The federal legislation on "Medical Assistance in Dying" received royal assent on June 17, 2016. A year later, Archbishop Smith offers the following reflection on where we stand today.

A court decision has resulted in the legalization one year ago of physician-assisted suicide in Canada, something that was unthinkable just five years ago. The introduction of any such unprecedented change in society requires time and a balance of perspectives to understand fully its implications on future generations. We as citizens – whether people of faith or not – have a responsibility to look critically at the fallout of that decision and consider some important questions about how it is changing our society.

We hear that this is a matter of personal choice. But is it really a choice when a patient does not have access to palliative care, the kind of care that would improve their quality of life, that would relieve their physical or psychological distress, that would offer them comfort and support without prolonging or hastening their death? 

A disproportionate amount of attention has been given to “medical assistance in dying” (the benign legal term) primarily focused on legal rights, questions of access, reporting of numbers, with stories portraying those very few Canadians who choose this option. But we have not heard from the greater numbers in the past year who have elected to have quality palliative and hospice care. We have not probed deeply into whether people would be seeking a hastened death if palliative care options were readily available and introduced early enough.

It is no coincidence that in Alberta, the majority of palliative care beds are situated in Covenant Health facilities. Palliative care is a reflection of this truth: that every human life has meaning, dignity, and purpose – whether we are talking about a suicidal teenager, an adult living with a severe disability, or an elderly dementia patient lying in a nursing home bed. To wilfully take a human life is wrong; this is clearly codified in many of our civil laws as well as in the scriptures and traditions of the major faiths.

So we will continue to advocate for more and better access to palliative care and mental health care, for genuine mercy and compassion for those who are the most vulnerable among us.

Secondly, we continue to see the toll that this is taking on our physicians and other health-care providers. The vast majority of health-care professionals do not want to end their patients’ lives; they do not want to provide the drugs, they do not want to administer them, and they do not want to participate in the act by referring their patients to someone who will. There is continuing pressure on health-care professionals to participate indirectly in assisted suicide by providing such referrals. In Ontario, the requirement for physicians to provide an “effective referral” is being brought before the courts, and that decision will have ramifications. 

We also know that some doctors who initially thought they could provide “assisted death” have withdrawn from the practice because it caused them personal and spiritual distress, understandably. Surely in a society that purports to respect individual choice, we must defend and protect the right of every health-care professional to choose not to kill.

So we will continue to advocate for conscience rights of health-care professionals. And I assure all members of the health professions that they can continue to count on our support and our prayers.

Finally, we have to talk about money. It is a fact that the final weeks of a person’s life are often the most expensive to our health system. A University of Calgary study earlier this year informed us that doctor-assisted suicide could save Canada tens of millions of dollars annually by avoiding costly end-of-life care. In the U.S., we have seen insurance companies deny coverage for chemotherapy for a cancer patient, but readily offer to cover the cost of providing assisted suicide. In jurisdictions where assisted suicide and euthanasia are practised, we have seen a corresponding rise in the suicide rate in general.

In a nation already and rightly concerned about suicide, this past year has been a march in the wrong direction. Do we really want our children to grow up in a culture where suicide is considered a normal, cost-efficient solution to the suffering we encounter in life? What does that say about us? 

So our Catholic schools will continue to teach our children that life is a precious, God-given gift. Our Catholic chaplains and health-care providers will continue to accompany and advocate for patients through their darkest hours. Our Catholic social services will continue to care for the developmentally disabled, the addicted, the abandoned, the elderly, the unborn, people living with HIV and AIDS, homeless people with terminal illness, and many, many others.

God alone is the author of life; we are but its stewards. Every life does matter. That is the simple fact that must continue to inform the conversation around physician-assisted death.

+ Richard W. Smith
Archbishop of Edmonton

June 9, 2017