[llamaLord]

These are all excellent examples of how MAID should be used, I think the concerning thing is the widening of the eligibility criteria - especially when things like mental illness start to make you eligible.

Like... If your illness makes you suicidal... Is offering assisted suicide REALLY the best we can do? That starts to feel a lot like "eghh you're too hard for society to care about... We'll just let you die".

As horrible as this might sound, often it's failed suicide attempts that actually are the catalysts for people being able to get their lives back on track... What happens in a society where the government helps facilitate suicide and there's never any "attempts" anymore... Just successes...

[DanHulton]

If you are sufficiently mentally ill and determined enough to die that you get through the MAID screening, counselling, information sessions, etc, then you are determined enough to die by other, messier, likely more painful, certainly more traumatizing to the people around you methods.

As well, mental illness is not just a state of mind. Sure, there are stories where a failed suicide attempt was the catalyst for someone finally being able to reach out for help, there are also the stories where people have been reaching out for help forever, and help's just not coming. Where they can't afford the medication, or no medication seems to work, or they have an addiction problem and there just isn't any way for them to get into a treatment program, etc.

Not to mention the stories where their attempt left them powerfully sick and/or disabled. We're talking near-miss fatalities here -- recovery from those is rarely painless, quick, or complete.

This isn't a case of medical professionals and program officials just not caring. These eligibility criteria are very carefully considered. In fact, they're SO carefully considered that they've delayed eligibility for MAID due solely to mental illness THREE TIMES to ensure proper safeguards are in place. Currently, it's pushed back to 2027, so we're not even talking about anything that is even a present-day concern.

(https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#s1_1)

[Lewton]

> Where they can't afford the medication, or no medication seems to work, or they have an addiction problem and there just isn't any way for them to get into a treatment program

I would consider two of these absolutely monstrous reasons to assist someone in killing themselves. A broken society opting into killing its citizens because it can’t be arsed with fixing itself is next level evil

[robertlagrant]

> A broken society

I don't think this is necessarily broken by any reasonable standard. If no medication exists, that's not "broken society". Nor is there not being money to give a bespoke treatment to everyone, no matter how expensive it is. If that's broken, no society in history has ever not been broken. Which is just a poor definition.

[Neonlicht]

Yeah I wonder how people who say this stuff feel about the homeless? How do they feel about tax increase to fix "broken society"?

[weard_beard]

We feel fine. The ones against taxes never cared and pay the least proportion.

[robertlagrant]

This is vs them talk is honestly pointless. You don't speak for anyone but yourself.

[orf]

- It’s a fact of life that people die.

- Some of those deaths are suicides.

- It is pure fantasy to imagine we can have a society with 0 suicides (when accounting scale, complexity and size).

The choice then becomes: help, or punish.

It is absolutely monstrous to punish, and helping does not mean killing every Tom, Dick and Harry with a case of the Monday blues.

[DanHulton]

You're getting downvoted, but honestly, I agree with you.

That said, I don't have any actual insight into the process; I was just extemporizing. So if it sounds fucked up, that's because _I_ fucked up and didn't think long enough about circumstances where someone would be approved for MAID instead of offered other solutions. It's entirely possible and indeed likely that if you can't afford medication or treatment, there's options in place to get that to you instead of approving your MAID appointment.

Please don't judge Canada too harshly just because I misspoke. =)

[Lewton]

It’s all good, I didn’t take your comment as an indication of how it actually functions in Canada. Just reacting to the implications of your examples

[kstenerud]

My wife helped a friend die in Germany 10 years ago. He'd acquired some cyanide, which resulted in a long, protracted death because he took too much and vomited most of it up. It was messy, painful and traumatic, but she sat with him until the end.

When someone is determined enough to die, they find a way.

[b3lvedere]

Terrible to read he still suffered a lot. I hope your wife is ok.

I've read about four or five stories in my lifetime about people who assisted in aiding a dear friend. Most of them just stuffed a pillow in their face when they begged to end their very painful existence.

I've witnessesed my brother in law suffer immensly from cancer before he decided to end it all by assisted death. Near the end he was not human anymore for me. Just a body chock full of medicines constantly trying to survive as much as possible. I can't blame the cells trying to win that desperate war, but it was horrifying to watch him transition from a strong happy human to that state.

[sitkack]

I heard a first hand account of someone help their father with last stage cancer administer a morphine drip, everyone said their goodbyes and he went to sleep. Only to wake up hours later and say, it is working and they both struggled to milk the bag to increase the flow, they talked for 20 minutes while they both tried to "fix it" and he finally went back to sleep for the last time.

We need a humane way to treat humans.

[jamal-kumar]

That's wild, because in my understanding it's an indictable offence to aid and abet someone to end their own lives in Canada. Like more than 10 years jail

https://laws-lois.justice.gc.ca/eng/acts/c-46/section-241.ht...

Counselling or aiding suicide

    241 (1) Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than 14 years who, whether suicide ensues or not,

        (a) counsels a person to die by suicide or abets a person in dying by suicide; or

        (b) aids a person to die by suicide.

The document goes on to detail the medical exemptions we're talking about here. What's the law in Germany?

[kstenerud]

She didn't care, and she got away with it. And if she were still alive today, I wouldn't be talking about it since the statute of limitations is not passed.

Also this was in Germany, but still just as illegal.

She was the most amazing and remarkable woman I ever met. There will be an Arte documentary about her early next year (not about this; about her work in Ukraine).

[squigz]

I doubt GP's friend was really considering the law in that circumstance.

[wucaworld]

B.s. parent literally gave an example of someone that got access to MAID a week after their doc visit. I’ve changed my mind on things after a month. Not saying MAID is bad or should be banned. I’m saying people will 100 percent abuse the system. My concern is healthcare system practiioners. I am dealing with a ton of people whose job it is to press our family into a decision we don’t want to make. This includes an md, a social worker and a care coordinator. Canadas health care for old people and folks with dementia is a disgrace. Maid should not have to be the only option with dignity.

[Neonlicht]

But it is. Most people are not rich to pay for their own care. Society doesn't want tax increases. We don't have enough healthcare workers.

Reality doesn't care about how things should be.

[HeatrayEnjoyer]

Society != a small but influential wealthy minority

Framing it as unchangeable "reality" is intellectually dishonest.

[Neonlicht]

Run a political party on a "unlimited spending on healthcare" platform and see how far you get.

[sangnoir]

> I’ve changed my mind on things after a month

...and what is the implication here? After I broke a bone, I was given a choice between surgery and a cast. I chose surgery - which cant be undone - and I half-regret it because when I bump into things and the titanium bits transferred the force straight to the bone, resulting in exquisite pain. Should I have been denied surgery because it can't be undone? I think not; I was given the choice, I hose what I thought was best. Did I make the correct choice? Probably not, but it was my choice to make, and expecting a system with 0% regret rate is impossible.

[Olreich]

What’s another dignified option when it reaches terminal?

[neverartful]

Accepting suffering as part of the human condition. In the Christian faith, Christians are taught that suffering is part of life and good things can result from it. Like what? Empathy, love, and compassion from caregivers, friends, and family to the suffering person. Also, the suffering person may express love to those around them. Jesus allowed himself to be crucified and suffered one of the most horrible deaths imaginable. He did it as an act of love for humanity. A Christian might argue that it was also to serve as an example of enduring suffering.

[freedomben]

And you and anyone else can still opt to live and suffer if you see value in it. The beauty of freedom is that you can do you, and nobody can force their beliefs on you.

I would also caution with the old adage, don't knock it till you try it. Life in extreme pain is no life at all. Calling on Jesus isn't going to suddenly make excruciating pain more bearable, especially for someone who doesn't believe in Jesus. Maybe toughing it out for a few more weeks or months is worth extra presents in heaven, but unless we have some evidence of that, I think it would be grossly irresponsible, indeed evil, to legislate it. It is, in my opinion the equivalence of torture.

[aroberge]

I accept your suffering if you choose so. If I knew you personally, I would even do all I could to help and comfort you. However, I cannot condone you imposing suffering on others in the name of YOUR religion.

[neverartful]

I never said anything about me wanting to impose my religious belief on others.

[BrandoElFollito]

Christians can suffer as much as they like. To everyone their weirdness.

Just don't push it to others under the name of morality out other bullshit.

I would like to be able to die when I want to, in a simple and painless way. Because I will do it anyway jumping under a train or lorry it is just messy for everyone.

[mjh2539]

Your life doesn't belong to you. You need to reread the Phaedo.

[neverartful]

I never said anything about imposing my beliefs on others. I merely responded to the question about whether there was any other course when things are terminal.

[TheNewsIsHere]

It’s strange to me how resistant society is to the idea that mental health is health. Not all there is to health, but someone suffering from terminal cancer is typically regarded very differently from someone suffering from an incurable mental illness.

Not every mental illness makes someone of unsound mind.

I see no difference between a case of someone who does not wish continue because of some incurable mental health issue that makes their life hell, and someone who does not wish to continue due to e.g. terminal cancer.

[defrost]

I'm with @navane, you're concerned about what is very much a minority edge case.

Still, I'll bite - it's a good thing.

Why? Well an official path to suicide, as per the arrangements already in place, comes with layers of professional guidance and counselling.

It's not a dispassionate "wave 'em through" treadmill of corpse creation.

The best thing for young people with suicidal affixations is to talk to them and take their concerns seriously, correctly established this could arguably reduce teen suicides by recognising the problem, giving the at risk a place to go, requiring them to detail why they want to die, etc.

If you want to take a dim view of faceless government motivations then you might ask yourself why such a souless collective would want to deprive itself of a potential taxpayer before they've even really started to chip in.

[llamaLord]

I get your point, but there are already MULTIPLE examples of people combining the mental-health component + some externality that is fundamentally a societal failing and coming to the conclusion that MAID is the optimal outcome.

"An expert committee reviewing euthanasia deaths in Canada’s most populous province has identified several cases in which patients asked [AND WERE APPROVED] to be killed in part for social reasons such as isolation and fears of homelessness, raising concerns over approvals for vulnerable people in the country’s assisted dying system."

-

"Another case focused on Ms B, a woman in her 50s suffering from multiple chemical sensitivity syndrome, who had a history of mental illness including suicidality and post-traumatic stress disorder. She was socially isolated and asked to die largely because she could not get proper housing, according to the report."

https://www.theguardian.com/world/2024/oct/17/canada-nonterm...

[defrost]

And?

That's a serious ask, not a snarky response.

The headline is Canadians with nonterminal conditions sought assisted dying for social reasons

and my question is, so what happened? Was she killed by the state or did she get some much needed assistance with housing, etc. (or neither).

I'd argue that her coming forward is a good thing in the big picture as it adds concrete examples and data for making a case for better social policy and outcomes.

[dostick]

There’s a stigma/taboo attached to suicide, and that’s because suicide is kind of a show-stopper bug opened for modern society. And it does not want to admit the problem because it’s not capable of doing anything about it. Support phone numbers or “talk to someone” are there to defuse and keep the person living so they die of old age. Or if they do suicide successfully later on, the system washes its hands clean and avoids dealing with ingrained deep issues that cause suicides.

[llamaLord]

Both examples were killed by the state... That's my point, the safeguards failed and the people were euthanized...

[defrost]

Both cases concerned people who requested euthansia, and repeatedly so.

Both cases were borderline and raised concerns.

Both cases were reviewed.

It is imposssible to have any such system in the real world that does not have concerning edge cases.

It is a system that many people want for both themselves and for their relatives in cases that are clearcut.

The problematic reality about people with mental issues and disabilities is that they are also autonomous people who have opinions, think for themselves, and sometimes decide that their own circumstances are no longer tenable following years, decades even, of struggling through.

See eg: The Last Leg from the UK.

It's not desirable to have a system that kills people that don't want to die and wouldn't choose death if they had better options.

What are the housing options for people with chronic mental issues (eg: the extreme examples of schizophrenia, bipolar disorders, etc) that have no support and have exhausted friends and relatives?

These are not easy problems.

What is your proposed solution?

[navane]

That concerns a small minority of cases, the vast majority is elderly dying people who want to keep their dignity. By steering the discussion to that minority, which even itself is still debatable, you risk flushing the child with the bath water.

[mensetmanusman]

By hesitating to discuss, you enable bureaucrats to suggest maid when they want to save money instead of treating a disability (which has already happened in the case of the Olympian).

[defrost]

The single bureacrat in question was flagged, investigated, and removed from contact with veterans.

Their action in suggesting MAID was not policy, was rapidly caught, and was the subject of a very public inquiry.

Had the suggestion been followed up by the veterens in question there were layers in place, interviews and checks, to make sure that MAID was both desired and appropriate.

[mensetmanusman]

This is like trusting people to behave while owning guns. Curse of knowledge writ large.

[defrost]

It's a demonstration that the system currently in place has verification checks.

No one was killed against their will here.

There's a legitimate debate to be had on the question of whether it was even wrong to alert an injured veteren that MAID was an option given they had the free will and the gumption to reply No way, Feck off, Not interested.

The onus here should be on secondary interviews sorting out whether a person really did have insurmountable chronic pain and problems or whether they were depressed and lacked resources to deal with a situation.

[mensetmanusman]

There have been people killed against their will at the time because they previously signed something to ignore their future self.

[larme]

The same logic applies to capital punishment

[cocacola1]

I don't think Canada has the death penalty.

[addicted]

I don’t follow.

How does this apply to capital punishment?

[itake]

Many people are opposed to capital punishment due to the small minority of innocent folks it eliminates.

> By steering the discussion to that [innocent] minority, which even itself is still debatable, you risk flushing the child with the bath water [and killing the really bad criminals].

[areoform]

There's a difference. The people with MAID choose to die.

When innocent people are killed via capital punishment, they have no choice.

And it's not a "small minority" either. We don't have good numbers, but it's significant enough to be over 22% or roughly 1 in 5. That's not a small minority.

For Florida, since 1973, 30 people awaiting execution have been exonerated so far. The state has executed 106 people.

Out of 136 cases, 30 were shown to be innocent beyond any reasonable doubt. I have no doubt that there might be other innocent people within the 106 that were executed.

https://deathpenaltyinfo.org/policy-issues/innocence/innocen...

https://en.wikipedia.org/wiki/List_of_people_executed_in_Flo...

[TexanFeller]

Suicide is the ultimate “my body, my choice” issue, even more than abortion is. It’s monstrous to force someone with severe mental health problems to live if they don’t want to. I live an incredible life now that people envy, but I’ve had been through torturous mental health problems in the past. If I knew I had to face a year or two of my dark times again and I’d have 50 more years of my great life afterward I’m not sure if I’d choose to live.

[addicted]

The entire reason why the mental illness discussion is complicated is because with mental illness it’s not clear it is a choice.

And this isn’t even something made up for the particular case of assisted suicide. The idea that someone with mental illness cannot make legitimate choice has been around in the legal system for a while, with mental illness leading to reduced sentences, and even being the basis of acquittal in many situations.

[tpm]

> The idea that someone with mental illness cannot make legitimate choice has been around in the legal system for a while

There is mental illness and then there is competence, they are related but not the same. Complicating things further in this case would be things like reactive mental states (grieving etc) which might for a time manifest like mental illness but tend to be not diagnosed.

https://en.wikipedia.org/wiki/Competence_(law)

[llamaLord]

Thank you! This is EXACTLY the issue I've been failing to articulate.

[mensetmanusman]

They should do a study where they do fake maids (like catching a jumper) and then seeing if they regret living another month.

[dns_snek]

Are you calling for nonconsensual human experiments that will (depending on the outcome) either inflict grave emotional injury onto people who are already so badly injured that they want to die, or that'll be used as a justification for stripping people of their bodily autonomy?

[mensetmanusman]

Yes, like catching people with nets who jump off bridges (and a vast majority are thankful of it).

[dns_snek]

Catching people who jump off bridges doesn't involve lying to people who're entrusting you with their very last bit hope.

> and a vast majority are thankful of it

A statistic that (assuming it's true) suffers from the obvious self-selection bias of people who chose to jump off a bridge knowing there was a net to catch their fall.

[alphan0n]

MAID is the net in the context of impulse driven suicide. If a person’s natural death is not reasonably foreseeable, there is a 90 day assessment period.

[mensetmanusman]

The government defines reasonable to save money. I’m surprised at people who think bureaucrats like those from the motor vehicle licensing departments will be able to handle such decisions.

[datavirtue]

Oh well. You don't need to nanny everyone. They have probably tried all the drugs that have made it all worse. You don't have any real context for someones personal decision like this.

[MegaDeKay]

"Some provisions are in place, including a requirement of having two independent healthcare providers confirm that the patient is eligible before their request is approved."

[llamaLord]

Oh well that settles it then, because TWO medical professionals could never get something wrong, could they?