Legalizing assisted suicide does not decrease other suicide deaths?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A new research article published by the Journal of Ethics in Mental Health (JEMH) examines the question - Does legalizing assisted suicide reduce other suicide deaths? David Albert Jones, the Director, Anscombe Bioethics Centre tackles this issues by analyzing the suicide rates and other factors in nations that have legalized euthanasia and assisted suicide as compared to nations where it is prohibited.

Jones's research is significant as the assisted death lobby has continually argued that legalizing assisted death prevents other suicides. This argument was accepted by the Supreme Court of Canada in its Carter decision which led to the legalization of euthanasia and assisted suicide in Canada, now referred to as MAiD.

In other words, the Carter decision in Canada found that prohibiting assisted death directly affected the right to life because some people will die earlier by suicide, if assisted death is not an option.

David Jones

As stated by Jones:

This paradoxical hypothesis played a key role in the Carter v Canada decision of 2015. It was argued that the right to life was engaged because lives were endangered by the prohibition of “physician-assisted dying” (which in this context referred to euthanasia and/or assisted suicide): [57] The trial judge found that the prohibition on physician-assisted dying had the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable. On that basis, she found that the right to life was engaged. [58] We see no basis for interfering with the trial judge’s conclusion on this point. The evidence of premature death was not challenged before this Court. It is therefore established that the prohibition deprives some individuals of life. (Carter v. Canada [Attorney General], 2015)

Jones explaines that in 2015, he was part of similar research concerning suicide data comparing American states that had legalized assisted suicide to American states that had not legalized assisted suicide. That study they concluded that legalizing assisted suicide may have resulted in a 6.3% increase in other suicide rates.

Jones comments on criticism of his study by Downie and Lowe, who stated that similar trends did not exist in European countries that had legalized euthanasia and/or assisted suicide. Jones states that Downie and Lowe didn't argue that the American study was inaccurate but rather that other jurisdictions conflict with his conclusions. Jones then states that this study examines the European data.

Jones first examines the data from Switzerland. Switzerland did not legalize assisted suicide, but rather it has permitted assisted suicide since 1942 unless done for "selfish reasons." Jones explains that assisted suicide remained rare in Switzerland until about 1998. Jones then states:

Lowe and Downie provide a graph including OECD suicide data in Switzerland which they label “non-assisted suicide rates per 100,000 residents” (2017, p. 7). However, in this Lowe and Downie are mistaken. OECD suicide rates only began to exclude assisted suicide from the overall suicide figures in Switzerland in 2009 (OECD, 2019). Prior to this the OECD suicide rate for Switzerland was the rate of suicide inclusive of assisted suicide. To estimate what the OECD non-assisted suicide rate for Switzerland would have been prior to 2009 and to estimate what suicide rate (incl. AS) would be from 2009, on the basis on OECD Suicide Data, it is necessary to draw on assisted suicide data collated by Dignitas.

Jones then compares the suicide rate in Switzerland to that of Austria, a neighboring country to Switzerland. Jones found that:

From 1990, the non-assisted suicide rates in Switzerland and in Austria decline in parallel. There is a slightly larger drop in non-assisted suicide in Switzerland in 2003. This was the year Switzerland voted to reduce its army from 400,000 to 200,000 and it has been argued that this move reduced suicide among young men in Switzerland as fewer men had access to firearms (Reisch et al., 2013). However, overall, there is no discernible difference in the rate of decline of non-assisted suicide between the two countries over this period. In contrast, from 1998, the rate of suicide (incl. AS) increases in Switzerland relative to non-assisted suicide in Austria and, from 2010 to 2017, Swiss suicide incl. AS increases in absolute terms (from 16.1 to 22.2). Indeed, the rate of suicide incl. AS was discernibly higher in 2017 (22.2) than it was in 1998 (19.0).

Jones proves that the suicide rate in Austria, which prohibited assisted suicide decreased while between 2010 and 2017 the suicide rate in Switzerland increased. This does not prove a direct corelation but it does prove that legalizing assisted suicide does not reduce other suicide deaths.

When comparing the data with relation to men and women, there is a clear increase in the suicide rates for Swiss women as compared to Austrian woman. The data for women, who tend to have a much lower suicide rate, indicates a clear increase for Swiss women as compared to Austrian women.

Jones states:

By 2017 the suicide rate (incl. AS) for females in Switzerland is roughly twice the rate it was 1998 (from 9.4 up to 18.6) while the non-assisted suicide rate of females in Austria over this period declined from 8.7 to 5.0 and the non-assisted suicide rate of females in Switzerland declined by a similar amount (from 8.8 to 5.8). This dramatic rise in suicide inclusive of assisted suicide among women in Switzerland (which is the way the OECD suicide rate was calculated prior to 2009) is driven by large increases in assisted suicide and is associated with no discernible reduction in non-assisted suicide in Switzerland relative to Austria.

Jones concludes:

The rate of suicide incl. AS has clearly risen in Switzerland relative to Austria. At the same time, there is no indication of a relative decrease in non-assisted suicide.

Jones then analyses data from Luxembourg as compared to France and Germany. I will not comment on this data since Luxembourg is a very small country.

Jones then compares the suicide data in the Netherlands to that of Germany. Jones states:

In both jurisdictions there was a decline in non-assisted suicide between 1990 and 2001 which continued until 2007. However, whereas rates of non-assisted suicide in Germany remained relatively flat between 2007 and 2016 (as mentioned earlier), the rates of non-assisted suicide in the Netherlands have increased steadily since 2007. The rate of intentional self-initiated death in the Netherlands, which had been declining when the law was passed, has also risen steeply since 2007.

Overall, the Netherlands, which is the country with the longest continuous history of euthanasia in Europe, has seen the highest increases in non-assisted suicide in Western Europe between 2001 and 2016. From the statistics provided by OECD Suicide Data (2021), the only other EU country that saw a higher net increase in non-assisted suicide in this period was Greece, but the rates in Greece are still at much lower levels than those in the Netherlands (4.0 in Greece in 2016 compared with 10.5 in the Netherlands). Note also that Greece suffered a catastrophic economic collapse over this period.

Jones concluded:

In relation to the Netherlands it is certainly false to say that, “suicide rates either stayed the same or decreased after MAID legislation” (Dembo et al., 2018, p. 453). Non-assisted suicide in the Netherlands rose between 2001 and 2016 from 9.1 to 10.5 while in Germany, it fell from 12.8 to 10.2. Furthermore, this has happened at the same time as there have been dramatic rises in rates of intentional self-initiated death (up from 21.9 to 46.3 per 100,000). These patterns were all more pronounced in females.

The Netherlands suicide rate has increased since 2001 as compared to Germany. In 2001 the suicide rate was lower in the Netherlands than Germany and now it is significantly higher.

Finally Jones examines suicide data in Belgium as compared to France. Jones chooses France, for comparison, because 40% of Belgians speak French as their native language and the Belgian suicide data is very similar to that of France. Jones explains that unlike the Netherlands and Switzerland Belgium has seen a drop in the non-assisted suicide - suicide rate but the drop in suicide in Belgium is not as great as the drop in other European nations including France. Jones states:

Belgium introduced euthanasia by law in 2002 and, in contrast with the Netherlands and Luxembourg, has seen a decline in non-assisted suicide since passing the law. Nevertheless, the fall in non-assisted suicide in Belgium from 2002 to 2016 (19.5 to 15.9) is not as great as that in France (17.6 to 12.3). Indeed, in 2016 Belgium had the highest non-assisted suicide rate in Western Europe. Within the European Union, only the former communist countries Hungary, Slovenia, Latvia, and Lithuania had higher rates of non-assisted suicide (OECD Suicide Data, 2021).

The increase in non-assisted suicide relative to France, especially among females, at a time when non-assisted suicide rates where declining across Europe, explains how, by 2016, Belgium came to have the highest non-assisted suicide rate among women of any EU country, former communist countries included (OECD Suicide Data, 2021).

Jones research article proves that Lowe and Downie were wrong when they opined that in Switzerland, Luxembourg, the Netherlands, and Belgium “suicide rates either stayed the same or decreased after MAID legislation” (Dembo et al., 2018, p. 453). Jones then proves that:

• In all of the four jurisdictions (Switzerland, Luxembourg, Netherlands and Belium) there have been very steep rises in suicide (incl. AS) or in ISID after the introduction of EAS. A striking example is the suicide rate (incl. AS) of women in Switzerland which has roughly doubled since 1998. Many more people have died prematurely after these changes.

• In none of the four jurisdictions did non-assisted suicide rates decrease after introduction of EAS relative to the most similar non-EAS neighbour. There is no indication of prevention of non-assisted suicide at a population level.

• In one of the four jurisdictions, the Netherlands, which has the longest history and greatest number of deaths by EAS in Europe, the rates of non-assisted suicide have increased since EAS was legalised by statute. This was both an increase in absolute terms and an increase relative to its only non-EAS neighbour: Germany.

• In another of the four jurisdictions, Belgium, which has the second highest rate of the death by EAS in Europe, while the rates of non-assisted suicide decreased in absolute terms, they increased relative to its most similar non-EAS neighbour: France. It is striking that Belgium now has the highest female non-assisted suicide rate in Europe, based on OECD Suicide Data.

• In all these respects the pattern that emerges from the European data conforms with the pattern that Jones and Paton discovered in the United States data.

For Canadians, Jones proves that the assertion that legalizing euthanasia and assisted suicide will prevent suicide is not borne out by the data, even though the Supreme Court of Canada falsely agreed that legalizing assisted death was necessary to protect the Constitutional Right to Life.

Jones states:

Indeed, if one considers the community as a whole, it is not the prohibition of EAS but the introduction of EAS that is associated with “evidence of premature death” (Carter v. Canada [Attorney General], 2015, para. 58). Furthermore, the data from Europe and from the U.S. indicate that subsequent to the introduction of EAS, it is women who have most been placed at risk of avoidable premature death from changes in rates of intentional self-initiated death and from changes in rates of non-assisted suicide.

Legalizing euthanasia and/or assisted suicide does not lessen the rate of other suicides and may directly corelate to an increase in other suicides.

More articles on this topic:

• Suicide rates in jurisdictions that have legalized assisted death are not decreasing (Link).
• Legal assisted suicide encourages other suicide (Link).
• The Supreme Court of Canada was wrong on assisted dying (Link).

Legal assisted suicide leads to doctors killing without consent, expert claims

An article by Martin Beckford that was published today in the Telegraph in UK reports on a one-day seminar that was sponsored by the Royal Society of Medicine. The seminar featured Professor David Jones, a bioethicist from Twickenham, UK and Professor Bregje Onwuteaka-Philipsen from the Netherlands.

David Jones

Prof Jones said that:

If society agrees that it is in some people’s interests for them to end their own lives, (by assisted suicide) it is difficult to resist the logical conclusion that others should be helped to die even if they have not made such a request.

He claimed this situation already exists in the Netherlands, where voluntary euthanasia is legal but where about 500 patients are also killed a year by their doctors without requesting to die.

“My view is that it will lead from people who have asked to die, to people who cannot ask.”

Beckford reported Prof Jones as stating:

Anyone who wants to legalise assisted suicide must believe that it is better for some people, such as the terminally ill, to end their lives (by assisted suicide).

They must therefore agree that it is also right to help physically disabled people to die if they cannot administer the fatal dose themselves.

The logical conclusion of this is that society must permit doctors to kill mentally ill people, who are unable to give consent, if their life is deemed not worth living.

"The point is not that activity might escalate from moderate to extreme behaviour. The logical... argument is that voluntary euthanasia concedes the point that suicide or euthanasia is good for some people.

“It is in their ‘best interests’ to have their life ended. And it is the person assisting or doing the killing who must decide whether to assist in this case.”

Professor Jones explained that:

In the Netherlands, where voluntary euthanasia was legalised in 2002, latest figures show that more than 500 people were killed in 2005 by doctors without having given their consent.

When people realise the situation, they find this “deeply shocking”.

Beckford's then reported the response to Prof Jones by Prof Bregje Onwuteaka-Philipsen a Dutch academic who stated that:

non-voluntary euthanasia remains illegal and that the number of cases has fallen.

She showed the official figures that 0.4 per cent of euthanasia cases were classified by authorities as non-voluntary in 2005, down from 0.8 per cent in 1990.

She said that 90 per cent of doctors now say they would refuse to end someone’s life without their consent.

She also was reported to have stated that:

Although teenagers and those merely “tired of life” can request a doctor’s help in dying in the Netherlands, she said 80 per cent of those who do so are suffering from cancer and most are between 65 and 79 years old.

In other words, Professor Onwuteaka-Philipsen was saying that Professor Jones was correct, when considering the experience with euthanasia and assisted suicide in the Netherlands. Her only defense is that only a small number of euthanasia deaths occur without consent and 90% of the doctors would refuse to kill without consent.

As for people who are "tired of living", Prof Onwuteaka-Philipsen is saying that this does occur but most of the euthanasia deaths are for people with cancer.

After reading this article I must conclude that Prof Jones is correct, legalizing euthanasia leads to doctors killing without consent, while Prof Onwuteaka-Philipsen countered by agreeing but contending that it is not that common.

Link to the article in the Telegraph: http://www.telegraph.co.uk/news/uknews/law-and-order/7865305/Legal-assisted-suicide-creates-slippery-slope-to-doctors-killing-without-consent-expert-claims.html

Scotland's assisted suicide bill allows 16-year-olds with Anorexia to be killed.

Alex Schadenberg

Executive Director, 

Euthanasia Prevention Coalition

Professor David Jones

Georgia Edkins, the Scottish Political Editor for the Daily Mail reported on April 20, 2024 that 16 year-olds with Anorexia could be approved for assisted suicide under Scotland's assisted dying bill. Edkins reports:

Teenagers with anorexia could apply for state-backed ‘suicide’ under ‘extremely dubious’ laws proposed in Scotland, experts warned last night.

Newly published Holyrood legislation would allow NHS patients to request prescriptions for a life-ending cocktail of drugs that induce a coma, shut down the lungs and eventually stop the heart.

Edkins reporting on comments by ethicist David Jones writes:

David Jones, professor of bioethics at St Mary’s University in London and director of the Anscombe Bioethics Centre, said: ‘It is extremely, extremely dubious.

We’re talking about “assisted dying” as a euphemism, and it’s always assisted suicide.

‘Suicide is something that we should try to seek to prevent and provide alternatives to, whether it’s for an old person or a young person, whether they have progressive disease or disability.’

‘Terminal in the Scottish Bill is defined as someone having a progressive incurable disease from which you could die. It could cover anorexia.

Jones also warned that the assisted suicide bill that is sponsored by Liam McArthur would:

• Let people as young as 16 die before their lives had properly begun;
• Not require someone to be close to death to be eligible for ‘assisted dying’;
• Not make a psychiatric assessment mandatory ahead of the life-ending procedure.

Edkins reported Jones as stating:‘

It is called the Assisted Dying for Terminally Ill Adults (Scotland) Bill, so that proclaims itself as being restricted to people who are terminally ill, but it defines people that are terminally ill only as people who have a progressive incurable disease, which is at an advanced stage. It doesn’t mean that you’re dying.’

Jones referenced the fact that in Scotland, a person is deemed an adult at 16, whereas in Oregon the age is 18. Based on the definition of terminal illness in the bill, someone with Anorexia could be approved for assisted suicide at the age of 16. Jones states:

‘There have been cases of people with anorexia having assisted dying in Oregon.’

Edkins ends her article by stating:

Perhaps most troubling is Professor Jones’ suggestion that the embattled NHS in Scotland could resort to suggesting death as a viable replacement for treatment.

He said: ‘What you’re starting to see in Canada is that doctors will suggest to patients, “Have you thought of assisted dying”, including people who, for example, have had difficulty getting support for social services to live at home.

‘There’s nothing in the Scottish legislation that prevents that.’

Article: Scotland's Deceptive euthanasia bill redefines terminal illness to include people with disabilities (Link).

Living with end-of-life possibilities: Why she opposes euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New Zealand is debating the legalization of euthanasia as they approach a September 19th euthanasia referendum during the election. New Zealand's parliament passed a euthanasia bill in November 2019 by a vote of 69 to 51. In order to obtain the necessary votes to pass the bill the government agreed to a referendum on the bill.

Serena Jones

An article by Serena Jones published by Newsroom tells her story. Jones is a New Zealand business woman and mother who has been fighting cancer for many years. Jones expresses her concern with the legalization of euthanasia based on her personal experience. The article explains:

Seven years ago I was told I had a 25 percent chance of living five years without the cancer returning; two years ago I was given 12 months to live. Plainly the upcoming End of Life Choice referendum concerns me, others like me, and all those involved in my care. 

I’ve just put the phone down after my phone consultation. My results are excellent. No new disease showing up in my body and the tumour much the same as it was on the last scan. I’m back ‘under observation’ (meaning a doctor check-in every six weeks and CT scan every three months). It’s an upward-swing of the pendulum, another reprieve – delivered with care, grace, attentiveness, in the best possible way. 

...Two years on, and inconceivable as it seems to me, I’m facing the end of my life. We’re coming up to a referendum on this very topic. I’d like to add something personal to the conversation.

Jones explains that she first reacted to her cancer diagnosis by being frightened, angry and incredulous, her next reaction was to face it head-on. Jones writes:

My initial prognosis was 12 months. It wasn’t long before my oncologist was ‘keeping me alive till Christmas’. Since then my family and I have lived through two Christmases. Clearly, in my case at least, there’s deep uncertainty here. The defining clause in the Act relies on this. I’ll be able to ask for an assisted death.

She then writes about the relationship she has had with many of her doctors who have cared for her and worked with her as she battled the disease. She refers to the doctor patient relationship as gold dust. She then comments on the position of New Zealand physicians:

Many hundreds of Kiwi doctors want no part in assisted suicide, and believe that physician-assisted death is unethical and interferes with the doctor-patient relationship to the extent that it crosses a societal line. It seems to me we’re risking a great deal here.

Jones comments on the excellent care that exists and New Zealand and the need to maintain this commitment to care. She concludes by stating:

Let’s understand that dying is an intrinsic part of life. Let’s talk about what end-of-life care actually is and strengthen, extend and improve what we already have in our palliative care. Such care is a commitment, one we need to make. Euthanasia is an avoidance of this commitment.

Thank you Serena for advocating for excellent care rather than killing.

Why Dr Michael Jones will not kill you!

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Michael Jones

Dr Michael Jones is a 31 year family physician in Victoria who wrote a letter to the Victoria Times Colonist that was published on April 2. In his letter he explains why he will not kill his patients by euthanasia or assisted suicide. In his letter he tells the story of a patient in 2001 that has effected him for life. Dr Jones wrote:

I met Gerald (not his real name) in 2001 soon after he had immigrated to Canada to retire in our beautiful city. He had enjoyed a very successful professional career, and although he was making big changes in his occupation and living situation, he was still very youthful in his love for life, and was looking forward to a full and active life in Victoria. 

He consulted me infrequently due to his good health, but I always enjoyed his “joie de vivre,” and we struck up a good rapport. 

One day, I received a phone call from the ER doctor that Gerald had suffered a sudden collapse on the street, and was now in the ICU with what appeared to be a devastating stroke. It turned out that he had suffered a brainstem infarction, which effectively “disconnects” the brain from the rest of the body. Gerald’s ability to think and feel emotions, sensations and pain were unaffected, but he was unable to move anything at all, except his eyes. 

Think about that for a moment: Feeling pain at a pressure point or feeling mucus pooling in the back of your throat and being unable to move, or even communicate your pain or fear. Totally dependent on machines to breathe for you and feed you, and on other people for bathing and toileting you. 

We set up an alphabet board so we could laboriously point to each letter, and Gerald would blink at the letter he wanted and spell out a word. I remember sitting for the first time with some anticipation wondering what Gerald would want to say. Slowly, the words came: “p l e a s e k i l l m e.” 

He stared straight at me, and the desperation and commitment were as clear as if he had shouted it from a rooftop. He would repeat this phrase at the start of every spelling-board conversation over the next few months. This would cut me to the heart each time, as I had to explain that there was nothing I could do except ensure the best medical care possible, and try to anticipate and alleviate any physical pain. 

Slowly, over many months, Gerald’s condition stabilized and he could breathe on his own, with frequent suctioning. He was able to be transferred home with 24-hour care, and could use a computer with a controller in his mouth. He still could not talk, eat, drink or move any muscles apart from his eyes and now his lips. 

Because he had 24-hour care, my visits became less frequent, and as the months went by, his communications became more positive. In fact, he started to write articles about his experiences, and communicate with friends by email. 

One day, I summoned enough courage to ask him if he was glad to be alive. He answered: “Yes!” I then asked him if he was glad that I hadn’t killed him as he had asked me to all those times. He said: “Yes, very glad!” I think there was a little smile in his eyes, also. 

Gerald went on to live a fulfilling life before succumbing to pneumonia a few years later.

Dr Jones relates his experience with the Maurice Généreux assisted suicide case.

With regard to the present debate on assisted death, it is clear that Gerald would qualify on every possible criterion for “death by doctor.” Yet that was not what Gerald ultimately wanted. What he ultimately wanted could not have been known by anyone (including himself) at the time, no matter how many doctors were consulted to agree with the decision. 

The Holy Grail in medical ethics is “informed consent,” in that a person can give consent for any procedure on his person as long as he is fully informed. In truth, when we are dealing with issues affecting the rest of one’s life, no one is “fully informed” as to their future quality of life, or their future opinions and feelings. 

This point is well illustrated by an article in the National Post, dated March 3, about Dr. Maurice Généreux. He had prescribed lethal doses of sodium seconal to two HIV-positive patients with a view to “assisting their deaths.” Aaron McGinn died, and Mark Jewitt lived. 

Mark Jewitt subsequently received effective treatment and counselling, and 20 years later, according to the article: “He would have missed so much had he died.”
“I would have missed gay marriages. I would have missed AIDS becoming a manageable disease.” He was glad to be alive. 

Possibly, the same could have been said for McGinn had he received the correct treatment and counselling. However (and this is the point), both of these men would be eligible for assisted death under the current proposed legislation, effectively robbing them of ever having a chance at a fulfilling life, no matter how depressed they felt in the moment of making the decision.

Dr Jones ends the article by stating his commitment to his patients.

To my current patients: This is why I will not kill you, no matter how depressed or hopeless you feel, no matter how desperate your medical situation, no matter how much you may ask.

I have learned that feelings change, desperate situations become less desperate and you don’t know what the future holds any more than I do. And as your family doctor, I am not going to be the one to lose all hope in your future, no matter how bleak it might seem today.

When death does become imminent, as it will for all of us, you can count on me to strive to maintain your comfort and dignity until the end.

Dr Michael Jones is a doctor who truly respects the needs of his patients. Canadians need to respect his conscience rights.

Sylvia Jones: Roger Foley needs to receive self-managed funding.

Roger Foley needs to be able to leave the hospital and go home.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition has followed the plight of Roger Foley for a long time. In June, 2025; EPC promoted the online petition - Roger Foley needs to be fed (Petition Link).

Roger Foley, who lives with spino-cerebellar ataxia type 14, has been living at the London Health Sciences Centre for almost 10 years. Previously, Roger lived in his home and received attendant services from an agency that was contracted to provide care. Roger ended up in the hospital based on the substandard care that he received from the agency.

Roger applied for inclusion in the Self-Managed Attendant Services program that would give Roger direct funding to enabled him to hire his own care-givers. This is a program that exists in Ontario. Roger was turned down by the Ministry of Health for this program.

Hon Sylvia Jones, has been Ontario's Minister of Health and Deputy Premier since June 2022. In June, 2008; Sylvia Jones, as a member of the Conservative opposition, expressed strong support for self-managed home care funding.

Contact Hon Sylvia Jones at: sylvia.jones@pc.ola.org and state:

Roger Foley has been living at the London Health Sciences Centre for almost 10 years. Roger wants to leave the hospital and receive care in his home.

Now is the time to implement change and approve him for Self-Managed funding for Attendant Services.

Self-Managed direct funding will provide him the right resources for less money and enable him to leave the hospital and move home. Hospitals are the most expensive setting for health care service delivery and, quite frankly, not the best type of care for stable individuals with a disability.

Allowing him to go home with self-managed funding for attendant services will enable him to fully participate in the community.

 
Here is the video of her June 2008 speech in the Ontario Legislature:

Here is what Sylvia Jones says in the (legislature) video:

Ms. Sylvia Jones: It's a pleasure to rise today to support the member for Wellington Halton Hills on this important resolution to add attendant services to the provincial wait time strategy.

For many years, experts in health care have told members of all three parties that our health system is too focused on hospital beds. Hospitals provide wonderful acute care for the citizens of this province, but it is the most expensive setting for health care service delivery and, quite frankly, not the best type of care for stable individuals with a disability.

As the Ontario Community Support Association highlighted in their August 13 press conference, people on the attendant services wait list put pressure on the health care system because they remain inappropriately stuck waiting in long-term-care homes, acute care beds, chronic care hospitals and rehabilitation facilities, all at a much higher cost to taxpayers. It's important that members in this House recognize that a failure to support today's resolution to make attendant services a priority by adding it to the provincial wait time strategy will result in higher costs to the taxpayer.

At the same news conference in August, the Ontario Community Support Association told us that the wait list for attendant services is four to 10 years. For four to 10 years, individuals with disabilities and their families are not getting the services they need. They remain in hospital or long-term-care beds, or their families, many with aging parents, struggle to continue to provide for their daily care needs. So even though we know that it is more cost-effective and more appropriate to have individuals cared for at home and even though we know attendant services allow people with physical disabilities to actively participate in their communities, go to school, get a job and contribute in other ways, we continue to focus our health care dollars in other areas.

This issue is most important across the province, but it also touches specific families in Dufferin Caledon. This summer, I met with a constituent from Honeywood who receives the Ministry of Health's direct funding for attendant services. I suppose you could call her one of the lucky ones. The program is administered by the Centre for Independent Living in Toronto. She tells me it took four years for her application to be approved, and this year, when she applied for a slight modification of her level of care because her health had changed, she was told that the Centre for Independent Living in Toronto was not even considering 2008 applications; they were still reviewing 2007 applications. Why is that? The Centre for Independent Living has a huge waiting list, and this Liberal government has not increased their funding since they were elected in 2003. So CILT is trying to serve as many Ontarians as it can with too few resources. In fact, my constituent believes that something needs to happen long-term care or worse for an individual with direct funding before the next person on the waiting list can receive funding for attendant services. My constituent wanted me to know that she feels this is a wonderful program that allows her to routinely participate in the community and live in her home. For example, I know that she is an active member of the Dufferin county accessibility advisory committee, and the Honeywood community. She came to see me because she wanted to brief me on this issue, and she believes that other people with a physical disability need to have the same opportunity that she has.

In addition to direct funding not being a priority for the Ministry of Health, my constituents are also having issues with funding from community care access centres. The boundary change introduced by the Liberal government has resulted in my constituents being asked to do with less service. Their disability has not changed, but the level of service being provided has.

An Orangeville resident who is a quadriplegic as a result of a car accident had been receiving home care since 1995. Under the former Waterloo-Wellington-Dufferin CCAC, he received morning and night visits, seven days a week, to assist with personal care. Under Central West CCAC, he was discharged from nursing and occupational therapy. Respite care was eliminated. His case is under review to determine what other services can be cut. The minister responded to us in correspondence by suggesting that he use the CCAC complaint process and to call the long-term-care action line.

Another constituent who happens to suffer from ALS has been told he was receiving too much care from the Waterloo-Wellington-Dufferin CCAC. He's been told his CCAC hours are being cut and a referral has been made to the March of Dimes to make up the care hour difference. That's right. The CCAC is referring people to a non-profit agency and expects them to provide front-line care, rather than our universal health care system. The March of Dimes also has a waiting list. So now the Central West CCAC has agreed to provide attendant care hours, but only until the March of Dimes can implement its services. He also needs respite care hours, but of course there's no support for his wife.

All three of these examples are alarming. I'm sure that members of all three parties have similar experiences from their own ridings. So what are we going to do about it? Now is the time to look at implementing the change that health care experts have been advocating for more than a decade. Now is the time to provide Ontarians with physical disabilities with the services they deserve. These citizens can either be taken care of at home with the right resources for less money or be forced into long-term care, or a hospital setting, which puts added strain on an already beleaguered health system and doesn't allow individuals with disabilities to fully participate in our communities.

I encourage all members to support the resolution of the member from Wellington Halton Hills. Let's make attendant care services a priority by adding it to the provincial wait time strategy.

Hon Sylvia Jones, has been Ontario's Minister of Health and Deputy Premier since June 2022. Why has she abandoned Roger Foley by forcing him to live at the London Health Sciences Centre rather than enabling him to be cared for at home?

Responding to Gifford-Jones tirade on euthanasia

Alex Schadenberg

By Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Gifford-Jones in his recent tirade on "assisted death" attacks people who oppose euthanasia and assisted suicide as do-gooders offering "howling and irrational fears".

Yet Gifford-Jones is the one who howls when he states that in places where euthanasia and assisted suicide are permitted: "The blunt fact is that history shows there have been no abuses."

Were the researchers who published the 5 year meta-analysis of the Dutch euthanasia law in 2012 irrational when they found that 23% of all assisted deaths were not reported? How irrational were the researchers who published findings that 47% of all assisted deaths in the Flanders region of Belgium were not reported?

Is it only the do-gooders who are concerned by the 2010 study that found that 32% of assisted deaths in Belgium were done without request?

I guess that Gifford-Jones would like us to turn a blind eye when an Italian man, with a botched diagnosis is killed by assisted death in Switzerland or when the Netherlands approves euthanasia for newborns with disabilities.

The only irrational howling I have heard is from Gifford-Jones.

Links to:
- Belgium is moving closer to allowing euthanasia of children.
- Euthanasia is out-of-control in the Netherlands.

Government committee examining further expansions of Canada's euthanasia (MAiD) law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

When Canada legalized euthanasia and assisted suicide (MAiD) in June 2016, a section of the legislation required the government to conduct a full five-year review of the legislation, starting in June 2020.

Instead of conducting a full review of the law, the Canadian government decided to expand the euthanasia law and then do a limited review of the law.

On September 11, 2019 the Quebec Superior Court, in the Truchon decision, struck down the requirement that a person be terminally ill to qualify for euthanasia in Canada. In an unprecedented manner, the federal government did not appeal the decision.

Bill C-7 was introduced in February 2020 as the government's response to the Quebec Superior Court's Truchon decision. Bill C-7 went much further than what Truchon required. Bill C-7 became law on March 17, 2021.

The Canadian experience with legalizing euthanasia has been that there are never enough reasons to kill.

An article by Ryan Patrick Jones for CBC News examines the direction of the Special Joint Committee on Medical Assistance in Dying that is conducting the review of the law. 

Jones writes about three main areas of the review, that being: euthanasia for mental illness, euthanasia by advanced request and euthanasia of mature minors. 

None of these categories pertain to a full review of the law.

The review may not look deeply into the issue of euthanasia for mental illness since Bill C-7 already approved it but placed a 24 month "hold" on euthanasia for mental illness to devise protocols around the killing. Jones wrote:

The expansion of MAID to people suffering primarily from depression, schizophrenia, post-traumatic stress disorder and other mental illnesses left lawmakers with a number of unanswered questions.

For example — how can the doctors and nurse practitioners who assess patients' suitability for MAID determine whether a psychiatric condition is irremediable?

Many psychiatric conditions can be treated with drugs or other therapies, or can improve if life conditions that contribute to poor mental health — such as poverty, loneliness or lack of housing — are addressed.

"There is simply not enough evidence available in the mental health field … to ascertain whether a particular individual has an irremediable mental illness," the Centre for Addiction and Mental Health in Toronto stated in 2017.

Jones quoted from long-time academic euthanasia activist Jocelyn Downie on the topic of euthanasia by advanced request who stated:

"You make much better decisions when you're not in a state of intolerable suffering," Downie said. "So we want people having conversations and coming to an agreement with their clinician about a future provision of MAID."

Downie left out the fact that euthanasia by advanced request will only be an issue when the person slated to be killed has become incompetent, meaning, euthanasia will be imposed on a person who is unable to legally change their mind.

Concerning the issue of euthanasia for mature minors, Jones also quoted from Downie who stated:

Downie said that if mature minors have the legal right to refuse life-saving treatments, they should have the right to choose assisted death.

The government is examining future expansions of euthanasia without regard for the problems and misuse of the law.

The Euthanasia Prevention Coalition is producing a document outlining how the law is actually working. It is our hope to create a debate on how the law purposely enables doctors and nurse practitioners to kill their patients without providing effective oversight of the law.

Journal of Medical Ethics article: Scottish Support for assisted suicide is weakening.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Scottish Parliament

An article by David Albert Jones was published in the Journal of Medical Ethics on April 15, 2024 explaining that support for assisted suicide in Scotland is weakening.

On 27 March 2024, Liam McArthur introduced his Assisted Dying for Terminally Ill Adults (Scotland) Bill. He said that he was “absolutely convinced” that the legislation would be passed as “there is growing public support for the policy”. Similarly, when the Bill was proposed in 2022 it was argued that public opinion “seems to be shifting in favour of a law change.” Again, a recent article in defence of the Bill appealed to the “increasing and now overwhelming” support in Scotland for a change in the law. This was based on “several polls” cited in the Policy Memorandum that accompanied the Bill.

The Memorandum cites four polls giving 87% (March 2019), 72% (June 2021), 77% (July 2023) and 71% (December 2023) support for “assisted dying”. In addition, a more recent poll (March 2024) of 4,132 adults in Scotland showed 78% in favour.

It is noteworthy that the three polls commissioned by Dignity in Dying Scotland (March 2019, July 2023 and March 2024), generated the highest figures for support. This is in part because the questions referred to terminal illness and included other reassurances. They also asked if people “strongly support[ed]” assisted dying or only “somewhat” or “tend[ed] to” support. Asking in this way ensures that people who are ambivalent but tend to be in favour on balance or in principle are included as supporters.

Jones explains that strong support for assisted suicide is declining:

These polls thus measured how many “strongly support[ed]” legalising assisted dying. This was 55% in 2019, 45% in 2023, and 40% in 2024. It is evident that the level of strong support has declined and that a majority of Scots are no longer strongly in favour, but are ambivalent to some degree or are opposed.

Jones explains that the public is confused by the meaning of the term - assisted dying:

To measure change in support over time, it is important to use the same question and to conduct multiple repeated polling. YouGov provides a bimonthly “tracker” (August 2019 to April 2024) for the questions: “Do you think the law should or should not be changed to allow someone to assist in the suicide of someone suffering from a terminal illness?” and “Do you think the law should or should not be changed to allow someone to assist in the suicide of someone suffering from a painful, incurable but NOT terminal illness?”

Support in Scotland in April 2024, as measured by these questions, was 71% and 41% respectively. This is lower than the polls quoted above in part because of the reference to “assisted suicide” rather than “assisted dying”. There is evidence that many people are confused about what is included in “assisted dying”. A survey conducted in 2021 found that most people thought that this meant either “giving people who are dying the right to stop life-prolonging treatment” (42%) or “providing hospice-type care to people who are dying” (10%).

In any case, the usefulness of the tracker lies less in the snapshot of support and more in capturing change over time. These trackers, each repeated 31 times over five years, clearly show that support for assisted suicide in Scotland has declined measurably.

Support for assisted suicide is less than 50% when it applies to people who are not terminally ill and yet Scotland's euthanasia bill permits people who are not terminally ill to be killed by euthanasia. Jones explains:

The second tracker also shows that support is well under 50% if assisted suicide would be provided to people who are not terminally ill. It might seem that the Assisted Dying for Terminally Ill Adults (Scotland) Bill is indeed restricted to people who are terminally ill. However, unlike similar legislation in the United States, New Zealand or Australia, the Scottish Bill defines “terminal illness” with no reference to a person being close to death. The term is used to cover anyone with an advanced progressive condition that would be expected to shorten life if not treated. This would include conditions such as type 1 diabetes. It is unclear if this is what the public understands by the term “terminal illness”.

Jones ends his article by stating that support for assisted suicide is not overwhelming and it is not growing:

Public support for legalisation of assisted suicide in Scotland is thus neither “overwhelming” nor “growing”. Less than half strongly support a change in the law. Less than half want their MP to vote to change in the law. Less than half support assisted suicide for non-terminal conditions (as the proposed Bill seems to include). Few if any regard assisted dying / assisted suicide as being among the most important issues facing Scotland and all indications are that Scottish support for its legalisation has declined markedly in recent years.

MSPs should assess for themselves the merits and/or dangers of the proposed Bill without fearing that they will be out of step with public opinion. Indeed, if they feel ambivalent or hesitant on this issue then they are probably reflecting the views of most people in Scotland.

Scotland's deceptive euthanasia bill redefines terminal illness to include people with disabilities (Link).

Does legalizing assisted suicide drive up suicides in general?

This article was published by Aleteia on June 22.

By John Burger

When it comes to suicide, have modern Western democracies embraced a contradiction? On the one hand, we rue the fact that the suicide rate has gone way up in recent years. On the other, more and more segments of society are embracing suicide in one particular area of life.

Wesley J. Smith challenged academia and the medical world on this contradiction, in a recent article at National Review Online.

“It almost never fails. A learned article in a medical or bioethics journal laments our suicide crisis and urges greater efforts at prevention,” Smith wrote. “And yet somehow, the authors never once mention the elephant in the room: i.e., the impact of ubiquitous suicide promotion by ‘death with dignity’ activists, boosted by media commentators, in popular culture features, and as furthered by politicians.”

Wesley Smith

In an article published in the American Medical Association’s JAMA Psychiatry: researchers, led by Joshua A. Gordon, MD, director of the National Institute of Mental Health (NIMH), spoke about “flattening the curve” of America’s suicide rate. But the article, Smith complained, “doesn’t once mention assisted suicide as a contributor to the problem.”

“Pretending assisted-suicide deaths are not ‘suicide,’ as most laws require, doesn’t make them not suicide,” Smith commented, “and merely sweeps that aspect of our crisis under the rug.”

Gordon, through a spokesperson for the NIMH, declined to comment.

But just what research exists to show a correlation between physician-assisted suicide and suicide in general? Does the former influence the latter?

“I just spoke to a woman today who wanted assisted suicide,” said Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, when contacted earlier this month. “She was sick, depressed and lonely and said she cannot go on living any longer. She wanted suicide, but she said that she didn’t have the courage to kill herself, so she was wanting to apply for assisted suicide. You can clearly see the link.”

Alex Schadenberg

Schadenberg and others pointed to a 2015 article in the journal of the Southern Medical Association, in which authors David Albert Jones and David Paton lamented that “a policy area that has received surprisingly little attention is the effect of changes to the legal code addressing suicide itself.”

Jones and Paton went on to demonstrate how they found that legalizing physician-assisted suicide (PAS) in the United States was associated with a 6.3% increase in total suicides, including assisted suicides.

“Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in non-assisted suicides,” the authors wrote. “This suggests either that PAS does not inhibit (nor acts as an alternative to) non-assisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.”

They also found that states that legalized PAS were characterized by higher rates of non-assisted suicide, lower rates of religious adherence, and a lower proportion of the population that was black or Hispanic.

Commenting on Jones and Paton’s findings, Aaron Kheriaty, author of The Catholic Guide to Depresssion, wrote, “These results are important, and yet they should not surprise those familiar with the literature on the social contagion effects of suicidal behavior. … You do not discourage suicide by assisting suicide. Social contagion phenomena suggest possible mechanisms by which the findings of Jones and Paton may be explained.”

Kheriaty, who teaches psychiatry at the University of California Irvine School of Medicine, wrote in the same issue of the Southern Medical Journal that the phenomenon of suicide contagion has been known since at least the 18th century, when a wave of suicides in Germany followed the publication of Goethe’s popular novel The Sorrows of Young Werther. The protagonist of the novel took his own life after experiencing unrequited love.

“We can surmise that media attention surrounding instances of assisted suicide, such as the widely publicized case of Brittany Maynard, the 29-year-old California native who moved to Oregon in November 2014 to avail herself of that state’s assisted suicide option, could encourage copycat behavior among vulnerable individuals,” Kheriaty wrote. “Because the Werther Effect is well validated, the Centers for Disease Control and Prevention in partnership with the National Institute for Mental Health, the World Health Organization, and the Surgeon General have published strict journalistic guidelines for reporting suicides to minimize this effect.”

In the Maynard case, however, those guidelines were widely ignored, Kheriaty charged. Suffering from an incurable brain tumor, Maynard’s decision was “frequently presented in the media as inspiring and heroic.”

But if the Werther Effect can lead to more suicides, the Papageno Effect can lead to fewer. This, Kheriaty explained, is when individuals who are tempted to commit suicide have a conversion and choose life instead. Again, the name comes from the classical world, this time from a lovesick character in Mozart’s opera The Magic Flute, whose planned suicide is averted by three child spirits who remind him of happier alternative.

Valentina Maureira

A real-life example of this happened in 2015, when Valentina Maureira, a 14-year-old in Chile with cystic fibrosis, made a YouTube video begging the Chilean government for assisted suicide. She cited the Maynard case.

“She later changed her mind, however, after meeting another young person with cystic fibrosis who conveyed a message of hope and encouraged her to persevere.”

Sadly, Valentina died in May 2015, but passed away naturally.

Safeguards will not protect you from physicians who are willing to take your life.

By Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

Alex Schadenberg

Re: Gifford-Jones – Not all lunatics are in the asylum.

In his righteous indignation, Gifford-Jones claims in his article that:

“Nor is there any evidence that the elderly, those with disabilities or those who simply do not want to be part of assisted death, have ever been forced to seek it.”

In 2002 Belgium legalized assisted death giving doctors the right in law to lethally inject patients. Three studies concerning the experience with assisted death in Belgium clearly indicate that Gifford-Jones is wrong.

The first study found that 32% of those who died by assisted death did not request it.

The second study found that 45% of the assisted deaths that nurses were involved with, the person who died didn’t request it.

The third study found that 47.2% of all assisted deaths were not reported.

When analyzing the data, all of the studies found that those who died by an assisted death without request or without reporting it tended to be over the age of 80, incompetent to make decisions for themselves, had an unpredictable end-of-life trajectory and died in a hospital.

There is clear evidence that many elderly and incompetent people in Belgium have been killed by an assisted death without request. The act is a silent crime since the doctor negated to report it.

Don’t be swayed by the propaganda being promoted by Gifford-Jones.

Safeguards will not protect you from physicians who are willing to take your life.

This article was re-published by the Windsor Star on September 25, 2014.

Links to similar articles:

• Disability rights organizations oppose assisted suicide.
• Death with Dignity Act lacks effective safeguards to protect depressed people.
• Most doctors oppose assisted suicide.
• We do not live in a utopia. Assisted suicide is not safe.
• Abuse of older women overlooked and under-reported.