4 ms·

As a physician, I can tell you that euthanasia has been always around in every society and at all times. MAID just made the arrangement formal. Before MAID, it

by drgo 1y ago

As a physician, I can tell you that euthanasia has been always around in every society and at all times. MAID just made the arrangement formal. Before MAID, it was implemented by withdrawing life-saving treatments (usually due to side-effects), rising doses of narcotics (for painful conditions) or even "terminal sedation" (the most explicit form of euthanasia before MAID-like laws).(And of course, patients always had the option of taking their own lives). In any healthcare system, there has to come a point where patients (and their families) and their doctors decide to terminate efforts aimed at extending life. In most cases, MAID is just a way to shorten the unpleasant interval between that decision and death. Given all that, it is not that surprising that 5-7% of deaths are attributed to MAID. The debate about MAID is another example where a lot of otherwise rational people fall prey to misguided sloganeering.

johnnienaked 1y ago
No it hasn't. Euthanasia is illegal in most countries and almost always has been. Terminal sedation and intentional rising doses of narcotics would be considered ACTUAL murder in 100% of those cases where euthanasia is illegal. If you are a physician and don't know this you should be immediately investigated.
troad 1y ago
> The debate about MAID is another example where a lot of otherwise rational people fall prey to misguided sloganeering. This is the same level of argument as saying that people who vote for the other guys must have been tricked by FOX News / MSNBC / Russia / Tik Tok / transtrenders / tradwives, and if only they truly understood their actual self-interest they would agree with you on all things. It's a bad style of argumentation, albeit very popular in academia ('why do the poor keep voting wrong?'). There are legitimate reasons to oppose Canada's euthanasia program on its own terms, and it's not surprising the Canadian government has very carefully shielded MAID from any sort of public input or oversight, since it's deeply unlikely it would pass a majority vote in its current form. There is consistent public opposition to euthanasia being available to anyone but late-stage terminally-ill people (and even then, it's divisive at best). There is strong public opposition to euthanasia solely on the grounds of mental health. More broadly, I think people are increasingly sick of the misuse of the term 'healthcare' (or 'public health') to sneak unpopular or controversial policies past the electorate, and the idea of 'death as healthcare' is probably the most extreme example of this trend. When people cannot express democratic opposition to policies they deeply oppose, don't be surprised if you get pushback and populism.
- greygoo222 1y ago
  73% of Canadians support MAID https://pubmed.ncbi.nlm.nih.gov/38910003/ https://pubmed.ncbi.nlm.nih.gov/38910003/ 71% of Americans believe doctors should be "allowed by law to end the patient’s life by some painless means if the patient and his or her family request it" https://news.gallup.com/poll/648215/americans-favor-legal-euthanasia.aspx https://news.gallup.com/poll/648215/americans-favor-legal-eu... These policies are supported by a strong majority of people.
  - troad 1y ago
    Literally the abstract of that very study: > Only 12.1% correctly answered ≥4 of 5 knowledge questions about the MAID law; only 19.2% knew terminal illness is not required and 20.2% knew treatment refusal is compatible with eligibility. 73.3% of participants expressed support for the MAID law in general, matching a nationally representative poll that used the same question. 40.4% of respondents supported MAID for mental illnesses. Support for MAID in the scenarios depicting refusal or lack of access to treatment ranged from 23.2% (lack of access in medical condition) to 32.0% (treatment refusal in medical illness) Most Canadians express support for MAID but cannot correctly answer questions about it. When Canadians are actually told what's in MAID, they oppose it. It's also worth noting that quite a lot of polling on this question is done by, or on behalf of, pro-euthanasia organisations; there is often a huge mismatch between the questions asked and the actual legislation proposed and passed (in a very motte-and-bailey kind of way).
    - greygoo222 1y ago
      People stated they supported the policy after reading a full description of the policy. If you don't trust the paper (whose researchers are anti-euthanasia), the Canadian government found the same results. https://researchco.ca/2023/05/05/maid-canada-2023/ https://researchco.ca/2023/05/05/maid-canada-2023/ Nobody ever correctly answers questions about legislation, to put it glibly. Any piece of legislation newer than 10 years and more complex than a sentence is not going to pass such a test with the general public. 19.2% knew that terminal illness is not required? I would be shocked if 19.2% could correctly answer a few basic questions about the definition of "terminal illness."
snapplebobapple 1y ago
I don't think it's that misguided. The incentives are so perverse here that, if the government isn't abusing it, they are acting incompetently. it would almost be better if they just had the actuary provide an expected life and expected cost chart and we agreed to pay the potential MAID recipient's estate 10% of the savings remaining on the day the chose to go, if they choose MAID.
- Eddy_Viscosity2 1y ago
  How are incentives perverse? Would it be better to have a system that only incentivizes life extension, no matter the suffering it causes, no matter that it will still ultimately end in death?
  - snapplebobapple 1y ago
    It's not about whether the person should live or die, it's that the Canadian government has vested responsibility to provide healthcare in itself while making other options illegal. I can't make my own choice to, for example, buy my own medical insurance to ensure I live for as long as possible with the most effective (and likely expensive) treatments. The government has said they got this and limited everyone's choice to government only. They screwed this up via multiple mechanisms, because that's what government seems to do, and now there is a pretty decent shortage of healthcare up here. This makes the incentives highly perverse because the government can't provide the world class health care it promised even if it wanted to, which leads to political pressure to bring in MAID and chop tens to hundreds of thousands of dollars of medical liability off the end of many patient's lives (which I would actually support if the underlying incentive structure was different, or if the government was at least honest about what was happening and compensating the MAID recipient's estates for forgoing treatment the government is obligated to provide but would be better for said government if they didn't). The most concerning bit here is the lack of provision of other life improving services like joint replacement, the latest experimental drugs, etc. and the likelihood that that is funneling people into a situation where MAID is the obvious best choice sooner than it otherwise would be. This is certainly happening with cancer treatments (although probably not intentionally, just incompetently) as people get detections for cancer and then find a months long wait list instead of days to weeks long wait list to see someone who can progress their treatment.

by drgo 1y ago

johnnienaked 1y ago

No it hasn't. Euthanasia is illegal in most countries and almost always has been. Terminal sedation and intentional rising doses of narcotics would be considered ACTUAL murder in 100% of those cases where euthanasia is illegal. If you are a physician and don't know this you should be immediately investigated.

troad 1y ago

> The debate about MAID is another example where a lot of otherwise rational people fall prey to misguided sloganeering. This is the same level of argument as saying that people who vote for the other guys must have been tricked by FOX News / MSNBC / Russia / Tik Tok / transtrenders / tradwives, and if only they truly understood their actual self-interest they would agree with you on all things. It's a bad style of argumentation, albeit very popular in academia ('why do the poor keep voting wrong?'). There are legitimate reasons to oppose Canada's euthanasia program on its own terms, and it's not surprising the Canadian government has very carefully shielded MAID from any sort of public input or oversight, since it's deeply unlikely it would pass a majority vote in its current form. There is consistent public opposition to euthanasia being available to anyone but late-stage terminally-ill people (and even then, it's divisive at best). There is strong public opposition to euthanasia solely on the grounds of mental health. More broadly, I think people are increasingly sick of the misuse of the term 'healthcare' (or 'public health') to sneak unpopular or controversial policies past the electorate, and the idea of 'death as healthcare' is probably the most extreme example of this trend. When people cannot express democratic opposition to policies they deeply oppose, don't be surprised if you get pushback and populism.

greygoo222 1y ago
73% of Canadians support MAID https://pubmed.ncbi.nlm.nih.gov/38910003/ https://pubmed.ncbi.nlm.nih.gov/38910003/ 71% of Americans believe doctors should be "allowed by law to end the patient’s life by some painless means if the patient and his or her family request it" https://news.gallup.com/poll/648215/americans-favor-legal-euthanasia.aspx https://news.gallup.com/poll/648215/americans-favor-legal-eu... These policies are supported by a strong majority of people.
- troad 1y ago
  Literally the abstract of that very study: > Only 12.1% correctly answered ≥4 of 5 knowledge questions about the MAID law; only 19.2% knew terminal illness is not required and 20.2% knew treatment refusal is compatible with eligibility. 73.3% of participants expressed support for the MAID law in general, matching a nationally representative poll that used the same question. 40.4% of respondents supported MAID for mental illnesses. Support for MAID in the scenarios depicting refusal or lack of access to treatment ranged from 23.2% (lack of access in medical condition) to 32.0% (treatment refusal in medical illness) Most Canadians express support for MAID but cannot correctly answer questions about it. When Canadians are actually told what's in MAID, they oppose it. It's also worth noting that quite a lot of polling on this question is done by, or on behalf of, pro-euthanasia organisations; there is often a huge mismatch between the questions asked and the actual legislation proposed and passed (in a very motte-and-bailey kind of way).
  - greygoo222 1y ago
    People stated they supported the policy after reading a full description of the policy. If you don't trust the paper (whose researchers are anti-euthanasia), the Canadian government found the same results. https://researchco.ca/2023/05/05/maid-canada-2023/ https://researchco.ca/2023/05/05/maid-canada-2023/ Nobody ever correctly answers questions about legislation, to put it glibly. Any piece of legislation newer than 10 years and more complex than a sentence is not going to pass such a test with the general public. 19.2% knew that terminal illness is not required? I would be shocked if 19.2% could correctly answer a few basic questions about the definition of "terminal illness."

snapplebobapple 1y ago

I don't think it's that misguided. The incentives are so perverse here that, if the government isn't abusing it, they are acting incompetently. it would almost be better if they just had the actuary provide an expected life and expected cost chart and we agreed to pay the potential MAID recipient's estate 10% of the savings remaining on the day the chose to go, if they choose MAID.

Eddy_Viscosity2 1y ago
How are incentives perverse? Would it be better to have a system that only incentivizes life extension, no matter the suffering it causes, no matter that it will still ultimately end in death?
- snapplebobapple 1y ago
  It's not about whether the person should live or die, it's that the Canadian government has vested responsibility to provide healthcare in itself while making other options illegal. I can't make my own choice to, for example, buy my own medical insurance to ensure I live for as long as possible with the most effective (and likely expensive) treatments. The government has said they got this and limited everyone's choice to government only. They screwed this up via multiple mechanisms, because that's what government seems to do, and now there is a pretty decent shortage of healthcare up here. This makes the incentives highly perverse because the government can't provide the world class health care it promised even if it wanted to, which leads to political pressure to bring in MAID and chop tens to hundreds of thousands of dollars of medical liability off the end of many patient's lives (which I would actually support if the underlying incentive structure was different, or if the government was at least honest about what was happening and compensating the MAID recipient's estates for forgoing treatment the government is obligated to provide but would be better for said government if they didn't). The most concerning bit here is the lack of provision of other life improving services like joint replacement, the latest experimental drugs, etc. and the likelihood that that is funneling people into a situation where MAID is the obvious best choice sooner than it otherwise would be. This is certainly happening with cancer treatments (although probably not intentionally, just incompetently) as people get detections for cancer and then find a months long wait list instead of days to weeks long wait list to see someone who can progress their treatment.