Italian assisted suicide court decision is being challenged based on equality of people with disabilities.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Carmelo Leotta, one of the lawyer for four people who are asking the Italian court for equal legal protections, sent an explanation of a court intervention concerning assisted suicide. The intevention concerns four people who want to live who are arguing for the equality of persons with disabilities. Leotta writes:

On March 26, 2025, the Italian Constitutional Court will return to decide on aiding suicide (i.e., Article 580 of the Italian Penal Code, which punishes a person who helps another person commit suicide).

In 2019, in Judgment No. 242, the Court decided that the Italian Criminal Law does not have to punish a person who helps another to commit suicide if the person who wants to commit suicide is:

1. capable of making free and informed decisions,
2. ill with an incurable disease,
3. who has suffering that he or she considers intolerable,
4. who have ongoing life-support treatment. “Life-support treatment” is the treatment that ensures the patient's vital functions, that is, it is that treatment that if it is discontinued results in the patient's death in a short time. Life-support treatment, for example, is being attached to an artificial respirator or being fed with a nasogastric tube or having a permanent catheter.

Article: Italian assisted suicide court decisions focus on people with disabilities (Link).

The issue that the Court is being asked to decide on March 26, 2025 concerns the possible removal of the 4th requirement, which would expand the number of people who can request assisted suicide. Assisted suicide could be requested by people who:

1. are capable of making free and informed decisions,
2. who have an incurable disease,
3. who have suffering that they deem intolerable.

The Court is being asked to remove the “life-support treatment” requirement, so people who are permanently in a wheelchair as a result of a traffic accident or who are depressed, for example, would be able to access assisted suicide.

What's new in the March 26, 2025 trial is that there are four people applying for admission as witnesses to the case who want equal legal protection. Two people have already given testimony in favor of expanding assisted suicide. These four new people are seeking to offer a different view than the one already given.

The attorneys for the four people are Mario Esposito, (full professor of constitutional law in the University of Lecce, a lawyer from Rome) and Carmelo Leotta, (associate professor of criminal law in the European University of Rome, a lawyer from Turin).

The four people are:

1. capable of making free and informed decisions
2. have incurable diseases
3. have had/may have intolerable suffering

The four people do not require life-support treatment and do not want this requirement taken away. They do not want assisted suicide and want to continue living.

But why are they asking to participate in the process?

    1. If the Court decides to take away the requirement of life-support treatment, the lives of the four people would be less protected. The preservation of their lives would only depend on their willingness to live; in fact, the state would no longer punish the person who assisted them kill themselves. It is similar to allowing a person to put a loaded gun on the bedside table of someone who is sick. These four witnesses do not want the Italian state to allow this and they do not want the gun. The four people also consider this as an offense to their dignity, it is like saying, “if you want, go ahead and pull the trigger, you can throw your life away, because to us, your life is worth less than everyone else's. In fact, we punish those who help a healthy person kill die by suicide because his life has value, but because you are sick we allow another to put the gun on your table and we will not punish those who help kill you. In short, if you want to die we will facilitate this, and do it because you are sick and your life is therefore deserves less protection than a healthy person’s life.”

    2. Another consequence is that their dignity as people would not be equal to the dignity that healthy people have, because sick people who die by suicide, those who help them are not punished, whereas if a healthy person dies by suicide, those who help them are punished. This means that the state does not adversely judge the helping of the sick person to commit suicide (in fact, it does not punish those who assist a seriously ill person to commit suicide) but continues to punish the assisting of the healthy person to commit suicide. This false view of compassion violates the principle of equality, that dignity is accorded to all people equally.

This trial is of great legal interest because the 4 speople are effectively asking the Constitutional Court to be no longer only the supreme judge of who's life is worthy of equal protection in the law.

More articles on this topic:

• A history of the Italian way towards euthanasia (Link).
• Bad news: Tuscany has legalized assisted suicide (Link). 
• Italian woman with Multiple Sclerosis dies by assisted suicide (Link). 
• Disabled man is the first Italian to die by assisted suicide (Link). 

New Hampshire assisted suicide bill is likely dead in 2025.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New Hampshire legislature

The New Hampshire assisted suicide bill (House Bill 254) is likely dead in 2025 following a close vote to table the bill in the House of Representatives.

William Skipworth reported for The New Hampshire Bulletin on March 20, 2025 that:

By a single vote, the New Hampshire House of Representatives decided to table a proposal to legalize assisted suicide.

By tabling this bill, the House decided not to advance it to the Senate, but didn’t kill it entirely. Lawmakers can still bring it back up for a vote should they choose. The bipartisan vote to table it was 183-182.

Skipworth reported that a similar bill was debated last year:

The debate over assisted suicide is not a new one in the New Hampshire State House. The practice was almost legalized last year when 2024’s House Bill 1283, a very similar piece of legislation, was approved by the House, but failed in the Senate.

In tabling the bill House majority leader Jason Osborne said:

“I do enjoy a debate of nine speakers such as we have lined up here as much as the next guy,”

“But I also know that we don’t need to have the same debate every year.”

On March 21, 2024, the New Hampshire House passed assisted suicide House Bill 1283 by a vote of 179 to 176. The bill was referred to the Senate where it was stopped on May 16, 2024 by a vote to 17 to 7 when they sent the bill for further study. 

New Hampshire assisted suicide bill is dead in 2024 (Link).

Prognostic criteria are inaccurate for 6 month terminal prognosis.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An editorial that was written by Dr Scott Murray and Dr Simon Etkind that was published in the British Medical Journal on March 12, 2025 explains that prognostic criteria in providing a six month terminal prognosis are inaccurate.

The article is a response to the assisted dying bill in the UK that is sponsored by Kim Leadbeater (MP). The Leadbeater bill states that a person qualifies for assisted dying if they are:

“reasonably expected to die within six months,”

The authors write:

However, the challenges of prognostication in relation to eligibility for assisted dying remain underexplored. Prognostic eligibility criteria are limited by the fact that prognosis is inherently uncertain and there are no valid tools, tests, or clinical examinations that can reliably and safely identify that a person is expected to die within six months.

The authors are concerned with the language of the bill. They write:

Clarity about what is meant by “reasonably be expected to die within six months” is vital so that clinicians can understand the intended beneficiaries of the bill. It could mean that on the balance of probabilities the patient is expected to die within six months, but the word “reasonably” potentially incorporates a wide interpretation of likely prognosis.

I suggest that the use of the term "reasonably be expected to die" cannot be defined and suggests that the bill does not intend to enforce a 6 month prognosis rather the 6 month prognosis is included to suggest that the bill has "rigorous" safeguards.

The authors explain that only 37% of predictions based on a 12 month prognosis are accurate:

Prognostic criteria in legislation on assisted dying imply that accurate prognostication in advanced illness is possible. But clinicians’ predictions are often inaccurate. Looking specifically at the “surprise question” (Would I be surprised if this patient died in the next 12 months?), a meta-analysis found a positive predictive value of only 37%. Even in cancer, where we would expect a more predictable illness trajectory, the utility of prognostic tools was low over six months.

The authors conclude by stating:

Since uncertainty is inherent in advanced illness, we must embrace it as a trigger for person centred care and planning ahead. Many of the psychological, social, and existential issues raised by uncertainty at the end of life can be addressed through skilled communication and holistic support: core components of timely palliative care. Moreover, if people understand more about the process and timescales of dying, and the potential of palliative care to complement curative care, they may feel in greater control of their situation and empowered to cope with its demands, whether they have access to assisted dying or not.

Irreducible prognostic uncertainty makes it difficult to delineate the scope of assisted dying legislation that uses prognosis based criteria. Further evidence is needed to determine whether prognosis based judgments of eligibility can be consistently and safely applied.

The authors state that based on the uncertainty of a 6 month prognosis that requests for assisted dying should be accompanied by skilled communication, holistic support and palliative care.

I agree that it is impossible to accurately predict that a person has 6 months to live but I suggest that the purpose of the inclusion of a 6 month prognosis is only to claim that the bill has rigorous safeguards. If the bill passes, the 6 month prognosis is likely to be removed through future legislation.

Debunking the Ethical Argument for Assisted Dying for Minors

The following article was republished with permission from Kelsi Sheren.

Consider subscribing to Kelsi Sheren's substack.

Kelsi Sheren

By Kelsi Sheren

The conversation around Medical Assistance in Dying (MAID) for minors brings forth deep ethical, moral, developmental, and societal concerns that are essential to explore thoroughly. The idea that minors, even when labeled as "mature," should possess the autonomy to decide upon ending their own lives raises profound and multifaceted issues requiring careful examination, and by examination I believe it just shouldn’t be happening AT ALL.

Neuroscientific research makes it abundantly clear: the human brain—especially the prefrontal cortex, which handles decision-making, impulse control, emotional management, and planning—isn't fully matured until roughly age 25. This isn't just theory; it's a hard fact with serious implications for adolescent decision-making. Teenagers naturally react more intensely to immediate emotions, impulsively chasing short-term rewards, succumbing easily to peer pressure, and prioritizing instant gratification over thoughtful, balanced long-term outcomes.

We know that teenagers are wired to seek thrills and immediate satisfaction. This biological reality severely undermines their ability to fully grasp the long-term consequences of their actions—particularly when facing life-altering, irreversible choices like Medical Assistance in Dying (MAID).

When a decision carries permanent and profound implications—like ending one’s own life—it's irresponsible to assume minors have the maturity or cognitive ability to handle such a choice. This isn't just an isolated issue; we see similar concerns with minors making profound medical decisions about puberty blockers in the LGBTQ+. Both involve potentially irreversible decisions made by individuals who simply don't have the neurological maturity to fully understand their lasting impacts. We have seen the damage that allowing young, unwell minds make permanent decisions with their body. We have systems like the UK NHS rolling back such choices, so why are we so damn quick to allow for adolescence the choice to kill themselves?

The bottom line is simple yet critical: whether it's MAID for minors or puberty blockers for adolescents, the core question remains the same. Can we genuinely trust minors, given their neurological immaturity, to make fully informed, life-changing medical decisions? The neuroscience says no and I agree.

Society consistently recognizes the vulnerability of minors through the establishment of age-based restrictions specifically designed to shield them from irreversible harm and exploitation, unless it's found to save or make a government money. While minors may occasionally be deemed capable of making certain medical decisions, there remains a fundamental difference between refusing aggressive, life-extending treatments (which allows for a natural death) and actively choosing assisted death through medical intervention. Consenting to withdraw life-sustaining treatment respects bodily autonomy within the bounds of natural progression, whereas consenting to MAID involves an active decision to intentionally hasten death—introducing ethical complexities that minors are typically ill-equipped to comprehend or navigate fully.

Furthermore, ethical standards for medical practice highlight an obligation to "do no harm," suggesting the paramount importance of protecting vulnerable populations, particularly minors who may lack the developmental maturity to grasp the gravity and permanence of decisions related to assisted dying.

Proponents of MAID for minors frequently argue it is discriminatory to impose age-based restrictions. Yet society routinely applies such restrictions in contexts like voting, alcohol consumption, tobacco use, and military service, recognizing that developmental maturity is required to make informed decisions with significant, long-term implications. Suggesting that bodily autonomy alone should override these established protections fails to acknowledge the well-documented, substantial differences in adolescents' cognitive, emotional, and experiential capacities compared to adults.

Moreover, equating medical decision-making with other forms of adult responsibilities—such as voting or drinking—is misleading, as medical decisions related to life and death involve significantly greater complexity, irreversible consequences, and profound ethical considerations.

Even with rigorous psychological and medical assessments, minors remain particularly vulnerable to subtle or overt coercion, manipulation, or external pressure, potentially stemming from their families' emotional, financial, or psychological burdens. Adolescents often possess limited life experience, restricting their perspective on the possibility of future improvements or alternative coping mechanisms that may become evident only through maturation and increased life experiences.

Additionally, decisions regarding assisted death must never be influenced by transient emotional states or mental health conditions such as depression, anxiety, or existential crises—common among adolescents and typically treatable or temporary. Allowing minors to make such irreversible decisions without the full benefit of developed coping mechanisms or comprehensive life experience poses a profound ethical risk.

Instead of endorsing irreversible decisions made by adolescents, society has a crucial ethical responsibility to ensure robust support systems—including comprehensive psychological services, medical treatments, emotional care, social supports, and palliative care options. The tragic circumstances prompting minors to consider MAID should highlight a societal imperative to strengthen mental health resources, emotional support, pain management strategies, and holistic care rather than expanding assisted dying to younger, inherently vulnerable populations.

Providing better, compassionate care alternatives—addressing emotional distress, physical suffering, and psychological trauma—is an ethical priority that far outweighs facilitating the premature ending of young lives.

Expanding MAID to minors could potentially normalize premature death as an acceptable solution to complex emotional, medical, or existential problems, fundamentally altering society's valuation of life and the obligations we hold toward youth. It risks weakening societal commitment to exploring every possible alternative treatment and support system to preserve life, especially for individuals who are inherently more vulnerable and less experienced in navigating life's complexities.

Ethically, morally, neurologically, and socially, minors clearly lack the comprehensive maturity required to make fully informed decisions regarding actively ending their own lives. Society bears an overriding responsibility to safeguard adolescents, ensuring they receive every opportunity for holistic support and compassionate care, rather than empowering them to make irreversible choices that underestimate the complexities inherent in adolescent development and life itself.

The discussion surrounding MAID must always prioritize protecting the most vulnerable members of society, and minors undeniably fit this description. Therefore, the ethical stance must remain unequivocally clear: minors, irrespective of perceived maturity levels, should never be placed in a position to choose an irrevocable and irreversible path toward assisted death.

Links to more articles by Kelsi Sheren:

• Franchising Death (Link).
• Let's call MAiD what it is (Homicide) (Link)
• The Death Cult of the Euthanasia Lobby (Link).

Hidden signs of consciousness in comatose patients.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

As we approach the 20 Anniversary of Terri Schiavo's death by dehydration, I found it important to publish information about a study that shows that large numbers of people in a comatose state have hidden consciousness.

Chris Malone, the assistant science editor for the Daily Mail reported on March 3, 2025 that:

Scientists have discovered a hidden sign of consciousness in comatose patients that shows they can hear and understand the world around them.

The study found bursts of organized, fast frequencies in the patient's overnight brain recordings - indicating normal sleep patterns. The unique activity often appeared before doctors detected signs of 'hidden consciousness' - a level of awareness among people who appear to still be in a coma.

Researchers at Columbia University analyzed 226 recent comatose patients, observing a third displayed the bursts - a phenomenon scientists call 'sleep spindles.'

Therefore a third of the comatose patients showed signs of consciousness. Malone further reported that:

Among those displaying sleep spindles, 76 percent showed some level of consciousness before leaving the hospital and over 40 percent recovered some of their neurological function.

Malone reports that the research shows signs of hope:

Lead author Jan Claassen, a professor of neurology, said that this discovery provides new hope for families with critically injured loved ones.

'We're at an exciting crossroad in neurocritical care where we know that many patients appear to be unconscious, but some are recovering without our knowledge,' said Claassen.

'We're starting to lift the lid a little bit and find some signs of recovery as it's happening,' the lead study author continued.

Previous articles on this topic:

• Media still can't get facts right about Terri Schiavo (Link).
• Study finds that 25% of unresponsive patients have hidden consciousness (Link).
• Surprising new test for predicting recovery from coma (Link).
• Medical experts now agree that severely brain injured patients are often misdiagnosed (Link).
• Persistently unconscious patient awakens after 15 years (Link).

Delaware Assisted Suicide bill must be defeated in the Senate.

Delaware Legislature

The Delaware State Senate must defeat assisted suicide Bill HB 140.

On March 18, Delaware assisted suicide bill HB 140 passed in the State House by a vote of 21 to 17. HB 140 will now move to the Delaware State Senate.

Please contact every member of the Delaware State Senate and urge them to vote NO to assisted suicide Bill HB 140. (Link to the list of Delaware State Senators).

In 2024, a similar assisted suicide bill passed in the State House by a vote of 21 to 16 and then passed in the Senate by a vote of 11 to 10. Last September Delaware Governor John Carney votoed the assisted suicide bill, saving lives from assisted suicide in Delaware.

Governor Carney completed his term as Governor. The new Delaware Governor is Matt Meyer who has stated that he supports assisted suicide.

Therefore Delaware assisted suicide Bill HB 140 must be defeated in the Senate. Please contact every member of the Delaware State Senate and urge them to vote NO to assisted suicide Bill HB 140. (Link to the list of Delaware State Senators).

We require members of the Senate to vote NO to defeat Delaware Assisted Suicide Bill HB 140 in 2025.

Some good arguments opposing HB 140 include:

People with eating disorders are dying by assisted suicide. 

An article by Jennifer Brown that was published in the Colorado Sun on March 14, 2022 reported that Dr. Jennifer Gaudiani, an internal medicine doctor who specializes in eating disorders published a paper on how she was prescribing assisted suicide for people with Anorexia Nervosa in Colorado. Gaudiani approved assisted suicide for Anorexia Nervosa by falsely defining the condition as terminal.

Nearly every state that has legalized assisted suicide, has expanded their law. 

HB 140 claims to be a "tightly worded" bill. The assisted suicide lobby uses a "bait and switch" technique whereby they sell assisted suicide with a "tightly worded bill" and if the bill passes they pressure states to expand their laws or force them to expand their law with a court case. (Article Link).

Assisted suicide creates two tier medicine

Some suicidal people are offered suicide prevention while others are provided assisted suicide. Assisted suicide is inherently discriminatory.

We believe in caring for people not killing them.

Assisted suicide is an act of providing a poison cocktail to someone who is living with suicidal ideation, often related to their health concerns. 

 

Assisted suicide constitutes killing. We believe in caring for people at their time of need.

Assisted suicide is not about autonomy but rather it medically abandons a person to death.

 

Please contact every member of the Delaware State House and urge them to vote NO to assisted suicide Bill HB 140. (Link to the list of Delaware State Senators).

 

Almost 4000 Belgian euthanasia deaths in 2024.

Belgian euthanasia deaths more than doubled in the last 10 years.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Brussels Times reported on March 19, 2025 that there were almost 4000 Belgian euthanasia deaths in 2024. According to the Brussels Times report:

The number of patients opting for euthanasia in Belgium rose by nearly 17% in 2024, amounting to 3,991 cases, according to figures by the Federal Control and Evaluation Commission on Euthanasia (FCEE) on Wednesday.

The graph (2014 - 2024) shows that the Belgian euthanasia deaths have more than doubled in the last 10 years.

The Brussels Times stated that euthanasia represented 3.6% of all deaths in 2024 which was up from 3423 in 2023 or 3.1% of all deaths.

It is important to state that Belgium is known for having a significant number of unreported euthanasia deaths. Several years ago Dr Marc Cosyns stated that he does not report euthanasia deaths because he believes that euthanasia is no different than any other medical or palliative care procedure.

The Belgium euthanasia data indicates that there is a much higher rate of euthanasia among Dutch speaking as compared to French speaking citizens.

The figures show a sharp 25% increase in the number of Dutch-speaking patients: at 3,042, they represented more than 76% of cases in 2024. On the French-speaking side, however, there was a decline from 1,001 in 2023 to 949 last year. "The commission has no possible explanation for this," they said.

 The Brussels Times continued:

The bulk of patients were over 70 years old (72.6%) and over 43% were older than 80. "Euthanasia in patients younger than 40 years remains rare," said the FCEE. Last year, there were only 50 cases in this age group. One case involved euthanasia in a minor. "Since the extension of the law in 2014, this brings the total number of registered cases in minors to six."

Belgium expanded their euthanasia law in 2014 to permit child euthanasia. The Brussels Times reported that:

In 76.6% of cases, death was expected in the short term. However, euthanasia in patients who are not terminal did increase, especially among those with multiple chronic conditions. The vast majority of patients experienced both physical and psychological suffering (82%). Just under 16% experienced only physical pain and 1.9% only psychological suffering.

It is concerning that 26.8% of the euthanasia deaths were based on "polypathology", a term that includes people with various chronic and incurable diseases. These deaths are usually people with disabilities who are often not otherwise dying.

Luc Van Gorp, the President of Belgium's largest health insurance fund, Christian Mutualities (CM) stated in April 2024 that Belgium cannot fund its healthcare needs and requires more deaths by euthanasia. 

Bioethicists Get Legacy of Terri Schiavo Death Wrong

This article was published by National Review online on March 18, 2025.

Terri's Mom, Dad and sister (right)

By Wesley J Smith

Twenty years ago today, Terri Schiavo’s feeding tube was withdrawn with court approval, commencing a cruel deprivation of sustenance that resulted in her death by dehydration 13 days later.

For those who may not remember, the case became the most hotly contested bioethics issue since Roe v. Wade as Terri’s husband Michael fought in courts and in the media with her parents and siblings over his desire to remove all Terri’s food and fluids. In the end, he won — and Terri died.

Now, two bioethicists on the influential Hastings Center blog decry the case as wrongly brought. They get some facts wrong and omit crucial information — like that Michael was living with another woman with whom he fathered two children during the litigation — but let’s not relitigate the case here. (Read this post for a more complete discussion)

The authors, Arthur Caplan and Dominic Sisti, and I do agree that the Schiavo case was a cultural “canary in the coal mine,” but for diametrically opposing reasons. They complain that it has empowered the wrong cultural forces into political prominence:

In retrospect, Schiavo launched a new, emboldened prolife movement, one that would eventually lead to conservative rule in state houses across the U.S. and the election, twice, of Donald Trump. The seeding of a new ultraconservative judiciary would support a strategic assault on medical privacy that would eventually lead to the end of legal abortion protection in Dobbs.

The Schiavo case did not “embolden” the pro-life movement. It was thriving when the case hit the headlines. Moreover, some of the most vociferous opponents of dehydrating Terri to death were disability rights activists — who, generally speaking, are politically liberal and not pro-life on abortion.

Caplan and Sisti complain that the case led to intrusive health-care policies.

We hear the echoes of Schiavo’s death in today’s debates over reproductive rights, end-of-life care, transgender care, vaccinations, and medical privacy more generally. The end of Roe v. Wade, the continued attacks on gender-affirming care, and the looming threats to contraceptive access all stem from the foundational fight over Terri’s bodily autonomy. Today’s autocratic playbook remains unchanged from those days: intrude upon and weaponize deeply personal medical decisions, rally the support of a mob, enact draconian regulations, ignore what medicine and science have to say.

Few knew it then, but the case of Terri Schiavo was a canary in the coal mine, warning us of bad things to come. The fight to honor Terri’s values in death was won, but the broader battle over government intrusion versus health care privacy rages on.

Good grief, no: 

• The Schiavo case did not cause the overturning of Roe v. Wade. Rather, the key precedent was an assisted-suicide case called Glucksberg v. Washington.
• “Gender-affirming care” for children is not supported by “what medicine and science have to say.”
• Vaccine mandates impede the making of “personal medical decisions.” Indeed, Covid vaccine mandates (supported by Caplan) were “autocratic” and — as the thousands of fired members of the military, medical personnel, and others will attest — forced people to take jabs or lose their jobs. How’s that for “weaponized deeply personal medical decisions”?
• And if closing schools for so long weren’t “draconian regulations,” I don’t know what were.
  

The Schiavo case was a tragedy, but not for the reasons Caplan and Sisti claim. Before Schiavo’s death, most people were shocked that feeding tubes could be removed from disabled people who can metabolize food and water. After the case, polling majorities supported doing so. With that, people with severe brain injuries became a disposable caste.

As an Anorexic, I'd have longed for assisted dying.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Britain is debating an assisted suicide bill sponsored by Kim Leadbeater (MP).

The Committee that is examining the assisted suicide bill is stacked with pro-assisted suicide members. The committee has debated multiple proposed amendments to the legislation and yet all of the amendments that would tighten the bill have been rejected.

An article by Hadley Freeman that was published in The Times on March 2, 2025 looks at the issue of assisted suicide for people with Anorexia. According to Freeman, Leadbeater rejected the proposal in this manner.

One suggested amendment that would have protected anorexics was that a person can’t qualify for assisted death because they have stopped eating and drinking; Leadbeater rejected that, referring to a woman with mouth cancer who had her tongue removed and starved to death. “We have to be careful not to dismiss those cases because they are real stories of real human beings,” she said.

In response Freeman tells her story and the story of a friend who struggled with anorexia.

Here’s another real story of a real human being. When I was 15, I made a new friend. Her name was Nikki Hughes and she was a talented artist, kind and funny. She was also anorexic, and we met because we were admitted to an eating disorders ward on the same day, and that, she said, bonded us for life. I don’t know what doctors made of Nikki, but I do know what they made of me, 15 and on my fifth hospital admission for anorexia. One told my mother to prepare for the very real chance that I would die. That sounded — to my nutrients-starved, illness-addled brain — great, because it confirmed I was good at anorexia.

Nikki was different. She talked about the art she would make when she recovered and would tell me off when she caught me hiding food. Two years later, when I was recovering and back at school, I opened the newspaper and there was a photo of Nikki: she had died. The hospital she was in at the time was told it could not “override her wishes” to starve herself to death and it would be assault if it tried to save her life with a feeding tube.

Freeman continues by explaining anorexia:

Anorexia is complicated: it’s a mental illness that leads to physical complications, which exacerbate the mental ones, and so on. Even more complicated, the more ill a person becomes, the more they resist treatment (eating, in other words) and the more they want to die. Offering an anorexic assisted death is like offering her liposuction: her desire for it is a symptom of her illness.

Right-to-die campaigners love to talk about autonomy, but such terms are meaningless when it comes to women whose minds are crazed by starvation. (Danny) Kruger pointed out last week that increasing numbers of anorexics are being classified as “terminal” in the NHS and given “palliative care”, which the Royal College of Psychiatrists has described as “troubling”.

Freeman further explains her concerns:

As Nikki and I learnt, it is impossible, even for doctors, to predict outcomes. The patient most determined to starve herself into the ether can recover. As my psychiatrist 30 years ago told me, there’s always hope.

Freeman explains that the assisted suicide bill excludes assisted suicide for people with mental illness but anorexia also leads to physical conditions. She writes:

Some believe that the bill excludes those with mental illness. In fact, it excludes those who are terminally ill “only” because of mental illness — anorexia can lead to physical problems, and these can qualify a person for assisted death. Others say only a tiny number of anorexia patients could qualify. But what number is acceptable? Anorexics are already gaining access to assisted death in Colorado, California and Oregon. One consultant said she could foresee a time when “20 to 30 patients with anorexia access assisted dying in this country every year, because of the contagion effect”.

Freeman states that amending the assisted suicide bill was necessary but there was a "religious fervour" in the committee room among "right-to-die" campaigners to push the bill through.

Freeman concludes her article by stating:

It is impossible for most people to comprehend the mind of an anorexic, which hisses that death is preferable to eating. Which is why it is unforgivable that MPs decided not to get hung up on those who do.

More articles on this topic:

• Proposed assisted dying bill fails public safety test (Link).
• Netherlands woman dies by euthanasia based on anorexia (Link).
• Landmark study: Assisted death for eating disorders (Link).
• At least 60 people with eating disorders euthanized or assisted in suicide since 2012 (Link).
• ANAD clarifies that Anorexia Nervosa is not a terminal condition (Link)
• When I was Anorexic I would have chosen assisted suicide (Link).
• Psychiatrist: Anorexia does not justify Aid in Dying (Link).
• Anorexia is not a terminal condition (Link).

 

UK Royal College of GP's wrongly went neutral on assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Recently the UK Royal College of General Practitioners (GP'S) changed their position on assisted suicide from being opposed to being neutral on assisted dying. This is important because the UK parliament is debating a bill, sponsored by Kim Leadbeater (MP), to legalize assisted suicide.

On March 14, The Royal College of GP's released the results of a survey of GP's and based on the results The Royal College of GP's claimed that the membership wanted to change their position from opposed to assisted dying to neutral.

In a letter to The Times that was published on March 18, more than 260 GP's argue that the survey results did not support a change in position, but in fact represented a stronger position opposing assisted death than the previous survey in 2019. 

The Our Duty of Care letter stated:

We are GPs disappointed by the Royal College of General Practitioners’ (RCGP) move from opposition to “neither supporting nor opposing assisted dying being legal,” following a member survey.

This is despite a rise in the proportion saying the RCGP should remain opposed (47.6%, up from 46%) and a decline in support for law change (33.7%, down from 41.1%).

Even those who favour assisted dying in principle may not in practice, in the context of today’s pressured NHS, and may be unwilling to be personally involved in assisting deaths. The latest survey did not explore GPs’ views unlike the more detailed 2019 RCGP survey which found only 7% of GPs thought they should prescribe lethal drugs, and only 16% felt GPs should take responsibility for confirming eligibility for assisted dying. It is likely that similar practical opposition persists.

We believe assisted dying undermines public understanding of and access to palliative care, puts vulnerable populations at risk of self-coercion or abuse, and drives societal biases that devalue certain lives. We find assisted suicide incompatible with our values as doctors: to promote and preserve life, and to be worthy of our patients’ trust. We will not be involved in its provision and remain committed to easing suffering at the end of life through proactive, compassionate and holistic palliative care. We regret the RCGP’s stance and find it grossly misrepresentative of GPs’ attitudes to assisted dying.

The letter clearly explains that the 2019 GP's survey indicated that: 

46% opposed assisted suicide, 41.1% supported assisted suicide and the others were neutral.

The 2025 GP's survey indicated that: 

47.6% opposed assisted suicide, 33.7% supported assisted suicide and the others were neutral.

In other words, opposition to assisted suicide increased and support for assisted suicide decreased. They cannot justify going neutral.

Spain court refuses to prevent young woman's euthansia death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Agence France-Presse reported on March 17 that a Spanish court rejected an appeal by a father who tried to stop his 24-year-old paraplegic daughter's euthanasia death.

Decisions, like this one, emphasize how the euthanasia laws undermine the lives of people with disabilities.

According to the article, the 24-year-old woman, who was injuried in a suicide attempt, was scheduled to die by euthanasia in August 2024 when her father achieved a court injunction to prevent the death. The article stated that:

The father argued that his daughter suffered from mental disorders that "could affect her ability to make a free and conscious decision" as required by law.

He also said there were indications his daughter had changed her mind and that her ailment did not entail "unbearable physical or psychological suffering".

The article reported that the court decision that was decided on Friday but released on Monday (March 17) stated:

the woman met the conditions for euthanasia, which was legalised in the European country in 2021.

"All the professionals who have intervened in the process agree that... she suffers a serious, chronic and disabling illness, without any contradictory tests having been performed," the judge wrote.

The Spanish euthanasia law is similar to the Canadian euthanasia law since it only requires that a person has "a serious chronic and disabling illness."

Spains euthanasia law should be challenged based on the United Nations Convention on the Rights of Persons with Disabilities.

Disabled will feel forced to end their lives by assisted dying if benefits are cut.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Tanni Grey-Thompson

Greg Heffer, the political correspondent for the Daily Mail online reported on March 14 that Tanni Grey-Thompson, an eleven time paralympic gold medal winning athlete and member of the British House of Lords stated that:

Disabled people will feel forced to end their lives under assisted dying laws if benefit cuts make their lives 'intolerable'

Heffer reported that while:

A committee of MPs are currently continuing their line-by-line scrutiny of the (assisted dying) Bill before it returns to the House of Commons for further debate and a vote.

At the same time, the Government is next week expected to unveil plans for £5billion of welfare cuts - despite a mounting revolt among Labour MPs and some ministers.

Baroness Grey-Thompson, a crossbench peer, expressed her fears about the combined impact of slashing benefits and assisted dying legislation. Heffer reported:

'If you are disabled and terminally ill and your benefits are cut, making life intolerable, it's obvious more people will feel forced down this route to end their lives early,' she told Times Radio.

'And when you understand that we live in a relatively able society, there will be people who sit on the panel who will decide that a disabled person has nothing to offer society and will allow them to end their lives.'

While Chancellor Rachel Reeves argues that the British welfare system is broken, Rachael Maskell, the Labour MP leading a rebellion against cuts to welfare, also expressed fears about people with disabilities feeling pressure to end their lives.

Heffer reported that Sarah Olney, a Liberal Democrat MP who sits on the committee that is scrutinising the assisted dying legislation, warned cuts to welfare and a new law on assisted dying risked a 'perfect storm' for the disabled. Olney stated:

'Of course it's a concern that if some of those people are now facing cuts to their everyday living costs … that might well contribute to their feelings that they might be a financial burden on their relatives and that will influence them in terms of how they feel about assisted dying.

'It's absolutely a concern of the committee that people might be seeking an assisted death for that reason and this news about potential cuts to welfare can only … intensify that feeling for some people.'

Similar to what is happening in Canada, people with disabilities who have found themselves unable to afford the basic cost of living are dying by euthanasia. Legalizing assisted death opens the door to people who are living with social and financial pressures to simply exist, are often requesting euthanasia.

The same could happen in Britain. 

More articles on this topic:

• Canadian Human Rights Commission concerned about euthanasia (Link).
• Canada's euthanasia deaths continue to rise (Link).
• Canadian woman does not qualify for care but qualifies for euthanasia (Link).
• Vancouver man dies by euthanasia while on a psychiatric day pass (Link).
• Discrimination driven deaths (Link).
• Heart wrenching lessons from Canada's euthanasia regime (Link).
• Euthanasia is being used to kill people in poverty, isolation and social suffering (Link).
  

Poem: Glad to be me.

The following is a contribution to our EPC "Story Contest". Visit our "contributor info" (link) "recent stories" (link) and "story index" (link).

Please send your story (fact or creative fiction) to: story@epcc.ca

Helen Ryles is a deaf blind person from the UK who sent us the following personal message opposed to legalization of assisted suicide.

Helen Ryles wrote: 

The assisted dying bill is so frightening. Particularly for people like me who can be pushed into it. I have a right to live and I mean to stay alive. 

It’s been total hell for the last few weeks. I couldn’t concentrate on anything and even trying to write anything caused me to have something like a seizure as if someone had put a curse on me for want of a better way of explaining myself and I woke with severe pain several times a night. I know this must sound really crazy but there’s some very evil people out to get me but I flatly refuse to back down but it is more important than ever that we DO Not back down now. So for everyone who wants them dead we MUST fight this bill with tooth and nail with EVERYTHING we have so nobody else has all the meaningful things in their lives such as reading and knitting and making my dolls systematically take away from me. 

Poem by Helen Ryles

Glad to be me

glad to live as i, with all i can do,

glad when i am not in pain or in the blue

glad that i can read in braille

internet friends and exciting tales

inspiring and comforting dots help me through the bleakest spots

glad for my sense of touch

beauty at my fingertips that mean so much.

with a red and white cane i do roam,

feeling land marks to help me get home.

glad for many helping hands

friends who communicate with me to help me make fresh plans.

glad for vegan meals, fast rides, and challanging climbes, and other such activities to help me through hard times.

glad for many comforting dreams.

vegan lovers turn to ever lasting teams,

people who accept me as me,

i dont wish to be molded, i wish to be free.

dreams of being a published writer,

human and animal rights fighter,

journeys to india ireland and usa,

maybe to visit maybe to stay.

when the ghosts have gone, life will be so much fun

I'm glad to live as me, deafblind vegan and always will be.

Photo Creations by Helen Ryles (from a fantasy novel project now in progress)

 

Update on Assisted Suicide bills in Britain, Scotland and Ireland.

Join the Euthanasia Prevention Coalition and the Care Not Killing Alliance for a Zoom event on Thursday March 20 at 3pm ET (Toronto Time) (note changed to 3 pm).

Register for the Zoom event in advance (Registration Link).

Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition and Dr Gordon Macdonald, CEO for the Care Not Killing Alliance will provide an update on the assisted suicide bills and debate in Britain, Scotland and Ireland.

Dr Gordon Macdonald

Dr Gordon Macdonald will provide an overview of the current debate concerning the Leadbeater bill that proposes to legalize assisted suicide in England and Wales, the McArthur bill that proposes to legalize assisted suicide in Scotland and the debate in Ireland.

Macdonald and Schadenberg will also discuss the assisted suicide bills in the Isle of Man and Jersey.

Dr Macdonald has led the Care Not Killing Alliance for many years. He works with groups and individuals from multiple points of view.

We will make time for questions and answers at the end.

Register for the Zoom event in advance (Registration Link).

Do we know enough about euthanasia drugs?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Manuela Callari reported in an article published by Medscape on March 13, 2025 that we don't know enough about assisted dying drugs. Callari interviewed several physicians who are doing euthanasia and a doctor who does palliative care research.

Callari begins the article by stating:

The medical community is accustomed to rigorous standards for drug development and approval. But in the context of assisted dying, there is a surprising and persisting lack of robust scientific data.

Steven Pleiter

Callari interviews Steven Pleiter the former managing director of the Dutch Center of Expertise for Euthanasia (Euthanasia clinic) who states:

“It’s very hard to do scientific research with regard to the usage of drugs for euthanasia. If you apply euthanasia, you want to be successful, and you can’t use any other drugs than the drugs we know work,”

“But the evidence is based on years and years of experience.”

Claud Regnard, MD, a retired palliative medicine consultant in the United Kingdom told Callari that:

“The amount of evidence supporting the use of these drugs is astoundingly small,

 “The last study looking at efficacy and side effects was published 25 years ago, using data from 10 years earlier.”

Dr Claud Regnard

Callari reported that unlike other areas of medicine, assisted dying has largely escaped rigorous scientific evaluation. He reported Regnard as stating:

“You wouldn’t allow this in any way with any other sort of drugs,” Regnard said. In a 2022 study, he found that drugs used for assisted dying have not undergone the usual level of scrutiny.

The pharmacokinetics and pharmacodynamics of these drugs at high doses remain poorly understood. “We extrapolate from therapeutic doses, but we have no proper data on what happens at lethal doses,” Regnard said. "That's not science — that's guesswork.”

Collari explained that:

Euthanasia is when a doctor directly ends the life of a patient, while assisted dying is when a doctor provides the means for them to end their own life.

(Collari should use the term assisted suicide rather than assisted dying. Assisted dying is often used for both euthanasia and assisted suicide.)

Collari reported Regnard as stating:

He said most jurisdictions, like Switzerland, the Netherlands, Belgium, Canada, and Australia, do not systematically collect or publish data on assisted dying drug efficacy, mechanisms, and complications. “Oregon is the only jurisdiction providing some transparency, but even their data is severely incomplete,”

Collari continues:

The Netherlands, one of the first European countries to legalize euthanasia and assisted dying, has developed guidelines on their implementation, now in their third edition.

Pleiter explains how euthanasia is done in the Netherlands:

For euthanasia, the standard Dutch protocol involves an initial injection of thiopental or propofol at doses several times higher than those used in general anesthesia to induce a deep coma. This is followed by administering a neuromuscular blocking agent such as rocuronium, atracurium, or cisatracurium in doses sufficient to cause complete paralysis and eventual death. “Most people die after the coma-inducing drug because it’s such a high dose,”  

“The patient will die within seconds. It’s very rapid.”

We know that the patient does not die within seconds in Oregon, where the Oregon 2023 assisted suicide report indicates that the longest time of death in 2023 was 137 hours. Collari then explains how assisted suicide is done in Switzerland

In Switzerland, a commonly used drug is the fast-acting barbiturate sodium pentobarbital, according to documentation provided by Dignitas to Medscape Medical News. This is usually taken orally or, in some cases, via a gastric tube or intravenously. The documentation did not include specific data on this drug’s efficacy or complication rates. Dignitas declined a request for an interview.

None of these drugs are approved for euthanasia and there is no standardized protocol. Regnard explains:

There is no standardized global approach to drug selection and dosing for either euthanasia or assisted dying, and the process is mainly empirical. “There isn’t a single drug regulatory authority anywhere in the world that has assessed and approved assisted dying drugs [in the doses required for this purpose],”

Instead, these medications are approved for indications such as anesthesia or epilepsy, and their use in euthanasia or assisted dying falls under off-label prescribing. Physicians rely on guidelines established by medical associations, expert committees, and historical clinical practice for their use.

Since Oregon is the only jurisdiction that collects data on the use of assisted dying drug coctails, Regnard provides an analysis of the Oregon data:

In a 2023 report from the US state of Oregon, 74% of complication data were missing. Of the available data, 9%-11% of patients experienced complications, including vomiting, aspiration, agitation, and seizures. “In some cases, patients regained consciousness after ingesting a lethal dose,” he said.

The time to death also varies widely — from minutes to several hours. Factors such as the specific drugs used, the route of administration, and individual patient factors can all play a role. In some cases, death may occur rapidly, while in others it may take longer. This variability can be distressing for both the patient and their loved ones, particularly if they expect a swift and peaceful death, he argued.

Article: Death by assisted suicide is not what you think it is. (Link).

Pleiter agrees that the evidence concerning the safe use of these drugs and  evidence concerning complications is anecdotal. Pleiter's comments actually reinforce the research by Regnard. Regnard continues by pointing out that:

The lack of reliable data also raises concerns about informed consent. Patients are often reassured that their death will be peaceful, but without comprehensive studies, how can such promises be guaranteed?

Regnard asks:

“How can you get informed consent from a patient when the data isn’t there?”

“Until they produce the data, the data is purely anecdotal. We wouldn’t tolerate that level of uncertainty in palliative care, so why are we tolerating it here?”

Collari reports that Pleiter argued that, based on experience, the Dutch protocols work:

Pleiter noted that euthanasia has been practiced in the Netherlands for two decades, with consistent guidelines that have undergone only minor revisions. More than 100,000 patients have undergone the procedure using these established protocols. The core drug dosages have remained mostly unchanged. “When the correct drugs are administered at the right doses, there are no issues, and the outcome is always certain,” he said. Having overseen almost 5000 cases, Pleiter said he has never encountered complications.

But Mario Riccio, MD, a retired anesthetist, current advisor of the Luca Coscioni Association, an assisted dying group in Italy told Collari

“Even with precautions, the process is not always smooth. There can be moments of discomfort and unexpected reactions — things we simply cannot control. But for someone whose suffering is so excruciating that he is determined to die, minor complications are completely surmountable.”

Clearly there is no evidence concerning the use of euthanasia and assisted suicide poison coctails. 

Links to 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).