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The Supreme Court of Canada’s ruling on physician-assisted dying is a bellwether judgment. (Thinkstock)
The Supreme Court of Canada’s ruling on physician-assisted dying is a bellwether judgment. (Thinkstock)

VANIER and Card

In assisted dying, remember this: We all are fragile Add to ...

Jean Vanier is a humanitarian, author and founder of L’Arche, an organization dedicated to supporting people with intellectual disabilities. Hollee Card is the national leader of L’Arche Canada.

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We in L’Arche have had the privilege of accompanying many on life’s journey, not only in times of health and strength, but in times of fragility and weakness as well. Through this experience we have learned many things.

Most importantly, we have learned that it is the most fragile among us who are the closest to their humanity, to their suffering, and to their need to be loved. It is they who show the rest of us the way to live in truth and in love.

So much of the history of modern life has been a struggle to secure important personal freedoms. For many people, the freedom to die at the time of one’s choosing, in the midst of pain and suffering, is as important a right as any they can imagine.

Several countries including the Netherlands, Belgium and Switzerland, as well as the U.S. states of Oregon and Washington, acknowledge the right to the assistance of a physician to enable death. Now, at the insistence of its Supreme Court, Canada will enact changes to its Criminal Code to permit physician-assisted dying, too.

With this right – the right to die – we must take care not to obscure or forget the innate dignity of those who are vulnerable or reinforce an ideal that only an independent life has purpose and value. We are all fragile, and the vulnerability that comes with the passage from birth to death is one which we must each find a way to accept.

Living in a society that values independence over interdependence, we fear becoming a burden or losing the capacities that we think make us valuable or loved. Instead, we must be independent and strong, rather than vulnerable and weak. We dare not ask others to care for us. We feel shame when we imagine ourselves needing others – even when we think of needing our family and kin.

This fear is not a healthy state of mind. It is a symptom of how we view vulnerability and our responsibilities to one another. In a society where we show compassion and afford dignity to everyone, we do not need to fear the transition from one phase of life to the next. It is part of our humanity that we provide care to one another, and also that we receive care from one another.

In this way, we should all be able to meet death with dignity – no matter our condition or our needs.

This is why we have a special obligation to ensure that the care available to each of us throughout our lives, but especially in our final stages of life, affirms both our dignity and humanity. Otherwise, we diminish our range of experience to include only our independence. We diminish the love we can share, and the vulnerability we can show to one another.

Such a spartan culture ultimately devalues life. In its place we must recommit to honouring and accepting ourselves and others by finding ways to accept our frailties, and the full course of life.

Humans are not solitary creatures; each of us has both personal and communal rights. Modern societies have tended to privilege personal rights, while providing only very minimally to support the communal rights that are no less important.

Recent federal as well as provincial and territorial commissions examining the question of physician-assisted dying have each emphasized the importance of developing comprehensive end-of-life and palliative care services. Without a much stronger system of care to protect and value each of us in our final phase of life, we deprive ourselves of an important communal right and we deepen our suffering.

We also know that the decision to die must be carefully safeguarded. Physicians need to not only weigh competency, but also to take into account the possibility of coercion and what psychologists call “unconscious inducement.”

In this latter situation, individuals facing terminal illness come to believe that hastening their own death is a socially generous and responsible act. An ethos that may subtly support such thinking can lead to a deep and subversive betrayal of an individual’s right to live their life out to its natural end.

In L’Arche, we have learned much over the years accompanying people on the path of life, from fragility to strength and back to fragility. More than anything, we have discovered that there is an inexplicable grace to be found in learning to accept ourselves and one another, not only because of our strengths but also because of our weaknesses and fragilities.

Nothing is more fundamental to a society than its attitudes toward life and death. As Canada removes the legal prohibition to physician-assisted dying for certain exceptional circumstances, it enters a new medical and ethical realm.

It strikes us that this is an occasion to reaffirm life even as we permit those facing terrible suffering to choose death. We must ensure that the best safeguards exist, while redoubling our commitment to caring for one another in the most fragile moments of each of our lives.

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Jean Vanier’s letter on fragility coincides with the release of the Vulnerable Persons Standard – a series of important safeguards that will help to ensure that Canadians requesting assistance from physicians to end their life can do so without jeopardizing the lives of vulnerable persons who may be subject to coercion and abuse. The Standard will be released in Ottawa Tuesday. www.vps-npv.ca

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