Dutch Psychiatrist warns Canada: Don't extend euthanasia to mental illness

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Jim van Os

I had the opportunity to speak to the Joint Committee on Medical Assistance in Dying (euthanasia) on May 5, 2026 (Link to my testimony). 

Before my presentation, the committee featured three Psychiatrists from the Netherlands explaining their experience with euthanasia for mental illness. Dr Jim van Os, a Professor of Psychiatry at Utrecht University warned Canada not to extend euthanasia to mental illness.

Professor van Os told the Parliamentary committee:

 

The Dutch experience, in my opinion, offers a warning for Canada. For 20 years our euthanasia law left psychiatric cases largely untouched. However, over the past decade, a small group of activist physicians and organizations built a practice through sustained media campaigns.

In 2024, the Dutch Euthanasia Expertise Center (euthanasia clinic) received around 5000 requests, roughly 1000 on psychiatric grounds. Among people under 30, requests rose from about 30 per year to nearly 900 in six years. Completed euthanasia rose fivefold.

This pattern has been widely interpreted as a so-called suicide contagion effect amplified by the institutions that should safeguard against it.

This committee perhaps should keep in mind under the Dutch law physicians must agree that there are no reasonable options. Euthanasia is in principle the very last resort. Canadian law does not work this way. 

In Canada patient choice trumps the physician's professional judgment. So a doctor cannot insist that other options be tried first. That single difference will in our assessment drive Canadian numbers beyond ours. 

In 2024 the UN Committee on the Rights of Persons with Disabilities warned that the Dutch practice was unsafe. Persons with psychosocial disabilities have a fundamental human right of protection against premature death. 

Euthanasia for mental suffering cannot be cleanly separated from physician performed suicide. It is in many cases suicide carried out by a psychiatrist. 

Our research and clinical work reveal a minefield on every side.

Autonomy. Most who request euthanasia for mental suffering are traumatized, marginalized, often living in poverty without prospects.

Mental illness, by definition, compromises autonomy. Calling such a request a free expression of choice ignores the substance of the suffering.

Discrimination. The arguments that refusing euthanasia for mental suffering is discriminatory equates psychiatric suffering with terminal cancer. It is a false equivalence.

Cancer with a two-month prognosis is linear and progressive. Mental suffering is not. Recovery happens often unexpectedly through relationships, purpose, meaningful work, bonding with another person or even an animal.

The patient recovery movement insists that recovery is possible for everyone. Plasticity is the rule.

Criteria. Clinicians do not agree on irremediability, on futility, on competence. The result is something like a lottery.

Whether you receive suicide prevention or a lethal injection depends on which clinician you meet.

Substance. Recent Dutch analysis show that many who receive euthanasia for mental illness are women with unaddressed trauma. Their unconscious self-destructive dynamics get enacted in the procedure. The psychiatrist becomes recruited into a deadly outcome.

Toffrey Wayne and colleagues describe how, in the Netherlands, people with autism spectrum traits increasingly receive euthanasia for what is at root social suffering framed in medical language. The intervention should be social and existential, not lethal.

Psychiatry claims it can prevent suicide in one patient and help finalize suicide in another with the same suffering. That is incoherent. It is not autonomy, it is not anti-discrimination, it is a contradiction at the heart or our profession. 

My message to Canada.

Do not expand euthanasia to those with mental illness. The evidence is not there. The UN, the International Association for Suicide Prevention and our lived experience point the same way. 

The social trials that we run in the Netherlands show another path. Care that builds relational continuity, hope and connectedness. That is the system worth building, not procedural pathways to death.

Netherlands euthanasia and systematic incremental extensions.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Irish Times published a letter today from Dr E Garcia, Vrije Universiteit, Amsterdam, Netherlands who rebutts a letter by David Tomkins that was published on July 28 who asserted that the evidence does not support that safeguards have been removed in the Netherlands. Dr Garcia wrote:

Here in the Netherlands over the last two decades, there has been a systematic incremental extension in the grounds for euthanasia, and a clear removal of safeguards.

These facts have been detrimental to the safety of patients at a vulnerable time in their lives.

Since the legalisation of euthanasia in 2002 for mentally competent adults, we now have child euthanasia (introduced via the Groningen Protocol in 2007), euthanasia for patients with psychiatric illnesses (88 such cases in 2020), and last year our supreme court legalised euthanasia for patients with advanced dementia.

The facts of that particular case involved a woman with dementia who had revoked her prior consent to be euthanised, and had to be restrained after she woke up during the administration of the lethal drugs.

In addition to the above, our government is currently examining proposals to permit euthanasia for children aged between one and 12.

There are now also “mobile health teams” known as “end of life clinics”, that are willing to travel to patients to administer the lethal drugs.

This practice is particularly worrying as it circumvents the safeguard of the existence of a good doctor-patient relationship before euthanasia can be administered.

No matter what your opinion is on the practice of euthanasia, it is impossible to ignore the fact that the incremental removal of safeguards has been a reality in the Netherlands. – Yours, etc,

Links to more information on this topic:

• Legalizing euthanasia: What we can learn from the Netherlands (Link). 
• Let's not romanticize the Dutch euthanasia experiment (Link). 
• Legalizing euthanasia makes killing the norm, not the exception (Link). 
• Study uncovers euthanasia based on loneliness in the Netherlands (Link).
  

Legalizing Euthanasia: What we can learn from the Netherlands

Alex Schadenberg

Exeuctive Director, Euthanasia Prevention Coalition

Leo van Doesburg with The European Christian Political Movement (EPCM) and Diederik van Dijk with the NPV-Zorg voor het leven (NPV-Care for life) published a thorough article titled: Legalizing Euthanasia: What we can learn from the Netherlands, in response to the growing number of countries debating euthanasia and the growing practise of euthanasia in the Netherlands. (Link to the article).

Since the article is 20 pages, I have published the conclusion and I encourage people to read the full text (Link to the article).

Conclusion:

When the euthanasia law was adopted in 2001, it focused on persons who were terminally ill. As this publication showed, once the law was introduced, the grounds for performing euthanasia in the Netherlands have been broadened, becoming available to more and more groups of people.The arguments used were: ‘compassion’ (“it is better for him/her to die than to suffer any longer”) and ‘personal autonomy’ (“death is a personal matter; if someone wants to die, they should be helped”). This situation is, in our view, threatening because: 

1. Legal euthanasia undermines the idea that killing another person is bad. The legalization of the act of killing, shows a kind of justification. Particularly for those who are not able to make decisions for themselves, the following question needs to be answered: can we make life or death decisions and judge about the value of life of another human being? 

2. Legal euthanasia undermines the equality of people. Some groups are considered ‘suitable’ for euthanasia, while for other groups, we invest money in suicide prevention. What is the message given to the groups that are seen as ‘suitable’? For example, the discussions about the ‘completed life ending’ may indirectly emotionally press the elderly think about the possibility to terminate their lives. 

3. Vulnerable people become even more vulnerable. Having euthanasia as an option can lead people to harbor ideas of death which might be fanned further by the family, causing (indirect) pressure. Applying euthanasia for incapacitated people ignores the right of life for everyone. It also disregards the prerequisite ‘on request’, which initially was the cornerstone of the Dutch euthanasia law. The role of a government is to protect the vulnerable and to seek solutions to improve the quality of life of those who suffer, not to end their life. 

4. The ‘slippery slope’ has become a reality in the Netherlands. The reasoning “it is not fair that euthanasia is available for that group, but not for another group” is often mentioned (e.g., recently in the discussion for children aged 1-12). This shows that once legalized, euthanasia is difficult to be contained to one group of people. Numbers of euthanasia cases are growing every year, also for ‘special’ groups, like people with dementia or psychiatric disorders. 

5. Euthanasia has become normalized in Dutch culture. 99% of the Dutch citizens know what ‘euthanasia’ is, while only 53% know what ‘palliative care’ is.This has far-reaching consequences: 11% of Dutch citizens are afraid to get euthanasia in a secret way.

As a conclusion, we see that, although human dignity arguments were used to legalize or broaden the provision of euthanasia, in reality the human dignity of the vulnerable is in danger. Death is the opposite of life. We should not use the argument for dignity to assist people in dying, but focus on helping people to live. Therefore, it is imperative to invest in initiatives which alleviate loneliness in the elderly or isolated people and to fund good palliative care. It is our duty to protect the vulnerable among us against the dangers stemming from the expansion of access to euthanasia.

Netherlands euthanasia clinic: two year waiting list for euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On March 1, 2012; the Netherlands euthanasia lobby launched the euthanasia clinic with six mobile euthanasia teams. The euthanasia lobby anticipated that these mobile euthanasia teams would perform 1000 euthanasia deaths per year.

The mobile euthanasia teams planned to fill "unmet" demand by focusing on euthanasia for people with chronic depression (mental pain), people with disabilities, people with dementia/ Alzheimer, loneliness, and those whose request for euthanasia is declined by their physician.

Janene Pieters reported for the NL Times that there is now a two year wait time for euthanasia for mental illness at the euthanasia clinic. According to Pieters last year the euthanasia clinic received 3122 requests for euthanasia representing a 22% increase over the previous year.

Pieters reports that Paulan Starcke of the Expertise Center said:

While the coronavirus pandemic is an easy thing to blame for the increasing waiting times, the crisis was really only part of the problem... According to her, the pandemic caused a maximum delay of two months. 

"Our waiting list is primarily a signal that regular mental health care still does not often seriously respond to a request for euthanasia. We are referred to too often," 

Patients are referred to the Euthanasia Expertise Center if their regular doctor considers their request too complex to handle themselves. The Expertise Center provided euthanasia to over 60 people with mental health problems last year. Doctors who are not affiliated with the center only did so six times.

The Netherlands euthanasia clinic temporarily shut-down during the Coronavirus crisis. The euthanasia clinic which specializes in euthanasia for mental illness and euthanasia for people with dementia or questionable competency, reported that euthanasia deaths, increased to 898 in 2019 up from 727 in 2018.

The 2018 euthanasia report indicates that there were 6126 reported euthanasia deaths in the Netherlands in 2018. According to the Dutchnews.nl news:

Of the cases reported to the committee last year, 146 concerned people with dementia and 67 people had severe psychiatric problems. In 205 cases, patients had multiple problems derived from the ageing process.

I am concerned that in 2018, 205 people were placed into a new category off euthanasia for people who have multiple problems derived from the aging process. This sounds very similar to "the completed life.

I contend that very few psychiatrists, in the Netherlands, are willing to do euthanasia because it is counter to the role of a psychiatrist who is trained to prevent suicide not provide it.

The slippery slope is real says Dutch euthanasia doctor.

This article was published by Mercatornet on August 24, 2020. (edited for focus).

This article focuses on comments by Dr Bert Keizer, a euthanasia doctor in the Netherlands.

Michael Cook

By Michael Cook, editor of Mercatornet
 
Anti-euthanasia lobbyists want the public to believe in the inevitability of the slippery slope, but their fears are unwarranted, wrote a Canadian doctor earlier this year.

Where better to test this than the Netherlands?

In 2019, according to the official figures, there were 6,361 cases of euthanasia – 4.2 percent of all deaths. In other words, one out of 25 people are killed by doctors in the Netherlands. And those are just the official figures. It is widely accepted that a good number of euthanasia deaths are not reported, mostly because doctors don’t like the extra paperwork involved.

How do Dutch euthanasia doctors feel about this?

Pretty good, actually.

Writing in the NTGV, the Dutch Medical Association Journal, Dr Bert Keizer reflects on the history of Dutch euthanasia. Somewhat surprisingly, he endorses the notion that euthanasia is a “slippery slope”. Better said, he embraces it.

Dr Keizer is a Grand Old Man of Dutch euthanasia. A philosopher and a geriatrician, he now works for Expertisecentrum Euthanasie, the new name for Levenseindekliniek (the End of Life Clinic). It was born as a project of the NVVE, the Dutch Right to Die Society. He writes:

“After the turn of the [last] century, what our British colleagues had predicted years earlier with unconcealed complacency happened: those who embark on euthanasia venture down a slippery slope along which you irrevocably slide down to the random killing of defenceless sick people.”

He describes the progress of euthanasia in the Netherlands.

“And so it was with euthanasia. Every time a line was drawn, it was also pushed back. We started with the terminally ill, but also among the chronically ill it turned out to be hopeless and unbearable suffering. Subsequently, people with incipient dementia, psychiatric patients, people with advanced dementia, (high) elderly who struggled with an accumulation of old-age complaints and finally (high) elderly who, although not suffering from a disabling or limiting disease, still find that their life no longer has content. The unfortunate term ‘completed life’ was used for the problem of the latter group.”

What Dr Keizer has witnessed in his long career is the gradual but inevitable change in what doctors are willing to do for their patients. Perhaps “slippery slope” sounds too harsh, because it evokes the image of a headlong tumble down a cliff. He prefers to think of it as a gradual erosion of boundaries.

“In retrospect, it is true that we now provide euthanasia to people to whom we had said, a little indignantly, 20 years ago, ‘Come on, that is really impossible’. And looking ahead, there is no reason to believe that this process will stop in case of incapacitated dementia. What about the prisoner who has a life sentence and desperately longs for death? Or doubly disabled children who, although institutionalized, suffer unbearably and hopelessly according to their parents as a result of self-harm? I don’t believe we are on a slippery slope, in the sense of heading for disaster. Rather, it is a shift that is not catastrophic, but it does require that we continue to get involved as a community.”

This passage from Dr Keizer’s article suggests that the two sides of the euthanasia debate have zeroed in on the wrong word. Instead of arguing about whether a slippery slope exists – because they agree on that — they should focus on the meaning of “disaster”.

Obviously, if one takes the nihilistic view that death is a good thing, the more euthanasia, the better.

• Assisted death for people with dementia paves the way for non-voluntary euthanasia (Link).
• Five reasons to oppose euthanasia and assisted suicide (Link).

Belgium law violated to kill depressed woman by euthanasia. Here is the evidence.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Leone Groti, reporting for Tempi.it reports on the case of Godelieva de Troyer, the depressed Belgian woman who died by euthanasia in Belgium. (Google translated from Italian).

Godelieva de Troyer

Doctors who authorized and then carried-out Godelieva de Troyer's euthanasia in Belgium on April 19, 2012 repeatedly violated the law on euthanasia. The incredible case pending before the European Court of Human Rights, told in detail by Tempi in the March 2019 issue, came to a turning point after the Belgian government was forced to file the form completed by the doctor who killed the 64-year-old woman. The four-page document, submitted as per regulation to the Commission of Control of Euthanasia, charged in Belgium to verify compliance with the law, has been kept hidden for seven years. The form, as is indicated at tempos.it, which obtained a copy in consultation, confirms the violation of the law in black and white which since 2002 has caused the death of 19,420 people (data updated to 2018, latest communication available), an average more than 3 people a day.

The Two Months Late

Madame de Troyer was not dying or suffering from an incurable condition. However, she had suffered since she was 19 of depression, exacerbated in the last period of her life, as well as the suicide of her ex-husband, the breakdown of the relationship with her new partner and an often stormy relationship with her children. The case was brought to the Strasbourg Court by the son of the woman, Tom Mortier, after Belgian courts refused to initiate a trial. Mortier, who was kept in the dark about the euthanasia process, learned of the mother's death from a letter written by her and delivered to him on April 20, 2012, the day after her death.

Tom Mortier (son)

The "euthanasia registration form" number 607/12 was completed by the physician who killed de Troyer, Wim Distelmans, oncologist, professor of palliative care at the Free University of Brussels and above all a pioneer of euthanasia in Belgium, as well as Chairman of the Euthanasia Control Commission. Article 5 of the law provides that the forms must be completed after euthanasia has taken place and sent to the Control Commission "within four working days" from the injection. De Troyer was killed on April 19, but as the date stated on the form says, it was received by the commission only on June 20, more than two months late.

No "Independent Doctors"

Wim Distelmans

The law also requires that the doctor, before authorizing euthanasia, must consult two other doctors, who must be "independent of each other and with respect to the patient". On page 4, the form states that the first of the two doctors consulted is "a doctor in palliative care" belonging to the "Leif organization". The End of Life Information Forum is a pro euthanasia organization specializing in providing information on how to achieve "good death" and training doctors and nurses. Anyone can visit the Leif website and check the name of the president: Wim Distelmans.

Not only was there no independence between the doctor who killed de Troyer and the first consulted specialist. The second consulted doctor, a psychiatrist also "belongs to Leif", as it is written on page 4 of the form. As if the interdependence of the three doctors was not enough, before receiving the injection the woman made a bank transfer of 2,500 euros to the organization with the reason "Thanks to the Leif staff".

Dates Do Not Come Back

Violations of the law don't end there. As can be seen on page 2 of the form, the request for euthanasia was made by de Troyer on February 14th. Yet the legal consultation with the second "independent" doctor, the psychiatrist, took place almost a month earlier, on January 17, 2012. How is this possible? The law also provides that the doctor must ensure that the patient's request is "voluntary, well considered and repeated over time". In addition, the physician must have "numerous conversations with the patient over a reasonable period of time." From the day of the request to the day of the execution, however, barely 58 days pass, not even two months.

The amount of errors and violations is such that it is impossible not to notice it, yet the Euthanasia Control Commission that has viewed the form has decreed that everything has been done in compliance with the law. How is it possible? Could the Commission have been influenced by the fact that the material author of euthanasia, Wim Distelmans, is also the President of the Commission itself? And if so, how can this independent Commission be defined?

Conflict Of Interest

Here, too, there are at least two elements that do not return. In reply to the questions of the Strasbourg judges in writing, the Belgian Government stated that the approval of the case had been voted "unanimously" by the Commission. When the lawyers for Tom Mortier denounced the conflict of interest, the government explained that according to practice, if a member of the Commission is involved in the case of euthanasia examined, he remains silent.

But if Distelmans remained silent, how could he have voted? And how can this practice guarantee that there is no conflict of interest? At the same time that Distelmans had suddenly gone silent, would everyone have understood that the case concerned him and who would have dared to vote against the president and consequently send the file to the Belgian prosecutor's office to investigate him and put him on trial? It is difficult to think that there is no undue influence and pressure in the process of reviewing cases of euthanasia.

The Most Serious Problem

One last problem emerges from the form, perhaps the most serious. It states in fact that with Mrs de Troyer "all treatment attempts have been exhausted. The unbearable psychological suffering "can no longer" be cured ". The patient is also said to be "terrified that euthanasia does not happen" and "extremely happy that her suffering will finally end".

In Madame de Troyer's diaries, however, we read: "I miss my grandchildren so much. I won't see them grow and this pains me." And again: "I feel frustration and sadness because I have not been able to build a bond." The reference to grandchildren and children makes it clear that the difficulty of relating to the children was at the basis of the last phase of the depression of the woman, followed instead by a positive period. How then can the doctor say that depression cannot be cured and that "all medical avenues" have been explored, if he has never tried to make them restore their relationship with their children, as testified by one of them, Tom Mortier, authorizing his death within two months of the request?

The Right To Life Is Not Protected

All material and questions are now in the hands of the European Court for Human Rights, which will have to determine whether Belgium's euthanasia law has violated Article 2 of the European Convention on Human Rights, which sanctions: "The right to life of every person is protected by law", especially when this is in conditions of vulnerability, as in the case of de Troyer. They will also need to determine if Tom Mortier's right to respect for family life has been violated.

As Mortier 's attorney Robert Clarke, who is part of the Adf International legal group, declared to tempt.it, "the Belgian government has until September to present further arguments, then the Court will decide. The sentence is expected to arrive in 6-12 months. Regardless of what they may say, it is clear that Belgium has not protected de Troyer's right to life, that the law on euthanasia has been violated and that the Audit Commission does not act independently." If the case is full of obscure points, at least one has been clarified: it is now evident why the Euthanasia Commission refused to show the de Troyer case form for seven years.

Covid-19 crisis demonstrates the need for euthanasia and assisted suicide is abstract rather than practical.

Euthanasia is not an essential service.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill

Kevin Yuill, the author of the book Assisted Suicide: The Liberal, Humanist Case Against Legalisation, and Theo Boer, a former member of a Netherlands Regional Euthanasia Review Committee (2005 - 14) collaborated to write the article: What Covid-19 has revealed about euthanasia, that was published by Spiked on April 14, 2020.

The authors begin the article by commenting on Covid-19 and healthcare:

There has not been, in living memory, more focus on healthcare, the vital role of doctors, the sacrifices made by nurses, and the wonderful efforts of everyone involved in the sector. Amid the coronavirus crisis, daily heroism, the scale of human loss, and the awful scenes in hospitals underline what is important – and what is not.

Theo Boer

They authors comment on euthanasia and Covid-19 in the Netherlands:

It will surprise some that in the Netherlands, the only dedicated clinic providing euthanasia and assisted suicide has closed. Euthanasia Expertise Centre (formerly known as End of Life Clinic) has suspended all euthanasia procedures. The clinic’s website says that existing procedures have been put on hold and new patients are no longer admitted. The centre – which in 2019 alone ended the lives of 898 patients suffering from cancers, psychiatric problems, early on-set dementia, and accumulated age-related complaints – is willing to make an exception only for those expected to die soon and those who may soon lose their capacity for decision-making.

They comment on euthanasia and Covid-19 in Belgium:

Similarly, in Belgium, Jacqueline Herremans, a member of the federal commission reviewing euthanasia, has noted that there are few resources and even fewer doctors available for euthanasia at the moment: ‘The most important thing right now is that we fight the coronavirus.’

They then comment on euthanasia and Covid-19 in Canada:

In Canada, authorities are also shutting down services. For a process that requires two different medical assessments and witnesses, the lives involved are not worth the risk. According to the Globe and Mail, two places in Ontario, where euthanasia and assisted suicide have been legal since 2016, have stopped providing medical assistance in dying (MAID) because of the coronavirus pandemic (one has since resumed for existing patients and those whose deaths are imminent).

In Ontario, only Hamilton and Ottawa are known to have decided that euthanasia is not an essential service. 

The authors point out that the Netherlands euthanasia clinic state that euthanasia is not a priority during the Covid-19 crisis. The statement from the euthanasia clinic follows an opposite statement last year where Steven Pleiter, the director of the clinic said:

‘If the situation is unbearable and there is no prospect of improvement, and euthanasia is an option, it would be almost unethical [of a doctor] not to help that person’

The authors say that palliative care institutions have not shut-down during the Covid-19 pandemic.

So what has the Covid-19 pandemic taught us about euthanasia? The authors state:

What the Covid-19 crisis has demonstrated is that the need for euthanasia and assisted suicide is abstract rather than practical. In the Netherlands in the 1980s, assisted dying started out as the ultimate solution to impending horrible deaths. In present times, with a high level of care for the dying available in most countries with good healthcare, assisted dying is not about actual deaths, but about deaths that people fear. The reality is that most people die peaceful deaths. But many fear loss of control and find the prospect of others caring for them terrifying. 

Covid-19 brings the reality of death, the necessity of caring for others and being cared for by others, into our living rooms, making the preciousness of all lives and the tragedy of all deaths real. We see the humanity of the elderly and frail; no longer are they burdens to be dispatched from this world, but victims of horrifying disease that all are invested in fighting.

The authors conclude by stating:

"Perhaps, though, we can remember this time when we made huge sacrifices to preserve every life, no matter how frail and vulnerable. We can remember this time when euthanasia no longer seemed necessary."

Thank you Kevin and Theo. Euthanasia is not an essential service and it is not healthcare.

Euthanasia clinic shuts down amid Coronaviris Crisis.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Euthanasia clinic

The Netherlands euthanasia clinic has temporarily shut-down amid the Coronavirus crisis. This is the euthanasia clinic that reported euthanasia requests, in 2019, were up by 22% and euthanasia deaths increased to 898 from 727 in 2018. This is also the euthanasia clinic that specializes in euthanasia for psychiatric reasons and euthanasia for people with dementia or questionable competency.

The announcement from the euthanasia clinic (google translated) follows:

Corona crisis hits Euthanasia Expertise Center

The Corona crisis also affects the assistance of the Euthanasia Expertise Center. In the interest of public health, our patients, their loved ones and employees of the expertise center, it is no longer responsible to continue our current care provision.

Euthanasia expertise center temporarily will not accept new patients; clients are requested to submit their request at a later date. In addition, the care for current patients of the Euthanasia Expertise Center is suspended. Existing processes are put on hold and resumed at a later date. If euthanasia has already been agreed or promised, euthanasia can continue on condition that the group of attendees is limited to those who are absolutely necessary. Urgent case histories of current patients from the center of expertise are also dealt with, as long as a doctor and nurse are available for this. This concerns case histories of terminal patients or patients where there is an important risk that the ability to exercise will be compromised.

Unavoidable
...However, special circumstances force us to take these inevitable steps. However harsh: euthanasia care cannot be identified as a top priority in health care. The risk of infection is high and the expertise center employs ambulatory doctors and nurses who also work elsewhere. For example, they are general practitioners or work in the intensive care unit of a hospital. Other healthcare providers are retired and themselves fall under the definition of the group of "vulnerable".

Euthanasia consultants
The measures apply until April 6. The government's date is leading for the Euthanasia Expertise Center. Our euthanasia consultants continue to provide (general practitioner) doctors in the Netherlands with telephone support.

EPC has not obtained the 2019 Netherlands euthanasia report, but the 2018 Netherlands euthanasia report indicated that euthanasia had slightly dropped in 2018, likely because of the court case related to the incompetent woman who died by euthanasia, even though she had resisted. 

In the Netherlands there were 6126 reported euthanasia deaths in 2018. In 2018, the statistics included a new category where 205 people died by euthanasia based on: multiple problems derived from the aging process. I consider this category as an acceptance, in part, of euthanasia for "completed life".

Western Australian doctor recommends 'kill clinics.'

This article was published by Hope Australia on October 16, 2019.

While the suggestion that specialized “kill clinics” should be established to implement the government’s proposed euthanasia regime might sound shocking, their creation would be entirely consistent with the Bill currently before the WA Legislative Council, as well as the experience in overseas jurisdictions where euthanasia and assisted suicide have been legalised.

Dr Mal Hodsdon, a long-serving GP based in Kalgoorlie expressed his concerns that euthanasia and assisted suicide “goes against the grain” of the Hippocratic Oath taken by doctors and called putting the onus on a GP to become complicit in killing someone “a step too far.”

His radical solution is to establish a clear distinction between doctors who heal and those who kill by establishing specific death centres within the state. “I wouldn’t be prescribing the medication they need but I would be more than happy to refer them to a kill clinic at the Kalgoorlie Hospital,” he said.

While this solution might sound shocking, the legislative regime that passed through the WA Legislative Assembly and is now before the Legislative Council will pave the way for dedicated kill clinics to pop up around the state.

The doctors within these clinics would not have to have specialist qualifications in any of the terminal illnesses with which their patients may be suffering, because the proposed euthanasia laws do not require a doctor signing off on the eligibility of a patient for euthanasia have any specialised training in the illness of their patient.

A patient could also come to a ‘kill clinic’ as a one-stop shop, because the draft legislation does not require the two physicians required to sign off on a euthanasia request to be independent of each other.

Given that Dr Hodsdon also told media that he had not spoken to a GP who was in favour of euthanasia and assisted suicide, dedicated ‘kill clinics’ could even be quite profitable, given the lack of competition from doctors unwilling to contaminate their practice of healing with the prescription and administration of lethal drugs.

The notion of specialist ‘kill clinics’ or at the very least, specialist death doctors, can be inferred from the statistics in Oregon, which has had an assisted suicide regime in place for two decades.

The latest statistics from Oregon reveal that the median time of the patient-physician relationship in an assisted suicide is 10 weeks, indicating that, for the most part, the doctors who are signing off on assisted suicide are not those who have an existing relationship with the patient, but those who are specially sought out to authorize a patient’s death and prescribe them with lethal drugs. In some cases, the patient-physician relationship lasted only one week and one physician alone wrote 35 prescriptions for death-inducing drugs in a single year!

This is consistent with the most recent report from Washington State, which revealed that in 50 per cent of deaths, the doctor who prescribed the lethal drugs had known the patient for less than six months and that in some cases (the number of which was not reported), the length of the doctor-patient relationship was less than one week.

Kill clinics staffed by specialist death doctors are par for the course in states that legalize euthanasia and assisted suicide. And it will become par for the course in WA if the Legislative Council doesn’t reject this Bill.

Euthanasia advocates fund-raising for Saskatoon euthanasia clinic

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Euthanasia advocates are raising money to establish a euthanasia clinic in Saskatoon, a place that Jae Blakley, an assisted death advocate, has named Cider House.

Amanda Short, writing for the Saskatoon Star Phoenix, on September 7, 2019 reported:

Similar to hospice care, The Cider House would provide a homelike space for patients to access the procedure, staffed by either a doctor or nurse practitioner and a team of end-of-life doulas. 

Organizer Jae Blakley first started advocating for MAiD access when he was a care aide in the palliative unit of St. Paul’s Hospital.

One of the reasons Blakley wants to establish a euthanasia clinic is because the 15 bed hospice that is being built in Saskatoon is affiliated with St Paul's Hospital. Short reported:

However, according to a statement from the hospital, “Medical Assistance in Dying (MAID) is not a service that is provided at St. Paul’s Hospital. 

“If someone is considering MAID, staff at St. Paul’s will compassionately care for and support them as they make their decision and facilitate their transfer to a facility where that service can be provided,” it added.

There are euthanasia clinics in British Columbia and the euthanasia lobby has announced its intention to establish a euthanasia clinic in Toronto.