[rich_sasha]

To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

In a friend's family, there was a big rift as one family member in direct line of inheritance was accused of (successfully!) pressuring his mother to refuse medical care. She died sooner and more unpleasantly than she likely would have otherwise, leaving more money sooner to her children. And that wasn't even with euthanasia being legal.

I have lots of sympathy for people so desperate they would rather kill themselves, but I don't know how you square that circle.

[The_Colonel]

> how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework?

I would look into countries where euthanasia has been already implemented. It doesn't seem like it's a widespread problem, so apparently they made it work somehow.

Does it mean it's absolutely bulletproof and no-one will ever be pressured to undergo euthanasia? No, but you can't ever achieve such certainty, and it's better to look at it from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

[sramsay64]

> I would look into countries where euthanasia has been already implemented.

That's what puts me off of the idea in the first place. Cases like Christine Gauthier (a former army corporal and paralympian) who was offered euthanasia when trying to seek government disability benefits to install a wheelchair ramp. If it takes someone with existing fame to speak out about this, how many more people has this been pushed on?

> from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

I'm not totally convinced. I haven't run the numbers, and this also certainly takes into account my personal views on valuing life and family, but I do fear more pain and suffering will come with legal euthanasia than it will solve.

Just look at the end of the article. It gives several examples of the kind of thing that allows me as a utilitarian to say that the suffering of a few terminally ill is not as bad as the harassment of countless vulnerable people.

[philistine]

Should we keep medical assistance in dying illegal because bad eggs offer it outside the legal framework of their job in bad faith?

The Christine Gauthier case is used to justify the idea that the government will use it to reduce spending, when what happened to her is appalling, but was absolutely not something the government employee that offered it to her had the legal permission to do so.

What the Quebec law regarding medical assistance in dying does is guarantee its existence as a medical act. It does not allow any low-level government employee to offer it wily-nily to anyone. It is a medical act, reserved to doctors, to discuss assistance in dying.

[dghlsakjg]

> Just look at the end of the article. It gives several examples of the kind of thing that allows me as a utilitarian to say that the suffering of a few terminally ill is not as bad as the harassment of countless vulnerable people.

Countless vulnerable people haven't been harassed. There are 12 documented cases in the history of MAID in Canada where someone was allegedly offered MAID innapropriately. There have been inquests and reports that have counted them. Not one resulted in a death. Christine Gauthier's experience couldn't be substantiated when they reviewed her records, but they did find in that investigation that a single case worker had offered MAID to 4 veterans.

On the other hand there have been over 50k successful petitions for MAID most of which were for people with Cancer.

As a utilitarian, you should presumably look at the actual numbers, and balance the tens of thousands of people who chose not to suffer agonizing deaths against the 12 documented cases of people who were offered MAID as an option when they think they shouldn't have been.

[nickff]

To be fair to the grandparent, you can’t fully audit whether the cases of the people who successfully petitioned, because they’re now dead.

[dghlsakjg]

You can petition for MAID, and get approval, and then choose not go through with it.

[nickff]

And those cases could definitely be audited, but that will be a limited and biased sample.

[Martinussen]

I think these are valid concerns, but I would also say that there is an underlying issue with medical malpractice and disregard for the suffering and needs of certain groups of society which we tend to brush under the rug. I'm going to assume the concerns you have probably don't stop at just euthanasia - mine definitely don't, and I worry that a ban just makes the issue more... abstract, and PR-friendly.

If an individual in a difficult life situation comes to the state for help as a last resort, and there is a chance the representative they are assigned would recommend they should consider just dying as their last resort, the state has already failed to protect someone vulnerable, and obviously won't be giving them the help they deserve/need/should be entitled to as a human.

Any wrongful death is horrible, but I sincerely believe a "representative" like this and the harm they inflict is going to have an almost identical death toll, even if it's by way of consigning people to sub-human lives of physical or mental torment instead of pushing them towards a tool that "everyone" understands we need to keep a close eye on. My utilitarian take would be that many would happily extend the torment of the terminally ill and suffering, as long as they don't have to deal with the suffering their neglect inflicts on countless vulnerable people and the terminally ill already. (For e-clarity, I don't mean to imply that's your motivation here!)

[philistine]

> If an individual in a difficult life situation comes to the state for help as a last resort, and there is a chance the representative they are assigned would recommend they should consider just dying as their last resort, the state has already failed

Medical assistance in dying is a medical act, reserved to doctors. Just like a car salesman can't legally recommend you an abortion. No one in the government has the legal right to discuss it, even less offer it.

[Martinussen]

Yes, my point was that that person having a position where they are able to do that is already wrong. If a car salesman was telling every woman that came in they should get an abortion, there are places that person should be, and none of them are a car dealer's.

[buildsjets]

The Supreme Court then?

[okaram]

The way most countries who have it (including Canada) have solved it is to add waiting periods, and layers of reviews. In Canada, you need two different doctors to sign off on it. If you're not actively dying, you also have a 90-day period of reflection. And you have to be of sound mind.

This seems to me like good enough safeguards, don't you think?

[rich_sasha]

My ultimate point is that old people, especially those not very well, are very vulnerable to being forced to do this, and I saw ~first hand how easy and undetectable it was. You can add bureaucratic constraints but it's fundamentally a human problem. While expressing utmost sympathy to critically ill and unwell people, I don't know how you make this without endangering many more people than those would benefit from such changes.

How do you even measure if it's working "well" in Canada? They have a process. There is no way to question the people who went through with it whether, on reflection, it was their own free will.

But of course looking at how others do it is a good starting place for further analysis and I'll go now and educate myself.

[paulcole]

> This seems to me like good enough safeguards, don't you think?

No. I think it’s too much.

Nobody else should be deciding that my mind is unsound.

And if my body being “unsound” is a reason that makes it OK to want to die, why should an “unsound” mind be different?

[lucubratory]

The system in Canada results in the state killing homeless and disabled people rather than offering them support.

[deanCommie]

Does it? Or is this what anti-euthanasia advocates are spreading as misinformation around to acquire the support of progressives to their cause (which is driven not out of a care for homeless and disabled people, but out of religious/conservative mindsets)

Keep mind: I'm not asking "Do those cases ever happen"? Of course they do. There's already been stories. The question is what are the statistics. Every policy, every procedure, every decision can have mistakes and negative outcomes. Some homeless and disabled people have been offered euthanasia. Those cases should be investigated and the policies should be updated. But nothing will be perfect.

You can say "if you can't have a perfect system then you shouldn't have it at all." and while that may be philosophically justifiable in the same way that "I'd rather let 10,000 guilty people go free than convict 1 innocent person" is, but it's important to remember that despite that we still convict innocent people.

Some trans people regret their transition. They're a tiny minority. Some people abuse welfare. They're a tiny minority. Some people are pushed towards euthanasia when they shouldn't be. They're a tiny minority.

[LorenPechtel]

And note that the stories aren't always accurate portrayals of what happened.

I remember reading about one where someone drugged their mother to bring her in for euthanasia. What the naysayers didn't report was that that was by her own wishes--she knew her mind was going and set it up for when it was too far gone. I have no problem with that.

[lucubratory]

Comparing the act of people transitioning or people being given financial assistance to the act of people being killed by the state is genuinely sickening. Total inversion of reality and conflation of reversible benefits with literal death.

The government has no incentive to provide better housing or disability benefits to the working class when they can instead withhold those things and watch legions of poor & desperate people die. Do you know they actually calculate how much money killing all of these marginalised people saves them? That Canadian media advertises these figures to sell the state killing program?

[deanCommie]

I can't negotiate with people who have such a deep distrust of Government that they belie that the Government will kill it's citizens if given incentives to do so, or from pure $-based miscare.

This to me feels like a very dystopian way to have a relationship with it's government, and is a uniquely american perspective amongst the developed world.

The government is a proxy for society leadership. I expect human society to protect it's humans, and most of the world with functioning government does too.

The biggest threat to Canadian prosperity today is these american ideas percolating above the border and infecting the mind of Canadians who previously believed and trusted their government and no longer does.

[lucubratory]

I am not American, I am Australian and have never been to America, nor do I like the country; so much for "uniquely".

On what basis do you call yourself a communist when you explicitly advocate "trust" in a bourgeois government on the topic of state killings of homeless & disabled people? Shouldn't that be one of the last topics you would ever trust them on, given their clear class interest in killing members of the proletariat who are unable to continue labouring for profit? It seems fine to trust them not to lie about easily verifiable facts that don't threaten them, like weather warnings, but you should trust them about literally everything else before trusting them to "fairly" and "consensually" carry out killings of proletarians.

[raydev]

> The government has no incentive to provide better housing or disability benefits to the working class when they can instead withhold those things and watch legions of poor & desperate people die.

What was Canada's excuse for poor healthcare before MAID existed then?

[lucubratory]

They didn't have a good one, and people were mad at them for it and demanded better results. MAID ameliorates both some of the direct anger ("We have improved healthcare by reducing suffering, look at how severe disability is declining"), and ameliorates some of the proximate causes (killing the sick, disabled, & homeless reduces load on the healthcare system & leaves more funds for other parts of it).

[jacobgkau]

It seems like somewhat reasonable safeguards for most circumstances, except that other guy replied to you saying he thinks there should be zero safeguards and he may well continue espousing and voting for that viewpoint for the rest of his life now that the basic system's in place.

Even if you think the current safeguards are the "sweet spot," continued pressure to make it more difficult will be necessary to prevent it from being made less difficult. (And if you don't think it would be a problem for it to be made less difficult, then citing those safeguards as part of your argument would be disingenuous.)

[ljsprague]

Bureaucracy for the win.

[marcosdumay]

Bureaucracy is usually added for the win. But people only notice when it's not.

[AlexandrB]

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

This is why it's important to have a pretty detailed living will[1]. Especially is you're already chronically ill and have a pretty good idea of how that road ends.

[1] https://en.wikipedia.org/wiki/Advance_healthcare_directive

[twoodfin]

What you’re hitting on is the inescapable truth that there are problems government institutions can’t solve.

[JohnBooty]

Surely you can see that we could apply that principle to either pro- or anti-euthanasia arguments?

Either way, the government is profoundly involved.

Either the government is in the business of telling us we cannot end our own lives in humane and medically-assisted ways, and that medically assisted deaths are equivalent to murder with all of the attendant legal issues.

Or they are in the business of enforcing rules about how those medically-assisted deaths can happen.

[twoodfin]

It’s the government’s choice whether they allocate resources to investigate and prosecute “suspicious” deaths of terminal patients.

Deciding as a matter of policy, not law, “No, we don’t do that outside of extraordinary circumstances” is something a government institution can do.

[thinkingemote]

Manipulation and coercion can oppose the suicide too. There's some cases where family members don't want their loved one to kill themselves.

I'm not sure how these were resolved but it's very messy and hugely traumatic for all involved.

[14]

Well I am sure no system is perfect but the people that choose to end their life have to meet several criteria. They first need to be of sound mind when they make this decision (and this is one of the current issues being sorted out). So they talk with their doctor and express interest. They then are seen by other health care providers like psychologist who discuss it more. They are spoken to privately without the family present. It is their decision in the end and only theirs. Once they choose a time they need to still be fully alert and aware and they have to personally push the button that ends their life. And that is one of the issues, some people do not want to live if they become paralyzed or brain dead. But we can not euthanize those people even if they expressed that wish before.

I have worked in hospice and they do MAID there all the time. It was a weird feeling to see a family and their loved one head into the downstairs where they would all sit around and tell them person how much they are loved and then that person would end their life. But I know it is the right thing.

[invalidname]

How do you prevent people from smoking? Eating processed food?

Is the fact that the process of suicide is slower/more conventional a difference?

People seeking this process go through a psychological evaluation to determine if they are under duress and of clear mind. Also there's liability to the ones applying undue pressure which can be criminal.

I think there's a point of personal responsibility. Potential abuse of the system should not be the reason to deny it to everyone. I want to have control over the way I live and die. Alzheimer's is unfortunately in both sides of my family, if it has no treatment and I start showing signs I would rather die than live. It would be torture for me to put my family through that.

[rich_sasha]

As I say, my concern isn't academic. I was close to a situation where someone was allegedly coerced into refusing medical help. It was in fact investigated, ended up as word against word, and nothing came of it. That was in a jurisdiction where euthanasia is not legal and anyway such coercion would be illegal, for both the coercer and the doctors. It didn't stop the alleged coercion, and no one was prosecuted. So how leaky would the system be where euthanasia is in facr legal?

But please don't get me wrong, I am absolutely full of sympathy to people so desperately ill they want to call it quits.

[invalidname]

Neither is my concern academic. My MIL struggled with cancer treatments for a decade of terrible pain. My father was catatonic with Alzheimer and my mother is in a pretty bad place health-wise.

I don't want to appear dismissive of your concerns because I'm not. Such abuse is horrible, criminal and tragic. No question. But looking at the morality issue and consistency I think the answer is pretty clear. We need to give people agency over their own lives. Safeguards are essential for sure, and abuse will happen even with the safeguards in place. But the current situation is just tragic. People are afraid to go to the hospital because they're afraid they will be kept alive and in-effect tortured to a slow death.

[wat10000]

Would you support laws that force people to get medical treatment whether they want it or not? It would avoid the sort of problem you witnessed.

[nitwit005]

The much more common case seems to be families forcing treatment, effectively just prolonging the pain. People don't exactly easily come to grips with their parents dying. Some people never do.

[jncfhnb]

Sounds to me like your family friend’s mother would have died more pleasantly if euthanasia were legal.

There are plenty of ways to pressure people into death, as you have already demonstrated. That’s not going away.

Emotional burdens to encourage people to live as long as possible even if you think they’re suffering are likely a far bigger problem. People know it’s unethical not to euthanize animals that are suffering. Lacking the social apparatus to suggest euthanizing humans is almost certainly a huge moral weakness.

[kerkeslager]

> To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated.

How often does this actually happen?

EDIT: To be clear, I'm not saying this doesn't happen, I'm really asking.