Euthanasia is the next front in the culture of death’s juggernaut, and Canada represents one of its biggest wins. The Supreme Court of Canada has declared an entire “right” to “physician assisted death” from protections for life in Canada’s Charter of Rights, and the incumbent government is set, with the same single-mindedness with which it defends abortion, to implement the Carter decision.
Implementation of so profound a social change entails implications for other moral agents and the ability of the community to promote its own moral values independently of the individual’s. It certainly is not just a matter between a person and his physician. When such social changes become enshrined in law, society and culture must adapt their entire ways of life to accommodate the new “right.” Consider post-Obergefell America: homosexual “marriage” not only involves Adam and Steve but also demands that the butcher, the baker, and the picture taker all solemnize their “nuptials” through their professional services, any conscientious objections notwithstanding. Civil officials fall in line or are driven from their jobs. Communities that dissent feel the full fury of avant-garde corporate America, which celebrates all “diversity” except dissent from theirs.
So, in pro-euthanasia Canada, how should the Church provide pastoral care for those planning either their own suicides or hiring a physician to prostitute his healing vocation and kill them? For Catholics, pastoral care necessarily involves questions of sacramental praxis: pastoral care in advance of death usually encompasses sacramental Reconciliation, Anointing of the Sick, and the last Eucharist of one’s life (Viaticum). So, what does one do in the case where a Catholic intends to exercise his “civil right” and kill himself or be killed?
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Two groups of Canadian bishops have addressed this question: the Catholic bishops of Alberta and the Northwest Territories and the bishops of the “Atlantic Episcopal Assembly” (encompassing the Maritime provinces of New Brunswick, Newfoundland, Nova Scotia, and Prince Edward Island).
The two documents could not be more different.
The Alberta-Northwest Territories bishops promulgated “Guidelines for the Celebration of the Sacraments with Persons and Families Considering or Opting for Death by Assisted Suicide or Euthanasia: A Vademecum for Priests and Parishes.” The document is a thirty page treatment of “relevant principles for sacramental ministry to the sick and dying,” followed by “a Guide for Discernment of Particular Situations” that seeks to apply those relevant principles to various stages of decision making about one’s planned suicide/killing: indecision versus determination to proceed and remote or proximate actions taken to effectuate that decision.
The Maritime bishops, by contrast, produced a three-page letter providing a “pastoral reflection on medical assistance in dying.”
I prescind from a deeper analysis of the Alberta-Northwest Territories document, with the caveat that I do not necessarily endorse every conclusion it draws. I am, however, in far greater agreement with that document than the product of the Atlantic coastal bishops.
The Atlantic bishops see themselves as “discern[ing] how best to accompany those who find themselves struggling with illness, pain, and difficult medical circumstances.” Indeed, the letter is long on the “‘art of accompaniment’” and much shorter on concrete guidance.
My fundamental criticism of this document is what I regard as its mistaken, indeed false, understanding of what pastoral care involves. Pastoral praxis is and should not be separable from moral or sacramental theology: we do not believe one thing when it comes to what is right or wrong or the practice of the sacraments and another when it comes to pastoral care. Seamless pastoral care must be grounded in objective truth and cannot sanction, in the name of the “pastoral,” what is contrary to the Church’s moral or sacramental teaching. Pastoral care is not something separate from and independent of the Church’s doctrinal and moral teaching, including such core and absolute moral principles as the intrinsic evil of choosing to procure one’s death, either actively or by the hand of a surrogate. Likewise, it cannot divorce itself from such basic sacramental principles as the necessity of contrition prerequisite to valid absolution if one intends to commit an intrinsically evil act (suicide by one’s own or an agent’s hand), or which is contradicted by intending sacraments of the living (Anointing, Eucharist) that should not be received/administered if one remains unreconciled because of one’s intent to commit some future intrinsically evil act like suicide.
The bishops explicitly claim to be applying the methodology of the “art of accompaniment” which they attribute to Pope Francis. That methodology involves “healing, guiding, nurturing, and reconciling” modeled on the Good Shepherd who guides his sheep and on the Lord’s dealings on the road to Emmaus, who opens the eyes of the disciples through word and sacrament.
In one sense, none of this should be controversial: the Church’s task is to heal, guide, nurture, and reconcile her children as she encounters them where they are. That’s not up for debate. A mother guides her children where they are, but she should guide them out of the middle of a four-lane highway if they have decided to encamp there. The question is: Quo vadis? Where are we taking them?
On that point the letter is, most charitably put, disappointing. I say that because I agree with R.R. Reno: most frankly put, the letter is “appalling.”
The problem is not so much what the letter says as what it doesn’t, and what we should make of those omissions.
The Atlantic bishops admit Canada’s new euthanasia regime “challenges us as a Church and as individual Catholics to grow in our understanding of the Church’s moral teaching on this issue.” What does that mean?
Are Canadian Catholics to make their own the Church’s explicit teaching about the intrinsic immorality of suicide or procured killing? That no civil law can make right what is intrinsically morally wrong? That Catholics have a duty to change unjust laws?
Or does that sentence somehow suggest that the Church needs to “learn” (scil., revise its teaching or the teaching’s application) in light of the new situation brought about by the legalization of euthanasia?
Nor do they get to the problem of the social structure of sin (and the resistance due against it) that a euthanasia regime creates and reinforces when the larger culture repeatedly employs all the means at its disposal to communicate a message of ethical approval concerning a fundamental question about human life that the Church teaches is gravely immoral. This is not just a question of personal morality but of social justice.
The bishops (quoting the Catechism of the Catholic Church) write that “‘grave psychological disturbances, anguish, or grave fear of hardship [or] suffering … can diminish … responsibility [for] … committing suicide’” and conclude “[o]nly pastoral accompaniment can bring us to an understanding of the circumstances that could lead a person to consider medical assistance in dying.”
As put, that last statement doesn’t say much. Yes, many suicides’ personal moral responsibility is diminished because of factors like grave fear. “Pastoral accompaniment” should help a wise pastor to identify those factors. But then what? What should that pastor do? It seems that the pastor’s job is to help restore a person so that his moral responsibility is human, i.e., whole, not operating under fear, force, passions, or bad habits. The bishops never quite get around to saying that clearly.
What about the glaring contradiction here? If “medical assistance in dying” (and I score the bishops for employing that euphemism which masks what is really happening here) regards euthanasia to be a fundamental “right,” it must also regard the moral actor as being of sound mind, free of external factors affecting his freedom, in order to exercise so definitively self-dispositive an act as suicide. But if the pastor thinks the person seeking suicide is of impaired moral capacity, what is he to do? Does he raise that issue? Or is this just a wink and nod between the state that says this person is exercising his moral freedom and the church that says maybe he isn’t?
The bishops tell us “we must take into account the suffering person’s emotional, family, and faith context when responding to their specific requests for the reception of the sacraments.” We are also told “the pastoral care of souls cannot be reduced to norms for the reception of the sacraments.”
Where to begin? (1) Pastoral care of souls, especially in situations in extremis, is and should be primarily sacramental. The Church is here to be the sacrament of Christ’s Presence, which is made present in the here and now in the sacraments. Those on the threshold of eternity most need reconciliation, healing from the effects of sin, and food for the journey, provided by priestly ministration, not cuddly talks from Sr. Chaplain. As a sometimes hospital patient in the last decade, I am distressed by the growing difficulty in obtaining rapid priestly sacramental ministrations in hospitals. (2) The “norms” governing the sacraments are not legislative obstacles erected by the Church but essential aspects of the sacraments themselves. Reconciliation presupposes a contrition that is formally universal, i.e., is sorry for all mortal sins committed in the past with the intention of avoiding all mortal sins in the future. Anointing normally presupposes prior valid Reconciliation or at least the same dispositions requisite to valid Reconciliation in terms of attachment to sin. How do the bishops propose to square those elements, essential to the validity of the sacraments, with an intention at some nearer or farther future point to procure one’s death? The Alberta-Northwest Territories bishops at least wrestle with those issues. (3) The bishop’s enumeration of factors relevant to assessing requests for the sacraments is of a strange order. Since the sacraments are acts of faith, should not “faith context” rank ahead of emotions or even family? (One does not receive the sacraments to please others.) Nor do the bishops ever bother to tell us what that “faith context” means regarding administering the sacraments to one planning to commit suicide. Am I in good “faith” if I think I can be reconciled and anointed on the way to getting my lethal injection? Have the bishops ever heard of vincible ignorance?
Finally, we are instructed to “remov[e] our ‘sandals’ before the sacred ground of the other” because “each person’s situation before God and his/her life of grace are mysteries which no one can fully know from without. Consequently, we must not make judgments about people’s responsibility and culpability.”
One truly hopes that these ten bishops do not really believe this, or none of them will ever hear a confession again. Conscience is indeed man’s sacred sanctuary, but conscience only reflects—it does not create—moral value. The role of conscience is to discover the objective moral order and apply it to my circumstances; it does not create that order and can be mistaken in its judgments.
What we find in this letter is a flabby and deficient concept of conscience, one previously encountered in the writings of various episcopal conferences (including Canada’s) nearly five decades ago, when they did not want publicly to teach contrary to Humanae vitae but also did not want to make clear that the encyclical offered definitive guidance for the formation of a Catholic conscience regarding artificial contraception.
What we also see here is the noxious separation of the external and internal fora, a split already advocated by those promoting implementation of the Kasper proposals for recourse by the “divorced and remarried” to the sacraments absent ecclesiastical annulment in the external (public) forum of their putative marriage. I have previously warned that the sacraments are public acts of the Church. There should be no “privatization” of the sacraments, which will inevitably arise when the internal and external fora are divorced. This corrosive abuse is particularly pernicious if “pastoral care” uses the internal forum to subvert Church teaching (and scandalize the faithful).
The Atlantic bishops leave a lot of critical questions open. I think their course is wrong. Catholic moral theology affirms that one can be culpable for another’s sins through silence. By leaving the faithful to guess what to do when Catholic teaching already provides clear guidance, this letter undermines that teaching and fails to guide the faithful.