Since Medical Assistance in Dying (MAID) has already been legalized in Canada, it’s difficult to know how to ask the right questions. Moves toward re-criminalization seem unhelpful for those who are currently living with unbearable pain. Instead, we must ask how Christians, whether healthcare professionals, patients considering MAID, or family and friends of such patients could ever ethically justify MAID as a legitimate way to end life. To do that, we must enter the conversation and debate to understand both sides.
There are many different dimension to this conversation but I will only focus on four here. Other considerations are more complex than what I can offer, so I invite you to do your own study and to talk to people you know facing these situations.
The Sanctity of Life
Defining what makes a good life is always a difficult task. Some have tried to define human value by levels of productivity. This line of reasoning argues that once someone loses their ability to be productive in extreme cases of illness, their life is no longer worth living. In these cases, MAID seems like a legitimate and beneficial option. But who really gets to determine the criteria for the value of life?
For Christians, since God is the creator and sustainer of life, the right to live and die belongs to Him. We don’t have a right to take life, even if it’s our own, because we believe life has irreplaceable value. We have value because we are created in the image of God, not because of our productivity or desirability. No matter what happens to us, we are neither more nor less human because the definer of life is our creator Himself. This is the core of the sanctity of life argument.
However, although we claim God to be sovereign over both life and death, we have taken life into our own hands in countless ways. We have allowed ourselves to perform extreme medical procedures to prolong life, even in cases when it would have naturally ended. Doing anything we can to prolong life, especially now with new methods and technology, doesn't show trust in a God who is sovereign over all. If we've gone to the extreme on one end, why would we assume that it’s wrong to take death into our own hands when it becomes unbearable? It seems hypocritical to claim the sanctity of life argument for some situations but not others.
Also, although we have certain laws that protect against the breach of the sanctity of life, intentions are critical in determining if an action that results in death is murder. Self-defence or accidents don’t carry the same weight as premeditated murder. Perhaps there is room to see MAID not as murder (as has been done until now) because its intent is most often to alleviate suffering and pain.
By ruling that criminalizing MAID goes against Canada’s Charter of Rights and Freedoms, the Supreme Court has elevated personal autonomy above all else. If we already value people’s autonomy in things like refusing treatment that could lengthen life, why should it stop at the decision to die? It should be the right of each patient to choose MAID in specific, legal situations.
However, MAID isn’t a question of self-determination because, by definition, it involves other people. From the Christian perspective, what is most important is not our individualism, but relationship. We are made for community and communion with God and one another. We can’t assume that we are silos in society when everything we do has impacts on the relationships we hold. MAID requires the assistance of others: a person's right to choose MAID means that our health care system has the responsibility to carry it out. How can we choose whose autonomy is more valuable, the patient’s or the health care professional's?
The argument of autonomy simply doesn’t ring true to real life. But what if relational responsibility actually leads us to choose MAID? Could we have a “duty” to die when our lives become a burden to our communities. Keeping our bodies alive at all costs can have detrimental impacts on our families when we become a financial and emotional strain for them.
However, this is a dangerous road as the question of being a burden is contextual. If an affluent and poor person are in the same medical condition, but one has enough money to pay for proper care, is the poor person’s life not worth living because they’ve become a financial burden on their family? It seems irresponsible to determine ethics on such a variable.
Compassion in Suffering
For some, inevitable suffering and pain (or the fear of it) are enough to decide that they don't want to continue living. MAID becomes an act of mercy, relieving patients of something that no one would willingly choose. There is no question that this argument comes from a place of love and compassion, as it often pains us to see our loved ones suffer. However, the response to result to MAID is too finite in comparison to the call to Christians compassion.
To be merciful and compassionate isn’t to kill, but to share in one another’s suffering. As Christians, we are called to see our suffering through the lens of Jesus’ suffering. Through recent advances, medical treatments for physical pain have greatly improved, making it possible to endure far more pain than ever before. To simply end life when one goes through pain provides no hope for improvement, miracles, or the realization that sometimes diagnosis and prognosis are uncertain and inaccurate.
Of all the arguments, I’ll be honest that I find this one the most compelling. Seeing people suffer isn’t an easy thing, and when death seems inevitably close, it’s hard to make someone endure when they would rather die. And yet, we don’t find any instruction or suggestion that compassion and mercy for those with irreversible illness is to end their lives. I believe we would do well to dig deeper into the meaning of compassion and mercy for our fellow human beings.
The Slippery Slope
With only a few years of legalized MAID in Canada, it’s difficult to determine what the effects will be in our society. Some have argued that examples from other countries like the Netherlands show us the slippery slope that exists when a country decriminalizes voluntary euthanasia. Cases of families pushing for MAID for their elderly parents, even though the parents don't want to die, or cases of euthanizing the wrong patient, give us pause and fear of what might happen in Canada.
It’s significant to realize that once MAID is legislated as a right for all, it becomes harder and harder to set limits and boundaries for those who would be eligible, opening the door for misuse and malpractice. In some ways, we are at the mercy of time in Canada as we now wait to see what our slope looks like.
These are just four dimensions of the conversation and you may find that you have varying positions on what you believe is right. Whatever the case, we must remember to enter these conversations with gentleness and respect. Remember that we are talking about people, not just issues. But these are conversations we need to have, and as we do, we need to ask ourselves how we, as Christians, might respond. That is the theme of next week’s blog.