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
Community
Creed
Sin
3 min read

In the city of broken windows

Our fractures become fractal, breaking bigger and bigger windows.

Jamie is Vicar of St Michael's Chester Square, London.

a multi-paned window mural shows people while amid it are broken window panes.
A broken window mural, Ellis Island Immigrant Hospital.
Rhododendrites, CC BY-SA 4.0, Wikimedia Commons.

We weren't expecting a knock on the door from our next-door neighbour on New Year's Day. It was pouring with rain, and said rain was pouring into the boot of our car, with the window smashed. Thanks for letting us know. Annoying, inconvenient and expensive. But just how expensive is a smashed window? 

The 'broken windows theory', that visible signs of crime, antisocial behaviour and civil disorder begets more serious crimes, was introduced American sociologists James Q. Wilson and George Kelling: 

'Social psychologists and police officers tend to agree that if a window in a building is broken and is left unrepaired, all the rest of the windows will soon be broken. This is as true in nice neighborhoods as in rundown ones. Window-breaking does not necessarily occur on a large scale because some areas are inhabited by determined window-breakers whereas others are populated by window-lovers; rather, one un-repaired broken window is a signal that no one cares, and so breaking more windows costs nothing. (It has always been fun.)' 

This is not an academic theory. Where I live in London, i took the local council 1,315 days to replace a local resident's broken window. The sense of decay extends beyond borders, with fewer than half the residents thinking they live on clean streets, with rubbish and weeds gone unchecked. It is also one of the worst boroughs in London for varying types of crime, and over the past few years often being the worst. It's hard not to think the little things and the big things are linked. In other news, the now-resigned CEO of the council has pleaded guilty to drink-driving, failing to stop after a car crash and driving without insurance, and not guilty to possession of cocaine. 

Our problems in society all found their greenhouses somewhere inside of us.

Crime is on the move. As homes have become more difficult to burgle, crime has been pushed out onto the streets with shoplifting and bike theft. The Economist recently reported that 'stolen bikes and e-bikes have also become the getaway vehicle of choice for thieves, according to the Merseyside police. In one way or another, some 80 per cent of acquisitive crime in Liverpool involves a nicked bike.' It's going to be fascinating to see the wider impact, but simply by stopping suspicious riders and marking thousands of bikes across Liverpool, reported thefts have fallen by 46 per cent between July 2023 and July 2024 compared with the previous year. 

These problems can't be solved by overstretched police or the council. Everyone's responsible so no one's to blame. Practical implementations of the broken windows theory have not been without controversy. But for those of us who live in urban environments, to look out from our homes is to see a city of broken windows. The impact is more than weeds 'uprooting' pavements: it's an uprooted society. Correlation and causation might be blurred, but that's the point. In Christianity, sin is understood as having a polluting effect. Just as fossil fuels in China will pollute the atmosphere for someone in Scotland, sin is not hermetically sealed. Our problems in society all found their greenhouses somewhere inside of us. 

Jesus said 'what comes out of you is what makes you 'unclean'. For from within, out of your hearts, come evil thoughts, sexual immorality, theft, murder, adultery, greed, malice, deceit, lewdness, envy, slander, arrogance and folly. All these evils come from inside and they make you 'unclean'.' They pollute our lives. And they pollute the world around us. 

The Christian church, much like many institutions, is reckoning with prioritising competency at the expense of character. Little sins are not so little when they permeate and promote a culture where certain sins are permissible. Our fractures become fractal, breaking bigger and bigger windows. 

All this sounds pretty bleak and Dickensian when of course there's always another city to see: full of life, vibrancy and joy. But we'd be wilfully ignorant to ignore the disorder of broken windows and broken lives all around us. It might overwhelm us, or our eyes might glaze over as we see those broken windows. But we'd do well not to ignore the broken windows within us too. For our sake, and the sake of our streets.