Gabriel Peters: MAiD builds discrimination, not a remedy to it.

The following was published by Gabriel Peters on her substack on April 23, 2026.

 

By Gabriel Peters

Re: Eligibility of Persons Whose Sole Underlying Medical Condition is a Mental Illness

The following is a longer version of my testimony to Special Joint Committee on MAiD. Due to time restrictions I had to edit severely. However the session is an hour long and I had hoped some of the Committee members would use their time to ask me questions. Only one did.

Thank you for the opportunity to provide some brief comments. One of the hats I wear is that I sit as a care partner on the Providence Health Care Psychiatry Lived Experience Research Advisory Committee and I am always struck by the urgency accorded expansion of MAID for mental illness versus that of providing funding for comprehensive mental health care, supports, livable income and housing for those with mental illness.

Injustice can often be measured in time.

Today, I am speaking as co-founder of the Disability Filibuster.

As policy makers I am certain you are aware that neither people nor policies are islands unto themselves. And yet MAID is discussed as if it exists inside a vacuum, free of influence from, or consequence to, society.

In what little time I have I will address a couple of persistent myths that constantly derail and impede rather than build understanding.

Myth One: The reason people oppose expanding MAiD criteria to include mental illness as a sole underlying condition is because they believe mental illness is less real than physical illness and they treat it as less significant and less worthy of support.

False: The division between physical and mental illness is one asserted and maintained by the medical model and the Canadian state. Due to the exclusion of essential elements of mental health care from Canada’s publicly funded and arguably misnamed universal health care system, Canada has a two-tier mental health care system. The average provincial and territorial mental health care funding lags behind that of many peer countries. Proportionally, Canada’s public spending on mental illness is lower than its occurrence among all illnesses. People with mental illness face particular threats to their civil rights. A BC study found that for nearly a third of people with mental illness, their first contact with mental health care involved the police. A situation that the Canadian Mental Health Association attributes to the lack of community services, the limited scope of crisis services, a reduction in hospital beds so that even short stays are only available to those in the most acute crisis. A CMHA fact sheet states: “Police officers are, by default, becoming the first point of access to mental health services for persons with mental illness, earning them the nickname ‘psychiatrists in blue.’” They go on to explain that one of the consequences of this is that “​​public also receives reinforcement for the false perception that mental illness is a crime rather than an illness, and that persons with mental illness are a public danger – a common and erroneous belief which hurts both persons with mental illness and the public.”

Stigma requires power. Without power, stigma is just someone’s bad opinion.

I hope this isn’t too idiomatic a reference, but in terms of the claims asserted by the myth, the call is coming from inside your house, not ours.

As disabled people we understand disability as one large tent. Power divides and builds hierarchies. Justice unites through shared struggle and common goals.

There are differences and these do matter. Where physical disability can be met with a benevolent though also hostile othering that infantalizes, assumes helplessness, denies access and views our bodies with disgust, people with mental illness confront staggeringly pervasive, dehumanizing and isolating stigma and dangerous stereotypes while being simultaneously blamed for their illness and having its existence doubted.

The experience of oppression is not the same but the cause of it is.

And please remember that the majority of disabled people have more than one disability and a combination of both physical and mental illness is not uncommon. So when someone projects this myth onto one of us they are often accusing and pretending to defend the exact same person.

Myth Two: Failing to expand MAID is discrimination.

False: This and other assertions made by proponents of MAiD’s expansion reflect a profound lack of understanding of disability rights, history and what the causes, consequences and solutions to the discrimination and injustice disabled people experience actually are.

This myth exists as part of the hyper-individualization of human rights by neoliberalism. Instead of human rights as integral component for building a better society, your body becomes a container of assets that you manage. Universal human vulnerability is denied and instead treated as a deviance from ‘normal’ so that whatever social institutions and policies do exist, do not reflect the necessary conditions for broad resilience. Disability and illness are interpreted through the lens of self-ownership, (an extension of private property rights) and personal responsibility. That the neoliberal state is generously offering to aid you into the grave – for free – is not a pivot, it’s an unmasking of any pretence left covering Canada’s allegiance to the dictum of Margaret Thatcher: “there is no such thing as a society.”

In a zero-sum society where the state’s responsibility for social welfare of its citizens is eroded, it was almost inevitable that human rights would become a competitive race to the bottom. A throne of nails and a poison drip awaits the victor.

The urge to distinguish oneself as ‘free’ while yoked to neoliberal and eugenic logic leads to absurdly invoking the Charter to demand something simply because someone else has it - even if what that person has is killing them and those around them. MAID is particularly exploitative as it uses the same hierarchy of deservingness as the charity model to suggest you can reverse your way out of pity and ableist oppression, assert your freedom and prove your equality by asking the state to kill you. Surely this committee and the Canadian state is capable of a more sophisticated understanding of discrimination and human rights.

In a forthcoming chapter entitled, The Case Against Legalizing Assisted Death for Psychiatric Disorders,” Trudo Lemmens and Scott Kim demonstrate why parity arguments logically lead to absolute autonomy (death on demand for anyone).

“..the parity argument is difficult to restrain. For instance, it is not clear whether one can

draw a principled line around ‘medical and psychiatric suffering’ so that all other suffering is excluded, if all that matters is some formal criterion of equal treatment. What is unique about medically based suffering (both somatic and mental) that suggests a clear, principled line around it (Braun, 2023; Davis & Mathison, 2020; Kim, 2023)? That is, one could apply the parity principle to whether persons suffering from non-medical causes are being discriminated against. There is a perennial debate in the Netherlands about extending legal EAS [euthanasia, assisted suicide] to, for example, elderly persons who do not have irremediable medical suffering, but who are ‘tired of life’ and would like EAS. What principle would exclude suffering from abject poverty? The logical destination of the parity argument seems to be a pure autonomy-based EAS system.”[i]

This aligns with disability analysis that for years has asked “Why Us?” The actual discrimination exists at the level of deciding that our suffering - and only our suffering - makes us killable. Humans suffer in a myriad of ways and among the worst is feeling helpless while someone you care for is suffering. And those feelings also happen when you are the person who others might be feeling powerless to help. It makes me wonder how much unprocessed grief and feelings of powerlessness lead to a misguided desire to add meaning and purpose by participating in the construction of MAiD. Once you unravel and disentangle your thoughts and definitions of words like dignity from ableism, you are left with the realization that ableism is the only thing defining the perimeters of MAiD.

Disability analysis has evolved from its early focus on individual rights, independence and integration into existing systems. Breaking free of the medical and charity model and the explosion of knowledge that followed the freeing of many, (though not all), from institutions, led to the realization that the tools we were using were pre-coded to build ableism not dismantle it. As Jean-Sebastian Beaudry, Canada Research Chair in Health, Inclusion and Policy at McGill Law School explains, “Disability justice…requires the dismantling of the multifaceted ableist ideology that pervades the very tools used to achieve justice, and disguises policy shortcomings as unavoidable economic or biological necessities.” [ii]

MAiD is built discrimination, not a remedy to it. The Canadian state decided no dignity is possible for someone who is disabled and, as consolation prize, branded a lethal injection from a state-sanctioned provider “dignified” declaring, “There’s your human rights!”. Conveniently, this aligns with the commodification of human rights. A new revenue stream was created for some but, overall, killing us is vastly cheaper than building the necessary infrastructure and policy to make a dignified life plausible.

The reasoning behind this myth is akin to suggesting that ugly laws were discriminatory not because they banned visibly disabled people from public space but because they didn’t ban all disabled people from public space.

Those presenting the astroturf-autonomy of “access” to death to an actual-autonomy-deprived population are certainly making a choice to do so. But why?

At least one study found that support for euthanasia on the basis of mental illness was positively correlated with stigma towards people with mental illness. Not only the opposite of what one would expect if the myth were true but suggests that those spreading this myth may be projecting their own beliefs onto us.

The co-opting or, at best, outdated and incorrect understanding of disability rights invoked in the name of support for MAiD is made possible by the absence of disabled knowledge and understanding. The mythmaking - or some would call it misinformation – reflects broader epistemic injustice that has remained largely unchallenged and become more entrenched and fictitious as a result of MAID.

MAiD is discrimination not a solution to it. It must be repealed not expanded.


[i] Scott Kim & Trudo Lemmens, The Case Against Legalizing Assisted Death for Psychiatric Disorders

(Forthcoming in Matthé Scholten, Kelso Cratsley, and Tania Gerkel, eds., Mental Health Ethics:

Current Controversies and Emerging Debates (Oxford University Press))

[ii] Jonas-Sebastien Beaudry Ableism’s new clothes: Achievements and challenges for disability rights in Canada

University of Toronto Law Journal 2024 74:1, 1-40

Belgium 2025 euthanasia report: a record number of euthanasia deaths.

Belgian 2025 report: There were 4,486 reported euthanasia deaths up by 12.4% in 2024.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The European Institute of Bioethics (IEB-EIB) reported that the 2025 Belgian euthanasia report indicated that there were 4,486 reported euthanasia deaths in 2025 representing a 12.4% increase from 2024. According the IEB-EIB (Google translated from French):

On March 20, the Belgian Federal Commission for the Control and Evaluation of Euthanasia (CFCEE) released figures on euthanasia cases reported for 2025. 

The number of officially recorded euthanasia deaths last year reached a new record: 4,486 were reported to the Commission. This represents a 12.4% increase compared to 2024, a 51% increase over three years, and almost a doubling in just five years. 

Euthanasia now accounts for 4% of all deaths registered in Belgium, and this upward trend could intensify, judging by the reasons given on euthanasia registration forms. 

Multiple pathologies, the second most frequently cited condition after cancer, have increased by 67% in two years and now represent nearly a third of all reported euthanasia cases. More specifically, the proportion of euthanasia done on individuals who were not terminally ill due to multiple chronic conditions has literally increased tenfold in five years, rising from 5.9% to 57.3%. 

These percentages, which have been steadily increasing since the decriminalization of this practice in Belgium, raising serious questions: has old age become a sufficient reason to resort to euthanasia? 

Multiple chronic conditions: a vague category akin to the weariness of living.

In its latest biennial report published in 2025, the Control Commission highlighted this continued rise in euthanasia based on the criterion of multiple chronic conditions and explained that:

"this percentage will continue to increase, as multiple chronic conditions are associated with the aging process that patients undergo." 

Indeed, multiple chronic conditions, according to the Commission, refer to "a combination of conditions caused by several chronic illnesses that are progressing towards a terminal stage." In practice, these conditions can include end-stage heart failure, hemiplegia due to a stroke, as well as cognitive impairment, vision or hearing loss, rheumatoid arthritis, or incontinence. 

While some of these conditions are life-threatening, they primarily affect quality of life, which explains why, in 2025, more than half of the euthanasia deaths in this category (57.3%) were done when death was not expected in the short term. Is the fear of dependency becoming sufficient to shorten life? 

To understand what justifies euthanasia based on these conditions, that do not directly threaten life, one must bear in mind the subjective logic followed by the Oversight Commission in its verification of the legality of euthanasia, according to which the patient's perception of suffering is considered authoritative. 

In cases of multiple chronic conditions, the chronic progression of illnesses extends over several years and can cause significant psychological suffering, according to the Commission. Based on the scientific research of Marianne Dees, the Commission reports that:

"feelings of hopelessness, dependence on care, fear of further deterioration, and fear of increased physical suffering are determining factors in requests for euthanasia." 

In this context, it is also understandable that in 86% of all reported cases of euthanasia, both physical and psychological suffering were mentioned simultaneously. This finding underscores the vital need for better support for the elderly and at the end of life in general, so that weariness of living and fear of dependency do not become sufficient reasons to shorten a person's life.

The IEB-EIB refer to reported euthanasia deaths since previous studies indicate that there is a significant number of euthanasia that are simply not reported. Therefore the actual number of euthanasia deaths is likely much higher.

Some recent articles on Belgium's experience with euthanasia.

• Belgian bioethics committee supports eugenic euthanasia (Read). 
• Belgium debates expanding euthanasia to people with dementia (Read). 
• Almost 4000 reported Belgian euthanasia deaths in 2024 (Read). 
• The President of Belgium's largest health insurance fund promotes euthanasia as an answer to healthcare funding. (Read). 
• Belgian doctor completes euthanasia with a pillow (Read).
  

There have been around 90,000 Canadian (MAiD) euthanasia deaths since legalization.

There were around 16,500 Canadian euthanasia deaths in 2024 representing 5% of all deaths. There have been around 90,000 Canadian euthanasia deaths since legalization.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

On December 11, 2024, Canada's Ministry of Health released the Fifth Annual Report on Medical Assistance in Dying which outlines the 2023 reported euthanasia data. 

The 2023 report indicated that there were 15,343 reported Canadian euthanasia deaths representing 4.7% of all deaths. The number of reported euthanasia deaths was up from 13,241 in 2022. I predict that there were around 16,500 Canadian euthanasia deaths representing 5% of all deaths in 2024.

British Columbia 2024 euthanasia report.

Recently, EPC obtained the 2024 British Columbia (BC) euthanasia data which indicated that there were 3000 reported euthanasia deaths in 2024 representing 6.7% of all deaths, which was up by more than 8% from 2767 in 2023.

There are some clear concerns in BC. 

One concern is the number of euthanasia deaths in the Island Health region. Island Health is primarily composed of Vancouver Island with Victoria being the largest city. Island health cares for a little more than 1 out of 6 BC residents, and yet the BC data indicates that there were 904 reported euthanasia deaths in the Island Health region accounting for more than 30% of the euthanasia deaths.

Why does Island health have higher euthanasia rates?

Euthanasia is supposedly popular in Victoria BC and there is a euthanasia clinic which provides access, but the data is more likely related to less stringent approvals for euthanasia in that region.

The BC Ministry of Health must assure the public that euthanasia guidelines are being followed by Island Health. Independent research into the reasons for the higher rate of euthanasia deaths must be done.

Another concern is that 35% of the 2024 BC euthanasia deaths were approved based on "other conditions" which was up from 32.9% in 2023.

The number of BC euthanasia deaths related to "other conditions" is further exasperated by the fact that (65.9%) or 691 of the people who died by euthanasia based on "other conditions" that the approval was related to frailty.  

Frailty is not defined in the report but it likely refers to an elderly person who is not dying but has comorbities. In other words, the term frailty can also encompass euthanasia for "completed life."

Euthanasia for "completed life" means that an elderly person is not sick or dying, but wants to die. "Completed Life" is being debated in the Netherlands, but in Canada, it has never been debated, but based on the lack of definition in the law, it is being done.

The BC Ministry of Health must assure the public that euthanasia is not inappropriately being done by conducting independent research into the reasons for the higher number euthanasia deaths related to "frailty."

Based on the 2024 data from Ontario, Québec, Alberta, and BC; I predict that there were approximately 16,500 Canadian euthanasia deaths in 2024 representing 5% of all deaths. 

The 16,500 euthanasia death prediction for 2024 is based on data. By comparing the 2023 reported euthanasia deaths to the 2024 data you notice that:

• Ontario reported 4641 in 2023 and 4958 in 2024.
• Quebec reported 5691 in 2023 and 6058 in 2024.
• Alberta reported 977 in 2023 and 1116 in 2024.
• British Columbia reported 2767 in 2023 and 3000 in 2024.

Since Ontario, Québec, Alberta and BC represent 87% of Canada's population, and since there were 1056 more euthanasia deaths in those provinces in 2024, and since there were 15,343 reported euthanasia deaths in 2023, therefore it is safe to predict that there were around 16,500 reported euthanasia deaths in 2024. There was a 7.5% increase in euthanasia deaths in Ontario, Québec, Alberta and British Columbia in 2024.

As of December 31, 2023 there were 60,301 reported euthanasia deaths in Canada since legalization. I am predicting that there were approximately 16,500 reported euthanasia deaths in 2024. Therefore, as of December 31, 2024 there were around 76,800 reported euthanasia deaths since legalization. Since this article is published in late September, 2025, it is likely there have been around 90,000 Canadian euthanasia deaths since legalization.

Sadly, the number of reported euthanasia deaths continues to increase. From January 1 to June 30, 2025; there were 2551 reported euthanasia deaths in Ontario representing a 4% increase since 2024.

Canada is Killing Itself. Euthanasia: “There is no standard here; it’s just kind of up to you.”

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Elaina Plott Calabro wrote an exposé on Canada's euthanasia law that was published in the September edition of the Atlantic titled - Canada is Killing Itself. The article is too long to comment on in one article, so I have written a series of articles covering the important points.

Calabro explains out how fast euthanasia has been normalized:

It is too soon to call euthanasia a lifestyle option in Canada, but from the outset it has proved a case study in momentum. MAID began as a practice limited to gravely ill patients who were already at the end of life. The law was then expanded to include people who were suffering from serious medical conditions but not facing imminent death. In two years, MAID will be made available to those suffering only from mental illness. Parliament has also recommended granting access to minors.

There are many problems with the implementation of Canada's euthanasia law. Calabro writes:

There have been unintended consequences: Some Canadians who cannot afford to manage their illness have sought doctors to end their life. In certain situations, clinicians have faced impossible ethical dilemmas. At the same time, medical professionals who decided early on to reorient their career toward assisted death no longer feel compelled to tiptoe around the full, energetic extent of their devotion to MAID. Some clinicians in Canada have euthanized hundreds of patients.

Calabro explains how Canada's euthanasia law is vague and undefined.

The law, in other words, was premised on the concept of patient autonomy, but within narrow boundaries. Rather than force someone with, say, late-stage cancer to suffer to the very end, MAID would allow patients to depart on their own terms: to experience a “dignified death,” as proponents called it. That the threshold of eligibility for MAID would be high—and stringent—was presented to the public as self-evident, although the criteria themselves were vague when you looked closely. For instance, what constituted “reasonably foreseeable”? Two months? Two years? Canada’s Department of Justice suggested only “a period of time that is not too remote.”

Madeline Li

Calabro interviews Madeline Li, an early euthanasia pioneer who had developed the euthanasia program at the University Health Network in Toronto in 2017. In 2018 Li started questioning the euthanasia program.

It was not long into her practice, however, that Li’s confidence in the direction of her country’s MAID program began to falter. For all of her expertise, not even Li was sure what to do about a patient in his 30s whom she encountered in 2018.

The man had gone to the emergency room complaining of excruciating pain and was eventually diagnosed with cancer. The prognosis was good, a surgeon assured him, with a 65 percent chance of a cure. But the man said he didn’t want treatment; he wanted MAID. Startled, the surgeon referred him to a medical oncologist to discuss chemo; perhaps the man just didn’t want surgery. The patient proceeded to tell the medical oncologist that he didn’t want treatment of any kind; he wanted MAID. He said the same thing to a radiation oncologist, a palliative-care physician, and a psychiatrist, before finally complaining to the patient-relations department that the hospital was barring his access to MAID. Li arranged to meet with him.

Li explained that the prevailing view was that:

A medical condition was incurable if it could not be cured by means acceptable to the patient.

In other words, the law was completely subjective. Someone who has a treatable condition can be killed by euthanasia. Li told Calabro that she agreed with this. Calabro continues:

This had made sense to Li. If an elderly woman with chronic myelogenous leukemia had no wish to endure a highly toxic course of chemo and radiation, why should she be compelled to? But here was a young man with a likely curable cancer who nevertheless was adamant about dying.

What was Li left with? According to prevailing standards, the man’s refusal to attempt treatment rendered his disease incurable and his natural death was reasonably foreseeable. He met the eligibility criteria as Li understood them. But the whole thing seemed wrong to her. Seeking advice, she described the basics of the case in a private email group for MAID practitioners under the heading “Eligible, but Reasonable?” “And what was very clear to me from the replies I got,” Li told me, “is that many people have no ethical or clinical qualms about this—that it’s all about a patient’s autonomy, and if a patient wants this, it’s not up to us to judge. We should provide.”

Li killed her patient but she regretted it:

And so she did. She regretted her decision almost as soon as the man’s heart stopped beating. “What I’ve learned since is: Eligible doesn’t mean you should provide MAID,” Li told me. “You can be eligible because the law is so full of holes, but that doesn’t mean it clinically makes sense.” Li no longer interprets “incurable” as at the sole discretion of the patient. The problem, she feels, is that the law permits such a wide spectrum of interpretations to begin with. Many decisions about life and death turn on the personal values of practitioners and patients rather than on any objective medical criteria.

Calabro explains that by 2020 Li had already participated in hundreds of euthanasia deaths.

Li then explains that the concept of a "completed life" is controversial in Europe but a reality in Canada. Calabro writes:

Li explained. “There’s no standard here; it’s just kind of up to you.” The concept of a “completed life, or being tired of life,” as sufficient for MAID is “controversial in Europe and theoretically not legal in Canada,” Li said. “But the truth is, it is legal in Canada. It always has been, and it’s happening in these frailty cases.”

Madeline Li explains why Canada's vague euthanasia law has become the most permissive killing law in the world. Even the controversial concept of a "completed life" is permitted in Canada based on lack of definition in the law.

Peter Singer endorses elder suicide.

This article was published by National Review online on April 14, 2025

Wesley Smith

By Wesley J. Smith

Peter Singer, the internationally influential emeritus bioethics professor from Princeton, is known as a moral philosopher — which in his case is an oxymoron. Not only has he repeatedly endorsed the moral propriety of infanticide, but he has also yawned at bestiality and suggested experimenting on cognitively disabled people rather than animals if they are not “persons,” among other ethically depraved opinions.

Singer and another philosophy professor — Katarzyna de Lazari-Radek — just took to the opinion pages of the New York Times to endorse geriatric suicide. It seems a noted 90-year-old psychologist named Daniel Kahneman committed assisted suicide last year at one of Switzerland’s death clinics. Kahneman wasn’t seriously ill or debilitated but feared the infirmities that he believed were coming, so off to Switzerland he flew. Singer and Lazari0-Radek heartily approve.

Peter Singer

Before Kahneman killed himself — and knowing what he planned — Singer and Lazari-Radek interviewed him on their podcast. At his request, the interview did not discuss the looming suicide — Kahneman died just a few days later. But Singer and Lazari-Radek noticed he wasn’t seriously ill or debilitated. From “There’s a Lesson to Learn from Daniel Kahneman’s Death:”

Despite his advanced age, he was still capable of research and writing and could still enlighten audiences on how to make better decisions. Apart from his intellectual gifts, he was healthy enough to participate in friendship and family life. Why did none of this give him sufficient reason to continue to live?

Do you see the problem with that attitude? Do the philosophers not understand how bigoted and anti-intrinsic dignity of life their relativistic assumptions are about when a life is worth continuing? It is as if one must earn the privilege of remaining alive and is very close in substance to the geriatric disdain expressed by the bioethicist Ezekiel Emanuel when he wrote in The Atlantic that he wanted to die at age 75 because “living too long is also a loss. It renders many of us, if not disabled, then faltering and declining.”

No matter. Singer and Lazari-Radek think that being made dead when one wants to die is “dignity:”

Professor Kahneman signaled concern that if he did not end his life when he was clearly mentally competent, he could lose control over the remainder of it and live and die with needless “miseries and indignities.” One lesson to learn from his death is that if we are to live well to the end, we need to be able to freely discuss when a life is complete, without shame or taboo. Such a discussion may help people to know what they really want. We may regret their decisions, but we should respect their choices and allow them to end their lives with dignity.

Of course, it is important to talk freely about wanting to commit suicide. Indeed, anyone in that situation should — so they can be helped with unequivocal suicide prevention and other interventions. Besides, sometimes “shame,” “taboo,” and worry about stigma can save lives if they prevent people from doing the deadly deed.

And get this. At the bottom of the column, the Times added this addendum:

If you are having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

What a sick joke. One way to help suicidal people continue living is to not publish pro-suicide opinion pieces!

Sometimes really loving someone means unequivocally supporting them in living — not in suicide — even when they can’t see a way forward themselves. But that is not the “lesson” taught by Singer and Lazari-Radek’s column. Rather, their opinions — and its publishing by one of the world’s most influential newspapers — promote the West’s devolution into a pro-suicide culture. The victims of such a nihilistic mindset will be the elderly, people with disabilities, the mentally ill, and the seriously sick in an ever-widening swath of premature deaths.

Dutch ethicist urges France to learn from the Dutch experience and reject euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

While a law on "assisted dying" will be debated in the French National Assembly starting May 12, a Dutch academic expresses his doubts about the continued expansion of the scope of its application in the Netherlands.

Professor Theo Boer

Theo Boer is a professor of health ethics at the University of Groningen, and a former member of a Netherlands government euthanasia oversight committee. Boer wrote a profound article that was published by Le Monde on April 8, 2025 urging France to learn from the Dutch by not legalizing euthanasia. (The text was google translated).

Boer begins by outlining the current situation in the Netherlands:

For more than twenty years, the Netherlands has been experimenting with euthanasia within a framework presented as strict, regulated, and ethical. However, the figures published in the latest report of the review committee, dated March 24, tell a different story of constant expansion, gradual trivialization, and a silent cultural shift. In 2024, the number of euthanasia cases increased by another 10%. One might have thought that the phenomenon would reach a plateau, especially after modest growth of 4% in 2023. This is not the case. The trend is picking up again, and the committee's chairman, Jeroen Recourt, predicts that the curve will continue to rise in the years to come. This is no longer a fluctuation: it is a structural trend.

Boer outlines the trends in the law:

It might be argued that this increase follows the aging of the population. But even as a proportion of overall deaths, the phenomenon continues to grow: from 5.4% of deaths in 2023 to 5.8% in 2024. In 2017, in some regions, this percentage had already reached 15%, and it is expected to have increased since then. Euthanasia is no longer exceptional: in many cases, it is becoming just another end-of-life option. But beyond the raw statistics, other developments are causing deep concern. The emergence of "euthanasia for two," which allows couples or siblings to die together, is one such trend. In one year, the number of these planned deaths in tandem has jumped by 64%, reaching 108 deaths in 2024. Above all, euthanasia for psychiatric disorders has increased by 59%, affecting people who are sometimes very young. Patients who are physically healthy, but plunged into mental suffering that medicine struggles to alleviate, are now asking to die – and are succeeding. The number of cases related to dementia is also increasing rapidly. Here, a request for euthanasia is often based on fears of dependency, a loss of dignity, or on a living will signed well before the first symptoms. We are entering a field where the patient's current wishes are sometimes unclear, and the medical procedure is based on interpretations. In my conversations with many Dutch doctors, one constant theme emerges: the pressure is increasing. It's no longer just an individual demand, but a social expectation. With increasing "normality," healthcare workers are asking themselves: "How far will we go? At what point will this stop being an act of compassion and become an automatic response to patients who refuse to accept a refusal?" For good reason, the government has now launched an investigation into the reasons for this increase.

Boer explains that the government continues to debate further expansions of euthanasia.

And yet, in the face of these doubts, the legislative movement continues. The Dutch Parliament will soon consider a bill to grant assisted suicide to anyone over the age of 74, even in the absence of serious illness. The sole criterion would be age. A major symbolic shift: we no longer die because we suffer, but because we feel we have lived enough. It's a radically new vision of old age and the value we place on our society.

As a former member of a euthanasia review committee, I believed, at the time, that a rigorous framework could prevent abuses: I'm no longer so sure. What I see is that each opening of the euthanasia field creates new expectations, new demands and a new normal. The internal logic of the system always pushes for expansion. Suffering deemed "unbearable" today is sometimes less so than that of yesterday, but the outcome remains the same.

Boer ends the article by urging France to reject euthanasia:

In France, some insist that "France is not Holland," and that these developments will not occur there. This is a risky bet because, in all countries where euthanasia or assisted suicide have been legalized, we observe a continuous growth in the number of cases. This is not a Dutch exception. This is a dynamic at work everywhere medically induced death becomes an option. I am not a fierce opponent of euthanasia. In certain extreme cases, it can be a last resort. But I am convinced that its legalization does not calm society: it worries it, transforms it, and weakens it. It changes our relationship to vulnerability, to old age, to dependency. It introduces the idea that certain lives, under certain conditions, are no longer worth living—or even worth caring for. I address the French here, not to lecture, but to share my country's experience. Look at what's happening in our country. Listen to the voices, however quiet, of those who doubt. Before opening that door, ask yourself a simple but fundamental question: are we ready for killing to become a medical option among others, even in the presence of cutting-edge palliative care, and even in the absence of illness? Are we ready to burden caregivers with the burden of such a choice? Learn from our experience. There is still time.

Previous articles by Professor Theo Boer:

• British must learn from the Netherlands experience with assisted dying (Link). 
• British proposed assisted death criteria are similar to how Canada's law began (Link). 
• Euthanasia: Impossible to police once legal (Link). 
• Let's not romanticize the Dutch euthanasia experiment (Link). 
• Be careful what you wish for when you legalize active killing (Link).

A nurses story: Euthanasia (MAiD) death was not dignified.

This story was sent to the Euthanasia Prevention Coalition by a nurse who wanted to remain anonymous. The nurse changed all names to ensure the privacy rights of those involved. -Alex Schadenberg.

They say euthanasia is a compassionate, dignified way to die. They say everyone should have the option, and that a life with suffering is not a life worth living. But that's not what I've seen. I know Medical Aid in Dying (MAID) to be messier and more distressing than anyone cares to talk about. I have seen the ripple effects of euthanasia, and the complexity it adds to grief. I want people to know the impact MAID has on healthcare professionals. I am a palliative care nurse, and this is my side of the story.

One shift I worked with a patient named Laura who was scheduled to be euthanized later that day. Laura had a terminal metastatic breast cancer diagnosis, but with no exceptionally challenging symptoms that I could observe. However, she told me she was tired of living, and the thought of living longer scared her more than dying. Laura had picked out music to play in the background while she died, and had chosen which loved ones she wanted by her side. It was planned for 6 pm. She was alert and oriented, and had signed a waiver saying that if for whatever reason she was no longer judged to be of sound mind at the time of the MAID provision, she could be euthanized anyways. She thought she had complete control. Just a few hours before 6 pm Laura had a completely unexpected grand mal seizure. She wouldn't stop seizing and required large doses of a sedating anticonvulsant. The time of the provision came, and she was confused and groggy from the sedating medication, and unable to properly confirm she wanted the euthanasia, or say goodbye to her family members. She tried to speak but no one could understand what she was saying. Laura was euthanized at 6 pm, according to the waiver she had signed. This was what she had requested, but the family came out of her room shaking, with eyes wide. They cried, and kept saying it should have never happened that way. They had no closure. There was no dignified, peaceful ending. Just their loved one, killed in the middle of trying to say something.

This was a horrible death. If Laura had chosen to die naturally, maybe she would have lived two more weeks. Maybe she would've needed more sedatives, and spent more time sleeping. But we would've kept her comfortable. Her family could've been by her side and treasured any awake moments and words she had to give. As her nurse I would've battled any restlessness, worked to prevent any seizures, noticed a furrowed brow and given pain medication. I could've explained the dying process to Laura's family, spoken about the changes we were seeing in breathing, in circulation, and slowly walked alongside them in their grief as she grew closer to death. Instead her death was sudden, and traumatic, and the family went home right after without anyone to support them through the process.

It wasn't just the family traumatized by this death. For every MAID provision, a nurse is in the room, along with the MAID provider injecting the lethal medication. As a conscientious objector to euthanasia, I did not have to be in the room as it happened. Instead, my coworker volunteered. After Laura's life was ended, this coworker sped out of the room shaking and crying, distressed in a way no natural death of a patient has ever affected her. I know multiple other nurses who have been through the same experience. Although they had no religious or moral objections to MAID, after witnessing it first hand they swore to never be in the room again while it happened. They were deeply unsettled, and their conscience told them what they couldn't admit to themselves: the intentional ending of a life is wrong, no matter the circumstances.

The ripple effects of Laura being euthanized carried on, beyond her family, beyond the staff, to other patients on the palliative unit. Mark, who had the unfortunate position of a bed in the hallway, expressed to me, "I saw something today that I am not okay with, and I just have to bring it up". Mark carried on to tell me he saw Laura go by in her wheelchair, talking with a visitor as she went into her room. Later, Mark observed staff and family members going in, and then witnessed the family coming out weeping. He reported seeing a stretcher leave the room, with a black cover overtop, and realized Laura had died. Mark watched her family crying, and it brought up memories of his own wife dying. He was horrified that one moment Laura was up and talking, and the next she had died. He admitted to feeling scared he would die suddenly, too. I hadn't said a word about Laura due to confidentiality, but as a patient in the hallway Mark was able to observe and hear a lot of things. He and Laura were both mobile, and over the past few days they had spoken in the patient lounge on occasion. Her death brought up many complex emotions and distress for Mark, and I felt torn on how to support him.

For myself, Laura's death was exceptionally hard to deal with. Before she died, it was difficult to interact with her in a normal way. I kept watching the clock, and counting down the days, hours and minutes till her scheduled death. I had an awkward moment of bringing in the scheduled laxative she got each morning along with her other medications, to which she responded, "really? I'm dying today, does it matter if I'm constipated?". Every interaction I had with her I felt the weight of her impending death, I wanted to scream out "don't do it! Your life has value!". But instead I bit my tongue and supported her, and then went home morally distressed, wondering if I had spoken my mind, would it have made a difference? I wanted to rip up the waiver she had signed, and plead with the doctor injecting her lethal dose not to do it. After she died and my shift was over, I went home feeling profoundly sad, and helpless at how the situation played out.

The goal of palliative care is to alleviate suffering and support patients and families until natural death, neither hastening nor prolonging death. I am upset that in Laura’s case, we had to betray our own philosophy. When euthanasia was first legalized in Canada, palliative units and hospices were exempt from having to provide MAID on site, for good reason. The whole unit feels the impact when death is chosen before it’s time. Perhaps for staff who see natural death on a regular basis, we feel the impact even more than others. We see the contrast, we know a natural death doesn’t have to be scary or painful. If a patient like Laura has a grand mal seizure, we are skilled at adapting to changing circumstances to keep her comfortable. Letting death happen at its natural hour gives families the chance to bond, and soak in every last moment loved ones have to give. Patients may think that choosing MAID relieves their family of the burden of waiting for their death, or seeing suffering. But in reality it steals time and closure, and replaces a natural process with an unsettling ending. From what I have seen, loved ones of euthanized patients appear to struggle more in their grief than loved ones of patients who die naturally.

A story like Laura’s showcases a reality of euthanasia not often spoken about. And even though this was just one example, it is not an isolated incident. There are many more stories I could’ve shared, and the impacts of euthanasia are felt far and wide with each and every case - even the ones that go as planned. My hope in telling this story is that eyes will be opened to the horrifying reality of euthanasia, and perhaps hearts and minds will be changed as well. I am a palliative care nurse, and this is my side of the story.

Canada has become a world leader in euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill

Kevin Yuill, who authored the book, the Secular case against assisted suicide, wrote an article explaining how Canada has become the world leader in euthanasia that was published on October 26 by Spiked.

Yuill explains that in March 2023, Canada will permit euthanasia for mental illness alone. This would be the second expansion since Canada legalized euthanasia. He wrote:

On 17 March 2023, Canadian law will change to make people whose sole underlying medical condition is mental illness eligible for what Canada refers to as ‘medical assistance in dying’ (MAID). MAID covers both euthanasia and assisted suicide, although the vast majority of cases in Canada are euthanasia, which means that a doctor actively ends a person’s life, rather than giving that person the means to do so him or herself.

This will be the second expansion of euthanasia since it was legalised in 2016. In March 2021, Canada made a new category of patients eligible for MAID. Before then, only those whose death is ‘reasonably foreseeable’ were eligible. ‘Track Two’, however, is available to those with a ‘serious or incurable condition’ for whom death is likely but not imminent. Patients are now said to qualify for MAID if they suffer from a condition or disability which ‘cannot be relieved under conditions that they consider acceptable ’.

Yuill tells the stories of Mitchell Tremblay and a Veteran living with PTSD. He writes:

The next expansion could lead to a ‘rush for the doors’. These are the words of 40-year-old Mitchell Tremblay, who is hoping to take advantage of the law change. Tremblay was diagnosed with severe depression as a teen and also suffers from anxiety, alcoholism, personality disorders and continual suicidal thoughts. He can’t work and lives on a disability payment of just under $1,200 (£800) a month. ‘You know what your life is worth to you’, he told interviewers recently, ‘and mine is worthless’.

Tragically, MAID is increasingly being seen as a solution to people’s distress, no matter the cause. Some doctors and counsellors are even recommending it to certain patients and clients. In August, for example, an army veteran seeking treatment for post-traumatic stress disorder and a traumatic brain injury was rightly outraged to be offered MAID by an employee of Veterans Affairs Canada, entirely unprompted.

Yuill states that its not surprising that the number of euthanasia deaths has increased so quickly. He writes:

Last year, euthanasia accounted for 3.3 per cent of all deaths, a third more than in 2020. Statistics from Health Canada show that social reasons for wanting euthanasia are already important and will likely climb as the criteria for eligibility expands. In 2021, for instance, 17.3 per cent of people cited ‘isolation or loneliness’ as a reason for wanting MAID. In 35.7 per cent of cases, patients believed that they were a ‘burden on family, friends or caregivers’.

Yuill then writes about the expansion of euthanasia to people with mental illness:

Dr John Maher, a psychiatrist, was shocked when a patient recently discussed the possibility of MAID with him ‘because of his belief no one will ever love him’. No wonder it rattled him. Psychiatrists get up in the morning to help those in mental distress and to prevent suicide – not facilitate it.

Until recently, the Canadian public had been broadly sympathetic to MAID’s original goal – of alleviating suffering among the dying and seriously ill. But there is no majority support for allowing MAID for mental-health conditions. In a poll conducted this year, fewer than half of all Canadians supported extending MAID to adults diagnosed with a serious mental illness.

Yuill continues by commenting on the recent proposal to extend euthanasia to infants and those who are "tired of living":

Dr Louis Roy of the Quebec College of Physicians recently recommended to Canadian lawmakers that MAID be ‘offered’ to children born with severe disabilities up to the age of one. This disturbing proposal was unsurprisingly met with fierce criticism. But another of Roy’s shocking suggestions went almost unnoticed: that MAID should be provided for those elderly people who are ‘tired of being alive’.

Yuill then comments on the euthanasia lobby's past connection to eugenics.

These and other arguments marshalled in favour of euthanasia in Canada bear a striking resemblance to those made in the past to justify eugenics. At the turn of the 20th century, the most fierce proponents of euthanasia and eugenics were physicians and academics. In the US, Dr Ella K Dearborn cheerfully called for ‘euthanasia for the incurably ill, insane, criminals and degenerates’. Dearborn thought it entirely reasonable that everyone should pass an examination allowing them to continue living. In 1906, one sociologist noted in the Minneapolis Journal: ‘I would personally rather administer chloroform to the poor, starving children of New York, Philadelphia, Chicago and other American cities, than to see them living as they must in squalor and misery.’

The steady expansion of Canada’s euthanasia laws has echoes of this dark eugenicist vision. Take the case of Amir Farsoud, an impoverished 53-year-old with a chronic back condition, who is about to be made homeless. Farsoud has applied for MAID not because he wants to die, but because he fears the future. ‘I don’t want to die’, Farsoud said, ‘but I don’t want to be homeless more than I don’t want to die’. He already has one of the two doctor’s signatures required.

Yuill ends the article by suggesting that Canada's euthanasia law should cause other countries to reject euthanasia. He writes:

But perhaps Canada is also doing the world a favour. In six short years, it has shown that the initial justification for MAID – people’s freedom to alleviate their own suffering from terminal illness – is only a more palatable precursor to something much darker. What we’re seeing in Canada today is what happens when a country convinces itself that lethal injections are a normal part of healthcare. It is what happens when death is treated as a solution to life’s problems. This anti-human movement must be resisted.

Kevin Yuill is a long-time writer on issues related to euthanasia and assisted suicide.

Ximena's Butterfly Foundation: Working to ban "Substance X"

"I can't live like this but I don't want to die either"

Randy Knol with his wife.

Article by: Randy Knol, the father of Ximena, is the founder and chairman of Ximena’s Butterfly Foundation

The title is in one sentence of what suicide is about, it’s not a wish to die it’s an escape from the life you have at that moment. It’s the biggest misconception about suicide that people think death was a choice made by the person that died, it was not.

That’s the reason why my wife and I started the Ximena’s Butterfly Foundation, for prevention of suicide by young people and young adults. 

Ximena was our daughter, our love and joy. She escaped the life she was living on February 23rd, 2018. We named the foundation after her. The butterfly was because just before her escape she wrote as a WhatsApp status “When the caterpillar thought the world ended, it became a butterfly”. 

Ximena Knol

The false promise of Substance X

Ximena used the “Substance X” as promoted by a Dutch radical group that came in the news 6 months prior to her death. On a television news show FWC came out in a poorly acted report that it was a substance that was painless, fast and certain. They made the idea of death so easy, however the promise they made was a big lie, it’s one of the most inhumane ways of ending your life. With “substance X” death is in fact inhumane. Science cases report about an agonizing five-day struggle to die, where no antidote is available.

More articles about "Substance X" (Link).

A toxic cocktail

The combination of the substance being a secret, the false promise of a painless and sure death combined with the attention from the media made it, as Doctor Boudewijn Chabot wrote in his book, a toxic cocktail. As a leading voluntary end of life promotor Doctor Chabot loudly protested the false claim made by the FWC. In the latest release of his book about voluntary life ending he wrote two full chapters as a warning not to use “substance X”. With our permission he wrote the story of Ximena, our butterfly.

End of life terrorism

Three weeks after Ximena escaped her troubled life we warned against this substance through the media with a news article starting a wave of attention. We told our horrific story for the first time in a Late night talk show. I called the FWC radicals “end-of-life-terrorists”, which was apparently a good description because it made the headlines in many newspapers the next day. 

I literally said: “The FCW is so radical I call them end-of-life-terrorists, for them the goal sanctifies the means” They are so radical, they had the plan that after a six month membership you could acquire the substance, no consulting no questions asked.

If it’s yellow and curved it’s not an apple.

Despite all the secrecy, within an hour of its televised release, two names of what could be "Substance X" went viral. I explained it in the Late Night Show as: “If I explain it’s yellow and curved and needs peeling before you eat it, everybody understand it’s not an apple” Their description was so clear that the two substances went viral and began to be promoted as the substance. Two chemical compounds with an almost similar effect on the human body. Unfortunately Ximena found the names too, for 1 euro and 55 cent plus €9.95 p&p she bought 125 grams, sufficient to kill 24 persons.

It was very visible, Ximena laid in her bed as blue as jeans, we were only allowed to see her for a few minutes from a 2 meter distance. The prosecutor demanded a full autopsy, which hardly ever happens in The Netherlands after suicide. They were clearly looking for evidence regarding the FWC. Ximena seemed to be one of the first victims of Substance X.

Ximena was taken away, nobody informed us about anything, we got her back 3 days later. The coroner did an awful job, she wasn’t recognizable. Her face was swollen and dark, she was decomposing. Something must have gone wrong in the autopsy, we had seen her twice for 5 minutes since they couldn’t keep her outside the cooling. We had to say our goodbyes with a closed casket. Her brothers, sister, grandmother, other family and friends never saw Ximena.

The struggle to ban “Substance X”

After the funeral we started to get “substance X” banned. We needed to have the law changed making the substance forbidden to sell, only to be sold to companies that had a permit. In the meanwhile the prosecutor started an investigation against the FWC, big words, assisting suicide, encouraging suicide and naming it a criminal organization. As we say in Dutch “A lot of bleating, little wool” they never went further then a good talk with them and the promise that the FWC should not distribute the substance. However the FWC found their way around and where they say they don’t distribute it, they have an active role in people acquiring the substance.

A month after Ximena died we reached an agreement with resellers and manufacturers not to sell to people and companies that had no industrial use for the substances. However we carried on to get a ban by law. We had a meeting with the Ministry of health, without any result, they would look into the possibilities. More then a year later the minister of health proudly send out a statement to the press that after long negotiations they agreed in a "covenant" with the chemical industry and suppliers that they wouldn’t sell to private persons. He was showing off with what we had already established a year earlier. After a television interview we said that this was a bit late and the only way to stop is to make it illegal by law to sell and posses it. We were invited for a meeting with the Minister of health in person, our main question was “why is there no law to ban these substances” the shocking answer was, well more a lame excuse IMHO: “if we make a law then we have to name the articles in the text”. We were stunned, under which stone was our government living, if you search on google you get tens of thousands of hits naming the substance. I asked him if he really thinks that if someone wants to die, that the person will look into laws to find a way?

A covenant doesn’t work

There are still victims of the substance, the Dutch Poison Information Centre received 51 requests for info in 2020, keep in mind this is the tip of an iceberg. Many physicians know that there is no antidote for the substance. Most victims are found deceased, how many people died of the substance? 50, 100, 500 who knows we can’t get the figures. How many older people take the substance as a means to end their life as a "completed life" and how many doctors register the death as a natural cause.

The covenant obviously didn't work. On July 23rd the police arrested a 28 years old man from Eindhoven who is suspected to have sold the substance to hundreds of people with 6 confirmed deaths. He also sold a regulated anti-vomit-medicine that can only be given by doctors and he used the profits for his living costs without reporting it as an income for taxes. This thug, sorry I have no other name, is charged with assisting a suicide, trade in regulated medication and money laundering. His arrest and custody was first extended with 14 days and yesterday he got a 30 day extension for his custody. The total custody can be extended to 90 days after which he has to be brought to court, this is usually a Pro Forma hearing in which a trial date can be set.

With the arrest and custody of this “suspect” the substance has not been banned. Our foundation has located more resellers and gave this information to the prosecutor General office. We had three members of parliament ask questions about the substance and have urged for a ban. Fortunately these MP’s are also bringing the matter to the attention of the European Parliament. It will all take time but the main concern is how many lives will be lost before the ban happens.

The “struggle” has yet just begun”

Our foundation, Ximena’s butterfly, (www.ximenavlinder.nl) has been contacted by 8 suicide survivors that lost dear ones from “substance X”. We act as spokespersons for some of them and we will continue the fight to ban this substance.

We pay all costs from our private money and through donations from concerned people. Please help us in this fight by donating through our website: https://ximenavlinder.nl/doneer/