During the recent debate around the Assisted Dying Bill in the UK, I listened to a radio phone-in in which a palliative care doctor explained that it wasn't possible to relieve all suffering for all patients. They relayed an example of a person who had spent their last days vomiting fully-formed faeces.
If we can prevent five, ten or perhaps twenty percent of people having gruesome deaths, then not doing so feels like a moral failing.
Right, but there's a problem - the UK is in a real mess! Social services, medical services, all the services are underfunded and crumbling. There is a cost of living crisis as wages have barely moved in 15 years, food banks are everywhere, and now "multibanks" are popping up.
Our country first needs to ensure that people can choose to live, and if needed be cared for; nobody should feel pushed into assisted dying because of financial reasons.
I say this as someone who will be in pain for the rest of my life, and euthanasia has been on my mind at times. As much as I might "benefit" from such a law in the future, I don't believe it should be passed until we have a stable society with good services and safety nets.
To be fair, that is also the one issue with abortion that is legitimate. I am very pro-choice but also horrified by the reality that women sometimes are pressured to have abortion for economic reasons. Still I think that allowing abortion is a net good even when there is still economic imbalance.
As for euthanasia, I think it is similar. We need to fight for a stable society with good social safety and access to medical services for all while also giving people the rights to decide on how they want to go. (At least for older people, I think for younger people there is too much risk they would have changed their mind and should only be allowed when it is medically certain that they will die soon).
My hope is when cases of euthanasia for economic reasons happen, people will be horrified and it will put pressure into improving the system. But maybe I am naive.
> My hope is when cases of euthanasia for economic reasons happen, people will be horrified and it will put pressure into improving the system. But maybe I am naive.
I predict it will be the opposite. Economic reasons will pressure people to support euthanasia.
That's a hard subject - while I think I get your need to have a better safety net (so folks aren't tempted even more to opt out of existence), by delaying it, such choice is also causing indescribable suffering to patients now, and trust me those are not small number of people in topics where 1 is too many. A good 'pleasant' death rather a rarity.
Such vomiting isn't due to any medical failing, it's due to the bowels being completely blocked. It's not going out the other end, eventually it comes back up. The only fix is to go in there surgically and fix the blockage--but in a case like what you're replying to obviously that wasn't an option.
100% you articulated exactly what I couldn't - thank you. It feels very wrong to be considering this in the UK when we are on the decline. Espcially since the current government have demonstrated that they don't really care about pensioners.
OTOH, it's interesting that you and the parent comment are basically saying "We, as a country, are failing our pensioners so badly that death has become the more appealing option for many of them. Therefore, we must trap them here with us until we improve the conditions that lead to them making that bargain (which we will never do)"
Taking away someone's right to assisted dying because you live in a society that has made death preferable to living for many seems like a totally orthogonal leap of logic. That doesn't reduce net suffering one iota.
I am eluding perverse incentives by the government to employ such a scheme. I am sure if they use pure logic and numbers it makes sense to roll this out, especially at time like this. It would indeed help the balance the books and get rid of that pesky voter base who typically vote right.
The decision to offer assisted dying needs to be based on compassion and logic, not on logic alone.
I see your point, but the problem in the UK is we seem to have ground to a halt because "everything is awful".
Not the same argument, but near where I live people have campaigned against new houses for 15 years, because the roads aren't good enough, and the doctors and dentists aren't good enough, but those things haven't been good enough for 15 years, and they probably aren't going to get better.
I fear there is basically no chance we are going to fix the NHS to a high standard in 20 years, if ever, at this point. In that case, we can't simply do nothing until everything is improved.
The US is a mess too, and isn't likely to get better. This is in fact the reason I firmly hope some form of legal assisted suicide is available when I get old enough to need it. Societies with no safety net, where anyone -- even the reasonably well-off, like myself -- can end up unhoused with no medical care through a stroke or two of bad luck, need this right the most.
If we had a functioning system for providing the necessities of life for everyone, suicide would obviously be less necessary.
The link the other person posted didn't make it as immediately clear as a definition I found-- it's basically multiple types of charity banks (e.g. food bank, clothing bank, bedding bank, hygiene bank) operated as one entity.
There is no "we". There are people and their bodies and their wishes. And authoritarians who want a say on it. Doesn't matter if nice sounding words like law and democracy are used to describe the tyranny.
Reality is much messier than "There are people and their bodies and their wishes."
There are whole categories of people who we consider not well enough to make good choices about their bodies and lives, for a variety of reasons
Children are not emotionally mature or responsible enough to make such choices
Mentally ill people are sometimes in an altered state of mind where they are not making good decisions that are consistent with their regular state of mind
Some people are very suggestible and will more or less agree with anything that someone else is telling them to do, even if it is not in their best interest. People who have just received bad news (like a scary medical diagnosis) can easily fall into this, and just agree with whatever someone tells them
It's all well and good to want to respect people's wishes for their lives, but society does have some responsibility to ensure they aren't being pressured by outside forces into acting against their will or against their own interests
Mental health is one I can relate to. There were times when my loved ones struggling with mental health would absolutely go through with assistance euthanasia if they had it available. Years later they are living a much better life but at that point in time, euthanasia would’ve ended it.
I think bodily autonomy is necessary but not everyone is able to make the right decisions at all times. Legislation needs to account for that.
The fun part of the mentally-ill categorization is that being mentally ill also has a tendency to lead to poverty and homelessness which in turn will increase the likelihood that someone will opt for MAID but could be solved by other social means.
I mean, it's plainly evident that mental illness is associated with poverty, which is itself associated with homelessness. Here (https://care.org.uk/news/2024/10/poor-lonely-and-homeless-op...) is an article that references a report that says that people are opting for MAID for non-terminal illnesses and that those who do so are disproportionately likely to be from poorer areas. It also mentions at least one person who specifically mentioned lack of access to housing when opting for MAID. Granted, CARE is blatantly against MAID but the cherries they're picking are in the tree to be picked.
It is pro-social if you can separate objectively. And even then, who is that “social” to decide it? Some people aren’t social.
If the separation line gets drawn across questionable cases, then it’s authoritarian for them. As usual, any scalable implementation will look like a very jagged asterisk-shaped circle and some financial or political interest around it, acting far away from the real needs of people. And those who pick edge cases on its less certain side will push the whole setup further until it stops making sense. Systems like this are inherently vague, which is prone to “oh, we had another case, must regulate more”.
I’ll rephrase myself from the previous thread about suicides: the “society” keeps a blind eye on the fact that it is it who drives people to end their life and then puts a big “dying is prohibited and offensive” sign at the end of this road. If “society” wants to keep “healthy but confused” (subjectively to it) people from leaving, it should look to the root of the problem, not put a barrier at the end.
Ofc teens should be kept away from this for obvious biological reasons.
> Ofc teens should be kept away from this for obvious biological reasons.
Why of course? Is the reason this is obvious to you unique to teenagers? When they turn 18 (or 20) do the reasons to restrict their freedoms immediately go away? Is there no possibility the 'obvious' reason in your mind couldn't occur for a different person in a different age bracket?
Yes, they go away. 18 is a safe age of autonomy, not median. Normal procedures still apply, e.g. are you being coerced, does society physically demand too much from you (e.g. in a form of debt, pain, lack of sleep), etc. If they pass, they are free to die.
To reiterate, fix the problem, not the gate. All statements above are only valid as a whole.
I share your view, but it gets crazy complicated when you're dealing with homicide (I'm using this word to mean it's literal definition: 'death caused by another person', not to mean a crime occurred necessarily).
Euthanasia is controversial for a lot of reasons. Some people worry that authoritarians will use it as a way to "purge" or, such as here in Canada, as a way to "reneg" on health care obligations that tax payers are paying for. Others worry that family members and care providers will abuse the law for financial gain ("legal murder" for inheritance etc.).
It's complicated because we're not talking about an elderly person with terminal cancer. We're talking about a 27 year-old high functioning adult who sought, and was granted, medical assistance in dying due to a mental illness. When you dive into that story, even if you agree that the courts made the right decision and that the 27 year-old had the right to decide her own fate, your heart can't not break thinking about the father.
Morally, I agree that every [adult] individual has the right to commit suicide by any means of their choosing (as long as they're not infringing upon the rights of others in the process). That doesn't mean that there aren't valid reasons for people to debate whether or not ehutanasia should be legal and under what circumstances.
To your point about "Some people worry that authoritarians will use it as a way to "purge" or, such as here in Canada, as a way to "reneg" on health care obligations that tax payers are paying for."
In another thread the Canadian poster talked about someone who decided to go through with ending their life and one of the things they mentioned was "They had to drive 100km to the nearest dialysis clinic."
We have euthanasia in the Netherlands for decades now and there haven't been any controversies as far as I know. It's a solved problem and the discussion here is over. I do agree that the laws and procedures have to be carefully constructed to prevent abuse, but it is possible.
I'm not here to tell you about your country, for which I know very little. But since I'm Canadian and euthanasia here is very new and very controversial, I decided to look up the framework in the Netherlands.
> There is much discussion about people with early dementia who have previously stated in a written will that if they ever got dementia, they would want to get euthanasia.
This doesn't necessarily mean "controversy", but is very much an ongoing discussion and speaks to a problem that euthanasia introduces that has yet to be solved in the Netherlands.
And this really is the issue and complexity when it comes to euthanasia in general: we're talking about a form of legal homicide. So under what circumstances this should be permitted is a very valid legal question. Questions about consent, state of mind, paper trails and proof of consent are also very pressing questions and it sounds like no, not ALL of these questions are currently answered in the Dutch framework.
This is also not me arguing against euthanasia. I believe that adults have the right to commit suicide by any means of their choosing (assuming they're not infringing upon the rights of others in the process). The only thing I'm saying, really, is "it's a complicated issue with lots to consider."
We are at a stage where we are discussing edge cases of euthanasia and it's all related to widening the use; these discussions mostly happen among professionals. There is pretty much no discussion anymore on "vanilla" euthanasia among the general public. I agree it's complicated, but you don't have to solve every edge case with the first iteration.
There are concerns about assisted suicide being pushed on marginalized people who don't have terminal illnesses in Canada. I don't know if that is being driven by "authoritarians" but implying that the issue is just doctors providing death as a service (i.e. to people who are specifically requesting it unprompted) may not be completely accurate.
I'm not worried about anyone "pushing" it. I'm worried about groups being put at the back of the line for other forms of care because the decision makers know that "worst case" more of them will off themselves and find that to be a fine outcome.
That is a danger for sure, but every single path we as a society here take can be exploited by people with ill intentions.
The pharma companies and hospitals have a financial incentive to keep people alive indefinitely, even despite horrible suffering.
The folks paying for the treatment (government, insurance, etc) have a financial incentive to terminate lives prematurely.
Family members with ill intentions may have various nefarious reasons to push for either outcome.
So the question with which we should begin is, "what is the right thing?" and build safeguards around that.
We cannot let "fear of corrupting influences" be the primary guiding principle here because every possible choice as a society here because there's a pretty strong financial incentive to corrupt these choices in either direction.
The concept of "natural death" is self-evidently ridiculous. We treat disease with the best technology possible, but then death has to be "natural."
That notion is at best a distasteful joke before we even get to the ambiguity of what a "natural death" even is, and at worst an evil attempt to define one particular sort of arbitrarily Church-sanctioned death.
What even is "natural death?" Being eaten by a bear? Starving to death because there was a drought and there were no berries for you and your hunter-gatherer buddies to eat? Dying from untreated cancer?
According to Catholic doctrine (to choose an extreme example) we have to keep permanently vegetative people alive indefinitely via feeding tubes and whatever other modern medical technology is required for as long as it takes. What single aspect of that could be described by a sane mind as "natural?"
Because outside of the less than a dozen cases that were roundly criticized across the board, and resulted in no deaths, I can't find any evidence that this is happening or will happen in Canada.
"tyranny" also seems like a concept mostly unrelated to the topic at hand. Practically speaking, nobody can really prevent you from taking your own life.
Someone unable to move is unable to take their own life without assistance. A surprisingly large percentage of people go through some horrific experiences before their bodies completely fail.
Actively preventing someone from providing assistance is. There’s a big difference between not doing something yourself and actively preventing someone else from providing assistance.
> Actively preventing someone from providing assistance is.
Sure, but this happens with legalization, too. Only licensed physicians can assist in suicide. Other attempts to assist will result in state violence. Most people trying to provide assistance won't be licensed physicians.
Which is a completely different effort than the one intended to execute those undesirable to the market. God forbid we support people with anything other than a suicide implement.
Providing assistance isn’t limited to handing someone pills, making the appropriate calls is assistance and a tough moral choice for many. Also, as a purely practical matter physicians can provide both humane options and a clearer separation between direct assistance and murder.
Though obviously there’s other possibilities, it’s a tricker issue than it might at first appear.
Someone who is unable to move is probably also unable to unambiguously communicate their wish to be euthanized as well so I really don't think it's that relevant
Yep that's one side of the argument and it's valid and I sympathize with it.
The other side is when you're hearing stories of people being told that, in lieu of the procedure they're about to undergo, they can surely sign up to receive state-approved death.
"Are you sure you don't want to just die? This is gonna hurt a lot!"
Elderly cancer patients who have a recurrence of cancer often know exactly how uncomfortable another round of chemotherapy, radiation, or surgery will be. At the same time they may already be suffering neurological pain, pleural effusion (fluids building up in the chest), etc.
In this context the statement might be:
"This treatment, as you know, is going to be very unpleasant, has little hope of curing you, and you could live your life while the cancer progresses. We could slow it down and let you decide how you want to live your life."
A more important point is that even in a more normal palliative care situation, which previously may have involved a borderline illegal increase of drugs near the end to hasten and ease death, might now be recorded as an assisted death instead.
So a more interesting stat might be the expected quality of life adjusted years that have been cut off by the assisted deaths.
I'm not sure if QUALY can go negative but some measure that can might be appropriate when talking about assisted death.
Anyone who's been close to a dying cancer patient knows what the last couple months are like for many: unending suffering plus tomorrow will be worse. Many people would choose not to suffer like that and I can't understand who anyone else is to tell them they must endure utter misery for nothing.
Whether the official measure can go negative or not on a practical level it clearly can. I saw my father near the end--the morphine robbed him of the ability to make long term memory. From when he was on that dose it was short term memory only, his world was frozen to before that point. And he was still in pain. How can that be anything but a negative quality of life?
I'm not sure a link will contribute much? It's just the basic question whether some years (or days or whatever) are so awful that you are better off being dead.
In any case, the linked article says 'States worse than dead can exist and they would have a negative value and subtract from the number of QALYs.'
Even if this is true, it appeals to extremes to make a point. People agajnst the motion are against the misuses of assisted suicide due to conditions that may get better in time, or misunderstandings, or conditions of a mental nature which may change or be cured.
That’s part of it, however they are also against it from a morality and ethical point of view, with the central argument being that you can’t take an innocent person’s life, no matter how “good” you think your intentions are.
Basically they uphold the value of life above all else, including one’s desire to end it. By the same token, they are against any form of suicide.
citing individual cases is not the road to reason here IMHO. Every single person dies at some point. This is an "entire population" question. Ethics and Morality play an educational, character formation role.. and, a medical decision is not the same as other kinds of decisions.. Another point -- people who are unstable or overwhelmed personally often leap to extreme, graphic and emotional examples first and without context. The original post here fits that description IMHO
This is emphatically not an "entire population" question. This is an individual rights question. I don't know what safeguards exist in other countries to prevent "people who are unstable or overwhelmed personally" from "leaping to the extreme", but in Canada the rules are strict and multiple doctors have to sign off. You can read the MAiD eligibility criteria and the approval process here[0].
While people should have autonomy over their lives we should not be legalizing assisting them. This is a path that is well-trodden. Many dictatorships have "mercifully euthanized" various sectors of people. It always starts out as the disabled, cancer-stricken, or unviable. Then it becomes a simple way to get rid of the people deemed to be a burden. Suddenly being depressed is a good way to get the needle. Can't perform your job well enough? Yep you guessed it, needle. Or I guess these days they've made sarco pods for the personalized gas chamber experience. This isn't even a slippery slope, we're watching it happen in real time as the bar for euthanasia continues to be lowered.
There's been several cases that MAID has willfully disobeyed the law. Doctors not filing the correct paperwork, rushing patients, etc. We are already seeing the sprouts of a system that if allowed to continue will become a virtual Soylent Green.
Of course I'll be downvoted for this by the bleeding hearts but history has not been kind to people who allow this.
If there are abuses we should strive to minimize or abolish those abuses. The alternative - to tolerate incalculable human suffering and force the loved ones of those suffering to stand there and watch - is unacceptable.
So far there have been zero murder convictions for the KNOWN abuses. Bleeding hearts will downvote this knowing full-well the truth is that they are lowering the bar to the point anyone can be euthanized for any reason. "Mental Health" is an awfully wide net and described specifically in the article which it appears no one has read.
Unfortunately, it seems HN suffers from this pseudo-fascist "Altruism". "Ending the incalculable suffering" was the same justification the Nazis used for their euthanasia program. Virtually the same words too. "Mental health" was a reason thousands upon thousands of children and adults were euthanized. Sorry, this position cannot be compromised with. Euthanasia inevitably leads to mass murder. Very progressive of us to repeat history.
"They relayed an example of a person who had spent their last days vomiting fully-formed faeces."
Sounds like a fully-formed exaggeration. Vomiting once or twice a day is not spending your last days vomiting. More frequent vomiting? The supply could not possibly meet the demand. Especially if the patient stopped eating.
vomit is usually liquid or heavily digested stuff. feces is compacted and excreted. my imagination maybe a little specific here but so is the description "fully formed feces"
When there's no place for the compacted feces that's building up to go (due to a failure in peristalsis, for instance), it backs up into the the stomach, which naturally irritates the stomach and causes the person to vomit the contents, which includes their feces.
You are incorrect. You don’t have to be doing something 24 hrs a day to be spending your days doing it.
If you were a child who was raped every night by your father, you could absolutely say with honesty that you spent your nights getting raped.
What matters is - does the event significantly affect the rest of your day? Not - is the event happening non-stop. If that were the case, you could vomit every hour and still not be able to make the claim, since there are periods of rest.
If we can prevent five, ten or perhaps twenty percent of people having gruesome deaths, then not doing so feels like a moral failing.