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The unintended consequences are hard to think about ... but easy to see

All the scenarios in our ‘Unintended Consequences’ timeline video are grounded in clear experience from other countries where assisted suicide and euthanasia have been legalised.

2025

Assisted suicide legalised with ‘safeguards’

Mental capacity, terminal illness and only adults

  • These ‘safeguards’ are the key features of the ‘Oregon model’, as adopted in other US states (notably Washington and California), and proposed in Westminster for England & Wales.

2026

Annual report says vulnerable people feel pressure to end their lives

Fear of being a burden is involved in over 53% of assisted suicides

  • Vulnerable, elderly or disabled people in Scotland who are terminally-ill would opt for an assisted suicide because they do not wish to be a burden on family, carers or the NHS.

 

  • More than 53% of all people having an assisted suicide in Oregon, cite feeling a ‘burden on family, friends, or caregivers’ as one of the reasons in their decision to end their lives. That’s an average figure over a 5 year period (2018 – 2022).

 

  • Most people die by euthanasia because they are going through a difficult health condition and they are feeling depressed, isolated and lonely or experiencing feelings of hopelessness and they believe that their life has no purpose.

2027

Postcode Lottery for
dignosis, treatment and
care hits the poorest hardest

  • There have been well-documented cases of patients being denied expensive, life-sustaining treatment while assisted suicide or euthanasia were offered – in Oregon (Barbara Wagner and Randy Stroup) and Canada (Roger Foley).

  • In California, Stephanie Packer was approved for a less toxic form of chemotherapy before the state adopted assisted suicide, but insurers pulled funding a week after the ‘End of Life Option Act’ became law.

  • Within the NHS, there have been many examples of tests, treatments and drugs being restricted on account of location, age or cost, and the individual cost of serious illness can be huge: research by Macmillan found 83% of people are, on average, £570 a month worse off as a result of a cancer diagnosis.

ECONOMIC PRESSURES WILL impact DECISION MAKING

Lethal drugs are cheaper than care

  • Assisted suicide reduces the incentive to invest in high-quality palliative and social care.

  • At the same time, there would be a perverse incentive to not restrain assisted suicide since it is cheaper than providing palliative or social care.

  • Discussion of the financial savings of legalising assisted suicide is already happening. Cost savings for the NHS have even been described as ‘the elephant in the room’. This may be a very tempting option for future policy makers and NHS managers.

2028

Terminal illness ‘restriction’
ruled as ‘unfair discrimination
preventing equal access’

New parliament expands law by introducing a new ‘Intolerable suffering’ criteria which allows death for chronic illnesses & disabilities

  • Canada’s requirement that death be ‘reasonably foreseeable’ to qualify for euthanasia was ruled an unconstitutional restriction by a Quebec Superior Court judge in 2019. The bill to comply with the ruling (C-7) will broaden the six-year-old federal law’s scope to include chronic illnesses and disabilities, and allow advance requests for those with conditions like dementia. The outgoing restriction failed to prevent the deaths of non-terminally ill patients with depression (cf Alan Nicholls) and eating disorders, and the Canadian Psychiatric Association has called the new bill’s stated exclusion of mental illnesses ‘stigmatizing.’

 

  • The law in Oregon requires that participants be terminally ill, but without any change in statute, officials also now consider patents to be eligible if they forego otherwise life-sustaining treatment: 2019 saw assisted suicides for patients with diabetes, arthritis and ‘complications from a fall.’

 

  • Concerning a shift from one form of ‘assisted dying’ to another: the Carter court case which prompted Canada’s law originally concerned assisted suicide, but the legislation which fulfilled the court’s mandate allowed both assisted suicide and euthanasia; just six of the 5,085 MAID deaths across nine Canadian provinces between June 2016 and October 2018 involved assisted suicide rather than euthanasia. Six years on, the terminal illness restriction has been struck down.

 

  • Prominent campaigners in the current push for a Scottish law change supported a Scottish euthanasia bill in 2010.

2029

Healthcare staff
leave or retire early
as their conscientious
objection rights are eroded

  • In 2019, the Ontario (Canada) Court of Appeal affirmed a College of Physicians and Surgeons (CPSO) policy requiring physicians unwilling to participate in euthanasia and assisted suicide to make ‘effective referrals’ to willing practitioners or clinics.

 

  • The World Medical Association states that no doctor, nurse, or healthcare professional should be forced to participate in euthanasia or assisted suicide. They should also not be obliged to make referral decisions to that end, but Scottish proposals conflict with this.

Hospice forced to close after funding is axed for refusal to offer euthanasia

  • British Columbia (Canada) requires all non-religious hospices in receipt of majority state funding to offer patients euthanasia, and the health authority is forcing the closure of one hospice which refused.

 

  • In New Zealand, a judge ruled in 2020 that health authorities would have the right to defund hospices which similarly declined to offer euthanasia.

2031

MSP proposes bill to extend euthanasia to over-75s 'tired of life'

  • A bill currently before the Dutch parliament would allow for the euthanasia of healthy over-75s who feel their lives to be ‘complete’.

Elder abuse cases rise. Emotional & financial pressures mount on care givers.

  • Age UK reports that already in the UK, ‘almost half a million people aged over 65 will experience some form of abuse or neglect’ including physical, psychological and financial abuse.
  • Carers UK reports that one in eight adults across the UK provides unpaid care to older, disabled or seriously ill family and friends.

2033

Scottish teenager seeks the 'right to die' for incurable anorexia

Euthanasia debated for all children of any age including newborns with disabilities.

  • The Belgian Act on Euthanasia of 28 May 2002 only permitted euthanasia for adults and emancipated minors, but was extended in 2014 to all terminally ill children.
 
  • Dutch law already provided for euthanasia for children as young as 12, as well as the euthanasia of disabled newborns by way of the ‘Groningen Protocol.’
  • In December 2016, Canada’s Ministers of Health and Justice ordered a review on the possibility of extending euthanasia to mature minors, prompting doctors associated with a Toronto children’s hospital to develop guidance on whether age or capacity should be the deciding factor, whether doctors should be required to bring euthanasia to young patients’ attention, whether children should be able to undergo euthanasia without their parents’ knowledge – much less their consent – and whether hospitals have a responsibility to normalise euthanasia.

PROPER FUNDING FOR PROPER CARE

PROPER FUNDING FOR PROPER CARE

Support
Palliative
Care

Support
Palliative
Care

Oppose assisted suicide
and euthanasia
Oppose assisted suicide
and euthanasia

Promoting Care, Opposing Euthanasia

Care Not Killing was set up in 2006 as an alliance of individuals and organisations which brings together disability and human rights groups, healthcare providers, and faith-based bodies, with the aims of promoting more and better palliative care; ensuring that existing laws against euthanasia and assisted suicide are not weakened or repealed; and helping the public to understand the consequences of any further weakening of the law.

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