Physician-assisted suicide is in the news these days as the Canadian government tries to come up with a new law governing the practice. In this guest post, my friend Doug Koop reflects on the issue from his work as a Winnipeg-based spiritual health practitioner.
I was fielding questions at a palliative-care conference when the issue arose. "Doug, I hate to ask you this, but what are your feelings on physician-assisted suicide?"
I was not particularly surprised. The matter of medical aid in dying is very much in the news, and many medical teams and palliative-care workers are wondering how its impending introduction in Canada’s health-care system will affect them.
It’s a politically and emotionally volatile issue, with strongly principled activists of various convictions currently holding centre stage in the public debate.
But while it made perfect sense for the question to come, I had not prepared myself to face it, and eased into the discussion with something of a disclaimer.
"At one level, it doesn’t matter what my feelings are," I began. "The freedom for qualified patients to choose medical aid in dying — and the responsibility of the system to make it available — is about to become the law of the land."
Meanwhile, I work in a major hospital where this option is likely soon to be a recurring reality. It’s coming to my workplace, and I’m certain to encounter it in the months and years ahead.
I returned to the original question and tried to make a general point.
"On the whole," I said, "I think it will be better if people with palliative-care and spiritual-care sensitivities are available to patients and families who are making these decisions for themselves."
When I do find myself in such a situation, it will be important for me to suspend whatever judgments I might be inclined to make in order to offer the best spiritual care I can provide, and that the patient and family can receive.
Another hand went up. "I’m going to have to disagree with you, Doug. I believe in the sanctity of life from conception until natural death. No life is ours to take. We cannot make those calls. It’s up to God to decide when a life is to end."
I listened attentively as she gave eloquent expression to her deep convictions, and concluded with an air of finality.
"Yes," I acknowledged. "And that perspective has very much been a part of the broader public conversation. However, it doesn’t have much bearing on my response as a spiritual-health practitioner in a public institution. I feel that it’s better to be present to people in these circumstances, rather than to be absent on principle."
We left it there.
Facts of death
Personally, I believe we all need assistance in both living and dying, and that everyone should be involved. We are interdependent beings. It takes a village for a person to live well... and to die well.
I’m in favour of person-assisted dying (and pastor-assisted dying, and physician-assisted dying, for that matter) when it means we honestly and empathetically help people to be at peace with their impending death.
We need to face the facts of death. For some, that means letting go of the unrealistic expectations that so often hinge on the fixes and cures medical science strives so hard to deliver.
We are mortal beings, and our lives are ultimately beyond the reach of even the most sophisticated medicines and techniques.
I’m not one to try to either hasten or forestall the inevitable. Yet there is work for spiritual-health practitioners — and others — to do, even at the bedside of a person who’s deliberately choosing a medically induced demise.
It’s good when any of us can provide some assistance in the difficult work of releasing our tenuous grip on the things of this world.
Read more about the dilemma of my own dad's death and the issue of assisted dying.