Some facts

1. Pain is not the most important reason why people opt for ASE where it is legal. In every survey coming from Oregon since 1998, pain is not in the top 5 reasons.[1]
2. All countries where ASE has been legalised have seen dramatically rising numbers. Canada’s assisted dying deaths increased tenfold from 2016 to 2021[2]. Oregon’s fourfold from 2009 to 2020[3]; in the Netherlands, euthanasia and assisted suicide rose from 1.2% of deaths in 2003 to 4.2% in 2019.[4]
3. In every country where some form of ASE is now legal, the criteria for eligibility has expanded.[5]
4. In a recent poll, 81% of British palliative care doctors oppose a change in the law because they do not believe frightening stories told about the end of life.[6]
5. Control of pain and restlessness does not improve in countries where assisted suicide and/or euthanasia is legal. In the Netherlands, where euthanasia has been legal for more than 20 years, a 2022 article noted that ‘at least one symptom-related care goal was not achieved for 28.5%–42.8% of patients’.[7]
6. The claims made about suicide reduction by Dignity in Dying are similarly not true. There is little relationship between suicide rates and legalization of ASE.[8] If anything, a culture where death is an acceptable medical treatment may encourage suicide. Non-assisted suicides in Oregon have risen by one third since it legalised assisted suicide.
7. Proponents claim that 84% of the British public supports ASE is wrong. But there is evidence that support is skewed because a majority thinks that ‘assisted dying’ means turning off life support, stopping medical treatment, and receiving pain medication.[9]
8. Providing ASE is money-saving, especially when it is extended to those who are not terminally ill. A Canadian report notes that the estimated that, in the case of ‘reasonably foreseeable’ deaths, euthanasia would save the country $13,442 per patient in 2021 ($135,276,350 in total). However, once eligibility was expanded beyond ‘reasonably foreseeable’, it estimated, the savings would be $53,265 per patient.[10]
9. Where both euthanasia and assisted suicide are legal, those seeking death opt for euthanasia. In Canada, fewer than seven of the 10,064 MAiD deaths were self-administered.[11] In the Netherlands, 245 of the 6,095 deaths were assisted suicide.
10. Unlike same-sex marriage, ASE has been defeated many times. In the USA between 1994 February 2020, there were 284 proposals for legalisation. Only 11 were successful.[12]

[1]https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/ar-index.aspx. This is also the case in Washington, where assisted suicide has been legal since 2008. https://doh.wa.gov/sites/default/files/2022-11/422-109-DeathWithDignityAct2021.pdf?uid=63e3b5301ba12 California does not collect this information. In Canada, where the questions are worded differently, fear of adequate pain control only comes third. See https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html#a4.3

[2] https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html.

[3]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year24.pdf

[4] https://english.euthanasiecommissie.nl/the-committees/annual-reports

[5] Canada is the most dramatic example of the expansion of categories. In 2021 it removed the stipulation that death must be ‘reasonably foreseen’ instituted in 2016. In March 2024, those suffering only from mental illness are set to be included. The Netherlands expanded the range of conditions considered eligible in 2007, after making it legal in 2002, while the definition of ‘unbearable suffering’ central to the law was also loosened.

[6] See Matthew Doré, ‘Assisted suicide a 20th century problem, Palliative care a 21st century solution’, Ulster Med J 2023;92(1):4-8 https://www.ums.ac.uk/umj092/092(1)004.pdf

[7] https://spcare.bmj.com/content/bmjspcare/early/2022/11/21/spcare-2022-003718.full.pdf

[8] Dignity in Dying implies that the suicide rate will be lower if ASE is legalized and people have a ‘safe’ route to die. https://www.dignityindying.org.uk/why-we-need-change/suicides/  But, if anything, the opposite is true. See https://research.stmarys.ac.uk/id/eprint/3664/1/Suicide%20US%20SMJ%20as%20accepted.pdf and https://www.sciencedirect.com/science/article/pii/S0014292122000551 See also this excellent infographic. https://kadoh.uk/wp-content/uploads/2022/04/AD-and-suicide.pdf

[9] https://euthanasiadebate.org.nz/wp-content/uploads/2018/06/Euthanasia-Poll-Results-November-2017.pdf

[10] Cost estimate for Bill C-7 “Medical Assistance in Dying” https://www.pbo-dpb.gc.ca/web/default/files/Documents/Reports/RP-2021-025-M/RP-2021-025-M_en.pdf. Figures extrapolated from charts on p1 and p2.

[11] https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html

[12] See https://www.patientsrightscouncil.org/site/failed-attempts-usa/