New! Bioethics Matters: Challenges in Ontario Health Care: A Personal Reflection
Bridget Campion, PhD Recently I had the occasion to witness challenges in Ontario health care…
CCBI News: Catholic Facilities—No to MAID: Church Teaching on Cooperation in Evil
November 3, 2023
Dear Friends of CCBI,
Cooperation in Evil
On September 29, 2023, the National Catholic Register reported that,“The incoming president of the Canadian Conference of Catholic Bishops has served notice that so-called Medical Assistance in Dying is a no-go for institutions and associations the operate under the Church’s name.” Calgary’s Bishop William McGrattan stated at the end of the CCCB’s Plenary: “Once again, unanimously, the bishops indicated that Catholic-sponsored health associations and organizations do not permit MAiD…We are promoting positive accompaniment through palliative care.”
CCBI is grateful for this statement, although not surprised, since it is completely in conformity with official Catholic teaching which our Canadian Bishops always uphold. It does welcome its re-statement at this time when even some Catholics are suggesting euthanasia (MAID) should be allowed in Catholic facilities. This seems to be tied to fears about the survival of these facilities in light of potential government moves to compel MAID in all facilities, rather than to approval of euthanasia itself. While understandable, acquiescence to third-party entry to Catholic facilities to perform MAID is not an ethical response by Catholic institutions that exist to protect the inherent worth and dignity of life from conception until natural death. Any action that contradicts that principle is wrong, abortion and euthanasia being the most extreme in that both deliberately bring about death to a God-given human life.
The question whether a Catholic facility should allow the use of its space by a third-party to implement euthanasia procedures has been raised several times since the procedure was legalized in 2016. That is, could a Catholic facility distance itself morally by allowing a third party to perform MAID procedures on its premises, assuming, presumably, that all the arrangements were made by the person requesting the procedure, with no assistance from anyone employed in the facility? Since 2016, CCBI has always stated its opposition to giving such permission in response to different groups and individuals who have asked for an ethical opinion.
In a response I sent in July, 2023, to a Catholic facility reviewing the possibility of third-party use of its premises to provide euthanasia, I agreed with a statement suggested to the facility that, if “…a facility doing so does not share the evil intention of MAID, explicitly or implicitly, so (it) would not be involved in formal cooperation.” Other forms of cooperation are still involved, however, which demand serious justification for allowing certain actions to take place. Full material cooperation would be involved in giving permission and allowing entry to a third -party provider for the deliberate ending of the life of a resident in a Catholic facility, but could not be judged proportionate or justified, no matter that the action is now deemed legal, as in euthanasia. Legality does not supplant immorality and, I wrote, my opinion was that a Catholic facility cannot cooperate or give any form of permission for euthanasia to take place on its premises. Procedures such as euthanasia (MAID) are deemed intrinsically evil in Catholic teaching, and finding justification for material involvement in that action strains the principle of cooperation in evil to its breaking point.
Some ethicists argue that the use of a hospital room or other space in a Catholic facility does not contribute anything essential to the act to be performed and that a facility’s cooperation would be ‘mediate’ as opposed to material, therefore justifiable and permissible. On the contrary, I wrote in my opinion in July that allowing third party providers to use the Catholic facility’s space is essential to MAID’s being performed. Use of space and utilities are not part of the legalconditions for allowing the MAID request, but such use is clearly essential for its implementation. The use of space and utilities is presumably taken as a ‘given,’ offered in secular hospitals, hospices, homes, funeral homes (e.g., as now in Quebec), but it is not necessarily a ‘given’ and Catholic facilities should not be led to consider it ‘non-essential.’ Saying otherwise seems to me like a ‘back door’ attempt to allow euthanasia in Catholic facilities while continuing at the front door to say euthanasia is wrong and should not be performed. This amounts to a moral failure and also a failure in logic. I wrote that the provision of space is a sine qua non in these circumstances and, even if a third party threatens to enter forcibly, entry should be refused.
After all, the one thing preventing the practice of euthanasia in Catholic facilities is their refusal to allow their space and utilities to be used. Space and utilities are not neutral or non-essential in this context: they are owned or operated by the facilities, and their policies for use by others should apply. Some Catholic ethicists and others who say the use of space is non-essential are able to then go further in concluding that the cooperation in evil involved would be remote or distant, and a Catholic facility would then be morally justified in permitting third- party euthanasia procedures, thereby allowing the Catholic facility to continue its work of delivering the “great goods” of health care.
I disagree with such conclusions, mainly because I consider the cooperation in evil involved is not justified, for the reasons stated above. I recognize the importance of Catholic facilities’ role in delivering the ‘great goods’ of health care, but these goods are not specifically Catholic and are also provided in secular hospitals. The ‘great goods’ factor used by a Catholic facility to justify permission for euthanasia on its premises is not an overriding good, unavailable elsewhere. Even under duress, doing nothing to counter intrinsic evil is an act against the preservation of the value involved (life) and claiming justified cooperation in evil by sacrificing a fundamental value (life) for the great good of providing health care is, to say the least, disproportionate.
On the other hand, what a Catholic hospital does not do is even more important from the moral point of view in upholding its commitment to right action and in acting as a moral witness to secular society. I wrote in my opinion piece in July that, if it compromises that witness, it will no longer be a truly Catholic hospital. If basic life principles are compromised, the name of the hospital may be preserved, but not the substance. It will be just another good hospital, doing its best for its patients, but allowing euthanasia along the way.
The Canadian bishops are to be commended for their unwavering stance indicated in their recent statement and they deserve the support of the Catholic population in their opposition to the spread of euthanasia, especially in Catholic facilities. In promoting good palliative and end-of-life care, they witness once again to the development of the Culture of Life!
Pope Francis’ Intentions for November
For Pope Francis
We pray for the Holy Father; as he fulfills his mission, may he continue to accompany the flock entrusted to him, with the help of the Holy Spirit.
In “The Pope Video” for November, Pope Francis asks the faithful to “Pray to the Lord that He will bless me,” saying, “Your prayer gives me strength and helps me to discern and to accompany the Church, listening to the Holy Spirit.”… Specifically, he asks for prayers for the Pope “so that in the exercise of his mission, he may continue to accompany in the faith the flock entrusted to him by Jesus, always with the help of the Holy Spirit…And, hearkening back to the night of his election ten years ago, Pope Francis repeats his request for a “silent” prayer over him, concluding “And pray for me! Favorably!” Vatican News
Moira and Bambi