Ronald W. Pies, MD testimony opposing Massachusetts assisted suicide bill.

This testimoney was sent to the Euthanasia Prevention Coalition with permission to publish.

Dr Ronald Pies

Written Testimony of Ronald W. Pies, MD

Massachusetts psychiatric physician and medical ethicist

In opposition to H. 2505/S.1486 MASSACHUSETTS END OF LIFE OPTIONS ACT

Submitted to Massachusetts Joint Committee on Public Health - March 29, 2025

Dear Committee Members:

As a Massachusetts psychiatrist and medical ethicist, I write in firm opposition to H.2505/S.1486 MASSACHUSETTS END OF LIFE OPTIONS ACT—bills that would effectively legalize physician-assisted suicide (PAS) in Massachusetts. 

First, it is important to note the profound ethical problems inherent in the practice of PAS, misleadingly called “aid in dying” in some contexts. (PAS does not “aid” the natural dying process; rather, it terminates dying by terminating the patient, via provision of lethal drugs). The American Medical Association; the American Psychiatric Association; the American College of Physicians; and the National Council on Disability have all rejected physician-assisted suicide. [1] Neither the Massachusetts constitution nor the U.S. Constitution contains a right to assisted suicide; therefore, no individual has the right to authorize another to kill him or her in violation of federal and state criminal laws. (Washington v. Glucksberg, 521 U.S. 702, 735 (1997). Instead, Massachusetts has an unqualified interest in the preservation of human life. Furthermore, in the Massachusetts case of Kligler v. Att’y Gen., 491 Mass. 38, 70 (2022), the court rejected claims that a person has a “right” to assisted suicide. The court found no basis to “conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights.”

Contrary to popular misconceptions, the vast majority of persons requesting PAS are not in the grip of severe, intractable pain and suffering [2]. As data from Oregon have shown, the most common reasons for requesting medical aid in dying were fears regarding loss of autonomy (97.2%), inability to engage in enjoyable activities (88.9%), and loss of dignity (75.0%) [3] These understandable fears are best dealt with via empathic, face-to-face counseling and psychotherapy—not with the ingestion of poison.

Furthermore, a peaceful death is by no means guaranteed using current methods of PAS, as a recent piece by Lo pointed out: 

“Physicians who support PAD need to consider how to address the potential for adverse outcomes, including longer time to death than expected (up to 24 hours or more), awakening from unconsciousness, nausea, vomiting, and gasping.” [4] 

Data collected between 1998 and 2015 showed that the time between ingestion of lethal drugs and death ranged from 1 minute to more than 4 days. During this same period (1998-2015), 27 cases (out of 994) involved difficulty ingesting or regurgitating the drugs, and there were 6 known instances in which patients regained consciousness after ingesting the drugs. However, it is difficult to know the actual rate of drug-induced complications, because in the majority (54%) of cases between 1998 and 2015, no health care professional was present to attend and observe the patient’s death [5].

This last point highlights an additional ethical flaw in so-called “end of life options” bills, including H. 2505/S.1486: they do not require the presence of a physician or other medical personnel at the time the patient ingests the lethal drugs. In addition to denying the patient medical oversight of the suicide, this amounts to abandonment on the part of the physician who authorized the assisted suicide. To compound the ethical lapse, the physician is then permitted to falsify the cause of the patient’s death; i.e., “The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death” (lines 195-196 H. 2505/S.1486 ). This is plainly fraudulent, unethical, and inimical to research aimed at tracking the natural course of terminal illnesses.

A major failing of this bill is its ambiguity regarding the concept of “terminal illness.” The bill defines “Terminally ill”, as “having a terminal illness or condition which can reasonably be expected to cause death within 6 months, whether or not treatment is provided.” [italics added]. The phrase “whether or not treatment is provided” is vague and indecipherable. Does this mean that if a patient with, say, type 1 diabetes or anorexia nervosa refuses evidence-based treatment—and thus, is likely to die within 6 months—the patient nevertheless meets the criterion for “terminal illness”? Would a patient with a potentially fatal but treatable infectious disease who refuses treatment be classified as “terminally ill?” Such an interpretation radically distorts the historical meaning of the term “terminally ill.” Moreover, in practice, there are significant limitations in a physician’s ability to predict patient outcomes; this is true even for end-of-life physician specialists. For example, in a study of 364 doctors who provided survival estimates for 468 terminally ill patients, only 20% of predictions were accurate.[6]

Psychiatric and Medico-legal Considerations

As a psychiatrist, I find the bill’s safeguards against missing underlying psychiatric illness—which may compromise informed consent—woefully inadequate. Yes, the bill does mandate (section 8) that:

“…An attending physician shall refer a patient who has requested medical aid in dying medication under this chapter to counseling to determine that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. The licensed mental health care professional shall review the medical history of the patient relevant to the patient’s current mental health and then shall submit a final written report to the attending physician.”

However, the bill defines licensed mental health professional very broadly, as “…a treatment provider who is a psychiatrist, psychologist, psychiatric social worker or psychiatric nurse and others who by virtue of education, credentials and experience are permitted by law to evaluate and care for the mental health needs of patients.” In what is literally a life-or-death determination, it is far from clear that the average “mental health professional” possesses the requisite skill set to assess mental capacity in the setting of terminal illness—an assessment that would challenge the skills of even a forensic psychiatrist.

Furthermore, there is no requirement in the bill for psychological evaluation at or very near the actual time of lethal drug ingestion, despite the fact that the patient’s mental status and mental capacity may fluctuate from day to day or week to week, in the course of a terminal illness. In addition, it seems that the bill would permit evaluation and “counseling” of the patient without even a face-to-face meeting; i.e., the process could be conducted via “telemedicine”—to my knowledge, a completely untested method of determining mental capacity or providing counseling in the context of a terminal illness.

Finally, there are no well-defined procedures specified in the bill by which any unused lethal drugs would be located and disposed of, in the event the patient elects not to ingest them. The bill merely states, “Any medical aid in dying medication dispensed under this chapter that was not self-administered shall be disposed of by lawful means. The medication dispenser shall be responsible for informing the individual collecting the medication what disposal by lawful means entails.” This says nothing about when the unused medication shall be disposed of—a day after the patient decides not to ingest it? A week? A month? What about the risk that in the interim, a family member—perhaps a young child—will happen upon the lethal medication and ingest it? A recent report in the Journal of Emergency Medical Services reveals that this possibility is not merely theoretical. [7] Do Massachusetts physicians really want to assume medico-legal liability in such a scenario? The bills as written are an invitation to litigation.

Conclusion

End-of-life care deserves far better than effectively handing terminally ill patients a bottle of lethal drugs—a practice that flies in the face of more than two millennia of Hippocratic medical practice. As Dr. John R. Peteet and I have argued, physician-assisted suicide will lead to “distorting the physician’s role; cheapening individual life; and abandoning the most vulnerable people” at their time of most urgent need. Surely as a society we can do better, by providing optimal, accessible psychiatric and palliative care. [8] As physician and medical ethicist Dr. Leon Kass eloquently put it,

“The legalization of physician-assisted suicide [perverts] the medical profession by transforming the healer of human beings into a technical dispenser of death. For over two millennia the medical ethic . . . has held as an inviolable rule, “Doctors must not kill.” The venerable Hippocratic Oath clearly rules out physician-assisted suicide. Without this taboo, medicine ceases to be a trustworthy and ethical profession. . . . We need to care for the dying, not make them dead.” [9]

Respectfully,

Ronald W. Pies, MD ronwpies@gmail.com
Professor Emeritus of Psychiatry
Lecturer on Bioethics & Humanities
SUNY Upstate Medical University;
Clinical Professor Emeritus of Psychiatry
Tufts University School of Medicine

References

1. Snyder Sulmasy L, Mueller PS; Ethics, Professionalism and Human Rights Committee of the American College of Physicians. Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper. Ann Intern Med. 2017 Oct 17;167(8):576-578. doi: 10.7326/M17-0938. Epub 2017 Sep 19. PMID: 28975242.

2. https://www.hcplive.com/view/twelve-myths-concerning-medical-aid-in-dying-or-physicianassisted-suicide

3. Loggers ET, Starks H, Shannon-Dudley M, Back AL, Appelbaum FR, Stewart FM. Implementing a Death with Dignity program at a comprehensive cancer center. N Engl J Med. 2013;368(15):1417-1424. doi: 10.1056/NEJMsa1213398

4. Lo B. Beyond legalization - dilemmas physicians confront regarding aid in dying. N Engl J Med. 2018;378(22):2060-2062. doi: 10.1056/NEJMp1802218.

5. Oregon Health Authority, Public Health Division, Center for Health Statistics. Oregon Death With Dignity Act: data summary 2016. oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year19.pdf. Published February 10, 2107. Accessed June 6, 2018.

6. Nicholas A. Christakis, Extent and Determinants of Error in Doctors’ Prognoses in Terminally Ill Patients: Prospective Cohort Study, 7233 THE BMJ 469, 469-73 (2000).]

7. Death with Dignity: When the Medical Aid in Dying Cocktail Gets into the Wrong Hands. https://www.jems.com/patient-care/death-with-dignity-when-the-medical-aid-in-dying-cocktail-gets-into-the-wrong-hands

8. https://www.telegram.com/story/opinion/columns/2023/01/29/dr-john-peteet-and-dr-ronald-pies-oppose-physician-assisted-death/69831539007/

9. Kass LR. Dehumanization Triumphant. 1996. See: https://www.psychiatrictimes.com/view/deferring-mastery-death-hippocrates-judge-gorsuch-and-autonomy-fallacy

Dying with Deception: Exposing Dying with Dignity Canada's Dangerous Lies and the UN’s Call for Truth

The following article was published by Kelsi Sheren on her substack on March 28, 2025.

By Kelsi Sheren

Dying with Dignity Canada has once again shown its true colors—playing fast and loose with the truth, deliberately misleading donors, and cynically dismissing legitimate human rights concerns. Their response to the UN's critical stance against Canada's Track 2 MAID exposes not only their arrogance but also their willingness to CONTINUE to sacrifice vulnerable lives for the sake of ideological purity.

Let's cut through their carefully spun narrative, as usual they continue to make themselves out to be the victims here.

First, Dying with Dignity claims the UN's concerns are based on "unfounded reasoning and unsubstantiated grounds." This is a blatant lie, I often wonder how they write these articles with such conviction knowing they are intentionally lying to the vulnerable. The UN's Committee on the Rights of Persons with Disabilities meticulously and systematically reviewed substantial evidence provided by disability advocates, human rights experts, and firsthand testimonies clearly demonstrating how Track 2 MAID disproportionately pressures and endangers vulnerable populations.

Dying with Dignity’s insistence that the committee merely parrots the claims from the Ontario court challenge is another deliberate misrepresentation. The UN's findings are based on comprehensive international human rights analysis, not merely untested allegations. These concerns aren't hypothetical—they’re rooted deeply in real-world suffering, coercion, and injustice documented extensively by frontline advocates and medical professionals. Their willingness to discount real, true accounts of abuse is sadistic. We have a plethora of cases including Alicia Duncan's mother's case and at this point a disturbing amount of families have reached out with similar stories of abuse.

Dying with Dignity falsely asserts that structural vulnerabilities like poverty, housing insecurity, and racial discrimination don't substantially influence MAID requests, which once again we have a significant proof that this is happening all across the country. They conveniently ignore countless credible studies and heart-wrenching stories from Canadians whose desperate social circumstances have driven them toward assisted death. Their denial dismisses the tragic reality of disabled Canadians pressured into MAID not because they desire death, but because they are systematically denied dignified lives.

Dying with Dignity hypocritically promotes "policies that ensure stable housing, income, and healthcare" while simultaneously advocating for expanded access to MAID—a twisted contradiction. Their rhetoric of empowerment disguises a disturbing disregard for the realities faced by the disabled community. They speak of autonomy yet refuse to address the conditions stripping disabled Canadians of meaningful choice. This is not advocacy; it's negligence bordering on cruelty.

Lastly, let's get something crystal clear: disability rights advocates aren't seeking to limit autonomy; they’re desperately fighting to protect it and what we have left. Genuine autonomy cannot exist when death is presented as an easier alternative than addressing the systemic failures trapping people in suffering. Once again, we can access death care but we CANNOT access proper healthcare or support for disability rights and support.

Dying with Dignity owes Canadians—and especially their donors—the truth.

Knowing them and who is involved with them, this will never happen.

It's time they stopped manipulating the narrative, stopped hiding behind faux-compassion, and started genuinely supporting policies that enable life, dignity, and true autonomy for all Canadians, especially the most vulnerable.

We won't hold our breath, DWD will continue to show their true colours and we hope Canadian's will finally wake up to their continued manipulation.

Euthanasia is out of control in Canada. 241 euthanasia deaths based on dementia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article that was written by Angelo Bottone and published by thinkspot.com on March 25, 2025 examining Canada's 2023 euthanasia statistics.

Article: Canada - 15,343 reported euthanasia deaths in 2023 (Link).

Bottone reports on Canada's basic euthanasia statistics. He writes:

In 2023, 15,343 Canadians died by euthanasia or assisted suicide, according to the ‘Fifth Annual Report on Medical Assistance in Dying’. This marks a 15.8% increase over 2022 and represents 4.7% of all deaths in 2023. Since its legalisation in 2016, there have been 60,301 cases of assisted suicide and euthanasia cases in Canada that we know of.

Bottone writes about some of the contentious concerns such as:

Dementia was cited as a medical condition in 241 euthanasia recipients in 2023, and in 106 of these cases, dementia was their sole condition.

Euthanasia for dementia is significant because Canada's law permits euthanasia for people with dementia if the person is competent and if there are other co-morbities (another medical condition). The 106 euthanasia deaths where the sole condition was dementia should be investigated by the RCMP or the College's of Physicians.

Bottone points out that in 622 deaths, natural death was not deemed “reasonably foreseeable.” This category, called Track 2, allows euthanasia for non-terminal patients. Loneliness, as a reason for euthanasia, was far more common among Track 2 deaths than Track 1 (terminally ill) deaths.

Isabel Grant, a law professor at the University of British Columbia stated:

“When other people express loneliness or a loss of dignity or a desire to die, we usually respond with support or prevention. But with people with disabilities, we respond with an offer for MAID,”

Bottone notes that the percentage of people with disabilities among non-terminal euthanasia recipients was significantly higher: 58.3% compared to 33.5% for people with terminal conditions.

Bottone completes the article by explaining that the British Columbia Civil Liberties Association (BCCLA) who brought the original euthanasia case (Carter case) to the court has changed their position. Bottone reports the BCCLA concerns:

However, the regime has become so permissive that even the BCCLA has raised concerns, particularly about euthanasia for prisoners and disabled individuals. The organisation has highlighted reports of people accessing MAID due to intolerable social circumstances or being offered it in cases that may not meet legal requirements.

“Of particular concern are reports of MAID being used in prisons while incarcerated individuals were shackled to their beds, the programme’s lack of legal oversight, disproportionate representation of impoverished people receiving assisted suicide, and healthcare practitioners offering MAID when patients sought support for living,” the BCCLA stated.

Previous articles on this topic:

• Article: Canada - 15,343 reported euthanasia deaths in 2023 (Link). 
• Euthanasia is a national tradgedy and only getting worse (Link). 
• Canada euthanasia: Unmasking health and social failure (Link) 
• Canada's euthanasia deaths continue to rise with an estimated 16,500 in 2024 (Link).

British MP who supported assisted suicide, is opposing the assisted suicide bill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Naz Shah, a Labour MP who originally supported assisted suicide is opposing the Kim Leadbeater assisted suicide bill. The UK assisted suicide bill passed at second reading by a vote of 330 to 275. The bill was debated in committee where there were 393 proposed amendments with only 32 of the amendments accepted.

Shah is one of many MP's who support assisted suicide in principle but are opposing the bill. Opposition to the bill may be the reason why Leadbeater, the sponsor of the bill, recently stated that, if passed, implementation of the assisted suicide bill would be delayed until 2029.

David Maddox, the Political Editor for The Independent, wrote an article that was published on March 30. Maddox explains why Shah is opposing the assisted suicide bill:

A Labour MP who had originally been inclined to vote in favour of Kim Leadbeater’s assisted dying legislation has claimed that the bill now has weaker safeguards than when MPs voted on it in November.

Naz Shah spoke to The Independent in the wake of the laborious and, at times, tetchy committee stage of the controversial bill being completed in parliament last Wednesday.

The Bradford West MP, who served on the committee scrutinising the bill, had hoped that safeguards could be strengthened to make it workable but now claims the legislation is “fundamentally flawed”.

Maddox further reports on why Shah opposes the assisted suicide bill

...Ms Shah has said she is “very disappointed” and “disheartened” with the direction taken after hopes they could ensure the safeguards were robust.

She revealed: “Kim [Leadbeater] is a friend and when she first told me about the bill I was inclined to vote for it. But the more I looked at the details, the more concerns I had.”

Top among these were concerns over the way people who suffer from domestic abuse and have disabilities could potentially be coerced into ending their lives early. As someone who had suffered previously from domestic abuse in a forced marriage, these issues were important to her.

Ms Shah also made headlines during the process when she was forced to leave a session because her hearing aid batteries had run flat. An attempt to push through amendments had seen the session extended despite pleas from Ms Shah that she could not take part.

Maddox reported that Shah tried to amend the bill by strengthening it's "safeguards"

She had also backed attempts to toughen up the bill by ensuring eating disorders such as anorexia could not be given as reasons for assisted dying.

“I talked about a lot with the anorexia stuff, and that’s weakened. The amendment that [Kim Leadbeater] put in, in the capacity bit, that’s actually weakened the bill, not strengthened the bill.

“Then there’s the issue that children are now exposed, that doctors can have this [assisted death] conversation with children. You know, there’s fundamental flaws in the bill, and I just feel disheartened that I’ve gone in trying to help fix it and actually come out, not from my fault, but, you know, with it weakened.”

Maddox reported that Ms Shah was concerned that only 7 of the amendments were accepted were meaningful and none of the accepted amendments were "fundamental ones."

How the CBC is Manipulating Canadians into Accepting Death

This article was published by Kelsi Sheren on her substack on March 25, 2025.

Emotional Manipulation Isn't Journalism—It's Coercion

Kelsi Sheren

By Kelsi Sheren

Look, let's cut right to it: something deeply disturbing is happening here in Canada, and the CBC is front and centre today. They’re openly romanticizing euthanasia—Medical Assistance in Dying (MAiD)—as though choosing death is some beautiful, noble act instead of the tragic consequence of profound suffering and a failure of care. It's time we talked bluntly about what's really going on here, because the subtlety with which Canadians are being coerced toward assisted death is alarming.

When the CBC paints a sentimental picture of couples gently holding hands and listening nostalgically to their wedding songs moments before they're euthanized, it's not just storytelling—it's emotional manipulation. It glamorizes dying through MAiD, suggesting a death that's peaceful, romantic, and dignified, when in reality, the process is deeply complex, deeply troubling, and profoundly tragic. They're packaging death like a Hallmark movie to sell Canadians on euthanasia as something idealistic and desirable.

The CBC doesn’t just stop at emotional manipulation—they actively highlight the rapid increase in euthanasia requests as though it's something positive or simply routine. Today, one in every twenty deaths in Canada is via MAiD. That's staggering, thats terrifying and that say’s a lot about our society in Canada. Yet, CBC casually presents these numbers, implicitly suggesting this rise is not only acceptable but commendable. This normalization becomes coercive pressure, particularly for those who already feel like a burden—socially, financially, or emotionally. These carefully curated stories serve to subtly reinforce the notion that choosing death is an honourable escape from suffering rather than what it truly signifies—a societal abdication of duty to provide holistic care and compassionate solutions.

Moreover, the media’s repeated, sentimental portrayals overshadow the nuanced and often distressing realities of euthanasia. Rarely do these stories discuss the ethical dilemmas doctors face, the emotional trauma families endure, or the psychological turmoil individuals often experience leading up to their decision. Instead, the CBC chooses carefully selected anecdotes and gentle imagery that romanticize the experience, distorting public perception and sanitizing a deeply complicated and ethically charged practice.

But journalism should ONLY illuminate truth, not manufacture emotion or normalize troubling statistics. When media outlets resort to heart-tugging imagery and sentimental portrayals of euthanasia, they cross the line from reporting to coercion. They exploit readers’ and viewers empathy, subtly normalizing and even promoting MAiD as a romanticized solution to life's struggles, rather than exposing the gritty reality behind it. By doing so, they blur the crucial line between compassion and complicity, ultimately misleading their audience and perpetuating harmful ideologies. Let’s not lie here, the CBC has been doing this for years now but some reason we continue to allow our tax payer dollars to fund them.

Here's the unvarnished truth: vulnerable individuals—those grappling with severe illness, disabilities, chronic pain, isolation, or financial stress—don't need romanticized portrayals of death. They require genuine support, comprehensive healthcare solutions, robust mental health resources, and authentic human connection. Every polished narrative promoting euthanasia as "peaceful" and "beautiful" serves as a silent nudge, whispering to the vulnerable that death might indeed be preferable, or even admirable, reinforcing their internalized fears of being a burden.

What these individuals genuinely need is to be heard, supported, and uplifted through adequate care, not subtly guided toward prematurely ending their lives through orchestrated media narratives. Society owes it to those who suffer to demonstrate unwavering commitment to life-affirming solutions and meaningful support systems rather than offering death as the convenient alternative.

This is not compassionate journalism; it’s dangerous complicity. True compassion is standing alongside those suffering, championing life, and advocating for real solutions—solutions that value life over convenience, care over expediency, and hope over surrender. Journalism has a moral responsibility to confront uncomfortable truths, challenge societal norms, and demand better from our institutions. To do anything less isn't journalism; it's coercion masquerading as empathy, a betrayal of public trust, and a profound moral failure.

Truly the most frightening aspect of all this is how rapidly Canada is dismantling critical safeguards meant to protect vulnerable individuals from impulsive or pressured decisions. Just like the CBC chose to do today. The removal of mandatory waiting periods for people whose deaths are deemed "reasonably foreseeable" is outright dangerous. Without a waiting period, there's significantly less time for reconsideration, reflection, and second opinions—dramatically increasing the likelihood of impulsive decisions influenced by overwhelmed families, exhausted healthcare providers, or toxic societal messaging that death is the "brave" or "right" choice.

This isn't compassionate healthcare; it’s a healthcare system that's tired, overwhelmed, and more willing to suggest death than to truly care for its patients.

Let's Be Brutally Honest

The CBC—and many other media outlets—are contributing to a troubling societal shift, where assisted death is becoming normalized and even glamorized as a social duty rather than viewed as a heartbreaking last resort. We're dangerously close to a reality where the right to choose death morphs into an expectation or even a quiet obligation.

We must fight back against this dangerous narrative. We must demand real transparency, honesty, and integrity when discussing end-of-life care. Canada desperately needs better resources for palliative care, mental health support, and human connection—not more seductive narratives pushing death as a peaceful, noble solution.

It's time to stop romanticizing euthanasia. It’s time to fight for life and while were at it, it’s time for real journalism to come back to this country.

In case you read this CBC, shame on you.

Some previous articles by Kelsi Sheren:

• Debunking the ethical argument for assisted dying for minors (Link).
• Franchising Death (Link).
• Let's call MAiD what it is (Homicide) (Link)
• The Death Cult of the Euthanasia Lobby (Link).

Oregon 2024 assisted suicide report: Increase in death prescriptions again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The number of lethal poison prescriptions written under the Oregon assisted suicide law increased in 2024 with 607 prescriptions written, which was up from 566 in 2023 and 433 in 2022.

The 2024 Oregon assisted suicide report indicated that there were 376 reported assisted suicide deaths up by 71 from 305 in 2022. 

Similar to previous years the 2024 report updated the data from the 2023 report. The 2023 report stated that there were 367 reported assisted suicide deaths, but the 2024 report stated that there were 386 reported assisted suicide deaths in 2023. Therefore the Oregon Health Authority (OHA) received 19 assisted suicide death reports from 2023 after the 2023 report was completed.

Since every year late assisted suicide reports are submitted, I predict that there were likely 400 reported Oregon assisted suicide deaths in 2024.

Article: Oregon assisted suicide prescriptions increased by 29% in 2023 (Link).

Dr Sharon Quick

Mike Francis stated for The Lund report on March 27 that:

...opponents point to the steady growth in numbers of people requesting lethal medication — fewer than 100 people a year did so before 2011 — and say the system of physician-assisted suicide does a disservice to patients.

“A death request is often a plea for help, but legalizing assisted suicide may allow an option to die to transform into a duty to die,” said Dr. Sharon Quick, President of Physicians for Compassionate Care Education Foundation, in a prepared statement. “No one, including health care professionals, should be given god-like power to decide which vulnerable lives are no longer worthwhile because of the disability of terminal illness or psychological distress over disabilities associated with terminal decline.”

Possible under-reporting of assisted suicide deaths in Oregon

The 2024 Oregon assisted suicide report indicated that the ingestion status was unknown in 178 cases. This means that 178 people who were approved and received the lethal drugs that the OHA does not know how they died. 

• Some of these deaths are "late reported" assisted suicide deaths that will be in the updated data in the 2025 report. 
• Some of these people will die by assisted suicide in 2025. 
• Some of these people will have died a natural death. 
• It is likely, but unknown, because it is not investigated, that some of these people died by assisted suicide but no report was submitted.

Other important data: 

• 43 of the assisted suicide deaths in 2024 were people who received the lethal poison in previous years. 
• Only 3 of the 607 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. In 2024 there were 9 known complications based on 121 reports which was down from 10 known complications based on 103 deaths in 2023.

In 2024, the time of death ranged from 7 minutes to 26 hours. In 2023, one person took 137 hours (5 days and 17 hours) to die.

The report indicated that 23 of the 376 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.

Previously, residence information was collected from the patient’s death certificate. However, for patients who die outside of Oregon and are not Oregon residents, OHA has no way to obtain notice of those deaths.

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 2024, in 179 deaths the physician waived the 15 day waiting period which was up from 154 deaths in 2023. In some cases the lethal poison was ingested the day after being first requested.

Oregon is currently debating assisted suicide Bill SB 1003 would expand the Oregon assisted suicide law by:

• allows non physicians, such as physician assistants and nurse practitioners to participate in assisted suicide and,
• reduces the waiting period from 15 days to 48 hours while enabling the "providing prescriber" to waive the waiting period to essentially allow a same day death and,
• requires hospices and hospitals to publicly disclose their assisted suicide policy.

SB 1003, if passed, would be the third time that Oregon would have expanded its assisted suicide law. 

The Oregon Medical Association are against Bill SB 1003. Among other comments, the OMA stated in their intervention that the bill may allow euthanasia: 

Changing the Responsible Clinician from “Attending Physician” to “Provider” 

The bill proposes replacing “attending physician” with “provider,” a term that is overly broad and includes institutions and facilities, not just individual clinicians. Physicians undergo the most extensive and supervised medical training to diagnose, assess patient capacity, and evaluate mental health conditions before prescribing life-ending medication. Oregon’s Death with Dignity Act and MAiD must use the highest levels of training for those making these critical determinations. 

Confusing and Potentially Dangerous Language

Certain provisions in SB 1003 suggest that medications intended to shorten the dying process could be administered to the patient rather than by the patient, creating ambiguity and raising concerns about unintended movement toward euthanasia. For example, Section 1(2)(a) states:

“A hospice program shall publicly disclose its current policy regarding the Oregon Death With Dignity Act, including whether a patient receiving services from the hospice program may elect to end the patient’s life…”

This language implies that the hospice program, rather than the patient, plays a role in making the decision, which is inconsistent with the original intent of the law.

The Euthanasia Prevention Coalition has stated that the language of the legislation appears to permit euthanasia. We are thankful that the Oregon Medical Association commented on the same concerns based on the language of the bill.

UN Committee opposes Canada's euthanasia law.

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

On March 21, 2025; the Convention on the Rights of Persons with Disabilities Committee’s Concluding Observations on Canada’s Disability Rights Record report was released. Among the many recommendations, Sections 19 and 20 of the UN Committee report outlined their response to Canada's (MAiD) euthanasia law. (Link to the report).

Article: United Nations Committee directs Canada to repeal Track 2 MAiD deaths (Link).

The document states:

19. The Committee is extremely concerned about the 2021 amendments to the State Party’s Criminal Code through Bill C-7 that expanded the eligibility criteria for obtaining Medical Assistance in Dying (MAID), known as “Track 2” MAiD by removing the ‘foreseeable death’ criteria. The Committee recalls that similar concerns about Track 2 MAiD have been addressed directly to the State Party by the Committee on the Elimination of Discrimination against Women, the Special Rapporteur on the Rights of Persons with Disabilities and during the Universal Periodic Review. The Committee further notes that the Special Rapporteur on the rights of persons with disabilities, the Special Rapporteur on extreme poverty and human rights and the Independent Expert on the enjoyment of all human rights by older persons have stated that disability is not a reason to endorse medical assistance in dying. The Committee also notes with concern that: 

    (a) The federal government did not challenge the Quebec Truchon decision which fundamentally changes the whole premise of medical assistance in dying when natural death is reasonably foreseeable to a new program that establishes medically assisted dying for persons with disabilities based on negative, ableist perceptions of the quality and value of the life of persons with disabilities, including that ‘suffering’ is intrinsic to disability rather than the fact that inequality and discrimination cause and compound ‘suffering’ for persons with disabilities;

    (b) The concept of ‘choice’ creates a false dichotomy by setting up the premise that if persons with disabilities are suffering, it is valid for the State Party to enable their death, with safeguards not guaranteeing the provision of support, and ableist assumptions deemphasising the myriad of support options for persons with disabilities to live dignified lives, and the systemic failures of the State Party to address the social determinants of health and well-being, such as poverty alleviation, access to healthcare, accessible housing, prevention of homelessness, prevention of gender-based violence, the provision of community-based mental health supports and employment supports;

    (c) Evidence from the Ontario Office of the Chief Coroner and federal government data indicating that Track 2 MAiD is disproportionately accessed by women with disabilities and persons with disabilities in marginalised situations, and there is an upward trajectory of persons with disabilities killed through Track 2 MAiD;

    (d) The expansion of Track 2 MAiD in 2027 to persons whose “sole underlying medical condition is a mental illness” and the proposed expansion of MAiD to include “mature minors” and advance requests for MAiD;

    (e) The inadequate consultation process with Indigenous Peoples including non-status and off-reserve Indigenous persons with disabilities in relation to MAiD;

    (f) The absence of a federal independent oversight mechanism to monitor, regulate and handle complaints in relation to MAiD.

The concerns are excellent first step but they are limited to people with disabilities. People with terminal conditions who would qualify under Track 1 have equally concerning issues.

The recommendations:

20. To ensure the right to life for persons with disabilities, the Committee recommends that the State Party, in close consultation and active involvement of persons with disabilities through their representative organisations:

    (a) Repeal Track 2 Medical Assistance in Dying (MAiD), including the 2027 commencement of Track 2 MAiD for persons whose “sole underlying medical condition is a mental illness”;

    (b) Not support proposals for the expansion of MAiD to include “mature minors” and advance requests;

    (c) Significantly invest and implement comprehensive measures, at federal, provincial, and territorial levels to ensure the systemic failures in relation to the social determinants of health and well-being are addressed, such as poverty alleviation, access to healthcare, accessible housing, prevention of homelessness, prevention of gender-based violence, the provision of community-based mental health supports, care services at home and personal assistance, and employment supports;

    (d) Strengthen distinctions-based, community-led consultation processes with Indigenous Peoples, including non-status and off-reserve Indigenous persons with disabilities, respecting the principle of self-determination;

    (e) Establish and resource a federal independent oversight mechanism to monitor, regulate and handle complaints in relation to MAiD.

The Euthanasia Prevention Coalition considers the recommendation in Section 20 of the report as important for protecting people from the subtle and direct coercion to die that is often connected to euthanasia decisions.

There are many Canadians who have requested and died by euthanasia based on poverty, access to healthcare, accessible housing and homelessness, and more.

Social supports are not adequate to ensure that people with disabilities can at least live and have adequate housing and the necessary supports.

Nonetheless, these recommendations are important but limited to Track 2 concerns. Very similar concerns exist for people being approved for Track 1 euthanasia deaths.

Action Alert: A Tale of Two States. Montana and Delaware.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Montana may once again prohibit assisted suicide.

Montana was the third State to permit assisted suicide in America. In 2009, the Baxter court decision declared that Montanans have a right to assisted suicide. 

The Baxter decision was appealed to the Montana Supreme Court where it was decided that there is no right to assisted suicide in Montana but the Court found a "defense of consent" meaning a Montana physician who assists a suicide must prove that there was consent. 

On February 7, The Montana Senate voted 29 to 20, to pass Senate Bill 136 a bill that legislatively declares that there is no defense of consent in Montana.

Article: Montana bill that prohibits assisted suicide passes in the Senate (Link).

On March 24, the Montana House Judiciary Committee passed SB 136 by a vote of 11 to 9. SB 136 will go to a full vote in the Montana House. If the bill passes, Governor Greg Gianforte has agreed to sign the bill. Montana could become the first state to reverse access to assisted suicide.

We need everyone to contact members of the Montana House and urge them to support Senate Bill 136. There are 100 members of the Montana House (Montana House Contact List).

Delaware may legalize assisted suicide.

Delaware Legislature

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

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

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

Therefore Delaware assisted suicide Bill HB 140 must be defeated in the Senate. 

We need everyone to contact every member of the Delaware State Senate and urge them to vote NO to assisted suicide Bill HB 140. There are 21 members of the Delaware Senate. (Delaware State Senator Contact List).

Some good arguments opposing HB 140 include:

People with eating disorders are dying by assisted suicide. 

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

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

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

Assisted suicide creates two tier medicine

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

We believe in caring for people not killing them.

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

 

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

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

United Nations Committee directs Canada to repeal Track 2 euthanasia deaths

PRESS RELEASE: “Do Better” – Inclusion Canada Welcomes UN Committee’s Concluding Observations on Canada’s Disability Rights Record

FOR IMMEDIATE RELEASE

MARCH 26, 2025

OTTAWA, ON – Canada has received a critical review by the United Nations Committee on the Rights of Persons with Disabilities (the CRPD Committee). Canada has been directed to repeal Track 2 medical assistance in dying (MAiD), raise the “woefully inadequate” Canada Disability Benefit rate, and address regional disparities in how the CRPD is applied.

Track 2 MAiD is for people with disabilities whose deaths are not reasonably foreseeable.

The CRPD committee says it “is based on negative, ableist perceptions of the quality and value of the life of persons with disabilities, including that ‘suffering’ is intrinsic to disability rather than the fact that inequality and discrimination cause and compound ‘suffering’ for persons with disabilities.”

“The UN is clear that our country must do better in upholding the rights and dignity of persons with disabilities,” says Krista Carr, CEO of Inclusion Canada, “A top priority is Track 2 MAiD – a real and dangerous threat to the lives of people with intellectual disabilities. It must be repealed.”

Among the key recommendations, the UN Committee has urged Canada to:

• Repeal Track 2 Medical Assistance in Dying (MAiD), including the planned 2027 expansion to persons whose “sole underlying medical condition is a mental illness,” and reject proposals to expand MAiD to “mature minors” and through advance requests,
• Implement a coordinated deinstitutionalization strategy across federal, provincial, and territorial governments with clear timelines and targets,
• Withdraw Canada’s interpretative declaration and reservation to Article 12, which limits equal recognition before the law for persons with disabilities and undermines their right to exercise legal capacity,
• Establish a national inclusive education action plan to transition from segregated education to quality, inclusive education across all provinces and territories,
• Develop a strategy with specific timelines to transition from segregated employment settings such as sheltered workshops to open, inclusive, and accessible employment for persons with disabilities,
• Invest significantly in comprehensive measures to address systemic failures in social determinants of health and well-being, including poverty alleviation, accessible housing, prevention of homelessness, and community-based supports.

“These recommendations align with what people with intellectual disabilities and their families have been saying for years,” says President of Inclusion Canada, Moira Wilson, “Canada has an opportunity to lead in disability rights, but only if provincial and territorial governments and the federal government take these findings seriously and move swiftly to implement meaningful reforms.”

Inclusion Canada calls on all levels of government to implement the CRPD committee’s key recommendations. We are ready to support these efforts and will continue to advocate for a Canada where everyone belongs.

-30-

For Media Inquiries, please contact:
Marc Muschler, Senior Communications Officer
Inclusion Canada
Email: mmuschler@inclusioncanada.ca
Direct: 416-661-9611 ext. 232

About Inclusion Canada

Inclusion Canada is the national federation of 13 provincial/territorial member organizations and over 300 local associations working to advance the full inclusion and human rights of people with intellectual disabilities and their families. Inclusion Canada drives social change by strengthening families, defending rights, and transforming communities into places where everyone belongs.

Nearly 10,000 Netherlands euthanasia deaths. psychiatric euthanasia's increase by 60%.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

Bruno Waterfield reported for The Times on March 24 that:

The number of young people in psychological distress being offered lethal injections has caused growing controversy in the Netherlands.

The 2024 euthanasia statistics that were recently released indicated that there were 9958 reported euthanasia deaths in the Netherlands which was up by 10% from 9068 in 2023.

It is concerning that there were 219 psychiatric euthanasia deaths in 2024 which was up from 138 in 2023 and 115 in 2022. That represents an almost 60% increase in psychiatric euthanasia deaths in 2024 and a greater than 90% increase since 2022.

Waterfield reported:

There is concern that growing numbers of suicidal people, especially young people, are asking for help to die. Last year, there were 219 reports of euthanasia after psychological suffering, up by almost 60 per cent from 138 the previous year. In 2020 there were just 88.

Of the cases last year, 30 people were under 30 when they died. In 2020, that number was five.

Waterfield reported that Jeroen Recourt, the president of the RTE, a body comprising five euthanasia oversight committee's stated:

“Are we still doing this right?”

“I welcome social debate on euthanasia due to mental suffering in young people.”

Waterfield reported on one of the young people who died by euthanasia based on psychological suffering:

“The young man described his life as ‘luckless’. He felt very lonely, was deeply unhappy and did not enjoy anything. He could not connect with peers and society, and felt misunderstood,” said the committee, noting a previous suicide attempt. The boy’s parents were consulted in the euthanasia process, although “his relatives and care had tried for a long time to change his mind, without success”.

“The doctor was convinced that the young man’s suffering was hopeless. He did not expect current and any future treatments would improve the quality of life. The young man’s death wish was expected to continue, with a high probability that he would make another suicide attempt if his euthanasia wish was not honoured.”

The euthanasia report indicated that there were 6 concerning cases. Waterfield reported:

Only six cases referred by oversight committees as in breach of rules, mostly involving bungled lethal injections, with too long a gap between the induction of a coma and the deadly drug that stops the patient’s breathing.

One case involved an elderly woman suffering from a mental disorder that made her see faeces everywhere and cause her to clean obsessively who was not referred to an independent psychiatrist. Another elderly woman, in this case with with Parkinson’s disease, “may no longer have felt free to still abandon her choice of euthanasia”. 

I am concerned about the subtle coercion with euthanasia. I know of a Netherlands euthanasia death of an elderly couple where one of the partners was dying and the other was encouraged to die with the partner. 

How is it free consent when there is subtle coercion involved?

More articles:

• Britain must learn from the Netherlands experience with assisted dying (Link). 
• Netherlands euthanasia (homicide) death of 22-year-old averted at the last minute (Link). 
• Netherlands euthanasia death of 17-year-old criticized (Link) 
• Landmark study: Assisted suicide deaths for eating disorders (Link).
• Netherlands assisted suicide group leader found guilty of distributing suicide drugs (Link). 
• Why are the Dutch euthanizing young healthy women? (Link). 
• Netherlands 2023 euthanasia report. A 20% increase in euthanasia for mental illness. (Link).

Register for the next Compassionate Community Care - Visitor Training Program - March 26 and March 27

Kathy Matusiak Costa

Register for the free online visitor training program and becoming involved with visiting people in your community who are elderly and/or living alone.

 

Register online (Registration Link).

 

Caring for people. Gain the confidence to journey with those who are lonely, socially isolated, sick, or dying, to renew their hope and purpose in living until they die.

 

Alex Schadenberg

FREE Online Training – Live on Zoom! 

The Training Workshop is composed of two sessions, each session is two hours on: 

Wednesday July 3 (7 pm - 9 pm) (EST) and 

Thursday July 4 (7 pm - 9 pm) (EST)

With Kathy Matusiak Costa, Executive Director of Compassionate Community Care, and Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition. 

Register online now: (Registration Link)

 

Compassionate Community Care: 

383 Horton St. E, London, ON N6B 1L6
Office tel. 519-439-6445 

info@beingwith.org • www.beingwith.org

CCC Helpline: 1-855-675-8749

 

Charitable registration # 824667869RR0001

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

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

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

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

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

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

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

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

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

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

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

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

The four people are:

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

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

But why are they asking to participate in the process?

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

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

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

More articles on this topic:

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