Do Patients Without a Terminal Illness Have the Right to Die? | Hacker News Reader

Do Patients Without a Terminal Illness Have the Right to Die?

nytimes.com

15 pointspseudolus36 comments

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This is much more nuanced than many people realize.

Assuming you want to commit suicide by a sensible cocktail of drugs: - something against the anxiety

- something that puts you into a deep sleep

- something against the muscle spasms

- something that stops your heart / breathing

From the top of my head that would be: - ketamine

- propofol / thiopental

- potassium chloride

Most of these things are not available legally, you need a doctor to help you acquire them.

To implement the protocol in a way that prevents unnecessary suffering you need someone to administer the injections, preferable a professional.

Last but not least you might not want to be alone, but be accompanied by loved ones.

All involved people might face criminal charges, in some jurisdictions even not trying to resuscitate would be a crime.

Wouldn't an inert gas cylinder and a mask be sufficient? There's a history of accidents where victims suddenly pass out in enclosed, poorly-ventilated spaces (caves, etc), and even worse, people who go help them will themselves succumb to the same thing.

Even then you’d want a medical professional to supervise the procedure to ensure its efficacy, it being free from pain and avoid crippling but non lethal attempts.

Also not every person that expresses the desire to die should necessarily act upon that momentary desire.

By enabling a supervised procedure, that mandates counseling, such cases could be recognized.

Inert gas asphyxiation is less straightforward because some ventilation should be present to allow exhalation of carbon dioxide. Significant pain results if this is not provided.

It is not terribly complicated for most people given access to the right drugs. Right to die groups in Switzerland successfully use a single large dose of a barbiturate, either injected or taken orally (in the latter case, an antiemetic is usually also given to prevent vomiting). Barbiturates are also favored, where available, for medically assisted dying in the United States.

The larger problem is access to the drugs. Barbiturates are not favored for most other purposes due to the high abuse potential. I believe is why they are not recommended for this purpose in Canada, for example.

The devil is in the (implementation) details. Canada has had some pretty serious abuses of their right to die system. Oregon's right to die somehow doesn't attract all that bad press. Maybe there's no perfect implementation for right to die, but it'd probably be better if the error fell to the side of "if in doubt, don't".

I would quintiple-check any such claims of abuse. It's usually just clickbait and outright lies.

Here's a pretty good article which is by no means exhaustive.

https://www.theatlantic.com/magazine/archive/2023/06/canada-...

One of the more surprising stories about MAID involves a Canadian veteran and paralympic, who was entitled to have a wheel chair lift installed at her home, and was instead offered the equipment to end her life because the lift was too expensive. This was something Trudeau had to address:

https://www.independent.co.uk/news/world/americas/christine-...

The OP is correct that there are verifiable claims of minor abnormalities in the Canadian MAID system. The meat of the complaints that the anti-MAID crowd latch onto is that a single caseworker for veterans was proven to have raised the possibility of MAID in 4 known cases. There have been accusations of other instances with veterans. In all of the cases of inappropriate suggestions of MAID as an option, there isn't any proof that any of them resulted in death (likely because it is not a simple process, and has numerous avenues for concerned third parties and experts to raise concerns, and requires consultation with independent doctors). A generous interpretation of the known cases shows that there have been about a dozen individuals who have had MAID suggested inappropriately.

They are leaving out the denominator, however, which indicates that there are at least 15k MAID deaths per year, and increasing rapidly (probably closer to 20k, but statistics are generally at least 24 months behind), which doesn't include the people who qualify, but ultimately choose a natural death. Current estimates are that ~4-5% of deaths in Canada are MAID.

So yes, there are "abuses", but arguably no evidence of irreparable harm.

Lately I am becoming convinced everyone deserves the right to take their ball and go home.

Maybe one day this will be considered an inalienable human right.

But pushing people to take this decision should be criminalised as murder.

> I am becoming convinced everyone deserves the right to take their ball and go home.

But if people can decide to check out and do so painlessly, the Ponzi relying on everyone toiling and paying rent/taxes might collapse, so we can't have that!

The headline asks the wrong question. Everybody has the freedom to decide what to do with their own life. You need a damn good justification to argue that anybody has the right to force someone else to suffer longer than they want to.

Self-termination is sometimes referred to as "a permanent solution to a temporary problem."

This idea resonates with many as being true at some level, however a terminal-illness can be regarded as different, i.e. not a temporary problem.

If there is not a terminal illness in the equation, would you agree that the situation tends towards the idea of "temporary problem/permanent solution"?

If there is not a terminal illness in the equation, is there any sort of condition or threshold you believe should exist to deprive a human being this "right" under any condition?

For example: should a human who does not have a terminal illness and has not yet reached majority age, have the "right" to self-terminate? Why or why not?

https://archive.ph/TYKd0

Do Patients Without a Terminal Illness Have the Right to Die?

Rights are not applicable here. How exactly would you stop them from self termination?

It means whether we have to pay for their self termination.

not really. it's whether it's legal for doctors to do it.

Ah well in that case I am indifferent. There are many painless low cost or free methods that I will not mention here. I hope those that are suffering know people that know what I know and do not get suckered into paying for some service. Medical businesses are not required. Either way a doctor would violate their oath by performing this whether it is legal or not.

> Either way a doctor would violate their oath by performing this whether it is legal or not.

Are you referring to "do no harm"? According to my own moral compass helping someone end their life with dignity is not doing harm, quite the opposite. You could even argue that leaving them suffering when you have the means, knowledge, and consent to help them is doing harm.

It's no more your business than what roads "you" pay for with your tax dollars, you may never use those roads but you are not the protagonist of reality.

Paying attention to (and caring about) the philosophical, moral and economic implications of our legal system does not require elevating oneself to the level "protagonist of reality."

I don't know if I would even call that hyperbole.

>It's no more your business than what roads "you" pay for with your tax dollars

Wow. It's your duty to just accelerate into abuse and corruption.

You can put them in a closed facility and minimize their exposure to stuff they can harm themselves with (ropes, cables, strong fabrics, drugs). It’s not like this is unheard of.

Reagan closed most asylums in the US. While your statement is technically true how does that ease their suffering and not make it even worse?

I wasn’t talking about the US. And I also didn’t say that this is a good thing, I support a right to suicide. I was just saying that this is absolutely a right that the state can theoretically prevent with at least some success.

I think this is an issue where formalities and details really matter quite a lot.

Of course, it is not possible to absolutely prevent anyone from self-terminating if they are sufficiently motivated but "self-termination" tends to have legal/criminal aspects attached to it.

Thought experiment: if it is decided that a person without a Terminal Illness indeed has a right to die "would this or would this not completely negate something like an involuntary 5150 hold based on possible self-harm?"

The more I think about it, the more this seems not just possible, but likely. I can only speak for myself but this seems like an unintended consequence.

I think this is an easy thought experiment. If a person is considered a danger to others and not just themselves then involuntary hold is warranted given that the alternative often ends in termination by cop to protect the public. If they are only a danger to themselves then there would no longer be a need for involuntary hold if the only danger is truly just to themselves and in reality it isn't really even a danger given they consented to it whereas harm to the public can not be consented to. This is one of the rare cases where it is really their body, their choice.

You can't stop someone from stealing something. But it does make sense to say that people don't have the right to steal stuff.

So the concept of rights clearly does still apply.

Also, the concept of a right is very related to law. If you have the right to die, than it can't be criminal for someone to help you die.

If you steal the court can put you in jail or fine you. If you self terminate what would the court punish you with? I am assuming the person has already liquidated their assets and given it to whomever they choose. I do not believe the law has any bearing as it has no control. I believe the most they could do is yell at the moon.

The issue GP raised is the criminalization of “helpers” - e.g. a doctor administering lethal drugs. Certainly a law against suicide is irrelevant to someone who successfully uses a shotgun, alone in a field.

Of course they do. Unless a person is clearly insane and unable to comprehend what they are doing. It is inhumane and cruel to prevent someone suffering like that from dying - the very thought of it almost makes me cry, and i'm not a very empathic person.

And yes, mental illnesses are a particularly terrible case. Being insane does not mean not having a debilitating, painful and incurable - whether or not outright terminal - physical illness. And perhaps, a really bad and certainly incurable mental condition itself is enough. Just take advanced Alzheimer's. What's the point of forcing people to suffer like that? Themselves and their caregivers, too. But i understand that one is unapproachable because of immediate Aktion T4 = Nazi = BAD association and will probably remain so for a very long time.

But for fuck's sake, at least get off the butt of mentally fit people who don't want to suffer!

> Unless a person is clearly insane and unable to comprehend what they are doing

Like the person in the article who obviously is suffering from purely psychosomatic issues.

So you want her to suffer? If so how much time should she suffer while trying to find a remedy to her illness, psychosomatic or not? 1 year? 5? 30 years of suffering every day?

In a world telling her to get over her psychosomatic issues which are 'in her head' and that she should be dismissed as incapable of deciding for herself...

No, I think she should get the psychological help she needs instead of killing herself.

>> But i understand that one is unapproachable because of immediate Aktion T4 = Nazi = BAD association and will probably remain so for a very long time.

IMHO this would not make the TOP 5 for reasons why people may consider this unapproachable.

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