Book: Unravelling MAiD in Canada

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

There will be a book launch for the new research book: Unravalling MAiD in Canada in Toronto on April 15, 2025. 

Book launch registration information (Link).

The Euthanasia Prevention Coalition has ordered copies of this important book and will make them available soon.

Unravelling MAiD in Canada was edited by:

• Dr. Ramona Coelho, family physician and Senior Fellow of domestic and health policy, Macdonald-Laurier Institute
• Dr. K. Sonu Gaind, Professor, Temerty Faculty of Medicine, University of Toronto and Chief of Psychiatry, Sunnybrook
• Dr. Trudo Lemmens, Professor and Scholl Chair in Health Law and Policy, Faculty of Law, University of Toronto

Considering the number of MAiD deaths in Canada and how the law expanded in 2021 (Bill C-7), Unravelling MAiD in Canada is an important book for Canadians and other people in other countries that are debating the legalization of euthanasia and/or assisted suicide.

The effect of defining assisted suicide as medical treatment

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have been writing about euthanasia and assisted suicide for almost 30 years. During that time I have taken the clear position that killing is not caring and euthanasia and assisted suicide are not medical treatment.

The outcomes related to defining treatment to include killing are substantial.

Dan Hitchens was published in the compactmag.com on March 31, 2025 explaining: How assisted suicide will undo the NHS. The NHS refers to the National Health Service in the UK. Hitchens writes:

Last week, the MPs examining Britain’s assisted suicide bill voted through a very remarkable subclause. A single sentence, tabled by the bill’s chief architect Kim Leadbeater, quietly altered the definition of the National Health Service. The NHS’s original legislation in 1946 laid down that it must “secure improvement in the physical and mental health of the people of England…and the prevention, diagnosis and treatment of illness.” None of which really includes assisted suicide. If Leadbeater’s bill manages to pass its future votes in the Commons and Lords, this might have opened the government to a legal challenge.

I personally consider this change to the assisted suicide bill as revolutionary. Hitchens explains the significance of the amendment to the assisted suicide bill:

Hence the subclause, which allows the Health Secretary to declare that “commissioned VAD [voluntary assisted dying] services” are in fact part of the NHS’s legislative charter. The subclause doesn’t explain why: It just ensures that the government can say so. Which, as the Tory MP Danny Kruger observed, effectively admits that the National Health Service would turn into a different kind of institution. It would, through this tweak to its founding legislation, become the National Health and Assisted Suicide Service. But the alarm was loudest on the other side of the Commons. Labour MPs tend to regard the NHS as their party’s definitive achievement, the greatest edifice of the postwar welfare state built by Clement Attlee’s government. After the subclause went through, six Labour MPs signed a letter calling the bill “irredeemably flawed and not fit to become law,” noting—among a dozen other issues—that it makes “a change to the founding language and purpose of our NHS.”

Professor Sir Louis Appleby, who leads the National Suicide Prevention Strategy for England responded that they work on the principle that:

“Of protecting people at their lowest point, helping them find something worth living for, however bleak life looks.”

“Once the principle behind suicide prevention has been set aside, once any part of the ground has been ceded—not only to allow suicide but to assist it—we have lost something we may not get back.”

Hitchens explains that Kit Malthouse, a Tory MP argues that assisted suicide is not suicide. Hitchens makes reference to Australian MP Alex Greenwich who referred to assisted suicide as:

"an important form of suicide prevention.”

Hitchens explains that defining assisted suicide as part of medical treatment, with relation to the NHS will take the heart out of the NHS especially since Kim Leadbeater, the sponsor of the assisted suicide bill stated that trying to persuade a loved one from assisted suicide may qualify as “coercion.” Hitchens writes:

To recap: Taking your own life isn’t suicide, the provision of lethal drugs is suicide prevention, begging a loved one to stay alive is coercion, and the rejection of a safeguard “creates safeguards.” It is sometimes worth asking, in the words of WS Graham, what is the language using us for? This kind of language, this style of thought, uses us to obliterate what we thought we knew about our duties to each other.

Hitchens comments on how legalizing assisted suicide changes palliative care.

Palliative care, and more specifically hospice care for those nearing the end of life, is one of the signal achievements of modern medicine. Both in removing physical pain, and in addressing the complex emotional needs of the terminally ill, it can be transformative. But in jurisdictions with assisted suicide, it begins to hold a more brutal meaning. One Oregon nurse has lamented that “There is an attitude among many of our clients that ‘If I go into hospice, they’re going to kill me because that’s what a hospice does.’”

Hitchens continues by presenting data from a New Zealand study of healthcare professionals who work within a Hospice setting. The study by Dr Sinéad Donnelly indicates that the legalization of assisted death in New Zealand has changed the nature of hospice care. Hitchens comments on the change in attitude in New Zealand by writing:

Again, knock out the universal principle—we will care for you until the very end—and the atmosphere shifts decisively. There are two kinds of existences: those worth living, and those not worth living. A colder, more impatient, more utilitarian logic begins to work its way into our relationships.

Hitchens concludes his article by stating:

Stepping back a little, it is hard not to see a connection between the assisted suicide bill and the national condition in 2025: our crumbling public services, bewildered government, and extractive rentier economy. Hospices are struggling to stay open. The care sector survives on superhuman self-sacrifice and poverty wages (“a miracle sitting on top of a disgrace,” as one care manager has said.) Working-age parents are squeezed for every last penny and every last minute. There isn’t enough to go around—not enough cash, not enough time, not enough attention. And every one of those problems makes itself felt in the NHS, where waiting lists have hit record highs, 30 per cent of staff feel burnt out, and hospitals are so swamped that one hospital recently advertised for a “corridor care” doctor. Health and social care is perhaps the defining challenge for the current generation of politicians, and officially they all want to solve it. But wouldn’t it be easier, a voice seems to whisper, to just give up?

I believe that the problem goes further than described by Hitchens. When assisted suicide is considered to be medical treatment, the outcome is a requirement to inform everyone who may qualify for it based on the fact that people have a right to know about all medical options.

The reality is that assisted suicide is not medical treatment and in fact, it does not have a medical purpose. It does cause death, but death is not an intentional medical outcome, rather it is a reality of life.

Once assisted suicide is defined as a medical treatment, the legislation will be forced to expand. It becomes discriminatory to limit medical treatment to persons over the age of 18 and you cannot limit medical treatment to someone who is not dying, based on equality, when it can be offered to someone who is dying.

If euthanasia and assisted suicide are defined as medical treatment, then death becomes a treatment for conditions that require excellent care.

Assisted Suicide and Domestic Abuse.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Jess Asato (MP) and Cherryl Henry-Leach that was published by PoliticsHome concerns the UK Assisted Dying bill that is sponsored by Kim Leadbeater (MP) and the lack of protection, in the bill, for victims of Domestic Abuse.

Jess Asato is the Labour MP for Lowestoft and Cherryl Henry-Leach is CEO of the charity Standing Together Against Domestic Abuse (STADA). The writers explain their concern:

Jess Asato Labour MP

The bill as it stands does not adequately protect victims of domestic abuse. It needs more protections to prevent MPs from creating a new and legal way for perpetrators to abuse — and, ultimately, kill — their victims.

The Bill Committee did accept amendments that would require the medical practitioners and panel members involved in the assisted dying process to have undertaken training to help them identify domestic abuse. However, this does not go far enough, and the broader issue of how this bill will impact the lives of domestic abuse victims has been under-discussed.

Asato and Henry-Leach continue:

New data out this week from the National Police Chiefs Council shows that suicide following domestic abuse has overtaken homicide as the primary cause of domestic abuse-related deaths. We know from research by the women’s organisation The Other Half that 88 per cent of unlawful assisted suicides in the UK currently are perpetrated by men against women. These deaths are all too often romanticised as ‘mercy killings’, but given one woman is killed every week by their male partner and one in four women experience domestic abuse more generally, many of these suicides are likely in fact manifestations of abuse and control.

Asato and Henry-Leach explain that health care professionals often miss signs of domestic abuse:

We also know from years of working with Domestic Homicide Reviews that professionals across public services, particularly in health, often miss the signs of domestic abuse, sometimes with fatal consequences. Investment in policy and practice is needed urgently to resolve this. Research by Standing Together Against Domestic Abuse with Macmillan Cancer Support indicates that many domestic abuse survivors disclose their abuse in healthcare settings, yet these disclosures frequently go unrecognised or unacted upon by medical practitioners. Research from the Pathfinder project found that 80 per cent of women in violent relationships seek help from health services, usually from GPs, at least once, but the response is often inadequate, with many survivors not receiving the support they need, leaving them vulnerable to continued abuse.

The writers explain that assisted suicide enables abuse to lead to death:

This bill gives those most at-risk of abuse the means to end their lives, at a time when we do not have systems in place to identify their abuse and support them to live well. Older people, disabled people, severely ill people — these are some of the most vulnerable to abuse and coercive and controlling behaviour.

The writers conclude that:

We believe that one wrongful death is one death too many, but as this Bill progresses through Parliament, it is the responsibility of MPs to ensure that this Bill’s new assisted dying process leads to the fewest number of wrongful deaths possible.

The Euthanasia Prevention Coalition completely agree with Jess Asato (MP) and Cherryl Henry-Leach. They are correct that Domestic Abuse is more intensely carried out upon people when they are at the most vulnerable time of their life.

The founding Euthanasia Prevention Coalition VP, Jean Echlin, was a renowned palliative care nurse, but she was also a victim of domestic abuse. We have also written about elder abuse as it relates to euthanasia and assisted suicide.

The argument was clearly made by Asato and Henry-Leach and applies to every jurisdiction that is debating the legalization of euthanasia and/or assisted suicide.

Articles on similar topics:

• Homicide or Mercy Killing? (Link) 
• Euthanasia and assisted suicide - Ugly issue back again (Link). 
• A dance of death (Link).
  
• Death with Dignity or Obsenity? (Link).

Offered Assisted Death Instead of Surgery

Kelsi Sheren

Another horror story from inside Canada's Broken Healthcare System.

This article was published by Kelsi Sheren on April 2, 2025.

By Kelsi Sheren

Today I received a photo and post from a Dr friend of mine, who pointed out the most wild case of MAiD overreach I’ve seen in a while, and to be frank there has been several a day. This was what was stated "a Canadian citizen, injured in a workplace accident, was denied the surgery he needs and instead he was offered assisted dying (MAiD) by a healthcare practitioner and the system”.

When contacted by Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition he stated:

“She (the doctor) didn’t push suicide on me. To clarify, I’ve been begging for surgery and they have denied me. If I ask for assisted suicide they have everything ready to go. That’s the point I’m trying to get across. I asked for these forms out of anger and got them immediately.”

Canada’s healthcare system is supposed to embody compassion, empathy, and healing—but right now, it's failing us in spectacular fashion. Let’s put yourself in this man’s shoes, picture yourself injured in a workplace accident, in pain, terrified, and desperately needing surgery, already knowing the system was broken but hopeful that at least you could see a Dr in the next 18-24 months. A bleak reality every tax paying Canadian is currently facing now in Canada. You reach out for help, trusting that your healthcare system will take care of you, only to be faced with an unthinkable offer: assisted death (MAID). That's not healthcare—it's a horror story. Sadly, this nightmare isn't hypothetical; it's a grim reality that's unfolding right here in Canada and has been for years. Sadly, mainstream media will never expose or challenge the disturbing expansion of this program and its underlying purpose: removing anyone considered a burden—injured workers, individuals battling mental illness, suffering children, the elderly, Indigenous communities, the homeless, and even our VETERANS.

This tragedy isn't just a one-off mistake; it highlights an alarming trend and reveals how severely our healthcare system has deteriorated. When bureaucratic cost-cutting measures, red tape, and institutional indifference become more important than saving human lives, we have truly lost our way, and I am aware that I’m not saying anything new here other than pointing out the very obvious. But MAID was sold to the public as a lie, it was supposed to be a compassionate choice available to people facing unbearable, incurable suffering—never a convenient alternative to providing actual medical care. Yet, it is now dangerously obvious that it has become a shortcut for a strained healthcare system drowning under financial and staffing pressures.

We must face some tough questions: How did things go this wrong? How have we allowed a healthcare system, designed to heal and comfort, to instead propose death as a viable option? This isn’t simply a flawed policy—it’s a moral disaster, a profound ethical collapse of epic proportions that should deeply shame us all.

Canadians deserve much better than this. We deserve transparency, honesty, and full accountability from those who manage and deliver our healthcare. Immediate reforms are not just necessary—they're absolutely critical. Our “leaders” and I use this term incredibly lose, policymakers, and healthcare providers must stand up and address this constant need to use death as the solution to all things and fix the systemic failures that have allowed something so horrific to occur.

The lives, dignity, and humanity of injured and suffering Canadians hang in the balance. We have a duty—a sacred obligation—to protect and fight for them. Offering death instead of proper medical care isn't just unacceptable; it's disgraceful and morally indefensible.

It’s high time we demand better, loudly and persistently, until meaningful changes are made.

No Canadian should ever be abandoned by the system mean't to heal them.

Quebec can tell us about the lack of social legitimacy for euthanasia and assisted suicide

Gordon Friesen

By Gordon Friesen

President: Euthanasia Prevention Coalition

Peoples' eyes tend to glaze over at the sight of figures and statistics, so I will go directly to the bottom line:

Although Quebec has proportionally more assisted-suicide / euthanasia than any other jurisdiction in the world --including almost 10 times that of Oregon even after adjustment for wider eligibility criteria (see table 1)-- it still remains a decidedly marginal way to die. This is extremely significant. For just as we believe that euthanasia is wrong (and more is worse), so also, our adversaries believe that euthanasia is good (and more is better).

To be clear, these people are attempting to show that euthanasia is not only a "good death" but is actually the most desirable form of death for both the individual, and society. Their goal is to pragmatically prove this proposition by creating a perception, based on large numbers of people consenting to euthanasia, that this change in behavior represents some kind of inevitable social progress. And to that end, euthanasia doctors, administrators and politicians (especially in the Québec) are doing everything humanly possible to drive up consent rates as far as that may possibly be.

But that is precisely the insight we may now gain from statistics in that place: our adversaries are falling short, and failing in their plan. For there appears to be no medical circumstance, whatsoever (even under the most favorable marketing conditions imaginable) in which it might be termed statistically "normal" to consent to euthanasia. Indeed, when considered in the light of this data, no objective justification might ever be claimed for any particular case.

Most importantly, current Canadian public health policy cannot possibly be claimed as a reasonable response to spontaneous patient desire. On the contrary, the satisfaction of a marginal --and even arguably pathological-- demand for death has been used to undertake a complete transformation of public healthcare, without fundamental social legitimacy, towards a frankly death-based paradigm in which typical (non-suicidal) patients are increasingly unable to access real medical care. And yet, although we now suffer the full social cost of this institutional vandalism, the desired results have not been obtained!

Current policy is imposed from above, predatory in nature, and built upon a universal, State-mandated, systematic (and highly aggressive) marketing of death-as-cure. It's success depends upon the efficiency with which euthanasia may be sold to contextually helpless persons, by professionals who have learned to maximize the terrorizing diagnostic impact of serious illness, and to proactively reinforce any suicidal speculations born of depressive despair.

This dynamic is clearly illustrated in the official report of Quebec euthanasia most recently provided (2023-24) . Along the further banks of the St. Laurence River, far from both Montreal and Quebec City, we find two administrative regions on opposing shores. Both have the same traditions. Both watch the same TV; read the same papers; eat the same food; etc. On the South shore, (region 01, Bas-Saint-Laurent), the euthanasia ratio is an astonishing 10.6% of all deaths. Whereas across the water (region 09, Côte-Nord), the same ratio is below half of that, at 4.5%.

It would be difficult, I submit, to explain this difference in any other way than differing medical attitudes in their respective regional health administrations, resulting in turn from the personal bias of those doctors (and bureaucrats) working in each. Nor is this contrast unusual. Throughout rural Quebec, districts, literally side by side, show the same pattern of wildly differing euthanasia rates, split about equally, at or above versus well below the Provincial average.

There is no indication that patients are deprived of any valuable benefit in those regions with lower euthanasia prevalence. There is no population rising up with pitchforks, or crying out for release from "unbearable suffering". Lucidly considered, it would simply seem that at least half of all euthanasia deaths in the Côte-Nord (and other similar regions of Quebec) are not spontaneously requested at all, but "just happen", like those premature roof replacements, and encyclopedias, and vacuum cleaners --that no one really needs or wants-- but which are purchased, none the less, through the earnest eloquence of relentless door-to-door salesmen.

Certainly, knowledgeable patients might now have very rational misgivings about entering hospital at all, depending on where that hospital is located.

As noted above however, the more general problem --and regardless of where we happen to live --is that once institutional care teams are groomed to view euthanasia as the objectively indicated treatment for serious illness: very little appropriate life-affirming care is likely to remain for the vast majority of patients, who obstinately refuse to die.

Beyond political lobbying, therefore, our most important task, as advocates for life-affirming medical care, will be to create the conditions and institutions required to ensure that we, and our families, might have access to any such care at all. I am confident that, with growing citizen understanding of the true damage caused, the now developing medical model of euthanasia will eventually collapse under its own weight. However, that event may be decades away. Hence, we must not idly submit in the meantime.

This point is particularly timely in the US, because that country is not so far along the slope of State-mandated death-medicine as is Canada. There still remains a significant competitive element of patient choice. However, there should be no complacency on that score. Whatever advantage remains must be fully exploited by those with the vision and the courage to invent and create the structures required. There is no guarantee of future freedoms (just as there are now virtually no hospitals in Canada which are free of euthanasia practice). We are therefore urgently summoned to "use it or lose it!", right now, in the present moment.

The Euthanasia Prevention Coalition is fully committed to supporting all such initiatives.

A technical Post Scriptum for those who would like to see the proof

Facts, as they say, are stubborn things. And this fact (of politically structuring public healthcare to favor interests which are directly opposed to those of individual patients themselves) promises to be stubborn indeed. For how can social legitimacy be claimed for something so impactful, which so few people can be enticed to embrace?

I first made this argument in 2019 (in French), here and here and later in the Psychiatric Times (2022) and (2025). In each of these cases I used the worst examples then existing, which concerned cancer patients in the Netherlands. Approximately stated: 4% of all Dutch deaths were then due to euthanasia, while no less than 70% of euthanasia was performed on cancer patients. At the same time, only 30% of all deaths were due to cancer (including related euthanasia).

Doing the appropriate math (.7x.04/.3) we see that 9.3% of Dutch cancer patients died by euthanasia. I was thus able to demonstrate that in the most prolific euthanasia regime on the planet at that time, and in the most receptive patient category, less than 10% of patients would consent to die by euthanasia. Or conversely stated: 90% of such patients did NOT consent.

I also suggested that year-over-year growth of euthanasia was stabilizing, and that Dutch euthanasia would likely top out not far above 4%.

Unfortunately, these predictions have proved false, since the Dutch are now above 5%, but also largely irrelevant, since Quebec has now taken the lead with no less than 8.2% of all deaths (table 1). However, let us examine whether these new numbers actually contradict the underlying significance of our earlier conclusions before we assume that they have been discredited.

With rapidly rising incidence, euthanasia in Quebec has been metastasizing into other previously untouched patient groups. The proportion of such deaths associated with cancer has thus descended to 60%. At the same time cancer as a fraction of all deaths is now 26%. This means that the fraction of cancer patients who consent to euthanasia (.082x.60/.26) has now risen to nearly 19%.

Obviously, this is very different from before. Certainly, I can no longer claim that 90% of patients will never consent to euthanasia. However, if that claim is now "only" 80%, what essential difference is there in the meaning of those numbers? In fact, let us seek the greatest level of detail now available. It is stated in another recent Quebec report that certain specific cancers actually have a consent rate up to 25%. So be it.

Our revised claim may be stated as follows:

There is no medical circumstance, whatsoever, in which more than one quarter of patients will consent to die by euthanasia (even where that death is systematically promoted by the State and universally normalized by all care teams, in all medical facilities). Even in the face of such extraordinary psychological pressure, fully three quarters will refuse.

This I believe is the most important lesson which we may learn from data provided by the Province of Quebec. It is our interest and duty to ensure that medicine, public or private, be structured to serve the non-suicidal super-majority of patients. We must not allow clinical culture to be dictated by the cynical political exploitation of atypical views tragically espoused by a troubled few.

A note on misleading data concerning euthanasia for neurodegenerative diseases

It further appears in the above-cited report that up to 35% of deaths due to conditions such as Parkinson’s, ALS and MS, are now euthanasia deaths in Quebec. Please note, however, that this claim is extremely problematic. For people do not die of such diseases, they die with them. And thus any deaths so attributed will very likely be euthanasia deaths to begin with. Unlike cancer data, therefore, this statistic has no relation to the total number of people living with neurodegenerative diseases who might actually consent to euthanasia for that reason. Indeed, the fallacious suggestion made here, that voluntary death is so incredibly popular (and by implication appropriate) among such patients, constitutes a disturbing attack upon the physical and social security of people to whom we owe a completely different sort of respect and support.

Comparison of AD incidence in Oregon and Quebec

Assisted Death: 

Oregon 376 deaths (2024) (3) Québec 6058 deaths (2024) (1)

Total Deaths: 

Oregon 44,681 (2022) (5) Québec 79,300 (2023) (6)

Assisted deaths as a percentage of all deaths: 

Oregon 0.8%, Québec (7.6%).

1. Quebec End-of-Life Commission annual report (April 2023 - March 2024)
2. Quebec End-of-Life Commission five year review (April 2018 - March 2023)
3. Oregon Death with Dignity Act 2024 Data Summary  oregon.gov accessed April 2, 2025
4. Supplementary data from the Quebec End-of-Life Care Commission February 3, 2025  
5. Oregon total deaths (2022) oregon.gov accessed Nov.30. 2024
6. Total Quebec yearly deaths (2023-2024) statistica.com 
7. Fifth Annual Report on Medical Assistance in Dying in Canada , 2023, table 2.1a, www.canada.ca 

Elections have consequences. Don't vote for candidates who will expand the killing.

Alex Schadenberg

Alex Schadenberg
Executive Director, 

Euthanasia Prevention Coalition

Elections have consequences.

Please share this message with your like minded friends.

This is an important election for those who oppose killing people.

Canada's 2023 euthanasia report stated that there were 15,343 reported euthanasia deaths representing 4.7% of all deaths. 

My research uncovering the 2024 Canadian euthanasia data indicates that there were approximately 16,500 reported euthanasia deaths. In Québec, the number of euthanasia deaths increased again. Québec has the highest euthanasia rate in the world.

The Office of the Chief Coroner of Ontario released a report from the Ontario MAiD Death review Committee indicating that there were at least 428 non-compliant Ontario euthanasia deaths from 2018 to 2023.

Recently, Canada's federal government was studying expanding euthanasia to advance requests, meaning, to permit people who state in an advance directive that they would want euthanasia, that the person could be killed if they become incompetent.

Canada is currently scheduled to allow euthanasia for mental illness (alone) beginning on March 17, 2027. A report by the Special Joint Committee on Medical Assistance in Dying (AMAD) that was tabled in the House of Commons on February 15, 2023 called for a drastic expansion of euthanasia by recommending that children "mature minors" and patients with mental illnesses should be eligible for euthanasia and that patients with dementia should be permitted to make advance requests by advanced directives for euthanasia.

On March 21, 2025 the Convention on the Rights of Persons with Disabilities Committee report urged Canada's federal government to:

Repeal Track 2 Medical Assistance in Dying (MAiD), including the 2027 commencement of Track 2 MAiD for persons whose “sole underlying medical condition is a mental illness”;

Not support proposals for the expansion of MAiD to include “mature minors” and through advance requests;

Elections have clear consequences. 

I urge you to not vote for candidates or a government that will be committed to further expansions of killing. 

Reject the status quo. We cannot afford another euthanasia expansion government.

Ronald W. Pies, MD testimony opposing Massachusetts assisted suicide bill.

This testimoney was sent to the Euthanasia Prevention Coalition with permission to publish.

Dr Ronald Pies

Written Testimony of Ronald W. Pies, MD

Massachusetts psychiatric physician and medical ethicist

In opposition to H. 2505/S.1486 MASSACHUSETTS END OF LIFE OPTIONS ACT

Submitted to Massachusetts Joint Committee on Public Health - March 29, 2025

Dear Committee Members:

As a Massachusetts psychiatrist and medical ethicist, I write in firm opposition to H.2505/S.1486 MASSACHUSETTS END OF LIFE OPTIONS ACT—bills that would effectively legalize physician-assisted suicide (PAS) in Massachusetts. 

First, it is important to note the profound ethical problems inherent in the practice of PAS, misleadingly called “aid in dying” in some contexts. (PAS does not “aid” the natural dying process; rather, it terminates dying by terminating the patient, via provision of lethal drugs). The American Medical Association; the American Psychiatric Association; the American College of Physicians; and the National Council on Disability have all rejected physician-assisted suicide. [1] Neither the Massachusetts constitution nor the U.S. Constitution contains a right to assisted suicide; therefore, no individual has the right to authorize another to kill him or her in violation of federal and state criminal laws. (Washington v. Glucksberg, 521 U.S. 702, 735 (1997). Instead, Massachusetts has an unqualified interest in the preservation of human life. Furthermore, in the Massachusetts case of Kligler v. Att’y Gen., 491 Mass. 38, 70 (2022), the court rejected claims that a person has a “right” to assisted suicide. The court found no basis to “conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights.”

Contrary to popular misconceptions, the vast majority of persons requesting PAS are not in the grip of severe, intractable pain and suffering [2]. As data from Oregon have shown, the most common reasons for requesting medical aid in dying were fears regarding loss of autonomy (97.2%), inability to engage in enjoyable activities (88.9%), and loss of dignity (75.0%) [3] These understandable fears are best dealt with via empathic, face-to-face counseling and psychotherapy—not with the ingestion of poison.

Furthermore, a peaceful death is by no means guaranteed using current methods of PAS, as a recent piece by Lo pointed out: 

“Physicians who support PAD need to consider how to address the potential for adverse outcomes, including longer time to death than expected (up to 24 hours or more), awakening from unconsciousness, nausea, vomiting, and gasping.” [4] 

Data collected between 1998 and 2015 showed that the time between ingestion of lethal drugs and death ranged from 1 minute to more than 4 days. During this same period (1998-2015), 27 cases (out of 994) involved difficulty ingesting or regurgitating the drugs, and there were 6 known instances in which patients regained consciousness after ingesting the drugs. However, it is difficult to know the actual rate of drug-induced complications, because in the majority (54%) of cases between 1998 and 2015, no health care professional was present to attend and observe the patient’s death [5].

This last point highlights an additional ethical flaw in so-called “end of life options” bills, including H. 2505/S.1486: they do not require the presence of a physician or other medical personnel at the time the patient ingests the lethal drugs. In addition to denying the patient medical oversight of the suicide, this amounts to abandonment on the part of the physician who authorized the assisted suicide. To compound the ethical lapse, the physician is then permitted to falsify the cause of the patient’s death; i.e., “The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death” (lines 195-196 H. 2505/S.1486 ). This is plainly fraudulent, unethical, and inimical to research aimed at tracking the natural course of terminal illnesses.

A major failing of this bill is its ambiguity regarding the concept of “terminal illness.” The bill defines “Terminally ill”, as “having a terminal illness or condition which can reasonably be expected to cause death within 6 months, whether or not treatment is provided.” [italics added]. The phrase “whether or not treatment is provided” is vague and indecipherable. Does this mean that if a patient with, say, type 1 diabetes or anorexia nervosa refuses evidence-based treatment—and thus, is likely to die within 6 months—the patient nevertheless meets the criterion for “terminal illness”? Would a patient with a potentially fatal but treatable infectious disease who refuses treatment be classified as “terminally ill?” Such an interpretation radically distorts the historical meaning of the term “terminally ill.” Moreover, in practice, there are significant limitations in a physician’s ability to predict patient outcomes; this is true even for end-of-life physician specialists. For example, in a study of 364 doctors who provided survival estimates for 468 terminally ill patients, only 20% of predictions were accurate.[6]

Psychiatric and Medico-legal Considerations

As a psychiatrist, I find the bill’s safeguards against missing underlying psychiatric illness—which may compromise informed consent—woefully inadequate. Yes, the bill does mandate (section 8) that:

“…An attending physician shall refer a patient who has requested medical aid in dying medication under this chapter to counseling to determine that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. The licensed mental health care professional shall review the medical history of the patient relevant to the patient’s current mental health and then shall submit a final written report to the attending physician.”

However, the bill defines licensed mental health professional very broadly, as “…a treatment provider who is a psychiatrist, psychologist, psychiatric social worker or psychiatric nurse and others who by virtue of education, credentials and experience are permitted by law to evaluate and care for the mental health needs of patients.” In what is literally a life-or-death determination, it is far from clear that the average “mental health professional” possesses the requisite skill set to assess mental capacity in the setting of terminal illness—an assessment that would challenge the skills of even a forensic psychiatrist.

Furthermore, there is no requirement in the bill for psychological evaluation at or very near the actual time of lethal drug ingestion, despite the fact that the patient’s mental status and mental capacity may fluctuate from day to day or week to week, in the course of a terminal illness. In addition, it seems that the bill would permit evaluation and “counseling” of the patient without even a face-to-face meeting; i.e., the process could be conducted via “telemedicine”—to my knowledge, a completely untested method of determining mental capacity or providing counseling in the context of a terminal illness.

Finally, there are no well-defined procedures specified in the bill by which any unused lethal drugs would be located and disposed of, in the event the patient elects not to ingest them. The bill merely states, “Any medical aid in dying medication dispensed under this chapter that was not self-administered shall be disposed of by lawful means. The medication dispenser shall be responsible for informing the individual collecting the medication what disposal by lawful means entails.” This says nothing about when the unused medication shall be disposed of—a day after the patient decides not to ingest it? A week? A month? What about the risk that in the interim, a family member—perhaps a young child—will happen upon the lethal medication and ingest it? A recent report in the Journal of Emergency Medical Services reveals that this possibility is not merely theoretical. [7] Do Massachusetts physicians really want to assume medico-legal liability in such a scenario? The bills as written are an invitation to litigation.

Conclusion

End-of-life care deserves far better than effectively handing terminally ill patients a bottle of lethal drugs—a practice that flies in the face of more than two millennia of Hippocratic medical practice. As Dr. John R. Peteet and I have argued, physician-assisted suicide will lead to “distorting the physician’s role; cheapening individual life; and abandoning the most vulnerable people” at their time of most urgent need. Surely as a society we can do better, by providing optimal, accessible psychiatric and palliative care. [8] As physician and medical ethicist Dr. Leon Kass eloquently put it,

“The legalization of physician-assisted suicide [perverts] the medical profession by transforming the healer of human beings into a technical dispenser of death. For over two millennia the medical ethic . . . has held as an inviolable rule, “Doctors must not kill.” The venerable Hippocratic Oath clearly rules out physician-assisted suicide. Without this taboo, medicine ceases to be a trustworthy and ethical profession. . . . We need to care for the dying, not make them dead.” [9]

Respectfully,

Ronald W. Pies, MD ronwpies@gmail.com
Professor Emeritus of Psychiatry
Lecturer on Bioethics & Humanities
SUNY Upstate Medical University;
Clinical Professor Emeritus of Psychiatry
Tufts University School of Medicine

References

1. Snyder Sulmasy L, Mueller PS; Ethics, Professionalism and Human Rights Committee of the American College of Physicians. Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper. Ann Intern Med. 2017 Oct 17;167(8):576-578. doi: 10.7326/M17-0938. Epub 2017 Sep 19. PMID: 28975242.

2. https://www.hcplive.com/view/twelve-myths-concerning-medical-aid-in-dying-or-physicianassisted-suicide

3. Loggers ET, Starks H, Shannon-Dudley M, Back AL, Appelbaum FR, Stewart FM. Implementing a Death with Dignity program at a comprehensive cancer center. N Engl J Med. 2013;368(15):1417-1424. doi: 10.1056/NEJMsa1213398

4. Lo B. Beyond legalization - dilemmas physicians confront regarding aid in dying. N Engl J Med. 2018;378(22):2060-2062. doi: 10.1056/NEJMp1802218.

5. Oregon Health Authority, Public Health Division, Center for Health Statistics. Oregon Death With Dignity Act: data summary 2016. oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year19.pdf. Published February 10, 2107. Accessed June 6, 2018.

6. Nicholas A. Christakis, Extent and Determinants of Error in Doctors’ Prognoses in Terminally Ill Patients: Prospective Cohort Study, 7233 THE BMJ 469, 469-73 (2000).]

7. Death with Dignity: When the Medical Aid in Dying Cocktail Gets into the Wrong Hands. https://www.jems.com/patient-care/death-with-dignity-when-the-medical-aid-in-dying-cocktail-gets-into-the-wrong-hands

8. https://www.telegram.com/story/opinion/columns/2023/01/29/dr-john-peteet-and-dr-ronald-pies-oppose-physician-assisted-death/69831539007/

9. Kass LR. Dehumanization Triumphant. 1996. See: https://www.psychiatrictimes.com/view/deferring-mastery-death-hippocrates-judge-gorsuch-and-autonomy-fallacy

Dying with Deception: Exposing Dying with Dignity Canada's Dangerous Lies and the UN’s Call for Truth

The following article was published by Kelsi Sheren on her substack on March 28, 2025.

By Kelsi Sheren

Dying with Dignity Canada has once again shown its true colors—playing fast and loose with the truth, deliberately misleading donors, and cynically dismissing legitimate human rights concerns. Their response to the UN's critical stance against Canada's Track 2 MAID exposes not only their arrogance but also their willingness to CONTINUE to sacrifice vulnerable lives for the sake of ideological purity.

Let's cut through their carefully spun narrative, as usual they continue to make themselves out to be the victims here.

First, Dying with Dignity claims the UN's concerns are based on "unfounded reasoning and unsubstantiated grounds." This is a blatant lie, I often wonder how they write these articles with such conviction knowing they are intentionally lying to the vulnerable. The UN's Committee on the Rights of Persons with Disabilities meticulously and systematically reviewed substantial evidence provided by disability advocates, human rights experts, and firsthand testimonies clearly demonstrating how Track 2 MAID disproportionately pressures and endangers vulnerable populations.

Dying with Dignity’s insistence that the committee merely parrots the claims from the Ontario court challenge is another deliberate misrepresentation. The UN's findings are based on comprehensive international human rights analysis, not merely untested allegations. These concerns aren't hypothetical—they’re rooted deeply in real-world suffering, coercion, and injustice documented extensively by frontline advocates and medical professionals. Their willingness to discount real, true accounts of abuse is sadistic. We have a plethora of cases including Alicia Duncan's mother's case and at this point a disturbing amount of families have reached out with similar stories of abuse.

Dying with Dignity falsely asserts that structural vulnerabilities like poverty, housing insecurity, and racial discrimination don't substantially influence MAID requests, which once again we have a significant proof that this is happening all across the country. They conveniently ignore countless credible studies and heart-wrenching stories from Canadians whose desperate social circumstances have driven them toward assisted death. Their denial dismisses the tragic reality of disabled Canadians pressured into MAID not because they desire death, but because they are systematically denied dignified lives.

Dying with Dignity hypocritically promotes "policies that ensure stable housing, income, and healthcare" while simultaneously advocating for expanded access to MAID—a twisted contradiction. Their rhetoric of empowerment disguises a disturbing disregard for the realities faced by the disabled community. They speak of autonomy yet refuse to address the conditions stripping disabled Canadians of meaningful choice. This is not advocacy; it's negligence bordering on cruelty.

Lastly, let's get something crystal clear: disability rights advocates aren't seeking to limit autonomy; they’re desperately fighting to protect it and what we have left. Genuine autonomy cannot exist when death is presented as an easier alternative than addressing the systemic failures trapping people in suffering. Once again, we can access death care but we CANNOT access proper healthcare or support for disability rights and support.

Dying with Dignity owes Canadians—and especially their donors—the truth.

Knowing them and who is involved with them, this will never happen.

It's time they stopped manipulating the narrative, stopped hiding behind faux-compassion, and started genuinely supporting policies that enable life, dignity, and true autonomy for all Canadians, especially the most vulnerable.

We won't hold our breath, DWD will continue to show their true colours and we hope Canadian's will finally wake up to their continued manipulation.

Euthanasia is out of control in Canada. 241 euthanasia deaths based on dementia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article that was written by Angelo Bottone and published by thinkspot.com on March 25, 2025 examining Canada's 2023 euthanasia statistics.

Article: Canada - 15,343 reported euthanasia deaths in 2023 (Link).

Bottone reports on Canada's basic euthanasia statistics. He writes:

In 2023, 15,343 Canadians died by euthanasia or assisted suicide, according to the ‘Fifth Annual Report on Medical Assistance in Dying’. This marks a 15.8% increase over 2022 and represents 4.7% of all deaths in 2023. Since its legalisation in 2016, there have been 60,301 cases of assisted suicide and euthanasia cases in Canada that we know of.

Bottone writes about some of the contentious concerns such as:

Dementia was cited as a medical condition in 241 euthanasia recipients in 2023, and in 106 of these cases, dementia was their sole condition.

Euthanasia for dementia is significant because Canada's law permits euthanasia for people with dementia if the person is competent and if there are other co-morbities (another medical condition). The 106 euthanasia deaths where the sole condition was dementia should be investigated by the RCMP or the College's of Physicians.

Bottone points out that in 622 deaths, natural death was not deemed “reasonably foreseeable.” This category, called Track 2, allows euthanasia for non-terminal patients. Loneliness, as a reason for euthanasia, was far more common among Track 2 deaths than Track 1 (terminally ill) deaths.

Isabel Grant, a law professor at the University of British Columbia stated:

“When other people express loneliness or a loss of dignity or a desire to die, we usually respond with support or prevention. But with people with disabilities, we respond with an offer for MAID,”

Bottone notes that the percentage of people with disabilities among non-terminal euthanasia recipients was significantly higher: 58.3% compared to 33.5% for people with terminal conditions.

Bottone completes the article by explaining that the British Columbia Civil Liberties Association (BCCLA) who brought the original euthanasia case (Carter case) to the court has changed their position. Bottone reports the BCCLA concerns:

However, the regime has become so permissive that even the BCCLA has raised concerns, particularly about euthanasia for prisoners and disabled individuals. The organisation has highlighted reports of people accessing MAID due to intolerable social circumstances or being offered it in cases that may not meet legal requirements.

“Of particular concern are reports of MAID being used in prisons while incarcerated individuals were shackled to their beds, the programme’s lack of legal oversight, disproportionate representation of impoverished people receiving assisted suicide, and healthcare practitioners offering MAID when patients sought support for living,” the BCCLA stated.

Previous articles on this topic:

• Article: Canada - 15,343 reported euthanasia deaths in 2023 (Link). 
• Euthanasia is a national tradgedy and only getting worse (Link). 
• Canada euthanasia: Unmasking health and social failure (Link) 
• Canada's euthanasia deaths continue to rise with an estimated 16,500 in 2024 (Link).

British MP who supported assisted suicide, is opposing the assisted suicide bill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Naz Shah, a Labour MP who originally supported assisted suicide is opposing the Kim Leadbeater assisted suicide bill. The UK assisted suicide bill passed at second reading by a vote of 330 to 275. The bill was debated in committee where there were 393 proposed amendments with only 32 of the amendments accepted.

Shah is one of many MP's who support assisted suicide in principle but are opposing the bill. Opposition to the bill may be the reason why Leadbeater, the sponsor of the bill, recently stated that, if passed, implementation of the assisted suicide bill would be delayed until 2029.

David Maddox, the Political Editor for The Independent, wrote an article that was published on March 30. Maddox explains why Shah is opposing the assisted suicide bill:

A Labour MP who had originally been inclined to vote in favour of Kim Leadbeater’s assisted dying legislation has claimed that the bill now has weaker safeguards than when MPs voted on it in November.

Naz Shah spoke to The Independent in the wake of the laborious and, at times, tetchy committee stage of the controversial bill being completed in parliament last Wednesday.

The Bradford West MP, who served on the committee scrutinising the bill, had hoped that safeguards could be strengthened to make it workable but now claims the legislation is “fundamentally flawed”.

Maddox further reports on why Shah opposes the assisted suicide bill

...Ms Shah has said she is “very disappointed” and “disheartened” with the direction taken after hopes they could ensure the safeguards were robust.

She revealed: “Kim [Leadbeater] is a friend and when she first told me about the bill I was inclined to vote for it. But the more I looked at the details, the more concerns I had.”

Top among these were concerns over the way people who suffer from domestic abuse and have disabilities could potentially be coerced into ending their lives early. As someone who had suffered previously from domestic abuse in a forced marriage, these issues were important to her.

Ms Shah also made headlines during the process when she was forced to leave a session because her hearing aid batteries had run flat. An attempt to push through amendments had seen the session extended despite pleas from Ms Shah that she could not take part.

Maddox reported that Shah tried to amend the bill by strengthening it's "safeguards"

She had also backed attempts to toughen up the bill by ensuring eating disorders such as anorexia could not be given as reasons for assisted dying.

“I talked about a lot with the anorexia stuff, and that’s weakened. The amendment that [Kim Leadbeater] put in, in the capacity bit, that’s actually weakened the bill, not strengthened the bill.

“Then there’s the issue that children are now exposed, that doctors can have this [assisted death] conversation with children. You know, there’s fundamental flaws in the bill, and I just feel disheartened that I’ve gone in trying to help fix it and actually come out, not from my fault, but, you know, with it weakened.”

Maddox reported that Ms Shah was concerned that only 7 of the amendments were accepted were meaningful and none of the accepted amendments were "fundamental ones."

How the CBC is Manipulating Canadians into Accepting Death

This article was published by Kelsi Sheren on her substack on March 25, 2025.

Emotional Manipulation Isn't Journalism—It's Coercion

Kelsi Sheren

By Kelsi Sheren

Look, let's cut right to it: something deeply disturbing is happening here in Canada, and the CBC is front and centre today. They’re openly romanticizing euthanasia—Medical Assistance in Dying (MAiD)—as though choosing death is some beautiful, noble act instead of the tragic consequence of profound suffering and a failure of care. It's time we talked bluntly about what's really going on here, because the subtlety with which Canadians are being coerced toward assisted death is alarming.

When the CBC paints a sentimental picture of couples gently holding hands and listening nostalgically to their wedding songs moments before they're euthanized, it's not just storytelling—it's emotional manipulation. It glamorizes dying through MAiD, suggesting a death that's peaceful, romantic, and dignified, when in reality, the process is deeply complex, deeply troubling, and profoundly tragic. They're packaging death like a Hallmark movie to sell Canadians on euthanasia as something idealistic and desirable.

The CBC doesn’t just stop at emotional manipulation—they actively highlight the rapid increase in euthanasia requests as though it's something positive or simply routine. Today, one in every twenty deaths in Canada is via MAiD. That's staggering, thats terrifying and that say’s a lot about our society in Canada. Yet, CBC casually presents these numbers, implicitly suggesting this rise is not only acceptable but commendable. This normalization becomes coercive pressure, particularly for those who already feel like a burden—socially, financially, or emotionally. These carefully curated stories serve to subtly reinforce the notion that choosing death is an honourable escape from suffering rather than what it truly signifies—a societal abdication of duty to provide holistic care and compassionate solutions.

Moreover, the media’s repeated, sentimental portrayals overshadow the nuanced and often distressing realities of euthanasia. Rarely do these stories discuss the ethical dilemmas doctors face, the emotional trauma families endure, or the psychological turmoil individuals often experience leading up to their decision. Instead, the CBC chooses carefully selected anecdotes and gentle imagery that romanticize the experience, distorting public perception and sanitizing a deeply complicated and ethically charged practice.

But journalism should ONLY illuminate truth, not manufacture emotion or normalize troubling statistics. When media outlets resort to heart-tugging imagery and sentimental portrayals of euthanasia, they cross the line from reporting to coercion. They exploit readers’ and viewers empathy, subtly normalizing and even promoting MAiD as a romanticized solution to life's struggles, rather than exposing the gritty reality behind it. By doing so, they blur the crucial line between compassion and complicity, ultimately misleading their audience and perpetuating harmful ideologies. Let’s not lie here, the CBC has been doing this for years now but some reason we continue to allow our tax payer dollars to fund them.

Here's the unvarnished truth: vulnerable individuals—those grappling with severe illness, disabilities, chronic pain, isolation, or financial stress—don't need romanticized portrayals of death. They require genuine support, comprehensive healthcare solutions, robust mental health resources, and authentic human connection. Every polished narrative promoting euthanasia as "peaceful" and "beautiful" serves as a silent nudge, whispering to the vulnerable that death might indeed be preferable, or even admirable, reinforcing their internalized fears of being a burden.

What these individuals genuinely need is to be heard, supported, and uplifted through adequate care, not subtly guided toward prematurely ending their lives through orchestrated media narratives. Society owes it to those who suffer to demonstrate unwavering commitment to life-affirming solutions and meaningful support systems rather than offering death as the convenient alternative.

This is not compassionate journalism; it’s dangerous complicity. True compassion is standing alongside those suffering, championing life, and advocating for real solutions—solutions that value life over convenience, care over expediency, and hope over surrender. Journalism has a moral responsibility to confront uncomfortable truths, challenge societal norms, and demand better from our institutions. To do anything less isn't journalism; it's coercion masquerading as empathy, a betrayal of public trust, and a profound moral failure.

Truly the most frightening aspect of all this is how rapidly Canada is dismantling critical safeguards meant to protect vulnerable individuals from impulsive or pressured decisions. Just like the CBC chose to do today. The removal of mandatory waiting periods for people whose deaths are deemed "reasonably foreseeable" is outright dangerous. Without a waiting period, there's significantly less time for reconsideration, reflection, and second opinions—dramatically increasing the likelihood of impulsive decisions influenced by overwhelmed families, exhausted healthcare providers, or toxic societal messaging that death is the "brave" or "right" choice.

This isn't compassionate healthcare; it’s a healthcare system that's tired, overwhelmed, and more willing to suggest death than to truly care for its patients.

Let's Be Brutally Honest

The CBC—and many other media outlets—are contributing to a troubling societal shift, where assisted death is becoming normalized and even glamorized as a social duty rather than viewed as a heartbreaking last resort. We're dangerously close to a reality where the right to choose death morphs into an expectation or even a quiet obligation.

We must fight back against this dangerous narrative. We must demand real transparency, honesty, and integrity when discussing end-of-life care. Canada desperately needs better resources for palliative care, mental health support, and human connection—not more seductive narratives pushing death as a peaceful, noble solution.

It's time to stop romanticizing euthanasia. It’s time to fight for life and while were at it, it’s time for real journalism to come back to this country.

In case you read this CBC, shame on you.

Some previous articles by Kelsi Sheren:

• Debunking the ethical argument for assisted dying for minors (Link).
• Franchising Death (Link).
• Let's call MAiD what it is (Homicide) (Link)
• The Death Cult of the Euthanasia Lobby (Link).

Oregon 2024 assisted suicide report: Increase in death prescriptions again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The number of lethal poison prescriptions written under the Oregon assisted suicide law increased in 2024 with 607 prescriptions written, which was up from 566 in 2023 and 433 in 2022.

The 2024 Oregon assisted suicide report indicated that there were 376 reported assisted suicide deaths up by 71 from 305 in 2022. 

Similar to previous years the 2024 report updated the data from the 2023 report. The 2023 report stated that there were 367 reported assisted suicide deaths, but the 2024 report stated that there were 386 reported assisted suicide deaths in 2023. Therefore the Oregon Health Authority (OHA) received 19 assisted suicide death reports from 2023 after the 2023 report was completed.

Since every year late assisted suicide reports are submitted, I predict that there were likely 400 reported Oregon assisted suicide deaths in 2024.

Article: Oregon assisted suicide prescriptions increased by 29% in 2023 (Link).

Dr Sharon Quick

Mike Francis stated for The Lund report on March 27 that:

...opponents point to the steady growth in numbers of people requesting lethal medication — fewer than 100 people a year did so before 2011 — and say the system of physician-assisted suicide does a disservice to patients.

“A death request is often a plea for help, but legalizing assisted suicide may allow an option to die to transform into a duty to die,” said Dr. Sharon Quick, President of Physicians for Compassionate Care Education Foundation, in a prepared statement. “No one, including health care professionals, should be given god-like power to decide which vulnerable lives are no longer worthwhile because of the disability of terminal illness or psychological distress over disabilities associated with terminal decline.”

Possible under-reporting of assisted suicide deaths in Oregon

The 2024 Oregon assisted suicide report indicated that the ingestion status was unknown in 178 cases. This means that 178 people who were approved and received the lethal drugs that the OHA does not know how they died. 

• Some of these deaths are "late reported" assisted suicide deaths that will be in the updated data in the 2025 report. 
• Some of these people will die by assisted suicide in 2025. 
• Some of these people will have died a natural death. 
• It is likely, but unknown, because it is not investigated, that some of these people died by assisted suicide but no report was submitted.

Other important data: 

• 43 of the assisted suicide deaths in 2024 were people who received the lethal poison in previous years. 
• Only 3 of the 607 people who were prescribed lethal poison, were referred for a psychiatric assessment.

Complications are only known when a health care provider is present at the death. In 2024 there were 9 known complications based on 121 reports which was down from 10 known complications based on 103 deaths in 2023.

In 2024, the time of death ranged from 7 minutes to 26 hours. In 2023, one person took 137 hours (5 days and 17 hours) to die.

The report indicated that 23 of the 376 reported assisted suicide deaths were out-of-state residents. There could be more than 23 out-of-state assisted suicide deaths. The report included the following disclaimer related to out-of-state assisted suicide deaths.

Previously, residence information was collected from the patient’s death certificate. However, for patients who die outside of Oregon and are not Oregon residents, OHA has no way to obtain notice of those deaths.

As with previous years, the report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

Oregon Governor Kate Brown, in July 2019, signing Bill SB 0579 into law to essentially eliminate the 15 day assisted suicide waiting period. This expansion of assisted suicide allows the physician to waive the waiting period, and if the patient is depressed, the patient loses the opportunity to change their mind.

In 2024, in 179 deaths the physician waived the 15 day waiting period which was up from 154 deaths in 2023. In some cases the lethal poison was ingested the day after being first requested.

Oregon is currently debating assisted suicide Bill SB 1003 would expand the Oregon assisted suicide law by:

• allows non physicians, such as physician assistants and nurse practitioners to participate in assisted suicide and,
• reduces the waiting period from 15 days to 48 hours while enabling the "providing prescriber" to waive the waiting period to essentially allow a same day death and,
• requires hospices and hospitals to publicly disclose their assisted suicide policy.

SB 1003, if passed, would be the third time that Oregon would have expanded its assisted suicide law. 

The Oregon Medical Association are against Bill SB 1003. Among other comments, the OMA stated in their intervention that the bill may allow euthanasia: 

Changing the Responsible Clinician from “Attending Physician” to “Provider” 

The bill proposes replacing “attending physician” with “provider,” a term that is overly broad and includes institutions and facilities, not just individual clinicians. Physicians undergo the most extensive and supervised medical training to diagnose, assess patient capacity, and evaluate mental health conditions before prescribing life-ending medication. Oregon’s Death with Dignity Act and MAiD must use the highest levels of training for those making these critical determinations. 

Confusing and Potentially Dangerous Language

Certain provisions in SB 1003 suggest that medications intended to shorten the dying process could be administered to the patient rather than by the patient, creating ambiguity and raising concerns about unintended movement toward euthanasia. For example, Section 1(2)(a) states:

“A hospice program shall publicly disclose its current policy regarding the Oregon Death With Dignity Act, including whether a patient receiving services from the hospice program may elect to end the patient’s life…”

This language implies that the hospice program, rather than the patient, plays a role in making the decision, which is inconsistent with the original intent of the law.

The Euthanasia Prevention Coalition has stated that the language of the legislation appears to permit euthanasia. We are thankful that the Oregon Medical Association commented on the same concerns based on the language of the bill.