Saskatchewan Catholic Bishops’ response to Physician Assisted Suicide and Euthanasia
Introduction :
It has now been two years since the Supreme Court of Canada overturned the existing laws against physician assisted suicide (PAS) and euthanasia. During these past two years, alongside Catholic dioceses and organizations across the country, and often joined by other Christian communities and religious traditions, we have sought to express and articulate the reasons for our opposition to PAS and euthanasia.
●In July of 2015 and March of 2016 we issued pastoral letters arguing that eliminating a life is not an appropriate response to suffering; pressing for improved access to palliative care, including proper pain and symptom management, offering real choices that reduce suffering, rather than end life; and calling for the conscience rights of individual healthcare workers and healthcare institutions to be protected.[1]
●In striving to articulate our opposition to PAS and to educate our own faithful in this regard, we established a committee made up of representatives from Catholic health organizations and from our respective dioceses and eparchy. This committee has assisted us in engaging the faithful in political advocacy; in bringing ecumenical and interfaith partners together to write a joint statement in support of palliative care and the protection of conscience rights in the spring of 2016, and sending an interfaith delegation to the provincial legislature with our message;[2] and preparing materials to promote a Catholic vision of care for the dying, including the brief videos on palliative care and long-term care.[3]
●The five Bishops of Saskatchewan are the sponsors of Emmanuel Care, the Catholic Health Ministry in our province; Emmanuel Care has worked with the staff in Catholic facilities on policy which unequivocally states that our Catholic facilities will not provide PAS. This public work, alongside private advocacy and relationship-building, has led to strong support for finding a way forward where Catholics and other faith-based affiliate healthcare providers will have conscience protection in our province.
●Our dioceses have worked hard to provide opportunities with Catholic ethicists and leaders to form our pastors, lay leaders, and faithful regarding both Catholic teaching as it relates to developments in our society.
Now, at this critical time of implementation of PAS in our health system, we have felt it appropriate to publish three new texts, each with a different purpose and audience. First, we have written a Pastoral Letter on ‘Living Through Our Dying’, addressed to our brothers and sisters in faith and all people who have the gift of life. Our aim with this letter was to initiate a dialogue with our culture, recognizing that many struggle to see our opposition to PAS as an expression of compassion. We wanted to articulate what we stand for (more than what we oppose), to recognize the challenge of placing our trust in God, and to extend the invitation to hope that our faith offers. Secondly, we have written a Pastoral Reflection on ‘Jesus: The Word Who is Life’, which situates the Paschal Mystery as the foundation of our understanding of the meaning of human dying. It is intended to be formative catechesis primarily for our own faithful, but it may well be of use to our Christian brothers and sisters as well. Finally, we have written Pastoral Guidelines, addressed to priests, deacons and the Catholic faithful, intended to give support and guidance to those ministering to people facing the end of their lives. It was our hope to write guidelines which would equip those in ministry to follow Jesus faithfully, while extending his invitation of faith and life to those tempted to choose the circumstances of their own death.
[1] http://saskatoonrcdiocese.com/sites/default/files/pastoral_letter_re_legalization_of_assisted_suicide_and_euthanasia.pdf and http://saskatoonrcdiocese.com/sites/default/files/bishop/letters/pastoral_letter_march_2016.pdf .
[2] http://ecumenism.net/archive/docu/2016-06-21_saskatchewan-interfaith-statement-on-freedom-of-conscience-and-palliative-care.pdf .
[3] https://vimeo.com/193720740 and https://vimeo.com/193720005 .
On Living Through Our Dying :A Pastoral Letter from the Catholic Bishops of Saskatchewan To our sisters and brothers in faith and all people graced with the gift of life: an invitation to reflection on living through our dying.
Introduction – “Dying is a part of life”
Just as the sun makes its way toward the western horizon every evening and sets into night, every human life makes it way from birth to death. It can be difficult to think about our own dying. Perhaps it is even more challenging to contemplate the death of those we love. While it can be tempting to distance ourselves from death, Pope John Paul II reminds us that “dying is also a part of life.”[1]
In Canada today, we have become distanced from dying. Life expectancy is considerably longer than it has been at other times in human history, and even in other parts of the world today; we often take health and longevity for granted. Advances in medical knowledge and technology mean that we often live long enough that our children and grandchildren have long since established their own lives when we begin to face our own death. While people used to die at home, primarily cared for by extended family, death is now more commonly experienced in a hospital or other health care setting.
While we are grateful to live longer and healthier lives, we are all still going to die. The experience of dying is often a harsh and overwhelming experience. Our fear of death at times leads us to resist or ignore what this fundamental human experience might have to teach us, about God and about ourselves. Saint Francis, in his Canticle of the Creatures, dares to call death a sister, part of the human condition which God has authored and through which God speaks to us.
The recent legalization of euthanasia and physician assisted suicide[2] in Canada adds to our sense that we can control the circumstances of our dying in the same way that we try to control other aspects of living. It is in this context that we feel called to reflect on human dignity in the face of human mortality. Our faith invites us to live and die with trust in the God who gave us breath. We mourn any time a person seeks to end their own life. Our calling at this time and in this place is to form ourselves well in a Christian understanding of living and dying, so that we can witness to the world that there is another way.
1. To Hear the Good News
As Christians, we believe that life, despite its limits and struggles, is a gift of God to us. It is this very life that Jesus himself enters, promising: “I came that they might have life, and have it abundantly” (John 10:10). In living and dying among us, he showed us how to live and how to die; and his resurrection gives us the hope that in our living and our dying, we are ever in the hands of the living God, who came among us to wipe away our tears. Even where life is difficult, He is with us, inviting us to receive and live the gift that we have received.
Dying, in the light of God’s gift of life, is a part of our living. Living through death is both our final responsibility and the last gift we can make of our lives. It is something to be experienced and endured, learned from, and ultimately offered back to God. St. Paul writes that “If we have died with Christ, we believe that we will also live with him” (Rom 6:8). We believe that in living through our dying, we share an experience with Jesus, who turned his suffering and death into self-offering which brings redemption. To have faith in Christ is to face death as a part of the great mystery of the gift of living, and to participate in God’s redemptive work in this world and the next.
Ecclesiastes offers this advice: “Whatever you do, do well” (9:10). It is worth reflecting that it is possible for us to die well. God does not force us to do anything; rather, death offers us a final invitation to surrender all that we are, to the very last breath, into the hands of the one who gave us life and promises us eternal life.
2. Living Through Our Suffering and Dying
Jesus was not a stranger to the brutal physical pain and intense spiritual suffering that accompanies some human dying. We, too, are called to be mindful of just how hard the work of dying can be. Sometimes, chronic illness means that our dying is stretched over months or years, a steady decline of health and ability that is challenging for both the person and their family, friends, and caregivers. In other cases, dying happens too quickly, resulting in a different kind of suffering and grief. The journey towards death can be a struggle towards some form of acceptance and trust. Jesus himself struggled to make peace with his own impending death. The path is difficult and we have a responsibility to accompany people through it. And it can be even more painful for family and caregivers to witness the suffering of their loved one than it is for the dying person. Violence, uncontrolled pain, unforgiveness, lack of access to necessary supports, fear, and any number of other circumstances can make the work of dying feel completely overwhelming.
As Christians, we believe that our freedom, and ultimately our salvation, is linked to God’s loving presence and our response to it in the midst of every reality. It is not always easy to believe this or to feel it, but it is our call, our invitation to seek Him in all things, even, and maybe especially when we are at the end of our own capacity. Death confronts our deepest sense of who we are and what we hope for, and it is the final opportunity for us to embrace the reality that lies before us.
The response to God’s invitation is at once both deeply personal and profoundly communal. No one can force another person to embrace, accept or make peace with reality. To impose meaning on another person, to not hear another’s pain with empathy, to trivialize or ignore another’s grief: such actions damage our relationships with each other, distance us from loving like God loves, and violate the freedom God gives to each person. At the same time, the end of life decisions of one individual have great impact on that person’s community. When we suffer with resentment, blame, anger, and despair, we plant those seeds in the lives and experiences of others. We can also strive to let those dark and difficult feelings be transformed into acknowledgement, service, humility, and hope. The choice to end one’s life (with or without the assistance of others), while intended to end certain kinds of suffering, is not without consequences for those left behind. In accompanying the dying, we do not get to choose how they will face their own suffering. Still, we can choose how we will respond to them. God invites us to choose selflessness, generosity, kindness, peace, and love in even the most trying circumstances, and offers us his presence, grace, and strength, which we so profoundly need.
As we face our own mortality, we are invited to do the spiritual work of living through our dying. Such work is what makes dying well possible. And we are not called to do it alone. As people of faith, we can offer the gift of accompanying and supporting people through the spiritual work of dying, beginning wherever they are.
Living through our dying invites three key spiritual works: forgiveness, love, and surrender. Facing death can strip away our self-justification, self-righteousness, arrogance, pride, and excuses. We long to be reconciled, to ask for forgiveness and to be forgiven. Dying invites us to do the hard work of asking for and receiving forgiveness. In dealing with our need for forgiveness, we are freed to express love with a depth and finality that is often difficult in everyday life. Death presents the possibility that we have nothing left to lose in trying to express our love, however imperfectly. Finally, our dying invites us to complete the spiritual work of surrender, as age, illness, decreased ability, and dying gradually increase our dependency. Aging often pushes us to let go of the things we once worked so hard to develop and strengthen: our homes, our ease of movement, our hearing. At the end, we will be asked to surrender to God our very lives.
The world is in desperate need of our witness of living through our dying. So many have forgotten, or never knew, that death could be gift. With God’s grace, and the prayers and support of others, we can live through this dying as a gift even as we face difficulties we would never have chosen. And God, who knows the pain and struggle of death (cf. Heb. 5:8), will use our courage to witness to the value of this work to the people and the world we leave behind.
3. To Care for the Dying
As people face the end of their lives, they become increasingly reliant on the living. They may feel like a burden. While this is normal, sometimes we are meant to be in need, on the receiving end, calling forth the gifts of our family and those around us. There is a beauty in this interdependence. In receiving the gift of being cared for, the dying also give the gift of allowing others to care. The relationship of care, while imbued with deep meaning and the potential for profound moments of connection, joy and growth, can also be tremendously mundane, labour intensive, or wearisome. But the suffering of one is alleviated when we carry it together (cf. Gal. 6:2). And it is our privilege to care for one another, even and perhaps especially when this is difficult.
Caring for the dying also means caring for the caregivers. None of us are incapable of or exempt from offering this care in some way. We can provide food or other necessities, volunteer, advocate for, visit with, listen to, and pray for the dying and their caregivers in many and various ways. And if, in so doing, we live generously and faithfully now, we will have practiced living the way we hope to live through dying.
At the end, our responsibility moves from caring for the dying to accompanying those who grieve, and lifting the one who has died into the tender hands of God, who in Jesus has revealed to us the power and desire to transform darkness into light and death into life. As community and as individuals, we strive to live this well by attending to the rituals and rites of death and grief with faithfulness and hope; by praying for those who are meeting God; and by receiving the healing of grieving well those we have loved. This life is a gift that none of us keeps forever, but its end does not make it less a gift.
Conclusion
We do not know the day or the hour (cf. Matt. 24:36), but we are always preparing for our dying by the way that we live. Love well and deeply. Choose a life of service. Rely on God always, and especially when you reach the limits of what you can do on your own. Trust with an open heart that God can bring meaning out of the suffering you face, and look for God’s goodness and new life in every situation.
As salt for the earth and light for the world, we can transform personal and public conversations about death and dying. By sharing our perspectives, beliefs and actions, we can become authentic witnesses to the gift of living through dying in a world that is often afraid of death and desperate to control it. God has called us to walk through this life together, and this includes journeying with people to the end of their days on earth. Now more than ever, our world needs to know that we will not leave them to face their dying alone.
May the God who came to earth and showed us how to live and die draw near to us as we walk faithfully in a culture that has forgotten how to die well. May we receive the courage and strength of the Spirit that we need to be witnesses to the gift of living through dying. And may our hearts be fixed on Jesus, who has walked this path before us to show us the way.
[1] Pope John Paul II, Address at the Rennweg Hospice in Vienna, June 21, 1998.
[2] Euthanasia and Physician Assisted Suicide are formally called Medical Aid in Dying (MAID) within the Canadian healthcare system.
Jesus: The Word Who is Life: A Pastoral Reflection by the Bishops of Saskatchewan
Introduction:
At each moment, the Word of God sent forth from the Father speaks to every human heart. This Word is Jesus Christ whose life and suffering, death and resurrection, reveal the pattern of our own journey back to the Father. The Father invites us to listen to this Word, the Beloved (see Luke 9:35; Mark 9:7), and to follow him.
The clamour of life filled with its many demands and distractions often prevents us from hearing the voice of the Son. Illness, profound suffering and the fear of death are also moments that make it difficult to attend to the voice of Jesus.
The recent legalization in Canada of euthanasia and physician assisted suicide has introduced intense division and debate that can be unsettling and cause some to feel confused or uncertain of what voices to trust. We place our trust in the constant teaching of the Church, beginning with God alone being the author of life and death.
Beneath the din and noise of life, beneath its waves of chaos and conflict, Jesus Christ remains the Word of God spoken into the depths of each heart. By taking on human flesh, Jesus joined us in our living, suffering and dying, and beyond the door of death will ultimately share his own glorified and risen life with us. Jesus is the Word in whom we are also named the beloved of God, a daughter or son of the Father called to proclaim a word of hope in our day.
Jesus in our living
We are surrounded by messages that tell us our personal value and worth comes from outward appearances and achievements. We risk feeling inadequate and becoming discouraged if we sense we fall short of what others consider attractive, successful and healthy. This may lead some to conclude that their lives have no meaning or worth. In the Gospel of John, however, Jesus proclaims that he is our life (see John 14:6) and has come that we might have life and have it abundantly (see John 10:10). To know Jesus is to know the infinite worth of our life!
Life is God’s first and foundational gift to us; indeed, the story of salvation history is the telling of God’s unrelenting pursuit to share life with us. It began with the creation story in Genesis when God created humankind in God’s own image and likeness and called it very good (Genesis 1:27), and reached its climax when God sent his son, as we hear in the Gospel of John, “For God so loved the world that he gave his only son.” (John 3:16).
Even where our life journey is difficult, the Lord is with us inviting us to give him our struggles, pains and sufferings and to receive from him in return a share in the gentle yoke of his mercy and love (see Matthew 11:30).
Jesus in our dying
From the cross, Jesus teaches us that death is not an ultimate escape or a release from unbearable pain, nor is it the last gasp of our human existence. Instead he reveals it as a moment of profound surrender to the Father and as an entry into eternal life. For this reason, the priest proclaims at the Mass of Christian Burial, “Indeed, for your faithful, Lord, life is changed not ended.” (Preface I for the Dead, Roman Missal)
We acknowledge that pain and intolerable suffering is a part of life and will often accompany the dying process. Jesus is no stranger to the brutal physical pain and intense spiritual suffering that can accompany dying. As Christians, we believe Jesus, who pitched his tent among us (John 1:14), accompanies us at each moment of our living and dying. The writer to the Hebrews says that Jesus tasted death for everyone (see Hebrews 2:9). In Jesus we encounter God’s faithfulness, love and grace that can give us hope and courage to endure to the end.
As we follow Jesus in our own dying we believe that he will ultimately lead us through the valley of suffering and death and carry us home into the bosom of the Father to share in the eternal love of their Holy Spirit.
Jesus in our rising
Jesus is our resurrection! While we look forward to the day when we will participate in the Lord’s resurrection, we believe that we already meet the Risen Lord in our daily life. We encounter him within the community, in our family, friends, other pilgrims of faith and those we meet in our daily journey. Jesus invites us to recognize his presence in a special way in those who are homeless, poor, imprisoned, wounded, afflicted or infirm (see Matthew 25: 36-40).
Our loving relationships with one another affirm that our life is a journey of growing in intimacy with God and one another. These relationships blossom when at each moment we speak our ‘yes’ to God’s will for us, both in times of joy and also in times of great struggle and eventually in the acceptance of our own dying.
When our capacity to trust and surrender to God is tested by the many challenges we encounter in life, the belief that we will one day share in the resurrection of Jesus gives us strength to endure. All the while, our Risen Lord walks with us and goes before us; our very weakness, poverty and misery draws down God’s mercy and tenderness to comfort and support us.
Conclusion
May Jesus, in whose death and resurrection we encounter the merciful face of the Father, grant us the strength of the Holy Spirit to live our lives with courage and to face the journey into our own death with eyes of faith set on the resurrection. May Mary, our Blessed Mother, through whom the Word of Life came into our world, keep us close to her Son so that with Jesus and in him, we also may be a word of hope in our world today.
Catholic Bishops of Saskatchewan :Care for the Dying: Pastoral Guidelines in an era of Physician Assisted Suicide and Euthanasia
Dear brother priests, deacons, and Catholic faithful of Saskatchewan,
We have arrived, with sadness and mourning, at a time in our history and our country where physician assisted suicide and euthanasia[1]are legal and available through our health system. For those among us who minister to people facing chronic and terminal illness, this new context is deeply troubling, and made even more painful because as a society we have not prioritized access to palliative care with effective pain management for all our people. Our Catholic faith is unwavering in its respect for and protection of human life from conception to natural death. We cannot and will not participate in or support euthanasia or physician assisted suicide, to which we are morally opposed (cf. Ex. 20:13).
At the heart of our Christian faith is the conviction that God’s love is revealed most profoundly in the dying and rising of Jesus, and that in our living and dying, we are drawn into this paschal mystery, which opens onto eternal life. We believe that there is a great dignity in being human, and that God, who has authored human life, speaks to us and draws us into communion with Himself through our living and through our dying. As St. Paul says, “If we live, we live to the Lord, and if we die, we die to the Lord” (Rom. 14:8). In our Christian lives, we are invited to learn to live for others and for God, dying to self (cf. Rom 12:1); dying, as a stage of living, is always in the context of the redemptive work of God. This more than anything else shapes our approach to the end of life.
Trusting that God is present to and at work in every human life, we are called to minister generously to all who call on us, regardless of their faith, with a bias toward life and our understanding of it as God’s beautiful gift. We offer these guidelines to help our parishes to cultivate a healthy and positive attitude towards life, even amidst trials, and to assist our pastoral ministers and care givers in walking compassionately and faithfully amidst painful and complex end of life situations. Our ministry as Christians is twofold: first, to proclaim the good news and form people in it, and second, to be with God’s people wherever life leads them, especially when they invite us into their journeys.
1. To proclaim the good news and form people in it.
In light of our Christian hope, we are asking you to join us in doing formative work in your parishes and communities to change the conversation about dying so that fewer people will feel that ending their lives is an appropriate option. All Christians need to be able to speak about and witness authentically to the spiritual work of living through the painful mystery of dying, for our own sake and for the sake of the world. That witness is especially needed in a context where many have lost sight of the dignity of human life even amidst suffering and dying.
2. To be with God’s people wherever life leads them.
We are called into ministry with people as they are, not as we would hope them to be. This has always and ever been the case. In inviting us to share in his mission, the Risen Lord sends us to love His people in the messy and difficult circumstances of human life. We are privileged to be invited into people’s lives; this is holy ground and God precedes us there.
Within the church and outside of it, some people will consider and are considering physician assisted suicide. For any of us who might accompany one of these people, with respect for the roles and respective accountabilities we have as family members, caregivers, spiritual care providers, or pastors, there are five considerations which we would ask you to keep at the forefront of your ministry of care.
i) The generous and unconditional love of God. Our ministry is a participation in God’s love for His people. We are called to act as witnesses to and bearers of God’s generous love. God is the author of life and we are its stewards. Our bias is toward abundant life, and we offer sacraments, prayer, visiting, accompaniment in palliative care where possible, and many other kinds of support in the service of loving people as God loves them. Where people are contemplating decisions we disagree with, depending on your role, you may be able to assist in their discernment, gently and appropriately offering another way of seeing, with hope and trust in God.
ii) The call to walk with the dying. A normal reaction for caregivers as we witness the pain and suffering of others is our tendency to try to ‘do’ something to fix it, to make it better. But that is not always helpful. Often, the most important thing we can offer is to ‘be’ present and accompany them in their darkest hour of their fears, uncertainties, questions, and pain. Serious illness can be excruciating, and dying can be a prolonged agony. For some, the darkest moments may lead them to contemplate physician assisted suicide as an option. As people of faith and hope, this is not something we can support nor is it something we can participate in. What we can offer as Church is our promise to be there; to remain engaged and in relationship; to help create a space where hope can make a home amid lingering fears; and to pray constantly for the conversion of heart, which we earnestly desire and believe possible to the very end. Our role is as one who keeps vigil alongside others in times of joy or sorrow, and stands with humble trust between what is known and the mystery of the unknown.
iii) The freedom and conscience of the person who is dying. Each of God’s people has been given the gift of freedom, and even while we hope that everyone chooses God freely, we must never infringe on another’s freedom. In the very rare circumstances where a sacrament or funeral is denied, it is because that rite would be a violation of that person’s free decision to reject in some measure God’s grace, and therefore would not be an honest expression of the Church’s faith. Even in these instances, the Church never abandons people. Non-sacramental rituals can and should be offered with reverence for freedom and integrity. Ministry also must be offered generously to those who surround the person making the decision: friends and family, caregivers, and healthcare professionals.
iv) Your action on behalf of the whole Church. To be a Christian is to belong to the body of Christ, one part among many members. When we act, we necessarily impact our brothers and sisters. We encourage our priests and those working for the Church in pastoral care who face difficult pastoral decisions to please contact your bishop for designated resource persons to support your discernment around the pastoral approach to those who have raised the possibility of physician assisted suicide, or regarding funeral requests for those who have died in this way. You are on the front lines of the Church’s pastoral outreach, and we trust that you will strive to respond to situations which may be very complex with a deep pastoral engagement and a desire to show the face of God’s mercy. We cannot anticipate all of the circumstances you might face, but we can ensure that you do not face them alone. We urge you not to make decisions on these situations without consulting those experts in ethics, theology, canon law, and pastoral practice who can help you to make decisions in keeping with your conscience and the wisdom of the broader Church.
v) Your own well-being and conscience. These situations may well push us as individuals to the edges of our own comfort and/or capacity. Amidst circumstances that are ethically challenging and potentially compromising, you also have a duty to yourself: to violate your own conscience would be both damaging and sinful. For whatever reason, if you are not able to enter into a situation, there is no shame in asking for assistance; indeed it is your responsibility to do so.
In this, as in all things, we bring each and every person we serve to the Lord in prayer. We mourn every time a person contemplates or chooses to end his or her own life. We acknowledge and are deeply saddened by the burden placed on those asked to collaborate in ending a life. We place ourselves and our circumstances humbly in God’s hands; we commit ourselves to working faithfully to the best of our ability to be artisans of Christ’s healing and agents of the hope and love He came to bring. As we do so, we ask the intercession of Mary, Mother of Jesus, who points us to her son, and shows us how to accompany others by the way she was receptive to Jesus in his living and kept vigil with him in his dying.
Sincerely yours in Christ,
_________________________________ _________________________________
Most Rev. Donald J. Bolen Most Rev. Murray Chatlain
Archbishop of Regina Archbishop of Keewatin-Le Pas
________________________________ _________________________________
Most Rev. Bryan Bayda Most Rev. Albert Thévenot
Eparchial Bishop of Saskatoon Bishop of Prince Albert
[1] Euthanasia and physician assisted suicide are formally called Medical Aid in Dying (MAID) within the Canadian healthcare system.