Doctor Assisted Suicide and Related

[Eriol]

This is a thread about Doctor Assisted Suicide/Death/End of Life/Whatever. To be clear this is about people asking doctors for help with it due to ANY REASON WHATSOEVER, as well as any existing or pending legislation about such a thing. Will it spill over into more aspects of suicide? I'm sure it will.


To start it off, Canada had a ruling last year (ish) about how the blanket ban on this is unconstitutional in Canada. There is a Bill before parliament right now that is being hotly debated, amended, etc, to enable this and/or put federal restrictions on it. Of particular debate is the idea on whether somebody has to have an eminent "foreseeable death" (dying in under a year-ish, it's unclear) or if just going through "intolerable suffering" (ALS, other painful but not-immediately-terminal diseases, and possibly mental health, including dementia and/or Alzheimer's Disease) but won't die soon. This impacts "Living Wills" and such, especially in the dementia cases.

And now there's this interesting "quirk" on it: Prison watchdog asks for clarity on doctor-assisted death in prison

So... ya. We didn't have a thread on this, and it's definitely a current event in at least a few places.

 

[PatrThom]

You sure have had a thing for hot-button threads lately.

FWIW, I believe it should be an option, I have no clear idea how to determine who is or is not "deserving" of it, and I fully expect that bar will plummet as the world's population rises, possibly to the point where it becomes merely discretionary.

--Patrick

 

[strawman]

There are a number of very large concerns I have with physician assisted suicide, but the one on my mind at the moment (and probably not the biggest one over all) is that we are already bringing a lot of things into "healthcare" that probably should be split out. It makes sense in a twisted sort of way to bring death into healthcare, because they are the ones able to discern whether someone is in pain or is terminally ill, and they are the ones that control access to the medicines that might provide pain free suicide.

But they are tasked with life and the extension, preservation, and enjoyment of it. To bring death into their bubble forces them to also evaluate whether death is a reasonable path to choose in a profession long designed to promote life.

If a society must have a "death care" system, let's not mix it up with "health care" and let's not force doctors and their patients to put the bathroom in the kitchen. Create a separate "deathcare" system, legislate it differently, and if there's any involvement with the healthcare system let it be through official diagnosis reports - the deathcare system might require a doctor's signed diagnosis of terminal cancer before it will proceed, for instance.

The healthcare rules and regulations are already labyrinthian, to add deathcare to the same system would only result in greater, more complicated systems, when separating them out would make sense. Some physicians may open shops that perform both - that's fine - but at the government/regulatory level, you wouldn't require all physicians/hospitals/etc in the existing healthcare system to provide these services, nor would insurance companies be required to cover "deathcare" expenses - they could be tagged on as insurance riders if needed, but you'll probably find insurers will gladly add them since it reduces their overall costs to encourage people to kill themselves once their costs exceed their premiums.

I find the whole thought process terrible, in the same way I find abortion terrible, but at a minimum we should separate our life encouraging industries from our death producing industries.

 

[Denbrought]

I think that providing a legal and safe alternative to haphazard suicide methods would be helpful in destigmatizing it, and that might get people to better communicate their intentions to others, instead of bottling them up and winding up dead.

I would not support legal suicide channels that do not try to account for abuse, coercion, and mental unsoundness (which is an extremely hard line since there's a latent catch-22 there). That already happens on suicide by conventional means, I see no reason we can't at least try to tackle it for suicide 2.0.

 

[GasBandit]

This is an area about which I don't really even know my own thoughts.

I'm generally opposed to suicide as a rule, but I can conceive of a level of physical ailment where being alive is constant, real agony and there is no hope of recovery. In that case, it might be an act of mercy... but I worry how much it might be too easily a go-to for the healthy-but-suicidal... and I don't know where to draw the line to say "this is healthy enough to live, this is torment enough to end."

 

[strawman]

destigmatizing it

I don't think we should be destigmatizing it. I believe suicide is bad for society in the long run, and certainly bad for friends and family in the short run.

If we have it at all, it really should be severely limited. We can't stop people from killing themselves, but we can certainly provide greater access to resources that will improve their quality of life, and we should avoid making it easier for those in temporary pain to choose a poor long term permanent solution.

 

[Bubble181]

In Belgium, euthanasia is widely accepted for "unbearable suffering", both physical and mental. It's actually recently been expanded to be allowed for minors and mentally handicapped, as well. As long as....I think three? doctors sign off on the patient's mental capabilities and suffering, s/he can go ahead and get it done.

I dunno, I'm generally in favor of being allowed to take the dignified way out, rather than being forced to live through humiliating, painful, prolonged suffering out of some questionable idea of "sanctity of life". But the limits are grey, at the very least.

 

[Eriol]

You sure have had a thing for hot-button threads lately.

True. Probably a sign of something else happening, but generally I just would rather have threads dedicated to some of the LARGE issues that many have been talking about obliquely in other threads. And in this case, this is BIG NEWS in Canada right now. It has an air of inevitability due to the fact that the government can put through whatever it wants (Majority Government here) but it's still hotly discussed.

I find the whole thought process terrible, in the same way I find abortion terrible, but at a minimum we should separate our life encouraging industries from our death producing industries.

Nice line btw.

and I don't know where to draw the line to say "this is healthy enough to live, this is torment enough to end."

I'm somewhat surprised the libertarian in you doesn't say "it's up to them alone" and that it's not more-or-less just fee-for-service, and the only involvement government should have would be to prevent abuse/coercion, but nothing more. That doesn't jive with my views, but I thought it was more that way for you? Or is that misjudging you? If so, I don't mean to cast aspersions. Just presenting something that's generally conformant with your professed worldview.

 

[GasBandit]

I'm somewhat surprised the libertarian in you doesn't say "it's up to them alone" and that it's not more-or-less just fee-for-service, and the only involvement government should have would be to prevent abuse/coercion, but nothing more. That doesn't jive with my views, but I thought it was more that way for you? Or is that misjudging you? If so, I don't mean to cast aspersions. Just presenting something that's generally conformant with your professed worldview.

Well, even Libertarians don't like murder, and it's possible to murder a suicidal person. That the suicidal person lets it happen doesn't make it not murder. But on a more personal level, my mother having taken her own life when I was 14 probably also biases me against the practice in general. I've seen situations and spoken with people in the decades since which has shown me the other side of the coin, though, so my own position isn't solidified.

 

[Eriol]

Well, even Libertarians don't like murder, and it's possible to murder a suicidal person. That the suicidal person lets it happen doesn't make it not murder. But on a more personal level, my mother having taken her own life when I was 14 probably also biases me against the practice in general. I've seen situations and spoken with people in the decades since which has shown me the other side of the coin, though, so my own position isn't solidified.

Sure, but I meant more that the Libertarian worldview is more about if a person wants to do just about anything to themselves (up to and including self-harm and even suicide, because who is government to tell you what is and isn't harmful?), it's not up to the government to say no, maximizing personal freedom, but also personal responsibility. It should only step in with relations between others, and thus murder and coercion to suicide both being very much a government thing. At least that's my understanding of it, and your personal view will probably lay somewhere other than that declaration, especially considering the history you just said above.

Also, I do not hold that above view either, but that's my understanding of it. Also let me state that while that may be a libertarian view of government that does not necessarily apply to how a libertarian views a person or any other organization in society should necessarily act. e.g. the explicit PURPOSE of a Church/religion is to advertise morals, and thus it is consistent IMO to advocate libertarianism in government, but also advocate for other morals through other avenues.

 

[Bubble181]

That's more or less my POV, though. Smoking, drinking, all legal and just as sure to slowly "kill" you. Someone with Alzheimer's wanting to take the dignified way out, saying goodbye to family and friends without wanting to be a burden, without regressing to the point of being a plant/baby, to me, has the right to do so. Someone wanting to end their life after their partner's died, if they've been together for 40 years - why should they be forced to carry on?
There's definitely a grey area around children, mentally differently abled, temporary pain or sorrow - but that's at most a reason to ask a psych or a doctor to confirm the request, not to deny it categorically.

 

[GasBandit]

Sure, but I meant more that the Libertarian worldview is more about if a person wants to do just about anything to themselves (up to and including self-harm and even suicide, because who is government to tell you what is and isn't harmful?), it's not up to the government to say no, maximizing personal freedom, but also personal responsibility. It should only step in with relations between others, and thus murder and coercion to suicide both being very much a government thing. At least that's my understanding of it, and your personal view will probably lay somewhere other than that declaration, especially considering the history you just said above.

Well, adding a second person to do the killing/assisting definitely calls the practice more into question than one doing so themselves.

 

[Eriol]

That's more or less my POV, though. Smoking, drinking, all legal and just as sure to slowly "kill" you. Someone with Alzheimer's wanting to take the dignified way out, saying goodbye to family and friends without wanting to be a burden, without regressing to the point of being a plant/baby, to me, has the right to do so. Someone wanting to end their life after their partner's died, if they've been together for 40 years - why should they be forced to carry on?
There's definitely a grey area around children, mentally differently abled, temporary pain or sorrow - but that's at most a reason to ask a psych or a doctor to confirm the request, not to deny it categorically.

I'm more getting at trying to get people to think about it the other way around: why should the government be involved beyond making sure it isn't murder? Why should they care if the person is in deep "temporary pain or sorrow" or not? Why should government care either way? If the stated objective in many cases is to make government as amoral as possible, then they shouldn't care at all.

This comes from my general belief that just because the government CAN do something, doesn't mean it should. Thus any action by it must be covered by the "it must" rather than "it can" in more cases than not. Thus any paraphrase of "they're stepping in for the good of the adult" is suspect (adult is important in that statement).

This goes in a different direction than my beliefs around human life, and the value therein, but most of the governments of the world don't seem to value that either as a matter of dictating the other parts of law. Whether they should or not is not talked about anymore. So the discussion goes to the idea IMO of "now that they don't, and only value if a person takes another's life" then what? If personal choice is that high up, then why restrict anything beyond the ensuring of non-murder?

 

[strawman]

Once the government adopts the position that they should regulate death in the extreme cases, then it's not a very long legislative session to them deciding that they should regulate death in non extreme cases.

In other words, a lot of discussion abounds about people with no hope for quality of life, but inevitably, as in Belgium, it leads to people who only temporarily have depression and choose death over treatment. It leads to the inculcation of society that life is only valuable/valid/useful if it meets a certain bar for "quality" and suddenly you're teaching generations that maybe if you have a disease or disability you aren't experiencing enough "life" to justify living when things get hard. It leads to people thinking, "Well, wouldn't they just be better off dead?"

And while this is a slippery slope argument we can already see this happening elsewhere. This change in the public consciousness turns into a disadvantage to those who do choose life even with severe disability. Other's begin to wonder why they even try.

In some socialist countries there's an expectation that if you have a terminal illness and suicide is available, you are draining valuable healthcare resources by demanding continued treatment so one can seek what little enjoyment they can from what little life they have left.

In other words, choosing life is now becoming more commonly considered selfish, and death selfless in those countries that have embraced assisted suicide. Ultimately, though, and I honestly do not say this lightly, to geneticism and shades of "the final solution" where lives considered less worthy are pushed to choose death.

This is not a path that's worthy of light thought and consideration, and certainly not one to be jumped into wholeheartedly as some states in the US have done.

 

[Denbrought]

This short essay is probably relevant to the discussion, Slate Star Codex: The Right to Waive Your Rights.

 

[Eriol]

This short essay is probably relevant to the discussion, Slate Star Codex: The Right to Waive Your Rights.

I think it's useful, but only to illustrate short-sightedness (I did read the whole post, though obviously not the comments). He's pointing out the problems of the current system where you can't waive all rights. Can he even fathom the massive issues if you could waive 100% of them? The powerful would be the only ones with rights (which let's be honest, they don't need under such a system, since they have POWER), and everybody else would be subject to EULA-level madness at all times, 100% enforceable, aka: Legal Slavery. Yes the current system is flawed, but the opposite suggestion is a shitstorm.

 

[Denbrought]

I think it's useful, but only to illustrate short-sightedness (I did read the whole post, though obviously not the comments). He's pointing out the problems of the current system where you can't waive all rights. Can he even fathom the massive issues if you could waive 100% of them? The powerful would be the only ones with rights (which let's be honest, they don't need under such a system, since they have POWER), and everybody else would be subject to EULA-level madness at all times, 100% enforceable, aka: Legal Slavery. Yes the current system is flawed, but the opposite suggestion is a shitstorm.

Did you skip the first two paragraphs?

 

[Gruebeard]

I'm somewhat surprised the libertarian in you doesn't say "it's up to them alone" and that it's not more-or-less just fee-for-service, and the only involvement government should have would be to prevent abuse/coercion, but nothing more.

That's rather close to my view on this. It's on these sorts of topics that I lean Libertarian. Of course, our government will have to be involved more than that, given our health care system

 

[Eriol]

Did you skip the first two paragraphs?

No I didn't skip them, in that he lampshades my point, then completely ignores the implications as not plausible. We're already there with all kinds of contracts with providers, waving rights to class action suits, and many other things that may actually keep corporations accountable. And 1000s of other examples of if not outright collusion to keep contracts "industry standard" (ie: screwing over the consumer), the result is you can't shop around if everybody is screwing you.

So I completely disagree that it's not something to worry about, and that the current state it so much worse, which is the point of the article. I will agree the current state sucks and has problems. I still assert the alternative is much worse. Thus why I don't think you should be able to sign away many/most of your rights.

 

[PatrThom]

Related or not, I don't believe it should ever be possible to waive your rights.
After all, they are rights. You possess them by merely existing. Putting aside for the moment the debate over whether the things we call "rights" are actually Rights or merely "privileges," anything which is an actual Right is de facto something you are entitled to no matter what anyone else may say/do/think/want.
So if there is ever any debate over whether it should be possible that a thing could potentially be waived, I think the better discussion would be one of whether or not that thing is actually a right, or whether we should be forced to entertain the possibility that it should be reclassified as just a highly-regarded privilege. For everyone.

--Patrick

 

[Bubble181]

Related or not, I don't believe it should ever be possible to waive your rights.
After all, they are rights. You possess them by merely existing. Putting aside for the moment the debate over whether the things we call "rights" are actually Rights or merely "privileges," anything which is an actual Right is de facto something you are entitled to no matter what anyone else may say/do/think/want.
So if there is ever any debate over whether it should be possible that a thing could potentially be waived, I think the better discussion would be one of whether or not that thing is actually a right, or whether we should be forced to entertain the possibility that it should be reclassified as just a highly-regarded privilege. For everyone.

--Patrick

Also useful in "kill/search/torture them damn terrorists without a trial" discussions.

 

[Dave]

If I ever get a diagnosis of Alzheimer's, I'm going to throw a fucking HUGE goodbye party, then I'll be leaving on my terms. So I can see this as a thing. But for ANY reason? Not sure I'm for that. I mean, most doctors I know would be if not fine then at least at ease with assisting in the case of a terminal and painful disease, but doubt they'd be okay with someone just going in and saying, "Hey, doc, I'm feeling off. Can I borrow your Death-o-matic for a few minutes?"

 

[ThatGrinningIdiot!]

Related or not, I don't believe it should ever be possible to waive your rights.
After all, they are rights. You possess them by merely existing. Putting aside for the moment the debate over whether the things we call "rights" are actually Rights or merely "privileges," anything which is an actual Right is de facto something you are entitled to no matter what anyone else may say/do/think/want.
So if there is ever any debate over whether it should be possible that a thing could potentially be waived, I think the better discussion would be one of whether or not that thing is actually a right, or whether we should be forced to entertain the possibility that it should be reclassified as just a highly-regarded privilege. For everyone.

--Patrick

You describe rights almost as though they're imposed on an individual without their choice or thoughts on the matter. I believe it should be acknowledged that while rights are given or earned, can also be taken away or rejected entirely by people; despite these possible outcomes all efforts should be made continuing to endow individuals with rights. But forcing them onto others runs the risk of becoming just another form of tyranny. After all, not everyone holds the same meaning of freedom or rights as we would.

 

[Bubble181]

If I ever get a diagnosis of Alzheimer's, I'm going to throw a fucking HUGE goodbye party, then I'll be leaving on my terms. So I can see this as a thing. But for ANY reason? Not sure I'm for that. I mean, most doctors I know would be if not fine then at least at ease with assisting in the case of a terminal and painful disease, but doubt they'd be okay with someone just going in and saying, "Hey, doc, I'm feeling off. Can I borrow your Death-o-matic for a few minutes?"

It's what the Hippocratic Oath was invented for, see. Anyway, it'll always be something of a grey area. Alzheimer's is a great example, as it isn't lethal or particularly physically painful. Yet it's, to my mind, a good reason to have a goodbye bash and go jump off a cliff... This is why you do want some measure of control in there - as i said earlier, in Belgium you need, I think, 2 doctors and one shrink or vice versa to sign off on it as being "unbearable".

 

[PatrThom]

You describe rights almost as though they're imposed on an individual without their choice or thoughts on the matter.

Yes, that's it exactly. They are initialized and set to TRUE by default upon becoming a person.

I believe it should be acknowledged that while rights are given or earned, can also be taken away or rejected entirely by people; despite these possible outcomes all efforts should be made continuing to endow individuals with rights. But forcing them onto others runs the risk of becoming just another form of tyranny. After all, not everyone holds the same meaning of freedom or rights as we would.

And that's where we differ, a little. I believe that a person can choose not to exercise a right, but I don't believe a person should ever be permitted to outright renounce a right any more than they should be "allowed" to decide they want to live without a circulatory system. A person who says, "Y'know what, I've decided I want to give up my right to xxx" should be viewed with just as much skepticism as someone who pronounces, "I think blood is messy and stains things too easily and I don't like that, so I've decided to have it all removed." To do either is to cease to exist as a person.
I don't believe anyone's rights are ever "taken away" when they aren't allowed to do something, I just believe they're being ignored. Society may decide that it would be better served by willfully ignoring certain rights, and subsequently enforce that ignorance through superior numbers or force of arms, and that is where you'll find the tyranny. Yes, even when it is justified, because to say, "We're going to lock you up for the rest of your life so that you can't capriciously kill anyone" is still a form of tyranny, no matter how much it benefits the rest of humanity.

--Patrick

 

[Gruebeard]

You describe rights almost as though they're imposed on an individual without their choice or thoughts on the matter.

In Canada and the US, Rights are bestowed upon the citizens by the government. The Bill of Rights is what it's called down there, right? Ours is the Charter of Rights and Freedoms. What these documents provide are the only rights we really have, and they are indeed imposed on us the moment we become citizens.

We can choose not to exercise our rights, though, as you say. But I'm with @PatrThom in the thought that we should never be able to choose to forfeit our Rights, that choosing not to exercise a Right at this moment should never mean I don't get that Right at any moment I change my mind.



(Well, there's probably a UN declaration of Human Rights that are probably imposed upon us if our government signs on.)

 

[Bubble181]

Well, it depends on what rights. Some are inalienable universal human rights, others are conferred rights given to specific groups of people. Some would say those are by default privileges, but that means you're really, really limiting rights and expanding privileges enormously.

 

[PatrThom]

choosing not to exercise a Right at this moment should never mean I don't get that Right [back] at any moment I change my mind.

That's a lot of what I'm getting at, yes.

--Patrick

 

[Eriol]

Well, it depends on what rights. Some are inalienable universal human rights, others are conferred rights given to specific groups of people. Some would say those are by default privileges, but that means you're really, really limiting rights and expanding privileges enormously.

I picked your post to express the difference between what rights mean to different people that use the word. I've made this distinction before, be it years ago here, or even earlier on a different board.

1. Rights area construct useful to our social fabric, but only exist and have force because of force of law and/or government. This is simply because no "higher" laws exist than these other than physics. This is an atheistic view of "value" in that anything only has value because people believe it does. Nothing is inherent. New rights can be granted, and old ones revoked for whatever reasons those making the laws/rights can decide upon, and/or convince enough people of.

2. Rights are in-born traits that exist in us (and potentially animals, and/or the earth itself) because they are parts of our beings. This is at the LEAST an agnostic philosophy, if not fully religious. It relies on a concept of "right and wrong" outside of opinion of humans. Under this idea, all rights belong to all at all times, but sometimes they are violated and/or ignored or not recognized by governments and/or other people. This view is not incompatible with having laws that we CALL rights, but are clearly different, such as a right of internet access (it's a thing some places) for the sake of social good, but that is not the same thing.

We reach have our own ideas on which is true, and to what degrees, but do we agree that's the "ground-level" definitional distinction on "rights"?

 

[PatrThom]

Some of it is purely semantic, but using Internet access as an example, you can claim that the statement "Every resident of the city of Townsburg gets Internet access provided by the city" can be called a right IF it truly applies to everyone in Townsburg. New residents, old residents, businesses, renters, whomever. BUT once you start saying things like, "...but only if they are not delinquent on their taxes," then you are tacitly admitting that this is a privilege, not a right. If, instead, you say, "Anyone who is delinquent on their Townsburg taxes will have 90 days to pay or they will be evicted and their property condemned" then that means they would no longer be residents and so would no longer be entitled to the Internet access, and in that case Internet Access=a right for residents, but residency=not a right.

--Patrick

 

[Bubble181]

I strongly disagree about calling them atheistic and agnostic/religious. Atheism does not imply no belief in a higher structure or reason for existence, merely the lack of (a) God. Even accepting a lack of higher reason - it's all pure chaos - you can still have undeniable rights based on an individual's understanding of ethics and a value placed on human life. The idea that any atheist morality is based on external laws is deeply flawed and very typical of religious people trying to condemn atheism, it's a pet peeve of mine.

 

[Sara_2814]

I strongly disagree about calling them atheistic and agnostic/religious. Atheism does not imply no belief in a higher structure or reason for existence, merely the lack of (a) God. Even accepting a lack of higher reason - it's all pure chaos - you can still have undeniable rights based on an individual's understanding of ethics and a value placed on human life. The idea that any atheist morality is based on external laws is deeply flawed and very typical of religious people trying to condemn atheism, it's a pet peeve of mine.

Buddhism is an agnostic religion. There is no established creator deity, so belief in a 'higher power' is entirely up to the individual practitioner. You can even remove all the supernatural elements (using them only as metaphor), which gives you secular/atheist Buddhism. The Four Noble Truths still apply in all cases, they do not depend on the existence of a god.

 

[Eriol]

I strongly disagree about calling them atheistic and agnostic/religious. Atheism does not imply no belief in a higher structure or reason for existence, merely the lack of (a) God. Even accepting a lack of higher reason - it's all pure chaos - you can still have undeniable rights based on an individual's understanding of ethics and a value placed on human life. The idea that any atheist morality is based on external laws is deeply flawed and very typical of religious people trying to condemn atheism, it's a pet peeve of mine.

Fine, but at the point of "value placed on human life" that is outside of personal "because I think it's a good idea for me/other and making it "undeniable" goes somewhere beyond pure physics.

Atheism means you believe in NOTHING beyond physics. Any other values are human-made and enforced. Useful yes, but anything "intrinsic" that aren't physics means bringing something theistic (or spiritual or whatever) into it, which means you're not an Atheist. To an Atheist, "The Universe" doesn't fucking care and CAN'T care. PEOPLE can care, but an Atheist shouldn't fool themselves into thinking it has any more weight than any other human opinion about making a functioning society.

Buddhism is a non-deistic Religion, but is not Atheist. Stripping out the spirituality may turn it Atheistic, but the "Truths" then just become another opinion then.

 

[PatrThom]

To an Atheist, "The Universe" doesn't fucking care and CAN'T care.

Are there different sects of Atheism? Because I thought Atheism was merely the belief that there are no gods, and didn't make any claims about whether or not "The Universe" knows/cares about our existence. For instance, I know about my own cells, and I really can't be said to "care" about them or call myself a god to them even though I have the ability to influence them (and to some extent they influence me). They are merely a part of me.

--Patrick

 

[Eriol]

Are there different sects of Atheism? Because I thought Atheism was merely the belief that there are no gods, and didn't make any claims about whether or not "The Universe" knows/cares about our existence. For instance, I know about my own cells, and I really can't be said to "care" about them or call myself a god to them even though I have the ability to influence them (and to some extent they influence me). They are merely a part of me.

--Patrick

To my understanding as applied to the universe would be a variation of Gaia theory, which I would call theistic, but others may not depending on how literal it is.

The definition I put forth above is Atheists = physics only, human thought is the only measure of value. Agnostic (and beyond) = more than that in any way not defined by physics.