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> It fundamentally contravenes the Hippocratic Oath

The Hippocratic Oath is from between the fifth and third centuries BC, and its relevance has long since been superseded by modern ethical guidelines.

> Suffering can be alleviated, and it should be society's job to help patients

There is a lot of horrible suffering that can not be alleviated unless the doctor induces a coma and keeps the patient in a state of more or less total unconsciousness for weeks or months until death inevitably occurs. I agree we should help patients as much as possible, but there's a line where perhaps the only help we can give, and the only help the patient asks for, is a painless exit. Perhaps future drugs and treatments will eliminate the need for euthanasia, but we are not there yet.

“It’s old” is really not sufficient justification for “we know better now”. That kind of thinking led to some very dark places in the late 19th and early 20th centuries.

Neither is tradition a reason that it should be elevated above current thinking.

As an idea, it has the same starting point, not a privileged one, IMO.

If that’s true, GP should justify it on its merits instead of on “actually that’s really old”.

They probably should have done that by saying something like "its relevance has long since been superseded by modern ethical guidelines."

> Suffering can be alleviated

Sometimes.

I somewhat knew someone who committed suicide by dehydration. She understood the situation: broken hip, she wasn't going to live long enough to ever do anything more than lay in bed. She chose not to. Sure, the broken hip could have been treated but it wasn't even hurting her. The immobility was too much.

And I watched my father die of cancer. There was a period where he could be lucid and in pain, or comfortable but out of it. And then there was a period where he had no ability to make memories--if it wasn't in front of him it didn't happen. And in the end it took his remaining kidney function. We know there was a problem but he was too out of it to explain his distress.

And note that suffering can take forms other than pain.

Fundamentally, most slow forms of dying that don't take your mind will make life quite unpleasant before they kill you.

So stop regulating the poisons and allow access via a non doctor path, create a framework around it, trying to give the state control over others bodies has just as many negative externalities. Also please try to keep in mind that the original oath was created during a certain eras morality and philosophical leanings, most doctors these days take severely modified oaths mostly to uphold current profesional practices and ethics.

> So stop regulating the poisons

Most of them, like nitrogen and helium gas, are not regulated. Besides, there are a hundred other ways that require no poisons at all.

> trying to give the state control over others bodies

Yet it's only proponents of euthanasia who demand state sanction. There's something extremely infantile and undignified about this.

> most doctors these days take severely modified oaths mostly to uphold current profesional practices and ethics.

So much the worse, it seems.

The heart of the Canadian approach isn't a poison at all. Everything they use is perfectly ordinary stuff you'll find in the hospital. But if you paralyze somebody without taking over breathing for them they'll die. It also requires an IV line.

A machine that fed the drugs in sequence wouldn't be complex but the IV line takes some skill.

> I believe you'll find that most doctors are opposed to legalizing euthanasia

You believe incorrectly. Polls consistently show that a majority of physicians support physician assisted suicide.

See: https://compassionandchoices.org/resource/polling-medical-ai...

> Suffering can be alleviated

Lol. What world are you living in?

Sure, I suppose if you give someone enough downers and obliterate their mind, suffering becomes a non-issue.

Don't pretend this world can alleviate 'all suffering'. It's simply false.

"Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course"

Isn't this just chemotherapy? It seems like we already break the Hippocratic Oath quite regularly and many people are glad we do!

"Chemotherapy = Poison" is a meme.

In truth, "the dose makes the poison," as has been known since even before Paracelsus' time. In chemotherapy, strong and destructive drugs are indeed administered, but the aim is never to kill the patient, but instead to buy that patient -- otherwise facing an incurable and invariably fatal disease -- more time. In some cases, to cure that patient or send them into a long-lasting remission. This is not "poisoning" the patient. It is just the opposite; it is therapy with an eye towards lengthening the life of that patient.

In that case then, what is a poison? What is the intent of the oath, if it's literal meaning is different from the intent? What does it mean to not poison people? It can't strictly be "you must never do anything that shortens people's lives" because then hospice care would be unethical.

Did you miss the point I made in my previous post?

Strychnine can be a poison or it can be a tonic. If you take 1mg, it'll improve your athletic performance. If you take 100mg, you'll probably die.

Acetaminophen is totally harmless in very small doses -- it's given to infants every day. Take too much, however, and it'll kill you. In adults, it's responsible for nearly half of all cases of acute liver failure in the US, and hundreds of deaths annually. Is it a poison?

I could go on all day. Almost every drug can be a "poison," and, at the same time, only very strong toxins with zero therapeutic window are inherently poisons. In the context of medicine, whether or not something is a poison hinges on the drug, the dose of that drug, its expected therapeutic effect (which is basically statistical), and the condition of the patient.

In cancer, where the condition of the patient is very unfortunate indeed, sometimes only very strong drugs with powerful side effects can provide any hope of eventual relief. Surely you see...

> What is the intent of the oath, if it's literal meaning is different from the intent?

...That the intent is to hopefully provide that relief.

> What does it mean to not poison people?

...That offering something that might cure or abate the patient's underlying condition is the very opposite of poisoning them.

I understand that, but you see how that "intending to provide relief" is very very different from the original statement of "Neither will I administer a poison to anybody when asked to do so", right? Sure, words and context and meaning can change, but this is a very significant change in meaning such that quoting the original statement without clarification is misleading.

Plus, how does that answer my other question? You say the Hippocratic oath's true meaning is that a doctor must provide relief, right? What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient? And if they do, can't they decide death is a relief? I'm just unclear on how your quote from the oath makes it clear that euthanasia violates it.

"Neither will I administer a poison to anybody when asked to do so" = "neither will I administer a substance I know to be deleterious or harmful to life." The very first definition of "poison" in the OED is: "Material that causes illness or death when introduced into or absorbed by a living organism."

Medicine has a therapeutic window that's context-dependent. Part of the doctor's job, which is why they make real money and have relatively high social status, is determining the right course of treatment from that context. To cure -- not to harm, not to kill. If a cure is impossible, to comfort.

> What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient?

Patients have every right to refuse treatment. They can also end their own lives; nothing could be simpler. What's perverse is forcing the medical establishment -- in view of its other responsibilities, duties, and oaths -- to act as executioner. It disgraces everybody involved. The doctor ends up dishonored, the state itself is shamed, the human dignity of the patient is, frankly, severely reduced.

"Pure and holy"

So, I'm supposed to take you seriously? Some words in an oath mean one of my family members has to go insane and claw at himself until he bleeds because his brain has been destroyed by alzheimers? That's "pure and holy" to you?