Euthanasia, assisted suicide aren’t palliative care: Canadian bishops

OTTAWA (CCN)—Keep euthanasia and assisted suicide out of any provision of palliative care, Canada’s Catholic bishops said to a national consultation with Health Canada May 7 to July 13.

“We have to speak up and express our opinion, otherwise other lobbies and other groups will influence the government,” said bio-ethics expert Bishop Noel Simard of Valleyfield, concerning the Canadian Conference of Catholic Bishops’ (CCCB) submission published Aug.3. 

Other lobbies are trying to influence the government to include so-called Medical Aid in Dying (MAiD) in palliative care, said Bishop Simard, who is a member of the Pontifical Academy for Life and of a national committee on palliative care established by the CCCB.

“It is important to express clearly our opposition to Medical Aid in Dying and to euthanasia and how it is opposed to true palliative care,” he said.

“It is so urgent, because there are other issues at stake, the pressure made by the government on hospices to offer euthanasia, or to accept that physicians go into the institutions or hospice to perform euthanasia without respecting the objections or the right of the institutional conscience,” said Bishop Simard. “You cannot force or oblige an institution to offer something against its values.”

The government is pressuring institutions and hospices to permit physicians to euthanize patients at their location, Bishop Simard said. “If you accept this, it means you are an accomplice.”

He likened it to his accepting a physician coming into his office “to perform an abortion in front of me.”

While Bishop Simard said there can be some compromise with the law, such as allowing patients to be moved off site for a requested euthanasia, however allowing the practice in hospices or palliative care wards, jeopardizes “the value you want to promote.”

The World Health Organization (WHO) excludes both euthanasia and assisted suicide from its definition of palliative care, the CCCB submission said. In a comprehensive 12-page report, the bishops addressed not only issues of training and funding, but also “attitudinal” obstacles to seeing palliative care holistically, treating the “spiritual, psychological, and material needs of the ailing person” as well as that of their caregivers.

“While there are undeniable burdens and losses experienced in the dying process by both the patient and the caregiver, the person receiving care should be seen as a burden neither to themselves nor to others,” the CCCB submission stressed. The dignity of the human person must be promoted and defended “at all stages of life” and is “central to palliative care, to medicine and to all society.”

Conservative MP Marilyn Gladu, whose private member’s Bill C-277 calling for a national palliative care strategy was passed into law in 2017, praised the CCCB submission for its stress on excluding euthanasia and assisted suicide from palliative care. 

“Palliative care, under the WHO definition, does not hasten death,” Gladu said. “It has to be really clear.”

The WHO recommends euthanasia or assisted suicide be performed by different teams in different locations, “because MAiD may require medical interventions that are more appropriately done in a hospital,” Gladu said.

“There are inconsistencies across the provinces,” she said. “In B.C. they have now mandated that all hospices will perform MAiD. This is against the WHO and they are applying it to any hospice that receives at least 50 per cent public funding.”

“In Quebec, 29 out of 31 hospices have rejected doing MAiD,” she said. “In Ontario, they have generally gone with trained MAiD teams who sometimes perform in the hospital and sometimes at the hospice, but at least it is different teams than the ones doing palliative care,” she said. The inconsistency “speaks to the need for the Health Minister to speak to standardizing how we do this across Canada.”

Gladu described the CCCB submission as “excellent.”

“It was not just about the spiritual aspect about supporting people as they go through a palliative experience, but about other things---the training that’s needed, a whole integrated approach to palliative care,” said Gladu, who expects Health Canada will report on the results of the consultation after the House of Commons resumes sitting Sept. 17. 

“By law, on Dec. 11 the Health Minister will have to come up with a plan to get consistent access to palliative care for all Canadians,” she said.

“That was the requirement under C-277 and so my expectation there will be a multi-year plan that will address the training gap and the resource gap, that will build infrastructure, such as encouraging hospices and rural internet to access virtual palliative care, and perhaps they will identify someone to spearhead the implementation of a palliative care plan.”