Heart-wrenching lessons from Canada's euthanasia regime.

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

By Dr Ramona Coelho

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Previous articles by Dr Ramona Coelho.

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

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

UK "citizens' jury" supported legalizing euthanasia, has ties to the euthanasia lobby.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Previous article: Pro-assisted suicide committee (UK) publishes report (Link).

Alex Schadenberg

Keir Starmer, the UK Prime Minister,  announced that he may fast-track the legalization of euthanasia in the UK. This response came after the release of a pro-euthanasia report from a "citizens' jury" that called for the legization of euthanasia.

On September 12 I published a criticism of the citizens jury report by the Care Not Killing Alliance. One of the criticisms stated (Link to article):

Disappointingly, we note that the Director of the Nuffield Council on Bioethics was formerly Director of Compassion in Dying, the charitable arm of Dignity in Dying which campaigns for assisted suicide. Additionally, a leading Council member was previously chair of Compassion in Dying, and the project was funded by a group which has also funded another leading pro-assisted suicide campaign organisation.

It is significant that Danielle Hamm, the director of the Nuffield Council on Bioethics is a former director of Compassion in Dying, which is the charitable arm of the Dignity in Dying the leading euthanasia lobby group in the UK.

It is also significant that A B Charitable Trust which, in the past, funded a Humanist Association euthanasia campaign was the same group to cover the cost of the "citizens jury."

It is also significant that the "citizens' jury" supported child euthanasia.

This is a set-up. Instead of marching our the same old faces offering the same old rhetoric, choose a "jury" of "average" citizens and them to agree to the same old rhetoric.

Will the media let the response of 28 people who were picked by a pro-euthanasia campaign team change the course of history in the UK?

A recent UK poll found that UK citizens believe that there are - too many complicating factors to safely implement a euthansasia law (Link).

Euthanasia's Past and Present Connection to Eugenics

Ridding the World of People with Disabilities:

Euthanasia’s Past—and Present—Connection with Eugenics

Richard Weikart
Professor emeritus, Department of History
California State University, Stanislaus

Richard Weikart recently published the book: Unnatural Death: Medicine's Descent from Healing to Killing (Link to order from Amazon).

When pressing for legalization of euthanasia and assisted suicide today, proponents generally try to sell it as an act of compassion toward those enduring horrendous suffering. They also claim that they are promoting freedom and autonomy, since the laws only allow for voluntary euthanasia or assisted suicide.

However, from the time the euthanasia movement arose in the late nineteenth century until today, it has often manifested a darker side: a tendency to support the involuntary killing of people with disabilities. From the 1870s, when the earliest public discussions of euthanasia began, through the early twentieth century, euthanasia was closely tied to the eugenics movement, which aimed at improving human heredity by eliminating people deemed “unfit” or hereditarily “inferior” and fostering reproduction of those deemed “superior” biologically. Of course, not all eugenics proponents endorsed killing people with disabilities; some thought compulsory sterilization would suffice (leading to compulsory sterilization laws in many states of the US and in some European countries).

In 1894 the British philosopher F. H. Bradley published an essay in the International Journal of Ethics that exemplified some of these problematic attitudes. He rejected the idea that humans lives are equally valuable and expressed utter contempt for those with mental illnesses: “I am disgusted at the inviolable sanctity of the noxious lunatic,” he admitted. They should not be institutionalized, he thought, since “it seems wrong to load the community with the useless burden of these lives.” Rather he argued that those who are “worse varieties” of humans should face “punishment.” Of course, the “punishment” he wanted meted out to those he called “dangerous specimens” was death.(1)

Bradley was not the only famous intellectual to promote involuntary euthanasia. In 1870 in Germany the leading Darwinian biologist Ernst Haeckel became one of the first to publicly endorse killing infants with disabilities, when he endorsed the idea in a popular book on biological evolution.(2) Like many others in the eugenics movement, he overtly rejected the idea that human lives are equally valuable. Then, in a 1904 book he condemned the idea that we should always preserve human life, “even if it is completely worthless.” In that book he not only defended infanticide, but he also vigorously argued that people with mental illnesses should be put to death, if a panel of physicians deemed it proper.(3)

The nineteenth-century German philosopher Friedrich Nietzsche, like Haeckel, radically rejected the idea of human equality, and he believed that those he deemed superior—the so-called Supermen—should dominate and even destroy the inferior masses. Nietzsche vociferously rejected moral ideals, such as love and compassion. In The Genealogy of Morals (1887) Nietzsche stated, “To sacrifice humanity as mass to the welfare of a single stronger human species would indeed constitute progress.”(4) He also wrote, “The great majority of men have no right to existence, but are a misfortune to higher men.”(5) Nietzsche overtly promoted suicide, and in 1882 he wrote a parable about a man who brought a “miserable and deformed” child to a saint. The saint advises the man to kill the child, and when some bystanders criticize him for this advice, he responds, “But isn’t it crueler to allow it to live?”(6) Thus Nietzsche’s philosophy, which is still quite popular in many intellectual circles, undermines the value of human life (at least of most human lives) and opens the door to involuntary euthanasia.

When the Euthanasia Society of America (ESA) was founded in the 1930s, the organization decided to focus on legalization of voluntary euthanasia. This was mostly a tactical move, as many of their members supported involuntary euthanasia, too, largely as a eugenics measure. One of the early presidents of the ESA, the New York neurologist Foster Kennedy, actually opposed voluntary euthanasia for the terminally ill, but supported killing the “hopelessly unfit.” He stated, “I am in favor of euthanasia for those hopeless ones who should never have been born—Nature’s mistakes.” He proposed that if parents and physicians agreed, five-year-old “defective” children should be killed.(7)

One of the most famous scientists in mid-twentieth-century America, Alexis Carrel, promoted involuntary euthanasia. Carrell was a Nobel-Prize-winning biologist who was featured twice on the cover of Time magazine in the 1930s. In a 1935 article on “The Right to Kill,” Time reported, “The Rockefeller Institute's famed Nobel Prizeman Alexis Carrel declared that sentimental prejudice should not obstruct the quiet and painless disposition of incurables, criminals, hopeless lunatics.”(8)

The most flagrant and shocking example of eugenics leading to involuntary euthanasia was the Nazi program to kill people with disabilities. The ideology underpinning this murderous program had been laid out in 1920 in a controversial book, Permitting the Destruction of Life Unworthy of Life, which was coauthored by the psychiatry professor Alfred Hoche and the law professor Karl Binding. In that book Binding stated that mentally ill people, whom he defined as “life unworthy of life,” are “not only absolutely worthless, but existences with negative value.” Binding and Hoche not only considered such people’s lives useless, but also warned that they were an economic burden on everyone else.(9) These ideas were controversial at the time, but nonetheless, a substantial number of German physicians and medical professors embraced them. This was not just a Nazi idea.

Soon after Hitler came to power in 1933, he pursued eugenics by introducing compulsory sterilization for those with congenital disabilities. The Nazis were very radical in carrying this out, sterilizing 350-400,000 people during their short time in power. Once he was at war with Poland, Britain, and France, he secretly directed his personal physician, Karl Brandt, and other Nazi officials to organize a massive program to kill people with disabilities. From early 1940 to August 1941 they killed about 70,000 Germans with disabilities in gas chambers in six facilities. Then they shut down these killing factories, but they continued the murderous rampage in a decentralized process at numerous asylums and hospitals. Ultimately about 200,000 Germans with disabilities, plus tens of thousands of others in German-occupied territories, were exterminated by the Nazi regime.

After the Nazi atrocities, public support for eugenics and euthanasia declined in the US and Europe. However, in the late twentieth century the euthanasia movement would experience a resurgence, beginning in the Netherlands and Belgium, and then spreading to the United States and Canada. While proponents touted this as bringing individual freedom, the reality is that society had to decide who was eligible to receive euthanasia or assisted suicide. Thus some of the same attitudes that had been so problematic in the earlier eugenics movement resurfaced: some people’s lives were deemed too valuable to receive euthanasia or assisted suicide, while others were deemed not so valuable. While anti-suicide programs are spending millions of dollars trying to discourage (some) people from killing themselves, other categories of people are being told: It’s not only OK for you to kill yourself, but we will help you do it.

Further, surveys of people in Oregon who have opted for assisted suicide show that such people are usually not doing it to escape pain and physical suffering. Rather, many of them are lonely and socially isolated. Further, many report that they no longer want to be a burden on society, which is precisely the way that the eugenics movement portrayed people with disabilities. In Canada some people with disabilities or medical problems have been urged by medical professionals or social workers to get euthanasia, showing that social pressure—sometimes subtle, sometimes overt—plays a role in euthanasia, too. It is not all about individual freedom and autonomy. The line between voluntary and involuntary starts to blur in many instances (and evidence suggests that in countries that have legalized voluntary euthanasia, physicians tend to be more open to providing involuntary euthanasia--secretly, of course, because technically, it is still illegal.

I understand fully that many proponents of euthanasia and assisted suicide today reject some aspects of the earlier eugenics movement. However, some of the problematic attitudes that fueled the eugenics movement in the late nineteenth and early twentieth centuries persist in the euthanasia movement. Wittingly or unwittingly, euthanasia advocates perpetuate the idea that human lives are unequal in value—and, just as in the eugenics movement, those considered inferior are those with disabilities or serious medical conditions. In addition these allegedly inferior people are being portrayed as (and often feel like) burdens to society who should “get out of our way.”

The way out of this downward spiral is for us hold firmly to the truth that all people are equal in value. Further, we need to offer love and compassion to those who are disabled, ill, or suffering, for that is what they really need. (By the way, I am the primary caregiver for my mother-in-law, who has dementia, so I am not just saying this glibly—I know what it means to sacrifice my time and energy to help a person with mental illness have a better life).

End notes:

(1) F. H. Bradley, “Some Remarks on Punishment,” International Journal of Ethics 4 (1894): 269-84; quotations at 272, 280, 281, 283-84.

(2) Ernst Haeckel, Natürliche Schöpfungsgeschichte, 2nd edition (Berlin, 1870), 152-55; quote at 155.

(3) Ernst Haeckel, Die Lebenswunder: Gemeinverständliche Studien über Biologische Philosophie (Stuttgart: Alfred Kröner, 1904), 21-22, 134-36.

(4) Friedrich Nietzsche, The Genealogy of Morals: An Attack, in The Birth of Tragedy and The Genealogy of Morals, trans. Francis Golffing (Garden City, NY: Doubleday Anchor, 1956), Essay 2, § 12, p. 210.

(5) Nietzsche, Will to Power, part 872, quoted in Jean Gayon, “Nietzsche and Darwin,” in Biology and the Foundation of Ethics, ed. Jane Maienschein and Michael Ruse (Cambridge: Cambridge University Press, 1999), 183.

(6) Friedrich Nietzsche, Die fröhliche Wissenschaft, in Werke in Drei Bänden, ed. Karl Schlechta (Munich: Carl Hanser, 1966), § 73, vol. 2, pp. 84-85.

(7) Foster Kennedy, “The Problem of Social Control of the Congenital Defective: Education, Sterilization, Euthanasia,” American Journal of Psychiatry 99 (1942): 13-16; quotes at 13, 14.

(8) “The Right to Kill,” Time 26, 21 (Nov. 18, 1935): 59.

(9) Karl Binding and Alfred Hoche, Die Freigabe der Vernichtung lebensunwerten Lebens. Ihr Mass und Ihre Form (Leipzig: Felix Meiner, 1920), 27-32.

The woman who confessed to killing her disabled son 40 years ago has died.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Child euthanasia is infanticide

A UK woman who admitted to killing her 7 year old son more than 40 years ago by intentionally overdosing him as part of a campaign to legalize of euthanasia in the UK has recently passed away.

I recently learned that Antonya Cooper (77) died soon after she admitted to killing her son.

Harriett Sherwood reported for the Guardian on July 3 that:

A woman has admitted giving her terminally ill seven-year-old child a huge dose of morphine to end his suffering more than 40 years ago.

Antonya Cooper said her son Hamish had experienced “horrendous suffering and intense pain” as a result of his stage four cancer and “beastly” treatment.

“On Hamish’s last night, when he said he was in a lot of pain, I said: ‘Would you like me to remove the pain?’ and he said: ‘Yes please, mama’,” Cooper, 77, told BBC Radio Oxford.

“And through his Hickman Catheter, I gave him a large dose of morphine that did quietly end his life.”

I share sympathy concerning the suffering Hamish experienced, there were other options than killing him. Hamish needed pain and symptom management. He needed care not to be killed.

Cooper's admission to killing her disabled son is a warning as to why euthanasia should never be legal. Hamish was a child who was not capable of consenting.

Further to that, euthanasia is not legal in the UK and yet Cooper is promoting the case for expanding the law to killing children.

A Woman who admits to killing her 7 year old son more than 40 years ago, is campaigning for euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A UK woman who admitted to killing her 7 year old son more than 40 years ago by intentionally overdosing him is campaigning for the legalization of euthanasia in the UK.

Harriett Sherwood reported for the Guardian on July 3 that:

A woman has admitted giving her terminally ill seven-year-old child a huge dose of morphine to end his suffering more than 40 years ago.

Antonya Cooper said her son Hamish had experienced “horrendous suffering and intense pain” as a result of his stage four cancer and “beastly” treatment.

“On Hamish’s last night, when he said he was in a lot of pain, I said: ‘Would you like me to remove the pain?’ and he said: ‘Yes please, mama’,” Cooper, 77, told BBC Radio Oxford.

“And through his Hickman Catheter, I gave him a large dose of morphine that did quietly end his life.”

As much as I share sympathy concerning the suffering Hamish experienced, there were other options than killing him.

Further to that, Hamish was a child, he was not capable of consenting, but even more, his mother only asked him if he wanted the pain to go away. He wasn't asked if he wanted her to kill him.

When asked by Radio Oxford if her son knew that she was going to kill him, Cooper responded:

She said: “I feel very strongly that at the point of Hamish telling me he was in pain, and asking me if I could remove his pain, he knew, he knew somewhere what was going to happen.

“But I cannot obviously tell you why or how, but I was his mother, he loved his mother, and I totally loved him, and I was not going to let him suffer, and I feel he really knew where he was going.”

She added: “It was the right thing to do. My son was facing the most horrendous suffering and intense pain, I was not going to allow him to go through that.”

As sad as this story is, it shows how dangerous it is to legalize euthanasia. Once legal, similar cases of doctors killing their patients, without consent, will happen.

Further to that, euthanasia is not legal in the UK and yet Cooper is promoting the case for expanding the law to killing children.

Hamish needed pain and symptom management. He needed care not to be killed.

Private Members Bill would allow euthanasia by advanced request.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sylvie Bérubé BQ MP (Abitibi—Baie-James—Nunavik—Eeyou) is sponsoring Bill C-390 which would expand Canada's euthanasia law.

Sylvie Bérubé BQ MP and Luc Thériault BQ MP (Montcalm) held a press conference on May 22 to announce that they have introduced Bill C-390 to expand Canada's (MAiD) euthanasia law to, among other areas, permit euthanasia by advanced request.

Bill C-390 would expand Canada's euthanasia law by adding to each section of the law - the words:

"or an applicable provincial framework."

In June 2023 Québec expanded their provincial euthanasia law by passing Bill 11  expanding euthanasia in Québec by:

• creating an obligation for palliative care homes to offer MAID;
• offering MAID in cases of serious physical disability;
• offering MAID by advance request*

Amending Canada's federal euthanasia law based on Bill C-390 would expand euthanasia enabling it to be decided by an advanced request, by causing federal legislation to be changed when a Province changes it's provincial legislation.

The federal report by the Special Joint Committee on Medical Assistance in Dying (AMAD) that was tabled in the House of Commons on February 15, 2023 called for an expansion of euthanasia (MAiD) in Canada. The report recommended that children "mature minors" and patients with mental illnesses be eligible for euthanasia and that patients with illnesses such as dementia be permitted to make advanced requests by advanced directives for euthanasia.

Euthanasia (killing) is bad enough, but killing by advanced request changes the nature of consent, meaning, someone can be killed without a clear and present consent. When consent becomes secondary, it changes the question of who can be killed by lethal injection.

Provincial governments have the ability to amend the practise of euthanasia in their jurisdiction. Bill C-390 would allow provinces, such as Québec, to change their provincial law with it resulting in an immediate change to the federal law.

US Senators ask Pfizer about donation to Dying with Dignity Canada, Canada's pro-euthanasia group.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalitio

Marco Rubio

On February 28, Marco Rubio (US Senator for Florida) questioned Pfizer's position on assisted suicide and euthanasia considering the fact that Pfizer has received millions of dollars from the US tax payer. Senator Rubio wrote:

A recent report exposed Pfizer’s financial assistance to Dying with Dignity Canada (DWDC), raising questions about its stance on assisted suicide. DWDC has pushed to expand the eligibility for “medically assisted death” to children as young as 12 years old. Pfizer’s support for DWDC raises concerns that it is complicit in prematurely ending lives. 

U.S. Senator Marco Rubio (R-FL) and colleagues sent a letter to Pfizer CEO Dr. Albert Bourla regarding Pfizer’s donations to DWDC, and the company’s stance on “medically assisted death.” 

• “The practice of ‘medically assisted death’ contradicts Pfizer’s stated purpose of ‘delivering breakthroughs to change patients’ lives.’

• “As Pfizer has received millions of U.S. taxpayer dollars to develop treatments and conduct medical research, Pfizer must be completely transparent to the federal government, and the American public, about where the company stands on medically assisted death.” 

Joining Rubio were Senators Ted Cruz (R-TX), J.D. Vance (R-OH), Josh Hawley (R-MO), and Mike Braun (R-IN) and Representatives Brad Wenstrup (R-OH) and Chris Smith (R-NJ).

The letter to Dr Bourla is attached (Link). 

The Senators asked Pfizer to provide specific answers to the following questions: 

1. Were U.S. taxpayer funds used to make the donation to DWDC? If not, from which source did the donation come from? Why was such a donation made by Pfizer and not its individual shareholders? 
2. What is Pfizer’s official position on “medically assisted death?”
   1. If Pfizer supports “medically assisted death,” does Pfizer support DWDC’s position that minors have the mental capacity to consent to “medically assisted death?”
      1. If so, has Pfizer disclosed this to shareholders?
   2. If Pfizer does not support “medically assisted death,” will Pfizer publicly commit to cease donations to DWDC and similar groups that support “medically assisted death?”
3. Does Pfizer currently manufacture and/or sell products that are used (regardless of whether prescribed off-label) for “medically assisted death” in the United States or elsewhere?
   1. If so, does Pfizer support groups like DWDC in order to increase market demand for its products?
4. Which criteria does Pfizer use to determine to whom they donate? 
5. How much, in total, has Pfizer donated to “medically assisted death” advocacy groups over the past ten years? 
6. Will Pfizer continue to donate to DWDC, or other “medically assisted death” advocacy groups, this year? 
7. Has Pfizer ever utilized its donations to DWDC, or similar groups, as a justification for a positive Environmental, Social, and Corporate Governance (ESG) rating?
   1. If so, does Pfizer consider “medically assisted death” to be a legitimate method for addressing climate change, environmental challenges, or social issues? 

We thank Senator Rubio, and the other Senator's and EPC has asked them to share the response from Pfizer, if Pfizer responds.

Canada's euthanasia lobby is receiving significant money from Canada's federal government and it is clearly not appropriate for Pfizer, that produces end-of-life drugs to be donating to the euthanasia lobby and as stated by the Senator's, it would be even more inappropriate if Pfizer is donating money obtained from the US government to donate to Canada's euthanasia lobby.

Canada's Assisted Dying Regime Should Not Be Expanded to Include Children.

The following article was published by Aljazeera on February 16, 2024.

By Dr Romana Coelho, a family physician in London Ontario

When I was growing up, every week, my Indian immigrant parents would drive my two siblings and me to a long-term care facility close to where we lived, so we could spend time with the residents. I remember one elderly woman, in particular: she’d had a debilitating stroke and no family to visit her. My dad would sneak in Big Macs, After Eight chocolates; anything to bring her a bit of joy. My parents also regularly visited those without support in prison until they needed to move in with my family due to my father’s growing health needs. 

As a mother of five, a caregiver to my father, and a family physician who has practised since 2007, I try my best to continue my parents’ commitment to leave no one behind. My practice, which is based in London, Ontario, predominantly serves low-income and marginalised adults and children: refugees, people who are facing charges or have been incarcerated, people with chronic pain and others with disabilities and mental health issues, including substance use disorders. Many of them wait excessively long periods or are declined specialist care, housing, medications, or counselling. Some wait in line at food banks, while others are forced to choose between affording transit to keep medical appointments or buying nutritious food. They face discrimination, isolation, and inaccessibility, all of which negatively affect their health.

Witnessing these barriers firsthand, it was clear to me that our society does not prioritise supporting those who need it most. I was doubly alarmed to hear that some of my patients were contemplating or being offered medical assistance in dying, or MAiD, due to this lack of resources. In 2020, I began reaching out to Canadian politicians to raise my concerns that MAiD could become the path of least resistance for those with insufficient resources to live. Since then, I’ve been invited to voice my opinions in numerous disability, Indigenous, academic and parliamentary settings about MAiD, including appearing as an expert before our federal Special Joint Parliamentary Committee on MAiD in 2022.

Back in 2016, assisted suicide and euthanasia were legalised in Canada and the term medical assistance in dying (MAiD) was coined for both methods of administering death. MAiD was sold to Canadians as a humane way to end the lives of consenting adults who were experiencing intolerable suffering. Patients had to meet certain criteria, including having a “grievous and irremediable” medical condition, such as heart failure or cancer, and a “reasonably foreseeable natural death”. In recent years, the number of people who qualify for MAiD has grown: in 2021, Bill C-7 created a new track for adults with chronic illnesses and disabilities who aren’t dying. Bill C-7 also had a sunset clause that would allow future eligibility to those whose only medical condition is mental illness, which might be delayed again, but thus far is set to become legal in March.

Numerous alarming stories about MAiD abuses are emerging from Canada that should give us pause. For example, Rosina Kamis explains in her recordings and her writings that she was driven to MAiD by loneliness and poverty. I was interviewed for the Al Jazeera documentary, Do You Want to Die Today, which documents her story in detail. Like Rosina, many disabled Canadians are suffering from social distress, including poverty, and dying by MAID. Their disability qualifies them to die but it is their psycho-social suffering that can drive their MAiD request. I am distressed that some Canadian bioethicists even argue that providing MAiD for requests driven by “unjust social circumstances” can be understood as a form of “harm reduction.” Encouraging people to die through MAiD for “living in unjust social circumstances” is more injustice, not harm reduction.

From legalisation to the end of 2022, there had been almost 45,000 MAiD deaths – more than 13,000 of these took place in 2022. In 2023, the Special Joint Committee on Medical Assistance in Dying – the one I spoke at – made some alarming recommendations, including expanding MAiD to “mature minors” whose death is “reasonably foreseeable”. They specified that parents could be involved in this process but ultimately, the decision should rest with the child, provided they are deemed capable.

At the moment, the mature minors provision is merely a recommendation. However, it will likely be legislated, given it is a priority of powerful lobbyists who have already created momentum for the rapid expansion of Canadian MAiD.

Here’s how it could roll out: Under Canadian law, specifically the mature minor doctrine, a child’s capacity for decision-making around healthcare procedures is not based on their age. A capacity assessor determines whether the minor in question can fully understand and appreciate the consequences of a procedure. If they are deemed capable of consenting, they are considered a “mature minor”.

There are a few problems with the proposed application of this doctrine to such a high-stakes decision. One is that there is inadequate precision in these assessments. Even for adults, the existing data shows that different assessors can come to different conclusions regarding decision-making capacity in the same case. This is even less studied in children.

Another point of concern is that the Canadian Association of MAiD Assessors and Providers (CAMAP), a group that has received 3.3 million Canadian dollars ($2.5m) in funding from Health Canada to educate MAiD assessors and providers, has created a guidance document that suggests clinicians can be flexible in determining whether someone has a reasonably foreseeable natural death (RFND) since the law does not require that the person must be terminally ill or expected to die within six or 12 months to fit into this category. In this context, expansion of MAID to mature minors would mean that a child as young as 12 with cancer – even one with years to live – could be approved for a lethal injection without parental agreement.

This proposed expansion would also allow minors who aren’t terminally ill at all to choose MAiD. The document also states that a person may meet the “reasonably foreseeable death” criterion if they’ve demonstrated a clear and serious intent to take steps to “make their natural death happen soon, or to cause their death to be predictable”. This could come about as a refusal to take antibiotics for an infection, stopping oxygen therapy or a refusal to eat and drink. If legalised, a disabled minor who states their intention to refuse care or who makes themselves sick enough could qualify as having a reasonably foreseeable natural death under this provision, as is currently happening with adults who are not dying and yet having their lives ended within days of their first MAiD assessment.

As a mother, I can’t fathom living in a country where the government has the power to assist in the suicides of my children without my consent. It is concerning that parents’ knowledge of their children’s maturity and emotional drivers could be ignored by MAiD assessors in Canadian legal context. Parents will be devastated if their child’s request for MAiD is granted against their wishes.

As a physician, there are several reasons why I’m against the expansion of MAiD to mature minors. First, brain development takes a long time; it continues well into our 20s. As a result, pre-teens and teenagers can act impulsively, sometimes engaging in risky behaviours that get them into trouble. With a limited ability to see the future, these youth may be more likely to choose MAiD for misguided reasons – for example, to avoid bullying at school or to be reunited with a deceased loved one. Rates of depression in teens continue to rise, and this can be coupled with the known phenomenon of teenage suicide clustering – where suicides spike after news coverage of one, or after hearing of a close friend or loved one who has self-harmed. I can only imagine the potential for contagion if many Canadian teens begin choosing MAiD.

Evidence from countries where MAiD for mental illness is legal demonstrates that death is often chosen by those who have experienced early childhood trauma, including abuse, which can contribute to feelings of suicidality. In this context, experiences like bullying, discrimination or growing up in the child welfare system might influence a minor’s views on the value of life. One of my dearest friends spent time in the foster care system, and she would tell you that, as a child, she was often perceived as exceedingly mature. For her, this was a survival skill, not an indication of genuine development. In cases like these, some of Canada’s most vulnerable children – who appear capable of making life-altering decisions – could be put at risk by MAiD assessors who judge them at face value. Other minors who remain in abusive homes could choose MAiD as an escape route.

Socio-cultural failings could also contribute to mature minors choosing MAiD. Indigenous people have experienced the effects of trauma, brought on by colonialism, which has led to higher rates of suicide among Indigenous youth (PDF). I have met numerous Indigenous leaders across Canada who are concerned about MAiD, including Graydon Nicholas, who is an Indigenous elder and leader, working to stem suicide contagion among Indigenous youth.

Similarly, Toujours Vivant-Not Dead Yet, a disability-rights organisation, expressed alarm at the suggested mature minors expansion to MAiD. They explained that disabled children sometimes grow up in families where their parents, because of society’s negative perception of disability and lack of provided support, see their children as a burden which in turn causes childhood trauma. Yet this despair often resolves in adulthood and is replaced by an understanding that it is our society that needs to change. Many lives can needlessly be lost if such children are presented with the option to end their lives through MAID before completing their psycho-emotional development.

Lastly, emergency rooms are overcrowded, surgeries are at a standstill and so many Canadians don’t have regular access to family doctors, all of which limits care. Right now, there are no statistics on access to palliative care for Canadian children. Paediatric palliative care centres do exist in several major cities, but most other places have little to no resources. In remote areas, the best care many children can hope for is advice given over the phone to local practitioners – the first subspecialty programme in paediatric palliative medicine was launched in Ottawa in 2021. In a country where paediatric care is this insufficient, an expedient death programme should not be a priority recommendation. We should devote our time and energy to building up palliative-care centres and robust access to disability and mental health supports. We also need better community and educational systems that support children and families, programmes that help build relationships and a sense of meaning and belonging for children – things that make life better.

I lose sleep over Canada’s unchecked MAiD regime. The recent news that Canada might pause the MAiD expansion for mental illness offers little relief in the full scheme of things given the problems and abuses we are already experiencing. In any case, MAiD has expanded rapidly and lobbyists are still gunning for children as young as 12 to be eligible. This runaway train must be brought to a halt now.

Ending the lives of children prematurely is particularly tragic since treatments might be developed that could have extended and improved their quality of life in a future they’ll never have. The idea that we must relieve suffering immediately through MAID distracts from addressing the root causes and potential solutions for suffering. These are not the values of care for the disenfranchised that my parents taught me, that I try to practise in my life and profession, or that I believe most Canadians embrace. Rather than trying to expand its problematic regime of medically assisted death, the Canadian government should focus on improving care and support for all, and fostering community life, purpose and belonging – things we know make life worth living.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.

Suicide among elderly skyrockets after legalizing Assisted Dying in Victoria Australia

By Leslie Wolfgang

Assisted suicide or Voluntary Assisted Dying (VAD) has a correlation to increased suicide among the elderly, revealed a peer-reviewed article published this week. According to research published by Dr. David Albert Jones, Director, Anscombe Bioethics Centre in the Journal of Ethics in Mental Health (2023), the rate of suicide among the elderly in the Australian state of Victoria increased by an astonishing 50%, even exclusive of legalized assisted suicide and euthanasia.

Though assisted suicide is sold to the policymakers of Australia and America as a perverse method to reduce suicide generally, the societal outcome of permitting some people to legally commit suicide has caused many other people to attempt and succeed in their own suicides. It is as though suicide is a social contagion — which it is.

This is in addition to a steady increase in demand for legal assisted suicide year over year since VAD was adopted in Australia. According to the annual report of the Voluntary Assisted Dying Review Board’s latest publication for July 1, 2022 to June 30, 2023, the number of deaths via assisted suicide in Victoria increased by 11% to 306, and the number of applications for assisted suicide increased by six percent over the previous year.  

This data, coupled with the revelation that suicide among the elderly in Victoria has increased by 50% should give pause to any policymakers wondering if assisted suicide is good public policy. 

In the Australian state of Queensland, assisted suicide is happening at a shocking rate as revealed by latest reports. Australians there are dying from assisted suicide and euthanasia at rates even higher than Victoria or Western Australia. In a shocking international news story, the Australian Capital Territory Human Rights Commission in a report to the Voluntary Assisted Dying Committee criticized current Australian law for not permitting minors to utilize their “assisted dying” legal regime.

Many critics of assisted suicide claim that assisted suicide advocates are never satisfied with any restrictions or conditions on access and will continually fight for the expansion of criteria for accessing assisted suicide. Continued efforts for expansion in Australia, Canada, and America may prove them correct.

Leslie Wolfgang is a Board Member of the Euthanasia Prevention Coalition -USA.

Australia Human Rights Commission pushes Assisted Suicide for Children

This article was published by National Review online on January 4, 2024.

Wesley Smith

By Wesley J Smith

Assisted suicide is being legalized all over Australia, and I fear the country is going to go the dark route Canada has after it legalized euthanasia. Case in point: There is a bill before the Australian Capital Territory (ACT) to legalize assisted suicide. The Human Rights Commission criticizes the proposal for restricting assisted-suicide eligibility to adults:

Improvements to the proposed scheme:

We detail below certain of our earlier recommendations that have not been incorporated into the Bill.

1. Access for Children and Young People under 18: the current scheme is limited to individuals over the age of 18 years old. Human rights principles require due consideration for the rights of children and young people, including their right to access health care without discrimination and their right to have their views taken into account.

It is the Commission’s view that this extends to decisions for a child or young person to voluntarily end their life with dignity in the same circumstances as adults: namely where they have a condition that is advanced, progressive and expected to cause their death, where they are suffering intolerably, where they are acting voluntarily, and where they have demonstrated maturity and capacity to make such a decision. We recognise that there may need to be additional steps and safeguards for children and young people, particularly where the views of parents and carers differ from the young person or from each other.

If adopted, this means that “mature” minors would be able to be made dead without their parents’ permission and children no matter how young could be put down.

Canada isn’t there yet, but the same approach has been seriously proposed in that country. Belgium and the Netherlands already permit euthanizing children, and the Netherlands allows infanticide under the “Groningen Protocol.” 

Previous articles on this topic:

• The euthanasia lobby is pushing for child and infant euthanasia (Link).
•  Canadian children may be euthanized with or without parental consent (Link).

2023 Euthanasia Prevention Coalition Year in Review

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition (EPC) blog had almost 1.1 million blog articles read in 2023. 2023 was an active year for news related to euthanasia and assisted suicide. This article shares many of the most important stories.

We encourage you to renew your EPC ($25) membership (Link).

In early January 2023 we reported that a Colorado man accidentally ingested lethal assisted suicide drugs while attending an assisted suicide death (Link). This story emphasized the fact that there is no independent oversight for assisted suicide. In late January we reported that a Vancouver doctor euthanized a man who was deemed to be incapable of consenting (Link). Dr Ellen Wiebe is Canada's most notorious euthanasia doctor. We also reported on Tyler Dunlop who was homeless and seeking death by euthanasia (Link).

Dr Leonie Herx

In early February we reported that the United Church approved a euthanasia prayer (Link). Soon after, a Canadian Health expert issued a warning to Scotland's parliament concerning Canada's euthanasia law (Link). In mid February, Canada's Special Joint Committee on Medical Aid in Dying issued a report calling on parliament to extend euthanasia to "mature minors" and by advanced directive (Link). According to the report, Canadian children would be able to be euthanized with or without parental consent (Link).

In March we published the article - Where the Churches stand on euthanasia (Link).

In April a court case was launched to declare California's assisted suicide law as unconstitutional (Link). The court case is continuing into 2024.

In early May an Ontario man was arrested for selling a suicide substance online (Link). In mid May Bill C-314, a bill that would have prohibited euthanasia for mental disorders, had it's first hour of debate in Canada's parliament (Link). We also reported that a Québec funeral home was offering euthanasia (Link).

Rose Finlay

In June, the Uniform Law Commission came to stalemate on proposed changes to Brain Death protocols (Link). In June we reported that a Canadian quadriplegic woman was approved to die by euthanasia as she waited for approval for disability benefits to enable her to live (Link). In late June we reported how the Ontario government hides the cost of euthanasia (Link). We also reported that the euthanasia lobby had launched a campaign to force a Catholic hospital in BC to provide euthanasia (Link). In December, the BC government expropriated property from the Catholic hospital to build a killing center next to the Catholic hospital (Link). 

In early July the German Bundestag rejected bills to legalize assisted suicide (Link). Later in July a Canadian military veteran slammed the Canadian government for the euthanasia deaths of veterans with PTSD (Link). We also reported that a transgendered person, who was denied euthanasia, requested it based on post surgical pain and regret (Link).

Kathryn Mentler

In August we reported that a Canadian woman was offered euthanasia as a "treatment" during a mental health crisis (Link).

In September we reported that a Belgian doctor completed a euthanasia death with a pillow (Link). In mid-September I wrote about my experience visiting the Memorial to the Victims of Euthanasia in Berlin (Link).

In mid-October, Bill C-314, that would have prevented euthanasia for mental illness, was defeated (Link). In late-October Health Canada reported that there were 13,241 assisted deaths in 2022 representing 4.1% of all deaths (Link).

In November I published an article titled: Canada's euthanasia law has gone "mad" (Link). This article was made into a pamphlet that can be ordered from EPC (Ordering Link).

In December, Tyler Dunlop, who had applied to die by euthanasia, published a book titled: Therefore Choose Life - My Journey from Hopelessness to Hope (Link). Order the book from EPC (Order Link). We reported that a BC woman, who had cancer and offered euthanasia, was successfully treated in the US (Link). Soon after we reported that a BC cancer patient died by euthanasia after BC Cancer couldn't provide him chemotherapy (Link). Waiting lists for cancer treatment in Canada continues to get worse.

In December Canada's Justice Minister announced that the government may "pause" it's plan to extend euthanasia to people with mental illness (Link). EPC launched a petition campaign to prevent the extension of euthanasia to people with mental illness (Link).

You are not alone. The Life-Protecting Power of Attorney for Personal Care may save your life (Link).

We encourage you to renew/become a member of EPC ($25) (Link).

A Warning from Canada to Hungary about Euthanasia

Dear Hungarians,

Amanda Achtman

I visited your country this time last year and was deeply impressed and inspired by it. Now that I hear Hungary is considering legalizing euthanasia, I must issue a warning to you about this from my home country of Canada.

Canada legalized euthanasia nationwide in 2016. Since then, with the criteria expanded and safeguards eroded, euthanasia now accounts for 4.1% of all deaths and is the fifth leading cause of death.

In fact, the number of Canadians who have died by euthanasia since legalization is commensurate with the total number of Canadians who died of Covid.

Having monitored the debate and expansion of euthanasia closely for the past several years, I have some important information to share with you that will hopefully prevent Hungary from going down the same path.

Euthanasia will not be limited.

Initially, euthanasia was legalized for those whose deaths were deemed “reasonably foreseeable.” Patients were required to have a “grievous and irremediable” condition. But soon, this was seen as discriminatory against those who were suffering but not imminently dying. And so, a second track (literally named “Track 2”) was created to qualify for euthanasia those whose deaths were not imminent. Initially, this was for those suffering from physical pain but then this was seen as discriminatory against those who were suffering from psychological pain. So, euthanasia was expanded to those not imminently dying and to those with psychological suffering rather than physical all under the rubric of equality. As long as euthanasia is seen as a reasonable solution to suffering, then there is no limit as to who should quality for this relief. For this reason, euthanasia activists have advised euthanasia for children who, when speaking before parliamentary committess, they refer to as “mature minors.” As soon as euthanasia is seen as a good for society and for suffering persons, any rationale to limit it will be arbitrary and considered unjust by at least some of those who are excluded by the criteria.

Euthanasia will undermine suicide prevention efforts.

Though we have gone through many euphemisms, nothing can change the reality that euthanasia is simply suicide with an accomplice. The euthanasia lobby stopped using the terms euthanasia and assisted suicide because it is bad for public relations. And so, we have gone from “euthanasia” to “assisted suicide” to “physician-assisted suicide” to “medical aid in dying.” Now in law, politics, and journalism, the English acronym for the latter is used universally. This deadens people’s consciences so that they do not realize that premature killing is precisely what is meant by “MAID.” As George Orwell said, “As language corrupts thought, so thought also corrupts language.” Many people who work in palliative care believe that palliative care is the true assistance in dying; they would never dream of killing their patients. But now, these lines are becoming blurred. Unfortunately, we now have a two-tier society where some people get suicide prevention and others get suicide assistance. This is terribly unjust because everyone deserves suicide prevention.

Euthanasia will devalue the lives of people with disabilities.

Many people with whom I speak tell me they think euthanasia is reasonable for persons with a certain illness or disability. They will usually name a particular condition that, in their mind, justifies premature death. Yet, even if they would say that euthanasia should never be coerced, suggesting that there is any threshold at which a person’s life is not worth living denigrates their life and sends the message that their life is less valuable. Furthermore, many persons with disabilities attest that they are being de facto coerced to consider euthanasia due to lack of adequate supports to live. I cannot stand by idly when my fellow citizens with disabilities attest that they are tempted to seek euthanasia because they lack housing, money for food, accesibility provisions, or even family, friends, or visitors who care about them. This is clearly an urgent cry for help, not death.

Euthanasia will threaten the doctor-patient relationship.

When a doctor raises euthanasia with a patient, it already deflates them. Simply put, it is dehumanizing to tell someone that they qualify to die. In Canada, many advocates tried to ensure that euthanasia would only ever be patient-initiated. At least, this way, patients would not be counselled to consider suicide in a moment of weakness, vulnerability, or pain. But now it is the complete opposite. Doctors are being compelled to present “MAID” as an option to all eligible patients which, as you can see, is many of them. Even if someone does not choose euthanasia for themselves, it takes a toll to even have it suggested or to know that the phsyician has euthanized other patients or referred them to their deaths. This makes it harder to trust that the doctor will truly do everything for the sake of preserving health. Euthanasia is an easy way out and, since it is legal and commonplace, there is next to no investigation of the abuses which often leaves grieving family members traumatized.

Euthanasia will cut short our opportunities to love.

Premature death cuts short the capacity to show and receive kindness in the world. Every euthanasia death short circuits our opportunities to love. And if someone is asking for euthanasia because they do not feel loved in first place, then the right response is not lazy indifference (sometimes masqueraded as “support”) but rather a loving and urgent intervention. Those who are in need make an appeal to us. It is so important that we do not miss the opportunity to respond to them. It is the very basis of our humanity to be responsible in this way -- to care and be cared for.

To avoid descending into a euthanasia society, my recommendations are to:

1. Provide the supports that people across diverse demographics need to live.
2. Bolster self-harm and suicide prevention efforts across all generations.
3. Work toward ever-better inclusion of persons with disabilities.
4. Insist on the role of doctor as healer, not killer.
5. Affirm the value of those suffering and caregiving heroically by letting them know that it’s good they exist. Notice the challenge that it is to suffer, die, and caregive well and praise those who are doing it for their courage.

Through promoting these actions and attitudes, we can create a society where dying naturally is not shameful or “undignified”, but rather a supreme occasion for realizing what is significant in life. All of this is what the dying person deserves. And for all of us, one day that dying person will be us.

Amanda Achtman recently served as the senior advisor to a Canadian parliamentarian working to prevent the expansion of euthanasia on the basis of disability and mental illness. She currently works with Canadian Physicians for Life on ethics education and cultural engagement. Amanda is also the founder of Dying to Meet You, a project dedicated to preventing euthanasia and encouraging hope.

@AmandaAchtman / DyingToMeetYou.com