A friend watched his Dad suffer immeasurable pain for 6 months from bone cancer, and the final 2 weeks were inhuman. He was begging the hospital staff, but they couldn't. Three months after his Dad died, my friend committed suicide.
NOT allowing assisted suicide for terminally ill people is cruel and THAT should be the crime.
The first thing we need to make clear is that "severe, incurable, and unbearable" does not necessarily mean terminal or even physical pain. Plenty of psychiatric conditions often accompanying significant trauma are severe, incurable, and unbearable. But they're not terminal (except by suicide), and the reason they're incurable is because we know fuck all about psychic damage, and some might argue that if you've made it this far without killing yourself then it's de-facto bearable. And yet they definitely qualify unless the law specifically says that they don't, because "deemed unbearable by the patient" is not the same as definitively unbearable.
The biggest flaw I see in the model is if there's no significant determination of qualifications for whether a particular doctor should be allowed to approve the request (e.g. some might demand that the doctors be trained in appropriate specialties and have detailed knowledge of your history and situation), or whether you can ask 100 doctors who say no until you find 2 who say yes. I've seen firsthand that systems which don't mandate strict selection criteria create additional strife.
I think that fundamentally one has to decide whether a person gets to just say "I want to die" one day and forget that there are doctors involved. Because believe me there are many scenarios that basically feel that way to friends and family. Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
[edit: sorry for using british slang, drive-by commenter. "fuck all" does indeed mean "nothing"]
The law allow conscientious objection in doctors (for now), but also will justify death angels manipulating vulnerable people. We shouldn't forget that unbearable pain can be easily created with the appropriate medicines. People can be drugged and turn into addict puppets also. Has happened before. Even recently in US.
And that will taint the statistics also, removing a safety guarantee for everybody. Before the law, a warn was triggered when more than average people died in part of an hospital. After that, the hospital with an interest in lowering this value has a way to do it (falsifying consent). Protecting their public image, but also hiding any rotten apple present in their staff. Bad news for everybody.
If there is something that vulnerable elder don't need now is a new exception to kill them legally.
As far as patients are concerned: We have life support, and we withhold life support once we conclude that there is little to no chance of recovery. Assisted suicide allows this sort of thing sooner, for folks that are suffering.
Those death angels you speak of aren't angels. These are murderers. You are afraid folks are going to murder others. This already happens, and we already have laws against this. We can very quickly produce statistics on what sorts of people seek out assisted death: We can look to other places.
You're not starting from the belief that nobody supports banning gun ownership are you? Because many people do. I'm not sure where this is going.
Living in a country where I have the right to die, there's a formal framework that details the process that a patient goes through.
By handing healthcare professionals a framework, it allows them to build hands-on experience and develop best practices in how to actually have an on-going, involved and empathic disucssion with patients and their surroundings.
The big flaw in this "model" isn't the qualifications of doctors, it's pulling a moral and emotional conundrum into a set of abstract assertions and reducing the debate to the medical act itself: a doctor euthanizing a patient.
> Many people with trauma are extremely suicidal but also scared of the process. Do we establish a structure that makes it easy to get help dying or do we want to instead mandate state resources for helping them stay alive? For a lot of people the answer is not so clear _even_ when people want to be ok with letting people make their own choices.
The right to die, paradoxically, keeps patients from committing suicide. The knowledge that you have that right acts as a 'safety net' to open up towards healthcare professionals. Your wish to die is not a taboo, it's not an elephant that nobody wants to discuss. Any openings towards reflection on trauma isn't burdened by the imperative "you can't die, you must live" from the get-go. Taking that away, paradoxically, creates space to reach out and connect.
The answer your question, in that regard, isn't "either or". It's both.
The right to die can only be implemented in a meaningful fashion if healthcare and social infrastructure provides enough facilities to properly help, guide and reach out to individuals.
That's why it's paramount to invest in mental healthcare, hospice care, palliative care, local physicians, nurses, social workers, schooling, education and so on and see all of that as a commons embedded in communities.
Even so, the right to die isn't a silver bullet. Neither is healthcare a silver bullet. They don't provide or offer wholesale answers or solutions to social, medical, ethical issues on an individual or societal level. It's fallacious to look at these issues and discuss them in moral absolutes, those are tarpits and they leave no room for moving forward.
At the end of the day, death is an intrinsic part of life. However, the vast majority of people will feel uncomfortable discussing their own end of life. It's only when they are personally confronted with the finality of life that they will start to reflect. Personally, I think that a meaningful discussion about the right to die can only begin once you've recognized that your own life and your own health aren't self-evident.
My uncle recently died of Parkinson's and my aunt soon after of cancer. Both suffered immensely (especially my uncle), but they believed it wasn't up to them to end it. Both also had huge support from loving family and friends, the way it should be. I know it's easy to say here at a distance, but there's honour in a valiant fight to the end.
This is precisely why I want the option of legal suicide: a "valiant fight to the end" that lasts years of agony without acceptable quality of life is egoist. Your close relatives will be relieved when you pass away, partly because you were suffering, and partly because a very long agony could become a huge drain of time, money and emotional burden.
I want to be able to choose when and how to die on my terms, legally.
This inadvertently sends a message that some life isn't worth living and that it's moral thing to end your life when you "permanently" become a burden to others. Once this way of thinking becomes dominant, it will put incredible psychological pressure on to people with poor life quality that depend on others. What is acceptable quality of life? When does it become unacceptable? You may think it is a personal choice, but it really isn't. If majority of people around you think you are being egoistic for trying to live, despite the burden you are putting on others, you aren't given much real choice anymore. Look up how big influence can peer pressure and brain washing have on people.
> I want to be able to choose when and how to die on my terms, legally.
It's also egoistic supporting a law because of some personal wants, despite significant bad side effects it can bring.
IMO, upsides a legal suicide law brings are much lower than downsides. And even without legal suicide, person that commits suicide won't get a legal punishment. So, you still have a choice.
I’ve seen the agony it puts on family members when someone makes the (in their mind) rash decision to kill themself. We should work to prevent these rash decision type suicides, but many are carefully and methodically considered and if someone genuinely wishes to exit this place, why should society prevent them from having a chance to communicate that openly, to choose the time, and not leave a giant mess of brain matter that someone else has to clean up?
We allow our dogs to have a better end of life experience (and I’m not suggesting that we’d make the decision in humans quite as early as we do for our beloved pets, though if we could communicate verbally with them, perhaps we should).
Or perhaps we are jumping to conclusions. Without knowing what is the purpose of life (if there is such a thing), we cannot objectively know what life is or isn't worth living. We just have opinions that we try to rationalize one way or another.
We have to realize that we cannot build an ideal law without unwanted side effects. Best we can do is choose a system with less adverse side effects. A system where it is a bit harder to commit suicide (but not impossible) has IMO less adverse negative side effects that a system where it is easy to commit suicide, but also possible to manipulate and brainwash people into thinking their life isn't worth living.
Yes, sometimes suffering of a person is prolonged a bit and sometimes there is a bit more mess to clean. But there is also some small upside. We can observe, collect data and learn more about these diseases, ageing, depression etc., and maybe that helps us to faster discover new improvements that benefit future generations.
Also, compare living in pain for relatively short amount of time (as terminally ill don't live very long on average) with euthanasia abuse cases. Which is worse, unwarranted killing of a person or suffering of a person?
I'm not sure if the unwarranted killing of a person is worse than permitting their torture for months or years on end. I also don't know if that answer changes if for every 1 person who would be killed in an undesirable way that we had to torture 1000 people for an average of 6 months to avoid it.
That's the essence of this debate and it will never find an objective answer that will satisfy all, which is why I default to allowing people to choose, even if some will choose in a way that I would not. (After watching two of our beloved elderly family members struggle for many years and watching another two struggle for weeks in one case and months in the other, our family has expressed our thoughts to each other. We're not universally in agreement, but I'll support each of them in their choices.)
We had multiple loses in the past few years. One was a longer struggle. However, it wasn't torture the whole time. I admit, some days were pretty bad, but there were also good days. And there were also joyful new experiences, like meeting newly born family members. Thing is that while quality of life may look terrible from healthy persons perspective, body adapts to that state and combined together with moderen pain medication person is not in constant physical pain. Point being that it's usually not constant physical torture for years until person dies.
Another issue is psychological pain. This is where we can make a difference. Allowing people to not be perfect or the best, but still be equally worthy can do wonders.
> whether life is worth living should be primarily decided by the liver of that life
I find it that people can have quite significant change of heart. And it is not rare at all to have one.
It's too important for us to decide, does that logic apply in the other direction as well. Many diseases and conditions would kill people rather swiftly if not for medical intervention. Medical intervention that prolongs life seems to be making a decision that the natural or supernatural ordination of when someone should die can be changed.
First question then, do you think that medical intervention that prolongs life is acceptable?
If your answer is yes, then the idea that the end of a life is too important for individuals to make falls away. Sure one act moves the time of death earlier and one moves it later, but both acts move the time of death.
This means that the argument becomes different, that life is so important that death can only ever be moved further into the future, never closer to the present.
> There's also the aspect that suffering sometimes just happens, and we don't usually get to decide when and how it's going to happen to us.
I don't really understand this argument, suffering happens and people should not have any agency to end that suffering. By that logic I could come to your house and endlessly torture you and any attempt you made to stop me or free yourself, I could just say, "suffering sometime just happens, and we don't usually get to decide when and how it's going to happen to us."
Would that make the torture justified? Would it make you trying to end the torture somehow in the wrong? If instead of that torture taking place at your house, it takes place in a hospital and instead of me wearing a ski-mask I wear a doctor's coat, does that somehow change the situation?
I'm glad your Aunt and Uncle were able to pass with loving family and friends and die in a manner guided by their beliefs.
How do you possibly justify denying that to others? Forcing them to live out the end of their lives following your beliefs and not theirs. Forcing them to die on your terms and not their own.
Mixing God in the arguments as you do, and the main reason in Spain this law was delayed, is taking freedom away from people who think different.
Note that religious believers don't "mix" God in their arguments, they're just speaking from their perspective. They believe that God is just there, that he made and guides everything. What you call "mixing God in" we might call "practising what we preach". It's maybe a bit like asking a Native American to stop "mixing their tribal culture into everything". That's just who they are.
Who determines that their belief that people are not allowed to decide about their own death is more important than my belief that people are not allowed to decide whether others have to suffer. Reminds me of Mother Teresa. Helping the poor but at the same time believing the sick must suffer like Christ on the cross.
Shit, I've gone full libertarian now.
It's one thing to decide I want to suffer immensely to fulfill my own concept of "honour" but quite clearly it is something else to insist that everyone else does also.
People choose to end their own lives in opposition to unavoidable suffering, so the real question is are we going to make this harder or easier for them.
I empathize with anybody who has debilitating / terminal illnesses or is taking care of people with that.
I've been struggling with thoughts of suicide since I was ~10 yro. The reason why I haven't done it (yet) is that I keep telling myself to take 1 day at the time - if I still want to off myself there is always more time for it tomorrow. But not a chance that I let society/religion/psychologists/science (those who consider themselves "sane" and above those of us who are like this) dictate (or guilt) me into changing my mind. It will need to be a terrible accident or a sudden sickness that actually prevents me from ending it on my terms, which brings me to the second point.
Control. It is my life, my terms. Not my parents, or relatives, nor my children's, or friends, and definitely not the state/law. _I_ decide when I go and how.
> so I believe it is okay to put your dog down
it's the kind of people that make me hate humanity more. It might be a flippant comment that was carefully chosen to trigger those who have been let down by people, and who prefer to find true friendship in a dog/pet. But trust me if we were to go hiking and I would have the option saving my severely injured dog (who might not make it) or a stranger who I know nothing of, except that they don't like dogs: I would 12/10 save the dog.
Humans are not special no matter how much art they create or books they write, in the end we're a parasitic life form that thinks it's superior (the sheer fucking arrogance in that alone). I would never kill another human but when it comes to animal cruelty or perhaps violence against my family (that includes my dogs) I would probably enjoy the act if I were inclined to do so.
edit: there is a saying "those who live by the sword shall die by the sword", which to my ears always seems to be uttered by the biggest fools I know (who know nothing about death or fighting or living). The real wisdom in this phrase is not that it contains a warning but that it is a promise that you "go out with dignity". Not withering away on life support, shitting into adult diapers, in an old-peoples home where family only has time to squeeze you in every 1st Sunday of the month between 14:00-15:00. No thanks I'll rather take the knife, the cliff, the needle or the rope - all of which are more dignified ways to go. And besides if I have lived all my life by not killing other people for their cruelty to those with less power than them (even I had more), at least I should be able to off myself without getting judged by these entitled and arrogant pricks?
The love of a dog is bought with walks and food.
Also, just because someone takes their own life doesn't mean they lack honor. In fact, Japanese samurais has a ritual of committing suicide known as seppuku which is viewed as a very honorable thing to do in their culture.
Having recently witnessed my grandfather's slow decay into ultimately death from up close (living next door), I can say with conviction that there's no "honour" in "fighting to the end". He went from having developed trouble walking to laying stiffly in bed blankly staring ahead in just a month and one ER trip + hospital stay. He then stayed in bed for just under two years only occasionally moaning or grunting quietly gradually losing the last bit of his muscle mass with the only exceptions being:
- getting sponge-bathed by a visiting nurse, my uncle or my father,
- getting put on the toilet chair to pee/take a dump if it didn't already wind up in his diapers while laying in the bed,
- getting wheelchaired over to the table in the next room to get fed some pureed mush that was (almost always) the same as the lunch/dinner my Grandmother was having,
- etc. one can get the idea
> Both also had huge support from loving family and friends, the way it should be.
Having the support from the family involved basically putting their lives on hold for ~2 years. They always had to be there every single day to take care of one thing or another and watching my grandma take that for granted was frankly disgusting to witness. I was roped into plenty of tasks as well but thankfully one of the things I could avoid was having to wipe my grandpa's ass or bathing him. When my grandpa finally died in his sleep one night I wasn't really sad. I was more relieved that he wouldn't have to suffer anymore - my mother and I sometimes wondered if even in his mental state (severe dementia, basically a drooling vegetable) his occasional refusal to open his mouth during feeding was the only little bit control he could exercise, even though he was then just force-fed instead by prying his mouth open enough to get the spoon in. And the thing is, my grandfather was a VERY prideful man with strict principles during his conscious life. Going by what I remember from that time, he would've despised being in that position.
TL;DR: romanticizing long drawn-out physical and mental decay as some sort of "valiant fight" is just wrong and taking "huge support from family and friends" for granted during such death-spirals is frankly a disgusting attitude.
If you want to optimize for honor in a valiant fight to the end, so be it. But who are you to enforce your morals on someone else, who is making the most personal decision one can ever make for themself?
As popularly depicted, he probably wouldn't be too excited about gay marriage, either, or, if you take Leviticus seriously, mixed fabrics. Should Spain ban those, too?
This is a serious issue which should be carefully considered, but I'm not sure that the religious argument (certainly this rather simplistic case of "some entity might disapprove") should really have any standing.
1000 gods exist, they really do, they told me, you can trust me. For every position your god takes, my 1000 gods take the exact opposite position.
Any rational person would think, "You can't just assert that, you have made an extraordinary claim! The burden of proof is on you to show that your extraordinary claim of personally knowing 1000 gods exists has some basis in reality."
Know that that same logic applies to you and is why you are getting blasted with downvotes.
It's not about nature deciding, is it? Or are you against vaccines, heart bypass surgery, doctor-assisted births and in vitro fertilisation, too?
> and we don't usually get to decide when and how it's going to happen to us.
Whether or not we usually get to decide doesn't matter. What matters is whether we get to decide.
Would you politically strive to keep it illegal? If so, do you not consider that an illiberal stance, since you'd effectively be robbing people of their right to self-determination? I mean, if you're against it, the solution is simple: don't request assisted suicide - just as one might not cross-dress, smoke weed, vote or marry someone belonging to the same sex.
In aggregate, as a society, we've come to emphasize harm-reduction and a sense of fairness to the point of idolatry. They are valuable in their own right, but alone they will see us cascade into sheer darkness. The values for the sanctity and purity of life, the acceptance of authority outside ourselves, and even the difficult question of ingroup integrity will need to come back into balance.
As the parent comment says, the law applies to children, and has even applied to a nine year old.[0] I don't think anyone believes that a child that young can meaningfully consent to a decision as significant as ending their own life, so obviously in practice the decision will be made by the parents, who will be influenced by the difficulty of potentially having to support a disabled child, financially and emotionally.
Then there are questions of the judgement of medical professionals. A research paper found that "Almost nine out of ten [medical professionals] (89.1%) agreed that in the event of a serious (non‐lethal) neonatal condition, administering drugs with the explicit intention to end neonatal life was acceptable."[1] This suggests that doctors would approve the killing of newborns even without a terminal illness.
Beyond the issue of the law applying to children, there are several controversial cases involving adults without terminal illnesses. For example, a man serving a life sentence was allowed to end his life due to his feeling of "anguish"[2], despite the country not allowing the death penalty for criminals.
Another adult was given euthanasia due to their opinion about themselves after a sex change operation[3] (which was presumably also approved by medical professionals).
Finally, a man requested euthanasia (which has been initially accepted) as a result of his dissatisfaction with his sexuality.[4]
[0] https://allthatsinteresting.com/euthanasia-in-belgium
[1] https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/aogs.1...
[2] https://www.bbc.co.uk/news/world-europe-29209459
[3] https://www.telegraph.co.uk/news/worldnews/europe/belgium/10...
Saying doctors would be OK with post-viability abortions in the case of a major (though still viable) birth defect does not at all "suggest" to me that they would be OK with the killing of newborns.
Religious - life is sacred, suicide is a sin etc.
It is unethical for physicians to be assisting in suicide or making decisions about who should live.
People (especially the elderly) can be coerced into it, even if they are of sound mind.
The healthcare industry & government will be incentivized to push people into this vs. spending money for treatment.
(These aren't my own opinions FYI)
Probably true in the US, but far from reality in Europe.
I sincerely doubt that in the moments before committing a crime that could lead to life imprisonment or the death penalty, many perpetrators say to themselves "well I'm going to go ahead and do it because while I might end up in prison for the rest of my life, I won't have to worry about the death penalty." In many, many places, the death penalty would be the easier way out.
hmm never thought of this perverse effect .. indeed
What incentive? The healthcare industry (at least in the U.S.) makes more money be sparing no expense at keeping one alive.
But, overall, it at least seems pretty good. I have always been incensed that if I were terminally ill in most US states, the law would treat me worse than my dog. Laws like this are a huge step in the right direction, IMO.
Edit: I’d be fully satisfied when the law allows me to specify when I want my own suffering ended via advance directive. It really shouldn’t be the burden of a terminally ill person to have to make those decisions at the end of their life.
My wife’s grandfather had dementia, and my wife’s uncle who was technically their carer, sucked them dry of all their money then blocked medical care coming to them. The grandparents wereegally independent. If he could coerce out an assisted suicide, it would have all happened much more quickly.
This is second hand info, not enough for the police to bother (they were notified) but knowing the characters involved and enough facts, completely believable.
It’s maybe not a show-stopper anec-argument but definitely something to bear in mind.
You can really easily convince some people to end their life despite them being perfectly reasonable with everything else in life.
Like, really easily. Happens a lot completely by accident. Maybe I'm a bit more exposed living in a college town.
What exactly is your point?
Sometimes the inclined plane has a low coefficient of friction:
> Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the [Supreme Court of Canada] said, it can’t happen here.
> This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.
> Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.”
* https://www.theglobeandmail.com/opinion/article-on-assisted-...
* https://archive.is/hFXjJ (in case of paywall)
For that last part:
> A request is to be submitted twice in writing, 15 days apart. It must be approved by two separate doctors and an evaluation body, according to AFP news agency.
Given those requirements and safeguards, I'm having a difficult time understanding a rational argument against this law.