Comment by Freak_NL
3 days ago
> 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.
Society puts a lot of pressure on the people at the bottom. The chronically ill and the unemployed. That pressure in combination with an option to permanently relive yourself of that pressure is to many functionally equivalent to a recommendation.
Euthanization of the disabled has been a consistent part of the eugenics movement. For example George Bernard Shaw quote
> A part of eugenic politics would finally land us in an extensive use of the lethal chamber. A great many people would have to be put out of existence simply because it wastes other people's time to look after them.
Shaw and other Fabian Society members were supporters of the group now called Dignity in Dying [0], which used to be called The Voluntary Euthanasia Legalisation Society and was founded by a doctor.
Nazi Germany committed involuntary euthanasia of disabled people in a program called Aktion T4 [1]. It's probably not an accident that Dr Kevorkian, an American, started publishing his euthanasia papers in Germany. Before that he was trying to harvest blood and organs from inmates, which is another area where the incentives seem very bad.
I can't comment on how often modern assisted suicide programs recommend it to disabled people who don't want suicide. But it's clear that Kevorkian was not careful about who he recommended assisted suicide to. So given the strong desire of some people to euthanize the disabled against their will, the lack of carefulness is concerning and suggests that it likely happens with some regularity except in exceptionally run programs.
[0] https://en.wikipedia.org/wiki/Dignity_in_Dying
[1] https://en.wikipedia.org/wiki/Aktion_T4
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.
I don't necessarily agree with this take but I'd say it's probably because we're only willing to let people who are close to death "make a mistake."
Eg maybe a 16 year old who wants to end their otherwise healthy life might, 20 years later, be glad they didn't.
That seems less likely with someone who is almost certainly going to die (and probably painfully to boot) "soon".
12 replies →
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.
It's actually a good and relevant set of examples for the particular type of issue that was asked about. They didn't give any opinions for or against assisted suicide in general.
In the first 2 examples, Oregon Health Plan is arguably not a company. It's run by the Oregon government.
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.