Hope & Dignity: A Catholic response to MAiD

Affirm and accompany the person with Christian love and truth. When someone I love and care for requests euthanasia or assisted suicide (maid), I should be conscious that this request can be a cry for help. The first thing I should do is remind the person of how much I love them and also how much God loves them. In affirming that they are loved by God and by others, I should also reassure them that they will be accompanied during this difficult and trying time of their life. They are not alone on this journey.

Examine and Explore

Here are some examples of how to engage, in an open manner, someone who might be contemplating a request for euthanasia or assisted suicide. It is important to enter into this conversation as a dialogue. You are certainly not affirming the person’s desire for euthanasia or assisted suicide, but trying to understand the reason for the request.

• What I am hearing you say is that you cannot continue living like this in the way you are living now. Would you like to talk more about this? It must be a heavy burden to carry alone.
• I remember seeing other people who have experienced similar health challenges. They mentioned having difficulty with the following issues. Is that true for how you are feeling?

When exploring these sensitive issues with your loved one, you may hear the following responses:

• I am so afraid of being a burden on my family. I looked after them all of their lives and I don’t want them to have to look after me now. They can’t afford to take time off work—they have their own family to look after now.
• My pain is controlled right now, but I don’t want to die in agony or become even more incapacitated than I am now.
• I have no dignity left—I can’t walk, eat, stand, go to the toilet without help, etc. I am tired of living.
• It’s my life and I have the right to make decisions about how I live and when I will die.
• No one has the right to deny me my legal right to MAiD.
• If I don’t make this decision now when I am capable, I may miss the opportunity to make the decision if I become incapable. I will be living “like a vegetable.” I don’t want this.
• It’s time to go. I have had a good life. I am looking forward to seeing God and reuniting with my friends and family who have gone before me.
• I have nothing left to look forward to. My friends are dead. I haven’t seen my family in years. I am alone in the world. What’s the point in carrying on?
• There is no hope—not even in God.

Possible Responses

• If the person is experiencing physical pain, let them know that you will support them by seeking the advice and the help of their medical advisors find the best way to alleviate their physical pain, be it through medication or other treatments.
• The majority of people who request euthanasia or assisted suicide do so not because of physical pain but because of suffering due to anxiety and worry about their situation. It is essential to find out the particular cause of the person’s suffering. For example, they may feel that they are a burden to others or perceive that their quality of life has diminished. Or they may feel they are losing the ability to make decisions and control their life (their autonomy). These feelings can affect their mental health. This type of suffering can be much more difficult to deal with than physical pain. Just as physical pain can be addressed by medical professionals, mental health professionals can be of great assistance in helping to determine the cause of a person’s suffering and in finding the appropriate treatment to ease their suffering.
• If a person feels they are a burden to others, you need to let them know that they are not a burden; their life matters to you and to others. This can be a time to address a person’s spiritual well-being. You could call upon a priest or chaplain to speak with the person.
• Even a person who is experiencing great suffering should be told that their life is of inestimable value because it has been given to them as a gift from God. We can take the opportunity to remind them that in the light of our Catholic faith, suffering can be transformed and redeemed when it is seen as a participation in Jesus’ saving death and resurrection.

How is the Church to respond to people who have requested euthanasia or physician-assisted suicide? May the Church walk with them on that journey, as it is called to do in every other situation? What about reception of the sacraments and funerals for those who follow their own path on this issue, and not that of the Church? If you are facing these difficult situations or have questions on these matters, speak with your parish priest or bishop for guidance. For further reading, you may wish to consult the September 2020 letter entitled Samaritanus bonus: On the Care of Persons in the Critical and Terminal Phases of Life, published by the Congregation for the Doctrine of the Faith on 14 July 2020.

Suffering, either our own or that of a loved one, does not justify an act that is morally wrong. Suffering is a reality that we as Christians approach in the light of that endured by Jesus. From our Lord we learn that we are never alone in our suffering. His special love for the sick and his acts of healing call us, too, to be close to any who suffer and strive to lessen their pain whenever possible. In Jesus Christ, we find that suffering in no way diminishes human dignity. Suffering does not eclipse our capacity to love and be loved, to forgive and be forgiven, to serve and to be served. In fact, to choose MAiD only passes our own suffering on to those we claim to love. If you were to meet a stranger who was about to jump off of a bridge, would you give him a final push to end his suffering, or would you offer him your own hand to help him off of that ledge?

The same argument could be used to justify all suicides. That should be our first clue that it’s wrong. Asking someone else to assist you in dying implicates another person, a physician or nurse who is supposed to care for you. That we are stewards of our lives does not mean that we have complete autonomy to dispose of them. MAiD does not give you more control over your suffering or your death, because it will ultimately be a government bureaucracy that will decide whether you live or die.

• As Catholics, we recognize that we have been given the gift of life. Therefore, we are obliged to receive medical interventions that can help us.
• However, “Persons are not obliged to seek or accept medical interventions/treatments that will not accomplish the goal for which they are intended or when the burdens (excessive pain, extreme suffering, expense or other serious inconvenience) resulting from the treatment are clearly disproportionate to the benefits hoped for or achievable.” (Catholic Health Alliance of Canada, Health Ethics Guide [2012], #77)
• Pope St. John Paul II was clear on this point when he stated, “While life is always good it is not an absolute good.” (See Going to the House of My Father: A Statement on the Dignity and Destiny of Human Life, Ontario Conference of Catholic Bishops, 2007)
• “In principle, there is an obligation to provide food and water to persons, including medically assisted nutrition for those who cannot take food orally. This obligation extends to patients in chronic and presumably irreversible conditions who can reasonably be expected to live indefinitely if given such care. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be ‘excessively burdensome for the patient or [would] cause significant physical discomfort’.” When decisions regarding the provision of nutrition and hydration are needed, they should take into account the “needs, values and wishes of the person receiving care.” Withholding or withdrawing nutrition and hydration must never be to hasten death. (Catholic Health Alliance of Canada, Health Ethics Guide [2012], #84)

No. When we reach a point where continued intervention is deemed futile or disproportionate (the expected burdens of the treatment are greater than the expected benefits), withdrawing treatment simply allows nature to take its course. It is not choosing to cause or hasten death but choosing to not use futile or disproportionate means to prolong life. In Church teaching, this is morally acceptable. Such a decision should always be discussed carefully with your physician, pastor, and family. However, killing yourself, or having someone else kill you, is never morally acceptable.

Instead of offering death as a solution to pain and suffering, we believe that everyone should have access to the support and care that they need. This is especially true of those who suffer through the complications of age, disability and/or disease. The goal of true palliative care is to relieve physical, psychological, social, and spiritual suffering. It helps patients and their loved ones go through the end of life in a truly dignified way.

No. The World Health Organization (WHO) says that palliative care "intends to neither accelerate nor postpone death."

There are risks of coercion to use euthanasia and assisted suicide as a way to avoid the costs of treatment. As health care costs in Canada continue to increase, both in total dollars and as a proportion of all government spending, it is not hard to imagine that an economic case could be made to expand access to MAiD. Catholics should vigorously reject any attempt by government or health care providers to put a dollar cost on human life. Consider:

• The average cost saving of administering MAID to a patient, versus traditional end-of-life care, is $13,500, according to a fiscal analysis of Canada’s MAiD system by the Parliamentary Budget Officer in October 2020 (extrapolated from data).
• That report concluded that easing access to assisted suicide could save Canada’s health-care system up to $149 million a year, or less than 1% of annual health care expenditures. See: caedm.ca/2020/11/27/negligible-savings-from-assisted-suicide-parliamentary-report-says/
• However, the PBO study was based on less than 8,000 annual MAiD deaths and assumed that MAiD deaths would continue to comprise just 2.2% of all deaths in Canada.
• In 2021, MAID deaths accounted for 3.3% of all deaths and both the number and proportion continues to rise. For example, in 2022, the number of MAiD deaths in Alberta increased by more than 40% to 836 deaths up from 594 in 2021 (Source: albertahealthservices.ca/info/Page14930.aspx).
• According to Statistics Canada, the number of MAiD deaths in Canada has continued to grow at an accelerating rate since it was introduced in 2016, increasing by 34.7% in 2021 over 2020 (7,446 vs 10,029) (Source: www150.statcan.gc.ca/n1/daily-quotidien/230213/dq230213c-eng.htm).