Young Canadian with diabetes seeking assisted suicide in Switzerland

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Canadian government recently extended the implementation of euthanasia for mental illness until March 17, 2024, but the story of Kiano Vafiaen, the 23-year-old, who is not terminally ill but lives with type 1 diabetes continues. 

Kiano was originally scheduled to die by euthanasia on September 22, 2022. Then his mother started a campaign to stop her son from being killed, so the MAiD House rescheduled his death for September 28 and then cancelled it.

Margaret started a campaign and a petition to prevent Kiano from being killed.

The Euthanasia Prevention Coalition helped to prevent the killing of Kiano last year. After speaking with his mother I published an article titled: Mother wants to stop her 23-year-old son from being killed by euthanasia. (Link). EPC was given permission to republish Margaret's petition on CitizenGo. Almost 10,000 people signed the CitizenGo petition to prevent Kiano's death.

On March 17, Kiano was featured on an episode of the Rupa Subramanya Show. Rupa explains that 

Kiano was going to proceed with assisted suicide and was very close to completing the life-ending procedure before his family stepped in and his story ended up on the national news. 

The resulting backlash prompted the doctor who was going to perform the procedure to back out completely.

Rupa then explains that Kiano has now applied for assisted suicide in Switzerland.

Link to the episode of the Rupa Subramanya Show (Youtube Link).

Kiano remains alive but his suicidal ideation continues.

Euthanasia’s Cultural Collateral Damage: Edmonton man killed his wife given house arrest.

This article was published by the National Review online on March 21, 2023

By Wesley J Smith

Euthanasia causes egregious cultural damage beyond the direct consequences of allowing the killing — or facilitating the suicides — of sick and disabled people. Eventually, the lives of the elderly, disabled, mentally ill, and seriously ill come to be seen as less valuable than the “healthy” and able-bodied — to the point that their homicides are often winked at by society. (We saw this phenomenon during Jack Kevorkian’s mass assisted suicides in the ’90s, supported by the much of the media and accompanied by the unwillingness of several juries to convict for nearly a decade.)

A recent homicide case in Canada further illustrates the point. As regular readers of my work are well aware, Canada has fallen off the euthanasia moral cliff by allowing broad categories of people to be killed by doctors as a means of ending “suffering.” But that denigrating attitude toward people with serious health conditions is catching on, and now, a man who killed his disabled wife has only had his hand slightly slapped on the wrist by a judge for the crime. From the Edmonton Journal story:

A retired accountant who killed his severely disabled wife will be allowed to serve his sentence on house arrest rather than in prison, with a judge ruling the accused’s “caregiver burnout” lessens his moral responsibility for the crime.

Belzile pleaded guilty last month to manslaughter for injecting Christiane Belzile — a 69-year-old, non-verbal stroke survivor for whom Francois Belzile had been sole caregiver for seven years — with a lethal dose of insulin after she was injured in a fall in 2018. Belzile then tried to end his own life.

Despite Francois’s refusal of state assistance — and a threat to end their lives if they ceased to be able to live “independently” before the crime — he was deemed unable to form intent to murder and allowed to plead guilty to manslaughter. Good grief.

There is no question that euthanasia advocacy and legalization impacted the case:

[Defense attorney] Hurley added that Belzile saw his actions as “the compassionate shortening of the final step.” Hurley also noted societal attitudes toward assisted death are rapidly changing, noting, “The world has changed since Latimer, at least in Canada.”

(Canadian Robert Latimer murdered his daughter Tracy, who was disabled by cerebral palsy, back in the ’90s. He served about ten years — but only because it was mandatory — and had the support of a majority of Canadian people according to polls.)

So, in essence, Francios put Christiane out of his misery and out of pride — i.e., him preferring death over dependency — and the judge winked at the crime by imposing such a light sentence for an egregious act.

What a frightening illustration of the lowered respect for “compromised” human life that euthanasia consciousness breeds. People with disabling conditions and those who love them should be terrified.

Support the DEA in preventing assisted suicide by telehealth.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Drug Enforcement Administration (DEA) has proposed a new rule for prescribing drugs via telehealth. The rule states that when a person has not seen a medical practitioner and requires a Schedule II medication or narcotic that the prescription cannot be prescribed via telehealth. The patient would be required to see the medical practitioner in person before receiving the prescription.

This is an important rule in the assisted suicide debate in America. The assisted suicide lobby wants to provide lethal assisted suicide drugs to people via telehealth and then ship those drugs to the person via courier.

A person would then be approved for death by lethal drugs without ever being examined by the medical practitioner and receive the lethal drugs by courier.

Last year Vermont passed assisted suicide expansion bill SB 74 that permits assisted suicide by telehealth. The DEA proposed policy would prevent doctors in Vermont from approving assisted suicide by telehealth. This is important now that Vermont has become a suicide tourist state by eliminating their residency requirement.

Washington state's assisted suicide expansion bill HB 1281, if passed, will permit assisted suicide drugs to be sent by mail or courier.  There is nothing in the Washington state law that excludes approving assisted suicide by telehealth. Approval by telehealth and shipping the lethal drugs by courier will make assisted suicide doctors lethal drug prescribing vending machines.

Submit a formal comment to the Drug Enforcement Administrations (DEA) proposed rule change to prevent assisted suicide approvals by telehealth. (Link to submit a formal comment supporting the DEA proposed rule).

I support the DEA's proposed rule change preventing doctors from prescribing schedule II controlled substances via telehealth. 

This proposed rule change has a protective effect on every American.

Considering the problem with the abuse of opioids and the growing problem with addiction, the DEA is right to make this change. 

Americans need to be assured that controlled substances are not being inappropriately prescribed.

More articles on this topic:

• Vermont Bill SB74 permits assisted suicide by telehealth (Link).
•  Opposing assisted suicide by telehealth (Link).
•  Assisted suicide by telehealth and medical misdiagnosis (Link).

Minnesota Assisted Suicide bills are likely dead.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have great news. The Minnesota Alliance for Ethical Healthcare reported that companion assisted suicide bills HF 1930 and SF 1813 did not receive a hearing before the first legislative deadline (March 10). This is great news as these bills are likely dead in 2023.

In my article concerning the Minnesota companion assisted suicide bills I explained that these bills were far more permissive than the Oregon assisted suicide law and the bills used language, such as creating a "standard of care" to define assisted suicide as medical treatment in Minnesota.

The Minnesota Alliance refered to these bills as the most aggressive in America while thanking their supporters for the nearly 1,000 messages that were sent to state legislators who are heard from constituents that Minnesota needs to support real healthcare throughout life's journey that doesn't target those who are vulnerable and at-risk.

To learn more about the Minnesota Alliance for Ethical Healthcare and what they are doing to prevent assisted suicide, visit www.ethicalcaremn.org.

We all have to accept limits on our autonomy to protect others.

Meghan Schrader

By Meghan Schrader

Lately I’ve noticed some staunch right to die proponents arguing that people die in car accidents all the time, but we do not ban cars. This argument makes me very angry. It’s dehumanizing. Are the people who will die because of their agenda car accident statistics to them?

But, since some of them have used that example, I’d like to explore it by talking about my own experiences with cars. I have a Nonverbal Learning Disorder, which causes severe visual-spatial disorientation, and then some depression-induced short term memory deficits. Therefore, I cannot currently drive a car.

I did give it a try, though. In 2017 I hooked up with an agency that specialized in teaching people with autism and Nonverbal Learning Disorder to drive. Ultimately, it didn’t work out. In order to really master the skills needed to drive a car safely, I would need to practice for several hours every day, ideally in a simulator of some kind. I think with that instruction, I could learn to drive a car without killing anyone, but the instructor I had was only able to give me a couple of hours of instruction a week. Added to that I had a few hours of instruction from family members. It just wasn’t enough to master the skills needed to acquire a driver’s license.

I did, however, gain some driving skills. With someone else in the car, I was able to use my driver’s permit to drive myself safely to several places, like the grocery store, the lake, etc. I still remember some of those skills.

Therefore, if I wanted to, I could get into my parent’s car and drive myself somewhere without a license. I could probably do it without having an accident, but then again, there’s a significant probability that I would have one, and therefore endanger someone else’s life.

What the most vociferous right to die proponents basically want to do is say, “my car, my choice.” The car belongs to them, right? So, they should be able to drive their car wherever and whenever they want. They should be able to disregard stop signs and turn signals. They should be able to drive over the speed limit, and they think anyone who tells them that they can’t do that is an illogical, sadistic jerk.

That’s not fair. We all have to accept reasonable limits on our autonomy to protect others.

Meghan is an autistic person who is an instructor at E4 Texas at the University of Texas (Austin) and a EPC-USA board member. 

• More articles by Meghan Schrader (Link).
  

Barbara kay: Canada's Death System is Top of the Line

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Barbara Kay

Barbara Kay wrote an excellent opinion column that was published in the National Post on Saturday March 18 titled: Thanks to Trudeau, Canada's death-care system is top of the line.

Kay begins her article by announcing that Ed Fast MP introduced Bill C-314 titled the Mental Health Protection Act which would prevent euthanasia for mental illness alone. She then points out that Senator Stan Kutcher, who was responsible for the amendment to Bill C-7 that extended euthanasia for mental illness alone is arguing against Bill C-314 by stating that the issue is already decided.

• Sign our petition supporting Bill C-314 (Link).

Kay states that with reference to Canada's euthanasia law, slippery slope which conjures up an avalanche is more like a tobaggan ride.

Kay continues:

Writing in National Review in the fall, one American commentator called Justin Trudeau “modernity’s Doctor of Death,” whose willed expansion of MAiD makes Canada “arguably the assisted-death capital of the world.” An exaggeration? Consider that California, with the same population as Canada, and universally regarded as a singularly progressive domain, legalized medically assisted death in 2016, just like Canada. In 2021, 486 Californians availed themselves of the program. In the same year, 10,064 Canadians ended their lives with MAiD (a term for euthanasia used only in Canada, and brazenly stolen from palliative care, where it rightly belongs.)

Kay points out how Canada's MAiD law has become an international cautionary tale. A British writer used Canada's euthanasia law as an example bad public policy that is based on "good" intentions. Kay writes:

Canada’s MAiD, “originally marketed as a rational choice for sensible adults and therefore an indisputable moral good, it is now being used to kill the poor and the mentally ill as well as the physically sick and the elderly.”

Kay continues:

Too many reported incidents of MAiD chosen and executed for bad reasons — including credit card debt, poor housing, and difficulties getting medical care — attest to the truth of this criticism. In the legislative pipeline are “advance requests” — and consent by “mature minors.” Be afraid , be very afraid.

Kay then refers to the $86 million in health-care spending savings due to the original euthanasia law, as stated by the parliamentary budget office in October 2020. The budget office estimated, based on the expansions of euthanasia in Bill C-14, that there would be $149 million in health-care savings. 

I estimated that the numbers in the report were low based on several factors. First, I stated that there would be more deaths than predicted. Sadly I was right. Secondly, the shortened time of life was under-estimated by the budget office, meaning many people would die months, if not years before their death would otherwise had been. Sadly I am right.

Kay then writes about the fact that doctors are required to falsify the death certificate:

the medical certificate of death, physicians are obliged to list the illness, disease or disability leading to the request for MAiD as the cause of death, rather than the medications administered, the actual cause.

Kay argues that if euthanasia is a public good, then why the deflection?

Kay concludes:

This deliberate obfuscation is consistent, however, with the honed tactics of boundary-pushing activists whose Dignity-R-Us rhetoric captured the nabobs. Liberals settled on a winning strategy. Don’t make euthanasia a political plank; do use the courts to keep the expansion ball rolling. The fix was always in for expansion of the death as “reasonably foreseeable” guardrails established by the 2015 Carter decision. Thus, the 2019 Quebec Truchon decision that found Carter’s limits to MAiD access unconstitutional went unchallenged by Quebec and Ottawa, in spite of a flawed trial process.

• Canada's Healthcare Savings attributed to euthanasia (Link).
• Study: Legalizing euthanasia saves money (Link).

Daily Mail article exposes the expansion of euthanasia to children.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sign and share our EPC petition opposing child euthanasia (Link).

James Reinl, the social affairs correspondent for the Daily Mail published an exposé on March 19, 2023 concerning the possible expansion of euthanasia to children in Canada. Reinl writes:

When Canada changed its laws in 2016 to permit euthanasia, voters were assured the lethal injections would only be available for seriously ill adults who needed to hasten a looming death and end their suffering.

Much has changed these past seven years.

The government is now weighing whether to extend euthanasia to children and the mentally ill.

Reinl continues:

In another worrying sign, a top medical body in the French-speaking eastern province of Quebec says lethal injections should be made available to seriously ill newborns.

Supporters of assisted suicide say they help some very sick people end their agony. Critics say they are the start of a slippery slope that sees ever-more vulnerable people ending their lives prematurely.

Alex Schadenberg

Reinl asked me about the direction of Canada's euthanasia law. Reinl stated:

'Now we've legalized euthanasia, everything's turning upside down,' Alex Schadenberg, director of the Euthanasia Prevention Coalition, a campaign group, told DailyMail.com.'It used to be seen as a last resort. Now, we think in terms of denying people a service that should be available to them.'

Reinl then asked me about the government funded MAiD activity book for children. I told him that the Children's MAiD Activity Book is designed to normalize killing. Reinl wrote:

Schadenberg and others were stunned recently by a 'MAiD Activity Book' aimed at helping children understand why a relative would choose euthanasia, and how the process works.

Critics point to the innocent, child-like language used in the 26-page government-funded booklet to explain a process that is, for many, macabre.

Reinl describes the MAiD activity book:

A doctor or nurse practitioner uses medicines to stop the person's body from working,' says the booklet.

'When their body stops working, the person dies.'

It describes euthanasia as a last-ditch procedure reserved for consenting adults afflicted with a sickness or disability that 'hurts their body or their mind so much that it feels too hard to keep living.'

It explains how MAiD drugs make recipients doze off and lapse into a coma before a 'third medicine … makes the person's lungs stop breathing and then their heart stops beating.
'The person does not notice this happening and it does not hurt,' adds the book, which was written by Ceilidh Eaton Russell, a McMaster University lecturer and an expert on child grief.

'When their heart and lungs stop working, their body dies. It will not start working again.'

The MAiD activity book was published last year by Canada's Virtual Hospice and paid for with money from Health Canada. Reinl explains that Canadian politicians are debating the expansion of MAiD to minors, while the euthanasia lobby group, Dying with Dignity, advocate euthanasia for 12 year olds.

Reinl completes his exposé by stating that Quebec physicians want euthanasia of newborns.

That limit is too high for Dr Louis Roy, from the Quebec College of Physicians — he says newborns who enter the world with 'severe malformations' or 'grave and severe syndromes' should be entitled to a doctor-aided death.

In my interview with Reinl, I provided much more information. It hope that he will continue to investigate how insane Canada's euthanasia law has become.

• Article: Canadian Virtual Hospice promotes euthanasia book for children (Link).
• Canadian children may be euthanized with or without parental consent (Link).

Senator Denise Batters speech in the Senate opposing euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Senator Denise Batters has been one of the most clear and effective voices in Canada's Senate opposing euthanasia for mental illness. Bill C-7, that passed on March 17, 2021, legalized euthanasia for mental illness alone, but with a two year moratorium for implementation. 

The attached video is the speech by Senator Batters, in the Senate, concerning Bill C-39, a bill to delay the implementation of euthanasia for mental illness, for one year, until March 17, 2024. Dr Batters husband, Dave Batters, was a Member of Parliament when he died by suicide on June 29, 2009.

Senator Denise Batters

Senator Batters states in her speech.

• Euthanasia for mental illness alone is abhorent.
• Bill C-7 (passed in March 2021) which eliminated the requirement that people must be terminally ill to die by euthanasia, has led to the slippery slope with veterans with PTSD dying by euthanasia and disabled and impoverished Canadians are deciding to end their lives by euthanasia.
• The parliamentary committee on MAiD has recommended to expand euthanasia to children.
• Psychiatrists are warning that euthanasia should not be extended to people with mental illness, in response the government is delaying the implementation to gain time to sell Canadians on the concept.
• A recent Angus Reid survey found that only 31% of Canadians support euthanasia for mental illness.
• Batters very first social media post and article was titled: Help the mentally ill, don't kill them.
• Originally Bill C-7 excluded euthanasia for mental illness. The Senate passed an amendment to the bill to require euthanasia for mental illness and the government accepted the amendment but with a two-year moratorium for implementation.
• During the Bill C-7 debate, euthanasia for mental illness was never studied by a committee of the Parliament or Senate.
• The parliamentary committee on MAiD studied further of expansion of euthanasia, to minors and by advanced consent.
• Mental illness is not irremediable, one of the criteria required in the law.
• Recovery from mental illness is possible, but cannot be predicted.
• Dr John Maher, a respected psychiatrist who specializes in difficult cases, calls euthanasia for mental illness - facilitated suicide.
• Advocates of euthanasia for mental illness have changed their arguement from it being an irremediable medical condition to an inaccessible medical condition.
• One psychiatrist has stated that she would consider a long waiting list for psychiatric treatment as it being an irremediable medical condition.
• There are problems with access to Canada's healthcare system. The answer is to fix that system, not to confirm a mentally ill persons feeling of hopeless and offer them the lethal means to suicide.
• As a compassionate society we have the obligation to hold hope for mentally ill Canadians when they don't hold hope for themselves.

False claims by the government concerning euthanasia for mental illness.

• Justice Minister David Lametti claims that euthanasia for mental illness has been mandated by the courts. This is not true. The Carter and Truchon cases did not rule on the constitutionality of euthanasia for mental illness alone.
• The government and euthanasia lobby falsely claim that euthanasia for physical or psychological suffering are equivalent. A mental illness is not terminal. Death is not a reasonably forseeable outcome. Mental illness is not irremediable and it is unpredictable.
• Suicidality can be a symptom of mental illness.
• To recognize the difference between physical and mental illness is not discriminatory but a simple acknowledgement of fact.
• Canadians with mental illness do not have full access to treatment and support options.
• This is not equality for people with mental illness but a complete dereliction of our duty.
• The gaps in our treatment of mental illness are leading to people seeking death.
• I am livid that the government is offering death rather than treatment.

Recommendations:

• We should be using the year of delay for implementing euthanasia for mental illness to actually provide an indepth study into whether we should be implementing euthanasia for mental illness.
• Justice Minister Lametti has stated that the delay is to allow everyone to internalize the standards and allow universities to prepare teaching material. This is bunk.

Conclusion:

• The tide is turning and the government has actually delayed euthanasia for mental illness to give them more time to do a sell job to Canadians.
• The government is delaying euthanasia for mental illness because psychiatrists and professionals are against it. Canadians are not ready for it either.
• The rest of the world is looking at Canada's euthanasia law with shock as we have become the most permissive country in the world.
• Since everyone is uncomfortable with it, it is probably an indication that we are doing something wrong. We need to stop this runaway train before it's too late.
• The one year delay to euthanasia for mental illness is a start, but it is only a start. This government needs to completely re-evaluate extending euthanasia for mental illness. They have gone too far with this ideological experiment and are headed straight for the abyss.
• The law has gone too far for psychiatrists, too far for Canadians and it is hurting people who desperately need us to preserve hope, people with mental illness.

We must not let people with mental illness down.

Article: Senator Denise Batters: Help the mentally ill, Don't kill them (Link).

Quebec Bill 11 to permit euthanasia by advanced request.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A CBC radio program (french) by Davide Gentile & Daniel Boily reported on February 16.2023 that more than 7% of Québec deaths were done by (MAiD) euthanasia in 2022 representing more than 5,000 people dying by euthanasia, as compared to less than 1,000 deaths five years ago.

The CBC radio program reported that based on the data, the Commission on End-of-Life Care launched a consultation to research why Québec may have the highest rate of euthanasia in the world (British Columbia may have a higher euthanasia rate but the data is not available).

At the same time, Québec's legislature is debating Bill 11 which further expands their euthanasia law. Bill 11, among other changes, will permit euthanasia by advanced request (by advanced directive) in Québec. 

Bill 11 extends euthanasia by advanced request. Bill 11 states:

this Act allows the exercise of some of those rights by patients who are not at the end of life so that they receive end-of-life care in cases where their condition requires it.”

Bill 11 defines the act in the following manner and states:

Such a request is called a “contemporaneous request for medical aid in dying” or “contemporaneous request” where it is made with a view to an administration of such aid that is contemporaneous to the request. It is called an “advance request for medical aid in dying” or “advance request” where it is made in anticipation of a person becoming incapable of giving consent to care, with a view to an administration of such aid after the onset of that incapacity.

The only good news is that Bill 11, unlike the federal legislation, specifically excludes euthanasia for mental illness alone. Bill 11 states:

"a mental disorder other than a neurocognitive disorder is not considered to be an illness."

The federal report by the Special Joint Committee on Medical Assistance in Dying (AMAD) was tabled in the House of Commons on February 15 calling for an expansion of euthanasia (MAiD) in Canada. The report recommended that children "mature minors" and patients with mental illnesses be eligible for euthanasia and that patients with illnesses such as dementia be permitted to make advanced requests by advanced directives for euthanasia.

Bill 11 is Québec's unique way of pushing the legislative agenda by permitting euthanasia by advanced request before the federal government acts on the report.

The Euthanasia Prevention Coalition urges you to write a short commentary on Bill 11 and submit it to the Québec legislation (Link to comment). Even if you fear that your comments will be ignored, it is important to oppose killing.

Euthanasia (killing) is bad enough, but killing by advanced consent changes the nature of consent, meaning, someone can be killed without a clear and present consent. When consent becomes secondary, it changes the question of who can be killed by lethal injection.

Many people may not be aware that Canada has two euthanasia laws, the federal law which legalized euthanasia by creating an exception to homicide in the criminal code and the Québec law, that only applies to Québec, and considers euthanasia as medical treatment. Québec is known for asserting its provincial constitutional powers and having unique regulations.

Bill 11 reminds us that provincial governments have the ability to amend the practise of euthanasia in their jurisdiction. For instance, the federal government has legalized euthanasia for mental illness alone and Québec is specifically excluding it.

Not Dead Yet: Oregon Assisted Suicide Data Analysis 2023

Oregon Assisted Suicide Data Analysis (Link to the Not Dead Yet article)

March 16, 2023

How Assisted Suicide Laws Endanger People With Disabilities and Chronic Conditions

A disabled or chronically ill person who depends on life-sustaining treatment, even basic medications, would be able to qualify for assisted suicide if they lived where assisted suicide is legal. Oregon’s “Death With Dignity” law is the model for all U.S. states. As an Oregon official has clarified in writing, any person who becomes terminal because they do not receive treatment, for any reason, would qualify for assisted suicide under an Oregon type law.[1] If the reason they could not get treatment were an inability to afford insurance co-pays, they would be eligible for assisted suicide. In these days of private managed care companies taking over Medicare and Medicaid, where providing expensive care has a tendency to reduce profits, we should at least question whether there is an inherent conflict of interest in having healthcare providers administrate a state sanctioned assisted suicide program.

Anyone could ask for assisted suicide, but doctors are the gatekeepers with the power to decide who’s eligible. Since early 2020, the COVID pandemic has revealed that people with disabilities have been denied treatment for the virus due to their disabilities and pervasive healthcare provider biases about “quality of life.” According to a Harvard researcher, “In our survey of 714 practicing US physicians nationwide, 82.4 percent reported that people with significant disability have worse quality of life than nondisabled people. Only 40.7 percent of physicians were very confident about their ability to provide the same quality of care to patients with disability . . ..”[2] This is only the most recent academic confirmation of the real-life experiences shared by many disabled people. This is among the many factors that lead the National Council on Disability in 2019 to issue formal report entitled “The Danger of Assisted Suicide Laws.”[3]

Assisted Suicide Laws Violate the Americans with Disabilities Act

If a disabled person became despondent, for example if they lost a spouse or job and decided they wanted to die, they might not be given the same suicide prevention as a nondisabled and healthy person who despaired over divorce or job loss. Where assisted suicide is legal, they could be treated completely differently due to their condition. By denying equal suicide prevention and other supports to people deemed “terminal”, assisted suicide laws are inherently discriminatory against older, ill and disabled people. The discrimination of state licensed health professionals denying equal suicide prevention and instead providing suicide assistance is a fundamental violation of the Americans with Disabilities Act.

The Oregon Assisted Suicide Data Substantiates Disability Concerns

Oregon’s assisted suicide law, the oldest in the U.S., is held up as the model for other states. One of the most frequently repeated claims by proponents of assisted suicide laws is that there is “no evidence or data” to support any claim that these laws are subject to abuse, and that there has not been “a single documented case of abuse or misuse” in the 25 reported years. Based on the Oregon state assisted suicide reports, these claims are demonstrably false.

Regarding documented cases, please refer to a description of individual cases and source materials compiled by the Disability Rights Education and Defense Fund entitled Oregon and Washington State Abuses and Complications.[4] For an in-depth analysis of several cases by medical Drs. Herbert Hendin and Kathleen Foley, please read Physician-Assisted Suicide in Oregon: A Medical Perspective.[5]

The focus of the discussion below is the Oregon Public Health Division data.[6] These reports are based on forms filed with the state by the physicians who prescribe lethal doses and the pharmacies that dispense the drugs. As the early state reports admitted:

“As best we could determine, all participating physicians complied with the provisions of the Act. . . . Under reporting and noncompliance is thus difficult to assess because of possible repercussions for noncompliant physicians reporting to the division.” (Emphasis added.)

Why would doctors report their own non-compliance with the law? Further emphasizing the serious limits on state oversight under the assisted suicide law, Oregon authorities also issued a release in 2005 clarifying that they have No authority to investigate Death with Dignity case.[7]

Nevertheless, despite these apparently intended limitations, the Oregon state reports substantiate some of the problems and concerns raised by opponents of assisted suicide laws and bills.

Non-Terminal Disabled Individuals Are Receiving Lethal Prescriptions In Oregon

The Oregon Public Health Division assisted suicide reports show that non-terminal people received lethal prescriptions every year except the first.

The prescribing physicians’ reports to the state include the time between the request for assisted suicide and death for each person. Prior to the 2020 report, the online state reports did not reveal how many people outlived the 6-month or 180-day terminal prognosis. Instead, the reports gave that year’s median and range of the number of days between the request for a lethal prescription and death. This was on page 13 of the 2019 annual report.[8] In 2019, at least one person lived 1503 days, the longest reported duration between the request for assisted suicide and death so far. In every year except the first year, the reported duration has been significantly longer than 180 days.

The 2020 – 2022 reports revisit this “terminal” survival issue and state that 4 percent of individuals outlived their 6-month prognosis[9] in 2020, 3.8% in 2021[10] and 5.8% in 2022.[11] This does not take into account the individuals who took the drugs quickly but may have survived if they had waited longer.

The definition of “terminal” in the Oregon statute only requires that the doctor predict that the person will die within six months. There is no requirement that the doctor consider the likely impact of medical treatment in terms of survival. Unfortunately, while short-term terminal predictions of some conditions, such as some cancers, are fairly well established, this is far less true six months out, as the bill provides, rather than a few weeks before death, and is even less true for other diseases. Furthermore, it should be noted that the attending physician who determines terminal status and prescribes lethal drugs is not required to be an expert in the disease condition involved, nor is there any information about physician specialties in the state reports. And, as noted above, many conditions will or may become terminal simply because certain medications or treatments are discontinued, which would also qualify them for assisted suicide under the Oregon law.

Oregon reports that non-cancer conditions found eligible for assisted suicide have grown over the years to include: neurological disease, respiratory disease, heart/circulatory disease, infectious disease, gastrointestinal disease, “endocrine/metabolic disease (e.g. diabetes)”, infectious disease and, in the category labeled “other”, anorexia, arthritis, arteritis, blood disease, hernia, complications from a fall, kidney failure, medical care complications, musculoskeletal system disorders, sclerosis, and stenosis (2021 Report, pages 12 & 14). The addition of anorexia to Oregon’s and Colorado’s reports as a condition some physicians have viewed as warranting assisted suicide demonstrates how empty the law’s purported “safeguards” are. For the first time, the 25th Oregon report stopped listing the “Other” conditions in a footnote.

The Only Certifiers of Non-Coercion And Capability Need Not Know the Person

Four people are required to certify that the person is not being coerced to sign the assisted suicide request form, and appears capable: the prescribing doctor, second-opinion doctor, and two witnesses.

In many cases over the years, the prescribing doctor is a doctor referred by assisted suicide proponent organizations. (See, M. Golden, Why Assisted Suicide Must Not Be Legalized,[12] section on “Doctor Shopping” and related citations). The Oregon state reports say that the median duration of the physician patient relationship was 5 weeks in 2021 and 2022, and 11 weeks over all years (2021 Report, page 13). Thus, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.[13])

The witnesses on the Oregon request form[14] need not know the person either. In Oregon, only one of them may be an heir, but neither of the witnesses need to actually know the person (the Oregon forms say that if the person is not known to the witness, then the witness can confirm identity by checking the person’s ID).

In addition, under the Oregon law, the definition of “capable” allows third parties to communicate orally for the person to the doctors and witnesses, providing for the patient to communicate “through persons familiar with the patient’s manner of communicating.” This is especially dangerous for people with speech impairments, such as from a stroke or neurological disability.

So neither doctors nor witnesses need know the person well enough to certify that they are not being coerced. What might be an example of coercion? Many elder and disabled people would say the threat of being put in a nursing home.

No Evidence of Consent or Self-Administration At Time of Death

In less than half the reported cases, the Oregon Public Health Division reports state that no health care provider was present at the time of ingestion of the lethal drugs or that it is “unknown” whether a provider was present (2022 Report, page 14). Without requiring an independent witness, there is no way to confirm whether the lethal dose was self-administered and consensual. The initial request for assisted suicide does not prove that the person wanted to go through with it, as shown by the reported decision by many not to do so.

Therefore, although “self-administration” is touted as one of the key “safeguards”, in about half the cases, there is no evidence of consent or self-administration at the time of ingestion of the lethal drugs. If the drugs were, in some cases, administered by others without consent, no one would know. The request form constitutes a virtual blanket of legal immunity covering all participants in the process based on a mere claim of “good faith.”

Essentially, proponents of legalizing assisted suicide have taken a third-party legal immunity statute and marketed it deceptively as a personal rights statute.

Pain Is Not the Issue, Unaddressed Disability Concerns Are

The top five reasons doctors give for their patients’ assisted suicide requests over all reported years are not pain or fear of future pain, but psycho-social issues that are well understood by the disability community: “losing autonomy” (90%), “less able to engage in activities” (90%), “loss of dignity” (72%), “burden on others” (48%) and “losing control of bodily functions” (44%) (2022 Report, page 14).

These reasons for requesting assisted suicide pertain to disability and indicate that over 90% of the reported individuals, possibly as many as 100%, are disabled at the time of their assisted suicide request.

Three of these reasons (loss of autonomy, loss of dignity, feelings of being a burden) could be addressed by consumer-directed in-home long-term care services, but no disclosures about or provision of such services is required. Some of the reported reasons are clearly psycho-social and could be addressed by disability-competent professional and peer counselors, but this is not required either. Moreover, only 3% of patients who request assisted suicide were referred for a psychiatric or psychological evaluation (and only 3 patients in 2022), despite studies showing the prevalence of depression in such patients. Even if a bill requires such a referral, it’s only stated purpose is to determine whether the person has “impaired judgment,” not to provide actual “counseling” or support.

Basically, the law operates as though the person’s reasons don’t matter, and nothing need be done to address them.

Conclusion

The Oregon assisted suicide data demonstrates that people who were not actually terminal received lethal prescriptions in all 25 reported years except the first, and that there is little or no substantive protection against coercion and abuse. Examples of abuses have surfaced through mainstream media and professional journals, but not through the superficial and unmonitored physician self-reporting system used by the state. Moreover, reasons for requesting assisted suicide that sound like a “cry for help” with disability-related concerns are apparently ignored. Thus, even the paltry data collected by the state substantiates serious problems with the implementation of assisted suicide laws. The dangers of mistakes, coercion and abuse are simply too high.

For all these reasons, assisted suicide laws should be rejected and repealed.

[1] https://www.washingtontimes.com/news/2018/jan/11/diabetics-eligible-physician-assisted-suicide-oreg/;

https://drive.google.com/file/d/1xOZfLFrvuQcazZfFudEncpzp2b18NrUo/view

[2] Lisa I. Iezzoni, et al., Physicians’ Perceptions Of People With Disability And Their Health Care, https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01452

[3] https://ncd.gov/sites/default/files/NCD_Assisted_Suicide_Report_508.pdf

[4] https://dredf.org/wp-content/uploads/2015/04/Revised-OR-WA-Abuses.pdf

[5] https://dredf.org/wp-content/uploads/2012/08/Hendin-Foley-Michigan-Law-Review.pdf

[6] https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/ar-index.aspx

[7] https://dredf.org/wp-content/uploads/2012/08/Oregon-DHS.pdf

[8]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year22.pdf

[9]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf(page 11)

[10]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year24.pdf(page 12)

[11]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year25.pdf (page 13)

[12] https://dredf.org/public-policy/assisted-suicide/why-assisted-suicide-must-not-be-legalized/

[13] http://www.nejm.org/doi/full/10.1056/NEJMra1404688 ; See also, “New Report on Elder Abuse in Australia: Implications for Legalising Euthanasia” (Jan. 2022) https://www.australiancarealliance.org.au/new_report_on_elder_abuse_in_australia_implications_for_legalising_euthanasia

[14]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/pt-req.pdf

Sponsor Alex Schadenberg 30K run on March 26 for EPC

Alex Schadenberg will be running the 30K Around the Bay Road Race on March 26. 

The Hamilton Around the Bay Road Race is the oldest road race in North America.

Alex is running the Hamilton Around the Bay Road Race to raise money for the Euthanasia Prevention Coalition.

The training and commitment involved with preparing for a long-distance run is significant, but your donation to the Euthanasia Prevention Coalition will make it worth while.

You may donate online (Donation Link).
or you may donate by sending a cheque to:
Euthanasia Prevention Coalition
Box 25033, London ON N6C 6A8

Thank you for your support.

Vermont becomes the second assisted suicide tourist state.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Taking a one-way trip to Vermont.

Lisa Rathke reported on March 14 for the Associated Press that Vermont's attorney general's office reached an agreement with Lynda Bluestein, a Connecticut woman who is seeking death by assisted suicide and Dr Diana Barnard, who is willing to prescribe the lethal assisted suicide drugs to Bluestein, by dropping the Vermont assisted suicide residency requirement. The article stated that Bluestein, who is living with cancer, will likely be the first non-Vermont resident, to die by assisted suicide in Vermont.

Some history about the issue.

In October 2021, the assisted suicide lobby group, Compassion and Choices, and Dr Nicholas Gideonse, an assisted suicide prescribing doctor, launched a court case challenging the Oregon assisted suicide residency requirement.

Instead of defending the residency requirement the Oregon Goverment agreed to remove the residency requirement. A March 29, 2022 Associated Press article by Gene Johnson reported that: "Oregon will no longer require people to be residents of the state to use its law allowing terminally ill people to receive lethal medication."

On August 26, 2022, Compassion and Choices launced a lawsuit on behalf of a woman in Connecticut and a Vermontdoctor challenging Vermont's assisted suicide residency requirement.

An article by James Reinl for The Daily Mail reported in February 2023 that Dr Nicholas Gideonse has opened the first assisted suicide clinic to prescribe lethal assisted suicide drugs for death tourists. At least one person from Texas and an east coast resident had died by assisted suicide in Oregon.

Removing the residency requirement in Oregon and Vermont permits every American to die by assisted suicide and turns Oregon and Vermont into suicide tourist states. The assisted suicide lobby knows that many states will not legalize assisted suicide, so they are forcing states that have legalized assisted suicide to provide death to every American.