Euthanasia: When Freedom Weighs Heavily on the Most Vulnerable

In Oregon, nearly 40% of patients who sought assisted suicide in 2025 felt that they were a burden to their loved ones.^[1] Behind the image of a free individual in control of their own death lies a very different reality: a reality of elderly, isolated people abandoned by a failing system, warns Sofia Gauruel, a research associate at the European Center for Law and Justice (ECLJ).

Op-ed wrote by Sofia Gauruel published in French in Valeurs Actuelles on June 1, 2026.

Data available in countries that have legalized euthanasia or assisted suicide paint a relatively consistent picture of participants. Overall, the vast majority are elderly people, typically between the ages of 70 and 80.^[2] In Canada, the median age of people receiving medical aid in dying (MAID) was 77.6 years in 2023.^[3]

Aside from age, the most-often cited reasons for euthanasia are not physical pain but rather a sense of abandonment. In Oregon, one of the few jurisdictions that systematically documents sources of suffering such as those cited above, the top reasons are loss of autonomy (89%), diminished ability to participate in enjoyable activities (89%), and a sense of decline (65%).^[4] The feeling of being a burden to loved ones is also among the reasons regularly cited. In this sense, the decision to seek aid in dying is not a matter of fully chosen freedom but often arises as the consequence of a sense of abandonment that society has failed to prevent.

Isolation confirms and reinforces this observation. Canadian data show that individuals who seek assistance in dying are more likely to live alone, in areas characterized by greater residential instability, with higher proportions of inhabitants being renters or people without a partner. Yet loneliness is not a medical inevitability. In a 2024 study, the National Institute on Aging noted that in Canada, 19% of people aged 50 and older felt very lonely, 40% felt some degree of loneliness, and 43% were at risk of social isolation.^[5]

The sixth annual report on MAID in Canada provides a significant clarification on this point. In 2024, isolation or loneliness was cited as a source of suffering for 21.9% of requestors facing imminent death and for 44.7% of requestors whose death was not foreseeable in the short term.^[6] When isolation is cited, it never stands alone. It compounds multiple forms of suffering already in existence, making them even more intolerable. Isolation does not, therefore, replace other forms of suffering but instead adds to and exacerbates them. Consequently, what appears as a free and informed choice is sometimes rather a symptom of a systemic failure that requires appropriate public policies.

It is nevertheless important to acknowledge a significant limitation to these analyses: in the vast majority of European countries that have legalized euthanasia, regulatory systems do not collect individual socioeconomic data. Similarly, governments do not publish systematic statistics on the profiles of people seeking to die, the actual reasons for their requests, or any pressures that may have influenced them. This lack of data makes any rigorous comparison between countries difficult and deprives any public debate of the tools necessary to rationally discuss the effects of such legislation.

But this lack of statistical transparency is not insignificant. It allows the myth of free and informed choice to remain intact by avoiding documentation of the context in which it arises. The collection of socioeconomic data is necessary, and it is equally important to know who decides whether to collect such data and why.

The decriminalization of euthanasia and its consequences for the most vulnerable

The legalization of euthanasia does not affect everyone equally. It primarily affects those who suffer from dependency, isolation, or inadequate support within a failing healthcare system. For these individuals, the existence of a legalized lethal option is not neutral; it creates implicit pressure akin to a silent message from society. Legalization thus transforms a once-unthinkable option into a viable solution, altering the perception of life itself for those who lack the material, emotional, and medical resources to envision anything else.

Numerous cases illustrate the use of euthanasia as a solution to a seemingly insurmountable problem. In Canada, Sophia requested to die in 2022^[7] after years of wandering through a system unable to help her secure decent housing. In Belgium, Shanti de Corte, a survivor of the 2016 Brussels attacks, was euthanized in 2022 at the age of 23 due to post-traumatic stress disorder that the healthcare system had failed to treat. Also in 2022, Nathalie Huygens was granted euthanasia following a rape; her psychological suffering was deemed incurable due, once again, to a lack of care commensurate with the trauma she had endured. All these instances share the commonality of being officially classified as medical, yet their true causes are profoundly social.

These cases are not isolated in time: the Noelia Castillo Ramos case currently in the news is the latest illustration.^[8] A victim of gang rape, Noelia was granted aid in dying for psychological suffering that the authorities deemed irremediable. Her decision illustrates the extreme vulnerability of many individuals seeking euthanasia. Many such cases thus have social causes for choices being presented as individualized. The experience of pioneering countries such as Belgium and Canada confirms this: when housing is lacking, psychiatric care is inaccessible, and emotional support is absent, a lethal option fills the void that society has failed to fill.

The convergence of social factors and the responsibility of the French legislature

Behind the diversity of legal systems that have decriminalized aid in dying (the Netherlands, Belgium, Canada, Oregon, Switzerland, New Zealand, and others) emerges a distinct profile of social factors with characteristics sufficiently consistent to suggest more than mere coincidence.

For France, where the decriminalization of euthanasia is actively being debated, the lack of data at the European level serves as a warning sign rather than a guarantee. Legislating without a rigorous assessment of the empirical effects in neighboring countries amounts to moving forward on an uncertain path with potentially irreversible consequences.

France is not immune to the social factors that shape these requests elsewhere. The real question, therefore, is not whether individuals will be able to exercise a freedom under ideal conditions, but whether the state is prepared to institutionalize a system whose foreseeable effects will primarily affect the most vulnerable.

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^[1]Oregon Health Authority. (2026). Oregon Death with Dignity 2025 Act Data Summary (p.16).

^[2] Regional Euthanasia Review Committees (RTE). (2025). (p.20) Annual Report 2024.

^[3] Health Canada. (2025). Sixth Annual Report on Aid in Dying in Canada (Table C.2). Government of Canada.

^[4] Oregon Health Authority. (2026) (p.9).

^[5] Iciaszczyk, N., Gallant, G., Bronstein, T., Brierley, A., and Sinha, S. K. (2024). Perspectives on Aging in Canada: 2024 NIA Survey on Aging in Canada (p.19). National Institute on Aging.

^[6] Health Canada. (2025). Sixth Annual Report on Aid in Dying in Canada (Fig. 3.4a). Government of Canada.

^[7]  Favaro, A. (2022). Woman with chemical sensitivities chose medically-assisted death after failed bid to get better housing. CTV News.

^[8] Puppinck, G. (2026). How the ECHR Circumvented the Ban on Euthanasia. European Centre for Law and Justice (ECLJ).