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.

M. Ciftci

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?

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Digital

Freedom

30 October 2024

5 min read

Seen in Beijing: what’s it like in a surveillance society?

Cameras and controls remind a visitor to value freedom.

Alex Ross

A guard stands behind a barrier across an entrance to a station escalator.

A Beijing station gate and guard.

The recent Archers’ storyline wouldn’t have worked in Beijing. Here, great gantries of traffic cameras see into cars and record who is driving, so a court case which hinged on who was behind the wheel would not play out in months of suspense. The British press periodically runs stories on how much tracking and surveilling we are subject to, while the success of the TV series Hunted showed just how hard it is it to evade detection, and how interested we are in the possibility—but how often do we stop to think about the tensions inherent in the freedoms we enjoy?

It is difficult to explain just how free life in Britain is to someone in China, and how precious, and conducive to social good, that freedom is, to people at home. Take my recent experiences. Prior to entry at Beijing airport, I was randomly chosen for a health check and required to give a mouth swap. This may have been a benign Covid testing program, but it was impossible to tell from the questions on screen we had to answer—and a mouth swab certainly hands DNA to the authorities. At the university where I was studying, face scans are required for entry on every gate, and visitors must be registered with state ID in advance. Despite not having been in China since prior to Covid restrictions, my face had been pre-programmed into the system and an old photograph flashed up on screen as the barriers opened.

The first time I used a rental bike to cycle back to campus (the local Boris-bikes come on a monthly scheme, linked to a registered phone number), a message flashed up on my phone telling me that I had gone the wrong way down a one-way bike lane. The banner appeared twice, and the system would not let me lock the bike until I had acknowledged my error. The fact that the GPS system tracks the bikes so closely it knew I had gone against the traffic flow for a couple of hundred metres to avoid cycling across a 4-lane street was a surprise. Since that phone is registered to a Chinese friend, such infractions are also potentially a problem for him. What was less surprising, is the systemic nature of China’s ability to track its people at all times.

Walking through my university campus, where every junction has three or four cameras covering all directions, I occasionally wonder where students find space to have a quick snog.

No one uses cash in cities in China; in many outlets and places cash isn’t even accepted. Everyone uses apps like WeChat or Alipay to pay for goods—even at food trucks and casual stalls the vendor has a machine to scan a phone QR code. WeChat is WhatsApp and Facebook and a bank debit card and a travel service and news outlet rolled into one; Alipay, its only effective rival, offers similar. To obtain either account, a phone number is needed, numbers which have to be registered. And to pay for anything, a bank account in the name of the individual must be linked to the account. In other words, the government can choose to know every purchase I make, and its exact time and place. A friend who works in a bank says he uses cash where possible because he doesn’t want his colleagues in the bank to see what he's been buying.

Transport is also heavily regulated. To enter a train station, a national ID card is needed, which is scanned after bags are x-rayed. To purchase a high-speed train ticket, a national ID card—or passport for foreigners—is required. It might be possible to purchase a ticket anonymously in cash from a ticket window outside the station for an old-fashioned slow train, but one would still need an ID card corresponding to the face being scanned to make it to the platform—and the train station has, of course, cameras at every entrance and exit.

Cameras are pervasive. Walking through my university campus, where every junction has three or four cameras covering all directions, I occasionally wonder where students find space to have a quick snog. The only place I have not yet noticed cameras is the swimming pool changing rooms, which are communal, and in which I am the only person not to shower naked. There are cameras in the church sanctuary, and cameras on street crossings.

Imagine being constantly reminded by human overseers that your activity in person and online is both seen and heard.

Even when not being watched, out in the countryside, the state makes its presence felt. On a recent hike in the hills, our passage triggered a recording every few hundred metres: “Preventing forest fires is everyone’s responsibility.” Once or twice is common sense, ten or twenty times a stroll is social intrusion. One can, of course, learn to ignore the posters, the announcements, the security guards on trains playing their pre-recorded notices as they wander up the aisles and the loud speaker reminders that smoking in the toilets or boarding without a ticket would affect one’s social credit score and imperil future train travel, but white noise shapes perception.

As a (mostly) upright citizen, there are many upsides to constant surveillance. People leave their laptops unattended on trains, since they will not be stolen. Delivery packages are left strewn by the roadside or by a doorway: anyone stealing them will be quickly found. There is almost no graffiti. I can walk around at night safe in the knowledge that I am exceedingly unlikely to be a victim of petty theft, let alone knife or gun crime. Many Chinese have horrified tales of pickpockets in European cities or crime rates in the UK, while young friends are so used to the state having access to phone data and camera logs that they barely notice. Most Chinese I know are very happy with the trade-off of surveillance for safety—and the longer I spend in Beijing, the more appealing that normality seems.

To those who have lived outside, however, the restrictions make for a more Orwellian existence. Any church group wanting to hold an online service must apply for a permit. A friend was recently blocked from his WeChat account for a period after using a politically sensitive term in a family group-chat. Not being able to access certain foreign websites, search engines or media (no Google, no WhatsApp and no Guardian without an illegal virtual private network) might be an irritation for a foreign resident but means a lifetime of knowingly limited information for a citizen. Not being able to access information freely means, ultimately, not being able to think freely, a loss that cannot be quantified. The elite can skip over the firewall, but many cannot.

We have seen the dangers recently in the UK of limited information flow, and of social media interference by hostile players. Imagine never being able to know whether the information you are receiving is trustworthy—or being constantly reminded by human overseers that your activity in person and online is both seen and heard. Christians may believe in the benevolent and watchful gaze of God—but are rightly wary of devolving that omniscience to fellow humans.