Italian Doctors Under Threat of Criminal Prosecution for Refusing Participation in Assisted Suicide

This article was published by National Review online on September 17, 2026.

Wesley Smith

By Wesly J Smith

Assisted suicide/euthanasia legalization is spreading like a stain. But with most doctors refusing to participate, how do we ensure that people who want to die are indeed made dead?

Answer: Blatant coercion.

Usually, the attacks on “medical conscience” (as it is known) involves threatening refusing doctors’ professional licenses. The medical literature is rife with such advocacy by bioethics notables like Ezekiel Emanuel, Julian Savulescu, and Peter Singer, who argue that doctors either participate in requested legal medical procedures — even if morally opposed — or face processional discipline. If doctors don’t like it, these activists argue, they should get out of medicine.

Some doctors have already faced the music over such refusals. In Australia a doctor was disciplined for refusing a sex-selection abortion. Ontario, Canada, courts have ruled that doctors must either euthanize legally qualified patients or tender an “effective referral,” i.e., procure another doctor for the patient the refusing MD knows will provide the lethal jab — in other words: forced complicity.

Now in Italy, the next shoe has dropped. Doctors who refused to participate in the assisted suicide are under criminal investigation.

Because of a court ruling, dying Italian patients on life support have a constitutional right to access facilitated suicide. But there is nothing in that decision of which I am aware that requires doctors to participate. That state of the law may soon change.

The case involves a cancer patient — a famous actress — who asked to be evaluated for an assisted suicide. The doctors under legal threat refused. The actress later died at a suicide clinic in Switzerland.

Her family then filed a complaint against the refusing doctors. After an investigation, the prosecutors asked to drop the case, but the family objected. And now a court has agreed to determine whether the doctors should be prosecuted criminally for refusing to perform an official act:

Ten doctors from the ASL Roma 1 are under investigation for refusal and failure to perform official duties in the investigation into the case of Sibilla Barbieri , a Roman actress and director suffering from terminal cancer who in 2023 requested access to physician-assisted suicide from the health service. The Prosecutor’s Office had requested the case be dismissed, but the preliminary investigations judge, Marisa Mosetti, in a decree dated September 1, upheld the family’s objection and set a hearing before the judge for December 16. The investigating judge will decide whether to definitively dismiss the case, order further investigations, or order the ten doctors to be sent to trial. [Google Translate rendition.]

Imagine. Doctors investigated and potentially criminally prosecuted for refusing to kill. Even if the worst doesn’t happen, the threat of such investigations alone is profoundly coercive.

Why the increasing pressure to induce doctors to violate their medical consciences?

• States aren’t going to establish killing centers. So doctors and nurse practitioners have to be conscripted to do the dirty deeds if the culture of death is to advance.
• When doctors refuse to lend their authority to controversial procedures, it sends a clarion moral message to the patient and society that certain actions are just wrong. That burns activists like a branding iron.
• Medicine is being deprofessionalized into a technocratic order-taking enterprise that exists in part to fulfill customer desires. Hippocratic “do no harm” values have no place in such a system.
• Denying medical conscience seeks to impose a secularist hegemony over a vital sector of society.
• If willingness to take life or engage in other “do harm” practices becomes a required aspect of practicing medicine, it will drive pro-life and Hippocratic Oath-believing medical professionals out of the medical sector. Meanwhile, gifted young people may avoid the field altogether, knowing that to pursue a career in health care would require them to leave their moral beliefs at home. Alas, I suspect that is precisely what medical conscience opponents want.

There is also a practical consideration for those who want legal assisted suicide to consider. If society forces health care professionals to violate their moral beliefs, we could see a mass exodus from the medical professions. Older doctors and nurses will retire, taking their experience and knowledge with them.

Do we really want to require doctors, nurses, pharmacists, and others to participate in such acts if they consider them to be immoral or grievously sinful? Should health care public policy declare lived faith to be non grata in the medical professions?

I say emphatically: No! Forcing anyone to be complicit in the taking of innocent human life (not involving a legal military order) is profoundly authoritarian.

World Suicide Prevention Day Hypocrisy

This article was published by National Review online on September 10, 2026.

Wesley Smith

By Wesley J Smith

You may not have heard, but today is the annual World Suicide Prevention Day. Usually, such efforts are almost invisible. We don’t put nearly as much emphasis on suicide prevention as we once did.

I am all for suicide prevention, of course. I just wish that those efforts included assisted suicide/euthanasia, which costs the lives of approximately 25,000 people annually around the world — with that toll increasing every year. But despite proliferating laws allowing doctors and nurse practitioners to assisted suicides — or, as in Canada, Netherlands, Belgium, New Zealand, and other countries — actively kill suicidal people, prevention efforts are generally silent about this category of suicide.

I checked on the World Health Association link to Prevention Day for 2026. It has a four-tiered prevention strategy that goes by the acronym LIFE:

• L: Limit Access to Suicide;
• I: Interact with the media on responsible reporting;
• F: Foster life skills of young people;
• E: Early identity and support everyone affected.

That’s fine but assisted suicide/euthanasia directly violates three of those four prevention strategies. Let’s look at the “L”:

Limiting access to means of suicide is a universal evidence-based intervention for suicide prevention. Depending on the country, this may mean banning acutely toxic highly hazardous pesticides, restricting firearms, installing barriers in places where suicides are known to occur, limiting access to ligature points or taking other measures.

And yet, assisted suicide provides the means of self-termination to suicidal people.

Does the WHO oppose that — or even mention it? No, it does not.

What about the “I?”:

Interacting with the media for responsible reporting of suicide is significant because media reporting of suicide can lead to a rise in suicide due to imitation — especially if the report is about a celebrity or describes the method of suicide.

And yet, how many glowing media stories have we seen describing assisted suicides as “dying on his own terms,” or extolling suicide/euthanasia goodbye parties, and celebrating suicidal patients conjoining euthanasia with organ donation etc. Good grief, Brittany Maynard was declared by CNN to be an Extraordinary Person of the Year because she committed suicide after being diagnosed with brain cancer, and she was featured repeatedly on the cover of People.

Does WHO oppose that — or even mention it? No, it does not.

What about the “E?”:

Health services are often the entry point for people in distress or for those who have made a suicide attempt where early identification, assessment, management and follow-up care can be provided.

The health system is the “entry point” for all physician-assisted suicides. All are therefore identified. And virtually none receive suicide prevention services.

Does the WHO oppose that or even mention it? No, it does not.

With the exception of the International Association for Suicide Prevention, no suicide prevention associations of which I am aware ever mentions assisted suicide, much less explicitly opposes it. This despite studies demonstrating that legalizing and advocating for assisted suicide increase suicides generally.

One association shamefully says that it isn’t really suicide, but that suicide is a “what,” not a “why.” What an abdication of responsibility.

So, let’s stop the hypocrisy and rename it, “World Some Suicides Prevention Day.” At least that would have the virtue of honesty.

Big Money can be Made Assisting Suicides

This article was published by National Review online on September 5, 2026.

Wesley Smith

By Wesley J Smith

The New York Times published an unbelievably puffy piece about a new assisted-suicide clinic starting in New York as legalization kicks in, describing it oh, so objectively as “a start-up for better deaths”–complete with Buddhist chanting. Good grief.

But the saccharine story raises an important issue discussed too little in the debate over assisted suicide. Legalization creates acute financial conflicts of interest that have the potential to push suicidal people toward death.

For socialized systems and government funded health care, killing instead of caring for expensive patients can save a lot of money over time, particularly when the terminal-illness limitation is lifted. Indeed, some advocates argue that saving money is a big part of the point. The Canadian media has even celebrated that potential.

For now, however, that macro conflict of interest is muted in the U.S. Medicare does not pay for assisted suicide, nor does the federal portion of Medicaid — thanks to a law signed by President Bill Clinton in the 1990s. State Medicaid may pay for it, but currently the numbers don’t add up to that much money. Private insurance companies have been smart enough to stay out of the controversy. Some plans pay the cost of doctor visits but not the price of the prescribed poison.

But legalization also creates acute potential conflicts of interest at the micro level. There is big money to be made for individual doctors in writing lethal prescriptions. For example, a death doctor in New Jersey has assisted more than 200 customers — I refuse to call them patients, since prescribed suicide isn’t a legitimate medical treatment — at up to $8,000 per prescribed overdose. If the average charge was $5,000, that’s more than a million bucks in a short time for not doing a whole lot of doctoring.

The New York assisted-suicide start-up touted so glowingly in the Times is another case in point. The clinic plans to charge up to $12,000 per suicide facilitation. Here’s what twelve grand covers.

Patients get two medical evaluations and a mental health screening, as well as a prescription for the combination of drugs — sedatives, morphine, lethal doses of cardiac medication — that will kill them.

New York is a populous state. So, let’s do a little math. If 1,000 people receive assisted suicide over the next few years from these “clinicians,” at say an average of $10,000 per death, that comes to — holy cow! — $10,000,000! Again, for doing very little actual doctoring. And the assisted-suicide clinic doesn’t have an office, so no rent payments will cut into the cash flow.

Moreover, the assisted-suicide clinic isn’t offering any actual “treatments,” since the price doesn’t cover caring for patients’ illnesses or, apparently, palliating symptoms. Nor will the “clinicians” practice in the medical specialties that treat the various illnesses with which suicide customers will present, such as cancer, ALS, or kidney disease.

Indeed, according to the story, the leader of the clinic is a nurse practitioner who treats chronic pain, which isn’t the same thing at all as caring for terminally ill people. Another M.D. is an ER specialist. They don’t treat terminal illnesses over the long haul, either. A palliative-care doc is involved with the suicide clinic but, according to the story, appears most interested in psychedelics. There is a former “hospice worker” and Buddhist monk. They sure don’t diagnose or treat terminal illnesses.

I’ll also bet the twelve grand doesn’t cover suicide prevention, which I doubt will be offered in any event. At least, there is no mention of that essential hospice service in the story. Besides, if the good death prescribers find that a patient does not qualify for a prescribed poisonous overdose, one would assume they don’t get the $12,000, a clear potential conflict of interest in my book.

Assisted-suicide proponents always argue that it will be implemented by doctors who have long-term relationships with their patients. That has always been a crock since most M.D.s properly will have nothing to do with prescribing suicides.

This story proves that point yet again. These suicide facilitators may know their customers for only about the two weeks it takes to jump through the bureaucratic hurdles. They certainly won’t have a long-term doctor-patient relationships with them.

With assisted-suicide numbers increasing every year and more states pushed to legalize doctor-prescribed death, there is big money to be made by doctors from writing lethal prescriptions. The subjects of this story do not appear to be motivated by avarice. But do we really want to financially incentivize access to suicide and let doctors get rich providing it?

That would sure allow bad practitioners who fail in clinical practice to personally do well by doing bad. Which reminds me of a joke. What do you call a medical student who graduates last in his class? “Doctor."

Bioethical Advocacy to Compel Medical Help in Dehydration Suicides

This article was published by National Review online on August 31, 2026.

Wesley Smith

By Wesley J Smith

Many Western countries and jurisdictions are legalizing euthanasia and assisted suicide. That opens up a problem for the death pushers. Since states aren’t going to get into the wet work of the actual killing, medical professionals and caregivers are going to be conscripted to do the deadly deeds — even if that means violating their religious beliefs and moral consciences.

Instead of resisting this rank authoritarianism, the medical and bioethics establishments are increasingly going along. This proposed coercion includes requiring doctors’ participation in suicides when patients starve and dehydrate themselves to death — known as VSED for “voluntary stop eating and drinking.”

As I wrote a few weeks ago here, the British Medical Association just so opined. And now, following closely in that guidance’s wake, a major article in the Journal of Health & Biomedical Law argues similarly — using dementia patients as the prime example — that doctors have to both inform patients about their right to commit suicide by VSED and ease the process by providing palliative care against the agony that killing oneself in that manner causes.

(It is important to emphasize at this point that we are not discussing the common phenomenon of patients who stop eating as a natural part of the dying process when the body can no longer assimilate nourishment. That isn’t suicide. VSED is. That’s a big difference both morally and factually.)

The article’s definition of VSED is skewed to promote the propriety of facilitating such deaths (citations omitted):

VSED is “a deliberate, voluntary, self-initiated action to hasten death by a patient with decision-making capacity who is suffering from an irreversible illness or prolonged dying that the person finds intolerable.”

But as the BMA guidance stated, refusing food and water onto death isn’t limited to dementia cases but can be decided upon for any reason at all. Indeed, the euthanasia pushers Compassion and Choices used to advertise this method of suicide for elderly people who are not seriously ill but “simply done.”

The article claims that clinicians have the obligation to inform patients who inquire about the process of committing VSED:

Health care professionals are ethically obligated to inform their patients of relevant health care information. This is to help patients make informed decisions: “Respecting the principle of autonomy oblige the physician to disclose medical information and treatment options that are necessary for the patient to exercise self-determination and supports informed consent, truth telling, and confidentiality.”

But eating and drinking isn’t a medical act. Receiving nourishment orally in a health-care context isn’t a treatment. In fact, the VSED itself isn’t any more “medical” than asphyxiating oneself by running a car in a closed garage. Should doctors have to teach patients how to die by that means? Of course not. Nor should they with VSED.

The article argues that people diagnosed with dementia should not be encouraged to pursue that means of death but should be provided written information about VSED among other data provided, which really means encouraged subtly, as the text below makes clear:

Referenced sources in such a compendium can then direct patients and their families to the more detailed information they should consider, such as, for example, that simply stating in an advance directive that they do not want artificial nutrition and hydration may not be adequate to ensure care and support during VSED. Links and references to VSED should include an explanation of the importance of a VSED-appropriate advanced directive if patients plan to VSED as well as templates for such advanced directives. The referenced sources should direct individuals to prepare a video explaining why they chose to VSED, and how they want their health care proxy and caregivers to respond if the patient asks for food or fluid as they become befuddled during their VSED process.

By “befuddled,” the author means: Even if the patient asks for food or drink it should be refused if previously instructed, an idea also being pushed in bioethics advocacy as “VSED by Advance Directive.” Can you imagine forcing caregivers to deny patients who ask for nourishment? Because that is what is being increasingly advocated here and elsewhere in bioethics discourse.

The article further claims that doctors must palliate the agony that comes with starving and dehydrating oneself to death — even when it violates their moral consciences — based on the principle of non-abandonment: 

The second limitation on providers’ right to conscientiously object to providing patient care is the principle of non-abandonment. No provider is permitted to abandon a suffering patient: “The duty to relieve pain and suffering is central to the physician’s role as healer and is an obligation physicians have to their patients.” Providers are ethically and legally obliged to provide care to a suffering patient even if doing so violates their personal beliefs unless they assist the patient in transferring to a provider who will provide such proper care.

But surely patient autonomy has its limits. If a patient wants to burn themself with cigarettes, are doctors require to numb the flesh to make that easier? No.

We may not be able to legally prevent VSED deaths. Nor can we prohibit doctors from palliating such cases. Indeed, VSED is often touted by activists as a loophole to get around laws banning assisted suicide.

But requiring doctors to participate is to force them to assist in suicide. And that is just plain wrong. I can’t think of a more efficient way to drive pro-life and Hippocratic Oath medical caregivers out of the professions. In fact, I believe that is a big part of the point.

Where next with this darkness? Once the false premises of VSED are accepted and such suicides become normalized, people will eventually say, “Why make people die slowly by something as awful as self-starvation? Just get it over with by allowing doctors give them a lethal jab” — and ethical guidelines will soon require doctors to do that too (already the case in Ontario, Canada).

Finally, people sometimes ask why I pay such close attention to the discourse in professional journals. This particular article is a good example of the importance of that focus. Its opinions are justified by citing earlier pro-VSED journal articles, thereby bootstrapping the author’s opinions to greater authority. And the next such article will likewise cite this piece to add to its authority. And on and on it goes.

That is precisely how radical proposals in bioethics discourse move from hypothetical examples to implemented public policy. Once the “experts” reach a consensus, the law tends to go along.

Previous articles on this topic:

British Medical Association requires doctors to help patients commit suicide by dehydration (Link). 

VSED is part of the assisted suicide agenda.

Gordon Friesen

By Gordon Friesen
President, Euthanasia Prevention Coalition

One of our great friends and allies, Wesley J. Smith, has recently written about the British Medical Association's newly minted policy and other bioethics articles which require doctors to collaborate with patients who are attempting to kill themselves through hunger and thirst.

This practice is commonly euphemized as ‘voluntarily stopping eating and drinking’, which ungainly expression is then replaced with the more slick-sounding acronym ‘VSED’. However we must unfortunately note (as usual) that the most important facts of this matter are absent from that deceptive formulation: first, the primary fact of suicide does not appear at all; and second, a misleading confusion is suggested between this specific method, of suicide, and traditionally familiar practices of fasting.

To be clear on this score, our subject has nothing to do with fasting (even to the point of death). For our bodies are well adapted to suffer the naturally frequent periods of famine to which we have been exposed throughout our evolution.

That is what makes fasting so comparatively easy (as long as fluid intake is properly maintained). For after a brief period of normal hunger (familiar to all occasional fasters), our bodies literally hunker down to wait out the interruption of nourishment.

Indeed, dying of hunger takes approximately one day for every pound of fat on our bodies, followed by another day for every three pounds of muscle. Hence, suicide by fasting is relatively painless, but takes a very long time, which generally provides plenty of opportunity for second thoughts.

Deprivation of fluids, on the other hand, is an entirely different matter. In this case, death follows in a few days only. And for that practical reason, our bodies are not adapted to quietly suffer thirst. Indeed, thirst is a biological emergency, and our bodies ring the alarm on this emergency through the communication of insufferable discomfort.

It is this unbearable discomfort, in turn, which death-friendly doctors happily propose to alleviate, through the provision of various medications (which also heavily impair critical thought). In other words: because suicide by dehydration is virtually impossible to endure, it is only the assistance of doctors which make such deaths possible, by numbing both the body and the brain.

For that reason, so-called ‘VSED’ is clearly an instance of assisted suicide, not mere comfort care and because doctors are professionally responsible for their acts in a way that ordinary people are not, it is also a form of medical homicide.

In truth, while so-called ‘VSED’ might appear very similar to terminal sedation, it is also much more problematic. For palliative sedation is only to be used in the most difficult of medical cases. But suicide by dehydration may be chosen, by any person, for any reason. It thus represents a truly radical departure from accepted norms, by providing suicidal persons with a voluntary entry point to the practical equivalent of palliative sedation, but without the need of medical justification. 

In reporting on the decision of the British Medical Association (to force the collaboration of doctors with this practice) the headline message has quite properly been centered upon the serious attack, thus produced, upon individual and institutional rights of conscience. For dissenting doctors, and institutions, are thus robbed of that crucial medical status, of independent moral agent, upon which all patients rely for proper care.

It is also worthwhile, however, to recall the importance of medically assisted suicide by dehydration, even in those jurisdictions where no such compulsion has yet been contemplated.

In the simplest of terms: so-called ‘VSED’ is definitely a form of medically assisted suicide, and yet its practice is legal in all States. Which means that even if you live in a State where assisted suicide is illegal, medically assisted suicide (VSED) is still being practised, in your State.

Furthermore, all of the terrible harms of medical homicide are enabled through this practice. For if there is nothing illegal about informing patients of the dehydration suicide option (and there is not) then there is similarly no check on any death-practitioner's ability to energetically market their product, and thus to professionally deliver as many people from the pains of human existence, as they possibly can.

In fact, unlike any other form of medical homicide (in the US or even in Canada) medically assisted suicide by dehydration is already available for dementia patients, through professionally solicited advance requests (similarly legal in all States).

Such, then, is the portrait of that formidable Trojan Horse, medically assisted suicide by dehydration (aka ‘VSED’).

Becoming aware of this practice, as yet another finger on the hand of medical homicide (and by no means the least of these) is a powerful first step in pushing back.

And while we may understand the zealous actions of fully devoted death-cult physicians, it is less easy to understand why our leaders, as in this latest British example, are so keenly committed to the promotion, and facilitation, of that extreme death agenda.

British Medical Association Requires Doctors to Help Patients Commit Suicide by Dehyrdration.

This article was published by National Review online on August 19, 2026.

Wesley Smith

By Wesley J Smith

The subtitle of the revised and updated version of my book criticizing utilitarian bioethics, Culture of Death, is, “The Age of ‘Do Harm’ Medicine.” Helping patients kill themselves by self-starvation and dehydration — known in euthanasia parlance as VSED (for voluntary stopping eating and drinking) — certainly fits that designation.

Two major medical associations now have endorsed doctors assisting in such suicides by palliating the painful symptoms to help patients go all the way to death. The first was the American Academy of Hospice and Palliative Medicine (AAHPM) in 2023. This is especially notable because the organization shamefully went “neutral” on the legalization of assisted suicide, despite that action being the antithesis of the hospice philosophy enunciated by the great medical humanitarian Dame Cecily Saunders. The AAHPM’s journal also published a piece recently endorsing intentionally undernourishing dementia patients under certain conditions (MCF, or “minimal comfort feeding”) — VSED in slow motion, if you will.

Now, another “do harm” shoe has dropped. The British Medical Association has issued an ethical guidance that requires practitioners to participate in VSED when asked to do so by a patient. While the AAHPM guidance assumes that the act will only be done by terminally ill or seriously ill or disabled patients, the BMA guidance notably acknowledges that even those not in ill health can kill themselves in this slow manner — and that doctors must further the suicide palliatively. From the guidance (my emphasis):

We start from a position of understanding that: – patients with capacity are entitled to make decisions about treatment refusals and about their nutrition and hydration, including to voluntarily stop eating and drinking in order to hasten their death;– there is no requirement in the law that a patient needs to be ill or at the end of life to decide to voluntarily stop eating and drinking in order to hasten their death.

All doctors so requested are expected by the BMA to participate in VSED by assessing patients and easing symptoms; indeed, the guidance asserts that it is an ethical duty for doctors to be complicit in such suicides:

When an adult patient has made the decision to elect to VSED, the doctor’s initial responsibility is to assess the patient to check that: (1) the patient has the capacity to make the decision; (2) the patient’s decision is not a symptom of a mental disorder; and (3) the patient’s decision is being made free from coercion.

If the three criteria above are fulfilled, doctors have a professional duty to provide palliative care and symptom relief to their patient. The doctor’s role is not to consider whether the patient’s decision is rational, reasonable, or sensible. It is not for doctors to decide whether the patient should be permitted to end their life in this way. [Emphasis added.]

It’s one thing to say doctors can’t stop a suicidal patient from self-starvation — although one would think that suicide prevention would be on the table of which there is no mention in the guidance. But it is quite another to require doctors’ participation in such suicides.

A stunted conscientious objection clause is endorsed, but it is an essentially meaningless protection, with complicity in the preparation process still required.

Doctors cannot exercise a conscientious objection to seeing or having an initial consultation with their patient. However, some doctors may wish to exercise a conscientious objection to carrying out the detailed assessments (see section 3) and/or providing symptom relief, such as analgesics or palliative sedation (see section 4). Doctors exercising a conscientious objection must follow professional guidance and ensure that there is someone else available to take over the detailed assessments and the patient’s care without delay or detriment to the patient. This means that, with the patient’s consent, doctors must pass on their assessment and care to another doctor who is willing to provide that support. [Emphasis added.]

In other words, forced procurement of another doctor who is willing to help the patient commit suicide. And if the patient says no or another doctor can’t be found? It would seem that the original physician would have no choice but to provide whatever support is required to get the patient dead.

Suicide nihilism is exerting an ever-stronger gravitational pull in the West, with doctors increasingly expected to wield their expertise as so many death order-takers. The AAHPM’s and BMA’s blessing of physician participation in VSED deepens that darkness and strengthens the culture of death.

RFK Jr. Decertifies Kentucky Organ Procurement Organization

This article was published by National Review online on August 5, 2026.

Wesley Smith

By Wesley J. Smith

Say what you will about Health and Human Services Secretary Robert F. Kennedy Jr., but he definitely cares about ensuring that organ transplant medicine remains ethical, and unlike many government functionaries, he and his department are actually doing something about it. Thus, on the back of Medicare decertifying a Florida organ procurement organization for cause in 2025, the government is now decertifying the Network for Hope that operates in Kentucky and a few other states.

The government warned the network last year that its procurement procedures were ethically deficient. But the organ procurement organization never cleaned up its act despite knowing it was being scrutinized, including, apparently, for seeking to procure organs from people who had not died.

The unethical cases involve a procedure sometimes known as heart death (as opposed to brain death). In a heart-death donation, the donor is usually receiving intensive care. That medical support is withdrawn with consent and if cardiac arrest occurs — sometimes it doesn’t and the patient is then to be returned to care — after three or so minutes the patient is declared-dead because cardiopulmonary function has irreversibly stopped. After that, the procurement commences.

The case that caused the government to intervene is a real horror story as described by the New York Times:

In Kentucky, scrutiny began when a congressional committee heard testimony about the case of Anthony Thomas Hoover II, who had an overdose in 2021. After family members were told that he would not recover, they authorized donation.

As coordinators arranged for the surgery, Mr. Hoover began to stir, at one point “thrashing on the bed,” according to records reviewed by The Times. Still, Network for Hope, then called Kentucky Organ Donor Affiliates, tried to move forward. Finally, on the way to the operation, Mr. Hoover cried, pulled his knees to his head and shook his head, and a hospital doctor refused to withdraw life support.

Mr. Hoover eventually recovered, although he has lingering neurological injuries.

Good grief.

Despite that case, Network for Hope avoided punishment. But then:

A federal investigation last year determined that the group had similarly ignored signs of growing alertness in more than 70 other patients. Although the organ removals were eventually cancelled, the investigation said multiple patients exhibited pain or distress as they were being readied for surgery. Overall, more than 100 cases had “concerning features,” the investigators said, noting that the majority of transplants arranged by the Kentucky group were from circulatory-death patients.

Good for Kennedy and the government for moving on this. This is important. The people’s trust in organ transplant medicine is already shallow as unwise efforts to loosen ethical standards advocated by prominent bioethicists — such as allowing living people to be harvested — threaten to further erode public confidence. If we want to maximize the number of organs donated, people have to believe that their lives are deemed more important than their organs.

Next, the government should prohibit the use of a relatively new organ procurement procedure called “normothermic regional perfusion,” which allows cardiac arrest, cuts off circulation to the brain to induce brain death, and then restarts the heart before procurement. It seems to me — and I am far from alone in thinking this — that if someone is resuscitated successfully, he or she is not dead. Moreover, making patients brain-dead on purpose seems little different to me than actively killing them.

France legalized euthanasia. What's next?

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition.

On July 15, France's National Assembly passed a bill to legalize euthanasia and assisted suicide by a vote of 291 to 241. This was the final vote in the National Assembly and it over rides the previous votes rejecting the euthanasia bill in France's Senate.

Agence France-Presse reported on July 15 (translated):

For the fourth time in a year, the National Assembly – the lower house of the French Parliament – approved the bill, by 291 votes to 241 (and 29 abstentions).

In a restraint session, MPs, to whom the government gave the final say after three rejections from the Senate – the upper house – authorized assisted suicide assistance for the first time, or even euthanasia, with a series of conditions.

We are concerned that pressure to expand an already expansive law will lead to quick expansions of the law. Agence France-Presse also reported that:

Before attending the vote, the president of the Association for the Right to Die with Dignity (ADMD), Jonathan Denis, told Agence France-Presse (AFP) that the ADMD, spearheading the fight for this new right for decades, would continue to fight on the free choice between assisted suicide and euthanasia or the consideration of advance directives and psychological suffering.

The euthanasia lobby is pushing to expand the law to allow euthanasia by advanced request and euthanasia for mental illness alone, similar to the political push by Canada's euthanasia lobby.

 

Wesley Smith

Based on media reports, Wesley Smith wrote that:

• The bill does not require terminal illness. Rather, it requires a “serious and incurable illness” that “threatens life in an advanced or terminal stage” — meaning death could be years away. The patient must also experience “constant physical or psychological suffering” related to the disease that is “resistant to treatment or unbearable” (as defined by the patient). Psychological suffering alone does not make one eligible for hastened death.

• There is no time set for when a disease “threatens life.”

• Only French legal residents and citizens 18 and over are eligible.

• Doctors can kill requesting patients when they are unable to kill themselves. Inability to self-administer death is not defined.

• There is only a two-day waiting period between approved request and the ability to become dead.

• There are no meaningful conscience protections for doctors unwilling to kill or prescribe poison nor explicit protections for dissenting health-care institutions. While doctors need not personally end life, they must be complicit by providing patients with the names of doctors willing to do the lethal deed.

• France’s national health service will pay for the death (which could save it a lot of money, as expensive patients will be no more). 

The battle is not over. Agence France-Presse reported that:

The President of the Senate, Gérard Larcher, Prime Minister Sébastien Lecornu announced Tuesday that he would refer the matter to the Constitutional Council, to take into account the oppositions that persist, especially on the right.

In a decision that could take place around August 15, the Sages will have to say whether certain clauses, such as the minimum period of reflection of two days granted to the patient after the agreement of doctors to assist in dying, are compatible with the principles of individual freedom and human dignity, according to the services of the Prime Minister.

We hope that the Constitutional Council rejects, or at least moderates the bill. 

France's Presidential election will be in April 2027. It is our hope that Emmanuel Macron will be replaced by someone who opposes euthanasia.

France's Prime Minister, Sébastien Lecornu, opposed the euthanasia bill.

France legalizes euthanasia.

This article was published by National Review online on July 15, 2026.

Wesley Smith

By Wesley J. Smith

The West continues its love affair with the culture of death as the French National Assembly just voted to legalize euthanasia and assisted suicide, overriding the Senate’s rejection. I haven’t read the bill, but here are a few notes I discerned from various media reports: 

• The bill does not require terminal illness. Rather, it requires a “serious and incurable illness” that “threatens life in an advanced or terminal stage” — meaning death could be years away. The patient must also experience “constant physical or psychological suffering” related to the disease that is “resistant to treatment or unbearable” (as defined by the patient). Psychological suffering alone does not make one eligible for hastened death.

• There is no time set for when a disease “threatens life.”

• Only French legal residents and citizens 18 and over are eligible.

• Doctors can kill requesting patients when they are unable to kill themselves. Inability to self-administer death is not defined.

• There is only a two-day waiting period between approved request and the ability to become dead.

• There are no meaningful conscience protections for doctors unwilling to kill or prescribe poison nor explicit protections for dissenting health-care institutions. While doctors need not personally end life, they must be complicit by providing patients with the names of doctors willing to do the lethal deed.

• France’s national health service will pay for the death (which could save it a lot of money, as expensive patients will be no more).

Please remember that the law as it currently exists will surely not be the permanent ceiling of permissibility but as other jurisdictions illustrate, merely be the launching pad for an ever more expansive euthanasia regime. Moreover, even these weak-tea parameters will probably not be enforced meaningfully, because that’s how the culture of death rolls. And once euthanasia starts, it picks up steam year by year by year as hastened death becomes normalized.

The constitutionality of the law will surely be litigated, which could theoretically prevent it from going into effect. We will see, but that kind of holding action rarely works, and even when it does — as in Portugal — the prohibition doesn’t last for long.

More articles on this topic:

• France's National Assembly legalizes euthanasia (Read). 
• France's Senate once again defeats euthanasia bill (Read).
• France's National Assembly passes euthanasia bill. Final vote will be July 15 (Read).

Death by Organ Donation pushed in Medical Journal.

This article was published by National Review online on July 9, 2026.

By Wesley J Smith

The legalization of assisted suicide/euthanasia corrupts medical ethics and not just because killing patients or assisting their suicides is a direct violation of the Hippocratic oath. No: Transforming sick and disabled people into a killable caste also objectifies them as potential natural resources to be mined or harvested.

Hastened death and organ-harvesting have already been conjoined in Canada, Australia, New Zealand, Spain, the Netherlands, and Belgium. (In the latter two countries, some cases have involved mentally ill patients.) The practice has been supported in prominent medical journals. It is not alarmism to note that the idea is gaining ever wider acceptance among the medical and bioethics intelligentsia. 

But killing and then harvesting doesn’t go far enough for some mainstream bioethicists. Where euthanasia is legal, they don’t see why organ procurement can’t also be the means of death for patients who want to donate. In other words, don’t just kill and then harvest; harvest to kill.

Oh, Wesley! That would never be allowed!

No? The proposal was just pushed with all due respect in the world’s most influential medical journal, the New England Journal of Medicine, written by three prominent bioethicist-physicians (two of whom are from Harvard: all bow).

First, the authors correctly note that the “dead donor rule” — the prime ethical directive in organ transplant medicine — requires that vital organ donors to be dead before organ retrieval (let’s not get into the brain death controversy here). Moreover, it forbids organ procurement from being the cause of death.

But with the increasing legalization of euthanasia, the bioethicists urge a dramatic loosening of that foundational legal requirement. Where lethal jabs — death by homicide — are legal, they want the organ-harvesting itself to be the cause of death, what they call “death by organ donation.” From “Contextualizing the Dead Donor Rule in an Era of Voluntary Euthanasia“:

Voluntary euthanasia relies on this lawful waiver of the right to life under defined safeguards. This reasoning extends to organ donation after euthanasia, in which a patient knowingly consents to a death that will be followed by organ procurement. Organ donation after euthanasia creates a rare opportunity to honor end-of-life autonomy, since patients can articulate their own goals, including how their death might serve others.

Notice that they don’t call for suicide prevention. Once people can be lawfully killed, treating them as so many organ farms follows logically. But what to do about that pesky dead donor rule? Killing for organs may violate it, the authors admit, but it is within the spirit of righteous ethics, so loosening the rule can be “contextualized”:

In the context of voluntary euthanasia, in which patients provide first-person consent, trust doesn’t need to rest entirely on temporal sequencing. Voluntary euthanasia’s aim of relieving suffering with a humane end-of-life process aligns with the DDR’s concern for minimizing harm. When properly safeguarded, death by organ donation violates the Death Requirement without necessarily violating its underlying spirit of trust preservation and protecting patients from harm.

Baloney. Killing for organs can quickly become the primary reason for granting someone’s request to die “as a plum to society” (as I predicted back in 1993). Knowledge of that option can also be a material influence on whether and when a despairing person asks for euthanasia.

For example, a 16-year-old Belgian girl with brain cancer asked to be killed in part so that her organs could be harvested. She was put into a 36-hour coma — not for her medical benefit but to conduct needed tissue tests and find suitable recipients. The bioethicists claim that respect for patient autonomy should permit killing for organs:

Although death by organ donation may be viewed as a departure from the DDR, shifting focus away from the temporal relationship to death determination, we interpret it as consistent with a historical pattern of recontextualization. In the setting of regulated voluntary euthanasia and organ donation after euthanasia, death by organ donation warrants open, transparent dialogue. Since patients requesting voluntary euthanasia can provide first-person consent and articulate their values, that option might offer a unique opportunity to respect their autonomous wishes by integrating donation into their end-of-life planning.

Well, why should that rationalization not apply also to any suicidal person? After all, if someone really wants to die, who are we to interfere with his or her “autonomous wishes” by setting parameters on what kind of suffering qualifies for death by organ donation? Besides, killing for organs would result in a better product:

Death by organ donation would enable cardiac donation, typically prohibited with DCD, and improve recipient outcomes by reducing warm ischemia time, thereby lowering primary graft-dysfunction rates to levels similar to those achieved with donation after brain death. In addition, it might substantially increase the donor pool, potentially saving many lives. Since death would be a chosen and inevitable outcome in these cases, enabling retrieval under ideal conditions represents a Pareto improvement: no one would be made worse off, and multiple lives might be saved.

The morality of our society would be much worse off. And so would the patients, because they would become objectified once consent was granted, even if the desire to donate is the reason for their request.

How respectable is this kill-to-harvest proposal becoming? It has been proposed before without much objection. It doesn’t get more prestigious than the NEJM. And it is now sufficiently mainstream for NPR to have featured one of the latest proposal’s authors, Dr. Robert D. Truog, in a respectful interview.

We live in very disturbing times.

Concerns about Organ Donation.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Larry Black Jr with his sister Molly Watts

KFF Health News published an article by Cara Anthony on September 12, 2025 about organ donation featuring the story of Larry Black Jr who on March 24, 2019, at the age of 22, arrived at the SSM Health Saint Louis University Hospital after being shot in the head.

A week later, Black, was on the surgical table being prepared for organ harvesting when his physician demanded that Black be removed from the surgical table, because he was not declared brain dead and his heart was still beating.

Organ donation and assisted death (youtube link)

Anthony reported that:

Black’s sister Molly Watts said the family had doubts after agreeing to donate Black’s organs but felt unheard until the 34-year-old doctor, in his first year as a neurosurgeon, intervened.

Today, Black, now 28, is a musician and the father of three children. He still needs regular physical therapy for lingering health issues from the gun injury. And Black said he is haunted by what he remembers from those days while he was lying in a medically induced coma.

“I heard my mama yelling,” he recalled. “Everybody was there yelling my name, crying, playing my favorite songs, sending prayers up.”

He said he had tried to show everyone in his hospital room that he heard them. He recalled knocking on the side of the bed, blinking his eyes, trying to show that he was fighting for his life.

The Anglican Church of Canada Publishes Pastoral Liturgies Blessing Euthanasia

This article was published by the National Review online on June 26, 2026

Wesley Smith

By Wesley J Smith

The Anglican Church of Canada has authorized clergy to bless people being euthanized just before, during, and after being lethally jabbed (when permitted by the bishop). From “Pastoral Liturgies at the Time of Death in Contexts of Medically Assisted Dying”:

It is not our intent to enter into the ethical arguments regarding MAiD, nor to provide a moral argument for or against MAiD. . . . No matter where people are in their life journey, we as a Christian community and Christian leaders in particular are called to respond pastorally to the needs and concerns of the people before us. Wherever the church serves, we are the Body of Christ reaching out to the suffering, the sick, and the dying. When someone reaches out for pastoral care, the church responds: there is a duty of pastoral care.

If the Anglican Church can’t enter into an ethical argument about euthanasia what is the point of being a church? And given that suicide has always been considered an egregious sin in Christianity from its very early days, wouldn’t “Christian” pastoral care be obligated to at least try and help the suicidal person decide not to be made dead?

Here is another justification for blessing a euthanasia killing in the document:

Death is a natural part of life, and in the spirit of the Church’s continued ministry, we are called to walk alongside health care agencies and practitioners to offer a pastoral response and presence to those who are dying. As the Book of Alternative Services notes, “if the sick could not get to church, then the Church [. . . should] come to them.”

Natural death is “a natural part of life.” Being killed is not. Moreover, is it really properly a Christian act to “walk alongside” a doctor or nurse practitioner who kills? The earliest Christian ethical writing dating from about 100 — the Didache — explicitly condemns “murder” as profoundly sinful. True, Canada has legalized this particular form of homicide, but the issue with regard to a church is not statutory legality, but rather, ethics and morality.

The document spouts false premises and shallow rationalizations for supporting being euthanized:

People who choose MAiD freely and without coercion may indeed be ready to go. They have been living with and suffering through complex health challenges and they want the pain to stop. They want to be able to sleep. They desperately do not want their families and loved ones to watch and wait, wondering how much longer? They have exhausted all medical options, and they know, everyone knows, that there is no cure. Some wish, most of all, not to be alone at the time of their death, and to die well. Some, who are Christian, also desire not to be alone at the time of their death, and to die well, and with the grace and blessing of God and with the presence of the Church at their side.

The law in Canada does not require that “all medical options” be exhausted. And how can putting oneself out of their loved ones’ misery be blessed? Moreover, every suicidal person is “ready to go.” If someone who is disabled or ill can be supported spiritually in having themselves made dead, why not also any other suicidal person?