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Comment by nicoburns | Hacker News Reader

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.

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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.

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