Assisted suicide not the answer to NHS financial crisis

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

While Canada's parliament debated the expansion of the euthanasia law in 2020 to remove the requirement that a person be terminally ill, the Parliamentary Budget Officer projected that Canada's provinces would save at least $149 million per year if the expansion bill (Bill C-7) passed. An examination of the data reveals that this cost saving estimate was very conservative.

James Orr, an associate professor at the University of Cambridge, published an article in Newsweek on November 27, 2024. Orr discusses the financial crisis within the British National Health Service (NHS) and the proposal to legalize assisted suicide. 

The Labour party won a majority government in the July 2024 election giving Prime Minister Keir Starmer, a long-time supporter of assisted suicide, the responsibility of financially saving the National Health Service (NHS).

  Orr explains:

Labour's watershed budget exposed an existential challenge that threatens to drain our collective coffers. For the first time, the National Health Service's (NHS) annual budget has surpassed an eye-watering £200 billion. Taxpayers must pour ever-increasing resources to this bottomless void to prevent its total collapse.

The Chief Secretary's admission that "everyone recognises that the system is broken" rings hollow against the £20 billion emergency infusion for operational costs—a lifeline offered without any corresponding demands for enhanced efficiency, reduced waiting times, or structural reform. The arithmetic is unforgiving: Even substantial tax increases cannot satiate this growing appetite.

Starmer encouraged Labour MP Kim Leadbeater to sponsor a private members bill to legalize assisted suicide.

Orr writes:

Since this sobering fiscal reality check, parliamentarians are now racing to pass legislation that would enable physicians to facilitate their patients' deaths through assisted suicide. Although initially restricted to those with terminal diagnoses of six months or less, the experiences of Belgium, the Netherlands, and Canada serve as stark warnings: As surely as night follows day, such "safeguards" will disintegrate on contact with the messy reality of physical suffering and psychological discomfort to encompass an ever-widening circle of patients.

The economic calculus underlying assisted suicide advocacy has always haunted it. Consider the chilling prediction of Jacques Attali, former president of the European Bank for Reconstruction and Development, that euthanasia would become "one of the essential instruments of our future societies" once humans persist beyond their productive years, or Baroness Warnock's nakedly utilitarian arguments that those who burden their families or the state ought to be "allowed" to die.

What makes the assisted suicide debate in Britain even more telling is the lack of alternative policies that are being considered concerning the NHS economic woes.

 Orr warns that economic pressures will lead to more assisted suicide:

What begins as a right will shade rapidly and imperceptibly into an obligation, not least because the raw economic pressures are impossible to ignore. While inpatient hospice care costs £3,000 to £4,000 weekly, the administration of a cocktail of poisons or treatment in a portable gas chamber will cost a negligible fraction of that. One does not need to be an expert in public policy to recognize that such stark cost differentials will shape future policy decisions.

Orr urges the Labour government to protect society's vulnerable:

Whatever noble intentions Kim Leadbeater and her supporters may harbor, public policy must be evaluated by a concrete evaluation of its likely consequences. If this government truly aspires to progressive ideals of protecting society's most vulnerable, it must resist the temptation to sacrifice human dignity on the altar of fiscal expediency.

 

 Articles on this topic:

• Balancing Canada's Healthcare Budget with Euthanasia (Link) 
• Is the assisted suicide debate about healthcare savings? (Link).
  
• Canada's Healthcare Savings Attributed to Euthanasia (Link).

 

A plea for removing the "Medical" from Medical Aid in Dying

By Gordon Friesen
President, Euthanasia Prevention Coalition

Gordon Friesen

It is a singularity of the British debate on assisted suicide, that considerable attention has been given to the possibility of creating a non-medical framework for this practice.[1] [2] In what follows we will briefly review the "why" and the "how" of such propositions.

Protecting majority patient interest

In most discussions of medically assisted death, very little concern has been shown for the quality of future care available to those who wish to go on living.

This is a truly extraordinary omission, because although there are some people who might surely wish to die, most of us will not. Nor is this last statement born of speculative opinion. It is an observed fact.

For example, the iconic terror of terminal cancer accounts for roughly 70% of euthanasia deaths in Canada, Belgium, and the Netherlands. And yet, as a share of all cancer deaths, that number is only 1 in 10.[3] Which is to say that only 1 cancer patient in 10 will consent to die by euthanasia (and far fewer in any other group).

In truth, the principal concern of typical dying patients is not suffering. Their main fear is of death itself. And their main comfort, faced with that mortal inevitability, lies not in the willingness of others to cut life short, but in the trust and confidence that family and professionals will value what life remains; and foster that life to the end, allowing them to die without precipitation, in their own time.

Traditionally, this patient confidence has been founded upon a multi-millennial promise affirmed by each individual physician: "I will do no harm or injustice... Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course."[4]

In the opinion of many, the removal of that positive certainty cannot possibly occur without a radical destabilization of doctor-patient relationships.

Assisted suicide and traditional care: mutually exclusive paradigms

Promoters of MAID, for their part, deny that the medically assisted death of willing individuals will have any effect upon the care provided to anyone else.

And yet it seems impossible to believe that physicians (or nurses) who participate in any form of medical homicide might still be considered appropriate caregivers for patients of the non-suicidal majority. One cannot be all things to all people. It would appear frankly inconceivable that the same doctor might pass from one patient to the next --presenting medically in precisely the same manner-- but to change so radically between times in his professional opinions, as to honestly favour the death of one but not the other.

In truth, euthanasia and traditional medicine are not only different, but mutually exclusive visions of patient care, and are practiced by individuals who are different also. Plainly stated: assisted death cannot be "added" to Hippocratic medicine any more than steak can be added to a vegetarian diet.

It is our most emphatic conclusion, therefore (and especially considering the one-sided quantitative division noted above) that any minority accommodation of assisted suicide should be provided apart from existing medical practice, in separate spaces and by separate professionals; that such accommodation must not be allowed to compromise --for others-- that precious clinical culture of trust and safety which physicians have so carefully cultivated over the past 2400 years.

What a non-medical regulating body might look like

In essence, a non-medical framework for assisted suicide would require the creation of a dedicated judicial authority like the Landlord and Tenant Board, or the Food Standards Agency: to evaluate requests, authorize procedures, license providers, regulate practice, and analyze reported data.

To explain the relative advantages of such a system, we will compare its projected operation with that of the most coherent system of medical euthanasia thus far established, that of Britain's close Commonwealth partner, the former Dominion of Canada.

The institutional "footprint" of medically assisted death

In Canada, "Medical Aid in Dying" (i.e. voluntary euthanasia) is defined as medical care whose goal is to relieve "enduring physical or psychological suffering" (2014,[5] 2016, 2021[6]).

In accordance with State duties to provide medical care as a human right,[7] euthanasia is practiced in all Canadian institutions, and by all Canadian professionals (subject only to minimal conscience exceptions). In particular, euthanasia is now an integral part of palliative care,[8] long-term care, and rehabilitation.[9] In all of these areas, professionals are theoretically expected to remain officially neutral regarding a patient's will to live; to "respect" whatever suicidal ideation might arise; and are empowered even to both initiate and channel that ideation themselves.[10] [11]

Finally, all meaningful limits to eligibility --including "reasonably foreseeable death",[12] "major age",[13] [14] [15]and "mental capacity"[16] [17]-- are being (and have been) successively abandoned, since suffering itself knows no such boundaries. Euthanasia for mental illness alone is authorized to begin in March, 2027,[18] euthanasia of demented patients by advance request has already begun in the Province of Quebec.[19]

It would be impossible to imagine a system better designed to maximize the practice of euthanasia. And indeed, that maximization is to the obvious benefit of systemic budgetary interest.[20]

It thus transpires that the vast non-suicidal majority of Canadian patients are left with nowhere to go; no place where they may confidently expect care from professionals who believe that they should be allowed (and even encouraged) to persevere in living. They are forced, instead, to navigate a clinical environment which has become objectively indifferent (if not openly hostile) to their continued survival.[21]

A minimally intrusive judicial authority

As envisaged under a non-medical authority, assisted suicide is completely severed from medical practice. The proposed regulatory body would arise from the Ministry of Justice, structurally distinct from that of Health.

Most importantly, when assisted suicide is not defined as medical care, it confers none of the special obligations associated with that status. The liberty granted is one of permission only. There is no public guarantee of provision. No mandates. No funding. No entitlement of any kind.

To the greatest extent possible, other patients would be undisturbed by required formalities. Actual assisted deaths would occur in designated locations outside of National Health Service (NHS) facilities. No patients --to insist on this crucial point-- would ever be importunately engaged in death-suggestive discussions initiated by doctors, or other staff.

Delivery and Financing: NHS obscurity versus independent transparency

If offered as a medical service by the NHS, all of the work required for assisted death --from information, to evaluation, to provision of service-- would come from doctors and nurses employed by that body. In the absence of new funding, therefore, the full cost of MAID would be carved out from existing programs, effectively cannibalizing thinly-stretched professional resources.[22]

A paradoxical dynamic is thus created whereby money is reputedly saved (by substituting death for care) but where physician availability for traditional medical purposes is nonetheless reduced.

If, on the other hand, assisted death is allowed by permission only, no public costs need be assumed beyond that of the regulatory body itself (and even those might be recuperated, just as fees are charged for motor vehicle registration).

The actual work of evaluation, preparation, accompaniment, and treatment of remains would be performed by non-profit charitable entities, licensed and regulated to that end, whose billing of clients would not be a public concern.

In conclusion

On the principal question, concerning the extraordinary social perils of establishing a legal precedent for the wilful taking of life, lawmakers are hereby earnestly entreated to reject any authorization of assisted suicide whatsoever.

If, however, we are eventually reduced to choosing between what is bad and what is worse: defining assisted suicide as medical care --and providing that service through public medical administration-- creates further grievous and unnecessary harms to the natural interests of the citizen/patient/taxpayer, which might be avoided through a non-medical regulatory framework, and non-governmental service provision.

Regardless, therefore, of any separate concession to death-as-choice, we emphatically demand that the introduction of death-as-medical-care be abandoned; that legislators preserve the integrity of our healing institutions, professions, and clinical practice, “To cure sometimes, to relieve often, to comfort always”.[23]

Gordon Friesen,
President, Euthanasia Prevention Coalition
www.epcc.ca

December 2, 2024

Footnotes:

[1] Preston, Nancy; Payne, Sheila; Ost, Suzanne, Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach BMJ 2023;382:p1968 accessed July 22, 2024

[2] Twycross, Robert Assisted dying: principles, possibilities, and practicalities. An English physician’s perspective accessed July 22, 2024

[3] Note on Canadian and Dutch cancer euthanasia as a fraction of all cancer deaths: Terminal cancer is the category in which consent to euthanasia is most frequent (70% of all euthanasia deaths). However, in Canada and the Netherlands where all cancer patients are informed of their eligibility only 10-11% consent to die in that manner.

***

Canada total deaths: 330,380 statista.com accessed Nov.30. 2024

Canada euthanasia deaths: 15280 epcc.ca accessed Nov.30. 2024

Canada total cancer deaths 86700 cdn.cancer.ca pg. 35 accessed Nov.30. 2024

Cancer fraction of all deaths (86,700/330,380) ,26

Canada euthanasia fraction of all deaths .046 (note 2) Cancer fraction of all euthanasia .63 canada.ca chart 4.1a

Canada cancer euthanasia fraction of all deaths (.046 x .63) ,029

Canada euthanasia fraction of all cancer deaths (.029/.26) .11

***

Netherlands total deaths 170,100 statista.com accessed Nov.30. 2024
Netherlands total cancer deaths (2022) 49,790 wcrf.org accessed Nov.30. 2024
Netherlands (2023) total euthanasia 9,068; cancer euthanasia 5105 english.euthanasiecommissie
Netherlands cancer fraction of total deaths: (49,790/ 170,100) .29
Netherlands euthanasia fraction of total deaths: (9,068/ 170,100) .053
Netherlands cancer fraction of total euthanasia: (5,105/ 9,068) .56
Netherlands cancer euthanasia fraction of all deaths (.56 x .053) .03
Netherlands cancer euthanasia fraction of all cancer deaths (.03/.29) .10

[4] Hippocratic Oath wikipedia.org accessed July 22, 2024

[5] Quebec S-32.0001 - Act respecting end-of-life care accessed July 22, 2024

[6] Canada maid law as of 2024 (synthesis) accessed July 22, 2024

[7] Constitution of the World Health Organization accessed Jult 23, 2024

[8] Schadenberg, Alex, Euthanasia being forced on Montreal palliative care home, Euthanasia Prevention Coalition, December 2, 2023 accessed July 22, 2024

[9] Garcia-Santesmases, Andrea, El cuerpo deseado, la conversación pendiente entre feminismo y anti-capacitismo, Ed. Kaótica Libros, Madrid, 2023, pp. 210,211

[10] College of Physicians and Surgeons of Ontario HUMAN RIGHTS IN THE PROVISION OF HEALTH SERVICES September 2008 Reviewed and Updated: March 2015, September 2023 See Section 10 and 12 (not merely a permission, but a positive duty to raise MAID eligibility) accessed Nov. 30, 2024

[11] Collège des médecins du Québec, LE MÉDECIN ET LE CONSENTEMENT AUX SOINS, MIS À JOUR EN OCTOBRE 2023, see section 1.2, appropriate care-decisional process accessed Nov. 30, 2024

[12] Government of Canada Bill C-7 (2021): An Act to amend the Criminal Code (medical assistance in dying), eligibility changed to accept non-terminal patients accessed Nov. 30, 2024

[13] Canada, Special Joint Committee on Medical Assistance in Dying, Febrary 2023, Mature Minors accessed Nov. 30, 2024

[14] Coelho, Ramona Canada’s assisted dying regime should not be expanded to include children, Aljazeera, 16 Feb 2024 accessed Nov. 30, 2024

[15] Lévesque, Catherine, Quebec College of Physicians slammed for suggesting MAID for severely ill newborns, National Post Oct 11, 2022 accessed Nov.30. 2024

[16] (euthanasia of demented patients by advance request) QC Bill-11 (2023) An Act to amend the Act respecting end-of-life care and other legislative provisions , 29.1 and following: Special provisions applicable to advance requests for medical aid in dying" in force as of Oct. 30, 2024

[17] Ferrier, Catherine, Advance directives for assisted death a recipe for abuse Montreal Gazette, May 26, 2022 accessed July 23, 2024

[18] Canada to delay assisted death solely on mental illness until 2027, Reuters, February 1, 2024

[19] see note 17

[20] Schadenberg, Alex, Canada's health care savings attributed to euthanasia, Euthanasia Prevention Coalition, October 20, 2020

[21] Friesen, Gordon, Bad care brings euthanasia and euthanasia brings bad care, Euthanasia Prevention Coalition, May 30, 2024 accessed July 22, 2024

[22] Schadenberg, Alex, How the Ontario government hides the cost of MAiD (euthanasia), Euthanasia Prevention Coalition, June 30, 2023 accessed July 22, 2024

[23] Siegel, Mark David, To Comfort Always , Yale School of Medicine, June 24, 2018. accessed July 22, 2024

UK assisted death bill: a disability perspective

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Madeleine Kearns has written an excellent article examining the issues related to the UK assisted death bill from a disability perspective, published in The Free Press on November 27, 2024. 

Jamie Hale

Kim Leadbeater's assisted dying bill will have it's second reading vote on November 29. Kearns writes:

Jamie Hale has been in and out of the hospital for more than half his life. The 33-year-old Brit needs a wheelchair and relies on partial ventilation and round-the-clock care. Several years ago, he was critically ill and hospitalized for six months “as a direct result of not having had that care,” he told me from the back of a car on his way to a weekly visit at a National Health Service clinic in London. “I’d be dead without the NHS,” he concludes. 

Even so, Hale—who has a master’s degree in philosophy, politics, and the economics of health—often thinks about how much his life costs the state. “I’m very aware I’m not cost-effective,” he added. “It’s very hard not to be aware you are the kind of financial burden the system is creaking under.” 

Hale is deeply opposed to the assisted suicide bill that the United Kingdom’s Parliament is voting on this week.

Hale, who is not terminally ill, is concerned about assisted dying. Kearns explains:

At first glance, the law appears to have little to do with people like Hale. His condition, which he prefers not to specify, is chronic and progressive, but it isn’t terminal. Still, he’s among many disabled people, end-of-life doctors, and concerned citizens who fear the law could put vulnerable people under pressure to end their lives, and start a slippery slope toward future laws allowing euthanasia for the disabled, the poor, and the depressed.

Opposition to assisted dying comes from many perspectives:

If the law passes, Hale worries it will “change the way we think” about end-of-life care. “It’s going to make it look perhaps increasingly selfish to stay alive in an expensive way.”

Kearns interviewed Claire MacDonald, Director of development for the assisted death lobby group, My Death, My Decision. MacDonald argues that people want to avoid a bad death and many people in Britain are dying a bad death.

Matthew Doré

Matthew Doré, honorary Secretary of the Association of Palliative Medicine of Great Britain and Ireland, opposes assisted dying and says that legalizing assisted dying is not necessary:

... it’s common for people coming into a hospice to say, “I want to die, kill me now,” but once they have the holistic support they need, that feeling “just melts away, disappears pretty much completely in almost everyone.”

Not all assisted deaths are peaceful:

What’s more, assisted suicide does not always lead to a more peaceful death, Doré said. Studies show that complications from the lethal drugs include burning, nausea, vomiting, and regurgitation, severe dehydration, seizures, and regaining consciousness. In Oregon, the annual complication rate is nearly 15 percent, although it’s likely higher given that “patients often ingest the lethal drugs without a healthcare professional present to record complications,” one study reported.

Kearns states that legalizing assisted death will save healthcare money:

Once the jewel of the UK, the National Health Service has recently been dogged by staff shortages and strikes. A 2024 report found the UK lagging behind 10 other developed countries on hospital wait times. Only Canada had comparably long wait times, while the U.S. was one of the best-performing countries for timely access to care. ...Earlier this month, a Telegraph columnist wrote that “assisted dying will leave society financially better off” as well as help “people protect their family wealth.” Earlier this year, a Times of London writer suggested it would be “a healthy development” if assisted suicide for the infirm is “considered socially responsible—and even, finally, urged upon people.”

Cost savings studies from Canada:

In 2017, one year after Canada legalized assisted suicide, a report estimated the procedure could save the country between $34.7 million and $138.8 million annually. In 2020, ahead of the expansion of Canada’s Medical Assistance in Dying program (MAID) to include those with disabilities and chronic illness, the government projected it would save an additional $62 million a year. At the same time, the number of assisted suicides in the country keeps rising. In 2019, MAID accounted for 5,665 deaths; by 2022, that figure was 13,241. Today, MAID is at least the fifth leading cause of death in Canada.

Wes Streeting, the UK's Secretary of Health, opposes assisted dying:

Wes Streeting, the UK’s Health secretary, worries that assisted dying will come at the expense of NHS funding in other areas. Palliative care in the NHS currently receives only 37 percent of funding from the state, the rest coming from charity. Assisted suicide would be entirely state funded.

Paula Peters, who had a DNR placed on her medical chart without her consent:

And some say the NHS might already be encouraging people toward an untimely death. During the pandemic, Paula Peters, 53, was one of hundreds of people who discovered her doctor put a “do not resuscitate”—or DNR—notice on her medical records without her knowledge. After Peters discovered the DNR on her records, she had to fight for nine months to get it removed, she told The Free Press.  

“My doctor thought I was disposable and expendable because I was clinically extremely vulnerable, and that had a profound impact on me,” said Peters, who has rheumatoid arthritis and other disabilities. “I’m not a piece of rubbish you can just toss aside.” 

Kearns concludes:

If it becomes law, Hale worries that a society uncomfortable with disability will suddenly have more justification to remove people like him from it. “If you live long enough, you will probably become disabled,” he said. “People don’t necessarily want to engage with that. We are the future that they’re terrified of.”

Previous articles about the UK assisted suicide bill: (Link to articles).

Balancing Canada's healthcare budget with euthanasia

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Based on the number of euthanasia deaths, Canada's healthcare system saved at least $568 million in 2021, 2022 and 2023.

In October 2020, Canada's Office of the Parliamentary Budget Officer released a report titled: Cost Estimate for Bill C-7 "Medical Assistance in Dying." The report was created for Canada's parliament during the Bill C-7 debate. Bill C-7 (among other changes) expanded euthanasia to people who are not terminally ill.

The report concluded that Bill C-7, if passed, would enable Canada's healthcare system would save $149 million in 2021.

At the time of the report I published an article stating:

I estimate that the numbers in the report are low for two reasons. The first reason is that we will have more euthanasia deaths than predicted. The second reason is that people with months and years to live will be dying by euthanasia leading to cost savings far beyond predictions.

These cost savings will not only be related to the medical system but also to the cost of social services. People on a disability pension, or people living on welfare, as well as the cost savings related to retirement benefits.

Sadly, some people will point to the cost savings as a positive reason to promote euthanasia. 

There has not been another published report by the Parliamentary Budget Officer (PBO), but I believe that the estimates by the PBO were low. For instance, the PBO estimated that in 2021 there would be 6,465 Track 1 MAiD deaths and 1164 Track 2 MAiD deaths when in fact there were 9,869 Track 1 MAiD deaths and 223 Track 2 MAiD deaths. 

Based on the cost saving data from the PBO, euthanasia deaths accounted for at least $144.5 million dollars saved by Canada's healthcare system in 2021 ($132.65 million saved from Track 1 deaths and $11.85 million saved for Track 2 deaths).

The PBO did not estimate the amount of social service cost savings from euthanasia of people with disabilities or people living on welfare or people collecting retirement benefits. We know that some people who died by euthanasia were living with chronic conditions and would have had years, not months left to live.

What about the healthcare savings in 2022 and 2023?

Since I don't have the data to estimate the increase in the base cost of euthanasia I will stick to the conservative estimate by using the PBO report from October 2020.

The 2022 Annual Report reported that there were 13,241 reported MAiD deaths with 12,788 Track 1 deaths and 463 Track 2 deaths. 

Based on the conservative PBO data, in 2022 euthanasia deaths accounted for at least $196.5 million saved by Canada's healthcare system ($171.8 million saved from Track 1 deaths and $24.7 million saved from Track 2 deaths). 

Once again, the $196.5 million does not include increased healthcare costs related to inflation and other factors.

The 2023 annual report on Medical Assistance in Dying in Canada is not yet released but based on provincial data, that EPC collected I estimate that there were 15,300 MAiD deaths in 2023. Since I do not have all of the data I will estimate the Track 2 deaths as 3.5% of all MAiD deaths, as in 2022. According to my 2023 estimates, there were approximately 14,765 Track 1 MAiD deaths and 535 Track 2 MAiD deaths (there were likely more Track 2 deaths).

Based on October 2020 PBO report, in 2023 there was at least $227 million saved by Canada's healthcare system ($198.5 million saved from Track 1 deaths and $28.5 Million saved from Track 2 deaths).

Canada's healthcare system has saved at least $568 million since January 1, 2021 not including savings to social service costs and retirement benefits.

The actual amount is likely higher than $568 million. I am convinced that the original PBO data under-estimated the savings associated with killing Canadians and I did not include inflation data in my estimates for 2022 and 2023.

Euthanasia is not about freedom choice and autonomy but rather it abandons people at their time of need.

No amount of money can justify killing people. 

Assisted Suicide: A perverse disincentive in health care

This article was published by the Protect Children's Lives website.

By Michelle de Boer
Protect Children's Lives

Medically assisted suicide has become a controversial issue in Canada and other countries, as it raises moral and ethical questions about the right to die. While it may seem like a humane solution for those suffering from unbearable pain and terminal illness, there is a growing concern about the unintended consequences of this practice on the public health care system.

One of the most concerning issues is the creation of a perverse disincentive in health care, where death may be chosen as a cost-saving measure instead of providing necessary treatments and support. With the rising cost of health care and an aging population, some experts believe that medically assisted suicide could become an attractive option for healthcare providers struggling to balance the demands of cost-effectiveness and patient care.

For example, patients who are diagnosed with a terminal illness and require expensive treatments, such as cancer or a chronic condition, may be presented with assisted suicide as a way to end their suffering and save the healthcare system the cost of their care. This creates a situation where death becomes an option instead of life, and patients are forced to choose between their dignity and their right to receive proper care.

Moreover, the trend of medically assisted suicide also has a chilling effect on end-of-life care, as it shifts the focus from providing palliative care and support to patients and their families to the more cost-effective option of death. This not only undermines the core values of the health care system, but it also has severe implications for the quality of life of patients who are facing their final days.

In conclusion, while medically assisted suicide may seem like a solution to the growing concerns about end-of-life care and the rising cost of health care, it creates a disturbing disincentive in the public health care system, where death is chosen over life, and patients are denied the care and support they deserve. We must address this issue and find ways to ensure that all patients receive the best possible care and support, regardless of their health status or financial situation.

This is a call to action for all concerned citizens and healthcare providers to participate in the «Protect Children’s Lives Initiatives Against Child Euthanasia». Our responsibility is to ensure that children, the most vulnerable members of our society, are protected from the dangers of medically assisted suicide.

We must work together to raise awareness about the severe implications of this practice on children’s health and well-being and to promote alternative solutions that respect the dignity and rights of all patients, regardless of their age or health status. Through advocacy, education, or community outreach, we can make a difference in the lives of children facing life-threatening illnesses and conditions.

Join us in our efforts to protect children’s lives and ensure they receive the best care and support. Your voice, your support, and your commitment can make a difference. Together, we can make sure that the next generation grows up in a world where life is valued and where everyone has the right to receive proper care and support.

Roll back the euthanasia mandates now!

By Gordon Friesen
President, Euthanasia Prevention Coalition

Healthcare has long been the 300 lb. gorilla on the Canadian political stage. History has shown that there are few expenses that people will not incur to extend their lives. The tax revenues raised for this purpose are positively staggering: nearly a third of all government spending, and 18% of GDP.

Unsurprisingly, this enormous treasure is aggressively courted by all sorts of political actors (presenting their own pet projects as "healthcare") while actual medical care, itself, is shortchanged in the process. Waiting times, rationing, corridor medicine, these have become the hallmarks of Canada's healthcare system.

Imagine then the administrative enthusiasm which has been fueled by the notion that death (euthanasia) might now be provided as medical care!

(Please note that I am not talking about death-by-choice as a condition of personal self-determination. That is another question entirely. The subject now is euthanasia, prescribed as a cure for all that ails us, by doctors --and sundry other professionals-- working as agents for a State monopoly, whose interests are entirely different from our own.)

No. This is not only about "the most vulnerable", nor the disabled, nor even about the conscience rights of objecting doctors. Those are all real concerns, of course, but what we see in Canada today is no longer limited to any one special interest, or to any coalition of interests. What we are experiencing now is a complete shift of medical practice --a shift of the mission of the entire medical industry-- towards a model of utilitarian veterinary herd-management, where cost-intensive, non-productive members are being euthanized, in order to avoid the expense of maintaining their survival in a dependent state.

No. This is most definitely not about a free individual choice of death (which could be accommodated in any number of ways without vandalizing mainstream medicine). And the proof of that claim can be stated in just one word: mandates.

A liberty to choose death (and even to seek assistance in ending one's life) does not logically entail sweeping, invasive, government mandates --such as those enacted in Canada right now-- forcing virtually every health care institution, and every home-care program, to include the practice and promotion of euthanasia.

Nor can taxpayers have it both ways.

A medical environment where the doctors and support staff have been trained to see the death of expensive patients as an optimal clinical outcome, is not a place where typical non-suicidal patients can be properly treated. Euthanasia mandates do not support choice! On the contrary. They make it impossible for the non-suicidal majority to exercise their own choice of life-sustaining care!

Most of us, I believe, are not paying exorbitant healthcare-justified taxes in the hopes that the money will be stolen --for all sorts of peripheral agendas. And we are certainly not paying those taxes in the hopes that we will one day be put down like a horse or a dog! We wish to be cared for in our time of need, by professionals who believe that medicine can sustain life, well beyond any utilitarian calculation of cost-benefit. That is what we are paying for, and that is what we must demand, from the politicians and public servants who are entrusted with our money.

Once again: rolling back mandates does not involve a lack of choice! Absolutely not. Mandates are the opposite of choice! We must urgently act to nip these anti-freedom, anti-human, utilitarian death mandates, in the bud.

Otherwise, when you or your dear one falls ill: you might as well just take them to the vet.

Barbara kay: Canada's Death System is Top of the Line

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Barbara Kay

Barbara Kay wrote an excellent opinion column that was published in the National Post on Saturday March 18 titled: Thanks to Trudeau, Canada's death-care system is top of the line.

Kay begins her article by announcing that Ed Fast MP introduced Bill C-314 titled the Mental Health Protection Act which would prevent euthanasia for mental illness alone. She then points out that Senator Stan Kutcher, who was responsible for the amendment to Bill C-7 that extended euthanasia for mental illness alone is arguing against Bill C-314 by stating that the issue is already decided.

• Sign our petition supporting Bill C-314 (Link).

Kay states that with reference to Canada's euthanasia law, slippery slope which conjures up an avalanche is more like a toboggan ride.

Kay continues:

Writing in National Review in the fall, one American commentator called Justin Trudeau “modernity’s Doctor of Death,” whose willed expansion of MAiD makes Canada “arguably the assisted-death capital of the world.” An exaggeration? Consider that California, with the same population as Canada, and universally regarded as a singularly progressive domain, legalized medically assisted death in 2016, just like Canada. In 2021, 486 Californians availed themselves of the program. In the same year, 10,064 Canadians ended their lives with MAiD (a term for euthanasia used only in Canada, and brazenly stolen from palliative care, where it rightly belongs.)

Kay points out how Canada's MAiD law has become an international cautionary tale. A British writer used Canada's euthanasia law as an example bad public policy that is based on "good" intentions. Kay writes:

Canada’s MAiD, “originally marketed as a rational choice for sensible adults and therefore an indisputable moral good, it is now being used to kill the poor and the mentally ill as well as the physically sick and the elderly.”

Kay continues:

Too many reported incidents of MAiD chosen and executed for bad reasons — including credit card debt, poor housing, and difficulties getting medical care — attest to the truth of this criticism. In the legislative pipeline are “advance requests” — and consent by “mature minors.” Be afraid , be very afraid.

Kay then refers to the $86 million in health-care spending savings due to the original euthanasia law, as stated by the parliamentary budget office in October 2020. The budget office estimated, based on the expansions of euthanasia in Bill C-14, that there would be $149 million in health-care savings. 

I estimated that the numbers in the report were low based on several factors. First, I stated that there would be more deaths than predicted. Sadly I was right. Secondly, the shortened time of life was under-estimated by the budget office, meaning many people would die months, if not years before their death would otherwise had been. Sadly I am right.

Kay then writes about the fact that doctors are required to falsify the death certificate:

the medical certificate of death, physicians are obliged to list the illness, disease or disability leading to the request for MAiD as the cause of death, rather than the medications administered, the actual cause.

Kay argues that if euthanasia is a public good, then why the deflection?

Kay concludes:

This deliberate obfuscation is consistent, however, with the honed tactics of boundary-pushing activists whose Dignity-R-Us rhetoric captured the nabobs. Liberals settled on a winning strategy. Don’t make euthanasia a political plank; do use the courts to keep the expansion ball rolling. The fix was always in for expansion of the death as “reasonably foreseeable” guardrails established by the 2015 Carter decision. Thus, the 2019 Quebec Truchon decision that found Carter’s limits to MAiD access unconstitutional went unchallenged by Quebec and Ottawa, in spite of a flawed trial process.

• Canada's Healthcare Savings attributed to euthanasia (Link).
• Study: Legalizing euthanasia saves money (Link).

Is the assisted suicide debate about healthcare savings in the UK?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby must have forgot to tell Polly Toynbee that legalizing assisted suicide has nothing to do with money as she argues that assisted suicide needs to be legalized in the UK based on healthcare savings.

Toynbee wrote an opinion article that was published in the Guardian today. 

Toynbee doesn't come out with a crass statement demanding that people die to save money, instead she writes about The National Institute for Health and Care Excellence (Nice) decisions and protocols concerning end-of-life care as Nice attempts to control healthcare spending.

Toynbee writes:

On Thursday, it (Nice) opened a consultation period for new guidelines on how much NHS England should spend on end-of-life drugs, planning to remove some of the extra funding for very expensive drugs that may only delay death a little. About 15% of hospital spending goes on patients in their last year, and nearly a third on people in the last three years of life. 

Nice sets a standard limit: no drug can cost more than £30,000 a year, and it has to be a year of good-quality life. But a while back, under pressure, Nice raised that to £50,000 for drugs in the last three months of life. Professor Gillian Leng, Nice’s chief executive, tells me public opinion demanded it (the Mail had been running a ferocious campaign for hyper-expensive end-of-life cancer drugs). But now, she says, public opinion has shifted considerably against spending more on final months after Nice’s consultation with patients, the public and medical professionals. That extra £20,000 should be reapportioned.

Toynbee is saying that the purpose for Nice's consultation on spending guidelines is to save money in the healthcare system. Toynbee takes the issue of healthcare savings further. She writes:

Parliament may soon debate a bill on assisted dying proposed by Baroness Meacher and there are more new MPs ready to back the public view. One argument often used by opponents is that dying people would feel pressured “not to be a burden”. But supporters ask why that should be an illegitimate reason. Many in terminal illness have no wish to stay alive a few months longer as a great burden to family and community. That’s a matter for each person to decide.

Toynbee states - That's a matter for each person to decide - after she explains that the UK can't afford treatment at the end of life. In other words, if Toynbee is serious about the need for healthcare savings, then eventually the option will be no treatment or death.

While Canada's parliament was debating the expansion of the euthanasia law through Bill C-7, The Parliamentary Budget Officer projected that Canada's provinces would save at least $149 Million per year if Bill C-7 passed.

If its not all about the money, you cannot deny that legalizing assisted death is about the money.

Queensland Australia: Is voluntary assisted dying really going to remain voluntary or safe?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr's John Buchanan, Odette Spruijt & Haydn Walters wrote an excellent article that was published in the Spectator Australia on June 2 concerning the Queensland Australia euthanasia bill, asking the question: Is voluntary assisted dying really going to remain voluntary or safe?

The authors begin their article by stating that:

The Queensland Voluntary Assisted Dying Bill 2021, and reports that the Queensland Government will include mental suffering as a criterion, are of great concern to future medical practice.

The authors are right. Mental suffering is based on personal not objective grounds. The authors state:

An ethical medical assumption in most Western democracies, and especially Australia, has been that the state does not take or collude in the taking of the lives of its citizens; what politicians are doing in Australia at the moment is therefore quite profound and socially dangerous.

Legislation of this sort assumes it can put subtle and complex medical and psychological matters into a black and white legal framework. This is very difficult if not impossible without opening the door to harm for present and future patients.
We have seen this very harm after Canada legalized euthanasia in 2016.

The authors continue by uncovering further problems with the Queensland euthanasia bill. They state:

There is no obligation in this Bill for the doctor involved to confirm the pathology from which a person suffers, consult with their current treating doctor, refer for specialist palliative care consultation, or refer to a psychiatrist experienced in the field. And this is a situation where fear of the unknown and outright depression is rife, and the main drivers of suicidal thought.

An assumption is made that a requesting patient is fully informed about all of these matters, is having fully adequate care, does not suffer from depression, and is not under coercion by anyone, especially relatives.

The authors continue by focusing on the long-term problems with legalizing euthanasia.

The outworking of this sort of legislation will create a major medical ethical problem in coming decades. A somewhat hidden concern also must be future bureaucratic proposals about the expense of care for ageing and dementing people. Government itself is crossing a huge ethical boundary in legitimising the killing of its citizens; where may that end?

Will doctor-assisted suicide, voluntary or involuntary, be considered as part of the “management of ageing”. Once the ethical line is crossed, there is no logical end-point to terminating of life as part of future ‘medical management’ or indeed governmental social policy.

As I stated in an article last week, Queensland's euthanasia bill is deliberately deceptive while Liz Storer with Sky News called Queensland's euthanasia bill disturbing.

Canada's health care savings attributed to euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Soon after Canada legalized euthanasia, the Canadian Medical Association Journal (CMAJ) published a study by Aaron J. Trachtenberg MD DPhil, and Braden Manns MD MSc titled: Cost analysis of medical assistance in dying. 

The researchers suggested that the Canadian healthcare system will save between 34.7 and 138.8 million dollars per year, depending on the number of euthanasia deaths. Canada has a universal healthcare system, whereby the financial cost of healthcare is primarily covered by the government.

At the time I stated that the social pressure to save money will become the ultimate form of social responsibility. People will be socially pressured to die.

"How dare you choose to live. You are costing society money."

Today, Katie Dangerfield reported for Global News that:

Since Canada’s law on medical assistance in dying came into effect more than four years ago, health-care costs have dropped millions of dollars, according to a Parliamentary Budget Officer (PBO) report released Tuesday.

The report on assisted dying said since becoming legal on June 17, 2016, Canada's health-care costs have dropped $86.9 million.

The Parliamentary Budget Officer also projected that Bill C-7, the bill to expand Canada's euthanasia law, will lead to more euthanasia deaths per year and more healthcare savings. Dangerfield reported:

The budget office estimates the legislation would mean an additional 1,164 medically assisted deaths in Canada in 2021, on top of the 6,465 deaths expected under the current regime.

Provincial health budgets would see a savings of $149 million next year if the numbers hold true, largely from declines in spending on end-of-life care.

I estimate that the numbers in the report are low for two reasons. The first reason is that we will have more euthanasia deaths than predicted. The second reason is that people with months and years to live will be dying by euthanasia leading to cost savings far beyond predictions.

These cost savings will not only be related to the medical system but also to the cost of social services. People on a disability pension, or people living on welfare, as well as the cost savings related to retirement benefits.

Sadly, some people will point to the cost savings as a positive reason to promote euthanasia. 

It appears that euthanasia is not about "choice" or "autonomy" but rather killing people at the most vulnerable time of life.

There has now been approximately 19,000 euthanasia deaths in Canada.

Schadenberg: Study promotes legalizing euthanasia.

This article was published by OneNewsNow on March 23, 2020 (edited).

Will governments with legalized euthanasia require it for the common good?

Alex Schadenberg

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow two Scottish doctors have published "Cost analysis of medical assistance in dying" a previous study in the Canadian Medical Association Journal looked at medical aid in dying in Canada.

"They are arguing that assisted suicide saves money for the healthcare system, but it also provides more organs for organ donations; therefore, we should be doing this. We should be encouraging this," Schadenberg relays. "They continued throughout this study to say that we're not actually promoting euthanasia, but of course … it's a lie.”

That reminds him of the 1920 book, Allowing the Destruction of Life Unworthy of Life, that doctors of Hitler's time were required to read. It promoted and justified euthanizing people with disabilities, for the "common good."

"It's very similar, actually, because it's justifying these things based on cost and based on efficacy to the nation, meaning that, you know, you're going to get a lot more healthy organs out of this if you allow this, so this is a good thing to do also," Schadenberg poses.

But he is concerned that that philosophy is leading society down the path to forced euthanasia -- killing people in the name of compassion when it really just means saving money and benefiting others with their organs.

Further information:

• Article: Euthanasia saves money and provides organs for donation.

The Dangers of Removing Safeguards in Oregon's Assisted Suicide Law

An open letter from Dr Kenneth Stevens, President, Physicians for Compassionate Care

Dr Ken Stevens

Since 1994, the proponents of Oregon's assisted suicide law have touted the importance of the safeguards and protections of that law.

Now, Oregon's legislators are considering bills (HB 2232, HB 2903, SB 579) to eliminate many of those safeguards (eliminates waiting periods, expands definition of "terminal illness," permits lethal injection and inhalation euthanasia) and expand access to assisted suicide.

Why and Why now?

What is happening in medicine in the United States? There is increasing concern regarding the cost of medical care. A current (February 13, 2019) editorial in the Journal of the American Medical Association (JAMA), titled "Rationing of Health Care in the United States - An Inevitable Consequence of Increasing Health Care Costs" reviews the challenges of increasing medical costs, and it deems it critical to control health care costs.

One way to control health care costs is to expand Oregon's assisted suicide law, to make it available to more people. The assisted suicide drugs can be less expensive than continued medical care.

Derek Humphry, the founder of the Hemlock Society, argued in 1998 that physician-assisted suicide and euthanasia can solve the problem of rising health care costs, "Economics makes case for euthanasia", The Oregonian, Dec 2, 1998.

We have seen this in Oregon, where the Oregon Health Plan refused to cover beneficial life-extending cancer treatment to patients such as Barbara Wagner, but offered assisted suicide instead.

It is wrong and dangerous to expand the criteria for assisted suicide in Oregon. It is harmful to very vulnerable Oregonians. The Oregon legislature should not proceed with the proposed bills.

I encourage you to contact your legislators regarding these dangers.

Kenneth R. Stevens Jr., MD,
President, Physicians for Compassionate Care Educational Foundation 

Further information:

Oregon attempts to expand assisted-suicide license. 

Oregon will debate bills to expand the definition of terminal and waive the waiting period.