Tasmania has massive increase in assisted suicide deaths.

Alex in Tasmania

Tasmania to review assisted suicide law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Tasmania legalized assisted suicide in 2022, has now announced that it will conduct a review of their assisted suicide law based on concerns related to the massive increase in assisted suicide deaths.

Several years ago, I had the opportunity to speak in Tasmania where I warned about how the assisted suicide deaths would quickly increase once legalized.

The Tasmania assisted suicide reports indicate that the number of assisted suicide approvals, prescriptions and deaths have increased substantially since legalization.  The Tasmania reports are based on October to October. Link to the Tasmania (2022/23 report). Link to the Tasmania (2023/24 report).

Tasmania assisted suicide poison supplied: 2022/23 - 32, 2023/24 - 78, 2024/25 - 142.

Tasmania assisted suicide reported deaths: 2022/23 - 27, 2023/24 - 62, 2024/25 - 109.

You will notice that the data indicates that 2 deaths in 2023-24 were reported late. 

The Tasmanian reports refer to reported assisted suicide deaths since not all of the participants are accounted for in the data.

The rate of reported deaths by assisted suicide was 2.1% of all deaths in 2024/25 which was up from 1.2% of all deaths in 2023/24.

Meg Whitfield reported for the ABC News Australia on August 15, 2026 that:

An independent review into Tasmania's VAD legislation is currently underway to assess if it is still working as intended, and what improvements are needed.

It is being led by three experts — lawyer and former governor Kate Warner, end-of-life law expert Ben White, and palliative care specialist Michael Ashby.

A final report will be handed to the government by November 1.

Comments from the Australian Medical Association President, Meg Creely, provide concerns over the direction of the review. Whitfield reported Creely as stating:

President Meg Creely said that, overwhelmingly, medical practitioners involved with VAD found it "a really rewarding part of their medical career".

However, she said there was an administrative and financial burden on doctors that needed to be addressed.

"What we hear from our members is that legal access and practical access are not necessarily the same thing," Dr Creely said.

Creely seems to be suggesting that doctors who participate in killing their patients often find the act "rewarding" but they want to be paid more.

Canada has never reviewed their euthanasia law.

When Canada legalized euthanasia in 2016, the original law (Bill C-14) required that the law be reviewed beginning in June 2020. That review never happened.

Instead Canada expanded the euthanasia law in March 2021 when it passed Bill C-7. Bill C-7 allowed people who without a terminally condition to be killed, it removed the 10-day waiting period when a person has a terminal condition, it allowed a doctor to kill an incompetent person, when that person was previously approved for euthanasia, and it allowed euthanasia for mental illness alone, which is currently scheduled to go into effect in March 2027.

After passing Bill C-7, the Canadian government established a euthanasia committee composed of 10 members of parliament and 5 Senators. The AMAD committee did not review the law but rather it examines further expansions of the law.

On July 1, 2026, the Euthanasia Prevention Coalition launched a campaign demanding a complete review of Canada's euthanasia (MAiD) law.

Please sign and share the link to our EPC petition (Petition Link)

Now that Tasmania is doing a review of their law, maybe it's time for Canada to review its euthanasia law. 

Canada: How Death Care is pushing out Health Care

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin has written another excellent exposé on Canada's euthanasia regime published in the National Review on September 14, 2023 entitled: How Death Care pushed out Health Care. 

Raikin's previous article: No other options: An exposé on euthanasia in Canada, published by the New Atlantis on December 16, 2022, provides important insights into Canada's euthanasia law.

Raikin focuses on proceedings from the Canadian Association of MAiD Assessors and Providers (CAMAP), training seminars and interviews with patients and doctors concerning death 'care'. 

CAMAP is an independent organization funded by Canada's federal government to train doctors and nurse practitioners on how to euthanize (kill) patients (MAiD).

A panel at the CAMAP training seminar explained how "strict" the law is:

On the same day that a patient enters into an optional written agreement with only one of his or her two MAID assessors — even if it is unsigned, without any witnesses, and with no family members having been informed — the clinician can administer the lethal injection without asking for the final consent of the patient.

Quoting from a CAMAP training seminar, Raikin writes:

"Next question is from Debbie," the moderator of a discussion on medical decision-making capacity said to her fellow physicians. “How would folks interpret someone who has lost capacity with a waiver in place and is now delirious, shouting, pulling their arm away as one tries to insert the IV to provide MAID?”

The question is important because the patient is clearly unable to consent and is showing signs of resisting. 

The Moderator, Dr Ellen Wiebe, possibly Canada's most prolific euthanasia doctor, responds to the question by stating:

“I’m guessing I would bring in one of their other providers, you know, palliative care or, or whatever, and get them sedated. But what would you say?”

First to speak is Jim MacLean, who claims that he has performed more than 75 “provisions” since MAID expanded to include non-dying patients. “I don’t think I have any great thoughts on this one.” Wiebe laughed. “Everyone’s different. I mean, you try to deal with the situation. Calm the room down. See what you can achieve through conversation and calmness.”

Chantal Perrot is the co-chairman of a clinician advisory council for Canada’s largest pro-MAID lobby group. She described herself to a parliamentary committee as someone who has “cared for hundreds of patients . . . as they navigated the MAID process.” Responding to Wiebe, she said, “That’s a question. If they’re sedated, then have we sedated them into being accepting of MAID? You know, that’s a whole other question.”

Kevin Reel, a senior ethicist at Sunnybrook Hospital in Toronto and former president of the Canadian Bioethics Society, answers in part with another question: “If what we’re doing by trying to honour the waiver is reducing distress for the patient and also for maybe even the family around them, would it be acceptable to do something similarly covert to keep them from reacting in that way?”

Reel continues, “That might be a way around it, but — ” before being interrupted by MacLean, whose new answer takes the question from the hypothetical to the actual and clarifies what he meant by “conversation and calmness”: “One waiver I did use, the patient was a little agitated. So we did give her some subcutaneous hydromorphone” — an opiate ordinarily used for acute-pain control instead of sedation — “before I did the MAID, did the provision. So we did, we did use it in that situation and it was very helpful.”

“Good,” the moderator says, before moving on to the next question. 

No one on the panel or audience objects.

Raikin explains:

The asterisk in the law is that the agreement is in place only as long as the patient “does not demonstrate, by words, sounds or gestures, refusal,” or “resistance to its administration.” If this demonstration is “involuntary” and “made in response to contact,” the death of the patient may still proceed. But consent is a spectrum, and patients with delirium can flicker between having capacity and not; patients can also change their minds about dying at the hands of their physician or nurse.

The recording from an October 2021 training session documents the use of sedation to obtain consent. 

Raikin explains the importance of the use of sedation to obtain consent for death:

At the core of death care is the presumption that safeguards work and that consent, the most important safeguard, prevents death care from slipping into rampant homicide or suicide contagion. Instead, it is turning into the end of medicine.

Raikin provides examples of the use of sedation to gain consent for death:

In Belgium last year, after a lethal injection failed to kill a 36-year-old woman with terminal cancer, the presiding physician smothered her with a pillow. In New Zealand and Canada, suicidal patients seeking medical care for suicide prevention were prompted to consider assisted suicide instead.

In the Netherlands, a similar story of a physician sedating her patient into accepting euthanasia led to the first criminal trial of a euthanasia physician. She was acquitted. The judges said, “We believe that given the deeply demented condition of the patient the doctor did not need to verify her wish for euthanasia,” even though the patient repeatedly attempted to fight off her physician.

I have written previously about how a failed suicide attempt in Canada was completed through euthanasia, despite concerns of illegality by physicians involved with CAMAP, an organization that has held internal seminars on patients requesting euthanasia because of poverty, lack of medical care, homelessness, and credit-card debt.

Raikin quotes Michel Bureau, head of the Commission sur les soins de fin de vie (Commission on end-of-life care), the independent monitoring agency for MAID in Quebec who told the Canadian Press news agency this summer:

“We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.”

In every jurisdiction that has legalized assisted suicide, the number of deaths have ballooned and "safeguards" have been rescinded. Raikin writes:

In California, the number of assisted suicides last year increased by more than 63 percent. In Canada, the number of deaths by euthanasia is on track to increase more than 13-fold in just the first seven years of the practice’s legalization. Belgium has seen a more than twelvefold increase since 2003. In Switzerland, which legalized assisted suicide in 1941, the number of such suicides has doubled every five years since 1999.

Raikin gives examples of deaths that are outside of the law:

A sibling found out that his brother’s MAID paperwork in British Columbia listed only “hearing loss” as his qualifying condition. In the Netherlands, dozens of patients qualified for euthanasia only because of autism. In Canada, “advanced age” helps qualify patients to die, even though Quebec cautions that to rely on it as the sole criterion is illegal. Young patients have died through euthanasia in Belgium for a range of reasons, including a botched sex change, sexual exploitation by a psychiatrist, unresolved post-traumatic stress disorder after a terrorist attack, and again, this time in twins, hearing loss.

Last year the Swiss Medical Association saw a need to issue a statement reminding physicians, for the first time, that “assisted suicide for healthy persons is not medically and ethically justifiable.” The agency responsible for monitoring assisted suicides in Quebec issued a similar reminder over the summer.

Raikin quotes bioethicist Leon Kass, who warns that if the value of a human being is considered subjective, invariably the right to die metamorphoses into the duty to die.

Raikin explains the planning and goals of CAMAP:

In 2018, at CAMAP’s annual conference, the leading death-care practitioners gamed out their plan. It was nothing short of prescient. Many speakers, such as the CEO of Dying with Dignity, stressed that MAID is a “political issue” and that it would require “the political will to speak out against Catholic institutions around MAID.” Moreover, as some panelists insisted, it was important for practitioners to “recognize the harm to vulnerable populations that comes with the assertion of freedom of religion.”

 In comparison, MAID was “sacred.” One speaker implored non-MAID clinicians “to keep the spirit of MAID intact.”

Just two years into Canada’s euthanasia experiment, physicians were busy laying plans for how to expand euthanasia to children, especially Indigenous children, since they “are considered wise because they are closest to the ancestors.”

Raikin explains how CAMAP promotes euthanasia for poverty:

Senior CAMAP leadership has repeatedly denied that patients are receiving euthanasia primarily because of poverty. Yet in 2018, it devoted an entire panel to “providing MAID to vulnerable, Indigenous, homeless, and frail elderly populations.” Panelists described how they could “help to empower vulnerable populations” by helping “patients fight for options that would allow them to have access to MAID” — in other words, to help find “what supports” patients might need to die instead of to live.

“I have a First Nation patient who meets all the criteria for MAID, but much of their suffering is due to a life lived in poverty,” one panelist said. “If I could change their social determinants of health, their situation might improve.” Even a hypothetical example of a patient with “fixed delusions that are causing him severe suffering” was deemed potentially eligible because “it doesn’t matter what he wants [MAID] for.”

Stefanie Green, the leader of  CAMAP, advocated that opposition by hospices to euthanasia will be overcome. Raikin quotes Green as stating:

“Over time, perhaps ten years from now, I think this conversation will happen again. If we push it now too hard and too fast, I think that will put more wedges in.”

CAMAP’s strategy has already succeeded. In 2017, Vancouver Island had a Catholic hospital and four hospice beds. Now as a consequence of a public campaign by death-care advocates, there are no remaining “MAID-free” spaces on the island.

In 2021, Vancouver Island had the highest euthanasia rate in Canada. 

Raikin discusses the cases of several Catholic hospitals that have been taken over by the Australian government in order to provide access to death services. 

Raikin writes of the doctors who object to euthanasia and are being forced out of medicine:

Helen Lord, one of the nine palliative specialists in Tasmania, retired once                "death care" began.

“I know I actually can’t kill someone, I can’t do it.  

“I said I’m not going to have any part of this. It’s not medicine. It’s just not what we do. . . . Half of the people who came into [my] palliative care were scared that they were going to be euthanized.”

When Lord spoke out against euthanasia she was accused of being a right-wing Evangelical, which she is not. Lord does believe that "life is precious" and "time is precious."

Félix Pageau, a geriatrician practicing in Quebec, testified to a national parliamentary committee in Ottawa that in his opinion as a physician, based on research, Canada was not ready to expand MAID to advanced dementia. For this, he said, a colleague in his home hospital “filed a complaint to the Collège des médecins” saying he “lied” to the committee. The Collège decided to “open an inquiry, even though they don’t have jurisdiction over testimony at the federal [level] or in the Parliament.” The investigation became an ordeal — and an expensive one, since Pageau needed to hire a lawyer. Pageau in his parliamentary testimony was exercising his free-speech rights. Eventually, the Collège ruled that it did not have jurisdiction, but the point was made.

Raikin continues:

Another physician, a former director of a palliative clinic in Canada, told me, “I had to leave a job that I loved” because “the MAID situation” made it “just too difficult to practice medicine here.” After she spoke up publicly to urge that MAID and palliative care be separate, she was constantly harassed; her email was flooded with dozens of gory images. Another palliative-care physician told me that he started his own small clinic rather than stay at the hospital where he practiced. “Physicians that go against the narrative are sanctioned,” he said. “They’re marginalized. It’s hard. It’s risky.”

Dr David D’Souza and Dr Mark D'Souza are physicians in Ontario:

“I think already there’s a lot of abuse going on, and I’m seeing it in my own practice,” including when families pressure loved ones to die so that estates or insurance payouts become available sooner. “It’s making me think twice about whether I should be continuing in geriatric care.” His brother, Mark, also a physician, left palliative care entirely. “We’re literally doing harm even though it’s under the guise of compassion,” Mark said.

Raikin states: 

The effect of legalizing death care is not just the hostile takeover of medicine. It hurts those who are the most vulnerable, those who want not to die but to be helped to live.

Gabrielle Peters, a disabled writer and policy analyst in Canada, told Raikin that it is essential that there are MAiD free places in Canadian healthcare. Raikin interviewed Rachel, who lives with chronic pain, PTSD and depression.

Rachel, a woman with a condition that causes chronic pain, told me about the difficulties of the past year. “Every day was really hard to stay alive,” she told me. “I really felt like I was dead.” She also suffers from major depression and has a history of PTSD from childhood abuse. “If I said that I wanted to die or that I couldn’t hack it anymore” when she spoke with health-care practitioners before MAID was legalized, “I was met with, ‘Here’s some coping skills and let’s talk about it,’ and various forms of therapy and resources being brought to bear.”

Once her condition qualified for MAID, in 2021, she began to notice a trend. “I would call the crisis line, the suicide crisis line. Many of these mental-health professionals, their advice would be to go look up Dying with Dignity’s website.” She tried to get help for thoughts of suicide, and instead she was being offered advice for how to die from assisted suicide.

“I have been afraid, you know, over this last couple of years to go to just my local hospital, because I was afraid that if any doctor either brought up MAID themselves or met my kind of ambivalent desire for MAID, all I needed was a push and I would be dead right now.”

Rachel found help at the Centre for Addiction and Mental Health (CAMH), Canada’s largest mental-health teaching hospital, located in Toronto. 

Raikin writes:

Its policy is that no CAMH clinicians can provide MAID on site. She felt that she had found a MAID-free space that could treat her illnesses. (CAMH is yet to release a statement on whether its MAID policy will change when, in six months, MAID will be expanded to include mental illnesses.)

Rachel decided to risk everything. With her meager savings from her disability benefits, she purchased a one-way, long-distance bus ticket, not knowing whether she would be admitted to the hospital or instead end up homeless.
“I literally just presented myself at the CAMH ER,” she said. “Part of the reason I felt safe to go to CAMH is just because I knew that they do not endorse MAID for mental illness. They’re pretty strict on that.” In a sense, Rachel lucked out. Despite the usual long wait times at Canadian emergency rooms, especially for psychiatric illnesses, her poor condition meant that her case was triaged to the front of the queue. She soon discovered how MAID was viewed by doctors at the center. “On the psych ward at CAMH, my psychiatrist was terrified — terrified,” Rachel said, carefully enunciating every syllable, “that I would talk about MAID on the floor with the other patients. She was terrified of suicide contagion.”

Over the span of weeks, Rachel began to recover. She was finally put on a new form of pain control; her depression improved. But the most important change at CAMH was that, finally, she felt listened to. “Sometimes, all you need is someone to come alongside you. And just help you cope through the everyday,” she said. “Whether it’s a doctor or just the person who is walking alongside me while I’m in a lot of pain. It may not change how much pain I actually have. But it sure makes a big difference to how much I suffer from that pain.”

Rachel is now happily back home. “I have no intention of using MAID. I have 100 percent turned away from it. Only because I had health care. All I needed was health care and pain care.”

Raikin recounts his previous article about Rosina Kamis, who died by euthanasia and her friend James, who has a similar medical situation:

In the first story that I wrote about death care, “No Other Options,” published in the New Atlantis, I wrote about Rosina Kamis, a 41-year-old Toronto woman with fibromyalgia. She chose to die from MAID in part because of her inability to access proper medical care. Before she died, she entrusted her friend James, a former neighbor, to represent her as her power of medical attorney; since her physicians weren’t listening to her, she wanted to see if someone else who has fibromyalgia, as James does, could get her the medical care that she needed. Despite his efforts, James couldn’t help her — and now, after her death, he can’t get the help that he needs. He messaged me months after our first conversation to tell me that he now sees his own future in what happened to Rosina.

James told me that he is living with the specter of an imminent administered death, like Rosina’s. He could decide to stop fighting for the care he needs, too. It seems inevitable. “I’m going to take it one day. That’s how it feels to me. I don’t like that, but to me, the way things are going, this society is really sending us disabled people a message,” James said. “We got that message even before MAID. But now it’s codified into law and there’s these processes and resources to expedite it.”

“I have diagnosed mental-health conditions and I can’t get treatment. I need therapy. My doctor asked me the other day, What do I need? I need therapy. I need a long-term relationship with someone. And she told me, she said, That’s impossible.” Instead, he was sent YouTube videos on how to do stretches. He chuckles.

“I need actual health care,” James said. Eventually, he tells me, he’ll get death care instead.

CAMAP, which sells itself as the experts on MAiD in Canada, received $3.3 million from the Canadian government to develop a curriculum for MAiD clinicians.

Thank you Alexander Raikin for your research and your continued advocacy for health care not death 'care'.

Queensland Australia euthanasia bill is deliberately deceptive

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Queensland Parliament

The Queensland euthanasia bill, known as the Voluntary Assisted Dying Bill, is overly wordy (113 pages) and deliberately misleading. The Tasmanian euthanasia bill (122 pages) had similar concerns. It appears that Australian governments think that the abuses and problems with euthanasia bills can be hidden by a verbose bill.

The deception begins in the first sections of the bill. For instance, Section 7 (1) states that a health care worker is not to initiate discussion about voluntary assisted dying. Section 7 (2) allows a health care worker to initiate discussion about voluntary assisted dying when talking about other treatment options. Section 7 (1) is intentionally deceptive. Health care workers can initiate discussion about euthanasia, so long as it is within a discussion about treatment options in general.

The Queensland bill uses the term health care worker, rather than physician or nurse. In other words, the Queensland bill allows a wide group of health care providers to be involved with the act.

The Queensland bill limits the act to terminally ill people but the definition is very wide. The bill states:

A person is eligible for access to voluntary assisted dying if—

• (a) the person has been diagnosed with a disease, illness or medical condition that— 
• (i) is advanced, progressive and will cause death; and  
• (ii) is expected to cause death within 12 months; and 
• (iii) is causing suffering that the person considers to be intolerable; and

• (b) the person has decision-making capacity in relation to voluntary assisted dying; and 
• (c) the person is acting voluntarily and without coercion; and  
• (d) the person is at least 18 years of age; and...
  

The 12 month terminal illness requirement is wide-open. A person can refuse effective medical treatments and still qualify for euthanasia. There are many medical conditions that will lead to death if a person refuses medical treatment.

The requirements for euthanasia are subjective. The bill states that the person considers the suffering to be intolerable. If someone has suicidal ideation and wants to die, they will state that they consider their suffering to be intolerable.

The cause of death is to be labelled as the medical condition that resulted in the approval for death by lethal drugs rather than admitting that death occurred by assisted suicide or euthanasia.

It is interesting that under the heading - Residency exemptions a person who is not a resident of Queensland could be approved for euthanasia based on "compassionate grounds." Does this mean that Queensland is willing to become a suicide tourist destination?

The bill tramples on conscience rights. The bill requires medical practitioners who refuse to participate in euthanasia to refer a patient to a medical practitioner or service that is willing to provide euthanasia.

The bill requires medical practitioners who are willing to participate in euthanasia to be trained. This does enable medical practitioners who don't want to participate in the act to decide not to be trained.

Similar to other euthanasia laws, the bill is designed to give, in this case medical practitioners, the right in law to kill their patients. After the request to be killed is made, the decision to approve and then to kill is made by the medical practitioner.

Similar to the original Canadian law this bill allows euthanasia for psychological or mental illness, as long as the person is terminally ill. Since the Queensland bill focuses on the undefined concept of suffering, is this not a set-up to permit euthanasia for mental illness, a few years down the slippery slope?

Assisted dying legislation affects us all.

This article was published by Mercatornot on January 18, 2021.

There is a fundamental difference between assisted dying and palliative care 

Dr Helen Lord

By Dr Helen Lord

Tasmania, Australia’s smallest state, like many other jurisdictions, is currently considering legalising voluntary assisted dying (VAD). It is of great concern that legislators are seeking to incorporate this into palliative and medical care.

Voluntary assisted dying sounds like a description of what should be occurring in normal medical practice: clinicians recognising those who are dying and then assisting them to live comfortably until they die. Such medical practice is currently the domain of palliative care, which can, and does, deliver relief of pain and suffering for those who consent to receive it.

However, in the currently proposed legislation for Tasmania, VAD means no less than the legalisation of euthanasia and physician assisted suicide: the exact opposite of palliative care. As described, VAD is purely a legal process, through which people can access and be given lethal substances which will cause their deaths. In contrast, palliative care is about how each individual patient can be enabled to reach their full potential until a natural death, through the relief of pain, distressing symptoms, and suffering.

The delivery of palliative care is highly personalised; it is not an impersonal process involving the meeting of various legal criteria. Palliative care requires communication by those with the necessary skills and attitudes to assess, enable, ease, and give good holistic medical care. There is no medical condition that has as a treatment the prescription of lethal substances with the intention to kill.
Palliative care

There is an extensive, publicly available evidence base for palliative care. However, there is no publicly available evidence base for the giving of lethal substances to patients — except for that used in the United States for capital punishment.

Modern palliative care arose because many people witnessed the common experiences of dying last century: patients neglected and left alone in windowless small rooms at the end of a corridor with families and friends excluded. The hospice and palliative care movement arose to provide them with a suitable environment and with appropriate patient centred care that valued and respected the dying person. It involved and was concerned with care of the dying person’s family and friends.

The evidence bases for the pharmacology of pain relief and symptom control developed, and Palliative Medicine was recognised as a medical specialty in Australia in 2000.

Palliative care principles are based on respect, valuing the life of each individual patient, and seeking to ensure that the vulnerability of those dying does not lead to a denial of care or abandonment. These palliative care values are constantly being challenged by the increasing corporatisation, bureaucratization, striving for efficiency and fragmentation of modern health care. There continues to be a need for better, more available palliative care services — yet we now see a demand for VAD.  

Fear of pain and suffering

VAD is being driven in Tasmania by those who say they want choice because they fear pain and suffering at the end of life. They claim wide support from the community in general.

Yet experience so far in Victoria, the first Australian State to legalise VAD, is that only a small percentage of people take up the offer. Stories of pain and suffering in dying are repetitively aired by grieving relatives and friends or by treating clinicians who have not known about, or sought access to palliative care for advice. The powerful effect of transference of guilt and grief in these situations is clear, but not widely recognised.

These stories perpetuate the myth that the end of life is associated with pain and suffering, which I know from my experience is not true for the majority, and certainly not the experience of those who are referred to and are able to access palliative care in a timely manner.

There are still many people in Australia who do not have access to palliative care services or an appropriate place of care when they die. It is irresponsible that legislation based on “choice” is being proposed when there are many within society denied choices through lack of access to palliative care.
Effects on vulnerable patient groups

Patients with serious and terminal illnesses are vulnerable to suggestion due to the psychological effects of facing life-threatening disease. There are also many groups within our community who are likewise vulnerable: the elderly; those living in rural areas; those with physical disability; those with mental illness; those in marginalised minorities.

These groups of people will inevitably face increased pressure to accept VAD if such legislation is passed, because of their less privileged access to care.

Once VAD is allowed, although initially in strict circumstances, it will rapidly become normalised and will be seen by the medical profession as an easy option: the options of other care and treatment modalities will be not worth considering. This is already being observed in Victoria with VAD being suggested by clinicians as an option for people surviving suicide attempts.

Disability groups in Canada are reporting that people living with disabilities are asking to access VAD because they cannot afford financially to go on living.
Effects on the medical profession and palliative care

Maintaining the integrity of the medical profession, upon which we all rely when we are ill, should be of paramount importance. Having doctors licenced to assist in suicide or the deliberate termination of life lessens the trust that patients can have in their doctors. Such behaviours go against the long-standing convention that doctors do not harm their patients.

Doctors heal, restore, ease and comfort; they do not kill, even if asked. Being involved with VAD violates a moral code that most doctors rely on for their identity; hence the very existence of VAD creates for all doctors a risk of moral injury, in the same way as is seen in combat troops facing ethical dilemmas over life and death.

The impact of just one case of VAD on a clinician’s psychological health and practice is greater than in any other aspect of medicine. Clinicians in the Netherlands liken the psychological effort required for each case of euthanasia to being like that of “climbing Mount Everest”. It leaves “little else in the tank” for the practice of good medicine or for self-care.

For all the talk in public about VAD being for the relief of pain and suffering, it is known that most people accessing VAD do so because of issues of control or autonomy. Logically, therefore, there should be no need to involve doctors or palliative care services in the procedure of VAD. Survey results suggest most Australian doctors are unwilling to be involved in VAD, and most would refer patients for palliative care involvement. However, the legalisation of VAD places palliative care services in a moral bind.

The effects of legislation similar to Tasmania’s VAD, Canada’s Medical Assistance in Dying (MAiD), introduced in 2016, on palliative care practices are starting to become apparent. One Canadian palliative care unit has reported significant staff distress with clinicians being physically sick on the days of MAiD procedures; palliative care staff having to support patients who are ambivalent about MAiD so they can go through with it; patients not having pain relief in case it denies them being able to access MAiD on capacity grounds (perpetuating the myth of painful dying); having just one person considering MAiD causing considerable psychological involvement of all staff meaning that other patients needs are neglected; staff who are unwilling to be involved in MAiD being taunted by comments that they do not really care by patients wanting MAiD; staff being more uncomfortable in discussion of end-of-life matters in case they are misinterpreted.

Palliative care services in Victoria have also reported significant issues arising in their units since VAD was legalised there. Referrals to counselling for palliative care staff suffering from psychological distress because of their involvement in VAD have begun. Increased anxiety in palliative care patients because of the existence of VAD has been noted. In the interests of maintaining the functionality of heath care teams, and because of concern for other patients on their units, patients having VAD are being transferred elsewhere.

For all these reasons as caring communities we should be thinking most cautiously before bringing state sanctioned suicide and euthanasia into the medical and palliative care arenas.

There are fundamental ethical differences between palliative care and VAD procedures; we need to protect the vulnerable in our communities and those who are dying; and we need to support the staff of our palliative care and medical services in their work, not compromise them.

Dr Helen Lord MB BS MPHC FAChPM has worked in palliative medicine and general practice in Tasmania for over 30 years

The detail is where the Tasmanian Devil is in the Assisted Dying bill.

By David Foletta

The End-Of-Life Choices (Voluntary Assisted Dying) Bill 2020 (Tasmanian Bill) which is currently before the Parliament of Tasmania is another piece of assisted dying legislation in Australia which is unnecessary, dangerous, puts ideology before safety and erroneously labels euthanasia as assisted dying. The Tasmanian Bill is a private members bill sponsored by Mr Michael Gaffney.

Article: Tasmania bill will allow wide-open euthanasia.

Under the Tasmanian Bill “assisted dying” has the following definition “voluntary assisted dying means the administration to a person, or the self-administration by a person, of a VAD substance under this Act” The words “the administration to a person” are clearly euthanasia. This presentation of “euthanasia” as “assisted dying” which carries the dual problem of allowing another person kill another person, and, by virtue of that handing over of power, allows a potential abuser to more easily mask their actions is a departure (read, slippery slope) from the Oregon model that we have seen in Victoria, Western Australia and Queensland (Queensland is still at majority report acceptance stage).

The Tasmanian Bill and assisted dying generally in Australia is being legitimised by three one sided majority reports from Victoria, Western Australia and Queensland. Each of these three majority reports failed to make any reference to, or try to disprove, the Parliament of Tasmania’s own 1998 inquiry into end of life choices final report which stated:

“5.29 The Committee found that the legalisation of voluntary euthanasia would pose a serious threat to the more vulnerable members of society and that the obligation of the state to protect all its members equally outweighs the individual’s freedom to choose voluntary euthanasia.” 

The Tasmanian Parliament must consider evidence in a way that is more detailed than mere empirical, and see that any right to die legislation has negative consequences for a whole community, not only people who are actually using the legislation. It must also find reasons why the above recommendation is no longer correct. Assisted dying and euthanasia are inherently dangerous. No amount of alleged “popularity”, “change in values” or “distress” can cause a dangerous action to be made not dangerous however, these are what “progressive” decisions are being based on.

David Foletta is an attorney, in New South Wales, Australia.

Tasmania bill will allow wide-open euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

(Tasmania is an Australian Island state).

When debating the legalization of euthanasia or assisted suicide, the specific language of the legislation is often overlooked while people debate the concept assisted death.
 
The language in the 122 page Tasmania End of Life Choices bill which is expected to have its second reading in the Upper House on September 15, allows for a wide open assisted death regime.
 
This article focuses on the definition of medical condition in the bill.
 
For the purposes of the Act, the bill defines a relevant medical condition as:

(1) a disease, illness, injury, or medical condition, of the person that is serious, incurable and irreversible. 

(2)Despite subsection(1), a mental illness, within the meaning of the Mental Health Act 2013 is not a relevant medical condition for the purposes of this Act.

What does that mean? Unless the request for assisted death is based on mental illness, the person is only required to have a serious, incurable and irreversible medical condition.

The bill states that a person must be suffering intolerably in relation to a relevant medical condition. However, this is completely subjective because the bill states that the intolerable suffering is solely determined by the opinion of the person requesting assisted death

The bill also states that a person can be approved for an assisted death not only based on the serious, incurable and irreversible condition but also based on complications that may arise from treatment being received or treatment that may possibly be received.
 
Specifically, the bill states that a person can be approved for an assisted death if that person is concerned about:

"complications that have arisen, or may arise, in relation to the treatment of the relevant medical condition or its treatment or the combination of that treatment with the treatment of other medical conditions of the person."

The bill goes on to state that assisted death is permitted if, in the opinion of the person making the request, there is no reasonable treatment that will lessen the persons suffering to an extent that is acceptable to the person.

Therefore a person can be approved for an assisted death based on a fear of suffering related to a possible effective treatment, that the person has not tried. The caveat being that the person may in fact not only forgo the effective treatment but have never considered it in the first place.
 
Some people are delusional or have nosophobia about their medical condition. As noted above stated the language of the bill allows a wide open assisted death regime.

In summary, the definition of medical condition is completely subjective because it is based on whether the person finds the condition unacceptable, which is impossible for a physician to evaluate.

In other words, this bill gives pro-euthanasia medical practitioners the ability to approve deaths without fear of wrongful deaths leading to legal concerns.

The Tasmanian assisted death bill is 122 pages long. It is a massive spider web of text that appears to have comprehensive safeguards. 

This voluminous bill is not designed to protect a vulnerable person, but rather to protect medical practitioners who choose to kill.

Euthanasia and Elder Abuse

The following article was published by HOPE Australia on January 9, 2018

Helen Polley

One of the greatest dangers that we face as Australians, now that euthanasia is legalised in Victoria, is making the elderly feel as if they are a burden on society. There is an obsession in our culture with being young, and the older generations can tend to be neglected. The propagation of euthanasia further demeans the value of the lives of elderly Australians. As Senator for Tasmania, Helen Polley stated:

Voluntary euthanasia cannot promote the dignity or humanity of vulnerable older Australians in an environment in which our elderly feel undervalued, ignored and forgotten. Instead, it further will entrench ageist views, desensitise us to euthanasia and ultimately lead to a devaluation of life and premature death.

Elder abuse is a major concern, with a report last year from the Australian Law Reform Commission recommending detailed study into the prevalence of elder abuse in this country. If an individual is unable to take care of themselves, has reduced decision-making capabilities and/or financial management issues, their vulnerability to be pressured into euthanasia by family members or others responsible for their care increases.

Given that there is currently no robust system that has effectively prevented elder abuse, there is no reason to believe that adequate safeguards can be put in place for euthanasia.

Australia has an aging population; by 2050, more than one in four Australians will be 65 or older, and we need to be making good decisions about how we will treat them in their later years.

We say it often, but the truth remains, Australia needs better palliative care. To quote Polley:

If we want to change the culture of dying we should be looking at our end-of-life care system because it’s brimming with untapped potential but significantly underfunded. People should be able to rest assured knowing the end-of-life care and support they deserve will be there for them. We must not let voluntary euthanasia take the attention and resources away from this.

Under no circumstances should an individual feel the need to opt for euthanasia because they don’t have confidence that they will receive adequate end-of-life care.

Euthanasia and assisted suicide continue to be defeated.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Many media outlets are promoting the message that euthanasia and assisted suicide are being legalized everywhere and yet the reality proves that the opposite is true.

On Tuesday May 23 the Maine House defeated assisted suicide bill L.D. 347 in a bipartisan 85-61 vote and on Wednesday May 24 the Tasmanian parliament defeated euthanasia bill (Voluntary Assisted Dying Bill) by a vote of 16-8.

The Maine Press Herald reported that:

Maine legislature

The bipartisan 85-61 vote against the bill followed lengthy and oftentimes emotional debate among lawmakers sharing personal stories of watching loved ones battle terminal diseases. The so-called “death with dignity” bill had passed the Maine Senate by a single vote last week but faced a potential veto from Gov. Paul LePage even if it had passed the House. 

“My conscience tells me that this is the wrong direction for a variety of reasons,” said Rep. Gay Grant, D-Gardiner. “This is not a partisan issue. It is a human issue.”

Paul Russell, the Director of Hope Australia reported that:

Tasmanian legislature

In debate, Michael Ferguson MP criticised the euphemistic language of the bill, arguing that such a grave matter demands clarity: 

“We all agree it is a matter of life and death and if we cannot strip away the euphemistic language and discuss the reality of the matter then it will not be an honest debate and the public interest would not be served. 

“I ask those promoting this bill to be truly frank and honest in their descriptions, and for those listening to the debate today, if or when you hear those euphemisms, you need to remind yourself that the real words, however distasteful they are, are mercy killing and assisted suicide by a doctor.”

Many people will say, but Alex, that is only two jurisdictions. The fact is that in 2017 assisted suicide bills have been stopped or defeated in Hawaii, Utah, New Mexico, Nebraska, Minnesota, and Maryland while in several other states, assisted suicide bills were introduced but lacked support to even be debated.

This is an issue that is literally about life and death.

Legalizing euthanasia or assisted suicide gives physicians the right in law to kill their patients. 

Do suicides increase where euthanasia is legal?

This article was published by Mercatornet on May 22.

The euthanasia debate is on the front-burner in Australia, especially in the states of Victoria and Tasmania. In one of the latest salvos, ethicist Professor Margaret Somerville claimed that suicide rates rise in jurisdictions where euthanasia and assisted suicide are legal. This prompted a blast from Neil Francis, a former President of the World Federation of Right To Die Societies and a leading campaigner for euthanasia in Australia. This is Professor Somerville’s response.

B

Margaret Somerville

y Margaret Somerville

Neil Francis is correct in criticizing me for a loose statement that "the general suicide rate has increased in every jurisdiction that has legalized assisted suicide." 

Although I believe that my statement will prove to be correct, at this point in time I should have left out the word "every." 

One problem in obtaining the required evidence, is that it’s difficult if not impossible to know how often physician-assisted suicide or euthanasia (PAS-E) is being used in countries where those interventions are legal to commit what we should view as “ordinary suicide”–if one can ever regard suicide as “ordinary”, but for want of a better term. 

“Suicide by police”–a suicidal person engages in conduct with the intention that the police will respond by shooting them - is a recognized phenomenon. Now we can consider “suicide by physician”. 

Two features of legalized PAS-E make “suicide by physician” seem likely: The percentage of deaths occurring from PAS-E, for instance, in The Netherlands and Belgium, is rising by approximately 10 per cent each year and is now around 4 percent of all deaths. And the conditions for access to PAS-E are expanding in both jurisdictions. If one is not terminally or physically ill, neither of which is a legal requirement in either country, is euthanasia “ordinary suicide”? And what about if a person wants PAS-E because they are just “tired of life” or feel they have a completed life as the Netherlands is now contemplating allowing or, as an elderly couple proposed on ABC’s Q&A, simply want to avoid going into a nursing home, should these be classified as “ordinary suicide” cases? 

Cases in which using PAS-E as a substitute means of suicide seems very likely have made headlines around the world. They include the deaf Belgian twins who were going blind; the young gender-dysphoric woman with the botched sex-change operation; the anorexic woman in her 20s; the depressed 34 year old Eva, whose death by euthanasia is focused on in real time in the documentary film, “End Credits”, made by Dutch pro-euthanasia advocates; the convicted rapist and murderer in the Belgium prison. 

Dutch Professor Dr. Theo Boer, a former member of one of Holland’s five Euthanasia Regional Review Committees (2005-2014) has undertaken a study which will be published shortly which, in his words, shows 

Theo Boer

the assumption that euthanasia will lead to lower suicide rates finds no support in the numbers. The percentage of euthanasia deaths of the total mortality rate tripled from 1.3% in 2002 to 4.08% in 2016. During that same period, the suicide numbers did not go down: From being 1,567 in 2002, they went up to 1,871 in 2015, a rise of 19.4%. The suicide rates reached a relative low of 1,353 in 2007, compared to which the 2015 numbers constitute a rise of 38.3%. This is even more significant given the fact that from 2007 on euthanasia started becoming available to people with chronic diseases–psychiatric diseases, dementia, and others. In terms of the percentage of the overall mortality of suicide deaths, the numbers went up from 1.01% in 2007 to 1.27% in 2015.  

…For the sake of comparison, I have looked at the suicide rates of some countries which are close to the Netherlands in terms of ethnicity, age, religion, and language but which, with the exception of Belgium, lack the option of euthanasia. If the suicide numbers in the Netherlands have gone up, one would expect, at least a similar increase in the suicide numbers would occur in countries without the option of euthanasia. However,…the Netherlands of all countries show the biggest increase in the suicide numbers.” 

Mr. Francis dismisses researchers David Jones' and David Paton’s report on suicide data in Oregon on which I relied to show a rise in the state’s suicide rates on the basis that it was “published in a minor journal”, the Southern Medical Journal. This claim is specious, even if it were a “minor journal”. For the record, it is a peer-reviewed medical journal indexed and abstracted in Index Medicus, Current Contents, Science Citation Index, and EMBASE which has published over 45,000 articles. I leave it to others to decide its status. 

Moreover, if Mr. Francis’ claim as to its status were correct and if Jones’ and Paton’s article were, as Mr. Francis describes it, “a wobbly econometric modelling study”, it stands to reason that the journal would be more accessible in terms of publishing rebuttals or questions about the article. To date, to my knowledge, no one has done so, not there, not anywhere. 

Mr. Francis’, at best, woolly statements about what Jones’ and Paton’s study found need clarifying. They write: 

[W]e found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%–9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%–22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide. (Emphasis added)  

Conclusions: Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. 

As Jones and Patton recall, pundits claimed at the time of the public debate in Oregon about legalizing physician-assisted suicide that having access to assisted suicide would reduce “nonassisted” or “ordinary suicide”, which it clearly did not. This is something Australian legislators should note. 

I will just mention California, which has very recently legalized physician-assisted suicide. There was concern that people who were involuntarily hospitalized because they were mentally ill and “dangerous to themselves (they were suicidal) or others” could not have access to physician-assisted suicide. This has now been “remedied” and a special process established to allow them to apply to have physician assistance in killing themselves.