Assisted dying now accounts for one in 20 Canada deaths | Hacker News Reader

Assisted dying now accounts for one in 20 Canada deaths

bbc.com

505 pointsvinni2824 comments

My Canadian parents are in their 80's so naturally a lot of their friends of the same age are dying. And two of them have been via MAID.

In one case, which was surprising to me, a man who had survived cancer - he was not terminal but certainly wasn't getting any better - elected to die via MAID after his wife died. She passed, he called his doctor and less than a week later he was also dead. He got a chance to visit his family, apparently drive around his hobby farm one more time and then that was it. He didn't want to deal with being alone and seriously ill.

Another friend was in renal and congestive heart failure and possibly could have lived longer but they were driving 100km daily to get to the nearest dialysis clinic and again, this person was definitely dying. So made and appointment and decided to go sooner rather than suffer along for an indeterminate amount of time.

It's quite surprising to me, but these people are in their mid to late 80's and of sound mind and know what they want.

I wouldn’t call someone dealing with cancer and the loss of his wife sound of mind within one week of the loss.

He had apparently expressed his intention before she passed. I do not know all the details and this is second hand, but he apparently had a plan.

I would’ve expected at least a waiting period longer than a week after a traumatic event. Of course I don’t know all the circumstances around it.

A lot of equations and generally good advice for the younger set changes when you're in you 80s. I think unless you've had a pretty unstable life or have real serious mental illness you know yourself pretty damn well by that point.

Who decides on the duration of the waiting period? Why can’t people be in charge of their own lives? Especially people in their 80s, they have earned the right to agency.

It reminds me of OB/GYN providers that deny childless women sterilization procedures – even when they are in their 30s – ostensibly on the risk that the woman might change their mind about having children. Some people know things for certain and there is a 0% chance they are going to change their mind.

Yes, irreversible decisions warrant deep consideration. But denying a full grown adult control over their life decisions is cruel and unduly authoritarian.

The thing is, someone has to.

If you walk in very drunk asking to be euthanised, one would hope that they would have to wait until you are no longer drunk to confirm you really want to be euthanised. Then, who decides on the waiting period?

Likewise if a traumatic event clouds your judgement (as some events can do), it's not unreasonable to make you wait until your judgement is sound. Then someone has to decide on the waiting period.

Potentially this can be studied statistically. Just collect data regularly after an event (such as binge drinking event) to evaluate how quickly people's judgement stabilises. That way we may find that the death of a spouse doesn't cloud the judgement, in which case the waiting period is 0.

Convincing your drunk friend to go to the suicide clinic and kill himself is the absolute pinnacle of "thing that's the most hilarious thing in the world while you're smashed but is absolutely horrifying the second you wake up the next morning".

Anecdotally, I've heard that there's a strong link between heavy boozing and suicide, especially via firearm. One wonders if it's determined people needing courage, or drunk people becoming determined.

It's that "free will" isn't as free as people think".

Is there any country in the world with laws allowing assisted dying that actually allows what you describe, or is it a fantasy that’s irrelevant to the actual policies we’re discussing?

The user you're responding to is very clearly presenting a hypothetical argument, not something that actually exists.

The GP asked "Who decides on the duration of the waiting period? Why can’t people be in charge of their own lives?"

And the OP is making that point that (a) there must be someone in a position to make that decision, and that (b) there must be some waiting period.

In fact, if as you imply there are no countries that allow walk-in assisted euthanasia, that's a point in favor of the OPs point, because it suggests that we do widely recognize that there have to be some limits to individual freedom in this area.

i dont think id characterize those as limits on individual freedom, as much as a requirement of individual freedom. you actually have to want it, vs a whim where you might be drunk and not make the choice you wanted

Yes, it's true that for the choice to be a free one you have to actually want it, but making another person the arbiter of that reduces freedom insofar as there will be people who do freely want it and are forced to wait, or who freely want it and are rejected due to being able to prove they want to to the arbiter's satisfaction.

You can't access MAID in Canada any faster than 90 days unless you are at immediate risk of losing your faculties such that you couldn't make the choice. You need multiple specialists to assess you and sign off on it etc.

Really? Then how did the man in guyzero's anecdote do it in less than a week?

I'm not sure, I assume good faith on HN, so I'd guess that it was in the works for a a while? But yeah, it's 100% not a process that can be done in a week, like, for sure.

> anecdote

Perhaps it'd be best to circle back and check the actual specifics?

Absolutely. The thing is, guyzero told a nice little story in which the speed and seamlessness of the process were portrayed as a positive aspect. If it turns out those details were completely incorrect, then he was being extremely misleading with the way he told that story, and any emotional feel-goods one might get from it should be just as invalid as negative knee-jerk reactions.

That tends to not be what happens-- instead, the correction is used as a rebuttal against people who don't like it, but the correction and its implications aren't considered by people who liked how the story went in the first place. Even now, that comment is the top one in this thread, and it has not been edited to add any additional clarification or corrections.

Why do you assume he did? Specifically, why do you assume he started it in response to his wife's death rather than completed it in response to his wife's death?

> why do you assume he started it in response to his wife's death rather than completed it in response to his wife's death?

Are you saying if someone buys a rope and ties a noose, then lets it sit there for at least 90 days, then they can use it to hang themself after a bad day and that's not suicide in reaction to the bad day?

And sometimes one of the specialists can vote more than once to kill you to break the tie (crazy but it happened).

I guess there are many perspectives on this; these are questions that touches on many serious ethical and philosophical topics: health care, the value of life, death, autonomy, ...

There is a tendency in our time to think about all issues in terms of economy. I think that's wrong, that we shouldn't think about life and death as economical questions, that it is a reductive discourse. Others might disagree, of course

For example, is this really a question about being in charge of one's own life or about what services that should be offered in a society? I guess that's also a link to the OB/GYN example you give; at least some health care professionals might think it is unethical to damage an organ or body that's working: primum non nocere

Others, who have another philosophical view on what health care is, may say that the society should offer the services that people want or need

> Why can’t people be in charge of their own lives?

I think the obvious counterpoint is that MAID is about people enlisting others to help kill them, which is no longer merely "being in charge of their own lives".

The others are really not necessary from a technical pov, could have suicide pill vending machines around the place.

Right, but if the vending machines with suicide pills are specifically for suicide, then the help of others is still very much necessary. And of course, you'd want to prevents kids and drunk people from using the machines, so you'd need some kind of a gatekeeper.

And that point you've ended up right back at MAID.

Even with a pill machine every person involved in the process of setting is facilitating each suicide. This is not the same as recognizing that someone who hangs themselves has a right to do so.

The question is just as much about us as it is about them.

> Yes, irreversible decisions warrant deep consideration.

I think you’ve answered your own question there. Deep consideration is not usually something done quickly, and arguably depth of consideration improves when others are involved to provide additional perspectives.

“People should be in charge of their own lives” sounds superficially like an appealing principle, and in an abstract sense is a worthy one - but reality is messy at the edges, and we know that the concept of informed consent has nuances. There are many circumstances where it would be unethical to grant someone’s request even if they swear blind that it’s what they really want.

The same reason that pills come in blister packs and bridges have nets-if you add a delay to methods for ending one's life, a significant portion of people change their minds.

One is to prevent unsupervised actions from taking place. This is usually to empower younger people to reconsider.

The other is supervised. This is usually to empower older to people to consider their options.

We can agree to disagree on what supervision means, but a bridge net and a mandatory process without a (subjective) additional waiting period, are very different situations to me.

Would you feel the same way if the waiting period were objective? Say a study was performed with varying wait periods, the percentage of people who changed their minds and opted out was tracked, and the final length was set somewhere on this curve to minimize both the delay and the number of people who may have changed their minds. There are ethical problems with that precise setup, but you get the idea.

The human psyche is a frail and changeable thing-a pause in a long-held mental routine can lead to greater consideration at any age, not just for the young.

Making sure someone has actually done the deep consideration necessary for an informed decision of a certain magnitude is not cruel, authoritarian, or denying anyone their agency. It's simply making sure they're actually using their agency.

Requiring someone be of sound mind before making permanent decisions is reasonable and pretending it's not only makes it possible for people to make permanent -- and in this case, deadly -- mistakes because you don't want to inconvenience someone else.

Like you said, if you're 100% clear headed and you know you want to die, you'll be able to do it in two weeks just the same as you could in one. If you're going to have euthanasia it's more important to me that it be absolutely clear the people doing it are capable of making that decision in that moment than making it as easy and quick as possible. If you're not of clear mind to make the decision in the first place, you're not of clear mind to make the decision not to. Whether you said six months or a year ago that you want to die when your wife dies is irrelevant, you don't have the mental faculties at that moment to confirm you want to do it.

And this isn't choosing to end your life in isolation, this is asking someone else to kill you. They have the right to know that there is as little chance as possible you would regret this a week, month, or year from now if given the opportunity.

The issue is that every OB/GYN has seen patients that regret the decision. And for most they will have seen instances where that regret ultimately led to suicide.

Do you really want to be the doctor that didn't press for more consideration for a patient that ultimately takes their own life?

I get the idea of giving women control but as a doctor it's also their right to refuse a procedure to not bear that burden. It's similar to the theory of justice that states it's better for 99 guilty men to go free than 1 innocent person to be punished.

It's easier to deal with a lot of angry patients vs one that commits suicide.

At least with the euthanasia there's not really going to be any rebounding patient regret to deal with!

How common is this, really? I think you would have to weigh the chances of someone going through multiple specialists (psych evaluation, obgyn, possible other referrals) over the course of months and then magically they come to regret the procedure well into their full adulthood? At that point you might as well say that people shouldn’t be allowed cosmetic surgery, lasik, or braces.

It’s not common at all - on the contrary, the majority of ob-gyns have never seen a patient return and express regret about their voluntary sterilization, let alone know of one who was driven to suicide by it. I don’t know how this commenter came up with the idea.

>At that point you might as well say that people shouldn’t be allowed cosmetic surgery

Indeed, they shouldn't.

>lasik

Which a lot of people report regretting and saying that has only made things worse...? Not a great example.

You can't regret dying. Let people do what they want.

Doctors are humans too though and you can't just ask them to gas and mutilate perfectly healthy people so easily. Not what they signed up for.

And they don't have to. But the ones who are ok with it should be able to.

Oh, you absolutely can.

It's funny you say that, because I OD'd about 5 years ago and it reinforced my non-fear of death. It's fine. You're just gone.

I very, very much doubt that any of your claims are true.

Should the doctor have control over his life? Or just his patients?

And how exactly is the doctor supposed to distinguish between those who have a “0%” chance of changing their mind and those who have a 1% or 5% or 10% chance of changing their mind?

Grown adults are prevented from making decisions all the time. Wearing a seat belt for example. Why should it be OK to force someone to wear a seat belt all of the time, but not OK to have a waiting period if someone decides they want to die?

Well, partially, because it’s hell on the first responders to have to clean up a fatal accident scene, which is made worse if the death(s) could have been prevented.

I don’t disagree, but you are making the case for regulating grown adults. For the parent post “who decides how long the waiting period should be?” The answer is society. Right now society says none, but it shouldn’t be looked upon in horror if that changes. If I had to choose, I’d choose seat belts optional over on-demand euthanasia.

Society doesn’t say “none”, if you are talking about Canadian MAID laws. It says “months and a pile of paperwork”.

"It reminds me of OB/GYN providers that deny childless women sterilization procedures"

This is complicated, because forcing doctors into doing things that they consider unethical isn't ideal either.

> But denying a full grown adult control over their life decisions is cruel and unduly authoritarian.

You’re assuming a clear state of mind and perfect circumstances. Suicidal thoughts are very common in depression. I would say giving people with depression access to euthanasia is more cruel than forcing them to seek help. Suicidal thoughts are also common in people who are struggling financially or people who have curable ailments but no access to healthcare. I would also say letting people kill themselves because they are poor is also much more cruel than denying them euthanasia.

Bodily autonomy is important but we still require you wear seatbelts when you drive.

It is horrifyingly cruel to deny someone the option of death without also solving the problem that made them want it.

It is completely impossible to deny anybody the option of death unless you have them imprisoned.

Quite a few of us believe you shouldn't require seat belts for adults.

I believe that they should be mandatory if there is someone sitting in a seat in front of you (maybe to the side too).

You made your decision which is fine, though through choice you are now an unrestrained heavy object that could hit the other occupants of the car.

https://www.washington.edu/news/2004/01/20/unbelted-drivers-...

Everyone should be in charge of their own lives. Except doctors, who should shut the fuck up and do as their told. And people with moral and religious objections who should shut the fuck up and keep paying for this. And people who’d like to sell a kidney, who should shut the fuck up and understand that it’ll be taken after they’re dead when it’s of no value to them.

Nobody's forcing people to be doctors.

Nobody's forcing people with religious or moral objections to commit suicide. If they object to paying for others to do so, then they can stand with the people who have similar objections to paying for a military. Or with the people wondering why the churches those religions people belong to aren't paying taxes.

I don't even know where you're going with that kidney comment.

I lost my wife at 46. I didn’t get to a place that dark, but my decision making process was compromised for several months.

“Walks out of bar drunk - let me have the keys! How dare you wait!”

Once you understand the neuro-chemical underpinnings of stress etc. time delays will make more sense.

> who decides

Well, any person involved in the process of making something real? And that would include doctors right? Why doesn't doctor/health professionals opinion matters if they are the ones actually executing the request?

Full-grown adults in a society don't live alone - others opinion matters too.

>Of course I don’t know all the circumstances around it.

And that's the point. The person expressing the wish (and expressing it before the death) did.

People make choices. We should let them, wherever possible. Yes, there are consequences - but we also let people fly wingsuits and base jump, and those have known consequences as well. Would you also enjoin people from doing that after a traumatic event? What about mountain climbing? Diving? Crossing the street?

If you apply the "no major choices after a traumatic event for a while" line of thought, we'd need to install temporary guardians for anybody who has a traumatic event. That doesn't work.

If someone became extremely risk taking after a traumatic event, putting their life at stake at several occasions, it's not unreasonable to believe that - at least in some countries - the person would be forced to undergo a psychiatric evaluation, possibly through a temporary involuntary commitment

one line that is crossed is putting others at risk or pulling them into their actions. I can't think of many scenarios where I'd support involuntary commitment when it was just the individual and their actions.

Flying a wingsuit out of an airplane as part of a skydive is not particularly dangerous. It's the base jumping, wingsuit or no, that is extremely dangerous.

AFIAK you don't have a reserve when you're using a wingsuit.

You're thinking of BASE jumping. Base jumpers do not use reserves generally.

Someone jumping out of an airplane with a wingsuit is wearing an ordinary skydiving rig complete with reserve and AAD.

I don’t understand the confusion over the person’s express wishes, it sounds very reasonable, maybe even noble to me. I’m 30 and healthy (afaik), but if my main community is my spouse and they die when I’m 80, I’d like euthanasia as well. I don’t even need the cancer background, that just sounds horrible. Maybe my mind will change when I’m actually 80? But I doubt it

Longer waiting time also means longer suffering. It is a trade-of to consider.

One week seems a bit short but honestly not like he has that many years left anyway so the best he can hope for is going out on his on terms.

I am super critical on euthanasia for younger people. I think it should only be allowed for cases when it is absolutely medically certain that they will die soon. But 80+, if you lived that long you probably know yourself pretty well at this point and are unlikely to change your mind. Aging, when coupled with mental decline, is horrific. It is good to allow them to go in a humane way.

I had multiple relatives with dementia die and I have always felt a sense of relieve that their suffering had finally ended.

IIRC they do have a waiting period longer than a week.

But they do permit contingencies. I would assume he went through the application process before she died.

[flagged]

I believe they had a funeral together. That was part of the reason for the short waiting time.

Ok it just feels so sad in some way.

Please don't add snark into a topic like this. It demeans the discussion, and we're all worse for that.

https://news.ycombinator.com/newsguidelines.html

Ye sorry didn't mean to come out as snarky. There is this old man that get to watch a color movie before being put to death in the movie. I didn't mean the escavator scene in some sort of meme reference. More like some slippery slope argument.

Details left out of the anecdote may have included a natural death after a long period of illness. Or it may have been a sudden death.

I think in a case like this, it’s simple to introspect, hard to empathize with the person that matters, and easy confuse the two.

Agreed, but requiring one's psychology be stabilized before they can die of despair seems to miss the point

This happens with transgender individuals looking to start hrt stuck in a basically the same catch-22.

It's an uphill legal battle to get people to understand that laws saying you have to get the patient's depression, anxiety, and suicidal ideation completely under control before they're allowed to start hrt when that's the source of those problems is untenable. Because while there are reasonable and empathetic folks there's faction who is pushing these laws as a means of soft-outlawing the treatment all together.

Ahh local politics, truly nothing else like it.

To be honest, my grand parents both died in their nineties and their last two years were really sad. It was not so much the physical decline but the mental one. At the end, while technically alive, so little of who they were as persons remained, they might as well have been dead.

I fully understand someone in their 80s knowing the end is near choosing to leave on their own term.

I appreciate you sharing your perspective. I wondered, when you described feeling "really sad" and the sense that people "might as well have been dead," I'm wondering if you're speaking about your own emotional response or trying to convey how the individuals themselves felt about their situation?

Edited to sound less harsh

Well, they experienced extended physical suffering and having the mental acuity of a toddler. Feel free to try to convince me that not being able to recognise your own kids and the person you have been married with for seventy years while gradually fully losing your hearing and sight and not being able to leave a bed is somehow a worthy experience. I personally question if you can even talk of experiencing anything because that would imply there is something left which can meaningfully process experiences. And that’s the part which came after the initial decline when they were just insanely mean to their loved ones all the time.

You do sound harsh by the way.

Thank you for clarifying! I've edited my comment to - hopefully - sound less confrontational

My grandfather had Alzheimer's, and for years he lived a stressful life. He constantly kept wondering why he's not in his home (he was), as well as some random paranoia, like that I was a thief that had come to steal from him, or that he was elected mayor against his will, etc. It wasn't great for him.

(I’m not op) The full quote is

> At the end, while technically alive, so little of who they were as persons remained, they might as well have been dead.

It sounds like there was some severe mental decline. When undergoing this kind of mental decline, does anybody remain happy? That’s meant as a genuine question, not rhetorical. Of course I’ve heard of the cases where people are constantly scared, feel unsafe, confused, etc. But I wonder if there are more peaceful examples that just make “boring” stories, and aren’t recounted.

My Oma went through Alzheimer's. Sbe went from being a functional adult, to forgetting how to speak English, to mistaking family members, to recognizing no one, to being unable to feed herself over the course of 10 years. But she seemed happy most of the time, usually smiling, would light up when she saw people, she would attempt to sing along to whatever music was playing. So I'd say she remained happy most of the time, which made it much easier to deal with from our end.

I’m sorry for your loss. Her story brings me a lot of comfort, thanks for sharing it.

My mother passed from Alzheimer's. There was a few-month period in the middle-end phase where she no longer had the capacity for long-term fear or existential dread, but was still able to eat food and listen to music. What remained of her was reasonably content until things progressed. Happy? No, not really. But it was a lull in the storm of pain that preceded and followed. A silver lining to the mushroom cloud.

My mom ran an adult foster care home. Half the population was elderly, half developmentally disabled. I liked helping out with the developmentally disabled folks. They were a handful, but they were basically enjoying life. But the elderly wing was mostly people warehoused and waiting to die. I remember happy moments, but I don't remember anybody who I'd call happy, and quite a lot of them were miserable.

There was one guy, an occasional escapee and reasonably physically healthy for his 80s, who had severe Alzheimer's. He just wanted to go home. All the time, that's what he wanted. I forget the details, but he didn't have a home anymore. Nobody came to visit him. We did our best for him, but what can you do with that?

We did our best for all of them. But I remember one evening over dinner where my mom and my brother and I were talking about getting our medical/legal paperwork in order. My mom said, "If I end up like that, just wheel me out to a field and leave me."

We couldn't, of course. But when her time came, we did move her to hospice as soon as there was no hope of recovery. She lived her life and bravely fought the end of it, but she didn't want to be kept around as a body, a shrine to her former self. A choice I deeply agree with.

> When undergoing this kind of mental decline, does anybody remain happy?

According to some people I know who work in care homes: yes, some people do. They're confused, have no idea what's going on, but are nevertheless mostly happy.

(but that is in no way to negate the fact that many don't)

Yeah any time I've been to a nursing home they have a lot of activities to keep them stimulated - usually some sort of musical performance every week day (usually by volunteer community groups, sometimes school kids), themed days ( Valentine's Day, farm day, pet day, Easter, Christmas, etc) - even the immobile and mentally-declined still enjoy the music and patting a dog.

If you know an ancestor with Alzheimer's or other generic "you just kinda decline" diseases, they "die" long before their heart stops beating.

I haven't been able to talk to my grandfather, or hear his stories, or learn about him, or share anything with him, or even be a part of his life for at least 5 years now. He will probably be "alive" for another five years. He mostly just coasts through life. He doesn't really get to interact with friends, because the ones that aren't dying, he doesn't remember. When I see him, he asks me about graduating high school, which I did over a decade ago now.

I doubt he would choose to die, but when I get to experience the exact same thing in 40 years, I'm pretty sure I'd rather chew on a 12 gauge. Having a more reliable and less terrifying option is important.

You feel now that you don't want it live like that, but how can you know what you would want, then?

What does it have to do with anything? What I want for my future self now is obviously 1. having the choice and 2. reasonable care so that the choice isn't forced.

FWIW this seems like a reasonable question.

My grandmother was absolutely unambiguous about it. Even when she was still mobile and living at home, she'd say things like "I hope it's my time soon" and "I want to follow your grandfather." Quite happily, too. She didn't seem depressed. Just sick and tired of her friends dying and her own inability to do anything for herself.

My mom is 94 and in reasonably good health for that age. My dad just died after a decade of decline with dementia. My mom often tells me that she just doesn't want to wake up one morning. And she wants to go out while she is still on top. All her friends are gone, husband is gone, she lives but can't do any of her hobbies like gardening anymore. She is tired and there is nothing left in life besides waiting for death. I think it would be good if we had a better culture around dying and let people die in dignity if they don't want to live anymore.

My bio father (he was not a part of my life, which is important to note when you get to the end of this comment) lived to 89, for certain values of "lived". He had long ago exhausted his ability to support himself financially, he was blind, deaf, unable to get around town on his own, had substantial age-related mental health issues, as well as a litany of small but significant health issues. I cannot speak for him, but I'd like to think that if I came anywhere close to that existence and I had the option available, I would opt for an end on my terms that respected my dignity and that of my family. As an American, however, I expect to die like he did: poor, mostly alone, and in pain.

>"I would opt for an end on my terms that respected my dignity and that of my family. As an American, however, I expect to die like he did: poor, mostly alone, and in pain."

I think there is more than enough info about how to end it painlessly should one decide to part. No 3rd parties needed assuming that person is still mentally and physically adequate enough.

That's just it: I wouldn't trust myself to be expert enough to do it properly. That, of all the things I might be asked to experience in life, begs for a knowledgeable, caring expert. You're right, of course, but that raises the endlessly fascinating question of why more people don't make that choice.

It is probably hidden a lot more than we think when old and sick people make that choice. When you're weak enough and want to end your life, it might not be a huge effort, and it might not be noticeable. And health care people probably hide it sometimes to not upset relatives.

When you have young and healthy people, it's not that easy to hide a suicide, because suspicions of murder will naturally arise.

My mom died on her own terms in the states at 57 and her doctor gave her the pills to do it at home. It wasn’t as nice as dying in the hospital, but her life quality had been pretty bad for the last decade and doctors will help even in my state where assisted suicide isn’t legal (Washington state rather than Oregon).

How long ago was this? Ever since war on opioids started, doctors have been extremely closely scrutinized by the DEA. Actually helping and even treating patients in some cases is a good way to risk losing your license and livelihood, and possibly your freedom. (and the War on Opioids didn't just apply to opioids, it caused a massive pendulum swing that affects all "controlled substances" not just pain pills, hence why it would be relevant here)

2009, so 15 years ago?

    > As an American, however, I expect to die like he did: poor, mostly alone, and in pain.

All you need is a "beer brewer's kit" - gas bottle, simple plastic bag, and hose from the tank. There is an Aussie guy who explains how it all works on YouTube.

If I start to develop some kind of age-related mental deterioration that is uncurable (eg dementia, alzheimers), I'll probably find a way to exit before I become incapable of making decisions like that independently, because I'm less scared of death than I am of losing myself like that

This! People feel like they cannot live alone or they cannot want that someone else be caused hardship (time or money) because of their difficulty.

I feel like I will get downvoted to oblivion just because people vehemently disagree, but THIS CANNOT be the meaning and choice behind death. It is simply immature, arrogant, and selfish. But more plainly, it is suicidal / self-relentment.

My sample size as an adult is still small, but I've seen this in pets and I've seen this in humans.

The downward slope quickens faster than any would like once it starts. The body or the mind slips away, leaving someone either trapped in a shell that doesn't work, or momentary fragments of the person who was among a sea of futile vapid existence.

Our medical technology is not there and shows little sign of being close to resolving either issue.

Rather than slowly wasting away I too would rather have the option to twist to the side off the cliff rather than the long slow painful stair tumble down the hill.

You might be narrowing the definition of life to mean "body and mind fully active; useful spirited existence; painless existence". But ask the senile when they are no longer senile, or the once-despressed, or the ones who live in pain (sickle-cell anemic?) if death is better.

Who are you to judge whether someone who has lived for over seven decades should go on living or not? If they feel their life is done, have nothing left to live for, and fear degenerating into a husk of their former selves (dementia) stuck inside a broken brain for as long as their body holds out, than why should they hang on?

It's arrogant and selfish to force people to live on for as long as doctors can keep their body alive. No euthanasia just means more messy suicides.

> Who are you to judge whether someone who has lived for over seven decades should go on living or not?

When an old man claims this, that is arrogant.

> to force people to live

I don't think anyone can force another to live beyond their ill-fated death.

Immature, arrogant, and selfish is a good description of a person who demands other people stay alive despite immense suffering, just so you can feel morally superior and not have to experience loss.

I agree that we should avoid such terms in general in this forum as it degrades the discussion. I think we can all agree that these are complex ethical questions where several values are at stake and there isn't one obviously superior ethical stand.

What I read from your comment, is that you think peoples fear of loss impacts the discussion to much and shouldn't be given much weight in the question?

Not the OP, but I think fear of loss is part of it. But a lot of it is just an entrenched/assumed (and IMO not particularly justified) moral valuation of life above all else.

My own view is that a happy life has value. Death is neutral (for the person who dies - it's affect on others may be either positive or negative). And that (all else being equal), causing someone to live an unhappy life has negative moral value.

That latter bit seems to be something that many people not only disagree with, but don't even give proper consideration. Perhaps due to stigma around devaluing of life, so evolutionary bias towards life, or perhaps because their own life is good enough that they find it hard to empathise with those for whom life is an overall negatige experience.

I'm partially with you, in that I do see tragedy in these choices. I see tragedy that we lack the cultural and economic institutions to support peope towards the end of life in ways (especially ones that don't make them feel like a burden.)

However, I don't think the solution to that tragedy to to make people suffer through. I think the solution is more and better institutions that reduce that suffering so fewer people are pushed to make the choice to end it.

Forgive me, but your last sentence seems like a platitude. What would such institutions look like, and how might they reduce the suffering of someone with, say, advanced dementia?

I'm not trying to have a go btw - it genuinely seems an intractable problem to me.

I think the idea is that there are many factors that might motivate somebody's decision that their life is not worth living any longer. Each individual will have a different threshold for that, but if there are institutions that can alleviate the reasons for the people on the fringe, then there will be net fewer people that choose death when they otherwise may have.

Someone with advanced dementia may be too far from that threshold to change the decision for them, but that doesn't mean that better institutions wouldn't move the needle.

I think dementia and euthanasia is already legally and morally very complicated so not sure that is the best example. I do think that dementia often causes problems due to strain on caregivers and cost of outside help. If you have systems of support and resources for these caregivers, then fewer people would be inclined to end their lives to avoid becoming such a huge burden. If you legalize euthanasia and have good frameworks for people to use to determine where their limit is, then people who don't want to become a burden aren't pushed to kill themselves while they still have time.

There are lots of ways we can change systems and institutions to change the choices people make and I see good people working to make that happen.

I guess it is a kind of a platitude. I'm not trying to claim that such changes are easy, simple, fast, or even obvious (though some may be.)

Thanks for replying! I agree with you.

You know what? Yes, I make selfish decisions about my life. So does everybody else. We do not exist to satisfy the needs of other people.

The choice behind death is that it's preferable to the alternative. Before we had medically assisted options, people would do it in more painful ways, but they'd still do it. Many cultures had the idea of "walking off into the wilderness" when your time was there.

When that time is is a personal choice. By all means, let's put some non-gatekeeping hurdles in the way (e.g. mandate a conversation or three with a therapist), but ultimately, we should all be in charge of our own life.

Most honest gloomful comment so far, and need I say selfish.

> It is simply immature, arrogant, and selfish.

How is the desire to avoid burdening others selfish?

"You can't choose to kill yourself because that would be suicide" is a tautology, not an argument. What's the basis for these beliefs?

I will define it for you:

immature: "I know what life means and this is not the meaning of life" OR "we should not burden others with our remorse and pain and so share nothing with anyone lest it cause them pain too." (I hope I don't have to elaborate how this is immature.)

arrogant: "who knows better what I need than me? I know it well enough that no one else matters"

selfish: "If I am the one who wants something, why can't I have it? who are you to say I can't have what I want?"

suicide is a mental disease and a psychological imbalance. The suicidal need a redefinition of what life means.

Thanks for the clarification. I'm curious how you can reconcile your beliefs with those definitions, which I feel apply equally well to your own arguments:

immature: "I know what life means and that is not the meaning of life." or "Suffering cannot be unbearable, can always be improved by sharing it, and everyone has a robust support network ready and willing to share their pain."

arrogant: "15 thousand suffering people, their families, and their doctors and support staff all need to redefine life as I see it."

selfish: "I know what's best for everyone. Differing opinions are mental disorders and psychological conditions and should be discarded out of hand."

What makes your opinion the only privileged one here? Honest question, I just feel like we're operating under different frameworks and there must be something else I'm missing. Can I ask your opinion on the soul and afterlife?

In order to play a reverse uno card, you would have to at least use established reasons. Instead you chose libertarianisms: “dont tell me what to do; I will decide what is best for me”

I don’t operate under libertarian principles.

I understand, but many do. Society as a whole is no longer entirely aligned with you, as is evidenced by Canada, Spain, Switzerland, Belgium, parts of the US, parts of Australia, and a number of others.

So, what principles do you operate under? That's been my question the whole time. If this is your personal beliefs vs that of the states above, I think that seems rather arrogant, hence my thought that maybe religion is involved? I'd love to know how you came to feel so strongly.

Let's loop back around on this comment when you're in your 80s, alone, and dying a slow death.

I would be in the same state as when I was depressed. The only people to prevent you from making such mistakes are the people around you.

"The only moral assisted suicide is my own assisted suicide".

I'm well-aligned with Seneca, the Stoic philosopher who said death is an open door. If you want to die, do it. However, if you choose not to go through that door, your must live your life with purpose and conviction. There's no shame in going through that door if you no longer have the capacity to live purposefully, though.

In these cases, I'm not sure these people had the agency and capacity to continue living in a way that makes sense as human beings.

I gauge much of my value and purpose in life based on how I can serve my family and community. I don't really exist for me in a sense, and I can't exist without other people. I'm part of something a lot bigger than I am. If at any point it comes to be that I'm not serving a purpose in this great network, well, I'm not sure I'd see a point in carrying on. I may still be breathing, blood still pumping, but I'd be functionally dead as a part of a community.

hear hear! in line with another comment I made: https://news.ycombinator.com/item?id=42402703

Choosing death is literally gambling that the purpose is over despite never knowing the future.

> gambling that the purpose is over despite never knowing the future

I guess we're on the same page to some degree. If the future might hold some meaningful potential, wait it out.

But we disagree about grandma, in this case. If grandma doesn't have the emotional and general psychological capacity to offer care, concern, stories, or heart, then she shouldn't be expected to anymore. There are limits to humans. It's why we die in the first place; we're not immortal, and we aren't supernatural.

In situations where I've seen this play out, I think it's actually quite unfair and cruel that we expect grandma to continue offering her humanity to those around her when she has clearly lost most of it, and is barely hanging on anymore. If her life hurts her, we should not expect her to extend herself so we can hopefully gain something for ourselves despite her suffering.

We have to ask ourselves: do we want these people to live for themselves, or for us? Is this a reciprocal, mutual desire we have for them, or does it fit a narrative or convention that's more suitable to us and our own wants and comforts? Is letting someone die too scary and uncomfortable for us? Are we attuned to how much they actually suffer and how little their future really holds?

I suppose at some point we have to admit it doesn't make sense to lament not knowing the future. For example, when my mom died it took her 7 years, 3 of which were absolutely awful for her, 2 of which were spent in relative confusion or outright senility. It was all downhill, no turning around, no improving, just a steady descent into pain and madness. Saying "I can't predict the future" at that point is kind of insane. She'd lost her mind. She was enduring kinds of pain I came to understand as being indescribable and unbearable.

Hoping for a turn around so I could hear her voice, her care, more stories, etc... No, that's for me, and she's already gone. Why make her suffer more?

For what it's worth, I don't eat animals because I despise the idea of needless suffering. I won't intentionally cause suffering of a sentient creature because it's one of the most needless, unnecessary, overtly harmful things I know of in the universe. I can't bring myself to have an animal suffer because I want to enjoy eating its meat, and likewise, I can't expect a human to suffer because I want to (hopefully) enjoy their presence or some function they serve for me. No, that's a bizarre pressure or expectation to put on someone. Especially if it's for my own fleeting gratification. That doesn't enrich our relationship or deepen our connection. It's just me and what I want. Who cares what I want, when someone is in the throes of dying?

Because it is downvoted to oblivion:

> This! People feel like they cannot live alone or they cannot want that someone else be caused hardship (time or money) because of their difficulty.

> I feel like I will get downvoted to oblivion just because people vehemently disagree, but THIS CANNOT be the meaning and choice behind death. It is simply immature, arrogant, and selfish. But more plainly, it is suicidal / self-relentment.

My dad (age 75) got diagnosed with ALS and within a month of the diagnosis opted for MAID. He had only just lost control of one leg, but he knew what was coming. As much as we begged him for more time, he didn't want any of it.

Till his dying breath he kept repeating how thankful he was that he lived in a country that didn't force him to live on when he didn't want to.

He was a clear Track 1 case, and I realize Track 2 cases are more complicated, but just wanted to add my story as reporting on MAID spins out of control in our culture war milieu.

I'm sorry for your loss.

Yeah man, it does suck. I do wish I'd had more time with both my parents, they both died really early in their 50s, I don't think you can ever have "enough" time.

I wish my mother had been given the option in her early 50s, the number of people punished by authoritarian governments that deny self determinism and force people to be put through experiences literally worse than torture is mind boggling, I cannot fathom it.

I don't think anyone who has seen it even a single time can honestly make slippery slope arguments, I have to assume it's ignorance and that these people are simply "actually" nerds doing recreational theory crafting. I assume it's the same headspace as flat earthers, it doesn't effect me so why should I care about aligning my thoughts with the real world, let me invent theoretical overlords and victims and argue about this new synthetic world that exists in my imagination.

I just can't be uncharitable enough to believe a person who has seen it first hand, that a person would embrace such unfettered cruelty as to deny a person living in constant hell a drop of water.

That being said... fuck, back in 2000 I did meet a bunch of people that denied hiv existed and said even if it did it was a punishment on gay people and it would be better if it wasn't cured so they would be scared and "behave" (yes, I personally met these people, the non-existence was rare but the "shouldn't develop treatment" was not a minority view in the city I lived in at the time.)

After my mother died, for a while I volunteered with "No one dies alone.", I doubt a single person who has done so for any length of time is going to argue "slippery slope".

I think it would take flat-earth level idiocy to think you need the government's blessing to "self-determine".

It's not about blessing, it's about people being sent to jail for colluding with a self determinator.

People get sent to jail for assisting someone, even if it's just to buy some stuff.

That's government overreach.

> I just can't be uncharitable enough to believe a person who has seen it first hand, that a person would embrace such unfettered cruelty as to deny a person living in constant hell a drop of water.

I have seen it first hand. Suicide is not a drop of water, it's a loaded .45.

That said there's a qualitative moral difference between easing someone's pain in a way that may hasten death and killing them to ease their pain. Almost no one who argues against MAID is arguing for "all medical interventions, forever".

> ... I don't think you can ever have "enough" time.

Unfortunately there are situations where things are a bit different from that. For example, where a parent is (very) abusive. :(

Of course your absolutely right and I'm very sorry if that's been your experience.

I was trying to allude to the saying "you can never have enough time with the ones you love" which I took as a pivot away from solely parents (ones that are loved) but maybe I was too implicit and that isn't a widly known saying and it seems that by trying to allude to it, I left my intended meaning unclear. Sorry about that.

Sorry for your loss. I don't know if he got to explain to you (all) the reasons behind his choice.

My fear is that I will be 70-80-90, I won't be able to serve myself even for the very basics, I will have lost my memory, and will be a total burden (all the pain - zero joy) to my close family. Why would I do this to them? Perhaps he had a motivation like this - to make sure he won't hurt your lives, your relationships, etc.

Either way, it is a very difficult choice..

> I will have lost my memory, and will be a total burden (all the pain - zero joy) to my close family.

We need some kind of "smart contract" for such cases. Maybe an IFTTT or Zapier workflow that automatically activates the MAID clause if predefined conditions (that you chose while you are still conscious) are met.

These are all excellent examples of how MAID should be used, I think the concerning thing is the widening of the eligibility criteria - especially when things like mental illness start to make you eligible.

Like... If your illness makes you suicidal... Is offering assisted suicide REALLY the best we can do? That starts to feel a lot like "eghh you're too hard for society to care about... We'll just let you die".

As horrible as this might sound, often it's failed suicide attempts that actually are the catalysts for people being able to get their lives back on track... What happens in a society where the government helps facilitate suicide and there's never any "attempts" anymore... Just successes...

That concerns a small minority of cases, the vast majority is elderly dying people who want to keep their dignity. By steering the discussion to that minority, which even itself is still debatable, you risk flushing the child with the bath water.

The same logic applies to capital punishment

I don't think Canada has the death penalty.

I don’t follow.

How does this apply to capital punishment?

Many people are opposed to capital punishment due to the small minority of innocent folks it eliminates.

> By steering the discussion to that [innocent] minority, which even itself is still debatable, you risk flushing the child with the bath water [and killing the really bad criminals].

There's a difference. The people with MAID choose to die.

When innocent people are killed via capital punishment, they have no choice.

And it's not a "small minority" either. We don't have good numbers, but it's significant enough to be over 22% or roughly 1 in 5. That's not a small minority.

For Florida, since 1973, 30 people awaiting execution have been exonerated so far. The state has executed 106 people.

Out of 136 cases, 30 were shown to be innocent beyond any reasonable doubt. I have no doubt that there might be other innocent people within the 106 that were executed.

https://deathpenaltyinfo.org/policy-issues/innocence/innocen...

https://en.wikipedia.org/wiki/List_of_people_executed_in_Flo...

By hesitating to discuss, you enable bureaucrats to suggest maid when they want to save money instead of treating a disability (which has already happened in the case of the Olympian).

The single bureacrat in question was flagged, investigated, and removed from contact with veterans.

Their action in suggesting MAID was not policy, was rapidly caught, and was the subject of a very public inquiry.

Had the suggestion been followed up by the veterens in question there were layers in place, interviews and checks, to make sure that MAID was both desired and appropriate.

This is like trusting people to behave while owning guns. Curse of knowledge writ large.

It's a demonstration that the system currently in place has verification checks.

No one was killed against their will here.

There's a legitimate debate to be had on the question of whether it was even wrong to alert an injured veteren that MAID was an option given they had the free will and the gumption to reply No way, Feck off, Not interested.

The onus here should be on secondary interviews sorting out whether a person really did have insurmountable chronic pain and problems or whether they were depressed and lacked resources to deal with a situation.

There have been people killed against their will at the time because they previously signed something to ignore their future self.

Under MAID and against their will?

Can you provide details of this?

I'm with @navane, you're concerned about what is very much a minority edge case.

Still, I'll bite - it's a good thing.

Why? Well an official path to suicide, as per the arrangements already in place, comes with layers of professional guidance and counselling.

It's not a dispassionate "wave 'em through" treadmill of corpse creation.

The best thing for young people with suicidal affixations is to talk to them and take their concerns seriously, correctly established this could arguably reduce teen suicides by recognising the problem, giving the at risk a place to go, requiring them to detail why they want to die, etc.

If you want to take a dim view of faceless government motivations then you might ask yourself why such a souless collective would want to deprive itself of a potential taxpayer before they've even really started to chip in.

I get your point, but there are already MULTIPLE examples of people combining the mental-health component + some externality that is fundamentally a societal failing and coming to the conclusion that MAID is the optimal outcome.

"An expert committee reviewing euthanasia deaths in Canada’s most populous province has identified several cases in which patients asked [AND WERE APPROVED] to be killed in part for social reasons such as isolation and fears of homelessness, raising concerns over approvals for vulnerable people in the country’s assisted dying system."

"Another case focused on Ms B, a woman in her 50s suffering from multiple chemical sensitivity syndrome, who had a history of mental illness including suicidality and post-traumatic stress disorder. She was socially isolated and asked to die largely because she could not get proper housing, according to the report."

https://www.theguardian.com/world/2024/oct/17/canada-nonterm...

And?

That's a serious ask, not a snarky response.

The headline is Canadians with nonterminal conditions sought assisted dying for social reasons

and my question is, so what happened? Was she killed by the state or did she get some much needed assistance with housing, etc. (or neither).

I'd argue that her coming forward is a good thing in the big picture as it adds concrete examples and data for making a case for better social policy and outcomes.

There’s a stigma/taboo attached to suicide, and that’s because suicide is kind of a show-stopper bug opened for modern society. And it does not want to admit the problem because it’s not capable of doing anything about it. Support phone numbers or “talk to someone” are there to defuse and keep the person living so they die of old age. Or if they do suicide successfully later on, the system washes its hands clean and avoids dealing with ingrained deep issues that cause suicides.

Both examples were killed by the state... That's my point, the safeguards failed and the people were euthanized...

Both cases concerned people who requested euthansia, and repeatedly so.

Both cases were borderline and raised concerns.

Both cases were reviewed.

It is imposssible to have any such system in the real world that does not have concerning edge cases.

It is a system that many people want for both themselves and for their relatives in cases that are clearcut.

The problematic reality about people with mental issues and disabilities is that they are also autonomous people who have opinions, think for themselves, and sometimes decide that their own circumstances are no longer tenable following years, decades even, of struggling through.

See eg: The Last Leg from the UK.

It's not desirable to have a system that kills people that don't want to die and wouldn't choose death if they had better options.

What are the housing options for people with chronic mental issues (eg: the extreme examples of schizophrenia, bipolar disorders, etc) that have no support and have exhausted friends and relatives?

These are not easy problems.

What is your proposed solution?

"Some provisions are in place, including a requirement of having two independent healthcare providers confirm that the patient is eligible before their request is approved."

Oh well that settles it then, because TWO medical professionals could never get something wrong, could they?

Suicide is the ultimate “my body, my choice” issue, even more than abortion is. It’s monstrous to force someone with severe mental health problems to live if they don’t want to. I live an incredible life now that people envy, but I’ve had been through torturous mental health problems in the past. If I knew I had to face a year or two of my dark times again and I’d have 50 more years of my great life afterward I’m not sure if I’d choose to live.

They should do a study where they do fake maids (like catching a jumper) and then seeing if they regret living another month.

Are you calling for nonconsensual human experiments that will (depending on the outcome) either inflict grave emotional injury onto people who are already so badly injured that they want to die, or that'll be used as a justification for stripping people of their bodily autonomy?

Yes, like catching people with nets who jump off bridges (and a vast majority are thankful of it).

MAID is the net in the context of impulse driven suicide. If a person’s natural death is not reasonably foreseeable, there is a 90 day assessment period.

The government defines reasonable to save money. I’m surprised at people who think bureaucrats like those from the motor vehicle licensing departments will be able to handle such decisions.

Catching people who jump off bridges doesn't involve lying to people who're entrusting you with their very last bit hope.

> and a vast majority are thankful of it

A statistic that (assuming it's true) suffers from the obvious self-selection bias of people who chose to jump off a bridge knowing there was a net to catch their fall.

The entire reason why the mental illness discussion is complicated is because with mental illness it’s not clear it is a choice.

And this isn’t even something made up for the particular case of assisted suicide. The idea that someone with mental illness cannot make legitimate choice has been around in the legal system for a while, with mental illness leading to reduced sentences, and even being the basis of acquittal in many situations.

> The idea that someone with mental illness cannot make legitimate choice has been around in the legal system for a while

There is mental illness and then there is competence, they are related but not the same. Complicating things further in this case would be things like reactive mental states (grieving etc) which might for a time manifest like mental illness but tend to be not diagnosed.

https://en.wikipedia.org/wiki/Competence_(law)

Thank you! This is EXACTLY the issue I've been failing to articulate.

If you are sufficiently mentally ill and determined enough to die that you get through the MAID screening, counselling, information sessions, etc, then you are determined enough to die by other, messier, likely more painful, certainly more traumatizing to the people around you methods.

As well, mental illness is not just a state of mind. Sure, there are stories where a failed suicide attempt was the catalyst for someone finally being able to reach out for help, there are also the stories where people have been reaching out for help forever, and help's just not coming. Where they can't afford the medication, or no medication seems to work, or they have an addiction problem and there just isn't any way for them to get into a treatment program, etc.

Not to mention the stories where their attempt left them powerfully sick and/or disabled. We're talking near-miss fatalities here -- recovery from those is rarely painless, quick, or complete.

This isn't a case of medical professionals and program officials just not caring. These eligibility criteria are very carefully considered. In fact, they're SO carefully considered that they've delayed eligibility for MAID due solely to mental illness THREE TIMES to ensure proper safeguards are in place. Currently, it's pushed back to 2027, so we're not even talking about anything that is even a present-day concern.

(https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#s1_1)

My wife helped a friend die in Germany 10 years ago. He'd acquired some cyanide, which resulted in a long, protracted death because he took too much and vomited most of it up. It was messy, painful and traumatic, but she sat with him until the end.

When someone is determined enough to die, they find a way.

That's wild, because in my understanding it's an indictable offence to aid and abet someone to end their own lives in Canada. Like more than 10 years jail

https://laws-lois.justice.gc.ca/eng/acts/c-46/section-241.ht...

Counselling or aiding suicide

    241 (1) Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than 14 years who, whether suicide ensues or not,

        (a) counsels a person to die by suicide or abets a person in dying by suicide; or

        (b) aids a person to die by suicide.

The document goes on to detail the medical exemptions we're talking about here. What's the law in Germany?

I doubt GP's friend was really considering the law in that circumstance.

She didn't care, and she got away with it. And if she were still alive today, I wouldn't be talking about it since the statute of limitations is not passed.

Also this was in Germany, but still just as illegal.

She was the most amazing and remarkable woman I ever met. There will be an Arte documentary about her early next year (not about this; about her work in Ukraine).

Terrible to read he still suffered a lot. I hope your wife is ok.

I've read about four or five stories in my lifetime about people who assisted in aiding a dear friend. Most of them just stuffed a pillow in their face when they begged to end their very painful existence.

I've witnessesed my brother in law suffer immensly from cancer before he decided to end it all by assisted death. Near the end he was not human anymore for me. Just a body chock full of medicines constantly trying to survive as much as possible. I can't blame the cells trying to win that desperate war, but it was horrifying to watch him transition from a strong happy human to that state.

I heard a first hand account of someone help their father with last stage cancer administer a morphine drip, everyone said their goodbyes and he went to sleep. Only to wake up hours later and say, it is working and they both struggled to milk the bag to increase the flow, they talked for 20 minutes while they both tried to "fix it" and he finally went back to sleep for the last time.

We need a humane way to treat humans.

> Where they can't afford the medication, or no medication seems to work, or they have an addiction problem and there just isn't any way for them to get into a treatment program

I would consider two of these absolutely monstrous reasons to assist someone in killing themselves. A broken society opting into killing its citizens because it can’t be arsed with fixing itself is next level evil

You're getting downvoted, but honestly, I agree with you.

That said, I don't have any actual insight into the process; I was just extemporizing. So if it sounds fucked up, that's because _I_ fucked up and didn't think long enough about circumstances where someone would be approved for MAID instead of offered other solutions. It's entirely possible and indeed likely that if you can't afford medication or treatment, there's options in place to get that to you instead of approving your MAID appointment.

Please don't judge Canada too harshly just because I misspoke. =)

It’s all good, I didn’t take your comment as an indication of how it actually functions in Canada. Just reacting to the implications of your examples

> A broken society

I don't think this is necessarily broken by any reasonable standard. If no medication exists, that's not "broken society". Nor is there not being money to give a bespoke treatment to everyone, no matter how expensive it is. If that's broken, no society in history has ever not been broken. Which is just a poor definition.

Yeah I wonder how people who say this stuff feel about the homeless? How do they feel about tax increase to fix "broken society"?

We feel fine. The ones against taxes never cared and pay the least proportion.

This is vs them talk is honestly pointless. You don't speak for anyone but yourself.

- It’s a fact of life that people die.

- Some of those deaths are suicides.

- It is pure fantasy to imagine we can have a society with 0 suicides (when accounting scale, complexity and size).

The choice then becomes: help, or punish.

It is absolutely monstrous to punish, and helping does not mean killing every Tom, Dick and Harry with a case of the Monday blues.

B.s. parent literally gave an example of someone that got access to MAID a week after their doc visit. I’ve changed my mind on things after a month. Not saying MAID is bad or should be banned. I’m saying people will 100 percent abuse the system. My concern is healthcare system practiioners. I am dealing with a ton of people whose job it is to press our family into a decision we don’t want to make. This includes an md, a social worker and a care coordinator. Canadas health care for old people and folks with dementia is a disgrace. Maid should not have to be the only option with dignity.

What’s another dignified option when it reaches terminal?

Accepting suffering as part of the human condition. In the Christian faith, Christians are taught that suffering is part of life and good things can result from it. Like what? Empathy, love, and compassion from caregivers, friends, and family to the suffering person. Also, the suffering person may express love to those around them. Jesus allowed himself to be crucified and suffered one of the most horrible deaths imaginable. He did it as an act of love for humanity. A Christian might argue that it was also to serve as an example of enduring suffering.

And you and anyone else can still opt to live and suffer if you see value in it. The beauty of freedom is that you can do you, and nobody can force their beliefs on you.

I would also caution with the old adage, don't knock it till you try it. Life in extreme pain is no life at all. Calling on Jesus isn't going to suddenly make excruciating pain more bearable, especially for someone who doesn't believe in Jesus. Maybe toughing it out for a few more weeks or months is worth extra presents in heaven, but unless we have some evidence of that, I think it would be grossly irresponsible, indeed evil, to legislate it. It is, in my opinion the equivalence of torture.

I accept your suffering if you choose so. If I knew you personally, I would even do all I could to help and comfort you. However, I cannot condone you imposing suffering on others in the name of YOUR religion.

I never said anything about me wanting to impose my religious belief on others.

Christians can suffer as much as they like. To everyone their weirdness.

Just don't push it to others under the name of morality out other bullshit.

I would like to be able to die when I want to, in a simple and painless way. Because I will do it anyway jumping under a train or lorry it is just messy for everyone.

Your life doesn't belong to you. You need to reread the Phaedo.

I never said anything about imposing my beliefs on others. I merely responded to the question about whether there was any other course when things are terminal.

But it is. Most people are not rich to pay for their own care. Society doesn't want tax increases. We don't have enough healthcare workers.

Reality doesn't care about how things should be.

Society != a small but influential wealthy minority

Framing it as unchangeable "reality" is intellectually dishonest.

Run a political party on a "unlimited spending on healthcare" platform and see how far you get.

> I’ve changed my mind on things after a month

...and what is the implication here? After I broke a bone, I was given a choice between surgery and a cast. I chose surgery - which cant be undone - and I half-regret it because when I bump into things and the titanium bits transferred the force straight to the bone, resulting in exquisite pain. Should I have been denied surgery because it can't be undone? I think not; I was given the choice, I hose what I thought was best. Did I make the correct choice? Probably not, but it was my choice to make, and expecting a system with 0% regret rate is impossible.

It’s strange to me how resistant society is to the idea that mental health is health. Not all there is to health, but someone suffering from terminal cancer is typically regarded very differently from someone suffering from an incurable mental illness.

Not every mental illness makes someone of unsound mind.

I see no difference between a case of someone who does not wish continue because of some incurable mental health issue that makes their life hell, and someone who does not wish to continue due to e.g. terminal cancer.

Oh well. You don't need to nanny everyone. They have probably tried all the drugs that have made it all worse. You don't have any real context for someones personal decision like this.

ALS will destroy your family if you try to stick it out. Best to go on your own terms.

I know it's morbid to discuss but the relief of financial burden on society is also significant. Not only do they die with dignity, but they are giving back to society.

Not to society, but to their loved ones. Whether their children via inheritance or their spouse they didn't bankrupt.

This is not a good argument for MAID, and I think there are countless dystopian sci-fi stories that exhibit this reasoning that I’d like to avoid (The Giver, Logan’s Run, Soylent Green, etc)

If we start looking at people who use MAID as selfless because they are “giving back to society”, and relieving the “financial burden”, what does that make people who choose to stick around? Are they selfish?

No one should be pressured or guilted into choosing an option like MAID - people are more than just balances on a spreadsheet.

To clarify, it's not an argument being made, it's an appreciation for the full extent of what they are doing.

Agree 100%. I am hoping to use the MAID option on myself one day. Cancer runs in the family. Of course I hope to get to at least 80 or so. There is definitely such a thing as a "good death" and a "bad death" having seen both close-up in family members. Knowing my $ is going to my children instead of some scammy health insurance providers will give me the final smile on my face, and my last thought will be "I WON"

They've already given to society, probably for most of their lives. It is now their turn to have some small amount returned.

And there it is - "Lebensunwertes Leben" [1], but compassionately

[1]: https://www.nytimes.com/1986/09/21/magazine/german-doctors-a...

IMO the financial aspect is the strongest argument against assisted suicide. When the government can save money by encouraging you to kill youself the incentives are just really bad.

In your first example, I suspect there was probably other things present you weren't made aware of. Currently the requirements in Canada include (only copy those relevant to your example).

-have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2027)

-be in an advanced state of irreversible decline in capability

-have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable

https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#s1

Yes, I know very little other than that he was a cancer "survivor" - he wasn't about to die of cancer imminently but I think he had some sort of long-term ongoing health issues. But he was apparently well enough to drive a car!

It sounds like the last one is the get out of jail free card.

The "alleviated under conditions the person considers acceptable" clause is very broad, but doctors have to first agree that the person is suffering intolerably, so it's not entirely a blanket clause.

That isn’t the full list, and all of the criteria must be met, not just one of them.

Yeah, I get that. Once you've accepted death is inevitable, you start to think carefully about what kind of death you want.

My parents both died of glioblastomas, a particularly aggressive form of brain cancer. As the surgeon explained after the biopsy, "This is what you will die from." 3 months from diagnosis to death for my mom, a year and change for my dad. Seeing that process up close made very clear to me what I wanted for myself.

All of this was reinforced for me by the experience of Brittany Maynard: https://en.wikipedia.org/wiki/Brittany_Maynard

She was diagnosed with a glioblastoma and was given 6 months to live. She moved from California to Oregon so she could die in a controlled and humane manner. She wrote about that here: https://www.cnn.com/2014/10/07/opinion/maynard-assisted-suic...

I get the thought of medically-assisted suicide wigs some people out, and we have to be careful to make sure the urge isn't just a temporary distortion of mood and thought. But having seen it up close, I am very much not interested in spending months dying slowly and dragging my family through hell just to make sure random people not involved don't have to think about hard things or deal with their feelings about death.

That must have been tough. May I ask what made them ill? The odds that they both got the same relatively rare disease by chance seems slim

Yeah, they were actually both left temporal lobe glioblastomas. Every time that comes up with a doctor they get a funny look and ask where they lived, obviously suspecting some environmental cause.

The short answer is people almost never know the cause of a glioblastoma. My parents only lived in the same place for like 6 years, and they moved around a fair bit. Nobody else in my family had one so far, so the next likely data points are me and my brother. Not a lot you can do anyhow, so ¯\_(ツ)_/¯

It's not at all surprising to me! I fully expect to want to euthanise myself once I'm done with life (and I'm going to be pretty upset if it's not an option for me when it gets to that point).

People tell me I'll change my mind (perhaps similarly to how people treat people who say they don't want kids). But I doubt I will. I've seen lot's of older people (and people who's lives are not good) still want this when it comes to the time when it applies. The only reason it's not more commonplace is social stigma (and legal obstacles) against it.

I live in the neighbourhood in Canada with a lot of elder people. I mentioned in one of my previous comments as well, and MAiD is probably one of the best things that happened in our country in the past decade. I have distant relatives who took the MAiD way out (one because of the age, the other one terminal illness). It's not very uncommon to hear once every quarter in the coffee shop in my neighbourhood people chatting about this program. Older people are generally happy having a way out, rather than suffering and bringing pain to their close ones.

Both of my parents (in their 70s) mentioned how they want to go out the same way once they're incapable of living and start suffering. I feel the same about it as well. I understand there are very small amount of cases where people shouldn't be able to take this way out, but it's a net good. I really hate how global media is trying to turn it into a big conversation and "slippery slope", because if anyone who has seen their loved one suffer... they would never want this program to end.

These HN comments are both uplifting and wild to me at the same time. I live downtown Toronto, work on Bay St and all I hear is how insane we are allowing all these people to kill themselves with MAID, even on the occasions I log onto twitter, if Canadian stuff comes up I always see some "omg the Canadians are crazy all killing themselves" - I always thought MAID was great but had started to wonder if I'm wrong headed about that.

Yeah, I hear that in the west as well. I’m relatively young, but enjoy having chats at the park and cafes around me, where median age is probably 50+. So, you get to hear personal stories from people who lost someone in recent times. Obviously there’s always reluctance in discussions as well, like “that person is very strong, I don’t think I’d be able to sign up for that”. But they usually end with “I’m glad that they passed away on their own terms”. I think there’s a disconnect between our social circles (ages 25-50) and supermajority of people who end up taking MAiD way out (70+). So, we don’t hear the heartbreaking but peaceful stories that often.

Don't take your news and opinions from X.

You can talk to real people that work or live in a hospice or care home to better understand the death process (they need volunteers for all sorts of stuff). Or look into the formal studies that have been done on the Canadian side.

Controversial cases aside, MAID is more the scheduling of an event that can be seen coming from quite a ways away. I have family members that work in hospice care, and the reality of death makes it seem cruel not to allow MAID.

This isn't healthy people offing themselves when they turn 90. This is people seeing a slow and certain decline and loss of dignity due to a known illness. If you knew that your last six months would be extremely painful, you would lose the ability to walk, lose concentration to have a cogent conversation, not be able to go to the bathroom by yourself, and finally your body would just shut down; wouldn't you want the option to shorten or skip out on the final parts of that experience?

The problem I have with MAiD is I’m not sure the subject really decided it. Forged signatures do exist (a lot) and you’re only a socialist state away from trying to save on public health expenditures by incinerating unwilling patients after pretending their agreement. Without much trace than two witnesses who say “He said it”. Not like it already happened for handicapped people in Germany. I’m quite sure it already happened in Canada, and by dozens.

Consentment fraud is a lesser difficulty than stealing someone’s wallet at gunpoint or horribly mutilating people and leaving them in a bathtub. And yet, the consequences of this fraud are fatal, more fatal than extorting their entire life savings from a person. You just take someone who’s currently lonely, not really looked after, perhaps at odds with their parents… and hop, their life is over. Drug addicts, rape victims, lonely adults. So much taxes can be saved.

Easy fraud for doctors, with plenty of incentives to commit it, and the highest consequences for the victim.

No system is perfect, and at some point there will be fraud. From what I recall, at every single point the patient has the ability to stop the process up until the last minute. All patients require to be in a state of mind to keep making authorizations at every step. I understand your concerns, but I would be willing to take this risk, as I really want both my parents and everyone I know to have this option. Whether they choose it or not, I will always respect and support them at every step, but leaving them in agony and continuous suffering is not something I'm willing to overlook.

But I genuinely understand your concerns.

IIRC the patient can make a request in advance specifically covering the case of them being too out of it to consent. Obviously, in such a case if they're then out of it there's no final authorization needed.

You are so sure of this, yet you have no evidence at all. I'm not sure your problem, is what you think it is.

You call this "fraud," but aren't you describing murder? So in essence, you're suggesting that doctors are murdering people because of incentives?

I wonder why OP thinks doctors would have any incentive to do this. It doesn’t benefit them personally and there is just a vague benefit of lower medical care costs provincially.

It's a job that pays money.

And people can become zealots for what they believe is best for others

This is probably the worst part of living in a lower trust society. We just keep decreasing the bar of "good faith". It really sucks, yet I get your point.

> Easy fraud for doctors, with plenty of incentives to commit it, and the highest consequences for the victim.

I find this a bizarre way to assume that a person who has committed their entire lives to helping people would behave.

Ah yes, the new Hippocratic oath, “above all else, maximize your profit.”

Insurance companies in the US have armies of doctors whose sole purpose is to deny care to sick people. CA health system is less fucked, but no reason to think this system is exempt from various forms of corruption. Families wanting to fast-forward their inheritance, romance scammers trying to marry people who they can manipulate into this, doctors who want to get rid of difficult patients. That's just off the cuff what I could think of.

Have you never heard of eugenics in the 1900s? The most highly respected doctors working for the most highly respected governments were sterilizing, surgically dehumanizing and murdering men, women and small children for the greater good of society. Doctors being some kind of benevolent super-humans is a cartoon fantasy.

The problem I have with NOT having programs like MAiD is that you CAN be sure that the person didn't decide it. They are at the mercy of the whims of fate because we are not willing to give them agency.

I mean if you replace "taxes" with "profits" you have the current American healthcare system. Condemning people to die from a lack of treatment in order to save on profits.

That does not make any sense. Old people’s healthcare gets paid by the US government, literally everyone up and down the healthcare chain earns more profit by extending someone’s life who would rather die.

Wait, so if you cut out the middleman, doctors would make more money keeping people alive and the government would pay for it? Huh that's the opposite of "death panels".

Meanwhile private insurers definitely deny coverage to people with chronic illnesses (not everyone who is sick or dying is on Medicare/Medicaid). In a single-payer system those folks wouldn't slip through the cracks and .... the doctors would be incentivized to keep them alive! (assuming doctors are profit-motivated sociopaths like your average HN poster)

On the flip side, you're only a capitalist state away from propping up a tortured husk and milking all its family assets before tossing it to rot.

Oh we’re already doing that. Retirement communities, assisted living, nursing homes, they are all about that.

Solved by multigenerational living.

Incentive to commit it?? How??

It's not complex, most of it is actually covered even in paramedic training. It's just that instead of sticking the ventilator tube in they inject some potassium chloride. Last month Costco was selling it for about 50 cents a pound. (Potassium salt for water softeners.)

The main cost will be the evaluation, not the procedure.

I've been in many discussions over the decades about this--and I see a huge skew: those who have never seen someone have a bad death tend to think euthanasia is a bad thing, those that have had someone close die a bad death tend to have a recognition that there are situations worse than death.

I've been a paramedic for a long time and I completely agree with this. Years ago I may have been against something like MAID, but once I got into healthcare and especially this job, I now fully support it. It's something that I would hope is there for myself when I need it.

If it's not, unfortunately, I've seen what people will do anyway. Allowing people to die with dignity and on their own terms is something that I believe in.

Thank you, that has been my honest take as well. My grandma went through extreme dementia/Alzheimer's while she lived with us when I was a kid. I remember being worried about her state every day when both of my parents had to work. Remember hearing her passing out in the hallway and dragging her back to her bed when I was 13, before calling my mom. Before she got into that state, she was cheerful and mentioned how she didn’t want to lose her sanity ever. The day she passed away has been ingrained deep into my memory. I would never want my children to ever experience what I have felt during those days.

100% agreed.

I look at my grandma. She's 85, in the middle stages of Alzheimers (usually find and lucid, but sometimes thinks she's in Michigan or Georgia when she's been in Oregon for 4 years), constantly soils herself, can't get up from a chair without assistance (even then it's a struggle), and can barely walk, even with a walker. She got COVID and somehow survived, but got permanent lung damage and now needs an oxygen tank.

She's not living, she's merely surviving. I don't want to be like that. If I found myself in the state she's in, I like to think that I'd admit that I've had a good run, but it's time to move on.

It’s always an option. It’s just not always an option to force someone to help you, which is what maid is.

I guarantee you that enough people would take on the profession without being forced to if it wasn't illegal to do so.

I can understand this intellectually/rationally, but I can't imagine actually making such a decision.

Imagine being in pain, all day, every day.

Can you imagine such a decision now?

Without access to painkillers, sure, yes.

Painkillers don’t work for many types of pain

And they often come with a host of awful side effects and/or are addictive in nature, and often requiring a slowly increasing dose to be effective.

I could see making the decision and then chickening out as soon as it was time to get to business.

Me too.

My great-grandfather stuck around for a year or two with various eldery-issues after his wife died.

Then he had to hang himself, because there was no legal or easy way to humanely end his own life.

Apparently he did it wrong, but died anyway. Just more slowly and more painfully, without any support.

I’ve never seen a sensible argument against the idea that somebody of sound mind shouldn’t get to decide when to check out for themselves.

There are many sensible arguments both for and against. BBC has a very short review of some main arguments for and against:

* For: https://www.bbc.co.uk/ethics/euthanasia/infavour/infavour_1....

* Against: https://www.bbc.co.uk/ethics/euthanasia/against/against_1.sh...

Most of these aren't sensible.

They really aren’t, I can’t believe someone here would link that.

While I disagree with some of them and find some more important than others, I think that the lists cover most of the arguments and positions mentioned by people here on HN

I don’t think I’ve ever seen anyone use religious arguments on here and I’ve been here since the beginning. Most of those arguments are religious. I do not consider “Euthanasia is against the word and will of God” a sensible argument, though I realize, of course, that like half of humanity would disagree with me. But nobody who has any formal training and philosophy or debate would.

If the opposite of a statement is just as valid as a statement, it is not an argument. For instance, I could say it is God’s will that we do euthanize people so that they don’t suffer, and God gave us the intelligence to find ways to die that are significantly less painful. My argument has no less logic than theirs.

If “nuh uh” is a substantial rebuttal, your argument isn’t sensible.

While it's true that the first section in the arguments against euthanasia is "Against the will of God", the others aren't. Arguments such as

    * There's no way of properly regulating euthanasia
    * Euthanasia exposes vulnerable people to pressure to end their lives
    * Voluntary euthanasia is the start of a slippery slope that leads to involuntary euthanasia and the killing of people who are thought undesirable
    * Proper palliative care makes euthanasia unnecessary

are not primarily religious and you will find them repeated several times here in various wordings. The argument "Euthanasia weakens society's respect for the sanctity of life" may be based on religious belief but I don't think it's a uniquely religious standpoint that life has some form of sanctity

Those arguments aren’t all religious but they are mostly very weak. It is properly regulated in places. Nobody is pressured into it. There’s no evidence or logic to support the idea that euthanasia is some slippery slope to concentration camps, in fact it’s been legal in places for a time and nothing of the sort has happened.

If I said “euthanasia leads to long lines at the grocery store“ it would be a no weaker of an argument than most of those.

Arguments like these may not all be directly religious, but they come from the same place.

I realize it’s just my opinion, but I’ve still never heard one intelligent argument against it.

>She passed, he called his doctor and less than a week later he was also dead.

this doesn't sound right? MAiD has a 90-day waiting period. He had to have started that process before his wife passed, and just picked the date after she passed.

I completely admit I have a limited, second-hand account of the situation. It's quite possible that the circumstances were such that this was planned in advance of the wife's passing.

I'm sorry but people that just lost their life partner a week ago are really not "of sound mind" when it comes to taking such kind of decision and it's criminal in my opinion to let them.

What's next? We let teenagers choose to die after their first love breaks up with them?

I'm neither against nor for euthanasia, but I also think the situations where it's the best solution for everyone are extremely rare.

I doubt the story that poster wrote is true. The actual MAiD policies are very sensible.

https://www.canada.ca/en/health-canada/services/health-servi...

> Your eligibility assessment must take a minimum of 90 days, unless the assessments have been completed sooner and you are at immediate risk of losing your capacity to consent.

Depends on the person but surviving this kind of damage can also equate to near existential death anyway.

Other replies saying the process doesn't actually work like this notwithstanding, there's a pretty clear difference between someone in their 80s with ongoing cancer and a physically healthy teenager.

> he called his doctor and less than a week later he was also dead

This is wild. How can they differentiate between grief and actual clear thinking desire?

> How can they differentiate between grief and actual clear thinking desire

Personally I don’t think they should. Only I know what’s in my head.

I think my rules would be:

1. Terminal diagnosis at any age - No questions asked.

2. Over 70 - No questions asked — just request MAID and get it.

3. Over 50 but under 70 - Have to request MAID 2 times, separated by 1 month waiting period. Waiting period resets after a year.

4. Under 50 - Have to request MAID 3 times, each separated by 1 month waiting period. Waiting period resets after 6 months.

I’d also be in favor of no questions asked at all in any situation.

This is actually not possible per the requirements set out in the legislation; I suspect the poster didn't get the full picture. It's always possible an individual doctor can ignore the system and do whatever but I doubt it when there's a legal path for this spelled out.

Grief on its own isn't sufficient for assisted dying.

>> Grief on its own isn't sufficient for assisted dying

Who are you to make that call?

I don't make any calls related to assisted dying; I'm referring to what the law states.

If you make to your 80s you’re on borrowed time no matter what.

I would feel that way, also.

Losing a very long term partner is a horrible blow. You go through the grief to get to better times on the other side--but if there's no other side to get to, why go through it?

My memory is that the Canadian rules require more time than that so he probably had already set it up.

My grandparents were way to with it to suffer as much as they did. It was honestly traumatising to watch.

There is a HUGE amount of things you can criticize about MAID specifically (and should) but honestly there are only a few reason why we shouldn't let the living dead go:

- it's a slippery slope

- they are young, they might revive (metaphorically speaking)

- you believe god will punish them with eternal suffering or something, but then a lot of religions are fine with monks willfully passing one "through meditation" in old age

To be clear I mean "in general". Wrt. MAID specifically e.g., a week seem .... very short ... enough for some short term depressive bout or mental leap of judgment to end your live. But then like I said there is a lot to criticize about MAID.

But granting the living dead peace is, I think, not the problem here.

From other comments I learned that the period is not a week but more like 90 days and required conditions are more stringent, too. Just in case someone reads my previous comment at a later point.

The week thing is a myth. Either that part is blatantly false or someone violated MAID law. It can't happen that fast legally.

> In one case, which was surprising to me, a man who had survived cancer - he was not terminal but certainly wasn't getting any better - elected to die via MAID after his wife died. She passed, he called his doctor and less than a week later he was also dead. He got a chance to visit his family, apparently drive around his hobby farm one more time and then that was it. He didn't want to deal with being alone and seriously ill.

For some reason this made me emotional. I think I would make the same choice if I were in this position.

you will also end up with situations where people in that age group might be pressured by their family to choose this option.

Why surprising exactly? Sounds like their life sucked at that point.

It’s perverse and demonic.

Many people have the worst days or weeks or years that they look back on and are grateful for the life they live later, physically disabled, paralyzed, elderly, etc. During the darkest of times is when we have to care for each other, not offer a knife so to speak. Even when many during these times would’ve wanted to die and suffer greatly. It’s part of life. This is absolutely sick in a civilized society, but leave it to that murderous thug Trudeau.

It's fine if you want to suffer. I personally don't want to suffer, and that should be my choice.

I don’t think you realize that euthanasia legislation was forced by a court even before the Liberals took power.

Being grateful for a miserable life marginally improving does not negate otherwise unavoidable prolonged suffering.

Health care can do a lot these days and extend a persons life by a lot, but with this the question about the quality of life arises. Assisted dying is one answer to this. Personally, half-way through life, I plan to avoid it by keeping myself fit with exercises, cycling and running.

i know someone who is taking care of a parent who is bedridden and needs daiper changes every few hours.

Whats suprising to me is that these parents choose to punish their kids instead of end of ending their life. selfish fucks!!

Absolutely vile how you can frame wanting to continue living as "punishing their kids".

Talk to me when you have to put your life on hold and change diapers 6 times a day while tolerating abuse from dementia patient.

Did you tell you kids that this what you have in store for them because you want to "continue to live" regardless of pain that causes to ppl around you? Absolutely selfish and Vile .

I don't want my health holding back my family or depleting my wealth. I am 100% for MAID. If you have ever had persistent pain you know how little of it is required before you want to check out. People should be able when they want to.

After watching my father die with COPD, it because obvious that euthanasia happens in the US all the time. He opted out of lung-reduction surgery and was ready to die. So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours. How long can one live without water, a few days max? So that's what killed him. My sister-in-law who's a physician told me that's how it's typically done. I was horrified at the time.

My dad has COPD and continues smoking. I'm going to go through this sooner than later. I've already made peace with this, I've seen the alternative in other family members and ultimately its the decline in dignity that pushes my moral compass to accept self-euthanasia as a humane option.

I’ve heard it’s even more common per capita than in Canada, the difference being that it’s not on the record, so no statistics are collected about it.

It's ethically childish that we use roundabout measures like that instead of just putting someone out of their misery overtly.

It creates a drawn out process where the family has to wait around until they pass at some unknown point instead of coming together in one moment, making peace, saying their farewell, and witnessing the finality together.

It took my girlfriend's vegetative mother a week to die as she struggled to breathe that whole time, put on just enough morphine to supposedly feel no pain and not a drop more. By the time she finally croaked, most of the family that had shown up to see her out had left because nobody has time to wait around days or weeks for death to happen. And it was emotional hell for her two daughters.

They could've just given her a nice dose of morphine, but our ethics are too infantile. Instead we do make-believe.

> It's ethically childish that we use roundabout measures like that

Dogmas and tabus might be there for a reason. Culturally I think we need to pretend thing we don't think are true.

Comments here made me realize how heterogeneous our worldview actually is. There is a rather clear split between Canadian and American comments. The first group talks about euthanasia positively, but the second group is largely cautious, looking for negatives but not rejecting the idea altogether. I did not expect there would be such a dramatic rift.

Yes, I think that is not well understood.

When my father-in-law passed, in a rural assisted living facility, we found they had stopped feeding him despite saying they were and our requests that they continue.

We were stuck in this uncomfortable position of not being able to move him somewhere else, being completely blindsided by his (bone and bladder) cancer and how quickly it progressed, and not knowing what standard of care to advocate for understanding that he was passing.

One of the things that was also frustrating is that when we would ask for more pain medication, they would refuse as it might lead him to stop breathing (I thought, ‘so what?’), yet they were making decisions that ultimately accelerated to his demise.

Looking back, I don’t know that ceasing nutrition was a bad choice, but it wasn’t their decision to make. When I talked to friends in healthcare they effectively gave me the ‘oh, you sweet summer child’ talk.

My FIL, while he could communicate, could not wait to be out of pain and I wish he had the agency to make the decision before having to go through endless pain in the delirium of opioids.

There are, of course, details I’m leaving out, but my general takeaway is that in at least some cases the euthanasia debate is not about whether the call is being made, but who is making the call.

That is not alone reason to support one side of the debate or another, but it is an important nuance that I was naive about until I witnessed it first hand.

Edit: what I described does not appear to meet the traditional definition of euthanasia, but I will leave the post in its original form and just clarify that I mean making decisions that hasten someone’s death either passively or actively.

The setup for 'Living Wills' and directives to doctors, at least in the US as recently as ~4-5 years ago, suck. I remember thinking at the time that I saw what family was filling out that they failed to express the nuance that I would like for my own directives.

Generally if there's still hope for recovery to a not-shitty life then I'd prefer to proceed towards that. Even as extreme as E.G. that Leadale anime's setup where the protag's broken from the neck down but can live in a VR gameworld (deeper immersion so they can still move, taste, etc). If there's still real hope for reaching that, it might be worth toughing it out and waiting.

However that sort of nebulous criteria that requires a human to evaluate isn't present. I can't empower the doctors with such vague goals and say 'make your best call as a HUMAN doctor with that vague goal'.

If that good route isn't an option, then I wouldn't want to stick around either... and the lack of a clear legal euthanasia option in much of the US pushes people to roundabout failures for lack of food / water intake, or just giving in to inevitable statistics when a cold or stressed body complication like a heart attack happen. Heck, if my brain's the part that's fraying apart and I want to die anyway, please harvest the working organs as my method of death so someone else can live better.

Both my grandfather and my aunt were palliative care towards their end. Their respective care providers kept asking them if they'd like to increase dosage of their medicine (can't remember what my grandfather was one, but my aunt was on morphine). Despite both of them at the time said that they didn't want to increase dosage, but the care provider kept trying to increase. My family's theory is that they were trying to speed their passing. Both cases were in Canada.

    it because obvious that euthanasia happens in the US all the time [...]

    So the hospital withheld IV hydration and provided a morphine drip 
    and he was gone in 36 hours

I had a family member with late-stage terminal COPD opt out of further treatment. They were in respiratory crisis and were going to be intubated for the nth time with no real hope of recovery, and so they said "fuck it" and delined further intervention.

The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour.

I was never really clear on what killed them in the end, if it was the morphine or the COPD. I guess technically it was the COPD.

Anyway, as somebody who went through something similar: I'm so sorry. COPD is such a slow and crappy way to go. Have you been able to find some peace in the years since?

I have, thanks. I'll always remember his last words to me, "You're a prince."

I'm so glad to hear that. We were able to have some closure as well, similarly... it was a comfort...

That's a beautiful memory. I'm sorry for your loss.

That teared me up

> The hospital (a Catholic hospital, even) provided a morphine drip and they were gone within an hour.

FWIW, Catholic ethics are actually fairly well thought out on this issue. You're not allowed to withhold basic nourishment (food, hydration, non-invasive breathing support), but you are allowed to opt out of invasive procedures such as intubation and provide pain management if the patient or the patient's guardian decides that it would significantly affect quality of life and the patient doesn't have long to live. Obviously there is discernment involved in the last bit, but Catholicism is all about discernment.

Here's the National Catholic Bioethics Center on the topic: https://www.ncbcenter.org/resources-and-statements-cms/summa...

Thanks for that information. I have some major disagreements with the Catholic church but more knowledge and understanding is always a good thing. Appreciated.

Of course! I'm biased (as a Catholic), but I personally find the Church's moral stances to be fairly well thought out and systematic. But well thought out people starting from different axioms will often disagree with each other's conclusions!

It’s hard to ask this in a non-confrontational way, so I’ll just come out with it:

How do you square that with the modern Catholic church’s systemic support of sexual abuse of minors?

I mean this in the most inquisitive way possible. An organization’s what it does; the modern Catholic Church (leaders) have supported some horrible things. How do you separate out the good bits from the bad bits?

For me it boils down to this: the Catholic Church exists as a body of members who are all sinners- laymen and women, priests, bishops, cardinals, and the pope included. The clergy are simply functionaries within the church who serve very important roles, but are not sinless, perfect humans by any stretch of the imagination.

The way of life the Church offers along with its teachings, are what you might be able to consider the "good bits".

The "bad bits" are the members, who are sometimes clergy, who sin against God and against their neighbor.

I appreciate it, but there's no need to be delicate: sexually abusing minors is evil. It's especially evil when a priest does it, since they hold positions of special influence and, of all people, should be best acquainted with how evil sunders the soul from God (priests are specifically trained to hear confessions, absolve people of sin, and advise them on how to avoid sin).

So that's the categorical statement.

More concretely, every adult in our archdiocese receives training on the risks of sexual abuse and I regularly hear the sex abuse scandals addressed during homilies. So it seems like the church, as an organization, is taking steps to address the issue.

But to step back and take a wider view, I think Catholicism acknowledges the brokenness of human beings, but reserves eternal judgement for God. So most serious Catholics are not going to walk away from the church because there is evil inside of priests. There is evil inside all of us. But we are called to do battle with evil. For most of us, that battle is within our own hearts, but certainly we must also root out systemic evil within the Church.

And finally, I see this line of thinking a lot from atheists wrt religion, but I think it is more widely applicable. Which is this: "people have done evil in the name of (or under the banner of) this religion and I will choose to only consider that one particular thing when measuring the moral worth of this religion." So in this case, it would be "the Catholic Church facilitated the mass sexual abuse of minors, therefore it is evil and should be done away with." But I think we have to consider the good that people and groups do when measuring their moral worth. In this case, I would point to all the charitable works done by the church and its faithful as worthy of your consideration.

To see how essential this expanded consideration is, I think it helps to slot in institutions which have less emotional valence than the Catholic Church (or Christianity or whatever). For instance, there have been many cases of school teachers sexually abusing students. Yet I don't think anybody would argue that the entire institution of school should be done away with or that adherents to schooling should walk away from it. After all, school is a crucial institution where many children thrive and where most teachers are grinding out good acts on a daily basis.

> So most serious Catholics are not going to walk away from the church because there is evil inside of priests. There is evil inside all of us. But we are called to do battle with evil. For most of us, that battle is within our own hearts, but certainly we must also root out systemic evil within the Church.

I'm shooting from the hip here and I don't have CCC citations to back me up, but I want to say that the Church herself is not (and cannot be) inherently corrupt, because it is the mystical body of Christ. We must remember that actions of individual members of the Church (no matter how influential or high up they may be, even to the utmost) may be evil or disordered, but the Church will persist.

Christ included Judas among the twelve. The shenanigans some folks in the Church get up to these days don't exactly compare. Indeed, seeing that the Church has persisted these 2000 years despite schisms, etc, was a small part of what convinced me that it is the one true Church.

Every single organization that interacted with children pre-2000 has sex scandals. Boy Scouts, myriad public school districts, the Congressional page system, youth sports. It attracts pedophiles. Now we are all much more aware of the dangers.

https://x.com/rothmus/status/1828751103955292508?s=46

> How do you square that with the modern Catholic church’s systemic support of sexual abuse of minors?

I'm the first to criticize Catholicism given a chance, but ... I'm not sure that's actually a valid claim to make outside of the particular case of ... I think it was New York in the 1990s, which is a statistical outlier (at least in English-speaking countries).

There are a lot of Catholics and therefore it's unavoidable for a lot of pedophiles to be Catholics, but the same is true about teachers. Can you reasonably say "how can you support the school system given that teachers systematically sexually abuse minors"?

Remember, there are 4 kinds of lies:

  - lies
  - damned lies
  - statistics
  - things somebody said on the Internet

That’s an odd comparison to make. The ‘school system’ isn’t a monolithic system that is actively refusing to acknowledge or take action against sexual predators. Is there an example of a school district that has been shielding predators on an ongoing basis and refusing to take remedial action?

I'm an atheist and no fan of any church (or, y'know, sexual abuse) but I don't love this line of discussion because it's a real case of whataboutism.

The Cathlolic church's actions w.r.t. sexual abuse are certainly worth talking about. Their views on euthanasia (which I disagree with) are too. I don't know that they can be meaningfully discussed simultaneously within the same discussion.

The church used to be powerful. Being a priest included some sacrifices but it was balanced with significant social perks and power. Normal men were drawn to the role.

The church got less powerful, but they kept the restrictions on priests. Who wants to be a person with no power and no sex? People who are strange or who have ulterior motives.

If the power of the church was restored, I think the abusive priest issue would be gone in a generation. Or if they remove the sex prohibition, of course.

Thanks for the link. It affirmed my understanding of church teaching. Medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be excessively burdensome for the patient or would cause significant physical discomfort.

Yes, "when they cannot reasonably be expected to prolong life" is key, since there's some discussion in other parts of the thread about withholding nutrition as a form of euthanasia, which Catholic teaching is very much not okay with.

I think there is a ton of wiggle room in the words prolong, burdensome, or discomfort

Not as much as you'd think. Catholicism is very much has what is essentially statutory law and common law, and common law removes many of the ambiguities. It's the Protestants who are like "we all have the same book let's talk about how we interpret it" while Catholics have a canon interpretation over which much blood has been spilled to arrive at.

Here's the link to the OG https://www.vatican.va/roman_curia/congregations/cfaith/docu... It's some legalese.

From the url: When inevitable death is imminent in spite of the means used, it is permitted in conscience to take the decision to refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted. In such circumstances the doctor has no reason to reproach himself with failing to help the person in danger.

We're in a weird spot where the secular world asks us to simultaneously cause death (the euthanasia folks) while also asking us to evade it altogether (the Brian Johnson types).

Catholicism embraces natural death, which is what your family member (RIP) chose. Interventions that hasten death are fine. Just can't cause it.

We need to be clear on terms here.

Killing someone with a drug intended to stop the heart / prevent respiration is unequivocally euthanasia.

Withholding treatments is not euthanasia. Nor is pain medication that hastens death. Those are things we can have an ethical discussion about.

As for IV drip.. that's another discussion. I personally would not ever do that. Water is a basic thing for humanity, and should be provided. Unless he explicitly refused the water. Then, that's his choice.

I think I ultimately reject the idea that this is not well-understood, because the largest organizations opposed to euthanasia (the Catholic church for example) has given endless thought to this, and explicitly accepts the situation you described. Opponents of euthanasia are not ignorant.

Why can someone make the choice not to have water in their IV, but can’t make the choice to have a fuckton of morphine in their IV?

I think a lot of it comes down to deontological logic and morality versus consequentialist morality.

It is recognized that the outcome is the same. The difference lies and how you get there

I was thinking that the divide probably lines up pretty well with people who think the Trolley Problem is a great moral quandary versus people who think it’s obvious you pull the lever and don’t understand the fuss. Which is basically what you said.

I completely agree. I thought about bringing it up in the post, but opted for brevity.

Also, I am genuinely amused that my post is getting downvotes. People are fascinating

They can make both choices.

But if the person is non responsive and we are left to make a choice, we have to presume they want water.

Morphine is debatable

Both the lack of hydration and morphine were his choice, and he was lucid. My brother was angry that Dad decided to "give up." I wasn't, but was horrified at the ease with which the staff complied and knew exactly what to do.

Withholding aid is morally fundamentally different than proactively ending someone's life.

In the sense that it's worse?

My dad also spent days dying from extremely aggressive cancer, being in unimaginable amounts of pain, with all of his organs slowly shutting down, his limbs becoming swollen from pooling blood, unable to drink, unable to eat, crying about how much pain he's in and how much he wants to go home. And all the hospital could do was give him enough morphine to knock him our and we waited by his bedside for 4 days until he finally drew his last breath, probably due to lack of fluids at this point.

Tell me - where does the "morality" stand here compared to him proactively ending his own life with a drug before all of this happened, if he had such an option and decided to take it? How is what he went through morally better like some people say it is compared to euthanasia(I don't know if you think that, but it's a common argument). There's no dignity in any of this.

This is not at all decided.

This is just the trolley problem rephrased.

Reminds me of this experience of someone from the UK: https://jameshfisher.com/2017/05/19/granddad-died-today/

"Terminal dehydration is a way to skirt the Suicide Act, because we can claim that withholding water is just like withholding treatment. Ramping up painkillers and sedatives is a way to skirt the Suicide Act, because we can claim that the medication helps the patient cope with their death, rather than inducing their death."

> So the hospital withheld IV hydration and provided a morphine drip and he was gone in 36 hours.

I watched loved ones die this way. It's cruel, absurd and grotesque. A doctor will look you dead in the eye and say "your loved one will be dead within a few days" and instead of killing them mercifully you are forced to watch them die of dehydration. A maddening and indefensible relic that I believe younger generations will abolish. There's obviously far more complicated end of life situations, but this particular case is extremely common.

Death by dehydration, at least for an old sick person, is rather natural and though it sounds awful it’s not really painful for the dying person. Before IV hydration it’s how most people died.

I believe younger generations will abolish.

I wouldn’t count on it. I’ve learned young people are just the same as everyone else. I hope I’m wrong but I used to think they had more empathy. Let’s see.,

My BIL is a head hospice nurse.

If it helps, they don’t ever deny people fluids who want or need them. What happens towards the end is the body stops being able to process fluids due to failing organs. Pushing fluids into someone in this state makes them less comfortable. People aren’t thirsty or suffering from a lack of fluids.

As far as putting someone out of their misery, there’s a reason that they put them on high dosage opioids. If you want to keep someone out of pain while helping their heart and lungs stop peacefully, you couldn’t pick a better drug.

Thank you for this comment. I have also worked a bit with hospice. Unfortunately, there is a lot of misinformation regarding this issue. I find it sad that some are left with the incorrect notion that their loved ones were denied care at their last moment. I.v. fluids may somewhat alleviate sedation of a dying person, but they can increase swelling, formation of pleural fluids and cause shortness of breath. If a dying person won’t drink anything anymore, it’s mostly a sign that they don’t need any extra fluids.

I don't see drugging someone out of their gourd to be a plus in this situation.

It’s still all based on consent.

Doctors are mandated to obtain informed consent, and patients have the right to refuse any treatment or medication they don’t want.

It appears that you may not be well-informed about end-of-life care protocols. Once a patient is admitted to ‘hospice care,’ the focus shifts from extending and preserving life to enhancing their quality of life.

At a hospice literally right now for a loved one (who is sound asleep). The nurse working there quoted something like this: ca. 95% of the people admitted will die of dehydration since they can't take in fluids after a certain point.

My knowledge of anatomy is poor, so I am unsure how I feel about this. It isn't helped by the morphine, which seems to further separate the loved one from reality in a manner that seem premature (compared to the other painkillers that the person has been on that have been having a high degree of efficacy).

And to be clear, I am 100% behind the idea of hospice and medically-assisted suicide. Just feel very torn right now with the impending loss of the loved one.

That sucks.

I hope it brings you peace to know just how much all of the hospice workers I know care. Everything they do is about comfort and dignity, and there are chaplains, and medical workers that can help you with these concerns.

I mean you’re on morphine the whole time, you’re not going to feel a thing.

If only drugs worked that way.

During the recent debate around the Assisted Dying Bill in the UK, I listened to a radio phone-in in which a palliative care doctor explained that it wasn't possible to relieve all suffering for all patients. They relayed an example of a person who had spent their last days vomiting fully-formed faeces.

If we can prevent five, ten or perhaps twenty percent of people having gruesome deaths, then not doing so feels like a moral failing.

"They relayed an example of a person who had spent their last days vomiting fully-formed faeces."

Sounds like a fully-formed exaggeration. Vomiting once or twice a day is not spending your last days vomiting. More frequent vomiting? The supply could not possibly meet the demand. Especially if the patient stopped eating.

You can listen to the account yourself at https://www.bbc.co.uk/sounds/play/m00253mt, from around 25 minutes onwards. I found it convincing.

It doesn't sound particularly possible.

This is entirely possible. See copremesis, ICD10 code R11.13.

It usually occurs due to intestinal blockage or fistulae.

vomit is usually liquid or heavily digested stuff. feces is compacted and excreted. my imagination maybe a little specific here but so is the description "fully formed feces"

If your intestines are obstructed, and the fecal matter has started forming, and it's trying to come out, where do you think it will come out from?

When there's no place for the compacted feces that's building up to go (due to a failure in peristalsis, for instance), it backs up into the the stomach, which naturally irritates the stomach and causes the person to vomit the contents, which includes their feces.

I wouldn't wish it on anyone.

You are incorrect. You don’t have to be doing something 24 hrs a day to be spending your days doing it.

If you were a child who was raped every night by your father, you could absolutely say with honesty that you spent your nights getting raped.

What matters is - does the event significantly affect the rest of your day? Not - is the event happening non-stop. If that were the case, you could vomit every hour and still not be able to make the claim, since there are periods of rest.

Even if this is true, it appeals to extremes to make a point. People agajnst the motion are against the misuses of assisted suicide due to conditions that may get better in time, or misunderstandings, or conditions of a mental nature which may change or be cured.

That’s part of it, however they are also against it from a morality and ethical point of view, with the central argument being that you can’t take an innocent person’s life, no matter how “good” you think your intentions are.

Basically they uphold the value of life above all else, including one’s desire to end it. By the same token, they are against any form of suicide.

citing individual cases is not the road to reason here IMHO. Every single person dies at some point. This is an "entire population" question. Ethics and Morality play an educational, character formation role.. and, a medical decision is not the same as other kinds of decisions.. Another point -- people who are unstable or overwhelmed personally often leap to extreme, graphic and emotional examples first and without context. The original post here fits that description IMHO

This is emphatically not an "entire population" question. This is an individual rights question. I don't know what safeguards exist in other countries to prevent "people who are unstable or overwhelmed personally" from "leaping to the extreme", but in Canada the rules are strict and multiple doctors have to sign off. You can read the MAiD eligibility criteria and the approval process here[0].

[0] https://www.canada.ca/en/health-canada/services/health-servi...

A more important point is that even in a more normal palliative care situation, which previously may have involved a borderline illegal increase of drugs near the end to hasten and ease death, might now be recorded as an assisted death instead.

So a more interesting stat might be the expected quality of life adjusted years that have been cut off by the assisted deaths.

I'm not sure if QUALY can go negative but some measure that can might be appropriate when talking about assisted death.

Negative QALY values do appear possible, according to https://linkinghub.elsevier.com/retrieve/pii/S10983015106004... (via Wikipedia).

I'm not sure a link will contribute much? It's just the basic question whether some years (or days or whatever) are so awful that you are better off being dead.

In any case, the linked article says 'States worse than dead can exist and they would have a negative value and subtract from the number of QALYs.'

Yes, it's a fairly obvious point. The link was in the context of whether negative QALYs are a concept used by the medical profession.

Anyone who's been close to a dying cancer patient knows what the last couple months are like for many: unending suffering plus tomorrow will be worse. Many people would choose not to suffer like that and I can't understand who anyone else is to tell them they must endure utter misery for nothing.

Whether the official measure can go negative or not on a practical level it clearly can. I saw my father near the end--the morphine robbed him of the ability to make long term memory. From when he was on that dose it was short term memory only, his world was frozen to before that point. And he was still in pain. How can that be anything but a negative quality of life?

Hard cases make bad law.

There is no "we". There are people and their bodies and their wishes. And authoritarians who want a say on it. Doesn't matter if nice sounding words like law and democracy are used to describe the tyranny.

"tyranny" also seems like a concept mostly unrelated to the topic at hand. Practically speaking, nobody can really prevent you from taking your own life.

If only that were true.

Someone unable to move is unable to take their own life without assistance. A surprisingly large percentage of people go through some horrific experiences before their bodies completely fail.

This is a vanishingly small percent of cases

Someone who is unable to move is probably also unable to unambiguously communicate their wish to be euthanized as well so I really don't think it's that relevant

Bed sores are a reasonable proxy for people being unable to move and they are a common enough risk to be a significant concern.

If you can’t even roll over then you’re at the mercy of whatever people are willing to bring you even if you can speak or use a TV remote just fine.

> Someone unable to move is unable to take their own life without assistance.

Denying this assistance isn't really "tyranny", though, even if you do accept that suicide is a right.

> Denying this assistance isn't really "tyranny"

Actively preventing someone from providing assistance is. There’s a big difference between not doing something yourself and actively preventing someone else from providing assistance.

> Actively preventing someone from providing assistance is.

Sure, but this happens with legalization, too. Only licensed physicians can assist in suicide. Other attempts to assist will result in state violence. Most people trying to provide assistance won't be licensed physicians.

Which is a completely different effort than the one intended to execute those undesirable to the market. God forbid we support people with anything other than a suicide implement.

Providing assistance isn’t limited to handing someone pills, making the appropriate calls is assistance and a tough moral choice for many. Also, as a purely practical matter physicians can provide both humane options and a clearer separation between direct assistance and murder.

Though obviously there’s other possibilities, it’s a tricker issue than it might at first appear.

I share your view, but it gets crazy complicated when you're dealing with homicide (I'm using this word to mean it's literal definition: 'death caused by another person', not to mean a crime occurred necessarily).

Euthanasia is controversial for a lot of reasons. Some people worry that authoritarians will use it as a way to "purge" or, such as here in Canada, as a way to "reneg" on health care obligations that tax payers are paying for. Others worry that family members and care providers will abuse the law for financial gain ("legal murder" for inheritance etc.).

Then you have cases like this one: https://www.cbc.ca/news/canada/calgary/calgary-maid-father-d...

It's complicated because we're not talking about an elderly person with terminal cancer. We're talking about a 27 year-old high functioning adult who sought, and was granted, medical assistance in dying due to a mental illness. When you dive into that story, even if you agree that the courts made the right decision and that the 27 year-old had the right to decide her own fate, your heart can't not break thinking about the father.

Morally, I agree that every [adult] individual has the right to commit suicide by any means of their choosing (as long as they're not infringing upon the rights of others in the process). That doesn't mean that there aren't valid reasons for people to debate whether or not ehutanasia should be legal and under what circumstances.

I'm reminded of this guy each time this topic comes up:

https://www.youtube.com/watch?v=i4NU_84eCKI

https://www.thestar.com/news/canada/in-2000-walkerton-s-pois...

I agree it's a difficult subject.

To your point about "Some people worry that authoritarians will use it as a way to "purge" or, such as here in Canada, as a way to "reneg" on health care obligations that tax payers are paying for."

In another thread the Canadian poster talked about someone who decided to go through with ending their life and one of the things they mentioned was "They had to drive 100km to the nearest dialysis clinic."

We have euthanasia in the Netherlands for decades now and there haven't been any controversies as far as I know. It's a solved problem and the discussion here is over. I do agree that the laws and procedures have to be carefully constructed to prevent abuse, but it is possible.

I'm not here to tell you about your country, for which I know very little. But since I'm Canadian and euthanasia here is very new and very controversial, I decided to look up the framework in the Netherlands.

From the wikipedia article: https://en.wikipedia.org/wiki/Euthanasia_in_the_Netherlands, this stood out to me:

> There is much discussion about people with early dementia who have previously stated in a written will that if they ever got dementia, they would want to get euthanasia.

This doesn't necessarily mean "controversy", but is very much an ongoing discussion and speaks to a problem that euthanasia introduces that has yet to be solved in the Netherlands.

And this really is the issue and complexity when it comes to euthanasia in general: we're talking about a form of legal homicide. So under what circumstances this should be permitted is a very valid legal question. Questions about consent, state of mind, paper trails and proof of consent are also very pressing questions and it sounds like no, not ALL of these questions are currently answered in the Dutch framework.

This is also not me arguing against euthanasia. I believe that adults have the right to commit suicide by any means of their choosing (assuming they're not infringing upon the rights of others in the process). The only thing I'm saying, really, is "it's a complicated issue with lots to consider."

We are at a stage where we are discussing edge cases of euthanasia and it's all related to widening the use; these discussions mostly happen among professionals. There is pretty much no discussion anymore on "vanilla" euthanasia among the general public. I agree it's complicated, but you don't have to solve every edge case with the first iteration.

Yep that's one side of the argument and it's valid and I sympathize with it.

The other side is when you're hearing stories of people being told that, in lieu of the procedure they're about to undergo, they can surely sign up to receive state-approved death.

"Are you sure you don't want to just die? This is gonna hurt a lot!"

Ghoulish.

How often does this occur? Citations?

Elderly cancer patients who have a recurrence of cancer often know exactly how uncomfortable another round of chemotherapy, radiation, or surgery will be. At the same time they may already be suffering neurological pain, pleural effusion (fluids building up in the chest), etc.

In this context the statement might be:

"This treatment, as you know, is going to be very unpleasant, has little hope of curing you, and you could live your life while the cancer progresses. We could slow it down and let you decide how you want to live your life."

Authoritarians that want to force doctors to provide death as a service?

There are concerns about assisted suicide being pushed on marginalized people who don't have terminal illnesses in Canada. I don't know if that is being driven by "authoritarians" but implying that the issue is just doctors providing death as a service (i.e. to people who are specifically requesting it unprompted) may not be completely accurate.

I'm not worried about anyone "pushing" it. I'm worried about groups being put at the back of the line for other forms of care because the decision makers know that "worst case" more of them will off themselves and find that to be a fine outcome.

That is a danger for sure, but every single path we as a society here take can be exploited by people with ill intentions.

The pharma companies and hospitals have a financial incentive to keep people alive indefinitely, even despite horrible suffering.

The folks paying for the treatment (government, insurance, etc) have a financial incentive to terminate lives prematurely.

Family members with ill intentions may have various nefarious reasons to push for either outcome.

So the question with which we should begin is, "what is the right thing?" and build safeguards around that.

We cannot let "fear of corrupting influences" be the primary guiding principle here because every possible choice as a society here because there's a pretty strong financial incentive to corrupt these choices in either direction.

Natural death is the nash equilibrium, everything else is politics.

The concept of "natural death" is self-evidently ridiculous. We treat disease with the best technology possible, but then death has to be "natural."

That notion is at best a distasteful joke before we even get to the ambiguity of what a "natural death" even is, and at worst an evil attempt to define one particular sort of arbitrarily Church-sanctioned death.

What even is "natural death?" Being eaten by a bear? Starving to death because there was a drought and there were no berries for you and your hunter-gatherer buddies to eat? Dying from untreated cancer?

According to Catholic doctrine (to choose an extreme example) we have to keep permanently vegetative people alive indefinitely via feeding tubes and whatever other modern medical technology is required for as long as it takes. What single aspect of that could be described by a sane mind as "natural?"

Are these concerns well founded?

Because outside of the less than a dozen cases that were roundly criticized across the board, and resulted in no deaths, I can't find any evidence that this is happening or will happen in Canada.

Obviously doctors should have a choice not to provide a specific service if they don't want to

Reality is much messier than "There are people and their bodies and their wishes."

There are whole categories of people who we consider not well enough to make good choices about their bodies and lives, for a variety of reasons

Children are not emotionally mature or responsible enough to make such choices

Mentally ill people are sometimes in an altered state of mind where they are not making good decisions that are consistent with their regular state of mind

Some people are very suggestible and will more or less agree with anything that someone else is telling them to do, even if it is not in their best interest. People who have just received bad news (like a scary medical diagnosis) can easily fall into this, and just agree with whatever someone tells them

It's all well and good to want to respect people's wishes for their lives, but society does have some responsibility to ensure they aren't being pressured by outside forces into acting against their will or against their own interests

That's not authoritarian, it is pro-social

Mental health is one I can relate to. There were times when my loved ones struggling with mental health would absolutely go through with assistance euthanasia if they had it available. Years later they are living a much better life but at that point in time, euthanasia would’ve ended it.

I think bodily autonomy is necessary but not everyone is able to make the right decisions at all times. Legislation needs to account for that.

The fun part of the mentally-ill categorization is that being mentally ill also has a tendency to lead to poverty and homelessness which in turn will increase the likelihood that someone will opt for MAID but could be solved by other social means.

Is that actually true? Are people who choose MAID poorer than the average?

The article suggests that they are whiter than the average Canadian. Make of that what you will.

I mean, it's plainly evident that mental illness is associated with poverty, which is itself associated with homelessness. Here (https://care.org.uk/news/2024/10/poor-lonely-and-homeless-op...) is an article that references a report that says that people are opting for MAID for non-terminal illnesses and that those who do so are disproportionately likely to be from poorer areas. It also mentions at least one person who specifically mentioned lack of access to housing when opting for MAID. Granted, CARE is blatantly against MAID but the cherries they're picking are in the tree to be picked.

Thanks for digging that up.

It's a big country, so I suspect you'll find individual examples of just about anything.

It is pro-social if you can separate objectively. And even then, who is that “social” to decide it? Some people aren’t social.

If the separation line gets drawn across questionable cases, then it’s authoritarian for them. As usual, any scalable implementation will look like a very jagged asterisk-shaped circle and some financial or political interest around it, acting far away from the real needs of people. And those who pick edge cases on its less certain side will push the whole setup further until it stops making sense. Systems like this are inherently vague, which is prone to “oh, we had another case, must regulate more”.

I’ll rephrase myself from the previous thread about suicides: the “society” keeps a blind eye on the fact that it is it who drives people to end their life and then puts a big “dying is prohibited and offensive” sign at the end of this road. If “society” wants to keep “healthy but confused” (subjectively to it) people from leaving, it should look to the root of the problem, not put a barrier at the end.

Ofc teens should be kept away from this for obvious biological reasons.

> Ofc teens should be kept away from this for obvious biological reasons.

Why of course? Is the reason this is obvious to you unique to teenagers? When they turn 18 (or 20) do the reasons to restrict their freedoms immediately go away? Is there no possibility the 'obvious' reason in your mind couldn't occur for a different person in a different age bracket?

Yes, they go away. 18 is a safe age of autonomy, not median. Normal procedures still apply, e.g. are you being coerced, does society physically demand too much from you (e.g. in a form of debt, pain, lack of sleep), etc. If they pass, they are free to die.

To reiterate, fix the problem, not the gate. All statements above are only valid as a whole.

This is an appeal to emotion.

While people should have autonomy over their lives we should not be legalizing assisting them. This is a path that is well-trodden. Many dictatorships have "mercifully euthanized" various sectors of people. It always starts out as the disabled, cancer-stricken, or unviable. Then it becomes a simple way to get rid of the people deemed to be a burden. Suddenly being depressed is a good way to get the needle. Can't perform your job well enough? Yep you guessed it, needle. Or I guess these days they've made sarco pods for the personalized gas chamber experience. This isn't even a slippery slope, we're watching it happen in real time as the bar for euthanasia continues to be lowered.

There's been several cases that MAID has willfully disobeyed the law. Doctors not filing the correct paperwork, rushing patients, etc. We are already seeing the sprouts of a system that if allowed to continue will become a virtual Soylent Green.

Of course I'll be downvoted for this by the bleeding hearts but history has not been kind to people who allow this.

slippery slope fallacy that giving people control of their own deaths will turn into the state euthanized anybody against their will

It's not a slippery slope if it's actually happening

But you're right, the state isn't euthanizing anyone against their will, and they don't need to

They can simply change incentives in such a way that people decide that it is what they want all on their own

If there are abuses we should strive to minimize or abolish those abuses. The alternative - to tolerate incalculable human suffering and force the loved ones of those suffering to stand there and watch - is unacceptable.

"If there are abuses"

So far there have been zero murder convictions for the KNOWN abuses. Bleeding hearts will downvote this knowing full-well the truth is that they are lowering the bar to the point anyone can be euthanized for any reason. "Mental Health" is an awfully wide net and described specifically in the article which it appears no one has read.

Unfortunately, it seems HN suffers from this pseudo-fascist "Altruism". "Ending the incalculable suffering" was the same justification the Nazis used for their euthanasia program. Virtually the same words too. "Mental health" was a reason thousands upon thousands of children and adults were euthanized. Sorry, this position cannot be compromised with. Euthanasia inevitably leads to mass murder. Very progressive of us to repeat history.

It's not a slippery slope if it's real. They even describe the slope slipping in TFA if you are even capable of reading.

If we can prevent even one person from having a gruesome death, it’s worth the sacrifice of the other 99?

Who's being sacrificed and how in that case?

Those who jumped off the Golden Gate Bridge but weren’t caught (intentionally).

Right, but there's a problem - the UK is in a real mess! Social services, medical services, all the services are underfunded and crumbling. There is a cost of living crisis as wages have barely moved in 15 years, food banks are everywhere, and now "multibanks" are popping up.

Our country first needs to ensure that people can choose to live, and if needed be cared for; nobody should feel pushed into assisted dying because of financial reasons.

I say this as someone who will be in pain for the rest of my life, and euthanasia has been on my mind at times. As much as I might "benefit" from such a law in the future, I don't believe it should be passed until we have a stable society with good services and safety nets.

What if we triple your pain?

100% you articulated exactly what I couldn't - thank you. It feels very wrong to be considering this in the UK when we are on the decline. Espcially since the current government have demonstrated that they don't really care about pensioners.

OTOH, it's interesting that you and the parent comment are basically saying "We, as a country, are failing our pensioners so badly that death has become the more appealing option for many of them. Therefore, we must trap them here with us until we improve the conditions that lead to them making that bargain (which we will never do)"

Taking away someone's right to assisted dying because you live in a society that has made death preferable to living for many seems like a totally orthogonal leap of logic. That doesn't reduce net suffering one iota.

I am eluding perverse incentives by the government to employ such a scheme. I am sure if they use pure logic and numbers it makes sense to roll this out, especially at time like this. It would indeed help the balance the books and get rid of that pesky voter base who typically vote right.

The decision to offer assisted dying needs to be based on compassion and logic, not on logic alone.

That's a hard subject - while I think I get your need to have a better safety net (so folks aren't tempted even more to opt out of existence), by delaying it, such choice is also causing indescribable suffering to patients now, and trust me those are not small number of people in topics where 1 is too many. A good 'pleasant' death rather a rarity.

Perfect is usually the enemy of good.

That is a very good point.

To be fair, that is also the one issue with abortion that is legitimate. I am very pro-choice but also horrified by the reality that women sometimes are pressured to have abortion for economic reasons. Still I think that allowing abortion is a net good even when there is still economic imbalance.

As for euthanasia, I think it is similar. We need to fight for a stable society with good social safety and access to medical services for all while also giving people the rights to decide on how they want to go. (At least for older people, I think for younger people there is too much risk they would have changed their mind and should only be allowed when it is medically certain that they will die soon).

My hope is when cases of euthanasia for economic reasons happen, people will be horrified and it will put pressure into improving the system. But maybe I am naive.

> My hope is when cases of euthanasia for economic reasons happen, people will be horrified and it will put pressure into improving the system. But maybe I am naive.

I predict it will be the opposite. Economic reasons will pressure people to support euthanasia.

Google just results in weird crypto junk, so if you'll pardon me: what is a "multibank"?

Add 'UK' to the search and you get a result pretty easily: https://themultibank.co.uk/

The link the other person posted didn't make it as immediately clear as a definition I found-- it's basically multiple types of charity banks (e.g. food bank, clothing bank, bedding bank, hygiene bank) operated as one entity.

I see your point, but the problem in the UK is we seem to have ground to a halt because "everything is awful".

Not the same argument, but near where I live people have campaigned against new houses for 15 years, because the roads aren't good enough, and the doctors and dentists aren't good enough, but those things haven't been good enough for 15 years, and they probably aren't going to get better.

I fear there is basically no chance we are going to fix the NHS to a high standard in 20 years, if ever, at this point. In that case, we can't simply do nothing until everything is improved.

What was supposed to be done?

Such vomiting isn't due to any medical failing, it's due to the bowels being completely blocked. It's not going out the other end, eventually it comes back up. The only fix is to go in there surgically and fix the blockage--but in a case like what you're replying to obviously that wasn't an option.

The US is a mess too, and isn't likely to get better. This is in fact the reason I firmly hope some form of legal assisted suicide is available when I get old enough to need it. Societies with no safety net, where anyone -- even the reasonably well-off, like myself -- can end up unhoused with no medical care through a stroke or two of bad luck, need this right the most.

If we had a functioning system for providing the necessities of life for everyone, suicide would obviously be less necessary.

Anyone who has worked at a hospital can tell you how many people die in needless pain and suffering when nothing more can really be done for them. They just wait out the clock in pain or do increasingly horrible procedures that give them a little more time with terrible quality of life. 5% is probably an underestimate of that number.

Nurses/doctors don't like to speak up about that part and people don't want to confront it. But MAID is probably the more humane option in these cases.

I volunteered (and then worked) at a Federal hospital in the 90s, up until ~2002. Oncologists were notoriously underrepresented in the oncology department as patients. Instead, then tended to do whatever they wanted and then get dosed up to the gills with Morphine until dead, a few hours later. It was a very different way to run out the clock.

Yeah, I've heard similar things many times. The people with the best understanding of what's going to happen are the least likely to want it--extremely telling to me.

Like with so many things, what terrifies me is where you draw the line. The cases you're describing—where someone currently has to choose between paying ridiculous amounts of money to continue living in pain while confined to a hospital bed versus dying in terrible pain because the doctors are forbidden from helping you along—these are the easy ones.

But we also have stories here of people deciding to die while they're still mobile and while their loved ones are begging them to not to. Those are much less clear cut to me.

Radical individualism would say that every person should have full autonomy to make any decision they want that doesn't physically damage those around them. But I'm not a radical individualist, so I can't accept that argument alone. There are cases where an individual's choice to end it all early would be a net loss for their immediate community, and there are cases where it would be a net loss for the wider community and the state. At some point that net loss must overrule the individual's autonomy. But where? How do you draw the line?

"There are cases where an individual's choice to end it all early would be a net loss for their immediate community, and there are cases where it would be a net loss for the wider community and the state. At some point that net loss must overrule the individual's autonomy."

I'm presuming these are situations where a person has a terminal illness or something where it's a matter of time until they are disabled / not mobile / in great pain and so forth. What right does anyone else have to demand that a person continue living against their will in those scenarios? Why does a person have to wait for life to be unbearable before they can opt out?

My father died due to dementia. When he was of sound mind, he was very, very clear that he'd prefer to be dead than diminished that way. Unfortunately his condition crept up on him and he didn't live where assisted suicide was an option anyway. I'm convinced that caring for him actually killed his wife before her time, by contributing to her stress and so forth. (She died of a heart attack about 9 months before he did, despite being a decade+ younger.)

We don't give human beings the same dignity we give pets who are clearly dying because we have misguided ideas about longevity being more important than quality.

> At some point that net loss must overrule the individual's autonomy.

I'm curious why you think of this as such a concrete fact. It is hard to understand that you would consider it your right to override such a core component of human autonomy (the choice to continue living) because they owe you/society something.

If someone's suffering is so great (be it physical *or* mental) that they have reached a point where they personally would trade human life for non-existence, who are you to say "Sorry, we own you. You cannot make that choice"?

I am sorry if my comment sounds judgemental because I am genuinely interested in your opinion about who would ever be qualified to make that decision and decide "No, this person is bound to us."

> It is hard to understand that you would consider it your right to override such a core component of human autonomy (the choice to continue living) because they owe you/society something.

I'm curious why you consider individualism to be the default state that should be assumed, while my very broad statement that there is some level of social responsibility that overrules individual autonomy at some point (where that point is being the question) is the one that needs justification. I'm specifically calling out that I'm unsure where that line is, just that there is a threshold where individual entitlement must give way to the needs of the community.

This has been the default position of every human society we're aware of, so much so that it's essentially the definition of a society. It's wired into our biology. Radical individualism that teaches otherwise is a very new phenomenon.

That said, neither position can be argued for logically, because they operate on totally different axioms.

I don't think you're off base by saying that people have a level of social responsibility to the people they live around. I think that can be argued perfectly logically.

What I'm not sure I agree with is that it translates to a responsibility to stay. Isn't someone who emigrates permanently away from their local community breaking the same social contract as someone who chooses medically assisted dying? Should that be prevented for the same reasons?

I can see the position that MAID is genuinely abdicating a true responsibility in some extreme cases, like a parent with minor children.

If there exists a social responsibility then there exists a responsibility to stay. Emigration could very well be abdicating social responsibility, but not irrevocably so, and in the modern world much of your responsibility to those you left behind is still fillable even after emigrating. Dying is irrevocable and puts you entirely out of reach.

I can't adequately express my revulsion at the idea that "net loss to the state" ever must overrule my autonomy to the extent that I'm not even allowed to die. What entitlement.

Entitlement is exactly my issue with radical individualism.

I think there are a lot of people that are absolutists on the point. If the whole universe depends on one person's continued existence, that would still not justify forced prolongation.

If there is one thing that should be beyond social control, it is the choice over existence itself.

My grandma always told me when she couldn’t go on her walks anymore she didn’t consider life worth living. When she got dementia she was placed in a closed hospice, to “protect her”. Now she only walks when I visit, and I only see a shell of the woman she was.

Anecdotal of course, but why do people think it’s an ethics question when society is individualistic as can be? There is no choice in being born, why don’t we get a choice in when we leave?

Because half of society is a labour camp without guard towers- and if the slaves leave the camp it collapses in on itself.

Yeah, I knew someone who opted to have their dementia-suffering parent live with them until the end. That was tough, but... surely better than being left alone in a hospice/etc. as you mention. Unfortunately, yeah, you'll see the person just erode and ... it's really brutal as hell, ultra sad. Eventually the person is not even capable of consenting to euthanasia (nor any other medical procedure). Definitely something to discuss with family or closest friends especially upon getting diagnosed with an illness like that.

I have worked in hospice and would say typically the people who end up there are not what I would say left alone. But they are there to die. They usually end up there because the family who was looking after them is really struggling to do so any longer for various reasons like personal care or medication management being too much and they are approaching death.

When there they get basically as much drugs to fight pain, anxiety and other symptoms as much as they need. The goal is to provide as much as possible a comfortable end to their life.

Dementia patients are not candidates for MAID program here in Canada. You need to be of sound mind at this time. Perhaps in the future one can make a living will for future illness but currently if you are confused or suffering from dementia and can not understand what it is all about you can not consent to it.

Caring for dementia patients at home is seldom better unless the family has the resources for 24×7 care. I know from personal experience that dementia patients will wake up in the middle of the night to wander out into the street or accidentally start kitchen fires. And if the family tries to do it all themselves it takes an enormous unsustainable toll. At some point everyone is better off putting the patient in a professionally staffed facility. Of course the prices for those create other challenges.

One reason is religion. That aside, people are afraid that this could be abused. People could choose this purelyto avoid additional cost to their relatives.

It could be used as an excuse why more costly options to avoid pain and suffering in old people might not be covered by insurance anymore.

People could be talked into it for various reasons.

Canada is a good example of a country where I think the base to make it work in a positive way is given. Their insurance covers a lot of treatments for basically everyone. The country cares about its citizens in a way that makes you believe they won't use euthanasia as a cop out to avoid paying for medical care.

If these circumstances are not given, euthanasia can easily be seen as an easy way to get rid of people who are too expensive for society or too cumbersome to take care of.

> People could choose this purelyto avoid additional cost to their relatives.

Why is this a bad thing? If there's a choice between giving $100,000 to my descendants and using it to keep me intubated in a hospital bed for an extra 6 months, I find the former preferable by far. If someone else doesn't, that's fine, but I find comments like this both annoying and creepily authoritarian in saying that the correct choice is obvious and so they're going to make the decision for me.

Not the op but I guess the idea is that questions of life and death should not primarily be economical questions. You are free to disagree, of course, and there is, at some level, economical considerations for all medical treatments. But at least I'm my country is there a sharp divide; an individual should receive the best available treatment without economical considerations. What treatments that are available for various conditions (not individuals!), however, are decided by comparing cost and utility.

There is also an argument that can be made about the meaning of economy is to make lives better, but the opposite is not true

That's mostly tangential to my argument though. In many people's lives, there comes a point where you can spend arbitrarily large sums of money to postpone death, but only in a form that I, for myself, don't consider all that valuable: I would be willing to be bedridden, intubated, and barely-conscious as a temporary condition if it meant a full recovery for more life later. But as a holding pattern before death, which is what it usually is, I'd rather not, and I personally would like to spend that money in other ways.

Note that this applies even in cases where all the costs are paid by taxpayers. If the state is making me an offer saying, "we'd like to spend $100,000 to keep you barely-conscious for a few months", that might be more generous in some sense than offing me, but I'd still rather they just give that $100,000 to my kids.

> Not the op but I guess the idea is that questions of life and death should not primarily be economical questions.

Sure, but as an American life and death is already an economical question *above all else*. The quality of medical care that I receive is already directly linked to how much money is in my bank account and how much my employer is willing to pay for a medical plan.

End of life care in the US is designed with the primary goal of vacuuming every asset out of you and then letting you die once it's gone. It seems unethical to say "sorry, you don't get to opt out of this. Everyone's got to go through the whole process."

To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

In a friend's family, there was a big rift as one family member in direct line of inheritance was accused of (successfully!) pressuring his mother to refuse medical care. She died sooner and more unpleasantly than she likely would have otherwise, leaving more money sooner to her children. And that wasn't even with euthanasia being legal.

I have lots of sympathy for people so desperate they would rather kill themselves, but I don't know how you square that circle.

Well I am sure no system is perfect but the people that choose to end their life have to meet several criteria. They first need to be of sound mind when they make this decision (and this is one of the current issues being sorted out). So they talk with their doctor and express interest. They then are seen by other health care providers like psychologist who discuss it more. They are spoken to privately without the family present. It is their decision in the end and only theirs. Once they choose a time they need to still be fully alert and aware and they have to personally push the button that ends their life. And that is one of the issues, some people do not want to live if they become paralyzed or brain dead. But we can not euthanize those people even if they expressed that wish before.

I have worked in hospice and they do MAID there all the time. It was a weird feeling to see a family and their loved one head into the downstairs where they would all sit around and tell them person how much they are loved and then that person would end their life. But I know it is the right thing.

> how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

I would look into countries where euthanasia has been already implemented. It doesn't seem like it's a widespread problem, so apparently they made it work somehow.

Does it mean it's absolutely bulletproof and no-one will ever be pressured to undergo euthanasia? No, but you can't ever achieve such certainty, and it's better to look at it from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

> I would look into countries where euthanasia has been already implemented.

That's what puts me off of the idea in the first place. Cases like Christine Gauthier (a former army corporal and paralympian) who was offered euthanasia when trying to seek government disability benefits to install a wheelchair ramp. If it takes someone with existing fame to speak out about this, how many more people has this been pushed on?

> from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

I'm not totally convinced. I haven't run the numbers, and this also certainly takes into account my personal views on valuing life and family, but I do fear more pain and suffering will come with legal euthanasia than it will solve.

Just look at the end of the article. It gives several examples of the kind of thing that allows me as a utilitarian to say that the suffering of a few terminally ill is not as bad as the harassment of countless vulnerable people.

I think these are valid concerns, but I would also say that there is an underlying issue with medical malpractice and disregard for the suffering and needs of certain groups of society which we tend to brush under the rug. I'm going to assume the concerns you have probably don't stop at just euthanasia - mine definitely don't, and I worry that a ban just makes the issue more... abstract, and PR-friendly.

If an individual in a difficult life situation comes to the state for help as a last resort, and there is a chance the representative they are assigned would recommend they should consider just dying as their last resort, the state has already failed to protect someone vulnerable, and obviously won't be giving them the help they deserve/need/should be entitled to as a human.

Any wrongful death is horrible, but I sincerely believe a "representative" like this and the harm they inflict is going to have an almost identical death toll, even if it's by way of consigning people to sub-human lives of physical or mental torment instead of pushing them towards a tool that "everyone" understands we need to keep a close eye on. My utilitarian take would be that many would happily extend the torment of the terminally ill and suffering, as long as they don't have to deal with the suffering their neglect inflicts on countless vulnerable people and the terminally ill already. (For e-clarity, I don't mean to imply that's your motivation here!)

> If an individual in a difficult life situation comes to the state for help as a last resort, and there is a chance the representative they are assigned would recommend they should consider just dying as their last resort, the state has already failed

Medical assistance in dying is a medical act, reserved to doctors. Just like a car salesman can't legally recommend you an abortion. No one in the government has the legal right to discuss it, even less offer it.

Yes, my point was that that person having a position where they are able to do that is already wrong. If a car salesman was telling every woman that came in they should get an abortion, there are places that person should be, and none of them are a car dealer's.

The Supreme Court then?

Should we keep medical assistance in dying illegal because bad eggs offer it outside the legal framework of their job in bad faith?

The Christine Gauthier case is used to justify the idea that the government will use it to reduce spending, when what happened to her is appalling, but was absolutely not something the government employee that offered it to her had the legal permission to do so.

What the Quebec law regarding medical assistance in dying does is guarantee its existence as a medical act. It does not allow any low-level government employee to offer it wily-nily to anyone. It is a medical act, reserved to doctors, to discuss assistance in dying.

> Just look at the end of the article. It gives several examples of the kind of thing that allows me as a utilitarian to say that the suffering of a few terminally ill is not as bad as the harassment of countless vulnerable people.

Countless vulnerable people haven't been harassed. There are 12 documented cases in the history of MAID in Canada where someone was allegedly offered MAID innapropriately. There have been inquests and reports that have counted them. Not one resulted in a death. Christine Gauthier's experience couldn't be substantiated when they reviewed her records, but they did find in that investigation that a single case worker had offered MAID to 4 veterans.

On the other hand there have been over 50k successful petitions for MAID most of which were for people with Cancer.

As a utilitarian, you should presumably look at the actual numbers, and balance the tens of thousands of people who chose not to suffer agonizing deaths against the 12 documented cases of people who were offered MAID as an option when they think they shouldn't have been.

To be fair to the grandparent, you can’t fully audit whether the cases of the people who successfully petitioned, because they’re now dead.

You can petition for MAID, and get approval, and then choose not go through with it.

And those cases could definitely be audited, but that will be a limited and biased sample.

How do you prevent people from smoking? Eating processed food?

Is the fact that the process of suicide is slower/more conventional a difference?

People seeking this process go through a psychological evaluation to determine if they are under duress and of clear mind. Also there's liability to the ones applying undue pressure which can be criminal.

I think there's a point of personal responsibility. Potential abuse of the system should not be the reason to deny it to everyone. I want to have control over the way I live and die. Alzheimer's is unfortunately in both sides of my family, if it has no treatment and I start showing signs I would rather die than live. It would be torture for me to put my family through that.

As I say, my concern isn't academic. I was close to a situation where someone was allegedly coerced into refusing medical help. It was in fact investigated, ended up as word against word, and nothing came of it. That was in a jurisdiction where euthanasia is not legal and anyway such coercion would be illegal, for both the coercer and the doctors. It didn't stop the alleged coercion, and no one was prosecuted. So how leaky would the system be where euthanasia is in facr legal?

But please don't get me wrong, I am absolutely full of sympathy to people so desperately ill they want to call it quits.

Neither is my concern academic. My MIL struggled with cancer treatments for a decade of terrible pain. My father was catatonic with Alzheimer and my mother is in a pretty bad place health-wise.

I don't want to appear dismissive of your concerns because I'm not. Such abuse is horrible, criminal and tragic. No question. But looking at the morality issue and consistency I think the answer is pretty clear. We need to give people agency over their own lives. Safeguards are essential for sure, and abuse will happen even with the safeguards in place. But the current situation is just tragic. People are afraid to go to the hospital because they're afraid they will be kept alive and in-effect tortured to a slow death.

Would you support laws that force people to get medical treatment whether they want it or not? It would avoid the sort of problem you witnessed.

Manipulation and coercion can oppose the suicide too. There's some cases where family members don't want their loved one to kill themselves.

I'm not sure how these were resolved but it's very messy and hugely traumatic for all involved.

What you’re hitting on is the inescapable truth that there are problems government institutions can’t solve.

Surely you can see that we could apply that principle to either pro- or anti-euthanasia arguments?

Either way, the government is profoundly involved.

Either the government is in the business of telling us we cannot end our own lives in humane and medically-assisted ways, and that medically assisted deaths are equivalent to murder with all of the attendant legal issues.

Or they are in the business of enforcing rules about how those medically-assisted deaths can happen.

It’s the government’s choice whether they allocate resources to investigate and prosecute “suspicious” deaths of terminal patients.

Deciding as a matter of policy, not law, “No, we don’t do that outside of extraordinary circumstances” is something a government institution can do.

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

This is why it's important to have a pretty detailed living will[1]. Especially is you're already chronically ill and have a pretty good idea of how that road ends.

[1] https://en.wikipedia.org/wiki/Advance_healthcare_directive

The way most countries who have it (including Canada) have solved it is to add waiting periods, and layers of reviews. In Canada, you need two different doctors to sign off on it. If you're not actively dying, you also have a 90-day period of reflection. And you have to be of sound mind.

This seems to me like good enough safeguards, don't you think?

Bureaucracy for the win.

Bureaucracy is usually added for the win. But people only notice when it's not.

The system in Canada results in the state killing homeless and disabled people rather than offering them support.

Does it? Or is this what anti-euthanasia advocates are spreading as misinformation around to acquire the support of progressives to their cause (which is driven not out of a care for homeless and disabled people, but out of religious/conservative mindsets)

Keep mind: I'm not asking "Do those cases ever happen"? Of course they do. There's already been stories. The question is what are the statistics. Every policy, every procedure, every decision can have mistakes and negative outcomes. Some homeless and disabled people have been offered euthanasia. Those cases should be investigated and the policies should be updated. But nothing will be perfect.

You can say "if you can't have a perfect system then you shouldn't have it at all." and while that may be philosophically justifiable in the same way that "I'd rather let 10,000 guilty people go free than convict 1 innocent person" is, but it's important to remember that despite that we still convict innocent people.

Some trans people regret their transition. They're a tiny minority. Some people abuse welfare. They're a tiny minority. Some people are pushed towards euthanasia when they shouldn't be. They're a tiny minority.

Comparing the act of people transitioning or people being given financial assistance to the act of people being killed by the state is genuinely sickening. Total inversion of reality and conflation of reversible benefits with literal death.

The government has no incentive to provide better housing or disability benefits to the working class when they can instead withhold those things and watch legions of poor & desperate people die. Do you know they actually calculate how much money killing all of these marginalised people saves them? That Canadian media advertises these figures to sell the state killing program?

> The government has no incentive to provide better housing or disability benefits to the working class when they can instead withhold those things and watch legions of poor & desperate people die.

What was Canada's excuse for poor healthcare before MAID existed then?

They didn't have a good one, and people were mad at them for it and demanded better results. MAID ameliorates both some of the direct anger ("We have improved healthcare by reducing suffering, look at how severe disability is declining"), and ameliorates some of the proximate causes (killing the sick, disabled, & homeless reduces load on the healthcare system & leaves more funds for other parts of it).

I can't negotiate with people who have such a deep distrust of Government that they belie that the Government will kill it's citizens if given incentives to do so, or from pure $-based miscare.

This to me feels like a very dystopian way to have a relationship with it's government, and is a uniquely american perspective amongst the developed world.

The government is a proxy for society leadership. I expect human society to protect it's humans, and most of the world with functioning government does too.

The biggest threat to Canadian prosperity today is these american ideas percolating above the border and infecting the mind of Canadians who previously believed and trusted their government and no longer does.

I am not American, I am Australian and have never been to America, nor do I like the country; so much for "uniquely".

On what basis do you call yourself a communist when you explicitly advocate "trust" in a bourgeois government on the topic of state killings of homeless & disabled people? Shouldn't that be one of the last topics you would ever trust them on, given their clear class interest in killing members of the proletariat who are unable to continue labouring for profit? It seems fine to trust them not to lie about easily verifiable facts that don't threaten them, like weather warnings, but you should trust them about literally everything else before trusting them to "fairly" and "consensually" carry out killings of proletarians.

And note that the stories aren't always accurate portrayals of what happened.

I remember reading about one where someone drugged their mother to bring her in for euthanasia. What the naysayers didn't report was that that was by her own wishes--she knew her mind was going and set it up for when it was too far gone. I have no problem with that.

> This seems to me like good enough safeguards, don't you think?

No. I think it’s too much.

Nobody else should be deciding that my mind is unsound.

And if my body being “unsound” is a reason that makes it OK to want to die, why should an “unsound” mind be different?

It seems like somewhat reasonable safeguards for most circumstances, except that other guy replied to you saying he thinks there should be zero safeguards and he may well continue espousing and voting for that viewpoint for the rest of his life now that the basic system's in place.

Even if you think the current safeguards are the "sweet spot," continued pressure to make it more difficult will be necessary to prevent it from being made less difficult. (And if you don't think it would be a problem for it to be made less difficult, then citing those safeguards as part of your argument would be disingenuous.)

My ultimate point is that old people, especially those not very well, are very vulnerable to being forced to do this, and I saw ~first hand how easy and undetectable it was. You can add bureaucratic constraints but it's fundamentally a human problem. While expressing utmost sympathy to critically ill and unwell people, I don't know how you make this without endangering many more people than those would benefit from such changes.

How do you even measure if it's working "well" in Canada? They have a process. There is no way to question the people who went through with it whether, on reflection, it was their own free will.

But of course looking at how others do it is a good starting place for further analysis and I'll go now and educate myself.

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

How often does this actually happen?

EDIT: To be clear, I'm not saying this doesn't happen, I'm really asking.

Sounds to me like your family friend’s mother would have died more pleasantly if euthanasia were legal.

There are plenty of ways to pressure people into death, as you have already demonstrated. That’s not going away.

Emotional burdens to encourage people to live as long as possible even if you think they’re suffering are likely a far bigger problem. People know it’s unethical not to euthanize animals that are suffering. Lacking the social apparatus to suggest euthanizing humans is almost certainly a huge moral weakness.

The much more common case seems to be families forcing treatment, effectively just prolonging the pain. People don't exactly easily come to grips with their parents dying. Some people never do.

> why don’t we get a choice in when we leave?

Because dead folks don't pay taxes.

Terminally ill people generally aren't paying taxes either. You have to make money somehow to owe taxes.

There are so many people that really have no idea how taxes work.

So which one is it, the government assisting in deaths too often or not enough, it can't be both at the same time.

Alas, actually, it can be.

You can make both errors with false positives and false negatives at the same time.

> why do people think it’s an ethics question when society is individualistic as can be

Because we disagree that society is individualistic. We are social creatures, not individualist creatures. And we need people around us. Including you needing your grandma. And she needs people like you.

turn the question around: why do people feel easy escapes are ok? We came in this world and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?

What do you need from grandma, who is in constant pain and desires to die?

The touch, the voice, the eyes of love, the concern, the stories, the heart, the smile, ... shall I go on?

Grandma doesn’t want to share those stories because it hurts to talk and she can’t see well and just generally she’s in a constant bad mood because her life sucks.

That would be the fault of those who are responsible for her happiness

There are quite a few medical conditions in which it is impossible to make it not hurt.

Ok. Even if we hold that ridiculous assumption true… so what? Let’s say grandma is explicitly suffering because others are failing her?

Your proposed thesis still suggests she does not have justification for choosing death. What does she still owe us.

I think you pivoted to another argument. Better would have been if you had started with that argument. Instead you asked what is grandma good for?

Grandma is long gone, you’re prolonging suffering of her husk for selfish reasons.

All of this is beautiful stuff, but I think it no longer applies when suffering has removed a person's humanity such that they can't offer these things anymore. At that point they're only capable of putting their energy into suffering. Even your attempts to alleviate their suffering are probably useless, or offer little to no relief.

I don't see why you would think about or hope for these things when they're effectively gone; especially not if wanting these things for yourself is at a loved one's expense.

So you want grandma to suffer for you. How very selfish.

> why do people feel easy escapes are ok?

Because they are ok. Why wouldn’t they be? You don’t get bonus points after life for suffering on “hardcore”.

> We came in this world

I don’t remember anyone asking me whether I wanted to come in here or not and I sure as hell won’t let anyone dictate how I want to die.

> and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?

Because you’ll die anyway.

Because nobody has the moral right to demand that other people suffer for their own sake.

Because I’ve seen the slow end and I wouldn’t wish that degree of suffering on anyone.

Note: the title should be updated.

The BBC article title now says "Assisted dying" not "euthanasia". Often, the distinction hinges on whether the patient or a medical practitioner administers a substance that brings about death. The Canadian policy actually provides for both, but as I understand it the stats being cited in the article combine both, so only a subset of the tally are "euthanasia" deaths.

Some provinces (notably SK) do not offer self-administered MAiD, just FYI.

Ok, we've updated the title. It was originally "Canada euthanasia now accounts for nearly one in 20 deaths".

Fifteen years ago, flying into Vancouver, a local told me charities would give homeless people one-way bus tickets there from colder regions of Canada to prevent winter deaths. No return tickets in spring. Calls into question what we consider "charitable" when the solution is just moving vulnerable people elsewhere.

Worrying parallel: will euthanasia become another "solution" for those who can't afford proper care and treatment? Moving homeless people to warmer cities and offering euthanasia to those who can't afford treatment both avoid fixing the underlying problems.

> will euthanasia become another "solution" for those who can't afford proper care and treatment?

This is all but guaranteed to happen to some extent; after all, criminals exist who killed people, so a legalised form of that will be used at least once in the history of Canada. I guess the question is more: will this become more normal than would've been preferable, but in 20 years will just be one of those facts of life? Possibly? Certainly that possibility was the main objection to MAID.

Yes but undirectly.

-Can't afford therapy for curable or mitigable disease

-Let it worsen

-Death is the only charitable option as a cure is now impossible and life is miserable

I'm fairly sure a lot of conditions are incurable for you or me, but curable for billionaires.

Does that mean that the tax payer will have to spend billions on every human?

It's charitable. Cold snaps in Prairies can pretty easily hit -35, dropping down to -55 with windchill. You'll get frostbite on exposed skin in 2 minutes at those temperatures.

Most homeless will either take stay in one of the shelters available in the cities, or sneak onto the many freight trains heading towards the cities with milder climates when it starts getting cold. They'll head back when it starts to warm up again. A bus ticket is just enables the journey to be a lot more comfortable.

Charitable! Hah.

The process was operated more as a "don't provide shelters for these lazy bums, send them elsewhere."

https://www.wsws.org/en/articles/2001/12/can-d22.html

"In a 16-month period in 1993-94, the province’s welfare rolls were cut almost in half. One tactic used was to offer recipients a one-way bus ticket to leave Alberta."

> Worrying parallel: will euthanasia become another "solution" for those who can't afford proper care and treatment? Moving homeless people to warmer cities and offering euthanasia to those who can't afford treatment both avoid fixing the underlying problems.

Almost certainly. IIRC, in Canada there have already been cases where people got euthanasia mainly because their disability payments were insufficient.

I'm sure someone will try to frame it as a Catch 22: "If we knew for sure they would choose suicide if they didn't get the help they requested, we would prioritize them over non-suicidal applicants. But the only way we would know if they would actually choose suicide is if they actually committed to voluntary euthanasia".

...

I'm in Canada and I have a relative in hospital who say they are either returning home or doing MAID, as they were not going into a home or "assisted living." coming to terms with your own death is part of the culture here now.

Many people clearly prefer death to being dependent on services. Doctors themselves are known to eschew chemotherapy and difficult surgeries. Most men don't even see the doctors their taxes pay for "free" because the system is so bureaucratic nobody with any responsibilities can afford the time to use it, or the risks of being caught up in the system. Dignity is a big deal for people and many prefer to die with some of it than to live without it.

I think MAID itself is poorly defined and implemented, as really, the health system had no problem killing thousands of young people with loose opioid perscriptions, I don't like that MAID requires allocating execution powers to doctors and their increasingly politicized delegates. death as a service doesn't seem ethical compared to prescription and technical options.

the heart of it is that the institutions don't provide dignity and so people are choosing death. this seems lost on the leadership and its aspirational classes.

Regarding your comment on loose opioid prescription, in Québec (I cannot talk about other province because health care is a provincial juridiction) , they are not a thing anymore.

20 years ago it was like you said: I received 40 pills of oxycodone 20mg for a strained muscle. But nowadays they're quite strict, too strict imo: a few month ago my wife broke a vertebrae and she only received only 20 pills of hydromorphone 1mg and a month of antacid coated naproxen.

Extraordinary claims... what's the evidence for that?

if we killed all the homeless people, would our social problems be over? Sick thought. I know. But a part of me blindly believes that our problems will become worse.

Be coming homeless isn't a problem with the person, it's an outcome of the system we live in.

The population of homeless people would end up probably where it was when you killed them all. Though I do wonder how long that would take

> Be coming homeless isn't a problem with the person, it's an outcome of the system we live in.

Like most things in life, I don't think it's as simple as that. I think it's a complex mishmash of systemic factors and individual choices that cohere into a big ball of suffering.

For example, I had a close family member who was an alcoholic. He couldn't keep a job because of his drinking problem, and wound up going through all his friends and family who would take him in (before wearing out his welcome at each place in turn). He was getting put out of the last place he had available, basically, when he died suddenly. But if he hadn't died he would've been homeless. Was this a problem with the system? Maybe - he had a pretty good support network, but you could make a decent case that if we had the right support system in place at the right time it would've helped him. But also, there was absolutely an element of choice to it. I have a lot of sympathy for the guy, because addiction is a bitch. But systems of life or no, he made choices at various points that led him to the point of homelessness. A different person in the same circumstances very well might have had a different ending to their story.

I don't think blaming the homeless is productive, certainly. Their lives are shit and they don't need someone smugly telling them "just do better bro". So I do think that trying to improve the system we live in is just about all we can do (that, and be compassionate to people we meet). But unfortunately I also think it's not realistic to expect any amount of systemic change to be able to solve the problem.

>will euthanasia become another "solution" for those who can't afford proper care and treatment?

Yes, and I would argue that despite the awful connotations, this is not a bad thing.

It’s simply a fact of life that some people have more than others. Sometimes it’s not fair, but it’s still way better than any other social/economic alternative. And those who have more can afford better treatment, that is expensive.

So, assuming we can agree on this, would it not be better to offer some solution, even if not ideal? Remember, it may not be something that you would ever opt for, maybe because you have the means for better solutions, but for many this is a blessing compared to their only alternative which is to suffer. As sad as it may sound.

That is psychopathic.

It would be a bad thing.

> Fifteen years ago, flying into Vancouver, a local told me charities would give homeless people one-way bus tickets there from colder regions of Canada to prevent winter deaths

This is kind of one of those urban myths btw. Like yes it has technically happened before but if you chase down the stories it's not at all common and it's more of a situation of someone having some family or relationships in a province away and people trying to help by connecting them.

No. It was 35 years ago, but it's not an urban legend.

Back in '88, when he was just mayor of Calgary, Ralph Klein had the city "solve" their homeless problem for the Olympics by buying one-way bus tickets to Vancouver.

It is back in the news because it's started happening again in 2s and 3s.

https://edmontonsun.com/2013/03/29/remembering-ralph

https://globalnews.ca/news/2567494/reports-2-homeless-men-fr...

As I said,

> Like yes it has technically happened before

So the reason it's important underline the "urban myth" status here is that while you've correctly pointed to the few concrete examples where this has occurred, in general many people casually, incorrectly throw these statements around as if this is frequent and constantly happening and this is a really toxic and bad habit that our society has. At best it's lazy innuendo, but at worst intentional misinformation.

The reason that this urban myth of the homeless from somewhere else is so toxic is that it enables people to dismiss homeless people as not really part of their community and thus enables people to not care about poverty in their community or the impacts of poverty on their neighbours. Thus people can freely disengage themselves from the issues of poverty. It's not their neighbours it's some Other People.

I don't quite understand your point. I contradicted you because I'm old, and I'm getting tired of people calling things that I vividly remember "urban legends". Lizard people in the sewers is an urban legend. That mean old drunk giving one-way tickets to Vancouver is history.

The point is that there's a difference between "this is a thing that has happened" and "this is a thing that happens". The latter thing is the toxic exaggeration of the truth IMO.

Like you're absolutely right that this particular rare event has happened before and I'm not discounting that, but the phrasing of the OPs story more suggests at the form of this story that is the myth that this is a trend and frequent occurrence.

I follow your point. Certainly this is more real than lizard people in the sewer, but not as real as people would have you believe when they casually exaggerate and insinuate that all the homeless around are from elsewhere and are being trucked in to this day.

Please don't call real events that you acknowledge "urban legends". You demean our cognitive commons with language like that, and undermine your own credibility.

I decline to join you in your brave fight against context but good luck sir

> Fifteen years ago, flying into Vancouver, a local told me charities would give homeless people one-way bus tickets there from colder regions of Canada to prevent winter deaths. No return tickets in spring. Calls into question what we consider "charitable" when the solution is just moving vulnerable people elsewhere.

Does it? Given the number of homeless deaths caused by Canadian summers, I'm not seeing the urgency of homeless people returning to colder locations.

This obviously isn't a solution to the problem of homelessness: the solution to homelessness is homes. But it is a solution to the (much smaller) problem of homeless people dying due to seasonal weather.

Incidentally, this program was never large and fell out of practice due to bad press in both the US and Canada, and thousands of homeless people have frozen to death in its absence.

I'm reminded of the South Park episode where they bus all the homeless to California.

>harities would give homeless people one-way bus tickets there from colder regions of Canada to prevent winter deaths. No return tickets in spring

This, as far as I'm aware, still happens in the US nowadays[1].

[1] https://www.youtube.com/watch?v=048BUjNWZa8

IMO, the key quote:

> The vast majority – around 96% - had a death deemed "reasonably foreseeable", due to severe medical conditions such as cancer.

The standard for that is very loose. There's no requirement that the death be imminent. Iirc it basically means the condition could kill you, at some point.

This even applies if treatment would prevent death. It's whether the condition is capable of killing.

With everything medical it is complicated. If someone is 85 and gets a theoretically treatable form of cancer they're looking at months or years of grueling chemotherapy and surgeries to get at most few more years of life.

I would not blame anybody for skipping treatment or even getting euthanasia to avoid the really sucky part where the cancer is killing you painfully, especially if their life partner has already passed.

Overall it is best to avoid making too many blanket judgements about medical matters. Every case is unique and the circumstances matter. Most people are sane and rational and you should trust their judgement when it comes to their own life, weighing also the opinion of their physician.

When my mom had cancer I told her she better do everything she could to beat it (she was a super hippie no chemicals person). I remember she was taking some horrible toxic chemo pill that made her miserable (like even her, the person taking the pill, had to handle it with gloves taking it out of the bottle), and I was like mom, stop taking it if it makes you miserable. She broke into tears and was suddenly so grateful to me for giving her permission to stop taking it. I hadn't realized she was putting herself through hell because of what I had asked of her.

Friggen moms man. (╥﹏╥)

Sorry you had to go through that.

I'm so sorry, that's just awful. I am glad you guys had some resolution, I guess for lack of a better word... I hope that time has eased the pain some

So one thing old people never tell you, you don't really get over losing your parents (if you had relationships with them).

But... I can never doubt that my mom loved me. She might have messed up a lot, but she was willing to take actual poison that was torture for her just to ease my mind.

No, the standard is not "very loose". It is clear, and strict. And you also got the "condition could kill you" part wrong. So it's all wrong.

You can read about eligibility criteria here[0], specifically what constitutes a "grievous and irremediable medical condition". Like, believe it or not, but this legislation took a very long time to write, and quite a bit of thought was put into it.

I hate to post the link for the third time in the same thread, but seriously, talking about eligibility criteria necessitates reading what they are. Preferably before talking about them.

[0] https://www.canada.ca/en/health-canada/services/health-servi...

I've spoken with the administrator of a province's MAID program who interprets the law. Have you spoken with anyone involved in administering and interpreting the requirements?

Cannot be reversed is modified by under conditions acceptable to them. There's no requirement that a treatment be acceptable to any objective standard, only to the patient and two medical professionals who sign off.

And there's no time limit on when the death is foreseeable to occur for a death to be classed as reasonably foreseeable. Only that it could do so.

It is possible that the administrator misunderstood the law but they're the one running the program.

You should have mentioned a source in the original post, instead of 'Iirc it basically means'. I'm also unwilling to take a single anecdotal source as a citation.

To address the point about objective standards, yes, the patient has an option for personal medical discretion. This prevents doctors saying eg this Neuralink chip will fix you for sure. What is the risk to you, me or society if someone does not accept a medical treatment that they don't seem acceptable? This goes down the same path as the dumb abortion debate - medical care is a personal decision, fin.

From your link:

> experience unbearable physical or mental suffering from your illness, disease, disability or state of decline that *cannot* be relieved under conditions that you consider acceptable

That is indeed "very loose," and is not "clear" or "strict." Any mental condition that the patient thinks cannot be acceptably relieved now qualifies (or will after March 17, 2027, when that document says mental illnesses will begin to qualify, because it will somehow become more right on that date than when the law was passed).

that but also:

> The median age of this group was more than 77

I'm wondering who the 4% are whose death was not reasonably foreseeable. What exactly are their secrets to eternal life?

Specific cause is foreseeable

Everyone's death is "reasonably foreseeable".

I'm 33 and healthy sir. Pray tell, when will I die?

Sometime in the next 100 years.

The timing is clearly not foreseeable by any reasonable standard.

https://www.ssa.gov/oact/STATS/table4c6.html

Obviously, in this context foreseeable means that the nature has low uncertainty and the predicted timing is narrow

I find the terms and definitions around Canada's euthenasia law uncomfortably vague.

People have made arguments against abuse in vulnerable populations, which I think is an important argument. But one thing that I really haven't seen explored, and specifically where this applies to suicidal ideation, is the extent to which this is considered a 'condition' or not.

The human body / brain has extremely powerful mechanisms for ensuring certain 'drives' that are essential for the survival and propagation as a species. This is what is biologically 'normal' / 'healthy'. Whether we agree with these drives or not philosophically is another thing. But if someone is anorexic, we recognise that their drive for hunger has been compromised, and make sure to restore it. We don't go "oh it's ok, their desire not to eat is voluntary". Psychiatric diseases are complex. To just assume "will" can never be compromised in disease is naive. And equally more naive is to assume that there is no action that one could do to restore the diseased processes such that that will would be reversed.

So the fact that when it comes to suicidal ideation we are less prone to say "this is a disease which circumvents the brain's normal processes that create the imperative urge to survive, leaving one suicidal", and we just go "wouldn't it be nice if they could end their life peacefully without consequences" is bizzare.

Note that in the situation where a degree of suicidality is not the main issue, and we're talking about palliation by physicians, current laws and practices absolutely do not prevent a doctor from taking actions that are intended to palliate rather than prolong a life of suffering. So the euthanasia bill isn't really about that. It's about supporting people who actively want to die, by providing "assistance". Discussing whether their circumstances warrant them wanting to die is a red herring, no matter how dire those circumstances may be.

A very interesting point. But would you say the same about having offspring? If one can decide to not exercise their reproductive rights peacefully, why can't someone exercise the rights over their own death. Do you want to "cure" people that don't want to have kids? What constitutes a "normal" drive.

That's a fair point. And in a sense, the analogous law there is the right to medically-assisted sterilisation, which also exists (albeit, carrying a somewhat lesser impact in terms of finality).

I don't necessarily think a discussion down that line is entirely without merit, and one could of course "delve" into philosophy of benefits to society vs rights of the individual vs sanctity of life etc ... but this is not the main point I was making here.

For me the distinction is less about reproduction-aversion versus suicidality needing to be forcefully "cured" or not (or one of sanctity of life, for that matter), but more about one of capacity in the case of exercising reproductive rights as compared to exercising suicidal rights. At the risk of a bad analogy, the former is more like wanting a questionable piercing that others may think is a bad decision. Yes you may well also regret it as a bad decision eventually, but if you have capacity in your decision at the time, then there is little reason to stop you from exercising your right to self-mutilation if this is what you want. In which case, yes, if someone was claiming, either that "skin is sacred", or using circular logic that the very fact you want a mutilation proves you're sick and you need to be 'cured' of it, I would have had the same response as you.

Whereas there are good reasons there are lots of legal protections for proving or disproving capacity when dealing with people with dementia signing away their will to a total stranger, for instance. Yes, it's possible that the demented person still has enough cognitive capacity to sign away their will to a total stranger, despite the fact that cognitive capacity is the very thing that is compromised. And so, similarly, yes it's possible that the suicidal person still has enough capacity to judge the extent to which they wish to live, even though their ability to wish to live is the very thing that has been compromised. But I would be sceptical, and would want to see some guardrails before providing commercial services to help demented people exercise their peaceful right to sign away their wills. And we have enough medical knowledge currently to know that, capacity-wise, suicidality is much more like dementia in this context, than it is like wanting a bad piercing or deciding on reproductive rights.

Which is why it's rather frustrating to watch, and a very dangerous line to walk, when legislating such a provision away purely on the basis of a debate focusing on "personal rights vs sanctity of life", without having that discussion about capacity and obligations to attempt to restore it / protect it as the first priority.

> So the fact that when it comes to suicidal ideation we are less prone to say "this is a disease which circumvents the brain's normal processes that create the imperative urge to survive, leaving one suicidal", and we just go "wouldn't it be nice if they could end their life peacefully without consequences" is bizzare.

Those aren't conflicting beliefs. I think everyone would agree that suicidal ideation is a result of some form of abnormal state of mind, it doesn't need to be restated, but the fact is that we don't have cures. What if they've already received psychiatric care and they're still suicidal?

I agree that we should provide people with the best care that we can in order to treat the root cause but ultimately it's up to them to decide what they want to do with their own life, whether it be treatment or ending it in a humane way.

I understand that there is probably some sort of fear of murder or untimely death by doctors "throwing up their hands" or pressure from inheritors to "move on"

However the hard line makes no sense. In most places that human euthanasia is illegal no one has any problem killing animals because it is more merciful than allowing them to spend their final time suffering tremendously.

Yea, I don't understand this. Is "the woke mind virus" as another poster in this thread called it also responsible for me putting my 14 year old dog with aggressive cancer down? Of course not. Death came for her and it would have been cruel to prolong the suffering. Pretty simple, and it's no different for humans.

Put simply, animals are property. The idea of equating animals to people is not a widespread one, and relatively new besides.

You could apply the same logic to cannibalism. Given no-one has any problem killing and eating animals.

In fairness, it's a minority, but there are quite a few of us who have problems killing and eating animals and increasingly so depending on the species.

A "foreseeable" natural death must also be "forefeelable". I'm glad these people don't have to live through that painful and pointless decline stage.

My first instinct on seeing that number was "wow that's too high". My more thought-through reaction became "Actually, that number is still way too low".

It's not necessarily true that 19 in 20 people didn't get to choose how they die, but there's something to the converse.

It's always surprising to me the... Quesiness people have in discussing this. In the land of the free, what possible freedom is more fundamental to life than when to be done with it? I wonder if the higher uptake in Quebec is because it's a more secular society than some of our other provinces.

From personal perspective, I very much hundred percent totally want the freedom to have the option to decide how I go. From there, I don't want to stand in anybody way who also desires same freedom. A lot of counter-arguments seem thinly veiled religious origins -- Some are legitimate concerns about potential for abuse, but still a lot reek of disingenuity in core motivations.

Terminal lucidity is a thing I don't see mentioned here.

It is well known that even some advanced dementia patients days or hours before death can exhibit lucid coherence, even speaking and recognizing loved one before death.

Having watched my mother decay from Alzheimer's for 10+ years, I know for sure there is much more left to her than she can express, and every once and a while she speaks in clear sentences, says names of loved ones or pets, and when she talks--even though we barely understand 20% of what she says--it's clear she knows what she's saying based on her facial expressions.

I will also say it's one of the joys of my life to sit with these people, many of whom are "waiting to die" and just talk to them with and listen to them (even when I can't understand them). They light up, and they especially light up when I play them old music on a bluetooth speaker. Some sing, some sway, some even try to dance. Many cannot talk at all but they can still sing the lyrics.

I find it overall very unnerving how quiet this is and how the Canadian press never really finds issues with this.

I often saw Japanese media moving lock-step with the police (in terms of vocabulary to use for certain crimes, how to report certain issues), and thought it was creepy as hell. However, the complete lack of questioning of the purpose behind a sudden legalization of euthanasia (in a country with public healthcare and an inherent potential conflict of interest), and the entire concept of having "experts" sign off on it without any legal overview is creepy.

Even using "medicalized" terms like MAID instead of euthanasia is unnerving to me.

Put in another way, given how hard it is for people to see doctors, I wonder how much worse it would be without MAID? As it would clearly be worse, is this a mere sanitized form of cost cutting to deal with growing medical costs associated with treating the aging population?

A person can't choose for himself when or even if to come into existence in this world.

In an era when human rights are considered sacred above all, it is hypocritical to me that a person can't decide for himself when he wants to quit.

Your whole comment frames MAID as something the gov't does to patients, not something patients choose as a better option than spending 6-12 months in agony with only one possible outcome.

MAID isn't a cost cutting measure. The cost of palliative care for the terminally ill is trivial.

It's not a loud issue in Canada because we've had decades of grappling with this (there's nothing sudden about it: google "Robert Latimer") and come to a humane solution: the near-term terminally ill can choose MAID, and a small number of long-term terminally ill can also choose it.

Without MAID, you'd have the same number of deaths, they'd just be medicated into insensibility for the last few months instead of making a conscious choice about it.

There's a legitimate fear in Canada about the misuse or abuse of MAID, especially amongst the disabled community (again, google "Robert Latimer"). But we've found zero evidence since its introduction of its abuse, of its application as a cost-cutting measure, of it being forced on people.

You shouldn't take the fact that something is working as designed, as sinister.

>Your whole comment frames MAID as something the gov't does to patients, not something patients choose as a better option than spending 6-12 months in agony with only one possible outcome.

It is something the government (or people working for it) have tried to push onto patients: https://www.cbc.ca/news/politics/veterans-maid-rcmp-investig... .

Yeah, I think it's fair to be cautious about the topic and keep a close eye on the employment of the MAID process. It's definitely one of those things that warrants a lot of oversight IMO, lest the line between mercy and manslaughter be crossed by too much "suggestion" or "help". Not that I am especially well-versed on the subject - just my overall feeling on it.

"a now-suspended Veterans Affairs Canada caseworker.... which has now uncovered a total of four cases where veterans were allegedly offered MAID — all apparently by the same caseworker".

One person. Not the gov't, not many gov't employees. One person who presented the option overzealously or inappropriately, leading to four people feeling pressured, out of, IIRC, 45,000 people annually choosing MAID.

A lot of people who could be asked about whether they've been pressured or felt society could have done more for them than killing them are no longer available to collect evidence from for some reason.

One person...that we know of. The fact this one person did this, contradicts your earlier statement of "But we've found zero evidence since its introduction of its abuse, of its application as a cost-cutting measure, of it being forced on people."

Your assuming a motive in that case when none is known of.

A more generous reading of the comment might have read it as "widespread abuse"

They should have included the "widespread" disclaimer rather than making an absolute statement if they wanted that generous reading.

Well I don't think it's unreasonable to assume that people will understand that any system will be prone to abuse - what's more important is how much it realistically enables, and how it responds to that abuse

That's a great attitude when you're talking about other people (a.k.a. numbers). We'll see if you have the same attitude when it's you or someone you know.

I'm not really sure what point you're trying to make. If it were someone I knew, I would be upset, yes, and would pursue options for justice - which is, as I said, the more important aspect of such a system. Furthermore, even if my position changed if it were one of my loved ones, I wouldn't think my emotionally-charged thinking should be used to craft legislation.

If you're advocating for systems that cannot possibly be abused... good luck. Providing benefits to society often comes with avenues of potential abuse.

I'm advocating for not enabling a system that allows legalizing death. This is similar to people who are against the death penalty because it can and has been used to execute people who were later exonerated. "Move fast & break stuff because the benefits are worth the cost" is a better argument for almost any other policy than ones that explicitly result in death.

Tracing back, this one case of one case worker who suggested MAID to perhaps as many as five veterans .. did not result in death being "forced" upon any one.

The outrage over MAID being suggested as a viable option has resulted in even more scrutiny, oversight, and guard rails.

This is not the example that demonstrates abuse of the system.

> This is not the example that demonstrates abuse of the system.

I don't know how you can come to that conclusion. It's an example that demonstrates abuse, and "guard rails" (LOL) that are supposedly going to protect against future abuse.

"Legalizing death" isn't really accurate, isn't it? I mean, it's not illegal to die. And this isn't legalizing murder, as murder doesn't generally require the informed, prolonged consent of the person going to be murdered.

Death that isn't murder doesn't generally require someone else taking an action that kills you.

And while encouraging people to commit suicide may or may not be illegal depending on where you live, who it is, etc, it's generally not seen as moral.

> One person. Not the gov't, not many gov't employees.

Yes, a gov't employee working for the gov't. A.k.a. the gov't.

Given that 1 in 4 people die from cancer, I'm surprised the number is so low.

I've felt since I was young that I'd like to choose when and how I will die. I'm perfectly comfortable with the thought. I'm in my 30s and have a lovely life and family. I'm in no rush to end things. But when I'm old and the scales tip, I'd like to be the one to decide that it's time. I might not ever get there, but I want the option.

Amen. I want the option to leave gracefully and in peace, if a time comes where I cannot perform my basic needs by myself. I never chose when and how I would be brought into this world, so I think it's fair that I can choose when and how to leave.

Will I actually do it? That's irrelevant. I may decide to live and fight as much as possible, and that's fine, but I want the option.

I've been hearing young and healthy people say this for my entire, fairly long, life. But I have never personally known an elderly or disabled person to kill themselves over it. If you find life worth living despite its hardships now, it's likely that you always will even as those hardships increase.

At some point it may be more than just hardship. 80+, paralyzed from the waist down, bedridden, bed sores, muscles atrophying, all of your enjoyments gone, your friends dead, dying, or lost most of their mental facilities, and you're completely miserable.

I have known people in approximately similar situations and they still didn't want to die.

My description was of someone in my family who did. So, they took it into their own hands.

Mainstream media globally shifted from critizing governments to being their mouthpiece so absolutely no surprises here.

Do you know anyone who took the MAiD way out? Because once you know someone going through the pain, it changes one's perspective. I would never want my loved one, nor me to go through the agony of hell, if there's a more humane way of going through this experience.

> I find it overall very unnerving how quiet this is and how the Canadian press never really finds issues with this.

I suspect this claim to be dubious. I'm certain one can find 'Canadian press' that report issues with this.

However, putting that aside... I am not surprised, because most people feel that our current prevailing culture of extending life at any cost of suffering is... cruel. Most people are glad we have things like this, so their loved ones - and themselves - can go out with some amount of dignity.

As a Canadian, i would certainly write a very unpleasant letter to the editor of a Canadian newspaper publishing anything against MAiD. To me, euthanasia is unquestionably necessary. The problem of healthcare availability is completely orthogonal because MAiD is an option available but never forced as an alternative.

> The problem of healthcare availability is completely orthogonal because MAiD is an option available but never forced as an alternative.

> an option available

You're saying it's an "option," but also saying it's "orthogonal" whether the alternative option actually exists. What kind of logic is that?

My Mom escaped from some suffering by accessing MAID when the pain and suffering from her terminal cancer became too much for her to bear. She died in her own home surrounded by beloved family and friends, on her own terms.

I'm grateful that she was able to do this, and was spared a period of inhumane suffering at the end of her life.

It's hard and it makes me very sad, but I'm glad she could go this way. It would have been more difficult for her and everyone if she was forced to live through a hellish torture as cancer slowly took her life. In the end she beat cancer by taking herself out with it.

Euthanasia without good cheap universal healthcare is just a way to get rid of people in a sick society.

Canada might not be the worst but their healthcare only cover 60-70% of canadians' need. And it's slowly getting worse with the private sector eating the market.

Had to scroll too much to find this comment.

> Canada might not be the worst but their healthcare only cover 60-70% of canadians' need. And it's slowly getting worse with the private sector eating the market.

What's that figure based on?

Wikipedia has a very exhaustive page regarding Canada's healthcare system, and a large section at the end about its flaws and problems https://en.wikipedia.org/wiki/Healthcare_in_Canada

I was asking about that figure in particular. I thought it was an actual statistic.

> Euthanasia without good cheap universal healthcare is just a way to get rid of people in a sick society.

For the government, this is a feature, not a bug.

A large percentage of health care costs are from the last year of life. Instead of expensive interventions the government can have patients volunteer to end their life, the savings would be significant.

bad angle shot here:

>Assisted dying now accounts for one in 20 Canada deaths

>While the number of assisted deaths in Canada is growing, the country still falls behind the Netherlands, where euthanasia accounted for around 5% of total deaths last year.

1/20 != 5% ???

Perhaps it's something like 4.8% in Canada and something like 5.1% in the Netherlands? But yeah, that sentence doesn't make much sense.

I'm sure this is exactly the case. Assuming it is, then it's either so close it's not worth reporting on or so close it's worth reporting on accurately

The first sentence of the article gives the Canadian percentage as 4.7%.

A more enlightening statistic, but obviously harder to collect, would be what percentage of missed life-years could be attributed to MAID. I suspect it would be a much smaller percentage.

It's also worth noting that for every MAID horror story in this article, there is probably at least one horror story about a needlessly painful and drawn-out death that could have been avoided if MAID had been legal.

There are probably 100x more stories about needlessly painful and drawn-out deaths.

It’s a “one death is a tragedy, a million is a statistic” sort of thing. Rare cases of abuses of “voluntary” death are unusual and get attention. Common cases where dying people want to end their suffering and can’t are uninteresting, we all know it happens and we probably all know someone it happened to, and we just don’t think about it.

"For the first time, the report delved into race and ethnic data of those who died by euthanasia.

Around 96% of recipients identified as white people, who account for about 70% of Canada's population. It is unclear what caused this disparity."

Any good hypothesis about this?

Perhaps they tend to be richer?

Demographics in 75+ age group. It’s late here or I would have looked up in Stat Can before posting. But that’s where you should check.

Looks like 66% of people 75+ identify as European Origins

     math 1_710_255/2_595_470
    0.658938

https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=981003...

It's obscured because of how Canada formats their data, but the vast majority of "North American origins" respondents would fall under white as well. The total percentage is in the upper 80s.

Could be longer life expectancy for particular demographics that are mostly white.

Or it could just be that 70% of people of all ages today are white, but 80 years ago it was a much larger proportion (I didn't think it would be 96% but I also wouldn't be surprised if it was).

This is pure speculation, I have no data to support either of these hypotheses.

> I didn't think it would be 96% but I also wouldn't be surprised if it was

Wikipedia says 93% in 1981. https://en.wikipedia.org/wiki/Demographics_of_Canada#Visible...

My hypothesis would be that white people in Canada, and especially Quebec, are culturally very ok with MAID due to being less religious than other groups (on average). Since at least as far as I know most if not all religions condemn suicide/assisted suicide.

Culturally (though I have no data point but my own) my friends and family tend to be very comfortable with discussing death and assisted-dying. It's just not really taboo.

People of color are more religious and usually treat MAiD program as suicide over here.

Strange question but how does this affect life insurance? Typically a suicide would not be covered.

Wondering this myself, insurance in the states already tries to weasel out of every single charge if possible.

Does the ill person have a premium/annual plan?

That was implied, yes.

Then it would be worthwhile to keeping them alive for as long as the premium is being paid

...

Amazing! You've figured out insurance!

From a morbidly capitalistic point of view, insurance companies should rejoice at the prospect of a very ill person opting for assisted death. I imagine the procedure to end ones life would be much cheaper than multiple years of procedures and medicine to keep them alive.

And if this is the case (which I don't actually know for sure, I'm just speculating), then insurance companies would be incentivized to 'nudge' certain people towards this decision, which is a super duper slippery slope, and at the extreme end you'd have the Rick and Morty dead people spaghetti planet situation.

edit - this of course applies only to people that would have the procedures and medicine that would keep them alive covered.

This is true in health insurance but not true in life insurance. Life insurance policies pay out at time of death with certain exclusions. Common exclusions are death by: suicide, killed while committing crime, killed by policy holder beneficiary.

Therefore, the longer one lives, the benefit accrues to the insurance co, because the more premium policy holder pays to LifeInsuranceCo (LIC), LIC has more time to earn interest/investment profits from those premiums, and the cheaper the payout from LIC to policy holder beneficiary, because of inflation and since most payout amounts (eg $1M) are fixed at time of policy issuance.

> From a morbidly capitalistic point of view, insurance companies should rejoice at the prospect of a very ill person opting for assisted death. I imagine the procedure to end ones life would be much cheaper than multiple years of procedures and medicine to keep them alive.

This would make sense if life insurance and health insurance were covered by the same insurer, but they rarely are.

The more fundamental problem here is that insurance is a) to prevent financial hardship b) in the case of a rare event. Neither death nor serious illness are rare events for the elderly, and more often than not, health insurance fails to prevent financial hardship, so both of these fail as insurance in these situations.

Not sure how it works in Canada, but in the US I think most life insurance actually does cover suicide. There's usually just a stipulation that suicide isn't covered if it happens immediately after someone signs up

I could be wrong, but I think that term life insurance usually pays out but a whole life policy doesn't. At least that's been how my policies were.

CHLIA (the Canadian Health and Life Insurance Association) does not treat MAID as suicide. In addition, most plans cover suicide after two years of coverage regardless.

Thank you - this is helpful! It exempts it.

I would think it's like committing suicide, so no payouts. (in America)

People quote these figures, and I wonder: what would a reasonable ratio of MAID vs "natural" death be?

I understand that Catholics and others will assert zero, full stop. Fair enough. I am grateful they have argued their case so well in the UK.

But for those that approve of it in principle, how many is too many?

Well in terms of the question of whether we've 'gone too far', I don't think the total number or ratio is relevant - what is are what requirements are in place for this sort of thing. Even if 20% of deaths are through MAID, that doesn't necessarily mean that the requirements are too lax or that the system is being abused - another explanation would be that that many people simply don't want to suffer through an unpreventable death.

This number/ratio will surely only go up too, as people become more aware of it and it becomes more culturally acceptable.

Recently I listened to a 25 year old episode of Melvyn Bragg's In Our Time on the BBC (fantastic series btw, still going). Medical Ethics and back then, amongst other topics, the option of assisted death did already crop up. Unless medical treatment not only prolongs a life but also maintains, or towards the end of a long life realistically it has to improve, the quality of life, the idea of an early death will enter the mind of a lot of people.

Christiaan Barnard gets quoted with "The prime goal is to alleviate suffering, and not to prolong life. And if your treatment does not alleviate suffering, but only prolongs life, that treatment should be stopped."

The relevant part starts at 24:40 https://www.bbc.co.uk/programmes/p005465c

The program also mentions doctors limits in regards to genetic conditions which not only affect their patient but might also affect the patients relatives. I don't see that discussion ever, even though it turns out to be relevant for my ADHD.

People seem to forget that any able bodied person can end their life at any time they choose. Denying MAID is only denying this right to people who want to exercise it with dignity.

I consider it a blessing to have a choice in how I go, rather than leaving it up to nature and the medical system.

Both of my wife's parents died with cancer in their 60s before MAID. These days we're seeing the parents of others, and even our peers choosing MAID. It breaks my wife's heart every time that MAID wasn't available to her parents.

Here is the report - released 16 hours ago - that this news piece comes from: https://www.canada.ca/en/health-canada/services/publications...

Crude, maybe, but my opinion is that if someone -- healthy or not -- does not want to continue living, that's within their right. Add medical / health complications into the mix and it (again, imo) becomes inhumane to _not_ allow people to choose how it ends.

Where do I sign up?

My parent and an aunt both have dementia and there's no way I'm going to hang around not remembering who the hell my family is or where I am.

I could hang on like Jimmy Carter (who is mental sound) and go 20+ years as a shadow of my former self.

Not putting my family through that.

These deaths all replace other deaths that now won’t happen or contribute to the statistics.

Assuming a hypothetical case where the system operates without error, reaching a 100% rate is the ideal outcome. No accidental deaths and everyone leaving on their terms.

Alternatively, 1/20 die humanely at a time of their choosing while X/20, X>1, die a miserable and slow death at a time long past where continued treatment improved the standard of living. We all die eventually.

My grandmother had "Do Not Resuscitate” on her file, but it was not known (or ignored) by the medics who saved her. She was very happy to have been resuscitated, removed the order, and lived for years after that.

I submit that not everybody that commits suicide (whether medically assisted or otherwise) would make the same decision if they it to do over again.

If I could put the clock back there are lots of things I'd do differently though...

Yes, it's a well known fact that opinions can change. And yes, there's certainly a tiny subset of euthanized individuals who would regret their decision if they were still around to regret it.

When it comes to bodily autonomy, we generally strongly err on the side of respecting one's "opinion at the present time" vs. "the possibility of a different opinion in the future".

What is the intent behind your statement? Are you suggesting that we deny people bodily autonomy "just in case"?

That's sort of my hesitation with the idea

> One hundred forty attempters (35.6%) were classified as wishing they had not made the attempt and being glad to be alive, 168 (42.7%) were classified as ambivalent, and 85 (21.6%) were classified as wishing the attempt had succeeded.

https://psychiatryonline.org/doi/full/10.1176/appi.ajp.162.1...

I live in Switzerland. Last week my aunt and uncle both died in assisted suicide due to mental health problems they had for the past +10 years. They couldn't bare life anymore even though they were physically healthy.

Nice to see that most people get to pay into healthcare for their entire lives in Canada. Then at the end, when the healthcare system is needed, the only solution the inefficient system has to offer is suicide.

What is the steelman argument for why it's okay to help people kill themselves a la MAID, but not okay to execute murderers?

(Assuming the argument against capital punishment is that mistakes are often or sometimes made)

Consent.

> mistakes are often or sometimes made

I think the mistakes in question would primarily be around whether someone is of sound mind to consent.

As others in this thread have pointed out, pressure (economic, from family members, doctors, etc) is also a big concern. Probably more so than whether they're of sound mind.

> What is the steelman argument for why it's okay to help people kill themselves a la MAID, but not okay to execute murderers?

I would assume it's something that centers personal bodily autonomy above all other competing moral considerations. Under that libertarian moral framework, the murderer who does not want to be executed cannot be killed because they don't want it, while the person who want MAID can be killed just because they want it.

Under that framework, could it be argued that the murderer has implicitly consented by committing an act they should have reasonably foreseen would result in their own death?

(Not well thought out here, just trying this argument on for size)

Depends. Is it okay to sell oneself into slavery? Some radical right libertarians will answer that question positively, but even for libertarians this is a fringe position.

The other argument against capital punishment is that, aside from the satisfaction of watching someone who "deserves it" suffer, it doesn't really achieve any practical effect that detention doesn't. This makes even a single mistake morally unacceptable since it doesn't really "buy" anything.

With MAID, the practical effect is a very direct and incontrovertibly causal alleviation of suffering on a large scale, which has to be balanced against potential induced suffering due to mistakes.

Others have given you an angle related to consent.

I'll give a different take: Rehabilitation.

In some philosophies, Prison is designed to rehabilitate prisoners so they don't reoffend. Execution doesn't fit with this philosophy.

Assisted Dying is meant to be an option for those for whom there can be no rehabilitation. Eventually some day, when we've figured out the key to immortality and/or sufficiently advanced robotics, maybe we can offer a different way to rehabilitate people facing terminal illnesses and suffering. Until then, letting someone choose not to suffer out their final years and die on their own terms seems like a reasonable approach.

The main argument against capital punishment isn't even that mistakes are made. Capital punishment is more expensive and less effective as a deterrent for crime compared to life imprisonment.

The argument for MAID is more about terminally ill people being able to prevent excessive suffering. Also consent is a major difference between MAID and capital punishment

I support assisted suicide for people who are not capable of doing it without assistance (because dying moments of many people are really not pretty, as many stories in this thread attest to), but I think that the cases of medical and legal industries killing physically healthy young people due to mental issues are sick and wrong.

Physically healthy and young people do not need assistance in committing suicide if they actually want to do it. When they request it, what they are actually asking for is for “experts” and “professionals” to make the decision for them. They want the system to give them a stamp of approval, so that they don’t have to take responsibility.

Plus they get to avoid the pain, chance of partial recovery, messy cleanup for their family, and carrying out a criminal action.

Not saying it's right, but there are practical reasons why "dying" looks a lot more attractive than "killing yourself"

That's really good and humane. Canada appears to be one of the last sane countries around... if only it could fix it's housing market.

I wonder what percentage of deaths are from non-assisted suicide in countries without MAID that might be MAID if it were available.

old people ending it all is one thing, young people wanting to do the same not related to chronic illness is another.

I find it barbaric most countries don't give citizens freedom of choice over this most fundamental certainty.

What else do they give us choice over? What we put into our bodies? You can't, the government and "experts" decide in case it's a substance they don't like or which would reduce big pharma profits. Where you're allowed to roam and settle? Again, the government dictates this. Good for anyone who won the birth lottery but tough luck if you were born in North Korea or Mali. What you're allowed to speak? Most countries have laws regulating this and restricting people from saying what they really think. It's for your own good, big brother knows best.

The list goes on...

As someone who’s aunt just committed suicide by firearm yesterday, I do wish she had more dignified options.

My grandmother developed vascular dementia and spent the last half decade or so of her live non-verbal. My grandfather had Alzheimer's and eventually forgot that she had passed. They were exceedingly kind and frugal and had a strong support system, but that doesn't make it easy.

I'm unwilling to judge anyone's decision. Old age can be awful depending on your circumstances.

Before people start acting like "let's not kill old people to save money" is somehow right-coded, here's Jacobin on the matter:

https://jacobin.com/2024/12/uk-assisted-suicide-maid-canada-...

Yes, that article was sober and wise. I'm in Canada and I really hope other countries do not follow us down this path. I have fears grounded in facts based on what is continuing to unfold here in a relatively short number of years that very soon the sick, disabled, and elderly will be targeted by MAID, and I fear that after that the marginalized, (temporarily) impoverished, and even non-terminally injured may come into view. Human life is worth more than this!

Theses headlines are always sensationalist, because it sounds like these deaths are avoidable.

To be clear, all of these people were going to die within days, weeks, or at most a few months.

Death is certain. Dignity at the end is the least we can ask for.

'pain-free' and 'organized' perhaps, but don't fool yourself, it's never 'dignified'.

Makes me think of this:

https://www.imdb.com/title/tt0606035/quotes/?ref_=tt_dyk_qu

I've rarely seen a less convincing argument than a quote from a TV show.

"Dignity" means different things to different people--such as "on my own terms". Your pithy dismissal doesn't capture any of that.

Makes you think of narcissistic, cynic addict with problematic personal life?

Per my understanding, some deaths could have been avoided if not for the collapsed medical system in Canada. So if the person reaches the stage of advanced cancer because lack of care and is offered MAID first before getting cancer treatment, was it avoidable?

Just exactly which medical system has collapsed?

Things need improvement but perhaps you aren't aware there's like 12 different medical systems up here...

Doesn't matter, one country with multiple barely functioning systems. Median wait time of 30 weeks from referral to seeing a specialist [1]?

[1] https://torontosun.com/opinion/columnists/goldstein-medical-...

We're all going to die "eventually".

That's not exactly a convincing argument.

What if governments couldn’t create cute names like MAID?

I know it seems silly that a cute name would make something more likable because it shouldnt but i think probably it does, and what is the defense for having them anyway?

Downvotes but nobody can explain why we have cute palatable name for a government initiate related to killing people.

We don’t have one for execution. Wouldn’t it be absurd if somebody coined an acronym for it like WOAP?

We do have one for execution, obviously: it's "execution", not "killing".

"Killing" by itself doesn't accurately describe what MAID is, because it's not just ending someone's life, but doing so on a consensual basis after establishing that they are sound of mind and have a good reason to desire that.

But it’s also shifting the Overton window and normalizing making it banal even.

M. Scott Peck wrote a book about euthanasia long ago. I wonder if people still read Peck. “Denial of the soul,” that was the title. The foundational belief for euthanasia must be that there is no soul.

That sounds like a pretty wild leap of faith to me.

I hope the book makes a better argument than you present here for that claim, which on its face makes nothing obviously resembling sense.

You mean the belief in Christian fundamentalist version of the soul? U my view it doesn't say anything about not believing in soul, but it can be interpreted as lack of belief that somebody can control their soul.

Why can't the foundational belief be that we have a soul that has been sundered from our Creator by The Enemy during a primordial Manichean duel and keeping it separate is the highest sin and only by returning it to where it properly belongs are doing good?

It isn't like the only two options are "the Christian conception of a soul" and "the atheists rejection of the conception of a soul".

We keep ourselves separate by thinking instead of just being :(

Imagine you walk down a road and see a small forest ahead and a group of people before that forest. They all talk about what is beyond the forest. They all tell different things. But this does not mean they are all equally right or equally wrong or that one may simply choose the version one likes best. There is something specific behind the forest and if everyone tells their own incompatible versions, then everyone is wrong or everyone but one. (Or maybe some of the versions are not that incompatible.)

If you sneak away, go through the forest and come back, you will see a very nuanced picture of who is saying what. For example you found a stream. Someone may not mention a stream, but from his tale you will see that he indeed was there, but in winter and missed the stream just a bit. Or someone may loudly claim there is a stream, but you will clearly see that the person never was there and is only trying to persuade you to buy a flask.

But if you never was there all these tales will look same to you. This guy says this and that guys says that; how to decide? Logically? But is it clearly impossible to merely take all those words, somehow analyze them and get a correct answer. The clues one should look for are not in the contents of the tale.

As someone who just had to put down a beloved pet to prevent unspeakable suffering, I find that claim both stupid and insulting. If souls are real, I very much look forward to a reunion upon my own death.

Is it just me or has denial used in contexts like this a negative connotation? It sounds like there’s overwhelming evidence and people just ignore it.

Am I denying that aliens exist? I’m not a native speaker but it sounds weird to me.

It's so sad how religions are based on ending suffering but come up with so many reasons that prevent them from actually doing so.

This "foundational belief" is nonsensical. How about the belief in self-determination and responsibility for one's own actions?

I'm Dutch. Euthanasia has been legal for a few decades here. And was common practice before it got legalized. In exactly the same way as it is elsewhere. It's basically doctors putting their fingers on the scale using all sorts of euphemisms to bring relief in the final stages of death.

A little extra morphine puts people in coma. Once they are in a coma. They stop eating. You fiddle with their water access and they "pass away peacefully" hours/days later. This has been common practice for as long as there are doctors. Palliative care is a form of euthanasia that is referred to as passive euthanasia. But it's usually pretty active. If you stop giving people treatment they die. If you give people treatment that puts them in or near a coma and then you stop giving them treatment, they die. Providing food and water is a form of treatment. There's a nice grey area here. A little extra morphine puts people in a coma. And then you just unplug the drip feed with nutrients and water.

My grand mother (terminal brain cancer) was helped along a exactly like this forty years ago before active euthanasia (giving people a drug cocktail that first knocks them out and then stops their heart) became legal. My grand father was fiercely catholic so he never really knew what was happening but my mother, aunt, and uncles of course were of course aware and simply said enough is enough. I'm pretty sure my grand mother was lucid enough that she asked for this. Given this was still illegal at the time, it wasn't discussed a lot with us.

In any case, Patients and families asking for that extra bit of morphine to be administered is about as old as morphine is. And there were other ways before that. You probably know people that died this way.

I have a relative who is a GP and deals with euthanasia requests once in a while. Not her favorite thing to do, to put it mildly. It's a thing that is surrounded with a lot of protocol and has to be done by the book. Doctors can reject doing this for whatever reason, including moral/religious ones. This is not a right but a privilege. And if they go ahead, they have to get the opinion of another doctor. The whole thing is documented, double and triple checked, etc. In short, there is zero room for error/misunderstanding here and there has to be a confirmed diagnose of suffering that cannot be relieved and a confirmed wish for this. Any violations of protocol are taken extremely seriously.

My parents have many friends/relatives/etc. that have requested and received euthanasia. One fairly recent case involved a friend of theirs with early Alzheimer that just didn't want to stick around for the inevitable end. You have to still be able to decide on this for this to be legal. And Alzheimer's of course results in people not being able to think for themselves. A lot of people wait too long by which time they are no longer legally able to decide anything for themselves. Including whether they want Euthanasia. Anyway, this person was still able to decide and pretty vocal about what they wanted. There was a little farewell party and everything. And the funeral was a week later. Cases like this of course are controversial, especially with doctors. But then, undeniably we're talking about individuals who ask for this knowing full well what they are asking for.

A while ago a former prime minister and his wife were euthanized together. They were both in their nineties with all sorts of terminal medical issues. He represented a Christian conservative party when he was in office. Euthanasia is completely normal and uncontroversial at this point. Even so, this case caused a bit of debate. But everybody in the Netherlands has relatives, friends, etc. that died through euthanasia. I've never talked to anyone that still looks at this as murder, immoral, etc. My parents have both notarized letters ready to be invoked if it ever comes up. It's been decades since there was any kind of serious political debate about rolling this back. Just no chance in hell to get anything resembling even close to a majority for this.

The only people that are against this are against this for religious reasons. And, as far as I'm concerned, that's fine in so far that concerns their own life. But I just don't acknowledge their right to impose decisions about other people's lives. Especially not mine. This is a widely shared sentiment in the Netherlands. People like being in control.

I wonder how many of these deaths are due to the fear of living in destitution, because Canada's overall QOL has plummeted in the last decade.

"Nearly all of those who requested assisted dying - around 96% - had a foreseeable natural death. The remaining 4% were granted euthanasia due to having a long-term chronic illness and where a natural death was not imminent".

This is basically clickbait; the law is changing how people die of terminal conditions, but only a tiny fraction of those are deaths that really trace to the new law.

The corollary to the article is that almost all deaths in Canada result from severe or chronic medical conditions .. and now 5% of those cases are resolved via voluntary euthanasia.

They consider homelessness a chronic medical condition.

> Palliative care and end-of-life care are excellent in Australia. They help the vast majority of people to die without excessive pain and suffering.

> However, in a small number of cases palliative care cannot relieve all suffering. Palliative Care Australia estimates this to happen to around 4% of people

So 4% would be exactly the amount of people this is relevant for

You cannot trust this article. Just check out the cases where they basically tell poor people that euthanasia is always an option. It's horrible. If they don't talk about where the program goes horribly wrong, we shouldn't listen to them when they talk about the supposed positives.

I don't think you need to try very hard to convince a terminally-ill patient in constant agony to end it, poor or not.

My 93 year old grandmother has COPD and she wants to end her life but cannot. She is NOT poor.

In her state in the US, a bipartisan bill was introduced to allow for euthanasia but the religious extremists killed it.

She coughs so badly, even on oxygen with frequent albuterol treatments, that she is constantly fracturing her ribs and spine and going on regimens of narcotics to keep the pain down to bearable levels-- which cause unending constipation and generally scramble her brain.

Can't move, can't talk, can't breathe, can't sit without pain, can't even shit.

Can't die either.

Sounds horrible having to live through that.

Out of curiosity, because I assume you've discussed these questions: If she refused treatment except for opiates, would that allow her to die faster?

If she came off of oxygen and albuterol, she would be dead within a day or two or three.

It would be an agonizing death, worse than her current situation.

So instead of drinking something and peacefully going to sleep one last time she has to slowly degrade until the machinery of the healthcare system sees fit to give her a dosage of morphine large enough.

That's the shittiest part of all of this, nearly 100% of all hospice deaths are medically assisted already. Personnel just keep upping the morphine as the gurgling increases in order to make it stop because the gurgling is "pain".

Eventually the doses get so high that literally every single person on Earth who knows what morphine is knows, irrefutably, that the morphine killed the patient.

But nobody calls it that. You can't call it that. You "managed the symptoms".

The only thing MAID does is speed up the clock.

Canada has, to the best of my knowledge, a single documented instance of a single case worker who suggested MAID to perhaps as many as five veterens.

Not one was talked into euthanasia, complaints were made, oversight is strong, the case worker dismissed, further guardrails added, and even had any of the veterens chased up on the MAID suggestion there were secondary layers in place that required interviews with other medical professionals.

This HN thread already has several links to the same case (eg: https://www.cbc.ca/news/politics/christine-gauthier-assisted... and https://www.cbc.ca/news/politics/veterans-maid-rcmp-investig...) it's well publicised.

I think that's the point? The title is grabbing for attention, but the point of laws to choose assisted dying is basically always that people with terminal conditions often are in such pain that they choose a peaceful death over extending the pain.

You can read this title in an alarming way or just the same in a way that says "the law is working and people actually want this option".

God loves you.

Unbelievably sad for our neighbors up north.

Death will be the hot new pensioner duty in post-capitalism!

In an ideal world 100% of all deaths would be by euthanasia.

Instead there are accidents, which kill prematurely.

Homicides, which steal life.

And diseases, which cripple and degrade.

I've watched three of my four grandparents suffocate to death as their organs failed, blasted out of their minds on morphine, nothing more than a collection of organs with a slowly stopping metabolism. Two of them wanted to end it, but couldn't.

I suppose the only accident, homicide, and disease that cannot be defeated given enough luck, research, and effort is the eventual tiring, erosion, and destruction of one's mind so in an ideal world that would be the single cause of death, a death brought about by euthanasia once it is detected and things are put in order.

If the religious extremists who want to impose their morals on others and the private equity firms buying up all of the hospice providers are still bribing politicians to keep people from living their lives as they see fit by the time I get there, I'll be breaking the law.

I'd probably prefer to not know, and die in my sleep - surely preferred over the dread of knowing the moment, even if it would be painless/easy. Not sure, my opinion might be different if I'm old and suffering!

The moments before certain death were very relaxing for me. It was easy to identify the things that didn't matter and let go, and to make peace with my pain.

I share this optimistic take.

I'm Canadian and when I see these stats, and see that they are rising, I get the sense that there is a greater number of people able to experience a good death.

I'm old enough to have experienced a reasonable amount of death and suffering caused by aging.

A grandmother I wasn't particularly close to, but who when I asked "How are you" on the phone, would reply "I wish I was dead". Great Aunts and Uncles who experienced Alzheimers, Parkinsons, and dementia.

And a cousin who just recently chose MAID after given a terminal cancer diagnosis. I applaud her courage and bravery. My nine year old nephew was able to pass along a message to her. "Have a good death".

Far too many people don't have a good death. More people should have the option available to them.

It's possible to balance both the value and importance of MAID with the need to ensure the system is not being abused and is working well.

>I suppose the only accident, homicide, and disease that cannot be defeated given enough luck, research, and effort is the eventual tiring, erosion, and destruction of one's mind

I don't really see how you arrive at this. If someone has a disease that erodes their mind, they didn't die voluntarily, even if they choose euthanasia. In fact, you could say this about all euthanasia. Why choose to die? The HN answer is "because someone or something made me want to die".

If someone is bit by a tick and gets Lyme disease and signs up for euthanasia, then the tick has essentially killed you.

All effects that lead to voluntary euthanasia thereby become murder.

Now think one step further. Someone did something that causes another person to make someone want voluntary euthanasia. That is now also murder.

Notice something? That's a can of worms that society is not ready for yet. Since everything can lead to voluntary death, we must now make sure that society is such a good place that nobody ever wants to die. Society won't be that place, ever.

>Notice something? That's a can of worms that society is not ready for yet.

That's what people who think that others are too stupid to determine the course of their own lives think.

Anyone and everyone who thinks that I am not ready or able to determine the duration of my life can go fuck themselves.

If you're that ready to "determine the duration of your life," then you can do it yourself, without a publicly funded and legally authorized program to help you. Require anything more than you and your own devices, and you're not really as individualistic as you think you are.

> In an ideal world 100% of all deaths would be by euthanasia.

This is the start of the slippery slope.

First it's offered voluntarily. Then it's seen as "ideal" and "100% of all deaths should be euthanasia".

So healthcare workers go from just asking to "gently nudging" people towards MAID who otherwise wouldn't. "Just think of all the money we'll spend on you and you're going to die anyways".

I'm going to bet this will be a major political issue in the coming deacde.

Doctors and the medical system should not be involved in euthanasia. It should be different professionals and a different system. It's a conflict of interest for a doctor or medical system to be involved in this.

"But what if someone wants to kill themselves its against their rights for them to be restricted from doing so" We dont need to make it easier for people to kill themselves we need it to be easier to live a fulfilling life so they don't want to

Good luck helping somebody paralyzed from the neck down live a fulfilling life.

> Good luck helping somebody paralyzed from the neck down live a fulfilling life.

Honestly, you seem to suffer from a lack of imagination. There are famous examples of people profoundly paralyzed who most likely lived fulfilling lives (e.g. Stephen Hawking), and I believe there's research the people's happiness tends to return to baseline after both very good and very bad events.

Please don't trivialize peoples stuggles by offering pithy anecdotes.

> Please don't trivialize peoples stuggles by offering pithy anecdotes.

I think you're mistaken, I didn't trivialize anything.

If anything's being trivialized, it was the value of quadriplegic people, who some internet rando blithely declared as all being incapable of having a "fulfilling life."

I read his comment as an attempt to add nuance; people paralyzed from the neck down have various experiences. For example, in this study [1], only 12% of those with tetraplegy rated their quality of life as poor or very poor

[1] https://www.termedia.pl/Quality-of-life-in-patients-with-tet...

How many paralyzed with fulfilling life do you know personally?

From the article:

> Nearly all of those who requested assisted dying - around 96% - had a foreseeable natural death. The remaining 4% were granted euthanasia due to having a long-term chronic illness and where a natural death was not imminent. The average age of those seeking assisted dying was around 77 years old, with cancer being the most frequent underlying medical condition.

It’s ridiculous to jump to a conclusion that these are simply people that aren’t “fulfilled” enough.

Im not jumping to conclusions. The state wants disabled people dead instead of helping us. "Natural death" does a lot of heavy lifting for healthcare systems that kill us by a million papercuts

Yes, you are. First, you insinuated that these people died for a lack of fulfilling lives that was somehow withheld from them. Who are you to say none of them were fulfilled, or that there is some magic cure for mortality and the uncertainties of life? Now you’re doubling down by suggest this is some ulterior motive by the government to kill disabled people. If that’s not a huge jump to a conclusion then I don’t know what is.

You’ll get no argument from me that “the system”–whether it’s private or public–has put expediency over the dignified lives of its denizens. After all, I live in the US with dwindling few social nets and a for-profit healthcare system that quite purposely and openly prioritizes profitability over health and wellbeing, and uses our suffering as profit streams. But I will not make the mistake of conflating this with the idea that assisted dying is purposeful state-sanctioned murder. In fact, that detestable point of view is one that wishes to deprive me of perhaps one of the few choices I might have when the time comes, that wants to force me to endure suffering, all because some other person doesn’t feel the same way as a result of personal, religious, or whatever other reasons.

I’ll stand with you if the state wants to kill anyone that wants to live, but against you if you wish to deprive me or any independent individual their autonomy.

I think the real burden here will be had by those issuing the euthanasia as well as any family members or friends that do not understand the reasoning.

Perhaps this will just be an outlet for those sociopathic nurses/doctors though, get their kicks this way instead of poisoning patients etc?

I put an animal out of its misery once. I decided it needed to be done. Did I murder? If it would have been able to, and it asked me to, was that not a murder, then?

If twenty people ask me to put them out of their misery, and I oblige, does none of it bother me? Does having a license saying I can make it easier for me to process? Maybe this is just a market for sociopaths?

In a system of socialized medicine, is the goal of society to spend the money available to save the most people?

Taking into account that people have the greatest medical costs near the end of their life, should the system save others by limiting either the total available spend or the cost of any particular treatment according to some metric?

Should the system repeatedly and frequently remind people that are older and alone in the world without support from friends or family that euthanasia is an option?

How often reminding them would be considered coercive?

Is it coecerive if the system decides if you are over 70 years old that euthanasia is the only option you get offered when your condition is one of a long list of non trivial chronic conditions?

What if we find that in practice (as we almost certainly will if we dare to look honestly) people of certain genders, ages, ethnic groups, economic demographics, are more frequently told that killing themselves is an option they should seriously consider, compared to how often it is recommended to the general population?

Should the suicide prevention hotlines be shutdown and instead become suicide suggestion hotlines?

What about cases like chronic depression?

I'm just asking questions from a hacker perspective when people are busy considering offering euthanasia to everybody (sometimes advocating at every age) is some kind of virtuous undertaking.

People don't consider that throughout society in all walks of life and occupations some portion of people are sociopathic and pyschopathic (possibly with uneven distribution), and some plan administrators, whether that be socialized medicine, or large corporate insurance providers, will interpret their incentives to either their own benefit and/or the benefit of their organization, completely at odds with what you might consider the interests of the individual.

Isn't this overcomplicating it? Euthanasia doesn't require advertising, it seems like people yearn for it even in places where it isn't allowed. The point is that it should be a legitimate choice, not a suggestion by society. Just like your doctor doesn't tell you that it's probably time for you to become a parent, no doctor should recommend you to be gone.

Health care professionals consult with their patients to explore their needs and suggest options regularly. This is expected and normal.

The professionals making suggestions naturally have biases. That behavior gets a bit interesting when one of the options is euthanasia.

Here's a few cases:

https://www.cbc.ca/news/politics/veterans-maid-rcmp-investig...

"Last summer, Global News first reported a case where a veteran claimed to have been pressured by a veterans affairs case worker to consider medically assisted dying."

https://www.foxnews.com/politics/canada-offered-assisted-sui...

"Canada offered assisted suicide to a Paralympian veteran who wanted a wheelchair lift installed"

https://care.org.uk/news/2023/07/canadian-army-veterans-diag...

"Canadian army-veterans diagnosed with PTSD offered euthanasia"

These are all the same case. They were all huge headlines in Canada. Note it wasn't a doctor but rather a case worker.

This example showed that the system is working well enough it was caught.

Sick

Youth from Asia now accounts for nearly 19 out of 20 Canadians.

Here in Canada it begins, the glorification of death necessitated by socialized healthcare. It's horrifying the kinds of propaganda people will write for just a little bit of power isn't it?

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