Coroner examines case of Australia man who died after taking his wife's assisted suicide drugs

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Coroner in Brisbane Australia has opened an inquest into the death of a man who died after taking the assisted suicide drugs that were prescribed to the man's wife.

An ABC News report by Rachel Riga published on September 25, 2023 stated:

The ABC understands the man's wife had met the criteria and had been given the medication but she was admitted to hospital.

She passed away in hospital before taking the VAD substance.

Her husband was required to return the medication within 14 days but consumed it instead.

A recent article by Rex Martinich and published by AAP news Australia stated:

The Coroners Court in Brisbane today opened the inquest into the May 2023 death of a man aged in his 80s referred to by the pseudonym ABC.

ABC's name and those of his family members along with many other details surrounding his death cannot be published for legal reasons.

The substance involved in ABC's death was obtained legally after Queensland allowed voluntary assisted dying (VAD) in January 2023.

Under that law, a person can self-administer a VAD substance in a private location but they must nominate a person who will be legally required to return any unused or leftover portion within 14 days.

Coroner David O'Connell heard ABC kept the VAD substance in his home after it was no longer required for another person.

The issue of the State regulations was discussed:

O'Connell said he was concerned regulations around self-administering VAD could allow other people without a terminal illness to be physically harmed or suffer mental distress.

 

"We've got medication safety and patient autonomy; we've got to find where the pendulum swings to get the balance right," he said.

 

The nurse said VAD substances in a hospital were kept in a locked cabinet that required two keys to access but were not monitored after a patient took possession.

April Freeman, the lawyer for Queensland Health asked the nurse if pain medications in lethal amounts are ever given out. The nurse responded:

 it was not uncommon and she was not aware of health authorities having control over those drugs once they were handed to patients.

The Coroner's inquiry will continue. 

• Man dies after taking wife's assisted suicide drugs (Link).

Suicide among elderly skyrockets after legalizing Assisted Dying in Victoria Australia

By Leslie Wolfgang

Assisted suicide or Voluntary Assisted Dying (VAD) has a correlation to increased suicide among the elderly, revealed a peer-reviewed article published this week. According to research published by Dr. David Albert Jones, Director, Anscombe Bioethics Centre in the Journal of Ethics in Mental Health (2023), the rate of suicide among the elderly in the Australian state of Victoria increased by an astonishing 50%, even exclusive of legalized assisted suicide and euthanasia.

Though assisted suicide is sold to the policymakers of Australia and America as a perverse method to reduce suicide generally, the societal outcome of permitting some people to legally commit suicide has caused many other people to attempt and succeed in their own suicides. It is as though suicide is a social contagion — which it is.

This is in addition to a steady increase in demand for legal assisted suicide year over year since VAD was adopted in Australia. According to the annual report of the Voluntary Assisted Dying Review Board’s latest publication for July 1, 2022 to June 30, 2023, the number of deaths via assisted suicide in Victoria increased by 11% to 306, and the number of applications for assisted suicide increased by six percent over the previous year.  

This data, coupled with the revelation that suicide among the elderly in Victoria has increased by 50% should give pause to any policymakers wondering if assisted suicide is good public policy. 

In the Australian state of Queensland, assisted suicide is happening at a shocking rate as revealed by latest reports. Australians there are dying from assisted suicide and euthanasia at rates even higher than Victoria or Western Australia. In a shocking international news story, the Australian Capital Territory Human Rights Commission in a report to the Voluntary Assisted Dying Committee criticized current Australian law for not permitting minors to utilize their “assisted dying” legal regime.

Many critics of assisted suicide claim that assisted suicide advocates are never satisfied with any restrictions or conditions on access and will continually fight for the expansion of criteria for accessing assisted suicide. Continued efforts for expansion in Australia, Canada, and America may prove them correct.

Leslie Wolfgang is a Board Member of the Euthanasia Prevention Coalition -USA.

Australia Human Rights Commission pushes Assisted Suicide for Children

This article was published by National Review online on January 4, 2024.

Wesley Smith

By Wesley J Smith

Assisted suicide is being legalized all over Australia, and I fear the country is going to go the dark route Canada has after it legalized euthanasia. Case in point: There is a bill before the Australian Capital Territory (ACT) to legalize assisted suicide. The Human Rights Commission criticizes the proposal for restricting assisted-suicide eligibility to adults:

Improvements to the proposed scheme:

We detail below certain of our earlier recommendations that have not been incorporated into the Bill.

1. Access for Children and Young People under 18: the current scheme is limited to individuals over the age of 18 years old. Human rights principles require due consideration for the rights of children and young people, including their right to access health care without discrimination and their right to have their views taken into account.

It is the Commission’s view that this extends to decisions for a child or young person to voluntarily end their life with dignity in the same circumstances as adults: namely where they have a condition that is advanced, progressive and expected to cause their death, where they are suffering intolerably, where they are acting voluntarily, and where they have demonstrated maturity and capacity to make such a decision. We recognise that there may need to be additional steps and safeguards for children and young people, particularly where the views of parents and carers differ from the young person or from each other.

If adopted, this means that “mature” minors would be able to be made dead without their parents’ permission and children no matter how young could be put down.

Canada isn’t there yet, but the same approach has been seriously proposed in that country. Belgium and the Netherlands already permit euthanizing children, and the Netherlands allows infanticide under the “Groningen Protocol.” 

Previous articles on this topic:

• The euthanasia lobby is pushing for child and infant euthanasia (Link).
•  Canadian children may be euthanized with or without parental consent (Link).

Court rules that assisted suicide is suicide.

This article was published by Bioedge on December 7, 2023.

Michael Cook

By Michael Cook

Such is the stigma surrounding suicide that advocates of “voluntary assisted dying” insist vehemently that it is by no means suicide.

For instance, Go Gentle Australia, a leading lobby group for VAD, explains in its website’s FAQ that:

“People seeking voluntary assisted dying are not suicidal; they don’t want to die but are dying of a terminal illness and simply want to control how and when it happens and how much they need to suffer at the end. Australian laws expressly state that voluntary assisted dying is not suicide.”

In Australia, this is more than a quibble over words. In 2005 the Federal government amended the Commonwealth Criminal Code Act 1995. It introduced two sections which criminalised counselling or instructing people about suicide over “carriage services”, which included communication over telephones and the internet.

It had good reason to do so. Access to the internet was growing, young people were being bullied or coaxed into killing themselves in internet chatrooms. Introducing the bill at the time, the Attorney-General explained that “internet chat room discussions have led to a person attempting suicide, and sometimes successfully. This research points to evidence that vulnerable individuals were compelled so strongly by others to take their own lives that they felt to back out or seek help would involve losing face.”

Chatrooms in Japan were particularly gruesome. In 2003, NBC News reported that strangers were organising suicide pacts over the internet. In one shocking case, four young men organised to gas themselves in a car overlooking Mount Fuji.

Furthermore, Dr Philip Nitschke, an Australian assisted suicide promoter and facilitator, began providing information about suicide techniques over the internet. At the time, the changes were even dubbed “the Nitschke amendment”.

However, after all of Australia’s states have legalised VAD, the Federal criminal code has become, in the words of advocates, a barrier to access, because it equates VAD with suicide. People who want to access VAD in rural areas may not be able to find a local doctor who is prepared to cooperate. For other medical consultations, they would be able to speak over the phone with a specialist. But for VAD, such a consultation would be a crime. It purportedly causes “delay and hardship for patients”.

So a doctor from Victoria, Nicholas Carr, recently asked the Federal Court to rule that “voluntary assisted dying” is not suicide. The judge, Justice Abraham, refused.

After a long examination of the relevant legislation and parsing the word “suicide”, she concluded that:

“in so far as the VAD Act purports to authorise medical practitioners to provide information about particular methods of committing suicide via a carriage service, it purports to authorise them to engage in conduct that the Criminal Code has criminalised.”

Taking a common sense approach to the definition, Justice Abraham consulted Australia’s Macquarie Dictionary and the Oxford English Dictionary. They supported her stand. Suicide is “the intentional taking of one’s own life, and the act of doing so” and therefore VAD is suicide.

Dr Carr’s lawyers had another argument, an ingenious one. The Federal legislation bans incitement “to commit suicide”. The word “commit”, which is associated with committing a sin or committing a crime, must obviously mean that only stigmatised species of suicide are banned.

Justice Abraham dismissed this objection. 

“There is no basis to infer, from the text, context or purpose of the provisions that the word ‘commit’ was chosen by Parliament to denote that the term ‘suicide’ only applies to certain circumstances in which one takes one’s own life.”

When there is a clash between state and Federal law in Australia, Federal law prevails. For the moment, no one in Australia can use a telephone or the internet to give advice about VAD. It may be difficult to draft a law which will allow doctors to give advice about “voluntary assisted dying” but will stop people from encouraging unbalanced and distressed people to end their lives.

Australian Federal Court rules that assisted suicide is suicide under Criminal Code

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Natassia Chrysanthos reported for the Sydney Morning Herald on November 30, 2023 that Federal Court Justice Wendy Abraham ruled that:

voluntary assisted dying was considered suicide under the code, which means doctors could be charged under laws that prohibit using a carriage service – such as telehealth, email or phone calls – to incite or provide information about suicide.

The landmark decision means that doctors who approve assisted suicide via telehealth or by any other carriage service, can be charged under the federal law for inciting or providing information about suicide.

Chrysanthos reported that Nick Carr, a Melbourne doctor who brought the case to the federal court argued that:

the term suicide should not apply to voluntary assisted dying because the latter involved a legal right to intentionally take one’s life that was regulated by law.

The court disagreed and ruled that:

suicide, as used in the criminal code, applied to ending a person’s life under state voluntary assisted dying laws – meaning that doctors who consulted patients about euthanasia over the phone, email or telehealth were breaking the law, even if those actions had been authorised under state legislation.

Chrysanthos reported that a Victoria government spokesperson and the Queensland Attorney-General stated their intention of changing the law. Federal Independent MP, Kate Cheney announced that she will be introducing a Private Members bill to amend Australia's Suicide Act.

Australia's Suicide Act was amended to prevent suicide information sharing via a carriage service in order to stop Philip Nitschke from providing information and suicide advice.

Australia's federal court made the correct decision. Whether someone is counselling assisted suicide or suicide for other reasons, the act is the same.

Fighting Back Against Legalised Euthanasia and Assisted Suicide

Message from the Australian Care Alliance

Euthanasia and assisted suicide will, when the NSW Act comes into operation on November 28, be legal in 26 jurisdictions – including all six Australian states.

In Colombia, Italy, Germany, Austria and Canada it became legal following decisions of high courts based on an alleged constitutional or charter right.

In the Netherlands, euthanasia was first declared legal by courts interpreting the defence of “force majeure” (in the common law the “defence of necessity”) to mean that when a doctor is faced with otherwise unrelievable suffering in the patient he or she is, as it were, forced to kill the patient if the patient requests it.

In some US States, such as Oregon, assisted suicide became legal following a popular vote.

In all other jurisdictions, including the Australian states it came about as a decision of the legislature or Parliament.

BETTER OFF DEAD

In every case, legalisation creates an exception to the otherwise universally applied criminal laws prohibiting murder – to which consent is never a valid defence – and assisting a person to suicide.

Legalisation also abandons a public policy commitment to suicide prevention for all – in Australia commonly referred to as a “Towards Zero” policy. 

These carve outs from the criminal law and from suicide prevention efforts are based on the idea that some people are right to think they are better off dead. It then becomes a good thing for the State to authorise health practitioners (or in Germany anyone at all) to either supply the person with a lethal substance to commit suicide by ingesting it or directly administer a lethal substance to kill them. 

Generally, the public and parliamentary case for legalisation has been based at first on a claim that a small number of terminally ill (or chronically ill) people cannot be adequately helped by palliative care so that direct killing – by suicide or euthanasia – is the only way to provide them with a peaceful death. 

This has been combined with an argument that the choice to end one’s life is a valid exercise of autonomy. This argument has most often been advanced by the white, well and wealthy.

For example, James Downar, a pioneer of euthanasia in Ontario, has described the typical case as involving a self-willed captain of industry who demands the right to exit on his own terms because that is how he manages the rest of his affairs. 

Reported deaths by assisted suicide in 2022 accounted for 0.43% of all deaths of white Californians – 27 times the rate for blacks and 14 times the rate for Hispanics. 

However, there is accumulating evidence that once legalised euthanasia becomes a threat to more vulnerable people. 

Since 1998, 125 Oregonians have died from ingesting a prescribed lethal substance after expressing concerns about the financial cost of treatment. 

In Canada, euthanasia is now being openly offered as an alternative “solution” for poverty, homelessness and disability, including the notorious offer of euthanasia to a female veteran and Paralympian as an alternative to waiting for a stair chair. 

From March 2024 euthanasia will also be offered as a “solution” for people dealing with mental illness as it already is in the Netherlands and Belgium. 

Two cases from the Netherlands highlight the tragic abandonment involved in this approach: 

A man in his 60s with Asperger’s, described as “an utterly lonely man whose life had been a failure”, was euthanased because he was “horrified at moving into sheltered accommodation”. Although he had been diagnosed with “severe and probably chronic depression with a persistent death wish” another psychiatrist, after seeing him just once, certified that he was free of depression in order to facilitate his euthanasia. 

Another man in his 30s, also with Asperger’s, was euthanased based on his distress at “his continuous yearning for meaningful relationships and his repeated frustrations in this area, because of his inability to deal adequately with closeness and social contacts”. 

In Belgium, persistent suicidal ideation is now accepted as valid grounds for euthanasia. 

In opposition to the notion of being Better Off Dead is the wonderfully named disability group NOT DEAD YET! 

These are some of their astute observations on assisted suicide, based on their lived experience of disability: 

Although intractable pain has been emphasized as the primary reason for enacting assisted suicide laws, the top five reasons Oregon doctors report for issuing lethal prescriptions are all disability issues: “loss of autonomy”, “less able to engage in activities”, “loss of dignity” “loss of control of bodily functions” and “feelings of being a burden”. 

In judging that an assisted suicide request is rational, essentially, doctors are concluding that a person’s physical disabilities and dependence on others for everyday needs are sufficient grounds to treat them completely differently than they would treat a physically able-bodied suicidal person. There’s an established body of research demonstrating that physicians underrate the quality of life of people with disabilities compared with our own assessments. Nevertheless, the physician’s ability to render these judgments accurately remains unquestioned. Steps that could address the person’s concerns, such as home care services to relieve feelings of burdening family, are not explored. In this flawed world view, suicide prevention is irrelevant.

STATE PERMIT TO KILL 

In Victoria it is not sufficient for a doctor to agree that you are better off dead before being able to kill you. You also need a formal permit from the Secretary of the Department of Health and Human Services. 

Victoria boasts of its 68 so-called safeguards but these are illusory. Mostly they just require ticking a box. 

Dr Nick Carr was found to have acted unprofessionally and fined when he failed to get the required two people to actually witness an applicant sign the final request form. 

However, no action has been taken against the Secretary of Health for issuing a permit based on that unverified application despite the VAD Review Board clerk picking up the error. 

A recent Freedom of Information request obtaining Review Board minutes has revealed that the Board is more focused on threatening and persecuting any aged care or health facilities that resist euthanasia and assisted suicide or doctors that criticise its implementation than in preventing abuses. 

After receiving a report of a person having a seizure after ingesting the lethal poison prescribed under a State issued permit, the members of the Board with clinical experience simply claimed that the seizure was unlikely to be related to the ingestion of the substance – showing no awareness that this was a reported complication in Oregon. 

In response to reports of some deaths from assisted suicide being unduly prolonged the Board recommended more recourse to euthanasia instead. 

The promise of a peaceful death by assisted suicide or euthanasia is a false promise – the complication rate reported in Oregon averages 7.5% each year. 

In the Netherlands, complications occurred in 3% of cases of euthanasia, including spasm or muscular twitching, cyanosis (blue colouring of the skin), nausea or vomiting, tachycardia (rapid heartbeat), excessive production of mucus, hiccups, perspiration, and extreme gasping. In one case the patient’s eyes remained open, and in another case, the patient sat up. 

In 10% of cases the person took longer than expected to die (median 3 hours) with one person taking up to 7 days.

In Victoria and other Australian states there is no requirement for reporting complications.

COERCION 

Assisted suicide and euthanasia laws usually require that a request be voluntary and free of coercion. To be truly voluntary a request would need to be not just free of overt coercion but also free from undue influence, subtle pressures and familial or societal expectations. 

A regime in which assisted suicide is made legal and in which the decision to ask for assisted suicide is positively affirmed as a wise choice in itself creates a framework in which a person with low self-esteem or who is more susceptible to the influence of others may well express a request for assisted suicide that the person would otherwise never have considered.

 Elder abuse, including from adult children with “inheritance impatience” is a growing problem in Australia. This makes legalising assisting suicide unsafe for the elderly.

Some supporters of assisted suicide don’t care if some people are bullied into killing themselves under an assisted suicide law. AS Dr Henry Marsh, a British neurosurgeon and proponent of legalising assisted suicide and euthanasia, put it "Even if a few grannies get bullied into [suicide], isn’t that the price worth paying for all the people who could die with dignity?".

DEATH BY ADVANCED DIRECTIVE

Courts in the Netherlands have now authorised the direct killing by administration of a lethal substance of a person who is declaring they want to live and physically resisting the administration of the substance if a doctor considers them to no longer be fully competent and the conditions of a previously made advanced directive for euthanasia to be present. 

Signing a document stating that “If I ever have to go to a nursing home and I am no longer competent to decide, then I authorise in advance a doctor to kill me” is sufficient to justify what would otherwise be murder.

ERRORS 

Go Gentle founder, Andrew Denton, was forced to admit to the Project when pressed that “There is no guarantee ever that doctors are going to be 100% right”. 

Whether it is a wrong diagnosis, faulty prognosis, failure to offer effective treatment or missing depression or coercion, there are people wrongly killed by euthanasia in each of the 26 fatally flawed experiments in legalised euthanasia or assisted suicide.

SUICIDE PREVENTION LIES 

It was claimed during the parliamentary debate in Victoria that legalisation would prevent 50 suicides each year. Not only has there been no such decline, but there were 62 more suicides in Victoria in 2022 than in 2017, when this claim was made. The suicide rate among those aged over 65 years increased in Victoria between 2019 and 2022 by 42 per cent—five times the increase in New South Wales. 

The international evidence shows decisively that legalising assisted suicide and euthanasia does not prevent suicide and probably increases non-authorised suicide as well as the overall suicide rate. 

We need to reaffirm suicide prevention for all and not abandon those we think would be better off dead by affirming suicide or euthanasia as a valid choice.

FIGHTING BACK

Be informed – See Australian Care Alliance website – especially under FACTS. http://australiancarealliance.org.au/ 

Some hope – in Canada a recent attempt to prevent euthanasia for mental illness coming into force on March 2024 as scheduled was defeated by just 17 votes – 167 to 150. 

In Australia we need to analyse the evidence and keep criticising the dangers of the euthanasia program. 

In 1941, Hans and Sophie Scholl read the powerful denunciation of the Nazi’s Action T4 euthanasia of the disabled program by Bishop von Galen. In her trial for treason for the distribution of the White Rose leaflets urging opposition to Hitler and Nazism, Sophie said “Somebody, after all, had to make a start”. Professor Kurt Huber, who also was executed as a participant in the White Rose group, said the leaflets aimed “To call out the truth as clearly and audibly as possible into the German night”. 

We need to be those who “make a start” and “call out the truth”, and refuse to co-operate with in any way or to accept as permanent the euthanasia and assisted suicide regimes.

Man dies after taking wife's assisted suicide drugs

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Guardian reported  that a man in Queensland, Australia died when he ingested assisted suicide drugs prescribed for his wife.

Andrew Messenger reported on September 25 for the Guardian:

Queensland’s health minister has suggested the state may need to strengthen voluntary assisting dying (VAD) legislation after a woman’s euthanasia drugs were used by her husband after she died in hospital.

The coroner is investigating the reported incident, in which the elderly woman was approved to use the drugs at home under Queensland’s voluntary assisted dying scheme – but she died suddenly in hospital. Her husband subsequently used the drugs to kill himself.

According to Queensland law, unused lethal assisted suicide drugs are to be returned 14 days after a person's death. In this case a husband, whose wife had been approved for assisted suicide, consumed the lethal drugs.

Queensland's Health Minister, Shannon Fentiman, admits that this may have been the first time the law has been abused. 

Fentiman states:

“We will look at absolutely whether we need to strengthen the legislation about that 14-day turnaround for medication to be returned, which I suspect we will do,” she said.

“But we’re going to await the outcomes of that investigation. That investigation will also go to the coroner and I also expect the coroner will have some recommendations around that.”

An ABC News report by Rachel Riga published in September 25 states:

The ABC understands the man's wife had met the criteria and had been given the medication but she was admitted to hospital.

She passed away in hospital before taking the VAD substance.

Her husband was required to return the medication within 14 days but consumed it instead.

Messenger reported that even though the abuse of the new law has resulted in a death, Health Minister Fentiman is recommending that euthanasia be offered through telehealth: 

It also recommended amendments to the commonwealth criminal code to permit doctors to use telehealth for VAD consultations. The code is perceived to prohibit electronic transmission of prescriptions for a substance under the scheme.

Fentiman said more Queenslanders had taken up the option than in any other jurisdiction, and there had been almost no errors in the scheme’s first year.

She said the report showed the state’s system is “safe, accessible and compassionate”.

Those who oppose killing argue that legalizing euthanasia results in errors and premature deaths; euthanasia promoters respond by saying "there will be safeguards". When a person, who was not approved for assisted suicide, dies by taking another person's lethal drugs, the euthanasia promoters say there were "almost no errors."

Society needs to care not kill people.

Canada: How Death Care is pushing out Health Care

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alexander Raikin has written another excellent exposé on Canada's euthanasia regime published in the National Review on September 14, 2023 entitled: How Death Care pushed out Health Care. 

Raikin's previous article: No other options: An exposé on euthanasia in Canada, published by the New Atlantis on December 16, 2022, provides important insights into Canada's euthanasia law.

Raikin focuses on proceedings from the Canadian Association of MAiD Assessors and Providers (CAMAP), training seminars and interviews with patients and doctors concerning death 'care'. 

CAMAP is an independent organization funded by Canada's federal government to train doctors and nurse practitioners on how to euthanize (kill) patients (MAiD).

A panel at the CAMAP training seminar explained how "strict" the law is:

On the same day that a patient enters into an optional written agreement with only one of his or her two MAID assessors — even if it is unsigned, without any witnesses, and with no family members having been informed — the clinician can administer the lethal injection without asking for the final consent of the patient.

Quoting from a CAMAP training seminar, Raikin writes:

"Next question is from Debbie," the moderator of a discussion on medical decision-making capacity said to her fellow physicians. “How would folks interpret someone who has lost capacity with a waiver in place and is now delirious, shouting, pulling their arm away as one tries to insert the IV to provide MAID?”

The question is important because the patient is clearly unable to consent and is showing signs of resisting. 

The Moderator, Dr Ellen Wiebe, possibly Canada's most prolific euthanasia doctor, responds to the question by stating:

“I’m guessing I would bring in one of their other providers, you know, palliative care or, or whatever, and get them sedated. But what would you say?”

First to speak is Jim MacLean, who claims that he has performed more than 75 “provisions” since MAID expanded to include non-dying patients. “I don’t think I have any great thoughts on this one.” Wiebe laughed. “Everyone’s different. I mean, you try to deal with the situation. Calm the room down. See what you can achieve through conversation and calmness.”

Chantal Perrot is the co-chairman of a clinician advisory council for Canada’s largest pro-MAID lobby group. She described herself to a parliamentary committee as someone who has “cared for hundreds of patients . . . as they navigated the MAID process.” Responding to Wiebe, she said, “That’s a question. If they’re sedated, then have we sedated them into being accepting of MAID? You know, that’s a whole other question.”

Kevin Reel, a senior ethicist at Sunnybrook Hospital in Toronto and former president of the Canadian Bioethics Society, answers in part with another question: “If what we’re doing by trying to honour the waiver is reducing distress for the patient and also for maybe even the family around them, would it be acceptable to do something similarly covert to keep them from reacting in that way?”

Reel continues, “That might be a way around it, but — ” before being interrupted by MacLean, whose new answer takes the question from the hypothetical to the actual and clarifies what he meant by “conversation and calmness”: “One waiver I did use, the patient was a little agitated. So we did give her some subcutaneous hydromorphone” — an opiate ordinarily used for acute-pain control instead of sedation — “before I did the MAID, did the provision. So we did, we did use it in that situation and it was very helpful.”

“Good,” the moderator says, before moving on to the next question. 

No one on the panel or audience objects.

Raikin explains:

The asterisk in the law is that the agreement is in place only as long as the patient “does not demonstrate, by words, sounds or gestures, refusal,” or “resistance to its administration.” If this demonstration is “involuntary” and “made in response to contact,” the death of the patient may still proceed. But consent is a spectrum, and patients with delirium can flicker between having capacity and not; patients can also change their minds about dying at the hands of their physician or nurse.

The recording from an October 2021 training session documents the use of sedation to obtain consent. 

Raikin explains the importance of the use of sedation to obtain consent for death:

At the core of death care is the presumption that safeguards work and that consent, the most important safeguard, prevents death care from slipping into rampant homicide or suicide contagion. Instead, it is turning into the end of medicine.

Raikin provides examples of the use of sedation to gain consent for death:

In Belgium last year, after a lethal injection failed to kill a 36-year-old woman with terminal cancer, the presiding physician smothered her with a pillow. In New Zealand and Canada, suicidal patients seeking medical care for suicide prevention were prompted to consider assisted suicide instead.

In the Netherlands, a similar story of a physician sedating her patient into accepting euthanasia led to the first criminal trial of a euthanasia physician. She was acquitted. The judges said, “We believe that given the deeply demented condition of the patient the doctor did not need to verify her wish for euthanasia,” even though the patient repeatedly attempted to fight off her physician.

I have written previously about how a failed suicide attempt in Canada was completed through euthanasia, despite concerns of illegality by physicians involved with CAMAP, an organization that has held internal seminars on patients requesting euthanasia because of poverty, lack of medical care, homelessness, and credit-card debt.

Raikin quotes Michel Bureau, head of the Commission sur les soins de fin de vie (Commission on end-of-life care), the independent monitoring agency for MAID in Quebec who told the Canadian Press news agency this summer:

“We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.”

In every jurisdiction that has legalized assisted suicide, the number of deaths have ballooned and "safeguards" have been rescinded. Raikin writes:

In California, the number of assisted suicides last year increased by more than 63 percent. In Canada, the number of deaths by euthanasia is on track to increase more than 13-fold in just the first seven years of the practice’s legalization. Belgium has seen a more than twelvefold increase since 2003. In Switzerland, which legalized assisted suicide in 1941, the number of such suicides has doubled every five years since 1999.

Raikin gives examples of deaths that are outside of the law:

A sibling found out that his brother’s MAID paperwork in British Columbia listed only “hearing loss” as his qualifying condition. In the Netherlands, dozens of patients qualified for euthanasia only because of autism. In Canada, “advanced age” helps qualify patients to die, even though Quebec cautions that to rely on it as the sole criterion is illegal. Young patients have died through euthanasia in Belgium for a range of reasons, including a botched sex change, sexual exploitation by a psychiatrist, unresolved post-traumatic stress disorder after a terrorist attack, and again, this time in twins, hearing loss.

Last year the Swiss Medical Association saw a need to issue a statement reminding physicians, for the first time, that “assisted suicide for healthy persons is not medically and ethically justifiable.” The agency responsible for monitoring assisted suicides in Quebec issued a similar reminder over the summer.

Raikin quotes bioethicist Leon Kass, who warns that if the value of a human being is considered subjective, invariably the right to die metamorphoses into the duty to die.

Raikin explains the planning and goals of CAMAP:

In 2018, at CAMAP’s annual conference, the leading death-care practitioners gamed out their plan. It was nothing short of prescient. Many speakers, such as the CEO of Dying with Dignity, stressed that MAID is a “political issue” and that it would require “the political will to speak out against Catholic institutions around MAID.” Moreover, as some panelists insisted, it was important for practitioners to “recognize the harm to vulnerable populations that comes with the assertion of freedom of religion.”

 In comparison, MAID was “sacred.” One speaker implored non-MAID clinicians “to keep the spirit of MAID intact.”

Just two years into Canada’s euthanasia experiment, physicians were busy laying plans for how to expand euthanasia to children, especially Indigenous children, since they “are considered wise because they are closest to the ancestors.”

Raikin explains how CAMAP promotes euthanasia for poverty:

Senior CAMAP leadership has repeatedly denied that patients are receiving euthanasia primarily because of poverty. Yet in 2018, it devoted an entire panel to “providing MAID to vulnerable, Indigenous, homeless, and frail elderly populations.” Panelists described how they could “help to empower vulnerable populations” by helping “patients fight for options that would allow them to have access to MAID” — in other words, to help find “what supports” patients might need to die instead of to live.

“I have a First Nation patient who meets all the criteria for MAID, but much of their suffering is due to a life lived in poverty,” one panelist said. “If I could change their social determinants of health, their situation might improve.” Even a hypothetical example of a patient with “fixed delusions that are causing him severe suffering” was deemed potentially eligible because “it doesn’t matter what he wants [MAID] for.”

Stefanie Green, the leader of  CAMAP, advocated that opposition by hospices to euthanasia will be overcome. Raikin quotes Green as stating:

“Over time, perhaps ten years from now, I think this conversation will happen again. If we push it now too hard and too fast, I think that will put more wedges in.”

CAMAP’s strategy has already succeeded. In 2017, Vancouver Island had a Catholic hospital and four hospice beds. Now as a consequence of a public campaign by death-care advocates, there are no remaining “MAID-free” spaces on the island.

In 2021, Vancouver Island had the highest euthanasia rate in Canada. 

Raikin discusses the cases of several Catholic hospitals that have been taken over by the Australian government in order to provide access to death services. 

Raikin writes of the doctors who object to euthanasia and are being forced out of medicine:

Helen Lord, one of the nine palliative specialists in Tasmania, retired once                "death care" began.

“I know I actually can’t kill someone, I can’t do it.  

“I said I’m not going to have any part of this. It’s not medicine. It’s just not what we do. . . . Half of the people who came into [my] palliative care were scared that they were going to be euthanized.”

When Lord spoke out against euthanasia she was accused of being a right-wing Evangelical, which she is not. Lord does believe that "life is precious" and "time is precious."

Félix Pageau, a geriatrician practicing in Quebec, testified to a national parliamentary committee in Ottawa that in his opinion as a physician, based on research, Canada was not ready to expand MAID to advanced dementia. For this, he said, a colleague in his home hospital “filed a complaint to the Collège des médecins” saying he “lied” to the committee. The Collège decided to “open an inquiry, even though they don’t have jurisdiction over testimony at the federal [level] or in the Parliament.” The investigation became an ordeal — and an expensive one, since Pageau needed to hire a lawyer. Pageau in his parliamentary testimony was exercising his free-speech rights. Eventually, the Collège ruled that it did not have jurisdiction, but the point was made.

Raikin continues:

Another physician, a former director of a palliative clinic in Canada, told me, “I had to leave a job that I loved” because “the MAID situation” made it “just too difficult to practice medicine here.” After she spoke up publicly to urge that MAID and palliative care be separate, she was constantly harassed; her email was flooded with dozens of gory images. Another palliative-care physician told me that he started his own small clinic rather than stay at the hospital where he practiced. “Physicians that go against the narrative are sanctioned,” he said. “They’re marginalized. It’s hard. It’s risky.”

Dr David D’Souza and Dr Mark D'Souza are physicians in Ontario:

“I think already there’s a lot of abuse going on, and I’m seeing it in my own practice,” including when families pressure loved ones to die so that estates or insurance payouts become available sooner. “It’s making me think twice about whether I should be continuing in geriatric care.” His brother, Mark, also a physician, left palliative care entirely. “We’re literally doing harm even though it’s under the guise of compassion,” Mark said.

Raikin states: 

The effect of legalizing death care is not just the hostile takeover of medicine. It hurts those who are the most vulnerable, those who want not to die but to be helped to live.

Gabrielle Peters, a disabled writer and policy analyst in Canada, told Raikin that it is essential that there are MAiD free places in Canadian healthcare. Raikin interviewed Rachel, who lives with chronic pain, PTSD and depression.

Rachel, a woman with a condition that causes chronic pain, told me about the difficulties of the past year. “Every day was really hard to stay alive,” she told me. “I really felt like I was dead.” She also suffers from major depression and has a history of PTSD from childhood abuse. “If I said that I wanted to die or that I couldn’t hack it anymore” when she spoke with health-care practitioners before MAID was legalized, “I was met with, ‘Here’s some coping skills and let’s talk about it,’ and various forms of therapy and resources being brought to bear.”

Once her condition qualified for MAID, in 2021, she began to notice a trend. “I would call the crisis line, the suicide crisis line. Many of these mental-health professionals, their advice would be to go look up Dying with Dignity’s website.” She tried to get help for thoughts of suicide, and instead she was being offered advice for how to die from assisted suicide.

“I have been afraid, you know, over this last couple of years to go to just my local hospital, because I was afraid that if any doctor either brought up MAID themselves or met my kind of ambivalent desire for MAID, all I needed was a push and I would be dead right now.”

Rachel found help at the Centre for Addiction and Mental Health (CAMH), Canada’s largest mental-health teaching hospital, located in Toronto. 

Raikin writes:

Its policy is that no CAMH clinicians can provide MAID on site. She felt that she had found a MAID-free space that could treat her illnesses. (CAMH is yet to release a statement on whether its MAID policy will change when, in six months, MAID will be expanded to include mental illnesses.)

Rachel decided to risk everything. With her meager savings from her disability benefits, she purchased a one-way, long-distance bus ticket, not knowing whether she would be admitted to the hospital or instead end up homeless.
“I literally just presented myself at the CAMH ER,” she said. “Part of the reason I felt safe to go to CAMH is just because I knew that they do not endorse MAID for mental illness. They’re pretty strict on that.” In a sense, Rachel lucked out. Despite the usual long wait times at Canadian emergency rooms, especially for psychiatric illnesses, her poor condition meant that her case was triaged to the front of the queue. She soon discovered how MAID was viewed by doctors at the center. “On the psych ward at CAMH, my psychiatrist was terrified — terrified,” Rachel said, carefully enunciating every syllable, “that I would talk about MAID on the floor with the other patients. She was terrified of suicide contagion.”

Over the span of weeks, Rachel began to recover. She was finally put on a new form of pain control; her depression improved. But the most important change at CAMH was that, finally, she felt listened to. “Sometimes, all you need is someone to come alongside you. And just help you cope through the everyday,” she said. “Whether it’s a doctor or just the person who is walking alongside me while I’m in a lot of pain. It may not change how much pain I actually have. But it sure makes a big difference to how much I suffer from that pain.”

Rachel is now happily back home. “I have no intention of using MAID. I have 100 percent turned away from it. Only because I had health care. All I needed was health care and pain care.”

Raikin recounts his previous article about Rosina Kamis, who died by euthanasia and her friend James, who has a similar medical situation:

In the first story that I wrote about death care, “No Other Options,” published in the New Atlantis, I wrote about Rosina Kamis, a 41-year-old Toronto woman with fibromyalgia. She chose to die from MAID in part because of her inability to access proper medical care. Before she died, she entrusted her friend James, a former neighbor, to represent her as her power of medical attorney; since her physicians weren’t listening to her, she wanted to see if someone else who has fibromyalgia, as James does, could get her the medical care that she needed. Despite his efforts, James couldn’t help her — and now, after her death, he can’t get the help that he needs. He messaged me months after our first conversation to tell me that he now sees his own future in what happened to Rosina.

James told me that he is living with the specter of an imminent administered death, like Rosina’s. He could decide to stop fighting for the care he needs, too. It seems inevitable. “I’m going to take it one day. That’s how it feels to me. I don’t like that, but to me, the way things are going, this society is really sending us disabled people a message,” James said. “We got that message even before MAID. But now it’s codified into law and there’s these processes and resources to expedite it.”

“I have diagnosed mental-health conditions and I can’t get treatment. I need therapy. My doctor asked me the other day, What do I need? I need therapy. I need a long-term relationship with someone. And she told me, she said, That’s impossible.” Instead, he was sent YouTube videos on how to do stretches. He chuckles.

“I need actual health care,” James said. Eventually, he tells me, he’ll get death care instead.

CAMAP, which sells itself as the experts on MAiD in Canada, received $3.3 million from the Canadian government to develop a curriculum for MAiD clinicians.

Thank you Alexander Raikin for your research and your continued advocacy for health care not death 'care'.

Australian paedophile approved for euthanasia after serving one year in jail.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Lucy Slade reported for Australia's Adelaide News on August 29, 2023 that Malcolm Day, sentenced to 20 years in prison in June 2022, has been approved for euthanasia in South Australia. Slade reported:

Malcolm Day, 81, is thought to be the first prisoner in the nation to be granted a voluntary assisted dying permit after having been diagnosed with a terminal illness, believed to be cancer.

Day was sentenced to 20 years in prison. Candice Prosser reported for ABC News Australia on June 23, 2022, after Day was convicted:

The South Australian District Court heard Malcolm Winston Day, now aged 80, will die in prison after avoiding punishment for his crimes for decades.

After he was recently convicted and jailed for sexually abusing a young student in the 1980s, another victim, who had been disbelieved at the time, came forward.

Judge Jo-Anne Deuter strongly condemned Day's crimes and his subsequent denial to authorities."You presented to the world as a respected music teacher, an upstanding citizen and a family man, however this was a charade based on a lifetime of lies," she said

Prosser also reported Judge Deuter as stating:

She said the victim was a promising young musician whose life had been forever changed by Day's predatory behaviour.

"She has carried the burden of your abuse and lies for over 40 years," Judge Deuter said.

The court heard the victim has struggled with depression, anxiety and post-traumatic stress disorder and turned away from music after the offending, which was a loss she also had to grieve.The first three people to die by euthanasia in Canada's correctional system were aboriginal Canadians.

Malcolm Day's victims suffered for 40 years and instead of serving his sentence for his natural life, he has been approved to die by euthanasia.

Australia's Philip Nitschke, possibly the world's most notorious promoter of assisted suicide told Slade:

"By the sound of it, he satisfies all the conditions of the South Australian assisted dying legislation," Nitschke said.

"So there should be no impediment… he should be given the option that any other person would have if they were terminally ill."

Ivan Zinger

In April 2023, Ivan Zinger, Canada's Correctional Investigator, told Kathleen Martens reporting for the APTN network, that euthanasia should never be done in the prison. He stated:

“Under no circumstances should the procedure of MAiD be dealt with inside a penitentiary,”

“That is highly problematic, unethical and immoral in my view. I think we would be the only jurisdiction in the world who would do that.

Canada has the highest rate of prison euthanasia in the world.