Position Statement on Medical Assistance in Dying (MAiD)

Position Statement on Medical Assistance in Dying (MAiD)

The Prayer Book Society of Canada (PBSC) is deeply concerned by the rapid expansion in our country of “Medical Assistance in Dying” (MAiD), which is one of the world’s most permissive and fastest-growing euthanasia programs.  The leadership of the Anglican Church of Canada has taken the position that attempts to oppose MAiD would be ineffective, and that the church should rather focus on pastoral care.[i] However, the pastoral care that is being put forward actually embraces complicity in MAiD, as we explain below.

As a Society, we look to the established doctrine and discipline of the Anglican Church of Canada as enshrined in the 1962 Book of Common Prayer to determine a faithful Anglican response to those who are considering ending their own lives. The introductory rubric to the Order for the Burial of the Dead provides crucial guidance for Anglicans seeking to discern such a response. It states that the office “is not to be used for any that die … by their own wilful act while in a sound state of mind” (BCP, p. 591). (This is a softened and nuanced revision to the original 1662 rubric that forbade Christian burial in this form to any who “have laid violent hands upon themselves”.[ii]) The amended Canadian rubric is a pastorally sensitive acknowledgement that many who die by suicide are mentally ill, intoxicated or otherwise not “in a sound state of mind” when they take their own lives. Yet the Prayer Book is clear: a “wilful” act of suicide while “in a sound state of mind” is condemned as sin – although not necessarily unforgiveable – in keeping with the consensus fidelium of the one, holy, catholic and apostolic Church.[iii] According to this consensus, suicide is intrinsically immoral, since it is an egregious violation of the threefold command of love (love of God, love of self, love of neighbour).

With MAiD becoming so commonplace in Canada,[iv] many people are doing precisely what the Prayer Book condemns: wilfully choosing, and being encouraged to choose, assisted suicide while “in a sound state of mind”. As Anglicans bound by the teaching of the Prayer Book, we see this as a grievous evil. Often, this deliberate decision is celebrated as an act of individual autonomy and self-expression that enables death with dignity. This rhetoric, which connects one’s dignity as a human being to one’s self-actualization and independence, is contrary to the spirit and piety of the Prayer Book which teaches that we are not our own but belong to Christ and that our dignity in him is inviolable. For the Christian, death is not an opportunity for the final exercise of self-expression and autonomous choice, but rather for the dying person to be conformed to Christ in his or her death [v]and for loved ones to share the dying person’s burden by prayer and acts of mercy. The pro-MAiD rhetoric is not only contrary to our faith, but is particularly death-dealing to disabled people, who are told that their need for care renders them lacking in dignity and who are offered death as a treatment option for long-term disability. This is not just an academic worry. We have seen the repeated fears of disability rights and religious groups realized, as Canadians who are disabled, experiencing non life-threatening ailments, or lacking housing and employment are now being pressured into choosing MAiD by the actions of medical professionals or by their perceived lack of other options.[vi]

The argument is often made that MAiD is a means of avoiding unnecessary suffering.  But suffering, though not good in itself, is nonetheless an opportunity for the redemptive power of Christ to be exercised in one’s life (2 Cor. 5:7-10; 1 Pet. 4:1-2). Bodily suffering can be an occasion for the healing of the soul and a witness of Christ to others. Jesus himself is the paradigm for faithful suffering and dying. In the agony of Gethsemane, Christ’s human will was brought into alignment with the divine, providential will of the Father by his humble submission and obedience unto death (Matt. 26:39; Heb. 5:8). Thus, for the faithful Christian, suffering is to be humbly received, patiently endured, prayerfully engaged, alleviated when possible, but not to be avoided at all costs.  Moreover, alleviating the suffering of others is a moral imperative and a duty of all Christians.  Modern medicine has extremely effective treatments for bodily pain.  In very many cases, MAiD is requested because of a fear of being alone or of being a burden to others.  When the person is assured that others want to care for them, he or she almost always expresses great relief and does not pursue a MAiD request.

We are deeply dismayed by the examples of Canadian Anglican clergy who have blessed, liturgized and otherwise advocated for MAiD.[vii] Their actions are rooted in a flawed understanding of pastoral care as non-judgmental accompaniment and positive affirmation of whatever choice a person wishes to make. By contrast, the Prayer Book teaches a truly Christian model of pastoral care which encourages the Christian person to be conformed to Jesus Christ – incarnate, crucified, risen, ascended and glorified – and to live and die in his light with faith, hope and love, rather than in a spirit of infidelity, despair and impatience. Because we uphold the classical Anglican principle of lex orandi, lex credendi (that is, the law of praying establishes the law of believing, i.e., liturgy is an expression of doctrine), we are adamantly opposed to any blessing, liturgy or prayer used to sanction a MAiD procedure. Any such liturgical innovation is explicitly opposed to the doctrine and discipline of the Anglican Church of Canada, as enshrined in the 1962 Book of Common Prayer.

The PBSC also takes issue with the 2018 document entitled, “In Sure and Certain Hope: Resources to Assist Pastoral and Theological Approaches to Physician Assisted Dying”, published by the Anglican Church of Canada’s Faith, Worship and Ministry task force on the subject.[viii] The title, “In Sure and Certain Hope” is ironically a quote from the graveside portion of the Prayer Book burial office (BCP, p. 602). This memorable phrase has been taken far out of context and used to validate a document which, precisely in shying away from taking a firm position on MAiD and calling instead for non-judgmental accompaniment, is functionally a pro-MAiD document which provides “Prayer Resources” that may be used at a MAiD procedure, in flagrant defiance of the official doctrine and discipline of the Anglican Church of Canada as found in the Prayer Book. Furthermore, any “hope” offered by this document is neither “sure” nor “certain”, as it barely makes any mention of the Resurrection. The Prayer Book teaches that our only “sure and certain hope” is in “the Resurrection to eternal life, through our Lord Jesus Christ; who shall change our mortal body, that it may be like unto his glorious body, according to the mighty working, whereby he is able to subdue all things to himself” (BCP, p. 602).

In the hope of that Resurrection, we call upon the Primate, House of Bishops, and General Synod to issue a clear and public condemnation of Canada’s MAiD law as incompatible with the teaching of the Church. We call upon all Anglicans to model a Christian approach to death and dying to a world in desperate need of the Gospel. We pray that insofar as the Anglican Church of Canada has acquiesced in MAiD either by explicit endorsement or by silence, it may repent of its canonical disobedience and be subdued unto Christ, that we may be a light to our nation by resisting this insidious culture of death.


ALMIGHTY God, who showest to them that be in error the light of thy truth, to the intent that they may return into the way of righteousness: Grant unto all them that are admitted into the fellowship of Christ’s religion, that they may forsake those things that are contrary to their profession, and follow all such things as are agreeable to the same; through our Lord Jesus Christ. Amen.

-The Collect for the Third Sunday after Easter

[i] Sean Frankling, “Church should not oppose MAID law, primate says”, Anglican Journal, anglicanjournal.com, 30 September 2022. See also the excellent article by PBSC member Benjamin Crosby, “Where Are the Churches in Canada’s Euthanasia Experiment?”, Plough Quarterly, Number 35, Spring 2023; plough.com, 27 February 2023.

[ii] Jesse Billett, “Canada’s Prayer Book”, lecture given at St. Olave’s Anglican Church, Toronto, prayerbook.ca, 1 November 2022.

[iii] A further rubric to the 1962 burial office instructs that in cases where a person dies by suicide while in a sound state of mind, “the Priest may use Psalm 51 or 130, St Matthew 25.31-46”, and other prayers as deemed appropriate. Thus, such a person may still receive a church funeral, but with a particular liturgy that emphasizes human sin and the just and merciful judgment of God. No definitive pronouncement on the eternal destiny of the deceased is made. The point of this rubric seems to be to underscore that the deceased has not glorified God by his or her death and that the mourners ought not to celebrate or follow such an example.

[iv] According to Statistics Canada, in 2021 (the latest year for which complete statistics are available) more than 10,000 people died by MAiD, accounting for 3.3% of all deaths in Canada that year. This figure represents a 35% increase over 2020, when roughly 7,500 died by MAiD, and a tenfold increase since MAiD was legalised in 2016.

[v] Note the wording in the Burial of the Dead in the 1662 BCP, unchanged in the 1918/1922 Canadian BCP (bracketed words were deleted from the 1959/1962 revision): “Thou knowest, Lord, the secrets of our hearts; shut not thy merciful ears unto our prayer; but spare us, Lord most holy, O God most mighty, O holy and merciful Saviour, thou most worthy Judge eternal, [suffer us not, at our last hour, for any pains of death, to fall from thee.]”  Also the wording in the 1662 Visitation of the Sick, unchanged in the 1918/1922 Canadian BCP (omitted in 1959/1962): “Dearly beloved, know this, that Almighty God is the Lord of life and death, and of all things to them pertaining, as youth, strength, health, age, weakness, and sickness. Wherefore, whatsoever your sickness is, know you certainly, that it is God’s visitation. And for what cause soever this sickness is sent unto you; whether it be to try your patience, for the example of others, and that your faith may be found in the day of the Lord laudable, glorious, and honourable, to the increase of glory and endless felicity; or else it be sent unto you to correct and amend in you whatsoever doth offend the eyes of your heavenly Father; know you certainly, that if you truly repent you of your sins, and bear your sickness patiently, trusting in God’s mercy for his dear Son Jesus Christ’s sake, and render unto him humble thanks for his fatherly visitation, submitting yourself wholly unto his will, it shall turn to your profit, and help you forward in the right way that leadeth unto everlasting life.”

[vi] This has been shown conclusively by, among others, the investigative reporting of Alexander Raikin. See his “No Other Options”, The New Atlantis, Number 71, Winter 2023, pp. 3–24; TheNewAtlantis.com, 16 December 2022.

[vii] Kelly Grant, “Medically assisted death allows couple married almost 73 years to die together”, The Globe and Mail, theglobeandmail.com, 1 April 2018.

[viii] Faith, Worship and Ministry Task Force on Physician Assisted Dying, In Sure and Certain Hope: Resources to Assist Pastoral and Theological Approaches to Physician Assisted Dying, (The General Synod of the Anglican Church of Canada, 2018).

Position Statement on Medical Assistance in Dying (MAiD)