I hope we have the compassion as a society to get to the point where I can say, "If I am unable to recognize my children, please kill me." At that point I would have died regardless of the condition of my body.
I don't want to wait that long. If I get diagnosed with Alzheimer's, I am taking a quick farewell tour of family and friends and then I'm done. I don't want to wait so long that I need someone else to off me. I wish that all wasn't necessary but this country (US) isn't going to get smarter anytime soon.
I hope we have the compassion as individuals not to ask others to kill us. That's a heavy weight to put on someone else. It's not abstract "society" conducting the euthanasia: individual healthcare providers would have to decide that you met the criteria and then administer the drugs.
> I hope we have the compassion as individuals not to ask others to kill us.
When I've had to kill my pets, I didn't do it myself. I called in a professional to do it.
Surely you don't believe that OP is asking their friends to knife them in the chest if they're too far gone to ask to be euthanized? Surely you believe that OP is asking their friends to ask a doctor or nurse come in and do it, if OP is no longer capable of asking for it to be done?
Instead of posting snarky, low-effort comments you should spend some time learning the basics of medical ethics. This is not a religious issue. Medically assisted suicide for a terminal patient is one thing, but directly killing a patient with severe dementia who is mentally unable to give informed consent is quite another. This would put healthcare providers in an impossible situation. There are good reasons why no civilized country allows this.
Sure, I'll follow those goalposts as they walk down the field.
At the time it becomes relevant, a person with a DNR is usually (always?) in no state to give informed consent to being killed by their doctor's inaction. Same thing for someone in a irrecoverable coma who's being kept alive by machines when a family member or friend instructs the doctor to pull the plug on them.
Relatedly, angels of mercy have been releasing suffering folks who are at the end of their life from that suffering for ages.
You might find these things unpalatable, but they do happen, will continue to happen, and we're better off because they do happen.
I sincerely hope that through to the end of your life you remain lucid and able to clearly and convincingly express your preferences. I very much hope that you're not locked in a metaphorical hell of suffering, but unable to express to (let alone convince) anyone that you're ready to end it early.
Stop lying, I haven't moved any goalposts. In medical ethics there is a clear line between withholding care versus actively killing someone who is unable to give informed consent to the procedure.
You absolutely have moved them (and also refuse to talk about pre-registered requests to die (of which, the request that kicked off this subthread totally qualifies)). You started by saying
> I hope we have the compassion as individuals not to ask others to kill us. That's a heavy weight to put on someone else. It's not abstract "society" conducting the euthanasia: individual healthcare providers would have to decide that you met the criteria and then administer the drugs.
(while ignoring that asking a doctor or nurse to kill you is also asking another to kill us) and now you've moved to talking about specific situations that can be tricky, depending on the particulars.
Isn't that still less awful than having to administer other kind of drugs again and again for suffering and slowly dying patients that want to die?
The situation is just bad regardless.
So long as people can freely choose whether they will do it or not I don't see a moral problem. There would be a very big problem if healthcare providers were mandated to provide such a service. And note that while the evaluation certainly needs to be by a doctor a nurse is quite capable of doing it. Look at the Canadian method--for the most part it's something that's actually done quite routinely in emergency rooms across the world. Sedation followed by a paralytic. Usually that's a prelude to intubation but if you walk away in the middle it kills. Canada then pushes potassium chloride just in case as the paralytics wear off pretty fast.
And we are better off as individuals if we have the option of having external providers do it as that removes any dependency on actually being able to do things. There also is the benefit that it brings an external evaluation into the system that can recognize that maybe the evaluation was wrong. (I'm thinking of a case I heard about--woman thought she had lung cancer, chose to not treat it, simply work until she dropped. Autopsy said TB, not cancer.)
You completely missed the point. This discussion is about dementia. The assisted suicide laws in Canada and other countries generally require the patient to be of sound mind, as evaluated by a qualified clinician. The laws don't apply to patients with severe dementia.
In the comment above, @thinkingtoilet apparently wants someone to kill them if they ever have severe dementia. Presumably that desire would be expressed in some sort of "living will" type document. If the patient meets the criteria then should a healthcare provider strap them down and kill them, even if in the moment the patient says then don't want to die? That seems ethically dubious. It essentially puts providers in the position of being serial killers.
Canada has also had some serious abuses and ethically questionable situations. They are not necessarily a model to emulate.
Of course there are edge cases. Reality is continuous, not disjoint, and thus any attempt to impose a line will inherently create edge cases. What you are missing is that the case of inaction (not permitting it) also creates bad things. You can't make a situation without bad, all you can do is attempt to minimize the bad. Note that the "ideal" (as in maximum social benefit) amount of bad things happening is not zero. Preventing bad things always comes with a cost, there will always come a point where additional preventing of bad things causes net harm.
Consider, for example, nuclear power. It has basically been regulated out of existence in the US because of the standard that radiation exposure must be as low as reasonably achievable. The problem with this is that it doesn't result in safer nuclear plants, it results in plants that run on different power sources. Natural gas? Approximately 10x the risk (and that's not counting climate effects.) Oil? Approximately 10x the risk of gas, thus 100x the risk of nuclear. Coal? Approximately 10x the risk of oil, thus 1000x the risk of nuclear. The expected (and observed) safety benefit of the regulations is negative.
And to preempt the inevitable "Fukushima!", that was political. The expected death toll of staying put was approximately zero. The city was evacuated, killing hundreds, for no good reason.
I'm not missing anything. Medical ethics as commonly understood in modern western civilization imposes a clear line between withholding care versus actively killing someone who is unable to give informed consent to the procedure. The topic under discussion isn't even close to being an edge case. Minimizing the bad is not the goal. Nuclear power has zero relevance here and bringing it up is just an attempt to confuse the issue.
It used to be that medical "ethics" precluded actively killing someone. That's a religious legacy that more and more countries are coming to recognize is wrong. Fundamentally, this reduces to whether quality of life can be negative.
If quality of life can be negative then there will be cases where the humane act is to provide someone with a comfortable death.
And my point about nuclear power is that excessive regulation actually is counterproductive at maximizing human benefit.
Forcing someone to live through a disease when they have already lived a full life is simply cruel. Why should someone have to suffer on their way out?
Who is doing the forcing here? Are you personally volunteering to kill anyone who decided that they wanted to be killed if diagnosed with severe dementia? What if they change their mind (even if no longer of sound mind) and say they no longer want to die? Would you go ahead and kill them anyway?
> Who is doing the forcing here? Are you personally volunteering to kill anyone who decided that they wanted to be killed if diagnosed with severe dementia?
I cannot do that because I am not a medical professional and even if I was I wouldn't be the only one making that decision. I do have a lot of respect for the people whose job it is to perform euthanasia. It's not an act of cruelty, but of kindness.
> What if they change their mind (even if no longer of sound mind) and say they no longer want to die? Would you go ahead and kill them anyway?
No euthanasia program is going to kill someone who says they do not wish to die. The moral hazard mainly comes from when they are no longer able to express their wish. Then the decision is based on the wish expressed when they were still able and the wish of family members.
This is not all too different from someone who has suffered severe brain damage and is kept alive on life support. Would you keep them alive until they die of old age or would you respect the family's wish to stop treatment? People with severe dementia may not be on a breathing apparatus, but they also cannot survive without the constant support of hospice care.
But cases where the person can no longer express their wish are exceptional. It is often that their wish to end their suffering is so strong that they will stop eating to hasten their demise. What would you do in that situation? Would you forcibly feed them through a tube because you do not believe they are allowed to determine the manner of their death? Or would you simply ignore their suffering as they die a slow and agonizing death from malnutrition? This is what I mean when I say that you would be forcing someone to suffer.
In my opinion, there is a line that needs to be crossed and that line is extremely hard to define. To be safe, you have to go past the line so any blurriness is removed. I would ask the people I love the most to shoulder this burden and I would offer to shoulder the same burden for them. This is how love works.
No, you don't have the option. To have the option you must have the ability. Consider the hypothetical that started this: "if I don't recognize my children". At that point the ability to do it yourself is gone.
Another possibility is that millions of people have said that they don't want to live to grow so old that they don't have their wits. But when the days come, they don't really want to die.
