WATCH | James Buhagiar: ‘Church should have active role in assisted suicide process if enacted into law’

Humanists Malta Chairperson James Buhagiar believes the church should have an active role in the assisted dying process should it be enacted into law.

Buhagiar says the church has “good values and man power”, and so its spiritual guidance should be available to those going through the assisted suicide process.

His view provides a different perspective to the debate on voluntary assisted euthanasia, sparked by the public consultation process on the subject unveiled by the government.

The consultation document makes clear that euthanasia will not be available to individuals with disabilities, mental health conditions, age-related illnesses such as dementia, or those experiencing social isolation in care homes. Patients must be over 18, have been resident in Malta for at least 12 months, and must personally request assisted dying. Doctors will be prohibited from suggesting the option to patients.

Buhagiar tells me that chaplaincy services must be made available to patients seeking assisted suicide, saying they would be providing spiritual and moral guidance in such an important decision.

In his eyes these chaplains, who are trained to assist people of different faiths, would be part of a wider team which could include professionals like social workers.

“When we are debating assisted dying, we should not look at it only from a medical perspective, but also from a social perspective, and there should be a team of multidisciplinary people who accompany the person from their initial considerations on assisted dying to their final days,” he says.

Buhagiar even claims that in some countries, once good chaplaincy services are provided, the rate of people going through with assisted dying actually went down.

The NGO head stresses the importance of a living will, saying it will help patients, their families and professionals during the difficult time. He says a living will would help patients make a clearer decision and would ensure the person’s dignity is protected.

On palliative care, which has regularly featured in public discussions on assisted dying, he says retaining high quality care lies in the amount of investment the country’s authorities are willing to make.

Buhagiar says the NGO agrees with increased investment in palliative care, but one has to acknowledge that sometimes not much more else can be done.

“We have to protect the person’s dignity when living,” he tells me.

I ask whether such a law could end up being used by vulnerable sections of society but Buhagiar insists that is something only society can determine. “Maltese society’s track record is one of compassion. We have always helped each other, and assisted dying will not change anything,” he insists.

The following is an excerpt of the interview.  

Follow the full interview on maltatoday.com.mt and our socials. 

What does it mean to be a ‘humanist’?

I believe in some way or another everyone is a humanist. As an NGO we look at human rights in their various forms from a secular perspective, and abide by no specific dogma.

Obviously, we prefer to look at science instead of some rigid dogma, but it’s not the only thing we look at. We actually work a lot with people who hail from a religious minority, and became themselves victims of abuse and human rights breaches.

Before the interview you were speaking to me about the lack of chaplaincy services being considered in this public consultation. Can you elaborate on this?

By chaplaincy we are referring to that moral and spiritual guide which is accompanying you throughout your life. We face moments where life is difficult no matter who you are, and during those moments you find chaplains of a religious nature which accompany you. We did not find non-religious chaplaincy in our lives because it was not made available to us.

When we are considering assisted-dying, we should not look at it only from a medical perspective, but also from a social perspective, and there should be a team of multidisciplinary people who accompany the person from their initial considerations on assisted suicide, to their final days

[…]

I don’t want to see a humanist chaplain, or a Muslim chaplain, but a universal chaplain. You could have a catholic priest, but as an individual he would be trained in chaplaincy, specifically for these situations, and would still be able to accompany the person in their journey.

There are statistics, for example in Belgium, which show that when this service is offered in a good way, you even have people who choose not to follow through or delay assisted euthanasia.

People who suffer from degenerative diseases like ALS sometimes see their body deteriorating over a very long period of time. The law does not cater for these kinds of diseases; should the option of assisted suicide be made available to them?

I believe we should have a serious debate on these realities, and to which extent we want to take it.

As humanists we have always insisted there should be policies which are so good that they can cater for these realities with the assurance there would be no abuse.

People who speak against euthanasia are a lot of times afraid of the ‘slippery slope’. That is why I have always insisted there should be a debate which includes everyone. Who can tell you about ALS if not people who suffer from ALS right now? Who better to speak to us if not the professionals who work with ALS patients? Let’s consult them.

People who are deciding whether or not to go for assisted suicide are in a very difficult situation. They are in a state of anxiety, sadness and maybe are not thinking straight. We speak on how assisted suicide is a personal decision, but in that state, can you really take such a decision?

I think one has to start speaking about and discussing their specific case at the early stages, and help make an informed decision when you reach that point. In that moment of pain and fogginess, you might not take the best decision. That is why there is a need of chaplaincy, social workers and other professionals apart from the medical team. They will help inform and guide you in your decision.

Palliative care has become a major part of the conversation about voluntary euthanasia. There are some who argue that when assisted suicide is introduced, the quality of palliative care will go down. What are your thoughts on this?

I am a big fan of palliative care, and humanists agree with me. The problem is we are dividing and splitting the two. That does not make sense.

On these claims that palliative care quality has decreased in countries where euthanasia was introduced, I think the way the respective country is led and governed has a lot to do with this. It depends how serious the country’s policies are.

There are countries which saw their palliative care improve immensely when euthanasia was introduced. What I want to insist on is that investment must continue. But we must also acknowledge that no matter how much you invest, you can arrive to a point where there is nothing else you can do.