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Medically Assisted Suicide

John Demille ๐Ÿšซ

Old Dave posted his blog entry 'Why'

I replied with a blog entry:

https://storiesonline.net/blogentry/58025

I feel so strongly about this subject that I felt that it needs a discussion here.

While the subject can be very political, let's try to keep the discussion a moral one and not turn this thread into a political one so that lazeez doesn't shut it down.

LupusDei ๐Ÿšซ

@John Demille

Given your own answer there's zero chance in frozen hell for this not to turn political as your objections seem to be 100% political angst exclusively. There's like, nothing non-political to comment on your answer.

But for the "slippery slope" generics, maybe.

There's slippery slopes on both ends of the issue. If medics are not allowed to kill, not allowed to allow death, the medical expenses of your society will snowball into impossibility because technically we are already able to maintain nearly any corpse "alive" almost indefinitely. At some point someone will have to make the decision to turn the machines off. Or allow a crisis to go it's course unattended, killing the patient through inaction.

Assisted suicide laws are an attempt to regulate the inevitable. And best way to do so is to recognize in fact already inalienable right to choose suicide. Sure, once established and normalized we will have some people choosing it for reasons seemingly trivial to others.

The discussion then becomes a bit analogous to abortion. While no questions asked abortion should be available to everyone anytime, the price for that necessary right is that every live birth should go through a phase when that option is offered and rejected, deliberately and with clear reasoning. At times it may be daunting, I personally know of a case she had to sign entirely too many papers too many times that she's aware of risks and taking full responsibility of potentially unfavorable outcomes. But I also happen to know for a fact that even after reduced to tears in the process, she still would take up arms if necessary to defend her right to make the decision the other way should she see it as the right one.

Here we have a situation that may not be exactly mirroring, but certainly rhyme.

Anyone able bodied can if fact make the decision to kill themselves anytime, there's very little that can be done to prevent it if such decision is made. Unfortunately, exactly the persons that might be most in need for ending own life in dignified way may be least able to perform the necessary actions. Thus the offer for regulated help.

Sure, it highlights the question, the question we all have to respond everyday, "do I want to wake up tomorrow?" Mostly we do not pay attention to the ongoing affirmative as the default. Understandable, as our senses are tuned to only notice the changes. And the obscene offer, "do you want to kill yourself today?" tickle sensitivities many aren't used to expose to own consciousness all that often.

So yes, I understand the irritation.

John Demille ๐Ÿšซ

@LupusDei

If medics are not allowed to kill, not allowed to allow death, the medical expenses of your society will snowball into impossibility because technically we are already able to maintain nearly any corpse "alive" almost indefinitely. At some point someone will have to make the decision to turn the machines off. Or allow a crisis to go it's course unattended, killing the patient through inaction.

You do realize that there is a huge moral difference between what I highlighted and what you're suggesting, right?

If you can't tell the difference between my argument and yours, then you're part of the problem. You seem to be one of those that have no problem with expanding the terrible need to let somebody die and the institutionalization of killing people just because.

Do you really imagine a country of 36 million people having over 15,000 people in such painful situation of suffering and pain to require doctors to actively administer poison? MAiD is the active killing of people. Not through inaction, but through the very active administration of chemicals that kills them, and in the future in many cases fully healthy people.

Replies:   LupusDei
LupusDei ๐Ÿšซ
Updated:

@John Demille

Yes, as I said those are the opposite ends of the issue, but one can't exist without the other. The price for well regulated dignified end of life when it's necessary is to accept someone will abuse the system for frivolous suicides -- what they probably would have committed, or attempted, regardless.

I do agree that unsolicited offer to assist in suicide is, well at least somewhat obscene. Although, how much it differ from any other? You dismiss offers to buy a new car or to hire a prostitute everyday, without thinking about it. Probably, by argument you can't afford it. Just like that, I can't afford a suicide even if I wanted (I don't, currently), it would betray my commitments.

And yes, I will gladly admit to be part of the problem. If you haven't ever contemplated suicide seriously you won't understand.

Just like abortions save lives*, an optimally implemented suicide service (of with MAiD may possibly be far off; I admit I haven't done my research on them and argue a theoretical case instead) should save lives as much as take. By potentially reducing "wild" suicide attempts to asymptote zero. So, when throwing around numbers, that's the statistic that should be watched instead, with understanding that not all wild suicides are recognizable as such (part of them will be logged as accidents, exposure, or even natural causes). Because, if such an suicide offer doesn't come with free referral for psychological services by default, it's indeed a criminal implementation. It's not a decision that should be accepted lightly, and investigated for the best of ability, as there's virtually no time constraints on this decision (unlike abortion, where excessive demands of consultation are underhanded way to impose restrictions -- because of time sensitivity).

*on abortion in context: besides the analogy of medical need in extreme cases, in places where abortion restrictions are strict or total, the leading case of death for teens by far are suicide because of unwanted pregnancy, followed by complications from crude underground abortion attempts.

StarFleet Carl ๐Ÿšซ

@LupusDei

I do agree that unsolicited offer to assist in suicide is, well at least somewhat obscene.

No, it's right up there with Child of Horror's Dark Times and Irish Writer's Classy Conversions as far as being societally obscene.

There is a HUGE medical ethics difference between someone who is a DNR - Do Not Resuscitate - and hey, your life sucks, so why not kill yourself. My wife is a nurse that deals with elder care - she's made me well aware that she's a DNR, as she does not wish to be in that kind of situation. But she was appalled at the offer by Canada to help the veteran kill herself when all she wanted was assistance in getting a wheelchair lift - because that violates the very first precept of medical care.

First, do no harm!

Now, are you terminal stage 4 cancer, but still of sound mind? Yeah, you can choose to self-terminate. Are you brain dead due to an accident? Yeah, your loved ones could choose to terminate life-extending care. It's YOUR choice, though - not that of some nameless bureaucrat.

I admit I haven't done my research on them

Then how about do some research on reality instead of the theoretical best case situation you've created. There is a hell of a lot of difference between the two.

I can't afford a suicide

Yeah, you can. Go take a whole bottle of Benadryl. That's under $10. Or go find a highway bridge and jump off when you see that semi coming. Run a hose from the exhaust into the back window of a car. Lay down on a train track. The double barrel shotgun in the mouth works, too. Those are all cheap methods of killing yourself - and one's I've seen in real life. (Working with a police department for a few months will get you more experience in this department than you'll ever consider.)

Replies:   awnlee jawking
awnlee jawking ๐Ÿšซ

@StarFleet Carl

Lay down on a train track.

Covering a train track with downy feathers would make it more comfortable should you choose to lie down on one ;-)

AJ

Replies:   Pixy
Pixy ๐Ÿšซ

@awnlee jawking

Covering a train track with downy feathers would make it more comfortable should you choose to lie down on one

But make sure -if in the UK - that no errant feathers (or leaves for that matter) are on the length of tracks proceeding you in the approach, otherwise the train will just stop and not run over the top of you.....

Replies:   awnlee jawking
awnlee jawking ๐Ÿšซ

@Pixy

But make sure -if in the UK - that no errant feathers (or leaves for that matter) are on the length of tracks proceeding you in the approach, otherwise the train will just stop and not run over the top of you.....

Which is ironic because leaves mean the train skids rather than stopping so the train stops because it can't stop ;-)

AJ

Replies:   Pixy
Pixy ๐Ÿšซ

@awnlee jawking

because leaves mean the train skids rather than stopping

It also means they can't get traction to accelerate and get moving (and also losing traction and slowing down when moving), so sit there spinning and going no-where. A bit like the Houses of Parliament- saying lots and going no-where...

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@Pixy

A bit like the Houses of Parliament- saying lots and going no-where...

I thought that was the US Congress. :)

Replies:   JoeBobMack  mauidreamer
JoeBobMack ๐Ÿšซ

@Dominions Son

A bit like the Houses of Parliament- saying lots and going no-where...

I thought that was the US Congress. :)

And that's the best case scenario! It's when they decide that have to "do something" that I get worried.

mauidreamer ๐Ÿšซ

@Dominions Son

Where do you think the Founding Fathers copied the idea of two levels of houses ... and practices ... :-)

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@mauidreamer

Beyond both being bicameral, there is very little similarity between the US Congress and the British Parliament.

Replies:   awnlee jawking
awnlee jawking ๐Ÿšซ

@Dominions Son

The UK has more MPs and Lords so we're less efficient at doing nothing than the US ;-)

AJ

DBActive ๐Ÿšซ

@LupusDei

*on abortion in context: besides the analogy of medical need in extreme cases, in places where abortion restrictions are strict or total, the leading case of death for teens by far are suicide because of unwanted pregnancy, followed by complications from crude underground abortion attempts.

I strongly doubt that you have any reliable source for this claim. If you do, please post it.

Dominions Son ๐Ÿšซ

@LupusDei

*on abortion in context: besides the analogy of medical need in extreme cases, in places where abortion restrictions are strict or total, the leading case of death for teens by far are suicide because of unwanted pregnancy

Actually, in the US, the suicide rate for teen boys is significantly higher than for teen girls.

https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/teen_suicide/state/ALL

5.1/100,000 deaths for girls 15-19 vs 16.3/100,000 for boys in the same age group.

That makes it exceedingly likely that unwanted pregnancy is the leading cause of teen suicide.

awnlee jawking ๐Ÿšซ

@Dominions Son

Actually, in the US, the suicide rate for teen boys is significantly higher than for teen girls.

How many of those teen boys had unwanted pregnancies?

AJ

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@awnlee jawking

How many of those teen boys had unwanted pregnancies?

0.000000000000

Replies:   DBActive
DBActive ๐Ÿšซ

@Dominions Son

You aren't aware that current ideology says that many of these boys can and do become pregnant?

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@DBActive

You aren't aware that current ideology says that many of these boys can and do become pregnant?

I am aware that some people suffer from a delusion that such is the case.

helmut_meukel ๐Ÿšซ

@Dominions Son

That makes it exceedingly likely that unwanted pregnancy is the leading cause of teen suicide.

Maybe the angst becoming a father and suffering a shotgun marriage causes the higher male suicide rate?

A more serious explanation might be the angst not meeting the different expectations of parents and peers. The pressure may be too high and they break.

HM.

Replies:   DBActive  awnlee jawking
DBActive ๐Ÿšซ

@helmut_meukel

A more serious explanation is that the claim isn't true

awnlee jawking ๐Ÿšซ

@helmut_meukel

That makes it exceedingly likely that unwanted pregnancy is the leading cause of teen suicide.

Note that DS ignored the condition:

where abortion restrictions are strict or total

Somewhere like Northern Ireland might give more corroborative statistics, and there are probably plenty of third-world religiously zealotic, misogynistic countries with even stricter anti-abortion laws.

AJ

Replies:   Dominions Son  DBActive
Dominions Son ๐Ÿšซ

@awnlee jawking

Note that DS ignored the condition:

where abortion restrictions are strict or total

No I didn't. There are several US states that would qualify since Roe V Wade was overturned. And there has been no surge in suicides by teen girls (or at least not enough of one to bring suicides of teen girls into a more equal position with teen boys).

Somewhere like Northern Ireland might give more corroborative statistics

Not likely.

https://www.assemblyresearchmatters.org/2019/11/28/suicide-statistics-and-strategy-in-northern-ireland-update/

While Northern Ireland does show marginally more teen girl suicides than teen boys, it's not by a wide enough margin to make it possible that pregnancy is the leading cause of teen suicide(not gender qualified).

It's also worth noting that Northern Ireland has relatively few teen suicides in general and outside the 15-19 age group, suicides by men greatly outnumber suicides by women.

and there are probably plenty of third-world religiously zealotic, misogynistic countries with even stricter anti-abortion laws.

And even if you could show a high ratio of teen girl/teen boy suicides in one of those countries, you have to get around the possibility that "religiously zealotic, misogynistic" is driving teen girl suicides even absent pregnancy.

DBActive ๐Ÿšซ

@awnlee jawking

Note that DS ignored the condition:

where abortion restrictions are strict or total

And both you and Lupus Dei ignore the fact that there is nothing to support the claim.

Replies:   awnlee jawking  LupusDei
awnlee jawking ๐Ÿšซ

@DBActive

There have been newspaper reports of teen girl suicides in Northern Ireland because of the draconian anti-abortion laws, but they don't give an indication of the total number. Besides which, the situation has been somewhat alleviated by women's charities organising trips to the UK mainland for abortions.

AJ

LupusDei ๐Ÿšซ
Updated:

@DBActive

And you're ignoring that world outside your obliviousness exist.

https://www.theguardian.com/us-news/2022/dec/28/women-restricted-abortion-access-higher-suicide-risk

Read up on El Salvador if you want extreme example.

https://www.reuters.com/article/us-el-salvador-suicide-teens-idUSKCN0IW1YI20141112

There's also research on African data, perhaps the most obvious I have seen, but no, I can't link to that right away and won't be searching for you now.

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@LupusDei

And you're ignoring that world outside your obliviousness exist.

https://www.theguardian.com/us-news/2022/dec/28/women-restricted-abortion-access-higher-suicide-risk

We aren't ignoring it, but the relevance is limited. The initial statement that started this was that unwanted pregnancy was the leading cause of teen suicide(no gender qualification).

No one is suggesting that pregnancy (unwanted or not) has no affect on the suicide rate for teen girls. However, that's not particularly relevant to the original claim when most suicides are by boys/men.

Also from your first link:

"Enforcement of a Trap law was associated with a 5.81% higher annual rate of suicide than in pre-enforcement years," Wednesday's study revealed.

5.81% is not that big of an effect.

Read up on El Salvador if you want extreme example.

https://www.reuters.com/article/us-el-salvador-suicide-teens-idUSKCN0IW1YI20141112

There are issues with this source as pertains to the current discussion.

1. "El Salvador's ban on abortion is driving hundreds of girls who become pregnant after being raped to commit suicide". The article doesn't seem to make any attempt to separate the trauma of the rape itself from the pregnancy as a driver of the suicides.

2. "Three out of eight maternal deaths in El Salvador are the result of suicide among pregnant girls under 19". Okay, but the relevant comparison for this discussion is to other suicides, not other maternal deaths.

Replies:   helmut_meukel
helmut_meukel ๐Ÿšซ

@Dominions Son

"Enforcement of a Trap law was associated with a 5.81% higher annual rate of suicide than in pre-enforcement years," Wednesday's study revealed.

5.81% is not that big of an effect.

Hmm, depends on the base.
If in pre-enforcement years the rate was .97% and is now 6.78%, those 5.81% are a tremendous effect.

If however it was 10'000 suicides previously and it's now 10'581 suicides p.a. (5.81%) it's still uncomfortable high.

Two other problems with all those data:
โ€ข how gets a death categorized as suicide? In doubt who decides it was an accident or a suicide or murder?
โ€ข if suicide, why? Can't ask the dead, can you? Much place for speculation and guesswork.

HM.

Dominions Son ๐Ÿšซ
Updated:

@helmut_meukel

Hmm, depends on the base.

If in pre-enforcement years the rate was .97% and is now 6.78%, those 5.81% are a tremendous effect.

Yeah, it doesn't work that way, when they talk about a x% increase in the rate of something it's that the rate changed by x% of what the rate was. So .97% to 6.78% would be a 698% increase.

Replies:   helmut_meukel
helmut_meukel ๐Ÿšซ

@Dominions Son

Yeah, it doesn't work that way, when they talk about a x% increase in the rate of something it's that the rate changed by x% of what the rate was.

That's not the way they use it when reporting about inflation.
5% increase of inflation means if the rate was 2.4%, it's now 7.4% not 2,46%.

Sorry, I've learned you do not calculate percents of a percentage.

HM.

Replies:   Michael Loucks
Michael Loucks ๐Ÿšซ

@helmut_meukel

It's usually a problem of unclear language.

You can report a percentage change or a percentage point change. If I say something increased by 5%, I mean it went from, say, 60 to 63. If I say 5 percentage points, I mean from 60 to 65.

Sorry, I've learned you do not calculate percents of a percentage.

Calculating a percentage of a percentage is standard math. Rate of change is the first derivative. Rate of change change (i.e. calculating a percent of a percent) is the second derivative. Both are perfectly valid. The problem lies when they are confused.

Dominions Son ๐Ÿšซ

@helmut_meukel

if suicide, why? Can't ask the dead, can you?

No, but sometimes they leave a note explaining why before committing suicide.

awnlee jawking ๐Ÿšซ

@LupusDei

If medics are not allowed to kill, not allowed to allow death, the medical expenses of your society will snowball into impossibility because technically we are already able to maintain nearly any corpse "alive" almost indefinitely.

But medics routinely murder people, at least in the UK. There's the abhorrent Liverpool Care Pathway and its many rebrandings, where hospital doctors deprive patients, some capable of recovery, of water and nutrition to free-up hospital beds.

And there's also manslaughter, where the kindly family doctor administers an overdose of morphine. Harold Shipman was regarded as an angel by many of his patients for the way he
cared for the elderly.

We seem to have reached the surreal situation where medics, whether malevolent or not, have more rights over our lives and bodies than we ourselves have.

AJ

Replies:   LupusDei
LupusDei ๐Ÿšซ

@awnlee jawking

Exactly. And that is why this sphere should urgently be regulated. Ideally, by expanding personal agency, and recognizing the right of suicide is just that.

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@LupusDei

and recognizing the right of suicide is just that

Medically assisted suicide under government controlled health care is not just that.

Dominions Son ๐Ÿšซ

@LupusDei

If medics are not allowed to kill, not allowed to allow death

Sorry, there are significant legal, ethical, and moral differences between allowing death to progress naturally and actively causing death.

Replies:   LupusDei
LupusDei ๐Ÿšซ

@Dominions Son

The argument goes as follows: we are approaching a state where, given asymptotically infinite resources no deaths are "natural." Therefore there a clear need to make the terminal decision is identified. The question then is, whom you are comfortable with delegating that decision with?

As soon you recognize personal rights to make that decision, someone will use that right in ways or cases you don't approve.

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@LupusDei

we are approaching a state where, given asymptotically infinite resources no deaths are "natural."

Again, there are significant legal, ethical, and moral differences between not intervening to prevent death and actively causing death.

I do not consider your argument relevant to medically assisted suicide.

The question then is, whom you are comfortable with delegating that decision with?

The patient and/or the patient's family. Medical/government personnel should have zero input. Maybe raise the issue, but they should remain absolutely neutral on which way to decide.

Replies:   awnlee jawking
awnlee jawking ๐Ÿšซ

@Dominions Son

The patient and/or the patient's family.

"Let's off the old bastard and get our inheritance before he spends it all"?

Perhaps if the patient has nominated a family member to make the decision if the patient is incapacitated, but not otherwise.

There seems to be a trend towards recognition of Living Wills, in which the patient themselves makes the decision to cover the circumstances of future incapacitation.

AJ

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@awnlee jawking

Perhaps if the patient has nominated a family member to make the decision if the patient is incapacitated, but not otherwise.

Agreed, the decision only goes to the family if the patient is incapable of making the decision themselves.

Grey Wolf ๐Ÿšซ

@John Demille

Trying very hard to keep this from politics (hopefully succeeding), I'll say first that I strongly disagree with 'slippery slope' arguments in general. They're incredibly easy to abuse. That doesn't mean they're wrong, it means that they're often misapplied.

Sometimes they're right, in essence. For instance, Martin Niemรถller's 'First They Came For Me ...' is a slippery slope argument, and very powerful when you look at it as Niemรถller intended. But not every time 'they come for someone' is bad, and the idea that it's bad is dangerous, because (for instance, and verging on politics) a paramilitary antigovernment group can say 'First they came for us...' and try to elicit sympathy that way.

I'm trying to get at my knee-jerk reaction to the counterargument. The idea that something can become dangerous if taken too far is a reason to be cautious and careful and implement safeguards, not to say 'no, never'.

For myself, I believe that a person should have the absolute right (assuming competence, lack of coercion, etc) to terminate their life if and when they so desire. That doesn't mean people don't make terrible decisions there. I've been touched by some myself. It's horrible; I know several people who would have been just fine had they made it through one bad day (and I've also talked two people through their bad day and they've been fine).

But that's not relevant to advanced illness that's both debilitating and torturous. Someone who's dying and suffering is making a choice, and they should be able to make that choice, and they should be able to make that choice even if they are physically incapable of carrying it out.

The phrase 'First do no harm' is, to me, not a barrier. Forcing someone to undergo intense suffering that they wish to avoid is unquestionably harm. Failing to help them end that suffering until they die, when they wish to end it, is doing them more harm than ending it when they want it to end.

Coercion, manipulation, miracle cures, people who defy the odds, and so forth absolutely complicate things, and we need as much in the way of precaution as reasonably possible. There will absolutely be mistakes, too, but there are always mistakes. We can't engineer away mistakes, we can just minimize them.

I agree with many other responses in parts. Living Wills are part of the solution, just as DNRs are. Patients who are capable of making the decision themselves and competent should always (and only) be the decisionmaker. There are obvious concerns around coercion, manipulation, etc, but again, we cannot and should not put guardrails around anything. We don't forbid the elderly to make contracts (while competent) either, even though they are statistically far more likely to be manipulated and make bad ones; instead, we punish and deter abusers as much as possible (absolutely imperfectly, though).

Interesting topic, and I hope that's a non-political answer.

John Demille ๐Ÿšซ

@Grey Wolf

I guess nobody read my blog entry and followed the links.

I demonstrated the slippery slope. The slippery slope has been the expansion of pain and suffering and the reasons for this MAD service, I mean this MAiD service.

As of March 2023, this pain and suffering will include depression. We don't need to counsel you, let's just kill you.

And nobody commented on how veteran's affair offered MAiD services in response to a request for a chair lift. Does that sound like 'ease pain and suffering'? Or does it sound like the government would rather kill you than give you a chair lift.

We are down the slippery slope far enough that the government is using it to avoid expenses.

I never argued that nobody should be allowed to die. It still as easy as one taking a bottle of Tylenol and going to sleep. Even at Canada's exhorbitant prices is still a $10 affair. We don't need to make it a service that killed over 10,000 in 2021 alone.

When death becomes a service, those working in that service have a huge interest in expanding that service as much as possible to make money as much as possible. When there are 'clinics' (in other words human butcher shops) whose sole raison d'รชtre is killing people (yes who choose to die) then those clinics' best interest is lobbying the government for more business opportunities hence expanding the definition of 'pain and suffering'.

Nobody even commented on why would the government create pamphlets targeted at kids, presenting suicide and the act of dying in a clinic in a way to make it palatable to children. Why would they put out ads making suicide a beautiful thing?

Everybody took my post as completely against anybody dying or allowed to die. Read the blog, follow the links.

Replies:   Dominions Son  Grey Wolf
Dominions Son ๐Ÿšซ

@John Demille

Everybody took my post as completely against anybody dying or allowed to die.

No, not everybody.

Replies:   John Demille
John Demille ๐Ÿšซ

@Dominions Son

No, not everybody.

OK, not everybody true, but the pro-suicide as a service so far outnumbered the 'oh my god they're encouraging people to kill themselves' by 2 to 1 at least.

You should read some of the comments I received as direct message in response. Some were completely bonkers.

Grey Wolf ๐Ÿšซ
Updated:

@John Demille

I demonstrated the slippery slope. The slippery slope has been the expansion of pain and suffering and the reasons for this MAD service, I mean this MAiD service.

Which is irrelevant to my response. Trying again to avoid politics, the existence of a slippery slope in one case does not mean that it's inevitable or that one can do nothing.

Go back to the Niemรถller quote. There was absolutely a slippery slope in Nazi Germany. That does not mean that we can never 'come for anyone' again for any reason whatsoever.

Step back, fix the problems, do it better. My response was philosophical and intentionally not tied to any one implementation failing.

I can completely agree that everything in your blog post is a real problem and there are major mistakes and negative consequences without agreeing that the entire idea of assisted suicide is terrible.

Replies:   John Demille
John Demille ๐Ÿšซ
Updated:

@Grey Wolf

I can completely agree that everything in your blog post is a real problem and there are major mistakes and negative consequences without agreeing that the entire idea of assisted suicide is terrible.

Maybe it's the title that I used that's making things difficult to relate. Maybe I should have used 'Medically Assisted Suicide as a business or service'. (Lazeez can you make the change?)

I personally don't think doctors/medical personnel should ever be involved in suicide. Considering how easy it is for anybody to kill themselves painlessly (a bottle of Advil with a box of NyQuil will do the job painlessly), it's a perversion of the medical profession to have them kill people, regardless of the motive. If somebody needs help committing suicide, for example the completely incapacitated, the only people that should maybe assist them are people who care for them (children or siblings).

My biggest issue is with the suicide-as-a-business or suicide-as-a-service thing. Any time anybody has a financial incentive to do anything, to make more money, they will seek more business. How do you seek more business in the suicide business? Do you think a suicide clinic will ever decide 'we're killing too many people'? Do you think any business would turn away anybody that seeks their services, including suicide clinics? If a depressed person walks into a suicide clinic and fills in the application, does the clinic have any incentive to look that person in the face and tell them 'you don't need our services, go see a shrink'? You bet your ass they would never do it.

We should not make suicide a business. We should not give any government any say in this especially a government that has control over the medical system, a government that may want to cut cost and the easiest way is to kill the ones who create the cost.

Replies:   awnlee jawking  GreyWolf
awnlee jawking ๐Ÿšซ

@John Demille

I personally don't think doctors/medical personnel should ever be involved in suicide.

Not even psychiatrists, to ensure the patient is fully cognisant?

Many suicide attempts are half-hearted, being a plea for help rather than actually wanting to die.

AJ

Replies:   Keet
Keet ๐Ÿšซ

@awnlee jawking

Many suicide attempts are half-hearted, being a plea for help rather than actually wanting to die.

The operative word is 'attempt' and, like you stated, the person doesn't actually want to die. This kind of 'suicide attempt' has nothing to do with the medically assisted suicide that is the subject in this discussion. A person that really wants to die will rarely fail in his attempt.

Replies:   awnlee jawking
awnlee jawking ๐Ÿšซ

@Keet

This kind of 'suicide attempt' has nothing to do with the medically assisted suicide that is the subject in this discussion.

Actually it does. There have been several cases of medically assisted suicides, some in the Netherlands, for reasons that some of might find less than compelling - severe depression, phantom pain after losing a limb, body dysmorphia, myalgic encephalomyelitis etc. Once patients have approached a clinic about medically assisted suicide, there's a danger they might get railroaded if they have doubts at a late stage in proceedings.

However, those would be a minority of cases compared to eg terminal cancer etc.

AJ

GreyWolf ๐Ÿšซ
Updated:

@John Demille

Sigh. SoL has managed to eat my comment three times now, and I suspect I'm getting worse each time. It's certainly getting wordier.

So I'm going to rearrange and put the conclusion at the front, then the argument. I know it's wordy. Sorry.

TLDR:

If it is moral for one to choose to end their life to avoid suffering, it is then immoral to deny them that opportunity on the basis of their physical inability to end their life themselves or on the basis of their being alone in the world. Neither of those things has any bearing on morality. Being physically incapable of ending one's life or being alone in the world is not grounds to sentence that person to an agonizing death. We wouldn't do that in any other case; why should we do that here?

That doesn't mean we must allow or enable it it, but our reasons for refusal so must be sufficient to justify an immoral result. Simply 'We tried it; there were abuses; we're done' is not sufficient justification. And considerations of abuse must include the able-bodied; banning assistance for the incapable while allowing the capable to be wrongly encouraged to kill themselves is just a tiny band-aid with no moral weight.

That's the TLDR, now the much longer part. If you skim, jump to the last two or three paragraphs, since they bear directly on whether the decision to ban things is moral.

Yes, the title hurts, but it's not the only problem, or even the primary one. The title is a symptom, not a cause. The cause is that the entire question is artificially narrow in ways that warp the discussion.

My response started out with the first substantive line of your blog post ('Slippery slope is why'). Slippery slope arguments are extremely prone to logical fallacies. "It failed once, in this way, therefore it will always fail in the same way and no one should try it" is a logical fallacy.

I also (and this strengthens your argument, in my opinion) believe that 'government' is irrelevant. Whatever agency has cost incentives in medical care will want to cut cost. Private insurers would just as prone as government to push people to opt for suicide.

There are many problems here. Absolutely I can agree that your examples show very bad things happening, but I also disagree that they prove your point.

For instance, the paralympian situation is awful. That said, the essence of that case is that the person was pushed to kill themselves. The 'medically assisted' part of it is irrelevant. What if the person had enough use of their arms to lift a pill bottle? Would suggesting they kill themselves be any less abusive? The abuse is encouraging them to terminate their life. The mechanism by which their life is terminated is irrelevant. Banning assisted suicide merely removes one path by which some people can be abused, it doesn't prevent the health care provider from encouraging people who can lift pill bottles to kill themselves.

Your initial statement was that you wished to argue the moral case, but focusing on 'this abuse happened, and this abuse happened, and this one' is tangential to the morality of things.

To me, saying that people capable of lifting pill bottles should have the option of avoiding suffering but people who are not capable of lifting pill bottles should not have the option of avoiding suffering is a poor moral argument. Why should the condition of one's body affect the morality of their choice to end their suffering? Why should only people with siblings / children / parents / etc have this option? What is the moral distinction between a physically incapacitated person who is alone in the world and a physically incapacitated person who has a caregiver? And what prevents children and siblings from the exact same sorts of abuses the government, private insurers, etc are capable of? There are often motives for caregivers to wish to be rid of someone they view as a burden, after all.

Summed up, my view is that, if suicide to end suffering is moral, then providing a means for someone who is incapable of doing so themselves is also moral. That doesn't mean we should do it. Actually doing it means that we have confidence that we can avoid abuses in the great majority of cases.

Note: In my semi-cynical opinion, it's impossible to prevent all abuses in all cases, and making 100% abuse-free a criteria is simply an attempt to reach the desired end of a ban. We don't use a 100% abuse-free criteria on all manner of things which can be abused, including things which can lead to death.

Absolutely, sometimes we have to make the call that the potential abuses are so bad that we must deny something even though that results in an immoral result. But (in my view) the fact is that denying an incapacitated person the ability to terminate that life is immoral; therefore, the reasons given to deny them that must be so grave as to justify the immorality of the denial. Simply saying 'this failed once, we're done' is exceptionally insufficient as grounds to justify an immoral result.

As I wrote elsewhere (more or less): fix the problems, solve the issues, prevent abuse, do it better. Don't say 'Well, this failed once, therefore it'll always fail and we need not try.' That is, at best, a very weak practical argument. It's no moral argument at all.

If it can be reasonably shown that no system can solve the issues and prevent abuses (for the capable as well as the incapable) and do better, then there's the basis for an argument that touches on morality, but there's nothing here to show that.

Replies:   John Demille
John Demille ๐Ÿšซ

@GreyWolf

Yes, the title hurts, but it's not the only problem, or even the primary one. The title is a symptom, not a cause. The cause is that the entire question is artificially narrow in ways that warp the discussion.

That's because you keep insisting on arguing the points you want to argue instead of the point that I'm trying to make.

I'm saying that there should be no business or service whose sole purpose is to kill people.

You keep trying to argue that it's ok to kill people and ignoring my point.

You obviously want to kill people and you keep dragging the discussion way away from my point.

Let's hear your opinion on the point: Do you believe that suicide should be institutionalized and made into a business? Yes, or No.

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ
Updated:

@John Demille

If you TLDR this, look for two questions at the bottom.

That's because you keep insisting on arguing the points you want to argue instead of the point that I'm trying to make.

That's because you keep arguing the point you want to make instead of the point you said you were making. I'm much more interested in the point you actually stated at first than the one you've shifted to.

ETA: I'll apologize here. You're right: if you add 'as a business or service', the discussion is very different. But Old Dave's post has nothing at all to do with businesses and services, and your blog post goes a long ways before bringing up businesses and services, and keeps veering back and forth.

I also think there's a difference between 'business' and 'service' if one takes 'service' broadly. The answer is very different comparing 'non-paid or non-profit volunteer service' to 'business', but even there one can run into trouble.

However, I'm much more on your side when discussing businesses where there's a profit margin. It's just that, in my opinion, that's extremely far afield from the moral issues of assisted suicide.

The rest of this (except my answer for your 'business' question) should be read in the light of actually discussing the thread title, Old Dave's post, and more than half of your blog, but I agree that it's afield from what you apparently wanted to discuss. Unfortunately, that wasn't clear.

I honestly believe that there's room for compromise, if there's room for compromise on your side.

You obviously want to kill people and you keep dragging the discussion way away from my point.

Wrong. At no point have I argued for 'killing people,' as the term is commonly used, and using it that way is pejorative and dismissive. How can one express a position in favor of assisted suicide without some form of causing death? Phrasing it that way is equivalent to someone telling a vet 'You keep trying to argue that it's ok to kill pets.' Vets do not 'kill pets' except in a highly technical form of the work 'kill' and most would be appalled and angry at that description.

If your position is that any form of assisted suicide is morally 'killing people', that's fine. We could have an actual discussion. about that. Everything about business, government, and coercion is irrelevant if assisted suicide is 'killing people', and if it's not 'killing people', don't dismiss people by calling it that.

Let's hear your opinion on the point: Do you believe that suicide should be institutionalized and made into a business? Yes, or No.

I'll give you a 'no', but you may not be happy with why, I suspect. I also find that 100% irrelevant to Old Dave's post, at best tangential to moral issues (which was your starting point in your original post), and irrelevant to much of your blog post, which is why I haven't mentioned it before.

Here are a few base conditions for me - you may not agree (all of these take for granted that we are discussing people with serious life-ending conditions for which we have no reasonable hope of a treatment breakthrough and for which their death will be highly unpleasant):

I don't believe it makes any moral difference if someone is capable of killing themself or not as to whether they should be able to choose suicide as an option.

I believe that denying respite to people on situational grounds is immoral.

I don't believe it makes any difference whether we're talking about governments, businesses, health care professionals, family members, volunteers, or whatever in terms of the morality of actually assisting someone who wants to commit suicide in doing so.

Here are some things I suspect you will agree with:

I believe it's morally wrong for anyone in a care-giving relationship (government in single-payer, health care business, family member, etc) to push someone to kill themselves.

I believe that under many circumstances doing so may equate to criminal behavior and abuse and should carry penalties.

I believe that whatever system should not consider suicide as a cost-containment option.

HOWEVER, I also believe that someone who is in a position where their options are a painful death or suicide should have that option whether or not they are capable of carrying it out, and that it is immoral to deny it. Therefore, in the absence of physical capacity or some family/friend/whatever, it should be at minimum legal, and ideally mandatory, for there to be some trusted non-coercive non-manipulative non-abusive person to perform such a service. Lack of physical capacity or being alone in the world should not sentence one to a painful death.

So, that's not 'institutionalized and made into a business' (hence the no), but nor is it 'can't do it at all; slippery slope'. It's an in-between. Old Dave is happy, and on the point you seem to actually want to argue you're happy, theoretically.

Two questions back:

Is all assisted suicide 'killing people'? Yes or no. (ETA: your blog seems to indicate that you believe it is - unless I'm misreading - whether or not 'as a business or service', which makes focusing on 'business or service' curious)

Do you believe that someone who is terminally ill and facing a painful death should have the option to terminate their life, whether or not they are physically capable of such an action and whether or not they already have someone capable and willing of performing that service, assuming the entire time that this is a free, uncoerced, unencouraged, etc choice of the terminally ill person? Yes or No.

To me, THOSE are far more at the crux of 'medically assisted suicide' and of Old Dave's point, not arguments about governments or businesses.

Replies:   John Demille
John Demille ๐Ÿšซ

@Grey Wolf

So much verbal diarrhea. Geez.

Let's hear your opinion on the point: Do you believe that suicide should be institutionalized and made into a business? Yes, or No.

I'll give you a 'no', but you may not be happy with why,

If you qualify it, it's not a no. I'll take that as a yes.

Two questions back:

Is all assisted suicide 'killing people'? Yes or no.

Yes. Unequivocally.

Human life is human life. Any active action to end it is killing. It can be called mercy killing, but it's still killing somebody. With their consent doesn't change that fact. It's killing.

In the case of terminally ill and in pain it will be mercy killing. But it's still killing. Again, You cannot change that.

Do you believe that someone who is terminally ill and facing a painful death should have the option to terminate their life, whether or not they are physically capable of such an action and whether or not they already have someone capable and willing of performing that service, assuming the entire time that this is a free, uncoerced, unencouraged, etc choice of the terminally ill person? Yes or No.

As a believer, I can comfortably say No.

By asking somebody to kill you, you are asking them to condemn their soul. The reason for your suffering can only be known to God. By killing yourself, you're condemning your soul and by asking somebody else to kill you because you're too much of a coward to do it yourself, you're asking somebody else to condemn their soul for you. Especially if you're not too physically handicapped to do it yourself.

If it is about facing painful death, one can easily administer enough morphine for pain to go away and let the illness take its course without actively administering poisons into somebody's body. It seems most people arguing aren't even considering this. My father died that way; cancer metastasized through his abdomen from bladder cancer.

If the person facing the painful death really wants to die, it's their option, and they can easily request the removal of life support from their body. How long would a terminally ill cancer patient survive without any intravenous nutrition? A person can ask for the needle to be taken out of their veins. That is their option and it doesn't require anybody actively injecting any additional substances to kill them.

awnlee jawking ๐Ÿšซ

@John Demille

If it is about facing painful death, one can easily administer enough morphine for pain to go away and let the illness take its course without actively administering poisons into somebody's body

That's not actually true. Some people suffer more pain than can be controlled by non-lethal doses of morphine.

AJ

Replies:   John Demille
John Demille ๐Ÿšซ

@awnlee jawking

That's not actually true. Some people suffer more pain than can be controlled by non-lethal doses of morphine.

I've heard of that. But having worked in the medical field for over 10 years in my youth, I've never personally seen somebody in that kind of pain.

Replies:   Michael Loucks
Michael Loucks ๐Ÿšซ

@John Demille

I've heard of that. But having worked in the medical field for over 10 years in my youth, I've never personally seen somebody in that kind of pain.

A friend of mine (represented in AWLL by Stephie Grant) who had ovarian cancer that spread to other organs. In the end, even morphine couldn't stop the pain (back ni the 90s).

Replies:   awnlee jawking  DBActive
awnlee jawking ๐Ÿšซ

@Michael Loucks

But would you have approved of eg a morphine overdose to put her out of her misery? Did she express any feelings on the issue?

AJ

Replies:   Michael Loucks
Michael Loucks ๐Ÿšซ

@awnlee jawking

But would you have approved of eg a morphine overdose to put her out of her misery? Did she express any feelings on the issue?

She accepted the maximum dose that wouldn't require her to be on a ventilator. The last few weeks of her life were literally a living hell. She refused 'extraordinary measures' but she also would never have accepted an intentionally lethal dose of drugs.

DBActive ๐Ÿšซ

@Michael Loucks

That's why fentanyl was developed. It's much, much more effective than morphine. The trouble is that a lot of MDs are afraid to prescribe it for fear of the illegal/addiction scrutiny it can put them under.

Grey Wolf ๐Ÿšซ

@DBActive

Which brings us around to assisted suicide, of course. If a patient is terminal, there is no addiction risk. But the problem with fentanyl is that it's extremely easy to overdose. If physician X has a patient with extreme pain, prescribes fentanyl knowing it may cause an overdose, and the patient dies, is that morally okay? Wrong? What if they know an overdose is likely? What if they believe an overdose is unlikely, but it happens anyway? What if the overdose is intentional?

If the physician is free to prescribe fentanyl even at risk of overdose to terminal patients, problem (mostly) solved. If not, fentanyl really is not an option, because any doctor using it could be accused of illegal assisted suicide even if they had no such intention.

Michael Loucks ๐Ÿšซ

@DBActive

That's why fentanyl was developed. It's much, much more effective than morphine. The trouble is that a lot of MDs are afraid to prescribe it for fear of the illegal/addiction scrutiny it can put them under.

I had fentanyl (along with versed and propofol) when I had my recent foot surgery. They prescribed Tramadol for pain (I don't take acetaminophen/paracetamol, so no norco) but I didn't take it, relying instead on 600mg ibuprofen because I detest opiates (but would use them if there were no working alternative).

awnlee jawking ๐Ÿšซ

@John Demille

How long would a terminally ill cancer patient survive without any intravenous nutrition?

They're more likely to die from lack of hydration, and that's a cruel death - one of the reasons advocates of the Liverpool Care Pathway had to change the name to disguise the abhorrence of what they were doing.

AJ

Replies:   John Demille
John Demille ๐Ÿšซ
Updated:

@awnlee jawking

They're more likely to die from lack of hydration,

Probably, yes.

and that's a cruel death

Maybe.

Death is death. It's the ultimate step in life. It's the end of everything for a person on this earth.

If you're a believer, suffering may be a way to cleans your soul. Maybe God has a reason for you to suffer.

If you're not a believer and you believe that when we die we simply perish, then it doesn't matter. The brain will not retain the suffering after the person dies.

LupusDei ๐Ÿšซ

@John Demille

Well, there we have it. End run of your argument is simply to enforce your irrational beliefs on everyone, unconditionally. Therefore you are irrelevant to the discussion.

However, it is ironic that for how willing you are to jump to 'slippery slope' arguments to defend your belief, you don't seem to notice one in your own argument.

While there may be moral differences between "please let me die" and "please kill me" from the perspective of the person asking, from the perspective of rational actor pledged to defend their life there's none. A medic allowing that death is still guilty of murder unless the exception for suicide is provided.

Therefore your argument arrives at a contradiction you try to dismiss calling on the religion although I don't quite see how even that works. It seems it excuse you for not seeking to minimize unnecessary suffering, fine. Then you try to sidestep the logical maxim that everyone's life should be prolonged at whatever cost by providing exception for negligence.

Therefore, you are not against assisted suicide, it's just that the only method of assisted suicide you approve is by negligence.

All while you explicitly state that will of the sufferer is irrelevant -- they are not allowed to choose suicide no matter what.

Therefore you expect authority (ostensibly expressing God's will) to kill people by negligence.

Replies:   John Demille
John Demille ๐Ÿšซ

@LupusDei

Therefore, you are not against assisted suicide, it's just that the only method of assisted suicide you approve is by negligence.

So to you it's either active killing with a poison or it's negligence? No middle ground? You're reaching very far to invalidate my position simply because I declared that I'm a believer?

Negligence is considered negligence when we don't give care to those who need it and want it. If a patient asks you to stop care, then compliance with their wishes is not negligence.

It's interesting that you consider compliance with a patient's wishes to actively kill them with a poison a good thing and you consider compliance with their wishes to do nothing 'negligence'.

You are logically incoherent.

Grey Wolf ๐Ÿšซ
Updated:

@John Demille

Well, then. You have every right to your opinion (as I said, it's the belief of the church in which I was raised), and I wholeheartedly support that.

Since your actual issue obviously isn't 'MAiD', or the Canadian health care system, or 'business or service', but rather anyone (including the patient) ending their life, the entire thread was duplicitous from the start.

I also find your repeated intentional mischaracterizations of my positions problematic.

In any case, while I (obviously) find this an interesting topic, I have no further interest in responding to someone who mischaracterizes my responses and opens what pretends to be a discussion when any actual discussion turns out to be immaterial to them. I would never have replied to an honest thread such as 'Old Dave said this, but my religion disagrees, so he's wrong', which would have covered the whole thing.

Replies:   John Demille
John Demille ๐Ÿšซ
Updated:

@Grey Wolf

Since your actual issue obviously isn't 'MAiD', or the Canadian health care system, or 'business or service', but rather anyone (including the patient) ending their life, the entire thread was duplicitous from the start.

I also find your repeated intentional mischaracterizations of my positions problematic.

And by insisting that my actual issue is not MAiD and dragging it repeatedly back to assisted suicide as a whole you're not mischaracterizing my position?

Yes, I've always been against actively assisted suicide. But I always held that everybody has their beliefs and they are free to hold them whether I thought they were wrong or not.

However, that doesn't mean that when the issue reaches the current situation with MAiD where they're actively encouraging people who aren't really suffering to kill themselves that I shouldn't speak.

As long as a belief is held by the people doesn't affect others, then they're free to hold it. But when I see it being enforced on others, I speak up and oppose it, and if there is action to be taken, then I take it.

Just like I leave satanist be because they're free in their beliefs. But if they kidnap children for their sacrifices, then I have a huge issue with it and have no problem fighting them back.

MAiD is an abhorrent service. Its proponents are continuously expanding its 'business'. I have a problem with that. Yes, I do have a problem with institutionalized killings of humans. I especially have an issue with them targeting children like that pamphlet that I linked to. How evil is that? Is making death palatable to kids part of 'easing pain and suffering'?

You refuse to believe that I hold both positions.

Yes, I believe that you're free to kill yourself if you're in too much pain. That's between you and God if you're a believer. If you're not a believer, then you're absolutely free to end your existence at your whim. As long as it's you who does it.

Yes, I believe that nobody should hold a job where their job it is to kill you whenever you're ready to do it.

Yes, I believe that a service like MAiD should not exist.

Yes, I can hold all those beliefs at the same time and be coherent in my beliefs.

ETA:

And yes, the whole thing that started this whole discussion is still the slippery slope.

We started with 'yes we should help those who want to kill them and can't do it themselves' and we got to 'we need to encourage more people to want us to kill them'.

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ
Updated:

@John Demille

In which case, I'll reply:

Slippery slope arguments are prone to logical fallacies. Yours definitely is.

'It failed once, therefore it will always fail and we cannot try to do it right' is a logical fallacy.

Rephrasing slightly: the problem you seem to have is not the abuses of 'MAiD', but rather its existence. You refuse to credit the possibility of a non-abusive service. You also refuse to consider the lack of such a service a potential moral lacking.

In my opinion (not yours, I know) the following:

Yes, I believe that you're free to kill yourself if you're in too much pain. That's between you and God if you're a believer. If you're not a believer, then you're absolutely free to end your existence at your whim. As long as it's you who does it.

is immoral. You are telling those who wish to terminate their life, and believe God is okay with it, that they must suffer a lingering painful death simply because they are physically incapable of lifting a pill bottle. Under what other circumstances would you consider torture an acceptable sentence for someone whose crime is inability to life a pill bottle?

There IS a middle ground, though you may pretend not to see it, or may believe it, too, is forbidden: volunteers or other not-for-profit 'pill bottle lifters'. If that's acceptable, we have a compromise.

I agree with you that profit and cost-containment motives should not be part of the discussion and that it's dangerous for the same agencies to be involved, but I do not believe the slippery slope is inevitable even if they are. However, best not to.

I'm not sure what you would say to a physician who belives that they have a moral obligation to assist a patient in ending their life because there is no other viable means of relieving their patient's suffering and the patient has expressed a wish to die. Whose morals take precedence in that situation?

Replies:   John Demille
John Demille ๐Ÿšซ

@Grey Wolf

Slippery slope arguments are prone to logical fallacies. Yours definitely is.

No fallacy here. No silly hypothesis. I'm no arguing against the potential of something happening.

It already happened.

They're marketing suicide like they market a nice vacation spot.

We are so far down the slippery slope that they're marketing suicide to kids.

If that's not the ridiculous level far down the slippery slope, I don't know what is.

We have only one more step down the slippery slope: Mandatory killing if you become inconvenient for some reason.

And yet you keep insisting that something is wrong with my thinking.

Clearly you are one of those people who at least don't mind people dying and maybe you'd go as far as wanting people to die. You keep arguing for it.

Just like you argued in support of Woke crap all the while denying you're woke.

Dude, you're looking silly.

Do I need to call you the C-word again? (Communist)

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ
Updated:

@John Demille

No fallacy here. No silly hypothesis. I'm no arguing against the potential of something happening.

That's not the fallacy. Proof of existence is not proof of necessary recurrence. The fallacy is that because something happens once that it must necessarily happen every time in the same manner.

As I said: figure out what went wrong, fix the problem, do it right.

Your argument is of the exact same form people made several years ago: "No one has ever landed an orbital class rocket. They always crash and blow up. They will always crash and blow up. Stop trying!"

What I am arguing for is not for 'people dying', but for the right of people to make their own moral choices about their own lives without the government denying them that right. You are advocating that the government should override others' moral choices in favor of your own. I imagine you would feel differently were it their choices that were winning out over yours.

You are welcome to use the word Communist completely inappropriately, as I know you love to do. Call me a communist. Call me a reptilian from Arcturus. Both are equally accurate. I really don't care what someone who blatantly and admittedly misuses words calls me. I am a communist in the same way that Barry Goldwater, Ronald Reagan, or even Joe McCarthy were - but, then, you would call them all communists, too, should it suit your purposes.

I am definitely woke, by your definition, since your definition works out to 'Anyone who advocates not being horrible to anyone I don't like'.

Replies:   JoeBobMack  John Demille
JoeBobMack ๐Ÿšซ

@Grey Wolf

As I said: figure out what went wrong, fix the problem, do it right.

Your argument is of the exact same form people made several years ago: "No one has ever landed an orbital class rocket. They always crash and blow up. They will always crash and blow up. Stop trying!"

Politics and engineering are not similar endeavors. While I mostly agree with you, Grey Wolf, the idea that politicians will figure out what went wrong, fix the problem, and do it right seems bizarrely unrealistic.

StarFleet Carl ๐Ÿšซ

@JoeBobMack

the idea that politicians will figure out what went wrong, fix the problem, and do it right seems bizarrely unrealistic.

That's because the politicians are the ones who created the problem in the first place, and help contribute to making the problem worse.

Replies:   Dominions Son
Dominions Son ๐Ÿšซ

@StarFleet Carl

@JoeBobMack

the idea that politicians will figure out what went wrong, fix the problem, and do it right seems bizarrely unrealistic.

That's because the politicians are the ones who created the problem in the first place, and help contribute to making the problem worse.

And because if the politicians actually fixed the problem it would potentially reduce the money and power flowing through their hands.

There is more money, more power to be had in "fixes" that actually make the original problem worse.

"Oh, that fix didn't work. Give us even more money and power, the next fix will work for sure."

Rinse, repeat.

Grey Wolf ๐Ÿšซ

@JoeBobMack

Nevertheless, 'it failed once, therefore it will always fail' is a logical fallacy. Perhaps the right fix is to remove the politicians from the equation.

JoeBobMack ๐Ÿšซ

@Grey Wolf

Perhaps the right fix is to remove the politicians from the equation.

Actually, I think this may be a point of agreement between you and John Demille. I think I've both of you have said, in some form, that having the organization responsible for controlling health care costs also in charge of providing, even promoting, euthanasia is an approach fraught with the likelihood of abuse. So, where government has a significant responsibility for health care costs, government should neither provide nor promote euthanasia.

I am reminded of the ethical problems that confront elder law attorneys, especially in confirming the wishes and competence of the client. When child brings in parent and says parent wishes to change their will, the attorney has to be careful that the parent is both competent and not under duress.

That said, having anyone encouraging someone to kill themselves makes my skin crawl. When that person has the immunity of the government behind them, it's even worse.

Dominions Son ๐Ÿšซ

@Grey Wolf

Perhaps the right fix is to remove the politicians from the equation.

The only way to remove politicians from the equation is to remove the government from the equation.

John Demille ๐Ÿšซ

@Grey Wolf

That's not the fallacy. Proof of existence is not proof of necessary recurrence. The fallacy is that because something happens once that it must necessarily happen every time in the same manner.

As I said: figure out what went wrong, fix the problem, do it right.

Yes, just like communist do with communism. Fix what's wrong, do it right. And always end up with people dying.

See, you are a communist.

I am definitely woke, by your definition, since your definition works out to 'Anyone who advocates not being horrible to anyone I don't like'.

Yes, you are woke. By rational people's definition you are. Just because you deny it, doesn't mean you aren't. Walks like a duck...

awnlee jawking ๐Ÿšซ

@Grey Wolf

The phrase 'First do no harm' is, to me, not a barrier.

Much as we'd like to think that applies to the medical profession, it went the way of the Hippocratic Oath.

A doctor sworn to literally do no harm couldn't risk giving vaccinations because they cause illness and occasionally death.

AJ

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ

@awnlee jawking

My feeling is that 'harm' is restricted to things which the practitioner knows or should have reasonably known will cause more damage in the average case than the alternative.

There are hundreds of things that cause, or can cause, harm which are routine. Vaccinations are one, of course, but chemotherapy is essentially always 'harm'. Lasik eye surgery will fail in a given percentage of cases and harm the recipient, leaving their vision worse. Any surgery can potentially lead to a variety of poor outcomes.

And so on, and so forth.

The injunction remains: a doctor can ethically use chemotherapy drug X knowing that the good exceeds the bad in the average case, but if patient Y has a poor reaction to X the situation reverses.

Which is where I am with assisted suicide. Failing to assist in suicide may result in net harm to the patient compared to assisting in the case where the patient will inevitably die and will die an agonizing death, in my opinion.

Dominions Son ๐Ÿšซ

@Grey Wolf

There are obvious concerns around coercion, manipulation, etc, but again, we cannot and should not put guardrails around anything. We don't forbid the elderly to make contracts (while competent) either, even

The major problem occurs when there is medical assistance available for suicide and the government is the primary/sole payer for health care.

Under such conditions it is inevitable that the government will, as a cost savings method, start pushing people with expensive to treat but non-terminal conditions to choose death.

This is not just theoretical. It is demonstrably happening in Canada now.

https://www.ctvnews.ca/politics/paralympian-trying-to-get-wheelchair-ramp-says-veterans-affairs-employee-offered-her-assisted-dying-1.6179325

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ
Updated:

@Dominions Son

There will always be a tension between services provided and cost containment for any model of health care. Government is irrelevant to this discussion. If private health insurance had the option of assisted suicide, private health insurance would push it as a cost-containment method.

Right now, both single-payer and private-payer systems have 'just let them die a horrible death' as a cost-containment method, too. There are innumerable cases where people who obviously should have been covered were repeatedly denied.

But, of course, without cost containment we absolutely wind up with cases where someone's life is prolonged by a month at the cost of millions of dollars AND additional suffering with almost no quality of life for that extra month, which reduces resources to care for anyone else. There are documented cases of things like that happening.

The problem is intractable. There's always more need for resources than there are resources, and excepting 'The Singularity' or other hypotheticals, there always will be.

Which is a wordy (but, in my opinion, important) way of getting to the conclusion 'Just because someone has screwed it up doesn't mean that it will inevitably be screwed up.'

The debate (in my mind, anyway - and partly because we are explicitly trying to be apolitical) is not whether someone screwed up assisted suicide, it's whether the idea of assisted suicide has validity. Any given poor implementation is a useful data point but, unless that example provides some reason to believe that every implementation must inevitably fail in the same way, it doesn't speak to the heart of the matter.

Which is why I lead with cost-containment. The inevitable part is the tension between cost and cost-containment. One can envision rules under which the government was forbidden to push people to choose death (perhaps particularly in the case of non-terminal conditions). The simple existence of a tension doesn't imply that such rules must inevitably fail.

And, again, there's the problem of terminal conditions. If physically incapacitated (and therefore incapable of suicide) person X has a terminal condition which will inevitably lead to a highly painful death in a short (but non-trivial - months, say) period of time, and the only medical interventions known will simply lead to an even more painful death in a slightly longer period of time, should person X just be abandoned to die a highly painful death with no option of ending their own suffering, simply because the process could be abused to the detriment of persons Y and Z? Or do we seek to do the best we can for X as well as Y and Z?

That, to me, is the real core of the question. Do we deny those who really and truly are going to die, and die a horrible agonizing death, any option to avoid doing so simply because the potential for abuse in other cases exists? Or do we do our best to fix the potential for abuse?

joyR ๐Ÿšซ

@John Demille

It is a tough call.

Should we assist you so you are silenced and we can continue on sooner rather than later, or should we offer no assistance so that your suffering is intensified and extended for longer?

Tough call.

Replies:   John Demille
John Demille ๐Ÿšซ

@joyR

Should we assist you so you are silenced and we can continue on sooner rather than later, or should we offer no assistance so that your suffering is intensified and extended for longer?

You silence those who you disagree with when you have no argument?

awnlee jawking ๐Ÿšซ
Updated:

@John Demille

If you're a believer, suffering may be a way to cleans your soul.

Dogs qualify as sentient. They recognise themselves in mirrors, they have a language of sorts, they use tools (albeit with difficulty since they wield them with their mouths) and they perform acts of altruism. If humans have souls, I'm pretty sure dogs must have them too. I'm not comfortable with the idea that vets are condemning their souls by putting down suffering dogs.

AJ

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ

@awnlee jawking

Many Christian denominations simultaneously believe that:
1) Any failure to prolong one's life to the absolute limit, fighting every step of the way, is the moral equivalent of suicide;
2) Suicide is the one truly unforgivable sin, because one cannot ask God for forgiveness when one is dead;
3) Only human beings and no other creatures have souls.

If one has that set of beliefs, any form of suffering-avoidance suicide (personal or assisted) is a sin, while putting down dogs is not a sin.

I don't agree, but I grew up in such a church and I understand the source material and logical arguments used to arrive at the conclusions.

Some of it will always be the tension between those who cause excuse away any flaw in the world, no matter how horrible, as 'We cannot understand the mind of God, and all things have a purpose to God'. While that may be true - I'm not attacking the belief itself, nor saying those who hold it are wrong - I cannot myself believe it, because (to me!) it's inconsistent with many other attributes of God.

Also, the same people who follow that belief often (but not universally) also believe that the Devil and his minions cause ill effects in the world - even that the Devil is the master of the mortal world. If so, might unrelieved suffering instead be a tool of the Devil intended the break the will of the faithful so that they will reject God? Might ending it serve God and frustrate the Devil, in that case?

The problem with theology is that, unless two people start from a relatively close common ground, one can argue 'angels on the head of a pin' all day and all night forever and never make headway. One reason among many that basing the laws of a non-religious state on religion is a terrible idea.

Dominions Son ๐Ÿšซ

@Grey Wolf

Also, the same people who follow that belief often (but not universally) also believe that the Devil and his minions cause ill effects in the world - even that the Devil is the master of the mortal world. If so, might unrelieved suffering instead be a tool of the Devil intended the break the will of the faithful so that they will reject God?

It's not so much that they believe that God directly causes suffering but that the suffering is a test of their faith in God, because if they have faith, God will, at a minimum, give them the strength to endure.

By that belief, to commit suicide is a failure of faith and is in and of itself a rejection of God.

The other side of suicide as an unforgivable sin goes to denominations that strongly believe in repentance as a prerequisite to forgiveness, and that goes with a belief that it's too late to repent after you are already dead.

Replies:   Grey Wolf
Grey Wolf ๐Ÿšซ

@Dominions Son

The other side of suicide as an unforgivable sin goes to denominations that strongly believe in repentance as a prerequisite to forgiveness, and that goes with a belief that it's too late to repent after you are already dead.

Exactly - that's what I was trying to say, though you have to add that you can repent and be fine if you sin in between repenting/praying/etc and dying, as long as you don't reject God - but suicide is, as you say, a rejection of God. That's why it's different from an accidental or natural death.

The whole thing reminds me of Job, which is the ultimate 'suffering is a test' story. The thing about Job is that Job himself is faithful and rewarded, but it's incredibly hard on those around Job and many otherwise faithful people are harmed or killed during the whole mess.

I agree - I'm not saying that God causes the suffering (He doesn't in Job's story, either). My point is that perhaps God doesn't want them to suffer at all, but that the _whole_ thing is all about the Devil (mind you, this isn't what I believe, it's simply following the logic within religions who go down this path in the first place).

And, again, this is why we do not let religions set the rules in a secular society - there's no agreement, and many of the discussions rapidly become esoteric and almost beside the point to those who believe in anything else.

awnlee jawking ๐Ÿšซ

@Grey Wolf

3) Only human beings and no other creatures have souls.

I'm doomed then. Being a white European, depending on your source I have somewhere between 1% and 8% Neanderthal DNA so I'm not completely human ;-)

AJ

DBActive ๐Ÿšซ
Updated:

@John Demille

Assisted suicide for even those that can't ask for it because of either permanent or temporary inability to communicate? That's OK as long as the family approves - after all, the person won't have a "good quality of life" or the family can't stand to "see them suffer."

Assisted suicide for children who are suffering for what is likely temporary depression. That's OK.

Failure to treat newborn infants who suffer from problems the family and physician decide will either prevent them from having a "good quality of life" or will be too much of a burden on the family.

Turning off life support from people who have a good possibility of recovery because the physician and family decide that they will not have a "good quality life" or it is too much a burden. That's OK.

Actively starving and withholding hydration from a person who for medical reasons cannot communicate because the physician and family decide that they will not have a "good quality life" or it is too much a burden. That's OK.

Actively supplying misinformation and soft coercion of people to make "living wills", advanced directives, and DNR orders because it will be too much of a burden on their family. That's OK.

All of these are approved by people who think the "correct" way. And they gain consent from people through both misinformation and coercion of people.

After all, caring governments have done this in the past to prevent suffering. One world leader's (formal) euthanasia program was prompted by a family who requested a "mercy killing" of their severely disabled child. Something that all "right thinking people" on here should approve. He then made it available to all.

"Reichsleiter Bougler [sic] and Dr. med. Brandt are charged with the responsibility to broaden the authority of certain doctors to the extend that (persons) suffering from illnesses judged to be incurable may, after a humane, most careful assessment of their condition to be granted a mercy death. Adolf Hitler."

I see very, very often the misinformation and the soft coercion of people to make directive that are against their own wishes. Physicians and families do it all the time. The media does it all the time. And of course, the medical community formally refers to this as "assisted suicide" since the correct term, euthanasia, has unfortunate historical connotations

Personally, my wife and I were asked for consent to donate my 22 year old daughter's organs and to allow her to die. We were repeatedly told that she would never have a "good quality of life": she would never be able to communicate or understand communications due to brain damage. We got a new neurologist and new neurosurgeon immediately. Fifteen years later nobody would know she had any type of injury.

Physicians love being allowed to stop treatment or supply of nutrition and hydration. A retired oncologist I went to college with many, many years ago explained it best: he said if they choose to die it takes us completely off the hook for any blame for a bad outcome. Then again the entire euthanasia program and the holocaust were designed by physicians.

Here is a reasoned opposition to these laws: https://ncd.gov/sites/default/files/NCD_Assisted_Suicide_Report_508.pdf

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