Assisted Death – Normalizing Killing In Palliative Care

According to the  World Health Organization’s (WHO) definition

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care…affirms life and regards dying as a normal process…intends neither to hasten or postpone death…. [1]

Traditional palliative care provides assistance to the dying, without being overly concerned that one’s attempts to minimize distress may lead to an earlier death. Yet, the intent is not to deliberately shorten the person’s life.

That is until now.   It looks like the proponents of assisted death hope to rewrite the definition of palliative care.  The supreme court case, Carter vs Canada,[2] focused on the criminal code’s prohibiting of assisted suicide.  The definition of suicide is  the act of taking one’s own life voluntarily and intentionally.  Assisted suicide is when a person helps another person, who desires to die, to kill them selves.  The legislation and judgements that the Carter decision references seem to refer to “assisted suicide”  but the Carter decision goes a step further.  What the judges propose is no longer suicide. They propose that a physician or nurse practitioner take the active step to bring about death.  This is not suicide.  It is legalized killing.   What they propose is like suicide, for those killed are to clearly consent to being killed.  But they can legitimately avoid the distasteful term “suicide,” for the proposed killing by doctors is technically not suicide.  They also avoid the distasteful word “killing” opting for the more ambiguous terms “dying” and “death.”  The writers of Canada’s bill C-14[3]  take the same approach.  They use wording that has been part of traditional palliative care, calling this killing Medial Assistance In Dying.  The problem is  palliative care does provide assistance with dying and even with death.  Traditionally, this assistance, rather than intending to shorten life, has been primarily meant to provide comfort and relief from distress.   Now, the assistance of doctors and even nurses in palliative care is being redefined to include actively ending (killing) their patients lives.

Society seem ready for this redefinition of palliative care.  I wonder how long it will take the WHO to change their definition as well.

The definition is not only being broadened to include killing of the dying but to also include the killing of those not imminently dying but who perceive themselves to be suffering with no other way out. (to have a grievous and irremediable medical condition)

If our time on this earth is all there is then, when life becomes hard, suicide (or death) makes sense.  But what if there is more to life?  What if there is life after death?  What if it is true that once we die we have to give account of the life we have lived on this earth?  The Bible teaches, once we die we face judgement before the Lord our maker. (Hebrews 9:27)  It also teaches that we are not to take the life of another person. (Genesis 9:5–6)[4]  What if the following words about what is to come, written by the apostle John, are true?

Then I saw a great white throne and Him who sat on it, from whose face the earth and the heaven fled away. And there was found no place for them. And I saw the dead, small and great, standing before God, and books were opened. And another book was opened, which is the Book of Life. And the dead were judged according to their works, by the things which were written in the books….Then He who sat on the throne said, “Behold, I make all things new.”… And He said to me, “It is done! I am the Alpha and the Omega, the Beginning and the End. I will give of the fountain of the water of life freely to him who thirsts. He who overcomes shall inherit all things, and I will be his God and he shall be My son. But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.” (The Revelation of Jesus Christ 20:11-12, 21:5-8)

What if the proposed taking of life is murder in the eyes of the Lord God, our maker?  Is this a warning not to redefine palliative care and, instead, to do a better job assisting the dying to die well in preparation for their time to stand before the Lord God, their maker?


[1] World health organization`s (WHO) definition of palliative care found at
on May 18, 2016. I have included the definition below, anticipating that even the WHO’s definition of palliative care may change.

[2] Carter v. Canada (Attorney General), 2015 SCC 5, [2015]

[3] Gov of Canada Bill C-14, first reading″>Gov of Canada Bill C-14, first reading (as of Feb 17, 2019, this site was not available as https)

[4] Surely for your lifeblood I [the Lord God] will demand a reckoning; from the hand of every beast I will require it, and from the hand of man. From the hand of every man’s brother I will require the life of man.  Whoever sheds man’s blood, By man his blood shall be shed; For in the image of God He made man. (Genesis 9:5-6)


WHO – Definition of Palliative Care

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:

  • provides relief from pain and other distressing symptoms;
  • affirms life and regards dying as a normal process;
  • intends neither to hasten or postpone death;
  • integrates the psychological and spiritual aspects of patient care;
  • offers a support system to help patients live as actively as possible until death;
  • offers a support system to help the family cope during the patients illness and in their own bereavement;
  • uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
  • will enhance quality of life, and may also positively influence the course of illness;
  • is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

WHO Definition of Palliative Care for Children

Palliative care for children represents a special, albeit closely related field to adult palliative care. WHO’s definition of palliative care appropriate for children and their families is as follows; the principles apply to other paediatric chronic disorders (WHO; 1998a):

  • Palliative care for children is the active total care of the child’s body, mind and spirit, and also involves giving support to the family.

  • It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.

  • Health providers must evaluate and alleviate a child’s physical, psychological, and social distress.

  • Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited.

  • It can be provided in tertiary care facilities, in community health centres and even in children’s homes.


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