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There is an enormous conflict here. On the one hand a certain degree of mental illness means that you are legally incapable of making choices, while, on the oth

There is an enormous conflict here. On the one hand a certain degree of mental illness means that you are legally incapable of making choices, while, on the other hand you obviously need to be mentally well enough to make an informed medical decision of such gravity. How many people are so mentally ill that death is the only conceivable escape, but at the same time so mentally well that they can make an informed medical decision about the end of their life. Certainly I believe that number to be very low, potentially it might just be zero.

CaptainOfCoit 2y ago
> How many people are so mentally ill that death is the only conceivable escape, but at the same time so mentally well that they can make an informed medical decision about the end of their life. Certainly I believe that number to be very low, potentially it might just be zero. People suffering from non-suicidal mental illnesses could fit this description. For example, consider a patient who has undergone various therapies and medical examinations but remains irrationally terrified of fluids and can only receive them via injection. They'll be mentally sound enough to make an informed decision, and the patient concludes that life is not worth living.
- constantcrying 2y ago
  Is that just a thought experiment? Almost all mental illnesses I am aware of seem to be experienced continuously, maybe with an ebb and flow in intensity. But even if such a person existed and the phobia wasn't persistent without a doubt the person would suffer from related anxieties. I don't believe that you could suffer from such a condition and be mentally well for any amount of time, although I certainly see your point that during certain periods the person might be able to make an informed decision.
wdb 2y ago
That's the whole problem with euthanasia in The Netherlands. Most would opt for it when they have mental illnesses like Alzheimers or dementia in general but most often they would too ill to be able to make required informed decision. I am glad it's offered because why would someone need to wait until they die? Especially, when the person can't be treated further like when having cancer.
- constantcrying 2y ago
  I think it is understandable when the person is suffering from a painful and untreatable illness, but can otherwise make their own medical decisions. But that is a completely different scenario, with a mental illness, what you are escaping from is what makes you unable to make the decision.
  - wdb 2y ago
    No, you escape from living like plant
    - constantcrying 2y ago
      Obviously plants can't consent to being killed, what a meaningless argument.
microtherion 2y ago
It's actually really not so uncommon, if you classify dementia as "mental illness". Many people prefer (or say that they prefer) euthanasia to dementia, yet one has to make the final decision before the dementia is overly advanced.
- constantcrying 2y ago
  This doesn't relieve the conflict. What if someone says they want to die with less advanced dementia, but when the illness has advanced further they say they want to live? Many medical decisions are put into the hands of relatives when people become mentally unfit to make those decisions. Certainly in this case it shouldn't be allowed.
  - microtherion 2y ago
    Yes, people changing their minds is not uncommon. The law in my country is that the final decision has to be made by the patient itself, shortly before the euthanasia (no advance directives), and while mentally fit. The mental fitness has to be confirmed by the personal physician, and in reality, they will also take into account whether the decision has been maintained consistently, over a longer period of time before the onset of serious dementia, and if so, they might relax mental fitness criteria somewhat. Relatives don't enter the picture (as opposed to withdrawing of life support).
    - constantcrying 2y ago
      >Relatives don't enter the picture (as opposed to withdrawing of life support). But their doctor does? That is just bizarre. Here in Germany, if you aren't fit to make your own medical or legal decisions, the state will try to appoint a family member as your formal caretaker in those matters. Honestly hearing this made me significantly more apprehensive about the whole thing. This seems like an awful idea.
      - microtherion 2y ago
        The doctor certifies whether the patient is of sound mind when making the decision. In practice, both the doctor's history with the patient and the relatives may influence that certification in edge cases.

CaptainOfCoit 2y ago

> How many people are so mentally ill that death is the only conceivable escape, but at the same time so mentally well that they can make an informed medical decision about the end of their life. Certainly I believe that number to be very low, potentially it might just be zero. People suffering from non-suicidal mental illnesses could fit this description. For example, consider a patient who has undergone various therapies and medical examinations but remains irrationally terrified of fluids and can only receive them via injection. They'll be mentally sound enough to make an informed decision, and the patient concludes that life is not worth living.

constantcrying 2y ago
Is that just a thought experiment? Almost all mental illnesses I am aware of seem to be experienced continuously, maybe with an ebb and flow in intensity. But even if such a person existed and the phobia wasn't persistent without a doubt the person would suffer from related anxieties. I don't believe that you could suffer from such a condition and be mentally well for any amount of time, although I certainly see your point that during certain periods the person might be able to make an informed decision.

wdb 2y ago

That's the whole problem with euthanasia in The Netherlands. Most would opt for it when they have mental illnesses like Alzheimers or dementia in general but most often they would too ill to be able to make required informed decision. I am glad it's offered because why would someone need to wait until they die? Especially, when the person can't be treated further like when having cancer.

constantcrying 2y ago
I think it is understandable when the person is suffering from a painful and untreatable illness, but can otherwise make their own medical decisions. But that is a completely different scenario, with a mental illness, what you are escaping from is what makes you unable to make the decision.
- wdb 2y ago
  No, you escape from living like plant
  - constantcrying 2y ago
    Obviously plants can't consent to being killed, what a meaningless argument.

microtherion 2y ago

It's actually really not so uncommon, if you classify dementia as "mental illness". Many people prefer (or say that they prefer) euthanasia to dementia, yet one has to make the final decision before the dementia is overly advanced.

constantcrying 2y ago
This doesn't relieve the conflict. What if someone says they want to die with less advanced dementia, but when the illness has advanced further they say they want to live? Many medical decisions are put into the hands of relatives when people become mentally unfit to make those decisions. Certainly in this case it shouldn't be allowed.
- microtherion 2y ago
  Yes, people changing their minds is not uncommon. The law in my country is that the final decision has to be made by the patient itself, shortly before the euthanasia (no advance directives), and while mentally fit. The mental fitness has to be confirmed by the personal physician, and in reality, they will also take into account whether the decision has been maintained consistently, over a longer period of time before the onset of serious dementia, and if so, they might relax mental fitness criteria somewhat. Relatives don't enter the picture (as opposed to withdrawing of life support).
  - constantcrying 2y ago
    >Relatives don't enter the picture (as opposed to withdrawing of life support). But their doctor does? That is just bizarre. Here in Germany, if you aren't fit to make your own medical or legal decisions, the state will try to appoint a family member as your formal caretaker in those matters. Honestly hearing this made me significantly more apprehensive about the whole thing. This seems like an awful idea.
    - microtherion 2y ago
      The doctor certifies whether the patient is of sound mind when making the decision. In practice, both the doctor's history with the patient and the relatives may influence that certification in edge cases.