CCBI News – “Legal Suicide”; Dangers Inherent in Procedure of Euthanasia; Younger Mi Patients Qualify for Maid; the Law

January 27, 2023

Dear Friends of CCBI,

It has been clear for some time now that many people are having second thoughts about allowing euthanasia for people with a mental illness. At present this may be allowed where the person presents with a physical illness that is irremediable and causing extreme distress. If, however, the law is amended as the Justice Department advocates, then euthanasia procedures will be allowed solely on the grounds of mental illness.

Society has become aware that many psychiatrists are concerned that the proposed safeguards are insufficient, and we also know that many of those who apply could be treated successfully and even cured. Many psychiatrists treat patients who contemplate or even have attempted suicide, and it must go against the grain to know that their efforts to restore mental health could be for nought if MAiD becomes available to such patients – a form of legal suicide. ‘Assisted suicide’ or ‘assisted death’ are the terms used when the patient self-administers the lethal medication, not the physician.

Serious Considerations and Dangers Reviewed

The Globe and Mail published a lengthy article on Saturday, January 21, detailing incidents related by families whose loved ones had received euthanasia procedures unknown to anyone in the family. Along with other associations, CCBI has often written about the many dangers inherent in the procedure, including emphasis on the concept of personal autonomy as an ‘absolute,’ and inviolable. Autonomy is, of course, laudable in principle and it is an important part of health care ethics that a person should never be treated without giving consent, except in emergencies or when the person lacks competence to decide. In the latter case, there are legal provisions to appoint substitutes to speak for patients.

Clarifying Autonomy and the Principle of the Common Good

Nevertheless, it is dangerous to act as if personal autonomy is absolute, implying that the person has no responsibilities and duties towards others. The law could be, and sometimes is, interpreted in such a way, but that does not mean it must always be so interpreted. Catholic teaching emphasizes the dignity of the individual, also including the idea of autonomy. Personal agency and conscience rights are held in high regard since they protect the person from conception until natural death. At the same time, though, Catholic teaching invokes the principle of the common good, thus limiting the exercise of personal autonomy on the basis that every other person also has rights, and that these rights may sometimes clash. Simply put, we cannot always do what we want to do if it harms others. John Donne’s classic phrase that ‘no man is an island’ applies here, and we know we are connected to other people in many ways, most especially to our parents who brought us into this world.

Law in Canada

Autonomy in Canadian law, however, can be extreme, e.g., in excluding the right of a father to object to the abortion of his child: in these situations, only the mother has rights. The mother’s personal autonomy trumps the father’s, by virtue of legal fiat. This interpretation of autonomy now seems also to apply to people who apply for MAiD. The applicant does not need to inform anyone else about the decision, and no one has the right to delay the procedure if the applicant chooses to have it carried out.

This seems overly precise and ‘clinical’ in practice, in terms of human relationships. CCBI has talked about the dangers of euthanasia for decades, long before legalization and at a time when many people doubted that it would ever become acceptable in this country. I always emphasize that Catholic teaching is clear that our actions rarely affect only ourselves but have consequences with ripple effects in our families and in society. Some of the stories in The Globe and Mail article highlight this, and it makes very sad reading.

The brother of a woman who was euthanized related that she had not told her immediate family that she had been approved for medical assistance in dying, nor the date for the procedure: “Not her 88-year-old mother, whom she called twice a day. Not her older brother, who lived one town over. And not Mr. Hertgers, 61, who had only that Friday, after driving the four hours to Chilliwack, B.C., shared a pot of tea at Ms. Hertgers’s kitchen table.”

Given the heartbreak of family members in this case, it is clear that no one involved in providing MAiD has any concerns for the people left behind. Story after story comes to the same conclusion. When a family member commits suicide, those left behind are distraught, filled with grief that they could not prevent the death. Is MAiD so very different when it is carried out in a completely autonomous manner, with neither family nor friends involved or informed? There is something inhumane about this form of autonomy where the person is treated as a sort of ‘island,’ completely severed from his or her personal world and served by impersonal MAiD providers.

The law limits the medical information that can be shared with a third party. The Globe states, “Even caregivers can be excluded from MAID assessments and find out, only near the end, that a loved one has even applied. When they go looking for closure after the fact – to ensure a mistake didn’t happen, to know their loved one died peacefully – the system can turn them away.” We know that shock, grief and guilt can be devastating for families even after natural death, but closure is attained eventually when a family realizes or is reassured that it did everything possible for their loved one. In more secretive situations, however, closure may prove more difficult for families, and their lives will be affected in a different way. This is an indication of autonomy ‘gone wrong.’

Euthanasia is, of course, morally wrong in every situation, but my point here is that autonomy is yet another factor that exacerbates these procedures in prioritizing individuals over anyone to whom they are related, and, in effect, cuts those people out of their lives. I cannot imagine the shock to the system together with the hurt, rejection and pain that occur when, say, parents discover after the fact that their beloved child has been euthanized. We need to pay more attention to these aspects of MAiD, as well as to the wrongness of the procedure itself.

Consequences of the procedures are now turning some people’s thoughts in this direction. For example, Toronto’s Centre for Addiction and Mental Health, the country’s largest psychiatric teaching hospital, suggests there should be more consultation with patients and their families before permission for euthanasia is given, to be more certain that all options for the person have been explored. The Globe article also notes that:

…widening availability, national research shows, will lead to younger patients potentially qualifying for an assisted death. Doctors may also disagree about their chances of recovery, particularly in cases of mental illness. MAID decisions are already emotionally complicated. But it’s one thing to hold the hand of an elderly parent with terminal cancer who wants a better death. And quite another to say goodbye to a thirtysomething daughter with depression who may have decades yet to live.

While completely disagreeing about euthanasia in any circumstance, it is encouraging to see the article speak out about cases of mental illness. Another quote from the article highlights the anguish of family members who find out, too late, of a family member’s death: “It’s an impoverished view of autonomy,” says Christopher Lyon, who was given two days’ notice that his father was scheduled to receive an assisted death in July, 2021. “It separates us from our context.” Yes, it does – it removes the context of the care of a loving family from the individual who could most benefit from it.

We may not be able to overturn the laws allowing euthanasia for some time, but we can try to prevent acceptance of the current amendment that allows it for mental illness. Beyond that, we need to point out deficiencies in the Canadian legal interpretation of autonomy, in light of the type of the sad situations affecting families that we are learning about now.

https://www.theglobeandmail

https://www.theglobeandmail.com/canada/article-maid-death-family-members-privacy/

Pope Francis’ Intentions for January

For educators
We pray that educators may be credible witnesses, teaching fraternity rather than competition and helping the youngest and most vulnerable above all.

Moira and Bambi