NRL News

The Illusion of “Safeguards”

by | Apr 26, 2011

By Alex Schadenberg

Editor’s note. Alex Schadenberg is executive director of the Euthanasia Prevention Coalition. You can read his excellent blog at

Dr. Jose Pereira

Dr José Pereira MBChB MSc, who teaches at the University of Ottawa and is the chief of palliative care in Ottawa Ontario, has written one of the best articles concerning euthanasia and assisted suicide. It ‘s titled Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls and was published in the current issue of Current Oncology)

Dr. Pereira understands the issues well because he worked for three years as a palliative care physician in Switzerland, at a hospital where assisted suicide was practiced.

Pereira takes apart the argument that euthanasia can be controlled through “safeguards.” He explains how a social slippery slope exists when euthanasia or assisted suicide is legalized. He proves that legalizing euthanasia or assisted suicide does not result in improved palliative care services. He then proves that proper care and identifying why a person requests euthanasia or assisted suicide  will eliminate the continued request for an assisted death.

With reference to safeguards. Pereira examines the common safeguards that are part of the legalization regimes.

Pereira explains that in the Netherlands there are approximately 550 deaths without request or consent each year, and that approximately 20% of the euthanasia deaths go unreported. A recent report from Belgium found that 32% of euthanasia deaths are without request or consent. Another recent report found that approximately 47% of the euthanasia deaths go unreported in Belgium.

Pereira then shows that the safeguard of providing a psychiatric assessment to prevent assisted suicide of depressed or mentally ill people in Oregon is ignored. He then explains how the Compassion & Choices lobby group facilitates nearly all the assisted suicide deaths in Oregon, removing the veneer of objectivity.

Pereira goes on to examine the concept of the slippery slope and explains that a social slippery slope exists. He points to the Netherlands who originally promoted the acceptance of euthanasia for people who were terminally ill and suffering physical unrelieved pain.

Once euthanasia became accepted it evolved to allowing euthanasia for people who were not terminally ill, then to people who were experiencing mental pain, then euthanasia became accepted for children and infants and now the debate in the Netherlands surrounds the concept of euthanasia for people who are “tired of living.”

Pereira expresses his surprise that a palliative care consultation is not mandatory in jurisdictions where euthanasia and/or assisted suicide is legal. He explained that a study showed that more than 65% of people who request euthanasia will change their minds when given proper care.

Finally, Pereira exposes the lie that palliative care improves where euthanasia has been legalized. He explained that in Belgium when euthanasia was legalized in 2002 that palliative care was provided in 19% of all euthanasia cases. By 2007 only 9% of the people who died by euthanasia received palliative care support.

Pereira concludes his article by pointing to a study that shows that 15% of Dutch physicians are concerned that economic pressures lead to euthanasia decisions.

Pereira explains that when people are offered proper care and asked why they want to die, then the requests for euthanasia can be effectively dealt with for almost everyone, with good effective care without resorting to killing.

Categories: Euthanasia