Two doctors and the Anglican dean of Toronto approved and facilitated the assisted suicide of an elderly Canadian couple who asked to die together.

Two doctors approved George and Shirley Brickenden’s request for medically assisted suicide. However, while George endured heart problems and periodic fainting and Shirley suffered from rheumatoid arthritis, neither sustained terminal illness, according to The Globe and Mail. Anglican Dean of Toronto and St. James Cathedral Rector Andrew Asbil stood present at the couple’s assisted suicide as a show of support and approved “without hesitation” the Brickendens’ desire to have their funeral held at the cathedral.

No member of the Brickendens’ family or church leadership attempted to dissuade the couple or otherwise prevent their suicide despite being fully aware of their plans, according to LifeNews. One doctor denied the couple’s eligibility for assisted suicide during their initial request on the grounds George did not have a diagnosed illness or condition. Canadian law requires two doctors approve any assisted suicide request.

The first doctor, who approved the couple’s request, later performed the killing and is a known supporter of assisted suicide. The doctor also ensured that when the couple applied for assisted suicide a second time, they were assessed by a different doctor than the one who initially denied their request.

Asbil, the two doctors who approved their request, and several immediate family members stood present at the couple’s lethal injection.

Canada’s assisted suicide law stipulates the natural deaths of those who seek assisted suicide must be “reasonably foreseeable” and the patients must be enduring “intolerable suffering” and “irreversible decline.” The definitions of those terms are completely subjective, as they are not concretely defined in the medical community or in Canadian law. In the Brickendens’ case, rheumatoid arthritis and heart issues associated with fainting were all it took to qualify for death on demand.

Some experts, like University of Toronto Law and Bioethics Professor Trudo Lemmens, are concerned about the prospect of mere age and age-related medical issues being used as justifications for assisted suicide.

“From a societal perspective, this would be problematic,” Lemmens told The Globe and Mail. “Both the [Supreme Court of Canada] decision and the legislation treat active life-ending measures by physicians as an exceptional procedure, an exception to a still existing criminal law prohibition. We should be very careful not to normalize it as if it is the solution to all end-of-life planning, even when we may have sympathy for the idea that a couple prefers not to leave each other behind.”

Canada now joins the Netherlands, Belgium and Switzerland — sometimes called “the infamous three” — as a country that now permits the assisted killing of the elderly. Both the Netherlands and Belgium have made assisted suicide available to citizens of various ages, those suffering from mental illnesses, and those who are otherwise physically healthy but claim to suffer unbearable mental or emotional anguish.

The Anglican Church of Canada’s Task Force on Physician Assisted Dying published a report on assisted suicide. They said the church in general does not condemn assisted suicide, nor do they believe it marred the inherent dignity of individuals, who the church believes are all made in the image of God.

Theologically we continue to assert that human persons, being in the image of God, are the bearers of an inalienable dignity that calls us to treat each person not merely with respect, but with love, care, and compassion. This calling, being a reflection of God’s free grace, is in no way qualified by the circumstances that an individual may face, no matter how tragic. Neither is that inherent dignity diminished nor heightened by the decisions they make in those circumstances, even if they differ from the decisions that pastors might in good conscience make or recommend.

Neither the report nor the accompanying study guide offered a concrete position from the church on assisted suicide, beside noting it was not an affront to human dignity as being made in the image of God. The documentation instead urged church members to discuss the matter among themselves.

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