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> people with disorders negatively impacting their cognition and decision making. I think we should be really careful about how we think & talk about this. Th

> people with disorders negatively impacting their cognition and decision making. I think we should be really careful about how we think & talk about this. There are a few situations (like psychotic breaks) where people fully believe delusions that, in a short time, they will reject. We can cleanly call those experiences "irrational." On the other hand, people who experience long term depression literally experience the world differently in a way that we frequently cannot 'correct'[1]. Those people are not irrationally convinced that the world is hard to be in - they have brains for which things feel worse than for neurotypical brains. We can agree on all objectively measurable qualities of the world and their experience of that world will still be subjectively and consistently worse. The conversations from the right-to-die movement can be useful here, as chronic pain and disease offer a lens through which to understand. We have all experienced physical pain, but we have not all experienced serious depression. All I mean to say is that in the same way that someone with any chronic illness should have some choice in when and how they die, people who have chronic mental conditions should have the same right. We do not want to make the mistake of thinking that a person in a more complicated situation is compromised in some way - just that their world is more complex and we should take care to attend to the specifics of it. [1] It's not clear what way of seeing the world is 'right' but I will use correct here even with its implication that neurotypical people live in the real world.

s1artibartfast 5y ago
I totally agree that it is a very tricky subject, especially regarding depression. Having some experience with it myself, I would argue that irrational pessimism is a major feature of depression. For example, people cannot accurately asses actions and activities that would in fact make them happier if they were to follow through. In this way, I think they are clearly distinct from those with terminal illness or chronic pain. I agree that people should have the right to choose death, independent of the rationality of their decision. Ultimately, people are the owner of their body and steward of their life, even if they are imperfect and irrational ones. Taking autonomy away turns individuals and their body into the property of someone else. I think there is some room for temporary holds and crisis management, but all such activities should be finite in duration.
- aeturnum 5y ago
  > I agree that people should have the right to choose death, independent of the rationality of their decision I don't think that that there is an ethical imperative to allow people to carry out irrational decisions. I was trying to say that, if someone with depression or another chronic mental illness decides they would rather be dead than alive, then after we determine that decision doesn't come from a passing[1] delusion, then we should give that desire the same weight we give to people with other chronic conditions. We all have the right to choose, after a time, that we do not want to live this way. I also think that having a global standard for "rational" v.s. "irrational" is difficult enough that I think drawing strong lines tends to do more harm than good. So, in practice, I suppose I support people who "irrationally" wish to end their lives, but only due to the impossibility of determining what 'rational' means for each of our subjective perspectives. [1] Whatever "passing" means - it is not an easy question.
  - s1artibartfast 5y ago
    I think we agree in principle. I think that defining rational vs irrational IS difficult, and therefore choose to draw the line such that it doesn't matter for a persons right to choose. This addresses the fact that a severely depressed person may not be able to make the same objective assessments of the world that the chronically I'll can. A severely and chronically depressed person might think "I have no chance at happiness" when in reality, they actually do. If they base their decision on this premise, they would be following faulty logic. My point is that they have a fundamental right to act based on their conclusions, even if they are wrong.
    - aeturnum 5y ago
      > My point is that they have a fundamental right to act based on their conclusions, even if they are wrong. 100% agree!
- LorenPechtel 5y ago
  I think the fundamental issue comes down to whether the cause of the desire is fixable. If there's a fixable problem, fix it. If there isn't I think they should be allowed to (and even provided painless means to do so--say, a mask connected to a nitrogen tank.) Whether we agree with the reason or not I don't think enters into the picture.

s1artibartfast 5y ago

I totally agree that it is a very tricky subject, especially regarding depression. Having some experience with it myself, I would argue that irrational pessimism is a major feature of depression. For example, people cannot accurately asses actions and activities that would in fact make them happier if they were to follow through. In this way, I think they are clearly distinct from those with terminal illness or chronic pain. I agree that people should have the right to choose death, independent of the rationality of their decision. Ultimately, people are the owner of their body and steward of their life, even if they are imperfect and irrational ones. Taking autonomy away turns individuals and their body into the property of someone else. I think there is some room for temporary holds and crisis management, but all such activities should be finite in duration.

aeturnum 5y ago
> I agree that people should have the right to choose death, independent of the rationality of their decision I don't think that that there is an ethical imperative to allow people to carry out irrational decisions. I was trying to say that, if someone with depression or another chronic mental illness decides they would rather be dead than alive, then after we determine that decision doesn't come from a passing[1] delusion, then we should give that desire the same weight we give to people with other chronic conditions. We all have the right to choose, after a time, that we do not want to live this way. I also think that having a global standard for "rational" v.s. "irrational" is difficult enough that I think drawing strong lines tends to do more harm than good. So, in practice, I suppose I support people who "irrationally" wish to end their lives, but only due to the impossibility of determining what 'rational' means for each of our subjective perspectives. [1] Whatever "passing" means - it is not an easy question.
- s1artibartfast 5y ago
  I think we agree in principle. I think that defining rational vs irrational IS difficult, and therefore choose to draw the line such that it doesn't matter for a persons right to choose. This addresses the fact that a severely depressed person may not be able to make the same objective assessments of the world that the chronically I'll can. A severely and chronically depressed person might think "I have no chance at happiness" when in reality, they actually do. If they base their decision on this premise, they would be following faulty logic. My point is that they have a fundamental right to act based on their conclusions, even if they are wrong.
  - aeturnum 5y ago
    > My point is that they have a fundamental right to act based on their conclusions, even if they are wrong. 100% agree!
LorenPechtel 5y ago
I think the fundamental issue comes down to whether the cause of the desire is fixable. If there's a fixable problem, fix it. If there isn't I think they should be allowed to (and even provided painless means to do so--say, a mask connected to a nitrogen tank.) Whether we agree with the reason or not I don't think enters into the picture.