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
Comment
Identity
Nationalism
5 min read

Which nation are you flying the flag for?

Flag raisings, Ed Sheeran, and my split national identity

Juila is a writer and social justice advocate. 

A Union Jack is draped over a railing, next to a red flag saying Jesus.
A flag demonstration, Portsmouth.
TikTok.

Flags are flying from lamp posts around England. It’s newsworthy here – and yet reports barely note that for those of us from Northern Ireland, we know something of this. A couple of weeks ago, the backlash was loud when Ed Sheeran declared himself ‘culturally Irish’, attributing greater significance to his family’s heritage than being born and raised in England. When it comes to signs of identity, things can quickly get personal. 

In my family – Northern Irish mother, English father, two daughters born in London but most of our childhood spent living just outside Belfast – we’ve been known to debate points to tot up our national identities over the dinner table. Does a place of birth outweigh the school years? When does formation finish – on turning 18 or do the months away at university count for anything? Does it matter how our mixed DNA actually expresses in our hair, our eyes, our stature?  

It’s a game and it’s our deeply felt reality. It’s the years spent with my schoolmates teaching me to correctly say ‘how now brown cow’ – and the arrival in England to find people couldn’t understand me saying my own name. It’s the stomach churn I still feel when I see flags flying, having grown up in a country where banners signal who is in – and therefore who is out. It touches on the questions of belonging and home.  

Irishness seems to travel well. The popularity of the island’s artists and art (from Paul Mescal to Derry Girls) are all signifiers of this cultural moment. But being Irish has always carried more cachet when I’ve been abroad, and I confess that when it has suited, I have led with my more ‘palatable’ half (or quarter or… the family maths is still up for debate). It’s convenient – but there’s also a discomfort in the enduring appeal of ‘Irishness’ outside of the island. It’s an ‘otherness’ that evokes intrigue and warmth, rather than fear. Difference that is more than acceptable, sometimes desirable. Distinct enough to be interesting but unthreatening for often being associated with white skin. 

Underneath the light-hearted arguments of our dinner table is a question of formation. Ed Sheeran attributes his sense of being Irish to the things that he feels have shaped him. It’s in being away from Belfast, living in England, that that I have seen more clearly the ways that Irishness has formed me. Watching Derry Girls with my English husband I freely laughed at what I assumed were universal jokes, only to have to hit pause and explain them. The show unearthed memories – not bad, just not often recalled – of Bill Clinton’s historic visit and the ‘across the barricades’ style gathering of primary schools from different sides of the community. 

Signs and symbols matter. I recently rewatched an episode of tv show, The West Wing, in which the US flag may – or may not – have been burned as part of a trick by magicians Penn and Teller. A media maelstrom follows. Whether or not the flag burned matters, as does the symbolism of this act taking place in the White House, itself an emblem of national identity and power. 

Reflecting on the news, I find myself thinking about the signs of a different kind of kingdom, one that transgresses national borders. In the Bible there's the story of one man who died once for all the world. And in dying, he brought forth his kingdom – one that crosses boundary lines to be truly global. The signs of this kingdom are not division or disconnection but peace and justice, joy and comfort, healing and presence. 

This is not about homogenisation. It’s not about the erosion of cultures, but about the beauty of all represented. As Harvey Kwiyani, a theologian from Malawi, puts it: “We are all welcome to God’s kingdom with our unique cultures. Being in the kingdom of God does not erase our cultural differences… The kingdom of God finds its fullest expression in intercultural mutuality. It is a multicultural kingdom.” The kingdom of God in all its richness – that’s a tempting proposition.  

It’s easy to see that we aren’t living in the fullness of this yet. But the world is not a static place. One metaphor used to describe the kingdom of God is yeast; living cultures filling the dough, making it rise. This is an image that is expansive, generous. The kingdom isn’t wholly realised yet, but we can see more and more of it. 

And like the yeast, we have a role to play in culture changing. As Graham Tomlin wrote following debates about ‘Englishness’, belonging to the kingdom of God means we have an identity not defined by where we live. Being part of this kingdom, we also become active participants in it. Formation is not just about us; we get to play an intentional role in the formation of a kinder world, in the coming of God’s kingdom. In the midst of fear and uncertainty, our ability to engage in such life-giving action offers a concrete hope.   

This is not a defensive position, but a brokering one. The kingdom is bigger than our individual lives, churches or communities; recognising this helps us to break out of a fortress mentality. So far, this century has been marked by fortification. As well as the raising of flags, there have also been walls. At the end of the second world war there were fewer than five border walls; there are now more than 70, most of them built in the last two decades. But the kingdom of God offers a view of home that is not about defence, not about perimeters, or even places. It’s a relationship with God, who made and sustains this world, who crosses the divide to meet each of us. In meeting him, we can partner together in seeing more of his kingdom on this earth.  

Anthropologist Andrew Shyrock defines sovereignty as “manifest in the ability to act as host”. Or to ground it in the day to day: to be able to offer a cup of tea. Perhaps some of the anger about Ed Sheeran’s claim is because of what it seems to either take or reject, pulling towards one nation while turning a back to another. Belonging to the kingdom of God invites us to think beyond what we can have to how we can intentionally serve. It has room to honour heritage and at the same time, it bends forward towards eternity. In the day to day, I find this a comfort: to see formation as not just about the past, but also the power of creative act after creative act in shaping the world that’s coming. 

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