Dying together: Why a happily married couple decided to stop living | Hacker News Reader

Dying together: Why a happily married couple decided to stop living

bbc.com

22 pointsblondie9x36 comments

I respect their decision. I only hope that I have this option when the time comes. Watching my father, wither away in agony, was absolutely awful. I don't want that for my family, and I think it's my human right to decide my exit.

Wishing you health, happiness and peace for a very long time to come. Look after yourself.

There’s a big difference between something like this and the case of blinding, transient, despair-driven suicidality that we typically think of.

I’d agree that in the transient case, intervention should take place. But in a case like this where it’s planned and reviewed with a doctor, I don’t see any ethical problems.

In places with legal euthanasia multiple doctors need to sign off, as well as family. It's very controlled and not the sort of thing that happens without good reason.

Why don’t more countries enact laws like this? This makes perfect sense. I don’t want to live with conditions like dementia. I didn’t have a say in my birth, I sure as shit should have a say in my death.

Because humans have rigid mental models, tradition and cultural inertia, and broadly speaking, an unhealthy relationship with death. It comes for us all, but few want to deal with the anxiety and feelings about sudden loss of existence, not to mention system incentives to prevent a more optimal outcome for human participants.

I don’t want to live with dementia either. I bet the 50 million people in the world with it would rather not have it either.

How about option B? Cure the disease!

The woman in the article is only 71. It’s crazy that in 2024 we have no idea how to slow the disease enough so she gets another 10 years of quality life.

Curing a disease can easily take tens-to-hundreds of millions of dollars or more and up to decades of research.

For most individuals, this degree of personal financial and temporal expenditure isn’t available.

This. Time value of suffering. Certainly, we should continue to innovate, but also have the freedom to check out when we want on our terms when success is beyond our life light cone.

“In 2020, the direct costs to American society of caring for those with Alzheimer’s and other dementias will total an estimated $305 billion”

https://act.alz.org/site/DocServer/2012_Costs_Fact_Sheet_ver...

It costs a fortune to treat the disease. We’ll save a fortune by curing it.

You can’t stop treating people while we research for a cure.

And in fact both already do happen in parallel. So your point is moot.

How are we spending for research? Because we are going to spend $18 trillion for treatment by 2050.

“Cumulatively between 2023 and 2050, it will cost nearly $18 trillion (in 2023 dollars) — nearly two-thirds of which will be borne by Medicare and Medicaid.”

https://alzimpact.org/sites/default/files/2023-03/Fiscal%20Y...

So, my not so moot point is we are not spending nearly enough on research.

There is no guarantee the cure will be cheap or even cheaper compared to the current situation. Not to mention the increase in other medical conditions that are bound to occur in the added years of life and add to the total medical bill.

Also, note that this investment money is directly related to the number of working hours. All those people working on a cure in labs etc. will have a very different experience in life compared to those same people earning the same money for caring for their fellow humans. It is not a purely financial weighing.

It's all good and well making statements like that but, and at risk of repeating myself, you cannot stop treating people just because you want to spend more on research. And even if you did magic up more money to spend on research, there's no guarantee that a cure would be found by 2050. Or even if it's curable at all.

Nobody suggested euthanasia is an ”alternative” to researching treatment.

The problem we have right now is that there isn’t a cure and we don’t know when research will provide one. Or if it even ever will.

I didn’t suggest that anyone did. My point is that we can cure the disease by making a big effort.

Do we want to cure the disease by 2100, 2075, 2050, or perhaps 2040? Pick a year.

How does picking a year cure a disease? That's not how research works.

It’s about level of investment and effort.

And what about the myriad of cancers? Birth defects? Blindness? Parkinsons? ALS? Add to that poverty, malnutrition, starvation, wars… The problem is there is a limited amount of money, lab space, and researchers. Some pragmatism and realism is needed.

Don’t forget the $1 trillion in interest on the US debt.

The ICE Bucket Challenge raised $115 million for ALS in 2014. Maybe more events like that?

https://en.m.wikipedia.org/wiki/Ice_Bucket_Challenge

It’s entirely possible that dementia isn’t a curable thing, though it might be mitigable. A few technocrats who think they’re living in the Altered Carbon timeline aside, cellular aging is probably just a fact of living in a body.

> I didn’t suggest that anyone did. My point is that we can cure the disease by making a big effort.

We are making a big effort

> Do we want to cure the disease by 2100, 2075, 2050, or perhaps 2040? Pick a year.

That's not even remotely how research works. It's not like software engineering where the problem is known. We could find a cure tomorrow, or it might be in 2000 years time. We literally have no idea how long it would take.

Moreover, research into unrelated things might even be the breakthrough needed for understanding and "curing" dementia.

This is a pretty dumb argument.

> I don’t want to live with conditions like dementia.

My mom doesn't recognize me since ten years, she cannot move, she's thin as she had just been liberated from a WWII nazi concentration camp. She cannot talk, she cannot move. She shows no emotions at all.

And yet the doctor refuses, on the excuse that she's fed with a spoon and not a syringe, to sign the papers allowing to euthanize her.

There's of course money involved too: the elder care home she's in gets a hefty rent each month. And so does the doctor.

I am very angry at this entire system. There's also, of course, a whole issue of legal paperwork / signatures, etc. that are problematic.

For, I'm sorry to say it: an empty shell. My mom is long gone. Let her body go.

Just fuck these insane laws and rules. It's a totally rotten system.

> There's of course money involved too: the elder care home she's in gets a hefty rent each month. And so does the doctor.

Leaving this out might make your argument stronger. At least in Europe, there is no shortage of elder people that can be cared for. Most of these elder care homes have long waiting lists, and normal doctors have waiting lists as well. I think it would be more fair to say that it is an incredibly difficult decision to make as an 'outsider', and combined with how the law works with respect to death and liability, procedures and strictness with regards to euthanasia are not that strange.

I think the point they were making is that the care home and the doctor have a perverse financial incentive to maintain a life beyond the point there’s any quality to that life.

Obviously in a half-way decent society costs shouldn’t be a deciding factor in end of life care or euthanasia decisions for the elder or their family, but neither should rent + fees be a compelling interest in the decisions of those providing that care, yet it’s obvious that it can be.

Yes, that was what I understood as their point. My point is that it isn't that big of an effect, and also partially discrediting the people involved by saying they only think about money.

I think you’re seriously underestimating how big that effect may be. Group care for terminal patients is a massive, and growing, economy in many countries, and doctors and other caregivers are no more immune to perverse incentives and rent seeking behavior as any of us.

It may differ in your country, but here in the Netherlands there is just a shortage of supply, not a shortage of demand. All these services have massive waiting lists, so there will be ten others for each person 'leaving the system'.

I think it is just a risk calculation. How much does a lawsuit for 'wrongful termination of a life' cost vs how much does it cost to have a 'wrongful continuation of a life' and how often is it expected to occur within a given time period and given a set of safeguards. Then you choose the safeguards such that your expected cost is as low as possible. Doctors are only there to fill in the checklist.

Thinking of you and yours. Wishing you peace, health and happiness for as long as possible. I'm so sorry.

With the deterioration of the health care system in a lot countries people are afraid that these laws will be used to "fix" the healthcare system. Instead of helping people chose their end this gives administrations the possibilities of saving costs by pressuring patients into euthanasia programs.

If the systems worked great people might not have as much aversion to it.

Add to that the Abrahamic religions fighting against it as they consider killing yourself or helping somebody to die as a sin.

I think this makes politicians afraid of touching for fear of losing the next election. The topic probably loses them more votes currently than it gains.

Interesting that abortion is legal in ~37 states and this in ~10.

Kind of incomparable issues, though the number for both should be ~50 by now (~52 if America had ever been remotely sensible about DC and PR).

You cannot compare aborting a fetus which we do not yet classify as a full fledged human being with helping an adult commit suicide. If we did consider it a human being we would ban abortion as well. And technically we do not allow abortion in the last month except in exceptional cases.

Note as well that assisted suicide opens a bigger can of worms than abortion. For example unborn babies do not have accumulated wealth that you can inherit. The mother has no monetary incentive to abort the child. Parents however do often have accumulated wealth and unscrupulous kids have the incentive of finishing them off sooner.

Amazing. In absence of a cure, this is the most humane course of action. Dying together in a family circle with no pain and retaining dignity.

"He’s 70, and sits in the swivel driving-seat of the van, one leg bent underneath him in the only position that eases his continuous back pain. His wife, Els, is 71 and has dementia. Now, she struggles to formulate her sentences."

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