A Life-Affirming Life

Dr. Paul Saba Takes After the Great Physician

Dr. Paul Saba is a physician based in Quebec who has spent his career, both at home and abroad, living out what it means to enact the “Good Samaritan” model of healthcare. He has provided medical services in underdeveloped countries, helped the financially disadvantaged to receive life-saving medications, and worked tirelessly to keep his Quebec community hospital, Lachine Hospital, running, so that every person has access to needed healthcare services. His 2020 book, Made to Live: A Physician’s Journey to Save Life, details his arduous battle against Canada’s euthanasia and assisted-suicide laws, as well as his endeavors to save and honor the lives of his patients from their natural beginnings to their natural ends.

Your book is called Made to Live. What do you mean by this, and how did you come up with that title?

Before my daughter Jessica was born, we were told at 20- and 24-weeks’ gestation that she had a severe cardiac abnormality, that she probably was a Down’s baby, and that we should consider our options. That was code for “abortion.” We said, “Absolutely not.” And they continued to ask that question all the way up to the time that she was delivered. They would call my wife and say, “Have you reconsidered?” because in Canada, with abortion, there is no time limit. Third-trimester abortion in our province can be used for exceptional circumstances, including “social crisis.”

“Social crisis” could mean anything.

That’s right. My wife was very clear. She said, “You do everything for my baby.” Even though our laws will benefit the mom over the baby, my wife showed how committed she was to the birth of this baby. Jessica was born, and they had to do a procedure at six days. They opened up the valve, and her heart started to function. Then they had to do a redo procedure at 11 months. Recently, during a routine exam, the cardiologist said, “If I didn’t know what she had been through, I would never know she had a heart malformation.”

When Jessica was seven, I asked her to draw a picture of our family. She drew the picture of a family—Dad, Mom, sis, bro, “me, Jessica”—and above she wrote, “Made to Live.” That motivated me to write the book.

I love that. Why wouldn’t you do all you can to save your child instead of snuffing out her life prematurely?

Every aspect of life is stressful, and we do everything we can to alleviate it. We don’t prevent life, because we’d be preventing life every step along the way if we tried to remove all the stresses and difficulties. That’s why the book is about life from birth to the natural end, so that it’s a continuum. I’ve had people in the anti-euthanasia movement say, “You shouldn’t talk about abortion.” I said, “No, abortion is similar. It’s ending a life somewhere along the continuum.”

How did you work against the legalization of assisted suicide and euthanasia in Canada?

I’ve done many different actions from many different levels. I’ve participated in parliamentary commissions. I’ve sent briefs. I’ve done a petition drive. I’ve held conferences. I’ve participated in court and was able to stop the law for two weeks in our province. The attorney general sided with me, and then they did an about-face a short time later. The prime minister, Justin Trudeau, spoke out in support of euthanasia during the court proceedings. I decried this as government interference.

The attorney general of Canada and Quebec submitted to the court that I should not be allowed to speak or write against it. Since I wasn’t impartial, I would have to make a public statement [saying] that I’d be willing to be euthanized before I could speak in court against it. That goes against our Canadian charter of rights and freedoms. Thankfully, the judge didn’t accept their argument about that part. The problem is that it shows how far our governments will go to oppose and suppress any opposing views. They’ll do anything they can to prevent any opposition to the expansion of this “program.”

Once euthanasia becomes legal, it can take away people’s rights, kind of like vaccines. If they can mandate vaccines, which have certain side effects—I’ve always been opposed to mandated anything—why can they not mandate euthanasia?

Have you ever known doctors to be wrong about a diagnosis, or wrong about how long a patient has left to live?

I had a patient who was told he had lung cancer. He said that if euthanasia had been legal, he wouldn’t have gone to treatment; he would’ve just taken euthanasia. In Canada, the law doesn’t require you to undergo investigation or treatment. You can say, “That’s enough information for me, I want to be euthanized.” If you can find two doctors willing to sign, they can sign off. For all intents and purposes, it looked like he had lung cancer. All the x-rays and scans confirmed lung cancer. We were able to convince him to undergo a biopsy, and it turned out to be lymphoma. At one point, the resident had told him he didn’t have lymphoma [but] had lung cancer, so he had misinformed the patient. The patient underwent treatment several years ago, and he hasn’t had any recurrence. He’s very much alive.

I bring out in the book that for an estimate of doctors’ diagnostic errors in the U.S., you can look at insurance claims. For medical/legal claims there is up to about a 20 percent error rate in the diagnosis of severe illnesses. So not only do I have anecdotal reports, but it’s also known in insurance research.

What’s the most common reason you’ve seen for people requesting assisted death?

Most of the reasons people do it is because they don’t want to be a burden. They feel alone and isolated. They can’t do the activities that they used to do.

They feel a duty to die. They feel useless.

Yes. A lot of it is psychosocial distress. Occasionally the reason will be pain, but there’s no reason for people to have pain with all the medications we have.

God wants us to be actively involved in helping people, comforting them, healing them, [but] never shortening people’s lives. I like Dietrich Bonhoeffer. One of his famous quotes was “not to speak is to speak, and not to act is to act.” So when we don’t intervene to make people’s lives better, we’re actually condoning what is going on, and that’s why I can’t stand aside when I see people’s lives being shortened through euthanasia and assisted suicide. And I’m a strong advocate for more screening tests. If we can prevent cancers by doing more and better screening, we can give people a chance.

How can we make the lives of the dying meaningful?

I think we need to be there. We need to support them, spend time with them, and help them. If they can’t cook, find ways to bring meals to them, or groceries. When people fall sick, they’re financially strained. They can’t work. Insurance often doesn’t cover all that they need. If you can’t personally deliver groceries, you can send them. If you can, visit them. It’s always nice to be there and be with them.

Show them that they’re still valuable and worthy of life and dignity.

Yes. I talk in my book about a fellow who wanted to die, and his neighbor came by and just spent time with him, and he changed his mind. Spending time with that person changed his whole view because he didn’t feel alone.

Let me ask about healthcare in Canada. You have said that universal healthcare isn’t as great as people seem to think.

I wouldn’t say that Canada should take on a private-care system like the U.S., but I think what we need to do is make sure everybody has healthcare coverage so that nobody is deprived of medical care and so that euthanasia and assisted suicide won’t be the least-expensive alternative.

Canada is promoting it for savings. Once people are sick, they’re not productive. You can’t work when you’re sick. The insurance companies see it as a benefit, too, because then they don’t have to pay for ongoing treatment. What we have to change is the mindset, not so much the type of healthcare system.

We need to be building capacity. I often talk about the Titanic. People died because there was a lack of lifeboats. We need to provide more lifeboats. During the Covid epidemic, they talked about limiting access to intensive-care beds. They were going to deny critical care to anyone with less than a 70 percent score on a survival-evaluation scale. Intensive care and hospitals should be there to care for people who need care and not reject people who are considered complicated and in need of extra care.

Is there anything else you’d like readers to know about the work of making assisted death illegal?

I think the greatest danger is apathy. And apathy can come in many ways—apathy of thinking it doesn’t concern me, I will never sign up for it, and it probably won’t affect my family. Of course, that’s false because they’re discussing opening it up for children in Canada. Right now, if you have any child or family member 18 and over, it’s done independently of family involvement because the person is considered an adult. And eventually it will be for children as young as 11 or 12, without family involvement, because they’ll be considered mature children, even though they can’t always see around the bend. Children don’t always make the best choices. That’s why they’re not allowed to sign up for credit cards by themselves, get married, or drive a car.

The other thing is the apathy of the community, including churches. Assisted death is very ingrained here in Quebec. I think, in the church, it needs to be spoken about. Tragically, they often strongly oppose bringing up these subjects because they say it’s not the place of the church to bring up debates about abortion, euthanasia, and other life issues.

That’s absolutely the place of the church.

Jesus spoke out against what the Pharisees were doing during his time. He was very countercultural. To be a follower of Christ and of his example is to go against the culture, and the churches who refuse to do that are not following Christ’s teaching. It’s anti-Christian to not do everything in one’s power to speak for and support and act for life. It’s anti-Christian to not support and promote life from conception to natural death. We’re created in the image of God, and when we kill a person, we’re killing God’s image. They always say, “dying with dignity,” but suicide and euthanasia are undignified dying. 

—To learn more about Dr. Saba or to contact him, visit www.MadeToLive.com.