Anglicans divided over right-to-die ruling

Reactions to the Supreme Court of Canada’s decision to strike down the ban on assisted dying reveals just how diverse opinions on this subject are within the Anglican Church of Canada.

This was acknowledged directly in the diocese of New Westminster’s press release on the decision, which notes that, “Like many important issues, there is a wide range of opinion around the Anglican Church of Canada and in the churches of the Diocese of New Westminster…. A variety of views is characteristic of Anglicanism.”

John Chapman, bishop of the diocese of Ottawa, was unequivocal in his support. “I’m ecstatic,” he said. “Current practice, prior to the new legislation, has been so black and white that it has been unhelpful for those people who are living with unbearable suffering.” Chapman noted that the ruling “puts the decision back into the hands of the individual” even as he stressed that with freedom comes “enormous responsibility that will need to be exercised with prayerful caution and integrity that respects the dignity of human beings.”

Bishop Stephen Andrews of the diocese of Algoma, however, was “disappointed,” citing concerns over the vagueness of the decision’s wording and voicing concerns that the judgment was “lacking in definition.”

The historic ruling limits doctor-assisted suicides to “a competent adult person who clearly consents to the termination of life and has a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” Andrews said the decision doesn’t define competence nor describe what consent means. “I’ve just been in too many situations where people are in extremis [in an extremely difficult situation], where there are a host of psychological and emotional factors involved, which could complicate the decision under the definitions provided by the Supreme Court,” he said. “For example, if an individual was severely depressed, would they be competent, would they be capable of giving rational consent?”

Linda Nicholls, area bishop for Trent-Durham in the diocese of Toronto, noted that while “public opinion has been moving in this direction for some time, ” Canadians might not fully understand what medical options are already available, such as cessation of treatment – and like Andrews, she, too, was worried about vagueness of the language.

Though the court struck down the ban on assisted dying, it is not yet clear how new legislation will be crafted to deal with the new legal reality. The decision will not take effect for another 12 months, and whether it will be dealt with at the federal level, or if the rest of the provinces will take Quebec’s lead and create legal guidelines around assisted dying independently has yet to be seen.

If both federal and provincial governments fail to draft new laws, assisted dying will be dealt with on a case-by-case basis.

For Bishop Jane Alexander of Edmonton, it was important to see these developments in light the church’s historical and ongoing role in the provision of care. While the context for that care has changed, the mandate remains the same.

“We’ve consistently supported in the Anglican Church the use of palliative care and pain relief, and we know that sometimes pain relief can sometimes risk hastening death, but it’s a different field now,” she said.

Chapman, Andrews, Nicholls and Alexander all underscored the need to have conversations about how the church can help people navigate the complexities of the ruling.

Andrews said that while the House of Bishops tackled the right-to-die issue when it met last fall, more discussions are necessary. He is not convinced that the church has dealt with the issue from a theological perspective. “We need to talk a lot more about the nature of life and the difference between the intention to shorten life and the intention not to prolong the dying process. It’s a fine distinction,” he said.

“Just because people have the legal right to it doesn’t mean that that is a decision or a choice that they will make,” said Nicholls, “that’s where chaplains will need to sit with people of faiths and no faith – their role will be to listen very carefully to how human life is understood by the individual.”  When they are acting in the capacity of an Anglican chaplain, she said, their role would be to explain the church’s view on end-of-life. “That doesn’t mean that they are giving them an answer or insisting that they act in a particular way because at every level, a person’s conscience is the final judge.”

Nicholls expressed the hope that the ruling “will push us as communities to ask how do we better support people who are facing suffering that is chronic or terminal or intolerable and what are we doing to…support them and their families if they choose to make a decision that we disagree with.” Anglicans strongly believe in the sanctity of life and the gift of life, Nicholls said, “but we also respect that in the face of very difficult decisions, that individuals may choose a way that is not in the direction that church policy would take…”

How the church will minister to people given the change was also a question raised by Alexander.  “How can we support people at those times of their lives when they are in the most difficult situations of trying to make decisions?” she said.  “I suspect that one of the questions that families might have for chaplains and clergy is, ‘Do you think I am doing the right thing?’ And so those kinds of conversations are going to be very difficult to walk alongside because it is for people to make those decisions for themselves…Our job is to be there and provide prayerful and loving support and to proclaim hope even in these darkest of times.”

Chapman said he expects people to look to the church to provide “compassionate, helpful and insightful guidance” in understanding the ruling. “I think a challenge now rests before every diocese in the country to do whatever they can to help people to understand the implications of this new legislation.”

Despite the anxiety this decision has caused in some quarters, recent polling suggests that an overwhelming 84% of Canadians are in favour of allowing some form of physician-assisted dying, and some members of the clergy active in hospital visitation and chaplaincy have accepted that these measures are necessary for dealing with the complexities of modern healthcare.

They are also acutely aware of how much this could change in their practice on the ground.

The Rev. Keirsten Wells, the coordinating diocesan health care chaplain for the diocese of Nova Scotia and Prince Edward Island, was quick to point out that not all patients are in the same situation.

“It seems like a really good decision for a competent individual who is diagnosed with a terminal illness and wants to decide how they are going to engage in their own death,” she said. “I don’t know how it will impact people in the hospital who hadn’t anticipated their imminent death…who get up in the morning and think they are going to have a normal day and have a huge stroke and by the end of the week they are in discussions with doctors about whether to continue life support.”

While Wells personally believes this development to be a “positive” one, she is aware of how complicated it will be when put into practice.

For Dean Iain Luke, who serves St James Anglican Church in Peace River in the diocese of Athabasca,  and is often involved in care for the dying, the question was likewise less a matter of right or wrong and more about how the church should respond.

“I think it’s just complicated,” he said. “The world we are in has changed in this decision, and in a public policy sense it doesn’t matter much if we are for it or against it. And actually, from a Gospel sense I’m not sure that it matters that much either.”

Of greater importance to both Luke and Wells was attentiveness to the relationship between palliative care as it is currently practiced and the new – and as of yet, hard to predict – effects of the court’s decision.

While admitting that it would be “very difficult to assess” the decisions impact on palliative care, Luke expressed his hope that funding to palliative care would, in fact, be increased.

“If people are confronted by the reality that others are going to choose death because they don’t have appropriate care while dying, that may stir people to say that we need to be there for them,” he said.

For the Rev. Joanne Davies, the good thing that has come out of the court decision is that “we’re actually going to talk about death and dying and actually name it.” She expressed the hope that people – especially in the church – will actually say death and dying instead of using such euphemisms as “passing away, gone on, left us, lost.” The hope, too, is that people will see that “passage to death is one form of care,” said Davies, an Anglican chaplain in the diocese of Toronto, who serves as an ecumenical chaplain at Toronto’s Mt. Sinai Hospital and other health care centres in the city.

On Facebook, Anglicans also offered diverse views on the ruling. Roger Woodford was in favour of the decision saying,  “You can argue slippery slope to your heart’s content, but the fact remains that we’ve prolonged life to such an extent that sometimes existence itself becomes pure torture.”  George Ryder, who has worked in hospitals as a registered nurse, said doctor-assisted suicide was a “sad commentary on life.” Canadians have access to “amazing [facilities] offering palliative care to those who are dying in a compassionate way,” he said, adding that physicians whose role is to save lives may find it to difficult to participate in ending people’s lives.

Excerpts of the interviews can be found here.

(Editor’s Note: This story has been updated to include comments from readers, including laity.)