Health

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ramona Coelho

An excellent interview of Dr Ramona Coelho by Jonathon Van Maren was published in the European Conservative on April 24, 2024. 

As stated by Van Maren, Dr Coelho is a family physician in London, Ontario, with a practice largely serving marginalized patients, she has testified before Parliament, laid out the dangers of legal euthanasia on TV and in print, and presciently warned policymakers of many of the scenarios we now see unfolding. Dr Coelho is a leading voice opposing Canada's euthanasia regime.

Van Maren begins the article by bringing up two of the most recent Canadian euthanasia stories and commenting on the issue of euthanasia for mental illness alone:

For the past several years, the euthanasia horror stories unfolding in Canada have captured the attention of the press on both sides of the Atlantic. I have detailed many of them in my reporting; as I write this, a desperate father is battling in court to prevent his healthy 27-year-old autistic daughter from dying by doctor-administered lethal injection; another Canadian has been approved for euthanasia after developing bedsores while waiting for necessary healthcare that is increasingly difficult to obtain.

At the end of January, the Trudeau government delayed, for the second time, their plan to expand euthanasia eligibility to Canadians struggling solely with mental illness. Initially, a strong majority of Canadians supported legal euthanasia in limited circumstances. The events of the past several years have begun to erode that support, and the Conservative Party is campaigning on a promise to pass legislation banning euthanasia for mental illness. It is an incredibly pressing issue: if suicide-by-doctor were to be made available to the mentally ill, Canada’s ever-rising euthanasia death rate would spike overnight.

Dr Coelho defines what is mean't by the term MAiD:

Medical Assistance in Dying (MAiD) is the Canadian term that refers to both euthanasia and assisted suicide, although up to this point 99.9% of cases have been euthanasia (physician administered lethal cocktail to induce death, usually by IV) so I think it’s accurate and clearer to refer to this as euthanasia. However, it is possible that there might be more cases of assisted suicide (patient self-administers the lethal cocktail of drugs) in coming years as both are permitted. I will refer to it as MAiD just for ease and as some very few cases do involve assisted suicide.

Van Maren then asks Dr Coelho to comment on euthanasia for mental illness:

MAiD really never should have been an option for those with mental illness. Canadians face major barriers to access mental health care and numerous Canadian psychiatrists have voiced serious reservations about this expansion. We do not even understand how clinically to distinguish between the overwhelming majority of those with mental illness, who recover with suicide prevention and services, and those very few who might not. Such an expansion would allow healthcare practitioners arbitrarily to decide who deserves suicide prevention and who is deemed eligible for MAiD, potentially placing many Canadians’ lives at risk.

The legislation permitting MAiD for mental illness should have been permanently abandoned. But despite recommendations from its most recent parliamentary committee and most Canadian provinces asking that the legislation be indefinitely paused, the government has chosen simply to delay its implementation once again, this time until 2027. Politically, the delay in implementation of this legislation, rather than stopping it altogether, seems imprudent for the current government, as it may become a significant election issue. I would say Canadians are increasingly recognizing the risks of expanding MAiD to include individuals whose sole medical condition is mental illness.

Dr Coelho then comments on possible further expansions of MAiD in Canada:

And besides this, we still have the 2023 parliamentary recommendations to include MAiD for “mature” children and advance directives for euthanasia next. MAiD was initially introduced as an exceptional procedure to be used only for those near death with intolerable suffering, but once society embraces the intentional ending of one’s life as a treatment for suffering, it becomes practically impossible to contain, with Canada being a case in point.

Dr Coelho then comments on the concerns with medical safety:

In February 2024, the Canadian Human Rights Commission expressed ongoing concern over reports indicating that individuals with disabilities opt for MAiD due to a lack of essential support services. The CHRC is joined by UN human rights experts, Canadian disability groups, Indigenous advocates, social justice groups, and numerous medical and legal professionals in these concerns.

I was interviewed for a documentary featuring the tragic MAiD death of Rosina Kamis, who, citing poverty and loneliness, chose MAiD due to insufficient support. Some Canadian bioethicists argue that MAiD under “unjust social circumstances” is a form of “harm reduction.” However, this is not a free autonomous choice, but death driven by desperation and structural inequalities.

Messages promoting suicide and easier access to lethal means heighten suicide risks. MAiD exacerbates these dangers, endangering vulnerable individuals by increasing the likelihood of being induced into a premature death. Additionally, healthcare providers’ often inaccurately rate the quality of life of individuals with disabilities as poor, which may lead to their biases leading to suggesting or approvals of MAiD, particularly when patients are experiencing transient low points in their lives.

Dr Coelho then comments on the model practise standard:

Health Canada’s “Model Practice Standard for Medical Assistance in Dying” suggests informing patients about MAiD if the practitioner suspects it aligns with patient values and preferences. In contrast, other jurisdictions discourage or prohibit raising death as a treatment option due to concerns about undue patient pressure. The model practice standard’s stance on “conscientious objection” supports “effective referral” of patients. This means that, if a physician is concerned that MAiD is not a patient’s best option, they must still refer the patient to ensure access to MAiD, instead of pausing or stopping the process.

Examples of these unsafe policies are evident in MAiD training videos. In one, an instructor recognizes that patients may choose MAiD for unmet psycho-social needs, suggesting referral for MAiD completion if discomfort arises. Another instructor in a separate video advises continuing the MAiD process even if a practitioner believes a patient doesn’t qualify for MAiD, suggesting doctor shopping is acceptable.

Certain regions in Canada have the highest MAiD death rates globally. By 2022, nearly 45,000 MAiD deaths occurred across Canada since its legalization—almost 13,000 in 2022 alone, with estimates for 2023 approaching 16,000. Canada’s MAiD regime has chosen to prioritize accessibility over patient safety.

Dr Coelho then comments on her experience with the disability community:

Realizing my political naivety while advocating for legislative change has been a profoundly sad and eye-opening experience. Despite the government’s repeated assurances of listening to the concerns of persons with disabilities and their advocates, the reality witnessed during parliamentary hearings has been disheartening, as their voices are frequently disregarded or dismissed.

Throughout these hearings, committee members have consistently challenged the credibility of accounts detailing abuses within the Medical Assistance in Dying (MAiD) system. They assert an unwavering trust in MAiD assessors, portraying them as professionals deserving of complete faith and trust to get it right every time. However, this confidence is inconsistently applied, as committee members often interrupt and question the integrity of medical and legal experts expressing caution or offering alternative perspectives.

Furthermore, the presence of physicians who are now part of the government on MAiD parliamentary committees has not resulted in the expected depth of medical expertise or unbiased guidance. Instead, their contributions have often been marked by bias, with loaded questions designed to limit responses and paint concerned witnesses as advocating for prolonged suffering. This portrayal is starkly at odds with the reality faced by patients who endure lengthy waits for treatment. This waiting for care and being neglected by our society and health care system wears people down and can lead to choosing MAiD as the only accessible option.

Dr Coelho then comments on the euthanasia lobby:

Behind the scenes, powerful lobby groups in Canada wield significant influence in shaping the debate surrounding the expansion of MAiD. These groups, backed by substantial funding for government relations, dictate the trajectory of discussions, often overshadowing the voices of the underfunded and marginalized disability community. Despite the government’s claims of inclusivity, the reality is that this debate has been primarily driven by powerful interests, rather than the voices of those directly affected.

In essence, the legislative process surrounding MAiD in Canada has exposed systemic flaws and power imbalances, highlighting the urgent need for genuine inclusivity and meaningful dialogue that centers on the experiences and concerns of the real stakeholders, the disability community, which is most directly impacted by these policies.

Coelho is then asked about what must be done to reduce MAiD:

Thomas Insel’s book Healing drives home the critical role community life, support networks, and purpose have in dictating mental health outcomes, thereby highlighting the need for proactive measures. Firstly, the government must fulfill its duty to ensure everyone gets timely care, counseling, and the community resources they need. It’s unfortunate that we’re offering death as an option without properly supporting people who are struggling. At the same time, establishing a national suicide prevention framework is imperative to mitigate the risk factors that could contribute to MAiD decisions.

Palliative care centers have to be prioritized, offering a range of services including pain management, emotional support, end-of-life planning, and counseling individuals facing terminal illness, alongside robust access to disability and mental health services. This entails a concerted effort to build expertise, expand medical care systems, and ensure widespread accessibility.

Investment in community systems is essential too, fostering relationships and a sense of purpose and belonging. By organizing regular community gatherings, support groups, and educational workshops, communities can forge stronger bonds, mitigating feelings of isolation and despair. On the ground level, everyone can be involved in making sure neighbours and family members feel they are needed and cared for.

Furthermore, Canada’s commitment to the UN Convention on the Rights of Persons with Disabilities must be upheld, ensuring the provision of essential services and support for those with disabilities and chronic illnesses. The government has to address the systemic lack of social, economic, and health supports in order to alleviate the suffering that may otherwise drive individuals towards MAiD. We know that suffering from social and economic deprivation actually increases overall suffering from disability as it becomes conflated.

In essence, reducing the number of victims under Canada’s MAiD regime requires a comprehensive approach. Only through concerted efforts across these fronts can Canada ensure the dignity and well-being of its citizens, particularly those facing vulnerability and suffering. We need to make people feel they can live with dignity.

Dr Coelho is then asked what a future government must do:

Sadly, many Canadians remain unaware of the risks of our MAiD regime. As I mentioned, once a society embraces ending life as a solution to suffering, containing this procedure becomes nearly impossible. Tragically, the victims of this system are dead and can be forgotten, silenced, unable to recount the injustices that may have influenced their “choosing” death.

Therefore, to start, completely repealing Bill C-7 is imperative. Anything less is unacceptable to the disability community and greatly perpetuates the risks that death is driven by unjust circumstances.

There is also an urgent need to redefine the terms used in legislation, particularly ambiguous terms like reasonably foreseeable natural death (RFND). Through broad interpretations, individuals with potentially years of life ahead of them are prematurely ending their lives through the RFND track—a practice that was intended only for those in the final stages of life. Moreover, we have people who are simply stating they will refuse care to make themselves sick enough to qualify for RFND; MAiD should only be available to those with a disease prognosis of six months or less, not to individuals deliberately inducing sickness to qualify.

It is necessary to stem the influence of powerful lobby groups and expansionist medical advocacy organizations like the Canadian Association of MAiD Assessors and Providers (CAMAP). CAMAP received 3.3 million Canadian dollars in funding from Health Canada to educate MAiD assessors and providers and has many problematic guidance policies. A balanced independent panel of experts, as urged by the Canadian Human Rights Commissioner, should be convened to review the MAiD regime. This panel should guide legislative amendments, Health Canada policies, and provincial regulatory bodies to increase patient safety.

Many existing policies clearly require revision, including raising MAiD unsolicited, enforced mandatory referrals, and the worrisome trend of integrating MAiD into all care facilities. Ideally, a civil board comprising a multidisciplinary team should evaluate each case before approval to mitigate choices to die that are driven by structural inequalities. We also need better, publicly available, data collection all around.

This is not merely a matter of individual autonomy; it is a public safety concern that is affecting marginalized and disabled individuals. When discussing autonomy, we must consider relational autonomy—what we owe to each other and society as a whole. MAiD is a public policy, so we must consider the well-being of all—not just those seeking to end their lives on their own terms.

Previous articles by or articles concerning Dr Ramona Coelho (Article links).

Dear Senator

EPC-USA's Fact Sheet is testimony regarding the social harms attached to assisted suicide legislation like HB1283. However, given that assisted suicide’s negative impact is going to fall primarily on the disabled community, the EPC felt that we should submit a more detailed analysis of how assisted suicide undermines disability rights, and whose advice on this matter ought to be heeded by members of the Assembly.

Members of the EPC board with training in the fields of disability studies and advocacy have noted that some assisted suicide advocates are trying to hijack disability rights for their own purposes. For instance, an able-bodied man named Christopher Riddle has done pro-assisted suicide advocacy in the Northeast while presenting himself as a “disability rights advocate.” Riddle is a colleague of Udo Schuklenk, one of the architects of Canada’s euthanasia program, and Riddle enthusiastically approves of that program.

Moreover, Riddle’s theories about disability rights have been reasonably criticized as lacking any empirical grounding in the experiences of disabled people. He has no experience or personal stake in the practical implications of his ideas.

Furthermore, Riddle’s scholarship dehumanizes disabled people who are harmed by assisted suicide; he frames anyone who might be harmed by assisted suicide as the equivalent of a car accident statistic. He asserts that harm that assisted suicide might cause for people with disabilities “ought not to be of special concern.” Hence, Riddle is willing to sacrifice people with disabilities for the right to die movement’s agenda; he is not the “disability rights advocate” he claims to be.

For a more accurate understanding of how the disabled community has approached the issue of assisted suicide, we encourage you to watch a video created by disability studies ethicist Harold Braswell about disability rights opposition to assisted suicide. Braswell has studied the right to die issue extensively.

There are other very important facts that legislators must take into account when considering how assisted suicide is impacting the disabled community:

The American Association of Suicidology made a 2017 statement saying that “MAiD” was not suicide. But in 2023 the AAS had to retract that statement because it was used in the 2019 Truchon decision that expanded assisted suicide to disabled Canadians, which was opposed by the Canadian Association for Suicide Prevention.The consequences of the AAS’s statement are an example of how green lighting assisted suicide for the terminally ill easily results in violence against people with disabilities.

In 2021, the United Nations Special Rapporteur on the Rights of People with Disabilities asserted that all assisted suicide laws violate its Convention On The Rights of People with Disabilities.

Peer-reviewed research establishes that people are more likely to view suicide as acceptable if the victim is disabled, and people with disabilities often lack access to comprehensive suicide prevention care. This bill exacerbates that problem by laying the scaffolding for “MAiD” to become a substitute for the suicides of persons with disabilities.

Well-known right to die leader Thaddeus Mason Pope has tweeted that it’s good for disabled people to die by suicide; the director of Compassion and Choices appeared on Dr. Phil with Pope in 2023. If you pass this bill, you empower and reward a contingent of people who want disabled people’s suicides to be a “medical procedure.”

We urge you to allow HB1283 to die this session because regardless of its content, it rewards a movement that is hostile to people with disabilities. Exacerbating the oppression that disabled people already face so that the proponents can plan their deaths is unwise and unjust.

Sincerely,

Meghan Schrader, Disability Rights EPC-USA
Josephine L.A. Glaser, MD.,FAAFP
Colleen E. Barry, Chairperson
Kenneth Stevens, MD
William Toffler, MD
Gordon Friesen
Alex Schadenberg
Epc_USA@yahoo.com

Endnotes

1. https://twitter.com/cariddlephd/status/1373071051631038470
2. http://www.lpbr.net/2014/08/disability-and-justice-capabilities.html?m=1
3. https://www.tandfonline.com/doi/full/10.1080/09687599.2014.984931
4. https://philpapers.org/rec/RIDAD
5. https://www.dropbox.com/scl/fi/vdpwdt26wwq42ak0eraee/Braswell_PAS-Statement_To-Send-1.mov?rlkey=05vve2sis2s4sy51hma27jx2u&dl=0
6. https://www.slu.edu/arts-and-sciences/bioethics/faculty/braswell-harold.php
7. https://suicidology.org/2023/03/08/aas-update-on-previous-statement/
8. https://twitter.com/TrudoLemmens/status/1666067817035190272
9. https://suicideprevention.ca/media/statement-on-recent-maid-developments/
10. https://www.ohchr.org/en/press-releases/2021/01/disability-not-reason-sanction-medically-assisted-dying-un-experts
11. https://pubmed.ncbi.nlm.nih.gov/26402344/
12. https://www.youtube.com/watch?v=XXVrgtTNN2Y&t=2108s
13. https://twitter.com/ThaddeusPope/status/1669450726831976449

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Ann Farmer
Dear ... 

As your constituent I am writing to draw your attention to the above debate, in the hope that you will be able to attend and speak against attempts to legalise assisted suicide/euthanasia, now going under the euphemism 'assisted dying'.

Given the appalling outcomes reported from those jurisdictions that have gone down this route, most notoriously Canada, where 'strict safeguards' have been swiftly dismantled to allow death for disability and also poverty, https://alexschadenberg.blogspot.com/2024/04/a-call-to-defeat-new-hampshire-assisted.html it is vital that we do not follow them down this slippery slope.

Significantly, advocates of 'assisted dying' neglect to mention that this issue has been thoroughly debated and decisively rejected by Parliament in the past few years, on the very valid ground that there is no safe way of killing.

I trust you will attend, or alternatively make the case for 'assisted living' for all, rather than the money-saving expedient of euthanomics.

With all best wishes,

Ann Farmer
Woodford Green
Essex

Alex Schadenberg

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

Amy SmithWhile cleaning up my emails I came across this excellent commentary by Amy Smith, who is a physician-assistant in Minnesota titled: Pledge to 'do no harm' and say No to physician-assisted suicide. Smith's commentary was published in the Minnesota Reformer on April 13, 2024. Smith begins her article by explaining why she opposes assisted suicide.
I’ve spent the past 20 years of my career as a physician assistant saving lives in the emergency department. On a daily basis, I pledge to “do no harm” to my patients as I care for them and render lifesaving aid.

As a medical provider, the greatest harm I can imagine is being responsible for ending my patient’s life. That is why I am deeply troubled by ongoing conversations at the Minnesota Legislature to legalize physician-assisted suicide.

This proposed legislation goes against the fact that a health care providers’ obligation is to care for their patients — not to assist in killing them — no matter the circumstance.Smith is also concerned with the inevitable future extensions to the legislation.
It is also evident that limits on assisted suicide erode over time. These laws often begin with eligibility limited to terminal illness and a six-month life expectancy; however, countries like Belgium, Netherlands and Canada have gradually expanded criteria to offer assisted suicide to people with depression, disability and chronic pain, as well as people with limited income. Patients often seek assisted suicide out of fear of becoming a burden. Legalizing it reinforces harmful misconceptions that people experiencing chronic illness are a burden and encourages people to end their lives prematurely. And euphemisms like “medical aid in dying” make it more palatable for people to accept this as okay, masking the fact that medical professionals are prescribing medication that results in suicide.Smith continues by sharing personal experience with death and dying:
Like many Minnesotans, suicide is also a deeply personal subject for me. My dad ended his own life when I was 12 years old. Most people would say that my dad’s death at age 35 was a tragedy. They’d say we should try our best to prevent suicide. I agree.

I also lost my mom to Amyotrophic Lateral Sclerosis when she was only 62. This proposed legislation tells us that it would not have been a tragedy for my mom, with the assistance of her medical provider, to end her own life prematurely. Instead, this legislation says it would have been the caring thing to do. I disagree.

Both situations are absolute tragedies. In both scenarios, a person should have access to supportive, person-centered care — not a legal path to suicide.Smith concludes by repeating why she opposes assisted suicide.
Is physician-assisted suicide really how we want to care for patients in Minnesota? As a physician assistant, wife, mother — and as an orphan daughter — my answer is a resounding ‘No’.

The following Letter to the Editor was published on April 20, 2024 by The News Gazette.

As a physician, I would like to share my perspective on physician-assisted suicide.

While I agree with common concerns like abuse, misdiagnosis, medication issues and lack of safeguards, I want to focus on another aspect, especially from an emergency physician’s standpoint.

With over three decades of practicing emergency medicine, I have encountered numerous patients at the end of their lives. In emergency medicine, our aim is to cure whenever possible, but above all, to provide care. Sometimes, this entails accompanying patients and their loved ones on their journey towards the inevitable end of life.

Reflecting on physician-assisted suicide, it is impossible to ignore that facilitating a patient’s death contradicts the fundamental principles of medical care, upheld from antiquity to modern medical science. It is disconcerting to see physicians suggesting or providing a direct pathway to end a patient’s life, thus neglecting their duty of care, even towards those with terminal conditions.

Physicians advocating for physician-assisted suicide lack coherence in their justifications, citing reasons such as “dying with dignity” or alleviating suffering by ending life.

Instead of delving into comprehensive approaches to pain management, addressing social support deficiencies, or exploring the psychological, spiritual and emotional aspects of patients’ suffering, they advocate for the ultimate shortcut — facilitating death as the solution.

Redirecting resources from initiatives for physician-assisted suicide toward research for better end-of-life care, enhancing mental-health resources and optimizing pain management would better serve patients and society.

We must reconsider this tragic deviation from our responsibility as healers and stewards of health care.

Dr. GREGORY TUDOR
Peoria

 

The following article was published by Choice is an Illusion.

California Senate Chamber
Senator Catherine Blakespear has removed proposed Senate Bill 1196, seeking to expand assisted suicide and euthanasia in California, from consideration prior to its first hearing Blakespear said in a statement.

"At this point, there is a reluctance from many around me to take up this discussion, and the future is unclear,”

“The topic, however, remains of great interest to me and to those who have supported this bill thus far.”

Senator Susan Eggman, who authored the original act in 2016, commented that pushing forward now would would create a risk of pushback. She stated:

While I have compassion for those desiring further change, pushing for too much too soon puts CA [California] & the country at risk of losing the gains we have made for personal autonomy....

With just a few weeks left to pass bills through policy committees before the Legislature's summer recess, it's unlikely another lawmaker would propos[e] a similar measure this year.

Link to the original article.

Senate Bill 1196 shows us the direction of the American euthanasia lobby. The Bill was only withdrawn because, as Senator Eggman stated it was "pushing for too much too soon."

Article: Good news: California assisted suicide expansion bill is dead. (Link)

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Gordon Friesen
By Gordon Friesen
President: Euthanasia Prevention Coalition 

It is a widely shared principle that, as long as our actions cause no harm to others, we might all be allowed to do as we please.

And so it is that many principled people --and even many who are personally repulsed by the idea of assisted death-- feel a visceral duty to support the "right" of others to choose the manner of their own passing. Unfortunately, however, HB 1283 would not merely create a liberty of permission for this purpose. Indeed far from it.

At the heart of HB-1283[i] lies, first, the concept of "medical assistance in dying" (even though majority patient trust has traditionally been founded on the Hippocratic Physician's promise not to kill); and second, the associated legislative assertion that MAID is not suicide (even though it plainly involves people deliberately taking poison to end their lives). Together, these extraordinary definitions herald a radical conceptual transformation of assisted death --from forbidden medical homicide to legitimate medical treatment-- and therein lies the special significance of Bills like HB 1283.

For medical care is universally seen as a positive benefit and a human right. To legally define assisted death in this way is thus to necessarily create entitlements, obligations and mandates whose implementation is entirely foreign to any fundamental notion of free choice.[ii]

Moreover, if we look to our Northern neighbour, we can already see exactly how such a medically justified regime of assisted death is destined to unfold. For since the first appearance of the term "MAID" in Canadian legislation (Province of Quebec, 2014)[iii] legal statutes and regulations have been enacted which require the performance of euthanasia in all institutions; by all medical professionals (with limited conscience-based exceptions only); and the proactive mandatory discussion of MAID with all eligible patients. Indeed, Canadian hospitals, and care teams have normalized euthanasia, to such an extent, that the vast non-suicidal majority of eligible patients are now obliged to navigate a clinical environment which has become objectively indifferent (if not hostile) to their continued survival.[iv]

Very obviously, no coherent system of individual liberty might ever have produced such a result. Quite the contrary: the simplest and most direct explanation of Canadian euthanasia lies, not in personal choice at all, but in the utilitarian budgetary advantage --to the State-- of systematically purging expensive and dependent persons from the public role.

Most certainly, also, a principled defence of death-by-choice does not require liberty-minded citizens to espouse this extreme theory of death-as-care. Both Switzerland[v] and Germany[vi], for example, recognize a general right to suicide (including assisted suicide) but explicitly refuse to accord such actions any objective validation (medical or otherwise), precisely in order to avoid the disastrous effects of entitlements, mandates and obligations as described above.[vii]

In conclusion, therefore: Although I am personally opposed to any assisted death whatsoever, I also recognize that a sincere philosophy of "live-and-let-live" may indeed inspire principled support for death-by-choice. But not with just any Bill. And certainly not with this one.

In the end, we must decide whether New Hampshire’s medical industry will be structured to prioritize typical patient satisfaction, or that of a small suicidal minority. And above all: whether the radical new paradigm of utilitarian death-medicine now seen in Canada --and so clearly echoed in HB-1283-- will be allowed to high-jack the freedom agenda entirely.

With the greatest respect, I request the defeat of this legislation.

Gordon Friesen, President, Euthanasia Prevention Coalition

Endnotes:

[i] "An act relative to end of life options" New Hampshire HB1283, 2024 (Link to Bill).

[ii] Constitution of the World Health Organization (1946) as amended (2005) accessed April 17, 2024 (Article Link) accessed April 17, 2024

[iii] "Act Respecting End-of-Life Care" Province of Quebec, Canada, 2014, as revised 2024 (Link to Legislation) accessed April 17, 2024

[iv] Lessons from the Canadian Euthanasia Experiment, G. R. Friesen, April 4, 2023 (Link to article) accessed April 17, 2024

[v] Swiss criminal code art. 115 (Link to Swiss Criminal Code) accessed Nov 4, 2023

[vi] German High Court decision February 26, 2020 (Article Link) accessed Oct 28, 2023

[vii] Fundamental Considerations in the Creation of a Minimally Intrusive Liberty of Assisted Death (produced for the Irish Joint Committee on Assisted Dying), G.R. Friesen, November 12, 2023, (Article Link) accessed April 17, 2024.

Are you grieving the loss of a loved one through Medical Assistance in Dying (euthanasia)?

Compassionate Community Care and St John The Compassionate Mission are hosting a retreat day for hospitality, support, reflection and sharing for those who are hurting from losing a loved one (friend or family) through (MAiD) euthanasia.

Anyone who is grieving is welcome.

The event is: Saturday May 25, 2024 from 12 to 8 pm.

The location: 155 Broadview Ave., Toronto ON M4M 2E9

There is a suggested donation of $100. Meals are provided.

For more information and to register email: info@beingwith.org or outreach@stmarysrefuge.org

Project Anna and Simeon.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill
Kevin Yuill, who is an emeritus professor of history at the University of Sunderland and CEO of Humanists Against Assisted Suicide and Euthanasia (HAASE) was published in Spiked on April 18, 2024 is asking the question: Why are Dutch doctors euthanising healthy young women?

Yuill begins his article by telling the stories of Yolanda Fun and Zoraya ter Beek:

Alex Schadenberg
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have great news. The California assisted suicide expansion bill (SB 1196) has been pulled. 

This is great news, but let's be clear, the language of SB 1196 is the goal of the assisted suicide lobby but the bill was determined to have gone too far too fast.

Based on the summary of SB 1196 by Senator Blakespear I stated that the bill would have:

1. Allowed euthanasia by IV (intravenous), as in Canada. Currently, California permits assisted suicide (lethal poison that a person takes orally at the time and place of their own choosing, with or without witnesses). This bill allowed for death by IV. This constitutes euthanasia/homicide.
2. Changed the criteria from terminally ill (6 month prognosis) to the Canadian model: “a grievous and irremediable medical condition.” Thus, there would be no time limit  and no terminal illness requirement.
3. Allowed people with early to mid-stage dementia to consent to assisted suicide or euthanasia, even though they have a condition that impairs their capacity to consent.
4. Removed the California residency requirement. California would join Oregon and Vermont, dropping their residency requirements and allowing for suicide tourism.
5. Removed the 2031 sunset clause in the California assisted suicide law.

I published an article on March 18, 2024, stating that the California bill would legalize medical killing. After the language of SB 1196 was released I further explained how SB 1196 would have expanded medical killing in California.

SB 1196 would have changed the law from requiring ingesting of the lethal poison to utilizing the lethal poison. Utilize was not defined in the bill but it could be defined as: "to make practical and effective use of."

SB 1196 would have changed the law from requiring a terminal disease to a grievous and irremediable medical condition.

Terminal disease was based on a 6 month prognosis whereas grievous and irremediable medical condition had a long definition that essentially mean't that the person has a serious chronic condition that will continue to decline.

The bill stated:  

For purposes of this part, a “grievous and irremediable medical condition” includes a diagnosis of early to mid-stage dementia while the individual still has the capacity to make medical decisions. 

IV catheter
How would early to mid-state dementia have been defined in practise?

SB 1196 permitted non-doctors to participate in the law. SB 1196 added the following: nurse practitioners, physician assistants, and registered nurses.

SB 1196 removed the residency requirement in the California law by striking out the words - is a resident of California.

SB 1196 allowed the use of an IV (intravenous) catheter to "utilize" the poison. SB 1196 stated:  

death through ingestion, or through an intravenous pathway after a health care provider places an intravenous catheter if one was not already placed, to bring about the qualified individual’s own death. 

This statement did not limit the use of the IV catheter to assisted suicide and may have allowed for euthanasia/homicide.

Later SB 1196, stated:  

For purposes of this section, “assisting the qualified individual by preparing the aid-in-dying drug” includes a health care provider placing an intravenous catheter, so long as the health care provider does not assist the qualified individual in introducing the aid-in-dying drug into the qualified individual’s vein.

This statement inferred that the person must somehow utilize the IV catheter. The IV could be placed but the health care provider could not "assist". This was intentionally confusing. There may also have been circumstances, such as ALS, where the person has difficulty "utilizing" the IV catheter without assistance.

On June 22, 2022, a California federal judge rejected a case designed to permit euthanasia within California's assisted suicide act. Shavelson, a doctor that solely focuses on assisting suicide and Sandra Morris, who had ALS, argued that the state's assisted suicide law discriminated against people who had difficulty self-ingesting the lethal drugs and to remedy the situation the state needed to permit euthanasia in those cases.

In that case, Shavelson argued that allowing the administration of lethal drugs by IV catheter when a person has difficulty self-administering the lethal drugs was necessary. Justice Chhabria rejected the argument and stated:

Chhabria ruled the case could not proceed on the theory that it violates the ADA because the accommodation they seek would cross the boundary created by the End of Life Option Act, “from the ability to end your own life to the ability to have someone else end it for you.”Chhabria further ruled:
“Such an accommodation would ‘compromise' the essential nature of the act, and would therefore fundamentally alter the program.’”

The judge said the law’s self-administration requirement is the “final safeguard” to ensure the act remains voluntary.

“A person seeking to end their life pursuant to the act can opt out at any point — after requesting or receiving the prescription, after the drugs are in their hand, after the feeding tube has been installed, after saying goodbye,” he wrote. “The accommodation that the plaintiffs seek would significantly undermine these protections by opening a window during which there would be no way of knowing whether the patient had changed their mind.”

If SB 1196 would have changed the California law by removing self-administer, removing the terminal illness requirement and allowing the utilization of an IV catheter, these changes would make it impossible to distinguish between an act of assisted suicide and an act of euthanasia/homicide. 

Assisted suicide is receiving lethal poison and self-administer it for the purpose of causing death.

Euthanasia is when another person, usually a medical professional, administers the lethal poison for the purpose of causing death. Euthanasia is a form of homicide/murder.

Since SB 1196 did not require a "third/independent party" to witness the act, therefore SB 1196 would have enable euthanasia under the guise of assisted suicide and achieve for the euthanasia lobby what was denied to them by Justice Chhabria in 2022.

SB 1196 was a "Trojan horse" euthanasia bill.

SB 1196 is the end goal of the assisted suicide lobby.

Normal 0 false false false EN-CA X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-fareast-language:EN-US;} By Meghan Schrader

Meghan Schrader
Meghan is an autistic person who is an instructor at E4 - University of Texas (Austin) and an EPC-USA board member.

I am commenting on the cases of the young women with autism, ADHD, depression and Borderline Personality Disorder who are planning to have their lives ended in Canada and the Netherlands from the perspective of someone who also has autism, ADHD and depression. I am not a psychologist and I’ve never met either person, but I will do my best to share insights about those situations based on my own experiences.

The cases strike me as presenting a lot of issues so this article is long. The issues that stick out to me are the devastation a person might feel when they are told that their mental health conditions can never improve, the abusiveness of that advice, the right to die movement’s flippant attitude toward death, the nature of true friendship, the autistic tendency to fixate, and the complex experience of autonomy that occurs when a autistic adult lives with their parents.

I’ll start with the 28-year-old woman in Belgium with autism, BPD and depression. Ter Beek’s situation makes me think of two issues, one being the euthanasia movement’s flippant approach to death and the potential inaccuracy or hubris of doctors who dole out mental health diagnoses. Ter Beek was told that she could never get better, which is something I’ve been told during my struggles with treatment resistant depression, at my lowest moments after multiple futile hospitalizations and medication trials. Hearing those predictions was gutting, and I understand why some people who get that kind of prognosis might feel motivated to have their lives ended.

But just giving up on a patient and suggesting that they die is abusive. It’s common for clinicians to arrogantly dole out demoralizing predictions to disabled people that would make anyone fearful of the future; and that can certainly contribute to the conclusion that one should die. I’ll never forget one counsellor at a partial hospitalization program who barely knew me, but took it upon herself to announce to me that the combination of my learning disability, autism spectrum disorder and depression was so disabling that I would never work and would have to live in a group home for the rest of my life. (That’s not true; now I live in an apartment and work at a job I love.) A medical system or physician who tells people, “you’ll never get better; maybe you should kill yourself” is doling out an even more arrogant and abusive recommendation.

It’s worth noting that dark predictions of things never getting better fit into a pattern of people with Borderline Personality Disorder struggling to access adequate care. People with BPD are more likely to have clinicians give up on them because of stereotypes about people with BPD, because people with BPD have a higher incidence of suicide, and because the symptoms of BPD sometimes make the person difficult to interact with (Link to article). But, recovery from BPD is very possible; in fact, the woman who developed Dialectical Behavior Therapy, the gold standard treatment for BPD, had the disorder herself (Link to article). I have a colleague at my job who has BPD, and she’s now living her best life, doing wonderful work with our students. There’s also evidence that the symptoms of BPD, which can be very acute in a person’s twenties, decline with age. (Link to article) So, often clinicians assume that people with BPD are bad or unfixable people, but it’s just not true. People with BPD can effectively manage their condition and lead meaningful, happy lives (Link to a book on the topic).

Another thing that stood out to me when I looked at the article about Ter Beek is the euthanasia movement’s trivialization of death. Now, a mentor who provided feedback on this article pointed out to me that people have many different ways of processing what death is. He commented: 

“Many might argue that fear is not the only appropriate or even “reasonable” response. Many religious systems perceive death as a step toward eternal life, and other think of death as ‘not being,’ that is as potentially neutral as being, perhaps within the will/power of divine order that transcends us.” 

Zoraya ter Beek
Fair enough, but I still think that the right to die movement is trivializing the harm of death. In the interview she did for the Free Press, Ter Beek says that she’s a little scared to die, but the picture of her accompanying the article has her looking sanguine in a way that reminds me of someone who is modelling clothing; she refers to the urn her ashes will be kept in as “my new house;” as though being a pile of ashes kept in a urn on someone’s desk is the equivalent of buying a condo (Link to article). This description of death indicates an unverifiable certainty that death is a doorway to something good. The right to die movement’s current activities are as though many of the proponents have inured themselves to the concept that death is the great unknown and that dead people are lowered into graves where their bodies are eaten by worms. I think that if Canadian and Netherlands culture treated death with more reticence and a less like a trip to some amazing wonderland of delight, the choice to be dead might not seem so appealing to disabled people who are signing up for euthanasia.

Now I’ll move on to the the young woman in Canada with autism and ADHD, MV. The thing that sticks out to me the most is that she lives with her parents, and as someone who lived with my parents on and off in my twenties, I know that that can be a complex and potentially difficult experience for everyone involved, even when everyone is trying their best and loves each other very much. So, I’ll consider how I think that situation might be impacting MV’s “MAiD” request.

First of all, we live in a culture that highly prizes autonomy and expects adult children to move out of their parents house, and I’m wondering if that’s making the experience of living with her parents seem intolerable to MV (Link to an article). But, complete independence is not the only valuable or valid conception of autonomy to operate from. In the Latino culture (Link to article) it is common for multiple generations of a family to live in the same house far into adulthood. (Link to article).

Hence, I think it might help MV to consider that the Latino culture and disability justice culture emphasize interdependence-autonomy with help from others in the context of supportive relationships. Disability Studies professor Paul Longmore put the difference between mainstream Western conceptions of autonomy and the disability justice movement’s general approach to autonomy as follows:

“For example, some people with disabilities have been affirming the validity of values drawn from their own experience. Those values are markedly different from, and even opposed to, nondisabled majority values. They declare that they prize not self-sufficiency but self-determination, not independence but interdependence, not functional separateness but personal connection, not physical autonomy but human community. This values-formation takes disability as the starting point. It uses the disability experience as the source of values and norms. The affirmation of disabled values also leads to a broad-ranging critique of non- disabled values. American culture is in the throes of an alarming and dangerous moral and social crisis, a crisis of values. The disability movement can advance a much-needed perspective on this situation, It can offer a critique of the hyperindividualistic majority norms institutionalized in the medical model and at the heart of the contemporary American crisis.” (Link to article) So, if I could talk to MV, I would tell her that there’s no need to be ashamed that she lives with her family just because that’s not what most adults in Canada do; plenty of competent, fulfilled adults in this world do the same thing. In a way, those of us disabled adults who live with family are rebels living in a way that is counter-cultural, and that cultural deviance really isn’t a bad thing.

However, I also know that being a disabled adult child living in your parents house can sort of feel like you are stuck in a state of perpetual adolescence, and that this can cause a person to feel repressed. When I was living with my parents I was grateful for their support, but I wasn’t able to have the level of autonomy that I think most twenty-somethings want, and we sometimes struggled to communicate effectively about what each one of us needed. There were a lot of times when I found my parents well-meaning advice intensely grating or that they found various everyday behaviors of mine disruptive. That situation led to some very demoralizing conflict; being “roomates” with your parents can make some daily interactions start to feel like fingers on a blackboard, even if those family relationships are very loving.

My choice to move to Texas in my mid-thirties was also a good one. My parents and I are still very close, but they have more space to have time together as a couple and I have more room to say, “No, I don’t want to do that,” or, “I, Meghan Schrader the independent disabled adult, want help with thing A, but not thing B.”

Given my own experiences, I’m wondering if MV’s desire to die by “MAiD” is at least partially motivated by an attempt to assert autonomy in a situation where she isn’t experiencing autonomy in other domains of her life. Is there perhaps another family member or friend who she could live with for a while, who could provide support for her disability and would provide the same level of encouragement for her to live, but with whom she might feel a greater sense of autonomy? Would that make her feel as though she has better adult choices to look forward to? One thing that I think would’ve helped me in my 20s is going to a treatment facility for people with clinical depression; is that the kind of thing that MV might be willing to do that might give her a break from her environment? Perhaps MV could go on a long retreat somewhere? If a change in MV’s living situation isn’t possible right now, are there other ways that she could have more opportunities to make choices about her daily routine, establish clearer boundaries with others and direct the course of her life? (Link to a book on this topic). 

Of course, as I’ve said, I am not a member of this family and I don’t know what’s going on in their everyday lives; MV struggling to assert herself in a situation where she isn’t getting other opportunities to assert autonomy is just the kind of thing that I think might be going on based on my own experience.

However, although giving MV more autonomy in general strikes me as potentially helping to alleviate her desire to die, MV’s Dad’s statement that MV is “obsessed” with MAiD and that the obsession is related to her autism and ADHD strikes me as providing important insight into how she is experiencing the conclusion that she should die by “MAiD,” and that these dynamics complicate her experience of autonomy. An article on the situation reads:

“The wrinkle, and perhaps the tragedy, in this case is that the woman, identified only as MV, has autism and ADHD, lives with her parents and has never had an independent life. Her father, identified as WV, argued that her condition is mental, not physical, so she doesn’t qualify for MAID under current law. Her condition, he said, led to her being “obsessed” with MAID.” (Link to article). I think some people might read that statement as a parent erroneously and paternalistically painting an adult autistic child as lacking agency, but I can say from experience that the autistic tendency to fixate is a real thing. This hyper focus is even more intense in those of us who also have ADHD, and that hyper-focus can sometimes make it difficult to break out of irrational or destructive thinking patterns (Link to article). In that case the person is not “incompetent,” but the fixation distorts the person’s ability to think through all the facts about whatever they are fixated on, sort of like if the person were mildly intoxicated (Link to image). A family member’s efforts to prevent a loved one from making a choice based on those thinking patterns are not “paternalistic,” it’s the family member being loving and responsible. Or, that’s been my experience.

For instance, MV’s intent to die by “MAiD” reminds me a little bit of some of the decisions I’ve made in the context of symptoms of body dysmorphic disorder. I’m going to withhold the details, but a couple of times I’ve made choices related to perceptual distortions from that disorder that my parents strongly urged me not to make, and I could have saved us all a lot of suffering if I had listened to them, even though I’m an independent adult who can make her own choices. I also made some important vocational decisions in my late teens and early twenties that my parents strongly advised against, and in my thirties I came to deeply regret not following their advice.

But, at least I lived to regret those mistakes and move on with my life. This young woman is presumably fixated on the idea that killing herself isn’t really so bad. Unfortunately, the fact that she’s reached that conclusion is sort of understandable in the same way that some of the ways I’ve handled body dysmorphic disorder are understandable. Western culture inundates us with ideas about what is attractive in a similar way that Canadian & Netherlands culture romanticize “MAiD.” So, “MAiD” has been presented as just another choice, and that’s a sad combination with the fixation that is more typical for those of us on the spectrum.

I think I remember reading somewhere that someone urged MV to die by “MAiD,” and that makes me very sad. It reminds me of a terrible experience I had in my early 20s when a close friend of 20 years suddenly started treating me horribly because that’s what her new boyfriend urged her to do. It was deeply wounding to have one of my best childhood friends, with whom I had shared some of the happiest times of my life, turn on me in that way, and the eventual dissolution of that friendship caused desperate loneliness. The friend who is urging MV to kill herself is abusing MV in a similar way. Urging someone to end their life is not the mark of a true and caring friend, this is a mark of someone living out their appetite for destruction by pushing someone else toward destruction. In fact, a young woman in Massachusetts served time in jail for encouraging her boyfriend to end his life. (Link to article).

My hope for MV is that she is eventually able to find better friends who will truly love and support her, like a close mentor of mine who lives near my current apartment and generously serves as a listening ear, a lunch partner and problem-solver for me. I also found it helpful to get involved with the local chapter of the Autistic Self Advocacy Network; is there a Canadian chapter of ASAN or a similar group that MV could get involved with where she could experience comaraderie with other people who have disabilities, such as one of the groups that signed this letter opposing the extension of assisted suicide to people with disabilities in 2021? (Link to article)

The last thing MV’s situation causes me to reflect on is the euthanasia movement’s privileging of personal choice above all else. In respect to MV’s intent to die, the original trial judge wrote that: 

this choice “goes to the core of her being. An injunction would deny MV the right to choose between living and dying with dignity.” 

The judge’s logic shows just how cold the euthanasia agenda is; he was denying the woman’s father the opportunity to intervene to save their daughter because the impending suicide was a choice. Canada’s “MAiD” program’s operation from that logic shows that the right to die movement treats choice as something that can never be questioned, no matter the consequences: MV’s decision to kill herself with “MAiD” is a choice, so that choice must be carried out and MV’s parents should just stand there while someone injects poison into her arm.

A culture that privileges a “choice” facilitated by state-employed doctors over instincts of family and the efforts of parents to prevent their children from being killed is an empty one. Unfortunately, the politically powerful euthanasia movement values the right to be made dead more than the deepest bonds of love and care. My hope is that MV and Ter Beek will find the love and care that they need to move beyond the desire to die and achieve something much better for themselves.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A study was published on April 16, 2024 titled: The association between social connectedness and euthanasia and assisted suicide and related constructs. 

The concern with loneliness and isolation in relation to deaths by euthanasia and assisted suicide is real, but this study disagrees. The study concludes:

Our findings for all age groups are consistent with a those of a previous systematic review focused on older adults and suggest that poor social connectedness is not a clear risk factor for EAS or for measures more distally related to EAS.

The study acknowledges its weaknesses, nonetheless I found this study to be questionable because it was based on data from previous studies (no new research) and the data was not primarily based on interviews with people.

The best study on this topic was done by van der lee et al and published in the Journal of Clinical Oncology in September 2005 titled: Euthanasia and Depression: A Prospective Cohort Study Among Terminally Ill Cancer Patients

van der lee is a Dutch researcher who supported euthanasia and indicates that the purpose of the study was to prove that there was not an association between euthanasia and depression. In her explanation of the study van der lee states:

Second, in our experience, requests for euthanasia are mostly well considered and commonly not associated with depression.We therefore expected that patients requesting euthanasia might be even less depressed.

The conclusion of the study was opposite to its premise:

Of 138 patients, 32 patients had depressed mood at inclusion. Thirty patients (22%) made an explicit request for euthanasia. The risk to request euthanasia for patients with depressed mood was 4.1 times higher than that of patients without depressed mood at inclusion (95% CI, 2.0 to 8.5).

Depression in cancer patients with an estimated life expectancy of less than 3 months is associated with a higher likelihood to request for euthanasia. The question of whether depressed mood can adequately be treated in this terminally ill population, and if so, whether it would lower the incidence of requests for euthanasia needs further investigation.

The significance of the van der lee study was that the conclusion was counter to the bias of the researchers. Therefore you can't argue that research bias led to the outcome of the study.

Another strength with the van der lee study is that the researchers interviewed the participants in the study. The data was based on actual people who were requesting death by euthanasia in a country where it was legal and accepted.

Another important study that was based on communication with the participants is the Irish longitudinal study that examined the wish to die (WTD) among 8174 patients who were over the age of 50. The study that was published in February 2021 followed the participants for 6 years and it determined that people who had a wish to die (WTD), almost three-quarters reported being lonely and 60% had clinically significant depressive symptoms. Other factors leading to a WTD was functional disability and chronic pain.

When the WTD was reassessed two year later, 72% of the people indicated that loneliness and depression had receded, re-affirming previous studies that prove that a WTD fluctuates.

Once again, the strength of this study was that the data came from actual communication with participants and there was no known bias associated with the researchers. 

I am convinced by the studies that obtain their data from actual participants and I am convinced from the anecdotal experience I have in personally speaking to many people who are seeking to request or who have actually been approved for MAiD.

As stated in the conclusion of the van der lee study:

Our findings suggest that depressed mood in the last months of life is associated with a higher risk for request for euthanasia.

There is a direct relationship between requests to have one's life ended by euthanasia or assisted suicide and one's feelings of hopelessness, depression and loneliness. 

I have also found through conversations with people who have been approved for euthanasia that suicidal ideation is also prevalent.

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The following message was from a Quebec nurse concerning the quadriplegic man who "chose" euthanasia after being left on a stretcher for 95 hours and subsequently developed a bed sore.

I am writing because I am a nurse who is having a hard time coping with the extended MAID criteria. I have worked with vulnerable populations and see that this is the governments way of “getting rid” of the problem. But really they are cornering and making the most vulnerable feel like burdens. I live in Quebec and the story of a Quebec man who was left for 95 hours in a stretcher and then subsequently sustained a bed sore has gained attention. He then was presented the option for MAID and took it due to feeling like a burden. This is directly a result of the failure of our healthcare system, and as a Canadian I no longer feel comfortable watching this happen. What can I do to help raise more awareness on this issue? I am becoming increasingly angry, and feel that there is not enough advocacy around this. I feel that this is the start of the “extinction” of the vulnerable rather than creating proper supports, infrastructure and safety nets.We need more people speaking out, but we also need more stories uncovering the reality of euthanasia in Canada. The political shift that prevented the federal government from instituting euthanasia for mental illness alone came about from the many stories of people with disabilities who were approved for euthanasia, but requested it based on poverty, homelessness, an inability to get the care that they needed and more.

Québec quadriplegic man "chooses" euthanasia after suffering horrific negligent care. (Link).

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Stefanie Green is Canada's leading MAiD (euthanasia) physician. She does not do the most MAiD deaths in Canada, but she is a MAiD practitioner, MAiD trainer and more. Her own euthanasia access and promoting website states:
Dr. Stefanie Green spent 10 years in general practice and another 12 years working exclusively in maternity and newborn care. She changed her focus in 2016 and now spends the great majority of her clinical time working in assisted dying.

Based in Victoria BC, Dr. Green is the Founding President of the Canadian Association of MAiD Assessors and Providers (CAMAP). She is a co-lead for the Canadian MAiD Curriculum Project, is medical advisor to the BC Ministry of Health MAiD oversight committee, and moderator of CAMAP's national online forum.

Dr. Green enjoys speaking about MAiD to the public, to health care communities and to a wide range of audiences locally, nationally, and internationally. She is clinical faculty at UBC and UVic, and she is the author of the internationally bestselling "This Is Assisted Dying" (Scribner) about her first year providing assisted dying in Canada.

Without further investigation, it seems clear from the information on this site that Green does MAiD, regulates MAiD, teaches MAiD and is a medical advisor to the BC Ministry of Health oversight committee. How can a person who does the act and teaches people to do the act also be an advisor to the government when oversight is necessary?I am not privy to more information but a conflict of interest investigation is needed.

Swiss assisted suicide coffinBy Alex Schadenberg
Executive Director, 

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Scottish ParliamentAn 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: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.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Normand Meunier
Rachel Watts reported for CBC News on April 12, 2024 that a quadriplegic man, Normand Meunier (66) "choose" to die by (MAiD) after developing a severe bedsore at a hospital in Saint-Jérôme, Québec. Meunier experienced a tragic spinal chord injury in 2022.

Sylvie Brosseau told CBC news that:

Before being admitted to an intensive care bed for his third respiratory virus in three months this winter, Meunier was stuck on a stretcher in the emergency room for four days.

His partner, Sylvie Brosseau, says without having access to a special mattress, Meunier developed a major pressure sore on his buttocks that eventually worsened to the point where bone and muscle were exposed and visible — making his recovery and prognosis bleak.

"Ninety-five hours on a stretcher, unacceptable," Brosseau told Radio-Canada in an interview.

"Every time we go to the hospital, it's my duty to tell them that Normand is quadriplegic and needs an alternating pressure mattress … I don't understand how this can happen, because a mattress is the most basic thing."

Meunier's death by euthanasia is one of many stories of people who "choose" to die after receiving negligent medical care.

Jean-Pierre Beauchemin, a retired geriatrician and professor at Université Laval's faculty of medicine tod CBC news:

"When you're lying down, always in the same position, there's hyper-pressure between the bone and the skin,"

"A pressure sore can open in less than 24 hours, and then take a very long time to close."

The buttocks, heels, elbows and knees are particularly vulnerable.

A rotation schedule every two hours is generally necessary for a person confined to bed, according to a Quebec Health Ministry reference sheet.

Steven Laperrière, the director general of the Regroupement des activistes pour l'inclusion au Québec (RAPLIQ), which supports people with disabilities told CBC news:

"That whole story is a crying shame,"

"It's really a case of disbelief … What are we doing in order to help disabled persons or sick people to live in dignity prior to dying in dignity?"

He says the health-care institution was "negligent to say the least" and that getting a proper mattress is not like "trying to get a space shuttle into orbit."

"It's pretty basic … Nobody will convince me that within a few hours the proper mattress could not have been found," said Laperrière.

"To me, that's totally a lack of professionalism," said Laperrière, who says Meunier "would probably still be alive today" if staff had "been really professional about it."

Trudo Lemmens
Trudo Lemmens, The Scholl Chair in Health Law and Policy at the University of Toronto said that this case is "an illustration of problems in our health-care system." Lemmens told CBC news:

"Then the system responds by saying: 'well, you have access to medical assistance and dying,'"

"Medical assistance in dying is more easily available and on a more regular basis than some of the most basic care."

He says he is increasingly hearing stories of people who are struggling in the system and turn to MAID.

"It's deeply troubling,"

Watts reported that along with Brosseau, Moelle épinière et motricité Québec (MÉMO-Qc), an advocacy group for people with disabilities, is now demanding the Quebec government launch an independent inquest into Meunier's death. They believe the health authority's internal investigation is insufficient.

The disability group is seeking a meeting with Christian Dubé, Quebec's health minister, concerning the circumstances and lack of care that people with disabilities are experiencing in Québec.

By the way, euthanasia is all about "choice", "freedom" and "autonomy."

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Luc Van GorpThe Belga News Agency reported on April 8, 2024 that Luc Van Gorp, the President of Belgiums largest health insurance fund, Christian Mutualities (CM) is suggesting that Belgium cannot fund its healthcare needs and requires more deaths by euthanasia.

Van Gorp commented on the increasing financial pressure related to Belgium's aging population and healthcare funding.  He stated:
"No matter how much you end up investing, it will still not be enough"A Times of London article reported that Van Gorp's response is to promote euthanasia for those who are "tired of living":
Belgium’s euthanasia laws should cover elderly people who are “tired of life” or who feel they are a burden on the public purse, a health insurance chief has urged. Luc Van Gorp, 57, the president of the CM health fund, a Christian mutual insurance provider, said that the number of Belgians over 80 would double to 1.2 million by 2050.

“Many elderly people are tired of life. Why would you necessarily want to prolong such a life? Those people don’t want that themselves, and when it comes to budgets: it only costs the government money,” he told the Nieuwsblad newspaper. “We must remove the stigma.”Essentially Van Gorp is advocating for euthanasia for those who "tired of living." 

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Mary Fahey
Mary Fahey has written a powerful op-ed that was published in the Manchester Union Leader on April 10, 2024 in response to New Hampshire assisted suicide legalization bill HB 1283.

Fahey opposes assisted suicide based on her personal experience. She writes:

At 23 years old, I have more chronic, incurable, and life-altering diseases than I can count on one hand. I am also a survivor of a suicide attempt and have dealt with strong suicidal ideation as I’ve faced daily suffering and the loss of my health as I knew it. While I have gotten the help I need to learn to live happily with my near constant illness, it has been one of the hardest tasks of my life, a task further burdened by the countless doctors I saw who knew little to nothing of my conditions or how to treat them.Fahey states that she has found happiness, in her struggles from her friends and family in her life. Fahey continues:
This legislation fails to reinforce the value of New Hampshire citizens. Rather, assisted suicide, by its nature, creates a cruel scale of value on human lives, deeming some more worthy than others simply based on their circumstances. With assisted suicide, we are no longer stating that we should protect all lives from suicide, instead, we are saying that some lives should be exempt from that protection, that some lives are simply not worth living.Fahey, who has survived a suicide attempt continues:

As a society, we work diligently to prevent suicide in healthy individuals, because of the knowledge that their lives have inherent and immeasurable value, and we know their death would be a tragedy. Is it our place to remove that value and promote suicide simply because someone is challenged by suffering? Doing so has devastating and far-reaching consequences, especially for New Hampshire’s young people, for whom suicide rates are already on the rise.

The supporters of this bill assert that medical aid in dying (MAID) is not actually suicide, because those who utilize it do not wish to die, and those who end their lives by suicide do wish to die, and therefore it puts no one at risk. I find this claim incredibly false. When I attempted suicide, I did not wish to die, rather, I desperately wished to live. I simply saw no alternative to the mental and physical suffering I was experiencing.Fahey has also lost several friends to suicide. She writes:Recently, I lost a childhood friend to suicide. He was young, with a young family. Another young woman I know of took her life last month; her obituary reads “she made a heart-breaking decision in an effort to pursue peace.” Passing HB 1283 will clearly send the message to vulnerable young people that intentionally and unnaturally ending one’s life in the face of suffering is a legitimate solution to their pain.Fahey lives with suffering but normalizing suicide and death are not the answer. Fahey writes:
One of the greatest burdens in my personal health journey has not been the illness itself, but reconciling the unavoidable pain, discomfort, and fear with the goodness of life. I believe many young people in a similar position would say the same. I still struggle to accept this, but while I can hardly remember a day without bodily suffering, I also cannot remember a day where I have not been able to find great meaning and joy.

When the proponents of this bill state that it is not only permissible, but dignified, to take one’s life when confronting great adversity, it undermines the efforts of all of those, like myself, who have fought so hard to live in the face of grave, and often silent, suffering. It puts countless New Hampshire young people at risk by normalizing suicide as an acceptable solution to their burdens.Fahey ends her article by urging people to contact their state Senator to oppose assisted suicide.Contrary to the message of this bill, our suffering doesn’t define us. Our lives, however difficult, however limited, are worth living and celebrating. The Granite State needs to protect lives, not legislate ways to end them. I urge those who value every life to reach out to their state senator and ask them to vote against HB 1283.People with disabilities need help to live not to die (Link).