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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8 November 2024

10 min read

How to respond when politicians talk about “our way of life”

Alasdair MacIntyre’s thinking helps us understand what we share across society.

Joel Pierce

Joel Pierce is the administrator of Christ's College, University of Aberdeen. He has recently published his first book.

Four men in suits, sit next to each other smiling, in the House of Commons.

Reform MPs in the House of Commons.

House of Commons, CC BY 3.0, via Wikimedia.

What is “our way of life”? It’s a phrase which slides easily into the rhetoric of politicians of every stripe. It’s what the Reform Party says is threatened by multiculturalism, but what do they mean by it? What kind of politics is sustained by talk of “our way of life” and is there a better way of thinking about such politics?

This summer, we made an exception to the time limit rule for television in my house, mainly so that I could have the Olympics on from morning to night. It’s a habit I acquired growing up in the United States, where an obsession over the quadrennial medal count is one of the few remaining things which bridges political and regional divides. During the Cold War, the Olympics were a way for Americans to proudly affirm the superiority of our way of life over the rigid training schedules and alien ways of the rival Soviet Union.

Although my memories begin around the fall of the Berlin Wall, old habits die hard, and so the Olympics, to me, was endless coverage of plucky underdog Americans overcoming the odds to defeat the machine-like discipline of a new set of rivals–now Russia and China

I moved to Britain just before the 2010 Vancouver Winter Olympics at which Britain won exactly one medal. At first I was bemused by the BBC’s coverage, which, of necessity, had to focus on British Olympians with little chance of winning. I was invited to cheer on eighth or ninth place finishers who had committed their life to a craft which would never bring the rewards of lasting fame or financial security. For them the reward was the Olympics themselves, the chance to compete amongst peers, to push themselves to their highest level, enjoying their sport and their performance for what it was, not for any external reward. In the terms of philosopher Alasdair MacIntyre, what these Olympians displayed was dedication to the internal goods of their sport–those goods that make a particular activity worth doing for its own sake. The Olympics were not about medals for them, but about showing what could be achieved if, as Olympians must do, they made their sport their way of life, dedicating themselves to its unique forms of excellence.

Sports, for MacIntyre, are but one example of a broader category he labels ‘practices’. Although MacIntyre has a technical definition of what counts as a ‘practice’, the general idea can be conveyed through examples he gives such as farming, researching history, architecture, chess, and chemistry. Practices are human activities which are worth doing for their own sake, which require a degree of skill and excellence, and in which what counts as that skill and excellence is, in part, defined and discerned by the people who participate in the practice. This last criterion points at something important about practices for MacIntyre: they are inherently social.

This is obvious in the case of sport. For an individual athlete to compete in a race they need not just other competitors to race against, but also trainers and coaches to prepare them for it, governing bodies to organise it, and, hopefully, spectators to cheer them on. It is, perhaps, less obvious in the case of individual farmer, but even here, one has to be taught to farm and, if one is wise, continues to learn and adapt through consulting with other farmers. A different way of putting this is that practices are the kinds of things which it’s not absurd to call “a way of life”. For an Olympic curler, curling is a way of life, just as much as farming is for a farmer.

There are many ways of life, many modes of being British, as diverse as the professions, hobbies, and passions which we find to have inherent worth.

However, this seems to offer little help in defining “our way of life” if it is being used in the way our politicians like to talk about it. If there’s one thing that I learned from all those BBC features of British Olympians way back in 2010, it was that aside from geographic proximity, there was not much that their way of life had in common with mine. I may be within driving distance of the rink where Winter Olympian Eve Muirhead learned to curl, but my workdays of wrestling spreadsheets and answering emails have little in common with ones spent lifting weights, studying strategy with coaches, and perfecting the just right spin on a stone as it’s released.

And, of course that’s not just true of Olympic athletes. The investment banker who attends our church shares a way of life with his colleagues in Edinburgh, London, and Tokyo, that is completely opaque to my wife and I, immersed as we are in the worlds of ministry and academia. I glimpse some of the internal goods of the practices of our dentist watching her check my daughters’ teeth and our plumber as he fixes our leaking radiators, but their way of life, the rhythms of their days, and what gives them satisfaction in their work as they move from appointment to appointment, eludes my understanding.

Where does this leave the search for a British way of life? If practices are as important to forming us as MacIntyre thinks, then the quest for any singular British way of life will ultimately be fruitless. There are many ways of life, many modes of being British, as diverse as the professions, hobbies, and passions which we find to have inherent worth. And even this characterisation does not go quite far enough, because all of these practices have a way of bursting the boundaries of Britishness if they really are worthwhile. A century and a half ago, football, rugby, and cricket were quintessentially British sports. Now they belong to the world.

Similarly, valuing these practices well within Britain has a tendency to open us to accepting those from outside our borders who can help develop them. The best footballer in Britain is Norwegian. Many of the doctors who ensured my daughters arrived safely after complicated pregnancies were originally from India and Pakistan.

Still, one might wonder if thinking about community through the lens of practices, as MacIntyre does, is too much of a solvent. Isn’t it a way of imagining us living near each other, but not with each other; siloed in our practices, in each of our communities, not understanding what our neighbours are up to? Not necessarily. For MacIntyre, the familiarity that arise from living near someone, hearing their worries at planning permission hearings, arguing with them at the local school’s parent council meetings, organising a community fundraiser together, or, even, being part of a family with them, can help develop an understanding of the internal goods of practices which we do not take part in. I haven’t lifted a brush to paper to since my secondary school art class, but my mother-in-law’s virtuosity with acrylics has led me to acquire an increasing appreciation for painting. Part of what helps facilitate this recognition is that, as MacIntyre argues, although the internal goods and the skills required to achieve them tend to be different for each practice, the virtues which we develop while pursuing them–patience, honesty, courage, self-control–are universal. Part of what helps us recognise others’ activities as practices, as worth doing for their own sake, are the virtues we see them develop as they do them.

This sort of recognition requires familiarity, the sort I might have with my neighbours in our corner of rural Aberdeenshire, but that I am unlikely to have with fellow citizens in Cornwall, Cardiff, London, or Glasgow. How then are we to respond to national politicians talking about “our way of life”? One answer might be: with extreme scepticism. This is MacIntyre’s approach. He rejects the nation-state, which he calls “a dangerous and unmanageable institution”, as a potential channel of communal unity. Instead, he calls on us to admit that modern nation-states exist as a contradiction, being both “a bureaucratic supplier of goods and services” and yet also something treated as sacred, which we are asked, on occasion, to surrender our lives to preserve. He notes with characteristic acerbity, “it is like being asked to die for the telephone company.”

However, here I’d temper MacIntyre’s rhetoric somewhat. While my attachment to bankers in Canary Wharf is largely a happenstance of history, a contingent fact generated by long forgotten necessities of eighteenth century geopolitics, it has nevertheless resulted in both of us being issued the same passport, governed by the same tax regime, and having the same set of regulatory agencies to complain to when things go wrong. Those may be manifestations of what MacIntyre disparages as “a bureaucratic supplier of goods and services”, but they nevertheless do bind us together. As such we both have an interest in making sure this bureaucracy acts as justly as it can, not because it is the embodiment of all that is British, Britain is much too diverse and interesting to be fully embodied in our political institutions, but because we all have an interest in the institutions in which we are enmeshed, British or otherwise, being run as justly as possible.

Surely politics is all about securing as much money and resources as possible for the people most like oneself. That, it seems, is often the unstated assumption when the talk of “our way of life”

Because we find ourselves tied together by these institutions to a diverse collection of people, we have an interest in learning about those with whom we live. Even those who are far away. And to also celebrate when goods and services delivered by our institutions result in success to which we, in a remote way, have contributed. I may not share a way of life with Adam Peaty, but, thanks to the BBC, I can have a glimpse into what his way of life is and can be happy that through my taxes I have contributed, in a small way, to helping him win another medal. Since that 2010 Winter Olympics Britain has come quite a long way and there is nothing wrong with a little vicarious pride in our athlete’s accomplishments.

But I can also be proud of athletes who didn’t win. Ones like BMX rider Beth Shriever who handled her unexpected last place finish in her final with a kind of grace and maturity, the kind of virtue, which someone more dedicated to her practice than to just winning can demonstrate. It is the facilitating of this kind of moral achievement which is more valuable than any medal.

Similarly, I can rejoice when a new hospital gets built in a neglected area in London, or more council housing is supplied to people in need in Edinburgh, hopeful that these lead to my fellow citizens achieving the kind of flourishing lives they deserve. I can be angry, when I discover that the money I’ve paid towards postage has been used to prosecute innocent victims of a computer glitch, and pleased when the opening of a new rail line eases the otherwise stressful commute of tens of thousands in London. The state may be a bit like a telephone company, but a well-run utility can do a lot to supply people with the goods they need to make their lives. As long as I’m a subscriber, as long as I’m tied to people through national institutions like the state, I have a moral duty to ensure that they’re run as well as possible.

This way of thinking about politics may strike some as idealistic, the kind of view only a naive Christian ethicist could endorse. Surely politics is all about securing as much money and resources as possible for the people most like oneself. That, it seems, is often the unstated assumption when the talk of “our way of life” is deployed and why so much coalition building in our politics turns on finding a convenient other against which to define “our” similarity. Take your pick: immigrants, the EU, woke elites, the Tories, or Westminster (among a certain brand of politician here in Scotland).--. Growing up in the USA, the Soviets, and then the Chinese, and now, depending whether one lives in a Republican or Democratic district, the other political party, have served the same purpose. The problem is that we aren’t that similar, we are and always have been a diverse lot with diverse needs. Every nation is. There is no one British way of life and to allow our politicians to try to sustain the fiction that there is lets them off the hook. Solving deep seated economic and social inequality is hard. Blaming immigrants for not embracing our way of life is easy.

So, perhaps the sort of politics that I am talking about here is idealistic, nevertheless it is the only kind that can sustain a just government in the long term. Without acknowledging the importance of goods we only partly understand which are pursued by people whose ways of life are different from our own, we cannot hope to sustain the minor miracle of coordination and mutual aid that history has gifted us with in our united kingdom.