Canadian archbishop fights for right of church hospice to refuse euthanasia

Simon Caldwell

May 17, 2024 at 9:52 am

No-one ever slides up a slippery slope. They only ever go down. Euthanasia invariably involves a descent that is not so much like skidding to the foot of a steep hill as falling from a cliff. In no country in the world has this been quite as dramatic as in Canada.

The nation permitted euthanasia in 2016 when death was “reasonably foreseeable” in terminally ill patients. That safeguard was scrapped four years later and euthanasia has since been extended to people with disabilities. Moves are afoot to extend euthanasia to those with mental illness and a parliamentary committee last year recommended that children should be able to request a lethal injection without the consent of their parents.

The country has in many respects gone “euthanasia mad”, seemingly oblivious to the horror with which such laws are viewed throughout the civilised world where some people still remember that the Holocaust grew directly from the Nazi’s Aktion T4 euthanasia programme that murdered 300,000 incurably ill and disabled people and pioneered the gas chambers.

Such myopia might be explained by the dogged presentation of euthanasia always as a liberating choice. What euthanasia does in reality, however, is restrict choice by acting like cuckoo chicks in the nests of palliative care, diverting and gobbling up resources and crushing out and destroying good practice in the nursing of the dying. Not only do its advocates brook no intolerance, but actively harass and persecute those who hold contrary opinions.

It is on this point that the Catholic Church in Canada is on course to clash with the attorney general of Quebec over the Medical Assistance in Dying (MAiD) programme.

Archbishop Christian Lépine of Montreal has submitted an appeal to the Quebec Superior Court in what could prove to be a landmark case for religious and conscience rights. It demands a stay of the application of a 2023 amendment to the Act Respecting End-of-Life Care that specifies that “no palliative care hospice may exclude medical aid in dying from the care they offer”.

The objective is to prevent the Catholic-run St Raphael Palliative Care Home and Day Centre in Montreal becoming another clinic where doctors dole out death at the end of a hypodermic needle.

Besides interference with the exercise of the right to freedom of religion and conscience, the lawsuit argues that the practical effect of the amendment is the state appropriation of a church building to administer euthanasia.

“We speak about palliative care and MAID because it’s around those issues that the law is made,” Archbishop Lépine told The Catholic Register, a Canadian newspaper. “But it’s really the freedom of conscience, not only for individuals, but also for institutions.

“That’s what we hope to promote. Whoever we are, we need a society where there is a freedom of conscience for people and institutions. It’s a promotion of common good. It’s good for everyone. There’ll be a process, judicial process that will decide, but at least we make our part for promoting the freedom of justice, of religion and conscience.”

Lawyers for the archdiocese are clear in their view that if their case fails then the Church will have to withdraw from palliative care provision because euthanasia is directly contrary to Catholic teaching on the moral impermissibility of killing.

Canada will then surely follow the pattern of countries with older euthanasia laws and which have already seen the shrinking, and sometimes the collapse, of palliative care services.

Before permitting assisted suicide in 1997, the American State of Oregon, for instance, was comparatively advanced in palliative care provision, ranked highly in the US for hospice utilisation, hospital ICU utilisation, pain policy and advance care planning policy.

After 2000, palliative care funding and provision stagnated as assisted suicide, encouraged by health insurers, took hold. Very few new hospices have opened since and those that cling to their existence refuse to co-operate with the Death with Dignity Act, an exemption, which unlike the Canadians, they can enjoy under federal law.

A similar pattern of diminution in palliative care has been observed since 2012 in the Netherlands, where investment is a third less than in the majority of European countries which prohibit assisted death.

The killing of the sick in the Netherlands has now, incidentally, become so trivialised that last week Zoraya ter Beek, 29, a physically-healthy woman, was granted her wish for a lethal injection because she is suffering from a psychiatric illness. Under Dutch law, to be eligible for a doctor-assisted death, a person must be experiencing “unbearable suffering with no prospect of improvement”. They must be fully informed and competent to take such a decision. The caveat was introduced as a so-called safeguard but it is abundantly clear that it can be abused to catch almost anyone.

A similar reduction in palliative care services has occurred in Belgium since 2008 where promised increases in money for the care of the dying failed to materialise while the workload in doctor-assisted deaths climbed incrementally.

This sparked mass departures of palliative care specialists angry that their units were being turned into “houses of euthanasia” and their functions reduced to preparing patients and their families for lethal injections.

Professor Timothy Devos, a haematologist in Leuven, told UK parliamentarians that palliative care, rather than euthanasia, has become the reserve option and that most doctors are scared to propose it in case they are accused of erecting illegal barriers to the “right” to doctor-assisted death.

By that time doctors in Canada were also abandoning palliative medicine, bullied out amid the expectations placed upon them to end their patients’ lives, according to Ontario specialist Dr Leonie Herx.

In New Zealand, which joined the euthanasia club of nations in 2019, all but one of the nation’s 32 hospices declared they will not permit doctors to kill patients on their premises. The one exception – Totara Hospice in South Auckland – agreed to allocate space on its premises for the practice while its staff will conscientiously object to any participation. They clearly grasp what stands to be lost.

Nor is palliative care the only casualty. In Canada, patients complain with increasing frequency that they are made to feel like burdens on the state and there have been numerous instances of the sick finding it easier, for instance, to get a lethal injection than a wheelchair or a stairlift.

Euthanasia has not only become easy to obtain but it being almost forced upon people. It has been offered to war veterans suffering from trauma. In one case an elderly woman was given a lethal injection when she complained of isolation during a Covid lockdown and in another a pensioner was granted a euthanasia request simply because he said he feared he would be made homeless.

Two doctors, Ellen Wiebe and Stefanie Green, between them killed 700 people in a single year. This was described by Wiebe as “the most rewarding work we’ve ever done” in a 2020 event which was captured on film.

Last year about 14,000 people died at the hands of their doctors in Canada, accounting for 4.1 per cent of all fatalities but in some parts of the country the rates are higher than the national average. In Quebec, for example, 6.1 per cent of deaths were by euthanasia, making lethal injections the third highest cause of mortality after cancer and heart disease and more common than all accidental deaths there put together.  A similar proportion are killed by terminal sedation, a method of euthanasia by omission which is not officially recorded as such even though the clear intention is to bring about death by the denial of food and fluids.

Euthanasia advocates almost always seek changes to laws prohibiting doctor-assisted death with the promise that robust “safeguards” will somehow resolve any problems, yet every jurisdiction which has relaxed its laws to permit ‘assisted dying’ within the last decade have seen such restrictions weakened or swept aside to widen the criteria for those eligible to die.

 Australia is following a similar trajectory with the piecemeal legalisation of euthanasia across nearly all its states in the last seven years. The Australian Capital Territory will this year join the club but with extremely permissive legislation from the outset. Euthanasia will be offered widely, children and the demented included, and it would be reasonable to assume that other states will soon follow.

Like nearly everywhere else, the Australian experiment began modestly, only a year after Canada’s, when campaigners persuaded the Victoria legislature that “voluntary assisted dying” would lower suicide rates among the sick and elderly. 

Research conducted by Prof David Albert Jones of the Oxford-based Anscombe Bioethics Centre, an institute of the Catholic Church in the UK and Ireland, and published in the Journal of Ethics in Mental Health, has found, however, that the claim was spurious because the numbers of actual suicides have risen by more than 50 per cent in Victoria since the law came into force.

That doesn’t matter because suicide prevention was surely never the true objective. It is time for the lying to stop and to acknowledge euthanasia for the disaster it really is: the ideologically and financially-motivated murder of the sick and elderly and increasingly the poor. The Archbishop of Montreal should be commended for his initiative.