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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?    

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Sustainability
6 min read

Does COP make any difference?

When climate deal makers and justice seekers meet.

Juila is a writer and social justice advocate. 

A speaker holds two fingers up while sitting in front of a backdrop reading 'United Nations Climate Change.
Brazilian politician Geraldo Alckmin addresses COP29.
Vice-Presidência da República, CC BY 2.0, via Wikimedia Commons.

This year’s UN climate talks have come to an end with a headline-grabbing figure, reports of deep divisions and cries of failure. How do we understand the legacy of these negotiations for us now and for the generations to come?  

COPs bring together negotiators from almost 200 nations, along with tens of thousands of people from across business, civil society and local communities. They gather to make decisions about this crisis that touches every community and part of our lives and our world, though not equally (which is part of the issue). The annual negotiations are the culmination of months of action and diplomacy. The negotiators pore over draft texts to understand the implications of a new set of brackets, they search for sources of free coffee to power them through the increasingly sleepless fortnight, and scrabble at the end to land on a consensus.  

At COP29 this year, the key things at stake were a new finance deal that was three years in the making and a wave of 2035 national climate targets. Lurking amongst discussions were the implications of the US election results. The pressure was on to land strong decisions before Donald Trump – who withdrew the USA from the landmark Paris Agreement on climate last time he was in office and has stated his intention to do so again – returns to the White House. 

What did we get at the end of all of this? 

Finance in the spotlight 

The new finance goal of at least $300 billion per year by 2035 for lower-income countries seems like a big number, but is around a quarter of what is needed, $1.3 trillion. For what was dubbed 'the finance COP', wealthier nations came with a distinct lack of actual money, despite their obligations towards those countries least responsible and hardest hit by climate change. The $300 billion could be spun as a tripling of the previous commitment of $100 billion a year – but taking into account inflation, it’s nowhere near that in real terms. And it’s not just about the quantity; much of that money is likely to be loans, driving already strapped countries even further into debt. 

When lower-income countries argued for that $1.3 trillion, this wasn’t them trading Pokemon cards in the playground. It was about the very existence of people and whole communities. Climate Action Network, a global network of over 1,900 civil society organisations, labelled the outcome a betrayal, while India's delegate Chandni Raina called the final text “little more than an optical illusion”. 

To build meaningfully from this, the last-minute addition about using the next 12 months to develop a roadmap towards that $1.3 trillion needs to be a priority. This finance could come from sources such as taxes on shipping, aviation and the wealthiest in society. This money would be an investment in the world we need – more secure and stable in the face of growing climate chaos and more frequent flooding and storms. 

Emissions reductions left in the dark  

The other key test of this COP was meant to be the countries’ national climate commitments which are due to be updated and strengthened by February next year at the latest. Despite this, the UK was one of just a few countries to come with a new target. In Baku, nations had the opportunity to collectively agree how they will implement the commitments from last year to transition away from fossil fuels – but kicked those decisions to next year. This is in the context of plateauing action to curb warming; since 2021 we have been on a path toward 2.7°C by the end of this century. (This analysis suggests the recent election of Donald Trump could add 0.04 °C of warming due to rolling back US climate policies; not good, but not the derailing some feared. The potential impact on collective action is as yet unquantified.)  

A mirror to the world  

Questions are inevitably being asked about these COP events: are they “no longer fit for purpose”? Is it time for something else to deliver the scale and urgency of action required?  

I was struck by the words of Alden Meyer, with his 40 plus years of experience in climate policy: 

“COPs are where the world holds a mirror up to itself to see how well it is doing in the fight against climate change; when the image in the mirror is ugly, it does little good to blame the mirror.” 

We do not like what we are seeing. Two weeks of tough negotiations culminating in imperfect outcomes expose our frustration with the rate of our change. They magnify our longing for COP to solve this crisis that frightens and overwhelms us.  

But COPs are only as good as the governments, businesses and people that will turn the agreements into lived reality. That’s why those national climate plans due next year matter so much. This mirror indicates that climate seems to have slipped a little down the priority list, despite the growing urgency. 

The mirror analogy is a good one – but we also need to recognise where there are vested interests who would obfuscate what we see and what is decided. Among the thousands who descended on Baku were 1,773 fossil fuel lobbyists — more than all delegates from the ten most climate-vulnerable countries. This is part of a recent trend of outsized influence by those who would invest against our collective future for the profit of burning more fossil fuels.  

Weeks like last one remind us of the flaws in the COP process – but the answer is not to ditch the whole thing. COPs are the only forum where every country is heard on this global issue. Existing power imbalances are reflected and needed to be addressed; a concrete finance figure only appeared on the last scheduled day of negotiations, putting lower-income nations were under pressure to accept it as clock ran down. In the final hours, several delegations walked out of a meeting to express their frustration with what was on offer. 

COPs provide a space for civil society, youth activists, faith and community leaders to speak into global decisions and shape the world and our future. Getting the agreement we got is in part testament to the advocates who kept finance solutions on the agenda.  

The COP processes need to be made fairer and more accountable, to steer a clearer way forward for climate action of the scale and speed we need. But if we scrapped them, we’d only need to create a different space for international diplomacy in their place – and we certainly don’t have time for that.  

We see only in part   

Ultimately, our disappointment with COP shines a light on our longing for a more hopeful future. It would be easy to let weeks like the last one harden or discourage us. But legacies are hard to see in the moment. Prior to the 2015 Paris Agreement, we were headed for at least 3.5℃ of warming by the end of this century; a catastrophic change to our world and inheritance for future generations. COPs have played a key role in shaving almost a degree from that trajectory. It still isn’t enough, but it isn’t nothing.  

COPs show us something of the world as it is – messy, broken and yet suffused with people devoting themselves to justice again and again. For many, there’ll be some much needed rest to catch up on, because this is a race for the long haul. We live and act and speak for justice knowing that legacies don't fit nearly into a headline or media quote. They are slower to be realised and understood. The challenge to us all is to keep sowing faithfully, knowing we may not be the ones to reap in our lifetime. To keep acting in love and hope – even when the end is not in sight.  

One of the early church leaders, Paul, wrote in a reflection on love: “For now we see only a reflection as in a mirror; then we shall see face to face.”