10 ms·

The worst part is that there isn't a well-defined point where you can say "I'd like to have a medically-assisted suicide" that isn't going to upset people (assu

The worst part is that there isn't a well-defined point where you can say "I'd like to have a medically-assisted suicide" that isn't going to upset people (assuming it were legal). By the time you reach it, you quite possibly won't have the cognitive capacity to request it.

raincole 3y ago
I don't believe there should be a "point" where you can say that. Medically-assisted suicide should be available for everyone. Of course with a prolonged evaluation period.
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- thinkharderdev 3y ago
  I took the parent to be saying something like "even if medically assisted suicide were available as an option without restriction, there is no point at which you would decide to do it because the onset of dementia is so gradual." That is, it would be difficult to make the decision (for some/most people at least) while you were still having lucid moments where you could still have some quality of life. And by the point where you have completely lost it, you are no longer of sound mind to consent to a medically assisted suicide.
  - blagie 3y ago
    I think one way to go is to do this early, with a clear bound. For example, one might set a rule that if they can: * no longer compute ∫x²dx * remember the capital of France; and * recall where they were born Then they have crossed that threshold. Personally, though I don't want to be killed. At least by my values, killing is not okay. I think there are much better things to do, such as: - Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured. - Go some place where I will surely die, but where I can still do some good (running a school for girls in Afghanistan when the US was there is a good example) - If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go. And to be abundantly clear, that's my opinion and my values. I'm not trying to decide for anyone else. I don't think these sorts of decisions should ever be forced, mandated, or imposed. Footnote: Thresholds are hard to define. I did have one relative with complete loss of short-term memory who seemed to be having a wonderful life. They were happy, friendly, and told grand kids wonderful stories from decades past. It helped that they had a very easy-going personality. On the other hand, they didn't know how they got to where they were, or what we were talking about five minutes ago. They also didn't have any recent memories (e.g. if a relative had been married within the past half-decade or so, they wouldn't recognize the spouse). There was a point where I'm pretty sure they wouldn't have passed any reasonable threshold, but they seemed to be living a very full life surrounded by a big family who loved them. On the other hand, if my brain was where their brain was, I'm pretty sure I'd be completely miserable.
    - jeromegv 3y ago
      How is going to Afghanistan and manage a school something you should once once you reach advanced dementia? You’d think that it would make some good? To whom?
      - vwcx 3y ago
        +1. Those girls don't need to deal with old Uncle Al failing to manage the basic day to day logistics of their school. Might as well dedicate your waning days to living out a Robinhood fantasy stealing for the poor until you're killed by the landed gentry.
      - blagie 3y ago
        That's something I do well before I'd reach advanced dementia. Part of the point is to never reach that stage.
    - mindvirus 3y ago
      Flashbacks to high school Teacher: "Compute ∫x²dx" Me: "x^3/3" Teacher: "You forgot the + C!" RIP
      - mensetmanusman 3y ago
        "You forgot an infinite number of other answers!" /whipped for each one
    - candiddevmike 3y ago
      If you're an organ donor, you'll do more good than any of those three options once you die, IMO.
      - blagie 3y ago
        Unlikely and irrelevant. Unlikely: Organ donor is only an option in some circumstances. It's more typical with young people and accidents than elderly. There's no age cut-off, but for example: 1) The organs need to be fresh (e.g. you died in the ER). 2) The organs need to be in good shape (e.g. not sick) Irrelevant: It doesn't solve the fundamental question of values and ethics. I am against actively taking a life, including my own. I am not against putting my life at risk, especially for a good cause.
- mensetmanusman 3y ago
  Even with prolonged evaluation, there have been events where doctors are killing people who in the current state of mind changed their mind and resisted the entire time in front of their families. I'm of the opinion humans will never be able to not abuse such a system. We easily see now the data on assisted deaths before tax holidays.
  - prepend 3y ago
    This sounds terrifying. Do you have any articles or accounts of this?
stormfather 3y ago
This is an ideal use case for chatbots. Hook your carbon monoxide controller to an LLM trained to administer a reverse Turing test. I'm kidding, but not really. Our family is dealing with this and I am considering wiring this up for personal use down the road.
- hammyhavoc 3y ago
  With how much LLMs hallucinate, I'd say this is a terrible use for chatbots.
mtlmtlmtlmtl 3y ago
I would do it myself the same day I was diagnosed.
- andy_ppp 3y ago
  You’ll have days where you feel fine though and be having fun and enjoying life. It’s easy to say but the initial symptoms might be very mild.
  - mtlmtlmtlmtl 3y ago
    I've thought about it a lot. I want to die while I'm still enjoying life. So I can say goodbye to family and have them remember the person I was, not the shadow I became.
    - hammyhavoc 3y ago
      27 club y'say? Guessing that ship has probably sailed.
      - mtlmtlmtlmtl 3y ago
        Yeah, maybe. 30 actually...
    - VMG 3y ago
      Let's hope you don't get the diagnosis in the afternoon then - the goodbyes might be a bit rushed otherwise
      - mtlmtlmtlmtl 3y ago
        Yeah same day might be a bit excessive, come to think of it. Probably give it a week or so to set up a get together. Like a "living funeral" or something.
        tchaffee 3y ago
petercooper 3y ago
My dad is a good example of this. He was very adamant he wanted to die if he became debilitated by dementia. Unfortunately he ended up having three strokes in quick succession while being diagnosed for vascular dementia and is now a totally different person (with zero recollection or connection to his previous personality or memories, as far as anyone medical can tell) living a pretty miserable life in a facility with 24/7 care, zero language abilities, etc. There was no singular moment he could have made the call. He was entirely cogent one day and absolutely not the next. I would be very happy to sign off on his wishes, but there is no legal or medical route to do so, so whatever is left of him gets to suffer until his body gives up. I support them introducing some mechanism for this one day and would likely use it myself (all my ancestors went through dementia).

raincole 3y ago

I don't believe there should be a "point" where you can say that. Medically-assisted suicide should be available for everyone. Of course with a prolonged evaluation period.

deleted 3y ago
[deleted]
deleted 3y ago
[deleted]
thinkharderdev 3y ago
I took the parent to be saying something like "even if medically assisted suicide were available as an option without restriction, there is no point at which you would decide to do it because the onset of dementia is so gradual." That is, it would be difficult to make the decision (for some/most people at least) while you were still having lucid moments where you could still have some quality of life. And by the point where you have completely lost it, you are no longer of sound mind to consent to a medically assisted suicide.
- blagie 3y ago
  I think one way to go is to do this early, with a clear bound. For example, one might set a rule that if they can: * no longer compute ∫x²dx * remember the capital of France; and * recall where they were born Then they have crossed that threshold. Personally, though I don't want to be killed. At least by my values, killing is not okay. I think there are much better things to do, such as: - Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured. - Go some place where I will surely die, but where I can still do some good (running a school for girls in Afghanistan when the US was there is a good example) - If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go. And to be abundantly clear, that's my opinion and my values. I'm not trying to decide for anyone else. I don't think these sorts of decisions should ever be forced, mandated, or imposed. Footnote: Thresholds are hard to define. I did have one relative with complete loss of short-term memory who seemed to be having a wonderful life. They were happy, friendly, and told grand kids wonderful stories from decades past. It helped that they had a very easy-going personality. On the other hand, they didn't know how they got to where they were, or what we were talking about five minutes ago. They also didn't have any recent memories (e.g. if a relative had been married within the past half-decade or so, they wouldn't recognize the spouse). There was a point where I'm pretty sure they wouldn't have passed any reasonable threshold, but they seemed to be living a very full life surrounded by a big family who loved them. On the other hand, if my brain was where their brain was, I'm pretty sure I'd be completely miserable.
  - jeromegv 3y ago
    How is going to Afghanistan and manage a school something you should once once you reach advanced dementia? You’d think that it would make some good? To whom?
    - vwcx 3y ago
      +1. Those girls don't need to deal with old Uncle Al failing to manage the basic day to day logistics of their school. Might as well dedicate your waning days to living out a Robinhood fantasy stealing for the poor until you're killed by the landed gentry.
    - blagie 3y ago
      That's something I do well before I'd reach advanced dementia. Part of the point is to never reach that stage.
  - mindvirus 3y ago
    Flashbacks to high school Teacher: "Compute ∫x²dx" Me: "x^3/3" Teacher: "You forgot the + C!" RIP
    - mensetmanusman 3y ago
      "You forgot an infinite number of other answers!" /whipped for each one
  - candiddevmike 3y ago
    If you're an organ donor, you'll do more good than any of those three options once you die, IMO.
    - blagie 3y ago
      Unlikely and irrelevant. Unlikely: Organ donor is only an option in some circumstances. It's more typical with young people and accidents than elderly. There's no age cut-off, but for example: 1) The organs need to be fresh (e.g. you died in the ER). 2) The organs need to be in good shape (e.g. not sick) Irrelevant: It doesn't solve the fundamental question of values and ethics. I am against actively taking a life, including my own. I am not against putting my life at risk, especially for a good cause.
mensetmanusman 3y ago
Even with prolonged evaluation, there have been events where doctors are killing people who in the current state of mind changed their mind and resisted the entire time in front of their families. I'm of the opinion humans will never be able to not abuse such a system. We easily see now the data on assisted deaths before tax holidays.
- prepend 3y ago
  This sounds terrifying. Do you have any articles or accounts of this?

stormfather 3y ago

This is an ideal use case for chatbots. Hook your carbon monoxide controller to an LLM trained to administer a reverse Turing test. I'm kidding, but not really. Our family is dealing with this and I am considering wiring this up for personal use down the road.

hammyhavoc 3y ago
With how much LLMs hallucinate, I'd say this is a terrible use for chatbots.

mtlmtlmtlmtl 3y ago

I would do it myself the same day I was diagnosed.

andy_ppp 3y ago
You’ll have days where you feel fine though and be having fun and enjoying life. It’s easy to say but the initial symptoms might be very mild.
- mtlmtlmtlmtl 3y ago
  I've thought about it a lot. I want to die while I'm still enjoying life. So I can say goodbye to family and have them remember the person I was, not the shadow I became.
  - hammyhavoc 3y ago
    27 club y'say? Guessing that ship has probably sailed.
    - mtlmtlmtlmtl 3y ago
      Yeah, maybe. 30 actually...
  - VMG 3y ago
    Let's hope you don't get the diagnosis in the afternoon then - the goodbyes might be a bit rushed otherwise
    - mtlmtlmtlmtl 3y ago
      Yeah same day might be a bit excessive, come to think of it. Probably give it a week or so to set up a get together. Like a "living funeral" or something.
      - tchaffee 3y ago

petercooper 3y ago

My dad is a good example of this. He was very adamant he wanted to die if he became debilitated by dementia. Unfortunately he ended up having three strokes in quick succession while being diagnosed for vascular dementia and is now a totally different person (with zero recollection or connection to his previous personality or memories, as far as anyone medical can tell) living a pretty miserable life in a facility with 24/7 care, zero language abilities, etc. There was no singular moment he could have made the call. He was entirely cogent one day and absolutely not the next. I would be very happy to sign off on his wishes, but there is no legal or medical route to do so, so whatever is left of him gets to suffer until his body gives up. I support them introducing some mechanism for this one day and would likely use it myself (all my ancestors went through dementia).