(62%) of Canadians are concerned that socially and financially vulnerable will look to MAID based on inadequate health care.

Six percent of the respondents indicated that they knew a person who was offered MAiD (euthanasia) who had not requested it.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Angus Reid Institute in partnership with Cardus conducted an opinion poll of 1652 Canadians concerning MAiD (euthanasia). Similar to previous opinion polls, the current poll which was released on November 21, 2024 found that Canadians generally support access to MAiD (euthanasia) but have significant concerns with the application of the law.

The poll found that 63% of the respondents supported Canada's euthanasia law while 62% said that they worry about socially and financially vulnerable Canadians looking to MAID in lieu of adequate and quality health care.

Furthering the concerns is that people with disabilities are reporting barriers to accessing health care:

A majority (57%) of those living with disabilities which severely impact their day-to-day life have experienced some sort of barrier, including worse access to health care in general (31%), worse quality care (24%), difficulty finding a primary care doctor (21%), or inaccessible treatment or testing locations (12%).

The poll included 468 respondents who were healthcare workers. Among this group:

(45%) say they believe people living with disability receive poor or terrible care in their province.

The poll found that nearly 4 in 10 healthcare workers stated that Canadians with disabilities experience slower access to healthcare, a lower quality of care and are less likely to have their concerns taken seriously in the healthcare system.

The poll also found that almost 1 in 5 Canadians know someone who has died by MAiD (euthanasia) and 6% of the respondents indicated that they knew a person who was offered MAiD who had not requested it.

With instances of MAID increasing, the proportion of those who know a close friend or family member who received MAID has reached one-in-five (18%). This is higher among those older than 54 (24%) and those in Quebec (26%), the province which has seen the most medically assisted deaths since 2016. Exposure is close to evenly divided between close friends or family members.

Notably, six per cent of Canadians say that they had a close friend or family member who was offered MAID unsolicited, something opponents have been concerned about.

The 6% of respondents who stated that a friend or relative was offered euthanasia without asking for it, 37% stated that the person accepted the suggestion and died by euthanasia.

The Euthanasia Prevention Coalition has received many phone calls from people who were upset that healthcare professionals (often a hospital MAiD team) had asked them or a loved one if they wanted euthanasia. One person contacted me after being asked 5 times if they wanted euthanasia.

In June 2024, Heather Hancock, who lives with Cerebral Palsy, shared her story of being pressured at two Canadian hospitals to request MAiD (euthanasia).

Canada had approximately 15,280 euthanasia deaths in 2023 (Article Link).

Previous Angus Reid polls:

• The majority of Canadians oppose euthanasia for mental health (Link). 
• 28% of Canadians support euthanasia for mental illness (Link).
  
• The majority of Canadians say that religiously affiliated hospitals should not be forced to do euthanasia (Link). 
• Canadians oppose further expansions of (MAiD) euthanasia (Link).
  

The Alberta government seeks input into (MAiD) euthanasia regulations.

Take the online survey!

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Alberta government is establishing an oversight committee to ensure that euthanasia (MAiD) is effectively regulated. The Alberta government is seeking input from groups and individuals for the purpose of input and to possibly lead to new legislative regulations. (Information link).

The Euthanasia Prevention Coalition urges you to take the online survey before December 20, 2024, and share your thoughts on processes for and oversight of medical assistance in dying in Alberta. (Link to survey).

In their media release the Alberta government stated:

Medical assistance in dying is a process that allows an eligible person to receive assistance from a medical practitioner in ending their life. To be found eligible, a person must be suffering from a serious and permanent medical condition.

Alberta’s government is reviewing how MAID is regulated to ensure there is a consistent process as well as oversight that protects vulnerable Albertans, specifically those living with disabilities or suffering from mental health challenges. An online survey is now open for Albertans to share their views and experiences with MAID until Dec. 20.

“We recognize that medical assistance in dying is a very complex and often personal issue and is an important, sensitive and emotional matter for patients and their families. It is important to ensure this process has the necessary supports to protect the most vulnerable. I encourage Albertans who have experience with and opinions on MAID to take this survey.” Mickey Amery, Minister of Justice and Attorney General

In addition to the online survey, Alberta’s government will also be engaging directly with academics, medical associations, public bodies, religious organizations, regulatory bodies, advocacy groups and others that have an interest in and/or working relationship to the MAID process, health care, disabilities and mental health care.

Feedback gathered through this process will help inform the Alberta government’s planning and policy decision making, including potential legislative changes regarding MAID in Alberta.

“Our government has been clear that we do not support the provision of medically assisted suicide for vulnerable Albertans facing mental illness as their primary purpose for seeking their own death. Instead, our goal is to build a continuum of care where vulnerable Albertans can live in long-term health and fulfilment. We look forward to the feedback of Albertans as we proceed with this important issue.” Dan Williams, Minister of Mental Health and Addiction.

"As MAID is a federally legislated and regulated program that touches the lives of many Albertans, our priority is to ensure we have robust safeguards to protect vulnerable individuals. Albertans’ insights will be essential in developing thoughtful policies on this complex issue.” Adriana LaGrange, Minister of Health.

The federal Criminal Code sets out the MAID eligibility criteria, procedural safeguards and reporting obligations. The federal government has paused MAID eligibility for individuals with a mental illness as their sole underlying medical condition until March 2027 to ensure the provincial health care systems have processes and supports in place. Alberta’s government does not support expanding MAID eligibility to include those facing depression or mental illness and continues to call on the federal government to end this policy altogether.

On February 1, 2023, Alberta premier Danielle Smith objected to the expansion of euthanasia to include mental illness.

Alberta Health Services data states that there were 977 reported assisted deaths in 2023 which was up from 836 reported assisted deaths in 2022 and 594 in 2021. 

The Office of the Chief Coroner of Ontario released a report from the Ontario MAiD Death review Committee outlining six representative stories of non-compliant euthanasia deaths in Ontario. The report indicated that there were at least 428 non-compliant Ontario euthanasia deaths from 2018 to 2023 with 25% of all euthanasia providing doctors, in Ontario, having at least one non-compliant death. I suspect that similar concerns exist with euthanasia in Alberta.

Alberta has had the case of the 27-year-old autistic woman who was approved and scheduled to die by euthanasia on February 1, 2024 until her father challenged the euthanasia approval in court. There was also a case of a Calgary man who couldn't get experimental treatment for cluster headaches but could get euthanasia.

Take the online survey by December 20, 2024, to share your thoughts on processes for and oversight of medical assistance in dying in Alberta. (Link to survey).

Baroness Tanni Grey Thompson - legalizing assisted suicide could cause a seismic shift.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Tanni Grey-Thompson

An ITV news article that was published on November 17 quotes Baroness Tanni Grey Thompson, who is an 11 time gold medal paralympian as warning the UK that:

changing the law could cause a “seismic shift” in the way the health system cares for people.

A private members bill to legalize assisted suicide in the UK, that is sponsored by Kim Leadbeater MP is scheduled to be debated in Westminster on November 29.

Grey Thompson who is a long time champion of disability rights told ITV news that:

“I urge Parliamentarians to understand the significance of proposed changes to the law and the seismic shift it would cause to the way we choose to care for people at their most vulnerable,” she said.

“Protecting people is something the current prohibition on encouraging or assisting suicide does well,” Baroness Grey-Thompson said.

“Parliamentarians should be in no doubt that a change to this law would fundamentally alter the political and societal landscape for disabled people.”

The Euthanasia Prevention Coalition will continue to provide analysis of the bill.

More articles on this topic:

• The UK introduces bill to legalize assisted suicide (Link).
• UK assisted suicide bill. The vote will be close (Link).

Netherland Euthanasia Homicide of 22 year-old averted at the last minute.

This article was published by National Review online on November 15, 2024

Wesley Smith

By Wesley J Smith

Why do you oppose euthanasia, Wesley? If people want to die, we should help them die.

No. And here’s an individual example explaining just one reason why. A deeply depressed woman was about to be lethally injected in the Netherlands — but changed her mind just in the nick of time. From the New York Post story:

Romy, 22, who suffered from clinical depression, eating disorders, and anorexia due to childhood abuse, made the heartbreaking decision to end her life in accordance with legislation in the Netherlands, which allows for euthanasia under certain circumstances.

She decided not to go ahead with it at the very last moment.

After turning 18, Romy campaigned for four years for her right to die via voluntary assisted dying (VAD) to doctors, officials, and her family. But in 2023, when she found herself lying in a hospital bed in the Dutch city of Leiden, she had a sudden change of heart. Earlier that day, she had seen the coffin in which she would be taken to the mortuary.

That would certainly focus one’s attention. At the last second, she decided to live — no thanks to the death doctor:

The doctor stood over her and explained one last time the step-by-step process of what she was going to do as part of the lethal injection process under her country’s euthanasia laws.

Romy gave the doctor the green light, but she was sweating and her heart was pounding as she considered the finality of what was about to happen, she says.

As the doctor stepped up to administer the lethal injection, she was asked one final question to comply with Dutch law — “Are you sure?”

Romy, whose surname has been withheld, was not sure. She started to cry and so did her mother, and she decided to call it all off.

If the date of the killing had been a week earlier, or if she had not seen her soon-to-be coffin, she might not be with us today.

What can we learn from this?

First, just because someone says they want to die, that doesn’t mean that will always be the case. Years can pass and “want to die” can switch in a moment to a desire to live.

Second, most assisted suicide/euthanasia applicants do not receive suicide prevention services. How many would change their minds if they did? We will never know. And if the option of being killed wasn’t there, how many would go on to find other ways to grapple with their suffering and depression?

Third, this case exemplifies the tragedy that is euthanasia/assisted suicide legalization. How many who died by those means would have been so happy to still be alive in a day, week, month, or year if their death wish had not been accommodated? Again, we will never know.

Romy’s case illuminates the wrongness of the so-called “right to die”:

After initially backing out of her euthanasia, Romy requested to end her life once again and was scheduled to receive a lethal injection at a later date.

However, with the persistent support of her psychiatrist, family and friends, she decided to continue with her trauma therapy and now expresses that she wants “nothing more than to live.”

“I don’t regret the journey. Because I’ve been so close to death, I see life as something valuable. It won’t always go well, but I now know there is light at the end of the tunnel,” she told Dutch outlet NRC.

Today, Romy is studying for a diploma in adult education and lives in communal assisted living.

When the publication asked what gives her hope, she laughed, “This is going to sound crazy: I genuinely enjoyed paying rent. It gives my life meaning.”

Do you see the difference that caring family/doctors/society can make when they push against the darkness instead of shrugging and saying, “It’s your choice”?

Help suicidal people find their meaning. Don’t salute when they ask to end their lives and then, take on the mantle of compassion. Compassion means to suffer with. Euthanasia/assisted suicide is a form of discarding.

Ontario: 25% of euthanasia providers may have violated the Criminal Code.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin

On November 12 I published a commentary on Alexander Raikin's research essay that was published in The New Atlantis that I titled: Ontario: At least 428 non-compliant (MAiD) euthanasia deaths. After publishing the article several people emailed me suggesting that compliant or non-compliant, all euthansia deaths involve the killing of a human being and are inherently wrong. I agree.

On November 18, Alexander Raikin's article: A quarter of all Ontario MAiD providers may have violated the Criminal Code. Does Anyone Care? was published by The Hub. Raikin's article is based on the same research that led to his earlier article, accept that his most recent article adds significant historical context to the issue.

Raikin begins his article by stating that Canada legalized (MAiD) euthanasia and assisted suicide in Canada as an exception to the criminal code when it is done based on specificied circumstances, and outside of those circumstances these acts remain criminal acts. Raikin states:

In 2016, following a unanimous Supreme Court ruling in Carter v. Canada, Justin Trudeau decriminalized culpable homicide and counselling or aiding suicide in the Criminal Code, only if done by a physician or a nurse practitioner and if each eligibility requirement for MAID is met. Otherwise, clinicians would not be immune through these exemptions in the Criminal Code.

Some of these requirements include having a grievous and irremediable medical condition, a voluntary request to die not because of external pressure, and the ability to give informed consent. Failure by a physician or a nurse practitioner to submit necessary information on a MAID provision—or failure to inform a pharmacist of the purpose of the MAID prescriptions or to follow provincial guidelines—is also punishable by a prison sentence. It means that a clinician who does not follow any of these rules faces serious criminal punishment.

Raikin points out that even CAMAP (The Canadian Association of MAiD Assessors and Providers agrees with that statement. Their position statement:

“recognizes the need for oversight,” including the guiding principle that it “maintains the public trust and provides accountability for the delivery of MAID against the legislative framework and safeguards.”

Raikin points out that CAMAP lobbied the government to reduce oversight of Canada's euthanasia law.

Yet at the 2018 annual convention for CAMAP, the official summary of the proceedings also described how Quebec’s independent monitoring for assisted dying, Commission des soins de fin de vie, was too thorough: “Reviewing 43 percent of all MAID cases is considered harassment by providers.” CAMAP won. In the 2023 fiscal year, the independent monitoring agency in Quebec sent for further review only 4 percent of MAID cases; and in Ontario, the chief coroner of Ontario classified only 6 percent of MAID cases for full review.

In response Raikin points out that leading euthanasia doctors claim that there is nothing to worry about. Stefanie Green, the past president of the CAMAP said:

“If I break the rules anywhere, there’s criminal liability sitting in the back of my head,”

While Chantal Perrot recently told The Guardian that:

“I have never heard of a case of the MAID criteria being applied wrongly or abusively, or someone who has received MAID who should not have. I’ve heard of none reported by any of the coroner’s offices or any of their provincial oversight groups.”

In response, Raikin published the August 2023 statement by Michel Bureau, the head of Quebec’s independent monitoring board who stated that MAID cases in Quebec 

“are approaching the limits of the law.” 

Raikin also reminds the readers that in 2018, Dirk Huyer, the Chief Coroner of Ontario indicated that there was:

“a pattern of non-compliance, a pattern of not following legislation, a pattern of not following regulation.”

Raikin also points out that a study conducted by Huyer on the first 100 euthanasia deaths in Ontario indicated that from the inception of the law that there was a pattern of non-compliance.

Raikin explains that Huyer told a group of Nurse Practitioners in 2018 that there were

“some…compliance concerns with both the Criminal Code and regulatory body policy expectations, some of which have recurred over time.”

Raikin points out how non-compliance in Ontario has only worsened. The Ontario Chief Coroner (Huyer) pointed out that:

In 2020, his office identified 76 “issues with compliance,” and in 2024 his office identified 428 “issues with compliance.”

Raikin states that the recent report of the Ontario MAiD Death Review Committee found:

A quarter of all Ontario euthanasia providers received at least one compliance issue in 2023, though not a single provider was reported to the police, not even the provider who administered a death that the chief coroner described as “a blatant situation” where “the family and the deceased person suffered tremendously.”

Raikin concludes his article by stating:

It is difficult to understand how these accusations of non-compliance with MAID legislation have remained hidden for so long by all the parties responsible. No provincial report, no coroner statement, not even a leak from a concerned MAID provider or assessor. On the provincial subreddit for Ontario, my article was banned for spouting “false information with the intent to mislead.” It is as good an answer as any: compliance concerns with the Criminal Code are happening, but it seems no one cares.

Previous articles on this topic:

• Ontario: At least 428 non-compliant euthanasia deaths (Link).
• Euthanasia is being used to kill people in poverty, isolation and social suffering (Link).
• Ontario MAiD Death Review stories. Do you have a (MAiD) death story (Link).
• Canadians with disabilities are needlessly dying by euthanasia (Link).
• Ontario Coroner's euthanasia report. Poor at risk of coercion (Link).
• Ontario Chief Coroner report. Some euthanasia deaths are driven by homelessness, fear and isolation (Link).

The Canadian Province of Québec shows the way with euthanasia!

Where are we actually going with all of this? The Canadian Province of Québec shows the way!

Gordon Friesen

By Gordon Friesen

President, Euthanasia Prevention Coalition

Quebec is only one part of Canada you might say? Think again! Quebec does not even have English as an official language. The history of Québec and the British colonies was one of war and conquest. Although not a sovereign country Québec is nonetheless recognized as a "distinct society".

As concerns euthanasia, Canada's Parliament rejected euthanasia in 2010 by a vote of 228 to 59. But only five years later, in defiance of Canada's Criminal Code, Québec invented and proceeded with the application of Medical Aid in Dying (assisted death defined as a normal medical treatment).

When I state that MAID was invented in Québec, that might not be perfectly accurate from an academic point of view. Other people had indeed suggested the use of death as a medical treatment. However, Québec was the first to write that radical new concept into law, and it is they who have the most developed MAID regime on the planet.

This is no small thing, as one other country (Spain), and two American States (New Mexico and Colorado) have since adopted that concept in law. Furthermore, the idea has been enthusiastically picked up in other States (even without mention in legislation as such).

In sum, Québec is at the cutting edge of euthanasia (MAiD) theory and practice. And with all of the main Western countries now toying with medical homicide, essentially on the Québec model: examining Québec experience right now is surely our most accurate way of understanding where the whole of Western Civilization is actually headed.

Extra! Extra! Read all about it!

As it turns out, Québec has just released a yearly MAID euthanasia report (April 2023 to March 2024) which will help us to do just that.

The first take away (of course) is the sheer volume: 7.3% of all deaths, or 5700+ per year, in a population of only 9.1 million! Roughly translated to the scale of U.S.A. this would yield 210,000 medical homicides every year. I am wondering whether that number is big enough to grab the attention of our American friends?

Let us also remember that Québec did not achieve that number deliberately. Quite the opposite: absolutely no one predicted such a thing. Official estimates, before legalization, were for perhaps, 100 per year, or 57 times less! In reality, euthanasia in Québec has simply grown up like the carnivorous plant in the Little Shop of Horrors. This growth just logically stems from the MAiD concept itself, and any jurisdiction which enables that logic must lucidly expect the same.

To be clear, MAiD declares assisted death (assisted suicide or euthanasia) as a medical treatment to end suffering. No more, no less. But no one really seems to have thought it through... For there is a lot of suffering in the world, and a lot of sufferers. If we once decide that it is a medically good idea to kill sufferers in order to end suffering, then, honestly, there is no where to stop short of the kind of planet-busting bomb seen in Sci-fi fantasies. For that would be the only way to end suffering on Earth.

Sloppy here, sloppy there, sloppy, sloppy everywhere

It is this kind of absurd thinking which explains some of the more troubling findings in this report. For example, it is noted that 99.7% of all euthanasia procedures were performed with due respect to Law. However, that statement is also an admission that at least 17 of these deaths were not. And there have been no visible signs of professional retribution.

But that number also seems suspiciously low. In Ontario for example (having a much more conservative attitude to MAID) 428 potentially illegal instances are noted between 2018 and 2023. We can thus imagine that oversight provisions are less stringent from one Province to the next. Furthermore, earlier this year it was semi-officially felt that things were getting out of hand in Quebec to the point where a general letter was sent to Quebec physicians urging them to take a stricter view of eligibility requirements!

Interestingly, also, there are basic accounting discrepancies which lead us to believe that a significant number of euthanasia procedures are not reported at all.

We therefore wonder whether there is any serious intent to actually enforce legal provisions.

Holding their feet to the fire?

Many of my professional friends get very excited when they find that patients are euthanized --in what appears to be a very cavalier (and perhaps even illegal) fashion-- without ever examining what other alternatives might exist. However, these are people who believe that each euthanasia is a tragic failure of society to properly care for its dependent members.

Sadly, the definition of euthanasia as medical care encourages a completely opposite analysis. Viewed from this perspective, suffering simply must stop one way or another. And if procedures and laws must be bent to make that happen: so be it!

Finally (and unpleasant as it may be to consider) this last attitude is also compatible with one even worse: the utilitarian belief that only productive members of society deserve to be maintained. That beyond a relatively modest cut-off level, the only good patient is a dead patient; that the only good file is a closed file; and that the best file of all is one that is closed at the lowest cost.

The bottom line

Behold therefore the Canadian Province of Québec! That is the House that MAID built! Do not assume "it can not happen here"! People in authority who still believe that assisted death might be an exception which will only impact the "most vulnerable" and which can be managed with sufficient government supports, are --to put the thing delicately-- not being quite honest with themselves.

UK assisted suicide bill. The vote will be close.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A private members bill to legalize assisted suicide in the UK, that is being sponsored by Kim Leadbeater MP was recently released and is scheduled to have it's first debate on November 29.

Prime Minister Keir Starmer, the leader of Britain's Labour Party, is a long-time promoter of assisted suicide. During the election Starmer promised that an assisted suicide bill would be introduced with a free-vote on the bill. The July 4, 2024 election resulted in the Labour Party winning a massive majority with 411 out of 650 seats in parliament.

An article by George Eaton that was published in the New Statesman on November 14 not only suggests that the vote on Leadbeater's bill will be close and may in fact be defeated. Eaton states that:

Until recently, the consensus was that assisted dying would pass. Back in 2015, MPs voted by 330 to 118 against changing the law but the Commons now includes many more Labour and Liberal Democrat members (who have generally been sympathetic)...

Eaton explains that the mood in the UK parliament is changing:

Yet the mood is changing fast. Last month, Wes Streeting (Health Secretary) told a Parliamentary Labour Party meeting that he intends to vote against assisted dying on the grounds that palliative care is too poor to allow people a genuine choice. Yesterday the Health Secretary went further, warning that a change in the law could force the NHS to cut services elsewhere. “There would be resource implications for doing it. And those choices would come at the expense of other choices,” he said (having ordered an analysis of the costs by civil servants).

For several reasons, Streeting’s voice carries weight in Labour. As Health Secretary he would be tasked with implementing the bill and he is popular among new MPs in particular (a crucial swing group), with some regarding him as a future party leader. Streeting also voted in favour of legalising assisted dying in 2015 – and converts are often the most persuasive advocates of a position.

Eaton continues by outlining further how views on the bill are changing:

The Health Secretary is one of three cabinet ministers explicitly opposed to assisted dying, the others being Shabana Mahmood – who would be a central figure to the legislation as Justice Secretary – and Jonathan Reynolds, the Business Secretary. Angela Rayner, David Lammy and Darren Jones, the chief secretary to the Treasury, are also expected to vote against (three are publicly supportive: Ed Miliband, Lisa Nandy and Hilary Benn). Ed Davey, one of 72 Liberal Democrat MPs, is another notable opponent of the bill.

Eaton ends his article by stating that the rise of key cabinet ministers opposing the bill and with the lack of time allocated to the debate that the bill may be defeated.

As stated previously, the assisted suicide bill is scheduled for debate on November 29.

EPC Zoom meeting: Alexander Raikin discusses: A pattern of non-compliance with euthanasia in Ontario.

Please share this post with your contacts. 

Zoom meeting: Join Alexander Raikin and Alex Schadenberg on Thursday November 21 at 2 pm (ET) / 11 am (PT).

Topic: A pattern of non-compliance with euthanasia (MAiD) deaths in Ontario.

Register in advance for the meeting:
(Registration Link)

After registering, a confirmation email will be sent with the information to join the meeting.

The New Atlantis published an in-depth research essay by Raikin on November 11. Ontario: At least 428 non-compliant euthanasia deaths.

 Cardus published the research article by Raikin: The Rise of Euthanasia in Canada from Exceptional to Routine in August 2024.

Alexander Raikin is a visiting fellow in bioethics at the Ethics and Public Policy Center and the author of the Winter 2023 feature article “No Other Options.”

UK assisted suicide bill sponsor says there will be less than 1000 deaths per year.

Alex Schadenberg
Executive Director, 

Euthanasia Prevention Coalition

Don't believe Kim Leadbeater when she claims that there will be:

Fewer than 1,000 patients a year in England and Wales are expected to choose assisted dying should the law pass,

The UK assisted suicide law shouldn't be supported even if it were limited to less than 1000 deaths per year, nonetheless, Leadbeater's comments are reminiscent of the comments made by Gaétan Barrette, Québec's Heath Minister when Québec legalized euthanasia who stated that there would only be 100 deaths per year.

Both Leadbeater and Barrette claimed that the numbers of deaths would be low and they argued that they were introducing the "tightest" regime in the world.

Gaétan Barrette

It didn't take very long for Barrette to be proven wrong. An article by Caroline Plante that was published by the Montreal Gazette, on October 27, 2016 explained that in the first 7 months of the law there had already been nearly triple the number of projected euthanasia deaths. Plante reported:

The minister presented Quebec’s end-of-life care commission’s first report at the National Assembly on Thursday. He expressed surprise that since the law came into effect Dec. 10, 2015, 262 people have resorted to what the provincial government calls “end-of-life care” and what Ottawa refers to as voluntary euthanasia.

“I mentioned many times that I was expecting about 100,” Barrette said during the news conference. “It’s almost three times that. Actually, on a one-year period, it will be over 300 … that in itself is surprising to me.”

Barrette then stated that the number of euthanasia deaths was low compared to the Netherlands which was disingenuous since the Netherlands had legalized euthansaia in 2001 and had a track record with yearly euthanasia increases.

What Barrette did not say in the Québec National Assembly was that 14% of the euthanasia deaths did not comply with the law.

Leadbeater should be aware that in 2023 Québec had 5686 euthanasia deaths which represented the highest euthanasia rate in the world at 7.3% of all deaths. 

If legalized, how long will it take for the UK to rival the number of Québec euthanasia deaths?

Leadbeater is following the same strategy manual as other jurisdictions by claiming that their legislation is "tight" and minimizing the projections of deaths. 

After legalization they will expand the law, based on equality and compassion, by either eliminating some of the "safeguards" or by changing the interpretation of the law to enable more killing.

Heart-wrenching lessons from Canada's euthanasia regime.

This article was published in the Scotland Herald on November 12, 2024 titled: Heart-wrenching lessons from Canada's Assisted Dying regime.

By Dr Ramona Coelho

Twenty years ago, just out of medical school, I couldn’t have imagined that vulnerable patients might one day feel their suffering was so poorly dealt with that they'd ask their doctor to end their lives. Since our country, Canada, legalised Medical Assistance in Dying (MAiD) in 2016, we have seen over 60,000 MAiD deaths by 2023, with exponential yearly growth rates. Quebec’s recent report reveals that their MAiD annual death rate has surpassed 7%, and they can’t even assess the quality of palliative care provided.

The Canada I grew up in valued dignity and protected the vulnerable. Now, inadequate care and weak safeguards are pushing Canadians with disabilities toward assisted death. A recent report from an Ontario government committee I sit on confirms the warnings of Canadian and United Nations human rights experts: people are choosing death because they lack essential supports and services.

Take the report’s review of a man in his 40s with inflammatory bowel disease. Isolated, unemployed, and struggling with mental illness and addiction, he depended on family for housing and financial support.

Rather than receiving care for his mental health, a psychiatrist asked if he knew about MAiD. In the end, a MAiD provider personally drove him to the location where he ended his life — without input from his family, despite their deep concerns. Canada claims to have a social and health safety net, but in his case, was he not pushed toward death?

There are countless other stories like his — stories revealed in reports, the media, and those that I now frequently encounter first hand. Every time I hear them, I’m reminded that what was meant to be an exceptional option has come at an unacceptable cost.

I see patients who are trapped in a system that doesn’t care enough for them. For many, MAiD is the only “compassionate” option when palliative care, mental health support, and basic social services are inaccessible.

These stories are heart-wrenching, and they are far from rare. The report reviews the case of a woman with multiple chemical sensitivities who applied for MAiD because she couldn’t find housing that met her medical needs. She didn’t want to die — she wanted to live in a way that felt safe and supported. But when faced with few options, death seemed to be the only choice.

I care for many elderly and disabled patients, those battling loneliness, isolation, and the quiet anguish of feeling like a burden due to societal neglect. In Canada, MAiD is routinely raised to the elderly and disabled as a care option — sometimes even before palliative care is explored.

I recall a conversation with a man who felt he was no longer needed, that his family would be better off financially if he chose MAiD. I’ve also seen families pressuring elderly relatives, concerned about the financial burden of supporting them. It breaks my heart that, in Canada today, death can seem easier to arrange than creating a safe supportive community where everyone feels valued and connected.

As I prepare to testify in Scotland, I think of the patients I’ve seen swept along by a system that no longer protects them.

In 2016, MAiD was meant for those at the end of life, with reassurances that it would never be offered as a "solution" for social suffering. But those promises have crumbled, replaced by an increasing push for accessibility.

Today, in Ontario, most patients choosing MAiD who are not dying come from marginalised, poor backgrounds. They are younger, with a higher percentage being women (61%). These groups are more vulnerable, often suffering from social deprivation that could be treated with the right support, yet MAiD is offered as a quicker option than suicide prevention and care.

Worryingly, MAiD recipients often lack adequate mental health and disability supports. In Ontario, only 8.6% of those not dying who chose MAiD were offered housing support, and only 6% were offered income support. Those not dying but accessing MAiD are less likely to list an immediate family member as their next of kin — often naming a friend, lawyer, or healthcare provider instead, signalling a stark lack of social support.

The situation continues to worsen. When life’s difficulties become unbearable, MAiD is now presented as an answer, rather than addressing the root causes of despair. How have we, as a society, reached a point where death can sometimes be offered more easily and as a less costly solution than investing in social and mental health services, things that make life worthwhile?

Individual autonomy has been used as an argument to blow open access to MAiD. Mental illness as a sole medical condition to access MAiD will be allowed in 2027, and federal consultations about MAiD advance directives are currently underway.

Quebec has taken matters further, breaking the criminal code by allowing advance directives for MAiD, simply requesting non-prosecution for offenders. Our federal joint parliamentary committee on MAiD has recommended MAiD for children deemed capable of making their own healthcare decisions.

Look at Canada today and ask if this is the reality you want for your own people. Our experiences show that the road to legalising assisted dying is a slippery one. It starts with promises of compassion that have led to a system where some patients feel pushed toward death. This is the opposite of autonomy and choice – it is desperation and structural coercion to die. I would not wish this reality upon any nation.

If Scotland truly wants to offer compassion, it should strengthen palliative care and provide social support that help people live with dignity. Compassion is not offering death to those who feel like burdens or are lonely (which are highly cited reasons for choosing MAiD in Canada) — it’s lifting that burden by creating a society where people feel valued, and every person feels supported and safe.

Previous articles by Dr Ramona Coelho.

• Canadians with disabilities are needlessly dying by euthanasia (Link).
• Canada's assisted dying regime should not be expanded to include children (Link).
• Euthanasia for those with mental illness should not be on the table (Link).

Dr Ramona Coelho is a family physician whose practice largely serves marginalised persons in London, Ontario. She is a senior fellow at the Macdonald-Laurier Institute and co-editor of the upcoming book Unravelling MAID in Canada: Euthanasia and Assisted Suicide as Medical Care. She presented evidence to Holyrood on Liam McArthur MSP's Assisted Dying for Terminally Ill Adults (Scotland) Bill.

Ontario: At least 428 non-compliant euthanasia deaths.

The reason the public has been left in the dark about Canadian euthanasia providers’ noncompliance with the law is simple: the authorities have decided there is nothing to see.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

A research essay by Alexander Raikin that was published by the New Atlantis on November 11, 2024 uncovers that there have been at least 428 non-compliant euthanasia deaths in the province of Ontario. In his research essay Raikin sets out the tone of his conclusions in his opening paragraph by stating:

For years, there have been clear signals that euthanasia providers in Canada may be breaking the law and getting away with it. That is the finding of the officials who are responsible for monitoring euthanasia deaths to ensure compliance in the province of Ontario. Newly uncovered reports reveal that these authorities have thus far counted over 400 apparent violations — and have kept this information from the public and not pursued a single criminal charge, even against repeat violators and “blatant” offenders.

Firstly, I would like to thank Alexander Raikin for the incredible research and continued research into Canada's euthanasia law. Raikin's essay is long but thorough. I can assure you that Raikin is only uncovering the tip of the iceberg.

Raikin outlines his research by establishing the parameters of the law. He explains that Canada's euthanasia law is regulated by criminal law and through provincial and federal regulations. Non-compliance with the law may lead to convictions and jail sentences.

Raikin has conducted in-depth research into the compliance with the euthanasia law in Ontario and uncovered that non-compliance with the law. Raikin reports:

From 2018 to 2024, in presentations held behind closed doors and in reports that were nominally public but garnered little attention, Huyer has shown that his office has identified hundreds of “issues with compliance” with the criminal law and regulatory policies. In 2023, his office raised these concerns for a quarter of all euthanasia providers in Ontario.

Most of the information in these documents, which were shared with The New Atlantis by three physicians who had access to them on condition of anonymity, is being newly made public or reported on for the first time in this article. Raikin writes:

After more than four hundred identified issues with compliance, ranging from broken safeguards to patients who were euthanized who may not have been capable of consent, Huyer’s office has failed to alert the public or take any steps to prosecute offenders. Whether or not these hundreds of “issues” are in fact violations of criminal law is unclear precisely because none of them have been referred to law enforcement for investigation. Instead, Huyer’s office has deemed virtually all of them as requiring nothing more than an “informal conversation” with the practitioner or an “educational” or “notice” email. Even in one egregious case, in which the practitioner was found to have violated multiple legal requirements, and which Huyer himself described as “just horrible,” his office reported the case only to a regulatory body instead of the police.

Non-compliance with the law existed from the law's inception. Raikin explains:

In June 2017, a year after euthanasia was legalized in Canada, Dirk Huyer and two co-authors published a paper in the journal Academic Forensic Pathology that examined the first one hundred euthanasia deaths in Ontario based on reports to his office by euthanasia providers. The paper shows early warning signs that providers were not complying with the federal criminal regulations for MAID.

Raikin quotes from the paper:

“The MAID regulations require clinicians to notify the pharmacist of the purpose of the MAID medications before they are dispensed,” the paper notes. “However, some physicians listed that they did not abide by these regulations.” Only 61 percent did. Federal legislation at the time also required a 10-day waiting period between the request for euthanasia and the administered death to ensure that patients really did wish to die, a safeguard that could be waived only if the patient was approved and on the verge either of losing capacity to consent or of imminent natural death. Yet according to the paper, euthanasia providers recorded expediting deaths for reasons including not only loss of capacity or imminent death but “persistent requests” and “inconvenient timing of the death in relation to other familial life events.”

Huyer admits in 2018 that these issues with non-compliance never went away. Raikin writes:

In an October 2018 memo to all Ontario health care practitioners, Huyer announced that his office would implement a new system “to respond to concerns that arise about potential compliance issues.” That is because “some case reviews have demonstrated compliance concerns with both the Criminal Code and regulatory body policy expectations, some of which have recurred over time.”

In the new system, each compliance issue gets assigned a “level” of severity, with 1 being the least severe and 5 the most severe, along with an action the Coroner’s Office will take to address it, from an informal conversation (Level 1) to a report to the police (Level 5).

In a video uncovered by Raikin, Huyer tells a group of Nurse Practitioners that a pattern of non-compliance continues. Raikin writes:

At a private monthly webinar of Ontario nurse practitioners in December 2018, available as an unlisted video on YouTube where it has been viewed only a few dozen times, Huyer further explains...

...there is a “very small handful” of practitioners who “are not responding to our educational input and are maintaining the same practice repetitively. And so we see a pattern of noncompliance, we see a pattern of not following legislation, a pattern of not following regulation, and frankly we can’t just continue to do education to those folks if they’re directly repeating stuff that we’ve brought to their attention.”

In the video Huyer outlines one of the cases:

One is a blatant situation that’s published through the College of Physicians and Surgeons of just being completely unprepared and bringing wrong medications. They brought scopolamine and Ativan. Those were the drugs that the clinician brought to the home to administer MAID. And it was just horrible. It was horrible. The family, and I’m talking about what’s public, so this isn’t anything non-public, the family and the deceased person suffered tremendously.

Huyer explains that he reported this case to the College of Physicians and Surgeons who investigated the case and they concluded that the College:

“was of the view that Dr. Tjan” — the euthanasia provider in this case — “continued to underestimate the magnitude of providing medically-assisted death and the responsibility attached.”

Raikin states that Dr. Eugenie Tjan remains a licensed physician in Ontario and she continues to practise palliative care and euthanasia.

Raikin points out that if this case did not trigger a criminal investigation, no wonder the compliance concerns that Huyer’s office identifies have received so little public attention. Meanwhile, out of sight, the number of concerns continued to rise.

When Raikin asked Huyer by email about why no cases have been referred to law enforcement, Huyer replied that:

..the responses “are case specific and we look at each case wholistically.” If his office believes that “the MAiD process was overall appropriate” and “the issue was isolated,” then “we do not notify other organizations, e.g., regulatory bodies or law enforcement.”

Huyer gave a presentation in September 2020 titled: “Monitoring and Oversight of Medical Assistance in Dying in Ontario.” Raikin reports:

Dr. Huyer gave a presentation on “Monitoring and Oversight of Medical Assistance in Dying Ontario” at a symposium of the Canadian Association of MAID Assessors and Providers. According to slides The New Atlantis has obtained of this presentation, Huyer’s office identified 76 “issues with compliance” since it had implemented the level system in late 2018, roughly a two-year span. All of these compliance concerns were assigned one of the first three levels of severity, triggering at most a “notice email” to the practitioner.

Based on the 76 identified issues, Huyer responded by 16 cases - Informal conversation/email with the provider, 51 cases - sent an educational email, 9 cases - sent a notice email. Raikin continues:

Yet the concerns were not insignificant. They fell into two categories, the first of which was problems with “documentation and compliance with legislation.” This included “poor/no completion of accompanying assessment notes” on how eligibility for euthanasia was decided by the clinician. It also included “missing documents,” and “partial completion / no completion of federal reporting requirements by clinicians.”

That this information is missing or incomplete in some cases should be a very serious matter. After all, the mandatory reporting exists to establish that the requirements under criminal law for ending thousands of lives were met.

Raikin points out that ignoring the 10-day reflection period (waiting period) in the law, that was removed from the law in March 2021, was a common issue and the capacity to consent was a second serious issue with non-compliance.

When Canada legalized euthanasia it did so under the pretense that the law would be limited to people who were competent adults who were capable of consenting and yet one of the key areas of non-compliance was the capacity to consent.

Raikin continues:

Compounding these problems for the Coroner’s review process is that, after the patient’s death, it is very difficult and perhaps impossible to find out whether a patient in fact did or did not have capacity to consent to be euthanized. In his presentation, Huyer notes “consequent challenges in determining the capacity of a patient seeking MAiD from an oversight perspective after death has occurred.”

In his presentation to the 2024 annual conference of the Canadian Association for MAiD Assessors and Providers (CAMAP) Huyer gave a presentation titled: “Lessons Learned from the Coroner," Raikin reports that Huyer:

providing more detailed information up through 2023. The slides The New Atlantis has obtained of this presentation show that for 2023 alone, Huyer’s office identified 178 compliance problems — an average of one every other day — bringing the total since implementation of the level system to 428.

Raikin explains that of the 428 known cases of non-compliance that only 4 cases triggered a response to the regulatory body and not a single case was reported to the police.

Raikin points out that a quarter of all euthanasia providers have had a compliance issue, 12% of all dementia euthanasia cases had compliance issues, 8% of chronic pain euthanasia deaths had compliance issues, 15% of euthanasia cases for people who are not terminally ill had compliance issues. Raikin reports that Huyer presented this at the CAMAP conference:

Again for euthanasia deaths where the patients were not terminally ill, in some cases practitioners reported that they were not experts in the illness that caused the person’s suffering, and no outside expert was consulted — violating a safeguard mandated by federal criminal law. In a recorded video of Huyer’s conference presentation, also obtained by The New Atlantis, he described these cases as “a learning opportunity, let’s put it like that.” (The share of cases Huyer stated at the time, both in the video and the slide show, was 6 percent. In a revised report by the Coroner’s Office that has since been publicly released, the number is 1.7 percent.).

It is interesting to note that 10 euthanasia providers in Ontario had provided 25% of the euthanasia deaths.

Violations of the assessment period for non-terminal Track 2 euthanasia deaths.

In March 2021 Canada expanded it's euthanasia law to people who were not terminally ill but may have had chronic conditions. These cases are known as Track 2 euthanasia deaths and they require a 90-day assessment period before the death can be completed. Raikin uncovers significant violations concerning Track 2 deaths. Raikin writes:

In a May 2024 memo to Ontario euthanasia practitioners, the Coroner’s Office describes the “case example” of a person suffering from stroke, neurocognitive disorder, and vision loss whose assessment period was 71 days. The memo notes as a “learning point” both that the counting of the 90 days began too early in the process and that “the assessment period was incorrectly shortened” — the person was not imminently losing capacity to consent. Rather, the date of death was chosen by the person’s spouse “based on the spouse’s preference of timing.” Parenthetically, the memo notes that this “raised considerations regarding potential impacts to voluntariness and coercion.” Notably, this public report — unlike Huyer’s private presentations — did not identify whether physicians failed to comply with legislation.

Raikin then comments on the normalization of non-compliance in Ontario concerning it's euthanasia law.

Canada’s criminal law on euthanasia states that “Medical assistance in dying must be provided with reasonable knowledge, care and skill and in accordance with any applicable provincial laws, rules or standards.” And yet the Office of the Chief Coroner of Ontario has decided that euthanasia practitioners’ ongoing failures to comply are best resolved through emails. The highest-level response it routinely applies, Level 3, happens “when there are identified issues with statutory requirements and/or repeated practice issues.” The Coroner’s Office in these instances sends a “notice email.”

Level 4 is applied in cases of statutory requirements (such as “eligibility requirements”) and cases of “significant” issues with practice. This level triggers a report to a regulatory body. Huyer’s 2024 presentation offers as a hypothetical example the euthanizing of a minor. In other words, according to the Chief Coroner’s rubric in the presentation, and to the Coroner’s public website, last updated in May 2024, euthanizing a minor would not automatically lead to a police report.

Raikin explains that in 2024 there was one Level 4 reponse but no information has been made available about that case but he did find information about another earlier Level 4 reponse. Raikin explains:

This is the case of a woman whose son brought before the College a complaint that she was improperly assessed before being euthanized and that the roughly 4 weeks between her MAID request and her death was not enough time to understand her condition, since she was not in any physical pain.

Upon reviewing the case, the College’s investigative committee decided to not take any action. The committee reasoned that “the Coroner’s office … is responsible for reviewing each case to ensure that all the proper checks and balances were in place and that the process was followed properly,” and it “did not find any concerns.”

Raikin points out, even a case that is deemed to be serious by the Ontario Coroner and sent to the Ontario College of Physicians and Surgeons for assessment does not lead to any redress.

I notice that there wasn't even a temporary suspension of a medical license.

Raikin also questions why information is not being shared with the public. Huyer reponded by stating that:

“We share regularly through Health Canada and our presentations. Nothing was confidential — we are working to more systematic reporting.” In a follow-up, he added: “we have widely shared our response framework and have shared the number of levelled responses to a number of media outlets and at conferences and meetings over the past years.”

But Raikin points out that

Some of the information in this article was previously public, as noted throughout. But in many cases it was public in name only, as it remained at obscure online locations or available only to MAID professionals, and had not been previously reported on in the media. ...Finally, searches on multiple key phrases confirm that the 2020 and 2024 slideshow presentations at the center of this article had never been released publicly.

Raikin then states:

If it seems like Canada’s oversight of euthanasia should receive closer public, medical, and law enforcement scrutiny, that is a concern shared by at least two members of Ontario’s MAID Death Review Committee — an advisory group formed by the Chief Coroner to help improve the MAID system in the province — to whom I spoke for this article.

Trudo Lemmens, a University of Toronto law professor told Raikin that:

“In my opinion, any violation of the MAID law, considering that it’s a criminal law, should be reported to the police and to the College — as a matter of principle — and should certainly be investigated by an independent prosecutor…. I don’t know why that hasn’t happened,”

It’s a serious issue. I mean, this is a criminal law and I’m worried that the lack of referring for prosecution and for investigation by the College of Physicians and Surgeons reflects a kind of normalization of MAID as some kind of inherent beneficial practice.”

Dr. Ramona Coelho, a family physician from London, Ontario, and a senior fellow of the Macdonald–Laurier Institute, a public policy think tank, told Raikin by email:

“it has been distressing to learn that some authorities, well aware of non-compliance with the law, did not publicly report them.”

Raikin concludes his essay by stating:

The reason the public has been left in the dark about Canadian euthanasia providers’ noncompliance with the law is simple: the authorities have decided there is nothing to see.

Thank you to Alexander Raikin for his incredible research. It must be pointed out that Ontario represents about one-third of all euthanasia deaths in Canada. Considering the number of euthanasia deaths in British Columbia and Québec and the number of concerning cases that have been published in the media, I would not be surprised if there are a similar number of non-compliant cases in British Columbia alone and we already know from the Québec reports that a significant number of non-compliant cases have occurred in "La Belle Province."

Previous articles by Alexander Raikin:

• Insight into the cautionary tale of Canada's euthanasia regime. (Link).
• The rise of euthanasia in Canada, from exceptional to routine. (Link).
• Canada's Ministry of Death (Link).

The UK introduces bill to legalize assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A long-awaited bill to legalize assisted suicide in England and Wales was introduced and is likely to be debated on November 29. A report by Paul Godfrey for UPI news on November 2 states:

The Terminally Ill Adults (End of Life) Bill, a so-called private members' bill introduced by Labor MP Kim Leadbeater, would legalize assisted dying for mentally competent patients in England and Wales who have made a "clear, settled and informed decision" and have not been subject to any form of coercion or pressure.

Kim Leadbeater states that this is the tightest assisted dying bill in the world. Godfrey reported:

The patient must make two witnessed and signed declarations of their desire to die and two doctors must independently certify, a minimum of seven days apart, that the patient meets the requirements before one of them must go in front of a High Court judge.

The judge will have the power to cross-examine the patient and any other person germane to the case before signing off on the request. After that, there would be a further 14-day cooling-off period.

The Euthanasia Prevention Coalition will soon provide a further analysis of the bill.

From the outset the concept that the person has made a "clear, settled and informed decision" to be killed and has not been subject to any form of coercion or pressure will be impossible to ensure. These words are only a "sales technique" to convince politicians to support the bill.

American Election results. Where to from here?

By Gordon Friesen
President, Euthanasia Prevention Coalition

Many people have been very surprised --some elated, and some disappointed-- by recent political events in America. 

As President of the Euthanasia Prevention Coalition I think it is appropriate to underline the fact that all of our active members, regardless of their personal places on the political spectrum, will continue to carry on "business as usual" under the new American administration. For our concerns transcend Party politics.

I have lost many elections in the last fifty years or so since I first cast a ballot. On each occasion I was told the sky would fall. But the sky is still there. I have voted for candidates who won a number of elections in the same period. In each case I was told we would soon be led into the Promised Land. But nothing of the sort has occurred.

I am not saying elections do not matter. They do. But if we truly believe that the future of humanity depends upon our chosen party winning at the polls, and they lose. What then?

I would like to say without qualification: that I believe our basic civilization has always depended most upon people who tirelessly and deliberately determine to treat one another with love, respect and kindness, regardless of the varied regimes in which they have lived.

My own personal adaptation, however, is neither of the "burn it down" or "infinite submission" variety. I believe that our current environment of comparative political freedom offers opportunities of action which are not limited to partisan contests. In short: personal experience and study in specific areas enables us to learn more than our fellows, and demands of us the effort to share that knowledge.

Ironically enough, it is virtually impossible for me to offer any general examples, however truthful, for it is the nature of partisan conflict to disagree on everything.

And yet I have deep experience, and extremely strong personal views, on this one question of euthanasia. In fact, the strength of those views is such that I do not care which party defends or opposes them. In particular, I will not be bullied to modify those views in order to be accepted within any political grouping.

Simply stated: I intend to pass the next four years under President Trump in exactly the same way that I have passed the last four years under President Biden (and the previous Trump administration, and the years of Bush Jr. and B. Obama, and others before that).

I believe that euthanasia (and indeed any sort of "assisted death") is categorically bad for civilization (which for thousands of years has patiently evolved principles diametrically opposed to any such practice); specifically bad for those people who are considered (or even perceived) as eligible for euthanasia (since their lives are devalued and physically threatened --almost always against their will); specifically bad for our human relationships because of the constant distrust caused by throwing former loved-ones under the bus (and the fear of being thrown there oneself); specifically bad, also, for the primary mission of medicine which has been illegitimately permitted to carry out this anti-human program.

I believe that I can demonstrate these facts without running afoul of the litmus tests of either political party. I believe this is possible, because these are indeed facts (which can be demonstrated through observation), not mere ideological constructs (which can only be affirmed).

In short, as far as it is in my power as EPC President, and knowing the minds of my fellow Board Members (and witnessing the unwavering activity of our co-Founder): there will be no change at all in the activities of the Euthanasia Prevention Coalition, which will continue to advocate for euthanasia-free society in exactly the same way we have done (together and apart) for the last 30 years.

Gordon Friesen, Montreal, November 11, 2024