Physician-assisted dying: the next big challenge for the Church?

Renison College hosted two interesting forums – a wokshop on physician-assisted dying and a four-part series of Anglican-Muslim conversations entitled “Dealing with our darkness”.

 By Marilyn Malton

The questions and stories started swirling as soon as the first person entered the room.

By the time the formal conversation began at the Physician Assisted Dying Workshop, held at Renison University College on September 24, there was a tangled web of questions and concerns in our midst. “What do I do if I meet with someone who wants physician assisted dying?” “Doesn’t the bible say this is wrong?” “Why are our Scriptures silent about this?”

But that’s why we – lay people, deacons, priests, parish nurses, chaplains, and family members – came.

Canon Douglas Graydon

Canon Douglas Graydon

Each person at the workshop, co-sponsored by the Deanery of Waterloo and the Renison Institute of Ministry, had personal stories and particular concerns arising out of his or her life and faith experiences. As we conversed together, we created more rather than less complexity. But under the gifted leadership of Canon Douglas Graydon, we also helped each other untangle some of the knots and tease out some distinct strands.

Canon Graydon drew from his 20 plus years of end-of-life care experience – his work as the Coordinator of Chaplaincy for the Diocese of Toronto, and from his membership on the Anglican Church of Canada’s Task Force on Physician Assisted Dying – to weave together his insights and reflections from workshop participants.

Through a historical perspective on suicide and euthanasia, he illustrated the impact of changing theology, understandings of human self-determination, medical interventions, and legal decisions. For example, our recent ability to prolong life, sometimes for years, raises questions and necessitates decision-making unknown in previous generations.

The Anglican Church of Canada wrestled with the question back in the 90s. In 1998 General Synod received the “Care in Dying” report from a Faith, Worship and Ministry Task Group and it was commended for study by the Church. But with the Carter v Canada decision by the Supreme Court of Canada in February 2015, “the debate on physician- assisted dying took on a different shape”, said Graydon, as he clarified what the decision means.

Until the Supreme Court decision, it was a crime to assist another person to end his or her life; therefore the dying person had two choices – take his or her own life prematurely or suffer until he or she died from natural causes. The Court determined that this was cruel and contrary to the individual’s Charter rights of self-determination and personal freedom.

It is not legal for everyone to assist another person to die; only professionals designated by the state can legally assist another person to die, and only if the person wishing to die meets all the following criteria: he or she is eligible for health services in Canada; is at least 18 years of age, and capable of making decisions with respect to their health; has a grievous and irremediable medical condition; has made a voluntary request for medical assistance in dying; and, gives informed consent to receive medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care. Furthermore, there are procedural safeguards.

This knowledge helped to untangle some of the knots for participants.

At the same time, concerns were expressed over how to respond sensitively and appropriately when one person exercises self-determination that can impinge on the rights of other people, including parish nurses, physicians, clergy, or family members who do not want to play a part in physician-assisted dying, yet may feel pressure to do so.

It was in this changing Canadian landscape that a new Faith, Worship and Ministry Task Force met to study together and “assemble resources to assist theological and pastoral approaches to physician assisted dying”. The result is In Sure and Certain Hope (; the Task Force is also working on a study guide.

Graydon, who wrote a part of the report, emphasized that it is not a statement of position, doctrine, canon, or policy, and therefore has no authority for clergy or laity. However, it “provides a framework” for helping people of faith “reflect upon the questions and challenges of assisted dying.”

A turning point in the workshop conversation occurred when Graydon presented two critical questions posed by Archbishop Rowan Williams: “How does the choice(s) made manifest the selfless holiness of God as discovered in Christ? How might the choice(s) make build up a community called to a holy witness within society?

Our motive for making a faith-based moral decision rests within our action of making Christ visible to our world.

We are “called to ‘make sense’ of our decisions within the common language of our faith and the historic teachings of Christ.” Of course, said Graydon, this is dependent on who we think Christ is, but the focus shifts from “this is what I believe or this is what the church teaches” to “I am called by Christ to seek what is best for you in the context of your family and community relationships.”

Other strands of our conversation included working within a health care system where there is often no voice for faith; the lack of policy in some hospitals or long-term care facilities; our approach to Scripture in trying to discern God’s will; the gifts of sacraments, prayer, and ritual; the need for self-care for those engaged in the ministry of presence; the importance of community as we sort out our personal thoughts and feelings about death and dying; and ecumenical perspectives brought by Lutheran, Mennonite, and Community Church participants. Each participant left with a list of questions to help tap into these resources – both for self-reflection and discussion in their congregation.

When the workshop ended, not every tangled knot was worked out, and there wasn’t a tidy basket of colour-sorted yarn, but we did leave with new insights, resources, and yes, more questions. As Rev. Dr. Timothy Dobbin reflected, “Canon Graydon provided us a wealth of personal anecdotes from his ministry experiences infused with his wry sense of humour. His presentation was careful, thoughtful and nuanced, and his reflections were both helpful and enlightening. I am grateful for being far better resourced to engage in a topical and contentious dialogue which is likely to command more of the nation’s and the Church’s attention in the years to come.”

May the conversations and the untangling continue.

Lay Canon Marilyn Malton is Director at Renison Institute of Ministry