Treat People with Mental Health Problems: Don’t Kill Them by Euthanasia

Dr Saba (center)

In September 2023, the Angus Reid Institute survey revealed that most Canadians don’t support euthanasia also known as medical aid in dying (MAiD) for mental illness and want improvement in mental health care.

In just a few months on March 17, 2024, Canadians with mental health problems would have been eligible for euthanasia or assisted suicide. “This must never happen,” affirms Dr. Paul Saba.

Approximately 1 in 5 people will experience a mental illness in their lifetime. 

The family doctor is most often the first point of contact for someone with mental health problems before being referred to specialized care. 

In Quebec, the average waiting time between a referral to a psychiatrist and treatment is approximately 5 months. Meanwhile, the new law requires only a three month waiting period before euthanasia can be administered. In other words, the patient who wants to see a psychiatrist may have long died before even getting their first psychiatric appointment. 

According to family physician, Dr. Paul Saba, the desire to die is a symptom of mental illness. 

“Studies show that at least 90% of people who end their lives were affected by a mental disorder at the time of their suicide. A Harvard University study found that, with the right treatment and support - people don’t want to die,” Dr. Saba, said.

According to the study: 9 out of 10 people who attempted suicide but were unsuccessful in their attempt did not commit suicide following treatment. 

Most psychiatrists, do not support the legalization of euthanasia for the mentally ill because of the increased risks for certain groups such as women, young adults, the poor and other marginalized groups. Also, psychiatrists cannot determine without a doubt who is irremediable.

From a legal standpoint - the request for medical assistance in dying for those with mental illness, does not meet the condition of free and informed consent. The more a person lives with mental illness, the less capable they are of giving free and informed consent.

The recent COVID pandemic increased mental health problems with the greatest impact on young adults, the poor, those with pre-existing mental health conditions, aboriginal persons, women and other marginalized groups. 

Dr. Saba deplores that:  

“Canada’s social and healthcare system lacks ressources for people with mental health problems.”

To provide optimal mental health care, the family doctor needs the support of psychiatrists, psychologists, and other specialists who are often not available for lengthy periods due to shortages causing wait times.

“Canada has a responsibility to improve the healthcare system for people with mental health problems. This includes assuring rapid access to psychiatrists, psychologists and social workers. Canada must also ensure access to a wide variety of treatments, including art, music, dance, pet, recreation, individual and group therapy and other alternative therapies.”

“In addition Canada must ensure free medications, affordable housing, and food security.” 

Finally, Dr. Saba insists that “Canada must become a society that provides the best care for people with mental health needs. We must treat them and not kill them through euthanasia.”

For more information:

Dr. Paul Saba

pauljsaba@gmail.com

514-886-3447

EPC - USA Statement to the New York Legislature in opposition to Assisted Suicicde

RE: Euthanasia Prevention Coalition-USA Statement in STRONG OPPOSITION to A995A Assisted Suicide-also known as “Medical Aid in Dying”

Dear ...

Please let A995A die this session. Assisted suicide proponents are trying to sell you a "pig in a poke". It's not about pain or a quick, peaceful death. It spawns more suicides and provides less healthcare. EPC-USA's physicians and disability advocates express strong opposition to assisted suicide.

“Medical aid in dying" is not healthcare and will exacerbate systemic inequities faced by people with disabilities and people from other marginalized communities. Assisted suicide combined with a broken healthcare and home care system is a deadly mix for people who are economically poor, lonely, vulnerable, elderly, disabled, and historically marginalized in the healthcare system.

The Euthanasia Prevention Coalition USA supports public policy that promotes positive measures to improve the quality of life of people living with a terminal illness and their families; we oppose euthanasia and assisted suicide. We are disability advocates, lawyers, doctors, nurses and politicians.

Any safeguards are part of a deliberate bait-and-switch tactic by assisted suicide advocates to get a bill passed and then come back to amend it by gutting those safeguards.

• Amy Pauline recently stated. At an event promoting A995A and S2445A , “We've been criticized by some organizations that actually want an expansion …. but we've held firm because we want to get this passed first.” (starting at 18:40).(1)
• J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, who was quoted on a similar bill saying, “Once you get something passed, you can always work on amendments later.”(2)

Since 2020, there have been seven amendments to such laws across five states: in Oregon in 2020 and 2023; in Vermont 2022, and 2023; in California in 2022; in Washington in 2023; and in Hawaii in 2023 and an amendment has been introduced in New Jersey. All these changes expand access, for example, waive waiting times, allow nurses to prescribe the lethal medication, or drop residency requirements.(3)

It’s Not about Pain 

Dr. Lonny Shavelson, a California assisted suicide provider says promoting “aid in dying” as avoiding pain is a political sales pitch. See webinar(4) minutes 25:24-27:53. He says people choose assisted suicide because they are low energy or afraid of losing control.

It’s Not about a Peaceful or Quick Death 

Dr. Shavelson says the idea that assisted suicide creates a peaceful beautiful death is another myth. See webinar(5) minutes 37:35-41:00. Some people may suffer prolonged and difficult deaths from the experimental lethal drug cocktails.

Insurance Companies Use Assisted Suicide to Deny Curative Life-Saving Treatment 

Assisted suicide exacerbates the systemic problems patients face when seeking care for terminal illnesses. Dr. Brian Callister(6) of Nevada says he was stunned when insurance would not cover life saving treatment for his patients who were transferring to California and Oregon, but offered to pay for Assisted Suicide instead.

Assisted Suicide Spawns More Suicides and Attempted Suicides. 

Assisted suicide advocacy has already exacerbated the suicide crisis among people with disabilities. Disabled people have a higher rate of suicide than the general population and people are more likely to approve of suicide if the victim is disabled.(7) Worse, in 2023, the American Association of Suicidology (AAS) had to retract its 2017 statement that “Medical Aid in Dying” was not suicide, after it was used to justify expanding assisted suicide and euthanasia to disabled Canadians over the objection of the Canadian Association for Suicide Prevention.(8)

Moreover, a 2019 report found teen suicides in California increased by 34%(9)  since that state legalized Assisted Suicide in 2016. Oregon’s youth suicides increased 79.3% from 2000 to 2018.(10) Research about completed suicides in four states that legalized Assisted Suicide (Oregon, Washington, Vermont and Montana) found it was associated with at least a 6.3% increase in the rate of all suicide deaths.(11)

The Marginalized understand this will be used to provide them with poorer care. Even with insurance, people of color get poorer hospital care and pain relief. According to a New York Times article,(12) people of color disproportionately died of COVID-19. (article)Medical prejudices and neglect result in racial disparities in diagnosis and treatment of diabetes, cancer, and heart trouble. COVID-19 has killed Black, Indigenous, and People of Color (BIPOC) at a much higher rate than Whites.(13)

There Are Very Clear Cases of Abuse 

The Disability Rights Education and Defense Fund (DREDF) has cataloged a long list of abuse cases.(14) Moreover, a doctor suggested assisted suicide to her anorexic patients and helped them carry it out. Compassion and Choices has acknowledged this abuse of the law, yet repeatedly asserts that the law has never been abused.(15)(16)

EPC-USA's physicians remind us that Assisted Suicide laws exacerbate systematic inequalities that disabled people experience in the medical sphere. A "Federal study found that the nation's assisted suicide laws are rife with dangers to people with disabilities".(17)

EPC-USA’s physicians remind us that Physicians, clinicians, insurance companies, and healthcare systems are fallible. Misdiagnoses and unreliable terminal prognoses are documented by the cases of: Jeanette Hall,(18) John Norton,(19) and Rahamim Melamed-Cohen.(20) More and more diagnoses qualify for Assisted Suicide. As mentioned, the latest effort to stretch “terminally ill” treats anorexia as a qualifying terminal disease.

In 2021, the NY based United Nations Special Rapporteur on the Rights of People with Disabilities asserted that all assisted suicide laws violate its Convention On The Rights of People with Disabilities.(21)

As the cheapest state-sponsored “treatment,” assisted suicide diminishes patient choice and takes away patient autonomy. Assisted suicide combined with a broken health care and home care system is a deadly mix for people who are economically poor, lonely, vulnerable, elderly, disabled, and historically marginalized in the US healthcare system.

We urge you to allow A995A to die this session because exacerbating systemic social inequalities so that the proponents can plan their deaths is unwise and unjust.

Sincerely,

Colleen E. Barry, Chairperson
Josephine L.A. Glaser, MD.,FAAFP
Meghan Schrader
Kenneth Stevens, MD
William Toffler, MD
Gordon Friesen
Alex Schadenberg

Euthanasia Prevention Coalition USA, EPC_USA@yahoo.com

End Notes

1. Amy Pauline recently stated. At an event promoting A995A and S2445A , “We've been criticized by some organizations that actually want an expansion …. but we've held firm because we want to get this passed first.” (starting at 18:40) (Link).

2. Comerford to reintroduce medical aid-in-dying bill in wake of court decision (Link).

3. Journal of Medical Ethics. Twenty five years (Link).

4. COMPLETED LIFE APRIL 2021 LUNCH HOUR WITH LONNY SHAVELSON (Link).

5. COMPLETED LIFE APRIL 2021 LUNCH HOUR WITH LONNY SHAVELSON (Link).

6. Insurance companies denied treatment to patients, offered to pay for assisted suicide, doctor claims - Washington Times (Link).

7. Is suicide an option?: The impact of disability on suicide acceptability in the context of depression, suicidality, and demographic factors. (Link).

8. Statement on recent MAiD Developments. (Link) (Link).  

9. New health report for California shows 34% increase in teen suicide (Link).

10. National Vital Statistics Report. Suicide Rates Among... (Link).

11. How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide? (Link).

12. The Never-Ending Mistreatment of Black Patients (Link).

13. One Man's COVID-19 Death Raises The Worst Fears Of Many People With Disabilities (Link).

14. Some Oregon and Washington State Assisted Suicide Abuses and Complications (Link).

15. Terminal Anorexia Is Dangerous Justification for Aid in Dying (Link).

16. (Link).

17. The impact of disability on suicide acceptability (Link).

18. Jeannette Hall on dying well (Link).

19. Affidavit of John Norton (Link).

20. Twelve years after contracting Lou Gehrigs disease, Dr. Rahamim Melamed-Cohen (Link).

21. Disability is not a reason to sanction medically assisted dying – UN experts (Link).

Provincial Health Ministers urge the Federal government to indefinitely pause euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Canadian Press report from January 29, 2024 revealed that Health Ministers from several Provinces asked the federal Minister of Health, Mark Holland, to "indefinitely pause" the implementation of euthanasia for mental illness. On January 29, Holland announced that the government would delay the implementation of euthanasia for mental illness.

The Canadian Press reported that:

Health and mental-health ministers from all three territories, along with Alberta, Saskatchewan, Ontario, New Brunswick and British Columbia, asked Holland in a letter on Monday to give them more time to collaborate.

“It is critical that all jurisdictions, health authorities, regulators and (medical assistance in dying) practitioners have sufficient time to implement these safeguards and to address capacity concerns that are expected to result from the expansion,” it read.

The expansion date set for March doesn’t provide jurisdictions with enough time to get prepared, the letter said.

“Therefore, we encourage you and federal Justice Minister Virani to indefinitely pause the implementation of the expanded (medical assistance in dying) eligibility criteria to enable further collaboration between provinces, territories, and the federal government.”

While the Provincial Health Ministers called for an indefinite pause the Euthanasia Prevention Coalition is urging the federal government to reverse the legislation and reject euthanasia for mental illness.

The Canadian Press report also stated that the federal Conservatives are calling on the Liberals to cancel the plan to extend euthanasia to people with mental illness while the NDP are calling on the Liberals to put more mental health care supports in place before expanding euthanasia to people with mental illness.

EPC is urging its supporters to tell their Member of Parliament to oppose euthanasia for mental illness.

More articles on this topic:

• Great news: The federal government will further delay euthanasia for mental illness (Link).
• Tell your Member of Parliament to oppose euthanasia for mental illness (Link).
• Join our campaign to stop euthanasia of people with mental illness (Link).

Euthanasia (MAiD) for those with mental illness should not be on the table.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ramona Coehlo

Dr Ramona Coehlo wrote an excellent article that was published by The Province on January 29, 2024. Coelho, a family doctor whose practice predominantly serves marginalized patients in London, Ontario.

Coelho begins her article by explaining why she is concerned about patients with mental illness:

My family medicine practice predominantly serves low-income and marginalized patients. Many of my patients face discrimination, isolation and a lack of access to needed services, which are causes of considerable distress and hardship. Inadequate services, the direct result of government failures, cause many Canadians to struggle with demoralization — and sometimes death wishes.

It was in this context that our federal government had been planning to expand medical assistance in dying (MAiD), a lethal cocktail administered to induce death, to those whose only medical condition is mental illness, beginning March 2024. A recently released parliamentary report has now advised that this expansion should not go forward at this time. MAiD should never have been an option for mental illness. It is a travesty that we ever considered going down this path. It should be abandoned permanently.

Coelho explains that MAiD (euthanasia) was legalized in Canada in 2016 as an exceptional act to end the lives of physically disabled persons who were near death, suffering intolerably and wanting assistance to die. The government expanded MAiD in March 2021 to people who are not terminally ill. The expansion of MAiD to led to the many stories of people seeking MAiD based on a lack of access to services.

Coelho continues:

I was recently interviewed for a documentary which included the life and MAiD death of Rosina Kamis, a story which should make Canadians think twice about administering death for life’s suffering. She explains in her recordings and writings that she was poor and lonely and chose MAiD because she wasn’t being provided with the necessary support. Many disabled Canadians, like Rosina, are similarly considering dying by MAiD, and, no doubt, many with mental illness as their only medical condition would also choose this route for lack of access to services and care.

Canadian bioethicists have tried to justify this practice, asserting that providing MAiD driven by “unjust social circumstances” is akin to “harm reduction.” Let’s call it what it is — the furthering of injustice towards people already deprived of the means to live.

Coelho comments on how these issues affect euthanasia for mental illness.

Many Canadian psychiatrists have raised concerns about an expansion, testifying during Parliamentary committee meetings that we are not ready for this.

Medicine is supposed to operate with strict safeguards and evidence-based eligibility requirements for all treatments to ensure public safety. We simply do not understand how to distinguish those who would benefit and recover from suicide prevention and services and those very few who might not. Such an expansion would have put Canadians’ lives at risk and the medical community in an impossible dilemma of arbitrarily deciding who is fit for life or death.

Coelho continues

Following the Parliamentary Committee on MAiD over the past years has been a disturbing experience, where concerns raised by the disability and mental health community and medical and legal experts have been routinely ignored. At the same time, we are told that MAiD providers are professionals who should be trusted to get it right every time. This was never good enough.

...However, in this instance, powerful lobby groups have controlled the public discourse around MAiD expansion. Regardless, Canadians are increasingly recognizing the risks.

Coelho finishes by reinforcing that death is not the answer to mental illness.

Thomas Insel, former head of the National Institute of Mental Health, wrote a book called Healing in which he confirms the unknown prognosis of mental health disorders and discusses how community life, supports and purpose dictate positive outcomes. That the federal government even considered expanding MAiD to provide death for mental health suffering, while simultaneously failing its duty to provide timely care, counselling, community-enriching funding and livable income is unconscionable. Death is not the answer.

Canadians deserve better from their government.

More articles on this topic:

• Great news: The Canadian government will further delay the implementation of euthanasia for mental illness (Link).
• Tell your Member of Parliament to oppose euthanasia for mental illness (Link).

Euthanasia for mental illness should never come to pass

The following article was published by the Vancouver Sun on January 29, 2024.

By Kurt Goddard the executive director of Legal and Public Affairs at Inclusion Canada.

Canada’s plan to expand of Medical Assistance in Dying (MAiD) for those with mental illnesses is a profound and dangerous shift in our societal values, one that risks reinforcing deep-seated ableist beliefs and attitudes. We must never go down this path.

My perspective is both personal and professional.

My father’s violent and public suicide in 2010 left me grappling with untold grief and questions, while my mother’s complicated mental illness revealed both vibrancy and darkness.

As the executive director of Legal and Public Affairs at Inclusion Canada, an organization working to advance the full inclusion and human rights of people with an intellectual disability and their families, I have also spent years urging our lawmakers to engage with the issue of medical assistance in dying (MAiD) through a disability rights lens.

Inclusion Canada strives to build a Canada in which people with intellectual disabilities are equally valued. This has necessitated fighting back against the discriminatory aspects of Canada’s current assisted dying law, as came into effect in 2021.

I didn’t anticipate at the time that the Senate would subsequently suggest adding a “sunset clause” to Bill C-7, the assisted dying legislation, to make assisted suicide in Canada a sanctioned option for people with a mental illness as their sole underlying medical condition as of March 17th, 2024 — without the need for any further action by Parliamentarians.

A just released report from the Special Joint Committee on MAiD (AMAD) has recommended that Canada not go forward with MAiD for mental illness until there is agreement from key stakeholders that it “can be done safely.” The report does not provide an alternative timeline, though it does specify that the AMAD committee should be re-constituted one year before it coming into effect.

My preference would be that MAiD for mental illness never comes to pass.

In the face of a divided psychiatric community and political dissent, advancing state-assisted suicide for mental illness is untenable. It’s time to stop this rushed legislation. We must reject assisted suicide as a solution for mental health challenges.

I am haunted by a particularly difficult memory of my mother during a severe episode of her illness.

She once looked at me with desperation, expressing a wish for an end to her suffering in a way that was both shocking and heart-wrenching. This moment reminds me of the profound complexities surrounding mental illness. Her illness fluctuated; we later experienced many positive moments and memories.

Sharing this is not easy, but I feel it’s necessary to illustrate the stakes involved in the discussion on assisted suicide for mental illnesses.

The loss of my father to suicide was a profound rupture in my life and to my family. It’s a type of grief that is difficult to articulate, resonating through every aspect of our lives and leaving a lasting impact that we’re still navigating

His absence has been a constant reminder of the devastation that suicide, whether assisted or not, can inflict.

This personal tragedy has given me a unique perspective on the immense pain and far-reaching consequences that follow in the wake of such loss. It’s a perspective that informs my stance on assisted suicide policies, underscoring the need for careful consideration and compassionate understanding.

Editorials in major Canadian newspapers have echoed my unease against the expansion of MAiD, highlighting the alarming rise in assisted deaths in Canada, especially with vague justifications like “multiple co-morbidities” often linked to aging.

Experts have spoken to the lack of consensus in the psychiatric community about what constitutes an “irremediable mental condition” and pointed out the inadequacy of safeguards in the current MAiD framework for mental illnesses.State-assisted suicide must never be the answer to gaps in treatments and support.

A senate committee recently admitted that Canada’s suicide prevention framework has failed to have a significant impact. It is interesting to note that Senator Kutcher both sat on the suicide prevention committee and was the Senator who introduced the amendment to Bill C-7 to include MAiD for mental illness.

How can we promote suicide prevention while also endorsing policies that facilitate state-assisted suicide? This question plagues our current approach to mental health and assisted dying. We must confront these paradoxes head-on with a lens of compassion and responsibility.

My family’s story, marred by tragedy and resilience, stands as a testament to the need for policies that seek to solve these complex social problems — and not at the cost of losing Canadians to death by MAiD.

Please join me in demanding policies that uphold our Canadian values of dignity and compassion. We need our elected officials to take swift action — to prevent MAiD for mental illness from ever going forward as scheduled — for families like mine.

Great News: The Canadian government will further delay the implementation of euthanasia for mental illness.

The Euthanasia Prevention Coalition wants the Canadian government to stop the expansion of euthanasia to people with mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Canadian Press reported on January 29, 2024 that Canada's Health Minister, Hon Mark Holland, announced today that Canada is not ready to expand the euthanasia law to include euthanasia for mental illness alone but the government has not yet announced how long that they intend to delay euthanasia for mental illness in Canada.

Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition (EPC) said that he welcomes the further delay in implementing euthanasia for mental illness but EPC will continue to demand that the expansion of euthanasia to people with mental illness not only be delayed but be stopped.

The (EPC) launched a campaign to stop euthanasia for mental illness.  

The campaign includes a rally and media conference on Parliament Hill on February 6 at 11 am.

A parliamentary post-card campaign that states: I demand that the government reverse its decision to permit “MAiD” for mental illness alone. The cards are ordered for free by contacting EPC at: 1-877-439-3348 or email: office@epcc.ca.

A petition (Petition Link) to the Justice Minister and the Justice Critics urging the Canadian government to reverse the decision to permit euthanasia for mental illness and demanding that Canadians with mental illness not be abandoned to death by euthanasia (“MAiD”).

EPC also sent a copy of Tyler Dunlop's book: Therefore Choose Life—My Journey from Hopelessness to Hope to every Member of Parliament.

The Canadian Press reported today that Health Minister Holland said:

the Liberal government agrees that more time is needed and agrees with the conclusion of a joint parliamentary committee report released today.

The committee's final report, tabled just moments before Holland and Justice Minister Arif Virani appeared on Parliament Hill, says fundamental issues around the expansion have not been resolved.

MPs and senators on the committee say it would be "reckless and dangerous" for the Liberal government to allow the scheduled change to take place in March.

Justice Minister Virani was reported by the Canadian Press as stating that the government is aware of the March 17, 2024 deadline and will have a plan in place, he did not indicate when the new timeline or "rules" for killing people with mental illness alone will be released.

EPC will continue to demand that the Canadian government abandon its plan to permit euthanasia for mental illness.

More articles on this topic:

• Join the Euthanasia Prevention Coalition rally on February 6 at 11 am to oppose euthanasia for mental illness. (Link).
• Tell your MP to oppose euthanasia for mental illness (Link).
• Join our campaign. Stop euthanasia of people with mental illness (Link).

Canada, there’s still time to rethink this risky expansion of euthanasia

The following editorial was published by the Washington Post on January 27, 2024.

Few topics cause more impassioned debate than euthanasia. Ill people with no other options, suffering beyond a point they wish to bear, make a strong case that they should be allowed help to end their lives. On the other hand, establishing clear, consistent, ethical rules to govern where, when and how physicians might be involved in ending lives, rather than saving them, is inherently difficult. People of good will can disagree as to what compassion requires.

In recent years, a handful of countries have authorized medically assisted dying in the form of lethal injections or other interventions administered actively by physicians. In the United States, assisted dying still takes only the comparatively passive form of “physician-assisted suicide,” in which doctors prescribe a lethal dose of medications for self-administration. The practice is lawful in 10 states and in D.C. We have supported limited assisted dying programs of this kind.

The expansion of euthanasia Canada is currently contemplating, however, goes too far. The country already has one of the world’s most permissive euthanasia regimes, which empowers patients to seek “Medical Assistance in Dying” (MAID) — a practitioner-administered lethal injection — for physical conditions they deem unbearable, whether terminal or not.

And on March 17, barring a last-minute change in government policy, Canada will authorize MAID upon the request of patients whose only illness is a psychiatric one, such as depression or schizophrenia.

Advocates frame this as an advancement for patient autonomy and equal rights for the mentally ill. In fact, it would risk the lives of vulnerable people who, by definition, might have trouble assessing reality and whose symptoms and conditions are notoriously difficult even for experts to specify. There might, indeed, be mentally ill patients suffering from symptoms so debilitating and intractable that their options are uniformly dismal. But designing a system to distinguish them reliably from others in mental distress, who would benefit from treatment, is at least extremely hard, if not impossible.

Certainly, Canada’s system is not up to the task. Its MAID regulations are looser than those of Belgium and the Netherlands, where psychiatric euthanasia has been lawful since 2002 — and where serious concerns have arisen about that practice. Since Canada legalized euthanasia in 2016, some 44,958 Canadians have been granted permission to receive MAID for terminal or “grievous and irremediable” medical conditions.

Most of these cases have occurred in the past three years, with each year seeing an increase of 30 percent or more. Authorities rejected only 3.5 percent of written requests for euthanasia in 2022. Last year, Quebec’s top end-of-life care regulator decried rampant noncompliance with the rules in that province. If a medical provider rejects a request, nothing prevents Canadians from shopping around for another who will say yes.

Mental suffering can indeed be as real and, to those in the grip of it, as subjectively unbearable as the pain of other types of disease. However, empowering a mentally ill person to invoke a physician’s aid in ending his or her suffering — by ending life itself — inverts the most basic goal of psychiatry, which is to prevent suicide rather than to facilitate it. Many in the grips of psychiatric distress view, temporarily, suicide as their only way out, only to later be grateful they did not kill themselves in the depths of their suffering.

The American Psychiatric Association’s official policy is that psychiatrists “should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.” Two other English-speaking countries that allow assisted death, Australia and New Zealand, exclude purely psychiatric cases. Many Canadian mental health professionals have argued offering MAID to those with psychiatric illness is especially unwise in a country whose mental health system struggles to provide treatment to all who need it. The Canadian Association for Suicide Prevention opposes it.

Last month, Canadian Justice Minister Arif Virani said the government of Prime Minister Justin Trudeau has the “option” to delay implementation further, pending a report on the issue from a parliamentary commission due Jan. 31. This was a welcome sign of second thoughts, however belated.

No doubt Canadian advocates mean to enhance individual freedom and equality as between those with physical and mental illness. Perhaps they have high confidence in the procedures they’ve developed to control psychiatric euthanasia. They need to remember that no procedural protections are perfect — and building them for psychiatric euthanasia is a profound challenge.

Good intentions tend to have unintended consequences. In the United States, Americans need to keep a close eye on their neighbor’s experience, and learn from it’

More articles on this topic:

• Canada's euthanasia law. We've already gone too far. (Link). 
• Canada has revealed the horror of assisted dying (Link). 
• Canada must put the brakes on euthanasia for mental illness (Link).
• Don't abandon people to death by euthanasia (MAiD) (Link)

Minnesota assisted suicide bill (SF 1813/HF 1930) is lethally deceptive.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Minnesota assisted suicide companion bill (SF 1813/HF 1930), upon first reading, appears to be similar to the Oregon assisted suicide law but in fact it is more expansive than the Oregon law.

For instance, unlike Oregon, the Minnesota assisted suicide bill permits non-physicians to be the "provider" of assisted suicide. Also, the Minnesota assisted suicide bill does not have a "waiting period" therefore if passed it will permit a same day death. A person's bad day can be their last day.

The Minnesota Alliance for Ethical Healthcare point out that Minnesota's Assisted Suicide Bill doesn't require a mental health evaluation. They state:

Patients are not required to receive a psychological evaluation before the life-ending prescription is written. In some states, less than two percent of patients who die by assisted suicide receive a mental health referral.*

The Minnesota Alliance for Ethical Healthcare also point out that No witness is required at the death. They state:

The current bill has removed a previous safeguard which required two witnesses be present when the patient requests assisted suicide. Even more alarming, no witness is required when the patient takes the suicide drugs. Without supervision, patients can easily be coerced into ingesting the drug, or another person may administer the drug, leaving open the possibility for euthanasia.

Among other issues, The Minnesota Alliance for Ethical Healthcare point out that the bill does not provide conscience rights. They state:

Doctors who do not wish to provide assisted suicide face discharge or suspension if they do not refer patients to a doctor who will write the lethal prescription. Medical institutions that do not want to participate in assisted suicide are still required to refer patients to another provider.

What you need to know about the Oregon assisted suicide law

The 2022 Oregon assisted suicide report indicated that there were 278 reported assisted suicide deaths up from 255 in 2021. There were 431 lethal death prescriptions up from 383 in 2021.

The 2022 report indicates that even though there were 278 reported assisted suicide deaths, there were an additional 101 deaths where the ingestion status was unknown. When the ingestion status is unknown, the person received the lethal drugs and died but there is no information as to whether the person died by assisted suicide or by a natural death.

As with previous years, the report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

The assisted suicide lobby, for political reasons, the assisted suicide lobby in Minnesota has introduced a bill that is very similar to the Oregon law because their goal is to get it passed and then further expand it later.

Expansion of assisted suicide

Oregon Governor Kate Brown, in July 2019, signed Bill SB 0579 into law which essentially eliminated the 15 day assisted suicide waiting period by allowing the physician to waive the waiting period. If the patient is depressed, the patient loses the opportunity to change their mind.

The physician waived the 15 day waiting period in 109 assisted suicide deaths in 2022. In some cases the lethal drug cocktail was ingested the day after the first request.

 

The Minnesota assisted suicide bill already lacks a "waiting period."

Oregon has removed the assisted suicide residency requirement

A story published in the Daily Mail stated that an assisted suicide clinic in Oregon has started doing assisted suicide for out-of-state residents (suicide tourism). The Daily Mail reports:

Oregon has become America’s first ‘death tourism’ destination, where terminally ill people from Texas and other states that have outlawed assisted suicide have started travelling to get their hands on a deadly cocktail of drugs to end their lives, DailyMail.com can reveal.

In the liberal bastion Portland, at least one clinic has started receiving out-of-staters who have less than six months to live and meet the other strict requirements of the state’s Death with Dignity (DWD) law.

Dr. Nicholas Gideonse, the director of End of Life Choices Oregon, recently told a panel that he was advising terminally ill non-residents on travelling to Oregon to end their lives.

The assisted suicide lobby, over the past few years, has expanded existing assisted suicide laws. Oregon has eliminated their reflection period and their residency requirement. Vermont is permitting assisted suicide by telehealth and have eliminated their residency requirement, Washington state, California and Hawaii also expanded their assisted suicide laws. New Mexico has the most extreme assisted suicide law in America.

Assisted suicide drug experimentation

Assisted suicide activists have been experimenting with lethal drug cocktails on people approved for assisted suicide. An article by Lisa Krieger published by the Medical Xpress on September 8, 2020 uncovers information about the lethal drug experiments:

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change.

"The public thinks that you take a pill and you're done," said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. "But it's more complicated than that."

Assisted suicide is sold to the public as offering a peaceful death. Assisted suicide is far more complicated than that.

The 2021 Oregon report emphasizes that the use of the fourth generation of lethal drug cocktails showing that the length of time to die has reduced but the problems with the lethal drug cocktail experiments continue.

The yearly Oregon reports are based on data from the physicians who prescribe and carry-out the assisted suicide deaths. The data is not independently verified. 

 

Data concerning complications and length of time for death, etc., can only be reported when a healthcare provider is present at the death. Information from Oregon concerning complications is only available for 150 of the 278 reported assisted suicide deaths in 2022. For the other 128 assisted suicide deaths, no information is known about the death.

The assisted suicide lobby claims that Oregon has a "safe" assisted suicide regime but in fact the Oregon law lacks effective oversight.

Once assisted suicide is legal, the assisted suicide lobby will lobby or launch court cases to expand the law. The original assisted suicide bill is designed to pass in the legislature, once passed incremental extensions will follow.

Scotland MSP opposes assisted suicide based on "legislative creep"

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sue Webber MSP

Andrew Learmonth reported for The Herald (Scotland) on January 15 that Sue Webber, who is a senior Tory MSP has changed her position on assisted dying because she does not have confidence that the legislation will be properly scrutinised. Webber, in the past, supported assisted dying but she is now opposed. Learmonth reported.

Sue Webber told The Herald that while the parameters of Lib Dem Liam McArthur’s proposed Bill were narrow, she was anxious about “legislative creep” and parliamentarians passing a Bill that would see safeguards removed in the future.

Webber's concerns are not unfounded considering the Canada's experience where euthanasia was legalized in 2016 and expanded in 2021. Canada is now planning to implement euthanasia for people with mental illness. In the US most states that have legalized assisted suicide have now expanded the parameters of their legislation. "Legislative creep" as Webber calls it, is not a theory, but a reality with euthanasia.

Learmouth reported Ms Webber, who is the Convenor of Holyrood's Education, Children and Young People Committee, as saying:

“I was pro-assisted dying until I got in here. It's the reality of the fact that my vote actually makes a difference now. When I was out I could have an opinion, but there was actually no consequence to that opinion.“

“I'm in here now. And being in that role of legislating I don't think I would be able to feel comfortable knowing that one person has died because of a decision that I've taken.“

Learmouth further reported Webber as stating:

“But this Parliament right now hasn't got the best record of safeguarding in legislation,” she said. “So my confidence in us as a Parliament isn't there.”

The MSP added: “If you allow one group to ask to die, then what's to stop another group saying no, no, we need to let these group of patients people pass.

“And a wee amendment here, whatever it is, before you know, it's not the legislation that we passed.”

Learmouth reported Liam McArthur, the sponsor of the assisted dying bill as stating:

“No country that has introduced the type of narrow law proposed for Scotland has ever expanded its eligibility beyond terminally ill people."

I guess McArthur hasn't heard about Canada.

More articles on similar topics:

• Canada's euthanasia law. We've already gone too far (Link).
• Canada has revealed the horror of assisted dying (Link).
• The assisted suicide lobby passes restrictive assisted suicide bills and expands them later (Link).

Canada's euthanasia law - We've already gone too far.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

John Ivison

John Ivison, who is a columnist with the National Post, wrote a scathing column on January 23, 2024 concerning the impending expansion of euthanasia to include Canadians with mental illness alone titled: We’ve already gone too far on MAID. Parliament can still stop us going further, that he subtitled: The government should end the domino effect that will almost certainly see the extension of MAID to mature minors become the next frontier.

Ivison begins his column with outrage concerning an article by euthanasia academic activist Jocelyn Downie. Ivison writes:

I appear to have reached the stage in life where I am prepared to write outraged epistles to publishers and threaten to cancel my subscription after reading something with which I vehemently disagree.

That was the initial reaction when I read an opinion article on the National Newswatch website on the subject of the expansion of medically assistance in dying (MAID) to people suffering mental disorders.

The article in question by Jocelyn Downie offended on multiple levels.

Ivison continues:

Downie, the James S. Palmer Chair of Public Policy and Law at Dalhousie University’s Schulich School of Law, argued that “the courts have spoken” on the issue of cases where mental disorders are the sole underlying medical condition (MAID MD-SUMC), effectively denying Parliament any agency in the matter.

In effect, she said, the government should get out of the way and allow those with mental issues access to MAID from this March a move that was initially scheduled for March 2023, but which was postponed, the government said, to ensure it could “move forward on this sensitive and complex issue in a prudent and measured way.”

The fact that a parliamentary special committee is set to report on that very issue by the end of this month, is apparently neither here nor there to Downie. She claims that all the necessary steps are in place, from data collection to a national curriculum for assessors. There is “strong evidence” that the bodies that regulate psychiatrists and nurses are ready, she said.

Downie is the euthanasia academic activist who claims that the Supreme Court declared, in Carter, that Canadians have a right to euthanasia. She is wrong. The Supreme Court also never declared that euthanasia must be permitted for people with a mental illness alone. Downie has always made graniose claims that are only backed up by her euthanasia lobby friends.

Ivison explains how Canada got to the point of permitting euthanasia for people with mental illness alone, including the Quebec Truchon lower court decision and then states:

But the courts have not spoken with any finality. “It should be absurd to anyone that a lower court decision in Quebec determines what Parliament should be doing. It is absurd that anyone argues Parliament should legislate based on ‘here’s how the Supreme Court of Canada might rule’,” argues Trudo Lemmens, Professor of the School Chair in Health Law and Policy in the Faculty of Law at the University of Toronto.

He and 24 other law professors from across the country wrote to the prime minister arguing that the constitutionality, or lack of constitutionality, of an exclusion clause for MAID MD-SUMC has not been tested in the courts. Lemmens and his colleagues argued there is no legal requirement for the government to expand MAID because the Supreme Court has not reviewed the evidence on whether mental illness can reliably be diagnosed as irremediable.

The previous justice minister, David Lametti, was on record as opposing the expansion but he is gone and his successor, Arif Virani, has only said the government is weighing up its options over whether to seek a deferral.

Ivison then states that the Truchon lower court decision in Quebec was not appealed because it was a popular decision in Quebec and it came out during the federal election. Ivison continues:

A private member’s bill by Conservative MP Ed Fast that would have killed the expansion revealed how contentious the move remains. It was defeated by 17 votes, but only because the Bloc supported the government. The NDP voted with the Conservatives and several Liberals.

The government has every reason to be concerned about being pushed into a decision. An Angus Reid Institute survey from last February reveals strong support (61 per cent) for the existing MAID legislation. Most Canadians, including this one, agree that consenting adults facing intolerable pain should have the right to a compassionate end to their lives; that there should be an enlightened balance between access and protection.

But that support drops in half (31 per cent) when respondents are asked about extending MAID to those whose sole medical condition is mental illness.

Ivison concludes the article by summing up the situation:

The latest statistics we have are that 44,958 people died by MAID between 2016 and the end of 2022, more than the number of Canadian military deaths in the Second World War.

The trend lines are worrying: 31.2-per-cent more cases in 2022 over the previous year.

The fear is that those numbers will really blast off if access becomes too open. There are plenty of signs that Canada has gone too far already, without lifting more restrictions.

• As Lemmens points out, despite the safeguards in place, accessors have reasonably broad discretion in an area with a 50-per-cent accuracy rate of prediction.

• There is data from Europe that show many people seeking psychiatric MAID have unresolved socio-economic suffering.

• Canada is the only jurisdiction that does not see MAID as a last resort — it does not require the patient to be in a state of treatment when he or she seeks medically assisted dying.

• A 2:1 majority of Ontario Medical Association psychiatrists oppose MAID MD-SUMC, even though 80 per cent support medically assisted dying in other circumstances.

In these circumstances, the federal government should show some mettle, refuse to accept Parliament’s role of rubber-stamp that some activists would bestow upon it, and put an end to a domino effect that will almost certainly see the extension of MAID to mature minors become the next frontier.

More articles on this topic:

• Join our campaign to stop euthanasia for mental illness (Link).
• Euthanasia for drug addicts is an outcome of euthanasia for mental illness (Link).
• Canada's government may pause the implementation of euthanasia for mental illness. (Link)
• Canada passes Bill C-7 - permitting euthanasia for mental illness. (Link)
• Canada to delay euthanasia for mental illness until March 2024. (Link)
• The majority of Canadians oppose euthanasia for mental health. (Link)
• 28% of Canadians support euthanasia for mental illness. (Link)
• Bill C-314 defeated. Parliament divided on euthanasia for mental illness. (Link)
• Veterans Affairs Canada worker advocates euthanasia for PTSD. (Link)
• Canadian Quadriplegic woman approved to die by euthanasia faster than it takes to get needed disability benefits (Link)
• Canadian woman offered euthanasia as a "treatment option" during a mental health crisis. (Link)
• Globe and Mail editorial urges federal government to withdraw euthanasia for mental illness. (Link) 
• The problem with Canada's MAiD policy (Link)
  
• Ontario man seeks euthanasia to avoid homelessness. (Link)
• Why did they kill my brother. (Link)