Twenty five years of the ‘Oregon model’ of assisted suicide: the data is not reassuring

This article was published by the British Medical Journal of Medical Ethics on October 27, 2023.

By David Jones

On 27 October 1997, ‘physician-assisted suicide became a legal medical option for terminally ill Oregonians’. There are now 25 years of reports on the implementation of the Death With Dignity (DWD) Act. These give some insight into how the practice has changed since it was first introduced. The reports are all available online and an article has just been published analysing all 25 years. What do these reports show?

First and most obviously there has been a dramatic increase in numbers from 16 in 1998 to 278 in 2022. At the same time, the proportion referred for psychiatric evaluation prior to assisted suicide has dropped from 31.3% to 1.1%.

The 25-year review also highlights changes in the drugs used and in the rate of complications. Between 2010 and 2022 complications were reported on average in 11% of cases. In 2022, reported complications fell to 6%. Unfortunately this is not so reassuring as it seems, as an increasing percentage of data on complications is missing. In 2022 there was no data on complications for 74% of cases.

The reports also show shifts in the reasons given for seeking assisted death, with more citing the fear of being a burden and more citing financial concerns. The figures vary from year to year but in both cases the trend is clear. The increasing number of people seeking death because they feel they are a burden to others does not speak well of changes in social attitudes in Oregon since the DWD Act came into force.

Another shift evident in these reports relates to language. The first sentence of the first report refers to ‘physician assisted suicide’. This phrase is used in the first line of every report until the ninth report for 2006. This change in language was not associated with any change in practice in Oregon but it may have reflected political efforts in other States to pass similar laws. After 9 years Oregon was still the only State in the United States to have legalised physician assisted suicide. This political motivation is acknowledged by the philosopher Gerald Dworkin, an advocate of such laws: ‘the use of the term “Physician-assisted suicide” is now politically incorrect, for tactical reasons. I understand that the popular prejudice against suicide makes it more difficult to rally support for the bills I favor.’

The term ‘assisted suicide’ nevertheless remains the ordinary term in Europe and was used by Margo MacDonald MSP for the Assisted Suicide (Scotland) Bill she introduced in November 2013. That bill, which was rejected by the Scottish Parliament, was largely based on Oregon’s DWD Act. In 2017, the American Association of Suicidology adopted a statement opposing the characterising of assisted deaths as ‘suicide’. However, in March this year that statement was quietly ‘retired’, a move welcomed by some disability groups. The language of physician assisted suicide remains in use by the American Medical Association. It also has the advantage of distinguishing self-administration of lethal drugs (assisted suicide) from administration by doctors (euthanasia).

If political debates outside Oregon influenced its shift in use of language, they may also account for the recent expansion of the DWD Act. Before 2016 there were only three States with such legislation (Oregon, Washington, Vermont) and one where assisted suicide was legal through case law (Montana). However, by 2021 there were ten jurisdictions with statute laws plus Montana where assisted suicide remained legal by case law. It is remarkable that, before 2019 neither Oregon nor any other jurisdiction in the United States had amended their law on physician assisted suicide. However, in the four years since 2020, there have been seven amendments to such laws across five states: in Oregon in 2020 and 2023; in Vermont 2022, and 2023; in California in 2022; in Washington in 2023; and in Hawaii in 2023 and an amendment has been introduced in New Jersey. This amounts to six out of the ten jurisdictions with such legislation. All these changes expand access, for example, waive waiting times, allow nurses to prescribe the lethal medication, or drop residency requirements. Until 2019 it had been possible to argue that there was ‘no evidence of a “slippery slope”’ because ‘The Oregon law has remained unchanged since 1997’. This is no longer true. In recent years there has been a wave of expansion of such laws and further expansion is surely to be expected.

This increase in the number of States with assisted suicide and increase in number of deaths has also allowed more data on the secondary impact of legislation. In 2015 there were some indications of an association between legalisation of physician assisted suicide in the United States and increases in unassisted suicide. However, the association was not statistically significant once linear trends were included. In contrast, US data analysed in 2022 by two different methods showed a statistically significant increase in unassisted suicide after physician assisted suicide was introduced. Association does not, of course, demonstrate causation, but neither is such an association grounds for reassurance.

We now have twenty five years of data from Oregon and data from an increasing number of other States with similar laws. However, the more we know, the less reassuring the ‘Oregon model’ of assisted suicide seems to be.

David Jones is the Director, Anscombe Bioethics Centre, Professor of Bioethics; St Mary’s University, Twickenham; Fellow, Blackfriars Hall, University of Oxford 

Scottish Assisted suicide rhetoric is nonsense

This article was published on January 28 on the HOPE Australia website.

B

Paul Russell

y Paul Russell, the Director of Hope Australia

An assisted suicide bill is slowly making its way through various committees of the Scottish parliament before ultimately being debated in the Scottish Parliament itself.

This bill is something of a ‘legacy bill’ following as it does the death last April of the former champion of this cause, Margo MacDonald MSP who had sponsored an earlier, failed attempt.

It is certainly worth a hat-tip to the Scots inasmuch as both MacDonald’s bill and this new bill by Green MSP Patrick Harvie take some radically different approaches to the issue, presumably to attempt to make these efforts more palatable than other failed initiatives. However, the same concerns arise as with all legislation on euthanasia or assisted suicide: vulnerable people are not protected; the legislation is unsafe and open to abuse.

I want to focus, however, on some of the rhetoric and suggestions from the pro-assisted suicide lobby on this bill that are as dangerous as they are facile and errant. Slogans and catch phrases are fine in so far as they highlight and encapsulate a policy position or campaign thrust, but when they attempt to lead the reader to a simplistic and patently false conclusion, they deserve scrutiny.

This from a submission to one of the inquiries conducted on the Scottish bill:

Experts say: Scotland's assisted suicide bill will undermine suicide prevention efforts.

By Alex Schadenberg

International Chair - Euthanasia Prevention Coalition

The Herald newspaper in Scotland is reporting that experts are warning that the assisted suicide bill that is being debated in the Scottish parliament would undermine efforts to prevent suicide.

The Herald reported that:

A law that would legalise assisted suicide is facing growing opposition, as academics and ethicists raised fresh concerns that it would lead to the elderly being put under pressure to kill themselves. 

Figures within the medical profession have also raised new concerns that if the Bill currently making its way through Holyrood passes, it would undermine efforts to reduce suicides generally and open the door to euthanasia.

The article continued by quoting from the experts who submissions to the Scottish Health Committee on the assisted dying bill:

J Kenyon Mason Institute

The J Kenyon Mason Institute for Medicine, Life Sciences and Law, based at the University of Edinburgh, said in its submission that there were insufficient safeguards to protect patients "from coercion or undue influence in making decisions". 

... Robert Preston, director of Living and Dying Well, a research body established in 2010 to examine the evidence surrounding the end-of-life debate, claimed there was "no effective safeguarding system to protect the public and especially its most vulnerable members". 

He went on to argue that there are a number of important weaknesses in the Bill, including the lack of the need for a psychiatric assessment before an assisted suicide could take place. 

Mr Preston added: "In these days when home visits are not as common as was once the case, doctors often know little of their patients' lives beyond the consulting room. Yet the Bill is asking them to make life or death decisions without any objective assessment regime to guide them."

The Scottish Council on Human Bioethics stated:

labelled the proposals "dangerous" and said elderly and other vulnerable people may feel it is their "duty to die" as they are a burden or because their care was eating up family members' inheritance.

The Scottish government opposes the assisted dying bill but Members of the Scottish Parliament (MSP) will be given a free vote on the bill.

The previous assisted dying bill was sponsored by Margo MacDonald (MSP), that would have legalized euthanasia and assisted suicide in Scotland was overwhelmingly defeated on Dec. 1, 2010 by a vote of 85 to 16.

The current assisted dying bill was introduced by Margo MacDonald (November 2013). After she died it was picked up by Patrick Harvie (MSP).

Links to more information:

• Scotland may kill assisted suicide bill in committee.
• Scotland assisted suicide bill discriminates against people with disabilities.
• Scotland assisted suicide plan 'unethical and uncontrollable'.
• British Medical Association rejects Scottish assisted suicide bill.
• Dr Stephen Hutchinson: Assisted suicide is not safe.

Assisted suicide makes a mockery of us as guardians of justice and compassion

The Herald Newspaper in Scotland published this commentary on January 13, 2015.

In the debate on assisted suicide, we are all ultimately on the same side: we all want to limit suffering.

Compassion motivates all those who are genuinely interested in the debate. There is all the difference, however, between limiting suffering and ending life.

Committed supporters of assisted suicide have to as ask themselves two fundamental questions. First, how much risk to the vulnerable are they prepared to accept in order to facilitate suicide by the invulnerable? Secondly, where to draw the line in determining what suffering "qualifies" for assisted suicide?

No safeguard can ever be 100 per cent effective. As well as the clear abuses, there would also be the inevitable subtle pressures on those whose illness or condition met the criteria. On a recent BBC Radio 5 Live phone-in, Michael, who has motor neurone disease, explained how he is asked several times a week whether he would consider assisted suicide.

He said: "It makes one feel like I should be contemplating it for sake of the health service or my family watching what I'm going through. And I'm afraid that it will extend into the social conscience that people almost expect assisted dying."

There is a real danger of this societal pressure subtly eroding free choice from within. And this is something that no safeguard could ever protect against. Legalising an action normalises it so that it often becomes expected.

Scotland may kill assisted suicide bill in committee.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The Edinburgh News is reporting that the Scottish assisted suicide bill may die in the Health and Sport committee. The hearings will begin on January 13.

The group - Doctors for assisted suicide are concerned that too many groups opposing assisted suicide have been invited to present to the government committee. The Edinburgh News reported that: 

Duncan McNeil MSP, the convener of the health and sport committee, said it would consider all evidence placed before it and give it equal weight.

When reading Scotland's assisted suicide bill it is clear that the language of the bill will kill.

Section 1 of the bill says:

It is not a crime (of any kind) to assist a person to commit suicide.

This means that anyone can do it.

Scotland's assisted suicide bill is an offence to our human dignity.

This article was published by Peter Saunders on his blog on February 3, 2014.

A catalogue of reasons why Margo Macdonald’s Assisted Suicide Bill should be rejected

Dr. Peter Saunders

An opinion piece in The Guardian on Saturday by the Editor of the Daily Mail in Scotland, Kevin McKenna, provides a powerful critique of Margo MacDonald MSP’s Assisted Suicide (Scotland) Bill.

Mr McKenna highlights that, although Ms MacDonald’s Bill contains safeguards and claims to ensure that only terminally ill people or those suffering from deteriorating progressive conditions can seek assistance with dying, it may encourage those suffering from depression to take their life.

He continues by challenging the view upon which support for assisted suicide hinges - that we should ‘alleviate the suffering of a fellow human being in extremis’ - with the example of sufferers of locked-in syndrome (LIS).

McKenna highlights that, contrary to the assumption that most LIS sufferers must have reached a stage where life is simply not worth living anymore and should be put out of their misery, the largest-ever study of chronic LIS patients found that almost three-quarters were happy and that only 7% had suicidal thoughts.

He also suggests in the piece that Ms MacDonald campaign instead for a minimum quality of palliative care for everyone in Scotland who requires it at the end of their lives. 

Last week Marilyn Golden, Senior Policy Analyst with the Disability Rights Education & Defense Fund (DREDF) in the United States published a blog in which she neatly summarised why legislation allowing assisted suicide is so dangerous. Here’s her list of reasons which is equally applicable in the UK:

1. Assisted suicide is a deadly mix with our profit-driven healthcare system. At $300, assisted suicide will be the cheapest treatment. Assisted suicide saves insurance companies (and governments) money.

2. Abuse of people with disabilities, and elder abuse, are rising. Not every family is a supportive family! Where assisted suicide is legal, such as in Oregon, an heir or abusive caregiver may steer someone towards assisted suicide, witness the request, pick up the lethal dose, and even give the drug—no witnesses are required at the death, so who would know?

3. Diagnoses of terminal illness are too often wrong, leading people to give up on treatment and lose good years of their lives, where assisted suicide is legal.

4. Where assisted suicide is legal, no psychological evaluation is required or even recommended. People with a history of depression and suicide attempts have received the lethal drugs.

5. Financial and emotional pressures can also make people choose death for fear of being a burden upon others. Legislating increases these pressures.

6. Legalising assisted suicide is unnecessary. Everyone already has the legal right to refuse
treatment and get full palliative care, including, if dying in pain, pain-relieving palliative sedation.

7. There are no true safeguards against abuse. Where assisted suicide is legal, the safeguards are hollow, with no enforcement or investigation authority.

8. Prejudice against disabled people is already widespread and their quality of life underrated.  Will doctors and nurses fully explore their concerns and fight for our full lives? Will they get suicide prevention or suicide assistance?

This debate is primarily about autonomy versus public safety. The current law we have is clear and right. Through its blanket prohibition of assisted suicide it provides a strong disincentive to abuse and exploitation whilst allowing prosecutors and judges discretion in hard cases. It has both a stern face and a kid heart and does not need changing.

Scottish legislators should give the same short shrift to Macdonald’s latest bill as they gave to her last by overwhelmingly rejecting it. 

Assisted Suicide in fact involves killing

The following letter was written by Aidan Cook, the Campaign Director for the Care Not Killing Alliance in Scotland and published in the Herald Scotland.

ie: Malcolm Allan (Letters, November 15) argues that assisted suicide is not killing.

Quite simply, to deliberately bring about someone's death is to kill. Modern law and opinion is clear that to kill has a much broader sense than simply pulling the trigger. With assisted suicide, we as a society, and the individuals involved, would be bringing about the death of those whose lives we see to have no value.

John Black (Letters, November 15) is wrong to suggest that this is a boundary society crossed long ago. While some countries have introduced assisted suicide or euthanasia, Scotland has not, nor have the vast majority of societies.

He is also mistaken in suggesting that the criteria for assisted suicide in Margo MacDonald's bill are "carefully defined". Indeed, Ms MacDonald is clear that she is deliberately not defining the medical conditions. Moreover, the additional condition that the person find their quality of life unacceptable could hardly be less clearly defined.

Assisted suicide is killing and as such would cross a fundamental boundary with untold consequences for our society. That the conditions are so ill-defined points to the incremental extension of any legislation, an extension Ms MacDonald acknowledges in her policy memorandum. True compassion is found in good care, not in killing.

Aidan Cook,
Campaign officer,
Care Not Killing Scotland,

Care Not Killing responds to Scottish Assisted Suicide bill

This article was original posted on November 14 on Peter Saunders blog.

Margo Macdonald MSP (pictured) launched her new assisted suicide bill in Scotland. The Scottish government has said it does not support a change in the law and the British Medical Association (BMA) has in response reiterated its opposition to assisted suicide. 

The bill comes the day after the launch of the Euthanasia Prevention Coalition of Europe (EPCE) in Brussels. The Care Not Killing Alliance, a founding member of EPCE, has today produced a detailed response which is reproduced here. Macdonald’s last bill was overwhelmingly defeated by 85-16.

In 2010 MSP Margo MacDonald's very similar End of Life Assistance Bill was defeated by 85 votes to 16, in a free vote at the Scottish Parliament.

This should have settled the debate in Scotland for a generation.

Yet, Ms MacDonald now proposes her Assisted Suicide (Scotland) Bill, under which people as young as 16 would be able to tell their GP about their desire for assisted suicide.

Despite the fact that 65 per cent of responses to the consultation process were opposed to the Bill the MSP plans to take her Bill forward, essentially on a system based on that operating in Oregon, USA.

There, the annual number of assisted suicides has risen by 450 per cent since legalisation in 1997. One in six of those are depressed, less than one in 20 receive psychiatric assessments. Some patients have been denied medical care and offered assisted suicide as a cheaper alternative.

Care Not Killing, which is spearheading opposition to the proposed Bill, is an alliance of individuals and more than 40 organisations which brings together disability and human rights groups, healthcare providers, and faith-based bodies and believes that assisted suicide is unneccessary, unethical and uncontrollable.

Peter Saunders

Dr Peter Saunders, Campaign Director of Care Not Killing said:

“MSPs rejected Ms MacDonald's last attempt to legalise physician-assisted suicide and euthanasia in Scotland by an overwhelming majority of 85-16 recognizing that such a move would seriously endanger public safety. Instead, they sent a ringing endorsement to making the very best palliative care widely available and accessible. 

“The right to die can so easily become the duty to die and vulnerable people who are sick, elderly or disabled will inevitably feel pressure, whether real or imagined, to end their lives so as not to be a burden on others. The stories of incremental extension presently coming out of Belgium and the Netherlands give a stark warning about the dangers of going down this road. 

“Ms MacDonald’s new proposals are effectively her old ones dished up again. I expect the Scottish Parliament to give them short shrift.”

British Medical Association (BMA) rejects Scottish assisted suicide bill

By Alex Schadenberg

The Pulse news service reported today that the British Medical Association (BMA) stated that it will oppose the euthanasia bill that is being sponsored by MSP Margo MacDonald in Scotland.

The Pulse reported that Dr Lewis Morrison, chair of the Scottish BMA consultants committee said:

‘Despite the change in approach to this, Ms MacDonald’s most recent attempt to legislate on assisted dying in Scotland, the BMA will continue to oppose the introduction of such a law.’

The BMA was quoted by the Pulse as stating:

The BMA said that doctors would be taking on a role that was ‘alien’ to their role as a care giver and that it could not support it. 

The bill was brought by MSP Margo MacDonald - an independent member for the Lothian region - in Edinburgh today and would extend to patients who had been diagnosed with chronic, degenerative diseases. 

The bill is a revision of one defeated in 2010, it drops the contentious element of physician-assisted dying and stipulates the ‘cause of death must be the person’s own deliberate act’.

Dr Morrison was also quoted as stating:

‘If doctors are authorised, by law, to kill or help kill they are taking on an additional role which we believe is alien to the one of care giver and healer. The traditional doctor-patient relationship is founded on trust and this risks being impaired if the doctor’s role encompasses any form of intentional killing.’

Margo MacDonald's last attempt to legalize assisted dying in Scotland was defeated by a vote of 85 to 16.

Links to similar articles.

EPC Europe is launched ahead of Scotland euthanasia bill.

Dr Stephen Hutchison: Assisted Suicide is not safe.

MacDonald proposes new bill to legalize assisted suicide in Scotland.

Euthanasia Prevention Coalition Europe launches ahead of Scotland euthanasia bill.

Originally published on November 13, 2013 by STV news in Scotland.

Opponents of euthanasia will meet fellow campaigners from across Europe as they prepare to speak out against further attempts to legislate for assisted suicide at Holyrood.

The Euthanasia Prevention Coalition Europe (EPC-Europe) is being launched in Brussels, bringing together organisations which are against assisted suicide, including the CARE Not Killing group in Scotland.

The founding of the coalition comes as independent MSP Margo MacDonald gets ready to officially launch her members' bill, The Assisted Suicide (Scotland) Bill, on Thursday.

Ms MacDonald's previous attempt, in 2010, to legalise assisted dying in Scotland failed when Holyrood voted 85 to 16 against her proposal.

The former SNP politician, who has Parkinson's disease, said she has learned lessons from her previous attempt and is proposing a "clearer, more straightforward process".

Her latest Bill is opposed by CARE Not Killing, an umbrella group of around 40 professional, faith and human rights groups.

CARE Not Killing says Ms MacDonald's proposal is unethical and will put pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others.

Group convener Dr Gordon Macdonald, who is attending the launch of EPC-Europe, said: "I welcome this new initiative to coordinate efforts across Europe to prevent the legalisation of euthanasia and assisted suicide.

"The Scottish Parliament overwhelmingly rejected an attempt by Margo MacDonald to legalise euthanasia and assisted suicide in 2010. 

"MSPs concluded that vulnerable people would be put at risk from such legislation. Scotland can learn from the damaging effects legalising euthanasia and assisted suicide in other parts of Europe and North America. 

"Europe can learn from Scotland's example as a country which has rejected the view that some people lives are not worth living. We believe that society has a responsibility to protect the most vulnerable."

Kevin Fitzpatrick

Dr Kevin Fitzpatrick, co-ordinator of EPC-Europe, said: 

"The UK, France and Germany are currently considering legislation but overwhelming evidence from jurisdictions where euthanasia and physician-assisted suicide is legal, such as Belgium and the Netherlands, demonstrates beyond doubt how quickly and easily euthanasia is extended to others, especially disabled people and elderly people."

Euthanasia Prevention Coalition launches to halt growing threat of state-sanctioned euthanasia.

Assisted Suicide is not safe: Dr Stephen Hutchison

I was going through my emails and I found this excellent article written by Dr Stephen Hutchison and published on June 20, 2013 in the The Herald newspaper in Scotland under the title: Agenda: Assisted Suicide. 

Hutchison, a physician who specializes in palliative care, was commenting on assisted suicide based on the expected assisted suicide bill by Scottish MSP Margo MacDonald. MacDonald's previous bill was overwhelmingly defeated in the Scottish parliament.

Agenda: Assisted Suicide.

Dr Stephen Hutchison, Herald - June 20, 2013

Hardly a week goes past without court cases about assisted suicide, or celebrities and politicians commending it.

The argument goes along these lines: "We are autonomous and assisted suicide is our right. Leaving people to die in agony or forcing them to go to Switzerland is terrible. Assisted suicide is safe and there is no slippery slope. Doctors here are doing it anyway, so let's make it legal. At the very least, let's have the debate."

Actually the debate has been pretty well had. Independent MSP Margo MacDonald's 2010 proposals were thoroughly considered in the public arena, among lay and professional groups and the media before being overwhelmingly defeated in the Scottish Parliament. Official reports show that 87% of public responses to her consultation were opposed, and nearly two-thirds were against her 2012 consultation. Casual public opinion is in favour, but considered opinion is against. On numerous occasions over the past few years assisted suicide has been debated in our parliaments and has been consistently rejected because it is unsafe. The duty of government is to protect its citizens.

Autonomy means to be self-governing, acting independently, regardless of others. But we are all interdependent, not autonomous. Autonomy is a myth. We have freedom to decide and act, but not without responsibility to others. The Parliamentary Committee examining Ms MacDonald's 2010 Bill came to the same conclusion. Being a burden to others is often cited as a reason for assisted suicide. But you can only be a burden because you have some form of relationship with others. You cannot have it both ways. It is irresponsible for politicians to peddle autonomy as the basis for any law, let alone something cataclysmic like this. Selfish individualism creates havoc.

I grow frustrated when I hear assertions that medical care of the terminally ill includes using such high doses of morphine to relieve pain that we hasten death. That is another myth. There is good recent evidence that UK doctors never practise assisted suicide. Even if they did, that would not be a sound basis for legalising it.

What about intolerable suffering? In our country you have access to the best palliative care in the world, according to an Economist Intelligence Unit report in 2010. It is usually fear of pain, not actual pain, that makes people think of assisted suicide. Where there is suffering we need to research and refine care to relieve it, not hasten death. If someone goes to Switzerland that is their choice. Nobody is forcing them, any more than if I move to that country because I prefer its tax laws.

Elder abuse is an increasing problem. The perpetrators are commonly friends or relatives of the victim. When you are facing an incurable illness, or the prospect of suffering, or the costs of care are eating into your family's inheritance, and you feel vulnerable and scared, just how little pressure would be needed to make you choose assisted suicide, particularly if you are elderly and frail or feel that you are a burden?

Assisted suicide is not safe. If it was why would proponents emphasise the need for safeguards?

There is evidence of risk to the vulnerable where assisted suicide is practised.

As for slippery slopes, how about the steady increase in people who die this way? How about progressive relaxation of diagnostic criteria? How about institutional disregard for initial restraints intended to promote safety? How about the killing of hundreds of patients every year without consent?

How about almost complete indifference towards psychiatric assessment designed to identify depression? These are happening where assisted suicide is practised. And how about the subtle anaesthetising of our own moral principles so that we think it is a good idea to kill people?

Keeping our law unchanged may be problematic for a tiny minority but it protects the majority. Superficially, assisted suicide may seem compelling. But we must not be fooled.

Dr Stephen Hutchison MD FRCP (Glasg) is a consultant physician in palliative medicine.

Why should we trust the pro-euthanasia lobby if they can’t even agree amongst themselves about what they want?

Dr Peter Saunders

By Dr. Peter Saunders, Campaign Chair - Care Not Killing Alliance - UK


When euthanasia became a dirty word the Voluntary Euthanasia Society changed its name to ‘Dignity in Dying’ in January 2006. 

In 2008 Conservative MP for Reigate Crispin Blunt (pictured) claimed responsibility for the move. 

‘I claim responsibility for encouraging the Voluntary Euthanasia Society to change its name’ he exclaimed in a in a Westminster Hall Adjournment Debate on 11 November 2008. 

A Daily Telegraph editorial titled ‘Euthanasia’s euphemism’ remarked at the time of the name-change that it was ‘hard to shake off the suspicion that euthanasiasts are shy of spelling out what they are really about, viz killing people’.

Then when assisted suicide became a dirty term ‘Dignity in Dying’ began talking about ‘assisted dying’ instead. 

But whilst appearing to become more and more modest in their language at the same time they now so divided in their agendas such that we don’t actually know what they want.

When Lord Falconer published his sham assisted dying commission report in January this year (he has now published a new draft bill based on its recommendations) it was clear that the pro-euthanasia lobby had messed up their coordinated choreography. 

Falconer said that it would only be for people who were mentally competent and mentally ill. ‘Stringent safeguards’ would be put in place to protect those who may not have the mental capacity to make the choice, anyone suffering from depression or those who feel under pressure from friends and family. In addition, the patient would have to take the medicine themselves, as a sign that the decision was voluntary.

But DID patron, and fantasy novelist, Terry Pratchett, who funded Falconer's 'inquiry' told Sky News that the report did not go far enough. 

‘From my point of view, no (the report does not go far enough), but I am aware that my point of view is not the only one that matters.’

Right to die campaigner Debbie Purdy agreed. She was reported in the Evening Standard as claiming that thousands of other patients with chronic and painful health conditions should also get help to die if they asked for it. 

‘We need to find a way so that the non-terminally ill can also end their lives. Some people will want to fight on to the end but for others who are suffering unbearable pain it can be torture’, she said. 

And Margo Macdonald, Scottish MSP said in the Scotsman that while she welcomed Falconer’s report, her new bill in Scotland would go further. 

‘In the process of pursuing patient autonomy and the rights of the patient to determine when to end a life that has become intolerable to him or her as a result of their irreversible condition, I think our proposal may be slightly ahead of Lord Falconer’s work so far.’

It was no surprise then that Falconer himself told the Daily Mail that his plan that would allow doctors to help the terminally ill kill themselves was not ‘watertight’.

He admitted that no such system could ever be ‘completely watertight’ – undermining his own claim that his plan contains ‘stringent safeguards’.

Quite! Which is exactly why we should not be going down this road at all. 

If the pro-euthanasia lobby can’t agree themselves about what they want you can be certain that if the law ever does change at least some of them will not be satisfied and will soon be pushing for more. 

Best not to go there at all. Too dangerous! Legalising assisted suicide for anyone at all will inevitably lead to incremental extension. 


Link to the original article.

Huge increases in assisted suicide cases in Oregon and Switzerland

By Peter Saunders is the campaign director for the Care Not Killing Alliance - UK, and he is a leader of the Euthanasia Prevention Coalition - International.

Published on Peter Saunders blog - Sunday, 15 April, 2012

There has been a massive increase in cases of assisted suicide in both Oregon and Switzerland over recent years according to the latest figures.

The Oregon ‘Death with Dignity Act’ allows terminally-ill Oregonians ‘to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose’.

It also requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.

The latest figures show that cases of assisted suicide have gone from 16 in 1998 to 71 in 2011, an increase of 450% (see chart).

The US state of Oregon legalized assisted suicide in 1997 following a referendum. Thus far over 100 attempts to get other US state parliaments to change their laws have failed and only the state of Washington has followed suit, again on the basis of a referendum.

Switzerland has seen a 700% increase in assisted suicides over the same period. Swiss authorities have recorded a steady rise of assisted suicides in recent years, from 43 in 1998 to 297 in 2009. Earlier figures are not available, even though assisted suicide has been legal in Switzerland since 1942.

These figures include only Swiss nationals and not the growing number of people from abroad who are making use of facilities like Dignitas.

The experience of both countries demonstrates that when assisted suicide is legalized there will inevitably be incremental extension.

A major factor fueling this increase is suicide contagion - the so-called Werther effect. This is particularly dangerous when assisted suicides are backed by celebrities as they are here and given high media profile as they are frequently by the BBC.

The Oregon and Swiss numbers may not seem large to some but we need to remember that Oregon and Switzerland have small populations relative to the UK.

Back in 2006 the House of Lords calculated that with an Oregon-type law we would have about 650 cases of assisted suicide a year in Britain. But given the increase of numbers in Oregon the UK equivalent would now be well over 1,000. Currently assisted suicide is illegal here and we see only 15-20 Britons going to Dignitas in Switzerland to die each year.

However, later this year we will see renewed attempts to change the law in this country.

Margo Macdonald is planning to present a bill based on the Oregon model to the Scottish Parliament and the pressure group Dignity in Dying (formerly the Voluntary Euthanasia) is planning a mass lobby of the Westminster Parliament on 4 July in support of a new bill they plan to introduce by means of their parliamentary wing, the All Party Group on ‘Choice at the End of Life’.

We should learn from the Oregon and Swiss experience and be resisting these moves.

Any change in the law to allow assisted suicide (a form of euthanasia) would inevitably place pressure on vulnerable people to end their lives so as not to be a burden on others and these pressures would be particularly acutely felt at a time of economic recession when many families are struggling to make ends meet and health budgets are being slashed.

And once legalized there will inevitably be incremental extension as we have seen in Oregon and Switzerland. Legalization leads to normalization.

Let’s not go there.