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
Assisted dying
Comment
Freedom of Belief
Politics
5 min read

Holding an opposing view is not 'imposing' belief on the assisted dying debate

Opposing interventions from believers on dishonesty grounds is a sinister development in public debate

Nick is an author and Senior Fellow at Theos,a think tank.

A graphic shows a gallery of people with religious symbols on their clothing.

“There are some who oppose this crucial reform,” Esther Rantzen wrote recently of MPs who dared to opposed Kim Leadbeater’s Terminally Ill Adults (End of Life private member’s bill. “Many of them have undeclared personal religious beliefs…  [do] they have the right to impose them on patients like me, who do not share them?” 

This is a peculiarly common argument for those who support the right to Assisted Dying, which is surprising as it would be hard to come up with a less coherent case against religion in public life. The idea that elected MPs engaged in parliamentary debate are “imposing” their will on other people is odd. The idea that MPs have undeclared personal religious beliefs is strange too. I think it’s fair to say that most people know that Shabana Mahmood is a Muslim or Tim Farron is a Christian, and for those that don’t know that but do have access to Google, it takes less than five seconds to find out the religious beliefs of an MP. 

Perhaps most tellingly, however, why is it that we should be alert to – read wary of – MPs religious beliefs? Do the non-religious not have beliefs of which we should be cognizant? If my MP is motivated by a philosophy of relentless, Peter Singer-like utilitarianism or vague, incoherent secular humanism I’d like to know. 

In truth, Rantzen’s intervention in this debate, like that of a number of others – Lord Falconer, Simon Jenkins, Humanists UK, etc. – is part of a recent and rather dispiriting attempt to de facto exclude religious contribution to public debates by accusing them of being dishonest. 

To be clear, secular voices have long tried to exclude religious ones, but the tactics change. Back in the New Atheist heyday of the early twenty first century, all you needed to do was splutter something about sky fairies or Bronze Age beliefs or mind viruses to close down any sort of religious intervention. If, as Richard Dawkins famously put it, faith was one of the world’s great evils, comparable to the smallpox virus only harder to eradicate, no sensible parliament could possibly want to heed what faith had to say. 

Even back then, however, there were subtler arguments against faith, which usually came in the form of semi-digested Rawslian political liberalism, and demanded the religious participation in public debate had to obey the strictures of “public reasoning”, using logic and language that “all reasonable people” will understand. 

There are quite a few holes in this particular away of thinking (who are “reasonable people” anyway?) but as a rule of thumb, it’s not a bad one to follow. It is quite right and proper, if only as a matter of pragmatism, to speak in terms that your opponents will get, just as it is right and proper, as a matter of courtesy, to be open about what ultimately motivates you. 

And so that is what religious figures – MPs, leaders, institutions – do. Having read through pretty much all their contributions to the assisted dying debate, in parliament and beyond, I can testify that not many people, on either side of the debate, quote scripture or invoke papal teaching as a way of persuading, let alone commanding, others. (As it happens, parliamentarians haven’t really done that since the 1650s, but that’s another story).  

Rather, they argue in terms of policy and principles. They talk about the risk of legislative slippage, of changing attitudes to the vulnerable, of the need for better palliative care, of existing pressures on the NHS, etc. This is quite right and proper. As James Cleverly remarked in the Common debate in November, “We are speaking about the specifics of this Bill: this is not a general debate or a theoretical discussion, but about the specifics of the Bill”. And so that is what they did. 

Does anyone seriously think it is a good idea to compel a believing Jew to stand up in parliament and declare her faith before she were allowed to speak? 

In effect, religious public figures, whether or not their beliefs are “declared”, do what they have (rightly) been asked to do by those who have appointed themselves as gatekeepers for our public debate. And so this has forced the usual suspects to pivot in their argument. No longer able to dismiss religious contributions for what they say (“don’t quote the Bible at me!”) they are now compelled to dismiss them for what they don’t say. Hence, the trope that has become popular among such campaigners – “you are not being honest about your real motivations”. 

A new report from the think tank Theos, entitled, How much have your religious views influenced your decision?”: religion and the assisted dying debate, unpacks the various objections that have been levelled at the religious contribution to the debate, and then systematically dismantles them.

Some of these objections are old school in the extreme.  

Religious belief is too intellectually inadequate or disfiguring for debates of this nature. 

Religion is insufficiently willing to adapt and compromise for politics.  

Faith is ill-fitted or even inadmissible in a secular polity or culture.  

But the report majors on the newer objection, so clearly displayed by Esther Rantzen, what we might call “dishonesty” objection, that religious contributors are fundamentally dishonest about their motivations and objectives. 

In truth, this is no stronger than the more tried and tested objections, and it displays a serious, possibly intentional, misunderstanding of what a religious argument actually is. To quote the political philosopher Jeremy Waldron, such secular campaigners “present it as a crude prescription from God, backed up with threat of hellfire, derived from general or particular revelation, and they contrast it with the elegant simplicity of a philosophical argument by Rawls (say) or Dworkin [and] with this image in mind, they think it obvious that religious argument should be excluded from public life.” 

Contemporary arguments against religion in public life are slightly more sophisticated than Waldron’s caricature here, but not much. The idea that religio should be “declared” as a competing interest, so as to stop religious participants in debate from being “dishonest” is every bit as sinister, against both the letter and the spirit of plural, liberal democracy. Does anyone seriously think it is a good idea to compel a believing Jew to stand up in parliament and declare her faith before she were allowed to speak?  

As the assisted dying debate returns to parliament for the final push, there will be much animated debate. That is quite right and proper. A democracy needs vigorous and honest argument. But part of that honesty involves opening the doors of debate to everyone, and not subtly trying to exclude those with whom you disagree on the spurious grounds that they are being dishonest.

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