A pastoral letter to clergy and people of the Diocese of Toronto

Easter Week, 2016

To the Clergy and People of the Diocese of Toronto,

We are in the midst of the Easter season, when the death and resurrection of Jesus and the new life we are offered in him are at the forefront of our personal prayers, our public liturgies and our teaching. The issues of life and death are also in the forefront of public discourse, with the violence of war and terrorist attacks killing innocents in so many places, the ecological disasters that lead to sudden death from catastrophe or the slow death of starvation, or the tragic epidemic of youth suicides that devastates too many indigenous communities. It is in these contexts that I write, with the support of the area bishops, about the upcoming changes in Canadian law regarding medically assisted death. (The terminology keeps changing.)

The Anglican Church of Canada has addressed this issue for a number of years. As a church, we have extensive pastoral experience, to add to our biblical, theological and moral traditions, to call upon. I commend to you an excellent resource, “Care in Dying,” first published in 1998, to assist our church in reflecting on the debate. It distinguishes between termination of life support, ending treatment and euthanasia (voluntary, involuntary and non-voluntary). As importantly, it puts the discussion of the debate in the framework of the call to care. Caring at the end of life is not only about medical practice, technology and legal doctrine. It raises the moral, ethical and pastoral obligations placed on all of us to respond to individuals, families, professionals and communities in a variety of circumstances.

The Supreme Court of Canada’s decision in February 2015 declared unconstitutional existing laws prohibiting physician-assisted dying. It ruled that “a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition” has this right.

A recent joint parliamentary committee has recommended extending that even further. The scope of assisted dying moves significantly beyond those who are in the last stages of a painful natural death. This may include options to pre-determine a time of death, extending the option to the mentally ill or to minors.

As Christian pastors and leaders, we find some of these very disturbing.

The Anglican Church made a substantial submission to that committee on Feb. 3, 2016, raising a number of questions that need to be considered in developing legislation and regulations that Parliament is expected to adopt in the next few months.

As archbishop, I have spoken and written publicly about my serious concerns. Among these are the reduction of the definition of “provision of care” to a medical/technical “treatment,” the almost exclusive focus on the individual in isolation from their community, and the nearly unquestioned equation of human dignity with the capacity to author independently one’s own life (and hence death).

End-of-life matters are complex, with many nuances that are not easily resolved with simplistic solutions. Anglicans hold diverse perspectives on this, but we share a core commitment, echoed in our baptismal vows, “to uphold the dignity of every human being.” We are created in the image of God and redeemed by God’s gracious love in His Son, Jesus Christ. As Christians, we find the meaning of our life and our death in relation to Jesus’ birth, life, suffering, death and resurrection.

A new document, “Living and Dying, We are the Lord’s: Resources to Assist Pastoral and Theological Approaches to Physician Assisted Dying,” has just been written (to be released shortly) by the Faith, Worship and Ministry Task Force on Physician Assisted Dying. It is worth reading. Along with “Care in Dying,” it provides us with a very helpful pastoral resource.

Whatever the outcomes of the ongoing discussions, we must recognize the urgent and ongoing need for pastoral care to the person who is dying (or who is in significant and unrelenting physical or psychological pain), to the caregivers and family, to medical personnel and to the wider community. The church is one of the chief resources for this care, and we must be prepared to offer it to the very best of our ability.

Two of the glaring gaps in the public discussion are the inadequate provision of palliative care, along with the training of medical personnel in appropriate and effective pain management. If these are not widely available and easily accessible, the impetus for assisted death is much stronger. We urge you to advocate locally, provincially and nationally for comprehensive palliative care that, both short-term and long, will directly affect far more people than medically assisted death. In both advocacy and provision of care, we can call on our extensive practical experience in ministry with the elderly, the dying, and with those who suffer from mental illness.

These are deeply emotional issues. We urge you to deepen your understanding of this matter, to read, think and pray for wisdom, to discuss this with your families and neighbours, particularly with the medical professionals in your parishes. We encourage you also to write and speak with your local Members of Parliament to express your views as they make crucial decisions about the policies, laws and investments that will govern us all for a long time to come.

“Whether we live, we live unto the Lord; or whether we die, we die unto the Lord: whether we live therefore or die, we are the Lord’s. For to this end Christ died, and lived again, that he might be Lord of both the dead and the living.” Romans 14:8-9

Yours faithfully,

The Most Rev. Colin Johnson, Archbishop of Toronto and of Moosonee

along with the Bishops Suffragan of Toronto:

The Right Rev. Philip Poole, Area Bishop of York-Credit Valley
The Right Rev. Patrick Yu, Area Bishop of York-Scarborough
The Right Rev. Linda Nicholls, Area Bishop of Trent-Durham
The Right Rev. Peter Fenty, Area Bishop of York-Simcoe

The Care in Dying document can be found on the national church’s website at www.anglican.ca/faith/focus/ethics/care-in-dying/.