Medical aid in dying, my health, and so on
blog.the-brannons.com
blog.the-brannons.com
I had someone close to me opt for it. They were greatly suffering and had no chance of their condition getting better. Having a planned final date allowed us to say farewell and thank each other for all the great moment we shared without feeling ominous. The last phone call I had with them will stay with me forever.
No reason we shouldn't allow it to ourselves.
The risk with allowing humans to do this is that it’s possible for someone not of sound mind to come to this conclusion.
It seems like lots of people think you can just go to your doctor and be prescribed a cocktail of death because you feel down today. That's not what assisted death programs are like, at all.
There's waiting periods, evaluations by independent doctors and psychiatrists, interviews, etc. to determine your capacity and understanding of the decision. Someone who is not of sound mind is not getting approval for assisted death.
Anyone sufficiently determined enough is going to find a way to die, regardless of what laws or programs are there. These programs don't change that, and they aren't meant to.
For many of us, this is a classic catch-22 as requesting such approval demonstrates the lack of a sound mind.
This is wild to me.
I watched my father, who had a life expectancy measured in months, live in unbearable pain 24 hours a day. And you believe that him wishing to end that nightmare demonstrates a lack of sound mind? The sound decision, in your opinion, is to suffer in pain, knowing that there is no treatment nor cure coming, just pain for some number of months until death's release?
I find it particularly cruel that you (seemingly?) think that he should have had to continue to suffer. And, by extension, myself and the rest of my family, should have had to continue to watch him suffer.
(Before we get too far into it, I will say upfront, there's not much in way of argument that will sway me from this opinion. I am certainly open to hearing your opinion, though.)
Go into a nursing home in the U.S. sometime and walk the halls. Tell me if you think the majority of those people are waking up with something to look forward to? Some of them are sitting in their own shit for hours because the nurses are too short staffed. I’d rather be dead than sit in my own shit for hours while being in chronic pain, and abandoned in a nursing home.
There are other reasons to choose death too of course. But i digress. I’m not in the mood to make an exhaustive list.
If you’re old and in okay-ish health, and have _something_ to look forward to (hobby, seeing grandkids, reading, etc), then it’s a different story.
/s
We are already risking someone not of sound mind owning a gun or operating heavy machinery and ludicrous speeds in public places.
Do we really think the benefit doesn't outweigh the risk in case of medically assisted death?
Assisted dying is a horrifying, but probably overall good idea; however, we need to reform our medical bureaucracies before it's something that they can ethically provide.
Surely you don’t think an 18 year old claiming to be endlessly suffering due to failing a math test sound enough to terminate his life?
It is absolutely insane the way we do this stuff.
I understand why people are concerned about medically assisted death, but this is the sort of thing that happens without it.
It's now legal here, but family, religion and tradition can be obstacles to assisted dying.
In case you don't want to leave that way, you have to prepare ahead of time. There's different legal means in different countries, e.g. advance directive covers the case where you can't decide yourself anymore.
Besides with modern technology it has become debatable what death is. You can plug someone to a machine and keep their heart going for years.
Luckily we have our neighbor countries that are way more civilized than we are.
But I reject your framing.
You already have the option to choose suicide. Go make your arrangements, and then go do it privately. Nothing is stopping you except yourself, and no one can stop you if you don't make your intentions clear to someone willing and able to do so, in which case it is really a "cry for help."
What the pro-euthanasia/"aid in dying" legalization people really demand is not a right to suicide, but a right to social approval of their suicide. This is what they call "dignity," the right to broadcast their intention to kill themselves on their own terms, while anyone else in a position to intervene is forced to helplessly watch them do it.
And to integrate this into the healthcare system, and we've seen how that story plays out in Canada and in Europe. To the point where desperate people are pushed toward suicide and physically healthy, mentally sick children are killed off with state approval.
I'm a huge proponent for assisted suicide in general, even if you're not terminally ill. Regardless, these types of laws are a step in the right direction.
Because consent matters.
Many things work this way, they're wonderful or useful or helpful when you request/consent to it, but are despicably evil when done against your will.
I’ve had my dark moments, but I learned to deal and I’m sooo glad I didn’t end it.
You know, you always hear about people who survive a suicide attempt often find out after they’ve jumped that they really didn’t want to die! It’s an irreversible choice, and something about realizing that changes people.
You don't just walk into a building and say "I would like to die please" and then get assistance on the spot.
The two people I know who chose assisted death both had to go through various evaluations (over a period of several months) to determine that they thoroughly understood the decision they were making and that they had the mental capacity to make the decision.
The comparison to a child 'consenting' to sex is completely nonsensical.
What they really need is help, not death.
I agree that those (hypothetical) people need help. Though, to be honest, I'm not really convinced this is a real issue. Some of these programs have been around for multiple decades, and I've not seen any evidence that there is a pattern of abuse. Let alone the programs being apparently "ripe for abuse".
Disallowing assisted death programs is not help, though. It is a punishment to people who deserve a death of dignity instead of months or years of unbearable suffering.
If abuse of the medical system is a concern of yours, I feel like a much more prominent cause ( millions more preventable deaths) worth fighting is over-prescription of opiates. That's just my opinion, though. (And, for all I know, you're already fighting that fight too. If so, godspeed)
It's false dignity, and false compassion. Dignity does not come from control over one's life, and it does not come from the absence of suffering. Dignity comes from being made in the image and likeness of God. If anyone reading does not agree, well, that's fine, but I feel compelled to say it that someone might read it.
How many people will we lose to despair that could have been helped? I say this both as a Catholic and someone that has suffered and recovered from mental illness.
However:
>How many people will we lose to despair that could have been helped?
Assisted death is not something reserved for mental illness, and it's dishonest to frame your comment like it is. Terminal, painful diseases are the leading reason for assisted death. In fact, many assisted death programs do not consider mental illness alone to meet the criteria of acceptance.
The whole point of these programs is that there is no other help possible. Except, maybe, enough drugs to make the person basically dead anyways. Which, in my opinion, is not "help".
God allows suffering to bring about a greater good, His plan. He endows us also with free will, which sometimes means we make choices that cause suffering for ourselves or others. Free will doesn't mean all or even most suffering in a given life is because of our choices. Sometimes it is though.
Satan's playbook is all about denying these things, denying the cross, denying redemption. Satan is the one whispering that life isn't worth it, that it would be easier to end it, come down from the cross.
For a even better discussion of these things, I always recommend Life is Worth Living which is an old program hosted by Bishop Fulton Sheen. It is as relevant today as it was when he recorded it. Many of the episodes are on YouTube.
EDIT: many seem to be taking this as an anti-painkiller stance which it is not. Reducing pain until natural death is a great kindness.
If tomorrow I invented a machine that could keep us all alive indefinitely but also required us to be immobile and in great pain, who would choose that outcome?
Nothing in my comments is dependent on assisted suicide being available or not for any purpose or another. I am arguing against it in all cases to be clear.
Yes, reading your other comment, I now understand that you truly believe that suffering is a good thing and that, if you had it your way, my father would have had to be bedridden, in extreme agony, for several more months than he had already suffered. A cruelty beyond imagination.
We will never, ever agree on this, so I wish you a good day.
If your god approves of that, I disapprove of your god.
[1] https://www.camh.ca/en/camh-news-and-stories/maid-and-mental...
You seem to be saying that as this is inconsistent. I'm curious why do you think that is? Whether someone agrees to have something done to them or not is a crucial factor in whether doing said thing is OK.
Assisted suicide, in my view, is more like an escape hatch for people who don't want to participate any longer regardless of how much "potential" they may have. Making it available for terminally ill patients is good, but it misses the mark for people who struggle with more "invisible" illnesses like ones in their own mind or lifelong ones like a physical deformity.
There's also an issue with the death penalty process seemingly requiring suffering, as evidenced by the lack of use of inert gas which appears to be painless considering accidents with poorly-ventilated spaces where people unknowingly pass out (and sadly those who go help them suffer the same fate). Even in states where the "gas chamber" is a thing, cyanide is used instead of just inert gas despite it making the post-execution cleanup process safer (so would make sense even if you did not care one bit about the suffering of the condemned).
(And I'm not in favour of the state killing criminals or terminally ill people).
The situation is completely unlike the death penalty, where it's about punishment.
People in Canada are being offered assisted suicide because the wait for a wheelchair ramp is too long: https://www.telegraph.co.uk/world-news/2023/09/02/canada-par...
There are people who are suicidal who don’t feel they deserve help and feel that assisted suicide is an option for them. We should not give them that option. Instead, we should spend that effort as a society helping them deal / get better.
Also, people who find suicidal often will find a way, legal or illegal. This is about terminally ill people, and about not making things harder for them, or getting their loved ones in legal trouble.
Yes, of course. This is a concept called "consent", and it drastically changes the context and morality of various situations.
* A person believes that choosing to die is different than having that forced upon you
* A person disapproves of assisted suicide and capital punishment?
* A person approves of assisted suicide and capital punishment?
* The process is quite different for criminals vs voluntary medical participants?
etc etc?
Seems to me you're twisting things pretty hard to find a false equivalence.
How the health professional accompanies the subject is a major aspect of medicine. So some uncaring prison personnel carrying out an execution vs a caring health professional, a terrifying process vs acceptance/calm/accompanying is wildly different, re: "the medical process".
A careful surgical procedure on a toenail is wildly different to someone torturing you by taking your toenail.
Over the last six years it has been my responsibility to oversee the end-of-life care for three people: my paternal grandfather and grandmother, and maternal grandmother.
My grandfather died at home of congestive heart failure. He spent a week on hospice in a medical bed in the living room staring at the ceiling, barely conscious due to the morphine and pain, pissing and shitting himself, as he slowly suffocated to death.
My paternal grandmother lingered for two weeks in the hospital due to an embolism after falling and breaking her hip. Again, two weeks bedridden staring at the ceiling barely conscious due to the morphine and pain, with a machine breathing for her, until diffusion/perfusion stopped enough that no mechanical or pharmaceutical intervention could oxygenate her blood enough and she died.
My maternal grandmother was the worst. Having fought off COPD for the last 20 years it finally became too much. After a year of coughing fits that led to torn muscles and spine/rib fractures leading to her being in a near-constant state of opioid-induced stupor the oxygen and albuterol stopped working and she very slowly and painfully drowned to death. She had been aware of her impending death for about two years and constantly expressed her desire to die on her own terms, but she had made the mistake of moving into an assisted living facility. So she spent the last few years of her life in a recliner hooked up to oxygen as the albuterol treatments got more and more frequent until the point that she would have to wake up every couple of hours 24 hours a day to do them, with coughing fits between them to the point that she would paralyze herself due to neck or back pain and spend six weeks on pain killers, unable to urinate or defecate or dress or eat without assistance, as it became harder and harder to breathe until she mercifully slipped into unconsciousness and died.
We already have medical aid in dying, it's called "giving a little more morphine every time the patient starts gurgling in order to 'soothe their pain'".
In a just world the patient has the choice to accelerate the process.
All men must die.
I will not die suffocating to death as I stare at a blank ceiling, blasted out of my brains on drugs, while a TV blares in the background to cover up the sobs of my family.
In my late sixties I am going to start going to the doctor complaining of back pain, stockpile enough Percocet to kill me, and when the time comes (with good fortune many many decades later) I am going to settle my accounts, write a note with some directions, have a party, and say goodbye.
That's why I'm "for" MAID.
Refusing respiratory therapy or medication is not assisted suicide. Nobody has to die in an ICU or hooked up to tubes if that is not their choice and they prepare properly. And as you note, hospice painkillers given to alleviate suffering also not assisted suicide even if it has a double effect in accelerating inevitable death.
If you want to prepare an alternate plan to blast your brain out on drugs to the point of death that's your prerogative. That doesn't mean we should create a system where we doctors are in the business of deliberately killing their patients on demand (or worse, as it leads to, pushing this "service" on their patients).
>Regardless, these types of laws are a step in the right direction.
What direction would that be?
Providing people with options on how/when they leave this world and making suicide less taboo. You could say most technically have this option already but I think it's more humane if we provide reliable methods to do so via medical professionals. Leaving it up to individuals can be messy and violent.
On the cultural side, I guess I'd like to see less sanctioning of suicide so that we don't make people's lives more complicated for merely expressing their desire to do so (e.g. getting the police called and being held for days)
All of that to say that death is sad regardless of what time you leave and I'm not advocating for people to do it. Just that we should have the option like any other healthcare service with guardrails of course.
This line reminded me of a lecture from my Psych 101 class back in college:
There are three "views" of ourselves
1. Reality
2. What we wish we were
3. Where we think we are
If 2 and 3 match but are far from 1: we are happy but "delusional"
If 1 and 3 match but we are far from 2: this is VERY often found in people who have depression.
And, ideally for long term happiness, 1 and 3 are close together and 2 is a "reasonable" distance away or close to 1 and 3.
I know that when I have Alzheimer or ALS out similar stuff I will commit suicide, quickly. I will have to prepare early to have some poison or jump into a train (something I would like to avoid to not traumatize the driver).
Why not simply helping me when this is what I want, in the name of who knows what.
One of the common features of dementia is that you don't know you have it. It is just that everyone else around you seems to start behaving weirdly while your own reality is unchanged. It is both a blessing and a curse, but it does mean you may not ever have that moment where you can make the choice.
My mother has been bedridden for a year, completely helpless, on a daily drug regimen, recognizes nobody, would absolutely not want to continue living in this state, but is no longer capable of making that choice and so will stay in this condition for potentially several more years until she finally dies. It's a horrific final chapter.
I actually wondered about a dead man switch, where poison would be released into the bloodstream if I do not acknowledge that I am fine. This would also manzge comas and lock-in. Technically it is quite complicated though.
I pity you, and this is exactly the reason I want to quickly end it so that my family does not suffer for a long time.
I don't know the exact numbers but in practice it's basically worthless because the doctors at hand end up in an ethical catch 22. This person that was sound of mind might have consented to euthanasia, but now they're not sound of mind anymore.
It looks like a botched law, same as we have in France (and I thought we were the worst - not even because we do not have the laws but because the law is completely hypocritical)
“All lives are the same length, Lazarus. They're all just one moment long. It’s the moment we’re in. The rest is memory or imagination.” — Dora, in Time Enough for Love by Robert A. HeinleinI always think of the Five Remembrances:
I am of the nature to grow old. There is no way to escape growing old. I am of the nature to have ill health. There is no way to escape having ill health. I am of the nature to die. There is no way to escape death. All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them. My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground upon which I stand.
Not that you need to hear it from me, but you will be remembered and missed.
The absurdist humor of my impending demise making the front page of hackernews and being debated by the denizens thereof is not lost on me.
https://www.canada.ca/en/health-canada/services/publications...
>>> In 2022, there were 13,241 MAID provisions reported in Canada, accounting for 4.1% of all deaths in Canada.
in 2021 there were 305k deaths in 2023 there were 326k deaths, and we learned that one sixth of MAID requestors died before they were deemed eligible or ineligible
and 70% were in pallative care
a lot of people die slowly and painfully, and a lot of people think long and hard before making that request.
"I want to die like my grandfather, peacefully in his sleep with no pain, unlike his passengers who all died screaming and in agony"
Most "natural" deaths are just various forms of suffering. You decay while still technically alive, your body stops working, your brain turns to pudding despite your physical fitness and healthy life.
Why WOULDN'T more people choose to die peacefully, if they don't have religious or moral problems with suicide?
I would expect, in an imaginary utopia, that the vast majority of non-accidental deaths would be by choice.
The alternative is laying in an expensive bed for an indeterminate time while a doctor pumps you so full of opioids that you are barely you anymore anyway. Or like my Memere, you die by choking on your own vomit, alone in your home, with everybody coming to see you for your birthday in a few days but miss you, because you die first. She probably would have preferred to schedule it.
It's not that tough to gain German residency. There's even a "Freelancer Visa" that gives you a residence permit. If you pay an immigration consultant a few thousand bucks, and don't have a criminal history, it can be done rather quickly.
I can't imagine being that indifferent to life. I would give all I could to live just one more day if I were in that position.
I am saying this completely honestly, with no sarcasm:
I truly hope that you never have to experience (or witness a loved one experience) the kinds of illnesses/injuries/diseases that would make someone consider assisted death. It is a blessing that you can't imagine the situation. Because the situations that make you consider assisted death are awful.
Certain treatments take weeks to recover from while giving you months, years, even decades of life expectancy with good quality.
Other treatments of late stage terminal cancer only give you a few more weeks in the hospital.
Still in a patient like him it will eventually lead to VFib and then death, so you implant a device that prevents that cascade. There are settings for these devices about the threshold of when and how to shock, but ultimately it's still going to err on the side of caution because any sustained VTach is dangerous.
Seems a little strange to not want to try to commit to the requirements for transplant and instead just die.
Perhaps they (arguably justifiably) fear the trauma that further interventions will bring.
When you’re ready, you’re ready, but people should have the option of continuing if they want.
But if my health made me feel like I was going to miss them (or worse: derail them), then I would be forced to admit it wasn't for the best for me to keep going as is. If I was sure that was the case, it would be easy.
Conversely, it's easy to examine "from the outside" someone else's situation and say they should keep on going. I'm not so sure I could endure what TFA describes either, especially since it's probably hopeless, and especially after watching my own father sit dying for days in a hospital after his heart attack while the doctors poked him to make him move to show my mom he was still alive. It was gruesome and he died anyway.
It's very difficult for someone who hasn't experienced this (like me and, I guess, you) to put themselves in the other person's shoes. I think I can understand the decision he's making, and it doesn't seem to me to have been taken lightly.
I have no idea how I'd react in that situation - but I can understand people who'd rather not. Especially considering that you might not want to take one of the few organs from a person who might be willing to fully commit to that.
The most “usable” form of this would be to allow the patient to agree or disagree to the shock (maybe defaulting to agree if no response is given in time); this would place the agency in the hands of the patient and allow them to be mentally prepared. Missing that, at least a couple seconds of warning would be better than nothing.
(Disclaimer: I don’t know much about these devices or the latency requirements between detection of an abnormal condition and treatment; these suggestions only work if the heart can tolerate a few seconds of delay. It seems plausible since the detection itself is based on monitoring of heart rhythms over some period of time, but I am not an expert.)
Now the unpleasant experiences become something that I'm doing to myself, and that my animal brain in the moment has the power to prevent. Every intervention becomes a test of my willpower: I know that I need this, I know I don't want to do it in the moment... What's the harm in rolling the dice this one time, in exchange for avoiding just this one painful episode? The parallel that immediately comes to mind is "well, just this one cigarette won't kill me..."
I'd much, much rather pre-commit than have to face that aversive decision time after time and day after day. Knowing that my life is on the line if I'm caught in a moment of weakness. That calculus is much too important to me to leave to the whims of my reactive brain.
You just have different values than the OP. I have values different from yours as well that would have me turn down a transplant... and it's not that I wouldn't want to live longer. There are just some measures I'm unwilling to take.
Let me be clear: I understand the difference and I agree with you. The reality is that a transplant would probably be a lot of work and suffering and I can definitely understand opting out of it. All three of the grandparents I actually got to meet ended up doing this same math and getting the same result: sometimes life-extending care isn't worth what you have to go through to get the extension of life. I guess what I'm interested in playing with here is the language we use to abstract the reality, and how it doesn't really hold up once death is accepted. Treatment is a commitment. So is dying. Treatment will go on for the rest of his life. Without treatment, dying will go on for the rest of his life. A lot of the things we do and ways we look at things assume that dying is
1) very far off 2) to be avoided at all costs
If either of these things becomes untrue the calculus we do to determine reasonable courses of action goes flying out the window. Neither of these things is true for this person, but it's true for all (for a given value of all) of us trying to talk about it and I see throughout the thread this interesting disconnect that basically boils down to people saying "You can't kill yourself! You'll die!"
Getting a heart transplant doesn't necessarily mean buying yourself 40 more years. Could be 5, 10, 15. If I recall correctly, the average is around 10-15 years.
You also have to be on immunosuppressants for the rest of your life, with all the added risks that come with that (infections, cancer, organ damage, etc.).
For example if you would get stabbed 15 seconds after hearing a beep I think you would develop pavlovian like response to the beep itself.