[dathos]

My grandma always told me when she couldn’t go on her walks anymore she didn’t consider life worth living. When she got dementia she was placed in a closed hospice, to “protect her”. Now she only walks when I visit, and I only see a shell of the woman she was.

Anecdotal of course, but why do people think it’s an ethics question when society is individualistic as can be? There is no choice in being born, why don’t we get a choice in when we leave?

[rich_sasha]

To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

In a friend's family, there was a big rift as one family member in direct line of inheritance was accused of (successfully!) pressuring his mother to refuse medical care. She died sooner and more unpleasantly than she likely would have otherwise, leaving more money sooner to her children. And that wasn't even with euthanasia being legal.

I have lots of sympathy for people so desperate they would rather kill themselves, but I don't know how you square that circle.

[The_Colonel]

> how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

I would look into countries where euthanasia has been already implemented. It doesn't seem like it's a widespread problem, so apparently they made it work somehow.

Does it mean it's absolutely bulletproof and no-one will ever be pressured to undergo euthanasia? No, but you can't ever achieve such certainty, and it's better to look at it from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

[okaram]

The way most countries who have it (including Canada) have solved it is to add waiting periods, and layers of reviews. In Canada, you need two different doctors to sign off on it. If you're not actively dying, you also have a 90-day period of reflection. And you have to be of sound mind.

This seems to me like good enough safeguards, don't you think?

[AlexandrB]

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

This is why it's important to have a pretty detailed living will[1]. Especially is you're already chronically ill and have a pretty good idea of how that road ends.

[1] https://en.wikipedia.org/wiki/Advance_healthcare_directive

[twoodfin]

What you’re hitting on is the inescapable truth that there are problems government institutions can’t solve.

[thinkingemote]

Manipulation and coercion can oppose the suicide too. There's some cases where family members don't want their loved one to kill themselves.

I'm not sure how these were resolved but it's very messy and hugely traumatic for all involved.

[14]

Well I am sure no system is perfect but the people that choose to end their life have to meet several criteria. They first need to be of sound mind when they make this decision (and this is one of the current issues being sorted out). So they talk with their doctor and express interest. They then are seen by other health care providers like psychologist who discuss it more. They are spoken to privately without the family present. It is their decision in the end and only theirs. Once they choose a time they need to still be fully alert and aware and they have to personally push the button that ends their life. And that is one of the issues, some people do not want to live if they become paralyzed or brain dead. But we can not euthanize those people even if they expressed that wish before.

I have worked in hospice and they do MAID there all the time. It was a weird feeling to see a family and their loved one head into the downstairs where they would all sit around and tell them person how much they are loved and then that person would end their life. But I know it is the right thing.

[invalidname]

How do you prevent people from smoking? Eating processed food?

Is the fact that the process of suicide is slower/more conventional a difference?

People seeking this process go through a psychological evaluation to determine if they are under duress and of clear mind. Also there's liability to the ones applying undue pressure which can be criminal.

I think there's a point of personal responsibility. Potential abuse of the system should not be the reason to deny it to everyone. I want to have control over the way I live and die. Alzheimer's is unfortunately in both sides of my family, if it has no treatment and I start showing signs I would rather die than live. It would be torture for me to put my family through that.

[nitwit005]

The much more common case seems to be families forcing treatment, effectively just prolonging the pain. People don't exactly easily come to grips with their parents dying. Some people never do.

[jncfhnb]

Sounds to me like your family friend’s mother would have died more pleasantly if euthanasia were legal.

There are plenty of ways to pressure people into death, as you have already demonstrated. That’s not going away.

Emotional burdens to encourage people to live as long as possible even if you think they’re suffering are likely a far bigger problem. People know it’s unethical not to euthanize animals that are suffering. Lacking the social apparatus to suggest euthanizing humans is almost certainly a huge moral weakness.

[kerkeslager]

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

How often does this actually happen?

EDIT: To be clear, I'm not saying this doesn't happen, I'm really asking.

[bleakenthusiasm]

One reason is religion. That aside, people are afraid that this could be abused. People could choose this purelyto avoid additional cost to their relatives.

It could be used as an excuse why more costly options to avoid pain and suffering in old people might not be covered by insurance anymore.

People could be talked into it for various reasons.

Canada is a good example of a country where I think the base to make it work in a positive way is given. Their insurance covers a lot of treatments for basically everyone. The country cares about its citizens in a way that makes you believe they won't use euthanasia as a cop out to avoid paying for medical care.

If these circumstances are not given, euthanasia can easily be seen as an easy way to get rid of people who are too expensive for society or too cumbersome to take care of.

[Analemma_]

> People could choose this purelyto avoid additional cost to their relatives.

Why is this a bad thing? If there's a choice between giving $100,000 to my descendants and using it to keep me intubated in a hospital bed for an extra 6 months, I find the former preferable by far. If someone else doesn't, that's fine, but I find comments like this both annoying and creepily authoritarian in saying that the correct choice is obvious and so they're going to make the decision for me.

[amatecha]

Yeah, I knew someone who opted to have their dementia-suffering parent live with them until the end. That was tough, but... surely better than being left alone in a hospice/etc. as you mention. Unfortunately, yeah, you'll see the person just erode and ... it's really brutal as hell, ultra sad. Eventually the person is not even capable of consenting to euthanasia (nor any other medical procedure). Definitely something to discuss with family or closest friends especially upon getting diagnosed with an illness like that.

[nradov]

Caring for dementia patients at home is seldom better unless the family has the resources for 24×7 care. I know from personal experience that dementia patients will wake up in the middle of the night to wander out into the street or accidentally start kitchen fires. And if the family tries to do it all themselves it takes an enormous unsustainable toll. At some point everyone is better off putting the patient in a professionally staffed facility. Of course the prices for those create other challenges.

[14]

I have worked in hospice and would say typically the people who end up there are not what I would say left alone. But they are there to die. They usually end up there because the family who was looking after them is really struggling to do so any longer for various reasons like personal care or medication management being too much and they are approaching death.

When there they get basically as much drugs to fight pain, anxiety and other symptoms as much as they need. The goal is to provide as much as possible a comfortable end to their life.

Dementia patients are not candidates for MAID program here in Canada. You need to be of sound mind at this time. Perhaps in the future one can make a living will for future illness but currently if you are confused or suffering from dementia and can not understand what it is all about you can not consent to it.

[InDubioProRubio]

Because half of society is a labour camp without guard towers- and if the slaves leave the camp it collapses in on itself.

[nashashmi]

> why do people think it’s an ethics question when society is individualistic as can be

Because we disagree that society is individualistic. We are social creatures, not individualist creatures. And we need people around us. Including you needing your grandma. And she needs people like you.

turn the question around: why do people feel easy escapes are ok? We came in this world and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?

[wiseowise]

> why do people feel easy escapes are ok?

Because they are ok. Why wouldn’t they be? You don’t get bonus points after life for suffering on “hardcore”.

> We came in this world

I don’t remember anyone asking me whether I wanted to come in here or not and I sure as hell won’t let anyone dictate how I want to die.

> and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?

Because you’ll die anyway.

[jncfhnb]

What do you need from grandma, who is in constant pain and desires to die?

[int_19h]

Because nobody has the moral right to demand that other people suffer for their own sake.

[coffeefirst]

Because I’ve seen the slow end and I wouldn’t wish that degree of suffering on anyone.

[stronglikedan]

> why don’t we get a choice in when we leave?

Because dead folks don't pay taxes.

[bawolff]

Terminally ill people generally aren't paying taxes either. You have to make money somehow to owe taxes.

[barbazoo]

So which one is it, the government assisting in deaths too often or not enough, it can't be both at the same time.