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Comment by oleander73 | Hacker News Reader

As someone for whom this is a real life practical issue, not some idle philosophizing, even asking the question is repugnant to me. I have incurable cancer and at some point I will decide "enough is enough" and I'd like to be euthanized by a doctor. The doctor will then have to decide if my suffering is sufficiently unbearable and only if he comes to that conclusion is he allowed to do it. He'll have to justify his judgment to a committee and if they disagree he can (theoretically) be prosecuted for murder. This is insane and caused by assholes who believe human life is sacred or some such bullshit. (I'm in The Netherlands.)

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But euthanasia should not be allowed on a whim. For terminal diseases or other suffering it is more than warranted, but for folks who are going through a depressive episode and want to end their life, they may take a rash decision that they’d regret later. For you, I hope you’re not going to go through too much suffering and will be able to enjoy some quality moments before you leave us.

> That they’d regret later

You can’t regret stuff when you’re dead

I don't know if you're being serious or not, but this is actually a profound point that a lot of people don't seem to grasp (maybe because they don't really believe in death being final).

If you take this point seriously then it follows that there is only one important thing to do before you choose to die: Make sure your friends and family understand your choice and can live with it.

> they may take a rash decision that they’d regret later

Sorry to be that guy, but: "how?"

Our inacceptance of suicide and related concepts is entirely based what it does to others

No it’s not solely based off that. It’s also based off our knowledge of people who feel suicidal who later go on to lead happy and productive lives.

Assisting every person who feels suicidal is likely to assist in the death of plenty of people who would later have happy lives.

If the people that remain behind are at peace with the decision it doesn't really matter 'what might have been'.

Also, taking away the 'easy' option means that a large number of people will do it in a way that is more gruesome and much harder for the people left behind.

So what? This is unfortunate but in no way implies that a valid response is "might as well just help them instead". That's not better.

Hearing someone even present this sort if argument makes me wish I could turn their lack of empathy back on themselves. How about we have psyche tests and anyone who would so lightly let other people die, are killed themselves?

Somehow I bet you would say that's immoral and outrageous.

The psyche test would be great. That way anyone who wants to die only has to take the test.

>If the people that remain behind are at peace with the decision it doesn't really matter 'what might have been'.

The problem I have with this is that it also justifies murder. As long as the rest of us are cool with it who cares what the murder-ee thinks?

>> they may take a rash decision that they’d regret later

> Sorry to be that guy, but: "how?"

By surviving the attempt. The suicide success rate is not 100%.

Plenty of interviews of people who, after initiating the act, report realizing what they did was a mistake.

Saddest example of selection bias: many people try more than once (and some of course do change their minds eventually)

And it's a real life practical issue for me that there be no wiggle room or ambiguity, ever, in any context, about whether it's OK to kill me. Even if the doctor on the scene doesn't know me personally and I'm not capable of making my arguments to him and defend my self from his, say, religious belief that I'll be in a better place or have outlived his concept of usefulness or worth.

It makes sense to me that this is not something that can be done conveniently. It makes sense to me for the system to be rigged such that errors always result in "did not kill when should have" rather than "killed when should not have".

One of the rules is that two independent doctors need to be sure that you want to be euthanized, so this is already covered and has nothing to do with the ridiculous judgment of whether I am suffering enough.

I'm not aware of anyone who is advocating involuntary euthanasia. I've no doubt that someone is but it is far outside of the mainstream, even among those who support an unconditional right to euthanasia. In all current implementations and all the ones I've seen proposed it has to be actively sought by the patient who is to be euthanized. Your comment seems like more than a little bit of a strawman.

* https://en.wikipedia.org/wiki/Involuntary_euthanasia#United_...

* https://en.wikipedia.org/wiki/Non-voluntary_euthanasia

> I've no doubt that someone is but it is far outside of the mainstream […] Your comment seems like more than a little bit of a strawman.

For now perhaps, but sometimes the inclined plane has a low coefficient of friction:

> Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the court said, it can’t happen here.

> This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.

> Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.”

* https://www.theglobeandmail.com/opinion/article-on-assisted-...

* https://archive.is/hFXjJ

The miniscule risk of a slippery slope in some remote and unlikely future cannot serve as a reasonable justification for violating the bodily autonomy of adults in their sound mind today. Nor am I much impressed by the existence of an organization that advocated involuntary euthanasia eighty years ago in the US. There was all kinds of insanely messed up stuff going on in our country at that time. Involuntary euthanasia, even if they had succeeded in implementing it, wouldn't have remotely been the worst.

> The miniscule risk of a slippery slope

The slippery slope is occurring right now in Canada:

> Had you predicted [in 2015] that the right to an assisted suicide would soon come to apply, not only in cases of physical pain but psychological, and not only to patients in the last agonizing stages of death but those who were nowhere near it – had you predicted, indeed, that a patient’s request to be killed would not even have to be repeated and persistent for a doctor to act on it, that the whole process could be telescoped into a single day – you would have been accused of “slippery slope” thinking.

> Had you predicted that, by 2019, just the third full year after it was legalized, nearly one in 50 deaths in the country would be by assisted suicide, even on the (almost certainly underreported) official numbers; and that, this having been accomplished, talk would turn to extending the procedure – not just to competent adults, but the mentally ill and even children – you would have been carted off.

> Yet that, incredibly, is where we are. The cautious, limited exceptions that people understood the issue to involve at the start – what most people understand it to involve even now – have been overtaken by an accelerating drive toward death-on-demand. Had the public known this was where we were headed, they might have objected. Instead it has been done in stages, a series of bait-and-switch routines in which the courts and legislatures have taken equal part.

> The irony is that the very foundation of the Supreme Court’s decision in Carter was that there was no such slippery slope.

* https://www.theglobeandmail.com/opinion/article-our-cautious...

* https://archive.is/s5bPu

Would you consider killing newborns "involuntary euthanasia"? If so, then that would be an example advocation. Per Jerry Coyne:

> If you are allowed to abort a fetus that has a severe genetic defect, microcephaly, spina bifida, or so on, then why aren’t you able to euthanize that same fetus just after it’s born? I see no substantive difference that would make the former act moral and the latter immoral. After all, newborn babies aren’t aware of death, aren’t nearly as sentient as an older child or adult, and have no rational faculties to make judgments (and if there’s severe mental disability, would never develop such faculties). It makes little sense to keep alive a suffering child who is doomed to die or suffer life in a vegetative or horribly painful state.

* https://whyevolutionistrue.com/2017/07/13/should-one-be-allo...

* https://en.wikipedia.org/wiki/Jerry_Coyne

If not "involuntary euthanasia", do you have an opinion of it 'should' be classified (if at all)?

> The slippery slope is occurring right now in Canada:

I see that the right to end your own life is being expanded in Canada. I see no evidence from what you shared that the qualitative change over to involuntary euthanasia is in any danger of occurring, nor that there is any motion in that direction.

> [Baby-related stuff]

As the blog you cite points out, we withdraw care from infants in the first two categories on a routine basis, which has exactly the same effect as euthanasia, but with extra suffering for the infant. As far as I'm concerned, we already euthanize these infants. We just do it in the most painful way possible.

Hey Oleander, I'm not sure if you will see this reply as I'm a little late to the "party" but if you would like somebody to chat to anytime, please put an email address or something in your bio so I can get in touch (or I've put an email address in my bio that you could reach me at).

I see from taking a quick look at a couple of your previous comments that you might appreciate a postcard, even from a stranger.

Please don't feel any obligation whatsoever to respond, for you have no obligation to me whatsoever. I'm just putting this out there from one human being to another. I don't know your circumstances at all, you might have a hundred friends and family members to talk to and support you, but you might have very few or none at all. Or you might be happier to be left alone. I don't know.

In any case, if you would like somebody to talk to, even just once or infrequently, please don't hesitate, because I do very much know what it is like to suffer (not in the same way that people like yourself with cancer do) and I think many people do not understand how unbearable and terrible suffering can be. I find the question itself, being posed by the title of this article, as repugnant as you do.

In any case, whether or not you wish to respond or correspond any further, I do wish you well and I hope that you are spared as much suffering as possible. I will continue to fight for as long as I live, with the limited resources I have available to me, for what I see as an inalienable right for people to choose a happier or at least more comfortable but shorter life than a prolonged and miserable one.

I am sorry that life dealt you this hand. Life isn't fair, suffering isn't equally distributed, and anyone who thinks they have a right to decide whether another person's suffering is, as you put it, sufficiently bearable, is being callous or ignorant in a way I simply cannot understand.

Thank you for your kind reply. I'm actually doing pretty good. I'm not currently in pain and plan to die before I am.

I figured out a good way to end my life myself should my euthanasia request be denied.

I've always been a proponent of the right to die when you wish and my current situation has given me more time to think about this and made me empathize even more with people who want to die for whatever reason. I too try to spend a portion of my time to fight for this important freedom.

At least we in NL have access to Euthanasia. Frankly I would like to see Futurama style suicide boots.

OK, the latter may seem extreme, but why do we have all the liberty in the world to create life, including a lot of suffering, but not to end our own?

In America, Euthanasia doesn’t seem like an option, but access to guns solves that option in practice. Terrible, but the hard reality.

In the end, It is about quality of life not quantity of life?. And everything in the medical world should be focused on that. For example, don’t put people on ventilators when there is no possibility of recovery.

Anyway, @Oleander: I wish you the best under the circumstances and that you may get what you wish for.

There are actually a number of countries (and US states) that now have euthanasia laws. We got there first, but that also means we didn't get to learn from anyone. There are certainly problems with the Dutch laws, but there is no political will to change it, because it works 'well enough'.

I've extensively studied the Dutch euthanasia law and practice and think I know the right things to say to convince the doctor, but it really shouldn't have to be that hard.

Fair enough, Verder mee eens! Heel veel sterkte!

The irony being... isn't euthanasia the ultimate freedom? If it is our body, and we have full autonomy as long as we aren't causing direct harm, the "American Way" should be to allow the freedom of choice as to what happens to said body.

And you are free to commit suicide in the US. From what i understand most laws making suicide and attempted suicide are no longer enforced or were changed.

What’s we don’t do is make it easy for someone else to assist in your death. That opens up an entirely different can of worms and anyone who thinks that’s an easy change to make is delusional. It’s fraught with issues and one needs to tread carefully.

It's definitely complicated, but in two countries the courts have already ruled that the ban on assistance violates the European Convention on Human Rights.

That's a fair distinction. I did some digging, and it appears unassisted suicide only has common law implications in most states since the 90's; however, as of 2019, only 8 states have laws on the books legalizing assisted suicide (https://apnews.com/article/7f0fe9d789294a02852c1669c892f382).

Futurama style suicide booths would be terrible. A huge fraction of the people who use them would be people who if they had just had to wait a couple of years would no longer have been suicidal.

Some stats [1]. In 2013 among students in grades 9-12 in the US, 11.6% of males and 22.4% of females seriously considered attempting suicide in the previous 12 months.

19.6% of females and 10.3% of males made a plan about how they would attempt it. 10.6% of females and 5.4% of males did attempt it. But only 3.6% of the females and 1.8% of males made an attempt that actually resulted in injury, poisoning, or overdose that required medical attention.

With a Futurama suicide booth where all you have to do is step in and insert a coin, which you can easily do on impulse while passing by, I'd expect that most of those "seriously considered" cases would become "successfully suicided" cases. As would a lot of people who considered it but not seriously.

[1] https://www.cdc.gov/violenceprevention/pdf/suicide-datasheet...

Yes, many people who attempt suicide are later happier and glad they didn’t die. That’s why it was more of an idea or concept, not meant literally / too seriously.

But for those people that really had enough there is no legal, clean way to end their life. Not even in The Netherlands, where euthanasia was first legalized.

Especially people with severe psychological issues will have a hard time proving that they suffer tremendously and that there is no hope of recovery.

Presumably, suicide is illegal where I live because it may involve another person. Obviously, destroying my own life by my own hand leaves no perpetrator, though it does leave suffering [0] in my social circle. Of course, if I'm unsuccessful, our social net must pay to pump my stomach or sew my gash. Presumably, there is a punishment in place to prevent a proliferation of expensive, half hearted attempts. I agree that policy, unfortunately, affects people who aren't intending to harm themselves.

But, consider my semi mobile 97 year old, arthritic grandmother. If she did harbor a desire, she probably isn't in a position to end herself without suffering while she expires. She's not in a position to get a gun, or jump into a river. She doesn't control her pill supply, so she can't swallow all of her opiods. Maybe she could starve or dehydrate herself for an age.

Her greatest hope for dying without complication means involving an able bodied person. But, it's hard for uninvolved people to prove that murder didn't happen, given that the consenting party is gone. Sure, maybe the medical professional isn't interested in killing this person, but benefactors might be. It looks like murder in Los Angeles County in 2018 was 5 per 1e5 [2] and suicide was 14 per 1e5 residents [3]. (LA county contains 1e7 residents.) That is many cases that would need to be audited, and hence an expense that would be simpler to avoid with prohibition.

To be clear, I'm answering your question of why a society may choose to continue criminalizing suicide. I say this as someone who plans to off myself before my quality of life reduces to what (I perceive) my grandparents have experienced. Of course, it is easy for me to pronounce my intention [4] while my preferred date is still decades in the future.

[0] https://www.youtube.com/watch?v=zvkbHIrrrvU

[1] https://news.ycombinator.com/item?id=25526104

[2] http://www.laalmanac.com/crime/cr02.php

[3] https://www.americashealthrankings.org/explore/annual/measur...

[4] https://twitter.com/Ashton_Murdock_/status/12617511652110868...

There was this young Indian guy who sued his parents for bringing him into this world (to make a point). This sounds absurd, but it also makes one think - I and I alone should decide what to do with my life, no? Especially if I haven't had kids. Why should some politician, religious leader or bureaucrat decide if I have suffered enough?

Agreed. Although I do believe you have a moral obligation to attempt to make the people who care about you understand your thought process and ideally agree with your decision.

Thank you for your eloquent comments in this discussion.

> be euthanized by a doctor.

I wonder if suicide is just easier at this point...

It is, but there are complications. My parents are still alive and I'd like them to be present (and they'd like to be present), but when you are present at a suicide you automatically become suspected of 'assisting' and that is not something I want them to have to go through when they are mourning.

Sir, that is the social contract you agreed to when living your life - that it is good to live it. Please do not disparage the legitimate consideration of human life as precious with corruptible bureaucracy which presupposes you are too stupid to make decisions about your health. I, for one, believe it is your body ergo your natural right!

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