A Mother's warning about her son dies by assisted suicide in Switzerland.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An 82-year-old mother in the UK is warning people about assisted suicide after her 47-year-old son died at a Swiss assisted suicide clinic.

Judith Hamilton

Paul Brand reported for ITV.com on May 16, 2024 that the Pegasos assisted suicide clinic which assists the suicides of hundreds of people every year, assisted the suicide of Alastair Hamilton, who had an undiagnosed condition. 

Following an ITV News investigation, Pegasos said it would change its procedures to ensure that relatives were always informed in future. Brand reported:

The chemistry teacher had dramatically lost weight and complained of stomach problems in the months leading up to his death, but did not have a diagnosed illness.

His family had been supporting him in seeking medical help and had no idea he was really travelling to Switzerland to end his life.

When he failed to return to the UK and stopped answering his phone, his mother reported him missing.

Bank records eventually revealed that he had paid £11,000 to Pegasos to access what's known as a 'voluntary assisted death' in Switzerland.

ITV News travelled with his family to trace his final journey and confront the clinic which accepted his online application form, which has been seen by ITV News.

Pegasos approved Alastairs death even though they knew that he had an undiagnosed condition. Brand reported:

Limited to 300 word answers, Alastair told them that his undiagnosed condition was causing him "pain, fatigue and discomfort" which had "devastated my life".

However, he admitted that "there is no current, definitive medical explanation" for his illness and that his family did not know he had decided to take his own life.

Despite that, Pegasos accepted his application and within several days of arriving in Switzerland he was helped to die.

At first Pegasos did not respond to the Hamilton family but after ITV got involved they agreed to meet with the family. Brand stated:

Eventually, with the involvement of police and the British embassy, the clinic responded, confirming Alastair's death and returning his ashes to his family in the post.

We persuaded a representative from Pegasos to meet with Judith and Bradley in Switzerland to answer their questions.

At an anonymous office in central Basel, we were greeted by Sean Davison, who had spoken repeatedly to Alastair before he died.

Sean Davidson

Sean Davidson is a past President of the World Federation of Right to Die Societies and a former leader of Dignity South Africa who completed three years (house arrest) in South Africa for his conviction in the deaths of Anrich Burger (in 2013), Justin Varian (in 2015), and Richard Holland (in 2015). Sean Davidson was also convicted in the death of his mother in 2010 and he lost his medical license in New Zealand in 2020.

Brand ended the article by stating:

"In 2022, the Swiss Medical Association revised its guidelines regarding assisted dying. It is important to understand that these guidelines are not legally binding for the associations but are policies for the medical professionals. Several organisations for assisted dying, including Exit, Dignitas and Pegasos, publicly spoke out against the revised guidelines, because they are putting at risk the self-determination of people planning a voluntary assisted death and the freedom of choice in Switzerland."

Previous articles about Switzerland's assisted suicide law:

• My husbands death made me more opposed to assisted suicide (Link). 
• Swiss study: Legalizing assisted suicide does not lessen the number of common suicides (Link).a
  

New Hampshire Senate Kills Assisted Suicide Bill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New Hampshire's 2024 assisted suicide bill is dead (Link)

The New Hampshire Senate killed Assisted Suicide Bill HB 1283 by a vote of 17 to 7 by referring it to an interim study on the bill.

Sruthi Gopalakrishnan reported on May 16, 2024 for the Concord Monitor that:

New Hampshire’s bill also did not have a residency restriction, which was a point of worry for senators who voted against the bill during the Senate session.

“We’ve discussed in this chamber passing legislation to prevent us from becoming magnets for crime, drugs, human trafficking and more,” said Sen. Regina Birdsell, asking the Senate to refer it to an interim study. “This bill because it has no residency requirements would make our state a magnet for a much more tragic purpose.”

The question of whether this law is assisted suicide or a humane way to die has dominated the debate in New Hampshire for the past few months and this was evident in Thursday’s senate session.

Gopalakrishnan reported that Canada's experience affected the New Hampshire debate:

Other concerns about the bill stem from Canada’s decision to extend medical aid in dying to even individuals without a terminal illness. While New Hampshire’s legislation imposes safeguards, includes provisions for self-administration of medication to prevent potential abuse among the disabled population, critics fear future expansions. They worry that similar to developments in Canada, eligibility criteria could be broadened beyond the original scope.

The assisted suicide lobby will try again next year. Gopalakrishnan reports

Although medical aid in dying won’t reach the governor’s desk this year, advocates emphasize that the push to legalize it in New Hampshire will persist, asserting that the decision to conclude one’s life with dignity should remain within the individual’s control.

The President of the Euthanasia Prevention Coalition, Gordon Friesen, sent members of New Hampshire's Senate his article titled: A call to defeat New Hampshire assisted suicide House Bill 1283 (Link).

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New Hampshire assisted suicide bill is dead in 2024.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

On March 21, 2024, the New Hampshire House passed assisted suicide House Bill 1283 by a vote of 179 to 176 based on support from Libertarian Republicans. The assisted suicide bill was referred to the Senate where it was stopped on May 16, 2024 by a vote to 17 to 7 to send the bill for further study.  

Adam Sexton reported for wmur.com that:

After an emotional floor debate on Thursday morning, New Hampshire state senators voted 17-7 to further study a bill that would legalize "medical aid in dying," or assisted suicide, in New Hampshire.

The legislation, which already passed the New Hampshire House by a narrow margin, would allow a terminally ill adult patient of sound mind with fewer than six months to live to be prescribed a lethal cocktail of drugs, which they would self-administer to die by suicide. But now, the bill will be sidelined, likely until the next legislative session.

The President of the Euthanasia Prevention Coalition, Gordon Friesen, sent members of New Hampshire's Senate his article titled: A call to defeat New Hampshire assisted suicide House Bill 1283 (Link).

Finnish Medical Association maintains opposition to euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

At their recent meeting, the Finnish Medical Association upheld their opposition to euthanasia.

The Helsinki Times reported on May 16 that:

In a recent meeting on May 16, 2024, the Finnish Medical Association's (FMA) council upheld its opposition to the legalization of euthanasia and doctor-assisted suicide, reinforcing that physicians should not be compelled to perform procedures primarily intended to hasten a patient's death.

The FMA articulated that introducing legislation to permit euthanasia would represent a profound shift in values and could lead to unpredictable developments in medical practice.

The organization emphasized that the primary role of physicians is to protect life using current medical knowledge and to alleviate suffering, rather than addressing healthcare system deficiencies through euthanasia.

This decision follows an extensive period of research, international comparison, and consultation, including a survey conducted in collaboration with the University of Tampere. The survey gathered around 9,000 responses from Finnish physicians, revealing a slight increase in support for euthanasia over the years but also significant division among the medical community. Notably, doctors with specialization in palliative care tend to be more critical of euthanasia, and a majority are not personally prepared to perform it, with only 13.5% expressing full agreement that they would practice euthanasia if it were legal.

The FMA also raised concerns about the impact of legalizing euthanasia and physician-assisted suicide on public trust in healthcare, which is currently declining. Only 58% of respondents in a recent "Citizens' Pulse" survey reported high confidence in the healthcare system. The association argued that an irreversible procedure like euthanasia demands exceptionally high levels of trust in the healthcare system's ability to assess and fulfill patients' end-of-life wishes.

In conclusion, the FMA reaffirmed its position against the legalization of euthanasia, citing ethical concerns, the potential effects on physician well-being, and the equality of patient treatment. The organization believes that Finnish healthcare is not ready to incorporate euthanasia into its practice, highlighting the complex and multifaceted nature of the issue.

In May 2018, the Finish parliament rejected a bill to legalize euthanasia by a vote of 128 to 60 (Link).

Donna Duncan was fast-tracked for euthanasia even though she wasn't terminally ill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Liz Carr is an actress, comedian and disability rights activist produced a documentary titled; Better off Dead? that was aired on May 14 by BBC1.

Alicia Duncan

In the documentary, Carr interviewed Alicia Duncan, the daughter of Donna Duncan, who died by euthanasia in October 2021

Alicia explains that her mother was fast-tracked for euthanasia after experiencing depression and mental issues related to a concussion acquired in a car accident.

Elmira Tanatarova reporting for the Daily Mail on May 15, 2024 writes:

The daughter of a Canadian woman who was 'fast tracked' for euthanasia after she 'starved herself' - because she was 'depressed' following car accident complications - broke down in tears as she recounted being given 48-hours' notice that her mother was going to die.

Alicia Duncan spoke to Liz Carr for Tuesday night's BBC documentary, Better Off Dead?

Donna Duncan, 61, from Abbotsford, was involved in a minor car accident, resulting in concussion. Her health declined in the months that followed, but the exact cause remained a mystery.

However, she was 'not terminal', nor was she 'facing imminent death' - but rather was suffering from mental health issues, Alicia stressed.

Alicia Duncan explains that her mother was experiencing mental health problems. Tanatarova reports:

'What we we didn't know was that she was restricting her diet. She would say that it would hurt to eat solid foods so she was pureeing everything, having soups.'

Alicia also explained how her and her sister's worries for Donna escalated.

'She was very paranoid, she worried that if she left the house, she might be shot by a sniper at any moment.

'And I think that's when we really started becoming extremely concerned that this might be a mental health issue.'

She said the behaviour was 'completely uncharacteristic' of her mother, who 'was a highly educated psychiatric nurse'.

Alicia and her sister were shocked when learning that their mother was approved to be killed. Tanatarova reports:

Alicia tearfully revealed how little time she was given to process her mother's signing up for Canada's controversial euthanasia programme - called MAiD.

'I received a text message from my mom's common law partner he wanted us to know that my mom was in the beginning stages of looking into MAiD,' she told the documentary.

'We just thought there was no way - there was no way - she would be approved.

They were given a 48 hour notice for her death

'And my sister went to go see her and asked, "how did the assessment go". And she said "do you want to know". And my sister said yes, and she said "I've been approved".

'So we had less than 48 hours' notice that my mom was going to die.'

Alicia and her sister unsuccessfully attempted to prevent the death:

Donna was approved for track one of MAiD - the 'fast track' - on the grounds that her condition was terminal.

She and her sister managed to then 'gather enough evidence to have Donna taken into custody under the Mental Health Act'. 

Alicia 'pleaded with a doctor' because 'her mom was a psychiatric nurse who knew all of the right things to say'.

'At the end of the 48 hour hold they did another assessment,' she continued. 'We received a text message from my mom's partner that evening that my mom was dead and her body had been taken to a crematorium.'

Alicia told Tanatarova that her mother wasn't terminally ill and therefore didn't qualify under "track 1" but since she had stopped eating and drinking, she was immediately deemed to be terminally ill. Tanatarova then reports on the irregularity in her mother's death.

Alicia said that her mother had been approved by the head of the MAiD programme and a nurse practitioner.

'The second assessment, it was done over the phone,' she added. 'He never saw my mom. 

'And her general practitioner, who had been her GP for 20 years, would not approve her to die.'

Tanatarova reports that Alicia and her sister Christie launched an investigation into their mother's death that concluded without any arrests.

It is impossible for medical practitioners in Canada to be prosecuted for euthanasia since the law says that the medical practitioner only has be "of the opinion" that you fit the criteria of the law.

The Canadian law is not designed with effective oversight, as long as two doctors or nurse practitioners agree that a person qualifies under the law, then they qualify, even if many doctors and nurse practitioners say they do not qualify.

Previous articles about Liz Carr:

• Canadian euthanasia doctor giggles about killing (Link).
• Liz Carr: I'm fighting for the right to live (Link).
• Better off Dead? documentary to be aired on BBC1 on May 14 (Link).
  
• Laws against assisted suicide provide equal protection (Link).
• Liz Carr address to Victoria Australia parliament on assisted suicide (Link).
• Disability activists say no to euthanasia bill (Link).

Canadian euthanasia doctor giggles about killing.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Liz Carr is an actress, comedian and disability rights activist produced a documentary titled; Better off Dead? that was aired on May 14 by BBC1.

Better off Dead? documentary (Link) 

Carr who is best known for her role as Clarissa Mullery on the BBC series Silent Witness, interviewed Ellen Wiebe, a Vancouver doctor who has committed some of Canada's most controversial euthanasia deaths.

Ellen Wiebe

Elmira Tanatarova reported for the Daily Mail on May 15 that many of the viewers of the Better off Dead? documentary were uneasy with Wiebe as she giggled when discussing the number of her euthanasia deaths. Tanatarova reports:

A Canadian doctor who has personally euthanised more than 400 people has left viewers feeling 'uneasy' as she 'giggled' while discussing the solemn topic with a disability rights campaigner in a new BBC documentary.

Speaking to Liz Carr's programme, Better Off Dead?, Dr Ellen Wiebe, who works with Dying With Dignity, had audiences feeling uncomfortable as she laughed and smiled while discussing assisted death.

'I love my job,' she said in the show, which aired on Tuesday night. 'I've always loved being a doctor and I delivered over a 1000 babies and I took care of families but this is the very best work I've ever done in the last seven years.

Wiebe tells Carr that nobody is more grateful than the patients that she has killed. Tanatarova reports some of the comments from the BBC documentary viewers:

Enjoying her job a little too much I felt,' one wrote.

'She was extremely scary and oddly cheerful,' another added. 'But it might have been defensiveness which made her so very strange indeed.'

'Her eagerness and her excitement over grateful patients was unsettling,' one poster penned.

'Really eerie,' one comment read. 'Her job should bring feelings of solemnity, profoundness, sadness... anything but the weird euphoric state she seems to be in.'

The Better off Dead? document gives Wiebe an opportunity to explain her experience with euthanasia. Tanatarova reports:

'We have a law and I obey this law and there are people who are not eligible under the law,' she explained.

'There are situations where I might find somebody not eligible or eligible when another person won't because of the way our law is written.'

Ellen explained that the 'number one reason' people look into assisted death is autonomy.

'Everybody's different in what they think of as autonomy and control,' she added.

'They desperately want control. Like, they want to say "it's now".

'At the end we say "OK well I can get back here at seven o'clock is that ok?" and they'll say yes and they'll be so grateful that they can skip the last two days of their life.

'And I look at it and think all you really needed was some more drugs - but you want my drugs? I'll give them to you.'

Wiebe admits that she has killed people who only need "some more drugs" because they want euthanasia, she kills them.

When commenting on euthanasia for people with disabilities, Wiebe reportedly says:

'I've certainly met people who are no more disabled than I am saying that life is not acceptable in this state,' she explained.

'And I would say "hm, you and I are different". But not different in the sense of wanting to have some control.'

Carr then asks Wiebe if she would approve her for euthanasia. Tanatarova reports:

'So Liz right now you love life and you want to live but there's lots of nasty illnesses you might get,' the doctor continued.

'And if you got terminal cancer and you were having to deal with chemotherapy and radiation wouldn't you be thrilled if you had the choice to say "I'll go this far and no further?"'

'For me,' Liz replied. 'I'm concerned that giving the option and the right to a group of people puts another group of people at risk. But I don't feel you see that as a worry.'

Tanatarova responds with Wiebe stating:

'And I am so glad, so glad that I'm a Canadian and that we have this law so that people can choose that or not choose that

'But to say that somebody has to suffer like that is simply cruel.'

Tanatarova then explains that Wiebe has been involved with some controversial deaths.

Last year, it was reported that Ellen said she helped euthanise a man who was previously deemed unsuitable for assisted suicide.

Speaking in a seminar for physicians working in assisted suicide, she told attendees about the time she treated a patient who did not qualify for the end of life service.

A MAiD assessor had rejected the unnamed man because he did not have a serious illness or 'the capacity to make informed decisions about his own personal health.'

But the man eventually made his way to Ellen, who cleared him, flew him out to Vancouver, and euthanised him, The New Atlantic said.

Tanatarova reports on why Liz Carr produced the Better off Dead? documentary:

She told the programme: 'On an everyday basis, disabled people are dealing with a lower expectation and people actually saying to their faces: "Gosh, surely it's better to be dead than be you?"

'That happens. It's shocking. So I wanted that to be the starting point and then let's unravel why that is and how that leads to my fear of legalising assisted suicide.'

The British actress added that 'of course we don't want [a person at the end of their life] to suffer'.

She continued: 'The problem is, actually, a lot of disabled people do suffer. But what they suffer from are the barriers and the obstacles, the fact they have to fight for support, the fact there isn't social care, the fact of attitudes, the fact of lack of access to so many things.

'You know, we do suffer. So don't then make it legal to end that suffering through assisted suicide, that's the fear.'

Carr explains that she is treated differently by people who recognize her as an actress compared to those who don't recognize her. Tanatarova reports:

She explained: 'From my gaze, from somebody who lives in a world where, you know, if I'm recognised in the street, then people are giddy and excited and it's wonderful.

'If I'm not recognised in the street, then I'm ignored or sometimes I'm glanced at as I'm just trouble and I'm a problem and: "Oh god, have we got to get the ramp out? Ugh." I'm just a pain.

'So that difference shows me that oftentimes I think disabled people are just tolerated and I think that's the same with ill people and older people, and I think all those groups would be affected by these laws.

'As long as there's that inequality, it is not safe to legalise... no amount of safeguards will prevent us from mistakes and abuse and coercion, that's my belief.'

Previous articles about Liz Carr:

• Liz Carr: I'm fighting for the right to live (Link).
• Better off Dead? documentary to be aired on BBC1 on May 14 (Link).
  
• Laws against assisted suicide provide equal protection (Link).
• Liz Carr address to Victoria Australia parliament on assisted suicide (Link).
• Disability activists say no to euthanasia bill (Link).

Liz Carr: I'm fighting for the right to live.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

LInk to the Better off Dead? documentary (Link) 

Liz Carr is on the left

Liz Carr, who is an actress, comedian and disability rights activist, produced a documentary that she titled - Better off Dead? that will be aired on BBC1 on Tuesday May 14 at 9 pm (UK). Carr may be best known for her role as Clarissa Mullery on the BBC series Silent Witness.

Carr was interviewed by Anna Moore for an article that was published by the Guardian on May 14 titled: I'm fighting for my right to live.

Moore asks Carr about the timing of her documentary, Better off Dead? Carr responds by saying that she has wanted to do this since 2011, and then she says.

“It feels like it’s coming at us from all angles,”

“I’m so incensed that there is never any balance on this topic. Of course I’m worried I’ll be slagged off, that it’ll get nasty on social media. Will people come up to me on the street? But I worry more about my friends that are in the programme. The film is full of my world, my love and support. I feel a duty of care to them.”

Moore explains Better off Dead?

Better Off Dead? takes a deep dive into assisted dying and disability. Carr believes the two can’t be separated. It’s disturbing, of course, but also life-affirming and darkly funny, which isn’t surprising; Carr was a standup comic for years. In the opening shots, she and her disabled friends remember the times they have been told they would be better off dead. One, Jamie Hale, has even had someone offer to kill him. (“And this wasn’t someone I was particularly close to,” he says.)

The film is also intensely personal. Carr looks back at her childhood and the impact of having her life turned upside down by a rare autoimmune condition at seven. It’s something she has been reluctant to share in the past. “Our perception of disability is that it’s the greatest tragedy to befall you and I don’t want to compound that,” she says. “But I did want to show that I do know how your life changes so hugely when you join that camp – the most unsexy, unfun, unglamorous group. Who’d want that?”

Carr grew up healthy. At the age of 7 she went with her family for two years to America where she became ill from a rare autoimmune condition called arthrogryposis multiplex congenita. Moore explains:

At 11, Carr became a wheelchair user. In her early teens, a doctor told her bluntly that she wouldn’t live to be old. For Carr, the hardest scene from the programme was the one filmed in her mum’s kitchen, in which her mum reads aloud from the diaries she kept during that period, where she recorded what her daughter was experiencing. “She is very lonely,” reads one entry. “She gets very down and often says she wants to die rather than carry on, as she can’t see any good in the future.”

“I sat and listened to every awful thing that happened for the camera,” says Carr. “I had naively thought: ‘I’m in control of this,’ and then I wasn’t. I was quite damaged by it. I couldn’t tell my mum – she thought she was doing brilliantly. My mum was proud as punch!

Carr points out that Canada is considering extending euthanasia to "mature minors" when asked the question - what if assisted suicide had been available then?

Moore provides significant information about Carr's education and the development of her professional acting and comedy career. Moore then comes back to the issue of euthanasia and writes:

Through all this, the issue of assisted dying has been there, on her mind, in the background – but it crystalised and became urgent after the case of Daniel James in 2008. James had been paralysed during rugby training and died at a clinic in Switzerland 18 months later. He was 23. “I’m not here to judge him, but what I judged about that situation was the media response, the public response,” says Carr.

“He had died 18 months after becoming disabled. Not terminally ill – just disabled. But the press and public reaction was: ‘Of course, it’s the right things to do. It’s difficult, but it’s the brave decision.’ A disabled young man wants to end his life and we don’t question that? Nobody was asking: ‘How can we change? What must we do so that someone who can’t walk or do certain things has a quality of life that’s acceptable?’ I’d always known assisted dying was about disability – but oh my God.”

Moore then reports on why Carr clearly opposes assisted suicide:

Surely, though, assisted dying is about personal choice? Even if legislation were brought in and included “unbearable suffering”, which might make someone with Carr’s condition eligible, no one would be forced to take that route. “This isn’t because we think we’re going to be grabbed and taken,” says Carr. “The biggest catastrophe is that we’d choose it ourselves because there was no more choice for us.

“If an individual chooses to end their life, I’m very sorry and sad, but it’s private and personal – it doesn’t impact me. Changing the law to legalise assisted dying does. I know so many people who are suffering, not because of their condition, but because life is so much more difficult than it needs to be, because they need more than a 15-minute visit from a care worker in which to go to the loo and have a sandwich, because they’ve grown up in a world where they’ve been devalued, maybe told they’re a burden, and expectations of their lives are so low.

Carr is proud with the final cut of the documentary, but she is not done with the issue. Moore reports:

Carr’s next project is in similar territory. She will be at Galway international arts festival in July in a play called Unspeakable Conversations, based on the debate between the late lawyer and disability rights activist Harriet McBryde Johnson and the Princeton professor Peter Singer, who has argued that parents should be able to kill disabled babies. (“It’s about the same shit,” says Carr.) After that, she has some TV lined up that she can’t yet talk about: “But it’s fun stuff.”

In some ways, she will be glad when this is behind her. “It’s a tough subject, a tough campaign – you have to be so resilient,” she says. “Life is more fun when you’re not doing this stuff. Acting is what I love and what I really need to get back to. There are those that are fighting for the right to die. I’m fighting for the right to live.”

Previous articles about Liz Carr:

• Better off Dead? documentary to be aired on BBC1 on May 14 (Link).
  
• Laws against assisted suicide provide equal protection (Link).
• Liz Carr address to Victoria Australia parliament on assisted suicide (Link).
• Disability activists say no to euthanasia bill (Link).

Book review: How Should We Then Die?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ewan Goligher

Ewan Goligher is an intensive care physician in Toronto and researcher who focuses on mechanisms of diaphragmatic dysfunction during mechanical ventilation.

I have had the pleasure of listening to several presentations by Dr Goligher and I have always appreciated his professionalism and his way of connecting to others.

Dr Goligher recently published the book - How Should We Then Die? which is a Christian response to physician-assisted death. 

Purchase - How Should We then Die? from the Euthanasia Prevention Coalition (Link to Purchase).

Instead of commenting on this insightful book I am sharing a few paragraphs from the book. In the chapter - Assisted Death Devalues People, Goligher writes:

In providing or administering the lethal agent, the operator inevitably expresses a belief about whether it is good for the person to exist. By intentionally causing the death of the person who has requested death from them, they show that they believe that it is good for that person not to exist. After all, we are supposed to call assisted death the right thing to do in such cases. ...

What then does this say about the value of those who receive assisted death or who are potentially eligible for assisted death in comparison to those who are not eligible? Those for whom existence is deemed optional cannot possibly have the same value as those for whom existence is deemed essential. And if he existence of some persons is regarded as optional, then they do not have unconditional intrisic value...

In the chapter titled - Escape From Despair, Goligher writes:

The desire for physician-assisted death should be understood as a cry of despair, a cry that cannot be ignored. To ignore that cry denies the worth and value of the sufferer just as much as causing their death denies that value. ...

Likewise, even if we have successfully shown that physician-assisted death is an inappropriate and unwise way to respond to suffering, out task is not complete. We have failed to truly care for our patients if we hear their cries of despair, their requests for death, and simply throw our hands up to say "Sorry, it's wrong for me to end you, so I can't help you." Rather we must probe the reasons for the request; we must understand the fears and the pain that lead to such a cry. And we must find a way to come to their aid. It remains to us to offer a better way for our fellow humans who find themselves in the crucible of suffering.

Purchase - How Should We then Die? from the Euthanasia Prevention Coalition (Link to purchase).

Euthanasia and the loss of trust

Gordon Friesen

Gordon Friesen
President, Euthanasia Prevention Coalition

At the root of utilitarian death-medicine lies the idea that certain lives are not worth living, and/or collectively not worth paying for. It is often clothed in theatrical protestations of compassion for suffering, but the motivation is essentially practical, and that sort of practicality comes at a terrible price.

Unsurprisingly, the deepest social harm which is created by the practice of euthanasia (or perhaps merely revealed by it) lies in a general climate of fear and distrust.

For medically justified euthanasia creates distrust, providing a pseudo-scientific rationale for parents, spouses, children and friends --indeed for community itself-- to abandon those to whom they would otherwise owe a solemn and mutual duty of aid. It thus presents dependent individuals with the terrifying obligation of justifying their own survival. And it presents all observers to these facts with a similarly terrifying presentiment of their own future.

Or as jaded Soviet executioners were once said to joke: "You today. Me tomorrow."

We often touch on this harm obliquely, when we talk of the lost trust between doctors and patients, or more generally, between society and people who are "vulnerable". For these are the two sides of dependence most commonly exposed in a public and critical fashion.

Life supporting doctors now claim a right of continued practice, according to traditional ideals of ethical and trustworthy care; at the same time, the ill and disabled tell us of death now increasingly offered in substitution for that care. In both cases, we see a vigorous rejection of euthanasia: the ill and disabled overwhelmingly refusing this most insistently proffered "option"; and a strong majority of doctors refusing to personally provide it: both acutely aware that the willingness of some doctors --to kill their patients-- creates a corresponding distrust of any doctor at all.

But it would be a mistake to view the euthanasia problem only in this light.

For to be perfectly clear: all social relations depend upon trust. Pledges of friendship, marriage, inter-generational and community support --all must be unconditional, if they are to have any significance at all.

As stated above, the utilitarian vision of public health establishes patient viability upon "quality of life" judgments which closely mirror the more crude criteria of productivity and usefulness. Of course we all wish to be useful, but just as obviously: we will all one day lose that favored status; and so will every one that we know.

To make supportive relationships conditional on such judgments is thus to install a deep sense of fear and uncertainty in daily life.

"Is it time for me to throw my partner under the bus?", one might reasonably ask, "Or is she now preparing to dispose of me?"

Clearly, if such thoughts are admitted as possible, then they also become inevitable, and trust is no more.

There are a number of strategy games, and in particular an old board game named "Diplomacy", in which players must initially cooperate in order to prosper, but in which continued "success" eventually depends upon adroitly timed betrayals.

That, I believe, is the sort of pathological social dynamics which we are now creating with medical euthanasia.

Previous articles by Gordon Friesen:

• If euthanasia is legalized as a cure for suffering, then suffering people will be "cured" with euthanasia (Link).
• An unapologetic recommendation of absolute prohibition on killing (Link).

Better off Dead? documentary to be aired on BBC1 on May 14.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Liz Carr

Liz Carr, who is an actress, comedian and disability rights activist, produced a documentary that she titled Better off Dead? that will be airing on BBC1 on Tuesday May 14 at 9 pm (UK). Carr may be best known for her role as Clarissa Mullery on the BBC series Silent Witness.

John Pring interviewed Carr for Disability News Service for an article that was published on May 9, 2024. Pring begins with Carr telling him how frighting the concept of legalizing assisted suicide is for people with disabilities, within the concept of the failing National Health Service (UK):

Legalising assisted suicide, she said, would be even more dangerous at a time when “we are absolutely removing our welfare state, and we are dismantling our incredible NHS”.

Last week, at a protest outside the Houses of Parliament, she told DNS she was terrified by the government’s latest proposals to cut spending on personal independence payment.

She said: “I don’t even think the other side will make the connection over how terrifying that feels to disabled people yet again.

“We know disabled people have killed themselves because of DWP reforms in the past.

Carr speaks about her experience with interviewing Amir Farsoud, a Canadian with disabilities who sought euthanasia based on fears of homelessness. Pring reports:

“That’s what terrifies me: the kind of thing happening in Canada where people for socio-economic reasons are choosing to end their lives through euthanasia.”

In Canada, she interviewed Amir Farsoud, a disabled man from Ontario, who requested an assisted suicide because his landlord was planning to sell off his apartment building, and he was terrified at the prospect of being left homeless on the freezing streets.

He eventually changed his mind about seeking an assisted suicide after a crowd-funding effort raised tens of thousands of dollars to support him.

Farsoud told Carr that it was easier and quicker in Canada to apply for medical assistance in dying (assisted suicide) than disability benefits.

Carr comments on Keir Starmer, the leader of Britains Labour party, who is pro-euthanasia and currently leading in the polls, if an election were to happen:

She said: “I’ve always been a little bit worried about Starmer getting in power, because he introduced the guidelines [on prosecuting cases of assisted suicide, in 2010] when he was director of public prosecutions.

“I’ve known he’s been pro, we all have, for over 10 years.”

She said this was “quite frightening” and “makes it difficult for voters like me to know what to do for the next election”.

Asked if she had a message for Starmer, she said: “I would say, please watch the documentary.

Carr, who is an athiest, said that people who are concerned about the legalization of assisted suicide shouldn't sideline the opposition because they are marginalized or religious because there are many people who are concerned about legalizing assisted suicide.

Pring then spoke to Carr about her meeting with Canadian euthanasia doctor Ellen Wiebe:

She also spoke of the “chilling” attitude of Canadian doctor Dr Ellen Wiebe – who is herself disabled – who has provided assisted suicide to hundreds of Canadians since it was legalised and is shown in the documentary telling Carr she was “so glad, so glad” that they had medical assistance in dying laws in Canada.

She told her: “I love my job. This is the very best work I have ever done.”

Wiebe is also shown saying that she had never had so many grateful patients, which Carr said was “one of the most terrifying things in the documentary”.

She said: “When she says that doctors like grateful patients, that is chilling to me.

“And as somebody that’s had a lot of involvement with, you know, medics, that really frightens me.”

Pring then reported on Carr's message at a preview event for the documentary:

“If we ask the question, ‘Do you want to stop dying people’s suffering?’ everybody has to say yes to that, or you’re a psychopath.

“We all, I believe, want everyone to have a good death, so the answer is how we do that.

“And the only difference between me and [those supporting legalisation] is how you do that. That’s the only difference.

“I don’t want people to suffer. I want people to have a good death. I just think people will suffer more if we introduce assisted suicide.”

Carr commented on the media reports that indicate that legalizing assisted suicide is inevitable. Pring reports:

she said there was “nothing inevitable about it, nothing at all… I still think it’s time for a conversation and it’s not inevitable.”

Carr said she did not understand why those fighting for legalisation did not put their resources into pushing for improved healthcare and palliative care, or “into giving people choice and control in their lives”.

She said: “Because choice isn’t choice when you’ve got no choice. It absolutely isn’t.

“And I meet people in my life who are suffering absolutely because they do not have choices in their life.”

Pring reports that Carr produced the documentary to get people with disabilities prominent in the debate:

One of the things she wanted to do with the documentary, she said, was to ensure that the disabled activists who are “a big part of my life” and “who have waited for this voice for years… feel heard and seen”.

A series of disabled actors, artists and activists opposed to legalisation are either seen on film or interviewed in the documentary, including Lisa Hammond, Ellen Clifford, Jamie Hale, Paula Peters, Eleanor Lisney, Penny Pepper and disabled peers Baroness [Jane] Campbell and Baroness [Tanni] Grey-Thompson.

Pring concludes the interview with Carr stating that her interview with Melanie Reid, who supports assisted suicide, primarily focused on the experiences of being two disabled women, living in contemporary society, and the struggles and the fights to get our care needs met”.

The documentary, Better off Dead? creates common ground for people with disabilities to oppose the legalization of assisted suicide. 

Previous articles about Liz Carr:

• Laws against assisted suicide provide equal protection (Link).
• Liz Carr address to Victoria Australia parliament on assisted suicide (Link).
• Disability activists say no to euthanasia bill (Link).

Did California Dodge a “Right-to-Die” Bullet?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Mark Komrad

Psychiatrists, Dr's Mark Komrad and Annette Hanson, Ronald Pies and Cynthia Gepert, wrote a commentary on the recent attempted expansion of California's assisted suicide law that was published by the Psychiatric Times.

Komrad et al, express their concerns that, even though SB 1196 was pulled by its sponsor that it represents the strongest example of slippage with the US assisted suicide laws to a far more permissive position. They state:

As opponents of PAS/E, we often hear proponents claim that the “slippery slope” argument is merely hypothetical—an alarmist bogeyman used to scare away supporters of PAS/E. We also hear that, even if the slippery slope metaphor applies in foreign countries, “It would never happen here” in the US. We respectfully disagree. For while the angle of the slope is considerably greater in Canada and the Benelux countries than in the US, we find troubling signs of slippage here at home.

Annette Hanson

Komrad et al ask if SB 1196 is: A Harbinger of Things to Come? They explain:

California Senate Bill 1196 was introduced by Senator Catherine Blakespeare and represented a radical departure from existing California law.

Among its other provisions, SB 1196 proposed the following changes:

• It eliminated the California residency requirement for PAS.
• It replaced the criterion of “terminal disease” with “grievous and irremediable medical condition” that is “causing the individual to endure physical or psychological suffering… that is intolerable to the individual and cannot be relieved in a manner the individual deems acceptable.”
• It changed the criterion of the disease from “expected to result in death within 6 months” to “it is reasonably foreseeable that the condition will become the individual’s natural cause of death.” (This is identical to the vague language invented in Canada’s 2016 C-14 bill, which was never statutorily defined).
• It included a diagnosis of early to mid-stage dementia in the definition of a “grievous and irremediable medical condition.”
• It expanded the definition of “mental health specialist” to include neurologists and omitted any requirement for an evaluation by a psychiatrist or psychologist.
• It authorized “the self-administration of an aid-in-dying drug through intravenous injection.” This would have allowed health care practitioners to facilitate death by inserting an IV line—not merely writing a prescription, or dispensing and preparing the lethal drugs.

Ronald Pies

Additionally, SB 1196 contained language that would have turned these practices into a quasi-research protocol by requiring the prescribing physician to report the type of lethal medications prescribed; the time from drug ingestion/administration to death; and any observed complications.

Komrad et al explain how assisted suicide laws are "stretching the boundaries." They explain: 

This extraordinary attempt to expand California's law illustrates what many states may expect if laws permitting PAS (or euthanasia) are adopted. Indeed, contrary to the “It can’t happen here” argument, we have already seen examples of slippage in several US states. These expansionary rules may be categorized as modifications of (1) waiting periods for PAS; (2) conditions of PAS eligibility; or (3) expansion of authority to carry out PAS; or some combination of these modifications.

For example,

• In New Mexico, advanced practice nurses and physician assistants are now allowed to carry out assisted suicide, and the waiting period between evaluation and lethal prescription has shrunk from 15 days to 48 hours. In addition, “a provider can waive the 48-hour waiting period if the patient is unlikely to survive the waiting period.”
• In Oregon, the state residency requirement has been eliminated, and if the patient’s death is predicted to be within 15 days, the lethal drugs may be prescribed on the same day as evaluation of the patient. Notably, “Prescriptions for lethal doses of medication in Oregon increased by nearly 30% in 2023, the same year an amendment to the state's Death with Dignity Act removed the in-state residency requirement for patients…”
• In 2022, Vermont bill S.74 was signed into law, allowing patients to request the lethal prescription using telemedicine. S.74 also got rid of the final 48-hour waiting period. Then, in 2023, Vermont removed the residency requirement from Act 39, the Patient Choice at End of Life law.
• In Washington State, as of 2023, physician assistants and advanced registered nurse practitioners are now permitted to prescribe the lethal drugs, and mental competency can be evaluated by any licensed ‘mental health counselor.’ If death is deemed “imminent,” the lethal prescription can be written the same day as the eligibility evaluation.

Cynthia Geppert

As expansive as these recent modifications are, they pale in comparison to the radical changes proposed in SB 1196.

Komrad et al comment on the extension of assisted suicide to people with Anorexia Nervosa. They write:

In March of 2022, the Colorado Sun ran the following headline: “Denver doctor helped patients with severe anorexia obtain aid-in-dying medication, spurring national ethics debate.”

The article explains that Dr Jennifer Gaudiani assisted the suicides of three people with eating disorders. Komrad and Hanson explain:

The third patient—Alyssa B—was actually a coauthor of the paper with Dr Gaudiani. According to the published paper,18 “Dr. G prescribed the MAID medications about 6 weeks after Alyssa entered hospice care.”

The Gaudiani et al paper is notable in acknowledging that: 

“Alyssa had not completed a full residential eating disorder program; never fully restored weight; never tried newer psychedelic options such as ketamine, psilocybin, or MDMA; and hadn’t had a feeding tube. Dr. G acknowledged that all but the feeding tube might ordinarily be undertaken prior to someone’s seeking end of life care for AN. Yet, [Alyssa] had been suffering for so long, and despite many conversations about all these treatment possibilities, Alyssa would not consent to any of them. Therefore, given her clarity of understanding around these issues and her sense that she could not fight anymore, everyone had to accept that they weren’t meaningful options.”

Not surprisingly, the published paper and its rationale were vociferously criticized by many in the psychiatric community. For example, Dr Angela Guarda—the director of the eating disorders program at Johns Hopkins—is quoted as saying that using aid-in-dying medication for anorexia patients is “alarming” and “fraught with problems.” This is partly because “…it is impossible to disentangle this request [for PAS] from the effects of the disorder on reasoning, and especially so in the chronically ill, demoralized patient who is likely to feel a failure.”

Komrad et al explain how the three assisted suicide deaths of people with eating disorders is another clear sign of a practical slippery slope with US assisted suicide laws. 

They conclude their article by stating:

In our view, the phenomenon of the slippery slope is, in large part, the expectable consequence of “normalizing” or naturalizing the physician’s direct or indirect killing of the patient; ie, via euthanasia or PAS, respectively. The more widely these acts are performed, the easier it becomes to mischaracterize them as forms of “medical care.” This is epitomized in the obfuscating euphemism, “medical aid in dying.” As the American College of Physicians has stated:

“Terms for physician-assisted suicide, such as aid in dying, medical aid in dying, physician-assisted death, and hastened death, lump categories of action together, obscuring the ethics of what is at stake and making meaningful debate difficult.”

In truth, assisted suicide does not “aid” the dying process—it terminates dying by terminating the patient.

By the same token, the more PAS and euthanasia are viewed as medical care, the easier it becomes to enlarge the eligibility criteria to encompass almost anyone who feels they are “suffering.” Then the slide down the slope can accelerate, from terminal conditions to chronic conditions (such as mental illness), as is happening in our culturally and geographically adjacent neighbor, Canada. That opens the path for the next drift in the evolving ethos—transforming one’s “opportunity” to seek these lethal procedures into the virtue of relieving loved ones from the burden of their condition.

Finally, we believe it essential that the APA maintain its ethical opposition to PAS/E, consistent with the American Medical Association Code of Ethics.4 Doing otherwise will create a schism between the APA and the AMA. Indeed, we hope that as our colleagues consider these issues at the APA meeting, they bear in mind the teaching from medical ethicist Dr Leon Kass: “We must care for the dying, not make them dead.”

It is my belief that SB 1196 is the direction of the assisted suicide lobby, not just an experimental bill to gage a reaction. 

Lawmakers Seek To Allow Federal Funding for Assisted Suicide

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sign the Petition: I oppose US federal funding for assisted suicide (Link).

Maggie Hroncich

Maggie Hroncich wrote an article on a proposed bill to permit federal funding for assisted suicide that was published in the New York Sun. Hroncich reported that Democrat Members of Congress have introduced a HR 8137 to reverse the 1997 Assisted Suicide Funding Restriction Act and replace it with the Patient Access to End of Life Care Act. The language of the bill is not yet available but the new act would permit federal funding for assisted suicide. Hroncich reports:

For nearly 30 years — since Oregon became the first state to legalize physician-assisted death — Congress has prevented federal funding such as Medicare from being used by patients to pay for the practice. A bill proposed by Democratic lawmakers seeks to change that.

In 1997, Congress passed the Assisted Suicide Funding Restriction Act, which prohibits using federal funds to provide for any health care services that assisted in someone’s death, including “assisting in the suicide, euthanasia, or mercy killing of any individual.”

The sponsors of the bill, Democratic Representatives Brittany Pettersen and Scott Peters released a draft discussion which states:

“Medical aid-in-dying, an authorized medical practice, is not euthanasia, mercy killing, or assisted suicide,” a draft discussion of the new “Patient Access to End of Life Care Act’’ obtained by the Sun reads.

In other words Petterson and Peters intend to get funding approved for assisted suicide by redefining assisted suicide as not being assisted suicide.

The Euthanasia Prevention Coalition is opposing the Patient Access to End of Life Care Act. Hroncich reports:

Yet, an online petition with hundreds of signatures is already forming against the proposal, noting that it “would force Americans to pay for assisted suicide (medically approved killing by poison) with their tax dollars.”

“I oppose assisted suicide and I vehemently oppose paying for medically approved killing,” the petition on Canada’s Euthanasia Prevention Coaltion writes of the American legislation. “Thank you in advance for upholding my conscience rights by not approving the use of tax dollars for killing.”

The Canadian group is outspoken in warning America not to follow its path, arguing that legalizing medically-assisted death opens a door that can’t be shut.

Sign the Petition: I oppose US federal funding for assisted suicide (Link).