Medically Assisted Death In Canada

The View from Rabbi Aaron Flanzraich’s Pulpit

In 2015, the Supreme Court of Canada ruled in Carter v. Canada that a competent adult with a “grievous and irremediable medical condition causing enduring suffering” can consent to the termination of their life with the assistance of a physician.

The court ordered the government of Canada to have a law on the books that codified that right by June 2016. The government did, adding nurse practitioners to the category of those who may provide assistance as well as pharmacists to dispense the necessary “substance.”

Village Stories wants to know the views of local clergy on the subject, so we put the following fact situation to them.

You are summoned to the bedside of one of your congregants, A.B. They are bedridden at home. They say they are suffering intolerable pain and distress that cannot be eliminated despite receiving pain medication and other narcotics. They have trouble swallowing and can’t go to the washroom without help.

They are mentally competent and in extreme pain. Their doctor has told them their condition is terminal but it could be six months or more before they would die.

Prescribed treatment only makes them sicker.

You have no reason to doubt them.

You have spoken to them and they are coherent and understand their situation.

They want medically assisted death.

What advice would you give?

Rabbi Aaron Flanzraich

Thank you for the question – it is a current and pressing one that nearly every family has or will face in their lifetime.

The Progress Trap

The scenario you present is a classic example of what the sociologist Robert Wright termed a “Progress Trap.” Which is to say that for every step we take which seems to be progress also carries a problem: cars enabled humans to cover distances they never could by foot or animal, but anyone witnessing gridlock would question if we actually advanced.

The same could be said for many advances – cell phones (Remember when you could have a quiet moment?), antibiotics (whose effectiveness is threatened by Super Bugs) to name just a few.

It tells us that seldom do we advance without some measure of failure. Another example is medical science where our ability to keep people alive has outstripped our ability to cure them.

I have served as a rabbi to a large congregation for more than 25 years and have been called to many a bedside to answer questions of life and death. Many times, they are relatively clear: the person is being sustained by medical machinery that if removed they could not survive.

Judaism does not permit suicide

Judaism appreciates the difference between life and life sustained by medical support. But Judaism does not permit suicide; euthanasia, or medically assisted death is merely suicide by other names.

Suicide is prohibited in Judaism because no life is allowed to be taken by a person, not even our own. The root of this is accepting that humans are not given license to choose who should live and who should die – which is rooted in the belief that we are not to decide which life has value and which one doesn’t.

Pain management

Many end of life issues are fundamentally questions of pain management. We know we will die and when faced with the sure knowledge it is closer, then our hope is to be free from pain. Medical science has many ways to insure ease and peace of mind. But more than physical comfort is psychological comfort.

Tragic optimism

Our last and greatest act on Earth can show that life has meaning until its last breath, to express what the psychologist and Holocaust survivor Viktor Frankl termed as “tragic optimism”  – where the very last and greatest of human freedoms is to face the inevitable and never relinquish the meaning life has. It is in such moments that we are touched by our smallness and life’s greatness and reminded of the mysterious realities that lay just below the surface of what we see.

The funeral of a suicide

Would the service, eulogy or burial be different if the individual chooses assisted death?

No. I would not and never have amended or changed any religious funeral rites on how someone died leaving the judging to a Being more sentient and knowing than I.

Rabbi Aaron Flanzraich is a graduate of Bar Ilan University. In 1992, he was ordained at the Israeli Chief Rabbinate and has served as the Senior Rabbi of Beth Sholom Synagogue in Toronto since 1998. Rabbi Flanzraich is a past president of the Toronto Board of Rabbis, past president of the Christian Jewish Dialogue of Toronto, a board member of the Canadian Rabbinic Caucus and the author of a book on combating Jewish fundamentalism called The Small Still Voice. Rabbi Flanzraich is also a frequent guest on TVO, Vision TV, and the CBC.