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Canada is delaying plans which would allow people with mental illness to access medically assisted death amid concern from some clinicians that the healthcare system is not prepared to handle the complicated cases.

Starting March 2023, Canada is expected to become one of the few countries in the world to allow physician-assisted death for chronic mental disorders.

But on Thursday, justice minister David Lametti said the government would seek to delay the expansion of medical assistance in dying (Maid), following criticism from psychiatrists and physicians across the country.

“We are listening to what we are hearing and being responsive, to make sure we move forward in a prudent way. We know we need to get this right in order to protect those who are vulnerable and also to support an individual’s autonomy and freedom of choice,” Lametti said.

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Report to the Final Exit Network Board by Brian Ruder, President

Mary Ewert and Brian Ruder were among 12 FEN members attending the 2022 World Federation of Right to Die Societies conference held in Toronto, Canada November 3-6th. There were 170 delegates. Following are some highlights from the meeting:

• The Canadian law is set to include mental illness next March. However, there was a
feeling that the date may not be met due to the difficulty of defining the assessment
process. It was also mentioned that the Canadian health system is very strained at this
time, which may impact the implementation and process.
• A presentation by the doctor who provided for the first person to die with dementia in
Canada noted she was under review for a year after the death, before she was
completely cleared, even though she had been very careful and followed the law
explicitly. Approximately 1% of the deaths in Canada within the law are due to
• In the Netherlands, there are several right-to-die-organizations, the largest of which has
about 174,000 members. The two oldest and largest organizations in Switzerland
combined (they accept Swiss citizens only) claim around the same number. These
organizations perform advocacy, support and education. And with these numbers, they
have a big influence. All have noted that there are right wing issues in their countries.
• In the Netherlands, 90% of the providers are GPs who have known the clients for some
time. In the Netherlands, over 4.5% of deaths are hastened and in Switzerland 1.8%. (In
Oregon, it is less than one half of one percent after 25 years.)
• The original Canadian law, C-14 was based on reasonably foreseeable natural death. It
was changed in 2021 (C-7) based on a challenge from the disability community. This
allows for support of patients with mental illness and mature young people.
• There are now two tracks for people who want to use the Canadian law. Track one for
those with reasonably foreseeable natural death and Track two for mental illness and
other conditions where reasonably foreseeable natural death does not apply. Criteria
for track two are not yet defined and will be much more time consuming and difficult to
• The Canadian law does not allow a doctor to discuss or recommend the law unless the
client brings it up first.
• In her Nov. 5 keynote address, Senator Pamela Wallin spoke of her ongoing effort to
include a dementia advance directive in Canadian law, which would allow patients to
consent in advance, prior to the loss of menta

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25 years of end-of-life options in Oregon
By Laurie Trieger

This month marks the 25th anniversary of Oregon’s Death With Dignity Act; in approving the law, Oregon was the first state to authorize medical aid in dying. Though it was originally passed via ballot measure in 1994, the law was challenged in the courts and did not become formally available until Oct. 27, 1997.

All these years later, nine more states and Washington, D.C., have made this compassionate end-of-life choice available to its residents, and people across the country are learning how to have difficult conversations with their loved ones about their end-of-life wishes. I am inspired by the advocates before me who have given us this option. One of those advocates was my mother, a longtime supporter of medical aid in dying.

A trusted and time-tested medical practice, medical aid in dying allows a terminally ill, mentally capable adult with a prognosis of six months or less to live the opportunity to request from their doctor a prescription for medication they can decide to self-ingest to die peacefully in their sleep. My mother was a member of the Hemlock Society and taught me from an early age how critical it is for all of us to have agency over our bodies, our lives and our deaths.

Read the entire article in the Eugene Register-Guard 10/26/2022 at


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A group of French people will take part in a citizens’ convention that will help to determine whether to legalise euthanasia and assisted suicide.

The Citizens’ Convention on the End of Life the initiative of President Macron, who wants to put the debate on the right to die at the heart of his second term of office. The government has begun drawing the names of 150 citizens out of a hat to take part.

The issue is contentious, and the Pope denounced Macron’s initiative last week before holding private talks with the president in Rome on Sunday.

Macron is pressing for reform of French law, which allows doctors to give terminally ill patients enough sedatives to lose consciousness, but does not allow them to prescribe or administer lethal drugs.

Macron has said that France’s present legislation leads to “inhuman situations”, though he has conceded that the issue is not simple and he is unsure what modifications were required.

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E R G O honored

The Euthanasia Research and Guidance Organization (ERGO) has been given honorary life membership in the World Federation of Right to Die Societies in recognition of its service to the international movement since 1980.


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World premiere this Saturday 10/22 of a new documentary ADDICTED TO LIFE, and its powerful message supporting Medical Aid-in-Dying.

Showing at the Portland Film Festival in person and to stream online.

Strong-willed, funny and charismatic, at 37, Belgian athlete Marieke Vervoort’s time is running out. As her strength falters and her body begins to fail, she determines to end her life with the aid of her doctor. Liberated by the legal permission to die, Marieke rediscovers the freedom and thrill of living and competing and becomes a Paralympic champion. Her acceptance of death becomes an affirmation of life. Marieke demystifies one of the most controversial issues of our time.


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The MIT Technology Review reported 13 October:

In a workshop in Rotterdam in the Netherlands, Philip Nitschke—“Dr. Death” or “the Elon Musk of assisted suicide” to some—is overseeing the last few rounds of testing on his new Sarco machine before shipping it to Switzerland, where he says its first user is waiting.

This is the third prototype that Nitschke’s nonprofit, Exit International, has 3D-printed and wired up. Number one has been exhibited in Germany and Poland. “Number two was a disaster,” he says. Now he’s ironed out the manufacturing errors and is ready to launch: “This is the one that will be used.”

A coffin-size pod with Star Trek stylings, the Sarco is the culmination of Nitschke’s 25-year campaign to “demedicalize death” through technology. Sealed inside the machine, a person who has chosen to die must answer three questions: Who are you? Where are you? And do you know what will happen when you press that button?

Here’s what will happen: The Sarco will fill with nitrogen gas. Its occupant will pass out in less than a minute and die by asphyxiation in around five.

A recording of that short, final interview will then be handed over to the Swiss authorities. Nitschke has not approached the Swiss government for approval, but Switzerland is one of a handful of countries that have legalized assisted suicide. It is permitted as long as people who wish to die perform the final act themselves.

Nitschke wants to make assisted suicide as unassisted as possible, giving people who have chosen to kill themselves autonomy, and thus dignity, in their final moments. “You really don’t need a doctor to die,” he says.

Because the Sarco uses nitrogen, a widely available gas, rather than the barbiturates that are typically used in euthanasia clinics, it does not require a physician to administer an injection or sign off on lethal drugs.

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Freedom to choose

The right to CHOOSE to die at life’s end is the ultimate personal and civil liberty. — Derek Humphry

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As part of the Dutch system of transparency in its Termination of Life upon Request law, this week the Health Minister provided a report to the Dutch Parliament outlining the backlog which the increase in requests for euthanasia from mental health patients has created.

While Dutch psychiatrists are supportive of the right of those suffering from psychiatric illness to request euthanasia, far fewer are willing to get involved, or feel competent to do so.

Instead, psychiatrists tend to refer their patients to the Euthanasia Expertise Center in The Hague. This, in turn, has created a backlog with a current wait period of 2 years.

Health Minister Kuipers has reiterated the policy vision that: ‘‘People with a persistent euthanasia request on psychological grounds should be able to count on help at the right time, in the right place and preferably without a (long) wait’.

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