This fall, the Anglican Church of Canada’s task force on physician-assisted suicide will release a new pastoral resource. The material is designed to provide spiritual and other guidance for clergy and lay leaders dealing with the realities of the Supreme Court of Canada’s February ruling that will legalize physician-assisted suicide in 2016.
After a winter of research and conference calling, the diverse eight-member task force (which includes one Lutheran) met at General Synod offices in Toronto on June 1 and 2. It plans to complete a first draft by Sept. 1 and have the final document ready for Council of General Synod in November.
“We’re not looking at this point to come out with a document that says the Supreme Court was right or wrong,” says the Rev. Canon Eric Beresford, the group’s chair and theologian-in-residence at Trinity Anglican Church in Aurora, Ont., adding, however, that many Anglicans would like the group to do that.
An ethicist from the diocese of Nova Scotia and Prince Edward Island, Beresford served as an editor for the church’s 1998 study document Care in Dying: A Consideration of the Practices of Euthanasia and Physician Assisted Suicide.
“We made a pitch for a certain perspective in 1998,” he says, referring to Care in Dying. “We don’t see much [reason] to simply revisit that attempt to [influence] public policy because public policy has now very substantially moved and is not going to back any time soon.”
The real question now is what it means to witness as Anglicans in the midst of this altered ethical situation. “We are in a new context where people have a new legal choice. So it’s not going to be a revision of 1998,” says task force member the Rev. Dr. Eileen Scully, the church’s director of faith, worship and ministry. “We’re picking up where Care in Dying leaves off to create a resource that will be pastorally useful to clergy and leaders who are actually accompanying people in palliation.”
That will require addressing this complex issue from several angles: theological, ethical, medical and pastoral, something the professionally diverse task force is well equipped to do. “How do we walk with people dying or in severe pain and their families? What is the role of the pastor and the church in accompanying people into death?” Scully says. She adds that we are currently waiting in a middle place for appropriate federal and provincial legislation and health-care profession regulations to be put in place for next year as per the Carter v Canada ruling of Feb 2, 2015.
In this decision, the Supreme Court of Canada unanimously struck down a Criminal Code provision against physician-assisted suicide and gave mentally competent Canadian adults suffering intolerably and enduringly the right to a doctor’s help in dying. Suspending its ruling for 12 months, it gave federal and provincial governments and health-care organization regulators enough time to amend their laws and regulations by Feb. 2, 2016.
Beresford notes that there is broad diversity of views on the matter in the task force, which includes a physician, a retired nursing professor, a lawyer, a parish priest and a chaplaincy coordinator deeply experienced in hospital and hospice pastoral care. “But whatever our view, we are going to be facing the reality of people needing pastoral care in the middle of difficult situations, and just saying ‘No, no, you shouldn’t, it’s wicked’ isn’t going to be effective pastoral care,” he said.
Because the issue is such a complex one, the Anglican response will have to be multifaceted and capable of addressing omissions in the Supreme Court ruling, Beresford added. “When it talks about avoiding coercion and requiring consent. What exactly do those things mean? And a lot of decisions are now made with competent minors as if they were adults. Are they included in this?” Scully added that the task force will definitely be tackling gaps such as the lack of definition of adulthood and guidelines for assessing coercion.
Another potential loophole is that unlike jurisdictions such as Oregon, The Netherlands, Switzerland and Belgium, the Canadian decision doesn’t require the patient to be irreversibly in the process of dying, but rather in irremediable suffering. “Many of us recognize that there’s going to be some pressure in the future to say, ‘Well if it is unconstitutional to prevent someone who is a competent adult but who is facing unbearable pain of suffering from having that alleviated by being assisted in their dying, why do other groups who don’t pass the competency test have to be forced to face pain and suffering indefinitely?” Beresford said.
The task force will also assess the state of palliation and hospice in Canada and consider concrete actions the church could take to improve palliative care, once proposed as an alternative to assisted death. “At the time of Care in Dying, we had hoped for better palliation,” said Scully, “but 20 years later, not much progress has been made in most places.”
According to Beresford, the Supreme Court, in fact, dismissed the palliative alternative early on because the chief witness admitted that palliative care often didn’t fulfill patients’ needs. “Palliative care should be primarily patient-centred. It is about the patient’s being able to make effective and informed decisions about how the pain and discomfort of their dying process are managed, and that’s unfortunately not what’s happening,” he said.
That fact is a major challenge to the church, Beresford added, noting that the U.K.’s hospice program is a child of the church. “If we really believe that palliative care would give people more humane choices, then we need to be at the front of not just advocating for it but also of working to raise and provide resources in co-operation with the wider community.”
