Comment by mcdonje
3 days ago
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
This doesn't seem to be an example of assisted suicide being recommended to disabled people who didn't want to die. Mainstream medical practice at the time condemned Kevorkian, and anyone seeking out his services was certainly aware that what he offered was death.
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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.
From the article the safeguards seem fantastic and the biggest issue is the exclusion of mental health grounds.
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...
Why should only terminally ill people get this choice? A 16 year old can decide who to kill in the army but apparently they (and we) aren't competent to choose whether to take one's own life.
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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-...
It's a very odd take to think examples of insurance companies refusing life-extending treatment and instead offering assisted suicide indicates a problem with assisted suicide.
Just to be clear: the insurance companies are the problem here; and more broadly this whole for-profit model of healthcare.
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Offered != recommended.
However, the price difference is probably a strong incentive.
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.
No, it will always be wrong to kill an innocent person whether that is yourself or another doesn't matter. Our lives are lent to us by God
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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.
Their most expensive customers are not the oldest ones, it’s the ones getting targeted genetic treatment for cancer denied. They don’t need snipers: the patient dies for lack of treatment being paid for.
> There is a direct financial incentive for families to push people into this
What financial incentives are there in killing someone?
Many western countries make dying slowly with Alzheimer’s very expensive, by the standards of normal families.
Between doctors, nurses and lawyers you can burn through a million bucks in five years easily. And most families don’t have a million bucks cash to spare.
On the other hand, if they die after six months, instead of after 5 years? The family doesn’t lose the farm.
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Inheritance, and for the government/insurance companies, there's the incentive of the one-time cost of euthanization being lower than the cost of care for the poor, disabled and/or the terminally ill.
We don't talk about it a lot as a society, but some people just like killing people.
The ordinary outlet for them is the military. Sometimes they become serial killers.
A euthanasia industry would attract these people similarly to how police and security work attracts authoritarians and how clergy jobs attract pedophiles.
That's not to say that most people in the industry would enjoy killing people, but it would be a problem. And death is final; it's impossible to fix mistakes. This is the same reason many people are opposed to the death penalty.
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Inheritance.
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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.