Excellent. Hopefully the UK will be next, and it gets extended so tht it doesn't only cover terminally ill people. Luckily I'm still young and healthy so I've got plenty of time until I'll need this, but I'll be pretty upset if not available when I do.
It's been hard enough to convince countries to legalize assisted suicide for people are terminally ill that I think we're unfortunately very far away from the entension to people who aren't. Aside from the religious angle, what are the biggest arguments against assisted suicide for people who aren't terminally ill?
I mean, that can already happen, no? What difference does it make being able to commit legal suicide instead of 'illegal' suicide by downing some pills?
I guess because one is technically murder and you'd have to do it yourself, whereas the other you can get someone else to do it and you'd get away scott free and with less guilt.
They are both murder, but I think he's talking about legal guilt. If the assisted suicide you deniably talked your predecessor into was legal, you are legally guilty of no crime.
As someone who moved to Germany, I feel like I understand this better now. Many people here a real stickler for rules even when they make absolutely no sense at all. Many seem to actually care whether a law was broken before they care to consider whether the thing itself is good regardless of legal status. Avoiding the feeling of legal guilt is probably a thing here more than I thought it could be.
The only points this makes me reconsider is the legal right to murder your own children and having criteria for who gets to have children in the first place.
That's why the decision to allow assisted suicide is taken by two separate medical professionals following two requests by a person in pain. I think it's safe to assume that said medics (who swore a hypocratic oath, no less) will not just hand those over to whomever asks.
Allowing anyone to end his life it's the same as stating that we fully own our ourselves. If we accept that axiom as valid then there is no moral argument against free market of organs nor consensual cannibalism (https://en.wikipedia.org/wiki/Armin_Meiwes).
I was interested in selling a kidney to help a guy pay for life-saving surgery but found out it wasn't legal. Probably for good reason. I could donate instead though.
Interesting. Probably taking a leap here but now I’m imagining a scenario where this life-saving surgery guy is the buyer of your kidney and you’re bummed you couldn’t make money from it.
I just realized this sentence could be fairly easily interpreted to mean I'm selling someone else's kidney haha. I wouldn't do that, as immoral of a person as I may be seen to be.
I had thoughts like this too, but honestly, some slopes are indeed slippery. Once you normalize the practice of selling your own organs, the market will readjust - the value of your organs will become a part of your net worth, and you'll be pressured to sell them in situations where you'd prefer not to.
It's one thing to have an option to donate your kidney to save someone's life, it's another when selling your kidney will become the only way most people can afford mortgage.
To be honest, for many millennials selling their organs and/or body products in supplement to a full time job may already be necessary to get a mortgage where they'd be willing to live before they're so old they couldn't expect to pay it off.
> Aside from the religious angle, what are the biggest arguments against assisted suicide for people who aren't terminally ill?
Suicide is a permanent action for sometimes temporary circumstances. Plenty of folks who attempted suicide—because they saw no way out of their current situation—and failed are glad they ended up failing.
But that's already true of unassisted suicide. With assisted suicide, at least the person will be required to see a practioner (in my version of it, anyway) who might be able to diagnose and treat/address the temporary circumstances.
> Batters said she’s heard from hundreds of Canadians who have concerns about the clause. Many have told her they’ve suffered from mental illness, and would have chosen to end their lives if the option had been available to them before they recovered.
> Plenty of folks who attempted suicide—because they saw no way out of their current situation—and failed are glad they ended up failing.
The counterpoint is also true though: there are people who live long and persistently miserable lives. To me that is even worse than a premature death (I'd much rather be dead than permanently miserable).
Unfortunately, in the US, people have to rely on 2nd amendment rights to have such option.
Without guns, all other methods I know of are painful and non-instant: hanging, drug overdose, cutting veins, suffocation, what else?
It’s just sad that terminally ill people have to use a method that will put stigma and shame on how their live ended, doing it in secret and with mess.
Instead of a legal and graceful procedure, going away surrounded by family.
> Without guns, all other methods I know of are painful and non-instant:
Suffocation with inert gas (e.g. N_2) using mask with exhalation valve is safe, painless and leads to very fast loss of consciousness. Distress associated with suffocation is not caused by missing oxygen, but by excess CO_2, so it does not happen if a person can exhale freely. It sometimes happen in industrial accidents, people lose consciousness without noticing anything.
It's (relatively) long but painless. It would be hard to arrange, but only because it's illegal to provide such services. I dream of a day when such such services are provided by healthcare providers.
Without guns, all other methods I know of are painful and non-instant: hanging, drug overdose, cutting veins, suffocation, what else?
At Dignitas they have the person drink a cup of barbituates. There are a few videos of this entire process on YouTube if you're curious enough to watch such a thing. It appears to be generally painless.
But you can’t obtain these controlled drugs legally, while legal gun purchase is protected right.
> an oral dose of an antiemetic drug, followed approximately half an hour later by a lethal overdose of 15 grams of powdered pentobarbital dissolved in a glass of water
With international travel becoming so accessible I'm kind of surprised that suicide tourism (akin to medical tourism) isn't more of a thing. I wonder if there's a tacit understanding that opening that door would have diplomatic consequences.
FAFAIK, this is possible in Switzerland. However, the same safeguards apply there: the patient has to make their case and a doctor must assent to the request.
> Patients have to be Spanish citizens or legal residents and must be fully conscious when they request the procedures.
> A request is to be submitted twice in writing, 15 days apart. It must be approved by two separate doctors and an evaluation body, according to AFP news agency.
Given those requirements and safeguards, I'm having a difficult time understanding a rational argument against this law.
Agree 100%. I recently lost my Mum to cancer, and while the end wasn't nearly as bad as it could have been, it should have ended a day or two before it did. After battling for almost 3 years, there was no hope anymore. She couldn't eat or talk for two days, and on the last day wasn't lucid at all. In the proceeding years we had many, many conversations about death, and she was completely aware her cancer was a 100% death sentence.
A friend watched his Dad suffer immeasurable pain for 6 months from bone cancer, and the final 2 weeks were inhuman. He was begging the hospital staff, but they couldn't.
Three months after his Dad died, my friend committed suicide.
NOT allowing assisted suicide for terminally ill people is cruel and THAT should be the crime.
I don’t think there’s quite enough information in the article to fully evaluate it. Depending on what the precise requirements are, what this “evaluation panel” involves, and how long the panel can take to make a decision, you could certainly have a rational objection there.
But, overall, it at least seems pretty good. I have always been incensed that if I were terminally ill in most US states, the law would treat me worse than my dog. Laws like this are a huge step in the right direction, IMO.
Edit: I’d be fully satisfied when the law allows me to specify when I want my own suffering ended via advance directive. It really shouldn’t be the burden of a terminally ill person to have to make those decisions at the end of their life.
I'll take a stab (I'm against similar laws). It's more a moral and emotive argument than a "rational" one, but many people believe that taking a human life -- apart from certain cases like self defense -- is wrong, even if it's your own. The thinking is that it's too important to be something we should decide individually (and that it should be for nature, or God, to decide). There's also the aspect that suffering sometimes just happens, and we don't usually get to decide when and how it's going to happen to us. I believe humans are inherently different from animals (a philosophical or religious debate), so I believe it is okay to put your dog down.
My uncle recently died of Parkinson's and my aunt soon after of cancer. Both suffered immensely (especially my uncle), but they believed it wasn't up to them to end it. Both also had huge support from loving family and friends, the way it should be. I know it's easy to say here at a distance, but there's honour in a valiant fight to the end.
There are always going to be some things that people believe we shouldn't be able to decide, even for ourselves. Someone else on the thread posted about consensual cannibalism -- most people would consider that over their line. A lot of it comes down to whether you believe we (as gotsa said) "fully own ourselves" or not.
Note that religious believers don't "mix" God in their arguments, they're just speaking from their perspective. They believe that God is just there, that he made and guides everything. What you call "mixing God in" we might call "practising what we preach". It's maybe a bit like asking a Native American to stop "mixing their tribal culture into everything". That's just who they are.
IMHO you can practice as much as you want as long as that does not affect others, and if I know something that does not fully own me, for sure is someone else beliefs.
This is all fine if it concerns themselves. But it's bonkers if it concerns others with other beliefs.
Who determines that their belief that people are not allowed to decide about their own death is more important than my belief that people are not allowed to decide whether others have to suffer.
Reminds me of Mother Teresa.
Helping the poor but at the same time believing the sick must suffer like Christ on the cross.
None of the responses are going to reply to your bit about consensual cannibalism, but it's an excellent point.
Just because we hear a story where a person really wanted to do something or make some choice but they could not, doesn't mean that person needs the right to do that thing.
Choice and rights and liberty aren't the most important things in the world. And people who take the deification of those things to the extreme that they advocate for the kind of Futurama world where everyone can just hop in a suicide booth no questions asked are pushing their beliefs on everyone else without realizing it.
What's wrong with consensual cannibalism anyway? It's their life, I don't care if they like human meat or broccoli as long as that doesn't go above the freedoms and rights of another living being.
> but there's honour in a valiant fight to the end
This is precisely why I want the option of legal suicide: a "valiant fight to the end" that lasts years of agony without acceptable quality of life is egoist. Your close relatives will be relieved when you pass away, partly because you were suffering, and partly because a very long agony could become a huge drain of time, money and emotional burden.
I want to be able to choose when and how to die on my terms, legally.
> a "valiant fight to the end" that lasts years of agony without acceptable quality of life is egoist. Your close relatives will be relieved when you pass away, partly because you were suffering, and partly because a very long agony could become a huge drain of time, money and emotional burden.
This inadvertently sends a message that some life isn't worth living and that it's moral thing to end your life when you "permanently" become a burden to others. Once this way of thinking becomes dominant, it will put incredible psychological pressure on to people with poor life quality that depend on others. What is acceptable quality of life? When does it become unacceptable? You may think it is a personal choice, but it really isn't. If majority of people around you think you are being egoistic for trying to live, despite the burden you are putting on others, you aren't given much real choice anymore. Look up how big influence can peer pressure and brain washing have on people.
> I want to be able to choose when and how to die on my terms, legally.
It's also egoistic supporting a law because of some personal wants, despite significant bad side effects it can bring.
IMO, upsides a legal suicide law brings are much lower than downsides. And even without legal suicide, person that commits suicide won't get a legal punishment. So, you still have a choice.
Perhaps rather than inadvertently sending a message, it acknowledges the reality that some life isn’t worth living.
I’ve seen the agony it puts on family members when someone makes the (in their mind) rash decision to kill themself. We should work to prevent these rash decision type suicides, but many are carefully and methodically considered and if someone genuinely wishes to exit this place, why should society prevent them from having a chance to communicate that openly, to choose the time, and not leave a giant mess of brain matter that someone else has to clean up?
We allow our dogs to have a better end of life experience (and I’m not suggesting that we’d make the decision in humans quite as early as we do for our beloved pets, though if we could communicate verbally with them, perhaps we should).
> Perhaps rather than inadvertently sending a message, it acknowledges the reality that some life isn’t worth living.
Or perhaps we are jumping to conclusions. Without knowing what is the purpose of life (if there is such a thing), we cannot objectively know what life is or isn't worth living. We just have opinions that we try to rationalize one way or another.
We have to realize that we cannot build an ideal law without unwanted side effects. Best we can do is choose a system with less adverse side effects. A system where it is a bit harder to commit suicide (but not impossible) has IMO less adverse negative side effects that a system where it is easy to commit suicide, but also possible to manipulate and brainwash people into thinking their life isn't worth living.
Yes, sometimes suffering of a person is prolonged a bit and sometimes there is a bit more mess to clean. But there is also some small upside. We can observe, collect data and learn more about these diseases, ageing, depression etc., and maybe that helps us to faster discover new improvements that benefit future generations.
Also, compare living in pain for relatively short amount of time (as terminally ill don't live very long on average) with euthanasia abuse cases. Which is worse, unwarranted killing of a person or suffering of a person?
Absent an objective standard (which I agree we'll never have), it seems to me that whether life is worth living should be primarily decided by the liver of that life.
I'm not sure if the unwarranted killing of a person is worse than permitting their torture for months or years on end. I also don't know if that answer changes if for every 1 person who would be killed in an undesirable way that we had to torture 1000 people for an average of 6 months to avoid it.
That's the essence of this debate and it will never find an objective answer that will satisfy all, which is why I default to allowing people to choose, even if some will choose in a way that I would not. (After watching two of our beloved elderly family members struggle for many years and watching another two struggle for weeks in one case and months in the other, our family has expressed our thoughts to each other. We're not universally in agreement, but I'll support each of them in their choices.)
I'm sorry for your loss. It is hard to watch beloved person struggle and not be able to help.
We had multiple loses in the past few years. One was a longer struggle. However, it wasn't torture the whole time. I admit, some days were pretty bad, but there were also good days. And there were also joyful new experiences, like meeting newly born family members. Thing is that while quality of life may look terrible from healthy persons perspective, body adapts to that state and combined together with moderen pain medication person is not in constant physical pain. Point being that it's usually not constant physical torture for years until person dies.
Another issue is psychological pain. This is where we can make a difference. Allowing people to not be perfect or the best, but still be equally worthy can do wonders.
> whether life is worth living should be primarily decided by the liver of that life
I find it that people can have quite significant change of heart. And it is not rare at all to have one.
Your uncle and aunt are right, it is not for any person to cut their own life short by destroying themselves. It sends out an anti-social message that some amount of suffering or darkness we experience does cause us to consciously choose to annihilate ourselves. It's one thing for an individual to do that and send out this message, but by codifying the act into law, it implicitly further tilts us in the direction that so much suffering should cause us to consciously choose to destroy ourselves.
In aggregate, as a society, we've come to emphasize harm-reduction and a sense of fairness to the point of idolatry. They are valuable in their own right, but alone they will see us cascade into sheer darkness. The values for the sanctity and purity of life, the acceptance of authority outside ourselves, and even the difficult question of ingroup integrity will need to come back into balance.
In a way. Where freedom is made fundamental instead of deriving from an even higher fundamental principle it creates a power vacuum, and encourages those who fundamentally value something else to destroy it. Kind of like how we went from almost unilaterally valuing the sanctity of life a generation or two ago (as per the parent comment's aunt and uncle, rest in peace), to here and now, publically discussing the moralilty of destroying yourself.
Regardless, he doesn't matter. An omnipotent being is fully capable of coming to assert his authority anytime he wants. In the absence of that, there's no reason to consider his opinion when constructing laws for actual people to live under.
If it exists and has opinions on assisted suicide, the onus is on it to manifest its will (and prove its existence while it's at it.) In the mean time let's legislate without considering religion.
Well, he can always lodge a complaint with the Spanish government, if he likes. However, "a third party doesn't approve of this, maybe, but can't be bothered to object for themselves" would not generally be taken seriously as an objection to _anything_. Spain's a secular democracy and is under no obligation to defer to what some people think a putative deity thinks.
As popularly depicted, he probably wouldn't be too excited about gay marriage, either, or, if you take Leviticus seriously, mixed fabrics. Should Spain ban those, too?
This is a serious issue which should be carefully considered, but I'm not sure that the religious argument (certainly this rather simplistic case of "some entity might disapprove") should really have any standing.
Ok then, following that same logic I have some assertions.
1000 gods exist, they really do, they told me, you can trust me. For every position your god takes, my 1000 gods take the exact opposite position.
Any rational person would think, "You can't just assert that, you have made an extraordinary claim! The burden of proof is on you to show that your extraordinary claim of personally knowing 1000 gods exists has some basis in reality."
Know that that same logic applies to you and is why you are getting blasted with downvotes.
I have a slight logical argument that is a bit like death penalty. Justice shouldn't kill because you never know 100% what is true, and death is final. I think going through diseases is similar.. you stay until it's over, you don't decide because you could be wrong and a year later something could have come and changed your existence.
I empathize with anybody who has debilitating / terminal illnesses or is taking care of people with that.
"but they believed it wasn't up to them to end it."
And that doesn't change with that laws.
But what about the people who believe the opposite. Without such laws they have to suffer because others decided they have to.
> The thinking is that it's too important to be something we should decide individually (and that it should be for nature, or God, to decide).
It's too important for us to decide, does that logic apply in the other direction as well. Many diseases and conditions would kill people rather swiftly if not for medical intervention. Medical intervention that prolongs life seems to be making a decision that the natural or supernatural ordination of when someone should die can be changed.
First question then, do you think that medical intervention that prolongs life is acceptable?
If your answer is yes, then the idea that the end of a life is too important for individuals to make falls away. Sure one act moves the time of death earlier and one moves it later, but both acts move the time of death.
This means that the argument becomes different, that life is so important that death can only ever be moved further into the future, never closer to the present.
> There's also the aspect that suffering sometimes just happens, and we don't usually get to decide when and how it's going to happen to us.
I don't really understand this argument, suffering happens and people should not have any agency to end that suffering. By that logic I could come to your house and endlessly torture you and any attempt you made to stop me or free yourself, I could just say, "suffering sometime just happens, and we don't usually get to decide when and how it's going to happen to us."
Would that make the torture justified? Would it make you trying to end the torture somehow in the wrong? If instead of that torture taking place at your house, it takes place in a hospital and instead of me wearing a ski-mask I wear a doctor's coat, does that somehow change the situation?
I'm glad your Aunt and Uncle were able to pass with loving family and friends and die in a manner guided by their beliefs.
How do you possibly justify denying that to others? Forcing them to live out the end of their lives following your beliefs and not theirs. Forcing them to die on your terms and not their own.
What is your argument for deciding this for other people?
It's one thing to decide I want to suffer immensely to fulfill my own concept of "honour" but quite clearly it is something else to insist that everyone else does also.
People choose to end their own lives in opposition to unavoidable suffering, so the real question is are we going to make this harder or easier for them.
> it's too important to be something we should decide individually
I've been struggling with thoughts of suicide since I was ~10 yro. The reason why I haven't done it (yet) is that I keep telling myself to take 1 day at the time - if I still want to off myself there is always more time for it tomorrow. But not a chance that I let society/religion/psychologists/science (those who consider themselves "sane" and above those of us who are like this) dictate (or guilt) me into changing my mind. It will need to be a terrible accident or a sudden sickness that actually prevents me from ending it on my terms, which brings me to the second point.
Control. It is my life, my terms. Not my parents, or relatives, nor my children's, or friends, and definitely not the state/law. _I_ decide when I go and how.
> so I believe it is okay to put your dog down
it's the kind of people that make me hate humanity more. It might be a flippant comment that was carefully chosen to trigger those who have been let down by people, and who prefer to find true friendship in a dog/pet. But trust me if we were to go hiking and I would have the option saving my severely injured dog (who might not make it) or a stranger who I know nothing of, except that they don't like dogs: I would 12/10 save the dog.
Humans are not special no matter how much art they create or books they write, in the end we're a parasitic life form that thinks it's superior (the sheer fucking arrogance in that alone). I would never kill another human but when it comes to animal cruelty or perhaps violence against my family (that includes my dogs) I would probably enjoy the act if I were inclined to do so.
edit: there is a saying "those who live by the sword shall die by the sword", which to my ears always seems to be uttered by the biggest fools I know (who know nothing about death or fighting or living). The real wisdom in this phrase is not that it contains a warning but that it is a promise that you "go out with dignity". Not withering away on life support, shitting into adult diapers, in an old-peoples home where family only has time to squeeze you in every 1st Sunday of the month between 14:00-15:00. No thanks I'll rather take the knife, the cliff, the needle or the rope - all of which are more dignified ways to go. And besides if I have lived all my life by not killing other people for their cruelty to those with less power than them (even I had more), at least I should be able to off myself without getting judged by these entitled and arrogant pricks?
Having recently witnessed my grandfather's slow decay into ultimately death from up close (living next door), I can say with conviction that there's no "honour" in "fighting to the end". He went from having developed trouble walking to laying stiffly in bed blankly staring ahead in just a month and one ER trip + hospital stay.
He then stayed in bed for just under two years only occasionally moaning or grunting quietly gradually losing the last bit of his muscle mass with the only exceptions being:
- getting sponge-bathed by a visiting nurse, my uncle or my father,
- getting put on the toilet chair to pee/take a dump if it didn't already wind up in his diapers while laying in the bed,
- getting wheelchaired over to the table in the next room to get fed some pureed mush that was (almost always) the same as the lunch/dinner my Grandmother was having,
- etc. one can get the idea
> Both also had huge support from loving family and friends, the way it should be.
Having the support from the family involved basically putting their lives on hold for ~2 years.
They always had to be there every single day to take care of one thing or another and watching my grandma take that for granted was frankly disgusting to witness.
I was roped into plenty of tasks as well but thankfully one of the things I could avoid was having to wipe my grandpa's ass or bathing him.
When my grandpa finally died in his sleep one night I wasn't really sad.
I was more relieved that he wouldn't have to suffer anymore - my mother and I sometimes wondered if even in his mental state (severe dementia, basically a drooling vegetable) his occasional refusal to open his mouth during feeding was the only little bit control he could exercise, even though he was then just force-fed instead by prying his mouth open enough to get the spoon in.
And the thing is, my grandfather was a VERY prideful man with strict principles during his conscious life. Going by what I remember from that time, he would've despised being in that position.
TL;DR: romanticizing long drawn-out physical and mental decay as some sort of "valiant fight" is just wrong and taking "huge support from family and friends" for granted during such death-spirals is frankly a disgusting attitude.
Of course one can decide whether they should suffer or not. That's why there's a movement to legalize drugs for terminally ill patients. Your belief that people should suffer till the end of their days is actually quite disgusting.
Also, just because someone takes their own life doesn't mean they lack honor. In fact, Japanese samurais has a ritual of committing suicide known as seppuku which is viewed as a very honorable thing to do in their culture.
It's not about nature deciding, is it? Or are you against vaccines, heart bypass surgery, doctor-assisted births and in vitro fertilisation, too?
> and we don't usually get to decide when and how it's going to happen to us.
Whether or not we usually get to decide doesn't matter. What matters is whether we get to decide.
Would you politically strive to keep it illegal? If so, do you not consider that an illiberal stance, since you'd effectively be robbing people of their right to self-determination? I mean, if you're against it, the solution is simple: don't request assisted suicide - just as one might not cross-dress, smoke weed, vote or marry someone belonging to the same sex.
I might be stating the obvious, but want to point out the inherent assumption in your argument that your moral and emotively driven opinions should be enforced against another human being.
If you want to optimize for honor in a valiant fight to the end, so be it. But who are you to enforce your morals on someone else, who is making the most personal decision one can ever make for themself?
> Given those requirements and safeguards, I'm having a difficult time understanding a rational argument against this law.
Sometimes the inclined plane has a low coefficient of friction:
> Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the [Supreme Court of Canada] said, it can’t happen here.
> This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.
> Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.”
I have a small amount of experience with a similar process that exists in another country. It's easy enough to reason about the people in the last stages of cancer, but there are many other situations that are conceptually much murkier.
The first thing we need to make clear is that "severe, incurable, and unbearable" does not necessarily mean terminal or even physical pain. Plenty of psychiatric conditions often accompanying significant trauma are severe, incurable, and unbearable. But they're not terminal (except by suicide), and the reason they're incurable is because we know fuck all about psychic damage, and some might argue that if you've made it this far without killing yourself then it's de-facto bearable. And yet they definitely qualify unless the law specifically says that they don't, because "deemed unbearable by the patient" is not the same as definitively unbearable.
The biggest flaw I see in the model is if there's no significant determination of qualifications for whether a particular doctor should be allowed to approve the request (e.g. some might demand that the doctors be trained in appropriate specialties and have detailed knowledge of your history and situation), or whether you can ask 100 doctors who say no until you find 2 who say yes. I've seen firsthand that systems which don't mandate strict selection criteria create additional strife.
I think that fundamentally one has to decide whether a person gets to just say "I want to die" one day and forget that there are doctors involved. Because believe me there are many scenarios that basically feel that way to friends and family. Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
[edit: sorry for using british slang, drive-by commenter. "fuck all" does indeed mean "nothing"]
> The biggest flaw I see in the model is if there's no significant determination of qualifications for whether a particular doctor should be allowed to approve the request
Living in a country where I have the right to die, there's a formal framework that details the process that a patient goes through.
By handing healthcare professionals a framework, it allows them to build hands-on experience and develop best practices in how to actually have an on-going, involved and empathic disucssion with patients and their surroundings.
The big flaw in this "model" isn't the qualifications of doctors, it's pulling a moral and emotional conundrum into a set of abstract assertions and reducing the debate to the medical act itself: a doctor euthanizing a patient.
> Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
The right to die, paradoxically, keeps patients from committing suicide. The knowledge that you have that right acts as a 'safety net' to open up towards healthcare professionals. Your wish to die is not a taboo, it's not an elephant that nobody wants to discuss. Any openings towards reflection on trauma isn't burdened by the imperative "you can't die, you must live" from the get-go. Taking that away, paradoxically, creates space to reach out and connect.
The answer your question, in that regard, isn't "either or". It's both.
The right to die can only be implemented in a meaningful fashion if healthcare and social infrastructure provides enough facilities to properly help, guide and reach out to individuals.
That's why it's paramount to invest in mental healthcare, hospice care, palliative care, local physicians, nurses, social workers, schooling, education and so on and see all of that as a commons embedded in communities.
Even so, the right to die isn't a silver bullet. Neither is healthcare a silver bullet. They don't provide or offer wholesale answers or solutions to social, medical, ethical issues on an individual or societal level. It's fallacious to look at these issues and discuss them in moral absolutes, those are tarpits and they leave no room for moving forward.
At the end of the day, death is an intrinsic part of life. However, the vast majority of people will feel uncomfortable discussing their own end of life. It's only when they are personally confronted with the finality of life that they will start to reflect. Personally, I think that a meaningful discussion about the right to die can only begin once you've recognized that your own life and your own health aren't self-evident.
Is not only 'I want to die', is 'I want you to kill me' (and deal with it, and deal also with my sons or family if they don't want the same as me), that is a different case and involves more that "me, me, me".
The law allow conscientious objection in doctors (for now), but also will justify death angels manipulating vulnerable people. We shouldn't forget that unbearable pain can be easily created with the appropriate medicines. People can be drugged and turn into addict puppets also. Has happened before. Even recently in US.
And that will taint the statistics also, removing a safety guarantee for everybody. Before the law, a warn was triggered when more than average people died in part of an hospital. After that, the hospital with an interest in lowering this value has a way to do it (falsifying consent). Protecting their public image, but also hiding any rotten apple present in their staff. Bad news for everybody.
If there is something that vulnerable elder don't need now is a new exception to kill them legally.
By that reasoning, then gun ownership should be completely banned anywhere, to prevent self defense justifications in what are now legal scenarios. Surely, you'd support such a law change as well?
> By that reasoning, then gun ownership should be completely banned anywhere, to prevent self defense justifications in what are now legal scenarios. Surely, you'd support such a law change as well?
You're not starting from the belief that nobody supports banning gun ownership are you? Because many people do. I'm not sure where this is going.
Oh, but we already do this - just with a small subset of patients... and pets. Vets have to kill pets quite often.
As far as patients are concerned: We have life support, and we withhold life support once we conclude that there is little to no chance of recovery. Assisted suicide allows this sort of thing sooner, for folks that are suffering.
Those death angels you speak of aren't angels. These are murderers. You are afraid folks are going to murder others. This already happens, and we already have laws against this. We can very quickly produce statistics on what sorts of people seek out assisted death: We can look to other places.
Ironic part is the same group that says "life is sacred" are also more likely to be pro-capital punishment. Saying things like no one should have the say to take another's life including themselves but it's OK when it's a collective decision.
There is nothing ironic here: capital punishment is supposed to protect life of those who are potential future victims of a crime. It also lifts imbalance between the criminal and the victim. In a country without capital punishment criminals know that their live is protected, while victim does not have such guarantee - even if criminals torture, rape and kill a victim they know that in the worst case they will spend live in prison.
Capital punishment is driven by vengeance. If we are talking about protecting potential future victims, it does absolutely nothing that life in prison doesn't do.
I sincerely doubt that in the moments before committing a crime that could lead to life imprisonment or the death penalty, many perpetrators say to themselves "well I'm going to go ahead and do it because while I might end up in prison for the rest of my life, I won't have to worry about the death penalty." In many, many places, the death penalty would be the easier way out.
I thought it was like a pandoras box of slippery slope histories once these things come into being and are accepted. They morph into other cases that don't match the clean and tidy first introduction/nice-first-impression cases but devolve into euthanasia and it's in your best interest to die sort of stuff. Have we seen expansions in euthanasia in countries that wound up adopting it where these initial provisions basically are eroded and replaced with more generous expansive allowances? I thought I read so much at some point somewhere, like Belgium allowing children to be able to request assisted suicide and things like that. Maybe I'm totally off here though.
Let me give some examples from Belgium, to show what sort of difficult scenarios emerge once countries start moving along this slippery slope.
As the parent comment says, the law applies to children, and has even applied to a nine year old.[0] I don't think anyone believes that a child that young can meaningfully consent to a decision as significant as ending their own life, so obviously in practice the decision will be made by the parents, who will be influenced by the difficulty of potentially having to support a disabled child, financially and emotionally.
Then there are questions of the judgement of medical professionals. A research paper found that "Almost nine out of ten [medical professionals] (89.1%) agreed that in the event of a serious (non‐lethal) neonatal condition, administering drugs with the explicit intention to end neonatal life was acceptable."[1] This suggests that doctors would approve the killing of newborns even without a terminal illness.
Beyond the issue of the law applying to children, there are several controversial cases involving adults without terminal illnesses. For example, a man serving a life sentence was allowed to end his life due to his feeling of "anguish"[2], despite the country not allowing the death penalty for criminals.
Another adult was given euthanasia due to their opinion about themselves after a sex change operation[3] (which was presumably also approved by medical professionals).
Finally, a man requested euthanasia (which has been initially accepted) as a result of his dissatisfaction with his sexuality.[4]
> This suggests that doctors would approve the killing of newborns even without a terminal illness.
Saying doctors would be OK with post-viability abortions in the case of a major (though still viable) birth defect does not at all "suggest" to me that they would be OK with the killing of newborns.
To be clear, we're not talking about "post-viability abortions" here. The quote said "a serious (non‐lethal) neonatal condition, administering drugs with the explicit intention to end neonatal life", specifically referring to post-birth / newborn babies.
You can also really easily convince some people to drink way more alcohol than their body is capable of processing thus killing them of alcohol poisoning.
Like, really easily. Happens a lot completely by accident. Maybe I'm a bit more exposed living in a college town.
Old people, or people in immense pain, may not be in full control of their faculties, even if they are not certified so.
My wife’s grandfather had dementia, and my wife’s uncle who was technically their carer, sucked them dry of all their money then blocked medical care coming to them. The grandparents wereegally independent. If he could coerce out an assisted suicide, it would have all happened much more quickly.
This is second hand info, not enough for the police to bother (they were notified) but knowing the characters involved and enough facts, completely believable.
It’s maybe not a show-stopper anec-argument but definitely something to bear in mind.
I’m of the believe that people who are against assisted suicide have never had to provide end of life care to a person who died a painful death, riddled with disease and indescribable pain on the way out.
Seeing the final days of my grandfathers life, who died of colon cancer, being robbed of his dignity and condemned to suffering for an agonising six months made me a staunch advocate of assisted suicide.
(someone else answering) my reason for opposing it is that it creates opportunity for abuse, for example like pushing older relatives toward that decission because someone doesn't want to care for them.
So you can think of all the people suffering an inescapable and slow death and you want to force them to have to go through that because you are worried about a case of neglected older people who will get one more of many ways to commit suicide. Do you think those older people aren't talked into other stuff as we speak?
no, i am just afraid that this is going to be the common use case. Or that some other opportunity for abuse will be found, it's a very slippery road...
In a weird perverted way, I can see someone preferring assisted suicide over the alternative of being cared for by somebody who'd push you into assisted suicide because they don't want to care for you.
Now reverse it, would you want to force someone you care about to waste their life caring for you without any quality of life?
One gives you a choice, the other one doesn't. If you want to prevent abuse, make it difficult in the law. Restrict it to advanced directives, require a psychological assessment, etc.
The scenario you're describing is the easy one — if I have people who love me enough that they're willing to care for me, I wouldn't feel forced into making this decision and there's no risk of abuse. If anything, I might feel pressured to stick around to avoid hurting them.
GP's argument is trickier: Callous family members might want to force me into accepting assisted suicide against my will, because they don't want to care for me. My point was precisely that, in that position, I wouldn't want to be cared for by those callous relatives, and might choose assisted suicide of my own accord anyway.
Sounds like reasoning out of emotion instead of data. I'd have these fears if countries that already have assisted suicide report that most cases are healthy elderly people deciding to not live anymore.
What all the data says is that most of assisted suicide cases are people suffering from horrible incurable diseases.
Some time ago I looked for these data but was not able to find a «sound» source, apart from organizations promoting/fighting euthanasia. Do you have links to some objective sources? I would love to have a look at them.
Google Scholar has a bunch of papers, from Oregon to Netherlands and papers analyze individual cases, categorize illness, history of suicide attempts etc.
Here is a source, but it's not aggregated: https://www.euthanasiecommissie.nl/uitspraken-en-uitleg . The first page is just a list of primary aspects, they all lead to the same document search page but with a different search base. As far as I can see, there is no single just-list-all-reports page.
All Dutch euthanasia procedures are documented publicly. The documents include patient's condition, circumstances surrounding the request, assessments from multiple physicians, and the commission's judgement. They do not include the identity of the patient, for obvious reasons.
When something starts, the worst possible abuse isn't immediate.
It will take time for this abuse to pop up. But knowing how humans are, it will happen.
I don't think this is the reason to oppose it though. Life is important and protecting it from ending is the main function of the state. There are many many sad stories of people who cannot have assisted suicide and suffer. But there's a whole other kind of suffering that a society goes through when people just kill themselves whenever they wish to with the full blessing of everyone around them.
This is the same fallacious reasoning people use to advocate many laws, drug prohibition a popular one. For instance people will say if drugs are legal then it opens the door to people being intoxicated while driving or harming someone else in x other way. But of course these are already illegal in of their own.
What you’re looking for here is protections of the elderly against abuse via coercion to act counter to their best wishes. This is a separate concern that needs to have laws and parameters around it.
Virtually anything can be “an opportunity for abuse.” Look at the internet. That’s not a good reason at all to prevent it, it’s a reason to outlaw and protect against the abuse.
i don't think that the drug thing applies here; protecting the live of its citiziens is the most basic function of a state; if there are loopholes here then these loopholes will be exploited. I am afraid it's not the same situation so that your argument doesn't apply.
I am not arguing from a position of principle, my argument is one of computer security; if you got a zero day exploit then that's an invitation for taking advantage of it? Now if you can legally get rid of someone, then that's something similar to a zero day exploit with regards to the principle of having to protect the lives of the states subjects (who are paying taxes exactly for the purpose of upholding this principle).
Should the state’s citizens (or subjects as you call them) be allowed to run a different OS than the one which the state determines is “the absolutely most secure and therefore state-sanctioned”?
It’s exactly the same situation by the criteria you just gave. Intoxicated driving is illegal because it puts the lives of others at risk.
If you don’t find that particular analogy salient surely you can think of others. How about just driving itself in cars that can go faster than the speed limit? The point is there are a multitude of things that provide benefit and also the opportunity for abuse, but rarely, virtually never, does this justify forgoing the benefit.
no, if I get drunk than that's my decission (with all due respect); If someone else wants to end my live, and is able to apply all sort of trickeries to argue that this is in conformance with the law, then that's a different thing.
That’s already the case with say pollution. People constantly argue about how many people they can kill while it’s still legal. Assisted suicide is hardly a special case.
Yet, we don’t shut down every coal power plant because it’s useful just as we don’t ban cars etc. The benefits of
assisted suicide are similarly significant and therefore worth it.
How about from a different angle, without this law if someone wants to keep me alive at all costs against my will and force me to live in agony they an "apply all sorts of trickeries" to do so. For me, extreme prolonged agony is a fate worse than death. Death does not scare me, profound suffering does.
Again, the law you're after here is preventing elder abuse. This is indeed something we should pay great attention to and try as best we can to carry out the wishes of the elderly. This abuse is no uncommon, even if it's comparatively benign by changing estate inheritance at the end of life for instance.
It really has nothing to do with assisted suicide.
The law that has been passed requires that the person who is going to die gives consent twice, with a 15 days difference, and that a medical comission approves the decision. It has nothing to do with someone else deciding for you.
But some countries already have this and there's no evidence of this happening. It's the same thing time and time again, for example, gay marriage, abortion, etc. etc. For some reason we are unable to see outside of our countries where it's successfully implemented, but we'd sure as hell take notice if there was the smallest issue.
The fact is for me, I'd rather that it's available and legal for those that want it even if the sad reality is, someone, someday will abuse this.
Several reasons best not discussed here, as evidenced by the other thread. :) I just don’t agree that experience with pain leads to a singular political response and offered myself as a data point, since the GP had no experience with varied political opinions in this area.
> I’m of the believe that people who are against assisted suicide have never had to provide end of life care to a person who died a painful death, riddled with disease and indescribable pain on the way out.
Then your belief is wrong, and your claim utterly insulting and presumptuous. Having been in that situation, I will flatly reject the idea that somehow suffering robs a person of dignity. If anything, euthanasia is a perfidious assault on the dignity of a human being. The problem is with us and our attitude toward human beings and their suffering. We should do some soul-searching and take a good hard look at what really motivates us to think this way. We might be horrified at what we discover, as we should, and this horror might wake us from our moral slumber.
Be glad you didn't have the opportunity to be complicit in your grandfather's suicide and in his murder.
It's strange to me that people try to fight against legalizing assisted suicide. If there's one thing a person should have the right to do, it's to decide whether they want to continue their life or not.
A person who committed suicide was punished at common law by burial in the public highway with a stake driven through his body and by forfeiture of his goods and chattels to the king.
Quick reminder that religious people are completely on board with God letting children be born with incurable illnesses, suffer terribly for a few months, and die, instead of being born healthy; and that they will go to extreme mental contortions to justify such monstrous immorality.
So it's unsurprising that they also think that everyone should suffer as much as possible before dying.
Somehow the idea that someone can be perfectly sane and not want to live as long as possible is inconceivable to people.
They should really get over it. Just like those with different gender preferences they won't ever understand they will have to just take people's word that it's sincere and they're doing it of sound mind.
The rationalizations I hear people use are really hollow to me, like someone claiming a gay man just hasn't met the right woman yet. It's fundamentally different.
All of my friends who have taken their own lives struggled with it for years. I wish they weren't gone but I have to respect if after all therapy and help options were exhausted, they still were committed, then so be it. I wish they were here right now, of course I do. It fucking sucks.
It's personally traumatizing but as my final act of friendship I was there to support them in their decisions.
I had to sign off the release forms for my friend's ashes 6 years ago and drive up to santa barbara to give them to his mother. I remember sitting there in silence at her kitchen table with her when she said "we all knew it was the right thing."
This is something I was thinking about just reading this headline.
In a hypotetical future, it is possible assisted suicide rates will be down just before elections and up after elections because a group of people have already decided on the suicide, and are delaying the procedure to be able to vote.
I'm not dead yet, but definitely plan on voluntarily dying before my cancer gets a chance to kill me and I voted this week for a political party that is explicitly pro end-of-life choice.
I can not speak of you or your friends situations, but I disagree with your generalization:
>Somehow the idea that someone can be perfectly sane and not want to live as long as possible is inconceivable to people.
There are many people who have considered suicide, chosen not to follow through (or failed), and then realized that they were in an emotional state of mind. Suicide is a generally pathological phenomenon - horrible things will happen if we don't accept this as the null hypotheses in specific cases.
No one has a say in whether they want life in the first place. It seems perfectly imaginable that some may be unhappy with having it forced onto them, but endure it because the alternative is a taboo.
I disagree with your logic: the fact that there are (even possibly a majority!) of cases when not wanting to live as long as possible is the result of a pathology, it doesn't negate that there are perfectly sane people who do not want to prolongue their life. Just one such case is enough to make their statement accurate - I don't think he generalised those willing to die, but those unwilling to accept that as their choice. Based exclusively on my experience, that is a valid generalisation.
And yes, plenty of people have setup advanced directives, DnR's, and other such instructions while fully on their capacities, and that doesn't require them being in a pathological or even emotional state. It can easily be caused by having a standard of quality of life they intend to maintain.
I wasn't as clear as I'd like to have been. I agree that sane suicidal people exist. I don't believe it's surprising that people assume that suicidal people are not sane - the heuristic is accurate and helpful for those who need help.
Edit:
I feel compelled to add a qualification to what I've posted.
If anyone thinks they are rational and suicidal: I don't believe you. Self-harm is an emotional behavior. Our brains are designed to help us lie to ourselves when we're emotional. The odds that you are the one philosopher in an arbitrarily large crowd of people who's needs aren't being met is incredibly slim.
I grant no one abstract approval for ending their own life.
Ok that makes more sense. I also agree with you in that I don't believe it's surprising, but I think it's for entirely different reasons. Mine are rooted in my skepticism about the capacity for critical thinking in the general population.
So? Sorry to be so callus, but I'd wager there are many more people suffering daily in hospice and family members risking jail time to end the suffering of their relatives. I have second hand experience with this. The doctor told a relative of mine "whatever you do, don't turn this knob here, or they will die a painless silent death" and walked out of the room.
Thank you for making this point. I've never been brave enough to make this point, but often thought about it.
Even in psychiatric cases, I think it is not unreasonable to assume that having a more accepting approach to ending your life will not result in significantly more deaths and a lot less suffering.
Morality of suicide is a completely different discussion. Euthanasia (in practice) comes down to whether government-licensed doctors should get to decide whose lives are worthy of living. Some people will be approved, some won't.
The implications are pretty troubling to me personally. Someone gets diagnosed with a sketchy mental condition, which in turn causes them to contemplate death, and then the very same doctors approve their euthanasia.
If I tell anybody to kill themselves I will rightfully get criminally charged. Someone approving an euthanasia is pretty close. Sure, they may want it, but so will people who get denied, one cannot say the act of approving is completely meaningless.
I don't know much about real world cases related to sketchy mental conditions. I know cases about people terminally ill, put in palliative care, which simply cannot go on with the pains without any hope for ever getting better. These are the main (or sole, dare to say) consumers of assisted suicide, at least in Switzerland.
Euthanasia over psychiatric conditions is already a very real thing in Belgium [0] (and the Netherlands I believe). Swiss seems to be more conservative in approvals all across the board but mental isn't off the table either [1].
Sane people don't exist. Their vision is a product of the information they have been fed during their life and the cocktail of chemicals in their brains. Add some serotonin/dopamine or related substances and the whole view, the whole attitude changes immediately. MDMA-aided therapy should be made mandatory for such cases.
I don't mean you can cure a depression easily this way. But you can switch it off temporarily and let the patient experience a totally different perspective for at least some moments. In many cases this may help a lot. Many people believe what they see is always what exists and what they feel is always what the situation is. Knowing (as a result of your own experience!) you can have drastically different feelings about the same reality depending on chemicals you ingest change a lot: you know your fear, anger or apathy don't represent the objective reality (nor your self) and you don't have to act the way they push you any more.
> Somehow the idea that someone can be perfectly sane and not want to live as long as possible is inconceivable to people.
You're confusing not wanting prolong life in a state of unbearable pain because of an incurable, terminal illness, and willful, intentional suicide or homicide. There is a very big difference.
In medicine, a distinction is made between ordinary and extraordinary care. Ordinary care concerns the basic needs of the patient such as air, food, water. Extraordinary care concerns medical treatments meant to cure or otherwise treat the disease or disorder. Typically, neither a patient nor anyone else can deprive a terminally ill patient of ordinary care. However, when providing of such things constitutes an "undue burden", such as when the body is no longer able to digest food or absorb liquids and the offering of food and drink actually causes harm, the patient may refuse food. At that point, you are accepting your powerlessness in the current situation, i.e., one in which the patient is in a state from which he cannot recover and for whom death is imminent.
Even treatments that may extend the life of the patient can be licitly refused by the patient if it would, again, pose an undue burden (for example, a weak, terminally ill patient may refuse CPR if his condition is such that the procedure, which is physically traumatic, while potentially able to extend the life of the patient by some small amount of time, would leave the patient in a state of great suffering during their last few hours).
So extension of life at any cost is not the goal of most people who oppose euthanasia. Natural law theory is perhaps the most vehemently opposed to euthanasia and will serve as an excellent resource for considering these kinds of questions.
I would caution you against making appeals to subjective feelings in a vacuum, which your examples attempt to do. This is dangerous because we are capable of feeling all sorts of things and being confused about all sorts of things. The crude subjectivism of our times puts excess emphasis on such things without understanding them in an objective context (which itself may be misunderstood or crudely understood).
I have a rather metabolic disorder which will likely end in it being ... quite bad. An acquaintance opened up to me and revealed that a great deal of his watchfulness around me (I could not help but notice) stemmed from the fact that his mother died of what I have when he was just a teen. According to him, she spent the last decade of her life in the furthest room of the house, intermittently screaming and/or begging for death, so I can understand some of the lack of ease he exhibits: he's waiting for the other shoe to drop.
While I'm aware of the various slippery slopes (and who might be greasing the plane), I can't help but think that a few people could have been spared quite a bit of suffering had euthanasia been available.
It was immoral of this acquaintance to tell you such a graphic story if he knew about your condition. If he was truly compassionate he would have kept it to himself or formulated it more tactfully instead of putting this into your mind. Maybe he was abusive towards you.
Hardly. I have been aware of how the condition turns out almost from the beginning. You see, one of the hallmarks of it is extreme abdominal pain, which easily eclipsed my broken bones or other items like having a gallbladder infection due to stones. I am told childbirth and having an appendix rupture also aren't as high up on the scale, although neither have happened to me. After a few of those episodes sans painkillers (and of course feeling like death would be preferable to continuation of that state) I went hunting for information since doctors are typically uninterested in pursuing the concerns of teens. Once I matched everything up, the medical literature was not shy about what the endgame looks like; after confirmation with some unlikely tests, I was largely on my own to deal with this, which meant more literature dives and even more unattractive stories.
So when he relayed this story, my internal reaction was more of a nod, "yes, that's how it tended to go back then," a bit like hearing old stories of the agonizing, inevitable deaths of those who contracted rabies, because by then it was just another data point in a straight line. That's not immoral at all.
Immoral, to me, is hiding this sort of thing from the people to whom it will happen, because if you do not know, you cannot plan around it. Being uninformed removes agency, and that's what we're discussing here -- do we allow other humans legal agency over their deaths, since they haven't any over their births?
If it was not obvious: I am deeply sorry that you have to deal with a severe condition. I am just a random internet stranger, but hope for you that treatments that will alleviate it can be found soon. Staying on top of the literature will help you.
It is a sensitive personal decision whether you want to know what may happen to you in detail, or not; and nobody should make this decision for someone who is affected by disclosing graphic stories. Most people would therefore be too considerate to pass on such stories, so your friend may be a bit of an „outlier“. That’s all I wanted to say.
Not knowing makes so many more decisions for me, however. Non-disclosure of the reality affects so much. Consider the range of decisions that might be made by one in a state of "blissful ignorance."
1) I consider this the largest: the decision to reproduce or not. First off, it runs the risk of burdening offspring with the exact same condition. Then there is the "can I even manage to raise offspring?" question, at least to the level of the average parent?
2) Similarly, seeking a partner to raise that offspring with. Imagine you had a spouse who had been kept unaware of the situation, and so you were unaware of the situation, and then you were rather suddenly burdened with taking care of someone through a prolonged decline. Would that have seemed fair to you, not to have known?
3) The rest of life planning is almost trivial next to the first couple of issues, but you think about retirement, how one's life is spent given the expected years, and so on.
Non-disclosure is a horrifying trap for more than just the patient. I would find someone who would not disclose to be inconsiderate, frankly, similar to in kind, though not in degree, as someone not warning you of a danger in a road you are about to drive down.
Looks like the acceptance towards this is growing. If there was a service that wouldn't inconvenience anyone to manage my burial/cremation I would check out in a heartbeat.
I have nothing against this law of course. But I'm sad this makes it to the news, and it's a huge deal, and everybody is talking about it.
We should really be making a huge deal about cancer and aging in general, and what our science can do to fix those things, and have the public know all the ins- and outs- of human physiology and cellular biology, and have parliaments around the world oil the way for better and more medical research and treatments. Take the fight to God.
It’s a complex subject, but these rulings are a direct result of our nihilist materialist pseudo-rational thinking and easily seem to get out of bounds. There unusually seem to be complex interpersonal relations involved too.
Belgium allowed a 24yo with severe depression to “decide” for assisted suicide (this seems to be frequent, I’ve heard of a similar case of a student this year), and the Netherlands wants to allow childhood euthanasia soon (it is already allowed for those over 12). Decision makers seem to believe that they are rational and ruling out religious moral opinions on these subjects, however we seem to be gravitating towards the buddhist nihilist view that life is suffering, and that our reason to live is to end suffering by vanishing.
It's not the country that decides, it's the person and a panel of doctors, and there are requirements ( severe physical or mental issues). Point in case, there's a trial for murder on doctors that signed off on euthanasia for a woman which didn't fit the requirements - https://www.reuters.com/article/us-belgium-euthanasia-idUSKB...
> the Netherlands wants to allow childhood euthanasia soon
Doctors in the Netherlands want this simply as a better alternative to palliative sedation, which is already legal in NL and many other countries in the world.
Some children are terminally ill, and they are palliatively sedated when the parents and doctors agree that this is the best thing to do. The difference between palliative sedation and euthanasia in these cases is small, in the opinion of many Dutch people and doctors. Some quotes from a report[0] from the Dutch Association for Pediatrics, to give you an idea of what kind of cases we're talking about:
> 'Well, yeah, he had a period during which he was screaming from pain: "Help me, just help me!" That was truly horrible to see, that someone is really hitting his own head while begging for help. That went on for three days. Every time I called for a nurse and they could only increase his medicine further. And at one point a nurse came and said bluntly: "yes madam, your child has a brain tumour. Of course he is in pain". Well, I thought: "okay I guess"'.
> 'He didn't want to be sedated, because he said: "then I can no longer say whether I am in pain" [...] So we postponed that, but in the end he needed so much medicine that we asked him "do you want a little sleep medicine now?", and by then he wanted it". Child, 4 years old'
You are giving examples of the complexity of this topic when it comes to individual cases, which I do acknowledge and am aware of. However you did not acknowledge / wage them against the many complex loopholes euthanasia laws are opening, which I tried to point at.
As you say, we do already have palliative care. Why not improve much further on this front instead of opening all the legal loopholes, which can easily lead to more suffering in the end (if one wants to play this “sum of suffering” thinking game)?
You are clinging to generic fictional arguments and refuse to acknowledge that every case is individual.
What's your definition of "palliative care"? Should the goal of palliative care be to maximize the vegetative lifespan of a patient? Or should the care focus on making a patient's last few hours/days a meaningful experience for all involved?
Thinking about individual cases I’ve heard of during my time in NL (one being relatively close, a young depressed student) is what has lead me to the opinion that the floodgates have indeed been opened - which is what people have been warning about.
I’m otherwise not sure how you perceive me right now, but you might be attacking your straw man.
The goal of palliative care is increasing the quality of a dying person’s life with dignity and as little pain as possible, and allow them to make the best of the time that is left to them. Instead of opening euthanasia floodgates that just lead to difficult individual situations (such as not wanting to be a burden to one’s family, a very common feeling) I do believe we need more research in this direction.
To be honest, I perceive you as a zealous idealist that refuses to acknowledge that the world isn't perfect, and instead chooses to oppose any form of legal empathy with mere handwaving about moral conundrums.
I have no interest in debating someone who thinks that "floodgates" are a convincing argument.
In the PDF I linked to parents state how they stood in the hallway of the ICU, far away from their 3 year old daughter, because they could not handle her screams any longer. The doctors had advised them to go away. They were not with her when she died.
Doctors have experienced firsthand that palliative care isn't always possible in the last phase of life. But nonetheless the commenter wants "more research in [that] direction", and talks about "increasing the quality of a dying person's life".
So yeah, whatever. I'm glad most people in my country know better.
Many people in your or your neighboring country now seem to be very surprised by cases opponents have warned about before, such as Tine Nys, or this grandma with dementia who was opposing the jab and had to be kept down by her family until her last moment. The family members likely feel confident and „rational“ about their murder because the procedure was backed by the local public discourse. (A cynic may see parallels to widow burning, which is also backed by some local clan discourse.)
With such cases in public awareness I don’t understand how the cases you translated here for us (thanks for that, btw) don’t lead you to the conclusion that there must be more research into palliative care, and instead that one should be allowed to put an end to a human life that is more suffering than living. You list graphic descriptions of situations where the first is not possible yet so the latter would
likely have to apply, and I understand that - as I said, I’m aware of the complexity. But improving palliative care with dignity should still be the primary route.
That your legal floodgates are open now may prohibit a focus on palliative care research since it seemingly has already changed your national discourse quite a bit - which is another issue opponents have warned about. The Dutch / Belgian (and perhaps Canadian) discourse on euthanasia is an outlier in the world, and being on the outlier side is not automatically a good thing. It will derail even further and weaken more boundaries, and change how people act or feel are expected to act.
Yeah, don’t worry too much about the suicidal depressed guy, just open up an easy legal route to painless suicide with a ‚rationality’ flavor for him so that he can „ ‚decide‘ to end his suffering“. And tell all his friends (half of them depressed too) that ‚this is just a rational decision for a depressed person to make’. Don’t worry too much about implications, that’s just „unrealistic perfectionism“. Just put up your very confident face.
> [...] we do already have palliative care. Why not improve much further on this front
Because it simply isn't possible in some cases. That's also what the doctors in the PDF I linked to state, but it's Dutch so I can't blame you for not reading it of course.
1. "Parents and doctors acknowledge different kinds of physical, existential and psychosocial suffering. This suffering cannot be treated fully with medicine"
2. "There are cases of severe, untreatable suffering in children for which no treatments are applicable. [...] In two cases, the decision was made to not give food and fluids to a physiologically stable child."
3. "Multiple children with metabolic, neurological and neuro-oncological disorders had difficult to treat epilepsy in the final phase of their life. Different parents describe the process of dying of their child as 'inhumane' and 'traumatising for the child'"
Rather I think the point is we’re gravitating towards the idea that not all life is worth living, and the consciousness that must (alone) experience a given life should have primacy on decision rights of its continuation.
To relinquish some of the sacredness of life endowed by evolution is not to commit wholeheartedly to nihilism.
I'm going to copy/paste what I've posted in the other discussion about it.
The left has been fighting for this over the last years. They finally managed to pass their law of death. Suicide on demand.
Al this while palliative care is not given to those who need it. Only 40% of them do receive some kind of treatment to relieve their pain. Guess what the other 60% will think about now...
A person may want to end their life for a variety of reasons, and not just because they are terminal or in excruciating pain. If a person is determined to "leave this world", for whatever reason, they are many ways to do it that no one can prevent: a gun shot, slashing their arms in the tub, gobbling medicine (not always reliable), etc.
IMO, a person who wants to leave should be allowed to have controlled death without a mess or violence. I agree that counseling should be required, like maybe 2 sessions, but don't agree that anyone should have the power to deny assistance to die. It's my choice to leave or stay; all we are debating is whether I have to do something messy or can have a goodbye meeting with my family and have a peaceful death.
My mom had pneumonia when she was 74. She had been very sick with rheumatoid arthritis for 30 years - bedridden in some of them, on crazy amounts of drugs for all of them, and for the last few years of her life, could only barely walk bent over a walker because of a failed hip replacement. Her body was shot, so when she went to the hospital for the pneumonia, she refused to let them treat her. If she took the oxygen mask off, she turned blue. The doctor wanted to send her home with an oxygen tank to lug around, but she could hardly walk as it was, so that was completely impractical. I guess she convinced the doctors she did want to leave, because they had a conference with us, said she was going to die, and allowed us to hasten it with morphine and Adavan. The shitty thing is, we (mainly me) had to go to the nurses station every 45 minutes to tell them she was "not comfortable" and get a morphine injection, and every hour do the same thing for Adavan. This went on for 9 hours, and it was only that short because they had her on 2 oxygen deliveries and I had to convince them that we couldn't keep doing this for 3-4 days. No one had eaten all day, my sisters are in the room crying their eyes out, and my mom had been unconscious for many hours. We knew what the end game was, but getting there was much more difficult that it needed to be. They could have easily put her on a drip for those 2 drugs to avoid adding to our suffering by forcing us to request drugs on some crazy schedule we had to track while our mother is dying. I am grateful they at least did it, but it was unnecessarily hard on us.
There are also cases where a person should be able to write a document, like a living will, that says "Under these circumstances, I want to be euthanized: haven't been able to communicate for N days" etc. There may be cirumstances, like an accident, where a person is not able to go to counseling or is not able to confirm their wishes verbally. That doesn't mean they've changed their mind. If a document is written when the person is sane (maybe someone needs to notarized that), there is no reason to not honor their wishes at the appropriate time.
We treat animals better than we treat people when it comes to end-of-life decisions, and that's a damn shame.
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[ 3.9 ms ] story [ 194 ms ] threadConservative parties and catholic church feed back each other.
It's one thing to have an option to donate your kidney to save someone's life, it's another when selling your kidney will become the only way most people can afford mortgage.
To be honest, for many millennials selling their organs and/or body products in supplement to a full time job may already be necessary to get a mortgage where they'd be willing to live before they're so old they couldn't expect to pay it off.
Indeed, there isn't.
In all seriousness, surrogate pregnancy is (thankfully) illegal in Spain.
Suicide is a permanent action for sometimes temporary circumstances. Plenty of folks who attempted suicide—because they saw no way out of their current situation—and failed are glad they ended up failing.
* https://ipolitics.ca/2021/03/17/assisted-dying-legislation-a...
The counterpoint is also true though: there are people who live long and persistently miserable lives. To me that is even worse than a premature death (I'd much rather be dead than permanently miserable).
Without guns, all other methods I know of are painful and non-instant: hanging, drug overdose, cutting veins, suffocation, what else?
It’s just sad that terminally ill people have to use a method that will put stigma and shame on how their live ended, doing it in secret and with mess. Instead of a legal and graceful procedure, going away surrounded by family.
Suffocation with inert gas (e.g. N_2) using mask with exhalation valve is safe, painless and leads to very fast loss of consciousness. Distress associated with suffocation is not caused by missing oxygen, but by excess CO_2, so it does not happen if a person can exhale freely. It sometimes happen in industrial accidents, people lose consciousness without noticing anything.
That way you can do organ removal at the same time.
At Dignitas they have the person drink a cup of barbituates. There are a few videos of this entire process on YouTube if you're curious enough to watch such a thing. It appears to be generally painless.
> an oral dose of an antiemetic drug, followed approximately half an hour later by a lethal overdose of 15 grams of powdered pentobarbital dissolved in a glass of water
> A request is to be submitted twice in writing, 15 days apart. It must be approved by two separate doctors and an evaluation body, according to AFP news agency.
Given those requirements and safeguards, I'm having a difficult time understanding a rational argument against this law.
A friend watched his Dad suffer immeasurable pain for 6 months from bone cancer, and the final 2 weeks were inhuman. He was begging the hospital staff, but they couldn't. Three months after his Dad died, my friend committed suicide.
NOT allowing assisted suicide for terminally ill people is cruel and THAT should be the crime.
But, overall, it at least seems pretty good. I have always been incensed that if I were terminally ill in most US states, the law would treat me worse than my dog. Laws like this are a huge step in the right direction, IMO.
Edit: I’d be fully satisfied when the law allows me to specify when I want my own suffering ended via advance directive. It really shouldn’t be the burden of a terminally ill person to have to make those decisions at the end of their life.
My uncle recently died of Parkinson's and my aunt soon after of cancer. Both suffered immensely (especially my uncle), but they believed it wasn't up to them to end it. Both also had huge support from loving family and friends, the way it should be. I know it's easy to say here at a distance, but there's honour in a valiant fight to the end.
Mixing God in the arguments as you do, and the main reason in Spain this law was delayed, is taking freedom away from people who think different.
Note that religious believers don't "mix" God in their arguments, they're just speaking from their perspective. They believe that God is just there, that he made and guides everything. What you call "mixing God in" we might call "practising what we preach". It's maybe a bit like asking a Native American to stop "mixing their tribal culture into everything". That's just who they are.
Who determines that their belief that people are not allowed to decide about their own death is more important than my belief that people are not allowed to decide whether others have to suffer. Reminds me of Mother Teresa. Helping the poor but at the same time believing the sick must suffer like Christ on the cross.
Just because we hear a story where a person really wanted to do something or make some choice but they could not, doesn't mean that person needs the right to do that thing.
Choice and rights and liberty aren't the most important things in the world. And people who take the deification of those things to the extreme that they advocate for the kind of Futurama world where everyone can just hop in a suicide booth no questions asked are pushing their beliefs on everyone else without realizing it.
Shit, I've gone full libertarian now.
This is precisely why I want the option of legal suicide: a "valiant fight to the end" that lasts years of agony without acceptable quality of life is egoist. Your close relatives will be relieved when you pass away, partly because you were suffering, and partly because a very long agony could become a huge drain of time, money and emotional burden.
I want to be able to choose when and how to die on my terms, legally.
This inadvertently sends a message that some life isn't worth living and that it's moral thing to end your life when you "permanently" become a burden to others. Once this way of thinking becomes dominant, it will put incredible psychological pressure on to people with poor life quality that depend on others. What is acceptable quality of life? When does it become unacceptable? You may think it is a personal choice, but it really isn't. If majority of people around you think you are being egoistic for trying to live, despite the burden you are putting on others, you aren't given much real choice anymore. Look up how big influence can peer pressure and brain washing have on people.
> I want to be able to choose when and how to die on my terms, legally.
It's also egoistic supporting a law because of some personal wants, despite significant bad side effects it can bring.
IMO, upsides a legal suicide law brings are much lower than downsides. And even without legal suicide, person that commits suicide won't get a legal punishment. So, you still have a choice.
I’ve seen the agony it puts on family members when someone makes the (in their mind) rash decision to kill themself. We should work to prevent these rash decision type suicides, but many are carefully and methodically considered and if someone genuinely wishes to exit this place, why should society prevent them from having a chance to communicate that openly, to choose the time, and not leave a giant mess of brain matter that someone else has to clean up?
We allow our dogs to have a better end of life experience (and I’m not suggesting that we’d make the decision in humans quite as early as we do for our beloved pets, though if we could communicate verbally with them, perhaps we should).
Or perhaps we are jumping to conclusions. Without knowing what is the purpose of life (if there is such a thing), we cannot objectively know what life is or isn't worth living. We just have opinions that we try to rationalize one way or another.
We have to realize that we cannot build an ideal law without unwanted side effects. Best we can do is choose a system with less adverse side effects. A system where it is a bit harder to commit suicide (but not impossible) has IMO less adverse negative side effects that a system where it is easy to commit suicide, but also possible to manipulate and brainwash people into thinking their life isn't worth living.
Yes, sometimes suffering of a person is prolonged a bit and sometimes there is a bit more mess to clean. But there is also some small upside. We can observe, collect data and learn more about these diseases, ageing, depression etc., and maybe that helps us to faster discover new improvements that benefit future generations.
Also, compare living in pain for relatively short amount of time (as terminally ill don't live very long on average) with euthanasia abuse cases. Which is worse, unwarranted killing of a person or suffering of a person?
I'm not sure if the unwarranted killing of a person is worse than permitting their torture for months or years on end. I also don't know if that answer changes if for every 1 person who would be killed in an undesirable way that we had to torture 1000 people for an average of 6 months to avoid it.
That's the essence of this debate and it will never find an objective answer that will satisfy all, which is why I default to allowing people to choose, even if some will choose in a way that I would not. (After watching two of our beloved elderly family members struggle for many years and watching another two struggle for weeks in one case and months in the other, our family has expressed our thoughts to each other. We're not universally in agreement, but I'll support each of them in their choices.)
We had multiple loses in the past few years. One was a longer struggle. However, it wasn't torture the whole time. I admit, some days were pretty bad, but there were also good days. And there were also joyful new experiences, like meeting newly born family members. Thing is that while quality of life may look terrible from healthy persons perspective, body adapts to that state and combined together with moderen pain medication person is not in constant physical pain. Point being that it's usually not constant physical torture for years until person dies.
Another issue is psychological pain. This is where we can make a difference. Allowing people to not be perfect or the best, but still be equally worthy can do wonders.
> whether life is worth living should be primarily decided by the liver of that life
I find it that people can have quite significant change of heart. And it is not rare at all to have one.
In aggregate, as a society, we've come to emphasize harm-reduction and a sense of fairness to the point of idolatry. They are valuable in their own right, but alone they will see us cascade into sheer darkness. The values for the sanctity and purity of life, the acceptance of authority outside ourselves, and even the difficult question of ingroup integrity will need to come back into balance.
As popularly depicted, he probably wouldn't be too excited about gay marriage, either, or, if you take Leviticus seriously, mixed fabrics. Should Spain ban those, too?
This is a serious issue which should be carefully considered, but I'm not sure that the religious argument (certainly this rather simplistic case of "some entity might disapprove") should really have any standing.
1000 gods exist, they really do, they told me, you can trust me. For every position your god takes, my 1000 gods take the exact opposite position.
Any rational person would think, "You can't just assert that, you have made an extraordinary claim! The burden of proof is on you to show that your extraordinary claim of personally knowing 1000 gods exists has some basis in reality."
Know that that same logic applies to you and is why you are getting blasted with downvotes.
I empathize with anybody who has debilitating / terminal illnesses or is taking care of people with that.
It's too important for us to decide, does that logic apply in the other direction as well. Many diseases and conditions would kill people rather swiftly if not for medical intervention. Medical intervention that prolongs life seems to be making a decision that the natural or supernatural ordination of when someone should die can be changed.
First question then, do you think that medical intervention that prolongs life is acceptable?
If your answer is yes, then the idea that the end of a life is too important for individuals to make falls away. Sure one act moves the time of death earlier and one moves it later, but both acts move the time of death.
This means that the argument becomes different, that life is so important that death can only ever be moved further into the future, never closer to the present.
> There's also the aspect that suffering sometimes just happens, and we don't usually get to decide when and how it's going to happen to us.
I don't really understand this argument, suffering happens and people should not have any agency to end that suffering. By that logic I could come to your house and endlessly torture you and any attempt you made to stop me or free yourself, I could just say, "suffering sometime just happens, and we don't usually get to decide when and how it's going to happen to us."
Would that make the torture justified? Would it make you trying to end the torture somehow in the wrong? If instead of that torture taking place at your house, it takes place in a hospital and instead of me wearing a ski-mask I wear a doctor's coat, does that somehow change the situation?
I'm glad your Aunt and Uncle were able to pass with loving family and friends and die in a manner guided by their beliefs.
How do you possibly justify denying that to others? Forcing them to live out the end of their lives following your beliefs and not theirs. Forcing them to die on your terms and not their own.
It's one thing to decide I want to suffer immensely to fulfill my own concept of "honour" but quite clearly it is something else to insist that everyone else does also.
People choose to end their own lives in opposition to unavoidable suffering, so the real question is are we going to make this harder or easier for them.
I've been struggling with thoughts of suicide since I was ~10 yro. The reason why I haven't done it (yet) is that I keep telling myself to take 1 day at the time - if I still want to off myself there is always more time for it tomorrow. But not a chance that I let society/religion/psychologists/science (those who consider themselves "sane" and above those of us who are like this) dictate (or guilt) me into changing my mind. It will need to be a terrible accident or a sudden sickness that actually prevents me from ending it on my terms, which brings me to the second point.
Control. It is my life, my terms. Not my parents, or relatives, nor my children's, or friends, and definitely not the state/law. _I_ decide when I go and how.
> so I believe it is okay to put your dog down
it's the kind of people that make me hate humanity more. It might be a flippant comment that was carefully chosen to trigger those who have been let down by people, and who prefer to find true friendship in a dog/pet. But trust me if we were to go hiking and I would have the option saving my severely injured dog (who might not make it) or a stranger who I know nothing of, except that they don't like dogs: I would 12/10 save the dog.
Humans are not special no matter how much art they create or books they write, in the end we're a parasitic life form that thinks it's superior (the sheer fucking arrogance in that alone). I would never kill another human but when it comes to animal cruelty or perhaps violence against my family (that includes my dogs) I would probably enjoy the act if I were inclined to do so.
edit: there is a saying "those who live by the sword shall die by the sword", which to my ears always seems to be uttered by the biggest fools I know (who know nothing about death or fighting or living). The real wisdom in this phrase is not that it contains a warning but that it is a promise that you "go out with dignity". Not withering away on life support, shitting into adult diapers, in an old-peoples home where family only has time to squeeze you in every 1st Sunday of the month between 14:00-15:00. No thanks I'll rather take the knife, the cliff, the needle or the rope - all of which are more dignified ways to go. And besides if I have lived all my life by not killing other people for their cruelty to those with less power than them (even I had more), at least I should be able to off myself without getting judged by these entitled and arrogant pricks?
The love of a dog is bought with walks and food.
Having recently witnessed my grandfather's slow decay into ultimately death from up close (living next door), I can say with conviction that there's no "honour" in "fighting to the end". He went from having developed trouble walking to laying stiffly in bed blankly staring ahead in just a month and one ER trip + hospital stay. He then stayed in bed for just under two years only occasionally moaning or grunting quietly gradually losing the last bit of his muscle mass with the only exceptions being:
- getting sponge-bathed by a visiting nurse, my uncle or my father,
- getting put on the toilet chair to pee/take a dump if it didn't already wind up in his diapers while laying in the bed,
- getting wheelchaired over to the table in the next room to get fed some pureed mush that was (almost always) the same as the lunch/dinner my Grandmother was having,
- etc. one can get the idea
> Both also had huge support from loving family and friends, the way it should be.
Having the support from the family involved basically putting their lives on hold for ~2 years. They always had to be there every single day to take care of one thing or another and watching my grandma take that for granted was frankly disgusting to witness. I was roped into plenty of tasks as well but thankfully one of the things I could avoid was having to wipe my grandpa's ass or bathing him. When my grandpa finally died in his sleep one night I wasn't really sad. I was more relieved that he wouldn't have to suffer anymore - my mother and I sometimes wondered if even in his mental state (severe dementia, basically a drooling vegetable) his occasional refusal to open his mouth during feeding was the only little bit control he could exercise, even though he was then just force-fed instead by prying his mouth open enough to get the spoon in. And the thing is, my grandfather was a VERY prideful man with strict principles during his conscious life. Going by what I remember from that time, he would've despised being in that position.
TL;DR: romanticizing long drawn-out physical and mental decay as some sort of "valiant fight" is just wrong and taking "huge support from family and friends" for granted during such death-spirals is frankly a disgusting attitude.
Also, just because someone takes their own life doesn't mean they lack honor. In fact, Japanese samurais has a ritual of committing suicide known as seppuku which is viewed as a very honorable thing to do in their culture.
It's not about nature deciding, is it? Or are you against vaccines, heart bypass surgery, doctor-assisted births and in vitro fertilisation, too?
> and we don't usually get to decide when and how it's going to happen to us.
Whether or not we usually get to decide doesn't matter. What matters is whether we get to decide.
Would you politically strive to keep it illegal? If so, do you not consider that an illiberal stance, since you'd effectively be robbing people of their right to self-determination? I mean, if you're against it, the solution is simple: don't request assisted suicide - just as one might not cross-dress, smoke weed, vote or marry someone belonging to the same sex.
If you want to optimize for honor in a valiant fight to the end, so be it. But who are you to enforce your morals on someone else, who is making the most personal decision one can ever make for themself?
Sometimes the inclined plane has a low coefficient of friction:
> Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the [Supreme Court of Canada] said, it can’t happen here.
> This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.
> Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.”
* https://www.theglobeandmail.com/opinion/article-on-assisted-...
* https://archive.is/hFXjJ (in case of paywall)
For that last part:
* https://en.wikipedia.org/wiki/Child_euthanasia
The first thing we need to make clear is that "severe, incurable, and unbearable" does not necessarily mean terminal or even physical pain. Plenty of psychiatric conditions often accompanying significant trauma are severe, incurable, and unbearable. But they're not terminal (except by suicide), and the reason they're incurable is because we know fuck all about psychic damage, and some might argue that if you've made it this far without killing yourself then it's de-facto bearable. And yet they definitely qualify unless the law specifically says that they don't, because "deemed unbearable by the patient" is not the same as definitively unbearable.
The biggest flaw I see in the model is if there's no significant determination of qualifications for whether a particular doctor should be allowed to approve the request (e.g. some might demand that the doctors be trained in appropriate specialties and have detailed knowledge of your history and situation), or whether you can ask 100 doctors who say no until you find 2 who say yes. I've seen firsthand that systems which don't mandate strict selection criteria create additional strife.
I think that fundamentally one has to decide whether a person gets to just say "I want to die" one day and forget that there are doctors involved. Because believe me there are many scenarios that basically feel that way to friends and family. Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
[edit: sorry for using british slang, drive-by commenter. "fuck all" does indeed mean "nothing"]
Living in a country where I have the right to die, there's a formal framework that details the process that a patient goes through.
By handing healthcare professionals a framework, it allows them to build hands-on experience and develop best practices in how to actually have an on-going, involved and empathic disucssion with patients and their surroundings.
The big flaw in this "model" isn't the qualifications of doctors, it's pulling a moral and emotional conundrum into a set of abstract assertions and reducing the debate to the medical act itself: a doctor euthanizing a patient.
> Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
The right to die, paradoxically, keeps patients from committing suicide. The knowledge that you have that right acts as a 'safety net' to open up towards healthcare professionals. Your wish to die is not a taboo, it's not an elephant that nobody wants to discuss. Any openings towards reflection on trauma isn't burdened by the imperative "you can't die, you must live" from the get-go. Taking that away, paradoxically, creates space to reach out and connect.
The answer your question, in that regard, isn't "either or". It's both.
The right to die can only be implemented in a meaningful fashion if healthcare and social infrastructure provides enough facilities to properly help, guide and reach out to individuals.
That's why it's paramount to invest in mental healthcare, hospice care, palliative care, local physicians, nurses, social workers, schooling, education and so on and see all of that as a commons embedded in communities.
Even so, the right to die isn't a silver bullet. Neither is healthcare a silver bullet. They don't provide or offer wholesale answers or solutions to social, medical, ethical issues on an individual or societal level. It's fallacious to look at these issues and discuss them in moral absolutes, those are tarpits and they leave no room for moving forward.
At the end of the day, death is an intrinsic part of life. However, the vast majority of people will feel uncomfortable discussing their own end of life. It's only when they are personally confronted with the finality of life that they will start to reflect. Personally, I think that a meaningful discussion about the right to die can only begin once you've recognized that your own life and your own health aren't self-evident.
The law allow conscientious objection in doctors (for now), but also will justify death angels manipulating vulnerable people. We shouldn't forget that unbearable pain can be easily created with the appropriate medicines. People can be drugged and turn into addict puppets also. Has happened before. Even recently in US.
And that will taint the statistics also, removing a safety guarantee for everybody. Before the law, a warn was triggered when more than average people died in part of an hospital. After that, the hospital with an interest in lowering this value has a way to do it (falsifying consent). Protecting their public image, but also hiding any rotten apple present in their staff. Bad news for everybody.
If there is something that vulnerable elder don't need now is a new exception to kill them legally.
You're not starting from the belief that nobody supports banning gun ownership are you? Because many people do. I'm not sure where this is going.
As far as patients are concerned: We have life support, and we withhold life support once we conclude that there is little to no chance of recovery. Assisted suicide allows this sort of thing sooner, for folks that are suffering.
Those death angels you speak of aren't angels. These are murderers. You are afraid folks are going to murder others. This already happens, and we already have laws against this. We can very quickly produce statistics on what sorts of people seek out assisted death: We can look to other places.
Religious - life is sacred, suicide is a sin etc.
It is unethical for physicians to be assisting in suicide or making decisions about who should live.
People (especially the elderly) can be coerced into it, even if they are of sound mind.
The healthcare industry & government will be incentivized to push people into this vs. spending money for treatment.
(These aren't my own opinions FYI)
hmm never thought of this perverse effect .. indeed
What incentive? The healthcare industry (at least in the U.S.) makes more money be sparing no expense at keeping one alive.
I sincerely doubt that in the moments before committing a crime that could lead to life imprisonment or the death penalty, many perpetrators say to themselves "well I'm going to go ahead and do it because while I might end up in prison for the rest of my life, I won't have to worry about the death penalty." In many, many places, the death penalty would be the easier way out.
Probably true in the US, but far from reality in Europe.
As the parent comment says, the law applies to children, and has even applied to a nine year old.[0] I don't think anyone believes that a child that young can meaningfully consent to a decision as significant as ending their own life, so obviously in practice the decision will be made by the parents, who will be influenced by the difficulty of potentially having to support a disabled child, financially and emotionally.
Then there are questions of the judgement of medical professionals. A research paper found that "Almost nine out of ten [medical professionals] (89.1%) agreed that in the event of a serious (non‐lethal) neonatal condition, administering drugs with the explicit intention to end neonatal life was acceptable."[1] This suggests that doctors would approve the killing of newborns even without a terminal illness.
Beyond the issue of the law applying to children, there are several controversial cases involving adults without terminal illnesses. For example, a man serving a life sentence was allowed to end his life due to his feeling of "anguish"[2], despite the country not allowing the death penalty for criminals.
Another adult was given euthanasia due to their opinion about themselves after a sex change operation[3] (which was presumably also approved by medical professionals).
Finally, a man requested euthanasia (which has been initially accepted) as a result of his dissatisfaction with his sexuality.[4]
[0] https://allthatsinteresting.com/euthanasia-in-belgium
[1] https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/aogs.1...
[2] https://www.bbc.co.uk/news/world-europe-29209459
[3] https://www.telegraph.co.uk/news/worldnews/europe/belgium/10...
[4] https://www.bbc.com/news/world-europe-36489090
Saying doctors would be OK with post-viability abortions in the case of a major (though still viable) birth defect does not at all "suggest" to me that they would be OK with the killing of newborns.
You can really easily convince some people to end their life despite them being perfectly reasonable with everything else in life.
Like, really easily. Happens a lot completely by accident. Maybe I'm a bit more exposed living in a college town.
What exactly is your point?
My wife’s grandfather had dementia, and my wife’s uncle who was technically their carer, sucked them dry of all their money then blocked medical care coming to them. The grandparents wereegally independent. If he could coerce out an assisted suicide, it would have all happened much more quickly.
This is second hand info, not enough for the police to bother (they were notified) but knowing the characters involved and enough facts, completely believable.
It’s maybe not a show-stopper anec-argument but definitely something to bear in mind.
Seeing the final days of my grandfathers life, who died of colon cancer, being robbed of his dignity and condemned to suffering for an agonising six months made me a staunch advocate of assisted suicide.
It’s a complex topic, for sure, but also a rather morally clear one.
One gives you a choice, the other one doesn't. If you want to prevent abuse, make it difficult in the law. Restrict it to advanced directives, require a psychological assessment, etc.
The scenario you're describing is the easy one — if I have people who love me enough that they're willing to care for me, I wouldn't feel forced into making this decision and there's no risk of abuse. If anything, I might feel pressured to stick around to avoid hurting them.
GP's argument is trickier: Callous family members might want to force me into accepting assisted suicide against my will, because they don't want to care for me. My point was precisely that, in that position, I wouldn't want to be cared for by those callous relatives, and might choose assisted suicide of my own accord anyway.
What all the data says is that most of assisted suicide cases are people suffering from horrible incurable diseases.
All Dutch euthanasia procedures are documented publicly. The documents include patient's condition, circumstances surrounding the request, assessments from multiple physicians, and the commission's judgement. They do not include the identity of the patient, for obvious reasons.
It will take time for this abuse to pop up. But knowing how humans are, it will happen.
I don't think this is the reason to oppose it though. Life is important and protecting it from ending is the main function of the state. There are many many sad stories of people who cannot have assisted suicide and suffer. But there's a whole other kind of suffering that a society goes through when people just kill themselves whenever they wish to with the full blessing of everyone around them.
What you’re looking for here is protections of the elderly against abuse via coercion to act counter to their best wishes. This is a separate concern that needs to have laws and parameters around it.
Virtually anything can be “an opportunity for abuse.” Look at the internet. That’s not a good reason at all to prevent it, it’s a reason to outlaw and protect against the abuse.
Both in isolation seem like laudable aims for the State, but lead us in opposing direction on this issue.
If they can’t, do they really own their computer?
If you don’t find that particular analogy salient surely you can think of others. How about just driving itself in cars that can go faster than the speed limit? The point is there are a multitude of things that provide benefit and also the opportunity for abuse, but rarely, virtually never, does this justify forgoing the benefit.
Yet, we don’t shut down every coal power plant because it’s useful just as we don’t ban cars etc. The benefits of assisted suicide are similarly significant and therefore worth it.
You're saying this as if we're talking about involuntary euthanasia.
Again, the law you're after here is preventing elder abuse. This is indeed something we should pay great attention to and try as best we can to carry out the wishes of the elderly. This abuse is no uncommon, even if it's comparatively benign by changing estate inheritance at the end of life for instance.
It really has nothing to do with assisted suicide.
The fact is for me, I'd rather that it's available and legal for those that want it even if the sad reality is, someone, someday will abuse this.
Then your belief is wrong, and your claim utterly insulting and presumptuous. Having been in that situation, I will flatly reject the idea that somehow suffering robs a person of dignity. If anything, euthanasia is a perfidious assault on the dignity of a human being. The problem is with us and our attitude toward human beings and their suffering. We should do some soul-searching and take a good hard look at what really motivates us to think this way. We might be horrified at what we discover, as we should, and this horror might wake us from our moral slumber.
Be glad you didn't have the opportunity to be complicit in your grandfather's suicide and in his murder.
A person who committed suicide was punished at common law by burial in the public highway with a stake driven through his body and by forfeiture of his goods and chattels to the king.
So it's unsurprising that they also think that everyone should suffer as much as possible before dying.
I'm unconvinced.
They should really get over it. Just like those with different gender preferences they won't ever understand they will have to just take people's word that it's sincere and they're doing it of sound mind.
The rationalizations I hear people use are really hollow to me, like someone claiming a gay man just hasn't met the right woman yet. It's fundamentally different.
All of my friends who have taken their own lives struggled with it for years. I wish they weren't gone but I have to respect if after all therapy and help options were exhausted, they still were committed, then so be it. I wish they were here right now, of course I do. It fucking sucks.
It's personally traumatizing but as my final act of friendship I was there to support them in their decisions.
I had to sign off the release forms for my friend's ashes 6 years ago and drive up to santa barbara to give them to his mother. I remember sitting there in silence at her kitchen table with her when she said "we all knew it was the right thing."
In a hypotetical future, it is possible assisted suicide rates will be down just before elections and up after elections because a group of people have already decided on the suicide, and are delaying the procedure to be able to vote.
>Somehow the idea that someone can be perfectly sane and not want to live as long as possible is inconceivable to people.
There are many people who have considered suicide, chosen not to follow through (or failed), and then realized that they were in an emotional state of mind. Suicide is a generally pathological phenomenon - horrible things will happen if we don't accept this as the null hypotheses in specific cases.
And yes, plenty of people have setup advanced directives, DnR's, and other such instructions while fully on their capacities, and that doesn't require them being in a pathological or even emotional state. It can easily be caused by having a standard of quality of life they intend to maintain.
Edit:
I feel compelled to add a qualification to what I've posted.
If anyone thinks they are rational and suicidal: I don't believe you. Self-harm is an emotional behavior. Our brains are designed to help us lie to ourselves when we're emotional. The odds that you are the one philosopher in an arbitrarily large crowd of people who's needs aren't being met is incredibly slim.
I grant no one abstract approval for ending their own life.
The implications are pretty troubling to me personally. Someone gets diagnosed with a sketchy mental condition, which in turn causes them to contemplate death, and then the very same doctors approve their euthanasia.
If I tell anybody to kill themselves I will rightfully get criminally charged. Someone approving an euthanasia is pretty close. Sure, they may want it, but so will people who get denied, one cannot say the act of approving is completely meaningless.
[0] https://bmjopen.bmj.com/content/5/7/e007454
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794705/
The idea that there is a biological 'switch' underlying depression is misleading. It is in a number of cases but it's only a small percentage.
The crux with depression (and mental health more generally) is that it's a vastly complex phenomenon [1] that we do not fully understand.
We are scoring wins in many battles (e.g. MDMA-assisted therapy) but we are still far away from winning the war.
[1] https://en.wikipedia.org/wiki/Biopsychosocial_model
You're confusing not wanting prolong life in a state of unbearable pain because of an incurable, terminal illness, and willful, intentional suicide or homicide. There is a very big difference.
In medicine, a distinction is made between ordinary and extraordinary care. Ordinary care concerns the basic needs of the patient such as air, food, water. Extraordinary care concerns medical treatments meant to cure or otherwise treat the disease or disorder. Typically, neither a patient nor anyone else can deprive a terminally ill patient of ordinary care. However, when providing of such things constitutes an "undue burden", such as when the body is no longer able to digest food or absorb liquids and the offering of food and drink actually causes harm, the patient may refuse food. At that point, you are accepting your powerlessness in the current situation, i.e., one in which the patient is in a state from which he cannot recover and for whom death is imminent.
Even treatments that may extend the life of the patient can be licitly refused by the patient if it would, again, pose an undue burden (for example, a weak, terminally ill patient may refuse CPR if his condition is such that the procedure, which is physically traumatic, while potentially able to extend the life of the patient by some small amount of time, would leave the patient in a state of great suffering during their last few hours).
So extension of life at any cost is not the goal of most people who oppose euthanasia. Natural law theory is perhaps the most vehemently opposed to euthanasia and will serve as an excellent resource for considering these kinds of questions.
I would caution you against making appeals to subjective feelings in a vacuum, which your examples attempt to do. This is dangerous because we are capable of feeling all sorts of things and being confused about all sorts of things. The crude subjectivism of our times puts excess emphasis on such things without understanding them in an objective context (which itself may be misunderstood or crudely understood).
While I'm aware of the various slippery slopes (and who might be greasing the plane), I can't help but think that a few people could have been spared quite a bit of suffering had euthanasia been available.
So when he relayed this story, my internal reaction was more of a nod, "yes, that's how it tended to go back then," a bit like hearing old stories of the agonizing, inevitable deaths of those who contracted rabies, because by then it was just another data point in a straight line. That's not immoral at all.
Immoral, to me, is hiding this sort of thing from the people to whom it will happen, because if you do not know, you cannot plan around it. Being uninformed removes agency, and that's what we're discussing here -- do we allow other humans legal agency over their deaths, since they haven't any over their births?
It is a sensitive personal decision whether you want to know what may happen to you in detail, or not; and nobody should make this decision for someone who is affected by disclosing graphic stories. Most people would therefore be too considerate to pass on such stories, so your friend may be a bit of an „outlier“. That’s all I wanted to say.
1) I consider this the largest: the decision to reproduce or not. First off, it runs the risk of burdening offspring with the exact same condition. Then there is the "can I even manage to raise offspring?" question, at least to the level of the average parent?
2) Similarly, seeking a partner to raise that offspring with. Imagine you had a spouse who had been kept unaware of the situation, and so you were unaware of the situation, and then you were rather suddenly burdened with taking care of someone through a prolonged decline. Would that have seemed fair to you, not to have known?
3) The rest of life planning is almost trivial next to the first couple of issues, but you think about retirement, how one's life is spent given the expected years, and so on.
Non-disclosure is a horrifying trap for more than just the patient. I would find someone who would not disclose to be inconsiderate, frankly, similar to in kind, though not in degree, as someone not warning you of a danger in a road you are about to drive down.
We should really be making a huge deal about cancer and aging in general, and what our science can do to fix those things, and have the public know all the ins- and outs- of human physiology and cellular biology, and have parliaments around the world oil the way for better and more medical research and treatments. Take the fight to God.
Belgium allowed a 24yo with severe depression to “decide” for assisted suicide (this seems to be frequent, I’ve heard of a similar case of a student this year), and the Netherlands wants to allow childhood euthanasia soon (it is already allowed for those over 12). Decision makers seem to believe that they are rational and ruling out religious moral opinions on these subjects, however we seem to be gravitating towards the buddhist nihilist view that life is suffering, and that our reason to live is to end suffering by vanishing.
Doctors in the Netherlands want this simply as a better alternative to palliative sedation, which is already legal in NL and many other countries in the world.
Some children are terminally ill, and they are palliatively sedated when the parents and doctors agree that this is the best thing to do. The difference between palliative sedation and euthanasia in these cases is small, in the opinion of many Dutch people and doctors. Some quotes from a report[0] from the Dutch Association for Pediatrics, to give you an idea of what kind of cases we're talking about:
> 'Well, yeah, he had a period during which he was screaming from pain: "Help me, just help me!" That was truly horrible to see, that someone is really hitting his own head while begging for help. That went on for three days. Every time I called for a nurse and they could only increase his medicine further. And at one point a nurse came and said bluntly: "yes madam, your child has a brain tumour. Of course he is in pain". Well, I thought: "okay I guess"'.
> 'He didn't want to be sedated, because he said: "then I can no longer say whether I am in pain" [...] So we postponed that, but in the end he needed so much medicine that we asked him "do you want a little sleep medicine now?", and by then he wanted it". Child, 4 years old'
[0] http://download.omroep.nl/nos/docs/280919_euthanasie.pdf
As you say, we do already have palliative care. Why not improve much further on this front instead of opening all the legal loopholes, which can easily lead to more suffering in the end (if one wants to play this “sum of suffering” thinking game)?
I'm pro right to die, but I'm also aware that it's a slippery slope and can go bad places.
That's a good thing to talk about, but it's not easy to do and I don't think your first remark made your concerns clear.
What's your definition of "palliative care"? Should the goal of palliative care be to maximize the vegetative lifespan of a patient? Or should the care focus on making a patient's last few hours/days a meaningful experience for all involved?
I’m otherwise not sure how you perceive me right now, but you might be attacking your straw man.
The goal of palliative care is increasing the quality of a dying person’s life with dignity and as little pain as possible, and allow them to make the best of the time that is left to them. Instead of opening euthanasia floodgates that just lead to difficult individual situations (such as not wanting to be a burden to one’s family, a very common feeling) I do believe we need more research in this direction.
I have no interest in debating someone who thinks that "floodgates" are a convincing argument.
Doctors have experienced firsthand that palliative care isn't always possible in the last phase of life. But nonetheless the commenter wants "more research in [that] direction", and talks about "increasing the quality of a dying person's life".
So yeah, whatever. I'm glad most people in my country know better.
With such cases in public awareness I don’t understand how the cases you translated here for us (thanks for that, btw) don’t lead you to the conclusion that there must be more research into palliative care, and instead that one should be allowed to put an end to a human life that is more suffering than living. You list graphic descriptions of situations where the first is not possible yet so the latter would likely have to apply, and I understand that - as I said, I’m aware of the complexity. But improving palliative care with dignity should still be the primary route.
That your legal floodgates are open now may prohibit a focus on palliative care research since it seemingly has already changed your national discourse quite a bit - which is another issue opponents have warned about. The Dutch / Belgian (and perhaps Canadian) discourse on euthanasia is an outlier in the world, and being on the outlier side is not automatically a good thing. It will derail even further and weaken more boundaries, and change how people act or feel are expected to act.
Because it simply isn't possible in some cases. That's also what the doctors in the PDF I linked to state, but it's Dutch so I can't blame you for not reading it of course.
1. "Parents and doctors acknowledge different kinds of physical, existential and psychosocial suffering. This suffering cannot be treated fully with medicine"
2. "There are cases of severe, untreatable suffering in children for which no treatments are applicable. [...] In two cases, the decision was made to not give food and fluids to a physiologically stable child."
3. "Multiple children with metabolic, neurological and neuro-oncological disorders had difficult to treat epilepsy in the final phase of their life. Different parents describe the process of dying of their child as 'inhumane' and 'traumatising for the child'"
etc. etc.
To relinquish some of the sacredness of life endowed by evolution is not to commit wholeheartedly to nihilism.
I am of course aware that it must be well tested and everything, it would be a relief to everyone.
I am happy, wealthy to the point I want to be, living in a great country and a great place, have a great job and family.
So I am far from being depressed, and yet I want that device to have the choice. I do not need anyone to explain why this is a bad idea.
The left has been fighting for this over the last years. They finally managed to pass their law of death. Suicide on demand.
Al this while palliative care is not given to those who need it. Only 40% of them do receive some kind of treatment to relieve their pain. Guess what the other 60% will think about now...
IMO, a person who wants to leave should be allowed to have controlled death without a mess or violence. I agree that counseling should be required, like maybe 2 sessions, but don't agree that anyone should have the power to deny assistance to die. It's my choice to leave or stay; all we are debating is whether I have to do something messy or can have a goodbye meeting with my family and have a peaceful death.
My mom had pneumonia when she was 74. She had been very sick with rheumatoid arthritis for 30 years - bedridden in some of them, on crazy amounts of drugs for all of them, and for the last few years of her life, could only barely walk bent over a walker because of a failed hip replacement. Her body was shot, so when she went to the hospital for the pneumonia, she refused to let them treat her. If she took the oxygen mask off, she turned blue. The doctor wanted to send her home with an oxygen tank to lug around, but she could hardly walk as it was, so that was completely impractical. I guess she convinced the doctors she did want to leave, because they had a conference with us, said she was going to die, and allowed us to hasten it with morphine and Adavan. The shitty thing is, we (mainly me) had to go to the nurses station every 45 minutes to tell them she was "not comfortable" and get a morphine injection, and every hour do the same thing for Adavan. This went on for 9 hours, and it was only that short because they had her on 2 oxygen deliveries and I had to convince them that we couldn't keep doing this for 3-4 days. No one had eaten all day, my sisters are in the room crying their eyes out, and my mom had been unconscious for many hours. We knew what the end game was, but getting there was much more difficult that it needed to be. They could have easily put her on a drip for those 2 drugs to avoid adding to our suffering by forcing us to request drugs on some crazy schedule we had to track while our mother is dying. I am grateful they at least did it, but it was unnecessarily hard on us.
There are also cases where a person should be able to write a document, like a living will, that says "Under these circumstances, I want to be euthanized: haven't been able to communicate for N days" etc. There may be cirumstances, like an accident, where a person is not able to go to counseling or is not able to confirm their wishes verbally. That doesn't mean they've changed their mind. If a document is written when the person is sane (maybe someone needs to notarized that), there is no reason to not honor their wishes at the appropriate time.
We treat animals better than we treat people when it comes to end-of-life decisions, and that's a damn shame.