At Least 60 People with Eating Disorders Euthanized or Assisted in Suicide since 2012

This article was published by National Review online on August 1, 2024.

Register for the August 9 webinar: Assisted Death for Eating Disorders (Link).

By Wesley J Smith

“Strict guidelines protect against abuse” my left nostril.

Wesley Smith

A very disturbing — but, alas, unsurprising — report has been published from a review of medical studies that demonstrates that at least 60, but almost surely more, people with eating disorders (EDs) have been euthanized or assisted in suicide between 2012 and 2024. From the long, meticulously researched and thoroughly detailed study published by Frontiers in Psychiatry  (citations omitted):

We identified 10 peer-reviewed articles and 20 government reports describing at least 60 patients with EDs who underwent assisted dying between 2012 and 2024 (Table 4). Note that this figure does not represent the total number of patients with EDs who have undergone assisted dying in countries where it is legal. It represents only those which were identifiable via the limited data available in public reports.

This includes at least three patients from the U.S.:

One case study has been published in the United States (2), which described three patients, two of whom were prescribed MAiD. . . .

Of the 78 data reports reviewed from U.S. states where assisted dying is only legal for terminal conditions, which report on a total of 11,983 cases, none include reporting on psychiatric conditions. Only one report mentions an ED specifically. Oregon’s Death with Dignity Report noted that seven individuals were prescribed MAiD for Other Illnesses, of which anorexia was listed as an example condition in the footnote. It is unclear how many of those seven deaths were persons with anorexia.

All of the descriptive cases reported were of women:

Of the 60+ cases identified across all studies and reports, 19 included descriptive case summaries with information about the patients and the clinical rationales that were used to justify assisted death. All 19 patients were women. Specifically, 32% were under the age of 30 (N = 6), 37% were between the ages of 30 and 50 (N = 7), and 31% were over 50 years old (N = 6). 61% (N = 11) had been diagnosed with anorexia, one person was described as obese (but her ED was not specified), and 28% (N = 5) had EDs (but the specific diagnoses were not identified).

Most had other mental illnesses:

All but one person described in the case reports had multiple comorbid psychiatric diagnoses. Rates of comorbidity were high; 95% had more than one psychiatric disorder, 61% had more than three, and nearly a quarter had four or more comorbid conditions (Table 6). Specifically, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) were common, occurring in 33% and 37% of cases respectively. One patient was described as having a mild intellectual disability, and 16% of patients (N = 3) had autism spectrum disorder. Nearly half of patients were diagnosed with at least one personality disorder.

Good grief. How might those mental disorders have affected these poor people’s ability to “choose” to be killed or kill themselves?

Also, the meaning of “terminal illness” was redefined to justify life terminations (my emphasis in bold):

In cases in the United States, where a terminal prognosis is a legal prerequisite for assisted death, authors asserted that ED patients prescribed MAiD had terminal conditions. . . .

Notably, this conception of terminality deviates from medical definitions of a terminal condition, by describing reversible cognitive behaviors (thoughts, thinking patterns, cognitive distortions) as indicators of a terminal illness (i.e., an understanding that treatment is futile, choosing to stop trying, and accepting death). Medical texts describe the terminal phase of an illness as a period of inexorable and irreversible decline leading to death, with no expectation of recovery and a survival prognosis of only months or less. Unlike cancer or Alzheimer’s disease, most medical complications associated with anorexia can be treated with adequate nutritional intake and weight restoration, even in severely emaciated patients. Furthermore, cognitive and emotional symptoms associated with anorexia, such as despair and cognitive distortions, also improve with effective treatment.

There is only one way to describe these cases: abandonment.

That’s certainly how 40 disability-rights, psychological, aging-advocacy, and anti-assisted-suicide organizations see it. From their Joint Statement against Assisted Suicide for Eating Disorders:

Eating disorders are treatable conditions that require timely and comprehensive treatment. Yet many cannot access care due to cost, inadequate insurance coverage, extensive wait times, and a shortage of specialist services. The notion that they are incurable or terminal is scientifically unsupported and dangerously misleading. The term “terminal anorexia” is not recognized by any formal medical body, has been widely rejected by researchers and clinicians, and represents a profound misunderstanding of these conditions.

Moreover:

People with eating disorders need access to evidence-based and inclusive treatment, not lethal medications. Poor outcomes, including deaths, are nearly always preventable.

Indeed.

Please stop buying the demonstrable nonsense that the legalization of assisted suicide would be a minor change in ethics. Once the legalization train leaves the station, it is no longer containable or controllable. Or, to put it another way, once a society decides that killing is an acceptable answer to human suffering, the category of “killables” never stops expanding.