Maltese Archbishop Charles Scicluna has appealed for people not to confuse supporting our dying elderly with supporting "unacceptable means that lead to death," thus denouncing euthanasia and assisted suicide.

Archbishop Scicluna gave these remarks during the Archdiocese of Malta's publication of its official ethical guidelines for elderly persons under care in residential church/religious homes.

The country's lead ecclesiastic called for the Maltese society to "let people die in peace."

Citing Pope Francis, Archbishop Scicluna said that "we must accompany those who want to die - but not kill them in the process."

"When you look at our elderly, pray that their right to die does not transform into the duty that they die," the Archbishop said.

The Head of the Maltese Church noted the importance to keep this point in mind so that society avoids any person's life ending "due to egoisms."

He added that no one wants to see anyone suffer, however, frail people must be accompanied throughout their final years and moments in a manner that enshrines respect and human dignity.

Archbishop Scicluna said that he will leave this issue for social consciousness to decide.

This sentiment was supported by the other speakers at Monday morning's launch, including Mgr. Prof. Emmanuel Agius, Dr. Antoine Vella, and President Emeritus Marie-Louise Coleiro Preca.

The Archbishop said that according to Christian ethos - which the Church's ethical guidelines are based upon - society has the duty to promote elongating one's lifespan, though not at the expense of their quality of life.

Therefore, the Church's ethical guidelines for elderly persons in care homes dictate that palliative residents should be kept comfortable and pain-free till their dying breaths, without resorting to measures which "artificially interfere" with the process of dying peacefully, condemning euthanasia outright.

Prof. Agius observed that our seniors must live free from exploitation and abuse, while being treated as dignified human beings.

"Rather than discussing physician-assisted suicide and euthanasia, the public debate in our country should focus on whether a robust palliative care strategy for the ageing population is in place to assist them to live with dignity while dying," he said.

The Church stated that euthanasia and assisted dying go against natural instincts, and therefore, these avenues should not be introduced or accepted in the Maltese islands. It was also noted that these methods are not even accepted within the EU's institutions.

The Curia's guidelines describe palliative care as an approach that improves the quality of life of residents and their families facing life-threatening illnesses through prevention and pain relief. It dictates that palliative care should follow these objectives by means of early identification, comprehensive assessments, and the effective treatment of pain and other physical, psychosocial, and spiritual problems.

On behalf of the Church, Prof. Agius invited Maltese society to reflect on these guidelines, as the Archdiocese of Malta would next wish to reflect on strategies surrounding palliative care.

Details on the published ethical guidelines

The Church's guidebook is divided into six chapters: ethical values, principles and norms, basic principles, guardianship and advance care planning, palliative care, medical assessment at an end-of-life stage, and regulations on policies and procedures.

These ethical guidelines will immediately affect 8 elderly homes across Malta and Gozo - three of which are managed by the Curia and five are religious homes.

In total, these 8 homes host 491 elderly residents, 401 in Malta and 90 in Gozo; they are supported by 327 total employees - 272 in Malta and 55 in Gozo.

These ethical guidelines revolve around sustaining a dignified living environment for all its elderly residents and their families, while supporting all staff present at these sites.

It has been instructed that, for as long as an elderly resident's mind remains able, each elderly resident deserves to know all the relevant information relating to them and their care.

As such, it believes that each mindful resident should be granted an active role, alongside their families, in determining their respective "care pathways." Hence, residents have the right to refuse certain kinds of care within their tailored "advanced care plans". This also includes regular access to professionals for review assessments.

Residents' right to privacy must also be enshrined, even while they live in these institutions, the Church said. Henceforth, it is vital that all residential homes respect this fundamental right (ECHR Article 8), while providing all the necessary facilities and upholding a safe living environment.

In addition, these guidelines recommend for all homes to feature the necessary facilities for care, in order to avoid a resident's transfer to an acute hospital. Through this recommendation, homes must be trained and able to feed residents via specialised feeding equipment and subcutaneous infusions (feeding tubes).

On this point, Dr. Vella commented that at the moment, basic procedures like this are not always available to give - including in government homes. Resultantly, training is being carried out so that this "relatively simple procedure" can be supplied.

For the sake of inclusivity, the Church remarked on the importance that these guidelines were not fully overridden by religious values. This approach was taken to recognise the non-believers residing in Church homes and religious homes around the country and offer them respect and a dignified living.

He delineated that in order to provide positive living conditions for residents, residential staff must be supported adequately at all levels. This includes educational training and offering accessible psychological support in the face of burnout or other psychological struggles.

All in all, it was deemed central for both Christian ethos and human ethos to be upheld in all these homes.

President Emeritus Marie-Louise Coleiro Preca recommended that these guidelines are heeded upon by all elderly residential homes, i.e., those already affected by this publication, as well as homes managed by the State and by the private sector respectively.

The former President of Malta described these guidelines as "an investment in humane values" founded upon the same values which developed the European Convention for Human Rights (ECHR).

She called for people to be treated with love and respect at all stages of life, citing the active Pontiff, Pope Francis, in describing the elderly generation as "guardians of memories and wisdom" and "the foundation pillar between the generations."