Legalization of Euthanasia and Physician Assisted Suicide Threatens the Quality of Palliative Care

The frenzy of debate and dialogue stemming from Canadian Parliament’s discussion of Bill C-384[1] has brought to light many concerns regarding the potential legalization of euthanasia and physician assisted suicide (PAS).[2] The Bill was defeated Wednesday, April 21 by a vote of 228-59,[3] however, significant concerns were brought to light vis-à-vis this discussion. Furthermore, the National Assembly of Québec will launch a public debate this autumn concerning the topic of dying with dignity.[4] Thus, continued awareness of this topic is necessary. While opponents of euthanasia and PAS voice legitimate and frequently obvious objections, the purpose of this article is to draw to light a less obvious, and frequently overlooked potential consequence of legalizing euthanasia and PAS. The passing of any euthanasia or PAS legislation threatens to diminish the quality of palliative care.

International Precedent

While some argue that palliative care is not antagonistic to euthanasia and PAS, and, in fact, that all practices coevolved and are complementary,[5] Ottawa based physician, palliative care professional, and professor of medicine at the University of Ottawa, Jose Pereira, disagrees. Pereira holds that the legalization of euthanasia and PAS in Canada could reduce the quality of palliative care available to the terminally ill.[6] Pereira’s concern stems from his experience. While Pereira was serving at a hospital in Geneva, Switzerland, PAS came into practice. As a result, palliative care programmes were cut, and the number of palliative care physicians serving in the hospital decreased.[7]

To be sure, Pereira’s concerns are not exclusive to Switzerland. Decline in the quality of palliative care, similar to that which Pereira hypothesizes and has observed, is visible in the United States state of Oregon, where PAS is legal. In Oregon, requests for palliative care are declined by institutions to those terminal-patients lacking health insurance. In such an instance, a terminal-patient is left with the decision to suffer pain, or opt for monetarily affordable physician assisted suicide.[8] Should euthanasia and physician assisted suicide be legalized in Canada, similar situations could conceivably appear in Canadian hospitals – largely because euthanasia and PAS are less expensive than quality palliative care.

While the United States evidently poses a distinct challenge due to its historic lack of universal healthcare, abuses resulting from legalization of euthanasia and PAS in Canada remain likely. Consider that Switzerland offers state sponsored healthcare. There, the efficiency and economy of euthanasia deem it fiscally favourable for the Swiss government. Canada’s healthcare, like Switzerland’s may prioritize expediency over integrity.

In areas where euthanasia and PAS are legal, these practices already present an even more visible threat to the quality of palliative care. Consider that in the Netherlands there are annually over one thousand instances of involuntary euthanasia.[9] Such high occurrence of involuntary euthanasia is evidence of the potential for the abuse of legislation favourable to the practice of euthanasia and PAS. If the strictest of legal framework cannot successfully contain the practice of euthanasia, it should not be legalized to begin with. The legalization of euthanasia and PAS, and specifically its delivery from the hands of palliative care professionals is a particularly frightening prospect. These professionals are trusted by terminal-patients to defend to the terminal-patient’s last breath, the inviolability of human life. Even if palliative care workers are not responsible for delivering death to terminal-patients, legalization of euthanasia and/or PAS threatens to diminish the trust and prestige held by palliative care, as euthanasia and PAS are popularly associated with end of life medical care.[10]

Quality of Palliative Care

Palliative care “allow[s] the person to die with a sense of respect, [and] a sense of dignity without that loss of control which they generally feel. [Palliative care is] a way which allows them to live the best that they can while they’re dying.”[11] Palliative care is concerned with the overall wellbeing of the patient, and not exclusively the physical needs of the patient. Palliative care is concerned with caring for the terminal-patient, in order to render her or him as comfortable as possible during the terminal-patient’s final season of life. The quality of palliative care has increased tremendously in recent decades. The holistic focus of palliative care, tailored to the terminal-patient’s emotional, physical, psychological, and spiritual needs render palliative care a discipline which ensures the terminal-patient’s passing can be made easier and even “beautiful.” Where all these needs are addressed by qualified professionals and family members, a terminal-patient is able to enjoy her or his last months, weeks, and days in this life.[12]

Evidently, the continued quality of palliative care is something quite consciously conducted. Contrastingly, euthanasia and PAS threaten the quality of palliative care as these practices discourage would be professionals from entering the discipline for fear of having to perform such practices which are opposed.[13] The World Health Organization’s definition of palliative care clearly states that the discipline does not intentionally hasten death.[14] If euthanasia and PAS ever become practiced in the palliative care units of Canadian hospitals, undoubtedly, professional integrity would decline, and the relationship of trust and care between physician and patient would be shaken.[15]

Public Perception

The legalization of euthanasia and PAS is not a topic to be gingerly considered. In a democratic society, public opinion is frequently considered the ultimate standard. However, with issues relating to human life, decisions must be thoroughly measured, beyond even public perception. The inviolability of human life is poorly regarded in a society which is eager to hasten life’s end. Values held, even by the potential minority of a society, should be carefully considered.[16] Evidently, proponents of euthanasia and PAS misunderstand the reservations of opponents of the legalization of euthanasia and PAS. Consider the following section extracted from Québec’s National Assembly’s Dying with Dignity: Consultation Document;

Opponents [of the legalization of euthanasia and PAS] believe that the ties of trust between patient and physician could be shaken. They fear that if a physician can carry out euthanasia, he or she will not do everything possible to keep the patient alive.[17]

Matters of Finance

Insofar as palliative care does not seek to hasten the terminal-patient’s passing, neither does it intend to prolong it.[18] The National Assembly’s understanding of euthanasia and PAS opponents’ concern is mistaken, because it is not these opponents’ wish that the palliative professional artificially “keep the patient alive.” The concern is that in a healthcare system where euthanasia is legal, the physician will not have incentive to do everything possible to care for, and keep the patient comfortable. Given the expense of quality palliative care, it is likely that with the availability of an alternative, the more expensive option will be under prioritized. Such will undoubtedly affect also the long term development of palliative care as it is likely that funding which provides for research of the discipline will be undercut. The possibility of such decline in the quality of palliative care is even more conceivable in a healthcare climate such as that of Switzerland and Canada, where healthcare provisions are state sponsored.

Quite significantly, euthanasia and PAS threaten the quality of palliative care because of the lesser monetary expense of the former. No one wishes to consider their healthcare provider so frugal and pragmatic as to choose the less expensive of two options, however, as earlier mentioned, in the state of Oregon, where healthcare is not universally provided, the cheaper route of PAS is more accessible. Where a more expedient and practical route is available, it is human nature and commercial protocol for such an option to be prioritized above others. This trend may result prominently within palliative care in Canada should euthanasia and PAS become legalized. While palliative care may remain an option in the event of the legalization of euthanasia and physician assisted suicide, certainly, resources available for the advancement and improvement of palliative care could decline.

A Pertinent Issue

Although Bill C-384 was overturned, consideration of euthanasia and PAS remains. Such is evidenced through recent developments spearheaded by the National Assembly of Québec. Thus, continued awareness of these issues is pertinent. If physicians begin to perform euthanasia and/or PAS, terminal-patients will fear their physicians have an intent to kill, instead of trusting physicians' intent to care.[19] The legalization of euthanasia and PAS will negatively affect the quality of palliative care.

Notes:

[1] Note: Bill C-384 was proposed by Bloc Québecois MP Francine Lalonde, and “would have allowed doctors to avoid murder and manslaughter charges for helping terminally ill people or those in severe chronic pain to die,” [CBC News and The Canadian Press, “Assisted suicide voted down by MPs,” in Blair Shewchuk (ed.), CBC News, (Canada, Canadian Broadcasting Corporation; Wednesday, April 21, 2010). Pg. 1. Accessed at ( http://www.cbc.ca/canada/story/2010/04/21/parliament-euthanasia-bill-vote.html ) on Friday, June 11, 2010.].
[2] Note: Physician assisted suicide hereafter to be referred to as PAS.
[3] CBC News and The Canadian Press, “Assisted suicide voted down by MPs.” Pg. 1.
[4] Rhéal Séguin, “Quebec committee to decide life and death questions: Public will have chance to weigh in on whether euthanasia, assisted suicide should be legalized,” in John Stackhouse, Sylvia Stead, Neil A. Campbell, Sinclair Stewart, Gregory Boyd, and Christina Vardanis (eds.), The Globe and Mail, (Toronto, CTVglobemedia; Tuesday, May 25, 2010). Pg. 1. Accessed at [ http://www.theglobeandmail.com/news/national/quebec-committee-to-decide-life-and-death-questions/article1580932/?cmpid=rss1 ] on Wednesday, June 16, 2010.
Note: The Select Committee on Dying with Dignity released a document entitled Dying with Dignity: Consultation Document (cited later) which implies through testimonial and anecdote a position of the National Assembly of Québec prominently in favour of the legalization of euthanasia and PAS.
[5] Jan Bernheim, Reginald Deschepper, Wim Distelmans, Arsène Mullie, Johan Bilsen, and Luc Deliens, “Development of palliative care and legalisation of euthanasia: antagonism or synergy?,” in Fiona Godlee (ed.), BMJ: British Medical Journal, Volume 336 Issue 7649, (London, UK; BMJ Group; April 19, 2008). Pg. 866.
Note: Bernheim et al submit that developments in palliative care and practices of euthanasia and PAS in Belgium during the 20^th century were driven by shared pioneering “workers.” (Pp. 864, 865).
[6] CBC News, “Doctor decries euthanasia bill,” in Blair Shewchuk (ed.), CBC News. (Canada, Canadian Broadcasting Corporation; Thursday, October 1, 2009). Pg. 1. Accessed at [ http://www.cbc.ca/canada/ottawa/story/2009/10/01/ottawa-euthanasia-bill-doctors-pereira.html ] on Thursday, June 10, 2010.
[7] Ibid.
[8] Jean Echlin, Death with Dignity or Obscenity? (Toronto, The deVeber Institute; 2009). Pp. 1-2.
[9] Stephan W. Sahm, “Palliative Care versus Euthanasia. The German Position: The German General Medical Council's Principles for Medical Care of the Terminally Ill.,” in H. Tristram Engelhardt (ed.), The Journal of Medicine & Philosophy, Volume 25 Issue 2, (Oxford, UK; Oxford University Press; April, 2000). Pp. 211, 212.
Note: Involuntary euthanasia is an instance of euthanasia being carried out against the wishes of a competent patient.
[10] Jose Pereira, Dominique Anwar, Gerard Pralong, Josianne Pralong, Claudia Mazzocato, and Jean-Michel Bigler, “Assisted Suicide and Euthanasia Should Not Be Practiced in Palliative Care Units.,” in Charles F. von Gunten (ed.), Journal of Palliative Medicine, Volume 11 Issue 8, (New Rochelle, NY; Mary Ann Liebert, Inc.; October, 2008).Pg. 1074.
[11] Paul Zeni, Compassionate End of Life Care for Adults with Developmental Disabilities, DVD, (Toronto, The deVeber Institute for Bioethics and Social Research, and L’Arche Toronto; 2009).
[12] Sharon Baker (Director of Palliative Care at London’s University of Western Ontario University Hospital/Health Sciences Centre), Telephone Interview. Interview conducted Monday, July 27, 2009.
[13] Ibid., pg. 1075.
[14] Ibid., pg. 1073; and, World Health Organization, “Palliative Care,” in WHO, World Health Organization Website. Accessed at [ http://www.who.int/cancer/palliative/en/ ] on Friday, June 11, 2010.
[15] Pereira et al, Pg. 1073.
[16] Séguin quoting Liberal MNA Geoffrey Kelley. Pg. 1.
[17] Select Committee on Dying with Dignity, Dying with Dignity: Consultation Document, (Québec, PQ; Assemblée nationale du Québec; 2010). Pg. 18. Accessed at [ http://www.assnat.qc.ca/media/Process.aspx?MediaId=ANQ.Vigie.Bll.DocumentGenerique_34839en&process=Default&token=ZyMoxNwUn8ikQ+TRKYwPCjWrKwg+vIv9rjij7p3xLGTZDmLVSmJLoqe/vG7/YWzz ] on Wednesday, June 16, 2010.
[18] World Health Organization, “Palliative Care.”
[19] Jean Echlin, "A dance of death," in John Coleman (ed.), The Windsor Star, (Windsor, ON; September 22, 2009). Pg. 4.

Oh Canada Rewrite

It seems that the buzz of Canada’s recently having hosted the 2010 Winter Olympic Games in Vancouver, and their magnificent success therein, has resulted in some excessively nationalistic flag waving and anthem singing. I love this country. There is so much about Canada that I hope I stand on guard for. Valuing life, protecting rights, and taking special concern for the protection of special interest groups. If you’ve followed this blog at all, it should come as no surprise to you that I am very pro-life. As much as I love this country, I think that Canada has missed the boat in a devastating way when it comes to preserving the rights of a most special interest group: the voiceless infant persons of our country.

That aside, during these Olympics, we heard the national anthem
Oh Canada, played probably more than it ever has been played in this country's Olympic history. It came to the attention of many that this inclusive and politically correct country maintains a politically incorrect national anthem. A Nova Scotia Chronicle Herald article (the URL for which linked in article title) described a new direction being taken by the Conservative Government vis-à-vis Oh Canada. The Government has decided to "examine the…wording of the national anthem," in particular, the phrase "in all thy sons command." The Government is "suggesting that a parliamentary committee examine the subject and report back to Parliament." The goal is to rewrite the lyrics of Oh Canada to include a more gender inclusive phrase.

I have no problem with determining a more gender inclusive phrase to replace the current wording of the anthem. In fact, I support the Government to that end. REAL Women of Canada, a socially conservative women’s lobby group, has a different opinion.
REAL Women requests that "Ottawa...address the real problems Canadians face, especially economic ones." To be sure, this has become a dialogue as complex as Canadian politics themselves.

I find this entire dialogue refreshing. As much as I enjoyed the spectacle of stadiums robed in red; ski hills and bobsleigh runs adorned by cowbell banging Canadians; and streets in every Canadian city replete with dancers celebrating glorious Olympic victory: I hope that thoughtful dialogue will never take second seat to red blooded, flag waving nationalism. As long as dialogues like this one – dialogues which hear and consider all positions – are afforded priority by the citizens of this country, and by this country’s government, I think we will not forsake our identity characterized by its unique values.

If you are unfamiliar with Canada’s anthem Oh Canada, listen to this powerful rendition provided by Montréal’s Nikki Yanofsky at the 2010 Vancouver Winter Olympics Opening Ceremonies in February.

Collège des médecins du Québec Proposes Legalization of Euthanasia

A recent statement from the Quebec College of Physicians proposes that euthanasia be included "as part of the appropriate care in certain particular circumstances."[1] Such a development would require legalization of euthanasia by amending the Canadian Criminal Code to distinguish euthanasia from homicide.

This development is deeply concerning given the possible outcomes of such a decision. Besides the obvious concern of legalization of euthanasia, another concern is that even the most rigid of so called safeguards can be side stepped. Legalization of physician assisted suicide, and specifically euthanasia in the Netherlands has led to many abuses. Also, the legalization of physician assisted suicide in Switzerland has resulted in such negative consequences as the practice of suicide tourism. Switzerland allows non-residents to receive physician assisted suicide frequently. Canadians are included among those non-residents who have solicited this assistance.[2] Granted, the Quebec College will attempt to propose safeguards to prevent such abuses when the College drafts its proposal due November. However, even with the presence of similar safeguards in the Netherlands and Switzerland, boundaries have been disregarded. This has been evidenced by prevalent instances of non-voluntary and involuntary euthanasia and suicide tourism respectively.

Euthanasia has been described by opponents as a process which puts the patient “out of our misery.” This statement pointedly implies that there are influences beyond the patient’s respective autonomy which prompt her or him toward a euthanasia decision. The Quebec College has proposed that the euthanasia procedure will only be practiced with the patient’s explicit consent. However, even proponents of euthanasia recognize that a patient’s decision is heavily influenced by those who surround her or him. Specifically acknowledged is the possibility of coercion toward euthanasia by the patient’s next of kin based on the patient’s perception of being a burden to those surrounding her or him.[3] The arguments motivating the College’s decision imply a supposedly altruistic solution during end of life care. However, if a patient is permitted the option of hastened death, and if their perception of the alternative to such a hastened death is being a burden to their next of kin, then the motivation toward euthanasia ceases to be altruistic and becomes a decision fuelled by coercion. What is billed as a “right to die” coerces the patient to assume a duty to die.

A significant argument presented by the College is the supposed presently occurring practice of passive euthanasia.

Sometimes, the pain is so unbearable that the amount of painkillers or analgesics used to control it can be fatal. And this, according to the Quebec College of Physicians, can be viewed as a form of euthanasia.[4]

This submission, however, may not be entirely informed. Examination of a patient’s analgesic doses at the time of death might lead one to conclude that a lethal dose had been administered. However, an overdose for a healthy individual does not constitute an overdose for a terminal-cancer patient. Terminal-cancer patients build up a tolerance to the analgesic and would thus require an intentionally excessive dose of analgesic in order to die from the analgesic. Such instances are rare. Even if such an overdose was accidentally administered, there remains an important distinction between accidental overdose, and euthanasia. The legalization of euthanasia will result in an end of life care system tainted by practices emphasizing the intent to kill. Contrastingly, in the very unlikely event of an accidental overdose, the intent is only to relieve pain.[5]

A London, Ontario based palliative care professional proposes an end of life care system where euthanasia would not even be desirable. Where appropriate palliative care is practiced – care which is multifaceted and draws upon the expertise of an interdisciplinary care team – the patient’s passing can be made easier and even “beautiful.” Many professionals in the field of palliative care recognize that strong attention must be paid to the patient’s every need. These needs are emotional, physical, psychological, and spiritual in nature. Where all of these needs are addressed by qualified professionals and family members, a patient is able to enjoy her or his last months, weeks, and days in this life. The desire to hasten passing may subside in light of how valuable this time of life remains.[6]

In instances where a terminally ill patient dies from causes other than her or his illness, dehydration and/or starvation are frequently the cause. Sometimes this occurs when a patient’s IV or feeding tube are removed because that patient is so close to natural death that sustenance becomes a burden to her or his failing body. However, there are other instances when a patient may be months away from a natural death, and sustenance is removed, thus hastening death via dehydration. The latter instance is an example of passive euthanasia. The legalization of euthanasia should be of great concern to palliative care patients as such a development might allow passive, involuntary, and/or non-voluntary euthanasia to be culturally acceptable. This has been the case in the Netherlands in spite of supposed safeguards.

A Foundational Medical Ethic is that of Proportionality, where the potential for good care outweighs the possibility of harm. Certain medical procedures inflict a degree of harm upon a patient, however, with the intent of an exponentially more positive outcome. The ethic of Proportionality is ignored in euthanasia because euthanasia is based on the assumption that hastened death is the ultimate good for the terminally-ill patient. There is no existing evidence which would indicate that the results of a hastened death are greater than those of a natural death. Ignorance of the ethic of Proportionality leads to an ultra-utilitarian approach to medicine where the proposition of a radical autonomy trumps the ethical framework and safeguards practiced by trained professionals. It is highly unfortunate that the Quebec College of Physicians should succumb to such radical demands.

Euthanasia contributes toward a culture of death, furthermore, it strips away the valuable last months of life for end of life patients. For this reason and others, Euthanasia should be viewed as a negligent, unethical, and uncaring attempt at treating end of life patients. If the solution to eliminating the patient’s pain requires eliminating the patient, then such a system should never be implemented. Should the euthanasia agenda advance at the hands of the Quebec College of Physicians, the patients of Quebec physicians will naturally lose trust in the medical profession. Already in the Netherlands, patients are advised to wear bracelets notifying medical professionals they do not desire euthanasia. In spite of such measures, however, prevalent occurrence of involuntary and non-voluntary euthanasia continues to plague the health care system in the Netherlands. Should Quebec physicians commence practicing active euthanasia “as part of the appropriate care,”[7] their patients may view the physicians as hanging up their care provider scrubs, and putting on the hooded, black cloak of executioner.

Definitions:

Euthanasia: The active, intentional termination of a patient’s life by a doctor who thinks that death is of benefit to the patient.

Active Euthanasia: The intentional taking of a patient’s life by a doctor who thinks that death is of benefit to the patient.

Passive Euthanasia: The cessation of medical treatment, hydration, and provision of sustenance with the intent of hastening death before natural causes would kill the patient.

Involuntary Euthanasia: Euthanasia carried out against the wishes of a competent person.

Non-Voluntary Euthanasia: Euthanasia carried out on incompetent patients such as babies or patients with dementia.

Assisted Suicide: The termination of a patient’s life by the patient through medication prescribed by a doctor.

Suicide Tourism: The travel of tourists to regions where euthanasia is legal with the hopes of receiving euthanasia.

Notes:

[1] Rhéal Séguin, “Quebec physicians tentatively propose legal euthanasia,” in The Globe and Mail, (Québec, Friday, July 17, 2009). Accessed at (http://www.theglobeandmail.com/news/national/quebec-physicians-tentatively-propose-legal-euthanasia/article1220196/)

[2] Ibid.

[3] J.M. Dieterle, “Physician Assisted Suicide: A New Look at the Arguments,” in Bioethics Vol. 21, No. 3. (Oxford, 2007), pp. 131, 139.
Note: Dieterle, a proponent of physician assisted suicide, acknowledged in this article the reality of a patient being pressured into choosing physician assisted suicide.

[4] Séguin.

[5] Elizabeth Cassidy, Barrie deVeber, Frank Henry, and Ian Gentles, “As Life Ends: Professional Care Givers on Terminal Care and Euthanasia,” in Ian Gentles (ed.), Euthanasia and Assisted Suicide: The Current Debate, (Toronto, 1995), pp. 52, 53.

[6] Drawn from telephone interview with Dr. Sharon Baker (Director of Palliative Care at London’s University of Western Ontario University Hospital). Interview conducted July 27, 2009.

[7] Séguin.

It's Been a Long Time...

I am disappointed in myself for not having created a new post in almost a year. I’ve been working very steadily in my new academic surroundings as a student at Toronto’s Tyndale Seminary. It’s been a very full year, accompanied by many new developments. Oh so much to talk about. I took a very heavy course-load. I probably wrote something in the neighbourhood of thirty essays. Don't worry though, I’m not going to post my boring essays on this site. However, there are so many more pressing issues which I’ve come across that I want to cover. Hold fast.

Activism

Activism…yet another broad discussion topic which I'm attempting to address with one short post. I think, however, that the way by which I arrived at this topic is fairly interesting, so please read on.

Over the weekend, my brother Derek; his girlfriend Alison; and I decided to take a day trip to beautiful Port Huron, Michigan, USA (pictured above). For those that don't know anything about Port Huron, not to worry. Simply put: Port Huron is a small industrial and semi-tourist town located near the USA/Canada border on the west bank of the St. Clair River opposite Sarnia, Ontario, Canada. It’s actually quite a scenic spot during the summer months. When my brother called me last week to talk about going over there for the weekend, he mentioned that Port Huron maintains several museums and boasts a rich history. It was at that point where the wheels in my head started turning as I began to remember a small piece of Port Huron’s history which I had retained from a while back.

I recalled a few history lectures I had at university where my professor had mentioned The Port Huron Statement. My family has a history of making quick day trips over to Port Huron (it’s about an hour’s drive from our house) so even at the time of first hearing about this statement, I remember being fascinated by it. However, hearing my brother mention Port Huron’s history further intrigued me to look deeper into something which I had all but forgotten.

The Port Huron Statement was written during a student retreat in Port Huron in 1962 by a group from the University of Michigan. This group represented a nationwide organisation called Students for a Democratic Society (SDS), which in turn contributed to an even larger development called the Student Movement. The Statement, which quickly became a manifesto for the Student Movement, encouraged egalitarianism and participatory democracy. It portrayed 1960s America as being undemocratic, militaristic, and bureaucratic.[1] After recently rereading the Statement, I realised that I don’t fully agree with all of the methods which it proposes, as some of them were quite radical, and in fact, over the top. However, a lot of what SDS proposed, I find very intriguing. For instance, SDS was very optimistic in its desire to establish a new community in which no group would suffer from isolation, want, or alienation.[2] All of the prominent social issues of 1960s America greatly disturbed the predominantly white students of SDS, and spurred them onto activism.[3]

As I revisited my notes about The Port Huron Statement and SDS, I couldn’t help but be impressed by those students’ motivations, convictions, and actions. As a result of having my interest piqued, I’ve recently been motivated to look into more examples of activism in our own country’s recent past. What immediately sprung to mind was the Women’s Christian Temperance Union (WCTU) which was founded in 1875. Interestingly, the WCTU was the first Dominion-wide, non-denominational women’s organization in Canada.[4] During the late 19th and early 20th centuries, the WCTU was convicted by the heavy consumption of alcohol and the prevalence of alcoholism in Canada, and sought to limit the largely unregulated and rampant distribution thereof.[5]

A more recent and perhaps more gripping example of activism as a result of conviction which I have become aware of is that of Greg Paul. Greg Paul is the founder and director of Sanctuary Ministries of Toronto, and furthermore, the pastor of the Sanctuary community: a charity and ministry to the homeless and destitute of Toronto. Greg Paul has dedicated his life to serving this community, and although he would never boast as such, he has humanly done more for them than most working in his field. Greg claims that the process which allows his success is also his greatest struggle: the action of picking up his cross. Greg explains this process as denying the enticement this world provides; confessing our deepest and ugliest shortcomings to the Lord; and following the teachings of Christ so as to become Christ-like.[6] It's a painful and arduous process, however, it's so deeply rewarding, and only in so doing are we able to achieve anything we’ve been called to.

All of this research has furthermore prompted me to ask questions directed mostly towards myself; questions such as: what am I doing today to be active? By that I mean; is there anything which convicts me to the point of action? Are all the battles already won? I don't think so. I know that there are many issues today which need be addressed, and as a Christian, it's only natural that I believe we approach these issues as collective Christians. It's time for us to wake up and take up our mutual crosses.

An organisation that is very present and very active today, that strikes me as one which daily takes on the task of carrying its cross is the National Campus Life Network (NCLN). NCLN exists to “educate, network and support post-secondary pro-life students across Canada to take the pro-life message to their campuses…work[ing] to maximize the promotion and effectiveness of the pro-life message on campus…”[7] Representatives of the NCLN from across the country toil to inform concerned students within their respective regions of the issues facing the pro-life movement today. I am fully aware that for many the abortion debate is very controversial, and furthermore one which results in polarisation. That said, the pro-life movement is very important to me, and it's an arena (among many others) which I believe Christians need to become more active in.

I'm sure that by now you're aware of the recent developments resulting in Dr. Henry Morgentaler being inducted into the Order of Canada on Tuesday, July 1.[8] While many believe the Order of Canada has long lost all credibility as a result of the perpetual induction of undeserving individuals, the NCLN took the approach of preserving the prestigious honour by protesting the induction of Morgentaler, a position which I agree with. When I received the NCLN update concerning Morgentaler, for the first time in my life, I actually contacted a politician over an issue which convicted me. Well, in all honesty, I didn’t contact any specific politician; I merely emailed the Prime Minister’s Office (PMO). A couple days after having done so, I was pleasantly surprised to see that a person actually wrote me back (as opposed to the typical automated response). Unforunately, the representative of the PMO informed me that I wrote the wrong office, and that appointments of inductees to the Order of Canada is an issue entirely outside of the Prime Minister’s influence. Interestingly, however, that representative added, “With respect to specific appointments to the Order, the Prime Minister's preference is for the Order of Canada to be an honour that unifies and brings Canadians together. Clearly, this appointment did not do that.” Call that response what you will, it may sound like nothing more than appeasement, but I was happy that a person actually wrote me back! I’m not trying to boast that I did anything spectacular, after all, I wrote the wrong office, but I have to admit, there was a feeling of fulfillment after sending off that initial email.

Working in ministry, I find I'm always walking a fine line between acting upon my conviction, and becoming too political, but I think there's a balance. Furthermore, what I'm about to suggest is as much directed towards myself as it is towards you, as I too have a lot to learn about getting involved. Some of the steps towards convicted and informed activism which I'm trying to implement into my own life are as follows:

Vote:

I believe democracy is a great privilege, and voting is the most basic way to exercise democracy. I encourage you to do it. Inform yourself on the issues, and vote as you feel led. As you become more informed, you could voice your concerns to your local representative at any level of government.

Work within your gifting and skill set:

I believe that God has blessed each individual with gifts that are unique to them, exercise them, practice them, and develop them.

Pray:

I’m mentioning this one last, but I’m doing it for the sake of emphasis! It’s the most important thing we can do in all of this. It should be what we do first, and constantly throughout any action we take. The above two suggestions should only be exercised after thorough prayer, and throughout the entire process, continue to devote your actions and words to prayer. Pray for those that are in leadership, that God would direct them. Ultimately, in all of the concerns we act upon, it’s important to realise that none of this is hopeless. God has a long term plan…a very long term plan. Have faith in Him, and trust Him to fulfill that plan.[9]

So, you may have noticed that we're not in Port Huron anymore, furthermore, you may feel that all of this is pretty basic stuff, but for me it's been a good reminder. I believe that activism is a word which describes something we've been called to. Activism is acting upon the conviction which the Holy Spirit has placed within you. It's entirely Scriptural; it's seeking God’s justice. One of my favourite passages describes very well what that means for a Christian; “Seek Justice, encourage the oppressed. Defend the cause of the fatherless, plead the case of the widow.”[10]

I encourage all of you to follow the above passage. Act upon the scripturally motivated convictions you feel God has placed within you. I’m hoping to do the same. One up me, and make sure you don’t email the wrong person.

[1] Alexander Bloom and Wini Breines (eds.), “Beginnings,” in “Takin’ It to the Streets”: A Sixties Reader,

(New York, 2003), pp. 49, 50
[2] SDS was particularly distressed by the ongoing violence and discrimination expressed by whites towards African Americans. SDS believed that it was their responsibility to reverse the trends which their parents, grandparents etc. had established.
[3] Alexander Bloom and Wini Breines, pg. 50

* SDS was inspired by the results they had witnessed achieved by the predominantly African American organisation; Student Nonviolent Coordinating Committee (SNCC), pg. 51
[4] Janene Pasierbek, The Women’s Christian Temperance Union: 1880-1920, (London, 2008), pg. 2
[5] Pierre Berton, Marching As to War: Canada’s Turbulent Years 1899-1953, (Toronto, 2001), pg. 100
[6] Greg Paul, God in the Alley: Being and Seeing Jesus in a Broken World, (Colorado Springs, 2004), pp. 73-75
[7] Accessed at:

http://www.facebook.com/group.php?gid=2376571702
[8] Cassandra Drudi, “Morgentaler inducted into Order of Canada,” The National Post, Wednesday, July 2, 2008, accessed at: http://www.nationalpost.com/news/story.html?id=625346
[9] Kevin Michael McKeehan and Michael Tait, Under God, (Minneapolis, 2004), pg. 371
[10] Isaiah 1:17, The Bible, New International Version,

(Grand Rapids, 1973)

Contagious

I'm working with an amazing team at Royal View Church this summer. All of the guys are great to be around. We often get into some interesting discussions and as a result we've all taken up the very contagious hobby of blogging! The guys all have something unique, albeit equally important to say. You can see their blogs in the section in the right margin of this page entitled "Further Reading." I encourage you to check them out!

I Gotta Have Faith

I want to talk about faith. Specifically, I want to talk about the action of faith. That is, the action of practicing faith, as opposed to Faith as a noun. In reality, the action of Christian faith and the noun of Christian Faith are not in opposition to each other. The reality is that they have to work in tandem with each other, and are similar enough to share a name. However, for the sake of this post, I wish to focus on the practice of faith.

So you may be thinking that faith is a pretty broad subject to address in one post. I am fully aware that there are volumes and volumes of studies that have been written and documented on the practice of faith. So this probably raises the question: what do I intend to accomplish with a post such as this? Obviously I can't wax eloquent as so many others have, and I don’t intend to. My goal is to share what I’ve learned recently in my own endeavours to practice faith.

I find it interesting that some consider faith to be very whimsical, in the sense that they consider it to be limited to putting weight in something abstract and intangible. This is simply not a true definition of faith. While the Bible does describe a child-like faith,[1] thus seemingly implying naïvety, the faith which Christ was describing in this instance is not naïve, and furthermore, is so much more than uninformed, wishful thinking.

“Now faith is being sure of what we hope for and certain of what we do not see. This is what the ancients were commended for. By faith we understand that the universe was formed at God's command, so that what is seen was not made out of what was visible.”[2]

Sureness, certainty, commendation, understanding.

The above passage has for a long time been a comfort to me. It is a quote which has often reaffirmed where/in whom I place my belief. The above passage is describing faith; however, it's specifically describing one aspect of faith, the action of belief.[3] Belief can be separate from the practice of Christian faith; however, faith cannot be separate from belief. I believe in God, specifically, the God of Israel. I furthermore believe that Jesus, His Son, is God. I believe this because of the evidence for Jesus (eyewitness, documentary, corroborating, scientific, psychological, medical, and circumstantial evidence – all of which I hope to write about at some point).[4] I believe all these things, however, faith takes it that next step. Understanding the evidence for Christ is one thing, and it is entirely necessary, however, I believe God calls us to take our faith to the next level by employing trust. We need to trust that the Lord will fulfill the promises he has made for us: we need to trust the Lord to be true to His Word.[5]

C.S. Lewis was a prominent intellectual mogul of the 20th century, and furthermore, one of the most prolific Christian authors of his era. In terms of articulating the practice of faith, I believe that none (outside of Scripture) capture its essence better than he; “Now Faith…is the art of holding on to things your reason has once accepted, in spite of your changing moods. For moods will change, whatever view your reason takes.”[6] As earlier described, the practice of Christian faith is often criticised as being flighty. The impression I got from Lewis, however, is that faith is the exact opposite. Lewis describes our reason as being wishy washy, and faith as being separate from emotion. In a sense, Lewis means that we practice faith by making an informed decision, and regardless of what our “reason” tells us down the road, we maintain our established beliefs. That said, Lewis makes very clear that whatever changes we may encounter, they are usually those of a more personal nature, and “any real new reasons against Christianity [which may] turn up…have to be faced and that is a different matter.”[7] I agree with this position, however, I might add that in all the years that Christianity has been challenged, it remains a widely regarded, practiced, and prominent Faith, a Faith which I believe to be true.

One thing that I have not addressed in this post is, in spite of all the “description” I provide of the practice of Christian faith, it is something which really remains indescribable. In my own experience, there is something that is, in fact, very abstract about it. However, my belief is that it is the Holy Spirit’s role (among many others) to provide the peace and direction to maintain such a peculiar practice. That, however, is another discussion altogether, one which I will save for another time.

[1] Mark 10:15, The Bible
[2] Hebrews 11: 1-3, The Bible, New International Version, (Grand Rapids, 1973)
[3] The above passage as displayed is isolated from the rest of the chapter, and furthermore from many other Biblical passages pertaining to the practice of faith. I recommend, if you have not yet done so, to read Hebrews 11 in its entirety.
[4] Lee Strobel, The Case for Christ: A Journalist’s Personal Investigation of the Evidence for Jesus, (Grand Rapids, 1998), pg. 67
[5] Kenneth Brighenti and John Trigilio Jr., Catholicism for Dummies, (Indianapolis, 2003) pg. 47
[6] C.S. Lewis, Mere Christianity, (New York, 1952), pg. 140
[7] ibid.