“Are euthanasia and assisted suicide appropriate faith responses to suffering?”
That was the question posed at a Clinical Ethics Symposium at the University of Toronto, Nov. 17. Marilynne Seguin, executive director of Dying with Dignity, and United Church theologian, Ruth Evans, argued they were; Dr. Abbyann Lynch, former director of the Bioethics Department of the Hospital for Sick Children, and Dr. Frank Foley of Casey House argued they were not.
Dr. Frank Foley, palliative care specialist at a Toronto AIDS hospice, said, “I never heard the word ‘suffering’ in my medical education, only pain. Pain happens to the body, suffering to the person. We are not just dealing with bodies, but with persons and there is grandeur in personhood. It has been said that, ‘Suffering is the vale of soul-making’. We must help our patients deal with their physical pain so they can work through their emotional suffering.”
“We suffer because of the past and because of what we perceive our future will be,” said ethicist, Abbyann Lynch. “A transcendent dimension gives us a way of stepping aside from our suffering, of moving above it. Certainly, where possible, we must alleviate the suffering. When suffering is seen as a mystery, then we can acknowledge that there are difficulties that human reason can’t solve. Why the good person, like Job or Jesus, suffers is inexplicable. However, if suffering is seen as a problem, then to eliminate the problem we must eliminate the person. If suffering is a mystery then in a faith tradition we must do nothing contrary to faith. A person can grow through the mystery of suffering.”
Lynch had spoken before the Senate Hearings on Euthanasia and Assisted Suicide. “We should be educating every single student within the medical faculty about [palliative care]. But beyond that we need to talk about the need to be with each other. There is a lot of accompanying that needs to be done in terms of dying; it is not just physical pain.”
“We are in our dying what we have always been. And to think that we can dignify it at the last minute with some kind of a manoeuvre of control, or that the deprivation depends on how we appear to others, is certainly self-deceptive.”
Marilynne Seguin, who was on tour promoting her book, Gentle Death, admitted “I have not previously considered euthanasia and assisted death in precisely the terms of a faith response. [While I do not practice] a religion, I am a very spiritual person. Personal beliefs direct my behaviour. My personal faith perspective must not intrude on the family. If there was a conflict I would withdraw. I have a faith beyond a theocratic system. I don’t think of the patient as a Jew or a Protestant or a Catholic.”
“I have never kept it a secret that I assisted my brother in his death at 39. I had a promise to him and I honoured it. I’m very proud of this. My mother kept her own peace about it. My father always said, ‘Why did you kill y son?’ He kept calling me ‘murderer.’ When my mother learned she had ovarian cancer she asked for me to be her only caregiver.”
Seguin told the Senate hearing on May 25 that, “Even when that solution [palliative care] is there, it is not the answer for everyone.” Senator Ray Perrault asked Seguin, “Would palliative care be your first option, rather than assisted death?’ She replied, “If that is the wish of the patient, that is my first option, but I do not believe I have a right to manipulate patients to accept that if it is not their wish…I cannot say, ‘You cannot choose death because palliative care is an acceptable and much more reasonable way to go.’”
“Death with Dignity receives many inquiries about the end of life, either for themselves or for a member of their families. In the last few years, about 30 per cent of those calls have been initiated by health care providers. Doctors, nurses, social workers and chaplains are calling. When Dying with Dignity was formed in 1980 it was rare that a health care worker would call us, but this has gradually changed.” Seguin reported to the hearings.
Phyllis Creighton, a writer experienced in palliative care, said, “Your faith presumptions do make a difference. Mine help me connect, affirm, create not destroy. They enable me to be with people in the midst of their suffering. It is impossible not to impose my values because my God doesn’t abandon anyone.”
One doctor in addiction research said that he has seen “a tremendous societal response around addiction” particularly with groups like Alcoholics Anonymous. “One of the most valuable skills parents can teach their children is how to make friends, especially with people living on the margins, because the only way to survive is in community.”
Eileen Ambrosio, who spent eight years in palliative care nursing, urged that “pain and suffering be recognized and validated. It is easier to acknowledge physical pain than emotional suffering, which is often hidden. When physical pain is brought under control, underlying emotional pain is exposed. When terminally ill patients review their lives, unfinished business surfaces.”
“Symptom relief is important. How can patients deal with psychological suffering, how do they process it is they are constantly vomiting?” Foley asked. “We need to respect the autonomy of the patient in a hopeful manner, not abandoning them to dysfunctional grief.”
Only five per cent of dying Canadians have access to palliative care according to The Journal of Palliative Care. “We need to address the pain of loneliness. When someone asks for euthanasia they’re looking for a connection with someone,” said Foley. “There is no palliative care in Holland; whereas in Britain, where euthanasia is unlawful, palliative care is strong.”
Foley said, “I still have validity as a person despite my suffering. Assisted suicide and euthanasia are quests for power not mercy. Too much suffering invades; it connects with our hearts, to be there with them. Is it really caring to kill? Whose needs are you meeting?”
Geriatric psychiatrist, Dr. Ian Ferguson agreed. “We don’t like people who are chronically ill. We’re terrified of them and we’re relieved when they die. That’s why we accept euthanasia.”
Ferguson took exception to Seguin’s attempt to “walk in the shoes” of the sufferer. “We need to remain empathetic and attached else we will not be able to offer ourselves, to be a strength. We need to come alongside and offer hope and challenge them in their suffering, not sink with them into it.”
“Could God ever smile on our decision to end our lives?” Ruth Evans, the theologian asked. “If euthanasia or assisted suicide were truly acts of love, could God smile?” She felt He could. Ferguson disagreed. An “act of love” is often the defence of a boyfriend who kills his girlfriend. Some of the most heinous crimes are committed “out of love.”
The symposium, presented by Ethics in Health Care Associates, was attended by health-care workers, hospital chaplains and ethicists.