Ipsos Reid poll, among others, found 83% of Catholics supported assisted suicide and euthanasia. So there will be, and doubtless already have been, individuals and/or family members requesting the sacraments before being euthanized and Catholic funerals afterwards.


The Alberta Bishops

The six bishops of Alberta-Northwest Territories were first to respond in September with their “General Principles and Reflections on Sacramental Ministry to the Sick and Dying in Light of Assisted Suicide and Euthanasia,” a 34-page vademecum (a handbook or guide) addressed to priests and parishes to assist their ministry to such persons. It followed a series of discussions hosted by Archbishop Richard Smith of Edmonton last spring, when it became clear that assisted suicide would be legalized. Priests and others in pastoral ministry sought guidance on how to respond and in collaboration with the other five bishops, the document was produced.

In a brief introduction, the bishops are clear: “Euthanasia is a grave violation of the law of God since it is the deliberate and morally unacceptable killing of a human person.” The theme is faithful accompaniment, which always includes compassion, love, prayer and support. Priests and ministers should guide the person to conversion to unite his or her suffering with Christ’s. It explains with great clarity the doctrinal norms around sacramental reception, what is required for them to be celebrated and how they can transform the despair and pain to hope in eternal life with Christ.

The Alberta bishops do not automatically deny sacraments to those seeking to end their lives, but say they could be delayed while the person reconsiders the decision with accompanying love, prayer, fasting and gentle teaching. If the person is determined to access assisted suicide, however, he or she, in consequence, would not be disposed to receiving absolution.

The reflection also includes a guide for priests with examples of how to deal with specific requests from either an individual or the family members of one seeking any or all of the sacraments and a Catholic funeral.

The document was released just before the annual meeting of the Canadian Conference of Catholic Bishops. Immediately, several Quebec bishops were quoted in the media saying they would not refuse funerals to people seeking to end their lives.


The Atlantic Bishops

Then, at the end of November, the 10 Atlantic bishops — who oversee the four eastern provinces of Newfoundland and Labrador, Nova Scotia, New Brunswick and Prince Edward Island — released a three-page “Pastoral Reflection on Medical Assistance in Dying.” It is addressed to all Catholics and reflects the bishops’ perspective of the Church as “a mother who lovingly accompanies us throughout life” and who “wishes to support and guide us when we are faced with difficult situations and decisions.”

The bishops, who use the Canadian government’s phrase “medical assistance in dying” throughout their letter, cite Pope Francis on the “art of accompaniment,” listening with an open heart and being attentive to the pain of the other, as a key part of the pastoral response to those seeking to end their lives.

The letter advises not to “make judgements about people’s responsibility and culpability.”

And while they acknowledge that the Catechism of the Catholic Church teaches that our lives belong to God and are therefore “not ours to dispose of,” the letter never actually says assisted suicide or euthanasia is immoral or sinful. Pastoral care should “communicate the compassion of Christ, his healing love and his mercy.”

It seems to suggest that the sacraments of penance, anointing and Communion could all be part of the accompanying process, even when the outcome will result in death by suicide or euthanasia. Confession, the Atlantic bishops note, is “for the forgiveness of past sins,” but they do not mention the resolve to sin no more, which is an integral part of the sacrament.

Another striking difference between the two episcopal documents is the repeated employment by the Atlantic bishops of the Canadian Legislature’s contentious phrase “medical assistance in dying” when referencing assisted suicide (when the patient utilizes deadly medications prescribed by medical practitioners) and euthanasia (when such medications are administered as well as prescribed by medical personnel).

The glossary in the Alberta document — the only place where the phrase appears in that pastoral document — states the term “medical assistance in dying” is “ambiguous and misleading.”

The Atlantic bishops declined to be interviewed by the Register about their document, as did the Alberta bishops.


Comparing the Documents

Peter Ryan, a longtime pro-life advocate who currently serves as president of the board of Life Canada, is a moral theologian with a licentiate in sacred theology who lives in Fredericton, New Brunswick. In an analysis of the two reflections he provided to the Register, he noted differences in theology specifically regarding conversion and repentance. The Alberta-Northwest Territories bishops, he wrote, “include a role for priests to teach about sin and gently correct a person pursuing a sinful path,” which should “not be misconstrued as harsh legalism.”

He noted that the Atlantic bishops show little interest in these normative guidelines from the Alberta bishops and instead state in their own guidelines: “We wish to say that the pastoral care of souls cannot be reduced to norms for the reception of the sacraments or the celebration of funeral rites.”

Ryan questions whether the “theology of accompaniment advocated by the Atlantic bishops has room for an approach that entails gentle verbal correction.” Their call for compassionate accompaniment without any practical direction to priests, he said, “may easily result in the view that everyone without exception is to be admitted to all the sacraments and funeral rites, even though a careful reading of the document does not support such an unqualified interpretation.”

Father Raymond J. de Souza, a priest of the Archdiocese of Kingston, Ontario, and a frequent Register contributor, also contrasted the Alberta and Atlantic bishops’ reflections in a commentary published by the Catholic Register, the newspaper of the Archdiocese of Toronto.

“As a parish priest, I found those guidelines were eminently practical, offering guidance for concrete situations, and underscoring that when eternal salvation or damnation is at stake in a matter of days, a pastor must be moved by the urgency of conversion,” Father de Souza commented about the Alberta pastoral document, whereas the Atlantic bishops’ brief document “does not offer any practical guidance for concrete situations.”

He said the Atlantic bishops’ failure to communicate Church teaching that says a person contemplating assisted suicide or euthanasia medical aid in ending his or her life should be disqualified from reception of the sacraments is an “approach that would be unimaginable if it were applied to any other serious moral issue.” 

And, Father de Souza said, “it is off-putting to read bishops, in a formal document, write of ‘medical assistance in dying.’ It is an Orwellian construction designed by those who wish to disguise the enormity of what is being done — the killing, voluntary or otherwise, of the sick by the very doctors and nurses pledged to care for them.”

However, Father Stefano Penna, a sacramental theologian and director of the Benedict XVI Institute for New Evangelization at Edmonton’s Newman Theological College, told the Register there is not a fundamental pastoral difference in the bishops’ responses, as both pastoral documents embrace an accompaniment model.

“True faithful accompaniment is accepting the call to conversion,” Father Penna said. “It’s an evangelical summons to the individual and community to witness to Jesus Christ.”

And whatever differences of tone or emphasis may be present, Father Penna noted that any document issued by any bishop cannot be read without placing it in the context of the Catechism of the Catholic Church and the magisterium of the Church.

“The sacraments cannot be suborned into a celebration of euthanasia or assisted suicide,” he said. “My own hope is that gentle, loving, faithful pastoral care will prevent that from happening.”


Cardinal Collins

The Archdiocese of Toronto, along with the other bishops in Canada’s most populous province of Ontario, has not yet released pastoral guidelines to address euthanasia and assisted suicide.

But Cardinal Thomas Collins highlighted the issue at the conclusion of his address to the annual Cardinal’s Dinner in Toronto on Nov. 10.

“We have been made more aware recently of the merciless assault on human dignity which is sometimes falsely called ‘mercy killing,’ or even more falsely ‘medical assistance in dying’ and most falsely of all ‘dying with dignity,’” Cardinal Collins said. “When we are dying, especially if it is as a result of a long illness, we may well not have, and probably will not have, the propriety of wholeness of mind and body which we had when young and in good health. But everyone dies with dignity, and it is not right to hasten death in the mistaken belief that doing that is what is needed to allow a person to die with dignity.

“It is essential, however, that we show the mercy of the Good Samaritan not only to the homeless, to the sick, to those suffering or in prison, to any victims of violence, and to refugees, but especially to those who are dying. We do that through true palliative care, by using the best medical expertise available to control pain, and by surrounding the one who is dying with the love that we all hope to sustain us as we come to that crucial moment which we Catholics constantly mention in our most frequent prayer: ‘the hour of our death.’”


 Register correspondent Joanne Byfield writes from Edmonton, Alberta.

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