I Hope My Father Dies Soon | Hacker News Reader

I Hope My Father Dies Soon

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Since this concerns the U.S. government, I'll say that the vendetta against euthanasia and doctor-assisted suicide by the Christian right is puzzling. The Bible has a very ambivalent view on suicide (as with any other topic), the tale of Samson being a prime example. The main argument against suicide comes from Corinthians, but it is starkly contradicted by other passages.

A person who is slowly succumbing, immobile, on the brink of death and suffering has nothing to offer or worthwhile to live for. Their life is effectively over and they're simply waiting for the moment their biological functions will at last cease.

Yet the Christian right insists that the agony be prolonged to a maximum. The religion is notably fascinated with martyrdom, asceticism and persecution complexes. But that suffering has no purpose in overcoming tribulation when you're a near-lifeless bag of meat. Then, of course, very few Christians actually ascribe to the ascetic life as laid down in their scripture.

Sorry for your loss.

> The religion is notably fascinated with martyrdom

Martyrdom and suicide are nothing alike. To a Christian at least.

About the same time I read a solemn flippancy by some free thinker: he said that a suicide was only the same as a martyr. The open fallacy of this helped to clear the question. Obviously a suicide is the opposite of a martyr. A martyr is a man who cares so much for something outside him, that he forgets his own personal life. A suicide is a man who cares so little for anything outside him, that he wants to see the last of everything. One wants something to begin: the other wants everything to end. In other words, the martyr is noble, exactly because (however he renounces the world or execrates all humanity) he confesses this ultimate link with life; he sets his heart outside himself: he dies that something may live. The suicide is ignoble because he has not this link with being: he is a mere destroyer; spiritually, he destroys the universe. And then I remembered the stake and the cross-roads, and the queer fact that Christianity had shown this weird harshness to the suicide. For Christianity had shown a wild encouragement of the martyr. Historic Christianity was accused, not entirely without reason, of carrying martyrdom and asceticism to a point, desolate and pessimistic. The early Christian martyrs talked of death with a horrible happiness. They blasphemed the beautiful duties of the body: they smelt the grave afar off like a field of flowers. All this has seemed to many the very poetry of pessimism. Yet there is the stake at the crossroads to show what Christianity thought of the pessimist.

http://www.leaderu.com/cyber/books/orthodoxy/ch5.html

I never said they are.

It was to illustrate Christianity's generally positive outlook on suffering as a trial.

One of the most prominent examples can be found in Mother Teresa of Calcuta, who had some disturbing ideas about suffering. To the point of denying painkillers to terminal patients.

Has this ever been conclusively documented? I've seen accusations by some and denials by those close to her, but never any proof of the claim.

This book may be a good start http://en.wikipedia.org/wiki/The_Missionary_Position

Right. Auto-euthanasia is martyrdom to let the living (family/friends/community) start living their lives again instead of waiting for the ill to die.

This is one concern that can't reasonably be considered. A person should first and foremost be in control of their own life.

Only when that is absolutely impossible for an prolonged indeterminite time (ie. not for an hour, not when he's drunk off his/her ass for a week, not even if for some reason someone would be unconscious for a year), then we can talk about letting someone else decide.

What the family or community or friends think of the matter, they can get fucked. They're only asked to provide an answer to the question of whether that person would have chosen suicide, no-one would never ask them to make an actual decision.

Call it "Doctor-assisted martyrdom" then. I'll be a martyr for the cause of not spending hundreds of thousands of dollars on something pointless.

On really?

Christians back change in assisted suicide law, poll finds: http://www.jacquelinejencquel.com/post/christians-back-chang...

By the way, it's great that you generalize an entire group because of your preconceived biases against them. Imagine if you changed the word "Christians" to "Muslims" or "blacks". Do you realize how bigoted you sound?

I was specifically referring to the Christian right, which is a political movement in the United States.

Obviously the views I described do not apply to all Christians.

Oh, and don't conflate religion with race.

There's another wrinkle from history. Depressed medieval Christians would avoid suicide, with its attendant eternal hellfires, by murdering children.

That's right, murdering children. The innocents, they believed, would ascend to heaven. The murderer would be able to apologize for the murder and receive last rites from the Church before the State put them to death for their crime.

They would die, go to heaven, and take someone along with them. It was a win for everyone, aside from the delusional bit, where it was all actually a horrific tragedy.

http://www.thisamericanlife.org/radio-archives/episode/473/t...

The parallel today is "suicide by cop".

The bible doesn't condemn suicide(or abortion) anywhere in it directly. However, as with any good moral book, it is ambiguous. You can use it advocate any position you chose.

> Yet the Christian right insists that the agony be prolonged to a maximum.

Christianity didn't always hold this view. I suppose some of the movement comes from the commandment "Thou shall not kill". Of course that is a very poor translation. A better one would be "Thou shall not kill without justification".

The one I've heard as being somewhat more accurate is "Thou shalt not murder."

That is, pre-meditated and with intent. The current version could wind up damning you for self-defence.

I don't think murder is a better translation, but my thoughts on the bible are best expressed by Tim Minchin's "The Good Book".

http://www.youtube.com/watch?v=kr1I3mBojc0

"Thou shall not kill"

Unless you're going off to war to kill bad people. Then it's justified. And the other side justifies it with their side's supernatural beliefs.

> The bible doesn't condemn suicide(or abortion) anywhere in it directly. However, as with any good moral book, it is ambiguous.

On abortion, it's surprisingly unambiguous. Kill an unborn baby, pay a fine to the parents. That's it. It even says this immediately after saying murderers should be put to death. It's in one of the harshest parts of the bible (Leviticus, I believe), and yet abortion is only a misdemeanor.

  > Christianity didn't always hold this view.

For the American Christian right, the transition began with Nixon's desire to win the Catholic vote away from the Democrats in his 1972 campaign[1]. (Even in 1979 Billy Graham's magazine Christianity Today included the argument that "God does not regard the fetus as a soul, no matter how far gestation has progressed."[2])

  [1] http://books.google.ca/books?id=zYZQBc9426QC&pg=PA14
  [2] bit.ly/zITvj3

I sort of don't understand the thought of turning "Thou shall not kill" into "Thou shall do everything in thine power to keep the person alive"

These rules are not actually from the bible, but from the Greeks, who had much stricter rules.

1) no abortion never jamais, under no circumstances. Nor advising women on how to do it themselves.

2) no euthanasia never jamais, under no circumstances. No advising people on how to DIY it either.

3) no refusing medical aid to anyone for any reason

4) never go against patient wishes for not getting treated

5) never, ever, advise anyone on the use of poison

Some highlights from the Hippocratic oath. The first source of which is, unsurprisingly, not the Bible.

Well, read the hippocratic oath. Learn that not everything comes from the bible. The world will make more sense afterwards.

And if that doesn't clarify things, read some Greek plays about just how wrong things can go, and you'll understand why physicians would want to avoid any involvement and keep things secret. It'll make sense. It'll make make clear even to people who assume the very worst about people that people can go much, much further than they ever dreamed in their worst nightmares. It'll make clear to even the most liberal person that, yes, there are things consenting adults can choose to do that justify throwing them in jail, even execution. Not just one, but plenty.

> Thou shalt not kill

IMO, the question at hand is more like: ‘should we keep someone on life support when there is little to no chance that person will get better?’. And is taking someone off life support really the same as murder?

I believe the question is much, much bigger than simply the involvement of life support. Just address that issue, and you've ignored many people who suffer unnecessarily with no reasonable hope. For example, ALS sufferers don't require life support until the very late stages of the disease. This is long after they've lost the ability to move, speak, or interact meaningfully with those around them.

They still require to be fed and watered and moved. You could neglect to do that.

I do think we should mention that there are definitely 2 cases to consider, maybe 3. First, if that person has made his choice clear. Second if he hasn't. Second case can be split up into "family/friends/significant others want to end it" and otherwise.

I realize it's our own doing, but there is nothing 'right' (or 'left') about Christianity.

That being said... your post is completely accurate (in my experience), and speaking as a Christian, that infuriates me (likely even more than it does you...)

In a 2 party system it pretty much is right or left. As a foreigner I'd argue that its far right and right though.

> I'd argue that its far right and right

Amein, that is my view as well. I was born in the Netherlands but have lived in the US for 8 years and I still spend 3 months out of the year there. My opinion is that US voters don’t really have choices. It’s right or far right. There are some fringe parties (like various socialist and green parties) but there’s no chance they’ll gain any power. In both the democratic party and the GOP there are conservatives and progressives, but it seems to me that the conservatives always win out.

As a member of Left Turn and the League of Young Voters, I volunteer to register people to vote. I know it’s not enough, but I don’t know what else to do.

This is something that amazes me about the Dutch. I'm working not too far from the Netherlands, and nobody here seems to have mentioned that the Dutch state effectively gives elderly 2 choices :

1) they can choose pain meds overdose and/or euthanasia (active/passive)

2) they can choose to go without medical care (when above a certain age, the rule is that if, on average, a treatment does not result in at minimum a 5% increase in the length of useful life per EUR 20k spent per year, that treatment will not be given).

An example I'm intimately familiar with. Someone who required dialysis since he was 38 due to late-onset diabetes which wasn't discovered for too long (ie. partially destroyed his kidneys at a -relatively- young age). The national health insurance would stop covering his treatments at the age of 62 (note that this age is going down due to medical expenses rising above inflation). So the choice was pain meds overdose, or self-poisoning.

To say that this person voluntarily chose euthanasia is a flat-out lie. He would have chosen to prolong his life, if there were no consequences.

The deciding factor for the timing of his death was the financial needs of the state.

Note that the royal family was actually scared of the government they led when it came to a prince who has slipped into a coma. They openly chose to have him treated in the UK (he had an accident in Austria skiing), to prevent the euthanasia choice being made for them. ( http://www.rnw.nl/english/article/dutch-would-have-stopped-t... )

I am scared to think how many, percentage-wise, elderly Dutchmen actually are forced to chose between euthanasia and the cessation of most medical aid.

And, frankly, knowing that that person paid decades for health insurance that promised health care until end of life, only to have the government change the deal under him ... I find it reprehensible.

But it never seems to gather much attention. It seems Holland just wants to get rid of it's elderly.

The phrase "Christian right" identifies a subset of Christians; it does not imply anything more.

>> "The Bible has a very ambivalent view on suicide"

I thought the argument against it was simply the commandment 'thou shalt not murder'.

That's what some people say, but the bible is rather clear about abortion not being the same as murder. The punishment for killing an unborn baby is a fine paid to the parents.

The alternative to euthanasia is not suffering, but better hospice care. The sad thing is that not every hospital provides that equally.

Samson wasn't exactly a role model.

> the Christian right insists that the agony be prolonged to a maximum

I'm not aware of anyone of any ideological stripe who insists disproportionate medical measures must be taken to keep somebody alive. On the other hand, the Hippocratic oath far predates Christ.

By the way, I'm not sure you understand Christianity's relationship to the bible. It's a small minority of Christians who subscribe to anything like the scriptural literalism you evoke. A lot of them happen to be American Calvinists, but they're still a small minority.

It doesn't matter what the scriptures say when the religion praises and sanctifies people like Mother Teresa. Suffering-worship is alive and well in Catholic practices.

http://en.wikipedia.org/wiki/Criticism_of_Mother_Teresa http://www.huffingtonpost.com/2013/03/04/mother-teresa-myth_...

I think what people praise in mother Theresa is her dedication to the poor. I think most people aren't aware of many of her more controversial positions.

Also it's hard to still talk about "the religion" when you separate it from its scripture; there are about as many views on Christianity as there are people in the world.

I take it you don't remember the Terry Schiavo thing?

You're oversimplifying. There were a lot of people on both sides who had reasons other than religion.

I'm folding "crass political appeal to the religious rubes" under religion for that particular case.

EDIT: Her parents obviously had different motivations than religion. The 10,000,000 politicians and talking heads? Either religion or political exploitation related to religion.

Her husband was already in a relationship with another woman, who he wished to marry. His memory was the only source for her supposed wishes, and he was the one pushing to end her life. You don't have to be a religious fanatic to see a problem here.

So we're not talking about the religious motivations of the bazillion people who never even met the woman anymore? We're attempting to impugn the husband's motives by implying he wanted her dead so he could date someone else? How does that even work, why would he need her dead?

I don't know anyone for whom it was about religion. And yeah, the husband had motives for wanting to get rid of her - both because he wanted to remarry and because of money. Is that why he did what he did? No idea. But in this case the parents should have been allowed to make the decision.

The key phrase was "culture of life". For George W. Bush and the congressmen who passed the ridiculous legislation at the time, that was what it was all about.

If you want to claim that that's an entirely secular political viewpoint, fine, go ahead.

You've lowered the bar a bit there, don't you think? Now I have to claim it's an "entirely" secular political viewpoint?

The reality is both sides of any political question are made up of different viewpoints. Sure, there were people on my side who were coming from a religious viewpoint. But there were also a lot of people who thought the husband's position is hopelessly compromised by his own interests, and since her parents were still alive they should have been allowed to take custody of their daughter.

People on the left have this idea that religious conservatives somehow control the Republican party or set the agenda. It's a mistake to think that.

You've actually changed my mind here.

My original contention was that the only reason someone would care about a power-of-attorney dispute over someone they had never heard of and had been in a coma for 15 years was religious. You've proven me wrong and changed my mind, though -- apparently secular "go team" loyalty to party is enough on it's own, without sharing religious views or really any reason to care besides rooting for the home team.

>You've proven me wrong and changed my mind, though -- apparently secular "go team" loyalty to party is enough on it's own, without sharing religious views or really any reason to care besides rooting for the home team.

Which is something I've always suspected about the people who sided with the husband. Thanks for the confirmation.

I can't speak for everyone, but I thought that it should be decided by the county/state court who's jurisdiction it was in. I know nothing about power-of-attorney disputes, and way less about the particulars of this case than you seem to. But I know the president shouldn't be signing legislation aimed at a single power-of-attorney dispute that happens to be a national controversy for some dumb reason.

Oh, well, if you're talking about the politics side I agree with you. It was a Florida case and the federal government should never have been involved.

But they were involved, and the reasons for that were entirely political. Those congressmen and President Bush didn't give a crap about the dispute at hand, and they didn't have deep feelings about the jurisprudence. It was entirely about 'right to life'. You flip the script and they'd have been supporting the husband and slandering the parents.

You're probably making some unwarranted assumptions here. I think George Bush did a lot of things because he felt they were the right thing to do even though they hurt him politically. Everybody says that's what they want in a politician, but nobody really wants that.

Does a coma preclude divorce?

Well, she's not going to sign the papers or get custody. Or if you have power of attorney to sign the papers there might be some conflict of interest.

On obvious solution is to not get married again and just shack up. Its the more intelligent thing to do anyway.

> Her parents obviously had different motivations than religion

Actually, Schiavo's family were all extremely devout right-to-life Catholics.

As should be obvious to even the casual observer, no, there wasn't anyone on the side of keeping the brain-dead vegetable plugged in except for people with particular religious views. Unfortunately there were a lot of such people in the U.S.

Yeah, but it's their frickin daughter. I think we can give the two of them a pass for having a hard time letting go.

Most folk would choose everything medically possible to be performed to keep them going for another 24 hours. Why question medicine and ethics when you can kick a Christian instead?

Please feel free to demonstrate that the majority of opposition to voluntary euthanasia in the United States is driven by groups other than Christian ones.

1. Hippocrates 2..

You may, or may not be aware, that the very vast majority of physicians practicing in the US today have never sworn an oath, let alone the Hippocratic Oath (which amongst other things, forbids surgery)?

As an EMS provider, my anecdotal evidence in the Pacific Northwest has providers overwhelmingly in support of "Death With Dignity" legislation.

There's a difference between "going for another 24 hours, lucid and able to wrap up lose ends" and "going for another 24 hours, unconscious" and "going for another 24 hours in constant debilitating pain".

Most people would choose the first of those three. For the other ones, I'm not sure. And if you replace "24 hours" with "a few months" I certainly wouldn't choose either of the latter two options. And neither would most people I've actually talked to about the issue in person. Would you?

>>Most folk would choose everything medically possible to be performed to keep them going for another 24 hours

And by "most" you mean people who would have a _quality_ 24 hours. Because the person of subject in this article certainly wouldn't have made that choice. He couldn't; his mind was gone.

And there's the rub.. you can't be certain.

But why disallow physician assisted suicide in cases where one is certain (as in, the patient is of sound mind, but in constant pain, and makes that decision), because of cases where you can't be 100.0000000% certain?

Have you ever seen someone suffer horribly for no reason and without hope? I swore myself that if I ever have a terminal illness with a bad prognosis, I would rather kill myself before it's too late, instead of risking ending up in a situation where I can't; where I beg medical staff to kill me and they have to say "sorry, but I'm just doing my job".

Yes, dementia is tricky, and so is suicide in general. It's a deeper issue than just being for or against it. How would we weigh the risk of people dying needlessly ("easier access to suicide and getting rid of the uncared for elderly"), versus the risk of people existing (I wouldn't call it living) in extreme pain, without hope, needlessly? I don't know, but I do agree that something has to change. Medicine is supposed to make life better, usually it does; but sometimes it makes it hell, and the ones suffering in that hell should have a say in wether they want out or not.

You talk a lot about the "christian right", and I would agree with you on this particular case, but the "socialist left" is far more intrusive in our lives than the "christian right" is.

Get the government out our lives and stop pretending that we need the government to be our nanny.

> the "socialist left" is far more intrusive in our lives

You’re giving the movement way too much credit if you believe the “socialist left” has any clout in the US. I also hope you don’t think the Obama administration is socialist or leftist, as in reality it doesn’t even pass for social-democrat.

In the US, the most circulated newspaper by far is the Wall Street Journal and the most watched news channel is FOX News. Both are owned by News Corporation (the Murdoch family) and they are far from socialist.

Have you envisioned in detail what a government that "isn't our nanny" would look like? Have you visualized the consequences of a transition to such a government?

Personally, while I agree governments screw a lot of things up, I have to recognize they have many advantages. Private property for instance often needs a strong government to be properly enforced.

While the idea of "strong government" has many vague interpretations, one doesn't need a nanny state to enforce property rights.

This is a good starting point for looking at what Benelux countries do: https://en.wikipedia.org/wiki/Legality_of_euthanasia

As a citizen of the Netherlands I can tell you that the country is as neo-liberal[1] as they come, and yet, we have universal healthcare, gay marriage, euthanasia, and abortion.

(Also, racism is rampant, culture and education spending continue to be cut, the housing market has been in a slump since 2009, and taxes are on the rise – but I digress.)

[1] http://en.wikipedia.org/wiki/Neo-liberal

> the "socialist left" is far more intrusive in our lives than the "christian right"

Is it? As far as I can see, the "socialist left" in the US is utterly powerless and negligible. Even the "christian left" has more impact.

Reminds me of a good C.S. Lewis quote:

Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.

Note that this quote only apply to human tyrants. As a Christian apologist, I'm sure C.S. Lewis didn't object to the benevolent tyranny of God. (I would, but I too have my own exception: Friendly AI).

And where does your "friendly-AI" draw it's moral template from?

I mean, I'm OK with an AI that works tirelessly in the background keeping the air clean and the habitat habitable. However I don't want a computer, no matter how smart; telling me what I and consenting partners choose to do. Or deciding whether or not we must or can use birth control. Or any of a thousand other forms of infringing on human agency.

You raise good points. In fact, that is the very problem of so-called "Friendly" AI. Note the capital F. It's a confusing term, I know, but the basic idea is an AI that "does what we want", in the most general sense. The idea behind FAi is the exact idea you present here.

The point is that it is a bad idea to just throw together an AI and hope that it is friendly (lower case f), but rather the big important problem of our time is to generate a mathematical model of Friendliness, so that we can explicitly define to the AI how we don't want all the bad things you mentioned or any other besides.

[Edit] Here are some relevant links:

http://intelligence.org/files/CEV.pdf

http://commonsenseatheism.com/?p=14047

http://www.acceleratingfuture.com/michael/blog/2009/08/a-nic...

> I'm OK with an AI that works tirelessly in the background keeping the air clean and the habitat habitable

Are you sure?

http://www.youtube.com/watch?v=IM1-DQ2Wo_w

"I'd like to share a revelation that I've had during my time here. It came to me when I tried to classify your species and I realized that you're not actually mammals. Every mammal on this planet instinctively develops a natural equilibrium with the surrounding environment but you humans do not. You move to an area and you multiply and multiply until every natural resource is consumed and the only way you can survive is to spread to another area. There is another organism on this planet that follows the same pattern. Do you know what it is? A virus. Human beings are a disease, a cancer of this planet. You're a plague and we are the cure."

Love that quote & scene.

C.S. Lewis had a lot to say that is germane to this conversation.

The pain so clearly reflected in Adams' words reminded me quite clearly of A Grief Observed.

No matter what you think about assisted suicide I'd highly recommend Terry Pratchett's (of Discworld fame) documentary about it: https://www.youtube.com/watch?v=slZnfC-V1SY

He's got Alzheimer's and documented his personal tour of looking into his end of life options.

> this is the way many of my patients die. Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented, in a sterile hospital room with someone from a volunteer program who just met them sitting by their bed.

I got half way through that and had to stop reading.

I have a very close relative with moderately advanced dementia, and it's heartbreaking to see.. I wish I lived closer, because every time I see her (which is as often as I can afford to make the trip), it's worse and worse..

I don't even want to imagine her getting to that stage..

Sorry, but I am getting really tired of this form of discourse.

A million interests prevent you from doing a million things every day, but apparently it's only objectionable and worth remarking about when it's the government. And it's not even like I disagree with him -- yes we should allow assisted suicide. But boy oh boy is it hard not to notice that he wastes no time thinking about why things are this way, or which interests specifically may be preventing things from changing. Nope, it's just THE GOVERNMENT. Short circuit, do not pass go, no further critical thinking necessary.

"The Nanny State Didn't Show Up, You Hired It" http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt...

If there wasn't a law against doctor assisted suicide, he'd be able to let his father die as he chooses.

The only entity that can make and enforce laws is government. This makes government distinct from all other entities.

Therefore, the government deserves the blame.

And yet, I live under a government, one that like the US government has been democratically elected, which does allow assisted suicide.

So maybe "government" isn't the problem. The people are.

But of course it is way scarier to imagine that it's not the government that is making your father suffer, but your friends, family, neighbors and coworkers.

Because that would really be too uncomfortable.

I'm not sure what inconsistency you're trying to point out. Not all governments are equal. Perhaps it wasn't clear from my comment; the US government is to blame.

Moreover, government is not the only perpetrator of evil things. It's certainly by far the biggest (read: wars), but there are plenty of other evil people and organizations out there. Is that supposed to make me uncomfortable? I'm just calling it like I see it.

This is incredibly shallow thinking. The government in the U.S. is an elected body. Elections have consequences. This is one of them. You can blame the individual politicians and want to see them die a painful death since it might be emotionally satisfying for you, but the reason the politicians are there in the first place and the reason they pull the lever the way they do has a little to do with their own personal viewpoints and more to do with the people who put them there.

Elections vote on who to put in an office. They don't (typically) vote on which laws to pass and enforce. Only the person in office does.

More to the point, elections are a function of government. Who makes the laws that govern elections? Who enforces them? Government.

If he wants to blames someone, he'd to better to blame usually religious-based lobby groups. But that wouldn't fit into his usual narratives, so I guess the government it is.

Religious based lobby groups don't force politicians to create and enforce particular laws. Politicians do it voluntarily.

They do it for votes and contributions. They do it for hire. I guess that it is also voluntary, but only in the sense that if they don't do it, they don't paid.

[I know, politicians are salaried, too. Let's make a distinction...]

Adams equally condemned all involved. If someone tortured your father in the traditional sense, it would not get them off to say "I was doing it for hire" nor would the hands be clean of those who paid the torturer.

I see nothing inconsistent about holding all parties involved responsible.

I agree with you. The post highlights a problem, but tantrum-like blaming of "the government" is counterproductive. There are a lot of interests (some legitimate, some not) and gotcha's (it's no accident that "they killed her for the inheritance" is a staple), and inertia (people don't seem to like to rally around assisted suicide as a cause).

If he points out specifically the groups who are against doctor-assisted suicide, then he'll alienate them - members of a group will easily revert to the way their groups think if you remind them about the connection between the issue and their group.

Instead he is talking about the issue alone, and I believe all he's really trying to convince everyone that doctor-assisted suicide is an O.K. thing. He's going about it the right way. His anger is justified and he's appealing to the right emotions.

As broken as our system is (and Scott's obvious pain should make it clear that it _is_ broken), there are things you can do to make it suck just a little less.

Please talk to your family and your doctor about your wishes in terms of life-sustaining care. Even in your 20's, in perfect health, please take some time to become informed about what the options are and how you can express what you want done or not done (this may be a DNR, a MOLST, a living will, or any of a myriad of other options depending on where you live).

If the decision you come to is anything short of "do absolutely everything possible to prolong my life" then be sure to have that paperwork in a safe and readily accessible place (and let your family members know where it is).

Recently, I dated a nurse who worked on the cardiac floor of the hospital. She had patients who died every day.

One day, the subject of DNRs came up. Interestingly, she mentioned that "they're meaningless". When I asked her about it, she said that if, for example, I had a DNR but an immediately family member told them to "save me", they would disregard the DNR and do it.

The reasoning, she told me, was that regardless of what they did (save you versus letting you die) there was a chance of a lawsuit and that the hospital would rather be sued for saving your life.

(I'm sure it isn't this way everywhere.)

I'm in a similar position on a fairly regular basis, and I can tall you that DNRs absolutely do matter. It would take the threat of physical violence to get me to perform ACLS on someone with a valid DNR (this is in a prehospital EMS setting). A DNR represents the expressed wishes of the patient. Disregarding that is a serious breach of medical this.

I'm not sure how often she came across that particular dilemma. As a nurse in an ICU she would have limited decision making authority when it comes to initiating and continuing things like ACLS[1]. That's a doctor's call.

I will say that in my experience as a prehospital EMS provider, I absolutely honor the wishes of the patient (as expressed in a DNR) over the demands of the family. In fact, in my experience, the issue that arises is exactly the opposite. The family doesn't want CPR, etc, and states the patient has a DNR, but they're unable to produce it (hence my original post). In the absence of a valid DNR, I have to assume the person _does_ want all resuscitation measures attempted.

[1] http://en.wikipedia.org/wiki/Advanced_cardiac_life_support

> I'm not sure how often she came across that particular dilemma.

Not very often -- AIUI she spent most of her time "freezing" patients (inducing hypothermia).

Somehow we got on the subject of DNRs and she explained their policy/reasoning to me. Basically, if a patient w/ a DNR "coded" and a family member was yelling to save them, they would.

That's really lousy of them... A patient's wishes supersedes those of their family, when it comes to their care and end of life decisions.

That really lousy of the families... of the providers... of everyone all around, really. I would absolutely refuse to participate in resuscitation efforts in that situation.

I'm hopeful that if that situation actually came up, they would decide differently (and that this was just a hypothetical conversation)

As a pre-hospital EMS provider, how do you have time to determine the presence and validity of a DNR before making your choice?

In addition to what Josh says, in ambiguous situations, we will begin CPR or other life-saving measures whilst efforts are made to obtain/ascertain. We can always discontinue these efforts - on the other hand, delayed starts of such measures are more likely (if they result in survival at all) to end up with exactly the kinds of situations described here, brain damage, serious side effects, and the like.

It's pretty simple... is there a DNR in my hand that hasn't expired and has been signed by both the patient and a doctor and hasn't expired? If yes, then don't initiate resuscitation.

Obviously a DNR could be forged, but baring obvious cases of forgery (which I've never seen), we're not liable for honoring a DNR that we reasonably believe is valid.

What about a "verbal DNR"?

I was recently involved in a pretty bad motorcycle accident and was asked multiple times (by EMS on the scene, medical staff in the ER, medical staff right before going into the OR, etc.) if I had a DNR and/or if I would want them to attempt to save me if something happened.

I remember thinking that was kinda weird since my assumption was that such requests would need to be in writing. Perhaps it was because I was incapable of writing or signing my name, though (two broken wrists)? Instead of me signing any documents, they just asked me verbally after making sure they had two other employees present as witnesses.

That's actually _better_ than a written document as far as I'm concerned. A DNR basically says "If I'm unable to speak for myself, here's how I would like to be treated." If you _are_ able to tell me how you want to be treated, then there's no question (assuming I'm confident in your ability to make informed decisions... not drunk off your ass... etc...)

Sure, but that reasoning applies in an emergency. After the emergency, once the patient stabilizes (perhaps unconscious), the paperwork can be reviewed carefully and a final decision made.

Also, the more extreme it is, the more you need a lawyer to verify it will hold up. For example, denial of food and water is considered "extreme", if you want that in your paperwork... have a lawyer do a double check.

My father was murdered about 10 years ago and really the only solace in the situation is that he was pretty sick at the time and would have suffered through the rest of his life and he was only 47 at the time. My mom has repeatedly told me she has no desire to get to an elderly age, like her mother is now. All I know is perspective on this stuff evolves over the years.

On another note, the only good thing about people being sick is that you can prepare for their death and thus when they die it can be more of a celebration. The funeral won't be as hard emotionally, and because they were sick, you are comforted by them not suffering any more.

I'm sorry for your loss, that's terrible, but at least you can find some peace in it. :(

Maybe he just didn't mention it, but nowhere in that post does it say that it was his father's wish to die if he was in such a situation.

Helping someone die who made their wishes clear, I'm perfectly okay with. But assuming someone wants to die, I'm not.

Whether his father made it clear or not, I don't know. It just isn't in the post.

Fair enough to say in "the abstract" ... but in reality, I'm sure Scott was in excellent position to declare his father wouldn't want to continue in that state. Alzheimer's in deep manifestations is devastating.

My wife and I both have clear (and durable) health care directives that would allow our children (and our doctors) to not kill us so much as 'stop trying to save us.' In my case it has specific check points (like if I'm > 80 yrs of age, well past my "sell by" date, all artificial ventilation is strictly prohibited, and it says if I turn 80 while being kept alive by machines, turn them off on my Birthday)

A number of these have been litigated (well at least arbitrated to my personal knowledge) in Calfornia and been found to protect the doctors and hospitals from pissed of relatives who wanted them to 'do more' so I pretty confident that they will be useful for my kids should I end up in that state.

What about assuming they want to suffer?

I looked for that also and there was no mention. There's no doubt that if that was actually his father's expressed wish he would have featured that prominently in his article.

What he does state is:

> I'd like to proactively end his suffering and let him go out with some dignity. But my government says I can't make that decision. Neither can his doctors.

He also points out early in the article that there are financial considerations:

> His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering.

"He also points out early in the article that there are financial considerations:

> His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering."

Now you understand the reason for opposition to euthanasia. The purpose of government is to keep the rich, rich, and the poor, poor. Emptying his estate into the medical industrial complex is not an incidental side effect, but the sole purpose of its existence.

You want to see pet (dog/cat) vet assisted euthanasia made illegal? Implement pet health insurance. Try it and see.

Pet health insurance does exist, just isn't widespread.

re: "medical industrial complex"

Right now, some arguments against euthanasia center on the heirs bumping someone off early to keep their estate. We rarely hear the opposite view which you so cynically bring up - it's in the financial interest of many megacompanies that we continue the practice of prolonging life at all costs.

That's quite a conspiracy you have there.

Politicians aligning laws to maximize corporate profits is not exactly unheard of...

Nobody would ask because it's not possible. Making the wish is pointless as well. If his father has lost most of his mental capability (as mentioned in the article) at this point it's far too late to ask the question.

You have to ask yourself if there was a formal process with the list of outcomes and possibilities, how would you answer?

I suggest watching Terry Pratchett's thought-provoking and humbling documentary Choosing To Die (http://www.youtube.com/watch?v=slZnfC-V1SY). It covers the topic of assisted suicide and towards the end of the film we can witness a man ending his life in a Swiss clinic. It is also a very personal subject for Terry, as he was diagnosed with Alzheimer's and is afraid to live without being able to use his mind and write books.

Wow. This touches home with me on many levels. I lost my parents a few years ago. Both suffered. I lost several other close family members who also suffered. And just last week somebody I was close to told me they were dying of cancer.

And I'm a libertarian that strongly believes that government should keep its nose out of my life.

So, of course, I'm going to play devil's advocate, at least a bit. Because if you can't defend the other side's points well, you shouldn't be in the argument.

Here's the thing: physician-assisted suicide is one thing if the doc gives you the pills and you take them on your own. It's something else if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you. Then we're getting into the state telling doctors what types moral views they should hold.

Hey, I'm all for you shooting your cat if it's sick. What I'm against is the community all making some collective decision about who's got to go and when, and who has to do the work. That's fucked up. This thing has to be a personal choice among everybody involved: docs, nurses, family, the patient. I could imagine in many cases the patient wants to whack themselves and the family hates the idea. Fine. Then let the guy do it. On his own. Or perhaps the docs have given up hope, but for religious reasons they will never pull the plug. Fine, then let the patient do it. There's a decision to be made, somebody should make it, and the rest of society should butt out -- either from disapproving or forcing everybody else from doing things they don't want to do. It's just as bad to make somebody kill somebody else as it is to make somebody keep somebody else alive in this endless suffering nonsense.

The problem here is a search for some universal rules for a very personal thing. I don't see that playing out too well.

In many cases, we have elderly losing their minds while family members hope against hope that they recover. What to do then?

With the lack of a living will, I think the family members get to decide. That's why we have living wills. I don't like that result, but there it is. (I'd also add that this means the family members should be able to dose up grandma with enough morphine to put her out of her misery -- and I imagine such a thing happens a hell of a lot more than we will ever know. Institutionalizing people and placing all of this in bureaucratic hands is the crux of this problem.)

Also Scott, sorry to hear about your dad.

It is important to understand that unless you build an "extreme" living will (food and water denial), there are many circumstances where you will still be tortured indefinitely. I speak from family experience.

My father suffered many strokes towards the end. This caused neuropathic pain ... completely untreatable pain coming from inside his brain (primary somatic sensory cortex). He lost his ability to speak, move, and was basically just in continuous agony, only really maintaining the ability to suffer, with no hope for recovery.

Even with durable power of attorney, withholding food and water requires court orders and takes time (sometimes months)... why is making someone die horrifically of dehydration perfectly legal, but painlessly giving them a shot is illegal?

> I'd also add that this means the family members should be able to dose up grandma with enough morphine to put her out of her misery -- and I imagine such a thing happens a hell of a lot more than we will ever know

That is how my fathers suffering ended. Not by a family member, in the end it was by a nurse. The nurses and doctors and everyone seemed to give quiet nods of agreement after days of failed attempts to mitigate the constant grimace of agony. I don't think anything was ever said explicitly, but eventually a male nurse came in and made it clear that if we wanted it, today could be the last day. The decision ended up falling on me, and I said yes, the door was closed and the nurse pulled out multiple needles of something, to this day I am not sure what, but it was obviously they were packaged individually for dosage control and he had a handful of them. he slowly injected each into the IV without saying a word and my father slipped away. I am not sure I have ever been more grateful for anything prior or since.

Something very similar happened with my mother. She spent the night incoherently begging to die. We talked with the doctor the next day, and asked him to end it. He explained that the laws did not allow that, they they could only do something for the pain.

A bit later the nurse came in with a big syringe of Dilaudid and pushed it as fast as possible (it should be injected very slowly over time). She bent over, looked into her eyes and felt her pulse, and told us to say our goodbyes now if we were going to, and left us alone. It was as kind an act as anyone could perform for a person and/or family.

Thank you for sharing this.

If you don't mind saying, in what country did this take place?

USA. It was absolutely illegal, but it was also IMHO, the only moral thing to do.

I am not sure why someone else's morals should dictate my life. If you don't want to do all the duties of a doctor, don't be a doctor.

Back up a few hundred years, and by some it was considered immoral to cut into a person. It was immoral to dissect a corpse for study. Heck, we still have people that think it is immoral to give medicine. Shall we allow Christian Scientists to take the Hippocratic oath and then refuse to medicate based on a moral stand? No thank you. Find another job if this job offends you.

End of life is far more important to get right than the above (IMO). At least while I am sane and mobile I could realize that my doctor thinks medicine is immoral and go find alternative care. But in my last days I'm not going anywhere, I'm not making any decisions, I just get to suffer, or not.

My morals say unremitting suffering is torture. I submit my morals trump your morals when it is my life, and only my life, in question.

I think the confusion here comes from viewing it as a single issue with sides rather than multiple aspects.

It's a crude comparison, but it reminds me of a discussion on Reddit where someone was struggling over whether it was time to put his dog down or not. One poster responded by essentially asking whether the OP liked their dog, and if they did why they would kill it, and then summed up by stating that anyone who could consider euthanizing a dog never loved it in the first place.

I actually like the sentiment if it is talking about a dog that had grown inconvenient, and it was probably expressed by someone who deeply cared about a first dog, but had never had a dog grow old. Of course, there were some pretty irate responses from people who had dealt with the real situation of a dear friend no longer enjoying life and feeling constant pain. Perhaps one of the difficult parts is that even the clearest cases, it is just resigning yourself, since doubts will always remain. It isn't difficult to imagine that you can always induce one more tail wag from your suffering dog, or presumably to imagine a glint in the eye from a loved one. That OP was in search of information to help make a difficult decision, and the only context that was relevant was that particular dog's health, not someone's ideological objection seeking to make it an issues with sides.

Imagine for a second if there were a sides debate over "medication" (of all types). There would be many constituencies lining up on those fakes sides. Some would talk about abuse, and health danger of using too much medication. Some would talk about personal liberty, and that people should be able to take what they want. Then there are some who believe that suffering is intrinsically virtuous, while others believe it is unethical not to treat pain. Some might believe that it is cheating for someone who doesn't exercise to take statins, while another group would argue that as prevention they ultimately save money and increase quality of life. I'm sure the people with eugenicist tendencies would want their say, too. And quite likely all of this would occur without any consensus over the relative importance of making people productive, or lucid, or comfortable, or keeping them alive, because the importance of these goals aren't only personal, but informed to varying degrees by the differences in regional and socioeconomic cultures.

Simply put, there aren't two sides to the vaccinations-and-marijuana issue, because it isn't even one issue in the first place. Is there someone who worries that it is a slippery slope from using general anesthesia in the operating room to vaccinating children? Probably, but you'd have to accept a lot of premises before even being able to engage in such a conversation. While there may be people who are in favor of or against two independent things for a single reason, those reasons are not the reasons that most people care one way or the other about either. Conflating them would be a trick to elevate those frameworks.

Likewise, whether or not to knock off an older person who wants to live but can't pay for their nursing home, isn't the same issue as assisted suicide, which isn't the same as a 'do not resuscitate' order, which isn't the same as decisions about who does or does not get access to a life-saving operation.

Allowing special groups to decide which issues get conflated into a single debate and then turns into two sides is an abdication of the responsibility to think critically on important policy matters.

It's something else if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you.

I think you're arguing against an argument nobody made. People who advocate for the legalization of assisted-suicide just want the person who does the assistance to not be persecuted.

>if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you

I'd see it working similarly to gay marriage: no bishop or chaplain is forced to marry two people, but it leaves plenty of open-minded officials to help if they want to.

They should have pinned a medal on him, instead they threw him in jail.

Thanks for trying, Jack. https://en.wikipedia.org/wiki/Kavorkian

Any form of suffering on the helpless scale is especially painful. There's something hellish about helplessness that can't be described, you just have to experience it. Anyone who goes through months or years of helplessness without committing suicide is a warrior. The particularly insidious part of this kind of trauma is the intense PTSD that is the result of this mental torture. Reading the S.Adams blog entry, you can just see the PTSD dripping off every word. I feel for him. I feel for anyone who has gone through this because there is no justice at the end of the bullst rainbow that the Christians describe.

The Singularity is about 30 years out, or so we're led to believe. It takes about 10 years and billions of dollars to create a new drug, and that time and cost is not decreasing.

Stories like this are a grim reminder of how much work we really must do. "Fixing" the human body is a really hard problem.

Yeah, the greatly heralded technocratic revolution will just mean they can keep vegetables alive and the sickly suffering indefinitely. One day we'll have the chance to remain an inert blob of flesh floating in a pool of artificial everythings designed to leech our remaining wealth far longer than anything we can currently imagine.

There is good sense in demanding people seek counseling and help if they are depressed and leaning toward self injury. The amorality of forcing the suffering to continue existing without possibility of respite using the former as the excuse is a social problem that no amount of technology will suffice to repair.

There is no problem at all. Wanting to live forever is just your body's primitive instinct, and you should be intelligent enough to understand that people don't need you, or anyone, being around for longer than you will live already. Just look at the current old people - how they drag the whole progress, the whole society back. Now Imagine what would happen if everyone would be old - stagnation, that's what. Human brain is not evolved enough to keep being fresh for so long. After some time we slow down our learning rate because we have already learned much things. If everyone would live forever we would stay at the exact generation the "singularity" would be invented. People need to die in order for everyone to push things forward.

If clinical immortality was possible, who's to say that mental rejuvenation couldn't be possible, as well? And that people will develop new psychologies as they become immortal?

Mental rejuvenation would mean wiping out your brain and growing new one, which would mean a new person. Brain has a limit on how fast it can adapt over time by design, not because of some illness.

What does "The Singularity" have to do with this? (serious question, I've never heard of this).

http://www.wired.com/medtech/drugs/magazine/16-04/ff_kurzwei...

Fascinating. Thank you.

I'm more worried the Singularity will result in everyone dying anyways, or possibly far worse.

I don't wish to minimise his situation but it seems like he considers his father's suffering not quite as bad as his own suffering were he just to do the killing himself and take the jail sentence.

Scott wants what he believes his father wants (since his father can no longer make decisions Scott must decide in a way he believes his father would want him to decide for him) and is best for his father. To kill his own father and risk prison (not to mention the devastation it would cause to Scott's immediate family) is simply not an option.

What kind of man would want his own son to risk life in prison in order to end their own suffering?

That's a good point actually. Especially if you could do it with low risk of being caught/convicted. Which should be possible with someone who is dying anyways and you have full access to them in the hospital and could just slip some poison or something into them.

I don't blame the author for not doing that though. Maybe it didn't even occur to him. But it's a good point that if you truly thought it was so terrible you should want to try to stop it even if it's illegal.

But there is also the risk of inflicting even more suffering. Even killing (instead of, say, crippling) oneself with all the time and resources in the world to do it is not an easy task; but killing someone you love, without inflicting even more pain and without getting caught, in a hospital of all places, now that seems near impossible for a layperson.

Depends on the method of killing. And even a painful one is still probably preferable than long drawn out suffering.

I assumed the poisoning would be easy and doctors wouldn't look for it but that may not be trivial. But if you actually cared it would be worth a few hours of research at the very least.

Doctors can tell when someone has been suffocated or poisoned.

To avoid the slippery slope, couldn't there be a jury system that could decide the genuineness and applicability of a case of euthanasia? Leaving it only in the hands of a single person, be it the patient, or doctor or relative is bound to attract criticism. But if a jury can sentence one to a life-sentence in a crime case, they could arguably be trusted to deal a similar sentence for someone terminally ill.

Although I'm on the author's side, things like http://www.independent.co.uk/news/uk/home-news/alzheimers-tr... make me think twice on whether I'm right or wrong.

1. Wait until something ships before thinking it's changed anything. Medicine is littered with would-be wonder drugs which turned out to have critical shortcomings — if these were easy problems, they'd already be done by now.

2. In many cases, new treatments don't help outside of the early stages — in the story you linked, the description suggests that the treatment wouldn't help someone who's already in an advanced stage of the disease. Great for the future, perhaps, but cold comfort to when someone is already past the point of permanent damage.

Miracle cures are announced all the time. Cancer-patients in their terminal phase usually get told that a new ground-breaking drug is right around the corner.

Follow the money

Today patient has to pay lot of money to be kept alive. Also deciding about death is expensive and this burden would be on government.

In a few decades elderly people will be 40% of population. Government will probably have to pay bills for most of them. Only then will this become norm, but in really hideous way.

> Also deciding about death is expensive and this burden would be on government.

Why? The burden should be on the person.

Please HN don't disappoint me with "slippery slope" and "it's too complicated" arguments. I want to continue to believe the level of discourse here is better than that. Its not just do-able ... doctor-assisted suicide is right.

Yes, because slippery slopes doesn't exist.

Or because we should not discuss the implications of a possible slippery slope?

Note I'm not telling you what is right or wrong but I insist on the right to discuss relevant issues, in ethnic as well as in technical questions.

Slippery slopes certainly exist. However, the use of "slippery slopes" as a counterpoint is not useful. In fact, its harmful as it is posed as an end to the argument. We can certainly all agree its a complicated issue that requires a complicated solution, but our discourse should be on the solution, not simply stopping calling it slippery.

You don't want a website of thousands of diverse people to "disappoint" you by disagreeing with you on a complex issue?

Maybe he likes them to use arguments instead of the nasty insinuations commonly used by those opposed to assisted suicide for deeply ideological reasons.

Ooooooh, this really makes me angry..............

How dare you?

Those two arguments are very valid and absolutely need to be included in any serious discussion about this. Just because you so arrogantly dismiss them, does not mean that other people wont, worse still cant have those concerns.

To suggest that mentioning these two issues means one is not "better than that", what ever you mean by that but clearly it is intended to put down and dismiss any one who is concerned about them, is frankly vile. You have loaded your statements outrageously.Especially in such a fundamental question of life, where people will be at their most vulnerable. Essentially you are saying that unless people agree with you, they are some how stupid.

Worse still, the idea that some how doctors are so special that they can be wholly trusted alone with this is insane. Heh, here in the UK, one of our most frighting and notorious serial killers was a family GP. Oh, and one of the London bombers was also a doctor. Doctors are a flawed as the rest of us.

BTW, I fully support the idea that in some cases ending life humanely is the best thing to do. I would want such for me, and any one else who wants it. I too think that is right. However, with such a serious fundamental issue like this, we almost have to be guided by the serious concerns people have first. We must get people who are deeply worried by the implications to also go along with any solution. Its like drilling for oil with the consent of environmentalists. We need solution that satisfies all, or all we will have is a god almighty mess. We much not have such a mess when it comes down to legally killing people. I can accept people being divided on war, welfare, economics, which programming language is best, etc, etc, fine. But the sanctity of life is a little more important than that.

Its too fundamental to humanity. Its about how we regard life it's self. This is one debate no one gets to lay down the rules on.

(Deep breaths............ calm.............hmmmmmmmmm happy place......)

>>Those two arguments are very valid and absolutely need to be included in any serious discussion

I do indeed arrogantly dismiss them. These are not arguments, they are statements that serve only to delay the conversation from moving to a discussion of solutions.

>>To suggest that mentioning these two issues means one is not "better than that", what ever you mean by that but clearly it is intended to put down and dismiss any one who is concerned about them, is frankly vile.

I do indeed dismiss any one who is concerned about them. If you think its vile, so be it. I agree whole-heartedly with the author that vacuous "arguments" designed to filibuster are truly vile.

>> you are saying that unless people agree with you, they are some how stupid

No, I'm saying that arguments counter to the urgent need for medically assisted suicide are stupid

>> the idea that some how doctors are so special that they can be wholly trusted alone with this is insane

Agreed. The solution shouldn't rest with the doctors. (there good -- now we are talking about the solution)

>>This is one debate no one gets to lay down the rules on

Disagree - true leadership should always try to frame the debate. I think this issue is so important and so fundamental that it shouldn't be mired in the search for consensus. The need for euthanasia policy is no longer a question. The discussion should centre on how.

Fortunately, doctors can still fiddle around the edges. My 96 year old grandmother went into the hospital last Thursday. After some tests it was concluded she would have a couple more months with rehab or maybe a couple weeks without. We decided to just have her loaded up with morphine and she passed on Sunday surrounded by her children. The morphine didn't kill her, her heart was mush, but it likely knocked some time and suffering off the end. It's unfortunate that we dont all get to die so gracefully.

I dont forsee euthanasia ever being legal in the US given the absurd response to medicare requiring just basic end of life planning with a doctor.

Very important: by law in most states, you can control the conditions of your end of life care. State laws vary but if you are in California, this[0] is the form you print out, fill out, have notarized, and give copies of to your regular physician and the person(s) holding your medical power of attorney.

Every person should do this, because without this clear and legally binding statement of your wishes, medical people are compelled to do everything possible to preserve your life.

Part 1 establishes who can act for you when you can't act for yourself (i.e. in a coma). Unless you are legally married or a minor (when your spouse or parent can act), nobody can intervene to make medical choices for you. Under privacy laws, nobody can even ask about your condition. So your live-in lover or best friend is helpless to change how you are cared for -- unless they are named in a document like this one.

Part 2 expresses your wishes on how you want to be cared for at end of life. If Scott Adams's father had filled out this form and checked 2.1(b), none of that tragedy would have happened! And you can add more conditions. On my form, for example, I specified that if I was unable to read, to watch TV, or listen to audio with comprehension, and had no reasonable prospect of regaining those abilities, my life was over and I wanted to refuse all medical interventions except pain management. My idea being, to die quickly of pneumonia is nearly as good as assisted suicide.

However you fill it out, do fill it out, and encourage your loved ones to do so as well. A stroke or fall or collision can wipe out your consciousness at any age, and this form relieves your survivors of a lot of horrible choices.

[0] http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCare... (PDF)

i am wondering if i am the only person who read this, who felt the piece was a very strange way to consecrate his father's passing. "i wish i could have put him down like a cat, and if you disagree with me, i hope you die a horrible death." there is a good case for euthanasia, and there is a case against it, it just seems inappropriate to approach a dialogue with this piece as a starting point. in the end, i'm sorry he lost his father in a painful and ugly way and felt captive to a hospital. the end of life situations in my family were also pretty gnarly but involved hospice care. i'd love to know the circumstances here, and how the situation could have been improved. but you'll never win over your opponents starting from a place like this.

I lost my grandfather (father really, he raised me) and I felt the same way, I signed his DNR and if nobody was looking, I would have turned off all measures to keep him stable myself. Watching somebody you love pass is entirely heartbreaking, it's satisfying to see them cross the line into the unthinking. If I had the talent of Scott Adams, the words I would have emitted would have been similar.

look, when your opponents are the sick pieces of human shit who exploited Terri Schiavo, there is no common ground to be had. Republicans like people to die as painfully as humanly possible, and the medical industry will cooperate. My experience was my father dying from cancer. There was no question he was going to die, and the only remaining questions where how soon -- tomorrow or in a month or two -- and how painfully.

So sorry to hear about the current situation, found myself filled with a lot of emotion as I read through it. Reminds me of a talk I had with a good friend of mine where we basically acknowledged that we're not afraid to die but that we're more afraid of the dying process.

Frontline had a nice piece on this issue a couple years ago called The Suicide Tourist:

http://www.pbs.org/wgbh/pages/frontline/suicidetourist/

Breathing pure nitrogen is a quick and painless way to die.

Indeed and I wish this was closer to the top than here at the bottom.

I get the story and am sympathetic to the OP, but a little confused about this line:

And while I'm at it, I might want you to die a painful death too.

Is he just angry at everyone?

Not everyone; he goes on to say "If you're a politician who has ever voted against doctor-assisted suicide, or you would vote against it in the future ..." and another clarification about citizens who have based a vote on opposing doctor-assisted suicide. I assume the original "might" is because you may or may not fall into one of these categories.

Yes. Everyone who supports the pointless dragging out of suffering. His dad went though hellish pain then died on the day that post was made, if you think that is a good thing -- he probably has a bit of a bone to pick with you.

"Is he just angry at everyone?"

He is irrationally distraught, to the point of advocating violence.

The reason this piece works (for me) is that everybody is irrationally distraught at this time in their life. So while I get that he wants pain and suffering inflicted on those he views as responsible for his dad's suffering, I could line up a million more people who want to cling onto dear grandpa as long as the old guy has a breath. Everybody is irrational and emotional at this time. That's the nature of the phase of your life that involves burying people you love. And it's the exact reason that others behave in ways he finds abhorrent.

Voting is already an act of violence.

His father was suffering agony every day because government and its voters decided if anyone in that condition wants to end their life, that the course of action be to put anyone who showed him mercy into a cage or worse.

Everyone who has/is voting against doctor assisted suicide was my interpretation.

I'm pretty sure his point there was the people he's criticizing want to deny the right to a painless death, so it's only fitting that they be denied that right as well. Not that they die painfully now, but that when they die, that it be painful.

I if ever become so weak as a man that I would vote someone else's conscience instead of my own, then on that day, Mr. Adams, be my guest: Kill me.

Physician assisted suicide is a super slippery slope. I'm stunned when thinking people advocate.

Really? This is probably the most common anti position ... and its effectively a filibuster. I have absolutely no doubt that we can properly define the conditions for medical assisted suicide (as other nations have done). Lastly, on a more personal note -- it is clear that anyone with the "slippery slope" argument has never lost a loved one to a protracted decline into the inevitable dirt sleep.

It works very well in countries such as the Netherlands, I've seen that first hand in cancer cases. It is the most dignified thing to do for a thinking person. Do you have examples where a large percentage of the cases are obvious malpractice?

I have long planned that I will do everything in my power not to stay on life support, and recommend you do the same for the sake of your family and your sanity.

> not to stay on life support

It's not such a simple decision. I know someone who was on life support and minimally conscious and recovered from there to more or less normal health.

It would be better to specify something like: no life support provided there is also no cognitive ability for 2 months.

That gives at least a chance of recovery.

There is a difference if you had a car accident and are 20 years old or if you are having terminal cancer at 80.

It's actually regulated quite well here in te Netherlands. Strict protocols to follow by at least two "independant" doctors. Doesn't mean stuff never goes "awry" though.

is "awry" better or worse than the status quo?

Awry as in: there recently was a case in which a doctor disregarded protocols in several cases; this was undetected for quite a while. This always leads to discussions here in NL, not about euthanasia practice in general, but about the amount of control and the ethical "framework" surrounding the protocols.

Perhaps glibly tossing out a country with a strongly collectivist ethos that sees the government provide fully-funded, universal care for those with long term illness, as an example of why voluntary euthenasia would work well in a country where "Devil take the hindmost" appears to be the approach is not the best.

I'm generally a fan of voluntary euthenasia. But pretending there's no scope for abuse, especially in a country where the single biggest cause of personal bankruptcy is illness, is at best hopelessly naive.

> not to stay on life support

Ceasing or preventing disproportionate medical measures is a very different thing than decisively murdering somebody. To my understanding, living wills already allow the former.

>decisively murdering somebody

Is that what Scott Adams was proposing? I'd think you'd be hardpressed to find someone who is interested in decisive murder.

Edit: lostlogin - you're right. Those horrors exist. I'm not from the U.S. so I forget that such medieval concepts are still in practice. Again, the great irony - the right to die is not allowed but can be forced on you.

The US. Drones and the death penalty are what I have in mind. And neither of those are going away soon. Not that many countries are any better, we just don't have the money to keep up.

> I'm stunned when thinking people advocate.

So you come out swinging with a combined ad hominem and argument from incredulity. Brilliant!

Pointing it out with a logically equivalent blaming statement probably isn't going to help.

It would be better to suggest an alternate wording: "People who are capable of higher level thinking and who are directly affected by a given issue may want to carefully consider whether or not advocating for a given solution will bring an overall positive impact to the issue. I'm surprised Scott Adams is wishing harm on others while at the same time appears to be ignoring the complex issues related to the government sanctioning assisted suicide."

Clearly Adams is grieving. From experience, having a parent suffer sucks. Losing a parent is even worse. Suicide is a complex issue and I respect the fact others consider how difficult it can be to legislate it properly.

Edit: clarified the 'assisted' portion of the argument.

> Pointing it out with a logically equivalent blaming statement probably isn't going to help.

It wasn't meant to help the OP. I have no belief a logical and reasoned conversation could occur there. It was meant to help those reading it determine what methods were used. It does help those unfamiliar with structured reason and Socratic thought principles.

> It would be better to suggest an alternate wording:

I completely reject your alternate wording. Make it your own, not mine.

We're talking about the same government that hands out death-by-protracted-torture penalties in the War on Drugs. "Are you insane?" is a logical, rational counterargument to the question of whether that government should be inferring a person's death wish. It is not even a slippery slope for an American assisted suicide law to kill someone with a heroin overdose for having a hopeless life owing to them being trapped in permanent solitary confinement owing to conviction on heroin possession.

Indeed. And the mother of friend of mine had to search for her own slippery slope so she could fall out of a window to end her life to end the constant pain of the tumors in her bones.

I had the relatively good luck of having my parents die quick and clean death - but still there were traumas that needed years to heal. My father spend in vegetative state only 48 hours - and the load was unbearable. Having to live with that for months or years - I am sure that no person would like to cause that to their children and relatives.

Ending the suffering soon is good for the patient, but is even better for the ones they loved. I don't want to burden anyone when my time comes and I insist on the right of going away the way I want to and not the way fate decides.

Life is a slippery slope. We need to deal with death like grownups.

To address your fears, we should have simple, straightforward protocols for how this would work.

I would say exactly the opposite. To the extent euthanasia might be called for we need unspoken nod and furtive protocols. Explicitly legitimized murder by doctors is a horrible idea.

we need unspoken nod and furtive protocols.

That pretty much guarantees the twisted version where the kids kill off grandma for the house.

You're not really giving any reasons why you oppose it. I am for it because it would greatly reduce suffering.

Why?

I'm (at least in my own judgement) a 'thinking' person. I'm involved in the medical field (in prehospital emergency medicine). Finally (as it may be relevant), I'm a fairly socially conservative person.

I am in favor of physician assisted suicide. I'd be interested to hear your concerns about it.

> super slippery slope

In countries where it is practiced, the slope appears to have a sufficient coefficient of friction.

I disagree entirely with you. That comes from an emotional place though as I had to watch my amazing grandmother die a slow painful death of suffocation for nearly three years. She begged to die, but we could do nothing. My grandfather (who was with her for over 50 years) confided to me that he considered quite heavily granting her wish, but the threat of legal persecution meant he couldn't. At least she got to be at home for those years, and when she finally passed, it was over quickly.

Slippery slope into what—mass suicide cults? This is a completely vacuous "argument".

It is something that should be monitored and have strict conditions on the age of the patient, maladies suffered, level of consciousness, and time spent attempting to cure.

That said, it should be weighed the morality of keeping a thousand people alive to die slowly and painfully so that one person might not get put down before their time.

To expand on this. How do you decide when it is appropriate for euthanasia? Is it only for terminal patients? Patients with chronic incurable diseases? What about people with Huntington's and are otherwise healthy? Are depressed people who can't bring themselves to commit suicide afforded access to physician assisted suicide? If a demented patient had previously requested not to be killed earlier, but now in their demented state the family, who are now responsible for all medical decisions, request it. What do we do?

Base it on a system that is already working:

http://www.patientsrightscouncil.org/site/holland-background...

EDIT: oh dear, I did not read the rest of this article. It is actually vehemently opposed to Euthanasia and quite interesting (though very biased).

"The study found that, in spite of the fact that medical care is provided to everyone in Holland, palliative care (comfort care) programs, with adequate pain control techniques and knowledge, were poorly developed"

That is ridiculous. I spent hours with a friend recently receiving the most extraordinary palliative care, in his own home, before deciding to euthanize (fortunately he died the day earlier).

How do you decide when it is appropriate for the police to use lethal force?

I think you've fallen into the trap that the world should only implement perfect solutions.

> Physician assisted suicide is a super slippery slope

This has been disproven by the countries that have implemented it and not "slipped...unless you have some evidence of it being slippery?

Well, abortion is a similar example.

Where I live abortion has been allowed since I don't know when.

Doctors have been able to opt out from assisting. This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license.

So, there is your slippery slope I guess.

> This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license.

That's a terrible example of a slippery slope. It sounds like the slope is so not-slippery that the best they could do was make a lot of noise about how things should be. If the slope was slippery, shouldn't they have easily passed a bill with very little friction?

go on...

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