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Catholics who consider undergoing doctor-assisted suicide must realize the act is a “morally great evil” and could mean they will be denied last rites, says a leading Canadian bishop.

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The Church might also refuse to conduct a funeral when families strongly support and champion their loved one’s assisted-death decision, said Archbishop Terrence Prendergast of Ottawa.

His comments underscore a little-mentioned dilemma that assisted death has presented to the religion of 13 million Canadians. Not only is the concept an ethical abomination in the Church’s eyes, but raises awkward theological questions for gravely ill Catholic patients and the clergy who tend to them.

A priest or hospital chaplain asked to attend to a patient planning assisted death should treat it as a “teaching moment,” and try to discourage the act, said Prendergast.

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But if the patient persists, the priest could well decline to perform the sacrament of anointing of the sick — and other parts of the last rites, he said.