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
Community
Freedom
Politics
4 min read

From councils to conclaves, there's a vital common ingredient

Church and state alike need pluralism.

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

A gate to a churchyard displays a sign saying polling station.
A polling station through a churchyard.
Southwark Diocese

Rumours that Donald Trump may suspend the US constitution in order to seek a third term as president and yet darker threats that his regime may even harbour autocratic ambitions have reminded the West that we should not take democracy for granted. 

Parliamentary democracy, we have widely assumed, is A Good Thing. It’s so good that we not only want to share it but impose it on other populations. The Iraq war on which the UK and US embarked in 2003 was fought, we were told, for freedom and democracy, but it didn’t quite work out like that. 

By democracy, we tend to mean political accountability, through which parties of government exercise power through the will of the people they serve, expressed in regular plebiscites which ensure that no one can cling unchallenged to power. The recent English council elections are a small example of what we mean by that. 

The Trump phenomenon, though, begins to point towards the prospect of a popular will that is in favour of a form of government that doesn’t correspond to our usual liberal assumptions. There are voices, among them that of the writer Margaret Atwood, which anticipate a suspension of US democracy as a consequence of the President’s insanity. 

Most of us in the UK might argue that democracy need to be more than a system in which majorities have their way. We want our governments to be under the law too. And then we have to decide not only what law, but whose law. For those of religious faith, that question will partly and significantly be answered by God’s law, on which arguably western civilisation is built. 

This is where pluralism comes in, without which democracy can’t operate effectively. A state is a collection of political and civic communities, in which individuals have rights and duties, which are protected in law. 

This model is based on Roman legislature, intensely centralised and systemically suspicious of private societies, which is why early Christians were persecuted under it. The collapse of that empire left a legalistic vacuum, into which stepped nation-state kingdoms and the early medieval Church.  

Unlike political parties, we don’t compete for control, but form a community that points towards a saved and healed world. 

It was this latter organ of state that inherited the basic principles of Roman law, centralised, universal and sovereign, under the Pope. And it is that organ that will meet in conclave to elect a new Pope. To describe that election as democratic is more than a stretch, in that the demos, as in common people, are uninvolved and arguably unrepresented. 

So the Church is not a democracy, any more than God is accountable to his creation. Rather the other way around – some denominations speak of God’s “elect”, those he chooses for salvation. In Christian thought, God is a servant king, but nonetheless an absolute and, some who oppose the divine might say, tyrannical authority. 

How are we to respond to an undemocratic deity? One answer to that might be found in that pluralistic characteristic of democracy. We’re not good, frankly, as recognising pluralism in our faith systems. At best, we operate in a kind of absolute duopoly – you believe, or you don’t. A pluralistic model would be one in which we learn of the divine will through the entirety of creation, all manifestations of belief and unbelief, rather than simply our own. 

Pluralism is healthy, in secular politics as well as in religious observance. It has been observed that the old UK political duopoly of Labour and Conservative has been broken in these local elections by Reform UK and resurgent Liberal Democrats and Greens. It’s the polar opposite of the gathering autocracy in the US and gives a voice to a range of worldviews. 

This is not an argument for theocracy, but it is to claim that the Christian tradition rests on the principle that no political order can claim the authority of God other than the Body of Christ. And the Body of Christ incorporates all members of the human race. Unlike political parties, we don’t compete for control, but form a community that points towards a saved and healed world. 

The choice here is between a kind of secular citizenship, a form of multi-culturism which strikes an accord between varied communities on universally enlightened principles. Or we can respond to the energy on which that secular utopia might be founded, in building communities of the willing towards global justice and peace. That is a diversity mission for the Church. 

So, it’s less about democracy than pluralism. And that pluralism has to become a recognisable characteristic of the body of the faithful, which it all too often historically hasn’t been. One can only hope and pray that it might be a mission that is also at the heart of the deliberations that lead to a puff of white smoke from the Sistine Chapel in the coming days. 

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