Today, I will attempt to summarize the document In Sure and Certain Hope issued by the Anglican Church in 2016. It is an update of the 1998 Statement on Euthanasia and Assisted Suicide, Care in Dying. The 2016 paper is intended as a, “Resources to Assist Pastoral and Theological Approaches to Physician Assisted Dying.” These two documents provide, I believe, a good perspective on this very complex and challenging issue for Christians.
The document begins with the affirmation that all people are created in the image of God and as such have inalienable dignity and should be treated in ways that reflect this:
Theologically we continue to assert that human persons, being in the image of God, are the bearers of an inalienable dignity that calls us to treat each person not merely with respect, but with love, care, and compassion. This calling, being a reflection of God’s free grace, is in no way qualified by the circumstances that an individual may face, no matter how tragic.
Consequently, this places a duty on society to care for people who require help in appropriate ways:
We need to pay attention to how we are to sustain communities of care around patients, respecting the decisions of, and exercising the best possible care first for the patient and then also with care for the immediate supportive community. In this context the church needs neither to surrender its basic principles and insights nor propound them in a way that simply isolates the church from the theologically essential task of empowering individuals caught up in these situations to make sense of their own lives, their hopes and fears, their pain and distress.
The document provides framework for appropriate support which reflects this understanding:
a framework for effective pastoral support for all concerned (patients, family, loved ones, care providers, and wider communities of support), whatever decisions particular patients ultimately believe themselves called to make.
Below are experts from the report which, I hope summarizes key points. The report is extensive so it is, of necessity longer than usual.
The report acknowledged that suffering might be meaningful. However, it also noted that suffering might be devoid of redemptive value in and of itself.
Life as Gift
Already in the case of the withdrawal of treatment we recognize that life is not an end in itself, and that the approach of death need not be resisted by all available means.
Care and Community
Understandings of care, and how those understandings shape and express community, lay at the heart of the reflections in Care in Dying. Indeed, the trajectory of that document was in many ways set by the way it answered the question of what constitutes care. In seeking to answer the question of whether a decision to participate in the ending of life could be construed as an act of care, the study was in some ways quite tentative.
Vulnerability and Justice
In the area of physician assisted dying there are still reasons to be concerned about the impact of this change on those in our society who are most vulnerable…for the churches it is important that we continue to express concern for those who might be adversely affected. This is not simply a slippery slope argument. It is rather based in the complexity of how constitutional protections work and the experience of other jurisdictions where the initially narrow grounds for physician assisted dying became widened out of legitimate concern that some who might benefit were excluded under the initial definitions.
In our society dignity is most commonly linked to the capacity to be the author of one’s own destiny. However, this is linked with understandings of human individuality and freedom that are difficult to maintain.
Perhaps the key point, however, is that the language of dignity is supposed to remind us that in decisions about the life of a person it is that person’s life, inherent worth (however that is ascribed), values, hopes, aspirations, story, etc. that drive the decision-making process and not the imposition of interpretive frameworks from without, the imposition of what Zizak and Brueggemann would call ideology
To uphold the intrinsic worth of the human person is to protect the very vulnerable members of society—those who have (or appear to have) little if any extrinsic value, because they do not have the capacity for full authorship or autonomy, and are not able to have the same sorts of relationships that more “productive” members of society have. This value challenges the linkage of dignity and worth with autonomy and ability to be in control of all aspects of one’s life.
It will surprise some people that the principle that the conscience must always be followed (conscientia semper sequenda) is a key element of Catholic moral theology that has continued if not with greater importance in the churches of the reformation. The role of conscience grants to the individual believer the responsibility to be the author of his or her own decisions.
As Christians we are called to lives shaped by hope. Hope involves the commitment that, whatever our circumstances, God is at work for our good (Ro 8:28 c.f. Mat7:11). It stands opposed to despair. At the same time hope is not to be confused with a passivity that is unresponsive to our circumstances. Hope requires that we cooperate with God in the purposes that God is working out in our lives.
While it is now clear that the provision of such alternatives cannot function as a bar to patients making decisions to seek assistance to end their lives we remain of the view that this change will not reflect the intended affirmation of the dignity of patients unless there are genuine alternatives amongst which they can discern real and significant choices.
Although often thought to be synonymous with “terminal” or “compassionate” care, palliative care is not confined solely to situations in which curative therapies are no longer possible or desired. Rather, the focus is on relief of distressing symptoms and maintenance or improvement of the quality of life of the sufferer regardless of the prognosis or projected duration of the illness.
What matters is that for many, the premium challenge of end-of-life is to continue to experience meaning, purpose and control over one’s life. This presents our church, and those who care for the ill, with two fundamental challenges. First: pastoral care-providers must discern honestly through prayer and consultation their personal views and values and how they affect their capacity to support patients in decision-making in relation to end-of-life and assisted dying. Second: pastoral caregivers must assess the strengths and limitations of available resources that can, or cannot, support the parishioner who seeks assistance with dying
Pastoral Care and the ministry of presence
Being present to another requires the sacred ability to listen, to speak and to touch. It is within the sacred conversation of being present that one can sometimes discern most clearly the needs, questions and desires of the other.