MARY came to see me last summer. She has Parkinson’s disease. “It’s not just the bloody Parkinson’s,” she said, “but I’m so lonely. I’ve been divorced for years, no children, and I just don’t have any friends. I’m depressed; it all seems pointless; I know I’m going to die; so I’ve decided that I’m applying for MAID.”

That is Canada’s Medical Assistance in Dying. Mary (not her real name) was eventually dissuaded from ending her own life by a group of us at church who organised a support group, helped her with some minor money problems, and simply made her life feel less bleak. The thing is, if she had gone ahead and made an application, there is a very good chance that it would have been accepted.

I have long been an advocate of a highly limited, strictly controlled form of assisted dying. Alas, zealots on both sides of the debate make it a very difficult subject to discuss, rather like abortion. As a priest who works a great deal with the severely ill, however, I have seen too many cases in which people plead to be allowed to go, cannot take the pain and the medical intervention any more, and live in constant fear of dying alone and in fear.

I have also seen young people who think that life is darkness, older people who are convinced that they are burdens on their family, or that all of their savings are being spent on care homes when the money could go to their children, and people such as Mary. A mature, genuinely compassionate, and humane medical and legal system would never allow those people to be helped to die. But many fair-minded people in Canada are now wondering whether that is so.

MAID was introduced in Canada in 2016. By now, more than 45,000 people have had their lives ended. In 2021, there were more than 10,000 cases, and, the following year, the rates had increased by 30 per cent. There is no indication that the increase will stop. A staggering 4.1 per cent of all deaths in Canada now are because of MAID.

There are countless horror stories about the system and its apparent abuses, but it is often difficult to know whether they are genuine or apocryphal. I do know personally of at least one doctor suggesting — some would say recommending — MAID to his patients. In British Columbia recently, a 52-year-old cancer patient, Dan Quayle, opted for MAID because the province’s medical system simply let him down. His partner, Kathleen Carmichael, said: “The oncologist would come in and say, ‘We’re pretty backlogged right now; so hang in there.’” He died on 24 November. That story became a prominent news item, and it would be absurd to consider it unique.

Canada’s public-health system is under siege financially and politically, and palliative care is one of the hardest-hit sectors. Although official reports of MAID deaths show that many of those who took advantage of the system had received expert and long-term care, they also reveal a number who either did not receive acceptable levels of help or were not made aware of what was available, especially in terms of pain control. Family doctors are the first line of help for the sick. In Canada, as in the UK, it can be incredibly difficult to find one.

THERE is another issue. From March, mental illness may qualify for assisted death. Recently approved amendments to the law will allow mental health to be considered as a “grievous and irremediable medical condition” required for MAID to take place. This expansion into areas of mental health is deeply worrying, and any priest, any person who works with those with psychiatric challenges, knows the connections with poverty, abuse, and homelessness.

To consider mental health as a criterion without addressing the horrors that may have caused the situation is downright terrifying. Aboriginal leaders in Canada have also spoken out about this, because native people are often over-represented in the area. They argue that what was conceived as a policy to ease suffering for those in unbearable pain could become yet another weapon with which to condemn the poor and marginalised.

Ironically, perhaps, the Conservative opposition in Canada, which is very likely to win the next election, has said that it will reverse any mental-health aspect of MAID; but that remains to be seen: once a medical policy is in place, it is extremely difficult to change it.

What has become obvious is the exponential nature of all this, and how quickly an idea became a reality. Canada is a sensible and moderate nation. If assisted dying is legalised in the UK — and that’s far from impossible under a new government — there have to be a national committee co-ordinating and supervising, constant transparency, and a long-term guarantee that the initial qualifications will never be expanded. Learn from our mistakes: don’t repeat them.

The Revd Michael Coren is a priest in the Anglican Church of Canada. His latest book, The Rebel Christ, is published in the UK by Canterbury Press (Books, 14 April 2023).