[mmastrac]

The whole argument against MAID feels ridiculously like the anti-abortion position. The other option to providing it is having them end their life in a way that might be risky or fail to succeed in a way that leaves them painfully scarred for life or suffering more than they had to.

Why are people forced to live if they don't want to?

[bmelton]

I am sympathetic to those who wish for assisted suicide to prevent pain for diseases or illnesses they've succumbed to. I agree with your thesis that death may be preferential to suffering, and should be available to those who seek it.

On the other hand, there are articles like this[1], wherein the main factor for the requested euthanasia is income.

"But until recently, he was able to live comfortably, sharing his modest home in Medicine Hat, Alberta, with his service dog.

Changes to his state benefits when he turned 65 in May meant his income was cut and he's now left with around $120 per month after paying for medical bills and essentials."

The bogeyman against a state monopoly on medical care has long been that the state will seek cost effectiveness over quality of care, and this adds the additional paranoia of worrying over whether other social safety net programs may lean into the notion that perhaps it isn't as beneficial to fund those who are less productive members of society due to age or inability when it is easier to put them down.

I don't have a particular dog in the fight either way, but where I want medical assisted euthanasia to exist as an option against suffering, I have some concern that it could become encouraged for what I consider less appropriate ailments, like poverty.

[1] - https://www.dailymail.co.uk/news/article-11516989/Canadian-m...

[mistermann]

My prediction is that this poor man is the leading edge of a massive tsunami that is heading towards Canadian shores. Housing/rent prices are beyond insane in Canada, we have 500k+ immigrants per year, and with food prices now on the rise 10% to 20% at least, I can't imagine how many people there are going to be who can't afford a roof over their heads.

And I've seen zero sign that this is even on the radar of government, though perhaps that's what MAID is for. At least it's an option to homelessness.

[mmastrac]

> I've seen zero sign that this is even on the radar of government

Perhaps you're being hyperbolic, but respectfully, if you really haven't seen any sign it doesn't feel like you've been looking that hard. There have been numerous steps for addressing both housing and food prices, and neither of those can be solved overnight.

[mistermann]

> There have been numerous steps for addressing both housing and food prices

Raising interest rates .000001% would technically qualify as "a step".

So would enacting policies that have technically more than zero effect, but also contain gigantic loopholes (purely accidental oversights, I'm sure) that facilitate avoiding the proclaimed spirit/intent of the policies.

Government is largely theatre, the manipulation of the perception of the public (producing "not to worry!" attitudes among the public if done well). Housing costs have been a MAJOR problem for WAY over a decade (as can be seen in various charts), substantial serious action could have been taken long ago before it was too late, now there are hundreds of thousands if not millions of people (recent buyers) in financial positions that could cripple them permanently, in addition to the MANY millions who remain in the position of likely never being able to afford a home (in a traditional sense of the word, or recommended ratios), or will be permanently poor due to having to spend a historically anomalous percentage of their income to just cover rent and food.

[nonethewiser]

When the state pays for your healthcare, your health will never be the top priority.

[grecy]

When a for-profit company pays for your {healthcare, education, prisons} the quality of that service will never be top priority. Profit will. Always.

One only needs to look at how high profits are in those sectors in the USA compared to other OECD countries, and then look at the quality of those services compared to other OECD countries.

Spolier: Americans pay the most, and get the worst.

[1] https://www.theatlantic.com/health/archive/2014/06/us-health...

[8note]

For most of your life, the state is best aligned with keeping you healthy. The state's top priority is making sure you will be working and paying taxes, and you can't do that as well when you are sick.

The state will stop caring once you dont have prospects for paying more taxes, but before then, the state has your health as a higher priority than even you do. Eg. The government doesn't like it when teens do risky behaviour, and tries to stop it, because it will have bad health, and thus tax results.

[larksimian]

I'd add that old people still vote, so the state or more exactly some political parties will still have a massive incentive to keep people alive as long as possible.

Regardless of age, healthcare scandals are a huge political risk so governments will always overspend to avoid them.

The comment you're responding to is like a singularity of wrong.

[Gravityloss]

I was first thinking "private healthcare can fix this gap". But in Canada there's no private healthcare alternative. Here in Finland we have all the alternatives: public healthcare (municipal and government level), employment health care benefit, health insurance and then even private pay cash immediately healthcare. It's got some side effects.

In a bizarre twist, the city of Espoo, which has about the highest GDP per capita in the country, is struggling with their municipal public healthcare absolutely overwhelmed and in crisis. People come to the emergency room for ailments that could have been remedied way earlier in non-urgent regular booked office hours medical center visits. But the budget for those has not been there, you couldn't get an appointment.

Why is this happening? Certainly they would have the money - it looks like they aren't acting rationally. One theory is that since most of the voters in Espoo have good jobs with a great health care benefit, they don't vote for politicians that would put money to public healthcare.

The Canadian system of there being only the public healthcare system would actually "fix" that.

[larksimian]

I think private options just cannibalize and parasitize public health services. I see it where I live in the UK and where I'm from in Romania.

In Romania it's just outright graft: public hospital doctors direct patients for cheap procedures to their private clinics and toss anything expensive back into the public system. The government pays for all treatments anyway, but public hospital budgets end up being harmed since 'profitable' treatments are being siphoned to the public sector(and doctors outright steal stuff from the public hospital).

In the UK it's a similar selection bias in what's treated privately leading to adverse selection effects for the public sector. Combined with consultant-cancer draining tons of money in order to figure out how to save money(hint: the money-saving solution is never firing the consultants). Society is getting older faster and the government is trying to cut costs on one of the cheapest healthcare systems in the OECD. Basically sabotage from the top down.

Similar effect happens with charter schools in the US, almost impossible to prevent adverse selection effects leading to increased problem-student concentration in the public schools.

[idontwantthis]

Is privatization a better alternative then? In the US, private hospitals spent years cutting staff so they were entirely unable to deal with Covid numbers.

[bhawks]

The US Healthcare system is shamelessly intertwined with the state to limit supply and extract rent.

Try to open a hospital and you will run into certificate of need laws who's primary objective flys in the face of supply and demand:

> A primary objective of state CON laws is to control health care costs by avoiding unnecessary expansion or duplicative services within an area.

Or simply try becoming a doctor in America; also known as assuming half a million dollars in debt and 8 years of college education and another 4 years of 'residency' a program where you work yourself to the bone for peanuts. All this courtesy of the professional organizations getting in bed with the state to limit competition and enrich themselves.

Let's not even discuss the pharma industry :).

Any discussion of bettering healthcare in the US that doesn't take on the rot at the core of the system is dead on arrival. Switching to a public solution tomorrow would just further enrich the cronies at the cost of the general public - and health outcomes would be largely unchanged.

https://www.ncsl.org/research/health/con-certificate-of-need...

https://www.theatlantic.com/ideas/archive/2022/02/why-does-t...

[bloaf]

I think it is more analogous to the laws prohibiting people from selling their own organs. The problem isn't that organ transplants are immoral, the problem is that allowing it can create perverse incentives especially for disadvantaged groups.

If you squint at MAID one way, you can see all the good it does for people who really need it. If you squint another way, you can see the medical system just killing off the people it failed.

[dbt00]

I don't have a problem with people getting MAID, but I do have a problem with medical practitioners pushing it on people who want to live but can't get basic resources to deal with very manageable disabilities.

[kannanvijayan]

I have a modest proposal.

We ensure that there are thousands more of them, promote them, and ensure that they are rewarded for denying health care to as many people as possible (after collecting money from the victims).

We'd need to do a bit of branding on the whole thing, of course. We would first want to ensure that they are not medical professionals making these decisions. "Adjusters" has a nice ring to it.

We could build an entire industry out of this. And I think if we did all of that, many people's problems with euthanasia would be ameliorated.

[FpUser]

>"but I do have a problem with medical practitioners pushing it on people who want to live but can't get basic resources"

Same here. This fucking abomination of a doctor should be screaming bloody hell and knocking on government doors to have them address the problem.

Here we are: rich developed democratic country basically telling our poor to go fuck themselves and die.

[mjjjjjjj]

Why aren’t you doing this exact thing?

[FpUser]

And you know this how?

[throwawaymaths]

There are cases where people do want to live but are counseled into suicide.

[Schiendelman]

You mean there was one case - and we quickly learned that person was being paid by a right wing organization to do so.

[voisin]

Being counselled to suicide should be ineffective if they want to live, no? This isn’t a 30 hour police interrogation without food, water, or sleep. Options are presented, and in some cases living with the debilitating sickness is worse than suicide. I think if they want to live, it is likely they want to live if the debilitating illness wasn’t there, but given that fact they choose death.

[VancouverMan]

There's a significant cultural aspect we need to consider, too.

Many Canadians, especially older ones who grew up when Canada was still a very high-trust society, have what could be described as a reverence for authority figures. This involves a significant degree of obedience, bordering on subservience.

Medical professionals are often among the most revered authority figures to these Canadians, even to the point of being seen as infallible. There are Canadians who won't question any advice made, nor any suggestions given, by these medical professionals.

If a medical professional were to recommend euthanasia to these kind of Canadians, even if it wasn't something that they really wanted to do, I think a significant proportion would feel obliged to go along with it, as irrational as this may seem.

This attitude became quite apparent over the last three years, when many Canadians completely bought into the many obviously nonsensical, and sometimes even outright harmful, policies being pushed by medical professionals and public health officials.

At the same time, however, those three years have been a significant eye-opener for some Canadians, too. For these people, the trust they once had in the various medical professions was completely shattered.

With a larger proportion of the Canadian population no longer trusting Canada's medical professionals and health care systems, it doesn't surprise me at all that we're starting to see more questioning of policies such as this one.

[mmastrac]

Can you elaborate on the harmful policies being pushed by medical professionals and public health officials?

[cantberight]

Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations.

In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost “north of $1,500 a day.” Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care.

“Roger, this is not my show,” the ethicist responded. “My piece of this was to talk to you, (to see) if you had an interest in assisted dying.”

Foley said he had never previously mentioned euthanasia. The hospital says there is no prohibition on staff raising the issue.

Catherine Frazee, a professor emerita at Toronto’s Ryerson University, said cases like Foley’s were likely just the tip of the iceberg.

https://apnews.com/article/covid-science-health-toronto-7c63...

[sterlind]

the director of ethics, no less!

which makes sense to me, in a cynical way. euthanasia was an ethical debate, so it makes sense MAID administration would go in ethics department. then as a director, their performance reviews are probably a function the hospital's bottom line. MAID was even promoted as a cost-saving measure. which.. yeah. you can save a ton of money if you only take on healthy patients and kill off the medically complex cases (like me!)

for the record I'm in favor of assisted dying, as a personal decision, but government programs for the disabled are already quite terrible, and the conflict of interest is massive and brutal.

[VancouverMan]

It varied by region, but in Canada we saw nonsensical and harmful policies like the lengthy forced shutdowns of businesses (causing job loss, business loss, and immense stress), lengthy school shutdowns and other education disruptions, curfews, coerced and forced medical procedures (testing, masking, shots), the clothing and shoes sections of retail stores being deemed "non-essential" and being taped off, golf courses and all outdoor playgrounds being closed in Ontario, and so on.

[viraptor]

> I think a significant proportion would feel obliged to go along with it, as irrational as this may seem.

It doesn't sound irrational to me. It's doctor's job to describe the available options, possible outcomes, and give recommendations. With enough trust, stating euthanasia as one of the best paths implicitly says: everything else is likely worse - do you really want to go through suffering that has the same end result anyway. And there will be lots of situations where that's literally true.

[throwawaymaths]

"Being counselled to suicide should be ineffective if they want to live, no?"

It should but it's possible to push real hard. There are literally TV interviews where MAID participants are like "I would like to live but they convinced me it's for the better"

I'm actually personally fine with counseling people to die, even moderately aggressively. In many cases it's the right thing to do and we should probably be doing it more. The problem is that when there is a conflict of interest because the org that is telling you to die is the org that benefits from it.

Given this conflict at best the Canadian government should be providing death services for free and mentioning it is an option. And that's it. They should be letting other nonprofit orgs with no funding from the govt counsel people to die.

[cantberight]

> Being counselled to suicide should be ineffective if they want to live, no?

The risk is that vulnerable populations such as the elderly and the sick will be (or are being) subjected to pressure. The case where a medical "ethicist" was trying to shame someone into accepting death because of the cost they were inflicting on the medical system was chilling, and convinced me that this was a real issue. Surely we can agree that we don't want that?

[JoeyBananas]

This is setting the bar far too low. The system should push people in the other direction, and it should not just be a gentle push. Doctors should push hard to keep patients alive because that's what the patient (or taxpayer) pays them for. I feel like I shouldn't have to say that.

[viraptor]

That's a bit too simple view. Another case where the often applies is older people about to die, but family arrives and demands more active treatment and care. Known as the daughter from California syndrome https://en.m.wiktionary.org/wiki/daughter_from_California_sy...

Doctor's job is to give available paths and explain possible outcomes, their likelihood and side effects. If your options are die today or die in 3 days while a machine breathes for you and you're drugged like crazy to avoid the pain... no, they shouldn't be pushing you to live.

Then, there's the whole range where it's not 3 days, but 3 weeks, 3 months, 3 years, etc. with different levels of discomfort.

[stubish]

Euthanasia is a decision you will never regret. We force people to live if they don't want to because of other people's feelings. Per the article, 'many people are choosing euthanasia because they’re not getting the “supports and cares” they need.'. On one hand, someone ends their suffering and stops caring about any 'what if' scenarios. On the other hand, a lot of people feel bad and look bad because they were involved in creating and supporting or failing to support the system that failed to provide the support and care the deceased needed. And the surviving friends and relatives who do care about the lost potential.

[rayiner]

> Why are people forced to live if they don't want to?

Because we live in a society, not some libertarian utopia of sovereign citizens. Your life doesn’t belong only to yourself, but it belongs to all of us. Your parents, your kids, your friends, your acquaintances. We are all affected by what you do to yourself and, concomitantly, get a say in it.

[ptttr]

If a person belongs to the society, then sick, suffering people are not a value but a cost and killing them becomes net gain for society. It's very dangerous to give away body autonomy freedom to the collective as it could be potentially weaponised to target not only sick, old and poor but political opponents as well.

[x86x87]

hah. no.

your life belongs to you. the options to end it on your own terms is IMHO an act of ultimate freedom. the same way where you should be free to do whatever you want as long as your actions don't impair the freedom of someone else.

[mmastrac]

Bodily autonomy is not a libertarian -only ideal, and the way you've phrased it comes across as some sort of extreme collectivism. I'm curious if anyone has a name for this philosophy.

[subradios]

Degrees.

The reason why abortion and suicide are considered fair game for regulation by some people is that it has potentially drastic impacts on the future of everyone around you and theoretically society as a whole.

There is a nanny state to some degree in all societies, and if we are obligated to put cancer warnings on cigarettes I think preventing incentives loops that lead to medically encouraged suicide is also fair game.

[rayiner]

No, your position is extreme individualism. Most societies have taboos on suicide. Attempted suicide was illegal in most of Europe and in America, and is still illegal in many countries ranging from India to Singapore. Assisted suicide remains illegal except in a handful of pathologically individualistic western countries.

[smitty1e]

> Why are people forced to live if they don't want to?

As with abortion, why must I cheerfully pay taxes for policy affecting individuals that's morally objectionable?

[mmastrac]

I have bad news for you. You will never gain the ability to pick and choose what your taxes fund, and the other people paying taxes have entirely different sets of important things that they wish to fund, and different sets of things that they are horrified that their taxes are supporting.

[mikem170]

> You will never gain the ability to pick and choose what your taxes fund

This is interesting to think about, though. Ideally people shouldn't be forced to pay for things they are opposed to, right? Or do we just take it for granted that is morally acceptable to be forced to do something if 51% of our representatives at some level of government say so?

What if wars were funded voluntarily? Perhaps we wouldn't have so many offensive wars. Wouldn't it be proper for drivers to pay all their associated costs, like a use tax? And property taxes if you want police and fire protection? Maybe opt-in for things like social security? Etc.

I understand this would be a significant change, and come with its own problems, and might not work for everything, given the way we currently govern ourselves. But doesn't the sentiment behind the idea has some merit, selling people on the idea of funding public works instead of forcing them? Maybe not everyone pays for everything, but does that need to be a deal breaker? If an idea doesn't have enough support to be voluntarily funded, perhaps it's not a good idea?

I guess that I like questioning assumptions...

[smitty1e]

Sure, but isn't influencing policy the whole point of the Federalist Scoiety, and a half-century of effort spent to overthrow a pagan, immoral ruling?

[ArtemZ]

I'm actually kind of able to pick where my taxes are going. By moving to other countries. Surely, Canada is not going to be on the list.

[FpUser]

Last time I checked with some exceptions especially for very rich people can't just go and land in a country of their choice. It is a rather long process that often does not lead to desired outcome.

[labster]

Bye Felicia

[smitty1e]

Missing the reference, sorry.