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Facing the pastoral challenges of euthanasia

30 April 2023 By David Guretzki

How should pastors respond to parishioners who choose medical assistance in dying? EFC president David Guretzki says it's time to figure that out.

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In recent months I’ve had urgent conversations with pastors who’ve been asked to be in the room with those receiving medical assistance in dying (MAiD). Should they join congregants or others? Or should they decline?

Pastors, spiritual caregivers, chaplains and mental health providers all have pressing questions about what to do when someone they’re caring for requests assisted death, or even what guidance to offer church members who might be walking with a loved one who is making that choice.

As hard as it is to fathom that these issues are even being considered, pastoral caregivers are going to be pressed to clarify how they will respond as MAiD expands even further.

The government planned to extend MAiD to people with mental illness alone in March 2023. Pressure from mental health, religious and disability groups thankfully helped pass a federal bill to extend the deadline one year. But make no mistake – March 2024 will come quickly.

Or what about the contentious issue of expanding MAiD to so-called mature minors, persons under 18 deemed sufficiently mature enough to make their own decision without their parents’ or guardians’ consent? What role will pastors play in this intractable situation?

Medically assisted dying creates a crisis for families left behind after an individual opts for it. Yet we’ve barely begun to discuss the impact MAiD is having pastorally.

facing the pastoral challenges of euthanasia


From a pastoral perspective, it’s relatively obvious how best to help dying and grieving people at the natural death of an elderly person, death by terminal or chronic illness, the premature death of an infant or child, a heart-rending death by accident or tragedy, and even death by suicide.

However, when someone dies by euthanasia or assisted suicide, there are no safe assumptions about how family and friends view the death. For some it will be a moral tragedy while others might feel comforted their loved one ended their life on their own terms. Spiritual caregivers are left in a perilous position – What kind of comfort does this death require?

The reality of MAiD is forcing us as theological, denominational and pastoral caregivers alike to think through how we will navigate the situation well – before we are called to do so. The best time to make these moral and practical decisions is not in the moment. We need to work out in advance how we will respond both to individuals and their families.

Questions also extend to pastoral practices in the days and hours leading to the death of a person who opts for MAiD. What should a caregiver say to a person contemplating MAiD? Should they seek to persuade them otherwise? Hold their moral tongues? Or are there other responses we haven’t yet contemplated?

Theological ethicists disagree on the moral acceptability of accompanying someone to the point of their arranged death. Pastors need to wrestle with that question. The Roman Catholic Church, for example, instructs pastoral caregivers not to accompany persons opting to have MAiD during the actual procedure because doing so is viewed as a form of moral complicity with a sinful act.

My moral conviction is that any intentional ending of a person’s life apart from divine permission is a form of murder. That aligns to how Canada’s law was worded prior to 2016.

Even though pastors aren’t the ones carrying out the procedure, they will need to answer, before God and their flocks, whether their presence is a form of permission or blessing to the person opting to have their life ended.

We need to work out in advance how we will respond both to individuals and their families.

I can accept others may come to different conclusions on this delicate point. But I believe spiritual caregivers need to resolve this issue in their hearts and minds. Better to resolve it long before being called to do it.

Incidentally, there is also emerging evidence of the moral injury that occurs to pastoral caregivers (not to mention medical personnel) present when someone’s life is intentionally ended. Some have spoken out on the moral and psychological trauma they’ve experienced.

We must consider the significant difference between being present at a person’s natural death and present when a person’s life is intentionally ended.

I do not envy the theological and moral stresses pastors are facing on this relatively new theological, moral and pastoral issue. Denominations, theologians and pastors need to face it and provide guidance, especially as more and more churchgoers opt to take this route.

That means not only tackling the question when faced directly with their involvement, but also how pastors will approach this in their teaching and preaching with their congregations.

I pray we’ll be able to work together to bring much-needed guidance to these daunting questions.

david guretzki
David Guretzki is the EFC’s president and CEO. Read more of these columns at

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