I'm part of the Jain community in Bangalore, and the version of this in society exists, called Sallekhna [1], a tradition that's developed over millennia, and this is venerated and celebrated.
The philosophical underpinning is giving up of materialness. The practicality of the 5 instances that I witnessed over the past year - typical terminal individuals choose this. They pass away surrounded by loved ones (they typically medicate for any pain, and the body starts shutting down when food and water stops). This is observed with somberness, but celebrated as very positive act.
When someone starts this process, it's a unique experience speaking with them, as there's usually nothing that comes up, and the moment does not really lend itself to small talk :)
Thank you for sharing this. My grandpa passed away earlier this year at the young age of 97. We discovered a kidney cancer and decided not to treat him and bring him back home.
During his final days, he became unresponsive, only sleeping. The doctors gave us the option of feeding him through a tube. We made the hard decision of not doing it. Gave him all the medicine to help his body heal, but no invasive procedures.
We stayed by his side for the next 5 days. Playing songs that he enjoyed. Audiobooks that he loved. And just taking care of him.
Finally, his breath became slower and slower until it stopped and he passed away. I had the opportunity of being beside him during his last breath.
The passing of loved ones is always difficult, but I am grateful for how he went. He lived a full life and was incredibly healthy until the end.
Without knowing, we decided on a sallekhana-like process for him. It was the right thing to do.
This is essentially what hospice is in the US. They stop curative treatment and focus on comfort. Then at the end when the person can no longer function to eat or drink they increase the morphine dose to a high level until they pass.
Right. It's a not-so-well-kept secret that hospice care is actually assisted suicide in disguise. It's done with a wink and a nudge, hiding behind the principle of double effect, but it's a mercy everyone knows is happening. It's sad that it has to be done covertly.
Hard fast (e.g. hunger strikes) usually take about 2 months to kill a healthy adult.
On the one hand according to the wiki this is more progressive removing food by degrees which would make the process a lot longer.
On the other hand being a mostly ascetic practice I'd assume it's done by people who have a lot less reserves (body fat and muscle) which would shorten the process significantly (the 207kg Angus Barbieri famously fasted continuously for 382 days[0] breaking his fast at 82kg, although he supplemented his liquids — water, tea, and coffee — with vitamins, electrolytes, and yeast extract, the latter for essential amino acids).
[0]: technically he was put on a recovery diet of salting then sugaring his water for 10 days, so ate no solid food for 392 days, breaking his fast with a boiled egg and a slice of buttered bread
I was curious about how he actually died and found an [1] article describing it:
> Kahneman used the services of Pegasos in the village of Roderis in Nunningen, Switzerland. In the death room with a view over green hills, wearing a suit and tie, he lay on the bed and turned on an infusion of sodium pentobarbital himself. A companion held his hand and told him they were holding it on behalf of his loved ones. Kahneman's last words were "I feel their love."
> Pegasos, a non-profit based in Basel, Switzerland, believes that it is the human right of every rational adult of sound mind, regardless of state of health, to choose the manner and timing of their death.
I found this bit "regardless of state" really interesting.
I wonder what their views would be for someone who wouldn't have a family and nothing much to do or explore after a certain age? Does it matter what nationality they are from? What if someone's reason is - they had savings and now they have run out of it and area already 55-60 or more and have no intention or plan to work anymore and don't want to go through the struggle of life? (Of course they would have had paid the euthanasia fees)
Well they did say “rational adult of sound mind”, and “rational” there easily disqualifies every human being on the planet, with all our evolved biases, heuristics, and common predictable misjudgments. I imagine its criteria applied arbitrarily.
Great guy, very sociable, knew everyone in the little town he lived in. Kept in touch with a lot of students. Good neighbour, friendly guy who'd talk to everyone.
He got Alzheimers. He started forgetting stuff, and it frustrated him. He got caught driving dangerously, and cursed the doctor who took away his license.
He argued with me about the state of some chicken he wanted to cook. I told him "this is pink all over, you have to cook it more". He got angry. I understood he'd become like this to everyone.
He pissed off everyone on his street, and all police, medical and social workers sent to help him. The disease made him blow up every relationship he had with anyone that he didn't know well, like me and a couple of colleagues.
He got found in his house, having left the gas on, endangering the whole street. He ended up in a care home, not knowing who he was, or who I was.
If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
It doesn't seem pleasant for the person themself either. Constant frustration, gaps in your memory growing ever larger, disorientation, loss — periodically augmented by brief flickers of recollection of what you used to be — and yet no one can legally end your misery, because you can likely no longer unequivocally consent to euthanasia or assisted suicide, even if you explicitly signed a declaration that you did not want to end up like this — legally, the current husk of your former self must consent, and it can't.
It’s still absurd despite what you say that we are implying that we should euthanize another human because they have become difficult to manage due to illness. Where do we draw the line?
This is such a cruel perspective, implying that he'd be better off dead, for what, 3 years of inconvenience to his community, despite the previous 80 years being spent contributing positively to it?
You even literally show that he isn't solely remembered for those last 3 years of his life. We owe people like that care and understanding, not murder framed as mercy.
It's always so painful to see old people around who are clearly living alone, forced to do everything themselves, having to ask strangers for help because they're afraid of being a burden, and their actual children can't find time for them. Only to now see people actually supporting murder because old people become a burden for a couple of years near the end of their life.
Thank you for saying this. It's not a popular view, but it is the correct one.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I don't think I've read a wilder defense of euthanasia in my entire life.
This is a "great guy" who committed his life to teaching kids, being a good neighbour, and his reward is one of his former pupils arguing he ought to be killed because he's grown unwell, he's unable to maintain his optics, and the community he gave his life to has therefore 'soured' on him. How very inconvenient for you, that this man is unwell.
What message is this supposed to send to anyone? "Don't get invested in trying to be nice to the neighbours, they're all ghouls who'll have you shipped to the glue factory as soon as you stop seeming useful." And once everyone internalises this level of social atomism, where do you expect these 'great guys' to keep coming from?
But this guy wanted to die right? Bit different. Agreed that 'how others view you' is such nonsense. People are cruel that way and also: those children who couldn't be bothered visiting or helping out, will be standing at the funeral sniffling and telling 'such great dad stories'. Makes my blood boil.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
The parent described someone who went above and beyond the norm of other members in his community in his constant positive interaction with his neighbors, collegues, and former students. It is highly likely this kind of person would give a considerable shit if he knew he would become a nightmare for the same community.
There may be others reading in the thread who also can relate to the personality of the teacher and may care about their affect on others when they are "not themselves".
In my experience having had a parent suffer this way, you lose them before they are dead and you grieve along the way. I can understand the "souring" phrasing - in that there is less affection for the altered person in the present even while feeling a duty for their care and a deep love for who they were.
I'm grateful for this story - it's powerful to see examples of autonomy at end of life - and contrasts starkly with the experiences many of us have with aging parents. End of life, at least in the US, can be deeply flawed and misery for all.
Valuing how others remember you is definitely a motivation in life for many. I respect that it is not your own, respect that it may be mine. It is by no means "absurd".
My brother had schizophrenia. No one thought well of him. I guess he should have killed himself as well by the logic some are professing on here. Oh, he tried, but he ended up dying of heart disease.
> Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
Yes, this is the focus. Science has stalled when it comes to neurological disorders. But the response is love and understanding. I do not understand how someone would "sour" on a person because they have an illness. A very absurd conclusion indeed.
the conclusion is true, though obviously the worst part is that this guy spent at least a year in varying states of despair, anger, and even worse psychological terrors.
you don't want dementia because it damages and hurts you and everything and everyone around you
(my grandpa physically attacked grandma multiple times in his last year)
>This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
They do matter.
Being concerned with how your behavior affects your family or your community, and the opinion they have of you, above your own self-interest, is how good parents, good friends, good citizens, and so on, are made.
My wife's grandma passed some years back due to dementia/Alzheimers. Her final memories of her were of struggling to change her diaper because she insisted "she didn't need a change" and being really racist.
I really don't want my family's last memories of me to be that. Yeah my wife remembers when her grandma was of sound mind, and has some good memories with her back then, but they stopped due to the disease.
Everyone should be entitled to their own opinions on how they want to be remembered. I would rather be allowed to pass in sane mind.
It's not so absurd. The only afterlife that exists (in a materialist sense) is what other people think of you. The only part of 'you' still around us quite literally just a memory in someone's head. That's not nothing.
Whether we should care about that or not is a philosophical conversation, I suppose. I would take the side of if we care about what people think about us when we are alive, surely we should care what they think of us when we are dead. Otherwise, we only value their opinion of us as a function of what they will do for/to us, which seems not great.
This is a maximalist view, in reality not feasible or scalable. Of course this is what we need to strive for, but aiming to decrease 'total unhappiness' with what we have, is a rational, if somewhat cynical, aim.
But even at aface value, more rational long-term approach would be to treat it, surely
Jason Zweig, Kahneman's friend, wrote about this and many other thoughts Kahneman would have gone through in making the decision.
As Barbara Tversky, who is an emerita professor of psychology at Stanford University, wrote in an online essay shortly after [Kahneman's] death, their last days in Paris had been magical...
One afternoon, according to her online essay, she asked what [Kahneman] would like to do. "I want to learn something," he said.
Kahneman knew the psychological importance of happy endings. In repeated experiments, he had demonstrated what he called the peak-end rule: Whether we remember an experience as pleasurable or painful doesn't depend on how long it felt good or bad, but rather on the peak and ending intensity of those emotions. "It was a matter of some consternation to Danny's friends and family that he seemed."
34M. I live with my mom who's had it for a few years.
It sucks. It's so easy to forget who they were before the disease. This is them now and it's hard as hell.
Simple things that take 1-step for us take 50+ steps for her. She doesn't readily communicate that she's hungry or thirsty or needs to use the bathroom, we have to constantly ask. She's always exhausted and walking around in circles but reacts aggressively to most suggestions to go to bed or take a nap (no matter how we word it). She can't focus for more than a few seconds, so she has no hobbies to occupy her time, and even the TV loses her interest after a minute at most. Her speech is one unbroken babble, and she gets annoyed if someone starts a conversation near her but doesn't let her interject.
Not sure how much more my dad and I have left in us. The disease stripped everything from her and it's stripping everything from us. In-home care is the likely course but she hates all strangers and is always paranoid about anyone other than us being in the house. There's no good solution.
Yeah but if you are in that state, you probably don’t give a shit and everybody else seems to be the problem. So how do you solve this? When dementia isn’t too far progressed, your life seems to be still worthwhile to live and once the dementia gets worse, it’s too late to realize this.
You could express your wishes about how you would like to be treated in advance, while you are still clear in the head. That’s already possible for other situations, like when you are braindead and entirely dependent on machines to keep you alive, with no chance of recovery.
You don’t. You try to take care of yourself before you’re gone. If you miss that opportunity, you and your loved ones suffer. Same as it is for everyone now.
Give me a timer. Like the previous discussion of a red button it verifies identity. I can set the timer for whatever I want, if it reaches zero it peacefully kills me. Dementia, set the timer for say 1 month. If my mind is too far gone to reset it it will run down.
I read your comment and it strikes me as a cautionary tale that can be used by bad people to justify or push for eugenics: "they took him; they said he developed Alzheimer's".
As we're currently seeing happen: whatever is left unsaid in the body of the law can and will be abused by evil people to concentrate more power (even if the spirit of the law advocates for something kind).
So, we have to normalize some sort of stress tests for laws... because you sure don't want to be dragged against your will because you're poor.
Yes, there is a danger of that in general. I think someone made a movie in Japan about the subject, specifically because there is a culture of the elderly not wanting "to be a burden on the younger generation." Some said it hit closer to reality than science fiction because of that specific cultural characteristic in Japan. It also supports Kahnemen's position of pulling the plug when "the going is good" from a ethical point of view, since it leaves no doubt of intention.
> I read your comment and it strikes me as a cautionary tale that can be used by bad people to justify or push for eugenics: "they took him; they said he developed Alzheimer's".
Isn't the point of eugenics to influence population genetic trends? Not a very effective strategy to kill people when they already have probably 2 generations of descendents.
Leading cause of death in older populations in Canada is assisted suicide. People have killed themselves for not getting timely services and the medical professionals bring it up as an option.
This comment really bothers me. I am not put off by the idea that the memory of a person is worth protecting, what I am put off by is the suggestion that death is a good option here, or that death is better than having lived those 3 years of life. The idea that when someone loses the capacity to retain their reputation and dignity it would be better for them and others that they were dead and that they have nothing good to offer is such a dangerous one and is just wrong. It applies to many people who are not near their end of life too. I am really pro assisted suicide as a way of shortening suffering when made as a conscious decision by people of sound mind, but comments like these make me very very uneasy.
>You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I completely agree that the disease is horrible, but your conclusion is bizarre. When you are in that condition, how anyone views you is the least of your worries.
Framing it as an obsession of rememberance or legacy distracts from the more crucial point: the fact that you will be causing chaotic emotional, psychological and physical distress in the real world to those you cared about. Again we should stop framing it as some weird obession with legacy and instead stick to the facts on the ground.
What you say is "you don't want to end up with mental state because people will hate you" but TBH mental illness, though really harsh on environment, shouldn't be viewed differently than any other illness like broken leg. When person is riding a wheelchair you don't tell them "hey you're a pain in the ass because you drive so slow and cannot jump on the stairs" - we tend to give them hand, help by building ramps and lifts. The same should be with mentally ill. Places safe for them, mabe remembering aids software in a watch?
That's just as much failure of everybody as it is of him. This was dementia speaking and society needs to learn that.
You wouldn't tell somebody with a broken leg to get it together and it's just their personality that they can't walk. Nor should you treat dementia like that. Yes, people seem to shift personalities and anger others. But those others need to understand that it's a medical condition, an untreatable and fatal one, so should have even more sympathy than with somebody who broke a leg (cause that will likely just be temporary). Not alienate the person and speak ill of them.
Imagine that the illness in question was unremitting and excruciating (unlike a broken leg), not only for you and the your loved ones, but everyone you come into contact with. And there's no hope it will ever get any better. That's what dementia usually becomes, and that inhuman level of misery can last for years until you finally slip away.
No animal other than man would consider perpetuating that state of decline. An elephant would simply wander away to die, freeing their community from their struggle to simply keep breathing.
I agree with Kahneman, at least that we all should seriously consider the cost of allowing that level of degeneration to consume us -- and more, the pain it inevitably will inflict on our loved ones -- and plan for it while we're still compos mentis.
We are human. Unfortunately all of our experiences with others change our perception of them, no matter how much awareness of their motivations and our history with them. We can try to ignore it and have patience. Apologies can help but relationships will constantly change.
It's certainly a failure point within us and something to be aware of to make effort towards understanding our own impact as you suggest. Sadly a problem with no full solution over long enough time periods.
>Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
I find the people who remember him as this guy somewhat contemptible though, so I guess my theory would be he wasn't remembered badly by anyone whose opinion mattered.
But on the other hand I guess that's the way the world works.
>> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I don't think this is fair. I know several people who died with Alzheimer's and although their final years were very difficult for them nobody has a bad opinion of them. It's certainly a strain on the family but intimating that if you have dementia you better kill yourself or your legacy will be ruined is not ok.
I think the suggestion needs more thought, but I don't necessarily disagree with the idea of making my exit before the dementia really sets in. I've directly cared for two family members who suffered from it (collective 5 years of my life, which I'd like to think gives me a pretty good view of what the disease can actually do to people) and I decided for myself that I'd rather be quietly killed than put my loved ones through what I went through as a caretaker. While also trying to work a full-time job and maintain my own sanity while I watched people I'd known all my life be destroyed, becoming tortured versions of themselves like something out of a body-snatchers horror film.
We, the loved ones, made the decisions to keep them going and I wonder how fair that was to them. We tend to not want to let people go, choosing to sacrifice quality of life for the sufferer and those around them for, what, a few fleeting moments of possible clarity? The opportunity to say goodbye to someone who may or may not even understand what is happening?
The events I went through with my family hurt us in ways that will not likely ever heal, despite effort on at least a few of our part, and it did leave me wondering if I would put my son or wife through that should something similar ever happen to me. I decided against it, seeing as I am at the age where these are very real possibilities. In the US, we have DNRs ("do not resuscitate") and living wills that offer prior directives, but something like assisted suicide is not allowed here unless some very extreme circumstances are met, because insurance companies and hospitals make more money from suffering people than dead ones. I'm a strong advocate of the right to die, but it is a decision that needs to be made some extensive consideration and documentation before one actually needs it.
> If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
I've really thought about this a lot after seeing a number of family members and friend's family members go through dementia, and it seems like it can go two ways: like this, which is how it went with my grandmother (whose hoarding behavior increased aggressively, and she started slapping people), or how it went with my grandfather on the other side (he became quieter and quieter, watched tv every day while understanding less and less of it, and when you caught his eye would repeat how much he loved you and how much seeing you "made an old man feel good.")
It has something to do with how you feel about the nature of people in general, and whether you feel they are all suspicious and possibly conspiring against you, or that you think they are basically good and want the best for you. When you have all of your mind, you can beat the demons or the angels back with your reasoning enough to have the personality that you want. My grandmother was very loving, and my grandfather was very shrewd and practical. But when that higher function can't regulate you, what shows is if you were someone who taught yourself how to see the good in people, or someone who taught yourself how to see the bad in people.
I suspect I'll end up like my grandfather, as much as I think of myself as like my grandmother. Deep down, I've always been crippled by the feeling that everyone is a wonderful person. My aggression and judgemental nature on a lot of things can really, embarrassingly, be interpreted as me looking for excuses for everyone's behavior.
This leaves a bad taste in my mouth. I see that the man was Israeli in the original story and I don't want to presume a religious perspective, but I can share some thoughts from my own based on his story and yours. I've read the New Testament within a Jewish framework and one of the things it says, Rabbi Shaul says in 1 Corinthians 12:23 that those people in the community who are most embarrassing or cause us to blush, like the parts of our own body who are honoured or dignified by being clothed with underwear, likewise in the community are owed a special covering and to be afforded dignity by the other parts of the same body/community. Just something to think about in light of this story!
Not all Alzheimers patients get aggressive/angry. I know it happens, I’ve known one person who did almost exactly what you describe above. He lived with his partner of many years, and seemed superficially very cogent and together. It was just that he started to see insults and conspiracies against his person everywhere around him. Not until later did the cognitive and memory decline become apparent, giving him a diagnosis that explained his bad behavior.
But my personal anecdata puts that man in a minority. None of my older relatives with Alzheimer’s have become aggressive or troublesome. Worry, anxiety and confusion seem to be much more common states of mind, which admittedly also doesn’t seem like such a fun way to spend your days.
I agree alzheimers turns everything to shit in every meaning of the word.
I disagree it’s up to you to conclude it would have been better if he had been killed 3 years earlier (which you imply).
In general you don’t have the right to such a statement.
Now, if you were discussing _your own_ condition this would be a totally valid consideration IMHO. But you (almost) _never_ have the right to conclude from someone elses part when it’s their time to go.
Assisted suicide is a humane option but ”I hope he had died with some dignity years ago instead of pissing everyone off” tarnishes the entire concept and is exactly the type of argument which stops assisted suecide becoming a more widely accepted option.
It’s basically getting rid of somebody when they become an inconvenience to others. Outside the bubble of HN, I suspect most people that talk about it as humane for the person actually mean humane for them.
Many countries hesitate to execute criminals despite very clear criteria that could be used to justify it. (Many countries banned entirely.)
Why would we have a lower bar for someone who hasn’t committed any crimes?
My issue is, anyone with half a clue should know that a formerly nice respected man doesn’t automatically turn into a mean guy that “pisses them off” because he wants to be. They should have known that he had dementia and it wasn’t his fault.
I’ve never been close to anyone who had dementia. My grandparents on both sides died with their mental facilities in tact and my parents who are 83 and 81 are independent and just as of 6 months ago passed a cognitive test. I can imagine if they started acting out of character and being mean to me or forgot who I was that I would be hurt, overwhelmed etc. But not pissed.
I think you are bit wrong. Once someone close to you dies you remember them by their legacy. Also, you just have to laugh at some of the chaos these elderly cause. They call you in the middle of the night being lost somewhere and you have to guide em home. Or help the cops guide em home.
I am pro assisted suicide. Not sure about Switzerland but some countries allows it for young people with mental health problems. That I can't accept that.
I think the takeaway should be you really don't want Alzheimer's regardless of what people think of you.
Think about what is happening from his point of view. The condition has fundamentally changed his perception of reality. You are trying to tell him that this perfectly cooked chicken is pink all-over when it clearly isn't. Everyone else has gone mad and he doesn't know why.
That's the part that doesn't matter at all. Your life isn't contingent on others having a specific view of you - the rest of the world can, for lack of better words, go fuck themselves.
What matters is if you want to live a life where you can't drive a car, you might poison yourself with your cooking, you lose your mental facilities, etc. That is the relevant choice here.
I hear quite a lot of these stories from my parents. Are these kind of personality shifting diseases, like Alzheimers becoming more common? And if so, is it because we take better care of our hearts and don’t die as early as?
Yes, I think that's right. The average age of death due to old age has climbed for over a century, probably due to greatly improved public health and personal medicine.
Because dementia and other neurodegenerative diseases take decades to manifest they've been especially hard to diagnose early and prevent or treat early, while cognition is still intact. Alas, I think that hasn't changed much in recent years, despite many scientists and businesses working toward that end.
Partly that's because few academic researchers can pursue a theory long enough in time to fully assess its potential, especially in combo therapies. Nor can the big pharma corporations who not only suffer from the same difficulty in long-term funding, but prefer the ROI of continuing treatments for disease to that of quick cures (or lifestyle advice). These are nowhere near as profitable a pill the patient must take for decades.
This is a heartbreaking story to read. But I think that pushing for assisted suicide as a "fix" like you're suggesting misses the bigger picture. We have a responsibility as a society to support people through these diseases, not cut their lives short because it's tough on everyone else.
The real issue is our broken systems for handling dementia and underfunded homes, overworked staff, no real community nets. Fixing that honors the full life someone led, instead of saying their value drops when they need help. Assisted suicide opens doors to abuse, like pressuring people who feel like burdens.
Not sure how to react. This is the second time in a month that someone thinks I used AI to write an HN post.
All I can say is that I didn't, and thank you for implying that it was so well written that it could only have been authored by a machine that has all of humanity's cultural output to hand.
I would say that this is a societal problem, not an individual one. Society needs to do better in taking care of people who do slip by the wayside, with mental illness and diseases like Alzheimer's.
So you're telling me Alzheimers is a death sentence? Also, what is the minimum nuisance that should lead to someone's death? Because that is the problem with the euthanasia obsession.
At some point everything indirectly leads to euthanasia and society is not built for that at all. Everything you do might or might not lead to someone's euthanasia, which means you are liable for their death.
Let's say we can predict school shooters before they shoot and give them an euthanasia to save lives.
If bullying or encouragement causes someone to start shooting up a school, then the latent shooter will die before they do their shooting, but it also means that the instigator is a murderer themselves, because in the absence of instigation, no crime would be committed and no euthanasia would be necessary.
Since it is probably not possible to assign liability of a euthanasia to a single individual, because multiple people contributed to the outcome, the liability will be shared. Ten people being involved means each has committed 10% of a murder, meaning that they should receive 10% of a life sentence. Are you ready to serve a cumulative year in prison spread throughout your life to account for indirectly causing euthanasia?
Note that this problem isn't necessarily unique to euthanasia. The problem applies to any cure all solution. (Think of series like "Common Side Effects")
If you punch someone's face in, but cure it with a blue mushroom, was it really a crime, since their face is intact? And yet, more punching happens as a result of the existence of the panacea, which is why there needs to be a punishment for making someone dependent on the panacea.
Daniel wrote one of my favorite books, Thinking: Fast and Slow (https://www.amazon.com/Thinking-Fast-Slow-Daniel-Kahneman/dp...). If you haven't read it, and you're into economics, behavioral psychology, and thinking about thinking then I'd highly recommend it. The first half of the book is especially compelling.
You will be missed! Sad to hear he passed, but glad he was able to go out on his own terms.
Part of the book has been swept up in the replication crisis facing psychology and the social sciences. It was discovered many prominent research findings were difficult or impossible for others to replicate, and thus the original findings were called into question. An analysis[51] of the studies cited in chapter 4, "The Associative Machine", found that their replicability index (R-index)[52] is 14, indicating essentially low to no reliability. Kahneman himself responded to the study in blog comments and acknowledged the chapter's shortcomings: "I placed too much faith in underpowered studies."[53] Others have noted the irony in the fact that Kahneman made a mistake in judgment similar to the ones he studied.[54]
A later analysis[55] made a bolder claim that, despite Kahneman's previous contributions to the field of decision making, most of the book's ideas are based on 'scientific literature with shaky foundations'. A general lack of replication in the empirical studies cited in the book was given as a justification.
I had read so many raves about that book, and heard the author got a Nobel prize for his ideas, so I started reading it.
I just could not digest it. I understood the words but I couldn't make whatever message he was trying to convey... it felt too "dense" for me. Maybe im just stupid, but I could not get past I think the first two chapters.
Don't worry, it doesn't matter, because at best a lot of claims in this books just cannot be replicated, and at worst the book is completely useless because it's based on shitty science - depends on your POV.
I really didn't get on with that one. Felt very much like a book that could have easily been shortened down to an essay and suffered for the additional length.
The sad demise of Robin Williams made me a believer of assisted suicide. The option to go out with dignity should be available to everyone.
That said, there is a problem in at least some places where assisted suicide is available where it keeps getting recommended to disabled people who don't want to die. That needs to be solved. Seems like an easy solve. Just don't do it.
There is a cost reduction incentive, though, which is why it happens. Costs can be reduced for abled people by convincing them to exercise and eat more fiber, so the same pressure can do good instead of evil. At some point we have to decide to care about people.
> That said, there is a problem in at least some places where assisted suicide is available where it keeps getting recommended to disabled people who don't want to die.
Where? This is a thing which always pops up in these debates because it is a deep-rooted fear, but are there countries where this is a thing?
> 60% of the patients who died with Kevorkian's help were not terminally ill, and at least 13 had not complained of pain....The report also stated that Kevorkian failed to refer at least 17 patients to a pain specialist after they complained of chronic pain and sometimes failed to obtain a complete medical record for his patients, with at least three autopsies of suicides Kevorkian had assisted with showing the person who committed suicide to have no physical sign of disease. Rebecca Badger, a patient of Kevorkian's and a mentally troubled drug abuser, had been mistakenly diagnosed with multiple sclerosis. The report also stated that Janet Adkins, Kevorkian's first euthanasia patient, had been chosen without Kevorkian ever speaking to her, only with her husband, and that when Kevorkian first met Adkins two days before her assisted suicide he "made no real effort to discover whether Ms. Adkins wished to end her life," as the Michigan Court of Appeals put it in a 1995 ruling upholding an order against Kevorkian's activity.[26] According to The Economist: "Studies of those who sought out Dr. Kevorkian, however, suggest that though many had a worsening illness... it was not usually terminal. Autopsies showed five people had no disease at all... Little over a third were in pain. Some presumably suffered from no more than hypochondria or depression."[27]
Canada. The critique is that people opt into euthanasia because of poverty, and that the government sees MAID economical alternative to investments in social programs and welfare. https://en.wikipedia.org/wiki/Euthanasia_in_Canada
I don't think things are as bad, but I also think that old age in poverty is a valid reason for euthanasia if there is no alternative. If the society is cruel to the poor, holding poor elderly as hostage to improve situation is cruelty on top of the cruelty.
MAID being inappropriately offered to people who haven't expressed interest in it, and also being extended widely to people without terminal illness, has certainly become a controversy in Canada.
>Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.
>What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.
Randy Stroup [2]:
> Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide.
Stephanie Packer [3] (although in this case she inquired herself):
> Then her doctors suggested that switching to another chemotherapy drug might buy her time. Her medical insurance company refused to pay. She says she asked if the company covered the cost of drugs to put her to death. She was told the answer is yes — with a co-payment of $1.20.
T. Brian Callister, MD, FACP, FHM [4]:
>When I spoke with the insurance medical directors of the patients' insurance companies by telephone on separate occasions, both of the insurance medical directors told me that they would approve coverage for either hospice care or assisted suicide but would not approve the life saving treatment option.
> Neither the patients nor I had requested approval for assisted suicide, yet it was readily offered.
I'd argue that sadly something like this is bound to happen for sure because many (if not most) humans are lazy, greedy and don't like sick people outside of movies. If it is happening systematically and encouraged by the government or insurance companies - that's of course a different matter and has to be prevented.
I think that Hunter Thompson basically did this. Kinda "on-brand" for him, really.
I had a friend that decided to stop treatment (dialysis), when he realized that he'd never get off it (he couldn't get a transplant). He was in his late 60s.
It was both a sad, and joyous experience. He took about a month to pass (renal failure). He was Catholic, and wouldn't do assisted suicide.
During that month, a bunch of us would go over to his house, almost on a daily basis, and we'd just hang out. It was actually a great experience.
You omitted the _most_ on-brand part of this story, which is the part where (per his last wishes) Johnny Depp spent $3m on a party that involved firing Thompson's ashes out of a 150-foot tower in western Colorado.
Well, not just the comment, but also the wikipedia article linked to in the comment.
Obviously, Jainism isn't Catholicism, but this part of the wikipedia article got me thinking:
>It is not considered a suicide by Jain scholars because it is not an act of passion, nor does it employ poisons or weapons.
Catholics are probably never going to think suicide is ok, but I wonder if they could come around to a definition of suicide that is more narrow and which excludes death-with-dignity. If they did make that adjustment, I would personally agree with their stance.
There is plenty of precedent for this legislation through definitional scoping in history in general, though I'm not an expert on Catholicism. The book "Legal systems very different from ours" talks about it, and gives examples. It's really the only option for any sort of change when you're dealing with decrees from a supernatural entity or an unchangeable part of a constitution.
That’s the problem. If there’s a financial incentive people will find way to push it.
That’s my biggest concern about assisted suicide for an otherwise healthy person who just wants to avoid the inevitable decline (as in this case). There is a direct financial incentive for families to push people into this.
The only way I can see to remove that would be to require that your estate can’t go to anyone who potentially has influence over you in the case of assisted suicide for with no terminal illness.
Yet you don't see insurance companies hiring snipers to get rid of their oldest customers. Maybe the solution is to prosecute those who would push MAID too aggressively as we would those who push to suicide.
I've waffled between support and opposition of MAID a lot, for similar reasons. I think the morality of it depends heavily on social and economic context. In the US specifically, I worry that MAID could serve as a roundabout form of eugenics, even if it wasn't disproportionately recommended to any particular group.
Imagine you're poor, your family is poor, and your friends are poor too. You spend 2 years in and out of inpatient care, and then die. Your family is now saddled with a debt they will never be able to pay. Your medical bills could make them homeless. Now imagine choosing between that, and MAID. MAID is obviously a cheaper "out."
Now remember the demographics of poor people in this country. If poor people end up being more likely to choose MAID, that necessarily means MAID would be used disproportionately on ethnic minorities and disabled people. So you end up with eugenics again, just because of the sorry state of our medical system and class demographics.
Not all assisted suicide is eugenics, to be clear. There's a discussion of Jain practices elsewhere in this comment tree.
But man did I lose sleep at the thought that we could have people volunteering to kill themselves solely because they're poor. You could argue that it's wrong not to give someone the choice to die sooner, given that dying later could cause so much strife for their family. But I hold that the right solution isn't making people die sooner, it's building a medical system where people never have to grapple with this choice in the first place.
I find it really weird. So someone pays CHF 10K to be given a lethal injection then it becomes dignified and the other way isn't? I think it is an insult to the departed if you question the path they choose - because then both the choices can be questioned and judged.
And did you just go to eating more fibre from euthanasia in the same few sentences? :D
Some of its wording is weird, like mentioning his wife dying in the same context of two other partners with no explanation. The original is a much better read.
I'm surprised and fascinated that this is apparently legal in Switzerland. The Netherlands, famous for allowing assisted suicide, has pretty strict criteria for this[1].
In particular, the physician must "be satisfied that the patient’s suffering is unbearable, with no prospect of improvement", which from this article sounds far from the case here.
It is surprisingly hard in NL; we have familiar Alzheimer and had some practice by now, but it is very easy (depressingly so) to arrange your assisted suicide for when you get Alzheimer a long time upfront and still not get it because you did something wrong in the procedures/paperwork and end up going through all the suffering you planned out not to go through. It is not 'oh then they just sit in a home without memories'; it is a devastating process definitely far worse than death.
Euthanasia in Switzerland ^ has been a notorious profitable practice for years, compared to the Netherlands where it's almost exclusively practiced on those with terminal debilitating disease.
^ Yes, it's "illegal" but it's effectively nulled if the means to it are made legal.
Then I do wonder why no company has come knocking to the door of the hospital room where I'm sitting right this minute waiting for my terminally ill mother to die.
Because since years she's member of EXIT, the well-known Swiss institution that is providing assisted suicide services, and it would still take several weeks for us to jump through all the required paper and legal hoops to get the ball rolling.
And now she being already unconcious and therefore incapable, most ways are blocked already, as others pointed out, so I'm not sure we could accelerate the process at all.
Sorry, but your comment smells rather about peddling fakery, especially as you have provided heaps of reliable references.
When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.
> It is difficult to reconcile that citizens may have the right to do almost anything to and with their own bodies– from participating in extreme sports to having elective plastic surgery– yet a terminal patient cannot choose to avoid experiencing additional months of discomfort or loss of dignity in their final months of life.
One issue I think about a fair bit is that without legal assisted suicide aside from all the usual issues with unassisted suicide you need to end things even earlier to make sure you do it while still physically capable: with age the risk of physical debilitation increases sharply, a bad fall or a small stroke will see you in the hospital or incapable of moving an arm. Which is on top of the risks of mental debilitation taking away your right to self determination (through simple incompetence).
So he was very old without any significant problems, but he wanted to avoid the inevitable problems?
If you’ve already made it to 90 with no major issues, you’re expected to make it to 95 and you could make easily live to 100. My wife’s grandad is 90 and he still lives alone, drives, plays golf nearly everyday, and regularly sees his 12 grandchildren and many great grandchildren. He even made the 9 hour trip to come see us last year.
I’m very wary of making it legal for doctors to euthanize an otherwise healthy person who just wants to avoid an eventual decline.
It’s relatively common for families to push people into nursing homes, but in this case there’s an even stronger direct financial incentive. I don’t trust the system to adequately prevent this.
> If you’ve already made it to 90 with no major issues, you’re expected to make it to 95 and you could make easily live to 100. My wife’s grandad is 90 and he still lives alone, drives, plays golf nearly everyday, and regularly sees his 12 grandchildren and many great grandchildren.
Counter-anecdote, my partners Granddad is 93. Age 90, we said the same as you. Now he's an old, rude, obnoxious liability - he's still great, and I don't hold it against him, he's earned the right. But I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
From the article:
> Kahneman knew that many would see his decision as premature. But that was exactly what he intended, he wrote: If you wait until a life is "obviously no longer worth living", it is already too late.
I personally wish my partners final memories of her Granddad were him at 90, and not at 93. I've known for a good 5 - 10 years I will take the same route as Kahneman. I feel the desire to stay alive long enough to be a liability for yourself and those around you is a decision motivated by ego and fear, rather than compassion or logic.
>I feel the desire to stay alive long enough to be a liability for yourself and those around you is a decision motivated by ego and fear, rather than compassion or logic.
Everyone becomes a liability at some point. By that logic we should just go full Logan’s run and kill people as soon as they stop being productive.
There nothing wrong with saying that you aren’t going to take extreme measures to preserve your life past a certain age.
But I don’t want this attitude of “you should kill yourself so you don’t burden your family” to become the norm either.
What if your partner’s grandad heard you calling him a rude obnoxious liability and felt pressured into killing himself?
>I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
But many people die suddenly with no serious mental decline at all. That can happen at 95 or 100 the same as it happens earlier.
If you rule out everyone who didn’t die of some nebulous cause as the result of a slow decline you are selecting for people who mentally decline.
I see a lot of elder people age very suddenly. It's like the capacity to recuperate from a problem is gone. With some luck no such problems appear and you can become old without much troubles. But once a problem appears, it hits in full force.
My nan made it to 92 without any mental issues, but then deteriorated significantly over the course of 18 months, forgetting she'd ever been married, had kids, etc, just reverted to believing she was a teenager who wanted to go home to her parents (in a house which was destroyed in ww2)
She couldn't look after herself was was forced into care by the courts. Since going into a home she's physically never been fitter, but mentally she's not the person she was 10 years ago -- it's not that she's changed personality, it's as if her memory of the last 80 years was wiped.
That’s terrible, but you never know when or if the decline is going to happen, so if you pick an arbitrary cutoff you’ll have killed people who had plenty of good years left.
No, he was an old man who cared for his wife with dementia until his death, an experience which changed him. And thus he has chosen to go on his own accord.
If the society treats people badly, that's not a reason to deny them the ability to do final exit with dignity. We must fight to fix the problem cases, not take dignity away from those who suffer from it.
> It’s relatively common for families to push people into nursing homes,
So you are rejected by your family and punished even more by taking away a dignified exit strategy?
Nothing is being taken away. Medically assisted suicide to prevent old age has never been a right anyone has had under any legal framework until very recently. And it’s not a right anyone has anywhere but a few countries.
You can argue that more countries should grant that right. But if you’re going to do so, you need to have an answer for the incentives it creates.
I agree with your legal assessment and still think of the case as very interesting. The article explicitly talks about how any such decision could have only been premature, for the slow cognitive decline is typically only noticed when it is too late, and because the change is continuous, there can be no good commitment to "I no longer consider this life worthwhile once condition X is no longer satisfied".
Took care of someone with Alzheimers for six years until they passed away. No one should have to exist like that, for that long. A biological shell simply of automatic inputs and outputs.
I think Alzheimer's is a particularly difficult case. Before diagnosis, many of us imagine that we wouldn't want to exist in a highly deteriorated state with no ability to care for ourselves. But as you start to decline, you still feel like yourself, just a very forgetful version of yourself. On which day do you decide that what remains of your mind isn't enough to make your available future days better than no future days?
The instinct for self preservation is strong. Knowing what will come requires foresight and clarity. You may lose the capacity for informed decision making before the point where it's clear that there's not much to live for.
Many of us lack the insight that Kahneman perhaps had that in order to take control of the end you may need to leave some good days on the table.
I’m young, but I’m at the age where I’ve seen many grandparents pass away and I must say, I support assisted suicide. The helplessness of the last stretch of your life, something that can last a couple of years, where you often need to help to even stand, doesn’t seem like a period of time worth living. Further modern medicines, in my opinion insane focus on extending life of the very old, compounds this situation to something much worse. I know of a relative who had 5 surgeries, 2 ICU admits in his final year, he was 84. First they were convinced his kidney was failing, then his liver, then they thought cancer and on an on that I couldn’t help but suspect whether this was a money grabbing scheme.
I do not know if this was ever widely practiced, but I think the ancient Indian ritual of going to the forest and starving to death in your last days is basically fine. It gives a dignified, sacred end to a life, while the modern medical sciences constant battle against the inevitable ends up distorting and deforming the last days of your life and forces you to leave without dignity clinging to the last vestiges of your humanity that’s left.
Ever since I watched my father waste away in agony and die in a veterans home, it has become my greatest fear in life to suffer until the bitter end. I choose euthanasia because I don't want to put my family through that, and the last thing I want to do, if you'll pardon me, is to waste away in my own urine and feces in what will likely be a sub optimal care situation.
You can get into a state of living death where the brain is mush and who you were is completely destroyed. That's hell for the family.
I saw my grandmother forget her daughter (my mother) it was heartbreaking. Seeing my mom realize her mom forgot everything about their life together was just painful.
It was just a sad existence to observe as well. Grandma lived for quiet a while with dementia and spent years trying to return to her childhood home. We'd constantly have to trick her into accepting help from us "strangers". Re-convincing her to come inside that these "strangers" wouldn't mind having her for a bit. Watching her read over the same page of a book for hours on end.
That's not an existence I want for myself or my family.
> Daniel Kahneman did not want to make a statement or start a debate. "I am not ashamed of my decision," he wrote, "but I don't want it to be discussed publicly either."
Lots of discussion of the morality of assisted suicide in this thread, and the circumstances under which it should be legal.
In the cryonics community, it's a common complaint that they have to wait until the patient is legally dead in order to cryopreserve, which can make it difficult to cryopreserve under ideal circumstances.
I like the idea of allowing individuals to opt for cryopreservation over end-of-life care. End-of life care costs so much money, it could even be neutral from a financial perspective.
Since cryopreservation lacks the finality of other forms of death, it could also address some of the ethical dilemmas around assisted dying. After all, a lot of end-of-life care seems to be motivated by a futile attempt to somehow delay the inevitable. From my perspective, cryopreservation seems slightly less futile.
If medical technology continues to advance, maybe in the year 2500 there will be people walking around who were born in the 1900s and can give talks about their experiences. Wouldn't that be cool? It would help a lot if just a single country to made it possible to get cryopreserved before you're legally dead.
You're talking about cryonics as if it were an established, scientifically proven and effective technology, but it doesn't work and is widely considered to be pseudoscience.
And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
>You're talking about cryonics as if it were an established, scientifically proven and effective technology
I don't believe that. I do believe it is a hair less futile than delaying the inevitable and then burying yourself 6 feet underground.
>it doesn't work and is widely considered to be pseudoscience.
The cryonicist claim is something like: "If we save your brain in a way that preserves its information content, it may be possible for future technology to reconstruct that information content, and effectively revive you." No cryonicist is claiming that cryonics "works" with existing technology.
Consider the state of medicine in the year 1925 vs the state of medicine in the year 2025. Now extrapolate that advancement trend forwards until 2525. Is extrapolating trends forward a form of pseudoscience? If so, what do you say about global warming?
>And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
Keeping a closed canister filled with liquid nitrogen is not especially costly.
(BTW, I appreciate that you made a falsifiable claim here, since that helps readers evaluate the credibility of your other claims. A sort of within-comment Gell-Mann effect.)
> And even at the end, when asked what he would like to do, he said: "I would like to learn something."
Don't have an exact word to describe how I feel after reading above. Find it beautiful that such an accomplished person wanted to learn something even towards the end of his life.
Everyone talks about Alzheimer's and dementia, but Daniel Kahneman has neither. He chose to commit suicide because he wanted to avoid “natural decline.” That's an unexpected statement from a 90-year-old. I'm more surprised by his lack of will to live and that he just “gives up” and throws away the most valuable thing he has.
This is one reason why as I’ve entered my 50’s, I’ve decided to take every advantage of modern medicine including hormone management and performance enhancing drugs. I started three years ago at 47 and now I’m living my best life at 50, in the best physical condition that I’ve been in since my early twenties. Although I’d certainly like to live a lot more years, I care more about my quality of life than the quantity of years. If I make it to my 80’s, it’ll be with the testosterone of a man in his 20’s and muscle mass on my body.
We definitely need a better culture around dying. My mom is 95 and slowly everything she likes is being taken away from her. Going for a walk is difficult because she has unpredictable falls, husband is dead, all friends are dead, eyesight is so bad she can't read anymore, memory is failing. Really nothing to look forward to. Just existing and waiting for things to get worse.
Mentally she is still pretty clear and she often says it would be best if she doesn't wake up in the morning.
I think it would be better for everybody if we had a way to have a ceremony where we all say goodbye and then end it.
”Daniel Kahneman did not want to make a statement or start a debate. "I am not ashamed of my decision," he wrote, "but I don't want it to be discussed publicly either."”
Seems like we should close this thread to honor these wishes
I think it's beautiful he got to go out on his own terms, when he felt it was the right time to do so.
I'm often reminded about a case in my own country: a young person had decided it was time to end her life after struggling for many years, without a sign of improvement. She was denied the right to euthanasia. After multiple failed suicide attempts, she went for the nuclear option and jumped in front of a train.
Everyone deserves to die in a dignified and humane way, not in multiple pieces or with a mind deteriorated beyond recognition. Forcing prolonged suffering is unnecessarily cruel. I wish more countries were as progressive with euthenasia as Switzerland.
Coincidentally, today there was an article in a Belgian newspaper about a 25-year-old woman who will undergo euthanasia in a few weeks due to severe psychological suffering with no prospect of improvement. After years of suffering and 40 failed suicide attempts, I indeed think it's much more dignified to have euthanasia as an option.
Euthanasia has some strict rules in Belgium, especially for cases involving psychological suffering. In 2014, the age restriction was dropped (except for psychological suffering). Since then, 6 minors have received euthanasia.
I saw someone interviewed who had set the criteria of being able to enjoy some ice cream with his children and grandchildren at the regular family dinner on Sunday late afternoons.
He said that alone made life worth living, for him and them, but once any deteriorating conditions rendered him permanently unable to participate in this weekly activity then he felt it was time to go.
Maybe having a pre-set condition like this is less arbitrary, and also allows everyone involved to understand as the time comes closer.
I think this is a fair measure of any life -- are there enough positives to offset the negatives? And that includes the cost (and the benefit) of your suicide on others. No one but you should be able to make that call. All that remains then, legally, is to ensure you are well informed about the de/merits of your choice and sane enough to make the call.
Of course, even if you lack legal permission, suicide doesn't strictly _require_ legal or medical assistance. An autonomous exit is always an option, though generally less painless than assisted.
I 100% understand his rationale, and in the same position I'd probably do the same -- "probably" because this is one of those things you can't possibly predict in advance.
My dad is in the early stages of Alzheimer's and it's made me think of what I'll do if I find myself in the same situation
Assisted suicide sounds like a fine option until you think of its impact on your loved ones. Imagining putting my wife and kids through my deciding to die, and the process of them bringing me to the place where it happens - or imagining one of them doing the same thing - just fills me with horror
Death comes for us all. It’s okay to cultivate emotional fortitude to die on own terms, at the place and time of our choosing, with grace. Would you rather them remember you as a shell of who you were, long dead mentally while the body continues on? Death is a part of life we cannot avoid, nor should we.
> If you wait until a life is "obviously no longer worth living", it is already too late —- Kahneman
Live your life in a way that it is worth living until you no longer can, I suppose. To exist is hard, do your best.
One of my friend's parents had a neurological disorder in his later years and was considering suicide. I don't know the details, but I know he had mentioned it to my friend. I believe he was convinced to try one more procedure that the logistics never lined up for. He ended up dying anyway a short number of years later.
He kept to himself, so I didn't know him well. I did know that he was an independent and thoughtful man who hated that his tremor got so bad he couldn't feed himself. I remember talking with his family about if those self-balancing Google spoons might help.
There are two kinds of people for whom suicide sounds appealing: those in poor health who don't want to experience it getting poorer, and those for whom the difficulty of being alive outweighs the joy of it. If you're in the former camp, that pain is coming for them anyway. If you're in the latter camp and still make the decision, maybe you don't have those close bonds that make you want to persevere.
Death happens to all of us. I’m 51 and as far as I know have no terminal illness. I stress to everyone that I focus on “living a good life. Not a long life”. My wife and I balance living every year like it might be our last and saving for a long life. We don’t put off traveling, concerts, hanging out with friends and other experiences so we can “retire rich”. If we can’t afford expensive travel in our 60s because we spent our younger healthier years traveling - so what? Statistically we won’t be healthier in ten years than we are now and we are both gym rats.
I “retired my wife” at 46 in 2020, eight years into our marriage so she could enjoy her passion projects and I have turned down more lucrative jobs that would have required me to work harder and be in an office so I could work remotely from anywhere - but realistically in US time zones.
Everyone who knows me, knows that I would die with no regrets. As far as my wife who loves me and my grown (step)kids who I know also love me, I don’t owe physical suffering to anyone. Assisted suicide because of Alzheimer’s is more tricky than something like cancer though. What can you do? Sign something in advance where once you can’t pass a cognitive test three months in a row - kill you?
I'm totally in favor of assisted suicide, and I think it's a good mechanism for those suffering, if voluntarily chosen.
That said, I think the same, and there are some non-obvious second-order effects around it being the menu, especially regarding life extension incentives and if people started to feel guilt-tripped by it.
The first thing that comes to mind is a reduction in commitment to the elderly. As soon as health care costs ramp up, people will start to make more decisions based on the economic aspect of the people's support instead of thinking in life extension mechanisms as a natural first choice.
Second, it is related to the public health services. From my experience in some parts of EU/America, if you have a disease until your 50s, you will get treatment. However, after that, there are probably some parts of the public/private health system that throttle down the treatments.
The 2-week interval between a return if you are 30s/40s, will become 6 weeks if you are over 60s.
The next one, the "inheritance social contract," will be changed. As long as folks know that assisted suicide will be placed on the menu, I do not doubt that folks terrified with the possibility of loved ones "not doing enough to keep them alive" will dilute everyone who lifts the gas.
And as a second-order, I can see the securitization and life insurance industry will demand insane premiums to cover elderly persons, given that potentially people can lift and coast the treatment for their loved ones, and this can break part of their actuarial models, which, yes, expect people to exhaust resources to keep their elderly alive and not to choose together to pull the plug in a single-digit number of years before.
And maybe a third-order effect (in Germany there are some cases) where people with resources (single-digit million real estate + assets) exercise liquidity on it and live the best of their lives after 70 or in some cases, legally marry 30+ nurses to take care of them in the last 3 years and offer a chunk of inheritance, post-death pension, or insurance premium.
Good account of his reasoning. Off topic, but my Dad’s last girlfriend before he died two years ago was a co-founder of the Hemlock Society/International Right To Die organization - huge effort to get assisted suicide made legal in different tax jurisdictions around the world and different states in the US.
assisted suicide bears risks similar to adding benevolent backdoors to software. The policy rests on the assumption that policies and those enforcing them will always be benevolent.
We're opening up tremendous abuses of power by allowing the state to kill people for non-criminal behavior.
Sure the first iteration is presented as "voluntary", but the next edition will be for the greater good. And how about sinister / malevolent abuses of "voluntary" suicide -- similar to abuses over guardianship.
at least with guardianship the person can be set free, because they are still alive.
This is a bit of an aside but I wonder if people who possess greater intellectual capacity are more resilient - at least outwardly - against old-age mental decline, as even their mental function diminishes, they have an excess buffer so that they are slower to cross the 'threshold' where their inability to mentally function in everyday life becomes apparent?
He had to know it would be. I wonder if that was maybe an attempt to say this is completely personal and I'm not trying to encourage others to do the same or suggest it is the right thing for everyone to do?
I see a lot of comments here expressing disapproval about assisted suicide.
I'd like to quote from the HN guidelines:
> Don't be curmudgeonly. Thoughtful criticism is fine, but please don't be rigidly or generically negative.
With that said I urge you those who disapprove to ask whether you are being "rigidly negative" about this.
1. Is this disapproval perhaps coming from your religious context? If so, please pause and consider why that may not apply to the rest of us. And also whether you really think that your religious beliefs must be forced on the rest of us.
2. Is this disapproval coming from a sense of deep unease that this post causes? If so, know that this unease is shared by most of us. But try and muster the fortitude to go past that unease and consider the decision from a place of compassion.
My mum died earlier this year. In hospital, she was approved for assisted dying. There is a mandatory waiting period as part of the process.
Many/most of the nursing staff are Filipino and strongly Roman Catholic.
As she lay dying and unable to speak, one of the nurses undertook to convert her at this last minute to their religion. At night, alone, after all visitors had left, she would come into mum's room and press mum, a very committed atheist, to pray for her salvation.
It's hard to describe how vulnerable someone is who is stuck in their bed and dependant on the nursing team for everything, even sips of water.
I will say this was not representative of her care, but it opened my eyes to the lengths religious believers will go to to push their views on others.
"His decision seems to have been based less on his famous scientific thinking and more on a very personal feeling. He wanted to retain his autonomy until the end and to shape his own end."
So you could say it was more system 1 thinking rather than system 2.
I would've expected the opposite given our survival instincts.
An interesting choice. It's fascinating that even for very ill or injured people the will to survive is so strong - I wonder if at a certain age this instinct diminishes making a choice like his easier?
> I wonder if at a certain age this instinct diminishes making a choice like his easier?
It's less likely to be "a certain age" and more surrounding factors: if most of your friends have passed and you don't have much chance to do things that interest you because you could pass at any moment yourself there comes a point where life has limited worth.
Essentially, hope runs out, and when it's run out entirely you either wait for death, or ... don't wait.
> It's fascinating that even for very ill or injured people the will to survive is so strong
If you have (grand)children, an important reason to wanting to stay alive is often not the fear of dying, but wanting to be there for them and fearing the grief they will endure if you are gone.
My grandparents stuck around too long, so I have the opposite fear of burdening my descendants with having to (if not legally, then via social pressure) spend too much time, money, and energy caring for me.
Maybe at a certain age other instincts strengthen making a choice like this easier? We all have to come to terms. And if you are older than 70 then it is just a fact that every day can be your last without any accident or noteworthy medical complication. And the guy has been probably thinking about this fast and slow for at least two decades then.
For every Daniel Kahneman case, there's a case where the victim doesn't give consent, is coerced, or pressured from caregivers. It always rapidly expands from terminal illness to mental illness or non-terminal conditions. There's also weak oversight and misaligned profit motives. The examples in the Netherlands, Switzerland, Canada, and Oregon are shocking.
You didn't mention Belgium so I'm pleased to hear that Belgium is doing well according to you (4000 cases of euthanasia per year of which 80 are for psychological suffering, 1 child per year).
It's another thing to not give palliative treatment to prolong life for a little more and another to provide poison to accelerate death. My opinion is to continue palliative care when the benefit outweighs the harm in the QUALITY of life (not necessarily quantity) and infuse some morphine 1 or 2 days before death in order to skip the last stage.
Not going to express an opinion, I'll just leave this except from the Hippocratic Oath [1], which reflects society's primary beliefs on this topic approximately up until the 19th century:
The modern hippocratic oath has no mention of poisons, also doesn't require the oath to be sworn before the gods of the pantheon. Up until the 19th century, physicians didn't believe in germs either. Attitudes change with the knowledge we accumulate.
To me, Daniel Kahneman humiliated himself by choosing suicide (if he was in a sound state of mind to make that decision). He was a scared, little old man. He made an assumption that his life was "obviously no longer worth living", how little he thought of life is pathetic.
Now he could have been depressed after his wife died and was just lying to himself that this was his own, autonomous, decision. Depression can do that to you, it can make you think suicide is the most rational decision.
As a person who lost my life partner six years ago to a brain tumor I completely understand what he did. After seeing things first hand I too don't intend to wait for old age and illness to devastate me. I'm barely over half of his age with no serious health issues that I know of so it's not the time for me yet. But I can fully understand his reasoning.
Seems like a good way to go out, "my choice, my body" . I realize some psychological exam should be necessary before such things but it really should be self-determined within reason. I hate that USA is so far behind the curve on this, but eventually we might catch up on it with Europe and not have to resort to more ugly methods.
I used to be for assisted suicide but I have changed to be against. The things that changed my mind is seeing how it has gone in countries that have implemented it like The Netherlands and Canada with what I consider to unethical assisted suicide of people with mental disorders and disabilities. It smacks of state sanctioned killings disguised as charity. The second one was what kind of psychopath assists in the killing and why is that person allowed to keep practicing. Finally if we can kill ill people what really is the difference in implementing the death penalty and justifying it by ending the criminal insane’s suffering?
This always comes up with this prize, but it’s generally considered one of the Nobel prizes, although it’s not one of the original prizes. Your opinion on whether it should count is up to you, but to call it media manipulation is reading a lot of malice into it.
Argument is that economists knew exactly what would happen when they got linked with Nobel Prizes and help solidify economics as hard science like physics, medicine or math in eyes of the public. Begin debate around how scientific is some economics.
The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
Ironic is the opposite of what you mean, don't you think? By your explanation, Kahneman acted according to his life's work.
> The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
That was possibly part of his motivation. But also the pain, suffering (goes broader than physical pain), confusion, and cost -- to him and his family.
I’m trying to figure out why this feels so unsettling to me. I can understand wanting to end one’s life because of unbearable pain or illness, but something about this just feels wrong.
It's not unsettling for me, but I have a similar feeling. On the other hand, maybe he did have a medical issue, just chose not to disclose it. In any case it is his choice, as is the wish not to discuss it. I think this will be difficult to enforce, but I will personally respect it.
I'm part of the Jain community in Bangalore, and the version of this in society exists, called Sallekhna [1], a tradition that's developed over millennia, and this is venerated and celebrated.
The philosophical underpinning is giving up of materialness. The practicality of the 5 instances that I witnessed over the past year - typical terminal individuals choose this. They pass away surrounded by loved ones (they typically medicate for any pain, and the body starts shutting down when food and water stops). This is observed with somberness, but celebrated as very positive act.
When someone starts this process, it's a unique experience speaking with them, as there's usually nothing that comes up, and the moment does not really lend itself to small talk :)
[1] https://en.wikipedia.org/wiki/Sallekhana
Thank you for sharing this. My grandpa passed away earlier this year at the young age of 97. We discovered a kidney cancer and decided not to treat him and bring him back home.
During his final days, he became unresponsive, only sleeping. The doctors gave us the option of feeding him through a tube. We made the hard decision of not doing it. Gave him all the medicine to help his body heal, but no invasive procedures.
We stayed by his side for the next 5 days. Playing songs that he enjoyed. Audiobooks that he loved. And just taking care of him.
Finally, his breath became slower and slower until it stopped and he passed away. I had the opportunity of being beside him during his last breath.
The passing of loved ones is always difficult, but I am grateful for how he went. He lived a full life and was incredibly healthy until the end.
Without knowing, we decided on a sallekhana-like process for him. It was the right thing to do.
Thank you for showing me this.
This is essentially what hospice is in the US. They stop curative treatment and focus on comfort. Then at the end when the person can no longer function to eat or drink they increase the morphine dose to a high level until they pass.
Right. It's a not-so-well-kept secret that hospice care is actually assisted suicide in disguise. It's done with a wink and a nudge, hiding behind the principle of double effect, but it's a mercy everyone knows is happening. It's sad that it has to be done covertly.
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Ever since I learned of Jainism I’ve wished I’d learned of it earlier.
Thank you I just learned about it. Seems compatible with atheism.
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In a similar vein India also has/had Thalaikoothal, which is more of a traditional method of homicide than suicide.
[0] https://en.wikipedia.org/wiki/Thalaikoothal
"They are given an oil bath and made to drink glasses of coconut water"
I'm surprised that someone can be killed in this way. Is it the electrolyte imbalance? There's a lot of potassium in coconut water.
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How did they medicate for pain for millennia before the advent of painkillers?
Are we pretending opioids do not exist in nature? What's next, how did people hallucinate before LSD?
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People were probably suffering a lot. I can't imagine being a migraine sufferer in 1500. It's miserable enough now.
How long does this actually take?
Hard fast (e.g. hunger strikes) usually take about 2 months to kill a healthy adult.
On the one hand according to the wiki this is more progressive removing food by degrees which would make the process a lot longer.
On the other hand being a mostly ascetic practice I'd assume it's done by people who have a lot less reserves (body fat and muscle) which would shorten the process significantly (the 207kg Angus Barbieri famously fasted continuously for 382 days[0] breaking his fast at 82kg, although he supplemented his liquids — water, tea, and coffee — with vitamins, electrolytes, and yeast extract, the latter for essential amino acids).
[0]: technically he was put on a recovery diet of salting then sugaring his water for 10 days, so ate no solid food for 392 days, breaking his fast with a boiled egg and a slice of buttered bread
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The earliest was under a day. The latest was about 2 weeks. I've heard of about 45 days one as well.. but thats unusual.
I was curious about how he actually died and found an [1] article describing it:
> Kahneman used the services of Pegasos in the village of Roderis in Nunningen, Switzerland. In the death room with a view over green hills, wearing a suit and tie, he lay on the bed and turned on an infusion of sodium pentobarbital himself. A companion held his hand and told him they were holding it on behalf of his loved ones. Kahneman's last words were "I feel their love."
[1]: https://www.aargauerzeitung.ch/schweiz/suizidhilfe-weltstar-...
Is this https://pegasos-association.com the one?
> Pegasos, a non-profit based in Basel, Switzerland, believes that it is the human right of every rational adult of sound mind, regardless of state of health, to choose the manner and timing of their death.
I found this bit "regardless of state" really interesting.
I wonder what their views would be for someone who wouldn't have a family and nothing much to do or explore after a certain age? Does it matter what nationality they are from? What if someone's reason is - they had savings and now they have run out of it and area already 55-60 or more and have no intention or plan to work anymore and don't want to go through the struggle of life? (Of course they would have had paid the euthanasia fees)
How does it all happen?
Well they did say “rational adult of sound mind”, and “rational” there easily disqualifies every human being on the planet, with all our evolved biases, heuristics, and common predictable misjudgments. I imagine its criteria applied arbitrarily.
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This hit me harder than I thought it would.
I had an old teacher who died almost a year ago.
Great guy, very sociable, knew everyone in the little town he lived in. Kept in touch with a lot of students. Good neighbour, friendly guy who'd talk to everyone.
He got Alzheimers. He started forgetting stuff, and it frustrated him. He got caught driving dangerously, and cursed the doctor who took away his license.
He argued with me about the state of some chicken he wanted to cook. I told him "this is pink all over, you have to cook it more". He got angry. I understood he'd become like this to everyone.
He pissed off everyone on his street, and all police, medical and social workers sent to help him. The disease made him blow up every relationship he had with anyone that he didn't know well, like me and a couple of colleagues.
He got found in his house, having left the gas on, endangering the whole street. He ended up in a care home, not knowing who he was, or who I was.
If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
It doesn't seem pleasant for the person themself either. Constant frustration, gaps in your memory growing ever larger, disorientation, loss — periodically augmented by brief flickers of recollection of what you used to be — and yet no one can legally end your misery, because you can likely no longer unequivocally consent to euthanasia or assisted suicide, even if you explicitly signed a declaration that you did not want to end up like this — legally, the current husk of your former self must consent, and it can't.
Some places permit consent in advance, the person specifies the conditions but hands the evaluation of whether they have been met to the doctor.
It’s still absurd despite what you say that we are implying that we should euthanize another human because they have become difficult to manage due to illness. Where do we draw the line?
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This is such a cruel perspective, implying that he'd be better off dead, for what, 3 years of inconvenience to his community, despite the previous 80 years being spent contributing positively to it?
You even literally show that he isn't solely remembered for those last 3 years of his life. We owe people like that care and understanding, not murder framed as mercy.
It's always so painful to see old people around who are clearly living alone, forced to do everything themselves, having to ask strangers for help because they're afraid of being a burden, and their actual children can't find time for them. Only to now see people actually supporting murder because old people become a burden for a couple of years near the end of their life.
Thank you for saying this. It's not a popular view, but it is the correct one.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I don't think I've read a wilder defense of euthanasia in my entire life.
This is a "great guy" who committed his life to teaching kids, being a good neighbour, and his reward is one of his former pupils arguing he ought to be killed because he's grown unwell, he's unable to maintain his optics, and the community he gave his life to has therefore 'soured' on him. How very inconvenient for you, that this man is unwell.
What message is this supposed to send to anyone? "Don't get invested in trying to be nice to the neighbours, they're all ghouls who'll have you shipped to the glue factory as soon as you stop seeming useful." And once everyone internalises this level of social atomism, where do you expect these 'great guys' to keep coming from?
He’d be dead either way, the question is if having those three years were a net improvement to his life
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But this guy wanted to die right? Bit different. Agreed that 'how others view you' is such nonsense. People are cruel that way and also: those children who couldn't be bothered visiting or helping out, will be standing at the funeral sniffling and telling 'such great dad stories'. Makes my blood boil.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
The parent described someone who went above and beyond the norm of other members in his community in his constant positive interaction with his neighbors, collegues, and former students. It is highly likely this kind of person would give a considerable shit if he knew he would become a nightmare for the same community.
There may be others reading in the thread who also can relate to the personality of the teacher and may care about their affect on others when they are "not themselves".
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In my experience having had a parent suffer this way, you lose them before they are dead and you grieve along the way. I can understand the "souring" phrasing - in that there is less affection for the altered person in the present even while feeling a duty for their care and a deep love for who they were.
I'm grateful for this story - it's powerful to see examples of autonomy at end of life - and contrasts starkly with the experiences many of us have with aging parents. End of life, at least in the US, can be deeply flawed and misery for all.
Valuing how others remember you is definitely a motivation in life for many. I respect that it is not your own, respect that it may be mine. It is by no means "absurd".
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My brother had schizophrenia. No one thought well of him. I guess he should have killed himself as well by the logic some are professing on here. Oh, he tried, but he ended up dying of heart disease.
> Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
Yes, this is the focus. Science has stalled when it comes to neurological disorders. But the response is love and understanding. I do not understand how someone would "sour" on a person because they have an illness. A very absurd conclusion indeed.
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the conclusion is true, though obviously the worst part is that this guy spent at least a year in varying states of despair, anger, and even worse psychological terrors.
you don't want dementia because it damages and hurts you and everything and everyone around you
(my grandpa physically attacked grandma multiple times in his last year)
>This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
They do matter.
Being concerned with how your behavior affects your family or your community, and the opinion they have of you, above your own self-interest, is how good parents, good friends, good citizens, and so on, are made.
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My wife's grandma passed some years back due to dementia/Alzheimers. Her final memories of her were of struggling to change her diaper because she insisted "she didn't need a change" and being really racist.
I really don't want my family's last memories of me to be that. Yeah my wife remembers when her grandma was of sound mind, and has some good memories with her back then, but they stopped due to the disease.
Everyone should be entitled to their own opinions on how they want to be remembered. I would rather be allowed to pass in sane mind.
It's not so absurd. The only afterlife that exists (in a materialist sense) is what other people think of you. The only part of 'you' still around us quite literally just a memory in someone's head. That's not nothing.
Whether we should care about that or not is a philosophical conversation, I suppose. I would take the side of if we care about what people think about us when we are alive, surely we should care what they think of us when we are dead. Otherwise, we only value their opinion of us as a function of what they will do for/to us, which seems not great.
This is a maximalist view, in reality not feasible or scalable. Of course this is what we need to strive for, but aiming to decrease 'total unhappiness' with what we have, is a rational, if somewhat cynical, aim.
But even at aface value, more rational long-term approach would be to treat it, surely
To more precisely represent the words of the person you're replying to, you should have said "memories" not "opinions".
This. Life is such a precious random occurrence that failing to protect it in the face [dementia|physical disabilities|etc] is the real tragedy.
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idk man whether the people I love hate me matters to me...
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Jason Zweig, Kahneman's friend, wrote about this and many other thoughts Kahneman would have gone through in making the decision.
https://www.wsj.com/arts-culture/books/daniel-kahneman-assis... / https://archive.ph/fEWrc, The Last Decision by the World's Leading Thinker on Decisions (March, 2025).
I have to wonder if they could have had one more magical day. Or maybe two.
Maybe in a different city, or with different friends.
If he did “learn something new”, could he have incrementally improved upon it, using his brilliant mind? Could he have made one more wise observation?
It seems he likely left something on the table.
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34M. I live with my mom who's had it for a few years.
It sucks. It's so easy to forget who they were before the disease. This is them now and it's hard as hell.
Simple things that take 1-step for us take 50+ steps for her. She doesn't readily communicate that she's hungry or thirsty or needs to use the bathroom, we have to constantly ask. She's always exhausted and walking around in circles but reacts aggressively to most suggestions to go to bed or take a nap (no matter how we word it). She can't focus for more than a few seconds, so she has no hobbies to occupy her time, and even the TV loses her interest after a minute at most. Her speech is one unbroken babble, and she gets annoyed if someone starts a conversation near her but doesn't let her interject.
Not sure how much more my dad and I have left in us. The disease stripped everything from her and it's stripping everything from us. In-home care is the likely course but she hates all strangers and is always paranoid about anyone other than us being in the house. There's no good solution.
Tell your parents you love them.
I've had just the smallest touch of this caring for my elderly parents, and you have my deep empathy. It's exhausting and really really hard.
Yeah but if you are in that state, you probably don’t give a shit and everybody else seems to be the problem. So how do you solve this? When dementia isn’t too far progressed, your life seems to be still worthwhile to live and once the dementia gets worse, it’s too late to realize this.
I read that in some societies, if you ended up not being able to feed yourself, they would bring you to your favorite tree and leave you there.
If you ended back in camp you’d be welcomed. If you didn’t, that was your end. I found that remarkably comforting and peaceful.
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You could express your wishes about how you would like to be treated in advance, while you are still clear in the head. That’s already possible for other situations, like when you are braindead and entirely dependent on machines to keep you alive, with no chance of recovery.
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> how do you solve this?
You don’t. You try to take care of yourself before you’re gone. If you miss that opportunity, you and your loved ones suffer. Same as it is for everyone now.
Give me a timer. Like the previous discussion of a red button it verifies identity. I can set the timer for whatever I want, if it reaches zero it peacefully kills me. Dementia, set the timer for say 1 month. If my mind is too far gone to reset it it will run down.
I read your comment and it strikes me as a cautionary tale that can be used by bad people to justify or push for eugenics: "they took him; they said he developed Alzheimer's".
As we're currently seeing happen: whatever is left unsaid in the body of the law can and will be abused by evil people to concentrate more power (even if the spirit of the law advocates for something kind).
So, we have to normalize some sort of stress tests for laws... because you sure don't want to be dragged against your will because you're poor.
Yes, there is a danger of that in general. I think someone made a movie in Japan about the subject, specifically because there is a culture of the elderly not wanting "to be a burden on the younger generation." Some said it hit closer to reality than science fiction because of that specific cultural characteristic in Japan. It also supports Kahnemen's position of pulling the plug when "the going is good" from a ethical point of view, since it leaves no doubt of intention.
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> I read your comment and it strikes me as a cautionary tale that can be used by bad people to justify or push for eugenics: "they took him; they said he developed Alzheimer's".
Isn't the point of eugenics to influence population genetic trends? Not a very effective strategy to kill people when they already have probably 2 generations of descendents.
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Leading cause of death in older populations in Canada is assisted suicide. People have killed themselves for not getting timely services and the medical professionals bring it up as an option.
This comment really bothers me. I am not put off by the idea that the memory of a person is worth protecting, what I am put off by is the suggestion that death is a good option here, or that death is better than having lived those 3 years of life. The idea that when someone loses the capacity to retain their reputation and dignity it would be better for them and others that they were dead and that they have nothing good to offer is such a dangerous one and is just wrong. It applies to many people who are not near their end of life too. I am really pro assisted suicide as a way of shortening suffering when made as a conscious decision by people of sound mind, but comments like these make me very very uneasy.
> I am really pro assisted suicide as a way of shortening suffering
You don't consider years of mental trauma on the individual and years burden and stress on loved ones to be suffering?
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>You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I completely agree that the disease is horrible, but your conclusion is bizarre. When you are in that condition, how anyone views you is the least of your worries.
Framing it as an obsession of rememberance or legacy distracts from the more crucial point: the fact that you will be causing chaotic emotional, psychological and physical distress in the real world to those you cared about. Again we should stop framing it as some weird obession with legacy and instead stick to the facts on the ground.
Is your position that you don’t personally care how people remember you?
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What you say is "you don't want to end up with mental state because people will hate you" but TBH mental illness, though really harsh on environment, shouldn't be viewed differently than any other illness like broken leg. When person is riding a wheelchair you don't tell them "hey you're a pain in the ass because you drive so slow and cannot jump on the stairs" - we tend to give them hand, help by building ramps and lifts. The same should be with mentally ill. Places safe for them, mabe remembering aids software in a watch?
> it totally sours everyone's view of you.
That's just as much failure of everybody as it is of him. This was dementia speaking and society needs to learn that.
You wouldn't tell somebody with a broken leg to get it together and it's just their personality that they can't walk. Nor should you treat dementia like that. Yes, people seem to shift personalities and anger others. But those others need to understand that it's a medical condition, an untreatable and fatal one, so should have even more sympathy than with somebody who broke a leg (cause that will likely just be temporary). Not alienate the person and speak ill of them.
Imagine that the illness in question was unremitting and excruciating (unlike a broken leg), not only for you and the your loved ones, but everyone you come into contact with. And there's no hope it will ever get any better. That's what dementia usually becomes, and that inhuman level of misery can last for years until you finally slip away.
No animal other than man would consider perpetuating that state of decline. An elephant would simply wander away to die, freeing their community from their struggle to simply keep breathing.
I agree with Kahneman, at least that we all should seriously consider the cost of allowing that level of degeneration to consume us -- and more, the pain it inevitably will inflict on our loved ones -- and plan for it while we're still compos mentis.
We are human. Unfortunately all of our experiences with others change our perception of them, no matter how much awareness of their motivations and our history with them. We can try to ignore it and have patience. Apologies can help but relationships will constantly change.
It's certainly a failure point within us and something to be aware of to make effort towards understanding our own impact as you suggest. Sadly a problem with no full solution over long enough time periods.
I agree with you, I would not want people to remember me that way.
Folks I know who have passed on also wanted to be remembered when they were strong, not when they were ill.
A society that sours on you due to an illness that’s totally out of your control seems a little inconsiderate to put it mildly.
I don't think anyone was suggesting that it would be society's call to make.
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>Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
I find the people who remember him as this guy somewhat contemptible though, so I guess my theory would be he wasn't remembered badly by anyone whose opinion mattered.
But on the other hand I guess that's the way the world works.
>> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I don't think this is fair. I know several people who died with Alzheimer's and although their final years were very difficult for them nobody has a bad opinion of them. It's certainly a strain on the family but intimating that if you have dementia you better kill yourself or your legacy will be ruined is not ok.
I think the suggestion needs more thought, but I don't necessarily disagree with the idea of making my exit before the dementia really sets in. I've directly cared for two family members who suffered from it (collective 5 years of my life, which I'd like to think gives me a pretty good view of what the disease can actually do to people) and I decided for myself that I'd rather be quietly killed than put my loved ones through what I went through as a caretaker. While also trying to work a full-time job and maintain my own sanity while I watched people I'd known all my life be destroyed, becoming tortured versions of themselves like something out of a body-snatchers horror film.
We, the loved ones, made the decisions to keep them going and I wonder how fair that was to them. We tend to not want to let people go, choosing to sacrifice quality of life for the sufferer and those around them for, what, a few fleeting moments of possible clarity? The opportunity to say goodbye to someone who may or may not even understand what is happening?
The events I went through with my family hurt us in ways that will not likely ever heal, despite effort on at least a few of our part, and it did leave me wondering if I would put my son or wife through that should something similar ever happen to me. I decided against it, seeing as I am at the age where these are very real possibilities. In the US, we have DNRs ("do not resuscitate") and living wills that offer prior directives, but something like assisted suicide is not allowed here unless some very extreme circumstances are met, because insurance companies and hospitals make more money from suffering people than dead ones. I'm a strong advocate of the right to die, but it is a decision that needs to be made some extensive consideration and documentation before one actually needs it.
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> intimating that if you have dementia you better kill yourself [...] is not ok.
Parent comment doesn’t say this, does it?
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Not to mention that you won't really care what people think of you because you'll be dead.
> If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
I've really thought about this a lot after seeing a number of family members and friend's family members go through dementia, and it seems like it can go two ways: like this, which is how it went with my grandmother (whose hoarding behavior increased aggressively, and she started slapping people), or how it went with my grandfather on the other side (he became quieter and quieter, watched tv every day while understanding less and less of it, and when you caught his eye would repeat how much he loved you and how much seeing you "made an old man feel good.")
It has something to do with how you feel about the nature of people in general, and whether you feel they are all suspicious and possibly conspiring against you, or that you think they are basically good and want the best for you. When you have all of your mind, you can beat the demons or the angels back with your reasoning enough to have the personality that you want. My grandmother was very loving, and my grandfather was very shrewd and practical. But when that higher function can't regulate you, what shows is if you were someone who taught yourself how to see the good in people, or someone who taught yourself how to see the bad in people.
I suspect I'll end up like my grandfather, as much as I think of myself as like my grandmother. Deep down, I've always been crippled by the feeling that everyone is a wonderful person. My aggression and judgemental nature on a lot of things can really, embarrassingly, be interpreted as me looking for excuses for everyone's behavior.
This leaves a bad taste in my mouth. I see that the man was Israeli in the original story and I don't want to presume a religious perspective, but I can share some thoughts from my own based on his story and yours. I've read the New Testament within a Jewish framework and one of the things it says, Rabbi Shaul says in 1 Corinthians 12:23 that those people in the community who are most embarrassing or cause us to blush, like the parts of our own body who are honoured or dignified by being clothed with underwear, likewise in the community are owed a special covering and to be afforded dignity by the other parts of the same body/community. Just something to think about in light of this story!
Not all Alzheimers patients get aggressive/angry. I know it happens, I’ve known one person who did almost exactly what you describe above. He lived with his partner of many years, and seemed superficially very cogent and together. It was just that he started to see insults and conspiracies against his person everywhere around him. Not until later did the cognitive and memory decline become apparent, giving him a diagnosis that explained his bad behavior.
But my personal anecdata puts that man in a minority. None of my older relatives with Alzheimer’s have become aggressive or troublesome. Worry, anxiety and confusion seem to be much more common states of mind, which admittedly also doesn’t seem like such a fun way to spend your days.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
Yes, the sixty-fifth worst thing about degenerative brain disease. Good observation.
I guess modern people need more empathy to their elderly. In Asian Village I believe they have more empathy if the elderly is having dementia.
*no data though, just observing my village
I agree alzheimers turns everything to shit in every meaning of the word.
I disagree it’s up to you to conclude it would have been better if he had been killed 3 years earlier (which you imply).
In general you don’t have the right to such a statement.
Now, if you were discussing _your own_ condition this would be a totally valid consideration IMHO. But you (almost) _never_ have the right to conclude from someone elses part when it’s their time to go.
Assisted suicide is a humane option but ”I hope he had died with some dignity years ago instead of pissing everyone off” tarnishes the entire concept and is exactly the type of argument which stops assisted suecide becoming a more widely accepted option.
It’s basically getting rid of somebody when they become an inconvenience to others. Outside the bubble of HN, I suspect most people that talk about it as humane for the person actually mean humane for them.
Many countries hesitate to execute criminals despite very clear criteria that could be used to justify it. (Many countries banned entirely.)
Why would we have a lower bar for someone who hasn’t committed any crimes?
My issue is, anyone with half a clue should know that a formerly nice respected man doesn’t automatically turn into a mean guy that “pisses them off” because he wants to be. They should have known that he had dementia and it wasn’t his fault.
I’ve never been close to anyone who had dementia. My grandparents on both sides died with their mental facilities in tact and my parents who are 83 and 81 are independent and just as of 6 months ago passed a cognitive test. I can imagine if they started acting out of character and being mean to me or forgot who I was that I would be hurt, overwhelmed etc. But not pissed.
I think you are bit wrong. Once someone close to you dies you remember them by their legacy. Also, you just have to laugh at some of the chaos these elderly cause. They call you in the middle of the night being lost somewhere and you have to guide em home. Or help the cops guide em home.
I am pro assisted suicide. Not sure about Switzerland but some countries allows it for young people with mental health problems. That I can't accept that.
I think the takeaway should be you really don't want Alzheimer's regardless of what people think of you.
Think about what is happening from his point of view. The condition has fundamentally changed his perception of reality. You are trying to tell him that this perfectly cooked chicken is pink all-over when it clearly isn't. Everyone else has gone mad and he doesn't know why.
> it totally sours everyone's view of you.
That's the part that doesn't matter at all. Your life isn't contingent on others having a specific view of you - the rest of the world can, for lack of better words, go fuck themselves.
What matters is if you want to live a life where you can't drive a car, you might poison yourself with your cooking, you lose your mental facilities, etc. That is the relevant choice here.
I hear quite a lot of these stories from my parents. Are these kind of personality shifting diseases, like Alzheimers becoming more common? And if so, is it because we take better care of our hearts and don’t die as early as?
Yes, I think that's right. The average age of death due to old age has climbed for over a century, probably due to greatly improved public health and personal medicine.
https://ourworldindata.org/life-expectancy
Because dementia and other neurodegenerative diseases take decades to manifest they've been especially hard to diagnose early and prevent or treat early, while cognition is still intact. Alas, I think that hasn't changed much in recent years, despite many scientists and businesses working toward that end.
Partly that's because few academic researchers can pursue a theory long enough in time to fully assess its potential, especially in combo therapies. Nor can the big pharma corporations who not only suffer from the same difficulty in long-term funding, but prefer the ROI of continuing treatments for disease to that of quick cures (or lifestyle advice). These are nowhere near as profitable a pill the patient must take for decades.
This is a heartbreaking story to read. But I think that pushing for assisted suicide as a "fix" like you're suggesting misses the bigger picture. We have a responsibility as a society to support people through these diseases, not cut their lives short because it's tough on everyone else.
The real issue is our broken systems for handling dementia and underfunded homes, overworked staff, no real community nets. Fixing that honors the full life someone led, instead of saying their value drops when they need help. Assisted suicide opens doors to abuse, like pressuring people who feel like burdens.
We owe better to people like your teacher.
Sounds like LinkedIn story to me. Written by claude trying to drive a point home.
Not sure how to react. This is the second time in a month that someone thinks I used AI to write an HN post.
All I can say is that I didn't, and thank you for implying that it was so well written that it could only have been authored by a machine that has all of humanity's cultural output to hand.
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This sounds like a big and somehow convincing but still rationalization.
If you apply at scale the same logic with more sensibility you will also be able to rationalize a genocide because someone felt bad about something.
What defines demonic inspiration?
And here I don't say "demonic" metaphysically but philosophically.
I would say that this is a societal problem, not an individual one. Society needs to do better in taking care of people who do slip by the wayside, with mental illness and diseases like Alzheimer's.
So you're telling me Alzheimers is a death sentence? Also, what is the minimum nuisance that should lead to someone's death? Because that is the problem with the euthanasia obsession.
At some point everything indirectly leads to euthanasia and society is not built for that at all. Everything you do might or might not lead to someone's euthanasia, which means you are liable for their death.
Let's say we can predict school shooters before they shoot and give them an euthanasia to save lives. If bullying or encouragement causes someone to start shooting up a school, then the latent shooter will die before they do their shooting, but it also means that the instigator is a murderer themselves, because in the absence of instigation, no crime would be committed and no euthanasia would be necessary.
Since it is probably not possible to assign liability of a euthanasia to a single individual, because multiple people contributed to the outcome, the liability will be shared. Ten people being involved means each has committed 10% of a murder, meaning that they should receive 10% of a life sentence. Are you ready to serve a cumulative year in prison spread throughout your life to account for indirectly causing euthanasia?
Note that this problem isn't necessarily unique to euthanasia. The problem applies to any cure all solution. (Think of series like "Common Side Effects")
If you punch someone's face in, but cure it with a blue mushroom, was it really a crime, since their face is intact? And yet, more punching happens as a result of the existence of the panacea, which is why there needs to be a punishment for making someone dependent on the panacea.
Daniel wrote one of my favorite books, Thinking: Fast and Slow (https://www.amazon.com/Thinking-Fast-Slow-Daniel-Kahneman/dp...). If you haven't read it, and you're into economics, behavioral psychology, and thinking about thinking then I'd highly recommend it. The first half of the book is especially compelling.
You will be missed! Sad to hear he passed, but glad he was able to go out on his own terms.
Part of the book has been swept up in the replication crisis facing psychology and the social sciences. It was discovered many prominent research findings were difficult or impossible for others to replicate, and thus the original findings were called into question. An analysis[51] of the studies cited in chapter 4, "The Associative Machine", found that their replicability index (R-index)[52] is 14, indicating essentially low to no reliability. Kahneman himself responded to the study in blog comments and acknowledged the chapter's shortcomings: "I placed too much faith in underpowered studies."[53] Others have noted the irony in the fact that Kahneman made a mistake in judgment similar to the ones he studied.[54]
A later analysis[55] made a bolder claim that, despite Kahneman's previous contributions to the field of decision making, most of the book's ideas are based on 'scientific literature with shaky foundations'. A general lack of replication in the empirical studies cited in the book was given as a justification.
I had read so many raves about that book, and heard the author got a Nobel prize for his ideas, so I started reading it.
I just could not digest it. I understood the words but I couldn't make whatever message he was trying to convey... it felt too "dense" for me. Maybe im just stupid, but I could not get past I think the first two chapters.
It’s largely a popsci book for poseurs. To wit: most of these people “into economics” haven’t read a word of Smith or Keynes.
It’s best use is to be announced your favorite book among undistinguished company. Some people need such books. Such as those from Smith and Keynes.
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That's weird. I had the opposite reaction. The ideas were so obvious to me that I couldn't understand what all the hype was about.
Don't worry, it doesn't matter, because at best a lot of claims in this books just cannot be replicated, and at worst the book is completely useless because it's based on shitty science - depends on your POV.
Some of the things in the book have a reproducibility problem so it definitely would need an update
I didn't even know he had died. I agree, Thinking: Fast and Slow is a great book.
His next big book, Noise, is possibly even better.
I really didn't get on with that one. Felt very much like a book that could have easily been shortened down to an essay and suffered for the additional length.
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The sad demise of Robin Williams made me a believer of assisted suicide. The option to go out with dignity should be available to everyone.
That said, there is a problem in at least some places where assisted suicide is available where it keeps getting recommended to disabled people who don't want to die. That needs to be solved. Seems like an easy solve. Just don't do it.
There is a cost reduction incentive, though, which is why it happens. Costs can be reduced for abled people by convincing them to exercise and eat more fiber, so the same pressure can do good instead of evil. At some point we have to decide to care about people.
> That said, there is a problem in at least some places where assisted suicide is available where it keeps getting recommended to disabled people who don't want to die.
Where? This is a thing which always pops up in these debates because it is a deep-rooted fear, but are there countries where this is a thing?
> 60% of the patients who died with Kevorkian's help were not terminally ill, and at least 13 had not complained of pain....The report also stated that Kevorkian failed to refer at least 17 patients to a pain specialist after they complained of chronic pain and sometimes failed to obtain a complete medical record for his patients, with at least three autopsies of suicides Kevorkian had assisted with showing the person who committed suicide to have no physical sign of disease. Rebecca Badger, a patient of Kevorkian's and a mentally troubled drug abuser, had been mistakenly diagnosed with multiple sclerosis. The report also stated that Janet Adkins, Kevorkian's first euthanasia patient, had been chosen without Kevorkian ever speaking to her, only with her husband, and that when Kevorkian first met Adkins two days before her assisted suicide he "made no real effort to discover whether Ms. Adkins wished to end her life," as the Michigan Court of Appeals put it in a 1995 ruling upholding an order against Kevorkian's activity.[26] According to The Economist: "Studies of those who sought out Dr. Kevorkian, however, suggest that though many had a worsening illness... it was not usually terminal. Autopsies showed five people had no disease at all... Little over a third were in pain. Some presumably suffered from no more than hypochondria or depression."[27]
https://en.wikipedia.org/wiki/Jack_Kevorkian
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Canada. The critique is that people opt into euthanasia because of poverty, and that the government sees MAID economical alternative to investments in social programs and welfare. https://en.wikipedia.org/wiki/Euthanasia_in_Canada
I don't think things are as bad, but I also think that old age in poverty is a valid reason for euthanasia if there is no alternative. If the society is cruel to the poor, holding poor elderly as hostage to improve situation is cruelty on top of the cruelty.
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MAID being inappropriately offered to people who haven't expressed interest in it, and also being extended widely to people without terminal illness, has certainly become a controversy in Canada.
https://archive.is/bd0PV
https://thewalrus.ca/assisted-dying/
https://www.ctvnews.ca/politics/article/doesnt-line-up-mps-c...
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Barbara Wagner [1]:
>Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.
>What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.
Randy Stroup [2]:
> Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide.
Stephanie Packer [3] (although in this case she inquired herself):
> Then her doctors suggested that switching to another chemotherapy drug might buy her time. Her medical insurance company refused to pay. She says she asked if the company covered the cost of drugs to put her to death. She was told the answer is yes — with a co-payment of $1.20.
T. Brian Callister, MD, FACP, FHM [4]:
>When I spoke with the insurance medical directors of the patients' insurance companies by telephone on separate occasions, both of the insurance medical directors told me that they would approve coverage for either hospice care or assisted suicide but would not approve the life saving treatment option.
> Neither the patients nor I had requested approval for assisted suicide, yet it was readily offered.
[1] https://abcnews.go.com/Health/story?id=5517492&page=1
[2] https://www.foxnews.com/story/oregon-offers-terminal-patient...
[3] https://nypost.com/2016/10/24/terminally-ill-mom-denied-trea...
[4] https://www.cga.ct.gov/2018/phdata/tmy/2018HB-05417-R000320-...
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I'd argue that sadly something like this is bound to happen for sure because many (if not most) humans are lazy, greedy and don't like sick people outside of movies. If it is happening systematically and encouraged by the government or insurance companies - that's of course a different matter and has to be prevented.
Canada.
I think that Hunter Thompson basically did this. Kinda "on-brand" for him, really.
I had a friend that decided to stop treatment (dialysis), when he realized that he'd never get off it (he couldn't get a transplant). He was in his late 60s.
It was both a sad, and joyous experience. He took about a month to pass (renal failure). He was Catholic, and wouldn't do assisted suicide.
During that month, a bunch of us would go over to his house, almost on a daily basis, and we'd just hang out. It was actually a great experience.
You omitted the _most_ on-brand part of this story, which is the part where (per his last wishes) Johnny Depp spent $3m on a party that involved firing Thompson's ashes out of a 150-foot tower in western Colorado.
https://www.nyswritersinstitute.org/post/hunter-s-thompson-s...
>He was Catholic, and wouldn't do assisted suicide.
I thought Jain the perspective shared in this comment is valuable: https://news.ycombinator.com/item?id=45548178
Well, not just the comment, but also the wikipedia article linked to in the comment.
Obviously, Jainism isn't Catholicism, but this part of the wikipedia article got me thinking:
>It is not considered a suicide by Jain scholars because it is not an act of passion, nor does it employ poisons or weapons.
Catholics are probably never going to think suicide is ok, but I wonder if they could come around to a definition of suicide that is more narrow and which excludes death-with-dignity. If they did make that adjustment, I would personally agree with their stance.
There is plenty of precedent for this legislation through definitional scoping in history in general, though I'm not an expert on Catholicism. The book "Legal systems very different from ours" talks about it, and gives examples. It's really the only option for any sort of change when you're dealing with decrees from a supernatural entity or an unchangeable part of a constitution.
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That’s the problem. If there’s a financial incentive people will find way to push it.
That’s my biggest concern about assisted suicide for an otherwise healthy person who just wants to avoid the inevitable decline (as in this case). There is a direct financial incentive for families to push people into this.
The only way I can see to remove that would be to require that your estate can’t go to anyone who potentially has influence over you in the case of assisted suicide for with no terminal illness.
Yet you don't see insurance companies hiring snipers to get rid of their oldest customers. Maybe the solution is to prosecute those who would push MAID too aggressively as we would those who push to suicide.
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> There is a direct financial incentive for families to push people into this
What financial incentives are there in killing someone?
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I've waffled between support and opposition of MAID a lot, for similar reasons. I think the morality of it depends heavily on social and economic context. In the US specifically, I worry that MAID could serve as a roundabout form of eugenics, even if it wasn't disproportionately recommended to any particular group.
Imagine you're poor, your family is poor, and your friends are poor too. You spend 2 years in and out of inpatient care, and then die. Your family is now saddled with a debt they will never be able to pay. Your medical bills could make them homeless. Now imagine choosing between that, and MAID. MAID is obviously a cheaper "out."
Now remember the demographics of poor people in this country. If poor people end up being more likely to choose MAID, that necessarily means MAID would be used disproportionately on ethnic minorities and disabled people. So you end up with eugenics again, just because of the sorry state of our medical system and class demographics.
Not all assisted suicide is eugenics, to be clear. There's a discussion of Jain practices elsewhere in this comment tree.
But man did I lose sleep at the thought that we could have people volunteering to kill themselves solely because they're poor. You could argue that it's wrong not to give someone the choice to die sooner, given that dying later could cause so much strife for their family. But I hold that the right solution isn't making people die sooner, it's building a medical system where people never have to grapple with this choice in the first place.
I find it really weird. So someone pays CHF 10K to be given a lethal injection then it becomes dignified and the other way isn't? I think it is an insult to the departed if you question the path they choose - because then both the choices can be questioned and judged.
And did you just go to eating more fibre from euthanasia in the same few sentences? :D
> it keeps getting recommended
In Germany, it was illegal for doctors to recommend or advertise abortion, and that worked pretty well. You could do the same for assisted suicide.
> That needs to be solved. Seems like an easy solve. Just don't do it.
I don’t do it, but I’m not sure how that solves the problem of other people doing it.
This is blogspam of the original WSJ article: https://www.wsj.com/arts-culture/books/daniel-kahneman-assis...
Some of its wording is weird, like mentioning his wife dying in the same context of two other partners with no explanation. The original is a much better read.
I'm surprised and fascinated that this is apparently legal in Switzerland. The Netherlands, famous for allowing assisted suicide, has pretty strict criteria for this[1].
In particular, the physician must "be satisfied that the patient’s suffering is unbearable, with no prospect of improvement", which from this article sounds far from the case here.
[1] https://www.government.nl/topics/euthanasia/is-euthanasia-al...
It is surprisingly hard in NL; we have familiar Alzheimer and had some practice by now, but it is very easy (depressingly so) to arrange your assisted suicide for when you get Alzheimer a long time upfront and still not get it because you did something wrong in the procedures/paperwork and end up going through all the suffering you planned out not to go through. It is not 'oh then they just sit in a home without memories'; it is a devastating process definitely far worse than death.
In the US, in the states that have medical suicide, the problem is that you need to:
1. Administer the medication yourself
2. Be of "sane" mind at the time you do it.
3. Have a doctor certify that at the time you choose to do it, you are in unbearable pain/suffering, and there is no realistic relief from it.
This rules out dementia (especially item 2). So people here who are in early stages of Alzheimers go to Switzerland as well.
In California two doctors must certify the person has less than six months to live. A friend of my mother just took the option due to terminal cancer.
Euthanasia in Switzerland ^ has been a notorious profitable practice for years, compared to the Netherlands where it's almost exclusively practiced on those with terminal debilitating disease.
^ Yes, it's "illegal" but it's effectively nulled if the means to it are made legal.
It is illegal to profit from assisted suicide in Switzerland. All organizations that are involved in assisted suicide are nonprofits.
Every assisted suicide is then investigated by the police to ensure no profit motives exist.
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Then I do wonder why no company has come knocking to the door of the hospital room where I'm sitting right this minute waiting for my terminally ill mother to die. Because since years she's member of EXIT, the well-known Swiss institution that is providing assisted suicide services, and it would still take several weeks for us to jump through all the required paper and legal hoops to get the ball rolling. And now she being already unconcious and therefore incapable, most ways are blocked already, as others pointed out, so I'm not sure we could accelerate the process at all.
Sorry, but your comment smells rather about peddling fakery, especially as you have provided heaps of reliable references.
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Stop spreading unsupported lies.
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Related, a 5 page page PDF, freely downloadable:
Should assisted dying be legalised?
Philosophy, Ethics, and Humanities in Medicine volume 9, Article number: 3 (2014)
Thomas D G Frost, Devan Sinha & Barnabas J Gilbert
https://peh-med.biomedcentral.com/articles/10.1186/1747-5341...
Abstract
When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.
A quote from the above:
> It is difficult to reconcile that citizens may have the right to do almost anything to and with their own bodies– from participating in extreme sports to having elective plastic surgery– yet a terminal patient cannot choose to avoid experiencing additional months of discomfort or loss of dignity in their final months of life.
One issue I think about a fair bit is that without legal assisted suicide aside from all the usual issues with unassisted suicide you need to end things even earlier to make sure you do it while still physically capable: with age the risk of physical debilitation increases sharply, a bad fall or a small stroke will see you in the hospital or incapable of moving an arm. Which is on top of the risks of mental debilitation taking away your right to self determination (through simple incompetence).
So he was very old without any significant problems, but he wanted to avoid the inevitable problems?
If you’ve already made it to 90 with no major issues, you’re expected to make it to 95 and you could make easily live to 100. My wife’s grandad is 90 and he still lives alone, drives, plays golf nearly everyday, and regularly sees his 12 grandchildren and many great grandchildren. He even made the 9 hour trip to come see us last year.
I’m very wary of making it legal for doctors to euthanize an otherwise healthy person who just wants to avoid an eventual decline.
It’s relatively common for families to push people into nursing homes, but in this case there’s an even stronger direct financial incentive. I don’t trust the system to adequately prevent this.
> If you’ve already made it to 90 with no major issues, you’re expected to make it to 95 and you could make easily live to 100. My wife’s grandad is 90 and he still lives alone, drives, plays golf nearly everyday, and regularly sees his 12 grandchildren and many great grandchildren.
Counter-anecdote, my partners Granddad is 93. Age 90, we said the same as you. Now he's an old, rude, obnoxious liability - he's still great, and I don't hold it against him, he's earned the right. But I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
From the article:
> Kahneman knew that many would see his decision as premature. But that was exactly what he intended, he wrote: If you wait until a life is "obviously no longer worth living", it is already too late.
I personally wish my partners final memories of her Granddad were him at 90, and not at 93. I've known for a good 5 - 10 years I will take the same route as Kahneman. I feel the desire to stay alive long enough to be a liability for yourself and those around you is a decision motivated by ego and fear, rather than compassion or logic.
>I feel the desire to stay alive long enough to be a liability for yourself and those around you is a decision motivated by ego and fear, rather than compassion or logic.
Everyone becomes a liability at some point. By that logic we should just go full Logan’s run and kill people as soon as they stop being productive.
There nothing wrong with saying that you aren’t going to take extreme measures to preserve your life past a certain age.
But I don’t want this attitude of “you should kill yourself so you don’t burden your family” to become the norm either.
What if your partner’s grandad heard you calling him a rude obnoxious liability and felt pressured into killing himself?
>I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
But many people die suddenly with no serious mental decline at all. That can happen at 95 or 100 the same as it happens earlier.
If you rule out everyone who didn’t die of some nebulous cause as the result of a slow decline you are selecting for people who mentally decline.
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I see a lot of elder people age very suddenly. It's like the capacity to recuperate from a problem is gone. With some luck no such problems appear and you can become old without much troubles. But once a problem appears, it hits in full force.
My nan made it to 92 without any mental issues, but then deteriorated significantly over the course of 18 months, forgetting she'd ever been married, had kids, etc, just reverted to believing she was a teenager who wanted to go home to her parents (in a house which was destroyed in ww2)
She couldn't look after herself was was forced into care by the courts. Since going into a home she's physically never been fitter, but mentally she's not the person she was 10 years ago -- it's not that she's changed personality, it's as if her memory of the last 80 years was wiped.
That’s terrible, but you never know when or if the decline is going to happen, so if you pick an arbitrary cutoff you’ll have killed people who had plenty of good years left.
Many people die suddenly with no decline at all.
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No, he was an old man who cared for his wife with dementia until his death, an experience which changed him. And thus he has chosen to go on his own accord.
As long as people are thinking clearly, i think it should be up to them.
There is no financial incentive. No-one is making any money from assisted suicide in Switzerland.
> No-one is making any money from assisted suicide in Switzerland.
This is obviously an outright falsehood. Nonprofit doesn't mean that no one gets paid.
Families can’t inherit wealth in Switzerland?
If the society treats people badly, that's not a reason to deny them the ability to do final exit with dignity. We must fight to fix the problem cases, not take dignity away from those who suffer from it.
> It’s relatively common for families to push people into nursing homes,
So you are rejected by your family and punished even more by taking away a dignified exit strategy?
Nothing is being taken away. Medically assisted suicide to prevent old age has never been a right anyone has had under any legal framework until very recently. And it’s not a right anyone has anywhere but a few countries.
You can argue that more countries should grant that right. But if you’re going to do so, you need to have an answer for the incentives it creates.
You got this the wrong way around: we should deal with the root cause instead of finding ways to make offing people acceptable.
I agree with your legal assessment and still think of the case as very interesting. The article explicitly talks about how any such decision could have only been premature, for the slow cognitive decline is typically only noticed when it is too late, and because the change is continuous, there can be no good commitment to "I no longer consider this life worthwhile once condition X is no longer satisfied".
Took care of someone with Alzheimers for six years until they passed away. No one should have to exist like that, for that long. A biological shell simply of automatic inputs and outputs.
Robin Williams had to hang himself.
There should be easy medical options in the US.
I think Alzheimer's is a particularly difficult case. Before diagnosis, many of us imagine that we wouldn't want to exist in a highly deteriorated state with no ability to care for ourselves. But as you start to decline, you still feel like yourself, just a very forgetful version of yourself. On which day do you decide that what remains of your mind isn't enough to make your available future days better than no future days?
The instinct for self preservation is strong. Knowing what will come requires foresight and clarity. You may lose the capacity for informed decision making before the point where it's clear that there's not much to live for.
Many of us lack the insight that Kahneman perhaps had that in order to take control of the end you may need to leave some good days on the table.
Robin Williams' end was even more grim than that sentence lets on. Horrible to think of such a loved man going out is such a desparate way.
I’m young, but I’m at the age where I’ve seen many grandparents pass away and I must say, I support assisted suicide. The helplessness of the last stretch of your life, something that can last a couple of years, where you often need to help to even stand, doesn’t seem like a period of time worth living. Further modern medicines, in my opinion insane focus on extending life of the very old, compounds this situation to something much worse. I know of a relative who had 5 surgeries, 2 ICU admits in his final year, he was 84. First they were convinced his kidney was failing, then his liver, then they thought cancer and on an on that I couldn’t help but suspect whether this was a money grabbing scheme.
I do not know if this was ever widely practiced, but I think the ancient Indian ritual of going to the forest and starving to death in your last days is basically fine. It gives a dignified, sacred end to a life, while the modern medical sciences constant battle against the inevitable ends up distorting and deforming the last days of your life and forces you to leave without dignity clinging to the last vestiges of your humanity that’s left.
Starving to death in the forest is probably not very dignified, I gotta say.
Ever since I watched my father waste away in agony and die in a veterans home, it has become my greatest fear in life to suffer until the bitter end. I choose euthanasia because I don't want to put my family through that, and the last thing I want to do, if you'll pardon me, is to waste away in my own urine and feces in what will likely be a sub optimal care situation.
Same with my grandmother that had dementia.
You can get into a state of living death where the brain is mush and who you were is completely destroyed. That's hell for the family.
I saw my grandmother forget her daughter (my mother) it was heartbreaking. Seeing my mom realize her mom forgot everything about their life together was just painful.
It was just a sad existence to observe as well. Grandma lived for quiet a while with dementia and spent years trying to return to her childhood home. We'd constantly have to trick her into accepting help from us "strangers". Re-convincing her to come inside that these "strangers" wouldn't mind having her for a bit. Watching her read over the same page of a book for hours on end.
That's not an existence I want for myself or my family.
> Daniel Kahneman did not want to make a statement or start a debate. "I am not ashamed of my decision," he wrote, "but I don't want it to be discussed publicly either."
Sorry mate.
Lots of discussion of the morality of assisted suicide in this thread, and the circumstances under which it should be legal.
In the cryonics community, it's a common complaint that they have to wait until the patient is legally dead in order to cryopreserve, which can make it difficult to cryopreserve under ideal circumstances.
I like the idea of allowing individuals to opt for cryopreservation over end-of-life care. End-of life care costs so much money, it could even be neutral from a financial perspective.
Since cryopreservation lacks the finality of other forms of death, it could also address some of the ethical dilemmas around assisted dying. After all, a lot of end-of-life care seems to be motivated by a futile attempt to somehow delay the inevitable. From my perspective, cryopreservation seems slightly less futile.
If medical technology continues to advance, maybe in the year 2500 there will be people walking around who were born in the 1900s and can give talks about their experiences. Wouldn't that be cool? It would help a lot if just a single country to made it possible to get cryopreserved before you're legally dead.
You're talking about cryonics as if it were an established, scientifically proven and effective technology, but it doesn't work and is widely considered to be pseudoscience.
And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
>You're talking about cryonics as if it were an established, scientifically proven and effective technology
I don't believe that. I do believe it is a hair less futile than delaying the inevitable and then burying yourself 6 feet underground.
>it doesn't work and is widely considered to be pseudoscience.
The cryonicist claim is something like: "If we save your brain in a way that preserves its information content, it may be possible for future technology to reconstruct that information content, and effectively revive you." No cryonicist is claiming that cryonics "works" with existing technology.
Consider the state of medicine in the year 1925 vs the state of medicine in the year 2025. Now extrapolate that advancement trend forwards until 2525. Is extrapolating trends forward a form of pseudoscience? If so, what do you say about global warming?
>And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
Keeping a closed canister filled with liquid nitrogen is not especially costly.
Alcor charges $80K out of pocket for neuropreservation: https://www.alcor.org/membership/pricing-and-dues/
The Lancet says a typical American accumulates $155K in healthcare costs during the last 3 years of their life: https://www.thelancet.com/journals/lanam/article/PIIS2667-19...
Long-term care costs are rising fast: https://www.nytimes.com/2025/05/24/business/retirement-long-...
(BTW, I appreciate that you made a falsifiable claim here, since that helps readers evaluate the credibility of your other claims. A sort of within-comment Gell-Mann effect.)
I wish billionaires believed in it. Would make the world a much better place.
> And even at the end, when asked what he would like to do, he said: "I would like to learn something."
Don't have an exact word to describe how I feel after reading above. Find it beautiful that such an accomplished person wanted to learn something even towards the end of his life.
"My work is done. Why wait?" - George Eastman's suicide note. He took a final walk around Kodak Park before he died.
Everyone talks about Alzheimer's and dementia, but Daniel Kahneman has neither. He chose to commit suicide because he wanted to avoid “natural decline.” That's an unexpected statement from a 90-year-old. I'm more surprised by his lack of will to live and that he just “gives up” and throws away the most valuable thing he has.
This is one reason why as I’ve entered my 50’s, I’ve decided to take every advantage of modern medicine including hormone management and performance enhancing drugs. I started three years ago at 47 and now I’m living my best life at 50, in the best physical condition that I’ve been in since my early twenties. Although I’d certainly like to live a lot more years, I care more about my quality of life than the quantity of years. If I make it to my 80’s, it’ll be with the testosterone of a man in his 20’s and muscle mass on my body.
We definitely need a better culture around dying. My mom is 95 and slowly everything she likes is being taken away from her. Going for a walk is difficult because she has unpredictable falls, husband is dead, all friends are dead, eyesight is so bad she can't read anymore, memory is failing. Really nothing to look forward to. Just existing and waiting for things to get worse.
Mentally she is still pretty clear and she often says it would be best if she doesn't wake up in the morning.
I think it would be better for everybody if we had a way to have a ceremony where we all say goodbye and then end it.
”Daniel Kahneman did not want to make a statement or start a debate. "I am not ashamed of my decision," he wrote, "but I don't want it to be discussed publicly either."”
Seems like we should close this thread to honor these wishes
I think it's beautiful he got to go out on his own terms, when he felt it was the right time to do so.
I'm often reminded about a case in my own country: a young person had decided it was time to end her life after struggling for many years, without a sign of improvement. She was denied the right to euthanasia. After multiple failed suicide attempts, she went for the nuclear option and jumped in front of a train.
Everyone deserves to die in a dignified and humane way, not in multiple pieces or with a mind deteriorated beyond recognition. Forcing prolonged suffering is unnecessarily cruel. I wish more countries were as progressive with euthenasia as Switzerland.
Coincidentally, today there was an article in a Belgian newspaper about a 25-year-old woman who will undergo euthanasia in a few weeks due to severe psychological suffering with no prospect of improvement. After years of suffering and 40 failed suicide attempts, I indeed think it's much more dignified to have euthanasia as an option.
Euthanasia has some strict rules in Belgium, especially for cases involving psychological suffering. In 2014, the age restriction was dropped (except for psychological suffering). Since then, 6 minors have received euthanasia.
I saw someone interviewed who had set the criteria of being able to enjoy some ice cream with his children and grandchildren at the regular family dinner on Sunday late afternoons.
He said that alone made life worth living, for him and them, but once any deteriorating conditions rendered him permanently unable to participate in this weekly activity then he felt it was time to go.
Maybe having a pre-set condition like this is less arbitrary, and also allows everyone involved to understand as the time comes closer.
I think this is a fair measure of any life -- are there enough positives to offset the negatives? And that includes the cost (and the benefit) of your suicide on others. No one but you should be able to make that call. All that remains then, legally, is to ensure you are well informed about the de/merits of your choice and sane enough to make the call.
Of course, even if you lack legal permission, suicide doesn't strictly _require_ legal or medical assistance. An autonomous exit is always an option, though generally less painless than assisted.
I 100% understand his rationale, and in the same position I'd probably do the same -- "probably" because this is one of those things you can't possibly predict in advance.
My dad is in the early stages of Alzheimer's and it's made me think of what I'll do if I find myself in the same situation
Assisted suicide sounds like a fine option until you think of its impact on your loved ones. Imagining putting my wife and kids through my deciding to die, and the process of them bringing me to the place where it happens - or imagining one of them doing the same thing - just fills me with horror
Death comes for us all. It’s okay to cultivate emotional fortitude to die on own terms, at the place and time of our choosing, with grace. Would you rather them remember you as a shell of who you were, long dead mentally while the body continues on? Death is a part of life we cannot avoid, nor should we.
> If you wait until a life is "obviously no longer worth living", it is already too late —- Kahneman
Live your life in a way that it is worth living until you no longer can, I suppose. To exist is hard, do your best.
One of my friend's parents had a neurological disorder in his later years and was considering suicide. I don't know the details, but I know he had mentioned it to my friend. I believe he was convinced to try one more procedure that the logistics never lined up for. He ended up dying anyway a short number of years later.
He kept to himself, so I didn't know him well. I did know that he was an independent and thoughtful man who hated that his tremor got so bad he couldn't feed himself. I remember talking with his family about if those self-balancing Google spoons might help.
There are two kinds of people for whom suicide sounds appealing: those in poor health who don't want to experience it getting poorer, and those for whom the difficulty of being alive outweighs the joy of it. If you're in the former camp, that pain is coming for them anyway. If you're in the latter camp and still make the decision, maybe you don't have those close bonds that make you want to persevere.
Death happens to all of us. I’m 51 and as far as I know have no terminal illness. I stress to everyone that I focus on “living a good life. Not a long life”. My wife and I balance living every year like it might be our last and saving for a long life. We don’t put off traveling, concerts, hanging out with friends and other experiences so we can “retire rich”. If we can’t afford expensive travel in our 60s because we spent our younger healthier years traveling - so what? Statistically we won’t be healthier in ten years than we are now and we are both gym rats.
I “retired my wife” at 46 in 2020, eight years into our marriage so she could enjoy her passion projects and I have turned down more lucrative jobs that would have required me to work harder and be in an office so I could work remotely from anywhere - but realistically in US time zones.
Everyone who knows me, knows that I would die with no regrets. As far as my wife who loves me and my grown (step)kids who I know also love me, I don’t owe physical suffering to anyone. Assisted suicide because of Alzheimer’s is more tricky than something like cancer though. What can you do? Sign something in advance where once you can’t pass a cognitive test three months in a row - kill you?
I'm totally in favor of assisted suicide, and I think it's a good mechanism for those suffering, if voluntarily chosen.
That said, I think the same, and there are some non-obvious second-order effects around it being the menu, especially regarding life extension incentives and if people started to feel guilt-tripped by it.
The first thing that comes to mind is a reduction in commitment to the elderly. As soon as health care costs ramp up, people will start to make more decisions based on the economic aspect of the people's support instead of thinking in life extension mechanisms as a natural first choice.
Second, it is related to the public health services. From my experience in some parts of EU/America, if you have a disease until your 50s, you will get treatment. However, after that, there are probably some parts of the public/private health system that throttle down the treatments.
The 2-week interval between a return if you are 30s/40s, will become 6 weeks if you are over 60s.
The next one, the "inheritance social contract," will be changed. As long as folks know that assisted suicide will be placed on the menu, I do not doubt that folks terrified with the possibility of loved ones "not doing enough to keep them alive" will dilute everyone who lifts the gas.
And as a second-order, I can see the securitization and life insurance industry will demand insane premiums to cover elderly persons, given that potentially people can lift and coast the treatment for their loved ones, and this can break part of their actuarial models, which, yes, expect people to exhaust resources to keep their elderly alive and not to choose together to pull the plug in a single-digit number of years before.
And maybe a third-order effect (in Germany there are some cases) where people with resources (single-digit million real estate + assets) exercise liquidity on it and live the best of their lives after 70 or in some cases, legally marry 30+ nurses to take care of them in the last 3 years and offer a chunk of inheritance, post-death pension, or insurance premium.
Good account of his reasoning. Off topic, but my Dad’s last girlfriend before he died two years ago was a co-founder of the Hemlock Society/International Right To Die organization - huge effort to get assisted suicide made legal in different tax jurisdictions around the world and different states in the US.
assisted suicide bears risks similar to adding benevolent backdoors to software. The policy rests on the assumption that policies and those enforcing them will always be benevolent.
We're opening up tremendous abuses of power by allowing the state to kill people for non-criminal behavior.
Sure the first iteration is presented as "voluntary", but the next edition will be for the greater good. And how about sinister / malevolent abuses of "voluntary" suicide -- similar to abuses over guardianship.
at least with guardianship the person can be set free, because they are still alive.
This is a bit of an aside but I wonder if people who possess greater intellectual capacity are more resilient - at least outwardly - against old-age mental decline, as even their mental function diminishes, they have an excess buffer so that they are slower to cross the 'threshold' where their inability to mentally function in everyday life becomes apparent?
> "I am not ashamed of my decision," he wrote, "but I don't want it to be discussed publicly either."
While I understand him, public personalities cannot really demand to avoid attention on such an existential topic.
The email was a "personal message to close friends", I think it's a reasonable request for him to ask them not to share the information.
They can ask. We're the ones choosing to ignore his wish.
He had to know it would be. I wonder if that was maybe an attempt to say this is completely personal and I'm not trying to encourage others to do the same or suggest it is the right thing for everyone to do?
Not even in the abstract?
I see a lot of comments here expressing disapproval about assisted suicide.
I'd like to quote from the HN guidelines:
> Don't be curmudgeonly. Thoughtful criticism is fine, but please don't be rigidly or generically negative.
With that said I urge you those who disapprove to ask whether you are being "rigidly negative" about this.
1. Is this disapproval perhaps coming from your religious context? If so, please pause and consider why that may not apply to the rest of us. And also whether you really think that your religious beliefs must be forced on the rest of us.
2. Is this disapproval coming from a sense of deep unease that this post causes? If so, know that this unease is shared by most of us. But try and muster the fortitude to go past that unease and consider the decision from a place of compassion.
My mum died earlier this year. In hospital, she was approved for assisted dying. There is a mandatory waiting period as part of the process.
Many/most of the nursing staff are Filipino and strongly Roman Catholic.
As she lay dying and unable to speak, one of the nurses undertook to convert her at this last minute to their religion. At night, alone, after all visitors had left, she would come into mum's room and press mum, a very committed atheist, to pray for her salvation.
It's hard to describe how vulnerable someone is who is stuck in their bed and dependant on the nursing team for everything, even sips of water.
I will say this was not representative of her care, but it opened my eyes to the lengths religious believers will go to to push their views on others.
Sorry to hear that, that is completely unacceptable behavior.
That was a heartrending account. Am so sorry for your loss. Both she and you deserved to be treated better.
"His decision seems to have been based less on his famous scientific thinking and more on a very personal feeling. He wanted to retain his autonomy until the end and to shape his own end."
So you could say it was more system 1 thinking rather than system 2.
I would've expected the opposite given our survival instincts.
RIP, his work made a huge impression on me. And I admire the dignity to go when one chooses.
I guess we are all Dying, Fast and Slow.
Death with dignity must be more accessible to more people who, by their rational choice, wants to use it.
I find it somewhat fascinating that the article has a giant "Suicidal thoughts? You can find help here:" footer.
I don't think it's a link to an assisted suicide/dying with dignity center.
Society's relationship with intentional end of life decisions is fraught, to say the least.
There's a Star Trek episode with this exact plot https://en.wikipedia.org/wiki/Half_a_Life_(Star_Trek:_The_Ne...
An interesting choice. It's fascinating that even for very ill or injured people the will to survive is so strong - I wonder if at a certain age this instinct diminishes making a choice like his easier?
> I wonder if at a certain age this instinct diminishes making a choice like his easier?
It's less likely to be "a certain age" and more surrounding factors: if most of your friends have passed and you don't have much chance to do things that interest you because you could pass at any moment yourself there comes a point where life has limited worth.
Essentially, hope runs out, and when it's run out entirely you either wait for death, or ... don't wait.
> It's fascinating that even for very ill or injured people the will to survive is so strong
Sometimes. Chronic illnesses are a massive contributing factor to suicide rates for instance: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
If you have (grand)children, an important reason to wanting to stay alive is often not the fear of dying, but wanting to be there for them and fearing the grief they will endure if you are gone.
My grandparents stuck around too long, so I have the opposite fear of burdening my descendants with having to (if not legally, then via social pressure) spend too much time, money, and energy caring for me.
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Maybe at a certain age other instincts strengthen making a choice like this easier? We all have to come to terms. And if you are older than 70 then it is just a fact that every day can be your last without any accident or noteworthy medical complication. And the guy has been probably thinking about this fast and slow for at least two decades then.
> It's fascinating that even for very ill or injured people the will to survive is so strong
For physical illnesses.
You get so tired
This.
How much of the taboos against the right to suicide and abortion are because modern societies and economies depend on an ever-increasing population?
The economic incentive here are the opposite for old people.
More of this, please.
What is the point of living your last 10 years of life bed ridden? This is how I will go.
You will have an eternity to be dead.
I want every second. Even if it’s painful.
I am still alive.
Are you sure you understand how painful pain can be? Especially when you experience it daily and there is no hope for recovery?
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How do you know if someone is anti-assisted suicide or anti-abortion?
They'll tell you, whenever you want to do anything with your own body.
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Cryonic preservation is assisted suicide but with a small bonus chance of living forever. Seems preferable.
It's a scam.
Unless the situation ends up like in https://xkcd.com/989/
For every Daniel Kahneman case, there's a case where the victim doesn't give consent, is coerced, or pressured from caregivers. It always rapidly expands from terminal illness to mental illness or non-terminal conditions. There's also weak oversight and misaligned profit motives. The examples in the Netherlands, Switzerland, Canada, and Oregon are shocking.
Please provide shocking examples, especially for Switzerland. I'm eager to learn about real arguments from the other side.
Can you please list some of those examples?
You didn't mention Belgium so I'm pleased to hear that Belgium is doing well according to you (4000 cases of euthanasia per year of which 80 are for psychological suffering, 1 child per year).
It's another thing to not give palliative treatment to prolong life for a little more and another to provide poison to accelerate death. My opinion is to continue palliative care when the benefit outweighs the harm in the QUALITY of life (not necessarily quantity) and infuse some morphine 1 or 2 days before death in order to skip the last stage.
Not going to express an opinion, I'll just leave this except from the Hippocratic Oath [1], which reflects society's primary beliefs on this topic approximately up until the 19th century:
> οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε
In English:
> Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.
[1]: https://en.wikipedia.org/wiki/Hippocratic_Oath
The modern hippocratic oath has no mention of poisons, also doesn't require the oath to be sworn before the gods of the pantheon. Up until the 19th century, physicians didn't believe in germs either. Attitudes change with the knowledge we accumulate.
Change doesn't inherently mean better.
That's likely to be a consequence of prevailing religious norms of the time.
I will, ahem, take steps to ensure I never get dementia
To me, Daniel Kahneman humiliated himself by choosing suicide (if he was in a sound state of mind to make that decision). He was a scared, little old man. He made an assumption that his life was "obviously no longer worth living", how little he thought of life is pathetic.
Now he could have been depressed after his wife died and was just lying to himself that this was his own, autonomous, decision. Depression can do that to you, it can make you think suicide is the most rational decision.
Assisted suicide is not how a healthy society should respond to serious mental health conditions.
The guy chose to quit on his own terms, healthy society shouldn't have a say in it.
As a person who lost my life partner six years ago to a brain tumor I completely understand what he did. After seeing things first hand I too don't intend to wait for old age and illness to devastate me. I'm barely over half of his age with no serious health issues that I know of so it's not the time for me yet. But I can fully understand his reasoning.
Seems like a good way to go out, "my choice, my body" . I realize some psychological exam should be necessary before such things but it really should be self-determined within reason. I hate that USA is so far behind the curve on this, but eventually we might catch up on it with Europe and not have to resort to more ugly methods.
I used to be for assisted suicide but I have changed to be against. The things that changed my mind is seeing how it has gone in countries that have implemented it like The Netherlands and Canada with what I consider to unethical assisted suicide of people with mental disorders and disabilities. It smacks of state sanctioned killings disguised as charity. The second one was what kind of psychopath assists in the killing and why is that person allowed to keep practicing. Finally if we can kill ill people what really is the difference in implementing the death penalty and justifying it by ending the criminal insane’s suffering?
What kind of psychopath is against people dying in a dignified way?
Dignified is what we say it is.
Perhaps we should instead not see a part of our natural lives as undignified?
A psychopath that reads stuff like this https://www.theatlantic.com/magazine/archive/2023/06/canada-...
You have to somewhat lacking in critical thinking if you look at assisted suicide and its implementation and still back it.
I mean...is there anyone here who isn't on this bandwagon?
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This always comes up with this prize, but it’s generally considered one of the Nobel prizes, although it’s not one of the original prizes. Your opinion on whether it should count is up to you, but to call it media manipulation is reading a lot of malice into it.
Argument is that economists knew exactly what would happen when they got linked with Nobel Prizes and help solidify economics as hard science like physics, medicine or math in eyes of the public. Begin debate around how scientific is some economics.
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That sounds a bit harsh - probably more simplification than manipulation.
Your quote says Nobel Memorial Prize or what am I missing?
In a piece about life and death, about the will to live a full life, you choose pettiness.
> But some media just want to manipulate its readers.
Obviously not bluewin.ch
Now this is hilariously non-ironic.
The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
> Now this is ironic.
Ironic is the opposite of what you mean, don't you think? By your explanation, Kahneman acted according to his life's work.
> The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
That was possibly part of his motivation. But also the pain, suffering (goes broader than physical pain), confusion, and cost -- to him and his family.
Thanks, I had a mental lapse - fixed it.
I’m trying to figure out why this feels so unsettling to me. I can understand wanting to end one’s life because of unbearable pain or illness, but something about this just feels wrong.
It's not unsettling for me, but I have a similar feeling. On the other hand, maybe he did have a medical issue, just chose not to disclose it. In any case it is his choice, as is the wish not to discuss it. I think this will be difficult to enforce, but I will personally respect it.