Study uncovers concerns with the practice of euthanasia and assisted suicide.

Alex Schadenberg

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A recent research article concerning euthanasia and assisted suicide was published July 5 in the Journal of the American Medical Association (JAMA) titled: Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada and Europe; uncovers significant concerns.

The media mainly reported on this research article by once again promoting the legalization of euthanasia and assisted suicide. The media reports essentially reported that:

Euthanasia and physician-assisted suicide are increasingly being legalized, remain relatively rare, and existing data does not indicate widespread abuse of these practices.

The media reports often ignored the concerns identified within the conclusion:

Problems and complications with the performance of euthanasia or PAS occur, but the available data make it difficult to determine the precise rates.

The researchers uncovered several concerns with the practice of euthanasia while sadly ignoring a couple of significant concerns. For instance the article states that:

The most recent death certificate studies in those countries, which incorporate unreported cases, found a prevalence of 2.9% of all deaths in the Netherlands (2010) and 4.6% in Belgium (2013) from euthanasia and PAS.

The Netherlands death certificate study, referred to in the article was based on data from 2010 and published July 11, 2012 in the Lancet. The Lancet study found that 2.9% of all deaths were from euthanasia or assisted suicide in 2010. The Lancet study also found that:

• the number of euthanasia deaths had increased significantly (4051 in 2010, 2425 in 2005). Since 2010, the number of reported euthanasia deaths has increased by more than 77%. 
• the under reported euthanasia deaths in the Netherlands increased (23% in 2010, 20% in 2005). The Lancet study indicated that there were 3859 euthanasia deaths 192 assisted suicide deaths. There were 3136 official reported euthanasia deaths in the Netherlands. The remaining 723 euthanasia deaths were not reported. 
• hastening of deaths without explicit request continued (310 in 2010, 550 in 2005).

Since 2010, people with psychiatric conditions and/or dementia are now dying by lethal injection in the Netherlands. In 2015 there were 109 people who died by euthanasia based on dementia and there were 56 people died by euthanasia for psychiatric reasons.

The Belgian death certificate study that was referred to in the article was published in the NEJM on March 19, 2015 was based on deaths in the first 6 months of 2013 in the Flanders region of Belgium. The Belgian study found that:

• The number of euthanasia deaths increased from 1.9% of all deaths in 2007 to 4.6% (2834) of all deaths in 2013 representing a 242% increase. From 2013 - 2015, the officially reported euthanasia deaths increased by 12%. There is no indication that the number of unreported euthanasia deaths decreased.
• The study indicated that 4.6% of all deaths were euthanasia, therefore around 2834 euthanasia deaths occurred in 2013 in Flanders Belgium. The official Belgian euthanasia report  indicates that there were 1454 reported euthanasia deaths, in the Flanders region in 2013. Therefore 1380 assisted deaths may not have been reported in Flanders Belgium in 2013. The percentage of unreported euthanasia deaths remained around above 40%. 
• The study found that 1.7% of all deaths were hastened without explicit request. Since there were 61,621 deaths in Flanders, therefore 1047 deaths may have been hastened without explicit request in Flanders Belgium in 2013.

Similar to the Netherlands people with psychiatric conditions and/or dementia are dying by euthanasia in Belgium. The co-chair of the Belgian euthanasia commission commented in March 2015 that the number of psychiatric euthanasia deaths:

"It is a small group, 50 to 60 patients. But it is not a negligible number:. 2 to 3 percent of the 1,924 people who were euthanized last year."

The research article made some key conclusions. One conclusion relates to the data on euthanasia and assisted suicide, the article stated:

Data about the practices of assisted dying are limited. Therefore, collecting reliable data to evaluate end-of-life practices should be prioritized in all countries, and not only in countries legalizing euthanasia or PAS.

The Netherlands and Belgium have conducted death certificate studies examining every death. These studies uncovered abuses and under-reporting of the law.

Since Oregon and Washington States have not conducted death certificate studies, as in Belgium and the Netherlands and since the death certificate studies uncovered mis-use and under reporting of assisted death, therefore comments suggesting that assisted death laws in Oregon and Washington State have not been abused is only conjecture.

There is proof that there is under-reporting of assisted death in Washington State.

Legalizing euthanasia and/or assisted suicide gives medical professionals the right in law to directly and intentionally cause the death, or be involved with causing the death of their patients. It is never safe or ethical to enable one group of people to cause the death of another group of people. 

Society needs to focus on how it cares for its citizens, not how it kills its citizens.