10 votes

‘Disturbing’: Experts troubled by Canada’s euthanasia laws

17 comments

  1. [15]
    JakeTheDog
    (edited )
    Link
    This is one of my biggest gripes with the euthanasia debate. If there is every practical mechanism put in place to prevent someone from choosing death on a whim or in the heat of the moment, and...

    His application for euthanasia listed only one health condition as the reason for his request to die: hearing loss.

    The law was later amended to allow people who are not terminally ill to choose death, significantly broadening the number of eligible people. Critics say that change removed a key safeguard aimed at protecting people with potentially years or decades of life left.

    This is one of my biggest gripes with the euthanasia debate. If there is every practical mechanism put in place to prevent someone from choosing death on a whim or in the heat of the moment, and they are informed of the available therapeutic resources available, who is anyone else to decide wether or not their reason for requesting death is sufficient? To me this is inhumane and indecent. If I want to die, give me a year to think about it over with some people I respect, and then respect my decision to die.

    There is such a lack of respect displayed with our lack of respect for death. It's treated like an inherently bad thing, when there's so much nuance. On the extreme end is favoring life extension and traumatizing therapies (like much of chemo) when it only leads to more suffering, while making the self-righteous decision-makers feel like they were doing society a favor. God knows a hospice or old folks home is far from the ideal place to be spending your remaining years and hours. More subtle are the criminal cases of direct manipulation of cognitively-disabled folks for financial gains, but those are not unsolvable and rare enough to not warrant throwing out the baby.

    Why can't we just talk more about death? Revere it like birth. Reflect on our death and the death of our loved ones and how we would ideally like it to happen. We don't treat it seriously enough. It's rare to have the opportunity to leave the party by our own volition. More often we are kicked out, begging and clawing back.

    Personally, I plan on living until I can't live well anymore. "Well" as defined by me. I hope that in a few decades, when I hope it's my time, we all have the choice to leave this life peacefully and on our own terms.

    15 votes
    1. [10]
      lou
      (edited )
      Link Parent
      Mental health issues often deprive the patient of a firm grip on reality, in such a way that any temporary obstacles may seem insurmountable. The depressed is biased torwards negativity and...

      This is one of my biggest gripes with the euthanasia debate. If there is every practical mechanism put in place to prevent someone from choosing death on a whim or in the heat of the moment, and they are informed of the available therapeutic resources available, who is anyone else to decide wether or not their reason for requesting death is sufficient?

      Mental health issues often deprive the patient of a firm grip on reality, in such a way that any temporary obstacles may seem insurmountable. The depressed is biased torwards negativity and pessimism, which makes them incapable to anticipate possible solutions that are just around the corner.

      Euthanasia is a medical procedure that cannot be reversed. Like in all medical procedures, specially those that cannot be reversed, scrupulous external assessment (and even vetting, to some extent) should be required to make sure that the patient does not make a permanent decision based on a skewed or incomplete self-assessment.

      7 votes
      1. [9]
        JakeTheDog
        Link Parent
        Okay, so what? Suffering is subjective. No amount of assessments changes what the person experiences. I don't dismiss mental health concerns, which is why I mention having the practical mechanisms...

        Okay, so what? Suffering is subjective. No amount of assessments changes what the person experiences.

        I don't dismiss mental health concerns, which is why I mention having the practical mechanisms that make sure the patient is fully informed and taking the matter seriously. Did you mean to say something else? Because to me it sounds like you're rationalizing a way to take away the patients volition and agency by stating that they're incompetent.

        10 votes
        1. [8]
          lou
          (edited )
          Link Parent
          Let me put it this way, with some admittedly very reductio ad absurdum counter examples Suppose that George (a random hypothetical human) arrives at the doctor's office requiring to be...

          Let me put it this way, with some admittedly very reductio ad absurdum counter examples

          Suppose that George (a random hypothetical human) arrives at the doctor's office requiring to be euthanazide. The doctor asks for what reason, and George responds: "I must die because, otherwise, the little demon that lives in my throat will take over my body and use me to give rise to the Antichrist, leading the world to its doom" (Situation 1).

          I'm sure you'll agree that this person must be treated for its delirium before we take their wish for euthanasia seriously. That is a very vivid example, but valid, believe.

          Now imagine that George does not believe there's a demon in their throat -- instead George believes that are the epitome of uglyness, are intellectualy worthless, and do not possess the qualities necessary to engage in any kind of sexual or romantic relationship. Ultimately, George believes he's completely disposessed of redimong qualities of any kind (Situation 2).

          Now, there's a great chance that George is wrong -- let's assume they are. They're clouded by crippling depression, and this skewed view of reality leads him to desire euthanasia.

          The Situation 3 is the same, but instead of mentally ill George is very very drunk.

          In all situations, an inability to correctly asess reality is most likely one of the core motivations for the desire for euthanasia. That brings complication. Should they be promptly euthanazide? Maybe after a while? Should they receive euthanasia at all? I'm not saying I know the best outcome. What I'm trying to say, ultimately, is that this is not as simple as it may seem.

          In any case, I believe most people would wait for situations 1 and 3 to improve before taking George's desires seriously. Situation 2 may seem like an exception, but not by much (all situations involve an inability to asess, or at the very least a very strong generalized bias), and some people might address it in the same manner.

          3 votes
          1. [7]
            JakeTheDog
            Link Parent
            Okay, I appreciate the examples, but I don't see how it changes the argument, or more to the point: where you are disagreeing with me. In my top-level post, I state that there should be some...

            Okay, I appreciate the examples, but I don't see how it changes the argument, or more to the point: where you are disagreeing with me.

            In my top-level post, I state that there should be some mechanism to protect against impulsive assisted suicide.

            Your examples 1 and 3 are ridiculous and resolved simply in today's legal medical processes: we would answer both with a rejection. It's less absurdum than strawman. My point is that there is no authority on whether or not the suffering justifies suicide but the suffering individual. To say otherwise is to unnecessarily complicate the situation. You say it's not as simple as it seems, but it is simple: they have been suffering for a length of time, are fully informed, and want to die. Yes there should be attempts to help, of course. Yes there are cases of bad faith manipulation, but that's not the discussion here.

            To put it simply: if people want to die, let them die (with the framework of informed consent). Who are you to take that away from them?

            For the record, I'm a strong advocate for doing everything we can to support people living a good life. I would even say that teaching more philosophy in grade school would be a fundamental component for preventing such cases of psychological suffering. But that doesn't address the fundamental issue of choosing our own death.

            7 votes
            1. [6]
              lou
              (edited )
              Link Parent
              First, calling an argument "ridiculous" (even when an argument really is ridiculous) is not a good way to further a friendly conversation. My flawed arguments are made in good faith, and I expect...

              First, calling an argument "ridiculous" (even when an argument really is ridiculous) is not a good way to further a friendly conversation. My flawed arguments are made in good faith, and I expect to be treated with civility and kindness. You made me much less inclined to answer your concerns -- in fact, I won't.

              I wrote before about the use of fallacies in online conversations, so I'll just paste it here:

              Pointing out fallacies in conversation, both online or IRL, is, and always will be, pointless. That is not because people don't care about being logical. Dropping fallacies is just lazy and makes you sound like a dick. It's lazy because you're trying to solve the problem without doing the work. It's a shortcut. The knowledge of fallacies is useful to identify common flaws in arguments and is particularly useful for you to construct a better, more persuasive counter-argument. No one should expect the "opposing side" to do that for them. You can't just shout "strawman!" and drop the mike. That's not how a conversation works.

              I have no interest in getting tangled in heated emotional disputes with people over the internet. You do you, my friend. Take care.

              4 votes
              1. [5]
                JakeTheDog
                Link Parent
                Sorry if I came off as aggressive, I didn't mean it. I only used 'ridiculous' because you already prefaced by saying they were absurd. And I wasn't dismissing your argument as such, I said that...

                Sorry if I came off as aggressive, I didn't mean it. I only used 'ridiculous' because you already prefaced by saying they were absurd. And I wasn't dismissing your argument as such, I said that examples 1 and 3 are. Which was important for me to point out, because they were strawman examples, and would derail my line of reasoning.

                I hope you see that I was indeed trying to understand you by first stating that I want to know where you disagree with me, because I am/was confused on that point. I mostly saw agreement, but your post implied disagreement.

                3 votes
                1. [4]
                  lou
                  Link Parent
                  I am sorry, then, for having misinterpreted your words. Sometimes there's a distance between what we mean and how we are perceived. You know, every time I feel the urge to write "strawman", or...

                  I am sorry, then, for having misinterpreted your words. Sometimes there's a distance between what we mean and how we are perceived.

                  You know, every time I feel the urge to write "strawman", or whatever, I bite my tongue and write something else instead. Usually, merely explaining what you perceived as fallacious is more likely to persuade. I think the knowledge of logical fallacies is like a car engine -- essential, but better left under the hood. Naming fallacies only rarely elicit the desired effects.

                  2 votes
                  1. TheRtRevKaiser
                    Link Parent
                    In my opinion this is because, knowingly or not, calling a poor argument a logical fallacy is claiming intent on the part of the person making the supposed fallacy. If I say you are employing a...

                    I think the knowledge of logical fallacies is like a car engine -- essential, but better left under the hood. Naming fallacies only rarely elicit the desired effects.

                    In my opinion this is because, knowingly or not, calling a poor argument a logical fallacy is claiming intent on the part of the person making the supposed fallacy. If I say you are employing a strawman argument, what I'm saying is that you are intentionally setting up a weak argument so that you can easily refute it. It is claiming that the person making the argument is arguing in bad faith or employing manipulative tactics, rather than the more charitable assumption that the person just isn't aware of their poor argument, or perhaps in the example of the "strawman" that they just aren't aware of the stronger arguments for a particular position and so are refuting weaker arguments instead.

                    It's one of those things that I don't think people do intentionally, but that really raises the temperature of online discussions. I've rarely been in a face to face conversation where a person accused me of employing logical fallacies. I'm sure some people do this, and I'm sure it's just as unpleasant as when it happens online.

                    4 votes
                  2. [2]
                    JakeTheDog
                    Link Parent
                    Good point, I'll add that to my dialectic toolbox for the future. If I can get a redo: So, examples 1 and 3 may seem analogous to 2, but 1 and 3 are two extremes that distinct from example 2 with...

                    Usually, merely explaining what you perceived as fallacious is more likely to persuade.

                    Good point, I'll add that to my dialectic toolbox for the future.

                    If I can get a redo:

                    So, examples 1 and 3 may seem analogous to 2, but 1 and 3 are two extremes that distinct from example 2 with respect to agency. In example 1, there is no chance of informed consent because there is a lack of reasoning abilities. By definition of delusion/delirium, temporary or otherwise, there's not even an objective framework of reality that would allow communication. In example 3, it's the same problem of informed consent, albeit it's a temporary one. In example 2, there is the possibility of informed consent. Even though there may be some bias from the person towards the outcome, their ability to reason is fundamentally intact.

                    Your first comment generalized

                    Mental health issues often deprive the patient of a firm grip on reality

                    Which may be true for some people some of the time. But, and this is crucial, there is no objective "reality" when it comes to our experiences. How we feel is fundamentally isolated from other individuals, hence the hard problem of consciousness. When someone is incapacitated by their anxiety or depression, that is their reality. They're in a prison of suffering, regardless of the blue skies everyone else experiences.

                    It seems complicated, but only because we all fundamentally are not able to emphasize with the experiences of others. But it really is simple once one stops trying to solve the lives of others and instead respect the validity of their experience and uphold their agency.

                    So, again, I think we're both agreeing on having people be well informed and having some kind of guardrails. I'm still unsure about what you are arguing against. My explanation in this comment is to give background on why I don't think it's a fundamentally complicated issue.

                    2 votes
                    1. lou
                      (edited )
                      Link Parent
                      I believe it is important to note that, when I talk about euthanasia, I'm not talking about bioethics as a whole, but rather its intersection with medical ethics, practices, and regulations. All...

                      I believe it is important to note that, when I talk about euthanasia, I'm not talking about bioethics as a whole, but rather its intersection with medical ethics, practices, and regulations. All medical treatments and procedures are subject to external vetting, and health professionals will determine, based on the symptoms and information at their disposal, what is the most beneficial course of action. Medical doctors routinely refuse to prescribe the medications and procedures their patients demand because they believe doing so would bring more harm than good, and I don't see why euthanasia should be any different. There are situations in which medical doctors are more able to predict an outcome than their patients, of which I presented a few examples. From that, I'd conclude that there are situations in which a patient overestimates their misery and undervalues their potential for improvement, both physical and mental. In such cases (which may be related to mental health, but not exclusively), when there's a high likelihood of short to mid-term improvement, it may be logical to deny the fulfillment of the patient's desire for euthanasia. If not permanently, at least for a period.

                      3 votes
    2. [4]
      vord
      Link Parent
      Even the case of 'lost hearing' in the article makes sense to me. If I couldn't ever hear my loved ones, favorite songs, or nearby hazards again my will to live would be significantly affected. I...

      Even the case of 'lost hearing' in the article makes sense to me. If I couldn't ever hear my loved ones, favorite songs, or nearby hazards again my will to live would be significantly affected.

      I believe in a somewhat extreme "Freedom extends until your fist hits someone else," which includes full rights to suicide. Not even limited by sane measures like mandatory waiting period.

      If we're so concerned about people offing themselves in the moment, then we should offer better options for living than a complicated legal process. Make it easier to choose life so death is rarely the preferred option.

      No arguements about "good for society to keep people alive against their will." That's an arguement for forced labor that would otherwise rather be dead.

      5 votes
      1. Chobbes
        Link Parent
        Completely agree with everything you have said. I also think it's deeply concerning how afraid people are of death, to the point where this stuff is taboo to talk about and improve. I agree with...

        Completely agree with everything you have said. I also think it's deeply concerning how afraid people are of death, to the point where this stuff is taboo to talk about and improve.

        I believe in a somewhat extreme "Freedom extends until your fist hits someone else," which includes full rights to suicide.

        I agree with this. I think some people would argue that "suicide affects more than just you" i.e., it has an impact on your friends and family and other people, and I guess some people might argue that's "your fist hitting someone else"... But I think that's problematic for a number of reasons, for instance I assume most people would agree that people shouldn't stay in an abusive relationships, even if it would make the abusers happier... I think it's okay for people to walk away from a bad situation, or just a situation where they're not having a good time.

        Currently I kind of think it's problematic to insist on some kind of documented disability for people to take their leave in peace and comfort... If somebody is seeking for this option that's probably reason enough? I think it's maybe a good idea to ask why people are looking for the option, maybe have some time for reflection and to provide assistance to the person, but I think we should listen to people and trust them... There's also something a little messed up to me about kind of implicitly saying "disabled people would be better off dead".

        4 votes
      2. JakeTheDog
        Link Parent
        I agree, but I think it should be less of a legal one (that's for the doctors) and more of a social and spiritual one. Most people probably won't leave the party so readily, as the will to survive...

        we should offer better options for living than a complicated legal process

        I agree, but I think it should be less of a legal one (that's for the doctors) and more of a social and spiritual one. Most people probably won't leave the party so readily, as the will to survive is one of the strongest inherent motivators we have, but I think it would be a benefit for humanity just to double check with those willing to die that they are definitely willing, and they didn't e.g. by happenstance miss an aspect of philosophy or available option in their life paths that would dramatically improve their wellbeing.

        Which I assume is similar to what you meant by:

        Make it easier to choose life so death is rarely the preferred option.

        3 votes
      3. nukeman
        Link Parent
        Obviously we only have the families side of the story, but they mention him not taking his medication, and not using his cochlear implants. Those are solutions which could significantly improve...

        Obviously we only have the families side of the story, but they mention him not taking his medication, and not using his cochlear implants. Those are solutions which could significantly improve quality of life. The right to die should not be treated lightly, and alternatives should be considered prior to looking at assisted dying, especially in non-terminal cases.

        3 votes
  2. post_below
    Link
    There's a lot of interesting discussion in this thread about the pros and cons of assisted suicide. I'd add what I think is the most important point: We know from experience that making things...

    There's a lot of interesting discussion in this thread about the pros and cons of assisted suicide.

    I'd add what I think is the most important point: We know from experience that making things illegal doesn't stop them from happening, and in many cases makes the problems dramatically worse (prohibition, the wars on drugs, criminalized prostitution, et al.)

    So it seems to me that allowing people to get help leaving this world in a safe and controlled environment where they have access to support and counseling which may cause them to reconsider, is absolutely always going to be better than leaving them to solve the problem themselves with a bridge, or worse, an assault rifle.

    The more stigma and difficulty we stack on top of assisted suicide, the more likely people will be to go another way.

    Using the, no doubt oversimplified, example of hearing loss... I don't personally think that's a good reason to want to die. But I don't have a right to project my value system onto anyone else. They have the right to decide.

    Having an exit path administered by professionals, free from ideology and unecessary barriers to access, is better for both individuals and society at large. Our personal feelings about death shouldn't be a part of the equation.

    6 votes
  3. nukeman
    Link

    TORONTO (AP) — Alan Nichols had a history of depression and other medical issues, but none were life-threatening. When the 61-year-old Canadian was hospitalized in June 2019 over fears he might be suicidal, he asked his brother to “bust him out” as soon as possible.

    Within a month, Nichols submitted a request to be euthanized and he was killed, despite concerns raised by his family and a nurse practitioner.

    His application for euthanasia listed only one health condition as the reason for his request to die: hearing loss.

    Nichols’ family reported the case to police and health authorities, arguing that he lacked the capacity to understand the process and was not suffering unbearably — among the requirements for euthanasia. They say he was not taking needed medication, wasn’t using the cochlear implant that helped him hear, and that hospital staffers improperly helped him request euthanasia.

    4 votes