The appointment of a medical aid in dying (MAiD) provider as interim clinical director of palliative care at a Catholic hospital in Ontario has provoked renewed concern about the future of Catholic health care in Canada.
Dr. Danielle Kain is a palliative care specialist who is associate professor and division co-chair of palliative medicine at Queen’s University. She was appointed to the directorship of palliative care at Providence Hospital in Kingston, Ontario, July 1.
The Kingston hospital is one of 22 health care institutions in Ontario under the sponsorship of Catholic Health Sponsors of Ontario (CHSO). The CHSO was formed in 1998 to assume responsibility for institutions formerly under the guidance and management of congregations of religious sisters.
Kain is both a staunch proponent and practitioner of euthanasia.
In a 2018 Canadian Medical Association Journal article, Kain and a colleague published a personal reflection on MAiD, citing two individual cases in which they were involved.
“At the ensuing team debrief,” Kain wrote, “I was struck by how rare it is for health care providers to be so deeply moved together; we realized that a medically assisted death could be both poignant and peaceful.”
On social media, Kain has argued that all publicly funded institutions, including Catholic hospitals, should be compelled to offer MAiD. She has also expressed support for the Effective Referral Policy: doctors who have conscientious objections to euthanasia must refer patients to MAiD-offering doctors. In a 2016 Twitter post, Kain wrote: “Making an effective referral is not an infringement of rights.”
In Catholic ethics, a MAiD referral would constitute a proximate material cooperation with an immoral act.
A variety of professional associations of Canadian Catholic health care providers, including the Canadian Federation of Catholic Physicians, have made appeals to both the CHSO and the local ordinary, Archbishop Michael Mulhall, to intervene.
According to the website, the CHSO “appoints the board members and CEO of each organization; provides CHSO member organizations with tools and guidelines to ensure a certain consistency in meeting sponsor expectations; approves any changes to member organization mission, values, or philosophy.”
Health care institutions under the CHSO umbrella are bound by the guidelines of the Health Ethics Guide, a 2012 publication of the Catholic Health Alliance of Canada.
Article 87 of the guide states that “treatment decisions for the person receiving care are never to include actions or omissions that intentionally cause death (euthanasia).”
Dr. Pascal Bastien is an internal medicine specialist in Ottawa. Along with 20 Catholic medical professionals, Bastien communicated his concern about Kain’s appointment to Mulhall in a June 29 letter.
The archbishop’s office did not respond before publication to a request for comment.
Bastien said he has been reassured that the boundaries provided by the Health Ethics Guide will protect the hospital in the case of internal or external pressure to provide MAID.
Bastien is not convinced.
“If we are hiring her, a public promoter of euthanasia, we are falling short in the promotion of Catholic values and the understanding of the human person,” he said. “We have already demonstrated in the hiring process that we are not following the Health Ethics Guide.”
One of the principal arguments the Canadian bishops have made in the end-of-life debates is that Canada needs a well-funded and regionally equitable palliative care system. Palliative care has been proposed as the antidote to the ever-expanding promotion and practice of euthanasia.
In a 2021 message to the faithful, the Canadian Catholic bishops stressed that “palliative care, and not euthanasia or assisted suicide, is the compassionate and supportive response to suffering and dying.”
The bishops and palliative care physicians like Kain have a fundamental disagreement about the definition of palliative care.
“Our Catholic hospitals are being usurped by people who are fundamental opponents of what Catholic faith is about,” Bastien said.