No system is perfect, and at some point there will be fraud. From what I recall, at every single point the patient has the ability to stop the process up until the last minute. All patients require to be in a state of mind to keep making authorizations at every step. I understand your concerns, but I would be willing to take this risk, as I really want both my parents and everyone I know to have this option. Whether they choose it or not, I will always respect and support them at every step, but leaving them in agony and continuous suffering is not something I'm willing to overlook.

But I genuinely understand your concerns.

IIRC the patient can make a request in advance specifically covering the case of them being too out of it to consent. Obviously, in such a case if they're then out of it there's no final authorization needed.

The problem I have with NOT having programs like MAiD is that you CAN be sure that the person didn't decide it. They are at the mercy of the whims of fate because we are not willing to give them agency.

> Easy fraud for doctors, with plenty of incentives to commit it, and the highest consequences for the victim.

I find this a bizarre way to assume that a person who has committed their entire lives to helping people would behave.

Ah yes, the new Hippocratic oath, “above all else, maximize your profit.”

Insurance companies in the US have armies of doctors whose sole purpose is to deny care to sick people. CA health system is less fucked, but no reason to think this system is exempt from various forms of corruption. Families wanting to fast-forward their inheritance, romance scammers trying to marry people who they can manipulate into this, doctors who want to get rid of difficult patients. That's just off the cuff what I could think of.

Have you never heard of eugenics in the 1900s? The most highly respected doctors working for the most highly respected governments were sterilizing, surgically dehumanizing and murdering men, women and small children for the greater good of society. Doctors being some kind of benevolent super-humans is a cartoon fantasy.

You are so sure of this, yet you have no evidence at all. I'm not sure your problem, is what you think it is.

You call this "fraud," but aren't you describing murder? So in essence, you're suggesting that doctors are murdering people because of incentives?

I wonder why OP thinks doctors would have any incentive to do this. It doesn’t benefit them personally and there is just a vague benefit of lower medical care costs provincially.

It's a job that pays money.

And people can become zealots for what they believe is best for others

This is probably the worst part of living in a lower trust society. We just keep decreasing the bar of "good faith". It really sucks, yet I get your point.

I mean if you replace "taxes" with "profits" you have the current American healthcare system. Condemning people to die from a lack of treatment in order to save on profits.

That does not make any sense. Old people’s healthcare gets paid by the US government, literally everyone up and down the healthcare chain earns more profit by extending someone’s life who would rather die.

Wait, so if you cut out the middleman, doctors would make more money keeping people alive and the government would pay for it? Huh that's the opposite of "death panels".

Meanwhile private insurers definitely deny coverage to people with chronic illnesses (not everyone who is sick or dying is on Medicare/Medicaid). In a single-payer system those folks wouldn't slip through the cracks and .... the doctors would be incentivized to keep them alive! (assuming doctors are profit-motivated sociopaths like your average HN poster)

On the flip side, you're only a capitalist state away from propping up a tortured husk and milking all its family assets before tossing it to rot.

Oh we’re already doing that. Retirement communities, assisted living, nursing homes, they are all about that.

Solved by multigenerational living.

Incentive to commit it?? How??

It's not complex, most of it is actually covered even in paramedic training. It's just that instead of sticking the ventilator tube in they inject some potassium chloride. Last month Costco was selling it for about 50 cents a pound. (Potassium salt for water softeners.)

The main cost will be the evaluation, not the procedure.