[lambdasquirrel]

The worst part is that there isn't a well-defined point where you can say "I'd like to have a medically-assisted suicide" that isn't going to upset people (assuming it were legal). By the time you reach it, you quite possibly won't have the cognitive capacity to request it.

[petercooper]

My dad is a good example of this. He was very adamant he wanted to die if he became debilitated by dementia. Unfortunately he ended up having three strokes in quick succession while being diagnosed for vascular dementia and is now a totally different person (with zero recollection or connection to his previous personality or memories, as far as anyone medical can tell) living a pretty miserable life in a facility with 24/7 care, zero language abilities, etc. There was no singular moment he could have made the call. He was entirely cogent one day and absolutely not the next.

I would be very happy to sign off on his wishes, but there is no legal or medical route to do so, so whatever is left of him gets to suffer until his body gives up. I support them introducing some mechanism for this one day and would likely use it myself (all my ancestors went through dementia).

[raincole]

I don't believe there should be a "point" where you can say that. Medically-assisted suicide should be available for everyone. Of course with a prolonged evaluation period.

[thinkharderdev]

I took the parent to be saying something like "even if medically assisted suicide were available as an option without restriction, there is no point at which you would decide to do it because the onset of dementia is so gradual." That is, it would be difficult to make the decision (for some/most people at least) while you were still having lucid moments where you could still have some quality of life. And by the point where you have completely lost it, you are no longer of sound mind to consent to a medically assisted suicide.

[blagie]

I think one way to go is to do this early, with a clear bound. For example, one might set a rule that if they can:

* no longer compute ∫x²dx

* remember the capital of France; and

* recall where they were born

Then they have crossed that threshold.

Personally, though I don't want to be killed. At least by my values, killing is not okay. I think there are much better things to do, such as:

- Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured.

- Go some place where I will surely die, but where I can still do some good (running a school for girls in Afghanistan when the US was there is a good example)

- If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go.

And to be abundantly clear, that's my opinion and my values. I'm not trying to decide for anyone else. I don't think these sorts of decisions should ever be forced, mandated, or imposed.

Footnote: Thresholds are hard to define. I did have one relative with complete loss of short-term memory who seemed to be having a wonderful life. They were happy, friendly, and told grand kids wonderful stories from decades past. It helped that they had a very easy-going personality. On the other hand, they didn't know how they got to where they were, or what we were talking about five minutes ago. They also didn't have any recent memories (e.g. if a relative had been married within the past half-decade or so, they wouldn't recognize the spouse). There was a point where I'm pretty sure they wouldn't have passed any reasonable threshold, but they seemed to be living a very full life surrounded by a big family who loved them. On the other hand, if my brain was where their brain was, I'm pretty sure I'd be completely miserable.

[grandfield]

> - Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured.

Given that cryonics is currently essentially just a scam, you might just as well. For all practical purposes, it's equivalent to killing. (Legally, you need to have just died though, in most Western countries, so I think you don't actually have this option.)

https://bigthink.com/the-future/cryonics-horror-stories/

Or you meant just traveling there, going on an extended hike from which you don't return because you just purposely one day didn't get out of your tent. That's not a pleasent way to die though, and nobody is going to go there 300 years from now to unthaw you.

> - If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go.

How do you know that a drug overdose is a pleasant experience? You could be hallucinating the most terrible things in the world for as it may feel like an eternity. Unless you are talking about sleep medication, but then again, just taking a bunch of sleeping pills is not different from a "classical" suicide.

[blagie]

The cryogenics industry is a scam, but I'm more optimistic of the progress of the potential progress of technology. I'm not going to describe what's going to happen, since I think there's an infinite number of options, but I'll give one scenario:

- Machine learning advances, and we have LLM-like/SD-like models for the human brain, which can reconstruct a plausible brain from limited data.

- DNA preserves pretty well (and again, see above for restoring from degradation).

- There is an archive of what I look and behave like

It's not beyond the realm of plausibility that in a few hundred years:

- "Frozen in Antarctica in a concrete container" will preserve enough data to reconstruct a person

- We'll have bioengineering technology to do so

- There will be enough curiosity about what people were like a millennium ago to try

Will it work? Probably not. However, it somehow moves this out of "suicide" into "morally acceptable" under my values.

> How do you know that a drug overdose is a pleasant experience?

Perhaps I'm more interested in interesting experiences than pleasant ones. Again, you're trying to map your values onto me.

[jeromegv]

How is going to Afghanistan and manage a school something you should once once you reach advanced dementia? You’d think that it would make some good? To whom?

[blagie]

That's something I do well before I'd reach advanced dementia. Part of the point is to never reach that stage.

[vwcx]

+1. Those girls don't need to deal with old Uncle Al failing to manage the basic day to day logistics of their school.

Might as well dedicate your waning days to living out a Robinhood fantasy stealing for the poor until you're killed by the landed gentry.

[mindvirus]

Flashbacks to high school

Teacher: "Compute ∫x²dx"

Me: "x^3/3"

Teacher: "You forgot the + C!"

RIP

[mensetmanusman]

"You forgot an infinite number of other answers!"

/whipped for each one

[bigDinosaur]

Setting a rule is difficult because in n+1 years of dementia you've effectively started to become another person, and at some point you don't know if that person will honour the rule you made, or even be aware of how incapable of satisfying it they have become.

[candiddevmike]

If you're an organ donor, you'll do more good than any of those three options once you die, IMO.

[blagie]

Unlikely and irrelevant.

Unlikely: Organ donor is only an option in some circumstances. It's more typical with young people and accidents than elderly. There's no age cut-off, but for example:

1) The organs need to be fresh (e.g. you died in the ER).

2) The organs need to be in good shape (e.g. not sick)

Irrelevant: It doesn't solve the fundamental question of values and ethics. I am against actively taking a life, including my own. I am not against putting my life at risk, especially for a good cause.

[mensetmanusman]

Even with prolonged evaluation, there have been events where doctors are killing people who in the current state of mind changed their mind and resisted the entire time in front of their families.

I'm of the opinion humans will never be able to not abuse such a system. We easily see now the data on assisted deaths before tax holidays.

[prepend]

This sounds terrifying. Do you have any articles or accounts of this?

[mtlmtlmtlmtl]

I would do it myself the same day I was diagnosed.

[andy_ppp]

You’ll have days where you feel fine though and be having fun and enjoying life. It’s easy to say but the initial symptoms might be very mild.

[mtlmtlmtlmtl]

I've thought about it a lot. I want to die while I'm still enjoying life. So I can say goodbye to family and have them remember the person I was, not the shadow I became.

[VMG]

Let's hope you don't get the diagnosis in the afternoon then - the goodbyes might be a bit rushed otherwise

[mtlmtlmtlmtl]

Yeah same day might be a bit excessive, come to think of it. Probably give it a week or so to set up a get together. Like a "living funeral" or something.

[tchaffee]

And on it goes. Nephew really wants to say goodbye but has to finish studying for finals so a week turns into a month. For those who enjoy life, these decisions are easy in theory just like losing weight. And much harder than imagined when attempted to carry out.

[hammyhavoc]

27 club y'say?

Guessing that ship has probably sailed.

[mtlmtlmtlmtl]

Yeah, maybe. 30 actually...

[carlmr]

If you're not physically too old, maybe a good time to start a risky hobby like motorcycling, free solo rock climbing, base jumping.

[andy_ppp]

Strangely you become more risk averse and stuck in your little loops as you get older and the routines you have become fine, good even.

[carlmr]

I mean in general it makes sense. As you age your body becomes more brittle, injuries take longer to heal, some you might not recover from at all.

Also psychologically you will have experienced more injuries so you will instinctively avoid doing the same again.

My point was rather that if you know you will die a slow painful death, but not now,and you don't want to commit suicide, you could try riskier stuff that you always wanted to try but would be too dangerous.

[grandfield]

Problem is that it's not all-or-nothing. Lots of activities have failure modes that leave you severly disabled for the rest of your existence, even unable to do any of the standard suicide activities or even speak/write.

That's all worse than having another decade of a good life.

Or perhaps even a broken hip that never heals is not too great. Now you won't just get dementia, but you'll do so while you can't even go to the toilet yourself even on your clear days.

[stormfather]

This is an ideal use case for chatbots. Hook your carbon monoxide controller to an LLM trained to administer a reverse Turing test. I'm kidding, but not really. Our family is dealing with this and I am considering wiring this up for personal use down the road.

[hammyhavoc]

With how much LLMs hallucinate, I'd say this is a terrible use for chatbots.