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?    

Editor's pick
Belief
Comment
Politics
6 min read

How to navigate a culture war

Blaise Pascal shows us what really underlies our contemporary battles.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Two goats lock horns.
Maxime Gilbert on Unsplash.

We often say these days that we are more polarised as a society than ever before. But we're wrong. Maybe the USA is experiencing a particularly sharp divide right now, but they have had their own, much more violent troubles in the past. And in Europe, and especially in Britain, we know a fair bit about culture wars that were literally that – wars.  

In the 17th century, we English had our own civil war where we literally killed each other over religion and politics. We even killed a king. The French did something similar and even more vicious just over 100 years later. That is real polarisation. However spiteful Twitter/X arguments may get, I don't think Charles III or even Kier Starmer is quaking in their beds expecting to be put on trial for treason.  

So maybe our history has something to teach us about how we navigate culture wars.  

The literary critic Terry Eagleton once wrote of our age:  

“the world is accordingly divided between those who believe too much and those who believe too little. While some lack all conviction, others are full of passionate intensity.” 

 We tend to think our contemporary divide between left and right, progressives and conservatives is something new. But we can find echoes of this in previous times.  

A case in point was the mid-17th century – the time of many other upheavals in Europe. Part of the febrile atmosphere of the time saw fierce arguments between rationalists and sceptics.  

There were at the time, two broad strands of thinking about the human condition. On the one had there were the ‘Dogmatists’ who were sure that they knew everything through use of reason or the application of philosophical or scientific method (like René Descartes). On the other hand, there were the ‘Sceptics’ who thought everything was random, or custom, and there is no final Truth to be found (like a figure from the century before – Michel de Montaigne). 

Of course, our own time has its fair share of people with an overwhelming confidence in the power of human knowledge, and the physical sciences in particular, to unlock the secrets of life, the universe and everything. The ‘new atheist’ project of Richard Dawkins and friends was hugely confident in reason and its capacity to tell us all we need to know, dispatching religion to the dustbin of history and instead placing an unshakable faith in the empirical methods of science. It had - and has - definite similarities with this picture of human knowledge.  

Yet on the other hand we also have, in the progressive postmodern project, those who reject any kind of underlying rationality or sacred order either above us or beneath us. For them, there is no underlying Truth to be discovered, and they delight in revealing the instability and illusory nature of any claim to truth. It sounds very much like the culture wars of our time. 

One enigmatic 17th century figure charted a way through this dilemma - Blaise Pascal. When he looked at his century’s culture war, he thought both sides had a point. There is, he observed… 

…open war between men in which everyone is obliged to take sides, either with the dogmatists or with the sceptics, because anyone who imagines he can stay neutral is a sceptic par excellence…. Who will unravel such a tangle? This is certainly beyond dogmatism and scepticism, beyond all human philosophy. Humanity transcends humanity. Let us then concede to the sceptics what they have so often proclaimed that truth lies beyond our scope and is an unattainable quarry, that it is no earthly denizen, but at home in heaven lying in the lap of God, to be known only insofar as it pleases him to reveal it. 

So far, he says, the sceptics, like Montaigne, are right. Truth is beyond our grasp, it does not reside here on earth, openly obvious and ready to be found. If it exists, it exists in some world above us, beyond our reach. How do we even know if we are asleep or awake, given that when we dream, we are as convinced that we are awake as we are when we are truly awake?  

And so, modern progressives, looking to dismantle the assumed results of previous understanding, due to its inherent colonial, patriarchal or abusive past, delight in showing how random and arbitrary is so much of what we take for granted from the past. And, Pascal would add, they have a point. Many of our legal, political and cultural assumptions are purely cultural and arbitrary, and sometimes simply serve to the advantage of the rich and powerful rather than the poor and marginalised. 

Yet on the other side, the ‘dogmatists’, like Descartes, have their strong point, which is that we cannot doubt natural principles. The acids of deconstruction can only take you so far. The most sceptical philosopher still puts the kettle on assuming that it will boil to make a cup of tea. She gets up in the morning assuming that the sun will rise and set again at the end of the day. Despite the corrosive effects of scepticism, Pascal wrote,  

“I maintain that a perfectly genuine sceptic has never existed. Nature backs up helpless reason and stops it going so wildly astray.”  

Despite all our doubt, we still live in a world with order and predictability. Scepticism keeps bumping up against reality.   

So, modern conservatives point to a deeper ‘givenness’ to things, an order within the natural world that we did not create, and yet, mysteriously, seems to be prearranged before we got here. Scientific exploration does make sense. There is a regularity to nature that we can, indeed have to, depend on. Sexual differences exist and can’t be ignored. We are not entirely free to override the natural order of things - there is a deeper rhythm to nature and its capacity for renewal that we only mess with at our peril, as climate change has taught us. As a result, the age-old battle between rationalists and sceptics, progressives and conservatives, will never find resolution, as the arguments flow back and forth.  

Christian faith includes both progressive and conservative impulses. It can make sense of both of them. Christians are aware of the brokenness of the world and therefore long to see it changed. The progressive impatience with the way things are, and the yearning for a better world has its roots in Christian faith.

Yet at the same time, Christianity discerns a divinely created order to the world, a rhythm to the natural world, that cannot be broken and needs to be respected. Therefore, an inherent conservatism is part of Christian faith as well. In other words, the Christian story can explain both and offer a bigger picture than either.  

For Pascal, Christianity offers a diagnosis for this mystery of the human condition, the complex mix of grandeur and misery, infinity and nothing, sceptic and rationalist, in the simple, yet endlessly generative idea that we humans are gloriously created, deeply fallen and yet offered redemption through Jesus Christ. Our sadness is heroic and tragic. In Pascal’s suggestive image, it is “the wretchedness of a great Lord, the wretchedness of a dispossessed king.” 

“We show our greatness,” says Pascal, “not by being at one extreme, but by touching both at once and occupying all the space in between.” For him, the very existence of such culture wars points to the truth of the Christian diagnosis of the human condition. 

Pascal offers us a way between the Scylla of Progressivism and the Charybdis of Conservatism – or perhaps better, to embrace the best of both. Culture wars are tricky to navigate. Yet they might find resolution if we allow them to point us to a deeper reality - our strange mixture of greatness and sadness. And not losing sight of either side of this enduring truth.  

 

Graham Tomlin is the author of Blaise Pascal: The Man Who Made the Modern World  (Hodder) £25.  

Watch Graham explain why he is fascinated by Pascal.

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