Thursday, March 28, 2024

Scotland's deceptive euthanasia bill redefines terminal illness to include people with disabilities

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

Scottish Parliament
On March 28, 2024, Liam McArthur (LibDem) MSP introduced the Assisted Dying for the Terminally Ill bill that is expected to receive its first debate sometime this fall in Scotland's parliament.

The language of the legislation is everything.

McArthur's euthanasia bill is deceptive. It redefines terminal illness to allow for euthanasia of people with disabilities who are not terminally ill. It provides full legal immunity to doctors or nurse practitioners who are willing to participate in the act. 

I was recently in Scotland meeting MSP's and sharing Canada's experience with euthanasia. Many of the MSP's had been lobbied by members of Dying in Dignity who told them that Scotland will not have the same experience with euthanasia as Canada. I told them that Canadians were told, during Canada's euthanasia debate, the same thing concerning the experience in the Netherlands and Belgium. The reality is that Canada is worse than those jurisdictions in many ways.

Getting to the crux of the bill

McArthur claims that the bill is limited to terminally ill people. In fact the bill does not require that the person have a terminal illness. The bill redefines terminal illness in the following manner:

For the purposes of this Act, a person is terminally ill if they have an advanced and progressive disease, illness or condition from which they are unable to recover and that can reasonably be expected to cause their premature death.

McArthur redefines terminal illness to include people with irremediable medical conditions or people with disabilities. By redefining terminology McArthur can claim to limit euthanasia to terminally ill people while allowing euthanasia for people with disabilities who are not terminally ill.

McArthur's bill is not clearly limited to assisted suicide. McArthur's bill uses the term assistance to end their own life, but it does not appear to limit the act to assisted suicide. Instead it employs the statement -- uses the substance.

Nowhere in the bill does it state that the person must self-ingest or "take the substance." Even in the declaration it states: "I wish to be provided assistance to die" but it does not define it as self-ingesting.

McArthur's bill does not limit the participation to physicians. The bill refers to registered medical practitioners, medical practitioners and health professionals but it doesn't differentiate them. It defines health professionals as:

(a) a registered medical practitioner, 
(b) a registered nurse, 
(c) a registered pharmacist (within the meaning of section 108(1) of the National Health Service (Scotland) Act 1978), 

Under McArthur's bill it would be impossible to prosecute medical practitioners who have approved and participated in a euthanasia death outside of the parameters or "spirit" of the law. The bill only requires that the medical practitioner be "of the opinion" that the person meets the criteria of the law.

The same term "of the opinion" is used in Canada's euthanasia law. The law only requires the medical practitioner to be "of the opinion".  When a case, such as Donna Duncan's was investigated, the final determination was that nothing was done outside of the law. It is impossible to prosecute a medical practitioner when all they need to be is "of the opinion" that the person fits the criteria of the law. This gives medical practitioners full immunity when killing their patients.

McArthur's "assisted dying" bill claims to legalize assisted suicide for terminally ill adults.

In reality McArthur's bill legalizes assisted suicide and may legalize euthanasia (homicide) for people who are not required to be terminally ill and might have an illness or condition (disability) from which they are unable to recover.

By redefining terminal illness McArthur can claim that he has introduced a "tight" bill with strong safeguards when in fact he has introduced a wide bill that allows doctors and nurse practitioners to kill disabled people who are not terminally ill.

Wednesday, March 27, 2024

Jersey proposes Canadian style euthanasia law

Jersey proposal will lead to similar horrific euthanasia deaths as has happened in Canada.

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

On March 22, 2024 a proposal for legalizing euthanasia and assisted suicide in Jersey was released in preparation for a debate on the issue on May 21, 2024. 

The proposal claims to be limited to people in certain circumstances but upon further examination, the proposal is not limited to terminally ill people. The definitions within the proposal would open the door to a Canadian style euthanasia law.

The Jersey proposal states that the law will set out the eligibility criteria for accessing assisted dying in the following manner:

A person must meet all the eligibility criteria. They must have been diagnosed with either:
  • a terminal physical medical condition, known as Route 1 - terminal illness
  • an incurable physical condition, causing unbearable suffering, known as Route 2 - unbearable suffering
  • have decision-making capacity
  • have a voluntary, settled and informed wish to end their own life 
  • be at least 18 years of age
  • have been ordinarily resident in Jersey for at least 12 months.
Route 1: terminal illness

To be eligible under Route 1, the person must have been diagnosed with a terminal physical medical condition that: 
  • is expected to cause death within 6 months, or within 12 months if diagnosed with a neurodegenerative condition such as Parkinson’s disease or Motor Neurone Disease
  • is causing, or is expected to cause unbearable suffering that cannot be alleviated in a manner the person deems tolerable
Route 2: unbearable suffering
  • To be eligible under Route 2, the person must have been diagnosed with an incurable physical medical condition that is causing unbearable suffering that cannot be alleviated in a manner the person deems tolerable.
Route 1 is not necessarily based on having a terminal illness since, similar to other western jurisdictions, a person is not required to try effective medical treatment. Therefore a person who is an insulin dependent diabetic would qualify to be killed.

Route 2 opens the door to Canadian style euthanasia because the person is not terminally ill be is experiencing unbearable suffering. The Route 2 definition (diagnosed with an incurable physical medical condition) includes nearly everyone with a chronic disability.

When reading the proposal it states:
  • (iii) that, further to the provisions of paragraph (b) where a person has a terminal physical medication condition, ‘Route 1 – terminal illness’, the minimum timeframe between a person’s first formal request for an assisted death and the administration of the assisted dying substance will be 14 days, except for when the person’s life expectancy is less than 14 days when there will be no minimum timeframe; 
  • (iv) that, further to the provisions of paragraph (c), where assisted dying is permitted for people who have an incurable physical condition but where there is no reasonable expectation of death within the specified timeframe - ‘Route 2 – unbearable suffering’, the minimum timeframe between a person’s first formal request for an assisted death and the administration of the assisted dying substance will be 90 days; 
Canadians with disabilities are being approved for euthanasia based on having an incurable physical condition defined as "having an irremediable medical condition". People with disabilities are being approved for euthanasia based on having an irremediable medical condition, but they are often requesting to be killed based on poverty, homelessness or an inability to receive medical treatment. Similar to Canada, the Jersey proposal would require a 90 day waiting period for killing people who are not terminally ill.

The recent case of the 27-year-old autistic woman who was approved for euthanasia is a good example of what could happen in Jersey, if this proposal is accepted. The 27-year-old autistic woman claims that she is experiencing unbearable suffering even though the source of her suffering is undetermined. 

The Jersey proposal recommends that a Tribunal approve euthanasia for people who are not terminally ill. It is impossible for a Tribunal to determine if a person has suicidal ideation and claim to have unbearable suffering because they want to be  approved for death.

The Jersey proposal advocates for both euthanasia (homicide) and assisted suicide. The proposal states:
(x) the assisted dying substance that ends a person’s life may be – i. self-administered by the person; or 
ii. administered by the Administering Practitioner; 
Administered by the practitioner means the practitioner directly causes the death (homicide). 

The Jersey Assembly needs to understand why the Canadian law has become so extreme. They need to reject the Jersey euthanasia proposal.

Some might say that Jersey should simply amend their proposal. Considering the Canadian experience, once the door opens to killing by euthanasia, based on equality and discrimination, the law will quickly expand to ensure that every Jersey citizen has equal access to being killed.

EPC April 8 Zoom event with Alex Schadenberg: Examining the growth of assisted suicide in the Western US.

This Zoom event will focus on Oregon, California, Washington state and Hawaii.

Alex Schadenberg
Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition will be providing a Western US assisted suicide Zoom event update on April 8 at 7:15 pm (Pacific Time) / 8:15 pm (Mountain Time).

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

After registering, you will receive a confirmation email containing information about joining the meeting. 

This event will uncover the incremental growth of assisted suicide, a reality that the assisted suicide lobby denies in states when they are trying to legalize assisted suicide.

Alex Schadenberg will examine the increasing number of assisted suicide deaths and the expansions to the assisted suicide laws in Oregon, California, Washington state and Hawaii and provide an analysis of the data and the assisted suicide expansion bills.

There will be a specific focus on recent legislation such as Oregon removing it's assisted suicide law residency requirement to permit suicide tourism and California Bill HB 1196, a bill that would blur the distinction between assisted suicide and euthanasia (homicide) in California.

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

Links to recent articles on these topics:

Tuesday, March 26, 2024

Judge rules that a 27-year-old autistic woman in Calgary can die by euthanasia

Her father claims that she is otherwise healthy and does not qualify to be killed under the law.
Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

CBC News reporter, Meghan Grant published an article yesterday explaining that a Calgary judge has ruled that a 27-year-old can go ahead with MAID death despite her father's concerns. There is a publication ban on the names of the participants.

This case is very close to me since I have an autistic son.

The judge removed the temporary injunction on January 31, 2024 that prevented the 27-year-old autistic woman in Calgary who lives with her parents. Grant reports:

While Justice Colin Feasby acknowledged the "profound grief" that W.V. would suffer with the death of his child, he ruled the loss of M.V.'s autonomy was more important.

"M.V.'s dignity and right to self-determination outweighs the important matters raised by W.V. and the harm that he will suffer in losing M.V.," wrote Feasby in his 34-page written decision issued Monday.

"Though I find that W.V. has raised serious issues, I conclude that M.V.'s autonomy and dignity interests outweigh competing considerations."

Justice Feasby decided that an interim injunction would be held for another 30 days to provide time for a possible appeal. Grant reported:

Feasby's decision sets aside an interim injunction the father was granted the day before M.V.'s assisted death was set to take place in the family's home.

But the judge also issued a 30-day stay of his decision so that W.V. can take the case to the Alberta Court of Appeal, which means the interim injunction will remain in place for the next month.

The daughter did not bring forth evidence proving that her health condition would qualify her for euthanasia since her defence was based on that it is none of her father's business.

The father brought evidence to the court to prove that the daughter is generally healthy. Grant reported.

But W.V. believes his daughter "is vulnerable and is not competent to make the decision to take her own life," according to Feasby's summary of the father's position. 

"He says that she is generally healthy and believes that her physical symptoms, to the extent that she has any, result from undiagnosed psychological conditions."

Her only known diagnoses described in court earlier this month are autism and ADHD.

The daughter had been approved for euthanasia by one doctor and turned down by another doctor. The father took issue with the role of the Alberta Health Service in finding the second doctor to approve the death. Grant reports:

Her father took issue with the third doctor who signed off on M.V.'s MAID approval "because he was not independent or objective."

At the March 11 hearing, Sarah Miller, counsel for the father, called the situation "a novel issue for Alberta" because the province operates a system where there is no appeal process and no means of reviewing a person's MAID approval.

Justice Feasby did order an assessment of the Alberta Health Service's role. Grant reports:

While Feasby found the "court cannot review a MAID applicant's decision-making or the clinical judgment of the doctors and nurse practitioners," he did rule the actions of the MAID navigator — a person who works for AHS and helps co-ordinate a patient's eligibility assessment — can be examined. 

Feasby ruled the courts can review whether the AHS MAID navigator followed its own policy. 

"There can be no doubt that it is a serious issue," wrote Feasby. "The AHS MAID policy is part of the legal framework governing medical assistance in dying and, as such, is a matter of life and death."

Nonetheless, Feasby only granted a 30 day continuance of the injunction based on a possible appeal, he did not extend the injunction until the role of the Alberta Health Service is examined.

Canada's euthanasia law was not designed to protect vulnerable people. The law is designed to protect the doctors who are willing to kill.

Monday, March 25, 2024

Message to Scotland: Don't buy into McArthur's "bait and switch" assisted suicide bill

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

I was recently speaking to MSP's in Scotland about the upcoming assisted suicide bill sponsored by Liam McArthur (LibDem MSP). 

During several meetings many of the MSP's suggested that McArthur was promising a "heavier safeguarded" model than previous euthanasia bills that were debated in Scotland. 

My response was that it didn't matter how "heavily safeguarded" the bill is because the goal of the euthanasia lobby is to get the bill passed and expand it later.

McArthur was interviewed on March 24 by BBC Scotland on The Sunday Show where McArthur explained that the new bill will be released on Thursday March 28. McArthur stated the following about the proposed bill:

"I detect a real shift in the political mood, driven in a large part by witnessing countries and states across the world introducing heavily safeguarded provisions of the kind I'm looking to introduce here in Scotland."

He said his proposals would require diagnosis of a terminal illness by two separate doctors and a 14-day cooling off period after which a medical substance could be supplied, to be self-administered.

The reality is that McArthur is describing a bill that is similar to the original Oregon assisted suicide law, a law that was expanded in 2019 and further expanded in 2023.

McArthur stated that the mood in Scotland has shifted based on "heavily safeguarded provisions" but the provisions that he is referring to do not remain in the Oregon or other assisted suicide law provisions in the United States.

While in Scotland several of the MSP's told me that McArthur had invited them to go to California on a "fact finding" trip. California is the prime example of a state that has expanded its law since legalization. 

Recently Senator Blakespear in California introduced Bill SB 1196 an assisted suicide bill that would change the law to specifically allow utilization of the lethal poison by IV (intravenous). (my article on SB 1196)

In 2016 California legalized assisted suicide. California expanded the law in 2021 when it passed Bill SB 380. SB 380 reduced the waiting period from 15 days to 48 hours, it eliminated the final attestation, and it forced doctors who oppose assisted suicide to participate.

In September, 2022, U.S. District Judge Fernando Aenlle-Rocha ruled that California Senate Bill 380, which amended the End of Life Option Act (assisted suicide law) in California, violated the First Amendment rights of doctors by requiring them to participate in assisted suicide. Aenlle-Rocha granted a preliminary injunction barring the state from compelling health care providers to document a patient’s request for assisted suicide. (my article on the decision).

In other words, McArthur is basing his "heavily safeguarded provisions" on an American law that originally contained those provisions but has been expanded and it may be expanded again this year.

Recently I published an article titled The assisted suicide lobby wants to legalize assisted suicide and expand it later

In that article I explain that the assisted suicide lobby claim that no legislative creep exists. Yet in the past few years existing assisted suicide laws have been expanded in nearly every state that has legalized assisted suicide by: reducing or eliminating waiting periods, allowing non-doctors to participate in assisted suicide, allowing assisted suicide approvals by Telehealth, expanding the meaning of terminal illness and removing the state residency requirement.

Assisted suicide law expansion bills have been passed in California (2021), Hawai'i (2023), Oregon (2019, 2023), Vermont (2022, 2023) and Washington State (2023). There are several assisted suicide expansion bills being debated in 2024.

For instance, Colorado assisted suicide expansion Bill SB 068 would expand the assisted suicide law by: permitting non-physicians to prescribe the lethal poison, reduces the waiting period from 15 days to 48 hours and it allows the 48 hour waiting period to be waived.

In January Josh Elliott, a three-term member of the Connecticut House, and a sponsor of previous assisted suicide bills was interviewed by Paul Bass for the New Haven Independent on January 4, 2024. Bass reported Elliott as wanting to get a "heavily safeguarded" assisted suicide bill passed and then make amendments later. Since Elliott admitted to his "bait and switch" tactic, 2024 was the first year in the past eleven where no assisted suicide bill was introduced in Connecticut.

J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, was quoted on a similar bill as saying,

“Once you get something passed, you can always work on amendments later.”

My message to Scotland's MSP's is don't buy into McArthur's "bait and switch" assisted suicide bill. 

McArthur realizes that the majority of the MSP's will not support a Canadian style euthanasia bille ha. He has decided to first legalize an Oregon style bill and then expand it later. The reality is, even the American assisted suicide bills have already been expanded

Friday, March 22, 2024

Maine assisted suicide report - the law lacks effective oversight.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Jon Chrisos that was published on March 19, 2024 by WTMW News states that there were 117 assisted suicide deaths in the first four years of the Maine assisted suicide law. While the article by Chrisos promotes assisted suicide, it encouraged me to take a deeper look into the Maine assisted suicide data.

Since the issue of assisted suicide concerns life and death decisions one would think that the law would have a high degree of oversight. The 2022 Maine assisted suicide report states:

There were 61 patients who started the process to self-direct end of life care; however, two patients died before making their written request and another did not complete the process after making the first oral request. The remaining 58 patients met all the requirements of the Act. At the time of this report, four death certificates could not be found on record and there was no record of any person rescinding the request. It was confirmed with the attending physician that these patients are still alive.

Of the 58 people who received the lethal poison, there were 4 people with no death certificate.

A little further down on the page the report states that of the 54 people who died (58 - 4) 40 died by assisted suicide, 13 died a natural death and the cause of death was unknown in 1 death.

There is 1 case where a person was prescribed the lethal poison and died but the cause of death was unknown. When the cause of death is unknown the person may have died by assisted suicide or a natural death.

The same reporting problem exists in every state that has legalized assisted suicide. My recent article on the Oregon 2023 assisted suicide report indicates that 367 people reportedly died by assisted suicide in Oregon and the ingestion status was unknown in 141 cases. Therefore the Oregon data indicates that 141 people received the lethal poison and their ingestion status was unknown. The report then states that of the 141 people, who's ingestion status is unknown, 41 were known to have died but their ingestion status was still unknown.

Did these people die by assisted suicide or by a natural death?

One would think that a high degree of oversight is necessary when lethal poison is prescribed to a person with the intention of causing their death. 

Whether it be one person or 41 people who died, when the ingestion status is unknown, it is a serious concern and it indicates that the law lacks effective oversight.

Thursday, March 21, 2024

Euthanasia Poisons People and Society

The following article was published on March 19, 2024 by The Human Life Review.

By Wesley J Smith

In my first-ever anti-euthanasia article, published in Newsweek in 1993, I described the suicide of my friend Frances, who killed herself under the influence of the euthanasia-promoting Hemlock Society (since rechristened Compassion and Choices). Toward the end of the piece, I predicted what would happen should assisted suicide become legal and normalized:

The descent to depravity is reached by small steps. First, suicide is promoted as a virtue. Vulnerable people like Frances become early casualties. Then follows mercy killing of the terminally ill. From there, it’s a hop, skip and a jump to killing people who don’t have a good “quality” of life, perhaps with the prospect of organ harvesting thrown in as a plum to society.1

I believed my conclusion would be uncontroversial. After all, it was only logical. Once the act of eliminating suffering by eliminating the sufferer is redefined from a crime to a beneficent medical intervention, there is no limiting principle. Terminal illness might be the gateway excuse for legalization, but since the real issue is the best response to suffering, I could not see how access would not expand continually over time. After all, many people who are not dying suffer more intensely and for a longer period than those who are. Moreover, once the law accepts the premise that some people are better off dead, a utilitarian calculus naturally follows that sees hastening deaths as beneficial—a “plum to society,” as I put it.

Boy, was I wrong! I received more than 150 letters reacting to the column. Most were hateful screeds. (Remember, this was before email, when my detractors had to pay the price of a stamp to wish me a slow and painful death from cancer.) Beyond the hate, almost all of my correspondents accused me of engaging in alarmist slippery slope argumentation. Even those who agreed that assisted suicide should not be legalized blithely assured me that it would never come to organ harvesting or mercy killing of those without a good “quality of life.”

Now, more than 30 years later, the facts are in. Euthanasia and/or assisted suicide has been legalized throughout the Western world—including in Australia, New Zealand, Colombia, Netherlands, Belgium, Spain, Portugal, Germany (by court ruling), Austria (by court ruling), and (most worrying of all to us in the United States) Canada. In the United States, assisted suicide is now legal in nine states and the District of Columbia. Tens of thousands of people throughout the world have had their deaths facilitated. And—just as I predicted—the practice of what death activists euphemistically call “medical aid in dying” (MAiD) has not only increased in numbers but expanded exponentially in scope, in some places including the instrumental use of those whose deaths have been facilitated. Indeed and alas, rather than being alarmist, my long-ago warning proved prophetic.

Euthanasia without Brakes

Most of the media are euthanasia-friendly, preferring to report on the issue in the glowing, uncritical language of empowered patients “dying peacefully on their own terms,” supported by loving family who are grateful that grandma is no longer suffering.2 In contrast, euthanasia abuses and horror stories—an ever-growing list—generally receive little focused media attention and remain outside the notice of people not engaged with the issue. But we now have enough experience with euthanasia/assisted suicide to demonstrate that the “slippery slope” is not only real but has become an avalanche of abuse and abandonment.

Space does not permit a complete recitation of the known examples of abuse or neglect associated with legalized euthanasia. But the following recitation demonstrates the danger:

Euthanasia “Patients” as “Organ Farms”: People killed by euthanasia are increasingly being looked upon by doctors and society as splendid sources of organs. Not only that, but the phenomenon of conjoining euthanasia with organ harvesting—becoming relatively common now in the Netherlands, Belgium, and Canada—is celebrated in the media. Thus, the Ottawa Citizen recently depicted the practice as “a growing boon to organ donation,” sighing:

Ontarians who opt for medically assisted deaths (MAiD) are increasingly saving or improving other people’s lives by also including organ and tissue donation as part of their final wishes. According to Trillium Gift of Life Network, which oversees organ and tissue donation in Ontario, the 113 MAiD-related donations in 2019 accounted for five per cent of overall donations in Ontario, a share that has also been increasing.3

Some readers might be asking, “What’s the problem? These are people who want to die, so why not allow them to donate their organs?”

The question itself demonstrates the danger. Imagine a healthy suicidal person asking to be killed and organ-harvested because he doesn’t believe his life to be worth living and hopes that through his death others—who want to live—can be saved. Would we allow that? No! (At least not yet.) Rather, the humane response would be to offer the person mental health support and suicide prevention to get past the darkness.

Now, notice the difference when a patient qualifies for euthanasia. Not only is suicide prevention not engaged, but in Ontario, once the patient is accepted for a lethal injection, the death doctor informs Trillium Gift of Life Network. In turn, Trillium contacts the soon-to-be-killed person to ask for their heart, liver, lungs, and kidneys. Again, from the Ottawa Citizen story:

“As part of high-quality end-of life care, we make sure that all patients and families are provided with the information they need and the opportunity to make a decision on whether they wish to make a donation,” Gavsie says. “That just follows the logical protocol under the law and the humane approach for those who are undergoing medical assistance in dying. And it’s the right thing to do for those on the wait list.”4

This is the opposite of “high-quality end-of-life care.” Canada does not restrict euthanasia to the terminally ill, but may include people with disabilities, chronic illnesses—and, beginning this year, the physically healthy experiencing mental illness. (The mentally ill are already eligible for euthanasia in Belgium and the Netherlands.) Thus, many euthanized organ donors would not be dying but for being lethally injected. Indeed, some might live indefinitely.

But because they are qualified to be killed under the law, their organs come to the forefront of policy. An article in the Canadian Medical Association Journal  recently updated the Association’s “guidelines” for conjoining euthanasia and organ harvesting when the patient is not terminally ill—these are called “Track 2” patients.5 (There are even more relaxed standards for “Track 1” patients, those whose deaths are “reasonably foreseeable.” Due to space considerations, I focus below primarily on Track 2 patients.) From “Deceased Organ and Tissue Donation After Medical Assistance in Dying” (my emphasis):

All Track 2 patients who are potentially eligible for organ donation should be approached for first-person consent for donation after MAiD once MAiD eligibility has been confirmed, regardless of when their eligibility for MAiD is confirmed within the 90-day assessment period.

This means that the death doctor is to contact the organ-donation association, which in turn will contact the suicidal patient and ask for his or her organs (which, as we have seen, already happens in Ontario).

The recommendations also suggest allowing a soon-to-be-euthanized patient to determine who receives organs:

Organ donation organizations and transplantation programs should develop a policy on directed deceased donation for patients pursuing MAiD, in alignment with the directed donation principles and practices that are in place for living donation in their jurisdiction  . . . Directed donation should not proceed if there is indication of monetary exchange or similar valuable consideration or coercion involved in the decision to pursue directed donation. The intended recipient in a directed deceased donation case should be a family member or “close friend”—an individual with whom the donor or donor’s family has had a long-standing emotional relationship.  . . . The intended recipient must be on the current transplant waiting list or meet criteria for the same  . . . Transplantation will proceed only if the donor organ is medically compatible with the intended recipient.

Do you see the danger? The need for a transplant by a medically compatible loved one could become the motive for asking for euthanasia.

The article grouses that waiting for the patient to initiate organ donation conversations means “missed opportunities”:

Given the variation in practices relating to both MAiD and donation after MAiD across Canada, some jurisdictions may be unable to apply the updated guidance. Specifically, in jurisdictions reliant on patient initiation of donation after MAiDlack of awareness of the option may result in missed opportunities. Jurisdictions without central coordination of MAiD may experience similar challenges. There are also jurisdictional variations in the education, training and support provided to coordinators who facilitate donation after MAiD.

Now, we can see that once the patient is accepted for medicalized homicide, his or her intrinsic human dignity is diminished—in at least some sense—from that of an equally valuable person into that of a mere natural resource usable for the benefit of others. In other words, the life, wellbeing, and future potential of the patient become secondary considerations to the potential benefit of garnering organs for other patients who want to live.

The impact of this dehumanizing force of gravity became blaringly clear in a recent case out of Belgium. A story in Le Soir recounted what happened when a 16-year-old girl with a brain tumor asked to be euthanized and have her organs harvested.6 Doctors agreed. At that point, she mattered less than the donation. The girl was sedated and intubated in an ICU for 36 hours before being euthanized and harvested.

The story lauds the girl as selfless. But it seems to me there is a terrible dark side to the tragedy. First, this was a minor terrified of decline who stated that by donating organs she believed she could do some good. But for that option, she might not have asked to die. Second, as far as we know, the girl wasn’t provided with suicide prevention nor assured that palliative care could alleviate her symptoms. Finally, the lengthy sedation to which she was subjected was primarily administered to allow her organs to be tested and to allow time to find compatible recipients. In other words, at least in some sense, once the girl asked to donate her organs, they became the paramount consideration.

Euthanasia as a Substitute for Care: When I first began my work against euthanasia and assisted suicide in 1993, both euthanasia and assisted suicide were permitted in the Netherlands under a decriminalized system that allowed doctors to end the lives of patients so long as there was (supposedly) no other means of preventing suffering and the death doctor reported the details to the authorities.7 (That system is now defunct. The Netherlands formally legalized euthanasia in 2003.)

When researching my first book on the issue, I came across data demonstrating that hospice was virtually unknown in the Netherlands. One reason for this deficiency was the Dutch medical system, which depends on general practitioners making house calls and has fewer specialists than the American system. But, I wrote, that might not have been the only reason:

The widespread availability of euthanasia in the Netherlands may be another reason for the stunted growth of the Dutch hospice movement. As one Dutch doctor is reported to have said, “Why should I worry about palliation when I have euthanasia?”8

In other words, once medicalized killing becomes normalized, it could eventually become a measure of first resort rather than last.

That abandoning paradigm can be seen playing out increasingly in Canada in recent years:

    • A VA counselor suggested euthanasia to a military veteran burdened by PTSD.9

    • A disabled woman with quadriplegia plans to be euthanized because she is destitute and it is easier and quicker to receive euthanasia than obtain disability benefits.10

    • A man with serious disabilities—refused coverage for independent living services—was told that Canadian Medicare would cover the costs of obtaining a lethal jab.11

    • A cancer patient decided to be euthanized because he couldn’t obtain the chemotherapy that would extend his life.12

    • Another cancer patient was offered euthanasia by her surgeon and told it would take months before she could see an oncologist. She chose instead to be treated in the USA.13

    • An elderly woman opted for euthanasia rather than be isolated from her family during a Covid lockdown. Her family was allowed to be with her when she died but would not have been allowed to visit her room if she continued living.14

Canada isn’t alone in this. A report out of the Netherlands finds that autistic people are being euthanized in lieu of being provided proper care. From the AP story:

Several people with autism and intellectual disabilities have been legally euthanized in the Netherlands in recent years because they said they could not lead normal lives, researchers have found. The cases included five people younger than 30 who cited autism as either the only reason or a major contributing factor for euthanasia, setting an uneasy precedent that some experts say stretches the limits of what the law originally intended Eight said the only causes of their suffering were factors linked to their intellectual disability or autism—social isolation, a lack of coping strategies or an inability to adjust their thinking.15

The same paradigm is seen in Belgium, where a healthy elderly couple received joint euthanasia deaths out of fear of future loneliness caused by widowhood—a killing arranged by the couple’s own children.16 A suicidal anorexia patient, despairing over being the object of sexual predation by her former psychiatrist, was euthanized by her new psychiatrist.17 A transgendered patient despairing over the adverse results of transition surgery was killed rather than helped to go on living.18 These kinds of cases are becoming ubiquitous.

Enough. The unintended cruelty of legalized euthanasia is now quite clear. It is about “choice,” they say. It is about compassion, they say. Bah. That is just a veneer. Medicalized killing eventually becomes a form of abandonment.

Future Concerns

The societal damage done by euthanasia expands exponentially as time passes and a nation’s population accepts doctor-hastened death as normal. Here are a few of the unfolding harms that have emerged recently.

Euthanasia Deaths, Going Up!: Euthanasia/assisted suicide is sold to a wary public as a last-resort option—a safety valve, if you will—to be rarely applied, and then only in cases of extremism. But in real life, hastened death tends to increase exponentially year by year. For example, in 1998—the first full year that assisted suicide in Oregon became legally available—the state reported 16 deaths from assisted suicide. In 2022, that number had risen to 278, with 431 prescriptions written.19

The Netherlands has experienced an even more dramatic increase. In 2004, 1886 people were killed by doctors. In 2021, the number had risen to 7,666. Even more notably, that number increased by more than a thousand in one year, with 8,720 lethal injections in 2022.20

Canada experienced the most startling death acceleration. The first year of full legalization, 2016, Canadian doctors killed 1,018 patients. The next year the total was 2,828. In 2018, it reached 4,493. In 2022, a horrifying 13,241 patients were killed.21 (If the same percentage of people were killed by doctors in the much more populous United States, that would amount to about 140,000 medical homicides annually.) And now that patients with clearly non-terminal conditions are killable in Canada, these numbers will undoubtedly rise to unprecedented levels going forward.

Follow the Money: There is a less visible but perhaps ultimately more dangerous force driving the euthanasia juggernaut: money. Whether in a socialized healthcare system like Canada’s, or one with free market elements and incentives as in the United States, once the most expensive-to-care-for patients can be killed—people with long-term chronic medical conditions, disabilities, or the frail elderly—it should become obvious that, over time, billions could be saved in the healthcare system.

This isn’t paranoia. Indeed, Derek Humphry, the co-founder of the Hemlock Society, made this point explicitly in his book (co-authored with Mary Clement) Freedom to Die: People, Politics and the Right to Die Movement. In a chapter entitled “The Unspoken Argument,” the euthanasia advocates write, “Elders or otherwise incurable people are often aware of the burdens—financial and otherwise—of their care.” They then get to the ultimate point:

A rational argument can be made for allowing PAS [physician-assisted suicide] in order to offset the amount society and family spend on the ill, as long as it is the voluntary wish of the mentally competent terminally ill and incurable adult. There will likely come a time when PAS becomes a commonplace occurrence for individuals who want to die and feel it is the right thing to do by their loved ones. There is no contradicting the fact that since the largest medical expenses are incurred in the final days and weeks of life, the hastened demise of people with only a short time left would free resources for others. Hundreds of billions of dollars could benefit those patients who not only can be cured but who also want to live.22

Canadians have already noted the costs being saved for their socialized system from legalizing euthanasia. Back in 2017, a study projected that Canada’s socialized medical system could save up to C$138.8 million annually by not treating patients (less C$1.1 million for the costs associated with euthanasia). It is worth noting that the authors based their cost-savings projections on more conservative practice than the country’s actual experience. They assumed that “40% of Canadians who choose medical assistance in dying would have their lives shortened by 1 week, and 60% of patients will have their lives shortened by 1 month.”23 In practice, many patients do not wait until the very end of their illnesses before being euthanized.

More recently, a 2020 projection found that if some 6,000 Canadians were to be euthanized under a proposed (and now in effect) expansion of death eligibility beyond “death being reasonably foreseeable,” the annual net savings would be C$149 million.24 But more than twice as many Canadians died by euthanasia than was predicted in 2022, with the total cost savings currently unknown. Moreover, with the elderly, people with disabilities, and those with chronic and (soon) mental illnesses now being euthanized, the cost savings will undoubtedly increase, providing a potential incentive to further normalize killing as a “medical treatment.”

Euthanasia Poisons a Nation’s Soul: Transforming killing from a negative into a beneficent means of eliminating suffering changes public morality. For example, when euthanasia began in the Netherlands, it was supposed to be strictly limited to cases of force majeure. But after decades of desensitizing the public to doctors causing death, the Dutch people now overwhelmingly support allowing euthanasia for what is known as a “completed life.” From the NL Times story:

A massive 80 percent of voters believe that people should be able to get help in dying when they feel they’ve come to the end of their life,Trouw reports based on a Kieskompas poll of almost 200,000 people. Only 10 percent of respondents disagreed with the statement that people who consider their lives complete should be able to end their lives with professional help. The other 10 percent of voters had no opinion on the matter.

The first focus of this idea are the elderly:

The [parliamentary] bill would allow people over 75 to decide when to die with professional help if they feel they’ve reached the end of a completed life. Added to the bill is a six-month process in which they have to meet with an “end-of-life counselor” at least three times.25

Note well that the concept of the “completed life” need not involve any physical illness, disabling condition, or psychiatric malady at all. People could decide they have lived long enough due to loneliness, boredom, fear of future widowhood, death of an adult child, dissatisfaction with living conditions, worries about being unproductive, you name it. In other words, “completed life” euthanasia would allow the healthy elderly to be terminated.

Moreover, in principle, why should eligibility be age-dependent? Once the concept of the “completed life” is accepted, why shouldn’t the death option be available to younger people? Indeed, doesn’t every suicidal person believe their useful life is completed? Again, as with many aspects of euthanasia, there is no effective limiting principle.

Meanwhile, in Canada, shockingly large percentages of people now support euthanasia as a remedy for the suffering caused by adverse social conditions! According to a recent poll, 27 percent of respondents strongly or moderately agree that euthanasia is acceptable for suffering caused by “poverty,” and 28 percent strongly or moderately agree that killing by doctors is acceptable for suffering caused by “homelessness.”26

Before the legalization of euthanasia, I’m confident that few Dutch would have supported allowing doctors to kill healthy geriatric patients—any more than (I hope) Americans would. But after decades of euthanasia normalization, only 10 percent think it would be wrong. And can we imagine more than one-quarter of Canadians supporting euthanasia as a remedy for homelessness if it had not already become widely accepted for the suffering caused by illness and disability? Do you see what I mean about how euthanasia is poisoning a nation’s soul?

“But Wesley,” some might say, “the same moral decay hasn’t happened in states that have legalized assisted suicide.” As a fact checker would put it, that’s partially true. People aren’t (yet) assisted in suicide for botched sex change surgeries or for having suffered sexual predation by their psychiatrist. But that shouldn’t make us sanguine. Almost every state that has legalized assisted suicide already has liberalized its regulations to allow easier access to doctor-prescribed death. Oregon and Vermont have done away with residency requirements, and some states even allow virtual assisted suicide, with doctors examining patients who want to die over the internet. Besides, the people of the United States have only nibbled at—but not yet swallowed— the snake’s proffered poison apple, which is why the death agenda has not yet swept the country. But if we ever do yield to the culture of death, the same tragic trajectory seen so vividly in the Netherlands, Belgium, and Canada will happen here. As I pointed out at the beginning of this essay, it’s only logical.


Euthanasia cannot ultimately be restricted only to the few for whom nothing but death can eliminate suffering. Once medicalized killing becomes normalized, the death agenda spreads, objectifies those who want to die, and corrupts public morality in ways that should shock the human conscience. The same progression will happen here too if we don’t change our current cultural trajectory. And many of those who dismiss the warnings contained in this article as alarmist will applaud when that dark time comes.

Those with eyes to see, let them see.



1. Wesley J. Smith, “The Whispers of Strangers,” Newsweek, June 28, 1993. The Whispers of Strangers | Discovery Institute

2. Such articles are ubiquitous. See, for example, “Model Ali Tate Cutler’s Grandmother is Choosing to Die on Her Own Terms,” Yahoo News, May 25, 2023, Ali Tate Cutler grandmother dying by choice, MAID (

3. Bruce Deachman, “Medically Assisted Deaths Prove a Growing Boon to Organ Donation in Ontario,” Ottawa Citizen, January 6, 2020.

4. Ibid.

5. Kim Wiebe MD, et. al., “Deceased Organ and Tissue Donation After Medical Assistance in Dying: 2023 Updated Guidance for Policy:” Canadian Medical Association Journal, CMAJ 2023 June 26;195:E870-8. doi: 10.1503/cmaj.230108: Deceased organ and tissue donation after medical assistance in dying: 2023 updated guidance for policy (

6. Alain Lallemand, “Euthanasia: I’ve Had Enough. I Want to Die Helping People,” Le Soir, October 16, 2023 (Google translation).

7. For details on how this now-repealed system worked—and the abuses that resulted—see Wesley J. Smith, Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder (New York, Times Books, 1997).

8. Ibid, p. 231.

9. Michael Lee, “Canadian Soldier Suffering with PTSD Offered Euthanasia by Veterans Affairs,” Fox News, August 22, 2022. Canadian soldier suffering with PTSD offered euthanasia by Veterans Affairs (

10. Tyler Cheese, “Quadriplegic Ontario Woman Considers Medically Assisted Dying Because of Long ODSP Wait Times,” CBC News, June 22, 2023.

11. CTV CA, “The Solution is Assisted Life: Offered Death, Terminally Ill Ontario Man Files Lawsuit,” March 15, 2018.

12. Katie DeRosa, “B.C. Man Opts for Medically Assisted Death After Cancer Treatment Delayed,” National Post, December 5, 2023.

13. Amy Judd and Kylie Stanton, “B.C. Woman Gets Surgery in U.S., Says Wait Times at Home Could Have Cost Her Life,” Global News, November 27, 2023.

14. CTV News, “Facing Another Retirement Home Lockdown, 90-Year-Old Woman Chooses Medically Assisted Death,” November 19, 2020.

15. Maria Cheng, “Some Dutch People Seeking Euthanasia Cite Autism or Intellectual Disabilities, Researchers Say,” Associated Press, June 28, 2023.

16. Simon Caldwell, “Elderly Couple to Die Together by Assisted Suicide Even Though They Are Not Ill,” Daily Mail, September 25, 2014.

17. Michael Cook, “Another Speedbump for Belgian Euthanasia,” Bioedge, February 8, 2013.

18. Damian Gayle, “Transsexual, 44, Elects to Die by Euthanasia After Botched Sex-Change Operation Turned Him Into a ‘Monster’,” Daily Mail, October 1, 2013.

19. Oregon Health Authority, Oregon Death with Dignity Act, 2022 Data Summary, March 8, 2023. DWDA 2022 Data Summary Report (

20. Statista, “Number of Euthanasia Deaths Reported in the Netherlands from 2000 to 2022.” Netherlands: euthanasia 2000-2022 | Statista

21. Government of Canada, “Fourth Annual Report on Medical Assistance in Dying in Canada 2022.”

22. Derek Humphry and Mary Clement, Freedom to Die: People, Politics and The Right to Die Movement (New York: St. Martin’s Press, 1998), p. 333.

23. Aaron J. Trachtenberg and Braden Manns, “Cost Analysis of Medically Assisted Dying in Canada,” Canadian Medical Association Journal, January 23, 2017.

24. Office of the Canadian Budget Office, “Cost Estimate for Bill C-7 ‘Medical Assistance in Dying’,” October 20, 2020.

25. Anne-Marijke Podt, “Widespread Public Support for Assisted Suicide at End of Completed Life,” NL Times, November 8, 2923.

26. Research Co., “Poll on Medically Assisted Dying in Canada,” May 5, 2023. Tables_MAiD_ CAN_05May2023.xlsx Group (

Assisted suicide: Safeguards debated as bioethicist warns of unintended consequences

The following article was written by bio-ethicist, Philip Reed, in response to Arthur Caplan's article supporting assisted suicide and was published by on March 19, 2024.

Reed begins his article by referring to Caplan's article and then writes:

In Canada, deaths by a physician have increased by more than 25 percent every year since legalization in 2016 and now make up over 4 percent of all deaths. Media reports have profiled physician-assisted death for non-terminally ill Canadians who were having trouble accessing medical care, housing, and social support. Caplan understandably wants to avoid this scenario.

The question, however, is how well the safeguards are really working even in the United States. Are they set up to protect the U.S. sufficiently against the Canadian scenario?

One safeguard originally built into these laws was that access to lethal drugs would be limited to state residents. States understandably did not want to become destinations for suicide tourism. But Oregon has stopped enforcing this requirement and Vermont passed a law last year overturning their residency requirement. Other states are expected to follow suit.

Another alleged safeguard is that people who are mentally ill or depressed cannot have access to lethal drugs. However, only Hawaii requires that terminally ill patients be evaluated by a mental health professional. The other states only require referral when they suspect depression or another mental disorder might interfere with decision-making.

In the 25 years of assisted suicide in Oregon, only 3 percent of patients have been referred for a psychiatric evaluation. On the one hand, this is surprising, given that by some estimates 1 in 5 Americans have some kind of mental illness. On the other hand, given that only specialized doctors are willing to prescribe lethal drugs, patients have to shop for the right doctor. In Oregon, the median length of the relationship between the patient who receives a lethal prescription and the doctor who prescribes is down to only five weeks. One can understand how psychiatric referrals get in the way of this transaction. But one also wonders whether this sufficiently protects depressed patients.

Even when a referral is made, the objective is only to determine eligibility for assisted suicide. Only one jurisdiction (the District of Columbia) requires that patients be informed about the option of mental health counselling.

Another safeguard of assisted suicide laws is to have significant waiting periods between the patient’s initial request and obtaining the prescription. This helps ensure the request’s authenticity and that the patient is not choosing rashly. The standard waiting period, endorsed by Caplan, has been 15 days but things are changing. In 2019 the Governor of Oregon signed a law allowing physicians to bypass the waiting period in certain cases. In 2021, California shortened its waiting period from 15 days to 48 hours and subsequently witnessed a 47 percent increase in lethal prescriptions. Hawaii and Washington shortened their waiting periods in 2023 and Colorado has pending legislation to shorten it. New Mexico, seeing the trend, said, “Why wait?” and started with a 48-hour waiting period.

Are people being pushed to choose an assisted death prematurely? I suggest that the ways in which some of these choices are made are subtle and stem from complex psychological and social forces that are not easily captured by evidence. For example, are we expressing to terminally ill patients that experiencing the burdens of their disease does not jeopardize their dignity when we label the alternative “death with dignity?”

About half of Oregon patients who use assisted suicide say that they don’t want to be burdens on their families. Is a choice for death authentic if it is motivated by the idea of sacrificing a potential life worth living in order to unburden one’s caregivers?

Also, in my view, it is unfortunate that some states have incorporated assisted suicide into hospice and palliative care. Hospice says to terminally ill patients, “We can give you an acceptable quality of life at the end of life.” The offer of assisted suicide contradicts this and undermines the mission of hospice.

Medicine in the 21st century is so impressive that we are genuinely surprised when the doctor tells us that nothing can be done. But medicine is not a panacea and it cannot treat mortality. The trouble with assisted suicide laws is that they present death as a neat and tidy way to solve one’s problems. The alleged safeguards are inadequate, and as they have gradually eroded, more and more people come to believe that death can solve their problems too.

Thank you Philip Reed for responding to Caplan.

Wednesday, March 20, 2024

Oregon assisted suicide poison prescriptions increase by 29% in 2023.

The longest time of death was 137 hours (more than 5.5 days).
The complications rate was almost 10% of the assisted suicide deaths.
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The number of lethal poison prescriptions written under the Oregon assisted suicide law increased substantially with 566 lethal poison prescriptions written in 2023 up by 29% from 433 in 2022.
The 2023 Oregon assisted suicide report indicates that there were 367 reported assisted suicide deaths up by 21% from 304 in 2022. 

The 2022 Oregon assisted suicide report indicated that there were 278 reported assisted suicide deaths meaning that the Oregon Health Authority received 26 assisted suicide reports after January 20, 2023; the date that the 2022 data was compiled. 

The Oregon report under reported the number of assisted suicide deaths by 26 in 2022 and corrected it in the 2023 report. I estimate that the 2024 report will say that there had been approximately 400 assisted suicide deaths in 2023.

The 2023 Oregon assisted suicide report indicates that the ingestion status was unknown in 141 cases. This means that the 141 "unknown" people were approved and received the lethal drugs but the Oregon Health Authority does not know how they died. Some of these cases are assisted suicide deaths that will appear in the 2024 report. Some of these people died a natural death and some of these people died by assisted suicide but no report was submitted. 

Other important data is that 30 of the deaths in 2023 were people who received their lethal poison in 2022. Only 3 of the 566 people who were prescribed lethal poison, were referred for a psychiatric assessment. 

Complications are only known when a health care provider is present at the death. There were 10 known complications based on 102 of the deaths, representing almost a 10% complication rate. In 2022 there were 7 known complications based on 76 deaths, representing a 9% complication rate.

The report indicated that 23 of the 367 reported assisted suicide deaths were out-of-state residents. There could be more than 23 out-of-state assisted suicide deaths. The report included the following disclaimer related to out-of-state assisted suicide deaths:

Information on a patient’s state of residence is not collected during the DWDA prescription process. OHA does not receive death certificates from other states unless the decedent was an Oregon resident. Therefore, if an Oregon DWDA patient dies out of state and was not a resident of Oregon, OHA is unlikely to obtain notice of the death. The out-of-state deaths reported in Table 1 thus may not represent all DWDA deaths from out-of-state residents who obtained a DWDA prescription from an Oregon health care provider.

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.

Oregon Governor Kate Brown, in July 2019, signing Bill SB 0579 into law to essentially eliminate the 15 day assisted suicide waiting period. This expansion of assisted suicide allows the physician to waive the waiting period, and if the patient is depressed, the patient loses the opportunity to change their mind.
In 2023, in 154 deaths the physician waived the 15 day waiting period - in some cases the lethal poison was ingested the day after being first requested.

An article by David Jones (ethicist) was published by the British Medical Journal of Medical Ethics on October 27, 2023. In his article Jones examines 25 years of Oregon assisted suicide reports and comments on what is missing in the data. Jones concludes that there are significant data gaps in the Oregon assisted suicide report which was not re-assuring.