Article
Assisted dying
Death & life
4 min read

The cold truth of Canadian lives not worth living

Canada’s implementation of medical assistance shows that a society considers some lives not worth living.

Mehmet Ciftci has a PhD in political theology from the University of Oxford. His research focuses on bioethics, faith and politics.

A IV drip bag hangs from a medical stand.
Marcelo Leal on Unsplash.

Alan Nichols’ application for euthanasia mentions only one health condition as the reason for his request: hearing loss. “Alan was basically put to death,” according to his brother. He was hospitalized after being found dehydrated and malnourished in his house. He asked his brother to “bust him out” of the hospital as soon as possible. A month after being admitting, he was euthanized through MAID (medical assistance in dying), despite the desperate objections of his family and his primary health practitioner. They were informed of the procedure over the phone only four days before it took place. They have since reported Alan’s case to the police; they argue he was not in a fit state of mind to understand the procedure or make decisions for himself. He had no life-threatening conditions. He was vulnerable. 

Canada’s relaxed laws around MAID came to international attention when CTV News reported that a fifty-one-year-old woman chose MAID after failing for two years to find housing that would allow her to manage her multiple chemical sensitivities. Despite the best efforts of friends and even her doctors to get her suitable housing in Toronto, letters left behind documented her desperate yet fruitless search for help. She begged officials at all layers of government to help find an apartment free from the chemicals and cigarette and marijuana smoke that worsened her symptoms. “The government sees me as expendable trash, a complainer, useless and a pain in the a**,” she said in a video days before her death. 

These are only some of the terrible stories that have been reported after Canada became the first Commonwealth country to legalise assisted suicide and euthanasia. Advocates of MAID will point to how comfortable Canadians are with it. As a recent poll revealed, MAID is supported by 73 per cent of Canadians, with 27 per cent supporting MAID even if the only affliction is poverty, 28 per cent for homelessness, and 20 per cent for any reason whatsoever. Those numbers may shift as disability activists and medical professionals continue to raise the alarm over the consequences of growing numbers choosing MAID, from 2,838 deaths in 2017 to 10,064 in 2021. 

MAID was introduced in 2016... Only those suffering from incurable diseases whose death was “reasonably foreseeable” were eligible, initially. 

There are two reasons why the Canadian example teaches us to remain firmly opposed to the legalisation of assisted suicide and euthanasia in the UK.  

The first is that the slippery slope in this case is real. Campaigners for Dignity in Dying claim they want only the legalisation of assisted suicide, not of euthanasia. The latter involves a doctor directly administering lethal drugs, without requiring the patient’s participation. (MAID permits both, although euthanasia is the method used in 99 per cent of cases.) They argue there is no evidence that legalising assisted suicide in the UK would lead to a loosening of laws over time. But this is contradicted by the timeline of events in Canada.  

MAID was introduced in 2016 following the Supreme Court of Canada’s ruling in 2015 that the criminalisation of assisted suicide violated the Canadian Charter of Rights and Freedoms. Only those suffering from incurable diseases whose death was “reasonably foreseeable” were eligible, initially. But the MAID evangelists did not wait long before complaining that this was too restrictive. The courts obliged, and in 2019 the court of Quebec found the “reasonably foreseeable” condition to contravene the Charter. In 2021 the laws were changed to allow MAID for those whose natural death was not foreseeable, but who have a condition considered intolerable by the applicant. Those suffering only from mental illnesses will be eligible for MAID in March 2024.  

The slope becomes more slippery still: the government is considering further expansion to allow “mature minors”, vaguely defined as children mature enough to make their own treatment decisions, to ask to be killed, even against a parent’s wishes.     

A society that kills those who ask to be killed has already made a choice to consider some lives not worth living,

The second lesson is about what kind of society we want to be. For a doctor to present the option of being killed, which Canadian doctors are now obliged to do whenever “medically relevant”, even if the patient does not bring it up first, does not expand patients’ freedom. It is rather an invitation to despair. This is frequently forgotten when some think that denying patients the choice to seek death is “imposing Christian values” as one cleric of the Anglican Church of Canada said. Roman Catholics, Evangelical Christians, and others have opposed MAID because a society that kills those who ask to be killed has already made a choice to consider some lives not worth living, and to invite those already made vulnerable by their pain and distress to see themselves as a burden to others. Not to mention the perverse incentives created to reduce medical and palliative care.  

We can and should support those who are frail and in need of care at the end of their lives to die with dignity, without hastening their deaths, without deeming their lives no longer worth living. Dame Cicely Saunders and other pioneers of the hospice movement have shown us what an alternative to assisted suicide and euthanasia would look like. Hospices put into practice the parable of the Good Samaritan, who responded with pity to the man beaten by robbers, bandaging his wounds and giving him a place to rest and receive care. Jesus tells the parable to show what it means to be a good neighbour to someone and how to react with compassion to suffering. What would have been the message of the parable if the Samaritan had instead reacted to the sight of the suffering man by reaching for his dagger?    

Article
Culture
Death & life
Politics
3 min read

Is a funeral the right backdrop for diplomacy?

Where there's an unavoidable collision between the universal and the individual.

Jamie is Vicar of St Michael's Chester Square, London.

Trump and Zelensky sit and face each other.
Ukrainian Presidential Press Service.

There’s an episode of Yes, Prime Minister where a state funeral provides an opportunity for negotiations with the French over the Channel. As ever, this particular satire has aged well. Most of the coverage of Pope Francis’ requiem mass has focused on either the ‘spectacle’ or the chance for world leaders to connect. It's tempting to think that the main stage of St Peter's Basilica was actually a sideshow to the fringe events of politicians carving up the world. With all the planning and confections that go into usual geopolitical summits, Vatican City has provided a spectacular impromptu backdrop. 

As an Anglican priest, I have mixed feelings about this. All the photos world leaders have been pushing out seem not a million miles away from the shocking taste of selfies in front of an open casket (any casket, for that matter). On the other hand, when there’s matters of life and death to discuss, there’s no better venue than a funeral. 

Of course, this presupposes that leaders have the presence of mind to acknowledge the dead body before them (not 'passed away'), rather than simply going through the motions and thinking about the photo op. But the cogs of death cannot be avoided. 

Tim Hamer, writing for the Lowy Institute, says, ‘bitter rivals can acknowledge the rituals of mortality.’ Some of the figures about leaders attending recent funerals are staggering. Pope Francis' funeral was no different. Along with those Francis prioritised - those pushed to the margins - there was also a critical 'mass' of those at the very centre of society. There were 170 delegations, including 50 heads of state, 15 heads of government and 12 reigning monarchs. Emeritus Professor of International Relations at the University of Leicester, Geoff R. Berridge writes that: 

 “Because death is always with us … there is little doubt that the working funeral is now the most important ceremonial occasion in the world diplomatic system”.   

Therefore, the off chance of bilateral diplomacy must be taken to its full advantage. 

It is precisely because, while the bodies are lowered, funerals elevate us out of the everyday, the 24 hour news cycle and the doomscrolling, that they provide us with an opportunity to connect with what really matters. Less than 24 hours before he died, the pope delivered the words on Easter Sunday: 'Christ is risen! These words capture the whole meaning of our existence, for we were not made for death but for life… God created us for life and wants the human family to rise again!' As our multilateral world order falters, the human family just might be able to rise again when the powers-that-be meet at a funeral.  

We will have to wait and see if there is any fruit from the geopolitical meetings that have taken place. We can live in hope. If world leaders learnt any lessons from the enigmatic late pontiff, they would see that he was like Teflon to the political labels people tried to pin on him. You get the impression that he was aiming for something more lasting than soundbites, quick wins and popularity. 

I would also add that funerals are for the living. Once we've brushed aside any theological quibbles over the efficacy of praying for the dead, funerals are there to help us to grieve. They help us to process loss, which is why the 'mortal remains' remain. The ancient declarations, the homily, the breaking of bread and pouring of wine, yes even the theatrics help us to situate our own lives on a world stage where we are both bit parts as well as worthy of the undivided attention of many onlookers.  

In a world where geopolitics threatens to depersonalise and dehumanise countless millions of people, funerals unavoidably collide the universal with the individual. The context of worship and thanksgiving also lifts us out of the orbital pull of the ephemera of nation-states and our own lives to discover the possibility of revolving around Someone far grander and steadfast. Just like conducting diplomacy, there's no better place to consider death than a funeral. 

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