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Suicide is not legal in many places, though it is correct that this is rarely enforced in any meaningful way. There are cases, however, where family members hav

Suicide is not legal in many places, though it is correct that this is rarely enforced in any meaningful way. There are cases, however, where family members have been prosecuted for assisting terminally ill people in committing suicide. Technically, in many legislation, you have a duty to assist someone whose life is in danger, and neglecting this duty is a crime. What you brush off as "official approval" can be the difference between a person's family members getting to say goodbye to their loved one before they die peacefully on their own terms, or them getting home one day to find their brains scattered all over the garage. It's about whether you get to make this painfully difficult decision about your life on the open, with the support of those around you, or whether you are forced to hide it from them, out of shame or to avoid legal repercussions. It's about whether your loved ones are able remember you as you were in life, or as the trauma, guilt and shame that followed your death. It matters a lot. Life is worth living, yes. On the abstract, and on a personal level, I wholeheartedly agree. But I do not get to impart that judgement on other people's concrete lived experiences, to decide that their life is worth living on their behalf. Just like I alone decide whether mine is.

vintermann 4y ago
The real horror of suicide, for survivors, is not really about the mess, even though it doesn't help. If it were only that, I guess we could educate people about methods. But no, the real horror is that their loved one wanted to kill themselves, and did. We're not getting away from this horror with suicide, no matter how clinical and "clean" it is. If you want to make the decision in the open with the support of those around you, involving them in your decision, I think you have to accept that they must be allowed to say "no, please don't do it", too. If you want their support, but don't give them that option, then it's downright cruel. And assisted suicide laws impose that obligation, not on relatives, but on doctors. They're not just stepping aside for someone else's decision, they are demanded to accept it, support it and actively assist in pursuing the objective of death (unlike in terminal sedation and cessation of treatment, where death is not the goal). They have to do this even for people who are not terminally ill, who we know from statistics in many cases would have abandoned their wish to die and lived long lives. I've known doctors from very different backgrounds (including non religious people, just so that's clear) who have been very disturbed by the prospect of being expected to do such things. I think the options of terminal sedation and refusing life-prolonging treatment should be the extent of what we demand from doctors. That's no small deal, it is important that no one's life is prolonged by medicine against their will at the cost of suffering. But doctor's and the health system's obligations should stop there.
- sdiacom 4y ago
  I think you severely underestimate the horror of knowing that your loved ones wanted to kill themselves, and didn't. Suffering is a state of being; death is an instant. Of course those around them are allowed to say "please don't do it" -- but the person who's making the decision might still choose to do it. This is true, independently of whether assisted suicide is on the table. Regardless, getting to have an open conversation about it will be a better starting point for healing, for everyone involved. You can't say "please don't do it" to a suicide note, or ask it further questions so that you can better understand why they made that decision. You have a profound misunderstanding of how most assisted suicide laws around the world work. Doctors are not demanded to do anything, and certainly are not held to any obligation to end the life of anyone who asks them to. They evaluate whether the request has validity based on medical criteria, and deny it or accept it on that basis. Doctors who object for religious or moral reasons are usually exempt from participating in it altogether. They definitely don't have to do it for people who aren't terminally ill -- although in some legislations, they might be allowed to. I'm also unsure what you believe terminal sedation and cessation of treatment are. Death is definitely the expected result. Or rather, death is the means to achieve the desired goal, which is ending the patient's suffering -- just like with assisted suicide. You speak of statistics where people have abandoned their wish to die and lived long lives. Did they live good lives? Can you, personally, promise to everyone in the world seeking assisted suicide, that if they do not follow through, they will live good lives? That their continued suffering will eventually end, or that it will be worth enduring? I think it's the least you can do, given that you've talked to a dentist once or whatever, and that apparently gives you the moral high ground to make that decision, on behalf of all doctors and of all people who seek assisted suicide alike.
  - vintermann 4y ago
    > You have a profound misunderstanding of how most assisted suicide laws around the world work. I got into this debate through reading and engaging with four doctors, over many years. One of them, the one I knew best, is a professor of medical ethics now. I borrowed Rawls' "A theory of justice" from him. Managed to return it too. Don't know how this is relevant, but since you speculated about "talking to a dentist" I guess it is? Can't say I know what laws are on the table at every point, but I think I got a reasonable overview. The right to conscientious objection is certainly important, but I really can't entrust it to people who don't understand the difference between "accepting an outcome" and "seeking an outcome as a means to an end". You won't let us keep it for long. > Or rather, death is the means to achieve the desired goal That's exactly what it is not. The sedatives relieve pain, they shorten the patient's life as a side effect. An easy way to see is, imagine if the painkillers killed the pain, but the patient miraculously didn't die. Would you be happy? Of course. Both of you, generally. If the patient was genuinely suicidal and wanted to die, they might not be. Not even if they recovered and went on live a long life. So no, I can't promise them that they'll find out why life is worth living. But I can promise them a nonzero chance that they someday will. And if that chance isn't enough to make them stop actively seeking to end it, I honestly think they're not thinking straight.

vintermann 4y ago

The real horror of suicide, for survivors, is not really about the mess, even though it doesn't help. If it were only that, I guess we could educate people about methods. But no, the real horror is that their loved one wanted to kill themselves, and did. We're not getting away from this horror with suicide, no matter how clinical and "clean" it is. If you want to make the decision in the open with the support of those around you, involving them in your decision, I think you have to accept that they must be allowed to say "no, please don't do it", too. If you want their support, but don't give them that option, then it's downright cruel. And assisted suicide laws impose that obligation, not on relatives, but on doctors. They're not just stepping aside for someone else's decision, they are demanded to accept it, support it and actively assist in pursuing the objective of death (unlike in terminal sedation and cessation of treatment, where death is not the goal). They have to do this even for people who are not terminally ill, who we know from statistics in many cases would have abandoned their wish to die and lived long lives. I've known doctors from very different backgrounds (including non religious people, just so that's clear) who have been very disturbed by the prospect of being expected to do such things. I think the options of terminal sedation and refusing life-prolonging treatment should be the extent of what we demand from doctors. That's no small deal, it is important that no one's life is prolonged by medicine against their will at the cost of suffering. But doctor's and the health system's obligations should stop there.

sdiacom 4y ago
I think you severely underestimate the horror of knowing that your loved ones wanted to kill themselves, and didn't. Suffering is a state of being; death is an instant. Of course those around them are allowed to say "please don't do it" -- but the person who's making the decision might still choose to do it. This is true, independently of whether assisted suicide is on the table. Regardless, getting to have an open conversation about it will be a better starting point for healing, for everyone involved. You can't say "please don't do it" to a suicide note, or ask it further questions so that you can better understand why they made that decision. You have a profound misunderstanding of how most assisted suicide laws around the world work. Doctors are not demanded to do anything, and certainly are not held to any obligation to end the life of anyone who asks them to. They evaluate whether the request has validity based on medical criteria, and deny it or accept it on that basis. Doctors who object for religious or moral reasons are usually exempt from participating in it altogether. They definitely don't have to do it for people who aren't terminally ill -- although in some legislations, they might be allowed to. I'm also unsure what you believe terminal sedation and cessation of treatment are. Death is definitely the expected result. Or rather, death is the means to achieve the desired goal, which is ending the patient's suffering -- just like with assisted suicide. You speak of statistics where people have abandoned their wish to die and lived long lives. Did they live good lives? Can you, personally, promise to everyone in the world seeking assisted suicide, that if they do not follow through, they will live good lives? That their continued suffering will eventually end, or that it will be worth enduring? I think it's the least you can do, given that you've talked to a dentist once or whatever, and that apparently gives you the moral high ground to make that decision, on behalf of all doctors and of all people who seek assisted suicide alike.
- vintermann 4y ago
  > You have a profound misunderstanding of how most assisted suicide laws around the world work. I got into this debate through reading and engaging with four doctors, over many years. One of them, the one I knew best, is a professor of medical ethics now. I borrowed Rawls' "A theory of justice" from him. Managed to return it too. Don't know how this is relevant, but since you speculated about "talking to a dentist" I guess it is? Can't say I know what laws are on the table at every point, but I think I got a reasonable overview. The right to conscientious objection is certainly important, but I really can't entrust it to people who don't understand the difference between "accepting an outcome" and "seeking an outcome as a means to an end". You won't let us keep it for long. > Or rather, death is the means to achieve the desired goal That's exactly what it is not. The sedatives relieve pain, they shorten the patient's life as a side effect. An easy way to see is, imagine if the painkillers killed the pain, but the patient miraculously didn't die. Would you be happy? Of course. Both of you, generally. If the patient was genuinely suicidal and wanted to die, they might not be. Not even if they recovered and went on live a long life. So no, I can't promise them that they'll find out why life is worth living. But I can promise them a nonzero chance that they someday will. And if that chance isn't enough to make them stop actively seeking to end it, I honestly think they're not thinking straight.