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
Freedom of Belief
Politics
5 min read

The UN promised freedom of belief — but 80 years later, it’s still elusive

Flawed, fragile but still vital to those without a voice

Steve is news director of Article 18, a human rights organisation documenting Christian persecution in Iran.

Trump address the UN.
Trump addresses the 80th session of the United Nations General Assembly.
The White House.

It’s been 80 years since the United Nations was founded, at the end of the Second World War, primarily in an attempt to avoid a third global conflict. 

So on that score, at least, I suppose one must accept that the UN has achieved its primary objective. But why, then, does the overall feeling towards the organisation today seem negative? 

The UN’s founding charter outlined three other major goals alongside maintaining “international peace and security”: developing “friendly relations” among nations; international cooperation in solving economic, social, cultural or humanitarian problems; and respect for human rights and fundamental freedoms, “without distinction as to race, sex, language or religion”. 

Given that the UN is comprised of 193 countries, it is perhaps little wonder that “friendly relations” and “cooperation” between all sides have not always been forthcoming, and that instead clear cliques have formed between Western countries on the one hand, and much of the rest of the world on the other. (Perhaps the clearest such clique at the moment is the 2021-founded “Group of Friends in Defence of the UN Charter”, the identities of whose members - China, North Korea, Iran, Russia, Venezuela, et al - may lead one to wonder what exactly it is in the UN charter they wish to defend. Short answer: “sovereignty”, code for doing whatever they wish, without interference.) 

As for the pursuit of “human rights” - my primary focus as an employee of an NGO - perhaps the greatest obstacle remains the lack of a truly united consensus over which rights should be included in the definition. 

The closest that the nations of the world have come to an agreement on this score was the adoption in 1948, three years after the founding of the UN, of the Universal Declaration of Human Rights (UDHR), which was backed by 48 of 58 member states at the time, but which failed to secure the support of others, including apartheid South Africa, the former Soviet bloc, and Saudi Arabia. 

A primary objection in the case of Saudi Arabia was to Article 18 of the declaration - the bit about religious freedom and which includes the claim that everyone should have the right to change their religion or belief, an issue that remains problematic for many of the not-so-united nations of the world today. 

The UK, meanwhile, was happy to ratify the UDHR but expressed frustration at its lack of legal force, and it was nearly 20 years before another treaty, the 1966 International Covenant on Civil and Political Rights, attempted to correct this.  

But while the 174 signatories to the ICCPR - including Iran, Russia, Cuba and China (though the latter two without ever ratifying the treaty) - are at least on paper legally obliged to uphold this international treaty, the challenge of enforcement remains. For example, while the signatories of the ICCPR are obliged to provide freedom of religion as defined by Article 18 of the covenant, which closely resembles the same article of the UDHR, few practical tools exist to hold to account any state that fails to meet its obligations.  

In the case of persistent violators like Iran - the focus of my work - it seems the best we can currently hope for is to see a “resolution” passed by the majority of member states, outlining the ways in which the particular violator has failed to provide its citizens with the religious freedom (among other things) that should be their right according to the international treaties it has signed, and calling on them to do better.  

But when pariahs like Iran can merely continue to deny that such failures exist, call them “biased” and “political”, and all the while prevent access to the country to the independent experts (“Special Rapporteurs”) best able to ascertain the veracity of the allegations, such “resolutions” can at times appear rather hollow. 

At the same time, for advocates of human rights in non-compliant countries like Iran, the public shaming offered by such resolutions at least provides an opportunity for otherwise voiceless victims to be heard on the international stage. And when real change inside the country can sometimes appear nigh-on-impossible, you tend to take the small wins, such as hearing the representatives of member states mentioning the names of individual victims or groups in the public arena. 

Many mentions are made, for example, about the plight of the Baha’is during every UN discussion of human rights in Iran, and while it is less common to also hear about my own area of interest - the persecution of Christians in Iran - there is usually at least one mention, which for us advocates (and we hope also the victims we represent) provides some comfort and hope for future change. 

So 80 years since the establishment of the UN, it is clear the organisation has much room for improvement, but I remain persuaded by the argument that if we didn’t have the UN, we’d have to invent it. 

“Friendly relations” - a helpfully loose term - between our disunited nations will always be a challenge, but increased economic ties globally over the past 80 years have also provided potential pressure points for those who fail to follow the rules. (If, for example, Iran wishes to see sanctions removed, Western countries can and should continue to demand improvements in the area of human rights.) 

As for the UN’s endeavour to see increased “respect for human rights and fundamental freedoms”, the question of what such rights and freedoms should entail will continue to be debated, with persistent areas of challenge including not only religious conversion but also abortion and same-sex relations. 

It is not uncommon, for example, to hear representatives of Muslim states such as Iran questioning what Western nations really mean by “human rights” and accusing them of using the term only as a “pretext” for their own “biased” agendas. 

But for all its challenges, 80 years after its establishment the UN continues to offer the only forum today where countries of contrasting beliefs can come together to discuss their differences on the world stage.  

Whether that is a worthwhile exercise remains a matter for debate, but to the degree that it is, the UN remains the primary channel through which such conversations can take place. 

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