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| Gordon Friesen |
President: Euthanasia Prevention Coalition
Peoples' eyes tend to glaze over at the sight of figures and statistics, so I will go directly to the bottom line:
Peoples' eyes tend to glaze over at the sight of figures and statistics, so I will go directly to the bottom line:
Although Quebec has proportionally more assisted-suicide / euthanasia than any other jurisdiction in the world --including almost 10 times that of Oregon even after adjustment for wider eligibility criteria (see table 1)-- it still remains a decidedly marginal way to die. This is extremely significant. For just as we believe that euthanasia is wrong (and more is worse), so also, our adversaries believe that euthanasia is good (and more is better).To be clear, these people are attempting to show that euthanasia is not only a "good death" but is actually the most desirable form of death for both the individual, and society. Their goal is to pragmatically prove this proposition by creating a perception, based on large numbers of people consenting to euthanasia, that this change in behavior represents some kind of inevitable social progress. And to that end, euthanasia doctors, administrators and politicians (especially in the Québec) are doing everything humanly possible to drive up consent rates as far as that may possibly be.
But that is precisely the insight we may now gain from statistics in that place: our adversaries are falling short, and failing in their plan. For there appears to be no medical circumstance, whatsoever (even under the most favorable marketing conditions imaginable) in which it might be termed statistically "normal" to consent to euthanasia. Indeed, when considered in the light of this data, no objective justification might ever be claimed for any particular case.
Most importantly, current Canadian public health policy cannot possibly be claimed as a reasonable response to spontaneous patient desire. On the contrary, the satisfaction of a marginal --and even arguably pathological-- demand for death has been used to undertake a complete transformation of public healthcare, without fundamental social legitimacy, towards a frankly death-based paradigm in which typical (non-suicidal) patients are increasingly unable to access real medical care. And yet, although we now suffer the full social cost of this institutional vandalism, the desired results have not been obtained!
Current policy is imposed from above, predatory in nature, and built upon a universal, State-mandated, systematic (and highly aggressive) marketing of death-as-cure. It's success depends upon the efficiency with which euthanasia may be sold to contextually helpless persons, by professionals who have learned to maximize the terrorizing diagnostic impact of serious illness, and to proactively reinforce any suicidal speculations born of depressive despair.
This dynamic is clearly illustrated in the official report of Quebec euthanasia most recently provided (2023-24) . Along the further banks of the St. Laurence River, far from both Montreal and Quebec City, we find two administrative regions on opposing shores. Both have the same traditions. Both watch the same TV; read the same papers; eat the same food; etc. On the South shore, (region 01, Bas-Saint-Laurent), the euthanasia ratio is an astonishing 10.6% of all deaths. Whereas across the water (region 09, Côte-Nord), the same ratio is below half of that, at 4.5%.
It would be difficult, I submit, to explain this difference in any other way than differing medical attitudes in their respective regional health administrations, resulting in turn from the personal bias of those doctors (and bureaucrats) working in each. Nor is this contrast unusual. Throughout rural Quebec, districts, literally side by side, show the same pattern of wildly differing euthanasia rates, split about equally, at or above versus well below the Provincial average.
There is no indication that patients are deprived of any valuable benefit in those regions with lower euthanasia prevalence. There is no population rising up with pitchforks, or crying out for release from "unbearable suffering". Lucidly considered, it would simply seem that at least half of all euthanasia deaths in the Côte-Nord (and other similar regions of Quebec) are not spontaneously requested at all, but "just happen", like those premature roof replacements, and encyclopedias, and vacuum cleaners --that no one really needs or wants-- but which are purchased, none the less, through the earnest eloquence of relentless door-to-door salesmen.
Certainly, knowledgeable patients might now have very rational misgivings about entering hospital at all, depending on where that hospital is located.
As noted above however, the more general problem --and regardless of where we happen to live --is that once institutional care teams are groomed to view euthanasia as the objectively indicated treatment for serious illness: very little appropriate life-affirming care is likely to remain for the vast majority of patients, who obstinately refuse to die.
Beyond political lobbying, therefore, our most important task, as advocates for life-affirming medical care, will be to create the conditions and institutions required to ensure that we, and our families, might have access to any such care at all. I am confident that, with growing citizen understanding of the true damage caused, the now developing medical model of euthanasia will eventually collapse under its own weight. However, that event may be decades away. Hence, we must not idly submit in the meantime.
This point is particularly timely in the US, because that country is not so far along the slope of State-mandated death-medicine as is Canada. There still remains a significant competitive element of patient choice. However, there should be no complacency on that score. Whatever advantage remains must be fully exploited by those with the vision and the courage to invent and create the structures required. There is no guarantee of future freedoms (just as there are now virtually no hospitals in Canada which are free of euthanasia practice). We are therefore urgently summoned to "use it or lose it!", right now, in the present moment.
The Euthanasia Prevention Coalition is fully committed to supporting all such initiatives.
A technical Post Scriptum for those who would like to see the proof
Facts, as they say, are stubborn things. And this fact (of politically structuring public healthcare to favor interests which are directly opposed to those of individual patients themselves) promises to be stubborn indeed. For how can social legitimacy be claimed for something so impactful, which so few people can be enticed to embrace?
I first made this argument in 2019 (in French), here and here and later in the Psychiatric Times (2022) and (2025). In each of these cases I used the worst examples then existing, which concerned cancer patients in the Netherlands. Approximately stated: 4% of all Dutch deaths were then due to euthanasia, while no less than 70% of euthanasia was performed on cancer patients. At the same time, only 30% of all deaths were due to cancer (including related euthanasia).
Doing the appropriate math (.7x.04/.3) we see that 9.3% of Dutch cancer patients died by euthanasia. I was thus able to demonstrate that in the most prolific euthanasia regime on the planet at that time, and in the most receptive patient category, less than 10% of patients would consent to die by euthanasia. Or conversely stated: 90% of such patients did NOT consent.
I also suggested that year-over-year growth of euthanasia was stabilizing, and that Dutch euthanasia would likely top out not far above 4%.
Unfortunately, these predictions have proved false, since the Dutch are now above 5%, but also largely irrelevant, since Quebec has now taken the lead with no less than 8.2% of all deaths (table 1). However, let us examine whether these new numbers actually contradict the underlying significance of our earlier conclusions before we assume that they have been discredited.
With rapidly rising incidence, euthanasia in Quebec has been metastasizing into other previously untouched patient groups. The proportion of such deaths associated with cancer has thus descended to 60%. At the same time cancer as a fraction of all deaths is now 26%. This means that the fraction of cancer patients who consent to euthanasia (.082x.60/.26) has now risen to nearly 19%.
Obviously, this is very different from before. Certainly, I can no longer claim that 90% of patients will never consent to euthanasia. However, if that claim is now "only" 80%, what essential difference is there in the meaning of those numbers? In fact, let us seek the greatest level of detail now available. It is stated in another recent Quebec report that certain specific cancers actually have a consent rate up to 25%. So be it.
Our revised claim may be stated as follows:
There is no medical circumstance, whatsoever, in which more than one quarter of patients will consent to die by euthanasia (even where that death is systematically promoted by the State and universally normalized by all care teams, in all medical facilities). Even in the face of such extraordinary psychological pressure, fully three quarters will refuse.
This I believe is the most important lesson which we may learn from data provided by the Province of Quebec. It is our interest and duty to ensure that medicine, public or private, be structured to serve the non-suicidal super-majority of patients. We must not allow clinical culture to be dictated by the cynical political exploitation of atypical views tragically espoused by a troubled few.
A note on misleading data concerning euthanasia for neurodegenerative diseases
It further appears in the above-cited report that up to 35% of deaths due to conditions such as Parkinson’s, ALS and MS, are now euthanasia deaths in Quebec. Please note, however, that this claim is extremely problematic. For people do not die of such diseases, they die with them. And thus any deaths so attributed will very likely be euthanasia deaths to begin with. Unlike cancer data, therefore, this statistic has no relation to the total number of people living with neurodegenerative diseases who might actually consent to euthanasia for that reason. Indeed, the fallacious suggestion made here, that voluntary death is so incredibly popular (and by implication appropriate) among such patients, constitutes a disturbing attack upon the physical and social security of people to whom we owe a completely different sort of respect and support.
Comparison of AD incidence in Oregon and Quebec
Assisted Death:
Oregon 376 deaths (2024) (3) Québec 6058 deaths (2024) (1)
Total Deaths:
Oregon 44,681 (2022) (5) Québec 79,300 (2023) (6)
Assisted deaths as a percentage of all deaths:
Oregon 0.8%, Québec (7.6%).
- Quebec End-of-Life Commission annual report (April 2023 - March 2024)
- Quebec End-of-Life Commission five year review (April 2018 - March 2023)
- Oregon Death with Dignity Act 2024 Data Summary oregon.gov accessed April 2, 2025
- Supplementary data from the Quebec End-of-Life Care Commission February 3, 2025
- Oregon total deaths (2022) oregon.gov accessed Nov.30. 2024
- Total Quebec yearly deaths (2023-2024) statistica.com
- Fifth Annual Report on Medical Assistance in Dying in Canada , 2023, table 2.1a, www.canada.ca
