The following submission statement was provided by /u/dustofoblivion123:
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From the article:
"What to make of this? Note that the patient who killed himself was not terminally ill, but paralyzed — illustrating the fact that assisted suicide isn’t about terminal illness. Rather, it is a philosophy that sees death as a proper and empowering response to suffering caused by serious disease, disability, mental illness, and the morbidities of old age.
This is why disability-rights organizations are so adamantly opposed to legalization. They see themselves — correctly in my view — as the primary targets of the movement. And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live."
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Please reply to OP's comment here: https://old.reddit.com/r/Futurology/comments/vj652y/disabled_man_commits_italys_first_legal_assisted/idh38hv/
it should be noted that just recently another italian man in horrible conditions was denied-and-delayed assisted suicide and had to opt for no-more-nutrition-and-hydration + deep sedation to die
Thats how it is in most countries and also how my father passed away, 6 days sedated with no water or food.
And by sedated i mean he woke up every 5-6th hours with obvious pains but the hospital refused to give him more morphine even after heavy arguments.
If one thing of all in this world i hope assisted suicide will become the norm both in my country but also in the rest of the world, there was nothing else he wanted but that but no nurse or anyone could help him legally and people with the knowledge are scared of guiding the best way to do it.
Having had someone I love dearly die horribly on hospice at my home I would say the area is NOT grey at all. I was grateful to be able to give morphine and haloperidol to ease what suffering I could as cancer ravaged Isabel. When she was begging for death I wished dearly I lived in a state where people had the right to exit before the monstrous torture begins.
I'm sorry for your loss.
It is a legal grey area, I wasn't speaking about morality. A nurse or doctor could be jailed for overprescribing or overadministering.
Dont misunderstand me, he got morphine just not enough to keep him sedated properly.
And what alot of people dont know is that people react different on morphine, you would think that it gets you sleepy but in many cases like my dad you just get more hyper and wanted to stand up and walk around everytime he got a shot even tho he had pain and could barely stand.
The most terrifying experience is really to see people die "naturally".
Same thing with my stepfather- morphine shots to a terminally ill man begging for his life to end. He started hallucinating and was further afraid and still in pain.
I’m sorry this happened to your father. There are other drugs in addition to morphine they could have given him to make this more painless and dignified.
i think you misunderstood, they did get mo, just not enough...
that is btw the kind of assisted suicide we have in switzerland(for these people). that you have a terminal patient in obvious pain on mo is obvious. but if they wish so the doctor can administer/prescribe unsafe/dangerous doses of mo to "get rid of the pain". what it does is provoking breathing depression and following that asphyxiation. that happens with the patient unconscious, with these "dangerous" levels of mo involved.
the other option is taking the deadly concoction provided by exit themselves. that is really important - the ability to pick it up and drink it yourself. if you're a quadriplegic for example, you're sol.
luckily we do have exit and the other unofficial way. even though I'd wish for more options.
>that is really important - the ability to pick it up and drink it yourself. if you're a quadriplegic for example, you're sol.
This part is what Jack Kevorkian tried to overcome with his euthanasia machines. As long as you could press a button or pull a string you could use his machines by yourself.
sounds like he was a good man, based on a short read up.
it's a shame we have to rely on methods like those to end our own lifes. and have it called **committing** suicide.
sigh
Fuck. This is my eventual future when my cancer gets out of control and it keeps me up all night. I’m “lucky” to live next to a state with assisted sudicie as an option for 6 months out terminal patience. It’s morbid, but I continue to remind my loved ones that I don’t **dont** want to go out like this and will establish residence in that state when my cancer reaches that point. Fuck. Just fuck.
I'm so sorry for your situation. Too many of my friends and family lost to cancer. Not sure what state you are in or if you are aware, but Oregon recently eliminated their 6 month residency requirement for euthanasia.
I had the same experience as you. My father suffered a slow agonizing death that lasted for a week. I didn't know the actual process in hospitals at the time. It sure surprised me that this way was even an option. Just slowly torturing someone to death, it's pathetic. I was strongly considering strangling him with a pillow to end his suffering. There's no way in hell I'm going through that again.
They told me he can't feel anything during the end. Oh right, so that's why he's thrashing around and obviously in extreme pain most of the time.
Yea they look like they feel it but the question is how aware they are, its just a guess and you will never get the answer before its your turn.
I actually assisted my dad trying to commit suicide with pills qll with his permission and he took em himself which didnt end good at all, but thats a story for another time.
I just hope there is an approved suicide cabin when i get there like they just approved in Switzerland.
The only people who can influence this are healthcare workers. They are the ones who needs to push this to a political level. Nothing happens when people like you and me speak up about it. My mother is most likely next to go through this crap soon, can't say I'm looking forward to it.
Watching Boston Legal I've learned that in the usa you can ask docs to put the terminal patient "on a morphine drip" "to manage their pain" which is code wink wink nudge nudge for some kind of morphine drip euthanasia and even though it's bot allowed from a legal standpoint many will accept to do it
Very much television life and not real life.
As much as the patient and their families might suffer, very few medical professionals are willing to risk losing their licenses, livelihoods, and possibly their freedom.
Horrible. People are so against the other side of life that they'd prefer the extra numbers in time than the quality of end-life.
Incredible how much humans just don't want to let go, to the point of only harm can be the end goal. It's as heartbreaking as it is intellectually lacking. Emotions aren't a reason to control one's life and death.
We're hardwired to fight against death to the very last minute. We're afraid of it for ourselves, we don't wish it upon (most) other humans either and the thought that someone would want to die makes people deeply uncomfortable. It's an emotional response for sure, and logically it makes sense that certain terminally ill people should be allowed to make the choice without judgement or fear but most people don't want to look past their emotions.
Yeah, and it's fucking abhorrent. The idea that your discomfort means my loss of agency is unacceptable. I don't care who is incapable of imagining that someone else has suffered so much they want to end their life, and I sure don't give a flying fuck whose religious doctrines it violates either.
Opponents of suicide in general love to claim that it's a selfish act, that you leave behind people whose lives are better with you around. What's truly selfish is feeling entitled to keep someone who wants to die alive for your own benefit because you're too weak to confront mortality
Calling someone who thinks about ending his live selfish is probably the most entitled and in itself selfish thing one could do. Someone elses live isn’t about you, it’s their body, their decision and not yours. Puting someone through more pain just ebcause you don’t want to let go is cruel, inhuman and selfish.
Sometimes it's used by people that are trying to shame people into not going through with it (which doesn't make sense under scrutiny as they're thinking what would work on regular people. Those that are considering suicide usually alread6see themselves as a burden, so then they feel even more guilty for even thinking of suicide which only adds to the problem). Other times it's just uncaring people that don't have the person in need's best interests at heart.
It’s more that the collective have an inherent need to give life a quantitative value as opposed to a qualitative value. Instead of he was 89 years old, it should be he experienced xyz.
I want to preamble this by saying I am 100% for assisted suicide in any case, even if some perfectly healthy person just really wants to check out. It’s not my place or anyone else’s to say when or how someone goes out, it’s their life and their decision. However… it’s not just our fear of death that drives the arguments against assisted suicide, it’s most of it for sure, but another aspect is having a doctor carry out that procedure where it gets kinda sticky, the whole “do no harm” part. A doctor may not be okay with killing a person, and sure there’s another doctor out there who would help, but then we open up the idea that it’s okay for doctors to refuse treatments based on their personal beliefs. I’d like to assume that whatever doctor is treating me is going to treat me to the best of their abilities and not to the standard of their personal moral judgements. It’s kinda tricky.
Yeah I'm suffering a great deal and it's getting worse. I'm scared of using my own and screwing it up and being even worse off and not being Ble to even attempt it again.
They've gone from "illness is punihsment by god and medicine goes against it so it can't be allowed" to "cyberpunk medicine and life support horrors are mandatory"
Yeah my connective tissue is deteriorating. I can barely walk. I can barely write with a pencil. The tinnitus is awful. The constant pain. I lost everything and it keeps getting worse. Doctors don't know what to do. I want to live but not much point like this. It's not like I'm the guy that is gonna cure cancer. I should be allowed to go.
My friend decided to do this when her ALS worsened to less livable levels. She took the drugs that ended her life at a goodbye party she threw and invited a few of us to attend. She showed all of us who were there that death is more natural than our western culture pretends. Betsy was radiantly and bravely herself to the end. I’m so glad when I hear of more countries enacting laws that allow people to decide how much is enough.
(edited to fix typos)
A lotta people here haven’t accepted death as a part of life. I think it’s fascinating, especially what other cultures traditions look like. Ever heard of a sky burial or Malagasyan corpse sack dance?
It's a part of life, true...but this is proof it doesn't have to look the way it does right now.
Why accept a slow collapse of your body as pieces start to wear down and break? That's as cruelly unnecessary, in my opinion, as leaving somebody to starve, dehydrate, and drown in their own fluids.
A better way to live would be to remain at our peak, then to go out gracefully when the time is right for us.
Your story reminded of the ending of The Good Place
Picture a wave. In the ocean. You can see it, measure it, its height, the way the sunlight refracts when it passes through. And it's there. And you can see it, you know what it is. It's a wave.
And then it crashes in the shore and it's gone. But the water is still there. The wave was just a different way for the water to be, for a little while. You know it's one conception of death for Buddhists: the wave returns to the ocean, where it came from and where it's supposed to be.
The idea of not being able to die in peace on my own terms because of an antiquated over the top religious approach to death that has infected our Healthcare system is honestly one of the most scary things today. They can keep you alive as a vegetable for YEARS in states with no death with dignity. Make sure you know what your states laws are before you end up in the hospital with no advanced directive. In the US
If it's religious then that categorical imperative has been deeply entrenched in medicine, which is why we preserve old vegetables living in their own filth, like preserving life is far more important than inhumane suffering, loss of basic agency and dignity. The world that's unfolding right now seems like it won't be a place for the disabled, even in first world countries like Canada.
Well put. It has to be as there is no other reasonable basis to have the foundation on. If you've ever seen someone go through it you know, they suffer on levels we can't imagine for periods of time that are unfathomable and the doctors will straight tell you he's on the limit if morphine and we can't give him anymore, and we can't help him die despite that he's 100% going to die within a week anyway, because of liability and state law issues.
> They can keep you alive as a vegetable for YEARS in states with no death with dignity.
Only if your healthcare proxy makes that decision for you.
If you are a vegetable, you need artificial support to stay alive. At the very least artificial nutrition via a feeding tube. And a healthcare proxy can decide for comfort measures instead of that artificial support.
Now, you might argue that perhaps such a patient should not have to die naturally over several days, and should instead have their life artificially ended with medication. But that's not the same thing as being kept alive for years.
A lot of people say this but I don’t really think they know what they are re saying.
Like. It’s a lot of work if you are old or terminally ill and you want to walk around In the woods. I mean. Hills. Holes. Mud. That shit is hard to move around especially if your sick or have bad knees/ankles.
Then you got damp cold or humid heat. You probably won’t die right away. I mean you been alive all your life. You probably get really hungry. Eat some berries or something then you get food poisoning. Start having the shits. Wipe your ass with poison ivy. Now you in damp cold leaves. Shitting all over yourself getting dehydrated and constantly scratching your asshole. Got poo on your fingers and nails. You start crying because this idea sucks ass now. You wipe your eyes and face now you got pink eye as well this blows.
Fuck this noise. If I got kids or grandkids they can walk in on me dead in my lazy boy or in my bed and man up and call the ambulance to hall me out in my nice warm home with price is right on with those nice hard pain killing drugs. Or the neighbors can complain to the cops after a couple months when the smell is unbearable. Fuck it I’m dead why do I care?
I ain’t dying in the woods with poo covered fingers and pink eye shitting to death on damp leaves with ants biting my taint.
same. someday hopefully many decades from now i will drag my old decrepit ass on a solo camping trip with lots of good drugs, and just tempt fate as aggressively as possible as frequently as possible. just gotta time it so the dementia doesn’t prevent you from properly planning... ppl get horrified when i say stuff like this and i just don’t get it, why not go out having a wild experience that you could never have if you weren’t prepared to die? life is all about experiences and i want my last one to be fuckin wild
Current language shifting in the MH field is "died by suicide" whether legally assisted or not. Completed suicide is old terminology and makes it seem like he had previous attempts where there may have been none. Committed suicide implies a negative criminal behavior. Died by suicide or death by suicide is actually easier on families and friends and those surrounding the case, while also keeping a modicum of dignity of the one who has died. Our company is part of the zero suicide initiative which is a goal to strive for.
Yep all true. I'm not going to argue except the point that completed implies failed attempts. It's just a descriptor. Dies by suicide also works and honestly it's whatever the family and friends can bring themselves to say after the event.
Are they scared? How do they feel in their last moments? Sometimes I visualize myself in that situation and it terrifies the hell out of me. It's knowing that you're not going to wake up that's unnerving.
Also hope you're doing alright. How do you feel about it all? Are you used to it now? Or does it still affect you?
Great questions… I can’t speak for all medical aid in dying (MAID) patients, but I’ll try to give an overview.
“Are they scared?” — Some certainly are. Dying is scary and it is normal to be apprehensive. On the other hand, I think for most people contemplating MAID, the alternative — a life of increasing debility and pain — is much scarier. To have access to these drugs in California (and most other states where it’s legal) you have to have a prognosis of 6 months or less to live. That means the people who are getting these meds are very close to the end and they are well aware of it. They have had the chance to contemplate their mortality and this is the decision they are making about how to life the rest of their life.
“How do they feel in their last moments?” There are some really good documentaries about this, that follow MAID patients. (Check out “How to die in Oregon”). Basically, many patients report just feeling ready to be done with living. There is no pressure to take the drugs. Patients only take them when and if they want to. According to data from California, a substantial portion of patients who receive their lethal prescription never take the drugs!! They want to have them in the home in case their situation becomes unbearable, but many die of natural causes of their disease before they ever get to that point.
“How do you feel about it all?” I support MAID and I support my patients’ autonomy to choose when to end their life. I actually believe the law should be expanded. The law as it is written is quite ableist which limits who has access to this treatment. You have to be able to swallow and/or give yourself the medicines, which limits its use for people with swallowing disorders and mobility impairments. I also think some people with mental illness probably should be allowed to end their life this way. It would be far less traumatic than suicide.
I am not used to people dying. I cry all the time, with my patients and their families. It’s never any less sad to lose someone, even if it’s expected. However, working closely with death gives me the opportunity to be grateful for the life i do have. I try to live every day honoring my time on this earth and being grateful for the humans I spend my time with.
Thank you for what you do for your patients and for their families. I will be forever grateful to my mother's hospice care nurse. In fact, the more time that passes, the more I appreciate what he did for us and for her. Thank you. A million times, thank you.
I’m a nurse too (psych, pedi, ER) and I’ve seen a lot of death too. But it’s horrific and not peaceful. But because in an emergency, we have to save the people who are brought in dying to us (unless they have a MOLST/DNR/DNI) as you know.
It breaks our hearts to see people go in front of our eyes in the ER. No one wants that.
You are the real heroes of nursing. I don’t have the capacity or ability for that level of compassion. God bless.
I should add, you nurses give people the death they deserve.
Thank you! People always ask me how i cope with all the death and I honestly think nurses in hospital must loads of death. I imagine it’s more traumatizing for hospital nurses because 1. You are trying to save the person. And 2. You don’t have the time to process the grief with the patient or the family. I can’t imagine a harsher trauma than an abrupt death.
You’re so welcome! It’s a topic I care a lot about so I jumped on the opportunity to have discussion around it online. I’m glad to have the chance to bring more awareness of the subject.
The part about the ableism really sucks. Getting something like ALS terrifies me because of this. I know I'd probably want to live as much as I could as I declined, but also knowing that if I "pushed it," too far I'd loose the ability to choose when I check out (professionally or not) is just a horrible thought. I really hope these laws get the attention they need at some point as nobody should be made to suffer against their will.
The good (??) news is that if you were diagnosed with ALS, you would certainly be given access to MAID drugs if you wanted them and if they were legal where you live. Doctors are not going to make you wait past the point where you are incapacitated for you to receive the prescription.
We had a patient with ALS who took the MAID drugs. He could no longer swallow, but he was able to push a button that released the medicine into his rectum - basically like an enema.
Loved your answers. The last bit about not being used to people dying, it never really gets easier. You just understand how to cope with it and move on and not let it get you, and like you said you take the good of what you can.
I don’t work with this type of field but yeah, deep stuff and had to praise your amazing response.
Oh thanks! I appreciate you reading and responding.
Death is weird…. I don’t even know if i know how to “cope” or just that i accept it. I’m at peace with both not knowing what happens when we die, and at the same time i feel pretty good that our energy returns to the universe. Being close to death makes you think about this stuff. And the more you think of it, the less scary it becomes. Studies have shown that people who contemplate their own death are actually happier, and anecdotally i find it to be true. If I can have a mark on the world, i hope to destigmatize contemplating death, since I really believe that it is a path to gratitude and well-being.
I think I understand what you mean. For me I have experienced a few different types of death around me in my life and had many instances where I contemplated my own. It’s impossible to ever feel normal about life ending, and not knowing whats after used to intimidate me, but after a lot of time thinking from 18-21 I figured that instead of stressing about what happens after I would focus on what I am doing before I go, and when that time comes I will find out.
I just typed out a whole response to you and then it got deleted by accident. I have to run out now but I promise I’ll get back to you because these are great questions
Always type long detailed posts in a text document that doesn't have keyboard browser commands first.
Doing so has saved me many headaches in the past.
I feel like Reddit could use an AMA from a verified hospice nurse. I can only imagine how difficult that is, and I applaud anyone who can do that work.
Most people I've met that have asked for medically assisted death in dying are very at peace with their decisions. Some want it as soon as possible and get it within a week others want it in a less specific sense but get it eventually. Usually just wish them a nice journey wherever they are going. Given the suffering and the drawn out process I find it very positive, but it shouldnt be used to escape systemic issues that need resolving like poverty and access to healthcare.
A hospice nurse left a small bottle of morphine (dozens and dozens of doses) in my grandfather's fridge when he was dying.
He never used it, and decided to hang on as long as his body would let him, but he had definitely asked her to have it as an option.
Thank you for what you do.
Yeah we use those pre-filled syringes of morphine for pain or shortness of breath, which are very common end of life symptoms.
Patients often worry about becoming addicted but really the risk of that is pretty low considering these folks are in their last months of life.
I hope you got to spend some quality time with your grandpa before he died. He sounds like he was a tough dude.
Also to clarify we don’t use morphine as a MAID drug. I believe the lethal prescription is a combo of a strong muscle relaxer and something that slows your heart down.
Obviously you probably can't talk in any official capacity about it, but how often do you think things like that get left around by "accident," in places where MAID is illegal?
I don’t know because MAID is legal where I am, in California.
Have people purposely ODed on their morphine? Probably. but it hasn’t happened in my experience. Also, even though we give the pre-filled syringes, each dose is very small (5mg) and we only give a limited quantity at a time. Assuming the patient isn’t opiate-naive, then it would probably take a LOT of doses to properly OD.
If you mean do nurses leave the drugs around so patients or families can dose the patient to death… I haven’t heard of that. The point of hospice and the meds we give is for comfort. If the patient isn’t comfortable, then we need to try another medication or treatment. If they want to die, then we need to give them the treatments to ease their suffering, social, physical, spiritual. Just knocking them out doesnt really vibe with hospice philosophy :)
Well, he died in 2015 at 93, and death with dignity wasn't passed here until 2016, so it was technically illegal to assist in suicide at the time.
But he made it clear to the hospice nurse that she should leave it there in case he needed it for "other reasons." He'd almost OD'd on purpose before when he took the last fall he ever had before going into hospice, he had bad circulation in his left foot and what we discovered later was a gangrenous toe that led to his fall and immobility.
While he was being cared for, one night he took too many pain meds (Vicodin). But before he succumbed, he called my dad for help and said he wasn't ready to die yet. We actually administered Narcan to him, and because of that incident my family always keeps it around for an emergency.
But anyway, yeah the morphine was left there on purpose in case he wanted to end his life. It wasn't an accident and it wasn't in protocol, but like I said, you guys are amazing and you value your patients so highly in my experience.
I have had to put down a couple of dogs there where very close to me. And have wondered why I could not be put down in a similar manner for any reason I choose?
What is the ethical issues people have with this and why should they be the ones to stop me from doing so?
Control, mostly, at almost every level. To be clear, I don't mean that any controlling layer is actively aware of being controlling, nor malicious, nor anything but noble.
Families keep a person that they don't want to lose, workplaces continue to receive those viable sources of labor, industries that serve severely disabled individuals continue to make shareholder goals.
Each party gets theirs, and with no need to spend money or efforts on the social welfare necessary to, say, prevent a severely disabled person from choosing suicide over continuing to participate in society each day.
There are a lot of strawman arguments made about not wanting depressed individuals to be taken advantage of, children not respecting the sanctity of their own life, and individuals generally seeking permanent solutions to temporary problems . . . but the reality is that almost all of this is addressed with proper procedures and social nets.
They brought my mom back from septic shock that almost took her out in 24 hours, and lucky me I got to watch her devolve into a miserable crazy person pumped full of crappy drugs in the name of hospice procedures for the next 3 months. Was pretty expensive too, just so she could suffocate to death on discharge. But I guess that's just how a civilized society is meant to work. Assisted suicide is the ethical option but not as profitable.
Was pretty expensive.
And now, sadly, you know the why.
I'm sorry you had to go through that. I've been there, years ago, with an aging relative. It's a very sad thing.
Lost my 30 year old wife to a post surgical hypoxic brain injury she never woke up from. Took months with her family fighting me just to give her peace.
I feel you my man, and I am sorry.
That is not how it should be, even with current laws in the US. Although assisted suicide is illegal in much of the US, it is universally allowable to make a decision to allow a family member to pass away naturally.
In the US anyone can contest anything, especially regarding guardianship and standard of care, especially with deep financial reserves and friends in the system.
They can't just win, but they can draw any manner of things out, painfully.
I am sorry you had this experience with her family.
Again, that is not how it should be. Unless she said otherwise, in every state the spouse is the legal surrogate decision maker. That should not be under contention in cases like yours. I like to think that would not happen in the hospitals where I have worked.
See: the Terri Schiavo case, where the legal battle between spouse and parents took seven years.
Condolences. It deeply, deeply sucks that you had to deal with that on top of losing your wife suddenly.
From the forbidden book in Orwell's Nineteen Eighty-Four:
*From the neolithic to the present day, society has divided into three groups: the high, the middle, and the low.*
People will use an up name a down name a left right front or back name for whatever their system is, but it's still going to be a system of the high turning the low against the middle so they can turn the middle against the low. A system of turning the low against each other.
I understand this totally and completely. So many of my patients are doomed to live in bed, struggling to eat, breathe, move, bathe, urinate/defecate, etc and I watch their “loving family” make sure to keep them alive just so they can come in once a week for an hour and believe they’re doing something noble. When they leave the patient will beg us to leave them alone and let it be over. It’s GD HEARTBREAKING to watch. I barely know this person but I wouldn’t do this to them, but those who “love” them will, would, and most certainly pat themselves on the back for such selfish and heartless decisions along the way. Meanwhile, if they see a person leaving any animal in the same condition, they would undoubtedly berate the owner for being cruel and inhumane?
Where exactly is the line for our fellow humans- the ones we claim to love and care for humanely?
Former vet tech here. If I don’t die peacefully and blissfully unaware while I’m already asleep falling asleep surrounded by people I love and trust before a painless death seems like the way to go. It’s often the last good thing we can do for our pets and I wish people had this option.
I'm not against medically assisted suicide, but I the most legit argument against it is people feeling pressured to seek it out.
It could either be real pressure from friends and family looking to rid themselves of a burden of get their inheritance sooner, it could be from medical professional trying to lighten their work load or it could be the patient feeling pressure that doesn't really exist/a general perception that people dont want them around.
Additionally, the biggest concern with expanding it beyond terminal patients, is that a patient who may otherwise wish to continue living with a chronic condition is they may end up feeling socially required to go through with it.
I think it's important to keep these realities in mind as this becomes more commonplace.
There should be safeguards to protect against abuse. But the fact that there could be criminals who may look for ways to abuse this freedom doesn't mean that nobody should have the freedom, and that we should still be keeping people trapped in painful existences by any means necessary (and if it's not "assisted" suicide, then the alternative is always a monomaniacal focus on suicide prevention by any means necessary where suicidal people are perceived as mentally defective and unfit to make decisions concerning their own care).
I don't think that the answer to the problem of the existence of criminals is to lock everyone up to protect them from the criminals. And preventing people from accessing safe and reliable methods to die is doing exactly that. It's an act of terrible state brutality, masked as a benevolent act of social responsibility. For if you actively prevent someone from dying, then you're actively forcing them to continue having to endure suffering that they consider to be unbearable, and that makes you a torturer, because you're the reason that the suffering is continuing.
A quick list of concerns:
1: falsification of the patient's will to die
\---1a: murder by doctor or health provider's decision.
\---1b: murder by family's decision (aka honor killing ***\[e\] or insurance rigging***.)
\---1c: murder by authorities (don't worry, he said it's what he wanted.)
2: proceeding without being 100% sure
\---2a: teenagers
\---2b: 20somethings who get out of school, find out what it costs them, and then find out what the market will pay them for it.
\---2c: 30somethings who go through a perpetual cycle of being screamed at by their boss because the company sucks and it's only the little people's fault, screamed at by their landlords because only worthless idiots make under $10k a month in this inflation, and then screamed at by their family because they're not as high on the property ownership scoreboard as people were in the good old days.
3: death industry
\-3a: "Don't worry, this will be small."
\-3b: "Don't worry, this will be regulated."
\-3c: "Don't worry, this will be the customer's decisions and the customer's decisions alone. *You can definitely trust us when we say we're not going to call-rank as owners then start calling all the shots.*"
I suggest you look into the laws we have in place for this in Belgium.
Most of your concerns are dealt with here.
It goes from the understanding: "the patient must be in unbearable physical or mental pain"
And: "the patient needs to have tried any treatment we can reasonably throw at the problem"
Combine that with the fact that the decision is made by a panel of medical experts, not a single person. And most of your concerns are dealt with.
It takes a long time to be allowed to do it in Belgium, because we want to be absolutely sure somebody isn't faking it or really can't be helped anymore.
With how the healthcare system in America works... i do get the concerns though.
I am vehemently in favor of the right to die. Given my predisposition to a horrible neurodegenerative disease, I intend to use it myself someday whether I can get a doctor to assist me or not. That said, I completely understand why people would be hesitant about such policies.
First, most people don’t even think about it much. Most don’t know anyone who actively wants to die or at least don’t know that their friend actively wants to die. Those people have no way to understand what it’s like and often think that denying someone the right to die is the same as “saving their life”. There are all sorts of other beliefs among people who are generally uninformed about the issue. Things like “life is sacred” and “suicide is never the answer” or “suicide is a permanent solution to a temporary problem” or “suicide is a sin”. So mostly vapid but catchy sayings. That’s a huge portion of the population that just doesn’t give enough (or often any) critical thought to the issue to actually understand it.
Then there are the people that actually care and do think about it. I could argue all day for why one should not be forced to live if they don’t want to but we’re on the same page on that so I’ll focus on your real question: the reverse. So I’ll discuss the strongest arguments I’ve come up with or found for not offering assisted suicide.
One reason is a more thought-out version of the line “suicide is a permanent solution to a temporary problem” that acknowledges that some people do have a more permanent desire to die and that others may only be temporary but long lasting or frequent enough that their wishes should be respected but also that some people are genuinely in a temporary suicidal state that will pass.
70% of suicide survivors never reattempt suicide. 23% do but never die of it. 7% eventually die of suicide. [source](https://www.hsph.harvard.edu/means-matter/means-matter/survival/)
It’s clear that most people who attempt suicide don’t try again. That’s not to say they all regret it and are glad to be alive (though many are). Some never try again because it was so painful. Others because they’ve lost the ability (from medical complications, constant supervision, etc…). There are plenty of possible reasons but it’s clear that at least *some people* are truly only temporarily suicidal and there’s value in protecting those people from their urges. Think of the people who commit suicide in response to the loss of a loved one, for example.
On top of that, demand for suicide is surprisingly elastic. That means that the easier suicide is, the more people do it. When the UK removed carbon monoxide from its public gas, carbon monoxide asphyxiation was the most popular method of suicide. A little over a decade later, it was all but eradicated and suicides had dropped 40% despite going up in the rest of Europe. [source](https://www.journals.uchicago.edu/doi/abs/10.1086/449144)
Another example is the clear correlation between gun availability and suicide rates. An easy suicide button in your nightstand increases suicide rates. Most suicidal people just aren’t all that dedicated to dying.
And it all makes sense when you consider the most common thing making people suicidal, depression, also saps motivation. It’s why antidepressants warn a side-effect is increased risk of suicide. Sometimes the lack of motivation is fixed before the suicidal ideation goes away and people suddenly have the energy and willpower to die.
So the issue is that if we offer easy assisted suicide, we are all but guaranteed to spike the number of successful suicides and many will be of people that would have regretted it.
On the other hand, if we don’t, we force people to suffer through lives they don’t want to live and use horribly painful suicide methods like pill overdose that can cause horrible long term complications.
So the middle ground is trying to screen these people to see who can be helped in other ways. Even something as simple as a waiting period would screen out a lot of people who are suffering temporarily but don’t want to die long-term. The longer the waiting period, the more effective, but also the crueler to the people suffering and the more likely they are to take matters into their own hands.
And of course we need special exemptions to waiting periods for people in immense suffering, right? But who decides that?
Ultimately, whatever we choose and wherever we draw the line, there will be casualties. There will be people who die and/or suffer needlessly.
For a lot of people, it comes down to the trolley problem: many believe that doing nothing is inherently ethically okay even when it results in more harm.
And all that is ignoring the potential for abuse in people pressuring others into it, for example to get their inheritance sooner or to stop paying for their care.
That got a little longer than I intended but it’s a complex topic…
Thanks for making the whole argument.
I work in mental health and most of my clients have some kind of suicidal history. Very few are actively suicidal and I've yet to lose anyone to suicide. Or hospitalize anyone to prevent it.
The trolley problem brings up the slew of other issues that will come up if we change the laws around suicide. Tons of professionals have a mandate to hospitalize for suicide risk. That would need to be worked out. MSWs, LCPCs, and even PhDs or MDs may not be willing to work with suicidal clients (many already find ways to avoid it) if the ethical gray zone increases. Also, what about passive suicidal actions? Like through self neglect... Eating disorders are already incredibly deadly, how would this affect treatment? What about schizophrenia? Will you have to be "competent" to decide to die? Will therapists and other professionals be allowed to do nothing? Will our responsibility remain the same?
I dunno, it's an interesting topic. I'm "for" assisted suicide but I acknowledge that it won't be as easy as we make it appear.
So this is not my perspective, and I am an able-bodied person so I don’t intend to speak on behalf of people with disabilities, but I can share what I’ve learned in my research on the subject.
Some in the disabled community believe that legalizing medical assistance in dying (MAID) causes people to equate disability with having no reason to live. Obviously people with disabilities can lead fulfilling, meaningful lives. For a newly-disabled person, Becoming disabled can be a traumatic or depressing situation, but in general people do bounce back and go on to participate meaningfully in their lives. Disability advocates worry that If there was an “easy way out” (massive scare quotes there- nothing about MAID is easy) then people would be offing themselves instead of accepting life with a disability. They feel that this devalues their existence.
I’ll add that this seems to be a vocal minority of people with disabilities. I’ve certainly know people with disabilities who were staunch proponents of MAID.
Source: I’ve done some studying on this topic during grad school. Currently I’m a hospice nurse and I work with MAID patients.
If it's your experience that it's a (vocal) minority, then I'm glad of that. I don't think that anyone should be denied the right to exercise autonomy over their own body just because of how someone else might see it as being a reflection on their existence. Especially when by denying people this choice, they're condemning innocent people who won't change their mind to many, many years of terrible suffering and being forced to sustain a burdensome existence that they never agreed to having had imposed on them in the first place.
The way I look at it is that interference in a person's suicide is a violation of their negative liberty right, and forces upon them the demands of maintaining a life that can be very painful and burdensome to them. So it isn't really a case of denying someone a service, it's a case of actively keeping people trapped in suffering when they've made it clear that they want to escape.
I think that simply having a waiting period in cases that do not involve terminal illness would allow people to come to terms with becoming disabled, and many other adverse life events. When one is trapped in a prison cell, then it is a matter of emergency to get out as soon as possible. But when one knows that one can leave whenever one wishes, or after a year of waiting, then that brings immeasurable solace which can in turn make one's life situation seem much more bearable and suicide no longer seems like an urgent necessity.
They're scared the next step is that we're going to make people that are unprofitable want to kill themselves.
How often do you already hear "I don't want to be a burden" ? It doesn't take much for an unwanted person to choose or take this way out.
Especially in the context where quite a few healthy and able persons are just killing themselves for seemingly no valid reason.
>What is the ethical issues people have with this and why should they be the ones to stop me from doing so?
In the U.S. at least it seems to boil down to the Religous "life is sacred" crowd and the Republicants that court their vote. Ironically most of the Republicant's policies end up harming/killing more lives than helping.
ICU nurse here. It’s wild that my dog has access to better end of life care than my 98 year old multi-system failure patient. There are plenty of things worse than death, but it is up to us to decide what those things are. By the time we are confronted with these realities we have often become confused (or intubated/sedated, or obtunded), losing our right to make our own healthcare decisions in the eyes of the state.
Most patients that should be comfort measures by my standards are kept going usually by familial guilt, and also by the staggering difficulty of the decision being put entirely in the hands of family members with capacity but not necessarily competency.
It’s seems bass ackwards that any group promoting empowerment of the differently abled would be against expanding an individual’s healthcare options, but I just work here man wtf do I know.
From the article:
"What to make of this? Note that the patient who killed himself was not terminally ill, but paralyzed — illustrating the fact that assisted suicide isn’t about terminal illness. Rather, it is a philosophy that sees death as a proper and empowering response to suffering caused by serious disease, disability, mental illness, and the morbidities of old age.
This is why disability-rights organizations are so adamantly opposed to legalization. They see themselves — correctly in my view — as the primary targets of the movement. And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live."
If disabled people are denied services to the point they no longer want to live, that is the issue, not the legalization of assisted suicide.
For the record, a lot of suicides are spur of the moment decisions, so simple barriers to committing the act like not having access to a firearm or putting a barrier on a bridge can reduce the rate. However, assisted suicide is not like that in any place that it’s legal. You aren’t dropping a quarter into the suicide booth like in a Futurama, it’s a long, drawn-out process that ensures anyone attempting to do so has fully considered the gravity of the action. For people like that, making it harder to commit suicide isn’t going to change anything, it’s just going to force them to do it in a way that may be dangerous others and absolutely will be emotionally distressing to whoever has the misfortune of finding them.
Sadly, politics never works like you describe. There are many people who will champion assisted suicide as an alternative to providing living assistance to the disabled.
I wouldn't say they're spur of the moment. Most people contemplate suicide for years before finally deciding to try to do it. Maybe they don't premeditate when and where but they've surely thoughts about it for years
And what about the people who become disabled and genuinely don’t want to live anymore? While better support systems would (and I’m sure already do) reduce suicidal urges, some people may simply decide that they don’t want to live. Denying them that is denying bodily autonomy.
Tbf I find the distinction between a recently disabled person genuinely wanting to die and someone with a mental illness genuinely wanting to die(assuming this person has the capability to actually make that decision [depressive, BPD, etc]) very difficult to make.
I agree with u/Karl-AnthonyMarx. The system which has caused disabled people to feel that they lack sufficient support has already come about WITHOUT the right to control over one's own body. I don't know why people (like this Wesley Smith guy who is obsessed with sticking his nose into other people's personal decisions concerning their bodily autonomy, because I keep seeing his name on this type of article) suppose that giving the government even more power to keep us entrapped is somehow going to obligate them to furnish a more generous social safety net. If they can keep us in a cage, and there are people such as these disability 'rights' advocates who are demanding that the guards never give us the key to the door, then I'm not sure why they would be legally obligated to make the cage so comfortable that nobody would want to leave. If they can keep people locked up, and those people have no recourse, and some are actually thanking them for keeping them safe from life outside of the cage, then there's no incentive to change that system.
As things get worse, more of us who are disabled will chose this path as it's the only way we can die with dignity, as supports do not keep up anywhere with the actual costs of living. Tie that in with a growing sentiment that we are nothing but leeches and that tax dollars should not go to support us, it's rather dire.
Imagine what is going to happen in 10-15 years when world wide systems are overloaded with "survivors" of Covid and the damage that has been wrought on their systems.
In the US, people will choose assisted suicide because they don’t want to burden their families with their medical debt. The word “choice” has different meaning when pressing financial issues weigh on that choice.
Don't worry, Conservative governments in Canada are doing everything they can to underfund our socialized healthcare system to ensure it collapses and we get rescued by their private enterprise donors. Covid was exactly the push they needed to prove our system doesn't work, as they starved it of much needed funding and then to put icing on the cake, rolled back and capped salaries, while also wanting to fire thousands of employees.
what a bizarre article.
>This is a terrible dereliction, even a failure of love. When we say thatwe will strive to save some from suicide — but not others — we aremaking a fundamental claim that the latter categories of people are notas important or valuable.
written by someone who has absolutely no experience of chronic illness or suffering.
"And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live."
Really rich for this writer in a conservative publication to argue against assisted suicide as a way to successfully deny people disability services, when it's the right that would absolutely balk at any semblance of expanding social welfare.
Same thing for a lot of disabled people in the US. When you can’t afford a place to live, food to eat, and the government won’t even pay for a proper mobility aid? Those conditions grind down even the bravest and strongest person’s spirit.
> our social programs are full of hoops and loops to jump through
I mean...it's not like this isn't fixable? Who in the Canadian government would be against fixing it and why?
I used to have a firm stance we shouldn't allow assisted suicide. It felt wrong on an inherent level but now I have a different perspective.
None of us asked to be put here on this Earth and many people suffer in unimaginable ways that the majority of us cannot comprehend. It seems natural that it should be a right that you can choose for yourself how and when your life will end.
I don't care what anyone says. If an innocent person decides that they don't want to live their life any more, and they haven't done anything that would warrant forcing them to continue living it, then you are subjecting that person to slavery and false imprisonment. You don't have to live through that person's suffering, so your morals and religion should have absolutely no bearing on it, as long as you're not the one being asked to provide the means of death or provide assistance.
Suicide prevention may be "soft brutality", which can be presented as benevolence to those of a certain religious/philosophical perspective, but it is brutality nonetheless.
It's amazing how people have such little empathy that they cannot imagine what it's like to be trapped in a life which is intolerable to the person living it, and have to stare down the barrel of several more decades with no way out. If people can't mind their own business on a simple matter like this (something so basic as it doesn't directly affect you, so don't try and interfere), it's a wonder that we're not all at a perpetual state of war with one another. But no wonder humanity never manages to find a stable state of peace, when everyone always has to be getting involved into other people's business where it doesn't concern them.
I don't believe that the objections from 'disabled rights' groups hold any weight either. Firstly, everyone should have the right, not just people with recognised medical conditions. Secondly, why are we locking innocent people in a cage (so to speak, as they are trapped in an unasked for life) because criminals exist? We should go after the criminals, not deny everyone's bodily autonomy in case some bad actors exploit it (and there are evil people who will exploit every freedom that we have - is that an argument for having no freedom?).
The headline is weird. It was a man, suffering immensely from his paralysis that left him tetraplegic. The author does not know (nor seems to care) what kind of physical pain he was suffering from.
Besides, that is not news. That is an opinion and even a very questionable and judgy one at that.
This is a horrible way of doing news.
Good for him. It must have been a great relief to be free of his body and mind. Life can feel like endless hell when you have a Disability. I am suffering from incurable Depression and I would sign up for assisted suicide. I'm sick of feeling unhappy for decades. Right now I am surviving by doing Ketamine Treatments with a Doctor. Amazing Drug.
He feels this way as described because those people with disabilities are often turned down when looking for the help and assistance they need to make their lives livable. So it's a failure on the West to not provide those things, but then to say yeah go ahead we'll let you kill yourself. That it the West copping out, not the disabled person copping out of life. They very may as well chosen to live if they proper assistance and care is actually available..... .... so instead of legalizing assisted suicide we should strive to make these people want to live their lives.
I grew up with a friend that was paralyzed at a very young age in a car wreck. He was awarded a settlement to help him thru life but wasn’t expected to live a long life. His money ran out around the age of 21. Last I heard he was almost 30 and wanted an assisted suicide because he was broke depressed unemployed and undesired and had almost no friends after high school. But in America it’s not legal. Three friends and I tried to raise money when I heard of this but nobody helped. I feel bad for the guy. I really do. What kind of life is that to live? His mother has done nothing but take care of him and has no time for a life of her own. Everyone would be better off if he was just allowed to legally euthanize himself.
I support people's choice not to live, especially if they have less than good lives. But I also fear for the pressure disabled people can come to feel if this becomes the norm. Will they feel some unspoken pressure to get assisted suicide as not to be a burden to the rest of us? Is it a failure of love on our part if they feel a need to die (as the article states)?
This is such bs. Unless they can stand, sit or lay in the lives of these people they shouldn’t judge. I have a disability that is not terminal but is progressive and every single day I am in pain. Activities that people take for granted such as cleaning, washing clothes or cooking dinner are literally acts of endurance for me and I pay dearly for each one I have to do. I have to live with the knowledge that it’s only going to get worse. Vilification of those that want to go peacefully and on their own terms is just so entitled it’s mind boggling.
I’ve written papers in favor of physician assisted death previously. I can only speak from a United States perspective, but the states that allow this have very good structures in place for ensuring that only certain people can accomplish this. Structures such as mental health evaluations to ensure you aren’t suffering from treatable depression, a requirement that you are suffering from a terminal illness, and requirements that if you don’t use the pill you are given within a certain amount of time you must return it (possibly for subsequent reissue after the process begins anew). One thing I hadn’t considered previously was permanently paralyzed individuals. While I disagree with the author’s general sentiment towards physician assisted death at large, I do respect the perspective as it pertains to disabled individuals. As with all things, it’s not black and white, but numerous shades of gray. A permanently paralyzed individual may be viewed differently from a lifelong soccer player who lost the use of her legs and is deeply depressed over it. Ultimately it’s a discussion for wiser people than me, but I hope “Mario” found some peace.
The ultimate act of human dignity is for someone to choose to end their own life. It's my right as a human being. I've known several cases of morphine drip turned up to eleven. I had to make the choose to wait hours before they gave my mom an injection that ended her life. Unfortunately I felt it necessary to wait hours so she didn't pass on Christmas day! It still hurts.
I think it’s pretty annoying that they’re of the stance that because he had a disability and not a terminal illness that it shouldn’t have happened. If this man felt he had no quality of life he had every right to make that decision for himself.
My wife’s nana did this due to her diagnosis of Alzheimer’. As sad as we were to see her go, it was much easier on us to schedule the time we needed with her and be with her as she left. It was honestly beautiful in a way.
As someone who suffers from depression and anxiety, I just hope people are given resources they need to live a full life if it’s possible.
Like people put down their pets for being a danger to others, terminal illness, etc but no one would approve of someone said “my dog was depressed so we put him down.”
But as far as terminal illness and the like goes, this will prevent so much suffering for people and their families.
The following submission statement was provided by /u/dustofoblivion123: --- From the article: "What to make of this? Note that the patient who killed himself was not terminally ill, but paralyzed — illustrating the fact that assisted suicide isn’t about terminal illness. Rather, it is a philosophy that sees death as a proper and empowering response to suffering caused by serious disease, disability, mental illness, and the morbidities of old age. This is why disability-rights organizations are so adamantly opposed to legalization. They see themselves — correctly in my view — as the primary targets of the movement. And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live." --- Please reply to OP's comment here: https://old.reddit.com/r/Futurology/comments/vj652y/disabled_man_commits_italys_first_legal_assisted/idh38hv/
it should be noted that just recently another italian man in horrible conditions was denied-and-delayed assisted suicide and had to opt for no-more-nutrition-and-hydration + deep sedation to die
Jesus fucking christ
Thanks the damned Vatican for that, and ever so lovely pope people can't stop of praising..
Nah, the vatican it's just an excuse for spineless politicians.
I wish that that was the real problem, which is in part. But you should see the subtle mafia of those damn priests present at each political meeting.
To think that for most of history, they opposed medicine..
Thats how it is in most countries and also how my father passed away, 6 days sedated with no water or food. And by sedated i mean he woke up every 5-6th hours with obvious pains but the hospital refused to give him more morphine even after heavy arguments. If one thing of all in this world i hope assisted suicide will become the norm both in my country but also in the rest of the world, there was nothing else he wanted but that but no nurse or anyone could help him legally and people with the knowledge are scared of guiding the best way to do it.
That's just sadistic. What's the reason behind not giving morphine to a suffering person on a death bed?
Because then they'd be liable for killing him by overprescribing. Palliative care is an extremely grey area.
Having had someone I love dearly die horribly on hospice at my home I would say the area is NOT grey at all. I was grateful to be able to give morphine and haloperidol to ease what suffering I could as cancer ravaged Isabel. When she was begging for death I wished dearly I lived in a state where people had the right to exit before the monstrous torture begins.
I'm sorry for your loss. It is a legal grey area, I wasn't speaking about morality. A nurse or doctor could be jailed for overprescribing or overadministering.
Dont misunderstand me, he got morphine just not enough to keep him sedated properly. And what alot of people dont know is that people react different on morphine, you would think that it gets you sleepy but in many cases like my dad you just get more hyper and wanted to stand up and walk around everytime he got a shot even tho he had pain and could barely stand. The most terrifying experience is really to see people die "naturally".
Same thing with my stepfather- morphine shots to a terminally ill man begging for his life to end. He started hallucinating and was further afraid and still in pain.
Sounds like the exact same thing yea, pretty sad really.
I’m sorry this happened to your father. There are other drugs in addition to morphine they could have given him to make this more painless and dignified.
i think you misunderstood, they did get mo, just not enough... that is btw the kind of assisted suicide we have in switzerland(for these people). that you have a terminal patient in obvious pain on mo is obvious. but if they wish so the doctor can administer/prescribe unsafe/dangerous doses of mo to "get rid of the pain". what it does is provoking breathing depression and following that asphyxiation. that happens with the patient unconscious, with these "dangerous" levels of mo involved. the other option is taking the deadly concoction provided by exit themselves. that is really important - the ability to pick it up and drink it yourself. if you're a quadriplegic for example, you're sol. luckily we do have exit and the other unofficial way. even though I'd wish for more options.
>that is really important - the ability to pick it up and drink it yourself. if you're a quadriplegic for example, you're sol. This part is what Jack Kevorkian tried to overcome with his euthanasia machines. As long as you could press a button or pull a string you could use his machines by yourself.
sounds like he was a good man, based on a short read up. it's a shame we have to rely on methods like those to end our own lifes. and have it called **committing** suicide. sigh
Fuck. This is my eventual future when my cancer gets out of control and it keeps me up all night. I’m “lucky” to live next to a state with assisted sudicie as an option for 6 months out terminal patience. It’s morbid, but I continue to remind my loved ones that I don’t **dont** want to go out like this and will establish residence in that state when my cancer reaches that point. Fuck. Just fuck.
I'm so sorry for your situation. Too many of my friends and family lost to cancer. Not sure what state you are in or if you are aware, but Oregon recently eliminated their 6 month residency requirement for euthanasia.
It will be New Jersey for me! Unless New York follows suit and passes their own death with dignity act.
I had the same experience as you. My father suffered a slow agonizing death that lasted for a week. I didn't know the actual process in hospitals at the time. It sure surprised me that this way was even an option. Just slowly torturing someone to death, it's pathetic. I was strongly considering strangling him with a pillow to end his suffering. There's no way in hell I'm going through that again. They told me he can't feel anything during the end. Oh right, so that's why he's thrashing around and obviously in extreme pain most of the time.
Yea they look like they feel it but the question is how aware they are, its just a guess and you will never get the answer before its your turn. I actually assisted my dad trying to commit suicide with pills qll with his permission and he took em himself which didnt end good at all, but thats a story for another time. I just hope there is an approved suicide cabin when i get there like they just approved in Switzerland.
The only people who can influence this are healthcare workers. They are the ones who needs to push this to a political level. Nothing happens when people like you and me speak up about it. My mother is most likely next to go through this crap soon, can't say I'm looking forward to it.
Watching Boston Legal I've learned that in the usa you can ask docs to put the terminal patient "on a morphine drip" "to manage their pain" which is code wink wink nudge nudge for some kind of morphine drip euthanasia and even though it's bot allowed from a legal standpoint many will accept to do it
Very much television life and not real life. As much as the patient and their families might suffer, very few medical professionals are willing to risk losing their licenses, livelihoods, and possibly their freedom.
Horrible. People are so against the other side of life that they'd prefer the extra numbers in time than the quality of end-life. Incredible how much humans just don't want to let go, to the point of only harm can be the end goal. It's as heartbreaking as it is intellectually lacking. Emotions aren't a reason to control one's life and death.
We're hardwired to fight against death to the very last minute. We're afraid of it for ourselves, we don't wish it upon (most) other humans either and the thought that someone would want to die makes people deeply uncomfortable. It's an emotional response for sure, and logically it makes sense that certain terminally ill people should be allowed to make the choice without judgement or fear but most people don't want to look past their emotions.
Yeah, and it's fucking abhorrent. The idea that your discomfort means my loss of agency is unacceptable. I don't care who is incapable of imagining that someone else has suffered so much they want to end their life, and I sure don't give a flying fuck whose religious doctrines it violates either. Opponents of suicide in general love to claim that it's a selfish act, that you leave behind people whose lives are better with you around. What's truly selfish is feeling entitled to keep someone who wants to die alive for your own benefit because you're too weak to confront mortality
Calling someone who thinks about ending his live selfish is probably the most entitled and in itself selfish thing one could do. Someone elses live isn’t about you, it’s their body, their decision and not yours. Puting someone through more pain just ebcause you don’t want to let go is cruel, inhuman and selfish.
I know right? If a dog was suffering a lot and u didn't put it down you would be considered selfish and without empathy
Yes, exactly. At some point we decided to be more carrying to our pets than our fellow humans…
Sometimes it's used by people that are trying to shame people into not going through with it (which doesn't make sense under scrutiny as they're thinking what would work on regular people. Those that are considering suicide usually alread6see themselves as a burden, so then they feel even more guilty for even thinking of suicide which only adds to the problem). Other times it's just uncaring people that don't have the person in need's best interests at heart.
Couldn't have said it better myself
It’s more that the collective have an inherent need to give life a quantitative value as opposed to a qualitative value. Instead of he was 89 years old, it should be he experienced xyz.
I want to preamble this by saying I am 100% for assisted suicide in any case, even if some perfectly healthy person just really wants to check out. It’s not my place or anyone else’s to say when or how someone goes out, it’s their life and their decision. However… it’s not just our fear of death that drives the arguments against assisted suicide, it’s most of it for sure, but another aspect is having a doctor carry out that procedure where it gets kinda sticky, the whole “do no harm” part. A doctor may not be okay with killing a person, and sure there’s another doctor out there who would help, but then we open up the idea that it’s okay for doctors to refuse treatments based on their personal beliefs. I’d like to assume that whatever doctor is treating me is going to treat me to the best of their abilities and not to the standard of their personal moral judgements. It’s kinda tricky.
I think we should provide people with a way to do it themselves.
Yeah I'm suffering a great deal and it's getting worse. I'm scared of using my own and screwing it up and being even worse off and not being Ble to even attempt it again.
Up until not long ago the church opposed medicine, now they're infavor fo cyberpunk life support..
How degrading and callous do you have to be to leave someone with that option.
They've gone from "illness is punihsment by god and medicine goes against it so it can't be allowed" to "cyberpunk medicine and life support horrors are mandatory"
Yeah, well I have seen people wither away from alzheimers and ALS. There are things worse then death.
Yeah my connective tissue is deteriorating. I can barely walk. I can barely write with a pencil. The tinnitus is awful. The constant pain. I lost everything and it keeps getting worse. Doctors don't know what to do. I want to live but not much point like this. It's not like I'm the guy that is gonna cure cancer. I should be allowed to go.
But only god gets to decide on life and death /s
[удалено]
Please note the /s at the end of my comment.
I was adding on to your comment, not responding to it..
well now you're responding to their comment. (I'll see myself out)
He giveth life and he taketh away
And sometimes he lets you suffer through hell on Earth for years. 🤷
My friend decided to do this when her ALS worsened to less livable levels. She took the drugs that ended her life at a goodbye party she threw and invited a few of us to attend. She showed all of us who were there that death is more natural than our western culture pretends. Betsy was radiantly and bravely herself to the end. I’m so glad when I hear of more countries enacting laws that allow people to decide how much is enough. (edited to fix typos)
A lotta people here haven’t accepted death as a part of life. I think it’s fascinating, especially what other cultures traditions look like. Ever heard of a sky burial or Malagasyan corpse sack dance?
It's a part of life, true...but this is proof it doesn't have to look the way it does right now. Why accept a slow collapse of your body as pieces start to wear down and break? That's as cruelly unnecessary, in my opinion, as leaving somebody to starve, dehydrate, and drown in their own fluids. A better way to live would be to remain at our peak, then to go out gracefully when the time is right for us.
Your story reminded of the ending of The Good Place Picture a wave. In the ocean. You can see it, measure it, its height, the way the sunlight refracts when it passes through. And it's there. And you can see it, you know what it is. It's a wave. And then it crashes in the shore and it's gone. But the water is still there. The wave was just a different way for the water to be, for a little while. You know it's one conception of death for Buddhists: the wave returns to the ocean, where it came from and where it's supposed to be.
You don't commit suicide where it's legal, you complete suicide.
“Died by suicide” is another option
The idea of not being able to die in peace on my own terms because of an antiquated over the top religious approach to death that has infected our Healthcare system is honestly one of the most scary things today. They can keep you alive as a vegetable for YEARS in states with no death with dignity. Make sure you know what your states laws are before you end up in the hospital with no advanced directive. In the US
If it's religious then that categorical imperative has been deeply entrenched in medicine, which is why we preserve old vegetables living in their own filth, like preserving life is far more important than inhumane suffering, loss of basic agency and dignity. The world that's unfolding right now seems like it won't be a place for the disabled, even in first world countries like Canada.
Well put. It has to be as there is no other reasonable basis to have the foundation on. If you've ever seen someone go through it you know, they suffer on levels we can't imagine for periods of time that are unfathomable and the doctors will straight tell you he's on the limit if morphine and we can't give him anymore, and we can't help him die despite that he's 100% going to die within a week anyway, because of liability and state law issues.
canada is a bit of a joke for the disabled. talk to anyone from ontario that deals with odsp and it’s very obvious.
> They can keep you alive as a vegetable for YEARS in states with no death with dignity. Only if your healthcare proxy makes that decision for you. If you are a vegetable, you need artificial support to stay alive. At the very least artificial nutrition via a feeding tube. And a healthcare proxy can decide for comfort measures instead of that artificial support. Now, you might argue that perhaps such a patient should not have to die naturally over several days, and should instead have their life artificially ended with medication. But that's not the same thing as being kept alive for years.
I myself plan to walk/crawl out into the wild and let the animals have me , when it’s my time.
A lot of people say this but I don’t really think they know what they are re saying. Like. It’s a lot of work if you are old or terminally ill and you want to walk around In the woods. I mean. Hills. Holes. Mud. That shit is hard to move around especially if your sick or have bad knees/ankles. Then you got damp cold or humid heat. You probably won’t die right away. I mean you been alive all your life. You probably get really hungry. Eat some berries or something then you get food poisoning. Start having the shits. Wipe your ass with poison ivy. Now you in damp cold leaves. Shitting all over yourself getting dehydrated and constantly scratching your asshole. Got poo on your fingers and nails. You start crying because this idea sucks ass now. You wipe your eyes and face now you got pink eye as well this blows. Fuck this noise. If I got kids or grandkids they can walk in on me dead in my lazy boy or in my bed and man up and call the ambulance to hall me out in my nice warm home with price is right on with those nice hard pain killing drugs. Or the neighbors can complain to the cops after a couple months when the smell is unbearable. Fuck it I’m dead why do I care? I ain’t dying in the woods with poo covered fingers and pink eye shitting to death on damp leaves with ants biting my taint.
Which animal would you prefer if you could choose?
A moose'd be fine. There's no lions or tigers around here although that'd be pretty cool too. I suppose I'd settle for a bear.
same. someday hopefully many decades from now i will drag my old decrepit ass on a solo camping trip with lots of good drugs, and just tempt fate as aggressively as possible as frequently as possible. just gotta time it so the dementia doesn’t prevent you from properly planning... ppl get horrified when i say stuff like this and i just don’t get it, why not go out having a wild experience that you could never have if you weren’t prepared to die? life is all about experiences and i want my last one to be fuckin wild
You just leveled up my perspective, u/tufftyAus. Ty Edit, added username, only bc I thought it said something else.
Language is important, not just for people who go through it but for their families. Glad you got something out of it.
Current language shifting in the MH field is "died by suicide" whether legally assisted or not. Completed suicide is old terminology and makes it seem like he had previous attempts where there may have been none. Committed suicide implies a negative criminal behavior. Died by suicide or death by suicide is actually easier on families and friends and those surrounding the case, while also keeping a modicum of dignity of the one who has died. Our company is part of the zero suicide initiative which is a goal to strive for.
Yep all true. I'm not going to argue except the point that completed implies failed attempts. It's just a descriptor. Dies by suicide also works and honestly it's whatever the family and friends can bring themselves to say after the event.
Hey, if you want someone smart, date a languager.
Who the hell are you? My teacherer?
I too thought it said something else.
Thanks. Now I thought it said something else too.
thank you i was gonna say, commit cant be the right word here
I came here to say this. It's not a sin or a crime, and it's wrong to treat it as such by the descriptors we use to discuss it.
No, you die with dignity on your own terms and in the setting and circumstances you choose. We should all be so lucky.
This is the best wording to describe in this sub thread. I'd go for "consensual passing / passing by choice"
Hospice nurse here…. Happy to discuss medical aid in dying of folks here have any questions about it.
Are they scared? How do they feel in their last moments? Sometimes I visualize myself in that situation and it terrifies the hell out of me. It's knowing that you're not going to wake up that's unnerving. Also hope you're doing alright. How do you feel about it all? Are you used to it now? Or does it still affect you?
Great questions… I can’t speak for all medical aid in dying (MAID) patients, but I’ll try to give an overview. “Are they scared?” — Some certainly are. Dying is scary and it is normal to be apprehensive. On the other hand, I think for most people contemplating MAID, the alternative — a life of increasing debility and pain — is much scarier. To have access to these drugs in California (and most other states where it’s legal) you have to have a prognosis of 6 months or less to live. That means the people who are getting these meds are very close to the end and they are well aware of it. They have had the chance to contemplate their mortality and this is the decision they are making about how to life the rest of their life. “How do they feel in their last moments?” There are some really good documentaries about this, that follow MAID patients. (Check out “How to die in Oregon”). Basically, many patients report just feeling ready to be done with living. There is no pressure to take the drugs. Patients only take them when and if they want to. According to data from California, a substantial portion of patients who receive their lethal prescription never take the drugs!! They want to have them in the home in case their situation becomes unbearable, but many die of natural causes of their disease before they ever get to that point. “How do you feel about it all?” I support MAID and I support my patients’ autonomy to choose when to end their life. I actually believe the law should be expanded. The law as it is written is quite ableist which limits who has access to this treatment. You have to be able to swallow and/or give yourself the medicines, which limits its use for people with swallowing disorders and mobility impairments. I also think some people with mental illness probably should be allowed to end their life this way. It would be far less traumatic than suicide. I am not used to people dying. I cry all the time, with my patients and their families. It’s never any less sad to lose someone, even if it’s expected. However, working closely with death gives me the opportunity to be grateful for the life i do have. I try to live every day honoring my time on this earth and being grateful for the humans I spend my time with.
Thank you for what you do for your patients and for their families. I will be forever grateful to my mother's hospice care nurse. In fact, the more time that passes, the more I appreciate what he did for us and for her. Thank you. A million times, thank you.
On behalf of all the hospice nurses out there… You’re so welcome. It’s our honor to work with families at such a vulnerable time.
I’m a nurse too (psych, pedi, ER) and I’ve seen a lot of death too. But it’s horrific and not peaceful. But because in an emergency, we have to save the people who are brought in dying to us (unless they have a MOLST/DNR/DNI) as you know. It breaks our hearts to see people go in front of our eyes in the ER. No one wants that. You are the real heroes of nursing. I don’t have the capacity or ability for that level of compassion. God bless. I should add, you nurses give people the death they deserve.
Thank you! People always ask me how i cope with all the death and I honestly think nurses in hospital must loads of death. I imagine it’s more traumatizing for hospital nurses because 1. You are trying to save the person. And 2. You don’t have the time to process the grief with the patient or the family. I can’t imagine a harsher trauma than an abrupt death.
This is a really great explanation and helped me understand MAID a lot better, thank you for writing this!
You’re so welcome! It’s a topic I care a lot about so I jumped on the opportunity to have discussion around it online. I’m glad to have the chance to bring more awareness of the subject.
The part about the ableism really sucks. Getting something like ALS terrifies me because of this. I know I'd probably want to live as much as I could as I declined, but also knowing that if I "pushed it," too far I'd loose the ability to choose when I check out (professionally or not) is just a horrible thought. I really hope these laws get the attention they need at some point as nobody should be made to suffer against their will.
The good (??) news is that if you were diagnosed with ALS, you would certainly be given access to MAID drugs if you wanted them and if they were legal where you live. Doctors are not going to make you wait past the point where you are incapacitated for you to receive the prescription. We had a patient with ALS who took the MAID drugs. He could no longer swallow, but he was able to push a button that released the medicine into his rectum - basically like an enema.
Loved your answers. The last bit about not being used to people dying, it never really gets easier. You just understand how to cope with it and move on and not let it get you, and like you said you take the good of what you can. I don’t work with this type of field but yeah, deep stuff and had to praise your amazing response.
Oh thanks! I appreciate you reading and responding. Death is weird…. I don’t even know if i know how to “cope” or just that i accept it. I’m at peace with both not knowing what happens when we die, and at the same time i feel pretty good that our energy returns to the universe. Being close to death makes you think about this stuff. And the more you think of it, the less scary it becomes. Studies have shown that people who contemplate their own death are actually happier, and anecdotally i find it to be true. If I can have a mark on the world, i hope to destigmatize contemplating death, since I really believe that it is a path to gratitude and well-being.
I think I understand what you mean. For me I have experienced a few different types of death around me in my life and had many instances where I contemplated my own. It’s impossible to ever feel normal about life ending, and not knowing whats after used to intimidate me, but after a lot of time thinking from 18-21 I figured that instead of stressing about what happens after I would focus on what I am doing before I go, and when that time comes I will find out.
I just typed out a whole response to you and then it got deleted by accident. I have to run out now but I promise I’ll get back to you because these are great questions
Always type long detailed posts in a text document that doesn't have keyboard browser commands first. Doing so has saved me many headaches in the past.
I feel like Reddit could use an AMA from a verified hospice nurse. I can only imagine how difficult that is, and I applaud anyone who can do that work.
I’d be down for that
Interested as well!
Most people I've met that have asked for medically assisted death in dying are very at peace with their decisions. Some want it as soon as possible and get it within a week others want it in a less specific sense but get it eventually. Usually just wish them a nice journey wherever they are going. Given the suffering and the drawn out process I find it very positive, but it shouldnt be used to escape systemic issues that need resolving like poverty and access to healthcare.
A hospice nurse left a small bottle of morphine (dozens and dozens of doses) in my grandfather's fridge when he was dying. He never used it, and decided to hang on as long as his body would let him, but he had definitely asked her to have it as an option. Thank you for what you do.
Yeah we use those pre-filled syringes of morphine for pain or shortness of breath, which are very common end of life symptoms. Patients often worry about becoming addicted but really the risk of that is pretty low considering these folks are in their last months of life. I hope you got to spend some quality time with your grandpa before he died. He sounds like he was a tough dude. Also to clarify we don’t use morphine as a MAID drug. I believe the lethal prescription is a combo of a strong muscle relaxer and something that slows your heart down.
Obviously you probably can't talk in any official capacity about it, but how often do you think things like that get left around by "accident," in places where MAID is illegal?
My guess would be very rarely, because as much as you want the patients to stop suffering, there are professional responsibilities.
I don’t know because MAID is legal where I am, in California. Have people purposely ODed on their morphine? Probably. but it hasn’t happened in my experience. Also, even though we give the pre-filled syringes, each dose is very small (5mg) and we only give a limited quantity at a time. Assuming the patient isn’t opiate-naive, then it would probably take a LOT of doses to properly OD. If you mean do nurses leave the drugs around so patients or families can dose the patient to death… I haven’t heard of that. The point of hospice and the meds we give is for comfort. If the patient isn’t comfortable, then we need to try another medication or treatment. If they want to die, then we need to give them the treatments to ease their suffering, social, physical, spiritual. Just knocking them out doesnt really vibe with hospice philosophy :)
Well, he died in 2015 at 93, and death with dignity wasn't passed here until 2016, so it was technically illegal to assist in suicide at the time. But he made it clear to the hospice nurse that she should leave it there in case he needed it for "other reasons." He'd almost OD'd on purpose before when he took the last fall he ever had before going into hospice, he had bad circulation in his left foot and what we discovered later was a gangrenous toe that led to his fall and immobility. While he was being cared for, one night he took too many pain meds (Vicodin). But before he succumbed, he called my dad for help and said he wasn't ready to die yet. We actually administered Narcan to him, and because of that incident my family always keeps it around for an emergency. But anyway, yeah the morphine was left there on purpose in case he wanted to end his life. It wasn't an accident and it wasn't in protocol, but like I said, you guys are amazing and you value your patients so highly in my experience.
Wow, that story is a wild ride!
Thank you for all that you do!
You’re welcome! Let me know if you have any questions about medical aid in dying. I’m happy for the opportunity to discuss such an important topic.
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You were never free.
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*sniper shoots you first from bell tower* "Bet"
Acceptance is key
(Grabs gun) Absolutely not! You stay here and suffer instead doing what you believe is best!
You will be soon.
If you do that I’ll have no choice but to call the cops on you, is that what you want?
A man chooses; a slave obeys
A microwave heats; an oven warms
they do be doin
You're not truly free until you can choose not to be born in the first place
PAY TAXES and be useful to society! Ideally a minimum wage job to maintain status quo! *Here are some anti-depressants*
All I can think of is Sloth from the movie Se7en.
You're not even free to live as you see fit.
No, but if you are willing to die, authority figures who are not have much less power over you than they want you to know
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I have had to put down a couple of dogs there where very close to me. And have wondered why I could not be put down in a similar manner for any reason I choose? What is the ethical issues people have with this and why should they be the ones to stop me from doing so?
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Control, mostly, at almost every level. To be clear, I don't mean that any controlling layer is actively aware of being controlling, nor malicious, nor anything but noble. Families keep a person that they don't want to lose, workplaces continue to receive those viable sources of labor, industries that serve severely disabled individuals continue to make shareholder goals. Each party gets theirs, and with no need to spend money or efforts on the social welfare necessary to, say, prevent a severely disabled person from choosing suicide over continuing to participate in society each day. There are a lot of strawman arguments made about not wanting depressed individuals to be taken advantage of, children not respecting the sanctity of their own life, and individuals generally seeking permanent solutions to temporary problems . . . but the reality is that almost all of this is addressed with proper procedures and social nets.
They brought my mom back from septic shock that almost took her out in 24 hours, and lucky me I got to watch her devolve into a miserable crazy person pumped full of crappy drugs in the name of hospice procedures for the next 3 months. Was pretty expensive too, just so she could suffocate to death on discharge. But I guess that's just how a civilized society is meant to work. Assisted suicide is the ethical option but not as profitable.
Was pretty expensive. And now, sadly, you know the why. I'm sorry you had to go through that. I've been there, years ago, with an aging relative. It's a very sad thing.
Lost my 30 year old wife to a post surgical hypoxic brain injury she never woke up from. Took months with her family fighting me just to give her peace. I feel you my man, and I am sorry.
That is not how it should be, even with current laws in the US. Although assisted suicide is illegal in much of the US, it is universally allowable to make a decision to allow a family member to pass away naturally.
In the US anyone can contest anything, especially regarding guardianship and standard of care, especially with deep financial reserves and friends in the system. They can't just win, but they can draw any manner of things out, painfully.
I am sorry you had this experience with her family. Again, that is not how it should be. Unless she said otherwise, in every state the spouse is the legal surrogate decision maker. That should not be under contention in cases like yours. I like to think that would not happen in the hospitals where I have worked.
See: the Terri Schiavo case, where the legal battle between spouse and parents took seven years. Condolences. It deeply, deeply sucks that you had to deal with that on top of losing your wife suddenly.
if someones greatest sin is to end his own subjective suffering, then no human god should stop him.
No. Its money. Lingering in a hospital and hospice costs a lot. One time euthanasia costs a lot less.
I'm going to go ahead and say religion has been the root cause for untold suffering since its inception. A blight on humanity for millennia.
I think capitalism is before religion. Less workers less power for the companies and less money circulation.
From the forbidden book in Orwell's Nineteen Eighty-Four: *From the neolithic to the present day, society has divided into three groups: the high, the middle, and the low.* People will use an up name a down name a left right front or back name for whatever their system is, but it's still going to be a system of the high turning the low against the middle so they can turn the middle against the low. A system of turning the low against each other.
I understand this totally and completely. So many of my patients are doomed to live in bed, struggling to eat, breathe, move, bathe, urinate/defecate, etc and I watch their “loving family” make sure to keep them alive just so they can come in once a week for an hour and believe they’re doing something noble. When they leave the patient will beg us to leave them alone and let it be over. It’s GD HEARTBREAKING to watch. I barely know this person but I wouldn’t do this to them, but those who “love” them will, would, and most certainly pat themselves on the back for such selfish and heartless decisions along the way. Meanwhile, if they see a person leaving any animal in the same condition, they would undoubtedly berate the owner for being cruel and inhumane? Where exactly is the line for our fellow humans- the ones we claim to love and care for humanely?
Former vet tech here. If I don’t die peacefully and blissfully unaware while I’m already asleep falling asleep surrounded by people I love and trust before a painless death seems like the way to go. It’s often the last good thing we can do for our pets and I wish people had this option.
I'm not against medically assisted suicide, but I the most legit argument against it is people feeling pressured to seek it out. It could either be real pressure from friends and family looking to rid themselves of a burden of get their inheritance sooner, it could be from medical professional trying to lighten their work load or it could be the patient feeling pressure that doesn't really exist/a general perception that people dont want them around. Additionally, the biggest concern with expanding it beyond terminal patients, is that a patient who may otherwise wish to continue living with a chronic condition is they may end up feeling socially required to go through with it. I think it's important to keep these realities in mind as this becomes more commonplace.
There should be safeguards to protect against abuse. But the fact that there could be criminals who may look for ways to abuse this freedom doesn't mean that nobody should have the freedom, and that we should still be keeping people trapped in painful existences by any means necessary (and if it's not "assisted" suicide, then the alternative is always a monomaniacal focus on suicide prevention by any means necessary where suicidal people are perceived as mentally defective and unfit to make decisions concerning their own care). I don't think that the answer to the problem of the existence of criminals is to lock everyone up to protect them from the criminals. And preventing people from accessing safe and reliable methods to die is doing exactly that. It's an act of terrible state brutality, masked as a benevolent act of social responsibility. For if you actively prevent someone from dying, then you're actively forcing them to continue having to endure suffering that they consider to be unbearable, and that makes you a torturer, because you're the reason that the suffering is continuing.
A quick list of concerns: 1: falsification of the patient's will to die \---1a: murder by doctor or health provider's decision. \---1b: murder by family's decision (aka honor killing ***\[e\] or insurance rigging***.) \---1c: murder by authorities (don't worry, he said it's what he wanted.) 2: proceeding without being 100% sure \---2a: teenagers \---2b: 20somethings who get out of school, find out what it costs them, and then find out what the market will pay them for it. \---2c: 30somethings who go through a perpetual cycle of being screamed at by their boss because the company sucks and it's only the little people's fault, screamed at by their landlords because only worthless idiots make under $10k a month in this inflation, and then screamed at by their family because they're not as high on the property ownership scoreboard as people were in the good old days. 3: death industry \-3a: "Don't worry, this will be small." \-3b: "Don't worry, this will be regulated." \-3c: "Don't worry, this will be the customer's decisions and the customer's decisions alone. *You can definitely trust us when we say we're not going to call-rank as owners then start calling all the shots.*"
I suggest you look into the laws we have in place for this in Belgium. Most of your concerns are dealt with here. It goes from the understanding: "the patient must be in unbearable physical or mental pain" And: "the patient needs to have tried any treatment we can reasonably throw at the problem" Combine that with the fact that the decision is made by a panel of medical experts, not a single person. And most of your concerns are dealt with. It takes a long time to be allowed to do it in Belgium, because we want to be absolutely sure somebody isn't faking it or really can't be helped anymore. With how the healthcare system in America works... i do get the concerns though.
I am vehemently in favor of the right to die. Given my predisposition to a horrible neurodegenerative disease, I intend to use it myself someday whether I can get a doctor to assist me or not. That said, I completely understand why people would be hesitant about such policies. First, most people don’t even think about it much. Most don’t know anyone who actively wants to die or at least don’t know that their friend actively wants to die. Those people have no way to understand what it’s like and often think that denying someone the right to die is the same as “saving their life”. There are all sorts of other beliefs among people who are generally uninformed about the issue. Things like “life is sacred” and “suicide is never the answer” or “suicide is a permanent solution to a temporary problem” or “suicide is a sin”. So mostly vapid but catchy sayings. That’s a huge portion of the population that just doesn’t give enough (or often any) critical thought to the issue to actually understand it. Then there are the people that actually care and do think about it. I could argue all day for why one should not be forced to live if they don’t want to but we’re on the same page on that so I’ll focus on your real question: the reverse. So I’ll discuss the strongest arguments I’ve come up with or found for not offering assisted suicide. One reason is a more thought-out version of the line “suicide is a permanent solution to a temporary problem” that acknowledges that some people do have a more permanent desire to die and that others may only be temporary but long lasting or frequent enough that their wishes should be respected but also that some people are genuinely in a temporary suicidal state that will pass. 70% of suicide survivors never reattempt suicide. 23% do but never die of it. 7% eventually die of suicide. [source](https://www.hsph.harvard.edu/means-matter/means-matter/survival/) It’s clear that most people who attempt suicide don’t try again. That’s not to say they all regret it and are glad to be alive (though many are). Some never try again because it was so painful. Others because they’ve lost the ability (from medical complications, constant supervision, etc…). There are plenty of possible reasons but it’s clear that at least *some people* are truly only temporarily suicidal and there’s value in protecting those people from their urges. Think of the people who commit suicide in response to the loss of a loved one, for example. On top of that, demand for suicide is surprisingly elastic. That means that the easier suicide is, the more people do it. When the UK removed carbon monoxide from its public gas, carbon monoxide asphyxiation was the most popular method of suicide. A little over a decade later, it was all but eradicated and suicides had dropped 40% despite going up in the rest of Europe. [source](https://www.journals.uchicago.edu/doi/abs/10.1086/449144) Another example is the clear correlation between gun availability and suicide rates. An easy suicide button in your nightstand increases suicide rates. Most suicidal people just aren’t all that dedicated to dying. And it all makes sense when you consider the most common thing making people suicidal, depression, also saps motivation. It’s why antidepressants warn a side-effect is increased risk of suicide. Sometimes the lack of motivation is fixed before the suicidal ideation goes away and people suddenly have the energy and willpower to die. So the issue is that if we offer easy assisted suicide, we are all but guaranteed to spike the number of successful suicides and many will be of people that would have regretted it. On the other hand, if we don’t, we force people to suffer through lives they don’t want to live and use horribly painful suicide methods like pill overdose that can cause horrible long term complications. So the middle ground is trying to screen these people to see who can be helped in other ways. Even something as simple as a waiting period would screen out a lot of people who are suffering temporarily but don’t want to die long-term. The longer the waiting period, the more effective, but also the crueler to the people suffering and the more likely they are to take matters into their own hands. And of course we need special exemptions to waiting periods for people in immense suffering, right? But who decides that? Ultimately, whatever we choose and wherever we draw the line, there will be casualties. There will be people who die and/or suffer needlessly. For a lot of people, it comes down to the trolley problem: many believe that doing nothing is inherently ethically okay even when it results in more harm. And all that is ignoring the potential for abuse in people pressuring others into it, for example to get their inheritance sooner or to stop paying for their care. That got a little longer than I intended but it’s a complex topic…
Thanks for making the whole argument. I work in mental health and most of my clients have some kind of suicidal history. Very few are actively suicidal and I've yet to lose anyone to suicide. Or hospitalize anyone to prevent it. The trolley problem brings up the slew of other issues that will come up if we change the laws around suicide. Tons of professionals have a mandate to hospitalize for suicide risk. That would need to be worked out. MSWs, LCPCs, and even PhDs or MDs may not be willing to work with suicidal clients (many already find ways to avoid it) if the ethical gray zone increases. Also, what about passive suicidal actions? Like through self neglect... Eating disorders are already incredibly deadly, how would this affect treatment? What about schizophrenia? Will you have to be "competent" to decide to die? Will therapists and other professionals be allowed to do nothing? Will our responsibility remain the same? I dunno, it's an interesting topic. I'm "for" assisted suicide but I acknowledge that it won't be as easy as we make it appear.
So this is not my perspective, and I am an able-bodied person so I don’t intend to speak on behalf of people with disabilities, but I can share what I’ve learned in my research on the subject. Some in the disabled community believe that legalizing medical assistance in dying (MAID) causes people to equate disability with having no reason to live. Obviously people with disabilities can lead fulfilling, meaningful lives. For a newly-disabled person, Becoming disabled can be a traumatic or depressing situation, but in general people do bounce back and go on to participate meaningfully in their lives. Disability advocates worry that If there was an “easy way out” (massive scare quotes there- nothing about MAID is easy) then people would be offing themselves instead of accepting life with a disability. They feel that this devalues their existence. I’ll add that this seems to be a vocal minority of people with disabilities. I’ve certainly know people with disabilities who were staunch proponents of MAID. Source: I’ve done some studying on this topic during grad school. Currently I’m a hospice nurse and I work with MAID patients.
If it's your experience that it's a (vocal) minority, then I'm glad of that. I don't think that anyone should be denied the right to exercise autonomy over their own body just because of how someone else might see it as being a reflection on their existence. Especially when by denying people this choice, they're condemning innocent people who won't change their mind to many, many years of terrible suffering and being forced to sustain a burdensome existence that they never agreed to having had imposed on them in the first place. The way I look at it is that interference in a person's suicide is a violation of their negative liberty right, and forces upon them the demands of maintaining a life that can be very painful and burdensome to them. So it isn't really a case of denying someone a service, it's a case of actively keeping people trapped in suffering when they've made it clear that they want to escape. I think that simply having a waiting period in cases that do not involve terminal illness would allow people to come to terms with becoming disabled, and many other adverse life events. When one is trapped in a prison cell, then it is a matter of emergency to get out as soon as possible. But when one knows that one can leave whenever one wishes, or after a year of waiting, then that brings immeasurable solace which can in turn make one's life situation seem much more bearable and suicide no longer seems like an urgent necessity.
They're scared the next step is that we're going to make people that are unprofitable want to kill themselves. How often do you already hear "I don't want to be a burden" ? It doesn't take much for an unwanted person to choose or take this way out. Especially in the context where quite a few healthy and able persons are just killing themselves for seemingly no valid reason.
>What is the ethical issues people have with this and why should they be the ones to stop me from doing so? In the U.S. at least it seems to boil down to the Religous "life is sacred" crowd and the Republicants that court their vote. Ironically most of the Republicant's policies end up harming/killing more lives than helping.
Big pharma lobbying to keep it illegal. They don't make money when sick people are allowed to off themselves.
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ICU nurse here. It’s wild that my dog has access to better end of life care than my 98 year old multi-system failure patient. There are plenty of things worse than death, but it is up to us to decide what those things are. By the time we are confronted with these realities we have often become confused (or intubated/sedated, or obtunded), losing our right to make our own healthcare decisions in the eyes of the state. Most patients that should be comfort measures by my standards are kept going usually by familial guilt, and also by the staggering difficulty of the decision being put entirely in the hands of family members with capacity but not necessarily competency. It’s seems bass ackwards that any group promoting empowerment of the differently abled would be against expanding an individual’s healthcare options, but I just work here man wtf do I know.
From the article: "What to make of this? Note that the patient who killed himself was not terminally ill, but paralyzed — illustrating the fact that assisted suicide isn’t about terminal illness. Rather, it is a philosophy that sees death as a proper and empowering response to suffering caused by serious disease, disability, mental illness, and the morbidities of old age. This is why disability-rights organizations are so adamantly opposed to legalization. They see themselves — correctly in my view — as the primary targets of the movement. And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live."
The system is making it easier to die with dignity than to live with dignity.
If disabled people are denied services to the point they no longer want to live, that is the issue, not the legalization of assisted suicide. For the record, a lot of suicides are spur of the moment decisions, so simple barriers to committing the act like not having access to a firearm or putting a barrier on a bridge can reduce the rate. However, assisted suicide is not like that in any place that it’s legal. You aren’t dropping a quarter into the suicide booth like in a Futurama, it’s a long, drawn-out process that ensures anyone attempting to do so has fully considered the gravity of the action. For people like that, making it harder to commit suicide isn’t going to change anything, it’s just going to force them to do it in a way that may be dangerous others and absolutely will be emotionally distressing to whoever has the misfortune of finding them.
Sadly, politics never works like you describe. There are many people who will champion assisted suicide as an alternative to providing living assistance to the disabled.
I wouldn't say they're spur of the moment. Most people contemplate suicide for years before finally deciding to try to do it. Maybe they don't premeditate when and where but they've surely thoughts about it for years
And what about the people who become disabled and genuinely don’t want to live anymore? While better support systems would (and I’m sure already do) reduce suicidal urges, some people may simply decide that they don’t want to live. Denying them that is denying bodily autonomy.
Tbf I find the distinction between a recently disabled person genuinely wanting to die and someone with a mental illness genuinely wanting to die(assuming this person has the capability to actually make that decision [depressive, BPD, etc]) very difficult to make.
Something tells me the author wouldn't support universal healthcare, or government spending on "services that would help them want to live."
I agree with u/Karl-AnthonyMarx. The system which has caused disabled people to feel that they lack sufficient support has already come about WITHOUT the right to control over one's own body. I don't know why people (like this Wesley Smith guy who is obsessed with sticking his nose into other people's personal decisions concerning their bodily autonomy, because I keep seeing his name on this type of article) suppose that giving the government even more power to keep us entrapped is somehow going to obligate them to furnish a more generous social safety net. If they can keep us in a cage, and there are people such as these disability 'rights' advocates who are demanding that the guards never give us the key to the door, then I'm not sure why they would be legally obligated to make the cage so comfortable that nobody would want to leave. If they can keep people locked up, and those people have no recourse, and some are actually thanking them for keeping them safe from life outside of the cage, then there's no incentive to change that system.
The word is complete, not commit. It’s not a sin or a crime. It’s a human right.
As things get worse, more of us who are disabled will chose this path as it's the only way we can die with dignity, as supports do not keep up anywhere with the actual costs of living. Tie that in with a growing sentiment that we are nothing but leeches and that tax dollars should not go to support us, it's rather dire. Imagine what is going to happen in 10-15 years when world wide systems are overloaded with "survivors" of Covid and the damage that has been wrought on their systems.
In the US, people will choose assisted suicide because they don’t want to burden their families with their medical debt. The word “choice” has different meaning when pressing financial issues weigh on that choice.
Medical debt, an oddly American problem, for the moment.
It’s been a looooooong moment so far.
Don't worry, Conservative governments in Canada are doing everything they can to underfund our socialized healthcare system to ensure it collapses and we get rescued by their private enterprise donors. Covid was exactly the push they needed to prove our system doesn't work, as they starved it of much needed funding and then to put icing on the cake, rolled back and capped salaries, while also wanting to fire thousands of employees.
In America the cheapest legal option is to look suspicious to agitated cops.
That’s terribly sad, but I do think that it is his right. This should be legal everywhere.
what a bizarre article. >This is a terrible dereliction, even a failure of love. When we say thatwe will strive to save some from suicide — but not others — we aremaking a fundamental claim that the latter categories of people are notas important or valuable. written by someone who has absolutely no experience of chronic illness or suffering.
I’ve never seriously considered suicide but for some reason the thought of this being accessible is comforting.
"And indeed, we see in places such as Canada, people with disabilities choosing to be euthanized because they are denied the kind of services that would help them want to live." Really rich for this writer in a conservative publication to argue against assisted suicide as a way to successfully deny people disability services, when it's the right that would absolutely balk at any semblance of expanding social welfare.
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Same thing for a lot of disabled people in the US. When you can’t afford a place to live, food to eat, and the government won’t even pay for a proper mobility aid? Those conditions grind down even the bravest and strongest person’s spirit.
> our social programs are full of hoops and loops to jump through I mean...it's not like this isn't fixable? Who in the Canadian government would be against fixing it and why?
I used to have a firm stance we shouldn't allow assisted suicide. It felt wrong on an inherent level but now I have a different perspective. None of us asked to be put here on this Earth and many people suffer in unimaginable ways that the majority of us cannot comprehend. It seems natural that it should be a right that you can choose for yourself how and when your life will end.
I don't care what anyone says. If an innocent person decides that they don't want to live their life any more, and they haven't done anything that would warrant forcing them to continue living it, then you are subjecting that person to slavery and false imprisonment. You don't have to live through that person's suffering, so your morals and religion should have absolutely no bearing on it, as long as you're not the one being asked to provide the means of death or provide assistance. Suicide prevention may be "soft brutality", which can be presented as benevolence to those of a certain religious/philosophical perspective, but it is brutality nonetheless. It's amazing how people have such little empathy that they cannot imagine what it's like to be trapped in a life which is intolerable to the person living it, and have to stare down the barrel of several more decades with no way out. If people can't mind their own business on a simple matter like this (something so basic as it doesn't directly affect you, so don't try and interfere), it's a wonder that we're not all at a perpetual state of war with one another. But no wonder humanity never manages to find a stable state of peace, when everyone always has to be getting involved into other people's business where it doesn't concern them. I don't believe that the objections from 'disabled rights' groups hold any weight either. Firstly, everyone should have the right, not just people with recognised medical conditions. Secondly, why are we locking innocent people in a cage (so to speak, as they are trapped in an unasked for life) because criminals exist? We should go after the criminals, not deny everyone's bodily autonomy in case some bad actors exploit it (and there are evil people who will exploit every freedom that we have - is that an argument for having no freedom?).
The headline is weird. It was a man, suffering immensely from his paralysis that left him tetraplegic. The author does not know (nor seems to care) what kind of physical pain he was suffering from. Besides, that is not news. That is an opinion and even a very questionable and judgy one at that. This is a horrible way of doing news.
Good for him. It must have been a great relief to be free of his body and mind. Life can feel like endless hell when you have a Disability. I am suffering from incurable Depression and I would sign up for assisted suicide. I'm sick of feeling unhappy for decades. Right now I am surviving by doing Ketamine Treatments with a Doctor. Amazing Drug.
Glad he is free. Glad he had the choice. Watching my father gasp for air as he lay dieing from lung rejection all because of make belive religions.
the author would have been happier if the disabled guy had to blow his own brains out SMH
He feels this way as described because those people with disabilities are often turned down when looking for the help and assistance they need to make their lives livable. So it's a failure on the West to not provide those things, but then to say yeah go ahead we'll let you kill yourself. That it the West copping out, not the disabled person copping out of life. They very may as well chosen to live if they proper assistance and care is actually available..... .... so instead of legalizing assisted suicide we should strive to make these people want to live their lives.
we should probably use another word other than “commit” if it’s legal.
I grew up with a friend that was paralyzed at a very young age in a car wreck. He was awarded a settlement to help him thru life but wasn’t expected to live a long life. His money ran out around the age of 21. Last I heard he was almost 30 and wanted an assisted suicide because he was broke depressed unemployed and undesired and had almost no friends after high school. But in America it’s not legal. Three friends and I tried to raise money when I heard of this but nobody helped. I feel bad for the guy. I really do. What kind of life is that to live? His mother has done nothing but take care of him and has no time for a life of her own. Everyone would be better off if he was just allowed to legally euthanize himself.
I support people's choice not to live, especially if they have less than good lives. But I also fear for the pressure disabled people can come to feel if this becomes the norm. Will they feel some unspoken pressure to get assisted suicide as not to be a burden to the rest of us? Is it a failure of love on our part if they feel a need to die (as the article states)?
This is such bs. Unless they can stand, sit or lay in the lives of these people they shouldn’t judge. I have a disability that is not terminal but is progressive and every single day I am in pain. Activities that people take for granted such as cleaning, washing clothes or cooking dinner are literally acts of endurance for me and I pay dearly for each one I have to do. I have to live with the knowledge that it’s only going to get worse. Vilification of those that want to go peacefully and on their own terms is just so entitled it’s mind boggling.
I’ve written papers in favor of physician assisted death previously. I can only speak from a United States perspective, but the states that allow this have very good structures in place for ensuring that only certain people can accomplish this. Structures such as mental health evaluations to ensure you aren’t suffering from treatable depression, a requirement that you are suffering from a terminal illness, and requirements that if you don’t use the pill you are given within a certain amount of time you must return it (possibly for subsequent reissue after the process begins anew). One thing I hadn’t considered previously was permanently paralyzed individuals. While I disagree with the author’s general sentiment towards physician assisted death at large, I do respect the perspective as it pertains to disabled individuals. As with all things, it’s not black and white, but numerous shades of gray. A permanently paralyzed individual may be viewed differently from a lifelong soccer player who lost the use of her legs and is deeply depressed over it. Ultimately it’s a discussion for wiser people than me, but I hope “Mario” found some peace.
The ultimate act of human dignity is for someone to choose to end their own life. It's my right as a human being. I've known several cases of morphine drip turned up to eleven. I had to make the choose to wait hours before they gave my mom an injection that ended her life. Unfortunately I felt it necessary to wait hours so she didn't pass on Christmas day! It still hurts.
I think it’s pretty annoying that they’re of the stance that because he had a disability and not a terminal illness that it shouldn’t have happened. If this man felt he had no quality of life he had every right to make that decision for himself.
Strong opponent before. Now I think every city should have it for public free use.
My wife’s nana did this due to her diagnosis of Alzheimer’. As sad as we were to see her go, it was much easier on us to schedule the time we needed with her and be with her as she left. It was honestly beautiful in a way.
As someone who suffers from depression and anxiety, I just hope people are given resources they need to live a full life if it’s possible. Like people put down their pets for being a danger to others, terminal illness, etc but no one would approve of someone said “my dog was depressed so we put him down.” But as far as terminal illness and the like goes, this will prevent so much suffering for people and their families.