Suicide Attempts: A Cry for Help

The following article is based on the article by Pat McGeehan that was published by the Fayette Tribune on October 10, 2024.

Vote YES on West Virginia Amendment 1 for protection from assisted suicide (Link).

For every suicide in our country, there are an estimated 25 non-fatal suicide attempts. Most people who survive a suicide attempt do not try to take their lives again: “nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date.”

Suicide attempts aren’t always about seeking death—they often express deep misery and are a cry for help. People who attempt suicide are usually looking for an end to their suffering, shame, and depression—not life itself. These attempts often prompt the intervention of loved ones and the medical community, and in the majority of cases, life, not death, is the final outcome.

 
Assisted Suicide: A Misleading Assumption

It is a mistake to think that a request for medically-assisted suicide is different from other suicide attempts. When a loved one expresses suicidal thoughts, we are advised to restrict their access to lethal means, like medication or firearms. However, in places like California, if someone opts for medically-assisted suicide, a highly lethal cocktail of poisons, sedatives, and painkillers (DDMA or DDMP) is mailed directly to their home.

Unlike other suicides—where the person is clearly torn between life and death—medically-assisted suicide is often assumed to be a rational, unchanging decision. This is a dangerous assumption.

Michael Freeland’s Story

Consider the case of Michael Freeland, as recorded by the National Council on Disability. At age 62, with a 43-year history of depression and suicide attempts, Michael was diagnosed with terminal lung cancer. He requested assisted suicide, and Dr. Peter Reagan, an advocate for Compassion & Choices, prescribed him lethal drugs. However, Michael later reached out to Physicians for Compassionate Care (PCC), who provided emotional support and medical care. With this help, his cancer symptoms improved, and he reconciled with his estranged daughter. Ultimately, Michael lived two more years and died naturally—having abandoned his wish for assisted suicide.

A Missed Opportunity for Intervention

Michael’s story shows that medically-assisted suicide, like other suicide attempts, stems from an ambivalent desire. In his case, support from friends and caregivers led him to choose life. But what if his desire to live had surfaced only after taking the lethal pills?

In states where assisted suicide is legal, there is no opportunity for a life-affirming intervention. The drugs used are designed to be maximally lethal, ensuring that survival isn’t an option. Assisted suicide becomes an irreversible decision with only one outcome: death.

Ignoring Underlying Causes of Despair

Proponents of assisted suicide often believe it is a clear-headed choice, but they fail to acknowledge the underlying hopelessness and neglect that drive many of these requests. In Oregon, for example, the time between a patient’s first request for assisted suicide and their death has shrunk significantly, from 18 weeks in 2010 to just five weeks in 2022. Only 1% of patients are referred for psychiatric evaluation, even though depression is a common factor in suicide.

West Virginia: A State of Hope

Here in West Virginia, when someone expresses a desire to end their life, we don’t ignore the cry for help by handing them lethal drugs. Instead, we offer support. Our doctors do not respond to despair by recommending death. This is a trust that we must protect.

Without rejecting medically-assisted suicide, we could follow Canada’s path, where it is now the fifth leading cause of death. That’s why it is crucial to vote for Amendment One this November. It will protect West Virginia from medically-assisted suicide and uphold our commitment to suicide prevention. It sends a message that our state values hope over despair.

Canadian cancer patient was "offered" euthanasia while entering the operating room.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Cameron Henderson that was published in The Telegraph on October 14 is an example of how aggressive the MAiD teams / euthanasia doctors and nurses are in Canada as they provide euthanasia but also promote it.

A 51-year-old Nova Scotia woman felt pressured to ask for euthanasia. Henderson reports:

Speaking anonymously, the 51-year-old cancer patient said of the moment she was offered death instead of surgery: “It floored me... [it was] the most vulnerable I’ve ever felt in my life”.

The patient, a married grandmother from Nova Scotia, explained she was set to undergo a mastectomy operation for breast cancer when a physician asked her if she knew about medical assistance in dying (MAID).

Henderson continues:

“I was sitting in two surgical gowns, one frontways and one backwards, with a cap on my hair and booties on my feet. I was shivering and in a hard plastic chair and all alone in a hallway,”

“The [doctor] sat down and went through all the scary things with me. Then he asked ‘Did you know about medical assistance in dying?’

“All I could say was, ‘I don’t want to talk about that’.

“I was scared and I was alone and I was cold and I didn’t know what was coming.

“Why was I being asked about assisted dying, when I was on my way into what I truly believe was life-saving surgery?”

The woman said that she was offered euthanasia again, nine months later, before undergoing a second mastectomy and then asked about MAiD a third time while in recovery from her second mastectomy.

The woman said that she felt - Better Off Dead - when she was asked multiple times. Henderson reported:

She said the repeat offers made her feel like a burden to doctors and that people in her position “were better off dead”.

“I felt like a problem that needed to be [gotten] rid of instead of a patient in need of treatment.

“I don’t want to be asked if I want to die,”

Dr Leonie Herx

Dr Leonie Herx, a palliative medicine consultant in Calgary, told Henderson that

staff-shortages are so bad in some Canadian hospitals that patients who are not at risk of imminent death are offered MAID before they’ve even had a chance to see a palliative care consultant.

In one instance, she claimed that one of her patients saw a MAID consultant first, and when she came back to check on him the next day, he had already been given an assisted death.

“In some cases, MAID has become the only therapy provided, which is completely horrific from a medical perspective,” Dr Herx said, in what will serve as a stark warning to the UK, where the NHS is facing a £37 billion funding gap with acute shortages in palliative care.

Herx's last comment concers the fact that the UK is debating the legalization of assisted suicide while the National Health Service is facing a massive funding gap. 

The Euthanasia Prevention Coalition has received multiple complaints concerning family member or friends being asked if they want MAiD on multiple occasions. One woman asked us how to get the MAiD team to stop asking her husband if he wants MAiD. She said, he had already said NO five times.

Scotland's assisted suicide bill is dangerous.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Professor Allan House

Assisted suicide bills will be debated in Scotland and the UK this year. An article by Professor Allan House was published in The Herald on October 14. House examines Scotland's assisted suicide bill and concludes that the:

Bill falls far short of containing the sort of safeguards we would expect in any other area of care for people with serious physical illness or those who are suicidal. In my view, it is a danger to vulnerable people and should not be allowed to pass into law.

House provides excellent insight. He states:

Throughout my career, I’ve worked to help people struggling with the impact of serious illness who may feel overwhelmed, unsupported, or suicidal. My profession has had a united approach on this. We seek to alleviate suffering while protecting the vulnerable and suicidal.

In the debate about assisted suicide a common concern, even among those who support the idea in theory, is whether a particular piece of legislation can have sufficient safeguards to protect vulnerable people. I’ve studied McArthur's proposals closely and concluded that the safeguards outlined fail to offer any real reassurance to those worried about the risks.

House brings up a good example of how assisted suicide legislation fails. He writes:

To understand why, it helps to consider a case study. Picture a 45-year-old woman who’s lived with multiple sclerosis for ten years. She has had two relapses since her diagnosis but lives independently and uses a wheelchair for trips outside her house. Going to see her doctor one day, she says she feels like ending her life. How should the doctor respond?

Under our current approach, a doctor would seek to understand more. He or she would discuss the reasons for their patient’s thinking, her personal circumstances, and consider her history of physical or mental health problems. They would want to involve others such as a partner or next of kin. They may then advise a referral to a psychiatrist – especially if the doctor did not have expertise in responding to suicidal thoughts. Work towards a more hopeful outlook and rewarding life would follow.

House explains the problem with doctors assisting suicides. He writes:

There is an unresolvable dilemma at the core physician-assisted suicide legalisation: it requires doctors to prescribe fatal medication and oversee the resulting deaths while they are not responsible for the recipient’s healthcare more generally – with no apparent requirement to follow best medical practice, exercise a duty of care, and work to prevent suicide.

Professor Allan House is an emeritus professor of liaison psychiatry and a supporter of Better Way.

When MAiD starts, its relentless, it goes after every part of society and affects everyone

This article was published by the Compassionate Community Care blog.

Calls have been steady on the CCC helpline. For some, callers are looking to help loved ones turn away from assisted suicide, for others, they need assistance regarding advocacy or ensuring their loved one’s needs are being met and they have not been treated wrongly. This article captures one caller’s response, her reality and experience with MAiD being drawn on around her, for her one family members, and to those vulnerable in her community.

Quotes from Laura*, one women’s experience (Ontario, Canada):

I was shocked when I first heard about MAiD, I was volunteering at a hospital and we were ordered not to talk about it; this was just before Covid. Then more and more people were talking to the patients about it, yet volunteers could not object and say anything to dissuade patients or their family members from choosing it: it was completely one-sided. I decided I was not going to go back to volunteering; I’m not going to comply with that.

When you find your own family members are talking about it, it hits a whole new level. “Yikes” – is my first line of thought, it’s creeping all over the place. My brother has terminal cancer, and he flew out the euthanasia term once while speaking to us: “when the time comes, I would go for MAID”, I was in shock. I didn’t know what to say. My query is when should we talk about? His comment caught me by surprise, I was not prepared and I did not know how to respond. Now I’m better equipped to deal with it.

It’s insidious, a friend of mine was all for having MAID done for her husband, ‘there’s nothing wrong with it.’ And yet, she goes to church all the time. It’s creeping into every element of society.

When I first called the CCC helpline, and was told about what actually happens when you get euthanized, the injections you get -- it’s not necessarily pain-free, no suffering, and the easy exit people assume it is. There are accounts and publications that share the experience of it each injection does something else: the first immobilizes you, then the second injection feels like an “internal inferno,” followed by a “drowning sensation,” and then finally, the heart stops beating, a cardiac arrest. All of it can last anywhere from 5-30 minutes. I’ve never heard of what the process may feel like, I liked knowing this so I can share it with others.

What so many who are desperate at end-of-life don’t realize, is that there is always a cure for the pain. Not long ago, a person was in hospital and getting treatment, after the staff approached her about her considering getting euthanized and she refused, they made it so she had another week in the hospital and after that she would be charged $800/day. She went through with and got MAiD, instead of being charged.

Recently at a local organizational meeting, one of the meeting members threw out the idea of MAID for her own husband (he was sick since 2009), I was shocked and saddened she would wish this for her own husband. I believe it was her sharing she needs helps, respite care and support as she’s probably burned out. She doesn’t have anybody and this is not a way for her to spend the last years of her life.

The bottom line is, MAiD/euthanasia - it’s not about caring for someone, it’s about money. The hospitals see this as a cost saving, and provide it readily to anyone for any reason.”

Canadian doctor considers euthanasia the best work she has done.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

British actress, comedian and disability rights activist, Liz Carr, produced a BBC documentary titled - Better off Dead? that was first aired on May 14. Carr is best known for her role as Clarissa Mullery on the BBC series Silent Witness.

One of the scenes in the Better off Dead? documentary features Carr interviewing Canadian euthanasia doctor, Ellen Wiebe. (Link to the scene)

David Kraydon wrote an article that was published in The Post Millennial on October 9 concerning Carr's documentary. Carr asks her about euthanasia and Wiebe responds:

“I love my job. You know, I always loved being a doctor and I delivered over a thousand babies, and I took care of families, but this is the very best work I've ever done in the last seven years. And people ask me why? And I think, well, doctors like grateful patients, and nobody's more grateful than my patients now and their families.”

Ellen Wiebe laughing

Carr wonders if Wiebe is concerned that Canada’s euthanasia program will go too far. Kraydon writes that Wiebe shuts down that debate by stating:

“What you're saying is to protect what you consider vulnerable people. You are condemning others to unbearable suffering, unbearable suffering, and I am so glad, so glad that I'm Canadian and that we have this law so that people can choose that or not choose that, but to say that somebody has to suffer like that is simply cruel,”

Better off Dead? viewers were shocked when Wiebe giggled while talking about euthanasia.

Professor Christopher Lyon told National Post writer Sharon Kirkey that:

“Some providers have counts in the hundreds — this isn’t normal, for any occupation,” he said. “Even members of the military at war do not typically kill that frequently. I think that’s a question that we’ve not really ever asked.”

Lyon recently published an article concerning health-care serial killers and Canada's euthanasia law.

Ellen Wiebe may be Canada's most prolific euthanasia doctor having killed hundreds. 

Liz Carr's Better off Dead? is available for you to watch on youtube (youtube link).

Is euthanasia part of palliative care?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Harvey Chochinov and Dr Joseph Fins have written an excellent article that was published in the Journal of the American Medical Association (JAMA) on October 8 titled: Is Medical Assistance in Dying Part of Palliative Care?

The authors are actually asking the question whether or not MAiD, better known as euthanasia, is a part of medical treatment and therefore can be part of palliative care. The problem is that in many jurisdictions, where it is legal, MAiD is already considered as part of palliative care.

The authors begin the article by stating that most national palliative care organizations, including the Canadian Palliative Care Association, believe that MAiD does not fall within the practise of palliative care. The authors therefore determine the purpose of this article is:

to determine whether MAID is part of palliative care, based on characteristics embedded within the practice of medicine.

Dr Harvey Chochinov

The first question the authors examine is whether or not MAiD is part of medicine? The authors examine this question based on the four canons of therapy as defined by Thomas et al. which are: restoration, means-end proportionality, parsimony and discretion.

Concerning restorative measures the authors conclude:

It is hard to conceive of MAID as restorative because the very act makes any return impossible.

Concerning means-end proportionality, the authors conclude:

It is difficult to regard death as “well-fitted” because nonexistence negates alternative means to address pain. Death cannot be titrated and trialed; hence, it does not qualify as a therapeutic, which means its pursuit resides outside the realm of medicine.

Concerning parsimony, the authors conclude:

This tailoring of a therapy to a specific condition, drawing on evidence based guidelines, is violated under MAID, where patient preference effectively dictates practice. By way of example, Canadians seeking MAID are under no obligation to try other treatments they deem unacceptable. In those instances, physicians may have to dispense with parsimony—despite their clinical judgment pointing toward other options—yielding to the patient’s intent on receiving MAID.

Dr Joseph Fins

Concerning discretion, the authors conclude:

Discretion “counsels that an awareness of the limits of medical knowledge and practice should guide all treatment decisions.” Since MAID was launched in Canada, eligibility has broadened from those whose deaths are reasonably foreseeable, to individuals who are not dying but living with disability; with consideration now being given to mental illness, children, and those anticipating the loss of mental capacity. Although some may see this as affirming individual autonomy, ethicist Paul Ramsey reminds us that physicians must recognize that the function of medicine is not to relieve the human condition of the human condition.

The authors then examine the Patient-Physician Relationship and conclude:

MAID undermines the patient-physician relationship by violating the principle of nonabandonment, even when it is well intended. At the height of patients’ distress, MAID truncates care and eliminates the possibility of healing. This distinguishes it from palliative medicine, which embraces patient and family at life’s end with fidelity and relationality extending into bereavement care for survivors.

The authors then MAiD, Hope and Palliative care and conclude:

It is impossible to sustain this therapeutic stance when assessing a patient’s readiness for MAID. The former (palliative care) entails holistic medical care, whereas the latter shifts to a legalistic paradigm centered on determining eligibility for MAID.

The authors then examine MAiD in relation to policy considerations and state:

The policy arguments separating MAID and palliative care are rooted in the notion that palliative care affirms life, regards dying as a normal process, and is committed to “neither hasten nor postpone death.” Organizations representing palliative care have been resolute in asserting that MAID falls beyond their mandate.

Chochinov and Fins have provided excellent arguments and prove that MAiD is not a medical treatment and thus it cannot be part of palliative care.

Nonetheless, in many jurisdictions, including Canada, MAiD is administered as if it is part of palliative care. One problem is that health care administrators, within the government and on a regional basis, have implemented euthanasia, which is the killing of a patient upon request, as if it were medical treatment.

The goal of medical researchers, such as Chochinov and Fins, must be to convince the medical administrators that MAiD is not a part of medicine and, if legal, it needs to be separated from services that actually constitute medical treatment, such as palliative care.

UK Labour MP's are divided on assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A private members bill to legalize assisted suicide in the UK, that is being sponsored by Kim Leadbeater (Labour MP) is scheduled to be released on October 16 and is being fast-tracked by Prime Minister Sir Keir Starmer to enable it to have a second reading vote before Christmas.

Prime Minister Starmer, the leader of Britain's Labour Party, is a long-time promoter of assisted suicide. During the election Starmer promised that he would introduce a bill and allow a free-vote on assisted suicide. The July 4 election resulted in the Labour Party winning a massive majority with 411 out of 650 parliamentary seats.

The Daily Mail reported that Starmer's Labour MP's are divided on the issue of assisted suicide. An article by Glen Owen and Brendan Carlin reported that, among others, Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood oppose assisted suicide. The authors report:

A Labour source said: 'The wheels are turning. It has been made clear to the MPs at the top of the ballot that the PM backs a change in the law.'

However, Sir Keir's Cabinet is split on the issue. Justice Secretary Shabana Mahmood has said: 'I don't intend to support it... I know some MPs who support this issue think, 'For God's sake, we're not a nation of granny killers, what's wrong with you'… [But] once you cross that line, you've crossed it forever. If it becomes the norm that at a certain age or with certain diseases, you are now a bit of a burden… that's a really dangerous position.'

And Health Secretary Wes Streeting has declared himself 'conflicted' on the issue, citing the poor state of end-of-life care and warning that the 'right protections' were needed to make sure people don't 'take their own life thinking they were a burden on others'.

He explained he was 'deeply uncomfortable' about the practical aspects of changing the law, saying: 'Candidly, when I think about this question of being a burden, I do not think that palliative care, end-of-life care in this country, is in a condition yet where we are giving people the freedom to choose, without being coerced by the lack of support available.'

Faith Ridler reported for Sky News (UK) on September 16, 2024 that:

Liberal Democrat leader Sir Ed Davey is 'sceptical' of the case for assisted dying for 'quite personal' reasons. Ridler reported that during an interview with Sky News' deputy political editor Sam Coates, Davey stated that MP's must deeply and carefully listen to all sides of the debate, considering it's outcome. Davey also urged MP's not to rush a vote on assisted suicide.

The four candidates vying to become the leader of the Conservative Party oppose assisted suicide.

More than half of the MP's elected in the last UK election are new. People who oppose assisted suicide need to meet with their MP's and urge them to vote no to the Leadbeater assisted suicide bill.

Assisted Suicide destroys Hope.

This opinion article was published by the Fayette Tribune on October 10, 2024

Vote YES on West Virginia Amendment 1 for protection from assisted suicide (Link).

Pat McGeehan

By Pat McGeehan

For every one suicide in our country, there are an estimated 25 non-fatal suicide attempts. (McIntosh, J.L. (for the American Association of Suicidology). (2009). U.S.A. suicide 2006: Official final data. Washington, DC: American Association of Suicidology, dated April 19, 2009, downloaded from http://www.suicidology.org.)

The vast majority of people who survive suicide do not attempt to kill themselves again: “nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date.” (Owens D, Horrocks J, and House A. Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry. 2002;181:193-199. Emphasis added.)

Suicide attempts don’t simply seek out death. They give expression to misery. They cry out for help. They seek an end, not to life, but to suffering, shame, and depression. By bringing these buried miseries into the light, suicide attempts often motivate the loving intervention of family, friends, neighbors, and the medical community. In the vast majority of suicide attempts, it is life, and not death, that has the final word.

It is baseless and unintelligent to imagine that an attempt at medically-assisted suicide is not as much a cry for help as any other suicide attempt. When a loved one expresses a desire to kill themselves, we are counseled to restrict their access to “lethal means” — to hide medication and move firearms out of the house. But, in places like California, if that same loved one would kill themselves by medically-assisted suicide, an incredibly “lethal means” — a cocktail of poisons, sedatives, and painkillers known as DDMA or DDMP — is mailed to their home.

Unlike every other form of suicide — in which the desire to live and the desire to die are so obviously at war in the individual — medically-assisted suicide is presumed to be a rational, unchanging choice. This is foolish. Consider Michael Freeman, whose story was recorded by the National Council on Disability:

At age 62, Michael Freeland had a 43-year medical history of significant depression and suicide attempts. After receiving a diagnosis of terminal lung cancer, he requested assisted suicide. Dr. Peter Reagan, an assisted suicide advocate who was associated with the group Compassion in Dying (later renamed Compassion & Choices), a leading pro-assisted suicide organization, prescribed lethal drugs to Michael Freeland...Freeland then made a telephone call to Physicians for Compassionate Care (PCC), a medical group dedicated to improving the care of seriously ill people without resorting to assisted suicide. The call was answered by a PCC volunteer who was trained in counseling people with serious illness. With encouragement from a doctor recommended by PCC, Freeland underwent chemotherapy and radiation treatment, which alleviated his cancer symptoms significantly. PCC volunteers arranged for him to receive adequate pain care, other appropriate medication, and 24-hour attendant services. A PCC volunteer stayed in touch with him to offer encouragement, as did some old friends, who began to visit him daily. He also received assistance to resolve other health and personal problems. With this multifaceted assistance, his suffering abated, as did his wish to take lethal drugs. He was able to fully reconcile with his daughter, who had been estranged from him during certain periods. In the end, he lived 2 years post-diagnosis; he eventually died of natural causes. (“The Danger of Assisted Suicide Laws: Part of the Bioethics and Disability Series” by The National Council on Disability, October 9, 2019)

Michael’s story shows that the attempt at medically-assisted suicide follows the same path as other suicide attempts: An ambivalent desire that does not end in death but in the intervention of friends and caregivers who reaffirm that life is worth living. But what if Michael’s desire to live became conscious and decisive, not after the appointment prescribing him poison pills, but after swallowing them?

Within suicide states, physicians help sick people to kill themselves in a way that ensures that their suicide attempt will not be the occasion of any positive, life-affirming change. The poisons commonly used in medically-assisted suicides are maximally lethal. Survival is not an option. Through the intervention of bad laws and spineless medical practitioners, suicide attempts “become” what they rarely otherwise are: Irreversible decisions with no other goal besides death.

...It is easy to imagine that no one regrets medically-assisted suicide — its victims are all dead! It is easy to imagine that medically-assisted suicide is an unchanging and unambivalent decision rather than a cry for help — suicide states like Oregon are not required to keep any record of the time between the ingestion of poison pills and death (Worthington A, Finlay I, Regnard C. Efficacy and safety of drugs used for ‘assisted dying.’ Br Med Bull. 2022 Jul 9;142(1):15-22. doi: 10.1093/bmb/ldac009. PMID: 35512347), records concerning complications are quickly destroyed, and “this destruction of essential data makes it impossible to carry out retrospective analysis of Oregon’s assisted deaths” (Regnard C, Worthington A, Finlay I, Oregon Death with Dignity Act access: 25 year analysis BMJ Supportive & Palliative Care Published Online First: 03 October 2023. doi: 10.1136/spcare-2023-004292).

Likewise, it is easy to imagine that those who attempt medically-assisted suicide are clear-headed individuals, rather than people suffering underlying causes of hopelessness and neglect. The trend, in suicide states, is to meet the request for suicide with great haste (Oregon has seen “a reduction in the length of the physician-patient relationship from 18 weeks in 2010 to 5 weeks in 2022”), to refer those requesting suicide to a willing physician, and decidedly not to investigate the possibility that the person requesting medically-assisted suicide might be depressed — “the proportion referred for psychiatric assessment remains low (1%)” (Ibid). Unwilling to listen to a cry for help, medical practitioners in suicide states are increasingly unable to recognize it when it is made in the form of a request for medically-assisted suicide.

We’re not like that in West Virginia. Here, when the sick, disabled, or ill express a desire to kill themselves, we do not ignore everything we know about suicide and prescribe them poison any more than we hand them a loaded gun. We help. Our mothers and fathers can trust a physician in West Virginia with what afflictions and depressions trouble them, and their physician will not repay their trust by recommending their death. This is a confidence we cannot take for granted. Without vigorously rejecting medically-assisted suicide, the future chosen by Canada — where medically-assisted suicide is the fifth leading cause of death — could well become our own.

That’s why it is vital to vote for Amendment One this November. It protects our state from medically-assisted suicide and the culture of indifference and carelessness that it promotes. It affirms the goodness of suicide prevention. And it sends a clear and confident message that West Virginia is not a state of despair, but of hope.

Pat McGeehan is a six-term state delegate from Hancock County. A graduate of the U.S. Air Force Academy, he serves as the dean of a private school in the Northern Panhandle. Pat resides with his daughter Kennedy in Chester.

Insight into The Cautionary Tale of Canada's Euthanasia Regime

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin

On October 9, 2024, The European Conservative published an interview by Jonathon Van Maren with Alexander Raikin. Raikin has recently published a research article titled: The Rise of Euthanasia in Canada: From Exceptional to Routine.

First question: In your view, why did Canada’s euthanasia regime go off the rails much sooner than other jurisdictions that have legalized euthanasia/assisted suicide? Raikin Responds:

The premise of your question is interesting. When the Supreme Court of Canada decriminalized euthanasia, it was based on the argument of a right to life—that those who would die from euthanasia would have otherwise died from suicide. It was a lesser evil. Yet every day in 2022, on average, Canadian physicians and nurses ended the lives of more than 36 people. It is now quadruple the official suicide rate.

In an ordinary country, in an ordinary time, this would be considered a national crisis: a royal commission would be called and weekly press conferences by worried government officials would dominate the news cycle, especially if the victims were all people with disabilities and the elderly. Instead, we now have cognitive dissonance of a national variety. News media credulously write about the horror of a Canadian man selling suicide kits online—and then report almost monthly on how a state-sanctioned, state-funded, and state-administered death from euthanasia is “beautiful.” Or how the lethal injection of prisoners in the U.S. is cruel and unusual, unless a prisoner denied for parole in Canada asks for a lethal injection instead.

This dissonance is reflected in what our public healthcare system funds. The median wait time for a CT scan in Canada was 66 days in 2023. A government-funded suicide, meanwhile? Only 11 days in 2022. I don’t know any elective medical procedure in Canada that is as rushed as euthanasia.

Canada is, of course, not the only jurisdiction with horror stories of what happens when we selectively decriminalize murder and assisted suicide by physicians and nurses. Every jurisdiction that has legalized permissive euthanasia or assisted suicide has seen wrongful deaths that shouldn’t have happened. It is as true in the Netherlands and Belgium as it is in Switzerland or Oregon. I could spend the rest of my life counting these cases: consider, for instance, the dozens of reported cases of euthanasia based on autism or an eating disorder that sparked some worldwide interest. The Swiss Medical Association had to issue a statement that suicide “for healthy persons is not medically and ethically justifiable.” Yet, even in a limited assisted suicide program which requires a terminal diagnosis with less than six months of natural life, we have seen the same excesses. In Washington state, according to the physicians responsible for ending their patients’ lives, 10% of all assisted suicides in 2022 were because their patients were concerned with “financial implications of treatment.” Not one media account reported on it.

But Canada surpasses all these jurisdictions, at least in how quickly we’ve seen the same stories. It was in the first hundred cases of euthanasia in Ontario, for instance, that we saw anorexia as a qualifying condition for euthanasia. Not a single newspaper reported on that either. There is no innate reason for why Canada’s euthanasia program has turned to be such a catastrophic failure in terms of human rights, especially for the people that the Supreme Court of Canada described as “vulnerable persons” who must be protected. On paper, Canada should have one of the strictest euthanasia programs in the world: the eligibility criteria and the safeguards are written as exemptions—in the Criminal Code—from homicide and aiding suicide. If a physician or a nurse practitioner breaks any provision, they would not be protected by these exemptions and could therefore face up to 14 years in prison. That hasn’t happened.

I have some speculations about why Canada’s euthanasia program has turned into a global canary in the coal mine for permissive euthanasia. It’s not because physicians or nurses in Canada are any more diabolical than in other jurisdictions—the vast majority have no interest in killing their patients, even as it becomes a surefire route for a promotion and a leadership position. The irony, of course, is that the exact physicians you don’t want to be involved in ending their patients’ lives are those who are most interested to do so.

I think the more likely reason is because of how Canada was forced to decriminalize euthanasia by the courts. Leon Kass warned that a ‘right to die’ invariably becomes a ‘duty to die.’ Once the Supreme Court of Canada enshrined this right much more forcefully than in other jurisdictions, the Criminal Code protections became moot—the relationship between physicians and their patients were ruptured. If it is a legal right to die, then there is no purpose for anyone else to be involved in this decision, even if it is a cop or a judge. No one else is in that room. It means that a physician and a nurse—who self-selected to reject their roles as healers—can break as many rules as they want, or pressure their patients to die from euthanasia.

It’s not a direct pressure, of course. It is more subtle: if you are suffering, why not be treated by this painless, ‘100% effective’ medical treatment? You are dying anyhow, even if it is a year or four decades from now, and other medical treatments are months away. Why not die? You feel in any rate like a burden to society, to your family, and to me, your caregiver. That is not a hypothetical: according to ‘MAID providers’ (their preferred description), over a third of their patients expressed that as at least one of their reasons to die.

Question 2: Your reporting has uncovered many disturbing aspects of Canada’s MAID system. What are some aspects of the way MAID has been implemented that would (or should) shock people?

Let’s start with something I found today. The Government of Canada created a website to tell physicians and nurse practitioners how to interpret its euthanasia legislation. It states, quite clearly, “Provinces and territories may create further policies and standards with respect to MAID. However, they cannot permit actions that the Criminal Code prohibits.”

Later this month, Quebec is set to unilaterally permit actions that the Criminal Code prohibits—it will allow people to sign an “advanced directive” for a clinician to end their life in the future when they lack the capacity to consent to their death. Let’s be clear what this means: physicians will have to approach a person with dementia, confused and unaware of what is happening, possibly emotional, and then restrain them and end their life. What if these patients changed their mind, maybe regained lucidity for a time, or learned to live a meaningful life with their condition? It wouldn’t matter. It is a murder warrant. One doesn’t have to go as far to read John Locke to know the virtue of why common law has made it so that no one can consent to their own death or harm. The idea that this can ever be made ‘safe’ is wrong.

Yet the truth of the matter is that Canada has already and quietly allowed a version of this. For National Review, I wrote a cover story last year about how Canada removed the requirement for final consent before a death from euthanasia, if a patient enters in a written agreement with one of their two MAID assessors. The form doesn’t need to be signed, and no one else needs to know about it. The exception is that, if a patient shows any verbal or physical signs of “refusal or resistance” to their death, then the euthanasia cannot proceed. MAID providers found and laughed about a loophole instead: they first sedated the patient who “is now delirious, shouting, pulling their arm away as one tries to insert the IV to provide MAID.” There can be no resistance for euthanasia if the patient is first sedated. These physicians then discussed with a bioethicist on the value of having this procedure potentially done away from the family of the deceased, because it would otherwise be distressful.

There are too many stories of abuse in Canada’s MAID program. I wrote about a suicide attempt that failed and then was ‘completed’ through MAID, even though a prominent supporter of MAID believed that it was potentially illegal. I’m writing a story right now on the Criminal Code violations of MAID. But these concerns were known virtually from the beginning of Canada’s euthanasia program. The Office of the Correctional Investigator said, in 2019, “There is no legal or administrative mechanism for ensuring accountability or transparency for MAiD in federal corrections.” Nothing was done. Yet think about what this statement means. It means that the MAID process, in itself, has no legal or administrative mechanisms to keep even the most watched people in our society safe. The federal government has explicitly excluded itself from any oversight role for a policy it created and a criminal law that it is meant to enforce.

Question 3: In your view, why have so many non-religious voices—suicide prevention advocates and disability rights activists—been ignored by the government and groups like Dying With Dignity?

Well, that the government ignores certain groups is not exactly controversial. But I think these groups are ignored not just because they lack a large lobbying purse or political power.

My theory—and I would prefer if I were wrong—is because these non-religious groups sound too much like religious groups. They both rely on an unprovable and therefore uncontestable notion of equality. Your next question asks me about my views on the lawsuit filed by disability organizations in Canada, which claims that Canada’s euthanasia program for people with disabilities who are not terminally ill is discriminatory and unconstitutional. I was listening to their first press conference last week. Heather Walkus, the National Chairperson of the Council of Canadians with Disabilities, Canada’s oldest disability organization, said at the press conference that “CCD will always fight for life.” Fight for life? In 2024? When was the last time that you heard those words from any Canadian or American NGO, let alone a progressive organization—or a religious group nationally in Canada?

Suicide prevention advocates, mental health professionals, disability rights activists: virtually all of them are opposed to the idea that certain lives are less worthy of living. The corollary is that each life has an inherent dignity by virtue of being alive. Call it anti-ableism or a culture of life, imago Dei or article 10 of the Convention on the Rights of Persons with Disabilities. We either believe that disabilities do not make a person less worthy of dignity and life, no matter how severe or life-altering, or we do not. Either we believe that human life is sacrosanct, or else that it is disposable.

A government that decriminalizes suicide and murder for only some people is fundamentally unjust. If it is true, as argued Lord Rabbi Immanuel Jakobovits, the late chief rabbi of the United Kingdom, “The value of human life is infinite and beyond measure,” then it logically means that “Any part of life—even if only an hour or a second—is of precisely the same worth as seventy years of it, just as any fraction of infinity, being indivisible, remains infinite.” That certainly doesn’t mean that a person who is dying and in pain must suffer: we have developed, even if we don’t fund it adequately, the most advanced form of palliative care, and dual intent for palliative medicine to treat suffering that shortens life is almost universally accepted in medicine and among faith groups. But to cross that line, to treat a patient’s suffering by ending the patient, is the difference between healthcare and deathcare.

I spoke to someone whose sister died from MAID. She had a non-terminal illness, and should therefore not have been eligible for MAID, at least according to the law at the time (in 2021, Canada expanded euthanasia to non-terminal illnesses and disabilities). He told me that, if his sister would have been on the side of a bridge, he wouldn’t have pushed her. But her MAID assessor believed otherwise. His sister couldn’t find a medical treatment option for her in Canada—besides euthanasia.

Question 4: What is your view of the Charter of Rights and Freedoms challenge filed in Ontario Superior Court by a coalition of disability groups and two affected individuals?

It is the start of litigation. It won’t be the end. If a law values some lives as less worthy of living than other lives—be it on the basis of disability, age, or identity—then that law is unjust. There’s a joke in Futurama of a suicide pod in the future where you must pay a nickel. It’s not a joke in Canada. When I lived in Canada, I needed to pay for my drug prescriptions. But MAID is free, always free. The financial and moral costs are paid for by society.

At this point, we need to put some limits on MAID legislation. Even by disability organizations simply launching a lawsuit, it is enough to say to people with disabilities across Canada that they matter, that their lives are worth living, and that simply having a disability is no good reason for suicide. It was a message that, a decade ago, healthcare practitioners used to say to their patients. Now it is disability organizations that are quite literally collecting names of their dead.

Question 5: How do you see this debate unfolding over the next several years? Can the expansion of the euthanasia regime be stopped?

The year is 1919. A group of scientists and physicians claim that using the scientific method and a rational approach, physicians can objectively decide which people would benefit from sterilization and which would not. About a dozen and a half states in the U.S. enacted this practice against the consent of the individual.

In Canada, it is 1928. Despite eugenics originating in the United Kingdom, the only part of the British Empire that legalized forced sterilization was in Canada. In Alberta, where most of these procedures happened, it was at first voluntary and in front of a four-member panel with at least two physicians. Then, in 1937, consent was no longer required.

The arguments for eugenic sterilization and euthanasia are surprisingly similar, partly because, as Ian Dowbiggin demonstrated in his book A Merciful End, these arguments were made by the same people. In both cases, it was pushed through by physicians who believed they were acting in their patients’ interest. In both cases, an objective rubric was meant to apply to decide which patients would be suitable for treatment and which would not. In both cases, it was supported by large majorities and the cultural elite—for a time.

As a society, we haven’t gotten over the role of eugenics. As long as we treat disabilities as a fate worse than death, we remain in the grasps of this dying ideology. Today, even bringing up eugenics in the context of permissive euthanasia is seen to be impolite (and a cancellable offense, as Dr. Harvey Schipper found when he was forced to step aside from a working group on advance requests—the same issue that Quebec is sliding into this month).

Yet eugenics is a dying ideology, at least outside of X. Those who effectively support it are forced to argue for it indirectly. As one prominent bioethicist and supporter of euthanasia suggested, we need infanticide because some babies become disabled through birth. It is a horrific opinion, one that, as G.K. Chesterton described in his Eugenics and Other Evils, could only be sustained through “terrorism by tenth-rate professors.”

We do not need to vacillate on what is right and wrong. Everyone has a right to life, and the experiment in saving life through legalizing some suicides has been an unequivocal disaster. In a generation, or maybe sooner, we will be speaking of euthanasia the same way that we speak of forced sterilization.

Rosina Kamis

Question 6: In your reporting, what story or stories have stuck with you the most?

Every few months, I think about Rosina Kamis. For my reporting in The New Atlantis, through the executor of her estate, I went through her entire email account and her Google Drive. “I think if more people cared about me,” she wrote in an email, “I might be able to handle the suffering caused by my physical illnesses alone.” To her two dozen subscribers on YouTube, she said, “Sometimes all the pain will go away just by having another human being here.” Even without a terminal illness, she was instead given a state-administered euthanasia—the exact condition that disability organizations in Canada are currently contesting.

The other story that struck me the most is how ghoulish proponents of euthanasia have been in promoting euthanasia for Indigenous people. Indigenous Disability Canada is one of the parties in the Track 2 lawsuit, and I hope they will include some of the evidence that I wrote about in National Review. At the 2018 annual convention for the Canadian Association of MAID Assessors and Providers, just two years after legalization of MAID, the physicians and nurses tasked with euthanasia advocated expanding MAID to Indigenous children “because they’re closest to the ancestors.” Even then, MAID providers were surprisingly tolerant of euthanizing “a First Nation patient” whose suffering was exasperated “due to a life lived in poverty.” These MAID providers then suggested that “as soon as a patient tells me their suffering is enough, whether I like it, that is their situation and their context.” Note the answer: try to get their basic needs met, try to fix the system, but above all else, don’t forget to kill a patient suffering from poverty. It’s the only right thing to do, at least in Canada.

Alexander Raikin has been covering Canada’s euthanasia regime for years and has consistently broken stories that other journalists missed (or ignored). His work on euthanasia and assisted suicide has been cited by The Atlantic and the New York Times and has been featured in cover stories for National Review and The New Atlantis.