Euthanasia isn’t palliative care, Canadian bishops say

  • August 20, 2018

OTTAWA – Canada’s Catholic bishops are urging the federal government to maintain a clear distinction between palliative care and the practice of euthanasia and assisted suicide so institutions are not forced to become “an accomplice” in causing an intentional death.

The bishops delivered that message to Health Canada during the agency’s national consultation on palliative care that ended July 13. 

“We have to speak up and express our opinion, otherwise other lobbies and other groups will influence the government,” said Bishop Noel Simard of Valleyfield, Que., speaking after the bishops’ submission was published Aug. 3.

Other lobbies are trying to influence the government to include euthanasia in its upcoming palliative care proposal, said Simard, an expert in bio-ethics and member of the Pontifical Academy for Life.

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

Institutions and hospices are already feeling pressure to give access to physicians to euthanize patients, Simard said.  

“If you accept this, it means you are an accomplice,” he said. 

“You cannot force or oblige an institution to offer something against its values.”

Simard conceded it may be necessary to allow patients to be moved off site for a requested euthanasia, but allowing the practice in hospices or palliative care wards jeopardizes “the values you want to promote.”

The World Health Organization (WHO) excludes euthanasia and assisted suicide from its definition of palliative care, the CCCB submission said. The 12-page report 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 said, noting 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 in support of a national palliative care strategy was passed into law in 2017, praised the CCCB for stressing that euthanasia and assisted suicide should be excluded from palliative care. 

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

The WHO recommends assisted deaths 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. 

Gladu pointed to British Columbia, where hospices which receive 50 per cent of their funding from the public purse are required to offer assisted death. 

“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.” The inconsistency “speaks to the need for the health minister to speak to standardizing how we do this.”

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.” 

Gladu expects Health Canada will report on the results of its consultation after the House of Commons resumes sitting Sept. 17.  

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