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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Justice

Leading

Politics

7 July 2025

5 min read

The consequences of truth-telling are so severe our leaders can’t admit their mistakes

When accountability means annihilation, denial is the only way to survive

Leah Brown

Leah is a campaigner for restorative practices and founder of The WayFinders Group.

Baroness Casey.

BBC.

Why do our leaders struggle so profoundly with admitting error?

Media and inquiries regularly report on such failures in the NHS, the Home Office, the Department of Work and Pensions, HMRC, the Metropolitan Police, the Ministry of Defence, and so many more public institutions. Often accompanied by harrowing personal stories of the harm done.

In a recent white paper (From harm to healing: rebuilding trust in Britain’s publicly funded institutions), I defined “harm” as a holistic concept occurring where physical injury or mental distress is committed and sustained and explained that harm is generally something that is caused, possibly resulting in injury or loss of life.

When we look at harm from an institutional perspective, structural power dynamics inevitably oppress certain groups, limit individual freedoms, and negatively affect the safety and security of individuals. But when we look at it through the lens of the individuals who run those institutions, we see people who often believe that they are acting in good faith, believe that their decisions won’t have a significant impact, who don’t have time to think about the decisions they are making, or worse still, prefer to protect what is in their best interest.

Even well-intentioned leaders can become complicit in cycles of harm - not just through malice, but through their lack of self-awareness and unwillingness to put themselves in the shoes of the person on the receiving end of their decisions.

Martin Luther King Jr supposedly said, “the ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” In contemporary politics, leaders are neither selected nor (largely) do they remain, because of their humility. Humility is synonymous with weakness and showing weakness must be avoided at all cost. Responsibility is perceived as something that lies outside of us, rather than something we can take ownership of from within.

So, why do leaders struggle so profoundly with admitting error?

The issue is cultural and three-fold.

First, we don’t quantify or systematically address human error, allowing small mistakes to escalate.

We then enable those responsible to evade accountability through institutional protection and legal barriers.

Finally, we actively discourage truth-telling by punishing whistle-blowers rather than rewarding transparency. Taken together, these create the very conditions that transform errors into institutional harm.

Nowhere is this plainer than in Baroness Casey’s recent report on Group-based Child Sexual Exploitation and Abuse that caused the Government to announce a grooming gangs inquiry. In this case, the initial harm was compounded by denial and obfuscation, resulting not just in an institutional failure to protect children, but system-wide failures that have enabled the so-called “bad actors” to remain in situ.

Recently, this trend was bucked at Countess of Chester Hospital where the police arrested three hospital managers involved in the Lucy Letby investigation. Previously, senior leadership had been protected, thus allowing them to evade accountability. Humble leadership would look like acting when concerns are raised before they become scandals. However, in this case, leadership did act; they chose to bury the truth rather than believe the whistle-blowers.

Until we separate admission of error from institutional destruction, we will continue to incentivise the very cover-ups that erode public trust.

The answer to our conundrum is obvious. In Britain, accountability is conflated with annihilation. Clinging onto power is the only option because admitting error has become synonymous with career suicide, legal liability, and is tantamount to being hanged in the gallows of social media. We have managed to create systems of governing where the consequences of truth-telling are so severe that denial is the only survival mechanism left. We have successfully weaponised accountability rather than understanding it as the foundation of trust.

If Rotherham Metropolitan Borough Council had admitted even half of the failures Alexis Jay OBE identified in her 2013 report and that Baroness Casey identifies in her 2025 audit, leaders would face not only compensation claims but media storms, regulatory sanctions, and individual prosecutions. It’s so unthinkable to put someone through that that we shrink back with empathy as to why someone might not speak up. But this is not justice. Justice is what the families of Hillsborough have been seeking in the Public Authority (Accountability) Bill: legal duties of candour, criminal offences for those who deliberately mislead investigations or cover-up service failures, legal representation, and appropriate disclosure of documentation.

Regardless of your political persuasion, it has to be right that when police misconduct occurs, officers should fear not only disciplinary action and criminal charges. When politicians admit mistakes, they should face calls for their resignation. Public vilification is par for the course. Being ejected from office is the bare minimum required to take accountability for their actions.

The white paper shows that the cover-up always causes more damage than the original error. Institutional denial - whether relating to the Post Office sub-postmasters, the infected blood scandal victims, grooming gang victims, Grenfell Towers victims, Windrush claimants, or Hillsborough families - compounds the original harm exponentially.

In a society beset with blame, shame, and by fame, it is extraordinary that this struggle to admit error is so pervasive. Survivors can and will forgive human fallibility. What they will not forgive is the arrogance of institutions that refuse to acknowledge when they have caused harm.

The white paper refers to a four-fold restorative framework that starts with acknowledgment, not punishment. The courage to say “we were wrong” is merely the first step. Next is apology and accountability followed by amends. It recognises that healing - not just legal resolution - must be at the heart of justice, treating both those harmed and those who caused it as whole human beings deserving of dignity.

Until we separate admission of error from institutional destruction, we will continue to incentivise the very cover-ups that erode public trust. I was recently struck by Baroness Onora O’Neill who insisted that we must demand trustworthiness in our leaders. We cannot have trustworthiness without truth-telling, and we cannot have that without valuing the act of repairing harm over reputation management. True authority comes from service, through vulnerability rather than invulnerability; strength comes through the acknowledgement of weakness not the projection of power.

We must recognise that those entrusted with power have a moral obligation to those they serve. That obligation transcends institutional self-interest. Thus, we must stop asking why leaders struggle to admit error and instead ask why we have made truth-telling so dangerous that lies seem safer.