Thursday, February 5, 2026

Amazing News: Virginia assisted suicide bill dies in Committee.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have amazing news. The Virginia assisted suicide bill died on February 5 (today) by a vote of 8 to 7 in the Virginia Senate Committee on Education and Health.

Congratulations to everyone who worked with the coalition and/or contacted their state politicians. Lives have been saved by the defeat of this bill.

Legalizing assisted suicide in Virginia, which is to poison people to death, has been a goal of the assisted suicide lobby for many years.

In 2025, Delaware, Illinois and New York passed assisted suicide bills. New York Governor Kathy Hochul stated that she would not sign the New York bill until amendments were made. Sadly the amendment bill passed in both of the New York State Houses on February 4 and Governor Hochul is expected to sign the bill on February 6.


Wednesday, February 4, 2026

Is assisted suicide always peaceful?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The question of whether or not assisted suicide poison cocktails actually lead to a peaceful death has been examined and studied by several researchers and medical professionals.

Manuela Callari just added to the debate with an article that was published in Medscape on February 3, 2026. Callari writes:
The scene was meticulously set for a final, serene farewell. Family and friends gathered, champagne was poured, and a pianist played softly in the background. In this atmosphere of profound emotion, Arjen Göbel, MD, a general practitioner in Amstelveen, Netherlands, began the procedure that would bring a planned and peaceful end to his patient’s life.

Following the standard protocol, he began by injecting a coma-inducing drug. The 48-year-old patient with breast cancer closed her eyes and a deep hush fell over the room as her breathing grew shallower.

But the expected stillness did not come. The family noticed that the patient continued to breathe. Göbel, maintaining an outward calm, saw it too.
Callari reports that the woman didn't die. Göbel fetched an emergency kit and injected her again, but she still didn't die. Callari reports:
Göbel called an ambulance service while he fetched two more emergency kits from a nearby pharmacy. The paramedics helped him inject the lethal cocktail directly into a vein in her groin, but nothing happened. They then injected the fourth dose into the artery in her neck. It wasn’t until half an hour later at 6 o’clock in the evening — 4 hours after the first injection — that she finally died. The planned, beautiful farewell had become a prolonged and traumatic ordeal. “It was the worst thing in my life,” Göbel told Medscape News Europe.

Callari continues by explaining that unlike other "procedures" there are very studies or protocols concerning euthanasia and assisted suicide.
Similar stories of long drawn-out deaths can be witnessed in the Oregon assisted suicide data which indicated that one death, in 2023, took 137 hours to be completed.

Callari then defines euthanasia and assisted suicide for clarity.
Euthanasia is the intentional, direct administration of a lethal substance by a physician to end a patient’s life at their voluntary request to end unbearable suffering.

Assisted dying (suicide) is the voluntary, self-administered ingestion of lethal drugs prescribed by a physician. Crucially, the patient, not the doctor, performs the final, fatal act.
Notice how Callari uses pro-death definitions by implying that the wish to be killed is based on ending unbearable suffering, when the data in nearly every jurisdiction that allows death by lethal poison indicate that only a minority seek death based on ending unbearable suffering.

Callari then explains how euthanasia was first legalized in the Netherlands. Callari comments on the lack of protocols by stating:
It wasn’t until around 2010 — 8 years after the Dutch Termination of Life on Request and Assisted Suicide Act was officially introduced — that physicians approached pharmacists to develop a joint guideline. This collaboration resulted in the first combined protocol in 2012, with its most recent major update in 2021.

Today, the Dutch standard for euthanasia is a two-step intravenous (IV) process: a high dose of a coma-inducing barbiturate (typically propofol) followed by a neuromuscular blocker (usually rocuronium) to paralyze the respiratory muscles. A small dose of lidocaine is often injected prior to the process to reduce the burning sensation of the barbiturate.
Without going into further descriptions around killing it is important to note that the Callari suggests that the complications rate is generally under-reported and states that the 2023 Oregon data indicates a 9.8% complications rate.

Callari also comments on studies on the effect of the poison drug regimen on the body, particularly the lungs, and states:
Philippe Camus, MD, professor of pulmonology and respiratory intensive care at Dijon University Hospital in Dijon, France, has studied the effect of drugs on the lungs since 1972, when he began collecting data as a medical student at the University of Burgundy. Over five decades, he has compiled more than 200,000 references into a global database tracking drug-induced respiratory disease.

Even at therapeutic dosages, he explained, anesthetics such as propofol can cause ventilatory depression, a deep coma, peripheral vasodilation, and myocardial dysfunction. At therapeutic doses, however, these risks are minimal and promptly managed. “The poison is in the dose,” he said.
Callari quotes Didier Cataldo, MD, PhD, pulmonologist at the University of Liège in Liège, Belgium who explains:
These drugs shut down the brain’s drive to breathe, the patient becomes comatose, and breathing slows and becomes shallow. A deep coma can lead to loss of airway reflexes, which means the patient is no longer able to cough or gag. The tongue falls back, blocking the upper airway and causing effort during inhalation. This creates a vacuum inside the chest. As the diaphragm contracts to draw air into the lungs against a closed glottis, the pressure inside the alveoli drops rapidly and becomes significantly lower than the pressure in the surrounding blood vessels. This pressure difference acts like a suction pump. It forces fluid, and sometimes red blood cells, out of the pulmonary capillaries and across the thin membrane into the alveoli, resulting in negative pressure pulmonary edema. This is why, in standard surgery, patients are sometimes intubated and connected to a ventilator before the full anesthetic load is delivered. Anesthetics can also cause vasodilation and myocardial dysfunction. This causes a drastic drop in blood pressure, making it impossible for the heart to pump blood to the rest of the body.

While Cataldo claims that pulmonary endema is rare he does refer to a case of an 18-year-old male who ingested a lethal overdose of pentobarbital, the same barbiturate used in the oral method for assisted death. When emergency teams arrived, they found the patient in cardiac arrest. But as they attempted to intubate him, they found a “substantial quantity of frothy, bloody secretions” discharging from his throat. A postmortem CT scan confirmed severe bilateral pulmonary edema. His lungs were sodden with fluid. The patient, sedated but perhaps not yet dead, might have struggled to breathe against a blocked airway, drowning himself from the inside.
Similar research by Dr Joel Zivot who researched autopsies of people who died by lethal injection capital punishment. Zivot found that the lungs were filled with fluid likely resulting in death by drowning.

Callari continues with comments by Philippe Camus:
Camus said that experiencing pulmonary edema would be like drowning on dry land. It feels like being forced to breathe through a narrow straw. Every attempt to inhale draws not air but a mixture of blood and fluid that churns into a thick, pink froth. This foam rises up the trachea, blocking the windpipe. The brain, starved of oxygen, triggers a state of panic. “We need to decide whether that’s pain,” Camus said. “It’s not physical pain but can be extremely distressing.”
Callari then interviews several euthanasia doctors who suggest that pulmonary edema is unlikely, but even if it is happening, that the amount of drug that is used causes the person to be in a deep coma and unlikely to experience pain or distress.

Nonetheless, Callari concludes by stating that we simply don't know if assisted suicide is always peaceful.

More articles on this topic:
  • Death by assisted suicide is not what you think it is (Link). 
  • Assisted suicide: Proceed with caution (Link). 
  • Assisted suicide is the wrong prescription (Link). 
  • Assisted suicide. It's not that simple (Link). 
  • Assisted suicide deaths are not what you think they are (Link). 
  • Assisted suicide is neither painless nor dignified (Link).

Monday, February 2, 2026

Wesley Smith: The effective use of language in the assisted suicide debate.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On Wednesday, January 21, the Euthanasia Prevention Coalition (EPC) and EPC-USA held a strategic meeting in Washington DC.

There were four speakers at our event, (Left to right: Alex SchadenbergAlexander Raikin, researcher and visiting fellow in Bioethics at the Ethics and Public Policy Center, Ales Primc an organizer of the referendum campaign that overturned Slovenia's assisted suicide law, and Wesley Smith, author, lawyer, bioethicist and long-term campaigner against euthanasia and assisted suicide. 

Wesley Smith spoke first concerning the use of language. 
Wesley stated these points.
 
Euthanasia and assisted suicide advocates continue to engage in word engineering. He who defines the words wins the debate, and often that is true. The media will often use the assisted suicide lobby language because they are generally supportive of assisted suicide. 

Smith created a list of terms that should and should not be used. He insisted on using descriptive terminology. 

The first word that was stolen by the death lobby was euthanasia by changing its meaning to mean killing as an answer to suffering. They don't like using that term anymore because it is associated with killing. So they have created gooey euphemisms with terms that avoid what they are talking about.

We should never use the death lobby terminology and if you have to, make sure you refer to it as a euphemism. 

When they say (MAiD), notice how the term MAiD doesn't refer to dying. We need to be accurate and say assisted suicide or lethal injection homicide or medical homicide or euthanasia. The death lobby activists will say that our language is not accurate but it is perfectly accurate and discriptive.

Suicide means to kill yourself, assisted means to have help.

Medical Aid in Dying (MAiD) is a gooey euphemism that is intended to deflect from the actual agenda that is being described. They are also using the term Medical Aid in Dying (MAiD) to transform killing into a medical treatment. 

When they say that MAiD is really not suicide because the person is terminally ill, the statement is nonsensical. 

Whether a person has a health condition, a mental health condition, or a terminal condition, the act of suicide remains suicide. Just because a doctor prescribes the poison, doesn't change what is actually happening.

When we are advocating we must always use the proper terminology: assisted suicide, euthanasia, medicalized homicide or poison.

In terms of euthanasia, the lethal jab is a homicide. Homicide means one person killing another person or a human being killing another human being. Even where it is legal it is still homicide.

As I wrote in my first book, Forced Exit, when it is legal it may not be defined as murder but it is homicide and it is a form of killing. It is alway perilous and dangerous to society and individuals.

When the death lobby uses the term "medications" (they will often say they are prescribing medications). A medication is supposed to make you feel better or alleviate pain or symptoms, therefore it is not a medication. It is poison. 

Always use the term poison and never use the term medication.

When the death lobby uses the term "choice" we need to say that it is the end of all "choices."

When they say "dying on our own terms," we would say that applies to all suicides. Anyone who commits suicide is dying on one's own terms. Again, it is a nonsensical statement that is based on emotion.

This whole death agenda is being pushed through emotionalism and not rationality.

When they say "death with dignity" we need to challenge their implication that dying naturally is not dignified. 

When they say it is a "medical treatment" we say no killing is never a medical treatment. 

When they refer to their organizaton name - "Compassion & Choices" you can make fun of it. They used to have a much more honest name, the Hemlock Society. The term Compassion & Choices is a name that was poll tested into existence.

When they say nothing is more powerful than an idea whose time has come, our response should be that it is not a good idea. Our job is to ensure that this is not an idea whose time has come.

Beware of social movements that use euphemisms to promote their agenda's. It means that they are trying to pull wool over people's eyes. If you have to use euphemisms and word engineering then there is probably something wrong with your agenda.

Links to previous articles on language by Wesley Smith:
  • Euthanasia lobby continues to engineer language (Link).
  • Euthanasia euphemisms (Link)
  • Assisted suicide: Word engineering propaganda (Link).
  • Euthanasia poisons people and society (Link).

Zurich Switzerland will require every care home provide assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Swissinfo.ch reported on February 2, 2026 that the Swiss Canton of Zurich is in favour of requiring assisted suicide in all hospitals and retirement homes but not in psychiatric facilities and prisons.

The Swissinfo article reported:
The cantonal government is generally in favour of assisted suicide in all retirement and nursing homes. It has drawn up a corresponding counter-proposal to the initiative “Self-determination at the end of life in retirement and nursing homes too”. This would mean that all homes would have to tolerate assisted suicide in the future.
This proposal, which requires every care home to provide assisted suicide, does not extend to psychiatric facilities and prisons. The article further explains:
The popular initiative challenges a cantonal decision in October 2022 that not all care homes should allow assisted suicide on their premises, but only those with a service mandate from a municipality. This considers religious care homes, that often reject euthanasia.
This news article is essentially stating that the new policy ordering all retirement homes to provide assisted suicide only differs from the previous policy by the fact that it requires religious care homes to also permit assisted suicide.

What begins as an option for people who are seeking assisted suicide becomes an obligation to provide assisted suicide, even for people and groups who oppose killing.

How SickKids Toronto and Parliament Aligned on “Mature Minors"

This article was published by Kelsi Sheren on her substack on January 29, 2026.

How is Canada moving toward Assisted Dying for children.

By Kelsi Sheren

Canada is approaching a line it has spent years insisting does not exist, you know the one so many of us have been warning about.

CHILDREN may be NEXT.

In February 2023, the Special Joint Committee on Medical Assistance in Dying (AMAD) tabled a report in the House of Commons recommending a further expansion of MAID eligibility. Buried among its many recommendations is one that fundamentally alters the relationship between children, parents, and the state. That alone should concern every parent in this country.

The report recommends that MAID be made available to “mature minors.”

More terrifying was how parental involvement is treated. What the parliamentary report actually recommends is very uncomfortable. 19 of the AMAD report states:

“That the Government of Canada establish a requirement that, where appropriate, the parents or guardians of a mature minor be consulted in the course of the assessment process for MAID, but that the will of a minor who is found to have the requisite decision-making capacity ultimately take priority.”

This is not ambiguous language. Remember when they said children should cut their breast off at 12? The only difference here is that, MAID (murder and poisoning by your dr—IS PERMANENT)

Parents or guardians “may or may not be consulted”, depending on what assessors determine is “appropriate.” Even if consulted, their consent is not required. If a minor is deemed to have decision-making capacity, their will takes precedence.

In other words, under the framework Parliament is considering, a child could be euthanized without parental consent.

This is not speculation. It is policy design, and this liberal government is quite alright with killing your children no matter what you do or say.

This idea didn’t start by the current corrupt government, it was pushed by the mentally ill people in the pro death cults of the country. To understand how Canada arrived here, it helps to look back a bit.

In 2018, ethicists at Toronto’s Hospital for Sick Children (SickKids) published a draft policy on MAID for mature minors in the Journal of Medical Ethics. That policy laid the philosophical groundwork now reflected in the AMAD report.

The SickKids Children’s Hospital working group argued that there is no meaningful ethical distinction between assisted dying and other end-of-life medical decisions already available to minors.

As journalist Sharon Kirkey reported at the time:

“The working group said it wasn’t convinced that there is a meaningful difference for the patient ‘between being consensually assisted in dying (in the case of MAID) and being consensually allowed to die (in the case of refusing life-sustaining interventions).’”
That equivalence is hyper critical here.

If withdrawing treatment and actively administering a lethal injection are ethically the same, then the same consent standards apply and in much of Canada, mature minors already have the legal authority to refuse treatment.

Most Canadian provinces allow minors deemed capable to make their own medical decisions, including refusing life-sustaining treatment.

In Ontario, for example, a minor may consent to or refuse treatment if they understand the “reasonably foreseeable consequences” of that decision. There is no fixed age threshold.

SickKids’ draft policy applied that same logic to MAID.

Sharon Kirkey explained that the hospital’s ethicists concluded
:
There is no meaningful ethical or practical distinction from the patient’s perspective between assisted dying and other procedures that result in the end of a life, such as palliative sedation or withdrawing or withholding life-sustaining treatments.
Once that premise is accepted, the conclusion follows almost automatically.

A child deemed competent to make medical decisions is also deemed competent to decide to die with or without parental consent.

A permanent decision made in their weakest moments with adults there pushing the narrative.

The AMAD report does not explicitly state that parents should be excluded. Instead, it reframes parental involvement as conditional and secondary to the assessed will of the child.

This is a profound shift.

Parental consent is no longer foundational. It is optional. Consultation replaces authority. As a parent, that notion is simple terrifying.

The report attempts to reassure readers by emphasizing safeguards, capacity assessments, and professional judgment. But the underlying principle is clear: the state is positioning itself as the final arbiter, not the family.

This is the same pattern Canada keeps repeating and never learning from. Canada has been told before that each expansion of MAID would be rare, limited, and carefully contained.

That was said when MAID was limited to terminal illness. It was said again when eligibility expanded beyond end-of-life. It was said again when mental illness entered the discussion.

Each time, the goal post continues to move. Dr’s and this government just can’t seem to get enough of killing their own people.

Now the same logic is being applied to children.

The AMAD report also supports euthanasia based on advance requests — meaning individuals who are no longer competent could be euthanized based on a prior directive. Taken together, the direction is unmistakable.

Consent, once the cornerstone of assisted dying, is becoming conditional. Capacity is redefined. Age is minimized. Parental authority is downgraded.

This debate is often framed as compassion versus cruelty, or autonomy versus paternalism.

People in this country continue to move away from the real, hard questions. Whether it’s because their too weak or whether it’s because they don’t genuinely care about how we care for our children. What does it mean when a society who is supposed to have the best socialized healthcare in the globe starts killing it’s kids.

I’ll tell you, this is a sign of a Godless country, killing it’s next generation just like the Nazi’s did. This is Eugenics all over again, framed as compassion and care. Anyone with two eyes can see that.

Every expansion of MAID has been justified as an exception. But exceptions accumulate and each new door opened makes the next one easier to justify.

Canada is no longer debating whether child euthanasia is conceivable.

It is debating how to implement it and kill more children.

KELSI SHEREN

Source: https://www.parl.ca/documentviewer/en/44-1/AMAD/report-2/page-5

Sick Kids Hospital Toronto will euthanize children with or without parental consent (Link).

Academia Routinely Dehumanizes Disabled People

Meghan Schrader
By Meghan Schader
Meghan is an instructor at E4 - University of Texas (Austin) and is a member of the EPC-USA board. 
 

I love a good philosophical discussion, but I am frustrated that academia has treated disabled human beings as walking moral conundrums instead of people. 

I think Alexander Raikin put this problem well when he posted on X,

“For all the talk about ‘cancel culture,’ if you're an academic, you can say whatever you want about people with disabilities. You can say that their lives aren't valuable, that being dead is an improvement. You won't be penalized for these views—it'll help you get published.”

Exactly. This pattern is a personal beserk button.

Now I come to my most recent foray into academia, a commentary I was invited to write for a prestigious academic journal’s special issue on “MAiD” and disability. I was told that the paper was enthusiastically accepted and later asked to make various adjustments. 

For nine months I worked diligently to carefully and open mindedly address each point, with input from the person who had asked me to write the commentary. Up to when I submitted the manuscript incorporating the second round of feedback, publication appeared likely.

But then I received notice that the editors didn’t want my commentary after all. 

On some level, I have to suck it up. Article rejections are part of academia. Nevertheless I think it’s worthwhile to examine the editors’ assertion that the final outcome occurred solely because editing my writing did not result in “changes to the style to better match the style of the other manuscripts in the special issue and the style of manuscripts in the journal in general” and had nothing to do with publication bias. 

I think the feedback I received complicates that conclusion. Regardless of their intent, the editors seemed to want me to use language and make statements that favor the “MAiD” movement’s ideology.

I know that this perception is influenced by my personal biases, but the second round of feedback I received strikes me as possibly being an example of the longstanding pattern of some powerful “MAiD” supporters being insincere when they say that they want to “have a discussion” about  “death with dignity.” They want a discussion, but only one where their ideology is cast in the best possible light and opponents are expected to make concessions that sanitize horrible bigotry. 

For instance, during the second round of feedback the lead editors wanted me to address disabled people who want “MAiD.” All I could offer was a more detailed version of the argument that I made in the first draft of the commentary and on this blog: I empathize with disabled people who would like to “use MAiD,” but the disabled proponents are in the minority and I think it’s common sense that their suicidal ideation/desire for autonomy should not be able to turn the rest of the disabled community into a killable caste. 

The editors also seemed to want me to make statements that I worried would imply that the disabled community is evenly divided on the issue of “MAiD,” which is one of the “MAiD” movement’s favorite canards. The  majority of the disability community opposes “MAiD” and has for decades. So, in addition providing an intersectional analysis of disabled people who do want “MAiD,” I added contextualized quotes from other, more accomplished disability justice opponents of “MAiD,” to establish that while not every disabled person opposes “MAiD,” my perspective is not unique, either. 

One of the editors suggested that I call Peter Singer’s assertion that raping some disabled people is acceptable “controversial.” I think they were ok with my proposed substitution of “callous,” but why has academia conditioned people to suggest adjectives like “controversial” when discussing raping disabled persons? The consensus among ethical people in our culture is that rape is abhorrent, not “controversial.” I think referring to the rape of a disabled person as  “controversial” reinforces our culture’s pattern of treating the horrible abuse of disabled persons as if it weren’t necessarily wrong, even if that wasn’t the editor’s intent. 

In addition to seemingly wanting me to imply that the disabled community is evenly divided on the issue of “MAiD” and refer to the rape of disabled people as “controversial,” the editors wanted me to say that killing disabled children with “MAiD” was hateful “in my opinion.” I added the phrase “in my opinion,”  but I also added contextualized quotes from other, more accomplished disability rights advocates who concur with that assessment. I worried that otherwise my commentary might suggest that my perspective on killing disabled children is unique and that such killings are something that 21st century people should agree to disagree about. 

That concession isn’t appropriate for a personal commentary. I’m a disabled disability justice advocate. Therefore I think that disabled people’s dignity demands that if a policy of killing  able-bodied children from other disenfranchised groups is considered hateful, killing disabled children be regarded as hateful.

Even if bias was not the intent, I am nonplussed by the sanitizing language the journal editors asked me to use in my discussion of raping and killing. I think academic and political debate is usually a very good thing, but there are limits to what responsible people should concede. 

Richard John Neuhaus remarked, “Thousands of medical ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptionable.” 

Yes. So I did everything I could to respond eruditely  to my reviewer’s feedback without becoming part of that process. I am sorry that my commentary was not published by the prestigious journal, but at least I didn’t have to say that raping disabled people is “controversial” or that killing disabled children is only hateful “in my opinion.”

Academia’s insistence on treating disabled people like walking thought experiments is obnoxious;  rhetoric that promotes raping and killing disabled people is oppressive. However limited my own influence may be, that’s why I’ve written blogs and X threads that say, “Oh, you want to have a nice, polite discussion about killing disabled people, eh? Here’s a picture of your book in a toilet!” 

Disabled people aren’t “porn” for scholars’ intellectual vulgarity sessions. We are not obliged to accept abuse from academics who wish to debate the merits of raping and killing us at conferences in posh hotels. Not using disabled people’s personhood as an intellectual plaything is one of the least things society could do for people with disabilities.  

Author Note 1: For an incisive, more comprehensive commentary on resisting the “MAiD” movement’s framing in discussions about assisted suicide and eugenics, please read disability policy analyst Gabrielle Peters’s article “Acceding To MAiD Proponent’s Framing Excludes Abolition As a Potential Solution” in the American Journal of Bioethics. 

Author Note 2: For clarification of what I mean when I say that Peter Singer said that raping some disabled people is acceptable, read this blog post.

The False Ally Fallacy

This article is written by Kim Carlson and Paul Magennis from the MAiD in Canada substack.

The following post is part of a structured, multi-week, simultaneously published exchange between Kim Carlson and Paul Magennis, authors of MAiD in Canada, and Gordon Friesen, President of the Euthanasia Prevention Coalition. These alternating messages will explore deeply divergent views on Medical Assistance in Dying (MAiD), and no mutual endorsement is implied.

Previously published exchanges between Friesen and MAiD in Canada have been:

Gordon Friesen, Monday, January 12, 2026.
Maid in Canada (MIC)     January 19, 2026.
Gordon Friesen                January 26, 2026.

The False Ally Fallacy:

Why Friesen’s references do not support his claims

It is disappointing that Mr. Friesen devoted so much time to matters unrelated to MAiD in cases where eligibility is based on mental illness and the central question is decision-making capacity. By our count, less than half of his latest submission addressed the topic we explicitly agreed to discuss. In addition to being red herrings,[1] this appears to be an attempt to introduce so many diversions that responding to them would distract us from addressing his central—and unsupported—claim.

For now, we simply ask Friesen how characterizing MAiD providers as “homicide-friendly professionals” reflects anything that could reasonably be described as “neutral,”[2] or even respectful, within the terms of this exchange?

Back to the topic

Friesen has not engaged with our previous arguments. Since he has not challenged the fact that people living with mental illness can possess decision-making capacity, we take this point as conceded.

What remains, then, is an argument from uncertainty: that there is no way to distinguish between a desire to die arising from acute symptoms of mental illness, and a reasoned and capable response to long-term, treatment-resistant suffering. Uncertainty is not justification for categorical exclusion, and arguments of this kind have already been considered and rejected by the Supreme Court of Canada.[3]

Denying the rights of an entire group demands substantial justification from those advocating for that denial.[4] Because Friesen’s purported justifications are unsupported—even by his own references—he has not met that burden.

The Canadian Psychiatric Association (CPA)

Friesen notes that the CPA “has not taken a position on whether MAiD should be available” on the basis of mental illness and then treats that as evidence of opposition. It is not. Declining to take a position is not the same as taking a position against, particularly in a complex and contested domain.

More importantly, the CPA’s statement contains no suggestion that decision-making capacity cannot be assessed in this context.[5] Instead, it acknowledges a lack of consensus within Canadian psychiatry—a point made explicit in the preceding sentence that Friesen omitted from his quote:

“Within Canadian psychiatry there are divergent opinions with respect to the provision of MAID, as well as whether access to MAID should be permitted on the basis of mental disorder.”

The CPA declined to take a position because of the complexity of the issue and because its members genuinely disagree—not because they believe decision-making capacity cannot be assessed. For those psychiatrists who believe MAiD might be appropriate in some cases, that view necessarily presupposes that capacity can be determined—further undermining Friesen’s claim.

Canadian Association for Suicide Prevention (CASP) & American Association of Suicidology (AAS)

Friesen again appeals to the CASP and AAS to suggest that MAiD and suicide are indistinguishable. CASP explicitly disagrees with that claim, and AAS doesn’t even make it.

CASP stated that MAiD for those without a terminal illness constitutes a form of suicide.[6] However, CASP does not argue that MAiD and suicide are clinically or ethically indistinguishable, nor that it is impossible to differentiate the two. In fact, in an earlier statement, CASP explicitly affirmed that “MAiD and suicide can, at least in principle, be distinguished,” even while acknowledging possible overlap.[7] 

Claims that CASP regards MAiD and suicide as indistinguishable are not just unsupported—they directly contradict CASP’s published statements.

Friesen makes a similar error with the AAS, who retired a prior statement recognizing a distinction between MAiD and suicide[8] [9]—a standard process for aging position statements.[10] [11] But the removal of that statement does not imply the adoption of the opposite position. Friesen’s conclusion here relies on an inference his source does not support.

The American Psychiatric Association (APA)

Friesen’s reference to the APA follows the same pattern. While the APA opposes MAiD based on mental illness, the objection does not rest on an inability to assess capacity.[12] On the contrary, in the reference Friesen provides the APA explicitly states that:

  • psychiatrists may be asked to assess capacity where psychiatric symptoms may impair decision-making;
  • some mental conditions involve temporary alterations in preferences that reflect the underlying disorder; and 
  • in jurisdictions where MAiD is legal, it is ethically permissible for psychiatrists to assess capacity in this context.

There is no suggestion here that capacity cannot be determined. Indeed, there is an explicit acknowledgment that psychiatrists can assess capacity for MAiD in the setting of mental illness.

The APA’s objection is instead tied to concerns about hope and incurability, stating that “labelling a mental illness as…irremediable is inconsistent with present treatment approaches in psychiatry.” That is a complex and contested claim, particularly given the growing discussion of palliative psychiatry[13]but incurability is not the subject of our exchange with Friesen.

Conclusion

This exchange now turns on a narrow question: whether the acknowledged difficulty, in some cases, of assessing decision-making capacity justifies denying assessment to an entire group. Neither clinical practice nor legal principle supports that move. Friesen has not shown why it should.