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
Character
Comment
Friendship
Virtues
4 min read

As algorithms divide us, who should we be loyal to?

An ethicist’s answer, shows we need courage and wisdom too.

Isaac is a PhD candidate in Theology at Durham University and preparing for priesthood in the Church of England.

Three people sitting looking out over viewpoint are silhouetted against the sky.
Priscilla Du Preez on Unsplash.

What is loyalty? As we plunge into this new year of 2025 it seems as pressing a question as ever. The war in Ukraine rumbles on, a fresh Labour government continues to struggle with public opinion, and America returns to the unpredictable rule of the first president in its history to be a convicted felon. The algorithms of social media continue to segregate and amplify different audiences into ever more closed feedback loops and echo chambers. This may bolster loyalty to a point of view, but estrange us further from our friends and neighbours whose loyalties lie elsewhere. All of these and many other cases highlight the conflict of loyalties in our society and wider world. What is even more obvious is that if we are to make peace, cultivate love for enemies, and pursue the common good, then perhaps the most in-demand virtue of 2025, at the top over every wish list, might just be loyalty.  

But what really is loyalty?  

I was struck by a persuasive answer given by Dr Tony Milligan, research fellow in philosophical ethics at King’s College London, during his appearance on a recent episode of The Moral Maze on BBC Radio 4 that asked ‘is loyalty a virtue or a vice?’ He said loyalty is, “Sharing another person’s commitments and the willingness to go through various kinds of adversity in order to pursue those commitments and to further them.” Under cross examination and asked if loyalty is then an absolute virtue he responded, “I think that it’s absolute in the sense that we absolutely need to have it, that it’s basic to the human condition and not optional.” His second interrogator, Giles Fraser, then suggested a ‘high doctrine of mates’. In this doctrine you are loyal to your mates in all circumstances, even if they are ‘wrong-uns’. Dr Milligan’s response, when asked how he would characterise this ‘doctrine of mates’ position, was fascinating: “Addiction.” Fraser then asked if that addiction could be love. “It’s a case of love, and we don’t get to choose the people that we love. We find ourselves in the predicament and then try to make the best of it…I love my wife Susanne, I’ve been with her 31 years, and it’s love, and it’s also addiction. I just can’t envisage a world in which I would be without her.” This framed Dr Milligan’s final powerful point: love, and the loyalty which love entails, gives us our sense of value.  

I can bear witness to the truth of Dr Milligan’s intertwining of love and loyalty. Last autumn I became a father for the second time. My love for my eldest is so great that there was a real question: ‘if my love for my eldest is so total, so all encompassing, how can I possibly love a second as much?’ This question melted away as I gazed into her screwed-up face, moments after she entered the world. I am completely dedicated to ensuring that she flourishes and I would “go through various kinds of adversity in order to pursue” her flourishing. As Dr Mulligan also said, loyalty “is basic to the human condition and not optional.” Of course, how this total and non-zero-sum loyalty of love to both of my children actually works in practice requires of me thoughtful negotiation. If one wants to go to the park and the other wants to go to the swimming pool I cannot split in two and do both things at once. Loyalty, as finite human beings, requires wisdom in living in the middle of a messy network of demands and desires, of the preferences and needs of others. 

If loyalty is then one thing, it is the willingness to recognise that we are tied to other people, whether we like it or not. Cain’s question to God, when God came looking for Abel, is still pertinent: “Am I my brother’s keeper?” Perhaps the greatest disloyalty is the implied ‘no’ in Cain’s rhetorical question. In denying that he is bound to his brother he is disloyal not only to Abel, but to himself because he denies his own humanity and isolates himself from the humanity of other people. If we isolate ourselves, having loyalty only to ourselves, we lose the joy of being fully human. If we simply kill those we dislike, whether literally (in war or murder) or metaphorically (‘unfriending’, cancelling, pretending they do not exist), then we follow Cain. Loyalty, as the tie that binds us to the messiness of the real world where people vehemently disagree all the time, requires not only wisdom then but courage also. It takes courage to commit to one person in marriage. It takes courage to raise a child. It takes courage to continue to talk with and to love those with whom you deeply disagree.  

When practising our 2025 New Year’s resolutions let us make sure that amongst the commitments to get back to the gym and practice that new hobby that we remember to practice loyalty. Loyalty not only to those we love, but to those we might come to love. Let us be wise enough and brave enough to be fettered to those with whom we disagree, loyal to the humanity that binds us together.

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