It's time to audit the death bureaucracy

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition has petitioned the US Food and Drug Administration (FDA) to investigate the assisted suicide drug cocktails. (Petition Link).

Last week the Washington Examiner published an editorial opinion calling on the US states that have legalized assisted suicide to audit their death bureaucracy. The article states:

A deeply disturbing investigative report in UnHerd last week uncovered rampant violations of physician-assisted suicide practices in states with the oldest and largest programs. The 11 states that have legalized assisted suicide require clinicians to submit compliance forms shortly after the “patient’s” death. But the chaotic assisted-suicide bureaucracy rarely follows regulations, and clinicians put people to death with little to no oversight.

Between 2009 and 2023, 515 compliance forms and 293 “written request” documents were missing in the state of Washington. In all, one-third of the state’s assisted suicides were improperly reported. In Colorado, which passed its End of Life Options Act in 2016, almost 1,800 compliance forms are missing. And in New Mexico, where annual compliance reporting is also required by law, there has not been a single report issued since assisted suicide was enacted in 2021. For years, the state’s website suggested that a report was “coming soon,” but state officials quietly removed that promise from its website this summer.

Disturbingly, there have been no suspensions or revocations of clinician licenses connected with these irregularities.

Failing to report an assisted suicide is no mere statutory violation. Washington law states medical providers and pharmacists who neglect to “make a good-faith effort to file required documentation in a complete and timely manner” risk losing immunity protection for criminal acts.

The missing compliance reports are only the tip of the iceberg. Officials in Colorado and California were unable to provide numbers for the total assisted suicides carried out by clinicians and held no record of the type of drugs prescribed to more than 1,000 “patients.” Authorities in Oregon don’t know the result of 178 cases from 2024 in which “aid in dying” medications were prescribed.

Did the “patients” take the drugs in those cases? Did those drugs cause death? Did the “patients” even die? Oregon has no records on any of this.

Record keeping in Washington is even worse. By law, the state is supposed to perform a review of reporting compliance each year. But, blaming funding cuts, officials announced that they will no longer issue these legally required reports.

As more and more states consider whether to adopt assisted-suicide laws, a true accounting is needed to provide voters with accurate information about the outcomes of these laws in states where they are already established.

Given the gravity of the new revelations, the Department of Health and Human Services Office of Inspector General, in coordination with the Justice Department, should launch an immediate investigation into states’ assisted-suicide programs. It should focus on three critical areas: the failure to file mandatory compliance forms, inadequate tracking of lethal prescriptions, and the absence of disciplinary action against clinicians who endanger “patients” through noncompliance.

As assisted suicide spreads, the risk grows that vulnerable people, those feeling like burdens or facing financial strain, will be nudged toward death rather than helped to live. This is not compassion — it’s the worst sort of cultural and moral failure.

It is time for accountability.

More articles on this topic:

• How America Abandoned its assisted suicide safeguards (Link).
• Assisted suicide lobby launches court case to force Colorado to permit suicide tourism (Link). 
• The push to legalize and extend assisted suicide in America (Link).
• Oregon 2024 assisted suicide report (Link). 
• Death by assisted suicide is not what you think it is (Link).  
• Assisted suicide laws, once passed will inevitably expand (Link). 
• New York assisted suicide bill is a "bait and switch" (Link). 
• Oregon bill would expand assisted suicide again (Link).

How America abandoned its assisted suicide "safeguards"

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin

Alexander Raikin wrote an excellent article: How America abandoned its suicide safeguards which explains how the US states that have legalized assisted suicide abandoned the "safeguards" in their assisted suicide laws. I have written several articles on this topic especially since nearly every assisted suicide law in America, once passed, was later expanded. Raikin explains:

In 2020, Jane, a 29-year-old Colorado woman with eating disorders, was “provided with lethal drugs … in the midst of a mental-health crisis”, according to a lawsuit filed this year by the Institute for Patients’ Rights, an advocacy group seeking to overturn Colorado’s assisted-suicide program. Jane qualified for assisted suicide, the lawsuit contends, yet she was discharged from a hospice because she no longer qualified for hospice care, and her hospice considered her no longer competent to consent to medical treatments. So how could she have consented to suicide-by-doctor?

Jane was fortunate: her parents successfully sued for guardianship, and a court ordered the medication to be destroyed. Jane “went on to recover from all of it, including her anorexia”, according to Matt Vallière, the executive director of the Institute for Patients’ Rights. Jane found work as an occupational therapist, went on vacation, and even purchased a home. Although she ultimately died two years later of complications from her history of eating disorders, she’d had an opportunity to “live her best life”, Vallière says. That any medical professional decided that Jane qualified for assisted suicide, he claims, was “absurd”.

Raikin states that Jane’s case isn’t unusual and violations of assisted-suicide laws are rampant with no known suspensions or revocations of clinician licenses, even when patients were endangered. Raikin explains how these laws are being violated:

Much of the issue is oversight. In each of the 11 states that have implemented suicide-by-doctor, regulations require clinicians to submit compliance forms, typically within days of a patient’s death. These forms document that the patient expressly consented to die through assisted suicide, and that the clinicians followed all necessary legal safeguards and eligibility criteria, including affirming that the patient is terminally ill and of sound mind.

Failure to submit this documentation isn’t just a statutory offense. Medical providers and pharmacists who fail to “make a good-faith effort to file required documentation in a complete and timely manner”, as Washington state law instructs, risk losing“immunity protection” for the criminal act of assisting someone’s suicide. Yet a Department of Health report found that physicians improperly reported compliance for a third of all assisted suicide deaths in the Evergreen State. Indeed, Washington is missing 515 compliance forms entirely for the period between 2009 to 2023, according to my calculations based on annual reports, and is also short of 293 “written request” documents that patients are required to sign attesting that they wish to die by suicide. In Colorado, my calculations find that almost 1,800 compliance forms have remained missing since 2017.

The actual number of assisted suicide deaths is unknown. Raikin writes:

States can’t answer the most basic question: how many physician-assisted suicides have been facilitated by clinicians in America? Across Colorado and California, state authorities have no record of the type of “aid-in-dying drugs” that were prescribed to more than 1,000 patients, according to my analysis of state reports, including the California End of Life Option Act 2024 Data Report. In Oregon, the health authority has records on 376 assisted suicides completed in 2024, but for another 178 cases in which medications were prescribed, authorities don’t know if the patient died by ingesting the drugs, or even died at all.

Washington State has decided to stop publishing the assisted suicide data.

In 2022, Washington state announced that its Department of Health is diverting “all available funding” for its assisted-suicide compliance-review program to “data entry of submitted forms”, due to lack of funding from the state. Data entry is commendable. But by law, the state is also required to “review” reporting compliance and issue an annual report. Instead, this summer, a pop-up appeared on the department’s website: “Important Note: Due to funding cuts, the Death with Dignity Program at the Department of Health is suspended. … A 2024 annual statistical report will not be released.”

Washington state’s decision surprised even assisted-suicide clinicians. Jessica Kaan, the medical director for End of Life Washington, an institution which facilitates assisted suicides in the state, warned on a forum for providers that “no one will even be monitoring or responding to emails or phone calls that come into the DOH [Department of Health] about the DWD [Dying With Dignity] program”. Kaan called it “a grim situation”. After this push back, the state announced that it will release the 2024 report after all — but it will be the last one ever to be released.

Raikin then explains that New Mexico does not publish an annual report, even though the assisted suicide law requires an annual report. States are also removing the "safeguards" in the law. Raikin explains:

This systematic disregard of safeguards is happening as the process is being fast-tracked: states are removing requirements that applicants reside in state; allowing less-credentialed providers, such as social workers, nurses, and physician associates,to perform assessments instead of psychiatrists and psychologists; and reducing minimum waiting periods. In Oregon, which waived waiting periods in 2020,clinicians have reported in Oregon’s annual Death with Dignity Act report that assisted suicides routinely occur on the same or next day the patient makes there quest. Since in some cases it takes up to five days for a patient to die from ingesting the death cocktail, it is possible that it will take a patient longer to die than to receive lethal prescriptions.

The proportion of vulnerable persons dying by assisted suicide has also increased. Raikin writes:

The proportion of deaths of vulnerable patients has also increased by magnitudes. In the first year of Washington state’s program, 16% of patients mentioned “the physical or emotional burden on family, friends, or caregivers” as a reason for their decision to die, and 2% were concerned about “the financial cost of treating or prolonging the patient’s terminal condition”. By 2023, according to the state’s reporting, the number concerned with “feeling like a burden” jumped to half of all assisted-suicide deaths, and a 10th were concerned about “financial implications of treatment”.

A similar trend is unfolding in Oregon. In 2009, the first year that the program was available, no patients told their assisted-suicide clinician that they were choosing to die because of financial concerns, and only 12% felt like a burden. By 2024, the state’s reporting revealed that it was 9% and 42% of all assisted suicide deaths, respectively. No other states even report this data. The “attending physician follow-up form” in California, which records patient concerns that contribute to the choice of “aid-in-dying”, doesn’t have “financial concerns” or “feeling like a burden” on its otherwise identical menu of options.

Compliance with the law from physicians and the government is lacking. Raikin interviewed Craig New who overseas the assisted suicide program in Oregon. Raikin reports:

Craig New, who told me on the telephone that he’s the sole employee of the Oregon Health Authority responsible for monitoring compliance reporting, says that “ultimately the things usually get resolved because we bug them until they finally send in the paperwork”,but even so, his office has reported around a dozen physicians to the Oregon Medical Board for violations of compliance reporting. Thanks to privacy laws regarding medical licensing, it is impossible to know whether the reported physicians faced repercussions, but my review of the Oregon Medical Board’s investigations reveals that few offenses are prosecuted.

Raikin reports that Dr Rose Jeanine Kenny, in Oregon, was reprimanded by the Oregon Medical Board for contravening the assisted suicide law:

One example is Rose Jeannine Kenny, a family doctor, who in 2016 was sentenced to five years probation by the Oregon Medical Board for dozens of alleged prescription violations. Later the board received “credible information” that Kenny may have again violated the same provisions she was previously reprimanded for, and may possibly have committed “violations of the Oregon Death with Dignity Act”, such as failure to ensure consent, follow the rules of written and oral assisted suicide requests, abide by the minimum waiting period, and file compliance records. Kenny once again kept her license, this time by agreeing to “participate in all physician steps” for 10 more assisted suicides, supervised by a mentoring physician from Compassion & Choices — the largest lobbying group for assisted suicide in the United States. (UnHerd was unable to reach Dr. Kenny at any of the medical practices with which she is associated online.)

Raikin states that no researchers or law enforcement are allowed to systematically review the assisted suicide records. He then tells the story of a person in Maryland with a eating distorder:

Recent court proceedings in Maryland eerily echo the lawsuit regarding Jane. Angela Guarda, the director of the Eating Disorders Program at Johns Hopkins Hospital, testified that she was contacted by an ex-patient of Jennifer Gaudiani, the physician who coined the term “terminal anorexia”, and who has prescribed assisted-suicide medication to at least one patient. The concept of terminal anorexia was meant to apply only to patients over age 30; for younger patients, Gaudiani stressed in a paper for the Journal of Eating Disorders that “every effort should be made to promote full recovery and continuation of life”.

The ex-patient reported that her assisted-suicide assessor told her “she would ‘make an exception’ for me and ‘allow’ me to die”. The patient reported feeling coerced. She eventually weaned herself off morphine and hospice drugs and, 18 months later, reports that she’s doing well, with a job, a group of friends and a new puppy.

Raikin ends the article by stating:

Patients like these, who need hope the most, are facing much more than their illnesses. They also confront an assisted-suicide regime that blatantly and routinely violates the legal safeguards that were meant to ensure their protection from a death they might not want.

Further articles on this topic:

• Assisted suicide lobby launches court case to force Colorado to permit suicide tourism (Link). 
• The push to legalize and extend assisted suicide in America (Link).
• Oregon 2024 assisted suicide report (Link). 
• Death by assisted suicide is not what you think it is (Link).  
• Assisted suicide laws, once passed will inevitably expand (Link). 
• New York assisted suicide bill is a "bait and switch" (Link). 
• Oregon bill would expand assisted suicide again (Link).
  

Washington State Ceases Publishing Legally Required Annual Assisted Suicide Reports

This article was published by National Review online on July 20, 2025.

By Wesley Smith

The legalization law requires annual reports to be issued by the state to promote transparency. Well, from now on, opaqueness will be the order of the day. From the Medical Futility blog, by pro-assisted-suicide activist Thaddeus Mason Pope (whose blog is a reliable source of information on these issues):

Like almost all other aid-in-dying jurisdictions, the Washington State statute requires the “department of health shall generate and make available to the public an annual statistical report of information collected.” In response, the Washington DOH dutifully published 15 reports between 2009 and 2023.

But because of funding cuts, the DOH announced that the 2023 report was its last. There will be no more reports on how many patients are using MAID in Washington. No more demographic information about these patients.

Some states are slow in publishing their data. For example, we have yet to see a report from New Mexico even though the law was enacted in 2021. Other states have not published any data for over a year or more. But only Montana has never even promised to provide public data. Now Washington will similarly provide no public data.

Just remember: when activists tell you they want strict controls on assisted suicide to induce you to go along, they don’t mean it. Their goal is to effectuate wide-open euthanasia through incrementalism — a tactic that begins almost as soon as the laws go into effect.

But many people don’t seem to care much about that, perhaps preferring a comfortable pretense to grappling with the inevitable consequences that flow from such a radical change in law and morality.

Petition: The US Food and Drug Administration must investigate assisted suicide drug cocktails

To the FDA's Compounding Incidents Program, (Link to the online petition). (Link to the paper petition).

The petitioners draw your attention to the following:

Whereas the compounded drug cocktails being used for assisted suicide have had high rates of overdose, failure of expected pharmacological action, and adverse experiences associated with their use for assisted suicide; and;

Whereas the experiments that continue to be done to develop the compounded drug cocktails used for assisted suicide violate the U.S. Department of Health and Human Services’ regulations for the protection of human subjects under 45 CFR part 46;

Therefore, we call on the Food and Drug Administration (FDA) to investigate the adverse drug experiences with the compounded drug cocktails used for assisted suicide.

(Link to the online petition). (Link to the paper petition).

Information:

Despite claims that assisted suicide is a painless death, complications with assisted suicide remain common, and in fact have increased over the last decade. The FDA’s Compounding Incidents Program aims to protect the public against poor quality compounded drugs, yet no research has been done on whether the assisted suicide cocktails currently in use meet current standards.

An article by Manuela Callari published by Medscape on March 13, 2025, asked the question, “Do We Know Enough About Assisted Dying Drugs?” (1) Claud Regnard, MD, a retired palliative medicine consultant in the UK told Medscape:

“The amount of evidence supporting the use of these drugs is astoundingly small. The last study looking at efficacy and side effects was published 25 years ago, using data from 10 years earlier. 

“You wouldn’t allow this in any way with any other sort of drugs,” Regnard said. In a 2022 study, he found that drugs used for assisted dying have not undergone the usual level of scrutiny.(2)

The pharmacokinetics and pharmacodynamics of these drugs at high doses remain poorly understood. “We extrapolate from therapeutic doses, but we have no proper data on what happens at lethal doses,” Regnard said. “That’s not science—that’s guesswork.”

Based on the Oregon data we know that there are serious problems with the use of compounded drugs for assisted suicide. 

The 2023 Oregon Death with Dignity Act report indicated that the longest time for an assisted suicide death was 137 hours (five days plus 17 hours) and the assisted suicide complications rate was almost 10%. In Oregon, complications are only reported when a health care provider is present at the death. In 2023, there were ten known complications based on 102 reports from health care providers. (3)

Regarding the assisted suicide drug trials, JoNel Aleccia reported the following for The Seattle Times on March 5, 2017:

[Dr. Carol] Parrot and [Dr. Robert] Wood are part of a seven-member group of doctors in the Northwest who came up with the three-drug protocol after Valeant Pharmaceuticals Inc. acquired the rights to secobarbital, known as Seconal, in 2015 and raised the price sharply. 

“We wanted the new drug regime to be safe, reliable and effective—and cost $500 or less,” said Parrot.

Earlier in the article, Aleccia states,

The first Seconal alternative turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients—and up to 31 hours in one case. (4)

Lisa Krieger’s article, published in Medical Xpress on September 8, 2020, also reported on the lethal drug cocktail trials:

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change. 

“The public thinks that you take a pill and you’re done,” said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. “But it’s more complicated than that.” (5)

Doctors who participate in assisted suicide developed lethal compounded drug cocktails with human trials. The developers were concerned with the lethal efficacy and cost of the drug cocktail as opposed to the negative consequences associated with its use. The assisted suicide drug cocktail trials appear to have violated the Nuremburg Code.

We, the petitioners, call on the FDA to perform an investigation into the use of compounded drug cocktails used for assisted suicide based on the high rates of adverse experiences and into the experiments done to develop the assisted suicide drug cocktails that appear to have violated 45 CFR part 46.

References:

1. Manuela Callari, “Do We Know Enough About Assisted Dying Drugs?” Medscape, March 13, 2025 https://www.medscape.com/viewarticle/do-we-know-enough-about-assisted-dying-drugs-2025a100064q?form=fpf, accessed June 16, 2025.
2. Worthington, A., Finlay, I., and Regnard C. (March 10, 2022). Efficacy and safety of drugs used for ‘assisted dying’ British Medical Bulletin. 142:15-22. https://doi.org/10.1093/bmb/idac009
3. Oregon Death with Dignity Act 2023 report https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year26.pdf, accessed June 16, 2025.
4. JoNel Aleccia, “Northwest doctors rethink aid-in-dying drugs to avoid prolonged deaths,” The Seattle Times, October 5, 2017, https://www.seattletimes.com/seattle-news/health/northwest-doctors-rethink-aid-in-dying-drugs-to-avoid-prolonged-deaths/, accessed June 16, 2025.
5. Lisa Kreiger, “Doctors seek life-ending drugs that smooth the way for the terminally ill,” The Medical Express, September 8, 2020, https://medicalxpress.com/news/2020-09-doctors-life-ending-drugs-smooth-terminally.html, accessed June 16, 2025.

Maine and New Jersey are debating assisted suicide expansion bills.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

I have written several articles explaining that the assisted suicide lobby in the US employ a "bait and switch" tactic. The assisted suicide lobby designs legislation that is designed to pass, with the intention of expanding the law later. The assisted suicide lobby knows that it is harder to legalize assisted suicide than to expand the bill once assisted suicide is legal.

I have already written about the Vermont, Oregon, Washington State and California bills to expand assisted suicide laws in 2025. Maine and New Jersey also have bills to expand their assisted suicide laws.

Maine Bill LD613 permits the attending physician to waive the waiting period. The bill states:

The attending physician may waive any portion or all of the waiting periods if, in the attending physician's medical opinion, it is in the best interests of the qualified patient, given the qualified patient's condition.

New Jersey S3588 also permits the 15 day waiting period to be waived. The bill states:

This bill waives the 15-day waiting periods in the case of a patient who, based on reasonable medical certainty, is not expected to survive for 15 days. The attending physician will be required to document the medical basis for the determination that the patient is not expected to survive for 15 days. The bill retains the 48-hour waiting period between submission of a written request and the issuance of a prescription for medical aid in dying medication.

Therefore there are six states in 2025 that have bills to expand their assisted suicide law.

The good news is that Montana Bill SB 136 passed in the Montana Senate by a vote of 29 to 20 and will soon be debated in the Montana House. This is a potential massive victory.

Assisted suicide laws, once passed will inevitably expand (Article Link).

The assisted suicide lobby emply a "bait and switch" tactic where the bill is designed for legalization and once legal it is later expanded. (Article Link).

California bill may extend assisted suicide to euthanasia.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

There are currently three states, in 2025, that have bills to expand their assisted suicide laws (Vermont, Oregon and Washington State).

Senator Blakespear, who last year sponsored Senate Bill 1196, a bill that would have expanded the California assisted suicide law to include euthanasia and removed the terminal illness requirement from the law, indicated that she will be sponsoring Bill SB 403, a bill to expand California's assisted suicide law.

Thaddeus Pope

The text of SB 403 has not been released but on February 18, euthanasia and assisted suicide activist and academic, Thaddeus Pope, published on his Medical Futility Blog that:

California is again looking to amend its 2015 End of Life Option Act. S.B. 403 will likely call for a study committee to examine several amendments:

1. Permitting IV self-administration of medications - because it is significantly safer and more effective than ingestion of medications,
2. Permitting APRNs to prescribe - because this has improved access with no risk to safety in other states (NM HI WA CO),
3. Eliminating the 6-month terminal illness requirement - because it is arbitrary and excludes patients with serious irreversible illnesses who want to avoid intolerable suffering,
4. Eliminating the sunset clause - because the EOLOA expires in 2031,
5. Eliminating the residency requirement - because it is unconstitutional and patients are coming to California for MAID anyway,
6. Other amendments.

SB 403 is very similar to last year's SB 1196. Since the language of the bill is not released I can only comment on the concepts related to the changes.

 

1. Permitting IV self-administration will allow for euthanasia, which is homicide. Euthanasia is done in Canada by IV administration. Since there is no oversight in California's assisted suicide law, meaning, the doctor who assists the death is also the person who reports the death (no third party involvement) therefore allowing IV self-administration cannot be distinguished from IV administration. Therefore permitting IV self-administration in fact will also allow euthanasia (homicide).

2. Permitting non-doctors to assist suicide by prescribing lethal poison is based on the lack of doctors who are willing to assist the suicides of their patients. More people who are permitted to kill leads to more killing.

3. Replacing the 6 month terminal illness requirement with a definition of serious irreversible illnesses who want to avoid intolerable suffering eliminates the terminal illness requirement. 

 

Eliminating the terminal illness requirement leads to people with disabilities "qualifying" for death by lethal poison for reasons of poverty, homelessness, an inability to obtain necessary services or medical treatment as has happened in Canada. The Ontario Coroner's MAiD death review committee report indicated that some euthanasia deaths are driven by homelessness, fear and isolation (Article Link).

4. Eliminating the residency requirement allows for suicide tourism. Pope states that the residency requirement is unconstitutional. In September 2024 a New Jersey court disagreed with Pope. Further to that, Pope admits that non-residents are already dying by assisted suicide in California. Breaking the law is not a reason to change the law.

The Euthanasia Prevention Coalition will expose SB 403 and this article will be updated when the language of the bill is officially released.

Washington state Bill HB 1876 permits non-doctors to assist suicides.

Alex Schadenberg

Alex Schadenberg
Executive Director, 

Euthanasia Prevention Coalition

Washington State Bill HB 1876 will expand the state assisted suicide law by permitting physician assistants and advanced practice registered nurses to participate in assisting suicide by expanding the definition of "attending qualified medical provider." The bill also permits the "attending qualified medical provider" to waive the 7 day waiting period within the law to enable a same day death.

The assisted suicide lobby is trying to expand assisted suicide laws in Vermont, Oregon and Washington state by expanding who can assist a suicide and to waive the waiting periods. 

The good news is that Montana Senate Bill 136 that will reverse Montana's assisted suicide acceptance and once again prohibit assisted suicide passed in the Montana Senate on February 7 and will soon be debated in the Montana House. If SB 136 passes, Montana will be the first state to reverse assisted suicide and prohibit it again.

On January 30, I published an article concerning Vermont Bill 75 that expands Vermont's assisted suicide law for the third time by allowing (non doctors) naturopathic physicians, nurse practitioners, and physician assistants to participate in assisting a suicide.

On February 12, I published an article concerning Oregon Bill SB 1003 that expands Oregon's assisted suicide law for the third time by allowing (non doctors) physician assistants and nurse practitioners to participate in assisting a suicide. SB 1003 also reduces the waiting period from 15 days to 48 hours while enabling the "providing prescriber" to waive the waiting period to essentially allow a same day death.

The assisted suicide lobby is responding to the fact that very few doctors are willing to be involved with killing patients. By adding physician assistants and nurse practitioners they increase the number of providers who are willing to be involved with killing.

The assisted suicide lobby is wanting to eliminate the waiting periods for assisted suicide to enable a "same day death." No need to wait to pick up your lethal poison cocktail, no chance to change your mind.

When the assisted suicide lobby is trying to legalize assisted suicide they sell the "safeguards" in the bill. This is the "bait and switch" sales technique that is used by the assisted suicide lobby. 

Once legal, assisted suicide laws inevitably expand (Article Link). 

In 2025, assisted suicide legalization bills have already been introduced in Arizona, Connecticut, Delaware, Florida, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Missouri, New Hampshire, New York, Rhode Island and Tennessee.

The assisted suicide lobby is focusing on Delaware, Illinois, Maryland, Massachusetts and New York.

2024 was a great year for preventing assisted suicide in America. 2025 will begin with a challenge.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alex speaking in West Virginia

On September 20, Delaware Governor John Carney vetoed Assisted Suicide Bill HB 140 (Link to the Statement by Governor Carney).

When Governor Carney vetoed HB 140 he continued the success with no new state having legalized assisted suicide in the past three years.

On November 5, West Virginia votes passed Amendment 1, preventing the legalization of assisted suicide. Amendment 1 passed with a narrow victory with 50.5% voting YES. West Virginia is the first US State to create a constitutional protection from assisted suicide.

Even though 2024 represented one of the most successful years in defeating at least 20 state assisted suicide bills. We will not rest.

2025 is expected to be as busy a year as 2024.

The assisted suicide lobby has already announced the introduction of a 2025 Delaware assisted suicide bill. The new bill will need to be defeated in the House or Senate since Delaware Governor-elect Matt Meyer has expressed support for legalizing assisted suicide.

The New York assisted suicide lobby announced the introduction of their 2025 assisted suicide bill with a planned campaign kick off and lobby day with other scheduled events. New York has faced assisted suicide bills nearly every year since 2016.

The assisted suicide lobby has also prepared a bill for Missouri, which is not likely to pass. In fact we expect to see at least 20 states debate assisted suicide bills in 2025.

Nearly every state that has legalized assisted suicide has expanded the law.

Colorado, which legalized assisted suicide in 2016, in 2024 passed Senate Bill 24-068 expanding the Colorado assisted suicide law by: allowing advanced practice registered nurses to approve and prescribe lethal poison, reducing the waiting period from 15 days to 7 days, and allowing doctors or advanced practise registered nurse to waive the waiting period if the person is near to death.

The original version of SB 24-068 would have removed the residency requirement for assisted suicide in Colorado. 

We expect that other states will attempt to further expand their laws in 2025.

In 2023 Washington State expanded their assisted suicide law by allowing advanced practice registered nurses to approve and prescribe lethal poison, by reducing the waiting period to 7 days and to force healthcare institutions and hospices to post their assisted suicide policies. 

Washington State has already announced another expansion bill. This bill defines assisted suicide as a "protected healthcare service" and will force healthcare providers to be complicit in promoting assisted suicide. The Washington State bill is part of the assisted suicide lobby's strategy of defining assisted suicide as healthcare and forcing healthcare institutions to provide it as a "service."

The Euthanasia Prevention Coalition predicts that assisted suicide will be debated in at least 20 US states, but since Oregon and Vermont removed their residency requirement assisted suicide has also become a national issue.

There is currently a legal challenge by the assisted suicide lobby to force New Jersey to remove it's state assisted suicide residency requirement.

It is possible that the battle to protect people from assisted suicide might move into the federal realm in 2025 since the assisted suicide lobby has removed state barriers to killing.

The goal of the assisted suicide lobby is to legalize assisted suicide in more states and to expand the scope of the assisted suicide laws in the states that have legalized it.

The goal of the Euthanasia Prevention Coalition is to prevent the legalization of assisted suicide in states where it is currently illegal while rolling back the legalization of assisted suicide in states where it is legal.

American experience with assisted suicide confirms slippery slope

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Public Discourse published an excellent article by Richard Doerflinger, where Doerflinger explains to jurisdictions, such as Great Britain, that the assisted suicide slippery slope in America is disturbingly genuine. Doerflinger, who has researched the issue of assisted suicide for many years is challenging an Economist editorial supporting assisted suicide. 

Doerflinger writes:

Permitting assisted suicide for terminally ill patients has been debated for many years in Great Britain, as in the U.S. and other countries. The Parliament has never approved such a law, but proponents think this year may give them a victory.

The respected London-based periodical The Economist, which has supported the idea since 2015, recently weighed in with an editorial that offers a convenient overview of the campaign for what the editors call “assisted dying.” While dismissing the idea of a “slippery slope” toward broader killing, their own arguments illustrate that slope.

Doerflinger states the argument made by the Economist:

They begin with a broad claim that Britons “should have the right to choose the manner and timing of their death.” On its face, this is an argument for a “right” to suicide for everyone. The article ends with a call for a right held by all “adults of sound mind who are enduring unbearable suffering with no prospect of recovery,” noting that many people “suffer terribly with a disease that is not terminal.” Suffering, of course, is also not restricted to people with an illness.

The editorial’s insistence that people have a right to “take matters into their own hands” also misstates the issue. This is not about legalizing efforts to cause one’s own death, which have long been seen as meriting counseling and treatment rather than punishment. It is about some people—especially members of what some of us still call “the healing professions”—helping to cause the death of other people.

Nearly Every US State That Has Legalized Assisted Suicide, Has Expanded Its Law

Alex Schadenberg

Executive Director
Euthanasia Prevention Coalition

Colorado Governor Gary Polis signed  Senate Bill 24-068 on June 5 to expand their State assisted suicide law. 

Nearly every state that has legalized assisted suicide has expanded their law.

Senate Bill 24-068 expanded the Colorado assisted suicide law by:

• allowing advanced practice registered nurses to approve and prescribe lethal poison,
• reducing the waiting period from 15 days to 7 days,
• allowing the doctor or advanced practise registered nurse to waive the waiting period if the person is near to death,
• Adding language specifying that if any end-of-life options conflict with requirements to receive federal money, the conflicting part is inoperative and the remainder of the law will continue to operate.

The bill also added language concerning insurance companies:

• Denying or altering health-care or life insurance benefits otherwise available to a covered individual with a terminal illness based on the availability of medical aid-in-dying; or
• Attempting to coerce an individual with a terminal illness to make a request for medical aid-in-dying medication.

The original version of SB 24-068 would have reduced the waiting period to 48 hours and removed the residency requirement for assisted suicide in Colorado.

Most of the states are expanding their assisted suicide laws to allow advanced practise registered nurses to participate because very few doctors participate in assisted suicide.

Nearly every state that has legalized assisted suicide has expanded their laws. 

In 2019 Oregon expanded their assisted suicide law by giving doctors the ability to waive the 15 day waiting period when a person was deemed near to death. In 2023 Oregon removed the residency requirement extending assisted suicide nationally to anyone.

In 2021 California expanded their assisted suicide law by reducing the waiting period from 15 days to 48 hours, it forced doctors who oppose assisted suicide to be complicit in the process (later struck down by the court) and it forced all medical institutions to post their policy on assisted suicide.

In 2022 Vermont expanded their assisted suicide law by removing the 48 hour waiting period, (allowing a same day death), removing the requirement that an examination be done in person, (allowing approvals by telehealth), and it extended legal immunity to anyone who participates in the act.

In 2023 Vermont expanded their assisted suicide law by removing the residency requirement expanding assisted suicide nationally by allowing anyone to die by assisted suicide in Vermont.

In 2023 Washington State expanded their assisted suicide law by allowing advanced practice registered nurses to approve and prescribe lethal poison, by reducing the waiting period to 7 days and to force healthcare institutions and hospices to post their assisted suicide policies.

In 2023 Hawaii expanded their assisted suicide law by reducing the waiting period from 20 days to 5 days, by allowing the waiting period to be waived if the person is near to death and by allowing advanced practice registered nurses to approve and prescribe lethal poison.

There is currently a lawsuit by the assisted suicide lobby challenging the New Jersey state residency requirement for assisted suicide.

The goal of the assisted suicide lobby is to legalize assisted suicide in more states and to expand the scope of the assisted suicide laws in the states that have legalized assisted suicide.

It must be noted that the American Clinicians Academy on Medical Aid in Dying have determined that when a person, who does not otherwise qualify for assisted suicide, decides to stop eating and drinking, that they will immediately qualify for assisted suicide based on becoming terminally ill.

EPC April 8 Zoom event with Alex Schadenberg: Examining the growth of assisted suicide in the Western US.

This Zoom event will focus on Oregon, California, Washington state and Hawaii.

Alex Schadenberg

Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition will be providing a Western US assisted suicide Zoom event update on April 8 at 7:15 pm (Pacific Time) / 8:15 pm (Mountain Time).

Register in advance for this Zoom event (Registration Link). 

After registering, you will receive a confirmation email containing information about joining the meeting. 

This event will uncover the incremental growth of assisted suicide, a reality that the assisted suicide lobby denies in states when they are trying to legalize assisted suicide.

Alex Schadenberg will examine the increasing number of assisted suicide deaths and the expansions to the assisted suicide laws in Oregon, California, Washington state and Hawaii and provide an analysis of the data and the assisted suicide expansion bills.

There will be a specific focus on recent legislation such as Oregon removing it's assisted suicide law residency requirement to permit suicide tourism and California Bill HB 1196, a bill that would blur the distinction between assisted suicide and euthanasia (homicide) in California.

Register in advance for this Zoom event (Registration Link).

Links to recent articles on these topics:

• Oregon assisted suicide poison prescriptions increase by 29% in 2023. (Link).
  
• The nationalization of assisted suicide in America (Link). 
• California assisted suicide deaths surge by 63% in 2022 (Link).
• Does California Senate Bill HB 1196 legalize euthanasia/homicide? (Link).
• Hawai'i expanded their assisted suicide law in 2023. Hawai'i assisted suicide deaths are increasing (Link).
• Washington State failed assisted suicide law (Link).
  

Assisted suicide: Safeguards debated as bioethicist warns of unintended consequences

The following article was written by bio-ethicist, Philip Reed, in response to Arthur Caplan's article supporting assisted suicide and was published by Kevinmd.com on March 19, 2024.

Reed begins his article by referring to Caplan's article and then writes:

In Canada, deaths by a physician have increased by more than 25 percent every year since legalization in 2016 and now make up over 4 percent of all deaths. Media reports have profiled physician-assisted death for non-terminally ill Canadians who were having trouble accessing medical care, housing, and social support. Caplan understandably wants to avoid this scenario.

The question, however, is how well the safeguards are really working even in the United States. Are they set up to protect the U.S. sufficiently against the Canadian scenario?

One safeguard originally built into these laws was that access to lethal drugs would be limited to state residents. States understandably did not want to become destinations for suicide tourism. But Oregon has stopped enforcing this requirement and Vermont passed a law last year overturning their residency requirement. Other states are expected to follow suit.

Another alleged safeguard is that people who are mentally ill or depressed cannot have access to lethal drugs. However, only Hawaii requires that terminally ill patients be evaluated by a mental health professional. The other states only require referral when they suspect depression or another mental disorder might interfere with decision-making.

In the 25 years of assisted suicide in Oregon, only 3 percent of patients have been referred for a psychiatric evaluation. On the one hand, this is surprising, given that by some estimates 1 in 5 Americans have some kind of mental illness. On the other hand, given that only specialized doctors are willing to prescribe lethal drugs, patients have to shop for the right doctor. In Oregon, the median length of the relationship between the patient who receives a lethal prescription and the doctor who prescribes is down to only five weeks. One can understand how psychiatric referrals get in the way of this transaction. But one also wonders whether this sufficiently protects depressed patients.

Even when a referral is made, the objective is only to determine eligibility for assisted suicide. Only one jurisdiction (the District of Columbia) requires that patients be informed about the option of mental health counselling.

Another safeguard of assisted suicide laws is to have significant waiting periods between the patient’s initial request and obtaining the prescription. This helps ensure the request’s authenticity and that the patient is not choosing rashly. The standard waiting period, endorsed by Caplan, has been 15 days but things are changing. In 2019 the Governor of Oregon signed a law allowing physicians to bypass the waiting period in certain cases. In 2021, California shortened its waiting period from 15 days to 48 hours and subsequently witnessed a 47 percent increase in lethal prescriptions. Hawaii and Washington shortened their waiting periods in 2023 and Colorado has pending legislation to shorten it. New Mexico, seeing the trend, said, “Why wait?” and started with a 48-hour waiting period.

Are people being pushed to choose an assisted death prematurely? I suggest that the ways in which some of these choices are made are subtle and stem from complex psychological and social forces that are not easily captured by evidence. For example, are we expressing to terminally ill patients that experiencing the burdens of their disease does not jeopardize their dignity when we label the alternative “death with dignity?”

About half of Oregon patients who use assisted suicide say that they don’t want to be burdens on their families. Is a choice for death authentic if it is motivated by the idea of sacrificing a potential life worth living in order to unburden one’s caregivers?

Also, in my view, it is unfortunate that some states have incorporated assisted suicide into hospice and palliative care. Hospice says to terminally ill patients, “We can give you an acceptable quality of life at the end of life.” The offer of assisted suicide contradicts this and undermines the mission of hospice.

Medicine in the 21st century is so impressive that we are genuinely surprised when the doctor tells us that nothing can be done. But medicine is not a panacea and it cannot treat mortality. The trouble with assisted suicide laws is that they present death as a neat and tidy way to solve one’s problems. The alleged safeguards are inadequate, and as they have gradually eroded, more and more people come to believe that death can solve their problems too.

Thank you Philip Reed for responding to Caplan.

Washington State House Bill 1035 prevents health care entities from prohibiting assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Washington State House Bill 1035 is being debated in the Washington State legislature. HB 1035 will prevent Health care entities from prohibiting health care staff from participating in assisted suicide. 

House Bill 1035 is an extension to Senate Bill 5179 that expanded the Washington State assisted suicide law last year.

House Bill 1035 removes the rights of religiously affiliated medical institutions in Washington State that currently prohibit assisted suicide. The bill states:

Section 2 (3) A health care entity may not discharge, demote, suspend, discipline, or otherwise discriminate against a health care provider for providing services in compliance with this section.

Section 3 (a) A person shall not be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance with this chapter. This includes being present when a qualified patient takes the prescribed medication to end his or her life in a humane and dignified manner;

(b) A professional organization or association, or health care provider, may not subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in good faith compliance with this chapter.

The assisted suicide lobby wants to remove the right of religiously affiliated healthcare institutions from prohibiting medical practitioners from participating in assisted suicide.

Last year, Washington State Senate Bill 5179 expanded the state's assisted suicide law (among other ways) by:

1. Changed the definition of who can approve and prescribe assisted suicide from physicians to "qualified medical providers" which includes: physicians, physician assistants and nurse practitioners.
2. Expanded who can counsel a person when the consent is considered questionable, from psychiatrists or psychologists to include independent clinical social worker, advanced social worker, mental health counselor, or psychiatric advanced registered nurse practitioner.
3. Permitted the lethal drug cocktails to be delivered by courier or mail service.
4. Shortened the waiting period from 15 days to 7 days.
5. It allowed the "qualified medical provider" to waive the 7 day waiting period if someone is nearing death, allowing a same day death.
   
6. It limited the right of a religiously based healthcare provider from preventing an employee from providing assisted suicide.

SB 5179 provided several minor amendments to the assisted suicide law that I have not listed.

Nevada Governor Joe Lombardo must veto assisted suicide bill SB 239

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Governor Joe Lombardo

Please help us send the message to Nevada Governor Joe Lombardo to veto assisted suicide Bill SB 239 that passed yesterday. Governor Lombardo only has five days to veto the bill.

Send a message to Governor Lombardo urging him to veto SB 239 through (this link) or call hin at: (775) 684-5670 and ask him to veto SB 239 or send your message by Twitter at: @JosephMLombardo

Remember when you are filling out the form to refer to Bill SB 239.

Bill SB 239 passed in the Nevada Senate by a vote of 11 to 10. Yesterday it passed in the House by a vote of 23 to 19.

Tell Governor Lombardo that legalizing assisted suicide gives doctors the right in law to be involved with causing the death of their patients at the most vulnerable time of their lives. Assisted suicide is not about freedom or choice but it is actually a form of cultural and medical abandonment. A caring culture supports good end of life care and it opposes assisting suicides. 

If you have a personal story, share it with Governor Lombardo. It is important to remind the Governor that the disability community opposes assisted suicide because it leads to a further devaluation of their lives.

The assisted suicide lobby, over the past few years, has expanded existing assisted suicide legislation. Oregon eliminated their reflection period and has eliminated their residency requirement. Vermont is permitting assisted suicide by telehealth, they are forcing medical practitioners who oppose assisted suicide to refer patients to death and they have eliminated their residency requirement. Washington state and Hawaii have also expanded their assisted suicide laws.

Once assisted suicide is legal, the assisted suicide lobby will lobby or launch court cases to expand the law. The original assisted suicide bill is designed to pass in the legislature, once passed incremental extentions will follow.

Send your message to Governor Joe Lombardo urging him to veto SB 239 through (this link) or you can send your message by Twitter at: @JosephMLombardo