Comment by mabbo | Hacker News Reader

Comment by mabbo | Hacker News Reader

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As a Canadian, I'm mostly okay with the system because I don't think it's changed much.

My grandmother was nearing her end a few decades ago- very fast moving lung cancer- long before these options were legally available. She was terrified of being unable to breath, dying from that. Her doctor looked her in the eye and said "I promise you, you won't die that way if you don't want to". And she didn't.

Medical assisted suicide for terminal patients has always existed, in the shadows. Now it's just legitimized and being done openly.

I have some concerns over depressed people dying when they might be able to get treatment to help them. I'm sure there are cases of this happening. But I also think most of those people were going to commit suicide on their own anyway. Now it's being done safely, in the sense that a failed suicide can make things even worse.

I'd like to see more being done to ensure these people truly have no other options, but I also know that I'm not qualified to pass judgement. I have faith that the doctors and medical system are doing what they think is best, and that they know more than I do.

> Medical assisted suicide for terminal patients has always existed, in the shadows. Now it's just legitimized and being done openly.

That's very good. My grandmother tried to kill herself with sleeping pills because she was desperate and no legal option for help existed back then. She was not successful and the end wasn't nice. It's nothing anyone should go through.

People working in the system don't have the same faith. From the article:

> In October 2020, the Office of the Parliamentary Budget Officer issued a report stating that MAiD would cut healthcare costs by over $66 million. In 2017, Aaron Trachtenberg, a research fellow and a doctor at the University of Manitoba, and Braden Manns, a health economist and nephrologist at the University of Calgary, published a paper predicting that MAiD could slash healthcare costs by as much as $100 million yearly.

> “I do worry MAiD is an easy solution to bed shortages and the terrible lack of resources patients are facing,” Dr. Ramona Coelho, a family physician in a suburb of Toronto, told me. She added that “the perverse disincentive that exists for administrators and governments with providing MAiD rather than care and resources to live can present a real danger to the lives of vulnerable or marginalized persons.”

There have also been reports of medical staff pressuring patients to sign up for MAiD to save the government money.

https://nypost.com/2022/11/08/canadian-man-assisted-suicide-...

> “They asked if I want an assisted death. I don’t. I was told that I would be charged $1,800 per day [for hospital care]. I have $2 million worth of bills. Nurses here told me that I should end my life. That shocked me.”

In the US, "medical error" is the third leading cause of death. Nurses and doctors are regularly fired or sued for serious wrongdoing. There's good ones and bad ones, competent ones and incompetent ones. Every profession is a mixed bag. I am sure it is no different in Canada.

You can never, ever, trust a system. You can trust individuals.

I'm not sure if the economic angle is convincing, since Canada spends over $300B a year on healthcare [0]. Are you suggesting MAID was introduced to save "as much as" 0.03% of healthcare expenditure?

[0] https://www.cihi.ca/en/news/covid-19-expected-to-push-canada...

I would suggest that, just as Canada decided they had to remove the “reasonably foreseeable death” criterion in response to a court decision, they’ll find some financial pressure in the future that forces them to expand MAiD programs. It’s likely to sound less like “we ought to kill some people to save money” and more like “here’s a great revenue-neutral idea for expanding access to the important MAiD program”.

If handing out lethal injections is considered to be no big deal, I don’t see how the Canadian healthcare system could avoid these pressures. You can’t make just one deal with the devil.

The economic angle is convincing only to sociopaths.

Sane people don't kill people to save money.

The hubris is astounding. Pick up a history book and lay your eyes upon the horrors that have been enacted by "good people". Literally every organization over a few hundred people where everyone is mostly just optimizing for their KPIs within their role behaves like a sociopath.

> The hubris is astounding.

Who me? You have no idea...

> Pick up a history book and lay your eyes upon the horrors that have been enacted by "good people".

I am a keen student of history, that's part of the reason I seldom leave the house. I know what people are like.

It seems to me that we are recovering from some disaster that deranged us in the prehistoric past. My favorite theory was the Younger Dryas comet impact, but I've gone off that recently. But it doesn't matter. Maybe our hominid past was itself sufficiently traumatic, and the condition we are recovering from is the human condition.

> Under the present brutal and primitive conditions on this planet every person you meet should be regarded as one of the walking wounded. We have never seen a man or woman not slightly deranged by either anxiety or grief. We have never seen a totally sane human being.

~Robert Anton Wilson

The horrors of the past do not justify the horrors of the present, they motivate the ongoing process of becoming a sane and mature sentient species.

> Sane people don't kill people to save money.

Of course, that isn't true in the abstract. Some number of people die in the US annually for lack of government spending on healthcare, and presumably we could spend less and kill more people, or vice versa.

Government healthcare systems are kind of fundamentally a tradeoff between spending and saving lives.

There's a difference between killing someone and not saving someone's life.

On a spreadsheet, they look quite the same.

Does this mean you should always pull the lever in the trolley problem?

That seems like a philosophical argument.

You're not sick, or old yet.

It gets less philosophical the longer you live.

Sure, but believing them to be the same is also a philosophical argument.

No, it was intended to save a lot more.

Like Civil Forfeiture, the medical system should never see a single cent "saved" via suicide. Because otherwise, yes, we're saying we think they'd optimize for it.

No, this is simply not a thing just because the NYPost wrote about it.

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