MAID Q&A

St. Boniface Hospital, Winnipeg, Manitoba

APOLOGIA

By Hendrik van der Breggen

The Carillon, July 6, 2017

MAID Q&A

In view of St. Boniface Hospital's recent controversial decision not to permit medical assistance in dying (MAID), it might be helpful to look at some questions and answers about MAID.

Q. What is MAID?

A. The term Medical Assistance In Dying/ MAID is a dangerous euphemism.

Yes, of course we all want medical assistance in dying: please, doctors and nurses, don't abandon us as we die, please provide clean sheets, food, and morphine as death takes its course.

But MAID—the procedure—is the KILLING of a patient.

MAID, in other words, suggests comfort care, but translates the meaning of "care" into direct killing action.

Q. Are there other concerns about MAID?

A. Yes, MAID weakens our society's respect for life because its practice assumes life is no longer the default position. There is no doubt a non-fallacious slippery slope that lurks close by when we accept killing the sufferer is a solution to suffering.

Also, MAID places yet another burden on the elderly, terminally ill, and disabled. How? By subtly implying they must justify their continued existence. This is not good, surely.

In addition, proponents of choosing MAID inadvertently insult the elderly, terminally ill, and disabled by communicating this message: We'd rather be dead than be like you!

Q. University of Manitoba ethicist Arthur Schafer says this: "The fundamental principle of health-care ethics is the needs of patients come first." What about that?

A. Let's think. A patient NEEDS to be killed? Really? There is confusion here between needs and wants.

Also, shouldn't we remember something called the Hippocratic Oath? We should remember at least this part of it, especially if we're having a discussion of fundamental health-care ethics: "I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect."

Q. Schafer (again) about St. Boniface Hospital: "They're not taking into account people's end-of-life comfort." What about that?

A. This is simply not true. Significantly, St. Boniface is one of two hospitals in Winnipeg which provides palliative care. Palliative care is a branch of medicine that focuses on patient comfort when facing a life-threatening illness. St. Boniface doesn't conflate comfort and killing.

Q. St. Boniface Hospital is a publicly-funded institution, i.e., it receives taxpayer dollars, so, as Schafer argues (in the words of a CBC reporter), "the church has no place deciding the care doctors can provide at a public hospital." What about that?

A. We should keep in mind that St. Boniface is not merely a public hospital. It's also a church-run hospital. It was founded by Grey Nuns and has historically been governed by the Catholic Church. The Catholic Church is part of the public, too. Catholics are taxpayers, too. And Catholics provide additional funding (beyond taxes) to St. B.

Moreover, not every hospital offers all services, nor is required to.

Conclusion. We live in a free, pluralist society which requires wisdom on the part of its government. It seems to me that the official statement by Manitoba's Health Minister Kelvin Goertzen shows such wisdom: "We think that we've struck the right balance by ensuring that there is access to MAID but also ensuring that those individual rights and those hospitals that are uncomfortable with the procedure can also have their rights respected as well."

Thank you, Health Minister Goertzen.

Hendrik van der Breggen, PhD, is associate professor of philosophy at Providence University College where he teaches ethics (and other philosophy courses). The views in this column do not always reflect the views of Providence.

P.S. Food for further thought for doctors and nurses who conscientiously object to MAID:

It's good for objecting doctors and nurses to insist on conscience provisions, i.e., insist that if a doctor or nurse thinks physician-assisted killing is wrong, then he/she shouldn't have to do it.

But is this enough? What about referrals to others who will do the killing?

Let's think about it. If we think killing patients is truly wrong, as, say, slavery is truly wrong, then it's not enough simply not to own slaves. We should also not refer slave-buyers to slave sellers. In other words, we must object that slavery itself is wrong, period, and wrong for all.

Perhaps objecting doctors and nurses may only be required to provide accurate information about physician-assisted killing. If so, keep in mind that although it may not be wrong to be required to provide accurate information about slavery, it would be wrong if this information included directions about where to purchase a slave.

Additional columns/ articles on physician-assisted killing, for further reading: 

• The Image of God: Why life is worth defending against physician-assisted suicide (Spring 2011)
• On putting down pets and people (August 18, 2011)
• Physician-assisted suicide is a slippery slope (December 1, 2011)
• Physician-assisted suicide: Look at pros AND cons (December 29, 2011)
• Are we ignoring a philosophical lesson from history? (May 31, 2012)
• Doubting euthanasia (June 12, 2014)
• Physician-assisted suicide (February 19, 2015)
• Physician-assisted killing (March 3, 2016)
• Physician-assisted suicide (old interview with ChristianWeek) (November 9, 2016)