[throwaway324324]

Thanks - yeah, I agree, we need better palliative care, better social support in general. I understand your perspective, but I do have trouble following it through - I need to be able to say "at this point, a life loses that value, and it becomes permissible to kill". I don't see that happening with consent, because dueling to the death is rightly illegal. I also don't see how we can get somewhere by counting up something (like suffering, failure to contribute back to society, whatever) that then makes it permissible to kill a person. And if I try to combine both, I end up with rules that are still problematic, but make it easier to kill the elderly, the dying, and other vulnerable people, which is a bad sign.

[hadagribble]

For what its worth, I think we're approaching this question from opposite ends of the spectrum. Rather than asking when it is permissible to kill, I look at it as "when is overriding free will (on victimless actions) for societal good permissible"? Forcing terminally ill patients to live through the misery doesn't meet my bar on that front.

I realise that you're drawing a distinction between taking your life and having someone else take it for you, but to me, in this case the difference is largely academic since the agency remains with the patient at all times.

The objections to dueling were, as I understand, more around the social pressures which required one to participate making the idea of consent much more fuzzy.

[throwaway324324]

Interestingly, family pressure to euthanize is a major practical concern for countries with euthanasia.

The point is actually that there is no distinction between taking your life own or someone else's. If consent is our metric, dueling is permissible (with societal pressure safeguards, if you'd like). Consent is irrelevant, the issue is that intentional killing should be a relic of a more barbaric past. The cure (resolving psychological distress over having a painful death by being willingly poisoned, often in front of your family) is worse than the disease.

Ultimately, you're saying that it's permissible to kill when a terminally ill patient would "live through misery", where someone who is not the patient defines what constitutes "misery". Am I understanding that correctly? On what grounds would that not apply to, for example, a severely depressed homeless person suffering from substance abuse, who a doctor might judge has much more suffering in store for them than a cancer patient with access to painkillers?

[hadagribble]

> "... family pressure to euthanize is a major practical concern..."

Agreed, and this is one of my major reservations about euthanasia. I still think it is overall for the best, but this aspect absolutely needs monitoring. I can only hope that better social services and support help reduce the financial burden on families (which is often one of the biggest reasons for pressure). The emotional aspect, of course, is another story.

> "The point is actually that there is no distinction between taking your life own or someone else's."

Here I have to disagree. Only one of these is an action on one's own body (which one should have relative autonomy). I think consent is absolutely key -- personally, I'm not opposed to the idea of legalizing dueling, as long as we have adequate societal safeguards against it. We don't outright ban other dangerous things that could end up killing people (tobacco, alcohol, free climbing...)

> "The cure ... is worse than the disease."

This is not a determination I am comfortable making for anyone else. Unless there is significant societal/family pressure which means that people are not making this choice themselves, I think they should have that right. If there is extensive pressure, there should be safeguards against that, as opposed to banning the practice?

I see a similar kind of argument in the anti-abortion debate -- there are folks who wouldn't opt for it themselves, but want others to have that right, while others feel that it should be banned for everyone because it is overall a societal ill.

I realise that this is a different question, but is this the kind of angle you are coming from?

> ... not the patient defines what constitutes "misery".

In the long run, it should absolutely be the patient who determines what constitutes misery and makes the choice. Unfortunately, there is entirely too much risk of it being used as a way for society to ignore people we should be helping ("if we wait long enough, maybe they'll just go away") for it to be practical to use it that way yet.

Terminally ill patients are a relatively well-defined set where there is less risk of society starting to ignore the problem (I don't see interest in cancer research drying up just because of this option), so it seems like a reasonable place to start?