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One of Canada’s prisoners of conscience, Mary Wagner, in a moving letter from her Vanier Centre cell, writes of her concern that many members of our Christian medical associations, “despite their earnest desire to resist doctor-abetted suicide, have succumbed to defeatism.”

She points to several signs of this defeatism, including the following: their willingness, as expressed in a Proposal last year to the Canadian Medical Association, to discuss “all legal medical options” with patients, and to provide information on how to access State mechanisms for assisted suicide and terminal sedation; their acceptance of patient autonomy as a controlling principle in medicine, even where it contradicts both the law of God and the good that medicine is supposed to serve; their collaboration in the use of euphemisms such as “medical aid in dying” or “physician-assisted death,” where suicide or murder are actually in view; and their retreat to a concern with conscience protections for physicians, and other forms of harm reduction, instead of mounting a determined resistance to State-sponsored killing.

I’m not sure that Mary is entirely fair to these associations, or that she has a full grasp of the principles, circumstances, and strategies in question, though I won’t try to offer my own analysis of the Proposal. I will only note, in case you are wondering, that it does draw a clear line in the sand between informing the patient of all legal options and referring the patient for an option that, while legal, is most certainly immoral. It roundly condemns the latter as cooperation with evil, while Mary’s letter condemns the former as well.

Many outsiders, including some who should know better, protest that they find the two positions difficult to distinguish. If a doctor refuses to refer, he may as well refuse to inform also; either way, he should lose his licence. But let us set that aside, along with insider debates about formal and material cooperation – Mary herself seems a bit confused on this – and where culpable forms of cooperation begin. What I want to underline is her point that language matters.

She is absolutely right: To join the State in calling assisted suicide, never mind the killing of another person by abortion or terminal sedation, a medical option, just because it is overseen by a doctor or paid for out of a healthcare budget, is already a defeat. Likewise when we get in the habit of substituting “death” or “dying” for “suicide” or “killing.”

Does this defeat, as she suggests, smack of defeatism? Could it be that, deep down, we think real resistance futile? That we are therefore settling, quite half-heartedly, for a mere show of resistance and a manageable, self-serving compromise while things continue to run their barbarous course? I fear that it may, and that some of us are.

Do I think it a mistake, then, to concern ourselves with conscience rights? Of course not! That is something we must do, lest the State make further progress in suppressing and corrupting consciences. I’m sure Mary agrees. She, after all, is a prisoner of conscience, and has been for many a long year. But what she is worried about is that we are more concerned with protection of conscience rights, and other such legal or professional manoeuvres, than we are with protecting lives. That we are more engaged with harm reduction strategies than with strategies to overcome evil with good. That we are more focused on saving ourselves than on actually taking a stand against the culture of death.

“Our Lord,” she writes, “gives us the grace to carry out the mission entrusted to us. He does not call us to defeatism, moral compromise, to the dismal task of harm reduction or to save ourselves.” In other words, He gives us the grace, if we will receive it, to live dangerously for the sake of the gospel.

Mary Wagner knows something about that. She has been undertaking, at great personal cost, what Martin Luther King Jr, in that famous letter written from another cell, called “the creation of tension” that is “part of the work of the nonviolent resister.” She has been doing this, however, not in the spirit of King’s “gadfly” but in the same spirit that animates Fr Ibrahim Alsabagh of Syria, to whom she alludes in her letter – bringing the fragrance of Christ into places where carnage presently reigns.

And now she is telling us that we do not need a more or less honourable truce with the culture of death. Indeed, that there can be no such truce. (As Elrond said to Glóin, “There is naught you can do but resist, with hope or without it.”) That what we need is a firm commitment, come what may, to the culture of life. Which means that we, too, must be prepared for civil disobedience, and for its costs.

Douglas Farrow is Professor of Christian Thought at McGill University and the author of Desiring a Better Country.

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