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ETHICS MADE REAL

GORDON SELF

It's been months since my friend's daughter died. Siobhán Rock-Zych passed away Jan. 12 at the age of 42 in Ottawa. She was diagnosed with amyotrophic lateral sclerosis (or ALS) in 2011.

Her father, Michael, spoke of his daughter's courageous witness in the WCR following a press conference at Covenant Health announcing the release of the Parliamentary Committee on Palliative and Compassionate Care report, in which we contributed substantive input ("Society must face up to human mortality," WCR, Nov. 28, 2011 by Lasha Morningstar.)

I thought of Siobhán while in Ottawa recently to participate in a national discussion among ethicists representing Catholic health care institutions. One topic was the potential imminent legalization of physician-assisted suicide.

My colleagues are preparing a public document to educate people about the long-standing Roman Catholic teaching and practice in providing quality, compassionate palliative and end-of-life care. A tradition that does not, nor ever will, condone assisted suicide and euthanasia as morally acceptable options, whatever the legal realities.

But we also decided it was prudent to develop a policy template for health care organizations like Covenant Health to guide staff and physicians in our facilities should a person ever request such potentially legalized options.

Given our moral tradition prohibiting acts or omissions that have as their intent the hastening of a person's death, physician-assisted suicide and euthanasia would have to be completely carved out from the basket of services provided in Catholic hospitals, much as we have historically done with abortion.

It is this non-negotiable stance that has contributed in part to what a Catholic health care organization stands for in defining its identity. Finding that balance in what Catholic health care won't do with what we will and must always do is crucial to positively defining our identity.

Still, if physician-assisted suicide is ever legalized, we could not simply pretend we didn't hear a patient's or resident's request for assistance to end their life. Some response is required. We will need to find a way to engage this conversation without abandoning the person in our care, nor abandoning personal, professional or institutional integrity.

VALUE-LADEN CONVERSATIONS

Often ethics is erroneously perceived as a set of rules and prohibitions about what we can't do. Rather, in my experience, ethics is about the earnest, value-laden conversations we have when confronted with seemingly insurmountable choices. I was reminded of this lesson again by Siobhán.

Shortly after her youngest son was born, Siobhán learned she had an incurable and debilitating disease. Despite this tragic news she made the conscious choice "to be happy," words she used herself, sharing her journey with ALS through a series of videos posted on the website created for her.

CANDID REFLECTIONS

I encourage readers to catch a glimpse of Siobhán and her candid reflections about her journey with ALS, including the tough choices she faced. One memorable video features her skydiving adventure a year after she was diagnosed. (see "Conversations with Siobhán" at www.conversations-with-siobhan.com)

While we await the outcome of a Supreme Court of Canada ruling as well as proposed provincial legislation in Québec that both have implications for legalization of assisted suicide, I see other efforts to provide a counter-witness.

The parliamentary committee on palliative and compassionate care is one such effort. A recent private member's motion by MP Charlie Angus calling on the federal government to establish a pan-Canadian palliative and end-of-life care strategy is another.

Siobhán and her family and friends are a third, as are the thousands of other people across the country who benefit each year from compassionate, quality care at the end of life, and the many dedicated professionals and family caregivers who serve them.

CHOOSE TO BE HAPPY

Siobhán reminds me what choices we need to make for ourselves and for our society. She reminds me that we must continually focus on what is possible and life-giving. She chose to be happy, no matter what circumstances life brought. Even in her palliative journey she had much to live for and give others.

She claimed her God-given dignity in her living and in her dying.

While it is prudent to prepare for what may come to pass in Canada, Siobhán reminds us that there is no need for such options as long as we have the support of family, friends, faith, and access to quality palliative and end-of-life care.

That is where we need to keep our focus, in defining what we do and will always do for people in our care.

(Gordon Self is vice president, mission, ethics and spirituality for Covenant Health and can be reached at mes@covenanthealth.ca.)