By Jonathan Turtle
The Supreme Court of Canada ruled in Carter v. Canada (February 2015) that parts of the Criminal Code prohibiting medical assistance in dying (MAID) must change in order to satisfy the Canadian Charter of Rights and Freedoms. There are now several criteria to fulfill in order to qualify for MAID, among them that the individual must “be at least 18 years old and mentally competent. This means being capable of making health care decisions for yourself.”
Nevertheless, a recent essay published in the Journal of Medical Ethics by three doctors at Toronto’s Hospital for Sick Children “explores the ethical challenges of providing [MAID] in a paediatric setting.” Their policy is written “with an eye to the near future when capable young people may gain access to MAID.”
It is only three years after the laws that prohibited MAID were struck down, and the conversation already includes those whom the initial legislation sought to protect, in this case those who are younger than 18. Moreover, the authors argue that while the family is usually intimately involved in end-of-life decisions, if capable patients indicate “that they do not want their family members involved in their decision-making, … ultimately the wishes of capable patients with respect to confidentiality must be respected.”
What are Christians and people of conscience to do? What is the vocation of the Church in a culture such as this?
Bioethicist Bridget Campion raises two important points that we need to seriously consider. First, she challenges us to build a culture of life and a culture of care: “if we can do that and make it so that people don’t wantmedical assistance in dying, then we will have achieved something.”
Second, she says that the argument for MAID based on patient rights and autonomy is “simplistic and overly narrow.” People are not autonomous beings but are rather located and understood as individuals only within a much richer web of filiation and relationships. Should we not take into account the common good, even if that good is only common to one family? “These days, what I’m thinking about is that we tend to think of medicine as a highly private thing — between the patient and the clinician,” she said. “We have to be thinking about communities of health as well, communities of wellness.”
These two points, taken together, help us to discern a possible vocation for the Church in the West today. The legislation is, in many ways, out of our hands. How now must we act?
What if the Church committed to being that “community of wellness”? What if the Church doubled down on nurturing a culture of care and of life within herself to the extent that her sick members no longer saw death as the only option?
It is, of course, precisely this that the Church has been known for from the very beginning. Julian, Emperor of Rome, wrote to Arsacius, the pagan high priest of Galatia: “It is [the Christians’] philanthropy towards strangers, the care they take of the graves of the dead, and the affected sanctity with which they conduct their lives that have done the most to spread their atheism” (quoted in David Bentley Hart, Atheist Delusions).
So far as Emperor Julian was concerned, Christianity was spreading quickly because of the utterly novel practices of showing charity to strangers and a belief in the sanctity of every human life, no matter how poor or disfigured. After their lives were reoriented toward the risen Jesus Christ, the early Christians saw a new moral horizon that resulted in practices and commitments that confounded their pagan neighbors: fidelity within marriage, treating slaves with respect as brothers and sisters, treating women with dignity as equals, caring for the sick, not scorning the poor but seeing in them the face of Christ, and refusing to leave infants at the mercy of the gods and nature.
For those early Christians in pagan Rome, following Jesus entailed resisting and rejecting what were otherwise normal practices. Moreover, the witness that their community of wellness bore resulted in growth throughout the Roman Empire and beyond.
So again I ask, what is the vocation of the Church — and a declining Church at that, if reports are to be believed — in a culture that has embraced MAID and would even consider extending it to children without the consent of their parents?
We need to think deeply about the opportunity that is in front of us to bear witness to another way: a way that Christians have long trod, a way made known in the gospel of Jesus Christ that opens to people of every age new moral horizons previously unimaginable. History may well tell the story of how such a common witness proved to be a green shoot amid the rubble of the Church in the West.
Christian ethicist and theologian Stanley Hauerwas has said that if in the future the Church is known simply as a community that refuses to kill her children and her sick then we will have done well.
The future is now.
The Rev. Jonathan Turtle is rector of the parish of Craighurst and Midhurst in the Diocese of Toronto.