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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28 November 2024

4 min read

Here's why we need to keep democracy holy

It's much more than a utilitarian deal that benefits the most.

George Pitcher

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

A sign reading 'polling station' stands by the entrance to a church.

Red Dot on Unsplash.

One of the more ludicrous constitutional contributions of late has been the parliamentary petition, with well past two million signatures when I last looked, demanding another general election be called, because the Labour government, elected in July, has “gone back on the promises they laid out in the lead-up to the last election.”

Prime minister Sir Keir Starmer has surprised precisely no one by saying that he won’t be calling one. And so we’ll move on. But, in passing, what is truly breathtaking is how little our democracy is understood and, apparently, how unseriously democracy in the west is now taken. If that sounds unduly censorious, I have a two-word response: Two million!

Little time need be spent on demolishing the premise of this spurious petition, other than to wonder how many of those signatories would have appeared on one calling for, say, a fresh mandate after the coalition government of David Cameron and Nick Clegg (where is he now? Ah yes) performed a massive reverse-ferret on a manifesto pledge not to raise university tuition fees.

Or how many of these same fearless electors believe the result of the Brexit referendum should be voided because of the lies of the Leave campaign, most notable the one painted on the side of Boris Johnson’s battle bus. But no – two million residual, self-righteous righties can only be mobilised against a Labour government.

This event none the less raises valid questions about what our democracy is (and is not) and why we should want to protect or even cherish it. These questions become the more critical because there’s a tangible feeling of slippage in western democracy, as if we’re growing a bit tired and even contemptuous of it.

There’s the ominous re-growth of nationalism across Europe. And not a few bien pensants – me included, to my shame – might admit to a feeling after Donald Trump’s re-election as US president that democracy is too important to be left to the people.

Slightly more seriously, we need to ask ourselves what the qualities of democracy are that we should seek to defend. The first of these is, quite obviously, the rule of law. Should a political actor seek to overthrow a democratically established electoral process, then that is a crime within the rule of law. Witness the horrors on Capitol Hill in Washington DC on January 6 2021.

That’s the Feast of the Epiphany as it happens, but nothing to do with the coming of wise men. With Trump at the centre of it. Draw your own democratic conclusions – and weep for the rule of law.

Natural justice is to ensure that vexatious petitions don’t overthrow legally elected governments, either by lobby or violence.

Again, why does this matter and what is it about democracy that we hold sacred, even holy? It can’t simply be that we hold dear a kind of hard utilitarian ideal that what we elect to do is for the benefit of most of the people, for most of the time, as decided by popular mandate among the demos.

If we believe in democracy, as I believe most of us do, we’re presented with a choice: We can look to secularism as a solution, universal Enlightenment principles built on citizenship and equality before the law. Or we can look to a multiculturist model, keeping the peace between essentially separate communities and the state.

Or we can shape something on Augustinian Christianity, that recognises the limits of political democracy, which would eschew undemocratic theocracy, but which would hold that no political order other than the Body of Christ (the Church) can claim divine authority.

We’re in classic Rowan Williams theological territory here: “[T]he Body of Christ is not a political order on the same level as others, competing for control, but a community that signifies, that points to a possible healed human world.”

Unsurprisingly, I buy that. Williams goes further to state this spiritual effect on the political environments in which we find ourselves is likely to be “sceptical and demystifying.” Which seems to be a reasonable manifesto in a democracy.

The principle of election can be a worrying one in theological terms. We don’t “elect” God, though some secularists would claim that the Godhead is our invention. Rather, it has sometimes been perceived to be the other way around historically.

Reformational Calvinism would hold, among many other things, the rather terrifying view that we’re elected by God. “The Elect” are those who will be saved, while the rest of us (I presume) can rot in hell. Little democracy there.

Less deterministically, a more modernist worldview would argue that the Christian faith, on which foundation western civilisation is built, offers a viable moral definition of the lawful state, with which politicians of all (democratic) persuasions can tackle issues of global justice.

One such issue of natural justice is to ensure that vexatious petitions don’t overthrow legally elected governments, either by lobby or violence. That’s an important aspect of Christian witness and will require true grit in in its application during the years ahead. That’s, if you will, our grit in the democratic oyster.