A deeply disturbing investigative report in UnHerd last week uncovered rampant violations of physician-assisted suicide practices in states with the oldest and largest programs. The 11 states that have legalized assisted suicide require clinicians to submit compliance forms shortly after the “patient’s” death. But the chaotic assisted-suicide bureaucracy rarely follows regulations, and clinicians put people to death with little to no oversight.
Between 2009 and 2023, 515 compliance forms and 293 “written request” documents were missing in the state of Washington. In all, one-third of the state’s assisted suicides were improperly reported. In Colorado, which passed its End of Life Options Act in 2016, almost 1,800 compliance forms are missing. And in New Mexico, where annual compliance reporting is also required by law, there has not been a single report issued since assisted suicide was enacted in 2021. For years, the state’s website suggested that a report was “coming soon,” but state officials quietly removed that promise from its website this summer.
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Disturbingly, there have been no suspensions or revocations of clinician licenses connected with these irregularities.
Failing to report an assisted suicide is no mere statutory violation. Washington law states medical providers and pharmacists who neglect to “make a good-faith effort to file required documentation in a complete and timely manner” risk losing immunity protection for criminal acts.
The missing compliance reports are only the tip of the iceberg. Officials in Colorado and California were unable to provide numbers for the total assisted suicides carried out by clinicians and held no record of the type of drugs prescribed to more than 1,000 “patients.” Authorities in Oregon don’t know the result of 178 cases from 2024 in which “aid in dying” medications were prescribed.
Did the “patients” take the drugs in those cases? Did those drugs cause death? Did the “patients” even die? Oregon has no records on any of this.
Record keeping in Washington is even worse. By law, the state is supposed to perform a review of reporting compliance each year. But, blaming funding cuts, officials announced that they will no longer issue these legally required reports.
The decision to help people die by suicide is, by nature, the most serious decision physicians in these states are sanctioned to make. Yet, killings are obviously carried out with a cavalier disregard for the law that reflects a complete lack of seriousness. It is almost as if the medical profession has lost its understanding of the grave moral implications of its work. Our culture has become hardened and cynical about issues of life and death as it increasingly disregards the claims of the vulnerable — the sick, the elderly, and the unborn — because it is inconvenient for the strong to pay proper attention to them and acknowledge the moral claim they have on us all.
When assisted dying was becoming legal for the first time, its advocates assured us that it would be done with the utmost caution and sensitivity. But it is not done this way. It is becoming increasingly common because too many people now accept it with a shrug.
In Oregon in 2024, 42% of “patients” told their assisted-suicide clinician that they were choosing to die because they “felt like a burden,” up from 12% in 2009 when the law was first passed. The gruesome reality is that a growing number of people are seeking assistance to end their lives because they are put under pressure to do so. Their deaths, like so many perpetrated by abortion, are done simply for convenience. Most states with assisted suicide don’t even report these statistics. California keeps records of “patients’” concerns that contribute to the choice of “aid-in-dying” but doesn’t list “financial concerns” or “feeling like a burden” as options to choose from.
As more and more states consider whether to adopt assisted-suicide laws, a true accounting is needed to provide voters with accurate information about the outcomes of these laws in states where they are already established.
Given the gravity of the new revelations, the Department of Health and Human Services Office of Inspector General, in coordination with the Justice Department, should launch an immediate investigation into states’ assisted-suicide programs. It should focus on three critical areas: the failure to file mandatory compliance forms, inadequate tracking of lethal prescriptions, and the absence of disciplinary action against clinicians who endanger “patients” through noncompliance.
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As assisted suicide spreads, the risk grows that vulnerable people, those feeling like burdens or facing financial strain, will be nudged toward death rather than helped to live. This is not compassion — it’s the worst sort of cultural and moral failure.
It is time for accountability.