Monday, March 18, 2024

California bill legalizes euthanasia and expands the criteria beyond terminal illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

California legalized assisted suicide in 2016, they expanded the law in 2021 and they are now debating further expansions to medical killing.

On March 8 I published an article concerning California Senate Bill 1196, a bill that would:

  1. Allow euthanasia—by IV, 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)
  2. Changing the criteria from terminally ill (6 month prognosis) to the Canadian model: “a grievous and irremediable medical condition.” meaning No time limit
  3. Allow 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. Remove the California residency requirement. This would allow California to join Oregon and Vermont, which dropped their residency requirements and now allow suicide tourism.
  5. Remove the 48 hour waiting period between first and second request by the patient. Same day death. 
  6. Remove the 2031 sunset clause in the California assisted suicide law.

Maggie Hroncich wrote an article that was published in the New York Sun on March 18, 2024 explaining the proposed changes to California's "End of Life Options Act. Hroncich writes:

Dubbed by critics as the ‘most extreme’ expansion effort in America, the bill’s backers say it would give patients greater medical autonomy.

As efforts to expand physician-assisted death ramp up across the country, California lawmakers will consider a measure to expand access to the procedures for dementia patients, add new ways drugs can be taken, and open access to out-of-state residents. 

Senate Bill 1196, introduced by a state senator, Catherine Blakespear, would expand California’s End of Life Options Act to include patients with a “grievous and irremediable medical condition” to request doctor-assisted death in addition to patients with a terminal disease. 

Senate Bill 1196 uses similar language to Canada's euthanasia law. Hroncich writes:

In Canada, a shocking four percent of the country’s deaths were from assisted suicide — leading to it being the fifth-leading cause of death there, as the Sun has reported. Recently, reports have emerged that a father is asking a Canadian court to stop his 27-year-old daughter’s assisted suicide, whom he says has autism and doesn’t meet the criteria for assisted death. 

The California bill would set new conditions that would require a patient to be in a state of “irreversible decline in capability” and experiencing “physical or psychological suffering” that is “intolerable to the individual and cannot be relieved in a manner the individual deems acceptable.” Additionally, it must be “reasonably foreseeable” that the condition would become the patient’s natural cause of death. 

The legislation, if enacted, would also expand assisted-death to allow patients with “early-to mid-stage dementia,” allow IV infusions of the drugs rather than the current requirement that it must be taken orally or through a digestive tract, remove the 2031 sunset date, and remove the state’s residency requirement. 

Hroncich quotes me explaining why the bill will permit euthanasia:

One vocal critic of the bill is the Executive Director of Canada’s Euthanasia Prevention Coalition, Alex Schadenberg, who is warning California lawmakers not to “follow Canada’s lead.” 

“Changing the criteria from a terminal illness (6 months prognosis) to having a ‘grievous and irremediable medical condition’ will lead to people with disabilities ‘qualifying’ for death by lethal poison for reasons of poverty, homelessness, an inability to obtain necessary services or difficulty with obtaining medical treatment as has happened in Canada,” he notes. 

The bill could lead to “homicide tourism,” he adds, and the IV infusion allowance would mean doctors are actively carrying out the death rather than assisting a patient in self-administering the fatal drugs. “Euthanasia is sold to the public as allowing competent adults who are capable of consenting to die by lethal poison,” according to Mr. Schadenberg. “Allowing euthanasia for people with dementia permits medical practitioners to kill someone who is not competent and unable to consent.”

Hroncich was careful in writing this article but clearly Senate Bill 1196 will not only expand the assisted suicide law, but it also legalizes euthanasia, otherwise known as homicide. This is not an expansion of the law but rather it legalizes euthanasia.

Sunday, March 17, 2024

Dutch doctors oppose euthanasia for "completed life."

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On March 17, the NL Times reported that the Royal Dutch Medical Association maintained their opposition to euthanasia for "completed life." The NL Times report stated:

Doctors are still opposing a proposal to make euthanasia possible for elderly people who feel their life is fulfilled. The Royal Dutch Medical Association (KNMG) says there are still too many risks for people in a vulnerable position.

D66 submitted an amended "completed life" bill in November. The bill states that people 75 years of age and older can decide to end their life when they feel they no longer wish to continue living. With the assistance of a new professional, the end-of-life counselor, they would be able to do so.

There are usually complex problems behind suicidal ideation in elderly people, KNMG warns. They mention problems like loneliness, depression, social isolation, financial problems, or a weak socioeconomic position.

The doctors' federation says more attention should be given to these issues. "The facilitating of suicide for the elderly in a vulnerable position is not a responsible or desirable way."

The age limit is also an issue for the KNMG, as it sends a signal "that life for the elderly is worth less than the life of younger people." KNMG expressed similar criticism about an earlier proposal.

The D66 party has been pushing for euthanasia for "completed life" for many years. In the last years general election the D66 fell from 24 - 9 seats. With the loss of political influence for the D66, it is unlikely that euthanasia will be extended to "completed life" any time soon.

Friday, March 15, 2024

Schadenberg message to the Isle of Man. Euthanasia: Don't go there.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alex Schadenberg (jet lag picture)
I just completed meetings with elected representatives in Scotland and the Isle of Man. Medical professionals, under the banner of Manx Duty of Care, brought me to the Isle of Man.

While in the Isle of Man I was interviewed, along with Dr Graham McAll, by the BBC. The BBC news report states:
The Isle of Man should not "open the door" to proposed assisted dying laws, a Canadian campaigner has said.

Alex Schadenberg from the Euthanasia Prevention Coalition believes proposed safeguards would be eroded over time.

Mr Schadenberg is set to share his views at public meeting on the issue in Douglas on Tuesday, organised by a group of island medics who have raised concerns about the bill.
According to the BBC the proposed legislation stipulates to be eligible you must be an island resident diagnosed with a terminal illness, with a life expectancy of six months or less. I reportedly stated:
In 2021, Canada loosened its euthanasia laws to no longer require that a patient's condition be terminally ill, allowing people whose condition is serious and incurable to request it.

Mr Schadenberg said: "Don’t go there... we were told in Canada it would only be for rare cases [but] you open the door to one thing, and you end up getting something else."
Dr Graham McAll - Manx Duty of Care
The BBC reported Dr Graham McAll stating
Retired GP Graham McAll is a member of Manx Duty of Care, an opposition group of about 150 health and social care workers and organisers of the meeting at the Manx Museum.

He said he believed the proposals were "dangerous" as he feared they would be eventually extended and "we won't be able to stop it once we open the can of worms".

The move was "unnecessary" as with improved care "the legislation should not be needed", Mr McAll said.
Manx radio provided a shorter but similar as the BBC report. Manx radio reported:
Once assisted dying has been legalised, it's hard to stop the criteria for those eligible being expanded.

That's the warning from a campaigner from Canada, who's been speaking at an event on the Isle of Man.

Canada introduced laws similar to those being considered on the Isle of Man in 2016, before widening the groups able to request an assisted death in 2021.
More than 130 people attended the public meeting and 9 members of the Manx parliament.

Assisted suicide is the wrong prescription

The following article was published by Kevinmd on March 15, 2024.

By Dr Joseph E Marine

America expends much time, effort, and resources when people become seriously ill, bringing many face-to-face with their own mortality. For patients and their families, it is an emotional and difficult time under the best of circumstances. As a cardiologist, I participate in the decision-making that comes at this time, and it has provided me with the honor of delivering care that has allowed patients to rebound from acute illness and to live better with chronic heart disease. But it has also provided me with the privilege of helping people nearing the end of life.

Because I practice medicine within an excellent hospital system, I know that our health care system has the capacity to provide life-saving care in dire circumstances. But I also know that not everyone has equal access to this care. For people with disabilities, people of color, older Americans, and others who lack access, they too often face inequitable barriers to care.

While our health care system is geared toward healing, we all will die. However, creating new public policy that would allow medical professionals to help their patients take their own lives with a prescription for lethal drugs is fraught with danger and has significant consequences for the health system and for our society. The medical profession crossing a red line from neither hastening nor prolonging death into the realm of intentionally causing it for some people, based on subjective criteria, has had terrible consequences throughout history.

Based on my experience, research, and observation, I have come to oppose legalization of assisted suicide, which is also known by several confusing euphemisms. Regardless of the term used, it creates great societal risk.

While downplaying the role of palliative and hospice care programs, advocates of assisted suicide continue to promote dangerous and misguided public policy that would transform suicide into a “medical treatment.” These policy proposals and legislation violate many basic principles of patient safety, erase critical civil and legal protections for vulnerable patients, and do nothing to address the real needs of patients with advanced illnesses and disabilities.

Assisted suicide is not medical care. It has no basis in medical science, practice, or tradition. In states that have passed assisted suicide laws, few physicians are willing to participate. In Oregon in 2021-2022, the median duration of the patient relationship with the physician prescribing assisted suicide was only five weeks, indicating that patients are getting the prescriptions from a small number of willing providers who do not know them well and not their regular physicians. The American College of Physicians and the American Medical Association, the two largest medical societies in the country, have consistently discouraged physician participation and not supported the legalization of assisted suicide.

Furthermore, the lethal drugs used in assisted suicide have never been scientifically tested for efficacy in causing death, and the U.S. Food and Drug Administration has never approved any drugs for this purpose. Rather, the drug recipes for assisted suicide have been invented by euthanasia practitioners, using methods known only to themselves. Moreover, the movement away from the use of barbiturates towards various combinations of other sedative-hypnotic and cardiac drugs indicates that assisted suicide physicians are experimenting with these poison cocktails without any conventional safeguards or oversight, in violation of the principles of the Declaration of Helsinki. Continued experimentation also suggests that the drug cocktails may not be “working” as well as proponents claim.

Proponents of assisted suicide assert that the enabling laws have “strong safeguards”; however, a close look at the facts shows that these safeguards are an illusion. The law in practice can be routinely violated because it relies entirely on self-reporting, with broad criminal, civil, and professional immunity given to physicians, protection of records from discovery and subpoena, no witnesses to consumption of drugs, falsification of death certificates (the cause of death is not reported as suicide but as the underlying illness), and no routine audits, investigations, or supervision by an independent safety monitoring board. In addition:

  • Some patients have not died quickly and have suffered as a result, in some cases taking 2 to 3 days to die.
  • Most other countries with legal assisted suicide use intravenous drugs because of complications and failure in up to 20 percent of patients who use pills.
  • In Oregon, which has had assisted suicide for 25 years, officials admit that in the 80 percent of cases with no medical witnesses, they have no way to know if complications occurred. Without witnesses, the state does not know whether the drugs were self-administered or whether some patients were assisted to die in other ways.
  • In states with assisted suicide, some patients have lived up to 3 years after receiving a prescription, in violation of the law, which requires a 6-month prognosis, with no accountability or consequences for the physician.
  • 15 to 20 percent of U.S. patients referred for hospice care survive their 6-month prognosis, and 6 percent are found not to be terminally ill.
  • Patients with some advanced illnesses have a 50 to 75 percent incidence of clinical depression, and at least one patient received a prescription in Oregon despite a history of severe depression and suicidality. Yet fewer than 2 percent of Oregon patients who received assisted suicide prescriptions had a formal mental health evaluation.

These facts are clear evidence that assisted suicide laws are not providing adequate protection for vulnerable patients and are ripe for abuse. What patients with advanced illnesses and disabilities need instead is more support and greater access to excellent palliative care, hospice care, and pain management programs. America has some of the best health care in the world. We should use it and not undermine our health care system with assisted suicide laws. It is the wrong prescription.

Joseph E. Marine is a cardiologist.

Belgian euthanasia deaths increase by 15% in 2023.

The European Institute of Bioethics published the following report:

On Tuesday, February 27, the Federal Commission for the Control and Evaluation of Euthanasia in Belgium (CFCEE) published the figures relating to euthanasia's declared during 2023. The number of euthanasia's officially practiced reached a new record with 3,423 euthanasia's declared to the Commission in 2023.

While the year 2022 had also been marked by an increase in cases (+10%), see. IEB news, this year marks an increase of 15% compared to 2022.

To these euthanasia's officially declared to the Commission, scientific studies estimate that approximately 25 to 35% of undeclared euthanasia's should be added (JPSM, 2018).

If the majority of reported euthanasia's concern elderly people, note that almost a third (30%) of people officially deceased by euthanasia were under 70 years.

Euthanasia's carried out at home represent 48.6%. We observe a confirmed increase in euthanasia carried out in rest and care homes (16.4% in 2022 and 17.4% in 2023). 32% of euthanasias were carried out in hospitals and palliative care units. This proportion is up slightly compared to the previous year.

The figures for 2023 also confirm the increase in euthanasias carried out due to multiple pathologies (+3% compared to 2022, i.e. the second type of condition mentioned, after cancer). Euthanasia for multiple pathologies thus represents 23.2% of euthanasia, of which almost half (47%) were carried out when death was not expected in the short term. As the Commission indicates, polypathologies designate “a combination of suffering caused by several chronic conditions which progress towards a final stage”. In practice, these conditions can notably consist of terminal heart failure, hemiplegia due to a stroke but also loss of vision or hearing, polyarthritis or incontinence.

Finally, in 76.2% of cases, physical and psychological suffering were mentioned simultaneously. Additionally, 89 people were euthanized due to psychiatric conditions (such as personality disorders or depression) or cognitive disorders (such as Alzheimer's disease). A figure again increasing compared to 2022.

UK Labour Party leader is dead wrong about assisted suicide.

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) wrote an article, that was published in Spiked on March 14 challenging Keir Starmer, the leader of the UK Labour party, announced that he would bring forth an assisted suicide bill, if his party is elected in the next UK election. 

I just completed meetings with elected representatives in Scotland and the Isle of Man. While in Scotland, the Keir Starmer news came out.

Yuill's states in his article in the Spiked:
He made the pledge earlier this week, in response to Esther Rantzen, the veteran broadcaster who is also a vocal advocate for assisted suicide. Starmer told her: ‘I’m personally in favour of changing the law. I think we need to make time. We will make the commitment.’
Yuill writes that Starmer has flip flopped on issues in the past, but Starmer is known to support assisted suicide. Yuill wrote:
He has, after all, continuously supported legalising assisted suicide. As an MP in 2015, he voted in favour of it. And when he was director of public prosecutions, in 2010, he issued guidelines that strongly discouraged prosecutions against anyone who helped a terminally ill person end their life. Indeed, his position on assisted dying may be the only consistent one he has ever held.
Yuill then explains how Starmer's promised "safegaurds" are an illusion:
Starmer has promised that any change in the UK law must be accompanied by ‘safeguards with teeth to protect the vulnerable’ from abuse. But herein lies the fundamental problem with legalising assisted dying. In almost every country where it has been legalised, the safeguards that were initially put in place have been trampled on. Like a cancer, the so-called right to die inevitably spreads.
Yuill then explains how Canada's safeguards have been withdrawn.
Canada is perhaps the most grim example of this. In less than a decade, its Medical Assistance in Dying (MAID) programme has expanded to a dystopian degree. When it was first introduced in 2016, euthanasia was only legal when a patient’s death was ‘reasonably foreseeable’. Now, just about anybody suffering from an illness or disability can access a state-sponsored death. In 2027, the law is set to expand further still to allow those suffering with mental illness to apply for MAID.
Yuill explains that expanding assisted suicide laws is a feature of legalization:
Expansion of the criteria is a feature, not a bug, of assisted-suicide laws. Once the right to die is enshrined in law, safeguards are almost immediately called into question by those who feel they are suffering unbearably, but do not qualify under the existing rules. There’s a grim logic to it. When death comes to be seen as the best treatment for suffering, then how can the state deny it to anyone who suffers?
Yuill provides specific examples of expansion of the laws from Canada and the Netherlands:
As a result, some truly disturbing cases have emerged from the places where assisted dying is legal. In Alberta, Canada, a 27-year-old autistic woman was approved for MAID earlier this year. Her father has gone to court to try to stop her from being euthanised. He has argued that, aside from her autism diagnosis, she is perfectly healthy. Despite this, two doctors signed off on her death. The case is still ongoing.

It’s a similar story in the Netherlands, where assisted suicide and euthanasia have been legal since 2002. Between 2012 and 2021, 39 people suffering only from autism and / or other intellectual disabilities have been euthanised. Nearly half of them were under 50.

One such case was an autistic man in his twenties. His record said that he was a victim of regular bullying, that he ‘had felt unhappy since childhood’ and that he ‘longed for social contacts but was unable to connect with others’. On this basis, and on his request, his doctor euthanised him.
Yuill ends the article by encouraging Starmer to flip flop on assisted suicide.
The essential problem with assisted suicide is that it turns death into a ‘solution’ to life’s problems. It does not alleviate people’s suffering. It merely encourages them to seek death, as an alternative to decent medical treatment or proper social support. Keir Starmer ought to think twice before setting the UK down this path. For once, his flip-flopping would be more than welcome.
Previous articles by Kevin Yuill on euthanasia and assisted suicide. (Link to the articles)

Jurisdictions that legalize euthanasia or assisted suicide will regret it. Just look at Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I am just returning from a speaking tour which included meetings with elected representatives in Scotland and the Isle of Man. Both jurisdictions are debating the legalization of euthanasia and assisted suicide. While in Scotland, a news story was published concerning Keir Starmer, the leader of the UK Labour party, who promised that if elected he would bring forth a bill to legalize assisted dying.

At the same time the French President, Emmanuel Macron, announced that an "assisted dying" bill would be introduced on May 27. As horrific as Canada's experience with euthanasia has been, the terrible euthanasia stories out of Canada is creating a hesitancy in other countries when they debate legalizing poisoning by doctors.

The recent article by Michael Deacon that was published in the Daily Telegraph is titled: If Starmer legalises assisted dying, we’ll live to regret it... Euthanasia may start off as being for those with terminal illnesses, but its justification would soon blur – just look at Canada.

Deacon writes:
“I’m personally in favour of changing the law,” Sir Keir Starmer told Dame Esther in a personal phone call – before promising her that a Labour government would give MPs a vote on it. “Esther,” he declared, “I can give you that commitment right now.”

Admittedly, Sir Keir has a less than 100 per cent record on honouring his “commitments”. In the past, I’ve often criticised him for it. In this particular case, though, I hope he performs another of his famous U-turns. Because, if he does legalise assisted suicide, I fear we’ll live to regret it.
Deacon continues:
Have they really managed to miss all the horror stories coming out of Canada?

Assisted suicide was legalised there in 2016. And ever since, there have been numerous cases showing how humane intentions can lead to chilling consequences. Take the 61-year-old man who was euthanised in 2019, even though the only health problem he’d listed on his application form was hearing loss. Or the 41-year-old woman who was euthanised in 2021 after telling doctors she wanted to end the suffering caused by her fibromyalgia. In private, however, she’d told friends that she actually wanted to die because she was so poor
Deacon makes it clear, Canada's experience will also happen in the UK:
We may tell ourselves that we’d never let that happen here. But I wouldn’t be so sure. After all, Canadians have long held a well-deserved reputation for being the nicest people on earth. And yet all of a sudden, here they are, eagerly clamouring to bump off the poor. Forget helping them find a decent home and a solid job. Just slip them a lovely, lethal dose of propofol. Well, it’s an awful lot cheaper.

This is the trouble with assisted dying. You start off legalising it solely for people suffering from terminal illness. But then there’s pressure to legalise it for other health conditions, and depression, and eating disorders, and drug addiction – until before you know it, you daren’t even visit your GP any more, for fear of what he might prescribe.
Deacon ends his article with some cautious leavity:
“Good morning, doctor. I think I’ve sprained my ankle.”

“Not to worry. There’s a wonderful new treatment that’s guaranteed to end your pain. And not just in your ankle, either.”

Such a scenario may sound far-fetched. Not least because getting a GP appointment in this country is next to impossible. But even so, it’s as well not to grant the state too much power – because it may well end up using that power in ways we never intended.

Think how often we’re warned that the future of our very society is imperilled by our rapidly ageing population. Back in 2010, Martin Amis proposed a solution. On each citizen’s 70th birthday, he or she would be handed “a martini and a medal”, and then marched to a street corner “euthanasia booth”.

Amis was of course joking. At least, he thought he was.
Deacon is correct. When Canada legalized euthanasia we were told that we wouldn't follow the Netherlands and Belgium experience. In fact, we are surpassing them.

Thursday, March 14, 2024

Treatment Resistant Depression Disorder Recovery and Euthanasia

By Meghan Schrader

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

In his 2015 essay “Treatment Resistant Depression Disorder and Assisted Dying,” Udo Schuklenk says that people with treatment resistant depression should be helped to die by suicide not only because the disorder can be excruciatingly painful, but because the person essentially has “two selves”: a real self that existed prior to the onset of the clinical depression, and a depressed self that has taken over the person’s life.  He asserts that for some people this former “real self” is never coming back, and so the kindest thing is to give them the option of being put out of their misery.

Indeed, as someone who has experienced episodes of treatment resistant depression since my teens, I must say that the most painful thing about my disorder is that I have not felt like myself. Between the ages of about seven and 16, before my mental illness started, I was considered unusually mature, wise, caring and polite for my age. So how did I go from that to the F word being every other word out of my mouth? Why was I yelling at people all the time and sharing whatever immature or rude thought that came into my mind? I had always been a good student, so why was my mind so cloudy now, like I was trying to think through static? I was a talented vocalist, so why didn’t I have the energy to sing anymore? Why was my impulse control suddenly so bad that I impulsively did foolish things that “the real me” would never do?

These changes in myself caused deep hurt. When I was about nine, my mom’s good friend told me that everyone had a metaphorical “love light” inside of them that guided how they treated others, and she kindly remarked that my “love light” was very bright. But in my late teens I began thinking and acting in ways that made me feel as though my “love light” had gone out or was constantly flickering. The real me was still “in there somewhere,” but I couldn’t put her back in the driver’s seat. The mental illness was always at least partially in control, and the intense dysphoria that it caused was like a stalker that wouldn’t leave me alone. This change in myself has sometimes been very difficult to understand.

There are, however, some logical explanations for why I’ve felt as though my “love light” isn’t functioning properly. I’m an adoptee, and since meeting my biological family about 10 years ago, I’ve learned that a lot of these issues are genetic. My bio family has a lot of terrific people in it and I’m glad that they are my family, but also many of those terrific people have suffered from severe mental illness. So, clearly there is a biological component to my symptoms that would exist no matter what, and that’s one of the reasons that I’ve experienced the sense of my “love light” not burning brightly anymore.

The other reason for that change is lack of accommodation for my Nonverbal Learning Disability. The disability is not painful by itself, but it causes a severely impaired sense of direction, slow processing speed, and various executive functioning weaknesses. However, despite that disability coming from a mild brain injury that I got when I was being born, people often don’t believe me when I tell them it exists. Usually that disability is not accommodated properly, no matter how many times I patiently explain what accommodations I need. That situation causes toxic stress: I experience getting hopelessly lost in public and having to constantly ask strangers for help, panic-induced autistic hand-flapping, making loud exclamations of despair that everyone around me hears, and having people stare at me because of these embarrassing behaviors. That situation naturally incites anger and depression; indeed, these kinds of circumstances lead to many neurodiverse and disabled people having suicidal thoughts. (Link) And of course those kinds of feelings get in the way of adding fuel to one’s “love light.”

This lack of accommodation for my neurological impairment and its impact on my “love light” is cruel. It’s not a situation that I chose, it’s a result of how the world has been designed. I firmly believe that I would have landed in the psychiatric hospital far less often-and maybe not at all-if only people would stop complaining about what a terrible hassle accommodating me is and just consistently do it.

But, in the last few years, a wonderful thing has happened to me and my “love light.” A mentor who loves me helped me find my job at the University of Texas’s postsecondary program for people with intellectual disabilities. I get all the accommodations that I need for my learning disability, so much of the environmental impetus for depression has been removed. My employer basically allowed me to create my own job mentoring students, advocating at the Texas state capitol, and offering lessons in ethics, the fine arts, independent living and peer support. In 2021 I accompanied a student who had a diabetic crisis to an emergency room and stayed with him until his family arrived. I consoled another student who was having suicidal thoughts. Last year I helped a student advocate for a bill to add disability history to the Texas state history curriculum. I take students to music performances at UT’s school of music to expose them to opera and symphonies and Caribbean music. This year I helped a student who was struggling with incontinence when she had an embarrassing accident. And this is the best part of my job: because of my work with these students, I have felt as though my “love light” has been turned back on, and the real me is alive again.

In Schuklenk’s world, mentally ill people should die — I should have died — because their (my!) unaccommodated disorders contributed to people's “love lights” going out. What a terrible waste it would have been if policies created by Schulenk and his pals had been able to shape my fate in such a heartless, thoughtless, evil way!

Tuesday, March 12, 2024

27 year old autistic Alberta woman approved for euthanasia. Her father is challenging the decision in court.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Link to the CBC News video (Link to video).

CBC News reported on March 12, 2024 of an Alberta court case concerning a father who has petitioned the court to prevent the euthanasia death of his 27-year-old autistic daughter, who lives at home. The father is stating that his daughter does not have a medical condition that qualifies under the law, whereas the daughter has already been approved for death by lethal poison.

This case affects me greatly since I have an autistic son and I have significant life experience concerning my sons lived reality.

CBC News reported on the case that:
A publication ban protects the identities of the parties and the medical professionals. CBC News will identify the daughter as M.V. and the father as W.V.

At issue is whether the courts can step in when family members, with no legal standing, have concerns about the MAID approval process.
CBC news stated that there is no explanation for the MAID qualification.
Court of King's Bench Justice Colin Feasby heard that M.V. — who lives with her father — was approved in December. Her date to receive MAID was set for Feb. 1.

The day before she was scheduled to die, W.V. was successful in seeking a temporary injunction, preventing M.V. from accessing MAID.

She has not submitted any medical documentation that could explain why she qualifies for MAID.

In a brief filed with the court, W.V. argued "M.V. suffers from autism and possibly other undiagnosed maladies that do not satisfy the eligibility criteria for MAID."
The lawyer for the daugher, "M.V." is stated that it is none of her father's business.
But M.V.'s lawyer Austin Paladeau argued she's "not trying to withhold or hide anything."

"She's saying 'it's none of [W.V.'s] or the public's business, I've been approved by two doctors, I am entitled to this and, court, it's none of your business either.'"

Sarah Miller, the lawyer for the father, called the situation "a novel issue for Alberta."

"As it stands, AHS [Alberta Health Services] operates a MAID system with no legislation, no appeal process and no means of review," wrote Miller in her brief for the court.

Miller has asked Feasby for a judicial review of M.V.'s MAID approval.
CBC reported that the father stated that his daughter's claims are unreliable.
The father submitted a 2021 report with the court, authored by a doctor at a neurology clinic who concluded M.V. required no followup and was "normal" and sent her back to her family doctor.

Miller also pointed out that on her initial MAID application, M.V. indicated her death had become "reasonably foreseeable" yet she was approved as a "track 2" MAID patient, which means death is not reasonably foreseeable.

"Therefore M.V. is not a reliable witness," wrote Miller in her brief.
According to CBC the father argued that his daughter is also depressed.
W.V. believes M.V. is not eligible for MAID and that her "capacity to consent to MAID is impacted by mental illness." He also feels she's been "unduly influenced by a third party," according to one of the documents filed with the court.

If the MAID approval process is not followed as set out in the Criminal Code, medical practitioners could be charged criminally.
CBC reported that a lawyer for the father argued that MAiD (euthanasia) is unique because a person who is wrongfully approved is dead.
Emily Amirkhani, another lawyer for W.V., argued that MAID is "an incredibly unique system" where if a person seeking MAID is wrongfully approved, "that person is never going to cause anyone to look behind that curtain" because they got what they wanted.

"It's unlike any situation I can think of where the wrongful administration of the system cannot be brought to light but for someone besides the patient," said Amirkhani.
CBC reported that the lawyer for the daughter argued that he understands that the father doesn't want his daughter to die, but she has autonomy.
M.V.'s lawyer Austin Paladeau stressed the case boils down to an adult's right to medical autonomy.

"He's at risk of losing his daughter and while this is sad, it does not give him the right to keep her alive against her wishes," said Paladeau.

"One of the real challenging parts of this process … is what's actually happening," said Paladeau.

"I completely understand [W.V.] does not want his daughter to die … I represent [M.V.], I don't want her to die either but that doesn't play into account here.

"Even though we have or may have very strong views … at the end of the day this is [M.V.'s] decision."
The Judge stated that this is a vexing case. The only medical assessment that was given is from 2021 and it indicates that the daughter is not ill. The Judge reserved his decision on the injunction.

Euthanasia lobby poll indicates that a majority of UK citizens support assisted dying for hard cases.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Paul Brand reported for ITV news on March 11 that a poll conducted by the UK euthanasia lobby group, Dignity in Dying, found that 75% of the repondents in the UK support legalizing assisted dying.

The news article did not publish the poll question, but it is known that when people are asked the question - Should terminally ill people who are suffering be able to ask for assisted dying, that the majority will say yes.

When you poll a group of people with a question that is based on a hard case scenario -- the person is terminally ill and suffering uncontrolled pain -- the respondent will react to that specific question.

If you ask people in a poll about real life scenario's, such as in Canada where we are having euthanasia deaths for poverty, homelessness, disability or an inability to obtain medical treatment (not based on futility but based on medical backlogs) then the response changes.

When you poll a group of people with a question that employs inaccurate language, then you will get stronger support. The media article indicates that the Dying in Dignity poll asks if a person should be legally allowed to seek assisted dying.

It is one question to be legally allowed to seek, it is another question whether a doctor or nurse should be legally allowed to poison their patients to death. 
Also, the term assisted dying is intentionally imprecise. We all want "assistance in dying". That assistance could be home-care or pain and symptom management (if necessary) but the euthanasia lobby use the term assisted dying to confuse us about the act of doctors and nurses killing their patients with poison.

Finally, it is the real life stories that are important.

When you legalize euthanasia or assisted suicide you may think that you are opening the door to specific scenario's but based on human reality there is always other doors behind the door that you have opened.

The recent court case in Alberta is a prime example of the further doors that are opened when you legalize euthanasia.

The Alberta court case concerns a father who has petitioned the court to prevent the euthanasia death of his 27 year old autistic daughter, who lives at home. The father is stating that his daughter does not have a medical condition that qualifies under the law, whereas the daughter has already been approved for death by lethal poison.

The father says that his daughter, who is autistic, has been influenced to believe that death is the answer to her social and personal difficulties, but she doesn't have an irremediable medical condition, as required by the law. Her father also believes that his daughter is depressed but depression doesn't qualify under the law.

The lawyer for the daughter is arguing that it is understandable that the father doesn't want his daughter to die by euthanasia, but the law doesn't give him legal standing. The lawyer for the daughter is saying that the law only requires approval by two medical professionals, and that has been accomplished.

When debating the legalization of euthanasia, the public is presented with the hard case scenario -- the terminally ill person who is suffering uncontrolled pain -- but the reality is that euthanasia cannot be legalized for specific hard case scenario's. The end result is a case of an otherwise healthy 27 year old autistic woman who lives at home who has been approved for death by lethal poison.


Killing is never the solution to social problems, we need a society that offers care.

Minnesota Assisted Suicide Bill is on a paved road to euthanasia.

Testimony in strong opposition to Minnesota Bill HF 1930 End of Life Option Act
March 12, 2024

Stephen Mendelsohn
By Stephen Mendelsohn

Rep. Jamie Becker Finn and members of the House Judiciary and Civil Law Committee:

I am an autistic adult and one of the leaders of Second Thoughts Connecticut, a coalition of disabled people opposed to the legalization of assisted suicide. I also serve on the board of directors of Euthanasia Prevention Coalition-USA.

I submit this testimony in response and opposition to previous testimony from Thaddeus Mason Pope, JD, PhD on March 7, 2024 before the House Public Safety Finance and Policy Committee.1 Pope argues that there is no “slippery slope” leading to a radical euthanasia regime like that in Canada. I will demonstrate that this “slippery slope” is actually a paved road, in which proponents have openly boasted about using an incrementalist, bait-and-switch strategy to first pass less ambitious legislation and then later expand the law whether by legislation or through the courts.

Pope erroneously claims that the Minnesota Legislature has total control to regulate the parameters of assisted suicide (which he calls “medical aid in dying” or MAID). Not so: Compassion & Choices has successfully sued the states of Oregon and Vermont to get them to eliminate their residency requirements. They currently have a lawsuit against New Jersey on the same issue. This shows that states that have legalized assisted suicide do not have full control over regulating the parameters of the legislation they pass.

It is true that under Washington v. Glucksberg, the Supreme Court has ruled there is no constitutional right to assisted suicide, and state courts have consistently rejected attempts to compel enactment of these laws. Nonetheless, challenges to laws legalizing assisted suicide based on equal protection and/or the Americans with Disabilities Act (ADA) from both sides remains largely an untested issue.

While one case (Shavelson et al. v. Bonta et al.) seeking to force California to allow for lethal injections for persons who may not be capable or may lose the ability was denied, it is easily conceivable that another court in another jurisdiction would rule otherwise. The core “safeguards” of six months terminal illness, mental competence, and self-administration all make distinctions on the basis of disability, granting some people suicide prevention and others suicide assistance. I would also note there is currently a disability-rights lawsuit, United Spinal Association et al. v. State of California et al., seeking to overturn the End of Life Option Act on ADA and 14th Amendment equal protection grounds.2

Pope claims that “… no U.S. legislature has ever even considered removing the terminal illness requirement. No U.S. legislature has ever even considered removing the self-ingestion requirement.” His testimony was rendered utterly false a mere one day after it was submitted. On March 8, 2024, California State Senator Catherine Blakespear submitted a press release on SB 1196, explaining the provisions of her bill to radically expand that state’s End of Life Options Act.3 This legislation would eliminate the terminal illness requirement, replacing it with “a grievous and irremediable medical condition” similar to what was originally enacted in Canada. It would allow people with early to mid-stage dementia to access the law, and would also allow for lethal injection, moving from assisted suicide to active euthanasia. In addition, it would eliminate the meager 48 hour waiting period, allowing for a same-day death.

Pope himself is a zealous advocate of expansion in this direction.4 He posted to his Medical Futility Blog, “California Makes Big Move on Medical Aid in Dying,” approvingly.5 Even under current law, he has advocated using voluntary stopping of eating and drinking (VSED) as a bridge to enable non-terminal patients to qualify for assisted suicide in states such as Oregon, California, New Mexico, and Hawai‘i which have either significantly shortened the waiting period or allowed it to be waived. Pope published an article in the Journal of the American Geriatrics Society approvingly citing the case of Cody Sontag, an Oregon woman with early-stage dementia who used VSED to qualify for lethal drugs under that state’s law.6 He notes that “if anyone can access VSED, then anyone can qualify for MAID,” thereby doing an end-run around the law’s terminal illness requirement.

The American Clinicians Academy on Medical Aid in Dying (ACAMAID) has an “Ethics Consultation Service” report on “Voluntary Stopping of Eating and Drinking and Medical Aid in Dying” noting that:

Legally, there is nothing in the letter of the law of any of the U.S. states’ aid in dying bills that explicitly prohibits accepting voluntary stopping of eating and drinking as a terminal diagnosis to qualify for aid in dying. This remains a legal gray zone.7
ACAMAID confirms that allowing VSED to qualify for lethal prescriptions would “essentially eliminate the criteria of terminal illness to qualify.”

Most significantly, if passed, HF 1930 would be the most expansive and permissive assisted suicide law in the nation to date. Similar to the extreme euthanasia bill in California, it has no waiting period at all, thus allowing anyone—theoretically even otherwise healthy people who may be depressed—to instantly qualify for the lethal dose and die on the same day. It would thereby enact two principal elements of Canada’s radical death regime—widespread eligibility for non-terminal conditions and same day deaths.

Passage of HF 1930 would also shift the Overton window toward more radical legislation. Over the past two years, while no new states have enacted laws to legalize assisted suicide, several states have moved to expand their laws. It is far easier to pass an expansion bill after a state accepts the principle that it is acceptable for doctors to prescribe lethal drugs to patients than it is to pass legislation to legalize the practice in the first place.

Proponents of assisted suicide bills across the United States have not been shy about their incrementalist bait-and-switch strategy and desire for future expansion. In my home state of Connecticut, Rep. Josh Elliott openly admitted he wanted to get anything on the books even if it was unusable so it could be later expanded. Paul Bass reports in the New Haven Independent:

Elliott has been sponsoring bills for years to allow terminally ill people to take their lives (aka “aid in dying”). The bill finally passed the legislature’s Public Health committee; it got stuck in Judiciary.

The version he plans to resubmit this year has been narrowed to cover terminally ill people with prognoses of less than six months to live, with sign-offs from two doctors and a mental health professional, monthly check-ins, and at least a year of state residence.

“Almost no one” would qualify under that restricted version of the law, Elliott said. But passing it would open the door to evaluation and expansion.8

Here is the full on-air quote from Rep. Elliott on Dateline New Haven:

The bill would be, um, exceptionally narrow in scope, it would be the most narrow in scope bill of this kind were we to pass it. It would be, uh, six months left to live, you have to get sign-offs from multiple doctors—two doctors and one mental health physician—uh, and then you need to go for frequent check ins—I think it's like once a month—and you have, there is a one year residency requirement, so there are so many ways we limit who could actually use this bill, to the point I believe if we were actually to implement the way that we are talking about it, almost nobody would use it. But the important thing for me is to get this bill on the books, and then see how it's working, and if it's not and people aren't using it, than make those corrections to actually allow people to use it. So that is what we've been discussing.9
Similarly, J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, was quoted on a similar bill in his state, saying “Once you get something passed, you can always work on amendments later.”10 And Compassion & Choices past president, Barbara Coombs Lee said almost ten years ago regarding assisted suicide for people with dementia unable to consent, ““It is an issue for another day but is no less compelling.”11

There is much here that I have not covered. To cite a couple of examples, there is an explicit requirement in HF 1930 Section 12 to falsify the death certificate as to the cause and manner of death, thereby covering up foul play. There is also widespread evidence, most recently from ACAMAID, that the laws in other states are not being followed, and with no consequences to the prescribing medical practitioners.12 You will hear plenty of testimony on other problems with this legislation, particularly from others in the disability rights community.

I conclude by emphasizing that HF 1930 is not merely a “slippery slope,” but a paved road north to Canada’s radical euthanasia regime where disabled people are routinely denied services needed to survive but offered “medical aid in dying” instead. Please do not put Minnesota—and the rest of the nation—on this path. 

Please reject HF 1930. Thank you.


1 Thaddeus Mason Pope, JD, PhD, Written Testimony in Support of H.F. 1930 , Before the Minnesota House of Representatives Committee on Public Safety Finance and Policy: https://www.house.mn.gov/comm/docs/peqp-qSyH0aRdWY7Tn41Bw.pdf, pp. 95-98
2 United Spinal Association et al. v. State of California et al. https://endassistedsuicide.org/wp-content/uploads/2023/04/Complaint_Accessible.pdf; for more detail, see https://endassistedsuicide.org
3 Senator Catherine Blakespear, Factsheet on SB 1196: https://img1.wsimg.com/blobby/go/cd607dce-3325-492b-b030-b0a22331af65/downloads/SB%201196%20(Blakespear)%20Factsheet.pdf?ver=1709911469736
4 Thaddeus Mason Pope (2023) Top Ten New and Needed Expansions of U.S. Medical Aid in Dying Laws, The American Journal of Bioethics, 23:11, 89-91, DOI: 10.1080/15265161.2023.2256244 https://www.tandfonline.com/doi/full/10.1080/15265161.2023.2256244
5 https://medicalfutility.blogspot.com/2024/03/california-makes-big-move-on-medical.html
6 Thaddeus Mason Pope, JD, PhD, Lisa Brodoff, JD, Medical Aid in Dying to Avoid Late-Stage Dementia, “ https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18785?domain=author&token=VA68TTBJN9VDRCRMRPIP
7 American Clinicians Academy on Medical Aid in Dying, Ethics Consultation Service, “Voluntary Stopping of Eating and Drinking and Medical Aid in Dying, January 3, 2023: https://www.acamaid.org/wp-content/uploads/2023/01/Voluntary-Stopping-Eating-and-Drinking-and-Medical-Aid-in-Dying.pdf Pope is part of ACAMAID’s Ethics Consultation Service’s team.
8 Paul Bass, Elliott Readies Next Legislative Steps Toward Freedom, New Haven Independent, January 4, 2004: https://www.newhavenindependent.org/article/elliott_readies_next_legislative_steps_toward_freedom
9 https://www.youtube.com/watch?v=Z0hWOjITspE at clip position 21:30

Sunday, March 10, 2024

Quebec euthanasia deaths increase in 2023 to the highest euthanasia rate in the world.

2023: Québec had a 17% increase in euthanasia deaths. 7.3% of all deaths were euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

CBC Radio Canada published an article on March 9, 2024 stating that there was a 17% increase in Québec euthanasia deaths with 5,686 reported deaths representing 7.3% of all deaths, which is the highest rate in the world in 2023. The Radio Canada report is based on the Quebec euthanasia deaths between January 1 - December 31, 2023.

I recently wrote an article based on the analysis by Amy Hasbrouck, the leader of Toujour Vivant - Not Dead Yet concerning the inconsistent data published in the The Quebec Commission on End-of-Life Care Annual Reports.

The Quebec Commission on End-of-Life Care Eighth Annual Report indicated that there were 5211 reported euthanasia deaths (April 1, 2022 - March 31, 2023) which was up from 3663 in the previous year (April 1, 2021 - March 31, 2022).

Hasbrouck's analysis of the Eighth annual report found that there were:

  • 5,211 euthanasia reported by doctors in declaration forms (§ 3.2 p. 13)
  • 5,401 euthanasia reported by hospitals and institutions (table C6 p. 46) 
  • 5,208 euthanasia declaration forms received by the Commission (§ 2.1, p. 6)

This means that there was a discrepancy of 190 euthanasia deaths in the Eight Annual Report. Further to that, the Seventh Annual Report had a discrepancy of 289 euthanasia deaths.

In my article I asked the question: How many Quebec euthanasia deaths actually occur?

In early February I wrote an article stating that: There were approximately 16,000 Canadian euthanasia deaths in 2023 and more than 60,000 since legalization I made my prediction based on the euthanasia data from Ontario, Quebec, Alberta and Nova Scotia.

Zoom Meeting (March 21): Euthanasia in Canada. What's Next?

Join the rescheduledZoom meeting on Thursday, March 21 at 2 pm (Eastern Time) (11 am Pacific Time) 

Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition, Kathy Matusiak Costa, Director of Compassionate Community Care and Ottawa human rights lawyer, Lia Milousis will discuss - Euthanasia in Canada. What's Next?

Register in advance for this meeting: (Registration Link). 

Lia Milousis
Lia has become an expert on euthanasia based on her professional and personal experiences.

Kathy Matusiak Costa will discuss the direction of Compassionate Community Care and its programs that provide training and support for community groups and families.

Alex Schadenberg
Alex Schadenberg will speak about the direction of the Euthanasia Prevention Coalition.

Bill C-62, the bill to postpone the implementation of euthanasia for mental illness alone until March 2027 has passed. We will talk about what is next.

We will discuss the problems and opportunities for Canadians to stop euthanasia.

Saturday, March 9, 2024

California Senator drops the mask, proposes the legalization of euthanasia.

Gordon Friesen
By Gordon Friesen
President, Euthanasia Prevention Coalition

Critical statements have quickly appeared across the web, denouncing proposed "expansions" to California's assisted death system. However, with respect, I would suggest that this word is not nearly strong enough. For although it is still hard to say exactly what California is up to (considering that the full text of proposed Senate Bill 1196 is not yet available), a preliminary fact sheet clearly reveals that a new phase may be reached in that State's march towards a true, Canadian-style, poison death-medicine paradigm.

In another place (please see appendix i table) I have demonstrated that there are two main regimes of medically justified assisted death (not to be confused with true "right-to-die" countries like Germany and Switzerland). And that one of these (including Canada, Belgium, the Netherlands and Spain) has a proportion of assisted deaths which is ten times greater that of its lessor competitor (commonly known as the "Oregon Model, and which includes all of the American States having legalized assisted death thus far).

What accounts for the lower numbers reported by American States lies in their common requirement of a "terminal condition" (usually understood to mean a six months prognosis) and self-ingestion (the exclusion of doctor-performed euthanasia). The basic idea being that someone who is already facing death might choose exactly how and when they would actually die. Hence the name of existing California Law: the "End of Life Options Act".

Crucially, there is no mention in this scheme of physical (or other) suffering, as we shall see: any legislation based on suffering is truly a "horse of a different color".

In Canada, by way of comparison, eligibility is all about suffering (for which euthanasia is explicitly defined as a medical treatment). And it is this fact which explains why all of the original Canadian "safeguards" have so rapidly fallen apart in that country (either through court challenge or new legislation). One after another --"major age", "capacity to consent", "death reasonably foreseeable"-- all have fallen by the way-side, because "suffering" knows no such boundaries.

Should SB 1196 pass (which, to be sure, it has every likelihood of doing) it is the Canadian model which California will effectively be adopting. The appropriate headline, therefore, should be: "California prepares to embrace Canadian-Style substitution of death for medical treatment".

Proposed changes in legal text

Getting down a little farther "into the weeds" (to satisfy the curiosity of those who have been following the nuance of legislative texts on this subject), the main change in SB 1196 is to be found in the replacement of "terminal disease" to "a grievous and irremediable medical condition", which term, as textually lifted from Canadian Law, is defined as "(a condition which) Causes the individual to endure physical or psychological suffering due to illness, disease, or state of decline that is intolerable to the individual and cannot be relieved in a manner the individual deems acceptable".

It will be most interesting to see whether or not California legislators will actually dare to take the final step of definitely defining "Medical Aid in Dying" like some other States have done, as "the medical practice of...". However, this is hardly even necessary, in light of the all-embracing "grievous condition" definition cited above, and of the fact that not only assisted-suicide, but euthanasia also (intravenous administration) will now be available in California. For how could euthanasia be considered in any other way than that of a true medical treatment, when it is defined as a procedure performed by a doctor in order to alleviate suffering?

In sum: we are rapidly approaching the end of any further obfuscation or deceit.

Practical effect of the medical definition

As seen in Canada, euthanasia (as a medical treatment for suffering) cannot be reserved for people at the end of life, or for those capable of consent, or for those of major age.

But there are also other factors which have, thus far, received little attention:

1) Euthanasia as a preventive measure, applied to perfectly stable patients, with the goal of avoiding not present, but potential future suffering (as presently practised in Canada, at the mere pronouncement of any serious diagnosis).

2) The systematic promotion and prescription of euthanasia (to all and sundry) by enthusiastic doctors who believe they are simply performing their most fundamental duty of proposing what they sincerely believe to be optimum medical treatment in specific circumstances.

3) (as also seen in Canada) The institutional normalization of euthanasia practice and promotion, which just happens to be in the budgetary interest of public health services such as the Veterans' Administration, Medicare and Medicaid.

4) Lessor development and availability of other treatments (for conditions such as cancer) which will inevitably be reduced in exact proportion to the adoption of euthanasia as a legitimate medical substitute.

In short:

California SB 1196 does not represent a mere expansion of eligibility requirements for a choice-based system of assisted death. It actually signals a full-blown tipping-point, where publicly funded medicine in that State will begin its transition to a euthanasia-based utilitarian paradigm of death-medicine --a routine substitution of death for care-- as already observed in Canada (from which place the relevant legal language has been textually copied).

One bright spot:

It will at least become more difficult for apologists of assisted death to keep a straight face --or even to make eye contact-- when using the word "safeguards" (or disparaging the "slippery slope").

Gordon Friesen, March 9, 2024