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
Freedom
Justice
4 min read

Free speech for me, but not for thee

A hate crime hoo-ha and the limits of free speech

George is a visiting fellow at the London School of Economics and an Anglican priest.

Two brown bears fight while baring their teeth.
Zdeněk Macháček on Unsplash.

It was the the legendary Manchester Guardian editor CP Scott who said “Comment is free, but facts are sacred.” His dictum hay have held a century ago, but it doesn’t stand up today. In post-truth societies, facts are anything but sacred. And, leaving aside for now whether the opposite of sacred is freedom, comment isn’t free either. 

I don’t mean in the sense of whether or not you have to pay for it – you’re not paying for this, for example – but whether comment, as Scott took it for granted to be, is an act of freedom. Graham Linehan, the Father Ted comedy writer, temporarily lost his freedom to a squad of police officers at Heathrow airport for a social media post he’d tweeted: "If a trans-identified male is in a female-only space, he is committing a violent, abusive act. Make a scene, call the cops and if all else fails, punch him in the balls." 

The subsequent hoo-ha has precisely been about whether Linehan should have been free to make his comment. The police, under prevailing hate-crime laws, felt obliged to arrest him. Subsequently the media, politicians and assembled chatterati – even the Met Police commissioner weighed in – wailed how ridiculous it all was and, adopting serious-face, what a threat it represented to free speech, which is one of the most potent graven images of our time. Facts may be free these days, but comment is sacred. 

 Except it also depends whose comments and opinions are deemed sacred. So some people’s speech is more free than others. Take the Free Speech Union (FSU), founded by the liberally-challenged Toby Young. Here, right-wing freedom of speech is inalienable and non-negotiable. So silly intrusions into the views of Islamophobes and critics of trans-activism? Outrageous. But supporters of Palestine Action (PA), nearly 1,000 of whose supporters had to be arrested by police for peacefully holding placards? Not a word. They’re all lefties, you see. 

As Hugo Rifkind pointed out in The Times, neo-conservative and FSU director Douglas Murray was asked by Daniel Finkelstein whether his free-speech principles extended to PA’s superannuated supporters. Apparently not. And Reform UK’s Richard Tice simultaneously believes that protesters outside asylum hotels are “part of who we are”, but that the correct response to PA protesters is to  “arrest and charge the lot. Jail them.” Forgive me, but I thought a central tenet of faith in free speech is that it’s consistently applied? 

“Part of who we are ” used to be a tolerant, inclusive and pluralistic society. Not just campaign for our lot and bang up all the rest. And I’d contend that we should self-regulate freedom of speech rather than legislate for it. The Met Police commissioner, Sir Mark Rowley, seems to agree with that: “Regulations that were understandably intended to improve policing and laws that were intended to protect the vulnerable are now tying officers’ hands, removing appropriate professional discretion — which some call common sense.” 

That “common sense” is much beloved of freedom-of-speech warriors at places such as FSU. But they always get to define what it is and who gets to benefit from it, because it’s tribal. “If they pick on you, we’ll pick on them,” declares Young on his FSU website. It’s freedom for my tribe to say what it likes, not yours. And freedom of speech is meaningless if it’s not for everyone, including your political enemies. 

Where we agree is that freedom of speech should not be adjudicated by the law. There are enough laws without legalising what people can’t say or write. Where, I imagine, we disagree is that it shouldn’t be adjudicated by Young and Murray and Tice either. As matters stand, we have those who want to legislate for the right to free speech and those who campaign to restrict it. Nothing can come of that. 

By regulating ourselves, the risk is run of sounding conservatively nostalgic for a golden age of civility that never really existed, or rather that was imposed by social authority. It’s the sort of proposed solution you hear when someone says it’s really a question of good manners. It’s true that freedom of speech largely worked in a period of deference, but deference was probably not a good price to pay for it.  

What can be said is that, like any freedom, freedom of speech comes with congruent responsibilities. We hold a responsibility not to cause violence with what we say, even or especially if that means turning the other cheek. In ecclesiological management terms, this would make freedom of speech a pastoral rather than systemic provision. We serve each other; we don’t require the state to serve us.  

Linehan’s post was fine up until it’s final phrase. But it’s peer pressure, not the law, that should have prevented him from using it. Taking the violence out of speech should be an educated, peaceful instinct. And that remains a social duty, not a governance one.

Support Seen & Unseen

Since Spring 2023, our readers have enjoyed over 1,500 articles. All for free. 
This is made possible through the generosity of our amazing community of supporters.

If you enjoy Seen & Unseen, would you consider making a gift towards our work?
 
Do so by joining Behind The Seen. Alongside other benefits, you’ll receive an extra fortnightly email from me sharing my reading and reflections on the ideas that are shaping our times.

Graham Tomlin
Editor-in-Chief