Investigating the relationship between euthanasia and/or assisted suicide and rates of non-assisted suicide: systematic review - "The findings of this review do not support the hypothesis that introducing EAS reduces rates of non-assisted suicide. The disproportionate impact on older women indicates unmet suicide prevention needs in this population."
End Wokeness on Twitter - "15 years ago most Democrats (even Obama) opposed legalizing gay marriage In 2023, even moderate Democrats support gender castration for minors Where will the slippery slope for euthanasia be in 15 years from now?"
How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide? - "Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals."
Is assisted suicide a substitute for unassisted suicide? - "Posner hypothesised that the legalisation of assisted suicide may substitute for unassisted (unregulated) suicide. We test predictions arising from this hypothesis using data from US states that have legalised assisted suicide. Event study regression estimates provide strong evidence that legalisation of assisted suicide is associated with an increase in total suicides, especially for females and older people. There is some evidence that assisted suicide laws are also associated with a smaller increase in unassisted suicide, though the statistical significance is weaker than for total suicides. Results using the synthetic control method (SCM) are generally consistent with the regression estimates. Overall the US experience to date provides little evidence in support of the Posner substitution hypothesis."
I was told that euthanasia doesn't lead to more deaths, since people would've killed themselves anyway. So much for that
People With Disabilities Were Denied Care In Oregon Hospitals Amid Pandemic - "At the start of the coronavirus pandemic, a small group of disability rights advocates found itself in a race against time to save the life of a woman with an intellectual disability. The woman was taken to the hospital with COVID-19. But the hospital, in a small Oregon town, denied the ventilator she needed. Instead, a doctor, citing her "low quality of life," wanted her to sign a legal form to allow the hospital to deny her care. Out of that quiet fight in early spring, the advocates — staff at a disability rights legal group, a state lawmaker and a few others — discovered something disturbing: There were many cases in Oregon of health care being rationed to people with disabilities. At the same moment, across the United States, disability groups and even a civil rights office of the U.S. government were raising a similar warning: that behind closed doors, people with disabilities, as well as elderly people, were in danger of being denied health care... There's no reason that these examples would occur more frequently in Oregon than in other states. But the fight for that anonymous woman with an intellectual disability peeled back the curtain on health care decision-making in Oregon in a way that did not happen in other states... "Nothing happened to that hospital. Nothing happened to that physician," Gelser told NPR. "The health authority confirmed that, in fact, that was a coerced do-not-intubate order, that they confirmed it happened ... but there was no sanction. So there was no remedy." Adds Gelser: "This is immoral. We do not respond to disability discrimination in the way that we should."... "Persons with disabilities should not be denied medical care on the basis of stereotypes, assessments of quality of life, or judgments about a person's relative 'worth' based on the presence or absence of disabilities or age," the civil rights office explained... a physician in an online call made a recommendation: The group home should stop the man's care and nutrition and begin end-of-life hospice care. According to Frazzini, the doctor said the man, with his multiple disabilities, had a "low quality of life." The staff member who worked for him was furious. The man was not dying. His condition was the same as before he'd entered the hospital. He'd lived this way for years. Frazzini says her staff felt the doctor had seen a man with significant disabilities and had made a judgment that his life didn't matter... In the documents obtained by NPR, there are other reports of people with intellectual disabilities being told to sign a do-not-resuscitate order as a condition before being admitted. At other hospitals, they were separated from their caregivers and pressured to sign a document they did not understand. Or, as in Sarah McSweeney's case, her guardians felt pressured... "We discussed the possibility of her being intubated and letting the lung rest, giving her time to heal and letting the antibiotics do their magic," says Conger. But then the doctor questioned whether it was worth doing, citing McSweeney's "quality of life." Conger says she objected to that. "And he looked at me and goes: 'Oh, she can walk? And talk?' " she says the doctor asked, moving his fingers in the air in a walking motion. Conger replied: "There's a lot of people who don't walk who have full quality of life."... A 77-year-old man with an intellectual disability contracted COVID-19 and went to another Oregon hospital for treatment. But she says a doctor there, acting unilaterally, reversed the man's legal order for full treatment. When Barnett and the man's advocates objected, she says the doctor stood firm, saying the man — who is diabetic and intellectually disabled — was "too difficult to treat." Says Barnett: "It was absolutely flooring to me." The man survived and returned home... There was one lingering question in all of these cases: Why was care rationed to people with disabilities at a time when Oregon's hospitals were not overcrowded, when there were no shortages of treatment?"
Weird. We keep being told that euthanasia is harmless. Of course it's a coincidence that this happened in probably the most pro-euthanasia US state
BBC Radio 4 - Best of Today, Should terminally ill people be permitted to end their own life? - "‘In Oregon, the drugs are prescribed and people can take them home, and they can sit on the shelf. It doesn't feel very safe to me that life ending drugs are sitting in somebody's home. So I do understand where people say that they feel this comfort from it. But actually, this, irretrievably changes the relationship with a doctor. And it becomes the every end of life discussion is about whether somebody should die or not… when we talk to people about whether they support assisted suicide, more than half of them believe they're supporting hospice care, or the right to refuse treatment, which is already legal, that they're not talking about sort of actually doctors being able to prescribe or help someone in their life’"
Don't make our mistake: As assisted suicide bill goes to Lords, Dutch watchdog who once backed euthanasia warns UK of 'slippery slope' to mass deaths - "A former euthanasia supporter warned of a surge in deaths if Parliament allowed doctors to give deadly drugs to their patients. ‘Don’t do it Britain,’ said Theo Boer, a veteran European watchdog in assisted suicide cases. ‘Once the genie is out of the bottle, it is not likely ever to go back in again.’... Professor Boer, who is an academic in the field of ethics, had argued seven years ago that a ‘good euthanasia law’ would produce relatively low numbers of deaths. But, speaking in a personal capacity yesterday, he said he now believed that the very existence of a euthanasia law turns assisted suicide from a last resort into a normal procedure. A ‘slippery slope’ for assisted dying in Britain would mean that euthanasia would follow the same path as abortion, which was legalised in 1967... Baroness Jane Campbell, who is a disability rights campaigner, said: ‘As happens in Holland, Lord Falconer’s bill could end up encompassing significant numbers of seriously ill people.’ Euthanasia is now becoming so prevalent in the Netherlands, Professor Boer said, that it is ‘on the way to becoming a default mode of dying for cancer patients’. He said assisted deaths have increased by about 15 per cent every year since 2008 and the number could hit a record 6,000 this year. He said he was concerned at the extension of killing to new classes of people, including the demented and the depressed, and the establishment of mobile death units of ‘travelling euthanasing doctors’. Activists, Professor Boer said, continue to campaign for doctor-administered death to be made ever easier and ‘will not rest’ until a lethal pill is made available to anyone over 70 who wishes to die. ‘Some slopes truly are slippery,’ he added. The Utrecht University academic has been a member since 2005 of a review committee charged with monitoring euthanasia deaths. Its role includes a duty to ‘tell doctors how their actions in particular cases are likely to stand up to legal, medical and ethical scrutiny’. Professor Boer admitted he was ‘wrong – terribly wrong, in fact’ to have believed regulated euthanasia would work. ‘I used to be a supporter of the Dutch law. But now, with 12 years of experience, I take a very different view. ‘Whereas in the first years after 2002 hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. ‘Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved. ‘Some of these patients could have lived for years or decades. Pressure on doctors to conform to patients’ – or in some cases relatives’ – wishes can be intense... The figures do not include deaths by terminal sedation, where patients are rendered unconscious before they are dehydrated and starved to death, an act often referred to as ‘euthanasia by omission’. This practice accounts for more than 12 per cent of all deaths in the country. The Netherlands is following a pattern that anti-euthanasia campaigners say has happened wherever the practice has been legalised. Doctors in neighbouring Belgium are collectively killing an average of five people every day by euthanasia – with a 27 per cent surge in one year."
Too much safety? Safeguards and equal access in the context of voluntary assisted dying legislation - "While safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access."
Yet, we are told the death penalty is bad because no matter how many safeguards there are, there's always the risk of killing an innocent
<Belgium and the Netherlands take step towards euthanasia for dementia patients - "There is also likely to be opposition to the move after the case of a dementia patient in 2018 who was euthanised without ever requesting to die. The decision was made at the family’s request, which led to outcry. A parliamentary health committee has separately voted in favour of removing rules that require the written euthanasia declaration to be renewed every five years"
Re: Assisted dying - "let’s examine the developments following the legalisation of abortion. Only a few years after Abortion was legalised the then Archbishop of York, Dr John Habgood, compared euthanasia with abortion: ‘Legislation to permit euthanasia would in the long run bring about profound changes in social attitudes towards death, illness, old age and the role of the medical profession. The Abortion Act has shown what happens. Whatever the rights and wrongs concerning the present practice of abortion, there is no doubt about two consequences of the 1967 [Abortion] Act: (a) The safeguards and assurances given when the Bill was passed have to a considerable extent been ignored. (b) Abortion has now become a live option for anybody who is pregnant…. (Rt Rev JS Habgood: Euthanasia – a Christian View (1974) quoted in Keown, Euthanasia, ethics and public policy. 2002; p. 71) One person who should know what happened once you legalise something like Abortion is Lord Steel, who, as a young MP was behind the Private Members Bill to introduce the 1967 Abortion Act. Forty years later he stated: "Everybody can agree that there are too many abortions. I accept that there is a mood now which is that if things go wrong you can get an abortion, and it is irresponsible really. People should be more responsible in their activities and in particular in the use of contraception. "There is a view that particularly those who present for repeated abortions are treating it as a 'long stop' contraception."... Are we, in forty years time (or earlier) after euthanasia has been legalised going to say that ‘Everyone can agree that there are too many cases of euthanasia.’ And, ‘there is a mood now which is that if things go wrong you can get euthanasia, and it is irresponsible really’ ? And, yes of course, when, forty years ago some warned that once you legalise abortion, one day abortions will be carried out for club foot and cleft lip they were accused of scare mongering. It took less than forty years for abortions to be carried out for these reasons. So, when today some wise people warn that, once euthanasia or PAS will be legalised that there will not be sufficient safeguards, they are being accused of scaremongering by the pro-euthanasia lobby. Of course, an observant individual will immediately recognise the fundamental parallels between abortion and euthanasia. Both are based on a utilitarian view of human life: if a pregnant woman can get rid of her social and financial pressures following unwanted pregnancy through abortion, why can we not get rid of pressures on society and the health service through euthanasing sick and disabled people? And why should they always need voluntary consent when Holland has shown that it can at times be done without the patient’s consent despite safeguards? As Godlee herself introduces the analogy with abortion legalisation, perhaps she and all the euthanasia enthusiasts should heed the warnings from the history of abortion legalisation. But then, we learn from history—that we don’t learn from history."
The "myth" of the slippery slope keeps being proven
So much for it being a myth that abortion is used as contraception
Why Psychiatric Euthanasia Is Legal in the Netherlands - The Atlantic - "In most countries, the debate over physician-assisted suicide has centered on adults in the final stages of incurable physical illnesses... A respected Dutch-language medical journal recently reported that an 18-year-old had died via medically assisted suicide for psychiatric problems. In the United States, debates about physician-assisted suicide are typically couched in terms of patient autonomy. The rationale for the landmark 2002 euthanasia law in the Netherlands, though, was that it codified a legal option for doctors, whose primary duties—to preserve life and to relieve suffering—were thought to conflict in the case of certain anguished patients... as long as the patient is at least 16, no other person’s consent except the patient’s is mandatory. (Parents of 16- and 17-year-olds are involved in the discussion, but their permission is not required. Patients as young as 12 can seek euthanasia with parental consent. In about 10 cases since 2002, children ages 12 to 17 have received euthanasia; as far as I know, all were for physical illnesses.) After the patient’s death, the doctors involved submit written reports, which are reviewed by one of five regional review committees consisting of a physician, a lawyer, and a bioethicist. These positions are not full-time jobs, but the five committees handle more than 6,500 cases a year. (In the United States, the per-capita equivalent would be 126,000.) Needless to say, the single physician on each committee cannot be a specialist on every disorder at issue. Over the years, only 0.18 percent of cases have been classified as “due care not met.” The doctor is virtually always right when it comes to euthanasia. Only one doctor has ever been prosecuted for violating the 2002 law. Until about 2010, the controversial practice of psychiatric euthanasia was rare, despite being permitted since the mid-1990s. Most Dutch psychiatrists—like most other doctors and the Dutch public—disapprove of psychiatric euthanasia. Still, there has been a steady increase... Unlike euthanasia in general, psychiatric euthanasia is predominantly given to women. Most of these cases involve the End of Life Clinic, a network of facilities affiliated with the largest Dutch euthanasia-advocacy organization. These clinics routinely handle euthanasia requests refused by other doctors... An obvious question arises: How can any physician be sure that any patient with a serious psychiatric disorder, much less an 18-year-old, meets the legal criteria for euthanasia? The short answer is that the law gives considerable weight to their professional judgment. Compared with cases involving cancer or other terminal illnesses, the application of the eligibility criteria in psychiatric euthanasia depends much more on doctors’ opinions. Psychiatric diagnosis is not based on an objective laboratory or imaging test; generally, it is a more subjective assessment based on standard criteria agreed on by professionals in the field... an otherwise healthy Dutch woman was euthanized 12 months after her husband’s death for “prolonged grief disorder”—a diagnosis listed in the International Classification of Diseases but not in the Diagnostic and Statistical Manual of Mental Disorders used by psychiatrists and psychologists around the world. Psychiatric disorders can indeed be chronic, but their prognosis is difficult to predict for a variety of reasons. There is a paucity of relevant, large longitudinal studies. Patients may get better or worse due to psychosocial factors beyond the control of mental-health providers. Also affecting prognoses is the varying quality and availability of mental-health care—which, even in wealthy countries, patients with significant symptoms may not receive. Noa Pothoven and her family had criticized the dearth of care options available in their country for patients like her. Indeed, more than one in five Dutch patients receiving psychiatric euthanasia have not previously been hospitalized; a significant minority with personality disorders did not receive psychotherapy, the staple of treatment for such conditions. When treatments are available, doctors in the Netherlands have the discretion to judge that there are “no alternatives” if patients refuse treatment. It is not easy to distinguish between a patient who is suicidal and a patient who qualifies for psychiatric euthanasia, because they share many key traits. In some cases, psychiatric euthanasia is simply a highly effective means of suicide, as in the case of a man who attempted suicide, was hospitalized, and then received psychiatric euthanasia. In the end, one does not need to be a psychiatrist to appreciate how psychiatric disorders, especially when severe enough to lead to euthanasia requests, could interfere with a patient’s ability to make “voluntary and well considered” decisions—especially when that patient is a minor. The basis for concluding that any teenager with a psychiatric disorder has “no prospect of improvement” and “no alternatives” is likely to be uncertain at best."
Targeting People With Mental Illness and Dementia for Euthanasia - "While competent, the patient asked to be euthanized when incapacitated, but she also instructed that she be allowed to say when. But before she did that, the doctor and her family decided that her time had come. The doctor drugged the woman’s coffee and, once she was asleep, began the lethal injection procedure. But the patient awakened unexpectedly and fought against being killed. Rather than stopping, the doctor instructed the family to hold the struggling woman down while she completed the homicide. This would seem to be a clear-cut case of murder. But a judge recently exonerated and praised the doctor for acting in the “best interests” of the patient by merely executing the woman’s previously stated wishes. In other words, the judge essentially ruled that the struggling patient was no longer competent to want to stay alive. The only unusual aspect of the “Case of the Struggling Alzheimer’s Patient” was the struggle. Even when incompetent and unable to make their own decisions, the law of Netherlands and Belgium allows dementia patients to be killed by doctors if they so order in written advance directives... Sometimes these legal homicides are accompanied by consensual organ harvesting after death. One case — reported in an international transplant medical journal — involved a self-harmer (or “auto-mutilator”) for whom doctors applied the ultimate harm as a “treatment.” Without criticism — or even a moment’s reflection about the moral questions raised by such an act — the medical journal reported approvingly that the lungs of the deceased psychiatric patient were well accepted by their recipients. The Supreme Court of Switzerland, a country that permits assisted suicide clinics — ruled several years ago that the mentally ill have a constitutional right to access death. Accordingly, there are many verified cases of the non-physically ill being assisted to kill themselves — including an elderly woman who wanted to die because she had lost her looks... the Alzheimer Society of Canada — which is supposed to advocate for the welfare of such patients — has officially endorsed allowing euthanasia by advance directive. This means that even if the incompetent patient is not suffering — perhaps even if he or she expresses no desire to die — their former self’s decision trumps the current self’s needs and desires. Meanwhile, there has already been at least one depressed Canadian apparently euthanized at his request even though his death was not foreseeable. The man’s family even begged doctors to spare his life, but to no avail... restricting assisted suicide to the dying is philosophically unsustainable... an article just published in the American Journal of Bioethics argues that since “the suffering associated with mental illness can be as severe, intractable, and prolonged as the suffering due to physical illness,” as a matter of “parity,” in “severe” cases, “PAD” (physician-assisted death) should be made available to mentally ill patients with “decisional capacity” — even when they have “a relatively long expected natural lifespan.” The authors, University of Utah psychiatry professor Brent M. Kious and noted assisted suicide advocate and bioethicist Margaret (Peggy) Battin, go so far as to suggest that “psychiatrists and other mental health professionals” could one day become “gatekeepers for PAD” once “a metric for suffering in both mental and physical illness” is established. Ponder this for a moment. Instead of being duty-bound to save the lives of all their suicidal patients, mental health professionals would become approvers for and facilitators of self-destruction. That should be unthinkable... The influential bioethicist Thaddeus Mason Pope... believes that a court could one day rule that an advanced dementia patient isn’t “competent” to want to eat."
French YouTuber with dissociative identity disorder rebuffed by Belgian doctors on euthanasia appeal - "A YouTuber who suffers from multiple personality disorder is documenting her bid to end her life at a euthanasia clinic. The French 23-year-old, who goes by the name Olympe, recently told the 255,000 followers of her mental health channel that she was 'in contact with doctors’ in Belgium, where assisted suicide is legal. The content creator suffers from dissociative identity disorder, a condition formed by trauma which is often deeply distressing to those it affects. But Belgian doctor Yves de Locht, approached by Olympe, said clinics were not 'euthanasia dispensers', and that the process can last many months or years before someone can access assisted suicide services. This follows the controversial death of another 23-year-old suffering with mental health issues who chose to end her life in Belgium last year. Olympe, who reportedly lives with about 40 distinct personalities, initially said in a post on Instagram, 'in the last quarter of 2023 I will have recourse to assisted suicide in Belgium... 48.6% of psychiatrists surveyed in 2019 did not support access to assisted suicide for persons diagnosed with severe and persisted mental illness. Nearly a third did support some degree of access, and just over 20% were neutral on the issue. The authors said there was an increasing number of psychiatric patients seeking assisted suicide. A 1994 paper concluded the availability of assisted suicide may lead to increased rates of suicide in the general population, especially among young people, due to copycat behaviour and destigmatisation. Authors of a paper last year highlighted the importance of assessing decision-making capacity when considering assisted dying. This could be complicated by underlying mental health conditions. Last year, Shanti De Corte, also 23, chose to end her life in Belgium, citing 'unbearable' mental distress. Corte suffered trauma as a witness of the ISIS attack on Brussels Airport in 2016. After pursuing psychiatric treatment and medication, she chose to end her life in May 2022. A neurologist later said the decision was premature, with options not yet fully explored, but claimed he was overruled by the woman's mother."
Belgium | Patients Rights Council - "On February 13, 2014, Belgium legalized euthanasia by lethal injection for children...
“Woman, 23, who survived 2016 Brussels airport ISIS bomb but could not live with the trauma is ‘euthanised’ in Belgium”
“Some Flemish doctors support legalization of infanticide: survey”
“Almost nine out of ten respondents (89.1%) agree that in the event of a serious (non-lethal) neo-natal condition, administering drugs with the explicit intention to end neonatal life is acceptable.”...
“We don’t want to pay for oldies, say Belgians”
According to the Belgian French language newspaper, Le Soir, 40% of Belgians believe that costs could be contained “by no longer administering costly treatments that prolong the lives of over-85s”. It further noted that “in the Netherlands, pacemakers are no longer provided for people over 75.”...
“First interdisciplinary study of Belgian euthanasia published”
"The system is not transparent. Just 16 members of a euthanasia commission are supposed to oversee thousands of euthanasia cases. …The system relies on self-reporting. Of the thousands of reported cases, only one has been referred to a public prosecutor and it is estimated that only half of all cases are even reported. …Since legalization in 2002, euthanasia has been “normalized”, with more and more cases of life-ending without request."
“Another euthanasia scandal in Belgium”
Belgium’s euthanasia law allows people to request euthanasia if they have unbearable psychological suffering, Tine was diagnosed with autism. The sickness from which euthanasia candidates are suffering is supposed to be incurable, but the doctors made no effort to treat her...
“Healthy 24-year-old granted right to die in Belgium”
The 24-year-old woman known simply as Laura, has been given the go-ahead by health professionals in Belgium to receive a lethal injection after spending both her childhood and adult life suffering from “suicidal thoughts”, she told local Belgian media.
“Belgian GPs ‘killing patients who have not asked to die’: Report says thousands have been killed despite not asking their doctor”...
“Brittany Maynard and Lauren Hill will leave very different legacies”
Another speaker, a respected researcher and oncologist, Prof. Benoit Beuselinck, described a surreal realisation he’s had when a woman requested euthanasia, but also wanted her little dog put down. He realised ending her life would be uncontroversial, but that animal rights activists would probably prevent him putting the dog down.
“Elderly couple to die together by assisted suicide even though they are not ill”
The pair from Brussels fear loneliness if the other one dies first. Identified only by their first names, they have the support of their three adult children who say they would be unable to care for either parent if they became widowed...
“Outrage as ‘Dr. Death’ offers euthanasia tours of ‘inspiring’ Auschwitz”
Belgian doctor Wim Distelmans has organized a “study tour” to Auschwitz. He claims the Nazi death camp is ‘inspiring’ and will help “clarify confusion.”...
“Paying the price for their autonomy”
The latest euthanasia scandal in Belgium shows that some doctors have discovered an easy way to dispose of some of their medical failures. They can kill them. Legally.
“‘Painless death’ or ‘precipitous cliff’? Transsexual chooses euthanasia after failed operation”...
“Euthanased patients a new source of organ donations in Belgium”"
Euthanasia and Assisted Suicide - "Three surveys done over a 10-year period by Dutch researchers show that in Holland, where euthanasia has been legalized, at least 1,000 patients are killed every year through euthanasia without consent or without request. This constitutes murder. The first report, published in 1991 showed that in 1,000 cases (equivalent to 0.8% of all deaths) physicians administered a drug with the explicit purpose of hastening the end of life without an explicit request by the patient. Two further reports from 1996 and 2001 confirm these findings. In 2001, still 1000 deaths (0.7% of total) were due to patients killed against their wishes or without explicit consent. (Van der Maas PJ et al.: Euthanasia and other medical decisions concerning the end of life. Lancet 1991; 338: 669-74. Van der Maas PJ et al.: Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990-1995. NEJM 1996; 335: 1699-705. Onwuteaka-Philipsen BJ et al.: Euthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001. Lancet online 17 June 2003. https:// image.thelancet.com/extras/03art3297web.pdf) • Dutch doctors currently only report half of all cases of euthanasia to the authorities. With such a low rate of reporting, Dutch claims of adequate control ring hollow... • The ‘slippery slope’ is shown by what happens in Holland and in Belgium: ‘Dutch doctors have gone from killing the terminally ill who asked for it, to killing the chronically ill who ask for it, to killing the depressed who had no physical illness who ask for it, to killing newborn babies because they have birth defects, even though, by definition, they cannot ask for it.’ (Wesley J Smith. Forced exit. Dallas 2003. p 111.) • Euthanasia does not stop with adults in the Netherlands. 9% of all neonatal deaths in the Netherlands occurred following the administration of drugs with the explicit aim of hastening death. This was noted in two surveys in 1995 and 2001. At least 2.7% of deaths of children between the ages of 1 and 17 in the Netherlands are due to euthanasia... To legalize euthanasia or PAS would put immense pressure on those who are ill and especially those who feel that – due to illness, disability or due to expensive treatment required – they have become a burden to others and to society, especially to relatives... • In Oregon, physician-assisted suicide (PAS) was legalized in 1997. A recent survey found that, with the increasing acceptance of PAS, the percentage of patients who died through PAS because they felt a burden to others (not necessarily the only reason, however) increased from 12% in 1998 to 26% in 1999 and to 63% in 2000. (Sullivan AD et al. Legalized physician-assisted suicide in Oregon, 1998-2000. New England Journal of Medicine 2001; 344: 605-607.) When Oregon legalized PAS, only a minority of patients requested PAS because they felt a burden to others. However, with the increasing acceptance of PAS, nearly two-thirds of those dying through PAS cite being a burden to family, friends or caregivers as one of the main reasons for requesting PAS... • With increasing acceptance of euthanasia, anyone with a medical condition – not just a terminal one – may consider euthanasia as a ‘treatment option’. Euthanasia then would become an acceptable treatment option for conditions such as depression, stress, loneliness, fear of impending disease or fear of decline, but also for disabled children or adults. Euthanasia would become part of the armamentarium of medical treatment alongside established medical treatments such as pain relief, antidepressant medication, radiotherapy and chemotherapy. • Dr Karel Gunning, a Dutch General Practitioner states: “Once you accept killing as a solution for a single problem, you will find tomorrow hundreds of problems for which killing can be seen as a solution.” • The profound changes in social attitudes can be compared to the changes that occurred after the criminal code sanctions against abortion were removed as being unconstitutional... To legalize euthanasia and PAS will ultimately undermine medical care, especially palliative care and seriously undermined the doctor-patient relationship... • Legalizing euthanasia would mark a fundamental change in doctor-patient relationship where patients will have to wonder whether …’the physician coming into my hospital room is wearing the white coat of the healer … or the black hood of the executioner.’ (British Medical Association statement – End of life decisions, 2000)... • It is easier and cheaper to kill a patient than to treat. We have serious concerns about the provision of adequate palliative care services if euthanasia were legalized... In Oregon, where PAS has been legalized, nearly one in two patients who initially requested physician-assisted suicide (PAS) changed their mind after initiation of treatment, such as pain control, prescription of antidepressant medication or a referral to a hospice. However, among those patients, where no active symptom control was initiated, only 15% of those who initially requested physician-assisted suicide changed their mind. (Ganzini L et al. Physicians’ experiences with the Oregon Death with Dignity Act. New England Journal of Medicine 2000; 342: 557-63.) • In a survey of terminally ill patients, a total of 60% supported euthanasia in a hypothetical situation, however only 10.6% reported seriously considering euthanasia or PAS for themselves. Factors associated with being less likely to request euthanasia were feeling appreciated, factors associated with being more likely to request euthanasia were depression, significant care needs and pain. At follow-up interview two to six months later, half of all terminally ill patients who had considered euthanasia or PAS for themselves changed their minds, while an almost equal number began considering these interventions. (Emanuel EJ et al. Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers. JAMA 2000; 284: 2460-8.) Among terminally ill patients occasional wishes that death would come soon were common in nearly half of all patients but only 9% of these individuals acknowledged a serious desire to die. The desire for death was strongest in those with severe pain and low family support but most significantly in those with severe depression... One of the main arguments in favour of euthanasia and PAS is that it gives patients the chance of dying a ‘good death’. However, the reality is very different. Dutch research shows that very distressing complications occur not infrequently when euthanasia and PAS are carried out. Rather than dying quickly, some patients took several days to die. • Even though Dutch doctors have the longest experience with euthanasia of any country in the world, still distressing ‘side effects’ occur: In 18% of cases where a patient attempted physician-assisted suicide the doctor had to intervene and kill the patient"
"Euthanasia, Morality, and Law" by John M. Finnis - "Arguments for legalising euthanasia rely on claims about autonomy rights, or claims about political pluralism, or on both sorts of claim. My response will make three main points. First, those demanding this legalisation have shirked their elementary obligation to describe the alleged right, identify who has it, and delineate its boundaries as a right supposed to trump other goods, interests, and the wellbeing or rights of others. Second, they have neglected, or at best hugely underestimated, the casualties who would be, and in some places already are being, created by the success of their campaign. Third, they proceed on an inadmissible conception of the nature and value of human life and dignity-on a theory which should be rejected for the same sorts of reasons of equality and dignity that lead us to reject as a matter of principle the alleged right (often recognised in former societies) to free yourself from perhaps crushing burdens by selling yourself into slavery... We should not try to estimate the impact of changing the law by looking at its new permission while holding steady and unchanged everything else in the picture. Ronald Dworkin has given the British public good advice: When considering the impact of introducing a justiciable Bill of Rights, do not for a moment assume that it will be interpreted and enforced by lawyers and judges with today's atti- tudes. A whole new breed of lawyers and law teachers and judges will rapidly come into existence to give effect to the new regime. So do not think of the euthanasia law being administered by to- day's medical practitioners and nurses and hospital administrators, whose codes of ethics exclude killing as a treatment and management option... A new zone of silence. Can I safely speak to my physician about the full extent of my sufferings, about my fears, about my occasional or regular wish to be free from my burdens? Will my words be heard as a plea to be killed? As a tacit permission?"