The panel handed off its recommendations for regulating doctor-administered death at the provincial level early in December. It recommended wider access to assisted suicide.

Sr. Nuala Kenny said she was guided by a passage of St. John Paul II’s pro-life encyclical Evangelium Vitae as she worked to protect conscience rights of doctors and Catholic health care institutions and to limit harm to the vulnerable in the panel’s recommendations.

In paragraph 73 of Evangelium Vitae, the pope addresses how Christians should respond to an unjust law that promotes either abortion or euthanasia. To vote for or promote a law which limits the damage when an outright ban is not politically or legally possible is the duty of Catholics who have exhausted all other alternatives, he said.

“This does not in fact represent an illicit co-operation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects,” said Pope John Paul II.

On protection of conscience for doctors and Catholic institutions, Kenny fought for a recommendation that provinces set up a central referral agency that performs assessments for all forms of end-of-life care.

Doctors who object morally to any involvement in deliberately killing a patient can refer patients who request assisted dying to that agency. The agency would perform assessments and help patients access whatever form of care is most appropriate.

Kenny likens the system to the patient navigator agencies for cancer now operating in most provinces. The result of such an assessment would not be pre-determined as medically assisted dying. Such assessments may also result in palliative care at home or hospice care.

“The problem, of course, is going to be the advocacy like mad now to make sure that every province has this resource, and the resource is a full resource for all end-oflife care options,” Kenny said.

Such a system also fulfils the moral obligation of doctors not to abandon their patients because they disagree over the course of treatment, said Kenny, who was once head of medical education at the Hospital for Sick Children in Toronto and founder of the department of bioethics at Dalhousie University in Halifax.

Protection for the vulnerable — the poor, those less educated, people whose first language is not English or French, the intellectually disabled, those with dementia — is much more difficult to address in regulation, Kenny said. It’s a matter of day-today clinical practice that must be carefully monitored.

“If you’re going to have this egregious practice of assisted death, for God’s sake somebody has to regulate it. Somebody has to monitor it,” she said.

To oppose a solution that allows Catholic doctors to work with a third-party assessment agency could have far-reaching implications, Kenny said.

“The wrong way (to oppose euthanasia) would be to hold to a standard that is so rigid that really what it means is... that people of Christian, Catholic faith can’t practice medicine,” she said. “This is not a compromise that is morally compromising.”

If there’s anything positive Catholics can do at this point, with the Supreme Court ruling in place, it’s to push hard for more and better-funded palliative and hospice care, said Kenny, “Or people don’t have any meaningful options.”

Participating in a panel where she was the only member who wasn’t an enthusiastic supporter of the new legal regime was far from easy, Kenny said.

“This is one of the most difficult things I’ve ever done in my life,” she said. “It took me a while to actually understand that if nothing was done by Feb. 6 of this coming year, 2016, we would have in Canada the most liberal, if we want to use that language, assisted-death regime in the world. It has nothing to do with terminal illness. It has nothing to do with end-of-life care.”

Many Catholics Kenny speaks to seem not to understand that the Supreme Court’s ruling to allow assisted suicide is now the law of the land and no delaying tactic will change the basic law.

“I’m totally opposed to assisted death, both as a Christian and as a physician. I think this is a horrific thing that’s happened to medicine,” said Kenny.

“But we don’t live in a Christian world any more.”

Kenny hopes Catholics will find a positive way of witnessing to their faith in medicine and in politics.

“Our biggest problem as Catholics, my boy, is that Catholics don’t understand that this is wrong.”