Assisted suicide for anorexia. Anorexia is not a death sentence — I am living proof of this.

The following vignette was published by the Patients Rights Council. 

Link to the PDF of this story (Link).

Heather Weininger

“My name is Heather Weininger and I am from Green Bay, Wisconsin. I’m a wife, mom, and executive director of a non-profit organization. I have it all, but years ago it could have all been taken away from me instantly. I would have gladly sought out physician-assisted suicide had it been available for anorexia back in the mid-1990s. I would have done so because the anorexia I experienced is not just a physical illness; it begins with mental health. As I sought not to nourish my body, my mind was also not being fed. I suffered from severe depression. So much so that one night I reached out to my sister and told her I wanted my life to be over. Thankfully, she reached out to my parents who were there the next day, taking me away to seek help. My struggle with anorexia did not happen overnight.

For years, I suffered but could always pass it off as something else. I wasn’t hungry; I was too busy to eat, etc. Over time, it took a toll on my body and mind. I went off to college and then I spiraled out of control. I would get it back together and then, I hit rock bottom which was the day I called my sister. I thought I wanted it to be over but reached out for help instead. Because I was over 18 at the time, I was in control of deciding what to do for care. The help my parents found included many facets. I needed to address my depression, my obsessive-compulsive issues, and then we could begin to address my challenges with food. I fought it. I wouldn’t say I liked it. I was angry at people. It was very difficult but with the help of professionals, I was able to overcome my depression, use tools to help with my eating, and know the warning signs of slipping back into old patterns. I was able to go to therapy and address my issues. It took months. I took medication to help with my depression. I overcame that depression and then was also able to learn to cope without medication.

We have already opened pandora’s box to physician-assisted suicide for ‘terminal illness.’ Now, I am distraught to learn it is being extended to anorexia in Oregon and Colorado. I shudder to think what would have happened if my family had not responded with help. What about others who don’t reach out for help, or don’t have a family willing to support? Anorexia is not a death sentence — I am living proof of this. Let us be the ones who are hearing the call for help with those struggling, as I did. Mental illness cannot be a reason for handing death to an individual so easily. I would not be the happy, thriving person I am today if it were. So, what other ‘illnesses’ are people willing to add to the life list that aren’t worth protecting? Rather than looking for a quick and easy out for someone who is suffering, what if we look at ways to help those needing the same kind of help that I did? If it weren’t for my family, who became my advocates, I would not be able to share my story with you. My advocates sought care, sought life and I am so grateful to have the outcome I did.

Now that anorexia is added to the list of reasons to grant physician-assisted suicide, I wonder how many other Heathers are out there who will instead take the out of physician-assisted suicide and not have a full life ahead of them.”

More articles on the topic of assisted suicide for anorexia. 

• Assisted suicide for anorexia violates the law (Link). 
• Assisted suicide for anorexia expands assisted suicide from terminal conditions to chronic conditions (Link).
  

Canada is NOT As Advertised. MAiD Is Eugenics.

Published by Gabrielle Peters, as speaking notes from her presentation at the United Nations Convention on the Rights of Persons with Disabilities (COSP15). Peters is a disability rights leader and expert on issues related to disability and Canada's MAiD law.

Speaking note for Canary in a Coalmine side event for COSP15 

Thank you. It is an honour to speak here today. We have very little time and so much to discuss so I will get right to the point. 

Canada is not as advertised. 

The myths and marketing that make up Canada’s international image insulate the Canadian government from the scrutiny and criticism its expansion of assisted suicide warrants.

Support for MAiD (Medical Assistance in Dying) relies heavily on Canada’s reputation as a champion of human rights and assumption that the external enabling conditions necessary for supporting autonomy exist here. 

The fight around MAiD is one for robust autonomy but not as the proponents of MAiD suggest. In reality the same institutions and professions that regularly deny us autonomy over our lives, disingenuously pretend to champion it over our deaths. We urge you to ask why.

In their rhetoric the proponents of Canada’s assisted suicide argue that the state should not impede anyone’s right to choose to die.

There are three deliberate falsehoods in their assertion.

The first is that MAiD is a negative freedom – meaning that the state agree not to interfere in a person’s ending of their own life. 

In truth, MAiD is a positive freedom. The state is providing death as a service.

This obfuscation of the state’s role in causing the death, not merely failing to inhibiting it, contributes to the lack of critical examination it receives. As a result, even the people who would oppose capital punishment in instances where the murderer confessed and requested it, remain silent about MAiD.

MAiD is fully covered under Canada’s healthcare system. 

This is significant given what is not covered under Canada’s healthcare, the barriers to accessing life-sustaining treatments and how ableism, racism, poverty and other intersecting oppressions impact medical diagnosis, treatment and outcomes. 

And it is especially significant since unlike other countries where euthanasia is legalized, Canada does not require that alternative options be made available.

Which leads us to the second falsehood – the claim  that MAiD exists within a framework of real choice. 

Canada’s universal healthcare system is in fact not universal. 

It covers some parts of the body and not others, some aspects of healthcare and not others. 

The ableist bias also extends to how it is practiced and delivered as well as in the use of the Quality Adjusted Life Years formula. 

Significant variations in availability of care and coverage occur not only from province to province but urban versus rural areas and regionally from north versus south. 

A 2018 study published in the Journal of the American Medical Association, ranked Canada 10th out of 11 well-off nations in terms of public spending on health as a percentage of GDP. 

• 30 percent of health spending in Canada is private.  
• In 1976, Canada had 6.9 hospital beds per 1,000 people.  
• By 2019 that number had shrunk to 2.5. 

Now, our chronically starved healthcare system is in crisis. 

One of the people involved in crafting Canada’s healthcare rationing protocols, Dr. Eike-Henner Kluge, has argued that parents of disabled children should be given the right to request their child be euthanized. He is also responsible for establishing the Canadian Medical Association’s Department of Ethics. 

Election campaigns are run on dehumanizing people with mental illness and promises to round up and re-institutionalize disabled people who are homeless. 

Disabled people, especially those who are Indigenous or Black, are killed by police conducting “wellness checks.” 

To this day, a significant number of disabled people under the age of 65, are forced into long term care due to absence of affordable and accessible housing and the non-existence of community support. This is what led a disabled man named Sean Tagert to apply for and receive MAiD.

Canada is also a country of great wealth inequality.

According to the Parliamentary Budget Officer 2020 report, the top 1% of Canadian households hold 25.6% of total wealth in the country while the bottom 40 percent possess roughly 1.2 percent.

41 percent of people living at low income level are disabled. 

Disability benefits vary by province but all are far below the poverty line – a poverty line that, according to recent research, has an ableist bias and ignores the increased costs associated with living as a disabled person in an ableist society. 

This means many disabled people regularly experience periods of hunger, go without medications or other essentials of life.

In Canada, the state provision of death exists in a landscape of denial of rights, care and deliberate deprivation and therefore acts as a coercive power against disabled people instead of enabling our autonomy or providing us with choice.

And this leads us to the third and final falsehood in their argument. MAID for those not near end of life is not available to just “anyone.” It is available solely to disabled people. 

Ableism is embedded in Canada’s history and has been codified and institutionalized into every aspect of our society. 

The ideological beliefs and systems that supported and arose out of colonialism and white supremacy, including eugenics, never ended. They were just rebranded. 

The elimination of the end of life requirement and broad expansion of MAiD depends on a belief that Canada’s institutions can and will guarantee the necessary, consistent, universal, and unbiased level of transparent, accountable delivery and oversight, within a society where the provision of real options to ensure that euthanasia isn’t the only way to escape socially constructed suffering. A guarantee that not a single instance of abuse or error will end the life of a disabled person who would have wished to live if proper supports and real choice had been provided.

Canada can not make such a guarantee. 

Next week is the one year anniversary of the heat dome in my province of British Columbia. 619 people, mostly disabled, died in one week due to policies that did not allow them to escape the heat. Some, who lived minutes from a hospital, died waiting hours for an ambulance. One year later, we are still waiting for those policies to change. 

Canada is not as advertised. 

Thank you for your time.

Leslyn Lewis: Holding On To Life: Fixing MAiD.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Last May, I published an article urging supporters of the Euthanasia Prevention Coalition (EPC) to buy a membership in the Conservative Party of Canada (CPC) to enable them to vote in the upcoming leadership. I stated that supporters of (EPC) are not a monolithic group, nonetheless, joining the Conservative Party to vote for a leader that opposes euthanasia (MAiD) is important.

We are currently sending questionnaires to the six candidates for leadership in the Conservative Party. We are hoping to receive responses from every CPC leadership candidate.

This morning Leslyn Lewis sent out the following article explaining her opposition to (MAiD) euthanasia in Canada. She wrote:

Holding On To Life: Fixing MAiD

"Our MAiD laws are falling off the cliff.”

Those were the words of Dr. Sonu Gaind, Chair of the Medical Assistance in Dying (MAiD) Team at Humber River Hospital in a recent interview with political commentator Anthony Furey.

So many of us warned about a slippery slope back in 2016 as the Trudeau Liberals pushed through the legalization of euthanasia across Canada.

Of course, we were dismissed and told that our fears of a government-funded death-on-demand system would never happen. Any of us who raised concerns were told that we  lacked compassion, and promised there would be no abuse, and that the vulnerable would be protected.

Sadly…we were right. In fact, the only thing we had wrong is that we underestimated how fast this Liberal government would sprint down the slippery slope, and run towards the cliff.

Just five years later the Liberals have pushed through the radical Bill C-7, which removed the main safeguard that the Liberals promised would limit access to MAiD – that the person’s death needs to be “reasonably foreseeable.” What’s more, in two more years, the bill allows those suffering solely from mental illness, like depression, to apply for MAiD.

Despite the outcry from across the political spectrum, from disability rights groups to mental health advocates to faith groups and from people from all walks of life, the Liberals rammed the bill through Parliament without full study, discussion or debate.

Even the far-left Toronto Star at the time put out an editorial saying the bill was “flawed” and “a far cry from what most people accepted as a valid, indeed compassionate reason for legalizing assisted suicide” and that the potential for abuse was “both obvious and frightening.”

The consequences are already unfolding and they are tragic.

Not only are euthanasia rates rapidly mounting with each year, Canadians have been horrified to learn that death by lethal injection has been offered to those who are poor and can’t afford proper housing, to those who don’t want to live alone in isolation, or those who are in desperate but treatable mental anguish. The most vulnerable Canadians are saying they want to die and our government seems happy to help them along.

Our country is disturbingly earning an international reputation for its "death-on-demand" regime.

I have been heartbroken as I’ve read these stories of suffering Canadians who might still be with us today if their government hadn’t promoted assisted death as an option. I’ve wondered why someone didn’t intervene and tell them that there is treatment and light on the other side of their suffering.

Canada’s MAiD law isn’t about compassion. It is a betrayal of the most vulnerable among us who we should be protecting. It’s time we have a Prime Minister and government who will offer help and hope, not a death-on-demand regime that threatens the poor, the mentally ill, youth, women, the elderly, and the disabled.

Death cannot be the only option. I promise as Prime Minister I will reverse course, and we will protect life once again in Canada:

• I will repeal and replace Bill C-7 to restore important safeguards to protect the vulnerable and refocus efforts to deliver care to the suffering, not push them towards death.
• I will expand mental health treatment services and suicide prevention resources, like crisis centres, by working with the provinces and better leveraging the charitable and non-profit sectors.
• I will lead national efforts to expand access to palliative care, like hospice and home care, including ramping up training for health care providers and caregivers.
• I will also double the number of weeks for EI caregiver benefits, including the family caregiver benefit and the compassionate care benefit, to make it easier for families to provide the care their loved ones need.

Finally, I will enshrine conscience protections for doctors. Doctors should never be coerced or pressured to violate their conscience by participating in MAiD. MP Kelly Block has put forward a private member’s bill to amend the Criminal Code to make it an offense to force a doctor to participate in MAiD or to be denied employment because of their refusal to participate. If the Liberals fail to support that bill by the time I am Prime Minister, I will amend the Criminal Code to protect the conscience rights of doctors.

With all the pressures and troubles facing so many right now, the message Canadians need to hear is that there is help and there is HOPE. That message is needed now more than ever before.

Help me share that message of hope and protect life in Canada once again

---------------

Hopefully every CPC leadership candidate will take a similar position.

US Suicide rates are now highest among the elderly.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Suicide is always a tragedy but a little known fact is that the highest US suicide rate is among the elderly. But this was not always the case.

When examining the suicide data published by the American Foundation for Suicide Prevention (AFSP) the highest suicide rate in America was historically among the 45 to 54 age group, but since 2019 the 85 years and older age group has the highest suicide rate and in 2020 the 75 - 84 age group had the second highest suicide rate.

The US suicide rate was increasing on a yearly basis but it has gone down since 2018. For instance, in 2011 the US suicide rate was 12.32 per 100,000 people. The suicide rate increased every year until 2018 when the rate was 14.23 per 100,000. The US suicide rate in 2020 declined to 13.48 per 100,000 people.

Why is this important?

As much as teen suicide is a national concern, there seems to be silence concerning the fact that the highest suicide rate in the US is among the elderly. Is there a form of reverse discrimination concerning suicide? Are not all suicides a tragedy?

The assisted suicide lobby continually publishes articles justifying the assisted suicide deaths of elderly people and people with disabilities. Does the promotion of assisted suicide lead to a suicide contagion effect among older Americans?

This is not an easy question to answer but there are some clues to the answer.

The suicide rate in Oregon, where assisted suicide has been legal for more than 20 years, is higher than the national average at 18.3 suicide deaths per 100,000 people. The suicide rate among seniors 85 and older in Oregon is significantly higher than other age groups at 42.6 per 100,000 people in 2019.

Similar to Oregon, the Washington state data, where assisted suicide has been legal since 1999, also shows a much higher suicide rate among seniors 85 and older.

It is important to note that the suicide data in Oregon and Washington state do not include assisted suicide deaths.

A recent study by bioethicist David Jones compared the suicide rates of European nations that have legalized euthanasia or assisted suicide to European nations that have not legalized assisted death. The study found that - suicide rates rise after euthanasia or assisted suicide is legalized.

I contend that legalizing assisted suicide leads to a suicide contagion effect. Jones found that in every country that had legalized euthanasia or assisted suicide, that relative to European nations that had not legalized euthanasia or assisted suicide that the suicide rates were higher.

Professor Theo Boer, who is a former euthanasia case reviewer in the Netherlands published an article titled: Be careful what you wish for when you legalize active killing. In that article Boer explains:

the percentage of euthanasia of the total mortality went from 1.6% in 2007 to 4.2% in 2019, the suicide numbers went also up: from 8.3 suicides per 100,000 inhabitants in 2007 to 10.5 in 2019, a 15% rise. If we would include the deaths through assisted suicide in patients considered to be at risk of committing suicide (psychiatric patients, people with chronic illnesses, dementia patients, elderly and lonely people), the total increase in self chosen deaths over the past decade would be closer to 50% than to 15%. Meanwhile in Germany, very similar to the Netherlands in terms of religion, economy and population, the suicide rates went down by 10%.

The difficulty with suicide data is that there are many factors that affect the suicide rate. Nonetheless, there have been several studies that have indicated that legalizing assisted suicide leads to a suicide contagion effect.

What is most concerning is the silence concerning the increase in the elder suicide rate at a time when, nationally, the suicide rate has dropped in the US.

Québec's euthanasia expansion bill is likely delayed until after the October election.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Bill 38 would expand (MAiD) euthanasia in Québec by allowing euthanasia by advanced directive and forcing medical institutions, such as hospices, to participate in euthanasia. Bill 38 was originally slated to be pushed through before the October 3, 2022 election but it has now been delayed.

• Quebec debates bill to allow euthanasia for incompetent people (Link)

The Canadian Press reported that politicians in Québec agreed that more time was needed to debate Bill 38. The article stated:

Quebec’s health minister says an end-of-life care bill that would have expanded access to medical aid in dying will not be passed before the legislature breaks for the summer. 

Christian Dubé says the members of the committee studying the bill have agreed that the subject is too complex to be pushed through without all the necessary time needed to study it.

Bill 38 would remove the requirement that a person be at the "end of life" to die by euthanasia, it permits euthanasia for incompetent people who requested it in their advanced directive and it permits euthanasia to be done by nurse practitioners. Bill 38 does not permit euthanasia for mental illness alone, as the federal legislation Bill C-7 had done.

Permitting euthanasia by advanced consent creates several problems, even for people who support euthanasia. First, advanced request creates the problem of who will decide the time and place of the lethal injection. Secondly, since the person is deemed to be incompetent, it denies the person the right to change their mind.

Bill 38 also removed conscience protections that were part of the original Québec regulations by forcing all hospices to provide MAiD (euthanasia).

The Canadian Press article explained that Quebec’s Health Minister, in order to get Bill 38 passed, removed a contentious part of the bill concerning euthanasia for people with disabilities. The committee studying Bill 38 decided that they needed more time.

It is good news that Bill 38 will be delayed until after Québec's October 3rd election. We hope that the election will lead to change enabling the next Québec National Assembly to reject this bill.

Senator Wallin introduced Bill S248 in Canada's Senate to also permit euthanasia by advanced directive. 

• Canadian bill to allow euthanasia of dementia patients (Link).

Currently Canada's Parliament and Senate are studying the expansion of euthanasia through the Special Joint Committee on Medical Assistance in Dying. This committee is examining the expansion of euthanasia to include: "mature minors", euthanasia by advanced directive and the rules that would be followed to implement euthanasia for people with mental illness alone.

• Offering euthanasia to a suicidal person leads to premature deaths (Link).
• Palliative care must not be confused with assisted suicide (Link).
• Government committee examining further expansions of Canada's euthanasia law (Link).

Euthanasia by Advanced Directive - A recipe for abuse.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Catherine Ferrier who is a Montreal physician who specializes in gerontology wrote an excellent article that was published in the Montreal Gazette titled: Advance Directives for assisted death a recipe for abuse.

Ferrier begins her article by outlining the challenges faced for people with dementia:

In my work in geriatric medicine, I have cared for thousands of people with dementia and their families. The challenge they face is not only the disease, but the stigma and neglect. The constantly fuelled perception that their life is undignified.

Ferrier then refers to advanced directives for Medical Aid in Dying (euthanasia), that is permitted by Québec's Bill 38 which is being debated. Ferrier refers to this as a quick fix to the concerns with dementia. Ferrier explains why it is a recipe for abuse.

I am regularly involved in legal disputes surrounding my patients. Is the will signed in the hospital three days before death valid? What about the protection mandate entrusting personal and financial decisions to an abuser?

The most public case in my career was chronicled in the Montreal Gazette: Veronika Piela, an elderly widow with no children, was forcibly removed from her home and had her bank account emptied, on the basis of a protection mandate later found to be forged. The crime would have been one of many that pass under the radar, had she not fled a nursing home without a coat in February.

Ferrier explains the differences between an advanced directive to refuse treatment versus an advanced directive requesting death:

Advance directives were invented to allow advance refusal of high-technology medical interventions expected to be futile or excessively burdensome. They are a request to be left alone, to not be touched. If one dies after treatment is refused or withdrawn, it is through the natural progression of the illness. An advance request for MAiD, on the other hand, is asking for an active intervention to end life. The important ethical distinction between these acts is often blurred in the current debate.

Ferrier shows how advanced directives are often inadequate in determining treatment decisions:

On the one hand, informed consent requires full knowledge of the condition for which an intervention is being considered, which is not possible in advance. On the other, research shows that people change their minds as an illness progresses, and later choices are very different from those they would have made when they were well or in the early stages of the disease. That is true also with dementia. 

The 2018 Council of Canadian Academies Expert Panel on Advance Requests for Medical Assistance in Dying studied in detail the literature on advance care planning. They found very few studies looking at written directives alone, and no evidence that they affected meaningful outcomes. In one Canadian study the documented preferences did not match the expressed wishes of the patient 70 per cent of the time.

Ferrier is concerned that advanced directives that are limited in their effectiveness for treatment decisions will now be used to end life.

Legalizing MAiD by advance request means, in stark simple terms, that doctors will kill people who are not asking to be killed. Some will resist and will have to be sedated without their knowledge or held down to inject the poison. That is what happens in the Netherlands now, and it has led to grave concern and decreasing support for the practice, even among those in favour of euthanasia for consenting adults.

Far from being the ultimate act of autonomy, MAiD by advance directive is a recipe for elder abuse.

Québec's Bill 38 would permit (MAiD) euthanasia by advanced directive and it will force palliative care institutions to participate in MAiD, even when the institution has determined that it is opposed to killing.

BC Woman approved for euthanasia can't access health care

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A report by Penny Daflos for CTV News Vancouver concerns a chronically ill woman in her 30s who is approved for MAiD yet is unable to obtain the medical treatment that she needs to live. "Kat" wants to live. 

Kat had an easier time accessing death care than accessing health care. Daflos reports:

The chronically ill woman is in her late 30s and lives in the Lower Mainland, but given the sensitivity of the subject matter has asked us to refer to her by the pseudonym of “Kat.” She has applied to Fraser Health and been granted a request for MAID – even though she wants to live.

“I thought, ‘Goodness, I feel like I'm falling through the cracks so if I'm not able to access health care am I then able to access death care?' And that’s what led me to look into MAID and I applied last year...”

Kat has been struggling to access health care:

A decade ago she received a diagnosis of Ehlers-Danlos Syndrome (EDS), a genetic disorder where the body doesn’t produce adequate collagen, essentially the glue that holds together connective tissues, skin and our internal organs, sometimes leading to complications and always resulting in significant pain.

As a result, Kat has been on opioids for years and says that’s interfered with finding a replacement for her family doctor, who moved away years ago. She’s been seeing nurse practitioners for several years, as well as a revolving door of rheumatologists, neurologists, psychiatrists and other specialist doctors, none of whom are experts in EDS.

Fraser Health, the health authority that defunded the Delta Hospice Society and expropriated their buildings for refusing to participate in euthanasia, approved MAiD for Kat but is not working to obtain the medical care that she needs. Danlos reported:

Fraser Health’s MAID documentation includes a summary noting that the “patient has an extensive medical chart” and that “there were no other treatment recommendations or interventions that were suitable to the patient’s needs or to her financial constraints.”

Kat was approved for euthanasia because the medical system is not providing her the care that she needs. Kat is not wealthy enough to personally pay for the care that she needs.

In 2019, Alan Nichols died by euthanasia in Chilliwack BC. Nichols, who was not dying, was deeply depressed. His family begged the doctors to re-assess Alan based on the fact that Alan had been living with chronic depression, but they refused (Link).

Donna Duncan, from Abbotsford BC, died by euthanasia in October 2021. Donna was not terminally ill. In February 2020, Donna was injured in a car accident and had post-concussion syndrome. Due to the COVID protocols, Donna did not receive adequate rehabilitation and her symptoms persisted until she decided to seek out death by euthanasia.

Portugal's Parliament tries to legalize euthanasia again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An Associated Press article by Barry Hatton that was published on June 9, 2022 explains that Portugal's legislature is attempting its third time to legalize euthanasia in 18 months.

On January 29, 2021, Portugal's parliament passed its first euthanasia bill. On February 19, President Marcelo Rebelo de Sousa did not to sign the bill into law but referred the bill to Portugal's Constitutional court for evaluation. President de Sousa stated that he thought that the bill was: 

"excessively imprecise," potentially creating a situation of "legal uncertainty."

On March 15, the Portuguese American Journal reported that the Constitutional court rejected the bill and stated:

“the law is imprecise in identifying the circumstances under which those procedures can occur.” The court stated the law must be “clear, precise, clearly envisioned and controllable.” The law lacks the “indispensable rigor."

President de Sousa

On November 30, 2021, President de Sousa vetoed the second euthanasia bill because of contradictions in the language of the bill. The Associated Press article reported:

This time, the president is returning the reworded law to the national assembly, according to a statement posted on the Portuguese presidency’s website late on Monday, arguing that further clarification is needed in “what appear to be contradictions” regarding the causes that justify resorting to death with medical assistance.

Whereas the original bill required “fatal disease” as a pre-requisite, the president’s argument followed, the renewed version mentions “incurable” or “serious” disease in some of its formulation. No longer considering that patients need to be terminally ill means, in De Sousa’s opinion, “a considerable change of weighing the values ​​of life and free self-determination in the context of Portuguese society.”

The Associated Press article reported that the new bills do not fulfill the President De Sousa's concerns. According to the article:

But none of the four new bills addresses Rebelo de Sousa’s specific concerns. Instead, they attempt to simplify circumstances where euthanasia and physician-assisted suicide are justified by referring to “a situation of intolerable suffering, with a definitive injury of extreme seriousness or a serious and incurable disease.”

That omission is unlikely to please the president.

The four bills next go to a committee stage, where they likely will be blended into one, before being voted on again and sent to the head of state. That process could take months.

Once again, the language in the bill is not clearly defined; meaning, if legalized, the acceptable reasons for euthanasia will expand over time. 

We hope that either President De Sousa or the Constitutional Court will once again reject the euthanasia legislation. Sadly, the previous election resulted in the election of a stronger contingent of pro-euthanasia legislators.

Loneliness as a root cause of symptom distress among older adults

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A study by Victoria Powell et al titled: Loneliness longitudinally predicts the symptom cluster of pain, fatigue, and depression in older adults was first published on April 12, 2022 for the annual scientific meeting of the Gerontological Society of America. The study concludes that:

Loneliness strongly predicts the development of pain, fatigue, and depression as well as the symptom cluster over time in a large, nonclinical sample of older American adults.

This study with 5974 participants over the age of 50 is important in relation to older adults who are being treated for pain, fatigue, and depression with drug therapy when addressing their loneliness may significantly relieve the person's symptoms.

I am concerned about cultural loneliness since lonely and depressed people are more likely to die by suicide, assisted suicide or euthanasia.

This study examines the prevalence the cluster of symptoms (pain, fatigue, and depression) when these symptoms may not be directly related to the medical condition. The researchers write:

That the cluster is found in multiple unrelated conditions suggests that its etiology may be distinct from a specific condition but perhaps shared with several. One factor that appears to be associated with the emergence of this symptom cluster is the subjective experience of social isolation even when other people are present, which defines the phenomenon of loneliness. Loneliness is only modestly correlated with objective social isolation, and feeling lonely may predict poor outcomes better than objective social isolation.

The health effects of loneliness have been known for a long time. This study point out that:

However, when loneliness persists, the same responses that are adaptive in the short-term can cause adverse long-term health consequences. Indeed, loneliness has been associated with many poor outcomes, including a 26% increased risk of premature mortality. Moreover, the negative impact of loneliness may be increasing due to social distancing measures necessary for controlling the coronavirus disease 2019 (COVID-19) pandemic.

The researchers state:

We found that loneliness independently predicts the development of the symptom cluster of pain, fatigue, and depression in a large sample of older American adults. Those who reported loneliness at least “some of the time” had more than two-fold odds of developing the symptom cluster compared with those who “hardly ever or never” felt lonely.

This study also finds that loneliness not only exasperates pain, fatigue and depression, but it is often the root cause of pain, fatigue and depression. The study states:

Some have posited that pain, fatigue, and depression in combination could cause activity and mobility restrictions, resulting in social isolation and, in turn, feelings of loneliness. However, our findings suggest that loneliness precedes the symptom cluster. Indeed, others have observed the same directionality supporting that loneliness may play a causal role in the development of these symptoms together.

Several studies have proven that there are significant negative health consequences related to loneliness while this study proves that often pain, fatigue and depression are not just related to loneliness but caused by loneliness.

As for the issue of euthanasia, I have listed a series of articles that prove that loneliness is often the primary reason for requests and deaths by euthanasia.

• A wish to die is most often linked to loneliness and depression (Link).
• Study uncovers euthanasia deaths based on loneliness in the Netherlands (Link).
• Hundreds of sick Canadians euthanized for loneliness (Link).
• Loneliness is an epidemic among seniors that requires a caring response (Link).

EPC-USA letter to Massachusetts legislators

June 8, 2022

President of the Senate Karen E. Spilka, Karen.Spilka@masenate.gov
Speaker of the House Ronald Mariano, Ronald.Mariano@mahouse.gov

RE: S.1384 and H. 2381 An Act Relative to End of Life Options, creating an exception to involuntary manslaughter for physician assisted suicide

Dear President and Speaker:

The Euthanasia Prevention Coalition USA supports positive measures to improve the quality of life of people and their families; we oppose euthanasia and assisted suicide. We are aging and disability advocates, lawyers, doctors, nurses and politicians.

Please let S.1384 and H.2381 die this session (192nd General Court), while legislators are deeply divided amid heightened concerns about inequities for people of color and those living with disability. Proponents are trying to sell you a pig in a poke. It’s not about polls, pain or a quick, peaceful death. Instead, it spawns more suicides and provides less healthcare.

It’s Not about Polls

Proponents are touting a recent poll that pegs public support at 77%. As seasoned legislators, you know support drops off as people learn more which is exactly what happened with the 2012 ballot measure. Back then, support was pegged at 60%+, but fell off leading to the measure’s failure. Polling support may be wide but it isn’t deep.

It’s Not about Pain

I’m often asked if I want people to die in pain. You probably have been asked that
question, too. The answer is this is not about letting people die in pain. People don’t use these laws to escape pain.

Dr. Lonny Shavelson, a California doctor who helps people die says promoting “aid in dying” as avoiding pain is a political sales pitch. See webinar minutes 25:24-27:53. He says people choose assisted suicide because they are low energy or afraid of losing control.

It’s Not about a Peaceful or Quick Death

Dr. Shavelson says the idea that assisted suicide creates a peaceful beautiful death is another myth. See webinar minutes 37:35-41:00.

Dying this way can be very unpleasant and even painful. People are given “aid in dying” concoctions that burn their throats and extend the dying period. When drugs that had been used in the past became expensive, death doctors experimented on people with other drug cocktails, some of which burned people’s throats causing them to scream in pain and extended the dying process by more than 3 hours and as much as 31 hours. The FDA does not regulate these drugs because they are compounded. Currently severe burning is expected in 10% of cases with drug cocktails now being prescribed by physicians.

Assisted Suicide Spawns More Suicides and Attempted Suicides.

If you enact this law, more people will die by suicide, more will attempt suicide and more will visit Emergency Departments as a result. This is the collateral damage caused by these laws. They send a message that suicide is an acceptable way to solve problems. Publicity about suicide also leads to more suicides; this is called suicide contagion.

Legalization of Assisted Suicide especially impacts youths. A 2019 report found teen suicides in California increased by 34% since that state legalized Assisted Suicide in 2016. Oregon’s youth suicides increased 79.3% from 2000 to 2018. Research about completed suicides in four states that legalized Assisted Suicide (Oregon, Washington, Vermont and Montana) found it was associated with at least a 6.3% increase in the rate of all suicide deaths.

According to the 2020 Massachusetts Public Health Data Brief, 615 people died by suicide in 2020. There were 591 monthly Emergency Department visits for attempted suicide (7,092 per year) and 4,882 visits per month for suicidal ideation (58,584 per year) during 2019 to early 2020.

A 6.3% increase following enactment would result in more deaths and need for medical care.

• Fatal Suicides 39 more people would die by suicide 
• ED visits, Attempted Suicides 447 more ED visits, following suicide attempts 
• ED visits, Suicidal Ideation 3,690 more ED visits for suicidal ideation
  

Insurance Companies Use Assisted Suicide to Deny Curative Life-Saving Treatment

Insurers stop covering certain treatments due to the availability of Assisted Suicide. Dr. Brian Callister of Nevada says he was stunned when insurance would not cover life saving treatment for his patients who were transferring to California and Oregon, but the company offered to pay for Assisted Suicide instead. These were people who could be cured with the denied treatment rather than being rendered terminal. In effect, Assisted Suicide is being used to shunt people off the curative, restorative medicine track, especially if they cannot afford to pay for treatments out
of pocket.

People of color understand this will be used to provide them poorer care. 

Even with insurance, people of color get poorer hospital care and pain relief according to a New York Times article. They are still disproportionately dying of COVID-19. So, it is unsurprising that Black and Latinx people oppose Assisted Suicide by 2-1 margins ‒ “… the voting results from Ballot Question 2 in 2012 show Assisted Suicide pits wealthier, whiter districts against those with poorer people and people of color according to Second Thoughts – Massachusetts.

In closing, I urge you to let this bill die.

Sincerely,
Sara Buscher, Chair
Euthanasia Prevention Coalition USA

Take Action Now: Oppose the Massachusetts Assisted Suicide bills.

John Kelly Director, Second Thoughts

Second Thoughts MA is a grassroots group of disability rights advocates from Massachusetts and the region who oppose the legalization of assisted suicide as a deadly form of discrimination against disabled people. We demand social justice against laws, policies, and media messages fueled by a “better dead than disabled” mindset. 

We organized in 2012 to help defeat assisted suicide Ballot Question 2. High turnout among black and Latinx voters made victory certain. Since then, we have successfully advocated against three more assisted suicide bills, led a month-long campaign in 2016 against the disability euthanasia movie “Me before You,” and are now advocating against the assisted suicide bills S.1384 / H.2381 in the legislature.

Please! Take Action NOW and oppose bills S.1384 and H 2381!

Reject Assisted Suicide

Insurer control

Real “choice” belongs to insurers, who can deny prescribed treatments at will, even if lifesaving. In Oregon, you can qualify as “terminal” if you can’t afford your treatment, or if treatment stops for any reason. Legalization makes assisted suicide a “medical treatment,” a so-called “benefit” to be extended to ever more people, and that will always be the most profitable and “cost-effective.”

Persuasion –> abuse

Everyone is vulnerable to suggestion and persuasion. Nothing prevents self-interested family members and medical professionals from pushing for assisted suicide. Meanwhile, it is estimated that 1 in 10 Massachusetts older adults are abused every year, and COVID-19 has only made it worse. Nothing in the law can stop an heir or abusive caregiver from steering someone towards assisted suicide, witnessing the request, picking up the lethal dose, and even administering the drug — no witnesses are required at the death, so who would know? The Oregon law has invited every sort of abuse. 

Misdiagnosis

Studies show that 12%-15% of people entering hospice with a terminal diagnosis outlive their prognosis. In 23 years in Oregon, 1900 people have been prescribed lethal drugs, but the survival rate past six months is only 4%. This suggests that a substantial number died by suicide when they were not dying. Oregonian Jeanette Hall wrote the Boston Globe in 2011 that after a terminal diagnosis she sought assisted suicide, but her doctor persuaded her to try more treatment. “If my doctor had believed in assisted suicide, I would be dead,” she wrote. She has now lived more than 20 years post diagnosis. Any other elective “treatment” with such deadly results would never be tolerated!

Not pain, but distress about disability

The Oregon reports show the first five “end-of-life concerns” deal with not pain, but “existential distress” over the disabling aspects of serious illness, from depending on others for care to grief over lost abilities, loss of social status (“dignity”), incontinence, and feeling like a burden. Proponents speak of “quality-of-life.”

Leading California prescriber Lonny Shavelson says, “It’s almost never about pain, it’s about dignity and control.” Palliative care expert Ira Byock said that almost all pain is controllable, and that marketing bills as all about pain “is a bait and switch.” In the eyes of the state, everyone must be seen as having equal dignity. We champion fully funded home and community-based services, for a caring society rooted in mutual aid and interdependence.

Medical Prejudice

In a recent national survey of practicing US physicians, “82.4 percent reported that people with significant disability have worse quality of life than nondisabled people. . . . [T]hese findings about physicians’ perceptions of this population raise questions about ensuring equitable care to people with disability. Potentially biased views among physicians could contribute to persistent health care disparities affecting people with disability.” Do Not Resuscitate orders have been placed in patient files against their wishes. Media messages and movies like “Me Before You” and “Million Dollar Baby” promote the mindset of “better dead than disabled.” 

Racial Disparities

Medical prejudice and neglect results in racial disparities in diagnosis and treatment of diabetes, cancer, and heart trouble. COVID-19 has killed Black, Indigenous, and People of Color (BIPOC) at a much higher rate than Whites. Assisted suicide legalization makes it more likely that Black patients will be “written off” as better off dead, like Black Texan quadriplegic Michael Hickson.

Social Divide

As the voting results from Ballot Question 2 in 2012 show, assisted suicide pits wealthier, whiter districts against those with poorer people and people of color. For long-standing reasons, Black and Latinx people oppose assisted suicide by 2-1 margins. The four most Latinx cities in the Commonwealth – Lawrence, Chelsea, Holyoke, and Springfield – all voted strongly against Question 2. For example, Lawrence voted 69%-31% no. White working-class and more socially conservative towns also rejected the ballot measure by strong majorities. The state must not adopt one social group’s focus on personal autonomy and status over communities that value above all connection and family.

Depression

Assisted suicide laws lead to the denial of suicide prevention services to seriously ill and disabled people, a violation of the Americans with Disabilities Act’s guarantee of equal program access. Assisted suicide laws redefine depression and feeling like a burden as “rational,” rather than as evidence of impairment or need for intervention. Suicide contagion is real and assisted suicide laws send the wrong message that suicide is an answer to personal problems.

Alternative of Palliative Sedation

Anyone dying in discomfort that is not otherwise relievable may legally receive palliative sedation. The patient is sedated to the point where the discomfort is relieved while the dying process takes place. So there’s no need for legalized assisted suicide.

Disability

In a society full of crushing ableism, reported “end of life” concerns all have to do with negative reactions to disability: distress and shame over dependence on others, lost abilities, loss of dignity, feeling like a burden and incontinence. But no one needs to die to have dignity. We champion meaning found in mutual aid and interdependence.

Outside Influence is Unavoidable

In her New Year’s Eve 2019 ruling against a state constitutional right to die, Suffolk Superior Court Judge Mary K. Ames summed up some of the stresses that might hurry the moment when people ingest the poison.

In such a situation, there is a greater risk that temporary anger, depression, a misunderstanding of one’s prognosis, ignorance of alternatives, financial considerations, strain on family members or significant others, or improper persuasion may impact the decision.

Summary

If Massachusetts legalizes assisted suicide, some people’s lives will be ended without their consent, through insurance denials, medical mistakes, and all the various forms of coercion and abuse. No safeguards have ever been enacted, or even proposed, that can prevent this outcome, which can never be undone.

Canadian Bill to Allow Euthanasia of Dementia Patients

This article was published by National Review online on June 6, 2022

Wesley Smith

By Wesley J Smith

The Netherlands and Belgium already permit people diagnosed with dementia to sign an advance directive ordering themselves killed when they become incapacitated. This has even resulted in one case in which such a patient was euthanized despite resisting — and the government responded by changing the law to enable death-doctors to drug and euthanize such patients without permission.

Now Canada — which last year greatly loosened the criteria for euthanasia — may be on the verge of taking the same path. A bill has been filed in the Senate that would permit patients to order themselves killed without final consent if they become mentally incapacitated. From S-248:

For the purposes of subparagraph (3.‍2)‍(a)‍(ii), a person may waive the need for final consent [to receiving lethal jab] if

(a) they made a declaration in writing that a medical practitioner or nurse practitioner may administer a substance to cause that person’s death should the person lose the capacity to consent to receiving medical assistance in dying and be suffering conditions related to their serious and incurable illness, disease or disability that are identified clearly in the declaration and can be observed by the medical practitioner or nurse practitioner;

(b) the declaration was made after a diagnosis of a serious and incurable illness, disease or disability by a medical practitioner, but no more than five years have elapsed since the declaration was made;

(c) in the declaration, the person consented to the administration by a medical practitioner or nurse practitioner of a substance to cause their death if they are suffering from the conditions listed in the declaration and have lost their capacity to consent to receiving medical assistance in dying prior to that point;

(d) the declaration was witnessed by two independent witnesses to confirm that it was made voluntarily and not as a result of external pressure and each witness signed and dated it . . .

If the patient resists, the killing is not supposed to take place. Right. As though the person would know what was happening.