Euthanasia and assisted suicide numbers continued to rise last year in Belgium and in Oregon, according to official reports released last month.
Belgium’s euthanasia rate increased last year to 2,357 deaths, up from 2,309 in 2017. While that’s a small increase from the previous year, it’s more than double the country’s 2010 euthanasia rate of 954.
The number of deaths by euthanasia, which doctors can administer, has historically grown at a much higher rate than assisted suicide, which people must self-administer. But 2018 saw an increase of just 2 percent in Belgium compared to 14 percent in 2017. Alex Schadenberg, director of the Canada-based Euthanasia Prevention Coalition, told me that the slowdown likely is due to recent high-profile investigations of euthanasia cases in the country. Earlier this year, the European Court of Human Rights decided to hear the case of Tom Mortier, who said that doctors wrongfully approved his mother’s euthanasia. Last year, three Belgium doctors faced a criminal investigation for approving the death of Tine Nys, a woman diagnosed with a mild form of autism.
“I think all of it is connected to the fact that there has been some cold water on the situation,” Schadenberg said. “Doctors are being more careful because they have the fear of possible prosecution.”
Unlike previous years, Belgian doctors did not report euthanizing any minors in 2018. The age group with the most euthanasia deaths was adults in their 80s, accounting for nearly 30 percent of all cases. Meanwhile, 14 people between the ages of 18 and 29 and 10 people over 100 years old died by euthanasia.
Oregon, which legalized assisted suicide in October 1997, saw its highest number of such deaths in 2018, according to last month’s report. In 2018, 168 died from assisted suicide, up from 158 in 2017. So far, 2,217 Oregonians have died by assisted suicide since the practice became legal.
Lois Anderson, director of Oregon Right to Life, told me that this year’s report comes with a special irony: While the current legislature considers bills to help prevent Oregonians between the ages of 10 and 24 from committing suicide, it is also eyeing several bills that would broaden assisted suicide access.
“Oregon is really not dealing with depression, mental health, suicide, on any level, well,” she said. “And having legal assisted suicide for 21 years hasn’t helped the situation at all. In fact, it’s gotten worse. In the Capitol, this legislative session, they’re calling it a suicide crisis.”
Anderson said it sends a mixed message to call suicide numbers a crisis while allowing certain ill people to swallow doctor-prescribed, life-ending drugs. Among U.S. states, Oregon ranks 36th for its suicide rate, with 19 out of every 100,000 deaths attributed to suicide. Following a national trend, that’s much higher than four years ago, when the suicide rate in Oregon was 14.9 out of 100,000 deaths. It’s currently the seventh leading cause of death for all Oregonian males and the 11th leading cause for Oregonian females.
Meanwhile, state legislators are considering multiple bills to broaden the existing Death with Dignity Act. H.B. 2232 would redefine “terminal disease,” removing the requirement that doctors expect the disease to cause death within six months to mean a disease that will “produce or substantially contribute to a patient’s death.”
The Oregon report cited other messy aspects of last year’s assisted suicide cases. Two physicians who failed to comply with the Death with Dignity Act were referred to the Oregon Medical Board, one person woke up after ingesting the lethal pills and died of an underlying illness, and the state doesn’t know the ingestion status of 43 people.
Notably, pain wasn’t one of the top three most cited reasons people wanted to die. The most common concerns were loss of autonomy, loss of ability to do enjoyable things, and loss of dignity. Schadenberg said fear rather than physical pain is the biggest driver of assisted suicide requests. He said the best way to help family members who have said they want assisted suicide is to tell them they won’t be alone, and that their life has value.
“You can’t mince words. You can’t say, ‘We prefer you not,’” he said. “No, you have to say, ‘We do not want this. We think this is the wrong way to go.’ And you have to be very clear that their life is important to you.”