6 ms·

I'm of the belief that in such a situation, a pre-cognitive decline "living will" or dead man switch is appropriate. If I were diagnosed with dementia, I'd bui

I'm of the belief that in such a situation, a pre-cognitive decline "living will" or dead man switch is appropriate. If I were diagnosed with dementia, I'd build automation to ensure that I'd appear to die a natural death when I enter the steep slope of cognitive decline. It's as easy as tying the results of frequent cognitive tests into a moving average that triggers my medication dispenser to start mixing in a toxin and or substituting key medication that keeps me alive with a sugar pill. These days, without the right medication, I'd be dead from "natural causes" in a week.

irrational 3y ago
How would you do it if you didn't take any medication? The most medication I've ever needed to take is an aspirin once or twice a year. I'm trying to think what other method I could use in place of substituting mediation.
- nanolith 3y ago
  Well, I would strongly advocate that such a system be used only after a diagnosis, at which point, you would be placed on medications to slow the progression. At that point, this would be seen as a rather innocuous thing by family members, since it's a machine meant to help you to remember to take medication that you need to help with your dementia. I have considered other machines -- again, as a theoretical exercise -- but ultimately, my decision process was that it had to maintain the plausible deniability to family members that I just died of natural causes. Allowing family to believe that I opted out because I felt that I was a burden would certainly lead to trauma beyond death from natural causes or an accident. I'm a strong believer in having the power of euthanasia. Part of the reason why dementia frightens me is because it would strip me of this agency. I currently suffer from heart failure, and dementia is a comorbidity in the later stages. Being able to choose a dignified end, hopefully in 30-40 years, is important to me.
_yb2s 3y ago
Having ADHD I've often wondered how I could even do a deadman switch. I'd eventually forget to renew it when I was otherwise perfectly fine.
- extragood 3y ago
  There was something I was supposed to do today.. huh. Must not have been important. << KILLBOT ACTIVATING >> oh no
  - Diris 3y ago
    Gosh, this made me laugh out loud. Thanks XD
- nanolith 3y ago
  It really has to be part of the routine, and there needs to be automated nagging in place to ensure that it goes off due to programmed conditions, and not due to neglect. I think this is especially important in cases of dementia. Daily routines will become one of the last things to go, as long as there is good nagware in place to keep you in line. I use nagware to remind me to take my medication, do my Duolingo practice, do my nightly checkins to GitHub, feed the various critters that don't or won't remind me themselves, and do my various work rituals. Weekly, monthly, and annual reminders (doctor appointments and birthdays) are also important.
niemandhier 3y ago
I have an assisted-suicide packt with my wife, that is probably the easiest solution.
- nanolith 3y ago
  For sure, if you can trust your partner to assist you with this, and if you can guarantee that your partner will not face legal consequences, this would be a great option. Dementia poses a legal wrinkle, in that in many jurisdictions, assisted suicide requires consent at the time of the procedure. In many states in the US, especially in the south, assisted suicide is a boogeyman that runs against prevalent religious beliefs. In this case, someone with diminished capacity may be seen as unable to give consent, which could land the assistant in legal trouble. This is why I like the idea of automation that acts on objective measures, with fail safes in place. Likewise, if after "doing the deed", the system erases itself and the firmware on the pill dispenser is glitched out, then the whole thing can look like an accident. A letter can be sent ahead of time to the family attorney, only to be opened under suspicion of foul play, which can clear up any potential investigatory wrinkles if law enforcement gets involved.
  - badRNG 3y ago
    I'm fairly certain in the US you cannot legally consent to being killed.
    - thesh4d0w 3y ago
      Wikipedia has a map - https://en.wikipedia.org/wiki/Assisted_suicide_in_the_United_States https://en.wikipedia.org/wiki/Assisted_suicide_in_the_United...
    - nanolith 3y ago
      It depends on the jurisdiction. A half dozen states now permit assisted suicide in the case of terminal illness. There's also an interesting bit of case law and state statutes that deals with "drug cocktails", which when combined, will lead to death. A physician can prescribe these in certain places without getting in trouble if certain criteria have been met. Either way, where this is legal, it requires that the person be of the capacity to consent, which someone with dementia cannot do.
credit_guy 3y ago
> It's as easy as tying the results of frequent cognitive tests into a moving average that triggers my medication dispenser to start mixing in a toxin You appear to me to be the type who never writes any bugs in their code.
- nanolith 3y ago
  Or, someone who would thoroughly test such a system and formally verify it long before use, as it would literally be a life or death thing...
  - pc86 3y ago
    Oh right we'll just "formally verify it," all good then!
    - klibertp 3y ago
      What's closer to "bug-free" (here, inside the cave) than formally verified software running on verified hardware in a distributed[1] system? [1] Because "you can't type-check being hit by lightning"...
    - lapetitejort 3y ago
      It works on my brain
Analemma_ 3y ago
That's fine in theory, but the problem is that many, possibly most, Alzheimer's patients report that they are happy and don't want to die, even well into severe cases. Whose preference should get priority, past you or present you? Maybe the internal experience of severe Alzheimer's isn't as bad as you are imagining, but if your living will is ironclad, by the time you realize that you'd have no way to signal it, and so you just get murdered.
- nanolith 3y ago
  The consciousness living in my body at that point may very well be happy, but that consciousness would not be me. I'd be gone, except perhaps in rare instances of lucidity. Sure, there is a Ship of Theseus argument to be had here, but I am very much opposed to being a burden on my loved ones, and if nothing were to change with my mind, that opposition would remain. I've seen first-hand the suffering that Alzheimer's inflicts on loved ones, and that's not something I would EVER consent to while in my right mind. The very idea horrifies me. That the alien consciousness that would be inhabiting my body at that point doesn't want to die, and holds a few of my memories, is of little consequence to me. Even if this experience is pleasant, at that point, it's not my experience -- what little of "me" is left to experience it -- that I care about.
  - danielheath 3y ago
    If the old you is already dead - why should it get to decide whether or not to kill the new one, which wants to go on living.
    - nanolith 3y ago
      It's not about me, it's about the trauma that my husk causes to loved ones. I'm a firm believer in euthanasia. I should get the choice while I am able to make that choice. If future me had the capacity to choose, future me would choose the same.
      - surfaceofthesun 3y ago
butlike 3y ago
I've been thinking about the question: "where will all the people go?" and instead of you having to do all that. Why don't we just pair the serial killers with the people who want to die? The right-to-die folks get what they want, and the "serial killer"-types get to pull the proverbial trigger, and we get to interview them after.

irrational 3y ago

How would you do it if you didn't take any medication? The most medication I've ever needed to take is an aspirin once or twice a year. I'm trying to think what other method I could use in place of substituting mediation.

nanolith 3y ago
Well, I would strongly advocate that such a system be used only after a diagnosis, at which point, you would be placed on medications to slow the progression. At that point, this would be seen as a rather innocuous thing by family members, since it's a machine meant to help you to remember to take medication that you need to help with your dementia. I have considered other machines -- again, as a theoretical exercise -- but ultimately, my decision process was that it had to maintain the plausible deniability to family members that I just died of natural causes. Allowing family to believe that I opted out because I felt that I was a burden would certainly lead to trauma beyond death from natural causes or an accident. I'm a strong believer in having the power of euthanasia. Part of the reason why dementia frightens me is because it would strip me of this agency. I currently suffer from heart failure, and dementia is a comorbidity in the later stages. Being able to choose a dignified end, hopefully in 30-40 years, is important to me.

_yb2s 3y ago

Having ADHD I've often wondered how I could even do a deadman switch. I'd eventually forget to renew it when I was otherwise perfectly fine.

extragood 3y ago
There was something I was supposed to do today.. huh. Must not have been important. << KILLBOT ACTIVATING >> oh no
- Diris 3y ago
  Gosh, this made me laugh out loud. Thanks XD
nanolith 3y ago
It really has to be part of the routine, and there needs to be automated nagging in place to ensure that it goes off due to programmed conditions, and not due to neglect. I think this is especially important in cases of dementia. Daily routines will become one of the last things to go, as long as there is good nagware in place to keep you in line. I use nagware to remind me to take my medication, do my Duolingo practice, do my nightly checkins to GitHub, feed the various critters that don't or won't remind me themselves, and do my various work rituals. Weekly, monthly, and annual reminders (doctor appointments and birthdays) are also important.

niemandhier 3y ago

I have an assisted-suicide packt with my wife, that is probably the easiest solution.

nanolith 3y ago
For sure, if you can trust your partner to assist you with this, and if you can guarantee that your partner will not face legal consequences, this would be a great option. Dementia poses a legal wrinkle, in that in many jurisdictions, assisted suicide requires consent at the time of the procedure. In many states in the US, especially in the south, assisted suicide is a boogeyman that runs against prevalent religious beliefs. In this case, someone with diminished capacity may be seen as unable to give consent, which could land the assistant in legal trouble. This is why I like the idea of automation that acts on objective measures, with fail safes in place. Likewise, if after "doing the deed", the system erases itself and the firmware on the pill dispenser is glitched out, then the whole thing can look like an accident. A letter can be sent ahead of time to the family attorney, only to be opened under suspicion of foul play, which can clear up any potential investigatory wrinkles if law enforcement gets involved.
- badRNG 3y ago
  I'm fairly certain in the US you cannot legally consent to being killed.
  - thesh4d0w 3y ago
    Wikipedia has a map - https://en.wikipedia.org/wiki/Assisted_suicide_in_the_United_States https://en.wikipedia.org/wiki/Assisted_suicide_in_the_United...
  - nanolith 3y ago
    It depends on the jurisdiction. A half dozen states now permit assisted suicide in the case of terminal illness. There's also an interesting bit of case law and state statutes that deals with "drug cocktails", which when combined, will lead to death. A physician can prescribe these in certain places without getting in trouble if certain criteria have been met. Either way, where this is legal, it requires that the person be of the capacity to consent, which someone with dementia cannot do.

credit_guy 3y ago

> It's as easy as tying the results of frequent cognitive tests into a moving average that triggers my medication dispenser to start mixing in a toxin You appear to me to be the type who never writes any bugs in their code.

nanolith 3y ago
Or, someone who would thoroughly test such a system and formally verify it long before use, as it would literally be a life or death thing...
- pc86 3y ago
  Oh right we'll just "formally verify it," all good then!
  - klibertp 3y ago
    What's closer to "bug-free" (here, inside the cave) than formally verified software running on verified hardware in a distributed[1] system? [1] Because "you can't type-check being hit by lightning"...
  - lapetitejort 3y ago
    It works on my brain

Analemma_ 3y ago

That's fine in theory, but the problem is that many, possibly most, Alzheimer's patients report that they are happy and don't want to die, even well into severe cases. Whose preference should get priority, past you or present you? Maybe the internal experience of severe Alzheimer's isn't as bad as you are imagining, but if your living will is ironclad, by the time you realize that you'd have no way to signal it, and so you just get murdered.

nanolith 3y ago
The consciousness living in my body at that point may very well be happy, but that consciousness would not be me. I'd be gone, except perhaps in rare instances of lucidity. Sure, there is a Ship of Theseus argument to be had here, but I am very much opposed to being a burden on my loved ones, and if nothing were to change with my mind, that opposition would remain. I've seen first-hand the suffering that Alzheimer's inflicts on loved ones, and that's not something I would EVER consent to while in my right mind. The very idea horrifies me. That the alien consciousness that would be inhabiting my body at that point doesn't want to die, and holds a few of my memories, is of little consequence to me. Even if this experience is pleasant, at that point, it's not my experience -- what little of "me" is left to experience it -- that I care about.
- danielheath 3y ago
  If the old you is already dead - why should it get to decide whether or not to kill the new one, which wants to go on living.
  - nanolith 3y ago
    It's not about me, it's about the trauma that my husk causes to loved ones. I'm a firm believer in euthanasia. I should get the choice while I am able to make that choice. If future me had the capacity to choose, future me would choose the same.
    - surfaceofthesun 3y ago

butlike 3y ago

I've been thinking about the question: "where will all the people go?" and instead of you having to do all that. Why don't we just pair the serial killers with the people who want to die? The right-to-die folks get what they want, and the "serial killer"-types get to pull the proverbial trigger, and we get to interview them after.