Reguest for Information Regarding Medical Aid in Dying

Letter from Senator James Lankford, Rep James L Correa and Rep Gregory F. Murphy (M.D.) to The Honorable Robert F. Kennedy, Jr. Secretary Centers for Medicare & Medicaid Services Department of Health and Human Services

June 1, 2026

RE: Request for Information Regarding Medical Aid in Dying (MAID) (CMS-1851-P) (RIN 0938-AV78)

Dear Secretary Kennedy:

We submit this comment as bipartisan, bicameral Members of Congress in response to the Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services’ (CMS) request for information regarding medical aid in dying (MAID), 91 Fed. Reg. 17338. Medically assisted suicide raises significant informed consent issues as well as concerns about disability and age discrimination. Since the vast majority of assisted suicide patients are enrolled in hospice—92% according to Oregon data and 90% according to Washington data‍1 this is problematic for HHS and CMS’ regulation of patient health and safety within the hospice program. We urge HHS and CMS to implement reporting requirements in the hospice program to monitor assisted suicide for discriminatory practices against vulnerable populations,‍2 as well as ensure compliance with the Assisted Suicide Funding Restriction Act.‍3

In 1997, the U.S. Supreme Court unanimously upheld Washington’s and New York’s bans on assisted suicide in Washington v. Glucksberg and Vacco v. Quill.‍4 The majority opinions found that there is no right to assisted suicide under the Due Process or Equal Protection Clauses.‍5 Justice Sandra Day O’Connor concurred, joined by Justice Ruth Bader Ginsburg and Justice Stephen Breyer, expressing concern about “the risk that a dying patient’s request for assistance in ending his or her life might not be truly voluntary.”‍6 Nearly thirty years of assisted suicide practice in the United States has not alleviated that concern.

Currently, thirteen states plus the District of Columbia permit assisted suicide.‍7 These laws permit certain medical practitioners to prescribe drugs at lethal dosages to a patient that is, among other criteria, eighteen years or older and “terminally ill” with a six month or less prognosis, with or without care, so that the patient may self-administer the drugs.‍8 Yet, as the National Council on Disability warns, under assisted suicide laws, “some people’s lives, particularly those of people with disabilities, will be ended without their fully informed and free consent, through mistakes, abuse, insufficient knowledge, and the unjust lack of better options.”‍9

There are grave informed consent issues within assisted suicide. Doctor shopping is rampant; Oregon data indicates the median patient-physician relationship is four weeks, with some relationships ranging as little as zero weeks.‍10 Mental health referrals are practically nonexistent, as only 0.5% of patients received them, even though many assisted suicide patients show signs of depression, which can impair the decision-making process.‍11 On top of this, “it is common for medical prognoses of a short life expectancy to be wrong,” and under the definition of terminal illness in assisted suicide laws, “[t]here is no requirement that the doctors consider the likely impact of medical treatment, counseling, and other supports on survival.”12

Assisted suicide drugs are experimental. The Food and Drug Administration (FDA) does not approve compounded drugs,‍13 which are commonly used in assisted suicide,‍14 and the FDA could never approve drugs indicated for assisted suicide because they are not “safe” for purposes of the Federal Food, Drug, and Cosmetic Act.‍15 As The Atlantic reported in 2019, “[i]n states where the practice is legal, state governments provide guidance about which patients qualify, but say nothing about which drugs to prescribe.”‍16 With “no government-approved clinical drug trial, and no Institutional Review Board oversight,” assisted suicide drug prescribers are left to experiment directly on end-of-life patients.‍17

Disability issues arise in assisted suicide. An individual with terminal illness meets the definition of a physical disability under the Americans with Disabilities Act and the Rehabilitation Act.‍18 In fact, individuals with disabilities and disability rights groups have raised this argument and alleged assisted suicide laws violate federal disability rights laws in litigation across the country.‍19 Patients seeking assisted suicide commonly request assisted suicide, not due to pain or concerns about future pain, but for disability-related reasons, citing concerns about “loss of autonomy,” being “less able to engage in activities,” and “loss of dignity.”‍20 Consequently, assisted suicide stigmatizes disabilities, and sends the message that the lives of persons with disabilities are less valued in society.

Age discrimination and elder abuse are also concerns within assisted suicide practices. Most assisted suicide patients are age 65 or older (88.3% under Oregon data and 86.2% under Washington data).‍21 Although assisted suicide laws require two witnesses to the lethal drug request, most states only require one witness to be disinterested, meaning, one of these witnesses may be a beneficiary to the patient’s will or life insurance policy.‍22 Assisted suicide laws do not require a prescriber or any witnesses to be present when the patient self-administers the drugs.‍23 Especially with patient age and education demographics—most patients are well educated—these circumstances are “consistent with elder abuse” and possible financial exploitation.‍24

Assisted suicide undermines America’s national posture of suicide prevention. America is facing an epidemic of suicide. In 2024, we lost more than 50,000 Americans to suicide and over 1.5 million Americans attempted suicide. Suicide is the eleventh leading cause of death in America and around 135 suicides occur every day on average. Additionally, over 14 million adults reported seriously considering suicide in 2024. Peer-reviewed data shows that where assisted suicide is legalized, rates of non-assisted suicide spike.25 Additionally, each year the U.S. government invests hundreds of millions of taxpayer dollars annually in suicide prevention services. States and localities spend millions each year as well. A 2024 NIH report shows that the economic cost of suicide/self-harm is estimated at $510 billion annually.26 New data shows that people living with serious and potentially life limiting health conditions are more than twice as likely to die by suicide compared with the general population.27 Assisted suicide undermines suicide prevention services, normalizes premature death for vulnerable populations, undermines their sense of autonomy and dignity, and pushes society away from robust care, support, and the protection of life.

Congress has restricted federal funding for assisted suicide and protected conscientious objections to the practice. The Assisted Suicide Funding Restriction Act broadly limits federal funds from “paying (directly or indirectly)” for the provision of “any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.”‍28 This prohibition extends to a “pay[ment] . . . for such an item or service” and a “pay[ment] (in whole or in part) for health benefit coverage” related to the coverage or expenses of “such an item or service.”‍29 The Affordable Care Act also provides anti-discrimination protections for an individual or institutional health care entity that does not participate in “assisted suicide, euthanasia, or mercy killing.”‍30

As you consider the assisted suicide issue further, we recommend you use the statutory language, “assisted suicide, euthanasia, or mercy killing,” which is more precise than “MAID.”‍31 “MAID” includes both assisted suicide and euthanasia,‍32 even though no jurisdiction in the United States permits euthanasia.

We also request that you establish reporting requirements within hospice programs regarding assisted suicide. In doing so, please consider monitoring assisted suicide practices for the following:

• Discrimination against individuals with disabilities, older persons, and other vulnerable groups; Eligibility of patients solely due to an eating disorder;‍33
• Proper disposal of unused medication and prevention of drug diversion;‍34
• Insurance denials of life-sustaining medical care that offer to cover assisted suicide drugs instead;‍35
• Drug complications;
• Experimentation of assisted suicide drug compounds;
• Compliance with federal restrictions on using funds, directly or indirectly, for health care items or services for assisted suicide.

As Senators and Members of Congress who are committed to the health and safety of hospice patients, especially those in vulnerable populations, we are grateful to see HHS and CMS consider how assisted suicide practices pose discrimination and informed consent issues. We urge HHS and CMS to establish reporting requirements to monitor assisted suicide for discriminatory practices and oversee compliance with federal funding restrictions within hospice programs. All hospice patients—regardless of physical disability, mental health, eating disorder, age, or financial means—deserve compassionate end-of-life care that is free of coercion and discrimination.

Sincerely,

James Lankford
United States Senator

J. Luis Correa
Member of Congress

Gregory F. Murphy, M.D.
Member of Congress

1 Oregon Death With Dignity Act: 2025 Data Summary (Oregon Report), Or. Health Auth. 1, 9 (Apr. 1, 2026), https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le8579_25.pdf; 2024 Death with Dignity (Washington Report), Wash. State Dep’t Health 1, 1 (July 2025), https://doh.wa.gov/sites/default/files/2026-02/422-109-DeathWithDignityAct2024.pdf.
2 See 42 U.S.C. § 1395x(dd)(2)(G) (directing hospice programs to “meet[] such other requirements as the Secretary may find necessary in the interest of the health and safety of the individuals who are provided care and services by such agency or organization”).
3 See 42 U.S.C. §§ 14401 to 14408; see also 41 C.F.R. § 411.15 (q) (2025).
4 Washington v. Glucksberg, 521 U.S. 702 (1997); Vacco v. Quill, 521 U.S. 793 (1997).
5 Glucksberg, 521 U.S. at 735; Vacco, 521 U.S. at 808.
6 Glucksberg, 521 U.S. at 738.
7 Euthanasia, Cornell L. Sch. Legal Info. Inst. (Oct. 2025), https://www.law.cornell.edu/wex/euthanasia; 410 Ill. Comp. Stat. 22/1 to /999 (2026) (eff. Sept. 12, 2026); N.Y. Pub. Health Law art. 28-F, §§ 2899-d to -s (McKinney 2026) (eff. Aug. 5, 2026).
8 E.g., Or. Rev. Stat. §§ 127.800, 127.805 (2023).
9 Nat’l Council on Disability, The Danger of Assisted Suicide Laws, Bioethics & Disability Series 14–15 (2019).
10 Oregon Report, supra note 1, at 18.
11 See id. at 15.
12 Nat’l Council on Disability, supra note 9, at 21–22.
13 Human Drug Compounding Laws, U.S. Food & Drug Admin. (Dec. 17, 2024), https://www.fda.gov/drugs/humandrug-compounding/human-drug-compounding-laws.
14 See Oregon Report, supra note 1, at 22.
15 See 21 U.S.C. § 355(b)(1)(A)(i).
16 Jennie Dear, The Doctors Who Invented a New Way to Help People Die, Atlantic (Jan. 22, 2019), https://www.theatlantic.com/health/archive/2019/01/medical-aid-in-dying-medications/580591/.
17 Id.
18 See 42 U.S.C. § 12102; 29 U.S.C. § 705(9).
19 E.g., United Spinal Ass’n v. California, No. 24-2751 (9th Cir. argued Mar. 26, 2025).
20 Nat’l Council on Disability, supra note 9, at 37.
21 Oregon Report, supra note 1, at 12; Washington Report, supra note 1, at 4.
22 Margaret K. Dore, “Death With Dignity”: A Recipe for Elder Abuse and Homicide (Albeit Not by Name), 11 Marq. Elder’s Advisor 387, 388 (2012).
23 Nat’l Council on Disability, supra note 9, at 42.
24 Dore, supra note 22, at 396; see also About Abuse of Older Persons, U.S. Ctrs. for Disease Control & Prevention (Nov. 7, 2024), https://www.cdc.gov/elder-abuse/about/index.html.
25 https://sma.org/southern-medical-journal/article/how-does-legalization-of-physician-assisted-suicide-affect-ratesof-suicide/
26 https://pubmed.ncbi.nlm.nih.gov/38479565/
27https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesamongpeoplediagnosedwithseverehealthconditionsengland/2017to2020
28 42 U.S.C. § 14402(a)(1).
29 Id. § 14402(a)(2) to (3).
30 42 U.S.C. § 18113(a).
31 42 U.S.C. § 14402; 42 U.S.C. § 18113.
32 See Medical Assistance in Dying: Overview, Gov’t Can. (Aug. 27, 2025), https://www.canada.ca/en/healthcanada/services/health-services-benefits/medical-assistance-dying.html.
33 See Chelsea Roth & Catherine Cook-Cottone, Assisted Death in Eating Disorders: A Systematic Review of Cases and Clinical Rationales, Frontiers Psychiatry, July 31, 2024, at 1.
34 See Oregon Report, supra note 1, at 4 (noting 400 people died by assisted suicide in 2025, but prescribers wrote 637 prescriptions).
35 Nat’l Council on Disability, supra note 9, at 20–21.

German nurse convicted of murdering 10 patients.

German palliative care nurse convicted of murdering 10 people to reduce workload.

Alex Schadenberg
Executive Director, 

Euthanasia Prevention Coalition

A German palliative care nurse was convicted in the murders of 10 people and attempted murder of another 27 people. According to the Reuters report on November 5:

A palliative nurse was convicted on Wednesday of the murder of 10 patients with lethal injections and the attempted murder of 27 others and was handed a life sentence by a German court.

Prosecutors had argued that the nurse injected his mostly elderly patients with painkillers or sedatives to ease his workload at night.

The court found the crimes to be particularly severe and suggested this should affect the ability to be paroled after 15 years.

An article by Kim Ga-yeon for The Chosun Daily reported that:

Investigations revealed that between December 2023 and May 2024, while working at a hospital in Würselen, the man administered large doses of painkillers and sedatives to elderly patients during night shifts to reduce his workload.

Among the drugs used in the crimes was Midazolam, a sedative used in some U.S. states for executions.

A’s defense lawyer argued for acquittal, stating that it could not be conclusively determined that the victims, who had serious illnesses, died due to the drugs. The defendant claimed, “Sleep is the best medicine,” and “I only tried to take good care of the patients by putting them to sleep, and I didn’t know the drugs would be that fatal.”

The prosecution stated, “A worked without passion or motivation. He did not empathize or feel compassion for the patients. He only got annoyed when encountering patients who required a higher level of care.” They added, “Even during the trial, A showed no sign of remorse.”

The prosecution also revealed that they are investigating the possibility of unidentified victims and noted, “A may face trial again.” 

This is not the first conviction of a German nurse for murdering patients. 

Niels Högel's, a former German nurse was convicted and given a life sentence for killing 85 patients while working in two hospitals in northern Germany. Högel's was suspected in the deaths of more than 100 people.

There are many cases of medical murder that were dealt with silently in order to prevent problems within the medical system. Suspected medical murder cases are rarely reported since the medical system lacks effective oversight. When abuse is uncovered, they avoid reporting the problem to authorities based on fear of lawsuits as in the Elizabeth Wettlauffer case in Ontario.

More known cases of medical murder.

In December 2016, in Italy, an emergency room anaesthetist Leonardo Cazzaniga, 60, and nurse Laura Taroni, 40, were arrested for the deaths of at least five patients but prosecutors were examining the medical files of more than 50.

Charles Cullen, a nurse who was also a medical serial killer in the United States. known as the 'Angel of Death' murdered at least 40 patients to become one of America's worst serial killers spoke from prison to chillingly claim: 'I thought I was helping.'

Dr Michael Swango is believed to have killed 35 - 60 patients, and similar to Cullen, he was simply asked to resign, or moved to another medical center. 

Aino Nykopp-Koski is a nurse who was convicted of killing 5 patients in Finland. 

In March, 2013 Dr Virginia Soares de Souza was arrested in Brazil and is suspected of killing 300 patients. 

Then there is Dr Harold Shipman, who was convicted of killing 15 people in England but is suspected to have killed between 250 and 400 of his patients. 

Then there is the case of William Melchert-Dinkel, the Minnesota nurse who was convicted of 2 counts of assisted suicide for counselling depressed people to die by suicide.

In August 2024, Professor Christopher Lyon published a research article concerning healthcare serial killers. The information in this report must be read to understand the reality in Canada, where there are a few doctors and nurse practitioners who carry-out a high percentage of the euthanasia deaths.

Australian Coroner's report after man dies from his wife's assisted suicide drugs.

Man died ingesting his wife's lethal assisted suicide drugs.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Julius Dennis reported for ABC News Australia that:

A coroner has found Queensland's voluntary assisted dying laws are not "well-considered" after an elderly man took his own life using drugs prescribed for his partner.

Coroner David O'Connell has recommended a health professional be present every time a deadly substance is administered.

Dennis reported that Coroner O'Connell criticized the assisted suicide law after a man died taking the assisted suicide poison that was prescribed for his wife. The news article states that the man's wife was approved for assisted suicide and had received the lethal poison but on May 8 she went to the hospital where she passed away before taking the lethal substance. Her husband was required to return the medication within 14 days but he died on May 16 after ingesting it.

Dennis reported the findings by Coroner O'Connell:

Mr O'Connell said the inquest established a person underwent fewer identity checks to become a contact person than he did entering a Brisbane nightclub.

"The fact that ABC had been medically diagnosed with depression and took medication was not something the VAD authorities considered, or even enquired on, when approving them to be a Contact Person. Indeed, there are simply no checks or enquiries of the Contact Person's suitability," he said.

O'Connell found further problems with the law. Dennis reported:

Mr O'Connell said the inquest heard evidence of "a number of 'near misses' … where various people have required the intervention of a health practitioner administer a supplementary IV VAD dosage to ensure a patient's death".

This included one patient who had alcohol before taking the drug and threw up some of the substance.

O'Connell concluded that there should always be a health professional present when a person takes lethal assisted suicide drugs.

Dennis concluded the article by stating:

Health Minister Shannon Fentiman said the government would consider the coroner's recommendations.

The better response is to prohibit assisted suicide. The Euthanasia Prevention Coalition has always warned that these laws lack effective oversight. Once a person has received the lethal poison, anyone could die taking it. Also, what happens to the lethal poison when a person dies without ingesting the lethal poison?

I wonder how often this same scenario has happened in the US? Not one of the American assisted suicide laws require oversight of the law. 

A Woman who admits to killing her 7 year old son more than 40 years ago, is campaigning for euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A UK woman who admitted to killing her 7 year old son more than 40 years ago by intentionally overdosing him is campaigning for the legalization of euthanasia in the UK.

Harriett Sherwood reported for the Guardian on July 3 that:

A woman has admitted giving her terminally ill seven-year-old child a huge dose of morphine to end his suffering more than 40 years ago.

Antonya Cooper said her son Hamish had experienced “horrendous suffering and intense pain” as a result of his stage four cancer and “beastly” treatment.

“On Hamish’s last night, when he said he was in a lot of pain, I said: ‘Would you like me to remove the pain?’ and he said: ‘Yes please, mama’,” Cooper, 77, told BBC Radio Oxford.

“And through his Hickman Catheter, I gave him a large dose of morphine that did quietly end his life.”

As much as I share sympathy concerning the suffering Hamish experienced, there were other options than killing him.

Further to that, Hamish was a child, he was not capable of consenting, but even more, his mother only asked him if he wanted the pain to go away. He wasn't asked if he wanted her to kill him.

When asked by Radio Oxford if her son knew that she was going to kill him, Cooper responded:

She said: “I feel very strongly that at the point of Hamish telling me he was in pain, and asking me if I could remove his pain, he knew, he knew somewhere what was going to happen.

“But I cannot obviously tell you why or how, but I was his mother, he loved his mother, and I totally loved him, and I was not going to let him suffer, and I feel he really knew where he was going.”

She added: “It was the right thing to do. My son was facing the most horrendous suffering and intense pain, I was not going to allow him to go through that.”

As sad as this story is, it shows how dangerous it is to legalize euthanasia. Once legal, similar cases of doctors killing their patients, without consent, will happen.

Further to that, euthanasia is not legal in the UK and yet Cooper is promoting the case for expanding the law to killing children.

Hamish needed pain and symptom management. He needed care not to be killed.

Coroner examines case of Australia man who died after taking his wife's assisted suicide drugs

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Coroner in Brisbane Australia has opened an inquest into the death of a man who died after taking the assisted suicide drugs that were prescribed to the man's wife.

An ABC News report by Rachel Riga published on September 25, 2023 stated:

The ABC understands the man's wife had met the criteria and had been given the medication but she was admitted to hospital.

She passed away in hospital before taking the VAD substance.

Her husband was required to return the medication within 14 days but consumed it instead.

A recent article by Rex Martinich and published by AAP news Australia stated:

The Coroners Court in Brisbane today opened the inquest into the May 2023 death of a man aged in his 80s referred to by the pseudonym ABC.

ABC's name and those of his family members along with many other details surrounding his death cannot be published for legal reasons.

The substance involved in ABC's death was obtained legally after Queensland allowed voluntary assisted dying (VAD) in January 2023.

Under that law, a person can self-administer a VAD substance in a private location but they must nominate a person who will be legally required to return any unused or leftover portion within 14 days.

Coroner David O'Connell heard ABC kept the VAD substance in his home after it was no longer required for another person.

The issue of the State regulations was discussed:

O'Connell said he was concerned regulations around self-administering VAD could allow other people without a terminal illness to be physically harmed or suffer mental distress.

 

"We've got medication safety and patient autonomy; we've got to find where the pendulum swings to get the balance right," he said.

 

The nurse said VAD substances in a hospital were kept in a locked cabinet that required two keys to access but were not monitored after a patient took possession.

April Freeman, the lawyer for Queensland Health asked the nurse if pain medications in lethal amounts are ever given out. The nurse responded:

 it was not uncommon and she was not aware of health authorities having control over those drugs once they were handed to patients.

The Coroner's inquiry will continue. 

• Man dies after taking wife's assisted suicide drugs (Link).

Kenneth Law charged with 14 counts of second-degree murder.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Canadian man who was charged on May 9, 2023 with two counts of aiding and abetting suicide in the Peel Region, allegedly through the online sales of a legal substance that is lethal in high doses, has now been officially charged with 14 counts of second-degree murder.

CBC News Toronto reported on December 12 that:

Law was charged with 14 counts of second-degree murder, in addition to the 14 counts of counselling or aiding suicide that he was already facing.

CBC News Toronto stated that York Regional Police Insp. Simon James, who heads up a multi-service task force investigating Law confirmed the charges at a news conference today. The new charges are related to the same alleged victims in multiple Ontario municipalities, from Toronto to Thunder Bay.

Imogen Nunn

On August 27, 2023 Jon Woodward reported for CP 24 that:

The British mom of a TikTok star is coming forward demanding justice after she found out her daughter died using a so-called suicide kit allegedly sold by a Canadian man, as deaths possibly tied to Kenneth Law rise to over 100.

Louise Nunn said it was sickening to learn that the death of her daughter Imogen, known as “Deaf Immy” to 710,000 TikTok followers, was one of 88 British people local police say died after ordering products from Law’s websites over a two-year period.

Nunn said it was heartbreaking to learn of other deaths months and years before Imogen’s, and believes many lives could have been saved if authorities had acted earlier.

Charges against Law include a 16-year-old suicide death in Ontario. CBC News reported on May 8 that 17-year-old Anthony Jones from Michigan allegedly died in connection to Law's suicide kit.

Law appeared for a bail hearing on Friday August 25, 2023 and pled not guilty. Woodward reported:

Police in Canada have warned about the websites, allegedly run by Mississauga’s Kenneth Law, ...Peel Police said at the time of his arrest that they had tracked some 1,200 products to 40 countries.

Law claims that he is innocent of the charges and had no control over what people did with his suicide substance. Law was selling a legal product, that was packaged in a lethal dose but he was promoting and selling it for the alleged purpose of suicide.

Canadian man faces 12 more charges for aiding and counselling suicide.

One suicide victim was 16 years-old, another was 17.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kenneth Law

A Canadian man who was charged on May 9 with two counts of aiding and abetting the suicide deaths of two people in the Peel Region, allegedly through the online sale of a legal substance that is lethal in high concentrations, has now 12 additional charges resulting in 14 total charges for counselling/aiding suicide.

Codi Wilson, reported on August 29 for CP 24 that Kenneth Law is now facing 12 new charges in Ontario for counselling or aiding suicide. Wilson reported:

Kenneth Law, who was previously charged by Peel Regional Police with two counts of counselling or aiding suicide, now faces 12 new charges in connection with deaths in regions across Ontario.

Police said the new charges involve four deaths in Toronto, three in York Region, one in Durham Region, one in London, Ont., one in Thunder Bay, one in Waterloo, and one additional death in Peel Region. All charges will now be heard at the Newmarket courthouse, police confirmed.

At a news conference at Peel police headquarters on Tuesday, York Regional Police Insp. Simon James, who is leading the multi-jurisdictional case, told reporters that the victims range in age from 16 to 36.

On August 25, 2023 I published an article about Kenneth being investigated by UK authorities for aiding the suicide deaths of at least 88 people.

Imogen Nunn

On August 27, 2023 Jon Woodward reported for CP 24 that:

The British mom of a TikTok star is coming forward demanding justice after she found out her daughter died using a so-called suicide kit allegedly sold by a Canadian man, as deaths possibly tied to Kenneth Law rise to over 100.

Louise Nunn said it was sickening to learn that the death of her daughter Imogen, known as “Deaf Immy” to 710,000 TikTok followers, was one of 88 British people local police say died after ordering products from Law’s websites over a two-year period.

Nunn said it was heartbreaking to learn of other deaths months and years before Imogen’s, and believes many lives could have been saved if authorities had acted earlier.

The new charges include a 16-year-old suicide death in Ontario. CBC News reported on May 8 that 17-year-old Anthony Jones from Michigan allegedly died in connection to Law's suicide kit.

Law appeared for a bail hearing on Friday August 25, 2023 and pled not guilty. Woodward reported that:

Police in Canada have warned about the websites, allegedly run by Mississauga’s Kenneth Law, ...Peel Police said at the time of his arrest that they had tracked some 1,200 products to 40 countries.

Wilson's report stated:

While Peel police first began their investigation in the spring, James said it is believed that Law started operating the websites sometime in late 2020.

Law claims that he is innocent of the charges and had no control over what people did with his suicide packages. Law was selling a legal product, but he was packaging it in a lethal dose and he was promoting and selling it for the alleged purpose of suicide.

Possibly hundreds of deaths could have been prevented if Canadian authorities had stopped the sale of the suicide kits when they first learned of the websites and the suicide deaths.

US Drug Enforcement Administration (DEA) consultations on prescribing controlled substances by Telehealth.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition  opposes the dangerous practice of assisted suicide by telehealth.

The US Drug Enforcement Administration continues the consultation on their proposed rules for prescribing controlled substances via telehealth. Listening sessions have been organized by the DEA for September 12 & 13, 2023 to hear all issues and concerns related to requiring an in-person visit before a physician can prescribe Schedule II controlled substances.

The Drug Enforcement Administration (DEA) began their consultation on February 24, 2023 on the proposed rules for prescribing controlled substances via telehealth. The proposed rule states that when a person has not seen a medical practitioner and requires a prescription for Schedule II medications or narcotics, the prescription cannot be made via telehealth and the patient will be required to see a medical practitioner in person before receiving the prescription.

The proposed rules are important. The assisted suicide lobby wants to approve assisted suicide drug cocktail prescriptions without directly meeting with or examining the person. They also want to have the lethal drug cocktail sent to the person by courier.

Kristen Senz reported for The Journalists Resource on April 17 that the DEA approved the new guidelines and that it will go into effect on May 1.

The proposed DEA rules states that Schedule II controlled substances will require an in-person visit. Patients being treated for opioid use disorder can be prescribed via telemedicine but they will be required to have an in-person visit within 30 days of receiving a prescription for buprenorphine (Suboxone, Zubsolv, and Sublocade) via telemedicine, to obtain refills.

But the story doesn't end there. 

Based on a massive response by the US assisted suicide lobby the DEA placed their guidelines on hold for six months. The assisted suicide lobby emphasized the need for emergency prescriptions for pain medications needed for palliative care.

The Euthanasia Prevention Coalition opposes the dangerous practice of assisted suicide by telehealth and supports the DEA proposed guidelines that were approved in April.

If the DEA decides to compromise their position, they should state that it is dangerous and unethical to prescribe assisted suicide drug cocktails by telehealth.

The DEA rules are based on reducing the opioid crisis to make it more difficult for people to obtain Schedule II controlled substances for resale. 

Previous articles:

• The US Drug Administration tightens regulations on Schedule II Controlled Substances (Link). 
• Help EPC stop assisted suicide by Telehealth (Link).
  

Wisconsin woman charged with using euthanasia drugs in alleged attempted homicide of husband.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Amanda Chapin

A Wisconsin woman has been charged with attempted first-degree homicide for allegedly poisoning her husband three times with veterinary euthanasia drugs.

A January 5, 2023 Associated Press story explained that Amanda Chapin (50) was charged for allegedly attempting to poison her husband, Gary Chapin (70), a veterinarian. The story states:

According to a criminal complaint, the couple got married in March. Following the wedding, Amanda Chapin forged the signature of one of her husband’s children on a power-of-attorney document, then demanded her husband amend his house deed so she would get the home if he died. The complaint says she poisoned her husband for the first time less than three weeks after the quit claim deed on the house was authorized.

The third time he drank the allegedly poisoned coffee, in early August, he fell into a coma that lasted for four days, the complaint said. Blood work showed barbiturates in his system came from drugs he used to euthanize animals.

Gary Chapin’s son subsequently filed a restraining order against Amanda Chapin on his father’s behalf, and Gary Chapin has filed for divorce, according to online court records.

I also published an article on a case in Colorado where a man accidentally ingested lethal assisted suicide drugs. As much as this story concerns an alleged attempted homicide, the story proves how euthanasia drugs can be used for homicide.

Similar recent stories:

• Netherlands man arrested for selling suicide powder resulting in at least 4 deaths (Link).
• Father of 19-year-old who died by suicide powder wants it banned (Link).
• Australian woman charged with killing her millionaire boyfriend (Link).
  

Lethal assisted suicide drugs were accidentally ingested in Colorado.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I was cleaning up my emails and found a report that was published in the Journal of Emergency Medical Services on November 29, 2022 titled: Death with Dignty: When the Medical Aid in Dying cocktail gets into the Wrong Hands. 

The report concerns an emergency whereby a 35-year-old man in Colorado self-administered part of a lethal cocktail of assisted suicide drugs. The report states:

Ambulance 64 is dispatched to a 35-year-old male with possible alcohol overdose. Upon arrival, the crew is directed to a back bedroom where they find two fully clothed males with their legs hanging off a bed. One is elderly, the other is middle aged. Both are unconscious and unresponsive with shallow respirations. A bystander hands a medicine bottle to the attending paramedic frantically saying, “They drank this! They drank this!” The bottle contains digoxin 100 mg, diazepam 1,000 mg, morphine 15,000 mg, amitriptyline 8,000 mg and phenobarbital 5,000 mg. She remarks that the older man “should be dead” and the younger one “should be alive.”

The bystander states that the older man is a “death with dignity” patient who invited loved ones to be present while he consumed the MAID medication. After his first swallow, he remarked, “Man that burns!” The younger man said, “Let me see,” and then also took a swallow. The attending paramedic directs rescuers to begin ventilating the younger man while requesting evidence of advance directives for the older man. Care was not rendered to the death with dignity patient because he had a valid Medical Orders for Scope of Treatment (MOST) form stating he wanted no lifesaving measures performed on him. The medication bottle was prescribed to the patient. Hospice was contacted to verify he was a terminally ill patient of theirs. Medical control was also contacted for a consult because this was not a typical call.

The younger male patient is found to be atraumatic. His skin signs were significant for cyanosis but otherwise warm and dry. Pupils were constricted, equal and reactive. Without ventilations, his respiratory effort is 6; Sp02 was 72%. The patient is placed on a cardiac monitor and the heart rate is recorded at 144 bpm, blood pressure is auscultated and found to be 134/96 mmHg. Blood glucose is 172 mg/dl. Intravenous access is achieved with a 16-gauge catheter placed in his right external jugular vein. After there is no change in the patient’s presentation following Narcan 2 mg via IV, he is endotracheal intubated. End tidal carbon dioxide is then measured at 56 mmHg. The receiving facility is notified that a patient with a massive polypharmacy ingestion is en route.

...This challenging case is an excellent illustration of the importance of prehospital providers to have an understanding of end-of-life-care as it pertains to advanced directives and to be aware they may practice in an area where they encounter patients who may be in a MAID program. In this case, the paramedic had to juggle a complicated scene with two potential patients who both were near death. Education regarding such programs should be a priority to EMS agencies, as is how to handle instances where family members are requesting that no resuscitation be attempted and either advance directives are not in place, or copies of them cannot be located.

The report continues with information about the recovery of the man who self-administered the lethal cocktail without legal permission and it then concludes:

Should accidental ingestion occur, care is mainly supportive. The patient should be placed on a cardiac monitor and have a 12-lead rhythm strip to evaluate for QRS prolongation and consideration of sodium bicarbonate administration. Continuous pulse oximetry monitoring and assisting ventilation as necessary is indicated. If necessary, placement of advanced airway with assisted ventilations with BVM and confirmation by end-tidal CO2 is appropriate. Intravenous or intraosseous access should be obtained and intravenous fluids can be administered if the patient is hypotensive. Naloxone can be trialed, although may not have much effect given the high dose of opiates in the compound. Consideration may be made for transport to an ECMO capable facility.

The US states that have legalized assisted suicide have done so in a completely irresponsible manner. Prescribing a lethal cocktail of drugs for suicide is always ethically wrong, but to do so without monitoring is irresponsible.

Is it possible that a grand child could find the lethal assisted suicide cocktail by the bed side or in the medicine cabinet? What happens to the lethal drugs that are not consumed?

The concept of freedom to choose to die is a lie. People don't ask for a lethal drug cocktail to express their freedom but rather it is a reaction to a social abandonment that has left them feeling that there is no hope, purpose or value to continuing life.

Infant euthanasia. Is history repeating itself?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The presentation by Dr Louis Roy for the Québec College of Physicians to The Special Joint Committee on MAiD on September 7 urging Canada's Federal government to adopt a protocol to permit infant euthanasia I wondered if our society has forgotten its history? Have we forgotten how eugenic attitudes led to the destruction of the lives of thousands of people with disabilities?

Many people believe that the German T4 Euthanasia Program was based on a unique evil Nazi ideology. However,the eugenic ideology was a socially and politically successful movement that existed throughout Europe and North America beginning in the nineteenth century. Books, such as "The Right to Death" (1895) promoted by the eugenics movement led to the writing of "The Permission to Destroy Life Unworthy of Life" (1920) by Karl Binding and Alfred Hoche. Binding and Hoche justified the killing of people who were "incurably sick, feeble minded, retarded, deformed, etc." and became the handbook for the eugenics movement in Germany.

The Nazi euthanasia program was launched in 1939 after Adolf Hitler received a letter from Richard Kretschmar, the father of an infant (referred to as "Case K" or the 'Knauer child'). Historians now know that the child was Gerhard Herbert Kretschmar.

The letter stated that Gerhard was born on February 20, 1939, that he was blind, had one leg and part of one arm was missing and was described as "an idiot". Hitler sent his personal physician, Karl Brant, to see the child in a hospital in Leipzig. Brant testified at the Nurembourg trial that he had been instructed that if the father's letter was correct that the physicians at the hospital would be told that euthanasia could be carried out - in Hitler's name. Gerhard was euthanized on July 25, 1939.

History indicates that the German T4 euthanasia program began with a parent's request for euthanasia and in the end resulted in the deaths of 250,000 to 275,000 people with disabilities.

Further to that, the technique killing large numbers of people by gassing them to death was first developed in the psychiatric hospitals for the euthanasia program and later installed in the death camps for killing millions of people. According to the Holocaust Museum, T-4 staff were redeployed to the death camps.

The holocaust museum states the following:

Hitler's authorization

In October 1939, after Adolf Hitler authorized “mercy deaths” for patients deemed “incurable,” the murder program expanded from children to adults. Operation T-4—referring to the address of the secret program’s headquarters at Tiergartenstrasse 4, Berlin—mostly targeted adult patients in private, state, and church-run institutions. Individuals judged unproductive were particularly vulnerable. From January 1940 to August 1941, more than 70,000 men and women were transported to one of six specially staffed facilities in Germany and Austria and killed by carbon monoxide poisoning in gas chambers disguised as showers. Growing public awareness and unrest over the killings influenced Hitler to halt the gassing program. Euthanasia murders resumed in other guises; patients were killed by means of starvation diets and overdoses of medication in hospitals and mental institutions throughout the country. From 1939 to 1945, an estimated 250,000 persons were killed in the various euthanasia programs.

The eugenics archive provides some data on the T-4 euthanasia deaths.

The numbers killed in the initial phase, code-named “T4” (after the administrative office at Tiergartenstrasse 4), amount to (according to one set of records) 70,273 persons. The killings were ordered on the basis of medical records sent to the clandestine panel of adjudicating psychiatrists at the central office in Berlin. So-called schizophrenics made up 58% of the victims, and there was a slightly higher proportion of women killed. There were 6 gassing facilities in Germany and former Austria (Brandenburg – replaced by Bernburg, Grafeneck, Hartheim, Pirna-Sonnenstein, and Hadamar).

A New York Times article by Kenny Fries attempting to identify the first date for the mass killing states that the exact date of the "test killing" was not recorded and no records were kept for the first mass killing by gassing. This is an historical concern but Fries makes an interesting comment that:

Unlike the Holocaust, there are no T4 survivors. We know about T4 and its aftermath mainly through medical records and from the perpetrators. Aktion T4 does not have its Elie Wiesel or Primo Levi.

The eugenic T4 euthanasia program that began in 1939 was based on the same ideology as the Quebec College of Physicians justificed to The Special Joint Committee on MAiD.

To further my concerns, an article written by Michael Higgins and published by the National Post on November 22 clarifies the position of the Quebec College of Physicians concerning infant euthanasia. Higgins wrote:

The president of the Quebec College of Physicians wants to explore the prospect of euthanizing suffering babies and believes it’s nobody’s business but doctors’. 

To be fair, Dr. Mauril Gaudreault would let parents have a say as well, so he’s not being totally arrogant.

Gaudreault’s rather obscene suggestion illustrates just how far down the slippery slope we have plunged when it comes to mercy killing, euthanasia, Medical Assistance in Dying (MAID), call it what you will.

The concept of eugenics is sadly, alive and well. Peter Singer and Udo Schukelenk, for instance, are popular philosophers who promote a eugenic ideology.

It takes one bad case to approve a bad law. It takes a bad law to change a culture.

Once a culture decides that there are some lives that are not worth living and decides to kill those people, then everything changes.

Infants cannot request or consent to being killed. If infant euthanasia is approved it may lead to the approval of euthanasia for other people who cannot request or consent to being killed. People with dementia who never requested or indicated an interest in euthanasia could also be approved to be killed.

The Euthanasia Prevention Coalition opposes all forms of euthanasia and assisted suicide, nonetheless, it is clear that expanding killing to babies (infanticide) negates the "safeguard" that only people who can capably request to die can be approved for death.

The question we ask in society changes from - Is it right for one person to be given the right to kill another? - to When is it right for one person to be given the right to kill another?

This is a eugenic ideology that can only lead to the destruction of many lives which are deemed life unworthy of life. 

Is history repeating itself?

Learn more, visit the websites: United States Holocaust Museum, The eugenics archive, and the Holocaust Education & Archive Research Team which shows that the propaganda portrayed support the same eugenic ideas and goals as the eugenic movement in the late 19th and early 20th Century promoted and led to the Nazi Euthanasia Program.

Dr. Husel Acquitted in 14 alleged overdose deaths in Ohio – What Happened?

Sara Buscher is a lawyer and
Chair, Euthanasia Prevention Coalition USA

On April 20, 2022 an Ohio jury acquitted former doctor William Husel of intentionally murdering 14 patients with extremely large and lethal doses of fentanyl. Some claim his acquittal means doctors are free to deliberately overdose patients to hasten their deaths. Apparently, they are unaware he has lost his medical license and still faces civil suits brought by the patients’ families.

Husel worked in the Intensive Care Unit of an inner city hospital in Columbus, Ohio where he ordered lethal doses of fentanyl (500 to 2,000 micrograms) be given to patients, all of whom died within 12 minutes. He was indicted by a Grand Jury for 25 counts of intentional murder. The Prosecution went to trial on 14 counts after Husel refused a plea deal for up to ten counts of reckless homicide. Near the end of the trial, the Prosecution asked the judge to include charges of negligent homicide as “lesser included” offenses. The Defense would not agree, so the judge ruled it was too late to include them for the jury’s consideration.

In a May 10 People Magazine interview Husel said he would prescribe the same doses now for patients. After the trial the Ohio State Medical Board permanently and irreversibly revoked his medical license, which he agreed to surrender. In 2019, the Board had suspended his license after finding his extremely excessive doses of fentanyl and painkillers created a public danger that clearly and convincingly violated the Ohio Medical Practices Act.

Lawyers for the families say, “It would be incorrect to assume that the criminal verdict means Husel cannot be held liable in civil court for his actions…. How did that work for O.J. Simpson?”

The law typically uses three different burdens of proof and all are at play here. To find a person guilty of a crime, the burden is “beyond a reasonable doubt” which you can think of as being 99% certain the defendant is guilty. The Medical Board used the “clear and convincing” standard or about 75% certainty and the civil suits use “a preponderance of the evidence” standard which is anything beyond 50%.

Reasons for acquittal relate to the elements of intentional murder that must be proven under Ohio law: having a purpose to cause death and actually causing the death.

Prosecutors typically overcharge because 90% of criminal cases are pleaded out rather than going to trial. So they overcharge and then plead the case down for an appropriate charge. In Husel, the prosecutor charged intentional murder, would have plead out for reckless homicide and would have given the jury the option of a guilty verdict on negligent homicide. Each degree of guilt is easier to prove and carries a lower penalty. By refusing to deal, Husel forced the Prosecution to prove Husel intended to kill his patients.

The Defense successfully confused the jury into believing the Prosecution had to prove Husel had a motive for killing his patients. Motive is the why-- the reason a person commits a crime. It is never an element that has to be proven. Intent is not the same as motive. Intent means the actor decided to purposely do something criminal. Here, Husel decided to give drugs that would cause deaths. We don't know why he did it. He said he did it to provide comfort care, yet the Prosecution’s expert said Husel’s doses were 5 to 10 times the amount needed to provide comfort. So, he obviously didn’t do it to provide comfort. Maybe he gets a thrill from killing. Maybe he was trying to churn beds faster. Who knows? In any event, the jury struggled with “intent.”

In a May 10 interview with jurors, the Columbus Dispatch reported:

“A juror said ‘he believes Husel was guilty, but said the Prosecution failed to prove its case. The question of intent was just really hard to find beyond a reasonable doubt… and that was a hard, hard burden.’… ‘My honest opinion — that dude is guilty as hell. The Prosecution didn't prove it…. Everyone in that [jury] room felt those (fentanyl) doses (Husel ordered) were insane. We all said that. I believe in my heart that he was guilty of at least four or five that you could actually prove [the hospital’s initial investigation concluded five could have recovered with treatment], but what I feel isn't what we had to go on. The Prosecution just didn't prove intent.’”

Ohio’s intentional murder statute uses the strictest, hardest to prove definition of intent to kill: “the person's specific intention to cause a certain result (e.g., death)”. Other states allow intent to be proven using a “knowingly” standard – “knows or is aware his or her conduct is practically certain to cause the result.” Here, Husel said his intent was to provide comfort to people who were already dying. And, here, the evidence was clear the doses he gave were practically certain to cause death. In my opinion, he would have been convicted under a “knowingly” definition of intent.

The Defense also raised doubts about what caused the people to die. Their expert testified all of these people died from their illnesses. The Prosecution did not call a rebuttal witness. All of the patients were on life support that their families had agreed to have withdrawn. All died in 12 minutes or less after receiving the fentanyl. The question that was left unanswered was whether they died from the withdrawal of life support before the fentanyl would have killed them. Hopefully, the civil suits will shed more light on this.

Article: Dr Wes Ely comments on the acquittal of Dr William Husel (Link).

Dr Wes Ely comments on the acquittal of Dr William Husel in the overdose deaths of 14 patients.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Wes Ely will be featured in an EPC zoom meeting on May 9 at 4 pm (EST). Dr Ely will speak about the Husel case and the proper use of opioids (Registration Link) 

Dr Wes Ely

Recently a jury found Dr. William Husel NOT Guilty on All 14 Counts of Murder, we learn that, after deliberating for five days, the jury found former physician William Husel not guilty of murder after overdosing patients with fentanyl and benzodiazepines. Husel claimed he was providing "comfort care" even though the doses of drugs were determined to be lethal, the defense claimed that he did not have "intent" to kill.

Charlie Camosy interviewed Dr. Wes Ely who was an expert witness in the Husel trial, a professor at Vanderbilt University Medical Center and the associate director of aging research for the Tennessee Valley Veteran’s Affairs Geriatric Research Education Clinical Center. 

The following comments by Dr Ely create significant concern about the jury's decision in the Husel trial. Dr Ely responded to Camosy about the verdict by stating:

I want to trust the justice system and I want to know that in the United States, that a jury of our peers can make good and well informed decisions that we can live by and achieve justice in our society.

On the other hand, this is a physician who we absolutely know gave upwards of one to 3,000 micrograms of fentanyl to 14 people, actually 25 people, but only 14 were taken to trial.

That amount of medication completely stops the brain from sending signals to breathe so that we would stop breathing at all if we get that amount of a narcotic opioid. In addition to that, with high doses of fentanyl like that in the operating room, we see very tight chest wall muscles so that we physically can’t breathe, even if you want to.

Camosy then asks Dr Ely - did these overdoses kill.

I think that these doses did kill these people. They were very critically ill people, and, yes, they were dying, but we are all dying over time. The patients weren’t going to die in 12 minutes, which was the average time to death after the drugs were injected.

At the end of the day, these actions taken by Dr. Husel, and I testified very clearly on this, did shorten these people’s lives, I think, without any degree of uncertainty.

And so I have mixed emotions because my gut and instinct as a physician and as a person goes against the decision that was made by the jury. However, I will accept the decision, while at the same time hoping for some reforms to prevent this from happening again.

In his conclusion Dr Ely states:

The case of William Husel is a breach of our understanding of truth, in that I think Dr. Husel was giving lethal doses of medications in the name of palliative care. And when he was not found guilty by a jury of his peers, the worry that I have is that it will give other people license to go about giving these sorts of euthanasia style doses to other human beings, even when the patients haven’t asked for it. 

Dr Wes Ely will be featured in a EPC zoom meeting on May 9 at 4 pm (EST). Dr Ely will speak about the Husel case and the proper use of opioids (Registration Link)