Canada euthanasia report - massive problems with reporting errors.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On July 8, 2026, we published an article explaining that Canada had approximately 17,700 reported euthanasia deaths in 2025 representing a 7.3% increase in killings from 2024 and representing about 5.6% of all deaths.

Our article reported that the British Columbia (BC) Health Authority released its 2025 euthanasia data indicating that there were 3189 reported euthanasia deaths in BC in 2025 which was up by 6.3% from 3000 in 2024.

We also shared similar data, in that article, from Alberta, Ontario and Nova Scotia.

 

Petition: Canada's euthanasia law needs a complete review (Link). 

Since then more 2024 BC euthanasia data was obtained by Terry O'Neill, a Catholic researcher in BC, showing massive errors with euthanasia (MAiD) reporting in BC. O'Neill obtained further data from the BC MAiD Oversight Unit, a department of the BC Health Authority.

According to the BC 2024 euthanasia data there were 4169 requests for euthanasia resulting in 3000 reported euthanasia deaths.

The data indicates that the MAiD Oversight Unit reported 2,807 errors with 51.9 per cent of “MAiD case outcomes” requiring corrective “follow-up.” The report said that “follow-up” means obtaining missing information or clarifying existing information.

That means that in BC, there were 3000 reported 2024 euthanasia deaths with 51.9% of those deaths required some type of follow-up, with some of the euthanasia reports having multiple reporting errors.

When examining the errors in the BC report one notices that:

• 22.7% MAiD outcome form had eligibility criteria errors,
• 14.9% prescriber form, errors in safeguards (assessments),
• 10.9% had missing forms,
• 9.4% MAiD outcome form eligibility criteria errors,
• 8.3% receipt of the written request error
• 6.4% Administration of MAiD error,

There were many more categories of errors that were less common.

 

Similar concerns about reporting errors exist in Canada's biggest province, Ontario.

On November 12, 2024; we published a commentary on Alexander Raikin's research published in The New Atlantis that we titled: Ontario: At least 428 non-compliant (MAiD) euthanasia deaths.

On November 18, 2024; 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, except that his most recent article adds significant historical context to the issue.

After publishing these articles several people emailed us stating that compliant or non-compliant, all euthanasia deaths involve the killing of a human being and are inherently wrong. I agree.

Euthanasia (MAiD) is about poisoning a person to death. Further to that, the law provides Canadian doctors and nurse practitioners complete legal immunity from the law for homicide, when the "safeguards" are followed. When the legal parameters of the law are not followed, the doctor and nurse practitioner can be prosecuted.

Nonetheless, there have been no prosecutions in Canada and Colleges of Physicians and Surgeons (Provincial bodies) have not removed even one medical license in Canada, even for the worst cases.

EPC urges the government to consider the many stories associated with our euthanasia law that have been publicized world-wide and recognize that the law needs to be reviewed.

Petition: Canada's euthanasia law needs a complete review (Link).

Washington state had a record number of assisted suicide deaths.

Alex Schadenberg

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Washington state legalized assisted suicide in 2009 and continues to have significant yearly increases in deaths.

The recently released 2024 Washington State assisted suicide report indicates a significant increase in assisted suicide deaths as compared to the 2023 report and 2022 report. 

The 2024 report stated that there were 655 participants which is up by 20% from 545 in 2023 which was up by 21% from 452 in 2022. 

The 2024 report further indicated that 491 people were known to have died by assisted suicide which is up by 15% from 427 in 2023 which was up by almost 18% from 363 in 2022.

There may have been more assisted suicide deaths.

The 2024 report indicates that: 655 people participated, 641 participants are known to have died, 491 are known to have died after ingesting the lethal poison, 57 died without ingesting the lethal poison and the ingestion status was unknown for 93 people.

The Washington state report indicates that there were 93 participants whose death status or whose ingestion status was unknown. When the ingestion status is unknown, the person may have died by assisted suicide but no assisted suicide report was filed.

Some important information:

The Washington state data is imprecise concerning the length of time between ingesting the poison and death. The 2024 report indicates that 15% of the deaths took longer than 2 hours which is under represented since in 28% of the deaths the data is unknown.

The 2023 Oregon data indicated that the longest time of death was 137 hours and previous to 2023 the longest time of death was 104 hours.

The Washington state data is also imprecise concerning the length of time between the first request and the death by assisted suicide. The 2024 report states that 15% of the participants lived more than 120 days after first request. The law requires the participant, to be approved, to have a 6 month (180 day) prognosis and yet the data does not provide an option stating how many participants lived more than 180 days.

It is important to note that none of the 655 participants received a psychiatric evaluation.

The lack of oversight of the law.

A significant number of required reports were not filed, even though the 2024 report states: 

To receive the immunity protection provided by chapter 70.245 RCW, qualified medical providers and pharmacists must make a good-faith effort to file required documentation in a complete and timely manner. In 2022 and prior years, providers were required to submit forms by mail. In April 2023, legislation was passed that allows providers to submit data electronically

For instance, there were 655 participants but there were only 641 pharmacy dispensing forms, 592 attending medical provider compliance forms, 579 consulting medical compliance forms, 580 written request to end life forms and only 590 after death reporting forms.

Alex Raikin

In his article: How America abandoned it's assisted suicide safeguards, Alexander Raikin states:

Failure to submit this documentation isn’t just a statutory offense. Medical providers and pharmacists who fail to “make a good-faith effort to file required documentation in a complete and timely manner”, as Washington state law instructs, risk losing“immunity protection” for the criminal act of assisting someone’s suicide. Yet a Department of Health report found that physicians improperly reported compliance for a third of all assisted suicide deaths in the Evergreen State. Indeed, Washington is missing 515 compliance forms entirely for the period between 2009 to 2023, according to my calculations based on annual reports, and is also short of 293 “written request” documents that patients are required to sign attesting that they wish to die by suicide.

There were assisted suicide deaths that Washington state could charge medical providers with breaking the law, as they are not protected by the Death with Dignity act when they fail to file all of the reports.

Last year, the Washington state Department of Health announced that they would no longer publish an assisted suicide report, even though the report is legally required by law. Therefore the 2024 is the final report.

The Washington state Department of Health is aware of the lack of oversight of their assisted suicide law and would rather hide the data than publish the data and have researchers point out the flaws. Washington state is not the only violator of the reporting requirements. New Mexico has never published an assisted suicide report.

Further to that, the Oregon reports also clearly show how there is no effective oversight of the law. People are being killed and for many of them, we have no idea how they died or even if the basic requirements of the law were followed.

Academia Routinely Dehumanizes Disabled People

Meghan Schrader

By Meghan Schader
Meghan is an instructor at E4 - University of Texas (Austin) and is a member of the EPC-USA board.  

I love a good philosophical discussion, but I am frustrated that academia has treated disabled human beings as walking moral conundrums instead of people. 

I think Alexander Raikin put this problem well when he posted on X,

“For all the talk about ‘cancel culture,’ if you're an academic, you can say whatever you want about people with disabilities. You can say that their lives aren't valuable, that being dead is an improvement. You won't be penalized for these views—it'll help you get published.”

Exactly. This pattern is a personal beserk button.

Now I come to my most recent foray into academia, a commentary I was invited to write for a prestigious academic journal’s special issue on “MAiD” and disability. I was told that the paper was enthusiastically accepted and later asked to make various adjustments. 

For nine months I worked diligently to carefully and open mindedly address each point, with input from the person who had asked me to write the commentary. Up to when I submitted the manuscript incorporating the second round of feedback, publication appeared likely.

But then I received notice that the editors didn’t want my commentary after all. 

On some level, I have to suck it up. Article rejections are part of academia. Nevertheless I think it’s worthwhile to examine the editors’ assertion that the final outcome occurred solely because editing my writing did not result in “changes to the style to better match the style of the other manuscripts in the special issue and the style of manuscripts in the journal in general” and had nothing to do with publication bias. 

I think the feedback I received complicates that conclusion. Regardless of their intent, the editors seemed to want me to use language and make statements that favor the “MAiD” movement’s ideology.

I know that this perception is influenced by my personal biases, but the second round of feedback I received strikes me as possibly being an example of the longstanding pattern of some powerful “MAiD” supporters being insincere when they say that they want to “have a discussion” about  “death with dignity.” They want a discussion, but only one where their ideology is cast in the best possible light and opponents are expected to make concessions that sanitize horrible bigotry. 

For instance, during the second round of feedback the lead editors wanted me to address disabled people who want “MAiD.” All I could offer was a more detailed version of the argument that I made in the first draft of the commentary and on this blog: I empathize with disabled people who would like to “use MAiD,” but the disabled proponents are in the minority and I think it’s common sense that their suicidal ideation/desire for autonomy should not be able to turn the rest of the disabled community into a killable caste. 

The editors also seemed to want me to make statements that I worried would imply that the disabled community is evenly divided on the issue of “MAiD,” which is one of the “MAiD” movement’s favorite canards. The  majority of the disability community opposes “MAiD” and has for decades. So, in addition providing an intersectional analysis of disabled people who do want “MAiD,” I added contextualized quotes from other, more accomplished disability justice opponents of “MAiD,” to establish that while not every disabled person opposes “MAiD,” my perspective is not unique, either. 

One of the editors suggested that I call Peter Singer’s assertion that raping some disabled people is acceptable “controversial.” I think they were ok with my proposed substitution of “callous,” but why has academia conditioned people to suggest adjectives like “controversial” when discussing raping disabled persons? The consensus among ethical people in our culture is that rape is abhorrent, not “controversial.” I think referring to the rape of a disabled person as  “controversial” reinforces our culture’s pattern of treating the horrible abuse of disabled persons as if it weren’t necessarily wrong, even if that wasn’t the editor’s intent. 

In addition to seemingly wanting me to imply that the disabled community is evenly divided on the issue of “MAiD” and refer to the rape of disabled people as “controversial,” the editors wanted me to say that killing disabled children with “MAiD” was hateful “in my opinion.” I added the phrase “in my opinion,”  but I also added contextualized quotes from other, more accomplished disability rights advocates who concur with that assessment. I worried that otherwise my commentary might suggest that my perspective on killing disabled children is unique and that such killings are something that 21st century people should agree to disagree about. 

That concession isn’t appropriate for a personal commentary. I’m a disabled disability justice advocate. Therefore I think that disabled people’s dignity demands that if a policy of killing  able-bodied children from other disenfranchised groups is considered hateful, killing disabled children be regarded as hateful.

Even if bias was not the intent, I am nonplussed by the sanitizing language the journal editors asked me to use in my discussion of raping and killing. I think academic and political debate is usually a very good thing, but there are limits to what responsible people should concede. 

Richard John Neuhaus remarked, “Thousands of medical ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptionable.” 

Yes. So I did everything I could to respond eruditely  to my reviewer’s feedback without becoming part of that process. I am sorry that my commentary was not published by the prestigious journal, but at least I didn’t have to say that raping disabled people is “controversial” or that killing disabled children is only hateful “in my opinion.”

Academia’s insistence on treating disabled people like walking thought experiments is obnoxious;  rhetoric that promotes raping and killing disabled people is oppressive. However limited my own influence may be, that’s why I’ve written blogs and X threads that say, “Oh, you want to have a nice, polite discussion about killing disabled people, eh? Here’s a picture of your book in a toilet!” 

Disabled people aren’t “porn” for scholars’ intellectual vulgarity sessions. We are not obliged to accept abuse from academics who wish to debate the merits of raping and killing us at conferences in posh hotels. Not using disabled people’s personhood as an intellectual plaything is one of the least things society could do for people with disabilities.  

Author Note 1: For an incisive, more comprehensive commentary on resisting the “MAiD” movement’s framing in discussions about assisted suicide and eugenics, please read disability policy analyst Gabrielle Peters’s article “Acceding To MAiD Proponent’s Framing Excludes Abolition As a Potential Solution” in the American Journal of Bioethics. 

Author Note 2: For clarification of what I mean when I say that Peter Singer said that raping some disabled people is acceptable, read this blog post.

Register online or in-person for our EPC update meeting on Wednesday January 21.

Register online or in-person for the Euthanasia Prevention Coalition update and directions event.

Wednesday, January 21, 2026 from: 1 - 3 pm (Eastern Time) at the Ethics and Public Policy Center at: 1730 M Street NW Suite 910 Washington DC.

To attend in-person, email info@epcc.ca

To attend online register in advance: (Zoom registration Link)

Delaware, Illinois and New York legalized assisted suicide in 2025. Each state had an excellent team of people working to stop the assisted suicide bill. The assisted suicide lobby is emboldened, as no new state had previously legalized assisted suicide since New Mexico did in 2021.

A recent assisted suicide lobby strategy meeting stated that they plan to introduce assisted suicide legalization bills in 18 US states in 2026.

The Canadian government is scheduled to extend euthanasia to mental illness alone, starting in March, 2027. Canada's parliament is now debating Bill C-218 that would prevent euthanasia for mental illness. How must we respond?

Aleš Primc

The event features:

Aleš Primc, the organizer of the successful referendum in Slovenia that overturned the assisted suicide law. that was passed in the Slovenian parliament. The Slovenian referendum was successful against all projections. Primc will be in Washington DC to share his successful strategy.

Alexander Raikin

Alexander Raikin is a visiting fellow in Bioethics at the Ethics and Public Policy Center. Raikin has been published by multiple journals and news agencies. 

Raikin has become a key researcher on issues related to euthanasia and assisted suicide. Link to some of the articles by Alexander Raikin (Articles Link).

Alicia Duncan

Alicia Duncan, has become an incredible leader after first attempting to prevent her mother's death by euthanasia, and after becoming an advocate for others, families, friends to prevent euthanasia deaths. 

Alicia's book will soon be published and she was recently featured in the film Life Worth Living.

 

Wesley J Smith

Wesley J Smith is a long time lawyer, writer and bioethicist who has spoken throughout the world on issues related to euthanasia and assisted suicide. His book - Forced Exit, is one of the most important books opposing assisted suicide. Wesley is a regular contributor on National Review online. 

Alex Schadenberg

Alex Schadenberg is the Executive Director of the Euthanasia Prevention Coalition and world-wide commentator and speaker on issues related to euthanasia and assisted suicide since 1998. Alex overseas the world's leading blog on issues related to euthanasia and assisted suicide.

Attend in-person or online.

The event is Wednesday, January 21, 2026 from 1 - 3 pm (Eastern Time)

To attend in-person, email info@epcc.ca
To participate online (Registration Link).

The Myth of a Safe Assisted Suicide Regime.

Alexander Raikin

Alexander Raikin was published by the Wall Street Journal on December 23, 2025 in response to a December 17 letter by Corinne Carey celebrating New York Governor Hochul's decision to sign the New York assisted suicide bill into law. 

Raikin is a visiting fellow in Bioethics at the Ethics and Public Policy Center, who has been published by multiple journals and news agencies. Raikin writes.

How humane is assisted suicide? Corinne Carey, from the advocacy group Compassion & Choices, suggests the answer is very (Letters, Dec. 17). New York’s bill places the decision only with a mentally competent patient, and “safeguards are in place to ensure that those who don’t qualify—say, those with eating disorders or psychiatric conditions—couldn’t receive it.”

No need to fear? Not quite.

That’s the same promise Compassion & Choices made in other states before legalization. Three years ago, the organization’s then chief legal advocacy officer—recently promoted to CEO—promised that Colorado’s legislation “does not and was never intended to apply to a person whose only diagnosis is anorexia nervosa.”

But physicians have simply stopped following the law. In at least Oregon, California and Colorado, patients with eating disorders have already qualified and died through assisted suicide. Despite the claim that this is illegal, in Colorado—the sole state to report “malnutrition” as a qualifying illness for assisted suicide—at least 30 MAID deaths between 2017 to 2024 were due to “severe protein calorie malnutrition.” The main lobby group for assisted suicide claims it is illegal to prescribe the “treatment” for eating disorders, and in response, the number of assisted suicides for eating disorders has increased nationwide.

Unfortunately, this follows a larger trend. A Washington state health department report in 2022 found that a third of all relevant physicians in the state failed to submit legally mandated compliance forms for assisted suicide. The result: The state looked hard at the practice, at the assisted-suicide physicians blatantly failing to follow the most minimal of safeguards, and then decided this year to discontinue “suspend” its monitoring program for the procedure.

Previous articles by Alexander Raikin. (Articles Link).

Canadians with disabilities are disproportionately dying by MAiD.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin

Alexander Raikin is a visiting fellow in Bioethics at the Ethics and Public Policy Center. Raikin, who has been published by multiple journals and news agencies. Raikin published this research article examining how Canada's euthanasia law violates the Carter Supreme Court decision which led to the legalization of euthanasia in Canada. (Link to this research article)

The question that Raikin answers concerns the impact of euthanasia on the lives of Canadians with disabilities. The lower court and the Supreme Court of Canada (Carter decision) insisted that legalizing euthanasia would not create a greater risk for people with disabilities. Raikin writes: 

In 2012, Justice Lynn Smith of the British Columbia Supreme Court concluded in Carter v Canada (Attorney General) that an appropriately safeguarded physician-assisted dying program could be adopted in Canada without creating a “heightened risk” or an “inordinate” impact on vulnerable groups, such as persons with disabilities. On appeal, in 2015, the Supreme Court of Canada affirmed Justice Smith’s reasoning, based on the trial judge’s review of evidence from international jurisdictions with assisted dying programs. The Supreme Court upheld the trial judge’s ruling, which struck down the prohibitions against assisted suicide and euthanasia in the Criminal Code, resulting in the decriminalization of assisted dying in Canada.

A few years after legalizing euthanasia (Bill C-14) the Truchon decision came down from Justice Baudoin, (Quebec Superior Court) extended euthanasia to people who are not terminally ill based on the Supreme Court Carter decision that assured Canadians that euthanasia would not disproportionately affect people with disabilities.

In contrast to the insistence of the courts, Raikin explains how legalizing euthanasia has disproportionately affected people with disabilities. Raikin writes:

The national and provincial MAiD data support the findings from chart reviews of MAiD deaths, which is that those who died from MAiD were more likely to have been living with a disability than those who did not die from MAiD, even though both groups had similar medical conditions and experienced diminished capability. In other words, the evidence indicates that MAiD is increasingly driven by disability status, rather than by underlying illness.

Raikin explains the data:

Health Canada’s data demonstrate that people with physical disabilities are overrepresented in MAiD deaths when compared to the expectations established in Carter. From 2019 to 2023, 42 percent of all MAiD deaths involved people who required disability services, including over 1,017 people who required but did not receive these services. During this period, the type of person who was most likely to die from MAiD was one who required disability supports or who had an unknown disability status. Moreover, nationwide in some years, and in Ontario in 2023 (the only data point in Ontario), people with disabilities were the most likely type of person to die from MAiD.

The Health Canada report of 2023 indicates that, of those persons with disabilities who did not receive disability supports before their MAiD deaths, in five cases care was not accessible, in 158 cases care was accessible, and in 259 cases it was unknown if care was accessible. These data confirm that MAiD providers in Canada have indeed euthanized disabled patients who needed disability supports and were unable to access them. The data also show that a large number of MAiD deaths occurred even when the provider did not know if disability supports were available, despite the legal requirement to inform MAiD applicants of available disability support services. The adequacy of these disability supports is not assessed, however, in any of these metrics, and therefore these data should be understood as highly limited and partial in regards to gauging access to disability supports.

There is more information in Raikin's research study (Link).

Another question that Raikin investigates is euthanasia for people with mental illness. Euthanasia solely based on mental illness or for non-terminal conditions was already happening before Bill C-7 was passed in March 2021. Raikin explains:

Evidence of overrepresentation of depression in MAiD cases comes from a retrospective chart review of all MAiD requests at a single tertiary care centre in Toronto between June 2016 and April 2019. The review found “high rates of psychiatric comorbidity among requesters of medical assistance in dying,” though unlike in the Ganzini study, most of these requests ended in MAiD. Of the 155 patients requesting, sixty (39 percent) had a documented psychiatric comorbidity (most commonly depression); 117 patients in total received MAiD. Moreover, these sixty patients had a statistically indistinguishable rate of eligibility compared to patients without a psychiatric illness (p=0.363). Compared to the Ganzini findings, patients with a psychiatric comorbidity were much more likely to have requested MAiD than those without a psychiatric comorbidity.

Euthanasia for people who are not terminally ill increased after Bill C-7, which extended euthanasia to people who are not terminally ill, increased. Raikin explains: 

As Canada left behind the initial safeguards that restricted MAiD to those who were terminally ill, the number of MAiD deaths of non-terminally ill persons began moving steeply upward. The 2021 expansion to non-terminally ill and disabled persons led to 223 MAiD deaths for non-terminally ill persons in 2021, 463 deaths in 2022, and 622 deaths in 2023. In 2027, Canada will expand MAiD to permit access by reason of mental illness alone, portending further increase in the numbers of non-terminally ill persons seeking state-administered death.

Among other issues, Raikin examined the data concerning euthanasia based on "feeling like a burden." Raikin writes:

While the true number of socially vulnerable persons choosing to die through MAiD in Canada is unknowable without a rigorous review process, the current data paint a dismal image (figure 4). The expectation that most patients who feel themselves a burden to others would be prevented from accessing MAiD did not materialize in Canada—and even the initial optimistic data from Oregon (on which Carter was based) have degraded over time.

According to MAiD providers in 2023, the suffering of almost half their MAiD recipients included the perception of being a burden on others, 10 percent more than the previous year. Because of the nature of the reporting mechanism, we do not know whether this suffering primarily drove the request or was but one contributing factor. Yet federal data reveal that, according to MAiD providers, more than 38 percent of their patients who received MAiD from 2019 to 2023 voiced concerns that they felt like a burden. Such data imply that Canadian physicians are not reluctant to provide MAiD for suffering that includes social vulnerability.

The concern around euthanasia for loneliness is important. Raikin reports that 22% of all euthanasia deaths in 2023 were related to loneliness:

In 2023, however, MAiD providers reported to Health Canada that 22 percent of their patients chose death because of “isolation and loneliness,” up by 5 percent over the previous year. This is a marked increase, but despite the public nature of these data, it does not appear to elicit concern from Health Canada or other government entities.

These data suggest that not only do MAiD providers know that their patients perceive themselves to be a burden or socially isolated but that these same providers may believe these factors are not an obstacle for MAiD access and are potentially even qualifying reasons for MAiD. Notably, clinicians in charge of Vancouver Coastal Health’s assisted-dying team have told patients with chronic pain conditions that choosing to die from MAiD because of feeling like a burden to loved ones can be considered an “expression of love.” While social isolation is not a medical reason for requesting MAiD, the data indicate that it is an important factor within MAiD requests.

There is a concern that people with neurological conditions who are unable to consent would be killed by euthanasia. The Carter court case suggested that this problem could be avoided in Canada. 

Euthanasia for people who cannot consent is legal, happening and increasing. Raikin explains:

Canada has already expanded MAiD to include patients unable to consent to MAiD at the time of their death, through the 2021 provision for a waiver of final consent. In Quebec, the provincial government has now gone much further, having sent an order barring prosecutors from launching criminal investigations into physicians who violate the criminal law by administering euthanasia to patients who have made an advance request for MAiD. The “slippery slope” warning that was rejected in Carter has proved prescient.

Health Canada’s annual reports also show that MAiD deaths of persons with dementia have increased dramatically in Canada. The number of MAiD deaths with a neurological condition as a qualifying factor has more than tripled in number from 2019 to 2023, and increased from 10.4 percent to 14.9 percent of all MAiD deaths.96 In 2022, dementia deaths were 9 percent of neurological MAiD deaths or 150 cases. In 2023, the number of MAiD deaths of persons with dementia increased to 241, which included 106 deaths in which dementia was the sole underlying condition.

Raikin's study to proves that outcome of legalizing euthanasia contrasts greatly with the position of the Supreme Court of Canada (Carter decision) and the lower court decision by Justice Lynn Smith. This is an important study because it begins to create the evidence that will be necessary for overturning Carter but it also undermines the acceptance of Carter in other jurisdictions.

Raikin concludes: 

The data are clear: Since MAiD eligibility has become increasingly broad in Canada, it has increasingly and disproportionately affected Canadians with disabilities.

This report compared MAiD’s impact on people living with disabilities with the findings made by Justice Smith in Carter and upheld by the Supreme Court. Further analysis of the disproportionate impact of MAiD on seniors, the poor, and other vulnerable groups also warrants attention, but is beyond the scope of this report.

This report’s findings are contrary to the assumptions by Canadian courts and the claims frequently made by cabinet ministers and Parliament. It corroborates, instead, concerns shared previously and repeatedly by disability activists and groups, including testimony ultimately rejected by the Supreme Court in Carter.

The death of disabled persons is not a rare or incidental effect of Canada’s legalized euthanasia program; instead, disability is a remarkably common characteristic among those who access MAiD. The average natural life expectancy of MAiD patients belies the claim that assisted suicide is restricted to those whose death is “imminent,” and MAiD’s reach is not limited to those who are terminally ill. Those seeking MAiD do not encounter a consistently “rigorous standard of scrutiny” that prevents most requests from ending in death. Specialist screenings for depression do not appear to have materialized, even at the very start of the MAiD program. Persons with neurological conditions are seeking death in high numbers compared to the expectations established in Carter. And the socially isolated, far from being protected, are instead being approved for MAiD at high—and increasing—rates.

Previous articles concerning research by Alexander Raikin (Articles Link).

It's time to audit the death bureaucracy

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition has petitioned the US Food and Drug Administration (FDA) to investigate the assisted suicide drug cocktails. (Petition Link).

Last week the Washington Examiner published an editorial opinion calling on the US states that have legalized assisted suicide to audit their death bureaucracy. The article states:

A deeply disturbing investigative report in UnHerd last week uncovered rampant violations of physician-assisted suicide practices in states with the oldest and largest programs. The 11 states that have legalized assisted suicide require clinicians to submit compliance forms shortly after the “patient’s” death. But the chaotic assisted-suicide bureaucracy rarely follows regulations, and clinicians put people to death with little to no oversight.

Between 2009 and 2023, 515 compliance forms and 293 “written request” documents were missing in the state of Washington. In all, one-third of the state’s assisted suicides were improperly reported. In Colorado, which passed its End of Life Options Act in 2016, almost 1,800 compliance forms are missing. And in New Mexico, where annual compliance reporting is also required by law, there has not been a single report issued since assisted suicide was enacted in 2021. For years, the state’s website suggested that a report was “coming soon,” but state officials quietly removed that promise from its website this summer.

Disturbingly, there have been no suspensions or revocations of clinician licenses connected with these irregularities.

Failing to report an assisted suicide is no mere statutory violation. Washington law states medical providers and pharmacists who neglect to “make a good-faith effort to file required documentation in a complete and timely manner” risk losing immunity protection for criminal acts.

The missing compliance reports are only the tip of the iceberg. Officials in Colorado and California were unable to provide numbers for the total assisted suicides carried out by clinicians and held no record of the type of drugs prescribed to more than 1,000 “patients.” Authorities in Oregon don’t know the result of 178 cases from 2024 in which “aid in dying” medications were prescribed.

Did the “patients” take the drugs in those cases? Did those drugs cause death? Did the “patients” even die? Oregon has no records on any of this.

Record keeping in Washington is even worse. By law, the state is supposed to perform a review of reporting compliance each year. But, blaming funding cuts, officials announced that they will no longer issue these legally required reports.

As more and more states consider whether to adopt assisted-suicide laws, a true accounting is needed to provide voters with accurate information about the outcomes of these laws in states where they are already established.

Given the gravity of the new revelations, the Department of Health and Human Services Office of Inspector General, in coordination with the Justice Department, should launch an immediate investigation into states’ assisted-suicide programs. It should focus on three critical areas: the failure to file mandatory compliance forms, inadequate tracking of lethal prescriptions, and the absence of disciplinary action against clinicians who endanger “patients” through noncompliance.

As assisted suicide spreads, the risk grows that vulnerable people, those feeling like burdens or facing financial strain, will be nudged toward death rather than helped to live. This is not compassion — it’s the worst sort of cultural and moral failure.

It is time for accountability.

More articles on this topic:

• How America Abandoned its assisted suicide safeguards (Link).
• Assisted suicide lobby launches court case to force Colorado to permit suicide tourism (Link). 
• The push to legalize and extend assisted suicide in America (Link).
• Oregon 2024 assisted suicide report (Link). 
• Death by assisted suicide is not what you think it is (Link).  
• Assisted suicide laws, once passed will inevitably expand (Link). 
• New York assisted suicide bill is a "bait and switch" (Link). 
• Oregon bill would expand assisted suicide again (Link).

How America abandoned its assisted suicide "safeguards"

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin

Alexander Raikin wrote an excellent article: How America abandoned its suicide safeguards which explains how the US states that have legalized assisted suicide abandoned the "safeguards" in their assisted suicide laws. I have written several articles on this topic especially since nearly every assisted suicide law in America, once passed, was later expanded. Raikin explains:

In 2020, Jane, a 29-year-old Colorado woman with eating disorders, was “provided with lethal drugs … in the midst of a mental-health crisis”, according to a lawsuit filed this year by the Institute for Patients’ Rights, an advocacy group seeking to overturn Colorado’s assisted-suicide program. Jane qualified for assisted suicide, the lawsuit contends, yet she was discharged from a hospice because she no longer qualified for hospice care, and her hospice considered her no longer competent to consent to medical treatments. So how could she have consented to suicide-by-doctor?

Jane was fortunate: her parents successfully sued for guardianship, and a court ordered the medication to be destroyed. Jane “went on to recover from all of it, including her anorexia”, according to Matt Vallière, the executive director of the Institute for Patients’ Rights. Jane found work as an occupational therapist, went on vacation, and even purchased a home. Although she ultimately died two years later of complications from her history of eating disorders, she’d had an opportunity to “live her best life”, Vallière says. That any medical professional decided that Jane qualified for assisted suicide, he claims, was “absurd”.

Raikin states that Jane’s case isn’t unusual and violations of assisted-suicide laws are rampant with no known suspensions or revocations of clinician licenses, even when patients were endangered. Raikin explains how these laws are being violated:

Much of the issue is oversight. In each of the 11 states that have implemented suicide-by-doctor, regulations require clinicians to submit compliance forms, typically within days of a patient’s death. These forms document that the patient expressly consented to die through assisted suicide, and that the clinicians followed all necessary legal safeguards and eligibility criteria, including affirming that the patient is terminally ill and of sound mind.

Failure to submit this documentation isn’t just a statutory offense. Medical providers and pharmacists who fail to “make a good-faith effort to file required documentation in a complete and timely manner”, as Washington state law instructs, risk losing“immunity protection” for the criminal act of assisting someone’s suicide. Yet a Department of Health report found that physicians improperly reported compliance for a third of all assisted suicide deaths in the Evergreen State. Indeed, Washington is missing 515 compliance forms entirely for the period between 2009 to 2023, according to my calculations based on annual reports, and is also short of 293 “written request” documents that patients are required to sign attesting that they wish to die by suicide. In Colorado, my calculations find that almost 1,800 compliance forms have remained missing since 2017.

The actual number of assisted suicide deaths is unknown. Raikin writes:

States can’t answer the most basic question: how many physician-assisted suicides have been facilitated by clinicians in America? Across Colorado and California, state authorities have no record of the type of “aid-in-dying drugs” that were prescribed to more than 1,000 patients, according to my analysis of state reports, including the California End of Life Option Act 2024 Data Report. In Oregon, the health authority has records on 376 assisted suicides completed in 2024, but for another 178 cases in which medications were prescribed, authorities don’t know if the patient died by ingesting the drugs, or even died at all.

Washington State has decided to stop publishing the assisted suicide data.

In 2022, Washington state announced that its Department of Health is diverting “all available funding” for its assisted-suicide compliance-review program to “data entry of submitted forms”, due to lack of funding from the state. Data entry is commendable. But by law, the state is also required to “review” reporting compliance and issue an annual report. Instead, this summer, a pop-up appeared on the department’s website: “Important Note: Due to funding cuts, the Death with Dignity Program at the Department of Health is suspended. … A 2024 annual statistical report will not be released.”

Washington state’s decision surprised even assisted-suicide clinicians. Jessica Kaan, the medical director for End of Life Washington, an institution which facilitates assisted suicides in the state, warned on a forum for providers that “no one will even be monitoring or responding to emails or phone calls that come into the DOH [Department of Health] about the DWD [Dying With Dignity] program”. Kaan called it “a grim situation”. After this push back, the state announced that it will release the 2024 report after all — but it will be the last one ever to be released.

Raikin then explains that New Mexico does not publish an annual report, even though the assisted suicide law requires an annual report. States are also removing the "safeguards" in the law. Raikin explains:

This systematic disregard of safeguards is happening as the process is being fast-tracked: states are removing requirements that applicants reside in state; allowing less-credentialed providers, such as social workers, nurses, and physician associates,to perform assessments instead of psychiatrists and psychologists; and reducing minimum waiting periods. In Oregon, which waived waiting periods in 2020,clinicians have reported in Oregon’s annual Death with Dignity Act report that assisted suicides routinely occur on the same or next day the patient makes there quest. Since in some cases it takes up to five days for a patient to die from ingesting the death cocktail, it is possible that it will take a patient longer to die than to receive lethal prescriptions.

The proportion of vulnerable persons dying by assisted suicide has also increased. Raikin writes:

The proportion of deaths of vulnerable patients has also increased by magnitudes. In the first year of Washington state’s program, 16% of patients mentioned “the physical or emotional burden on family, friends, or caregivers” as a reason for their decision to die, and 2% were concerned about “the financial cost of treating or prolonging the patient’s terminal condition”. By 2023, according to the state’s reporting, the number concerned with “feeling like a burden” jumped to half of all assisted-suicide deaths, and a 10th were concerned about “financial implications of treatment”.

A similar trend is unfolding in Oregon. In 2009, the first year that the program was available, no patients told their assisted-suicide clinician that they were choosing to die because of financial concerns, and only 12% felt like a burden. By 2024, the state’s reporting revealed that it was 9% and 42% of all assisted suicide deaths, respectively. No other states even report this data. The “attending physician follow-up form” in California, which records patient concerns that contribute to the choice of “aid-in-dying”, doesn’t have “financial concerns” or “feeling like a burden” on its otherwise identical menu of options.

Compliance with the law from physicians and the government is lacking. Raikin interviewed Craig New who overseas the assisted suicide program in Oregon. Raikin reports:

Craig New, who told me on the telephone that he’s the sole employee of the Oregon Health Authority responsible for monitoring compliance reporting, says that “ultimately the things usually get resolved because we bug them until they finally send in the paperwork”,but even so, his office has reported around a dozen physicians to the Oregon Medical Board for violations of compliance reporting. Thanks to privacy laws regarding medical licensing, it is impossible to know whether the reported physicians faced repercussions, but my review of the Oregon Medical Board’s investigations reveals that few offenses are prosecuted.

Raikin reports that Dr Rose Jeanine Kenny, in Oregon, was reprimanded by the Oregon Medical Board for contravening the assisted suicide law:

One example is Rose Jeannine Kenny, a family doctor, who in 2016 was sentenced to five years probation by the Oregon Medical Board for dozens of alleged prescription violations. Later the board received “credible information” that Kenny may have again violated the same provisions she was previously reprimanded for, and may possibly have committed “violations of the Oregon Death with Dignity Act”, such as failure to ensure consent, follow the rules of written and oral assisted suicide requests, abide by the minimum waiting period, and file compliance records. Kenny once again kept her license, this time by agreeing to “participate in all physician steps” for 10 more assisted suicides, supervised by a mentoring physician from Compassion & Choices — the largest lobbying group for assisted suicide in the United States. (UnHerd was unable to reach Dr. Kenny at any of the medical practices with which she is associated online.)

Raikin states that no researchers or law enforcement are allowed to systematically review the assisted suicide records. He then tells the story of a person in Maryland with a eating distorder:

Recent court proceedings in Maryland eerily echo the lawsuit regarding Jane. Angela Guarda, the director of the Eating Disorders Program at Johns Hopkins Hospital, testified that she was contacted by an ex-patient of Jennifer Gaudiani, the physician who coined the term “terminal anorexia”, and who has prescribed assisted-suicide medication to at least one patient. The concept of terminal anorexia was meant to apply only to patients over age 30; for younger patients, Gaudiani stressed in a paper for the Journal of Eating Disorders that “every effort should be made to promote full recovery and continuation of life”.

The ex-patient reported that her assisted-suicide assessor told her “she would ‘make an exception’ for me and ‘allow’ me to die”. The patient reported feeling coerced. She eventually weaned herself off morphine and hospice drugs and, 18 months later, reports that she’s doing well, with a job, a group of friends and a new puppy.

Raikin ends the article by stating:

Patients like these, who need hope the most, are facing much more than their illnesses. They also confront an assisted-suicide regime that blatantly and routinely violates the legal safeguards that were meant to ensure their protection from a death they might not want.

Further articles on this topic:

• Assisted suicide lobby launches court case to force Colorado to permit suicide tourism (Link). 
• The push to legalize and extend assisted suicide in America (Link).
• Oregon 2024 assisted suicide report (Link). 
• Death by assisted suicide is not what you think it is (Link).  
• Assisted suicide laws, once passed will inevitably expand (Link). 
• New York assisted suicide bill is a "bait and switch" (Link). 
• Oregon bill would expand assisted suicide again (Link).