Québec's Premier, who legalized euthanasia, has second thoughts.

"I'm not sure that I would have again voted for that law with the extension that we have seen in the recent years." Philippe Couillard.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Philippe Couillard

Philippe Couillard, who was the Premier of Québec in 2014 when euthanasia was legalized, stated on a CBC radio program that he is not sure if he would support that law today.

Darren Major reported for CBC News on October 10 that:

The former Québec premier who oversaw passage of Canada's first-ever medically assisted dying law says he now feels conflicted after seeing how far the practice has progressed since then.

Québec legalized euthanasia in 2014, before the Supreme Court of Canada promulgated the Carter decision which struck down Canada's criminal code statutes protecting Canadians from euthanasia and assisted suicide.

Quebéc legalized euthanasia by defining it (killing) as healthcare. Canada's constitution recognizes the provinces as having jurisdiction over healthcare in Canada.

Major reported that Couillard as stating on CBC radio - The House that he sometimes questions his 2014 decision after seeing how euthanasia has expanded in Quebec and Canada since that first law was passed.

"It was clearly reserved for terminal or pre-terminal conditions with a defined, unfortunate road to the end of life. And this is not the case anymore," he told host Catherine Cullen.

"I'm not sure that I would have again voted for that law with the extension that we have seen in the recent years."

Couillard, a former neurosurgeon, emphasized that the intention of Québec's original law was to limit euthanasia to those who with a terminal illness. Major reported:

"I was warned about this by people opposing the law that told me, 'We see your motivation is good, but you will see, once you open the door you will not close it and it will open wider.' And this is what happened," he said.

I had lunch with Couillard in 2014. I explained that euthanasia, in other jurisdictions, such as the Netherlands, was constantly expanding and I stated that, based on the language of the bill, that euthanasia would inevitably expand in Québec.

Major reported further comments by Couillard which indicate his division on the issue.

The poor oversight and expansion of euthanasia began immediately in Quebec.

Amy Hasbrouck, who was the President of the Euthanasia Prevention Coalition, wrote a report in October 2017 based on the first full year report of euthanasia in Quebec (June 10, 2016 - June 27, 2017). The report indicated that there were 638 reported euthanasia deaths in Quebec during that time-frame.
 

Hasbrouck explained that the Quebec report indicated that 31 euthanasia deaths (5%) were not compliant with the law and in 19 euthanasia deaths, the committee could not decide if those deaths were compliant. 

In June 2023 Quebec passed Bill 11 amending the Québec euthanasia law in the following ways:

• creating an obligation for palliative care homes to offer euthanasia, 
• allowing euthanasia in cases of serious physical disability
• approving euthanasia by advance request.

The Canadian Press reported that Bill 11 "also allows Quebecers to receive euthanasia in places other than hospitals, such as funeral homes and long-term care facilities."

The passage of Bill 11 in June 2023 forced all medical institutions, even those that were religiously affiliated, to provide euthanasia, it extended euthanasia to people with disabilities who are not terminally ill and it enabled pre-requests for euthanasia, thus eliminating the requirement that a person be competent.

The 2024–2025 Report of the Commission on End-of-Life Care on the Québec euthanasia data (April 1, 2024 to March 31, 2025) and the most recent data from Québec, indicated that there were 6,268 reported euthanasia deaths in that time-frame representing (7.9%) of all deaths, which was the highest rate in the world.

There were almost a 10 times the number of euthanasia deaths from the first full year of the law until (March 2025).

Based on the language of the euthanasia law, the legal expansions of the law and the normalization of euthanasia, one should not be surprised that euthanasia killings are "out of control" in Quebec.

Belgium Expands Killable Caste. Euthanasia Deaths Increase

This article was published by the National Review online on October 12, 2026.

Article: Almost 25% of Belgians who are killed by euthanasia are not terminally ill (Link).

Wesley Smith

By Wesley J Smith

I still marvel at people who think–even after decades of experience with these laws–that legalizing assisted suicide or euthanasia will remain limited to the few for whom nothing else can be done medically to prevent suffering. Not only is it not true, but it is never intended by euthanasia enthusiasts to be so constrained. Indeed, wherever killing as an answer to suffering is legalized, the numbers so dispatched continually rise, the guidelines expand, and euthanasia or suicide as a means of death becomes societally normalized.

In Belgium, that pattern continues. The Belgian Federal Commission for the Control and Evaluation of Euthanasia just issued a press release about its published euthanasia statistics for 2024–2025. A few observations: 

• As I perused the statistics, I was struck by how bloodless and stiflingly bureaucratic this killing machine has become. What was it that the philosopher Hanna Arendt said about the banality of evil?
• In 2003, there were 259 euthanasia killings. By 2023, there were 3,423, and in 2025, a whopping 4,487, a 31 percent increase from 2023. There will be even more this year, only to be topped every year thereafter going forward. In fact, only during the year of Covid in 2020 did Belgium record fewer euthanasia killings from one year to the next.
• In 2024–2025, 75.8 percent of the killings were of patients whose deaths were “within the foreseeable future.” That’s not the same thing at all as terminally ill. The rest — 24.2 percent — of the deaths were of people who were not anywhere near a natural death.
• Two of the killings were for minors under age 18. Expect pediatric euthanasia to increase going forward. Once killing is redefined as a medical “treatment,” how do you deny it to children?
• Fifteen were by “advance request.” This means incompetent people were killed who could not consent legally to being euthanized at the times of their deaths, and probably could not change their minds about being dispatched either because they were not legally capable of making their own medical decisions.
• One hundred twenty-nine people with mental illnesses who were not otherwise ill were dispatched. That’s a little less than one every 3 days. Only 9 of these were killed by psychiatrists, meaning doctors who do not specialize in treating mental illnesses killed the rest.
• Patients (536) were even euthanized in palliative care units. Killing isn’t palliation properly understood, but then, euthanasia corrupts everything it touches.
• Thousands (2592) of patients were dispatched in hospitals during the two years of the report. Some of these were for the purpose of organ harvesting, but the number of such cases is not discussed.
• Most of the euthanasia killings (63.5 percent) were carried out by general practitioners. GPs may not know all of the treatment options for serious diseases that require specialized care. A startling 48.4 percent of the killing doctors had no specialized training in end-of-life care.
• Many more Belgians were probably killed by doctors than the report indicates since terminal sedations are not included in euthanasia statistics.
• No policy is perfectly carried out, yet zero doctors were reported to courts for abuses. They rarely are anywhere euthanasia and assisted suicide are allowed. And on the few occasions when doctors have been reported, medical associations objected loudly because such cases could have a chilling effect on doctors’ willingness to kill patients.

The same pattern is happening here too, albeit more slowly. But if things keep up the way they are, we will — like our close cultural cousins in Canada — embrace the culture of death with great enthusiasm.

We must demand real end of life care --not killing.

Gordon Friesen
President: Euthanasia Prevention Coalition

Gordon Friesen

In the past weeks there has been much discussion of a particular Ontario case involving an elderly patient who deliberately chose a Palliative Care facility where medical homicide was allegedly not practiced, but where she was nevertheless subjected to several very aggressive proposals for euthanasia; where, under worsening circumstances she was actually told that no other relief was possible; where faced with outrage, from her supporting entourage, it was finally admitted that palliative sedation did, in fact, remain an option; but where such sedation was ordered, not at once, but only for a future date; and where the patient died a natural death in the meantime. There are clearly several disturbing elements to this story.

First is the profound penetration which medical homicide has apparently achieved in the past ten years.

The Palliative care facility chosen has officially exercised its right to refuse medical homicide on grounds of moral principle. No euthanasia procedures are performed in that place. And yet notwithstanding this clear mandate: the doctors and nurses working in that institution are apparently relying on euthanasia as their go-to, first choice treatment.

Second, is the aggressive nature of this professional steering towards medical homicide.

In this case, professionals not only refused to take "No" for an answer (returning multiple times to the charge) but they actually went so far as to pretend that they possessed no other options to relieve the patient's distress. And, even after they were forced to admit that other measures (such as palliative sedation) are, in fact, available, they did not actually initiate appropriate procedures at once, but projected that initiation for some days farther off. And so it is that the patient's discomfort was only ended by natural death, not by the care of her physicians.

It is difficult to read that description without suspecting that medical homicide is literally the only "treatment" in which these professionals are now interested, at least for difficult cases, and that both pain and time are cynically seen as allies in obtaining consent to provide it. Or in other words: the apparent inability to relieve symptoms is not a failure, but a strategy.

And yet, what should most concern us about such evident malpractice, is the normalization of medical homicide, which it indicates, and the effects of that normalization --not only for Palliative Care, but for the entire medical industry.

For if patients are only sent from Long-term to Palliative Care in order to die, then doctors will soon ask why they should not kill those patients right now, and save them the journey.

And, indeed, the circle of this pessimism is already much wider than that. For we now see medical homicide adapted as a style of Preventive Medicine, whereby people are killed --not to relieve suffering-- but to avoid that suffering in the first place (such as at the moment of difficult diagnoses where consent is obtained under the weight of shock, contextual despondency and a pathetic trust in physician benevolence).

So also, we now see medical homicide proposed before major surgery, in cases of catastrophic accident, an in rehabilitation.

In the end, it is to prevent these outcomes that we must patiently wait: even at the very end, and even where death occurs under profound palliative sedation.

We must be willing to wait, because we do not wish the normalization of medical homicide --at the very end of Palliative Care-- to become the normalization of medical homicide before patients even arrive in that place.

Clearly, none of this is done to benefit the people. Let us not be fooled! Medical homicide is NOT OK where it is (at least for now). We must demand real end of life care --not patient liquidation. It is what normal patients want. It is what normal doctors wish to provide. It is what we all deserve. It is what we have handsomely paid for with our tax dollars.

Canada backs off on euthanasia for mental illness, but targets people with dementia.

This article was published by National Review online on October 9, 2026.

Wesley Smith

By Wesley J Smith

Some are celebrating Canada’s government “indefinitely suspending” legalizing euthanasia for mental illness as a great victory for life. Not me.

Let me explain. Of course, I am gratified that mental illness will not become grounds for being killed in 2027 as was scheduled. But note: In announcing the suspension, the government mooted legislation likely to pass that would have permanently outlawed killing for mental illness. Moreover, “indefinite” can mean years — or a month. So, it’s not a matter of principle.

But here’s the kicker. The government is now promoting euthanasia for people with dementia. From the Global News story:

[Justice Minister Sean] Fraser also said the government will “grant access to medical assistance in dying to people who have provided consent at a time when they still have capacity but know that they have been diagnosed with an illness that will take that capacity from them subsequently.”

This is sometimes referred to as “advance directive” or “advance request” in medical parlance. It often involves a competent person making a written request for MAID, with the intention that it would be honoured later, if and when they lose the capacity to make the decision for themselves: for example, in people suffering from worsening Alzheimer’s or dementia.

Once this proposal is law, people will be able to order themselves killed in the future when they reach a particular point of incapacity. And they wouldn’t be able to change their minds once they became incompetent because they would no longer be legally entitled to make their own care decisions. So, even if they were happy, not suffering, and now wanting to live, they would still be lethally injected.

This is already the law in the Netherlands and Belgium, and it has led to a horrific story. One Dutch woman signed such a document. When she repeatedly refused the lethal jab after becoming incompetent, the doctor drugged her coffee and started the termination. The patient woke up and struggled against the procedure. The doctor instructed the family to hold her down and completed the killing. Of course, a court later found the doctor not guilty of any crime.

Dementia patients are the next target of the culture of death, with advocacy increasing to include such people in the killable caste. Euthanasia activists already push VSED — suicide by self-starvation — for patients so diagnosed and even want caregivers forced to refuse their patients food and water if the person had so ordered when competent. Once that idea is accepted by society, lethal injections will soon follow because it will be seen as more humane.

So, I am not surprised that Canada’s leaders decided to shift their focus from the mentally ill — which caused a pushback — to cognitively incapacitated patients as euthanasia’s next big expansion. Many are terrified of dementia, so I suspect they believe it will be a lighter lift. And think of the money in health-care resources that will be saved!

Euthanasia (MAiD) by advance request is euthanasia without consent.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Justice Minister Sean Fraser and Health Minister Marjorie Michel stated on October 7, 2026 that the federal government will introduce legislation, that will prevent the implementation of euthanasia for mental illness as a sole criteria. 

However, the government legislation will also permit euthanasia by advanced request.

The Euthanasia Prevention Coalition opposes killing people but why is euthanasia by advance request even more egregious?

Euthanasia by advanced request is a very dangerous concept as it permits doctors and nurse practitioners to kill someone who has become incompetent, based on an advanced request. The person who is killed requested to be killed while competent but is now incompetent and cannot confirm the request and is not legally capable of changing their minds.

Euthanasia was originally legalized in Canada under the guise of being for mentally competent adults, who are capable of consenting and who freely "choose." Euthanasia by advanced request undermines these basic principles.

Euthanasia by advance request means that a person, while competent, legally declares their "wish" to be killed, and if the person becomes incompetent, the person could then be killed, even though the person is not capable of consenting. Therefore euthanasia by advance request is euthanasia without consent.

Further to that, once a person becomes incompetent, they are not legally able to change their mind, meaning that some other person will have the right to decide when the person dies, even if that person is living a happy life.

Therefore a person who is approved to die by euthanasia based on an advanced request, who becomes incompetent, will lose their right to change their mind.

This is what happened in the Netherlands with the “coffee euthanasia” death where  an incompetent woman, who had previously requested euthanasia, resisted during the euthanasia. The doctor responded by putting a sedative in the woman's coffee but the woman continued to resist, so the doctor had her family hold her down as the doctor completed the lethal poison injection.

If euthanasia by advance request is approved, the law will discriminate against incompetent people who did not make an advance request. The law will be challenged in the court as it will be argued that the person didn't make the advance request based on timing (the option didn't exist yet) or lack of knowledge that it was possible to make an advance request. Will the court, in the future, expand the law even further?

Once killing incompetent people is viewed as "compassionate" it will be considered cruel not to kill an incompetent person who is deemed to be suffering, because the person didn't make an advance request.

Finally, euthanasia by advanced request is outside of the federal government jurisdiction. Every Canadian province has advanced directive laws based on their constitutional power over healthcare. 

Québec already expanded their law to allow euthanasia by advanced request. Whereas I oppose euthanasia by advanced request I recognize that based on provincial jurisdiction concerning healthcare, Québec had the right to do so, whereas the federal government does not have the right to do so.

Thank you Tamara Jansen for sponsoring Bill C-218

The Euthanasia Prevention Coalition is thankful to Tamara Jansen (MP) for sponsoring Bill C-218 and carrying this clear and important bill through parliament. Jansen's leadership was impressive.

Links to some excellent speeches by Tamara Jansen (Speech 1) (Speech 2) (Speech 3).

There were several other Members of Parliament who committed significant time and political capital to support Bill C-218, in particular Andrew Lawton (MP). 

Link to an excellent speech by Andrew Lawton (Speech)

Thank you also to the NDP caucus, Elizabeth May (Green Party) and Liberal members - Kent Macdonald and Marilyn Gladu who also supported Bill C-218.

The vote on Bill C-218 did not go as we had hoped but the campaign in support of Bill C-218 was excellent and resulted in the government announcing that they will introduce a government bill to prevent euthanasia for mental illness as a sole condition. We are not celebrating as we have not seen the language of the government bill, which may not have been written yet.

The government also announced that they will expand Canada's law to permit euthanasia by advanced request. This means that Canadians who declare, while competent, that they want to die by euthanasia, they can be killed at a later date, if they become incompetent.

The government announced that the bill will both prevent euthanasia for mental illness as a sole criteria and they will expand the law to allow euthanasia by advanced request. This is disgusting. The government will force Members of Parliament to vote on a bill that does both good and evil at the same time.

Since we have not seen the language of the bill we will not make a recommendation as to how Members of Parliament should vote on the bill.

We are nervous since euthanasia for mental illness, as a sole criteria is scheduled to begin March 17, 2027. The government does not have a lot of time.

Bill C-218 was defeated. What will happen next?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alex Schadenberg

It is too early to assess what will happen now that Bill C-218, the private members bill that was sponsored by Tamara Jansen (MP) was defeated in parliament by a vote of 187 to 141 on October 7. 

Bill C-218 would have amended the Criminal Code to prevent euthanasia for mental illness as a sole criteria.

The defeat of Bill C-218 was directly related to the announcement, the same day, at 12 noon by Justice Minister Sean Fraser and Health Minister Marjorie Michel. They stating that the federal government will introduce legislation, this fall, that will prevent the implementation of euthanasia for mental illness as a sole criteria. However, the government legislation will also permit euthanasia by advanced request.

Euthanasia by advanced request is a very dangerous concept as it would permit doctors and nurse practitioners to kill someone who has become incompetent, based on an advanced request. 

We knew that the language of Bill C-218 would have prevented euthanasia for mental illness, as a sole criteria, but we have not seen the language of the upcoming government bill. 

Language is everything. 

Who would make the final decision to poison an incompetent person to death?

The government bill, that we have not seen, may create a catch 22 situation where voting "No" to the bill would allow euthanasia for mental illness, as a sole criteria, but voting "Yes" to the bill would permit euthanasia by advanced request.

The government should separate the issues with two bills instead of one.

Until we analyse the language of the bill, we will not determine whether the government bill will actually prevent euthanasia for mental illness as a sole criteria.

Press Conference on October 7 at 11 am 

October 7 Press Conference

Dr Laurence Normand-Rivest, a family physician in Montréal who cares for geriatric patients and provides in-home palliative care, Dr Paul Saba a family physician in Lachine Québec who has personal experience with caring for people with mental health related trauma, Odile Marcotte, a retired professor from the Université du Québec à Montréal and a former deputy director of the Centre de recherches mathématiques, and a EPC Board member, and Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition spoke at a Press Conference.

Dr Normand-Rivest, Dr Saba, Marcotte and Schadenberg witnessed the historic and dissappointing vote on Bill C-218, at 3:30 pm in the parliamentary gallery.

Dr Laurence Normand-Rivest: Let us offer healing to the suffering

Presentation at the EPC Press Conference on October 7 in support of Bill C-218

Dr Laurence Normand-Rivest

My name is Laurence Normand-Rivest and I have been a family doctor for 13 years in Montreal, caring mainly for geriatric patients in clinic, long term facilities and providing palliative care at home for patients at the end of life. I also work 15 hours per week at the walk-in of my clinic where I meet patients of all ages and backgrounds.

I support Bill 218 to undo Bill C-39 coming into effect on March 17th 2027 that would allow those suffering solely from psychiatric illnesses to ask for MAID.

We should ask ourselves if homicide is an adequate answer to suicidal ideation. Have Canadians become lobbyists of suicide?

In 2016, Bill C14 defined MAID as assisted suicide provided by a doctor to a patient suffering from a terminal and grievous and irremediable condition in the context of a relationship between the patient and his doctor. Many safeguards have been removed since the introduction of the law, especially the initial delay of reflection of 10 days removed in 2021 with the introduction of Bill C7, which allows a patient in shock because of bad news to ask to be killed immediately. Bill C7 also expanded MAID for the people suffering from a serious illness when death is not foreseeable. With Bill C-39, patients wouldn’t need to have any physical illness to ask for assisted suicide.

Les idées suicidaires sont un symptôme de la dépression. Statistiques Canada estime que plus d’un Canadien sur 10 souffrira d’un épisode de dépression majeure dans sa vie. Des centaines de patients m’ont consultée au sans rendez-vous à cause de symptômes dépressifs. Je leur dis qu’ils peuvent prendre des rendez-vous de suivi avec moi et que je ne les lâcherai pas tant qu’ils ne seront pas guéris. La période initiale de détresse et d’idéation suicidaire, pouvant parfois durer des mois voire des années, est réversible pour la plupart des patients. J’ai même un patient qui avait été déclaré inapte au travail pour dépression chronique qui après dix ans, est redevenu assez fonctionnel pour réintégrer le travail qu’il aimait tant. Il est très réducteur de notre part de juger qu’une condition psychologique est irrémédiable, et plusieurs comorbidités physiques, comme des douleurs chroniques, nécessitent l’attention de plusieurs médecins spécialistes et de professionnels, ainsi que l’aide de ressources communautaires, avant de permettre au patient de sortir des bas-fonds de sa dépression.

English translation: 

(Suicidal thoughts are a symptom of depression. Statistics Canada estimates that more than one in ten Canadians will experience an episode of major depression in their lifetime. Hundreds of patients have consulted me at the walk-in clinic due to depressive symptoms. I tell them they can schedule follow-up appointments with me and that I will not abandon them until they have recovered. For most patients, the initial period of distress and suicidal ideation—which can sometimes last for months or even years—is reversible. I even have a patient who had been declared unfit for work due to chronic depression but, after ten years, became functional enough to return to the job he loved so much. It is overly simplistic to deem a psychological condition irreversible; furthermore, various physical comorbidities—such as chronic pain—require the attention of multiple medical specialists and professionals, as well as support from community resources, to help the patient emerge from the depths of depression.)

In 2023, Health Canada published the norms of practice of MAID, stating that patients should be informed of all the therapeutical options available to alleviate suffering. If the patients qualify for it, Health Canada stated that they should be informed of the possibility of MAID.

Why have we placed assisted suicide at the same level as healthcare? Have we designed suicide as a remedy to patients because of our incapacity to provide proper care to all? Roger Foley, a 51 year old man suffering from cerebellar ataxia hospitalized in London since 2016, has been offered MAID several times because our healthcare system couldn’t provide the homecare he was asking for.

I am very concerned for our patients who are psychologically in distress and wondering to whom they will turn to. We know that access to healthcare is often very difficult, especially for the most vulnerable, who are isolated, and prone to despair. AP News reported that patients have qualified for euthanasia because of isolation, poverty and obesity. In Montreal, I have heard of colleagues in my department administering MAID to a homecare patient who had chronic mobility issues but no grievous or irremediable condition, because he had asked for it a few days before Christmas in order not to be alone. Can MAID be a solution to the plague of loneliness? Have we thought of the despair of those suffering the loss of the deceased? How many victims will there be of our culture of death?

J’ai été responsable du service d’hébergement dans le CIUSSS Centre-Sud de Montréal pendant quelques années, et j’ai travaillé dans 8 CHSLD dans les CIUSSS du Sud et du Nord de Montréal, dont 2 unités où un grand nombre de patients souffrent de maladies psychiatriques chroniques. J’ai aussi parmi ma clientèle âgée au bureau et à domicile plusieurs patients souffrant de schizophrénie, de trouble bipolaire réfractaire ou de dépression chronique, dont plusieurs personnes invalides. Parmi eux, nombreux sont ceux qui trouvent une grande joie dans la simplicité du quotidien, et qui sont eux-mêmes des soignants par leur empathie qui apporte tant de consolation pour les personnes qu’ils rencontrent. La vulnérabilité ouvre le cœur à la souffrance de l’autre et nous permet d’y faire face.

English Translation: 

(I was in charge of the residential care department at the CIUSSS Centre-Sud de Montréal for several years and worked in eight long-term care facilities (CHSLDs) across the CIUSSS networks of southern and northern Montreal, including two units housing large numbers of patients with chronic psychiatric conditions. My caseload—both in the clinic and during home visits—also includes many elderly patients suffering from schizophrenia, treatment-resistant bipolar disorder, or chronic depression, including several individuals living with disabilities. Many of them find great joy in the simplicity of everyday life and act as caregivers themselves through an empathy that brings profound comfort to the people they meet. Vulnerability opens the heart to the suffering of others and enables us to face it.)

We know that suicidal thoughts are symptoms of an underlying depressed mood and that depression can be treated. Let us offer healing to the suffering, be present and faithful in our support, and not eliminate them.

Dr Paul Saba: Euthanasia of those with mental disorders is not mercy.

Presentation at the EPC Press Conference on October 7 in support of Bill C-218

Dr Paul Saba

My name is Dr Paul Saba. I am a family physician in Lachine Quebec.

One of my patients—a young mother of three small children was trapped in an abusive relationship. In despair, she attempted suicide by hanging. Found just in time by an neighbour, her life was saved. Had she been euthanized, there would have been no second chances. Today, she’s grateful to be alive, having had another child, and is now a grandmother to four grandchildren. 

Her story is a reminder that the darkest moments can give way to new beginnings—if we give people the chance to get better.

From a legal perspective, people with mental disorders who request  “Medical Aid in Dying (MAID)” a euphemism in Canada for euthanasia or assisted suicide, do not meet the criteria for free and informed consent, as the desire to die is often a symptom of mental illness. 

A Harvard School of Public Health study found that nine out of ten people who attempted suicide but survived did not die by suicide after receiving treatment. With proper care, the desire for suicide often disappears.  

Ninety percent of people who die by suicide have a mental disorder at the time they end their lives. Most who attempt or complete suicide do not truly want to die—they want an escape their emotional distress. 

I have spent my life caring for people at their lowest—facing distress, despair, disease and deprivation. What I’ve learned is that every life is valuable and worth fighting for. True compassion means supporting people through their dark times, not ending their lives.  

When someone turns to their physician in crisis, the doctor’s duty is to help them find a way out, not to offer death as a solution. A physician must stand with their patient and offer them treatment and help them find hope.  

People with mental disorders need proper care and support from psychiatrists, psychologists, and social workers. Many live precarious financial or social situations and need help with housing and food security. Our social and healthcare systems have failed them. 

Instead of expanding access to death, Canada must build a robust healthcare system that invests in world-class palliative care, mental health services, and social supports for people to live healthier and with dignity.  

Euthanasia of those with mental disorders is not mercy. It is murder masquerading as compassion. It is important that Members of Parliament support Bill C218 and stop the expansion of euthanasia to those with mental disorders. 

Euthanasia based on mental illness should never be approved

Presentation at the EPC Press Conference on October 7 in support of Bill C-218

Alex Schadenberg

My name is Alex Schadenberg and I am the Executive Director of the Euthanasia Prevention Coalition.

EPC opposes (MAiD), also known as euthanasia, as it constitutes the killing of a human being.

Euthanasia based on mental illness should never be approved. The law requires that a person have an “irremediable” medical condition to be approved for euthanasia and yet experts, for the most part, agree that it is impossible to determine which patient is irremediable and which one will get better.

The concept of euthanasia based on mental illness as a sole criteria is particularly concerning because the person’s mental condition might be driving them to suicidal ideation. 

I recently received the following story that explains our concerns through Carling Rygielski’s personal experience. Carling wrote: 

I am 30 years old, happily married, and a mother to two beautiful children. If you had asked me when I was a teenager where I would be at 30, I would have probably answered that I wouldn’t make it to 30.

I suffered from major depressive disorder, OCD, PTSD (albeit undiagnosed until my early twenties) since I was about 14. During those years, I frequently engaged in acts of self-harm. Though I didn’t have the words to explain it at the time, it is very clear to me now why I hurt myself as a child.

By the time I was 20, I truly felt suicidal ideation was going to be a lifelong battle. Every day was agony. I knew I needed critical care when I was speaking to a friend; I heard myself audibly share a thought pattern that had become so normal for me: “Every time I enter a room, the first thing my brain does is figure out how I could kill myself in that room. It's like a safety blanket that I have an escape route.”

I am incredibly grateful for the support of my parents, therapists, and doctors who supported me during this time to find the care I needed to reclaim my life. At the age of 21, after years of trying everything else, I decided to try medication.

It saved my life.

Of course, there were still speed bumps and moments that, at the time, felt they would be never-ending. Times where there was no light at the end of the tunnel. But then there was a new day.

I never attempted suicide because of my family.

I never attempted suicide because I was scared.

I never attempted suicide because when I went to my doctor to share the battle I had been facing for 7 years, she didn’t tell me I had an option of assisted suicide. In all the conversations we had, all of the time we spent looking for solutions; MAiD was never one of them.

Every morning I wake up, I see my beautiful children. How the morning light covers them, with their sleepy eyes. I hear the sounds of the world around me. I have my coffee. I am so grateful for this life. However mundane or extraordinary, I am so grateful I made it.

Please help to fight the good fight. Vote to pass Bill C-218.

Thank you Carling for sharing your personal story.

There is no consensus regarding euthanasia for people with mental illness.

Presentation at the EPC Press Conference on October 7 in support of Bill C-218

Odile Marcotte

Je m'appelle Odile Marcotte et suis professeure retraitée de l'Université du Québec à Montréal et ancienne directrice adjointe du Centre de recherches mathématiques. Je suis de très prés le débat sur l'euthanasie depuis 2010 et suis membre du Conseil de la Coalition pour la prévention de l'euthanasie. J'appuie fortement le projet de loi C-218 pour deux raisons. 

Tout d'abord je pense qu'il y a un manque fondamental de cohérence pour un gouvernement ou une société de tenter de prévenir le suicide tout en permettant le suicide indirect de personnes déprimées ou souffrant de maladie mentale. En effet, l'aide médicale à mourir (un euphémisme pour désigner l'euthanasie) revient à satisfaire la requête de suicide d'une personne, que celle-ci semble être sereine ou pas.

D'autre part, les audiences du Comité ayant étudié la question de l'euthanasie pour les patients souffrant seulement d'une maladie mentale ont démontré qu'il n'y avait pas de consensus parmi les psychiatres sur la probabilité qu'un patient donné puisse guérir de sa maladie. Prenons l'exemple des malades souffrant de ce qu'on appelle trouble de la personnalité limite (« Borderline Personality Disorder », en anglais). Le taux de suicide de ces malades est beaucoup plus élevé que celui de la population générale mais leurs symptômes s'atténuent souvent au fil des années et les psychiatres ont maintenant plus de succès auprès des malades jeunes (voir « A Concise Guide to Borderline Personality Disorder », par le docteur Joel Paris, professeur à l'Université McGill). Il semble donc contraire à l'éthique médicale d'euthanasier une personne souffrant du trouble de la personnalité limite.

Il n'y a pas non plus de consensus au sujet d'un quelconque droit à l'euthanasie pour les personnes souffrant de maladie mentale. J'aimerais vous rappeler que le Comité des Nations Unies pour les droits des personnes handicapées a critiqué la deuxième voie d'accès à l'euthanasie de la législation canadienne, celle qui permet aux personnes en situation de handicap d'être euthanasiées si elles en font la demande. Il semble évident que les critiques de ce comité seront encore plus vives dans le cas des personnes souffrant de maladie mentale uniquement, même si la Cour suprême du Canada statuait que l'interdiction de l'euthanasie dans ce cas violait la Charte des droits.

English Translation

My name is Odile Marcotte and I am a retired professor from the Université du Québec à Montréal and a former deputy director of the Centre de recherches mathématiques. I have been following the euthanasia debate very closely since 2010 and I am a member of the Board of the Euthanasia Prevention Coalition. I strongly support Bill C-218 for two reasons. 

First, I believe there is a fundamental lack of consistency in a government or society attempting to prevent suicide while at the same time permitting the indirect suicide of people who are depressed or suffering from mental illness. Indeed, medical assistance in dying (a euphemism for euthanasia) amounts to fulfilling a person’s request to die, whether or not they appear to be at peace.

Furthermore, the Committee’s hearings on the issue of euthanasia for patients suffering solely from a mental illness showed that there was no consensus among psychiatrists regarding the likelihood that a given patient might recover from their illness. Take, for example, patients suffering from what is known as Borderline Personality Disorder. The suicide rate among these patients is much higher than that of the general population, but their symptoms often subside over the years, and psychiatrists are now more successful in treating younger patients (see "A Concise Guide to Borderline Personality Disorder," by Dr Joel Paris, professor at McGill University). It therefore seems to go against medical ethics to euthanize a person suffering from Borderline Personality Disorder.

Nor is there any consensus regarding a right to euthanasia for people with mental illness. I would like to remind you that the United Nations Committee on the Rights of Persons with Disabilities has criticised Track 2 euthanasia under Canadian law, which allows people with disabilities to undergo euthanasia if they request it. It seems clear that this committee’s criticism would be even more severe in the case of people suffering solely from mental illness, even if the Supreme Court of Canada were to rule that the ban on euthanasia in such cases violated the Charter of Rights.

Belgium euthanasia data. Almost 25% of those who are killed are not terminally ill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Belga News reported on October 7, 2026 that almost 25% of all Belgium euthanasia deaths are people who are not terminally ill. Belga News reported:

Almost a quarter of euthanasia cases in Belgium involve patients who are not terminally ill, meaning their death is not expected in the near future. This is according to the biennial report by the Federal Commission for the Control and Evaluation of Euthanasia (FCEE). In 2025, there were 1,117 such cases, or 24.9 per cent of all registered euthanasia cases. A year earlier, the figure was 23.4 per cent.

The majority of these people were diagnosed as have 'polypathology' which means that they have multiple conditions but none of the conditions, alone, would likely lead to an approval to be killed by euthanasia. The Belga News reports:

In this group, a combination of different chronic and incurable conditions ('polypathology') is by far the most common reason for euthanasia: this accounted for 57.3 per cent of cases in 2025. Neurological conditions accounted for 15.8 per cent, while cognitive disorders (dementia) and psychiatric conditions each accounted for 6.3 per cent.

The indicates that the number of Belgium euthanasia deaths increased by 12.4% in 2025 to 4487 which was up from 3991 in 2024.

The article also states that the rate of investigating the deaths dropped. In 2024 80.2% of the deaths were only examined once while in 2025 85.6% were only examined once by the euthanasia commission.

The article states that euthanasia now represents about 3.8% of all deaths in Belgium. Many Belgian euthanasia deaths are not reported to the Belgium euthanasia commission.

Several years ago Dr Marc Cosyns stated that he does not report euthanasia deaths and studies show that Cosyns isn't alone in not reporting his deaths.

Euthanasia was sold to the public as being for mentally competent, terminally ill adults who were freely capable of consenting.

When Belgium expanded their euthanasia law, in February 2014, to include children, it was clear that eugenics was driving the force. Child euthanasia undermines the "safeguard" that a person is fully competent and capable of consenting.

By extending euthanasia to people with advanced dementia, the concept of being competent and consenting is completely ignored. These decisions are based on a decision that some human lives are not worth living.

A study by Belgian researchers and published in the Journal of Medicine and Philosophy on January 25, 2021, examines the practise of euthanasia in Belgium and concludes that legal requirements are being undermined and safeguards ignored. The study concludes that:

there are shortcomings in the Belgian euthanasia law, the application of that law, and the monitoring of euthanasia practice. This leads us to conclude that several of these shortcomings are structural and thus require more than simply increased oversight.

The study was conducted by Kasper Raus, Bert Vanderhaegen and Sigrid Sterckx from Ghent University and examines the official Belgian euthanasia data within the context of other studies that examine the application of the Belgian euthanasia law. This study is done by Belgian researchers who have been examining the Belgian euthanasia data for many years. One may disagree with the conclusion of the study but the data is impeccable.

The new eugenics is similar to the old eugenics, except that the new eugenics cloaks itself in the language of autonomy and choice, even when autonomy and choice are impossible.

Some recent articles on Belgium's experience with euthanasia.

• Belgian bioethics committee supports eugenic euthanasia (Read). 
• Belgium debates expanding euthanasia to people with dementia (Read). 
• Almost 4000 reported Belgian euthanasia deaths in 2024 (Read). 
• The President of Belgium's largest health insurance fund promotes euthanasia as an answer to healthcare funding. (Read). 
• Belgian doctor completes euthanasia with a pillow (Read).
• Belgium euthanasia study. Legal requirements are undermined and ignored (Read).

I am so grateful I made it. Support Bill C-218.

The following letter was sent to us with permission to share it.

Bill C-218 will go to a vote on October 7. Call your Member of Parliament today (Read).

My name is Carling Rygielski. I am 30 years old, happily married, and a mother to two beautiful children. If you had asked me when I was a teenager where I would be at 30, I would have probably answered that I wouldn’t make it to 30.

I suffered from major depressive disorder, OCD, PTSD (albeit undiagnosed until my early twenties) since I was about 14. During those years, I frequently engaged in acts of self-harm. Though I didn’t have the words to explain it at the time, it is very clear to me now why I hurt myself as a child.  

I was so scared of dying. I thought about it all of the time; it was the only way to escape the pain of the reality I was living in. In some very strange way, seeing my body heal from an injury told me: I am healing; something inside of me is working to care for my body. 

By the time I was 20, I truly felt suicidal ideation was going to be a lifelong battle. Every day was agony. I knew I needed critical care when I was speaking to a friend; I heard myself audibly share a thought pattern that had become so normal for me: “Every time I enter a room, the first thing my brain does is figure out how I could kill myself in that room. It's like a safety blanket that I have an escape route.” 

I am incredibly grateful for the support of my parents, therapists, and doctors who supported me during this time to find the care I needed to reclaim my life. At the age of 21, after years of trying everything else, I decided to try medication.

It saved my life.

Of course, there were still speed bumps and moments that, at the time, felt they would be never-ending. Times where there was no light at the end of the tunnel. But then there was a new day.

I never attempted suicide because of my family.

I never attempted suicide because I was scared.

I never attempted suicide because when I went to my doctor to share the battle I had been facing for 7 years, she didn’t tell me I had an option to assisted suicide. In all the conversations we had, all of the time we spent looking for solutions, MAiD was never one of them. 

I write this to implore you; please, stand up for our children.

There is always a light.

Every morning I wake up, I see my beautiful children. How the morning light covers them, with their sleepy eyes. I hear the sounds of the world around me. I have my coffee. I am so grateful for this life. However mundane or extraordinary, I am so grateful I made it.

Please help to fight the good fight. Vote to pass Bill C-218.

Sincerely, 
Carling Rygielski

We Implemented Canada’s Assisted Dying Law. We’re Concerned.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Gary Rodin

Dr Gary Rodin and Dr Madeline Li, who are both professors of psychiatry at the University of Toronto, co-wrote an article that was published in the New York Times on October 5 titled: Assisted Death is not a choice of last resort in Canada.

Rodin and Li begin the article by explaining that both of them work with patients with advanced cancer, both have counselled and assessed patients for the "procedure" and one of them has administered the drugs (poison) to end a persons life.

They then describe a case that they assessed as a good outcome for euthanasia. (I disagree). But they continue:

But Canada’s system for assisted death is no longer an option of last resort. Too many people are receiving the procedure without the opportunity for careful reflection about it with a health provider. In some cases, patients are being approved who should not be. Reports have emerged of people seeking assisted death in the context of poverty or loneliness, raising concerns that they may feel they have no other options. In other cases, including for many of our cancer patients, medical assistance in dying may be the right choice eventually, but there’s a risk of rushing into it and shortening what can be a meaningful period in patients’ lives.

Dr Madeline Li

Rodin and Li then comment on Canada's euthanasia history:

Canada’s medical assistance in dying program started in 2016 as an option only for patients with a “reasonably foreseeable” natural death. In 2021, Parliament removed the foreseeable death requirement. Today, Canada’s system is one of the most permissive in the world, allowing assisted dying for almost any form of subjectively intolerable suffering that has a medical basis, or even for medically unexplained physical symptoms. This latitude may contribute to Canada having the fastest growth rate of assisted dying in the world, increasing 16-fold in the eight years since legalization. The procedure now accounts for over 5 percent of all deaths in the country.

Rodin and Li comment on the euthanasia activists:

How did we get here? Within the Canadian system, medical assistance in dying is the result of a decades-long campaign aimed at enshrining it as a human right — often in the face of strong pressure from groups who opposed the procedure on religious or other grounds. Activists who support the procedure are still understandably wary of anything that could make it harder to get, often warning of unnecessary “gatekeeping” that might interfere with a patient’s autonomy. These activists helped shape the laws that govern the procedure and were instrumental in supporting the first medical networks that emerged to administer it.

Rodin and Li then comment on the attitude of physicians participating in euthanasia:

Perhaps as a result of this influence, many doctors have come to see their primary role to be making sure their patients meet the legal eligibility requirements to qualify for assisted dying. They must, for instance, be experiencing intolerable suffering and have the mental capacity for informed consent. The problem is that there has become far more focus on whether patients can get an assisted death and not enough on whether they should.

A study published earlier this year looked at how Canadian physicians involved in medical assistance in dying understood their role. One provider described being “just a conduit really for someone’s desires and someone’s choices.” In a separate but similar study, another provider professed to have no role in evaluating suffering — though one of the legal requirements to receive the procedure is that a clinician must confirm that the patient is experiencing intolerable suffering. Determining that degree of suffering “is entirely up to the patient — 100 percent,” that provider said.

Rodin and Li then comment on the important role of doctors guiding their patients. They then comment on recent research:

Our research shows that the suffering of patients with an advanced disease arises from a complex interplay of physical and psychological distress, family strain and a slow erosion of identity and meaning. In this context, the loss of the will to live is not a fixed state. It fluctuates. It can be treated. And it can be misread.

Rodin and Li then explain how Canada's law works:

Two clinicians (either physicians or nurse practitioners) are required to approve an assisted dying request. The vast majority of cases are what is known as Track 1, in which the patient must have an illness that will lead to a “reasonably foreseeable death” (although no time frame is specified in the law). In these cases, they can request the procedure and get it quickly — sometimes even on the same day. Track 2 cases, in which the person does not have a life-threatening illness, are much less common. In these cases, patients are required to wait 90 days before receiving the procedure.

Rodin and Li then explain that the law lacks effective oversight:

The law, however, does not require clinicians to engage in deeper conversations that explore the complex meaning of the request. We’ve seen cases where people request medical aid in dying in the face of a new cancer diagnosis or flare-up of an existing illness and get the procedure within a matter of days. There is no requirement in either track that patients attempt treatment to relieve their suffering. Nor does the law specify adequate safeguards to protect vulnerable individuals whose decision may be affected by social disadvantage.

We wonder whether inadequate consideration of such factors helps explain why in 2024, 98 percent of people assessed for medical assistance in dying in Canada were found to meet the criterion of “intolerable suffering” and over 92 percent were approved for the procedure.

In contrast, in the Netherlands, which legalized medical assistance in dying nearly 25 years ago, it’s common for cases to be rejected because a doctor judged that the patient’s suffering was not unbearable or that they did not pursue alternate treatment options.

Rodin and Li then examine several cases where the patient had the chance to change their mind:

We’ve seen how beneficial it is to pause and reflect with our own patients. One of them, a woman in her 70s, was the matriarch of her family, the one who made Sunday dinners. She sought and received approval for assisted dying after she lost the ability to cook. She felt she had lost her value to her family. Through counseling, she came to understand that her family valued who she was, not what she did for them. She decided not to go through with ending her life, at least for now. That Christmas, her family gathered and she sat proudly at the table, while others did the cooking and serving.

Another patient, a man in his 80s, refused a new treatment that might extend his life and instead requested and was approved for assisted dying. He survived the Holocaust as a child and viewed the freedom to choose the timing of his own death as a way of reclaiming what Hitler had taken away from his parents. However, his living family’s grief mattered to him, too, and they had concerns about him giving up too soon. With counselling, he chose to delay. Months later, he had adapted to his illness and continued to find meaning in his life. Eventually he got sicker and Dr. Li told him he was at risk of losing capacity to consent to assisted dying. This time, he chose the procedure, fully supported and surrounded by his family.

Rodin and Li then suggest that a medical "pause" in euthanasia will give patients a chance to discover alternatives or to establish that their life still has meaning. Rodin and Li then suggest that counselling is effective:

What form should that pause take? We do not believe patients requesting assisted dying need to be assessed for a psychiatric disorder as a matter of course. We do, however, find that most benefit from counselling and reflective conversations. Unfortunately, psychological care of this kind for patients requesting assisted dying is not routinely offered by doctors or other health care providers, nor is it routinely covered by insurance. It should be the standard of care and fully funded.

They then talk about an approach that they have developed:

We have developed and demonstrated the effectiveness of one such approach, which we have called Managing Cancer and Living Meaningfully, or CALM. This approach helps patients with advanced cancer sustain engagement in life, while approaching and preparing for the end of life.

Physicians are expected to explore what is driving a patient’s stated preference, whether it might change and what alternatives exist. This is called shared decision-making. It is standard practice in medicine — except for assisted dying in Canada.

They conclude by stating that:

A society that permits assisted dying should also ask whether it has done enough to help people sustain their sense of dignity and meaning in life. Death must not become the only kind of relief people can imagine.

The Euthanasia Prevention Coalition believes that killing people has led to the very problem that Rodin and Li are discussing. Since you can't force someone to avail themselves of counselling and you can't force someone to pause being killed because the law does not require it, therefore we must stop the killing.

Meaning is not discovered on the other end of a lethal injection, but rather meaning is acknowledged when someone cares enough to ensure you that your life is worth living.

Christa Pike didn't die by lethal injection. What happened?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week I reported on the failed Tennessee lethal injection execution of Christa Pike. In my article I explained how the concerns with failed execution deaths also apply to failed euthanasia or assisted suicide deaths.

Dr Joel Zivot, who is an anesthesiologist and intensive care physician and a medical expert for Ms. Pike’s lawyers, leading up to her execution explained, what happened to Pike, in an article published by the New York Times on October 4, 2026.

Zivot explains what happened to Christa Pike:

On Wednesday night, Christa Pike lay strapped to a gurney at Riverbend Maximum Security Institution in Nashville while the State of Tennessee injected pentobarbital, a sedative that is lethal in high doses, into her veins. When the first dose did not kill her, the execution team gave her a second. At one point, she told the room her arm felt as if it were about to burst. She was nearly correct. More than an hour after the procedure began, an ambulance was called. She was severely injured, but still alive.

By Thursday, Ms. Pike was in critical condition, receiving what her lawyers called lifesaving care. In a matter of hours, she had gone from a prisoner the state was trying to kill to a patient doctors were trying to save. As of this writing, she is unconscious. She is intubated and cannot breathe without a mechanical ventilator.

Zivot continues: 

I reviewed her medical records and warned her team that she had medical conditions that could lead to a painful and cruel death by lethal injection.

Tennessee has not explained what went wrong on Wednesday night, but the evidence so far points in one direction. Ms. Pike has small veins, which make it more difficult to insert an intravenous line. After the pentobarbital was administered, her arms turned purple. Her lawyers report blistering and burning at the injection sites. This suggests that at least some of the pentobarbital entered the tissue of her arms rather than her bloodstream because the intravenous lines failed.

Gov. Bill Lee has said that as far as he knows, the Department of Correction followed its protocol exactly. I take him at his word. That is the problem. Lethal injection failures are not glitches; they are features of the process.

Zivot explains how the lethal injection drugs, that are used in executions, work. It must be noted, that similar drugs are used in Canada for euthanasia.

Pentobarbital is highly alkaline, like bleach, and when injected into tissue, it causes a severe chemical burn. In Ms. Pike’s case, it appears that enough of the drug reached her brain to sedate her deeply, but not enough to stop her breathing. I cannot rule out that the drug itself was degraded, because Tennessee, like other death penalty states, does not disclose how it buys and prepares it. This is a state whose own independent review found that none of the drugs prepared for the seven people it executed between 2018 and 2022 had been fully tested.

Zivot challenges medicalizing killing:

Ever since Oklahoma became the first state to adopt lethal injection in 1977, prison officials have tried to make executions appear like medicine: There are gurneys, IV lines and heart monitors. But lethal injection is a sinister impersonation of the medical profession. There is no patient, no consent and no healing purpose. Even the drug is miscast. In the hands of the physician, pentobarbital is a medicine. I use drugs like it regularly in my intensive care unit to sedate critically ill patients. In the hands of the state, pentobarbital is a poison. Pentobarbital is not a painkiller, and when it is injected by the state, no one can say when a prisoner stops feeling pain.

This medical impersonation hides a great deal. I have reviewed the autopsies of more than 200 people executed by lethal injection. In most of them, the prisoners’ lungs were heavy with fluid, often with froth in the airways. These are signs of pulmonary edema, which suggests that the prisoners could have felt as if they were drowning, even if some looked peaceful as they were dying.

Zivot comments on other recent lethal injection executions:

After Tennessee executed Byron Black last year, his autopsy found the same thing. Witnesses reported that he moaned and said, “It’s hurt­ing so bad,” during the execution. In May, Tennessee’s execution team spent about an hour trying and failing to place an intravenous line in Tony Carruthers. In desperation, and because the state’s execution protocol said they could, they tried to insert a central line in Mr. Carruthers’s chest. That failed too, leaving Mr. Carruthers deeply shaken and bleeding from multiple puncture wounds. While aspects of Ms. Pike’s case are unique, the cruelty she experienced in the execution chamber is not an aberration.

Zivot comments on the outcome for Christa Pike:

Consider what a hospital team faces when a patient like Ms. Pike arrives. In my intensive care unit, a massive overdose is a familiar emergency. We secure the airway, support the blood pressure and monitor the brain. We watch an arm swollen by drug use to check for dying tissue and for pressure that can choke off its blood supply. Dying muscle cells leach poison into the bloodstream and deliver it into the kidneys. We count the minutes that passed before anyone called for help, because the brain keeps that count too.

It may take months to fully understand the extent of the damage that has been done to Ms. Pike’s body. Given that Ms. Pike was taken to the hospital over an hour after the lethal drug was administered, it is very possible that she sustained permanent brain injury. She most likely faces a very long road to recovery.

No one in the hospital where Ms. Pike is being treated would call what happened to her a medical procedure. To them it is a poisoning, and she is now a patient entitled to health care. Same body, same drug, same night: In one room it was called an execution; in the next it was treated as an injury. The doctors caring for Ms. Pike now owe her everything medicine can give. If they succeed, they will hand her back to the state that may try to kill her again.

Zivot ends his article by commenting on lethal injection execution:

The Supreme Court has ruled that the Constitution does not guarantee a painless execution, a decision states such as Tennessee cite to defend their lethal injection protocols. Very well. Then states should stop telling the public that lethal injection is clinical and not cruel. The illusion does not fool death row prisoners. I was a medical expert in three separate execution cases in Tennessee over the past 10 years. In each instance, the prisoner elected to die by the electric chair instead of by lethal injection.

Some states have already turned to nitrogen gas and firing squads. Christa Pike asked to be hanged. I do not endorse those methods. But they, at least, do not pretend to be medicine.

The deeper question is whether a state that executes its citizens is willing to look at what it is doing. Lethal injection was designed so that it would not have to. It puts the violence behind a sheet and a saline drip, and behind curtains that close the moment something goes wrong. After the pentobarbital failed to stop Ms. Pike’s heart, prison staff closed the curtains separating the execution chamber from witnesses for nearly an hour. The blinds could not conceal what had happened. A woman left the death chamber in an ambulance, and the only people who could help her were doctors.

Thank you Dr Zivot for your article explaining what happened to Christa Pike.

The concerns associated with lethal injection executions are the same concerns associated with lethal poison assisted suicide deaths.

In Oregon, where assisted suicide has been legal for more than 25 years, the longest time from ingestion to death in the 2025 assisted suicide report was 123 hours (more than 5 days). 

Deaths that take 123 hours are not peaceful or dignified deaths. But 123 hours to die by lethal poison is not an outlier. In 2023 the longest time of death was 137 hours (almost 6 days).

There may be many more assisted suicide deaths that took several days to be completed but the Oregon assisted suicide data only indicates the longest time of death. 

Clearly assisted suicide deaths can be inhumane.

The issues concerning assisted suicide also extend to euthanasia, which involves similar lethal injection drugs.

The story about the euthanasia (MAiD) death of Brigitte Stegemann (83) who lived near Belleville Ontario presented similar concerns. The Daily Mail reported:

Once back inside the home, the nurse started the IV, Kranendonk alleges. ...

The nurse struggled to insert the IV into Stegemann's right arm, and ended up piercing her repeatedly with the needle before attempting her left arm.

Kranendonk remembers in graphic detail the copious amount of blood, which made the whole procedure feel strangely unprofessional.

'She's asking us to hand her things, to flush out the needle. So we're now a part of this. She's asking us to grab things for her, and to hold things for her.

'This nurse is not wearing gloves. There's blood all over her hands, there's blood all over the place,' she says, horrified by the memory.

The problem begins with the concept that it is acceptable to kill people.

If death by capital punishment can be cruel and unusual punishment then killing people by lethal poison for assisted suicide or euthanasia is also cruel, inhumane and dehumanizing.