17 ms·

I Hope My Father Dies Soon

400 points by Garbage 13y ago

Strilanc 13y ago
Related: http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/ http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/ > this is the way many of my patients die. Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented, in a sterile hospital room with someone from a volunteer program who just met them sitting by their bed.
- sbarre 13y ago
  I got half way through that and had to stop reading. I have a very close relative with moderately advanced dementia, and it's heartbreaking to see.. I wish I lived closer, because every time I see her (which is as often as I can afford to make the trip), it's worse and worse.. I don't even want to imagine her getting to that stage..
a8da6b0c91d 13y ago
Physician assisted suicide is a super slippery slope. I'm stunned when thinking people advocate.
- lsdafjklsd 13y ago
  go on...
- pstuart 13y ago
  Life is a slippery slope. We need to deal with death like grownups. To address your fears, we should have simple, straightforward protocols for how this would work.
  - a8da6b0c91d 13y ago
    I would say exactly the opposite. To the extent euthanasia might be called for we need unspoken nod and furtive protocols. Explicitly legitimized murder by doctors is a horrible idea.
    - ohashi 13y ago
      Why?
    - moocowduckquack 13y ago
      we need unspoken nod and furtive protocols. That pretty much guarantees the twisted version where the kids kill off grandma for the house.
    - unfamiliar 13y ago
      You're not really giving any reasons why you oppose it. I am for it because it would greatly reduce suffering.
- marquis 13y ago
  It works very well in countries such as the Netherlands, I've seen that first hand in cancer cases. It is the most dignified thing to do for a thinking person. Do you have examples where a large percentage of the cases are obvious malpractice? I have long planned that I will do everything in my power not to stay on life support, and recommend you do the same for the sake of your family and your sanity.
  - a8da6b0c91d 13y ago
    > not to stay on life support Ceasing or preventing disproportionate medical measures is a very different thing than decisively murdering somebody. To my understanding, living wills already allow the former.
    - marquis 13y ago
      >decisively murdering somebody Is that what Scott Adams was proposing? I'd think you'd be hardpressed to find someone who is interested in decisive murder. Edit: lostlogin - you're right. Those horrors exist. I'm not from the U.S. so I forget that such medieval concepts are still in practice. Again, the great irony - the right to die is not allowed but can be forced on you.
      - lostlogin 13y ago
        The US. Drones and the death penalty are what I have in mind. And neither of those are going away soon. Not that many countries are any better, we just don't have the money to keep up.
  - ars 13y ago
    > not to stay on life support It's not such a simple decision. I know someone who was on life support and minimally conscious and recovered from there to more or less normal health. It would be better to specify something like: no life support provided there is also no cognitive ability for 2 months. That gives at least a chance of recovery.
    - 13y ago
- JshWright 13y ago
  I'm (at least in my own judgement) a 'thinking' person. I'm involved in the medical field (in prehospital emergency medicine). Finally (as it may be relevant), I'm a fairly socially conservative person. I am in favor of physician assisted suicide. I'd be interested to hear your concerns about it.
- GalacticDomin8r 13y ago
  > I'm stunned when thinking people advocate. So you come out swinging with a combined ad hominem and argument from incredulity. Brilliant!
  - kordless 13y ago
    Pointing it out with a logically equivalent blaming statement probably isn't going to help. It would be better to suggest an alternate wording: "People who are capable of higher level thinking and who are directly affected by a given issue may want to carefully consider whether or not advocating for a given solution will bring an overall positive impact to the issue. I'm surprised Scott Adams is wishing harm on others while at the same time appears to be ignoring the complex issues related to the government sanctioning assisted suicide." Clearly Adams is grieving. From experience, having a parent suffer sucks. Losing a parent is even worse. Suicide is a complex issue and I respect the fact others consider how difficult it can be to legislate it properly. Edit: clarified the 'assisted' portion of the argument.
    - GalacticDomin8r 13y ago
      > Pointing it out with a logically equivalent blaming statement probably isn't going to help. It wasn't meant to help the OP. I have no belief a logical and reasoned conversation could occur there. It was meant to help those reading it determine what methods were used. It does help those unfamiliar with structured reason and Socratic thought principles. > It would be better to suggest an alternate wording: I completely reject your alternate wording. Make it your own, not mine.
  - Daniel_Newby 13y ago
    We're talking about the same government that hands out death-by-protracted-torture penalties in the War on Drugs. "Are you insane?" is a logical, rational counterargument to the question of whether that government should be inferring a person's death wish. It is not even a slippery slope for an American assisted suicide law to kill someone with a heroin overdose for having a hopeless life owing to them being trapped in permanent solitary confinement owing to conviction on heroin possession.
- stickhandle 13y ago
  Really? This is probably the most common anti position ... and its effectively a filibuster. I have absolutely no doubt that we can properly define the conditions for medical assisted suicide (as other nations have done). Lastly, on a more personal note -- it is clear that anyone with the "slippery slope" argument has never lost a loved one to a protracted decline into the inevitable dirt sleep.
- COMS 13y ago
  As my critical thinking book says, most people walk carefully on ice.
- venomsnake 13y ago
  Indeed. And the mother of friend of mine had to search for her own slippery slope so she could fall out of a window to end her life to end the constant pain of the tumors in her bones. I had the relatively good luck of having my parents die quick and clean death - but still there were traumas that needed years to heal. My father spend in vegetative state only 48 hours - and the load was unbearable. Having to live with that for months or years - I am sure that no person would like to cause that to their children and relatives. Ending the suffering soon is good for the patient, but is even better for the ones they loved. I don't want to burden anyone when my time comes and I insist on the right of going away the way I want to and not the way fate decides.
- haldujai 13y ago
  To expand on this. How do you decide when it is appropriate for euthanasia? Is it only for terminal patients? Patients with chronic incurable diseases? What about people with Huntington's and are otherwise healthy? Are depressed people who can't bring themselves to commit suicide afforded access to physician assisted suicide? If a demented patient had previously requested not to be killed earlier, but now in their demented state the family, who are now responsible for all medical decisions, request it. What do we do?
  - marquis 13y ago
    Base it on a system that is already working: http://www.patientsrightscouncil.org/site/holland-background/ http://www.patientsrightscouncil.org/site/holland-background... EDIT: oh dear, I did not read the rest of this article. It is actually vehemently opposed to Euthanasia and quite interesting (though very biased). "The study found that, in spite of the fact that medical care is provided to everyone in Holland, palliative care (comfort care) programs, with adequate pain control techniques and knowledge, were poorly developed" That is ridiculous. I spent hours with a friend recently receiving the most extraordinary palliative care, in his own home, before deciding to euthanize (fortunately he died the day earlier).
  - darkarmani 13y ago
    How do you decide when it is appropriate for the police to use lethal force? I think you've fallen into the trap that the world should only implement perfect solutions.
- duaneb 13y ago
  Slippery slope into what—mass suicide cults? This is a completely vacuous "argument".
- IvyMike 13y ago
  > super slippery slope In countries where it is practiced, the slope appears to have a sufficient coefficient of friction.
- darkarmani 13y ago
  > Physician assisted suicide is a super slippery slope This has been disproven by the countries that have implemented it and not "slipped...unless you have some evidence of it being slippery?
  - eitland 13y ago
    Well, abortion is a similar example. Where I live abortion has been allowed since I don't know when. Doctors have been able to opt out from assisting. This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license. So, there is your slippery slope I guess.
    - darkarmani 13y ago
      > This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license. That's a terrible example of a slippery slope. It sounds like the slope is so not-slippery that the best they could do was make a lot of noise about how things should be. If the slope was slippery, shouldn't they have easily passed a bill with very little friction?
- girvo 13y ago
  I disagree entirely with you. That comes from an emotional place though as I had to watch my amazing grandmother die a slow painful death of suffocation for nearly three years. She begged to die, but we could do nothing. My grandfather (who was with her for over 50 years) confided to me that he considered quite heavily granting her wish, but the threat of legal persecution meant he couldn't. At least she got to be at home for those years, and when she finally passed, it was over quickly.
- unethical_ban 13y ago
  It is something that should be monitored and have strict conditions on the age of the patient, maladies suffered, level of consciousness, and time spent attempting to cure. That said, it should be weighed the morality of keeping a thousand people alive to die slowly and painfully so that one person might not get put down before their time.
rickdale 13y ago
My father was murdered about 10 years ago and really the only solace in the situation is that he was pretty sick at the time and would have suffered through the rest of his life and he was only 47 at the time. My mom has repeatedly told me she has no desire to get to an elderly age, like her mother is now. All I know is perspective on this stuff evolves over the years. On another note, the only good thing about people being sick is that you can prepare for their death and thus when they die it can be more of a celebration. The funeral won't be as hard emotionally, and because they were sick, you are comforted by them not suffering any more.
- girvo 13y ago
  I'm sorry for your loss, that's terrible, but at least you can find some peace in it. :(
DanielBMarkham 13y ago
Wow. This touches home with me on many levels. I lost my parents a few years ago. Both suffered. I lost several other close family members who also suffered. And just last week somebody I was close to told me they were dying of cancer. And I'm a libertarian that strongly believes that government should keep its nose out of my life. So, of course, I'm going to play devil's advocate, at least a bit. Because if you can't defend the other side's points well, you shouldn't be in the argument. Here's the thing: physician-assisted suicide is one thing if the doc gives you the pills and you take them on your own. It's something else if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you. Then we're getting into the state telling doctors what types moral views they should hold. Hey, I'm all for you shooting your cat if it's sick. What I'm against is the community all making some collective decision about who's got to go and when, and who has to do the work. That's fucked up. This thing has to be a personal choice among everybody involved: docs, nurses, family, the patient. I could imagine in many cases the patient wants to whack themselves and the family hates the idea. Fine. Then let the guy do it. On his own. Or perhaps the docs have given up hope, but for religious reasons they will never pull the plug. Fine, then let the patient do it. There's a decision to be made, somebody should make it, and the rest of society should butt out -- either from disapproving or forcing everybody else from doing things they don't want to do. It's just as bad to make somebody kill somebody else as it is to make somebody keep somebody else alive in this endless suffering nonsense. The problem here is a search for some universal rules for a very personal thing. I don't see that playing out too well. In many cases, we have elderly losing their minds while family members hope against hope that they recover. What to do then? With the lack of a living will, I think the family members get to decide. That's why we have living wills. I don't like that result, but there it is. (I'd also add that this means the family members should be able to dose up grandma with enough morphine to put her out of her misery -- and I imagine such a thing happens a hell of a lot more than we will ever know. Institutionalizing people and placing all of this in bureaucratic hands is the crux of this problem.) Also Scott, sorry to hear about your dad.
- marquis 13y ago
  >if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you I'd see it working similarly to gay marriage: no bishop or chaplain is forced to marry two people, but it leaves plenty of open-minded officials to help if they want to.
znowi 13y ago
I get the story and am sympathetic to the OP, but a little confused about this line: And while I'm at it, I might want you to die a painful death too. Is he just angry at everyone?
- ohashi 13y ago
  Everyone who has/is voting against doctor assisted suicide was my interpretation.
- kevinbowman 13y ago
  Not everyone; he goes on to say "If you're a politician who has ever voted against doctor-assisted suicide, or you would vote against it in the future ..." and another clarification about citizens who have based a vote on opposing doctor-assisted suicide. I assume the original "might" is because you may or may not fall into one of these categories.
- MetaCosm 13y ago
  Yes. Everyone who supports the pointless dragging out of suffering. His dad went though hellish pain then died on the day that post was made, if you think that is a good thing -- he probably has a bit of a bone to pick with you.
- DanielBMarkham 13y ago
  "Is he just angry at everyone?" He is irrationally distraught, to the point of advocating violence. The reason this piece works (for me) is that everybody is irrationally distraught at this time in their life. So while I get that he wants pain and suffering inflicted on those he views as responsible for his dad's suffering, I could line up a million more people who want to cling onto dear grandpa as long as the old guy has a breath. Everybody is irrational and emotional at this time. That's the nature of the phase of your life that involves burying people you love. And it's the exact reason that others behave in ways he finds abhorrent.
  - n3rdy 13y ago
    Voting is already an act of violence. His father was suffering agony every day because government and its voters decided if anyone in that condition wants to end their life, that the course of action be to put anyone who showed him mercy into a cage or worse.
melling 13y ago
The Singularity is about 30 years out, or so we're led to believe. It takes about 10 years and billions of dollars to create a new drug, and that time and cost is not decreasing. Stories like this are a grim reminder of how much work we really must do. "Fixing" the human body is a really hard problem.
- knome 13y ago
  Yeah, the greatly heralded technocratic revolution will just mean they can keep vegetables alive and the sickly suffering indefinitely. One day we'll have the chance to remain an inert blob of flesh floating in a pool of artificial everythings designed to leech our remaining wealth far longer than anything we can currently imagine. There is good sense in demanding people seek counseling and help if they are depressed and leaning toward self injury. The amorality of forcing the suffering to continue existing without possibility of respite using the former as the excuse is a social problem that no amount of technology will suffice to repair.
- Houshalter 13y ago
  I'm more worried the Singularity will result in everyone dying anyways, or possibly far worse.
- cLeEOGPw 13y ago
  There is no problem at all. Wanting to live forever is just your body's primitive instinct, and you should be intelligent enough to understand that people don't need you, or anyone, being around for longer than you will live already. Just look at the current old people - how they drag the whole progress, the whole society back. Now Imagine what would happen if everyone would be old - stagnation, that's what. Human brain is not evolved enough to keep being fresh for so long. After some time we slow down our learning rate because we have already learned much things. If everyone would live forever we would stay at the exact generation the "singularity" would be invented. People need to die in order for everyone to push things forward.
  - Apocryphon 13y ago
    If clinical immortality was possible, who's to say that mental rejuvenation couldn't be possible, as well? And that people will develop new psychologies as they become immortal?
forktheif 13y ago
Maybe he just didn't mention it, but nowhere in that post does it say that it was his father's wish to die if he was in such a situation. Helping someone die who made their wishes clear, I'm perfectly okay with. But assuming someone wants to die, I'm not. Whether his father made it clear or not, I don't know. It just isn't in the post.
- stickhandle 13y ago
  Fair enough to say in "the abstract" ... but in reality, I'm sure Scott was in excellent position to declare his father wouldn't want to continue in that state. Alzheimer's in deep manifestations is devastating.
- foobarqux 13y ago
  What about assuming they want to suffer?
- droithomme 13y ago
  I looked for that also and there was no mention. There's no doubt that if that was actually his father's expressed wish he would have featured that prominently in his article. What he does state is: > I'd like to proactively end his suffering and let him go out with some dignity. But my government says I can't make that decision. Neither can his doctors. He also points out early in the article that there are financial considerations: > His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering.
  - VLM 13y ago
    "He also points out early in the article that there are financial considerations: > His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering." Now you understand the reason for opposition to euthanasia. The purpose of government is to keep the rich, rich, and the poor, poor. Emptying his estate into the medical industrial complex is not an incidental side effect, but the sole purpose of its existence. You want to see pet (dog/cat) vet assisted euthanasia made illegal? Implement pet health insurance. Try it and see.
GalacticDomin8r 13y ago
Frontline had a nice piece on this issue a couple years ago called The Suicide Tourist: http://www.pbs.org/wgbh/pages/frontline/suicidetourist/ http://www.pbs.org/wgbh/pages/frontline/suicidetourist/
JshWright 13y ago
As broken as our system is (and Scott's obvious pain should make it clear that it _is_ broken), there are things you can do to make it suck just a little less. Please talk to your family and your doctor about your wishes in terms of life-sustaining care. Even in your 20's, in perfect health, please take some time to become informed about what the options are and how you can express what you want done or not done (this may be a DNR, a MOLST, a living will, or any of a myriad of other options depending on where you live). If the decision you come to is anything short of "do absolutely everything possible to prolong my life" then be sure to have that paperwork in a safe and readily accessible place (and let your family members know where it is).
- MetaCosm 13y ago
  Also, the more extreme it is, the more you need a lawyer to verify it will hold up. For example, denial of food and water is considered "extreme", if you want that in your paperwork... have a lawyer do a double check.
- jlgaddis 13y ago
  Recently, I dated a nurse who worked on the cardiac floor of the hospital. She had patients who died every day. One day, the subject of DNRs came up. Interestingly, she mentioned that "they're meaningless". When I asked her about it, she said that if, for example, I had a DNR but an immediately family member told them to "save me", they would disregard the DNR and do it. The reasoning, she told me, was that regardless of what they did (save you versus letting you die) there was a chance of a lawsuit and that the hospital would rather be sued for saving your life. (I'm sure it isn't this way everywhere.)
  - JshWright 13y ago
    I'm in a similar position on a fairly regular basis, and I can tall you that DNRs absolutely do matter. It would take the threat of physical violence to get me to perform ACLS on someone with a valid DNR (this is in a prehospital EMS setting). A DNR represents the expressed wishes of the patient. Disregarding that is a serious breach of medical this. I'm not sure how often she came across that particular dilemma. As a nurse in an ICU she would have limited decision making authority when it comes to initiating and continuing things like ACLS[1]. That's a doctor's call. I will say that in my experience as a prehospital EMS provider, I absolutely honor the wishes of the patient (as expressed in a DNR) over the demands of the family. In fact, in my experience, the issue that arises is exactly the opposite. The family doesn't want CPR, etc, and states the patient has a DNR, but they're unable to produce it (hence my original post). In the absence of a valid DNR, I have to assume the person _does_ want all resuscitation measures attempted. [1] http://en.wikipedia.org/wiki/Advanced_cardiac_life_support http://en.wikipedia.org/wiki/Advanced_cardiac_life_support
avar 13y ago
No matter what you think about assisted suicide I'd highly recommend Terry Pratchett's (of Discworld fame) documentary about it: https://www.youtube.com/watch?v=slZnfC-V1SY https://www.youtube.com/watch?v=slZnfC-V1SY He's got Alzheimer's and documented his personal tour of looking into his end of life options.
snez 13y ago
Although I'm on the author's side, things like http://www.independent.co.uk/news/uk/home-news/alzheimers-treatment-breakthrough-british-scientists-pave-way-for-simple-pill-to-cure-disease-8869716.html http://www.independent.co.uk/news/uk/home-news/alzheimers-tr... make me think twice on whether I'm right or wrong.
- dsego 13y ago
  Miracle cures are announced all the time. Cancer-patients in their terminal phase usually get told that a new ground-breaking drug is right around the corner.
- acdha 13y ago
  1. Wait until something ships before thinking it's changed anything. Medicine is littered with would-be wonder drugs which turned out to have critical shortcomings — if these were easy problems, they'd already be done by now. 2. In many cases, new treatments don't help outside of the early stages — in the story you linked, the description suggests that the treatment wouldn't help someone who's already in an advanced stage of the disease. Great for the future, perhaps, but cold comfort to when someone is already past the point of permanent damage.
vezzy-fnord 13y ago
Since this concerns the U.S. government, I'll say that the vendetta against euthanasia and doctor-assisted suicide by the Christian right is puzzling. The Bible has a very ambivalent view on suicide (as with any other topic), the tale of Samson being a prime example. The main argument against suicide comes from Corinthians, but it is starkly contradicted by other passages. A person who is slowly succumbing, immobile, on the brink of death and suffering has nothing to offer or worthwhile to live for. Their life is effectively over and they're simply waiting for the moment their biological functions will at last cease. Yet the Christian right insists that the agony be prolonged to a maximum. The religion is notably fascinated with martyrdom, asceticism and persecution complexes. But that suffering has no purpose in overcoming tribulation when you're a near-lifeless bag of meat. Then, of course, very few Christians actually ascribe to the ascetic life as laid down in their scripture. Sorry for your loss.
- JshWright 13y ago
  I realize it's our own doing, but there is nothing 'right' (or 'left') about Christianity. That being said... your post is completely accurate (in my experience), and speaking as a Christian, that infuriates me (likely even more than it does you...)
  - lostlogin 13y ago
    In a 2 party system it pretty much is right or left. As a foreigner I'd argue that its far right and right though.
    - Samuel_Michon 13y ago
      > I'd argue that its far right and right Amein, that is my view as well. I was born in the Netherlands but have lived in the US for 8 years and I still spend 3 months out of the year there. My opinion is that US voters don’t really have choices. It’s right or far right. There are some fringe parties (like various socialist and green parties) but there’s no chance they’ll gain any power. In both the democratic party and the GOP there are conservatives and progressives, but it seems to me that the conservatives always win out. As a member of Left Turn and the League of Young Voters, I volunteer to register people to vote. I know it’s not enough, but I don’t know what else to do.
dsego 13y ago
I suggest watching Terry Pratchett's thought-provoking and humbling documentary Choosing To Die (http://www.youtube.com/watch?v=slZnfC-V1SY http://www.youtube.com/watch?v=slZnfC-V1SY). It covers the topic of assisted suicide and towards the end of the film we can witness a man ending his life in a Swiss clinic. It is also a very personal subject for Terry, as he was diagnosed with Alzheimer's and is afraid to live without being able to use his mind and write books.
stickhandle 13y ago
Please HN don't disappoint me with "slippery slope" and "it's too complicated" arguments. I want to continue to believe the level of discourse here is better than that. Its not just do-able ... doctor-assisted suicide is right.
- eitland 13y ago
  Yes, because slippery slopes doesn't exist. Or because we should not discuss the implications of a possible slippery slope? Note I'm not telling you what is right or wrong but I insist on the right to discuss relevant issues, in ethnic as well as in technical questions.
  - stickhandle 13y ago
    Slippery slopes certainly exist. However, the use of "slippery slopes" as a counterpoint is not useful. In fact, its harmful as it is posed as an end to the argument. We can certainly all agree its a complicated issue that requires a complicated solution, but our discourse should be on the solution, not simply stopping calling it slippery.
- alan_cx 13y ago
  Ooooooh, this really makes me angry.............. How dare you? Those two arguments are very valid and absolutely need to be included in any serious discussion about this. Just because you so arrogantly dismiss them, does not mean that other people wont, worse still cant have those concerns. To suggest that mentioning these two issues means one is not "better than that", what ever you mean by that but clearly it is intended to put down and dismiss any one who is concerned about them, is frankly vile. You have loaded your statements outrageously.Especially in such a fundamental question of life, where people will be at their most vulnerable. Essentially you are saying that unless people agree with you, they are some how stupid. Worse still, the idea that some how doctors are so special that they can be wholly trusted alone with this is insane. Heh, here in the UK, one of our most frighting and notorious serial killers was a family GP. Oh, and one of the London bombers was also a doctor. Doctors are a flawed as the rest of us. BTW, I fully support the idea that in some cases ending life humanely is the best thing to do. I would want such for me, and any one else who wants it. I too think that is right. However, with such a serious fundamental issue like this, we almost have to be guided by the serious concerns people have first. We must get people who are deeply worried by the implications to also go along with any solution. Its like drilling for oil with the consent of environmentalists. We need solution that satisfies all, or all we will have is a god almighty mess. We much not have such a mess when it comes down to legally killing people. I can accept people being divided on war, welfare, economics, which programming language is best, etc, etc, fine. But the sanctity of life is a little more important than that. Its too fundamental to humanity. Its about how we regard life it's self. This is one debate no one gets to lay down the rules on. (Deep breaths............ calm.............hmmmmmmmmm happy place......)
everettkhurst 13y ago
While it is illegal for Scott to kill his father, or allow the doctors to kill his father, it is not illegal for his father to engage in highly dangerous behavior. If this were my dad, I would leave him alone in a house with lots of clearly marked poisons, and warn him explicitly not to drink any of them because I absolutely do not want him to drink any of them, and then I would go for a really long walk. It would be a shame if I were to come home and find that he had accidentally taken a drink of poison instead of his beer. A shame.
badman_ting 13y ago
Sorry, but I am getting really tired of this form of discourse. A million interests prevent you from doing a million things every day, but apparently it's only objectionable and worth remarking about when it's the government. And it's not even like I disagree with him -- yes we should allow assisted suicide. But boy oh boy is it hard not to notice that he wastes no time thinking about why things are this way, or which interests specifically may be preventing things from changing. Nope, it's just THE GOVERNMENT. Short circuit, do not pass go, no further critical thinking necessary. "The Nanny State Didn't Show Up, You Hired It" http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt_show_up.html http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt...
- mturmon 13y ago
  I agree with you. The post highlights a problem, but tantrum-like blaming of "the government" is counterproductive. There are a lot of interests (some legitimate, some not) and gotcha's (it's no accident that "they killed her for the inheritance" is a staple), and inertia (people don't seem to like to rally around assisted suicide as a cause).
- rodgerd 13y ago
  If he wants to blames someone, he'd to better to blame usually religious-based lobby groups. But that wouldn't fit into his usual narratives, so I guess the government it is.
  - burntsushi 13y ago
    Religious based lobby groups don't force politicians to create and enforce particular laws. Politicians do it voluntarily.
    - kabdib 13y ago
      They do it for votes and contributions. They do it for hire. I guess that it is also voluntary, but only in the sense that if they don't do it, they don't paid. [I know, politicians are salaried, too. Let's make a distinction...]
FrankenPC 13y ago
Any form of suffering on the helpless scale is especially painful. There's something hellish about helplessness that can't be described, you just have to experience it. Anyone who goes through months or years of helplessness without committing suicide is a warrior. The particularly insidious part of this kind of trauma is the intense PTSD that is the result of this mental torture. Reading the S.Adams blog entry, you can just see the PTSD dripping off every word. I feel for him. I feel for anyone who has gone through this because there is no justice at the end of the bullst rainbow that the Christians describe.
spacecowboy 13y ago
So sorry to hear about the current situation, found myself filled with a lot of emotion as I read through it. Reminds me of a talk I had with a good friend of mine where we basically acknowledged that we're not afraid to die but that we're more afraid of the dying process.
altero 13y ago
Follow the money Today patient has to pay lot of money to be kept alive. Also deciding about death is expensive and this burden would be on government. In a few decades elderly people will be 40% of population. Government will probably have to pay bills for most of them. Only then will this become norm, but in really hideous way.
- burntsushi 13y ago
  > Also deciding about death is expensive and this burden would be on government. Why? The burden should be on the person.
IanDrake 13y ago
Reminds me of a good C.S. Lewis quote: Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.
- JshWright 13y ago
  C.S. Lewis had a lot to say that is germane to this conversation. The pain so clearly reflected in Adams' words reminded me quite clearly of A Grief Observed.
- loup-vaillant 13y ago
  Note that this quote only apply to human tyrants. As a Christian apologist, I'm sure C.S. Lewis didn't object to the benevolent tyranny of God. (I would, but I too have my own exception: Friendly AI).
  - olefoo 13y ago
    And where does your "friendly-AI" draw it's moral template from? I mean, I'm OK with an AI that works tirelessly in the background keeping the air clean and the habitat habitable. However I don't want a computer, no matter how smart; telling me what I and consenting partners choose to do. Or deciding whether or not we must or can use birth control. Or any of a thousand other forms of infringing on human agency.
    - FBT 13y ago
      You raise good points. In fact, that is the very problem of so-called "Friendly" AI. Note the capital F. It's a confusing term, I know, but the basic idea is an AI that "does what we want", in the most general sense. The idea behind FAi is the exact idea you present here. The point is that it is a bad idea to just throw together an AI and hope that it is friendly (lower case f), but rather the big important problem of our time is to generate a mathematical model of Friendliness, so that we can explicitly define to the AI how we don't want all the bad things you mentioned or any other besides. [Edit] Here are some relevant links: http://intelligence.org/files/CEV.pdf http://intelligence.org/files/CEV.pdf http://commonsenseatheism.com/?p=14047 http://commonsenseatheism.com/?p=14047 http://www.acceleratingfuture.com/michael/blog/2009/08/a-nice-and-meaty-introduction-to-friendly-ai/ http://www.acceleratingfuture.com/michael/blog/2009/08/a-nic...
tunap 13y ago
They should have pinned a medal on him, instead they threw him in jail. Thanks for trying, Jack. https://en.wikipedia.org/wiki/Kavorkian https://en.wikipedia.org/wiki/Kavorkian
jl6 13y ago
I don't wish to minimise his situation but it seems like he considers his father's suffering not quite as bad as his own suffering were he just to do the killing himself and take the jail sentence.
- Houshalter 13y ago
  That's a good point actually. Especially if you could do it with low risk of being caught/convicted. Which should be possible with someone who is dying anyways and you have full access to them in the hospital and could just slip some poison or something into them. I don't blame the author for not doing that though. Maybe it didn't even occur to him. But it's a good point that if you truly thought it was so terrible you should want to try to stop it even if it's illegal.
  - PavlovsCat 13y ago
    But there is also the risk of inflicting even more suffering. Even killing (instead of, say, crippling) oneself with all the time and resources in the world to do it is not an easy task; but killing someone you love, without inflicting even more pain and without getting caught, in a hospital of all places, now that seems near impossible for a layperson.
    - Houshalter 13y ago
      Depends on the method of killing. And even a painful one is still probably preferable than long drawn out suffering. I assumed the poisoning would be easy and doctors wouldn't look for it but that may not be trivial. But if you actually cared it would be worth a few hours of research at the very least.
  - unethical_ban 13y ago
    Doctors can tell when someone has been suffocated or poisoned.
- billmalarky 13y ago
  Scott wants what he believes his father wants (since his father can no longer make decisions Scott must decide in a way he believes his father would want him to decide for him) and is best for his father. To kill his own father and risk prison (not to mention the devastation it would cause to Scott's immediate family) is simply not an option. What kind of man would want his own son to risk life in prison in order to end their own suffering?
ahi 13y ago
Fortunately, doctors can still fiddle around the edges. My 96 year old grandmother went into the hospital last Thursday. After some tests it was concluded she would have a couple more months with rehab or maybe a couple weeks without. We decided to just have her loaded up with morphine and she passed on Sunday surrounded by her children. The morphine didn't kill her, her heart was mush, but it likely knocked some time and suffering off the end. It's unfortunate that we dont all get to die so gracefully. I dont forsee euthanasia ever being legal in the US given the absurd response to medicare requiring just basic end of life planning with a doctor.
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fernly 13y ago
Very important: by law in most states, you can control the conditions of your end of life care. State laws vary but if you are in California, this[0] is the form you print out, fill out, have notarized, and give copies of to your regular physician and the person(s) holding your medical power of attorney. Every person should do this, because without this clear and legally binding statement of your wishes, medical people are compelled to do everything possible to preserve your life. Part 1 establishes who can act for you when you can't act for yourself (i.e. in a coma). Unless you are legally married or a minor (when your spouse or parent can act), nobody can intervene to make medical choices for you. Under privacy laws, nobody can even ask about your condition. So your live-in lover or best friend is helpless to change how you are cared for -- unless they are named in a document like this one. Part 2 expresses your wishes on how you want to be cared for at end of life. If Scott Adams's father had filled out this form and checked 2.1(b), none of that tragedy would have happened! And you can add more conditions. On my form, for example, I specified that if I was unable to read, to watch TV, or listen to audio with comprehension, and had no reasonable prospect of regaining those abilities, my life was over and I wanted to refuse all medical interventions except pain management. My idea being, to die quickly of pneumonia is nearly as good as assisted suicide. However you fill it out, do fill it out, and encourage your loved ones to do so as well. A stroke or fall or collision can wipe out your consciousness at any age, and this form relieves your survivors of a lot of horrible choices. [0] http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCareDirectiveForm-fillable.pdf http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCare... (PDF)
hrjet 13y ago
To avoid the slippery slope, couldn't there be a jury system that could decide the genuineness and applicability of a case of euthanasia? Leaving it only in the hands of a single person, be it the patient, or doctor or relative is bound to attract criticism. But if a jury can sentence one to a life-sentence in a crime case, they could arguably be trusted to deal a similar sentence for someone terminally ill.
eip 13y ago
Breathing pure nitrogen is a quick and painless way to die.
- srean 13y ago
  Indeed and I wish this was closer to the top than here at the bottom.
lmg643 13y ago
i am wondering if i am the only person who read this, who felt the piece was a very strange way to consecrate his father's passing. "i wish i could have put him down like a cat, and if you disagree with me, i hope you die a horrible death." there is a good case for euthanasia, and there is a case against it, it just seems inappropriate to approach a dialogue with this piece as a starting point. in the end, i'm sorry he lost his father in a painful and ugly way and felt captive to a hospital. the end of life situations in my family were also pretty gnarly but involved hospice care. i'd love to know the circumstances here, and how the situation could have been improved. but you'll never win over your opponents starting from a place like this.
- dxm 13y ago
  I lost my grandfather (father really, he raised me) and I felt the same way, I signed his DNR and if nobody was looking, I would have turned off all measures to keep him stable myself. Watching somebody you love pass is entirely heartbreaking, it's satisfying to see them cross the line into the unthinking. If I had the talent of Scott Adams, the words I would have emitted would have been similar.
- x0x0 13y ago
  look, when your opponents are the sick pieces of human shit who exploited Terri Schiavo, there is no common ground to be had. Republicans like people to die as painfully as humanly possible, and the medical industry will cooperate. My experience was my father dying from cancer. There was no question he was going to die, and the only remaining questions where how soon -- tomorrow or in a month or two -- and how painfully.
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bashcoder 13y ago
I if ever become so weak as a man that I would vote someone else's conscience instead of my own, then on that day, Mr. Adams, be my guest: Kill me.

400 points by Garbage 13y ago

Related: http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/ http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/ > this is the way many of my patients die. Old, limbless, bedridden, ulcerated, in a puddle of waste, gasping for breath, loopy on morphine, hopelessly demented, in a sterile hospital room with someone from a volunteer program who just met them sitting by their bed.

sbarre 13y ago
I got half way through that and had to stop reading. I have a very close relative with moderately advanced dementia, and it's heartbreaking to see.. I wish I lived closer, because every time I see her (which is as often as I can afford to make the trip), it's worse and worse.. I don't even want to imagine her getting to that stage..

a8da6b0c91d 13y ago

Physician assisted suicide is a super slippery slope. I'm stunned when thinking people advocate.

lsdafjklsd 13y ago
go on...
pstuart 13y ago
Life is a slippery slope. We need to deal with death like grownups. To address your fears, we should have simple, straightforward protocols for how this would work.
- a8da6b0c91d 13y ago
  I would say exactly the opposite. To the extent euthanasia might be called for we need unspoken nod and furtive protocols. Explicitly legitimized murder by doctors is a horrible idea.
  - ohashi 13y ago
    Why?
  - moocowduckquack 13y ago
    we need unspoken nod and furtive protocols. That pretty much guarantees the twisted version where the kids kill off grandma for the house.
  - unfamiliar 13y ago
    You're not really giving any reasons why you oppose it. I am for it because it would greatly reduce suffering.
marquis 13y ago
It works very well in countries such as the Netherlands, I've seen that first hand in cancer cases. It is the most dignified thing to do for a thinking person. Do you have examples where a large percentage of the cases are obvious malpractice? I have long planned that I will do everything in my power not to stay on life support, and recommend you do the same for the sake of your family and your sanity.
- a8da6b0c91d 13y ago
  > not to stay on life support Ceasing or preventing disproportionate medical measures is a very different thing than decisively murdering somebody. To my understanding, living wills already allow the former.
  - marquis 13y ago
    >decisively murdering somebody Is that what Scott Adams was proposing? I'd think you'd be hardpressed to find someone who is interested in decisive murder. Edit: lostlogin - you're right. Those horrors exist. I'm not from the U.S. so I forget that such medieval concepts are still in practice. Again, the great irony - the right to die is not allowed but can be forced on you.
    - lostlogin 13y ago
      The US. Drones and the death penalty are what I have in mind. And neither of those are going away soon. Not that many countries are any better, we just don't have the money to keep up.
- ars 13y ago
  > not to stay on life support It's not such a simple decision. I know someone who was on life support and minimally conscious and recovered from there to more or less normal health. It would be better to specify something like: no life support provided there is also no cognitive ability for 2 months. That gives at least a chance of recovery.
  - 13y ago
JshWright 13y ago
I'm (at least in my own judgement) a 'thinking' person. I'm involved in the medical field (in prehospital emergency medicine). Finally (as it may be relevant), I'm a fairly socially conservative person. I am in favor of physician assisted suicide. I'd be interested to hear your concerns about it.
GalacticDomin8r 13y ago
> I'm stunned when thinking people advocate. So you come out swinging with a combined ad hominem and argument from incredulity. Brilliant!
- kordless 13y ago
  Pointing it out with a logically equivalent blaming statement probably isn't going to help. It would be better to suggest an alternate wording: "People who are capable of higher level thinking and who are directly affected by a given issue may want to carefully consider whether or not advocating for a given solution will bring an overall positive impact to the issue. I'm surprised Scott Adams is wishing harm on others while at the same time appears to be ignoring the complex issues related to the government sanctioning assisted suicide." Clearly Adams is grieving. From experience, having a parent suffer sucks. Losing a parent is even worse. Suicide is a complex issue and I respect the fact others consider how difficult it can be to legislate it properly. Edit: clarified the 'assisted' portion of the argument.
  - GalacticDomin8r 13y ago
    > Pointing it out with a logically equivalent blaming statement probably isn't going to help. It wasn't meant to help the OP. I have no belief a logical and reasoned conversation could occur there. It was meant to help those reading it determine what methods were used. It does help those unfamiliar with structured reason and Socratic thought principles. > It would be better to suggest an alternate wording: I completely reject your alternate wording. Make it your own, not mine.
- Daniel_Newby 13y ago
  We're talking about the same government that hands out death-by-protracted-torture penalties in the War on Drugs. "Are you insane?" is a logical, rational counterargument to the question of whether that government should be inferring a person's death wish. It is not even a slippery slope for an American assisted suicide law to kill someone with a heroin overdose for having a hopeless life owing to them being trapped in permanent solitary confinement owing to conviction on heroin possession.
stickhandle 13y ago
Really? This is probably the most common anti position ... and its effectively a filibuster. I have absolutely no doubt that we can properly define the conditions for medical assisted suicide (as other nations have done). Lastly, on a more personal note -- it is clear that anyone with the "slippery slope" argument has never lost a loved one to a protracted decline into the inevitable dirt sleep.
COMS 13y ago
As my critical thinking book says, most people walk carefully on ice.
venomsnake 13y ago
Indeed. And the mother of friend of mine had to search for her own slippery slope so she could fall out of a window to end her life to end the constant pain of the tumors in her bones. I had the relatively good luck of having my parents die quick and clean death - but still there were traumas that needed years to heal. My father spend in vegetative state only 48 hours - and the load was unbearable. Having to live with that for months or years - I am sure that no person would like to cause that to their children and relatives. Ending the suffering soon is good for the patient, but is even better for the ones they loved. I don't want to burden anyone when my time comes and I insist on the right of going away the way I want to and not the way fate decides.
haldujai 13y ago
To expand on this. How do you decide when it is appropriate for euthanasia? Is it only for terminal patients? Patients with chronic incurable diseases? What about people with Huntington's and are otherwise healthy? Are depressed people who can't bring themselves to commit suicide afforded access to physician assisted suicide? If a demented patient had previously requested not to be killed earlier, but now in their demented state the family, who are now responsible for all medical decisions, request it. What do we do?
- marquis 13y ago
  Base it on a system that is already working: http://www.patientsrightscouncil.org/site/holland-background/ http://www.patientsrightscouncil.org/site/holland-background... EDIT: oh dear, I did not read the rest of this article. It is actually vehemently opposed to Euthanasia and quite interesting (though very biased). "The study found that, in spite of the fact that medical care is provided to everyone in Holland, palliative care (comfort care) programs, with adequate pain control techniques and knowledge, were poorly developed" That is ridiculous. I spent hours with a friend recently receiving the most extraordinary palliative care, in his own home, before deciding to euthanize (fortunately he died the day earlier).
- darkarmani 13y ago
  How do you decide when it is appropriate for the police to use lethal force? I think you've fallen into the trap that the world should only implement perfect solutions.
duaneb 13y ago
Slippery slope into what—mass suicide cults? This is a completely vacuous "argument".
IvyMike 13y ago
> super slippery slope In countries where it is practiced, the slope appears to have a sufficient coefficient of friction.
darkarmani 13y ago
> Physician assisted suicide is a super slippery slope This has been disproven by the countries that have implemented it and not "slipped...unless you have some evidence of it being slippery?
- eitland 13y ago
  Well, abortion is a similar example. Where I live abortion has been allowed since I don't know when. Doctors have been able to opt out from assisting. This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license. So, there is your slippery slope I guess.
  - darkarmani 13y ago
    > This fall politicians and pro abortion started making noise about how doctors that wouldn't participate should lose their license. That's a terrible example of a slippery slope. It sounds like the slope is so not-slippery that the best they could do was make a lot of noise about how things should be. If the slope was slippery, shouldn't they have easily passed a bill with very little friction?
girvo 13y ago
I disagree entirely with you. That comes from an emotional place though as I had to watch my amazing grandmother die a slow painful death of suffocation for nearly three years. She begged to die, but we could do nothing. My grandfather (who was with her for over 50 years) confided to me that he considered quite heavily granting her wish, but the threat of legal persecution meant he couldn't. At least she got to be at home for those years, and when she finally passed, it was over quickly.
unethical_ban 13y ago
It is something that should be monitored and have strict conditions on the age of the patient, maladies suffered, level of consciousness, and time spent attempting to cure. That said, it should be weighed the morality of keeping a thousand people alive to die slowly and painfully so that one person might not get put down before their time.

rickdale 13y ago

My father was murdered about 10 years ago and really the only solace in the situation is that he was pretty sick at the time and would have suffered through the rest of his life and he was only 47 at the time. My mom has repeatedly told me she has no desire to get to an elderly age, like her mother is now. All I know is perspective on this stuff evolves over the years. On another note, the only good thing about people being sick is that you can prepare for their death and thus when they die it can be more of a celebration. The funeral won't be as hard emotionally, and because they were sick, you are comforted by them not suffering any more.

girvo 13y ago
I'm sorry for your loss, that's terrible, but at least you can find some peace in it. :(

DanielBMarkham 13y ago

Wow. This touches home with me on many levels. I lost my parents a few years ago. Both suffered. I lost several other close family members who also suffered. And just last week somebody I was close to told me they were dying of cancer. And I'm a libertarian that strongly believes that government should keep its nose out of my life. So, of course, I'm going to play devil's advocate, at least a bit. Because if you can't defend the other side's points well, you shouldn't be in the argument. Here's the thing: physician-assisted suicide is one thing if the doc gives you the pills and you take them on your own. It's something else if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you. Then we're getting into the state telling doctors what types moral views they should hold. Hey, I'm all for you shooting your cat if it's sick. What I'm against is the community all making some collective decision about who's got to go and when, and who has to do the work. That's fucked up. This thing has to be a personal choice among everybody involved: docs, nurses, family, the patient. I could imagine in many cases the patient wants to whack themselves and the family hates the idea. Fine. Then let the guy do it. On his own. Or perhaps the docs have given up hope, but for religious reasons they will never pull the plug. Fine, then let the patient do it. There's a decision to be made, somebody should make it, and the rest of society should butt out -- either from disapproving or forcing everybody else from doing things they don't want to do. It's just as bad to make somebody kill somebody else as it is to make somebody keep somebody else alive in this endless suffering nonsense. The problem here is a search for some universal rules for a very personal thing. I don't see that playing out too well. In many cases, we have elderly losing their minds while family members hope against hope that they recover. What to do then? With the lack of a living will, I think the family members get to decide. That's why we have living wills. I don't like that result, but there it is. (I'd also add that this means the family members should be able to dose up grandma with enough morphine to put her out of her misery -- and I imagine such a thing happens a hell of a lot more than we will ever know. Institutionalizing people and placing all of this in bureaucratic hands is the crux of this problem.) Also Scott, sorry to hear about your dad.

marquis 13y ago
>if the state requires doctors to assist you, or the state requires insurance companies to require doctors to assist you I'd see it working similarly to gay marriage: no bishop or chaplain is forced to marry two people, but it leaves plenty of open-minded officials to help if they want to.

znowi 13y ago

I get the story and am sympathetic to the OP, but a little confused about this line: And while I'm at it, I might want you to die a painful death too. Is he just angry at everyone?

ohashi 13y ago
Everyone who has/is voting against doctor assisted suicide was my interpretation.
kevinbowman 13y ago
Not everyone; he goes on to say "If you're a politician who has ever voted against doctor-assisted suicide, or you would vote against it in the future ..." and another clarification about citizens who have based a vote on opposing doctor-assisted suicide. I assume the original "might" is because you may or may not fall into one of these categories.
MetaCosm 13y ago
Yes. Everyone who supports the pointless dragging out of suffering. His dad went though hellish pain then died on the day that post was made, if you think that is a good thing -- he probably has a bit of a bone to pick with you.
DanielBMarkham 13y ago
"Is he just angry at everyone?" He is irrationally distraught, to the point of advocating violence. The reason this piece works (for me) is that everybody is irrationally distraught at this time in their life. So while I get that he wants pain and suffering inflicted on those he views as responsible for his dad's suffering, I could line up a million more people who want to cling onto dear grandpa as long as the old guy has a breath. Everybody is irrational and emotional at this time. That's the nature of the phase of your life that involves burying people you love. And it's the exact reason that others behave in ways he finds abhorrent.
- n3rdy 13y ago
  Voting is already an act of violence. His father was suffering agony every day because government and its voters decided if anyone in that condition wants to end their life, that the course of action be to put anyone who showed him mercy into a cage or worse.

melling 13y ago

The Singularity is about 30 years out, or so we're led to believe. It takes about 10 years and billions of dollars to create a new drug, and that time and cost is not decreasing. Stories like this are a grim reminder of how much work we really must do. "Fixing" the human body is a really hard problem.

knome 13y ago
Yeah, the greatly heralded technocratic revolution will just mean they can keep vegetables alive and the sickly suffering indefinitely. One day we'll have the chance to remain an inert blob of flesh floating in a pool of artificial everythings designed to leech our remaining wealth far longer than anything we can currently imagine. There is good sense in demanding people seek counseling and help if they are depressed and leaning toward self injury. The amorality of forcing the suffering to continue existing without possibility of respite using the former as the excuse is a social problem that no amount of technology will suffice to repair.
Houshalter 13y ago
I'm more worried the Singularity will result in everyone dying anyways, or possibly far worse.
cLeEOGPw 13y ago
There is no problem at all. Wanting to live forever is just your body's primitive instinct, and you should be intelligent enough to understand that people don't need you, or anyone, being around for longer than you will live already. Just look at the current old people - how they drag the whole progress, the whole society back. Now Imagine what would happen if everyone would be old - stagnation, that's what. Human brain is not evolved enough to keep being fresh for so long. After some time we slow down our learning rate because we have already learned much things. If everyone would live forever we would stay at the exact generation the "singularity" would be invented. People need to die in order for everyone to push things forward.
- Apocryphon 13y ago
  If clinical immortality was possible, who's to say that mental rejuvenation couldn't be possible, as well? And that people will develop new psychologies as they become immortal?

forktheif 13y ago

Maybe he just didn't mention it, but nowhere in that post does it say that it was his father's wish to die if he was in such a situation. Helping someone die who made their wishes clear, I'm perfectly okay with. But assuming someone wants to die, I'm not. Whether his father made it clear or not, I don't know. It just isn't in the post.

stickhandle 13y ago
Fair enough to say in "the abstract" ... but in reality, I'm sure Scott was in excellent position to declare his father wouldn't want to continue in that state. Alzheimer's in deep manifestations is devastating.
foobarqux 13y ago
What about assuming they want to suffer?
droithomme 13y ago
I looked for that also and there was no mention. There's no doubt that if that was actually his father's expressed wish he would have featured that prominently in his article. What he does state is: > I'd like to proactively end his suffering and let him go out with some dignity. But my government says I can't make that decision. Neither can his doctors. He also points out early in the article that there are financial considerations: > His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering.
- VLM 13y ago
  "He also points out early in the article that there are financial considerations: > His smallish estate pays about $8,000 per month to keep him in this state of perpetual suffering." Now you understand the reason for opposition to euthanasia. The purpose of government is to keep the rich, rich, and the poor, poor. Emptying his estate into the medical industrial complex is not an incidental side effect, but the sole purpose of its existence. You want to see pet (dog/cat) vet assisted euthanasia made illegal? Implement pet health insurance. Try it and see.

GalacticDomin8r 13y ago

Frontline had a nice piece on this issue a couple years ago called The Suicide Tourist: http://www.pbs.org/wgbh/pages/frontline/suicidetourist/ http://www.pbs.org/wgbh/pages/frontline/suicidetourist/

JshWright 13y ago

As broken as our system is (and Scott's obvious pain should make it clear that it _is_ broken), there are things you can do to make it suck just a little less. Please talk to your family and your doctor about your wishes in terms of life-sustaining care. Even in your 20's, in perfect health, please take some time to become informed about what the options are and how you can express what you want done or not done (this may be a DNR, a MOLST, a living will, or any of a myriad of other options depending on where you live). If the decision you come to is anything short of "do absolutely everything possible to prolong my life" then be sure to have that paperwork in a safe and readily accessible place (and let your family members know where it is).

MetaCosm 13y ago
Also, the more extreme it is, the more you need a lawyer to verify it will hold up. For example, denial of food and water is considered "extreme", if you want that in your paperwork... have a lawyer do a double check.
jlgaddis 13y ago
Recently, I dated a nurse who worked on the cardiac floor of the hospital. She had patients who died every day. One day, the subject of DNRs came up. Interestingly, she mentioned that "they're meaningless". When I asked her about it, she said that if, for example, I had a DNR but an immediately family member told them to "save me", they would disregard the DNR and do it. The reasoning, she told me, was that regardless of what they did (save you versus letting you die) there was a chance of a lawsuit and that the hospital would rather be sued for saving your life. (I'm sure it isn't this way everywhere.)
- JshWright 13y ago
  I'm in a similar position on a fairly regular basis, and I can tall you that DNRs absolutely do matter. It would take the threat of physical violence to get me to perform ACLS on someone with a valid DNR (this is in a prehospital EMS setting). A DNR represents the expressed wishes of the patient. Disregarding that is a serious breach of medical this. I'm not sure how often she came across that particular dilemma. As a nurse in an ICU she would have limited decision making authority when it comes to initiating and continuing things like ACLS[1]. That's a doctor's call. I will say that in my experience as a prehospital EMS provider, I absolutely honor the wishes of the patient (as expressed in a DNR) over the demands of the family. In fact, in my experience, the issue that arises is exactly the opposite. The family doesn't want CPR, etc, and states the patient has a DNR, but they're unable to produce it (hence my original post). In the absence of a valid DNR, I have to assume the person _does_ want all resuscitation measures attempted. [1] http://en.wikipedia.org/wiki/Advanced_cardiac_life_support http://en.wikipedia.org/wiki/Advanced_cardiac_life_support

avar 13y ago

No matter what you think about assisted suicide I'd highly recommend Terry Pratchett's (of Discworld fame) documentary about it: https://www.youtube.com/watch?v=slZnfC-V1SY https://www.youtube.com/watch?v=slZnfC-V1SY He's got Alzheimer's and documented his personal tour of looking into his end of life options.

snez 13y ago

Although I'm on the author's side, things like http://www.independent.co.uk/news/uk/home-news/alzheimers-treatment-breakthrough-british-scientists-pave-way-for-simple-pill-to-cure-disease-8869716.html http://www.independent.co.uk/news/uk/home-news/alzheimers-tr... make me think twice on whether I'm right or wrong.

dsego 13y ago
Miracle cures are announced all the time. Cancer-patients in their terminal phase usually get told that a new ground-breaking drug is right around the corner.
acdha 13y ago
1. Wait until something ships before thinking it's changed anything. Medicine is littered with would-be wonder drugs which turned out to have critical shortcomings — if these were easy problems, they'd already be done by now. 2. In many cases, new treatments don't help outside of the early stages — in the story you linked, the description suggests that the treatment wouldn't help someone who's already in an advanced stage of the disease. Great for the future, perhaps, but cold comfort to when someone is already past the point of permanent damage.

vezzy-fnord 13y ago

Since this concerns the U.S. government, I'll say that the vendetta against euthanasia and doctor-assisted suicide by the Christian right is puzzling. The Bible has a very ambivalent view on suicide (as with any other topic), the tale of Samson being a prime example. The main argument against suicide comes from Corinthians, but it is starkly contradicted by other passages. A person who is slowly succumbing, immobile, on the brink of death and suffering has nothing to offer or worthwhile to live for. Their life is effectively over and they're simply waiting for the moment their biological functions will at last cease. Yet the Christian right insists that the agony be prolonged to a maximum. The religion is notably fascinated with martyrdom, asceticism and persecution complexes. But that suffering has no purpose in overcoming tribulation when you're a near-lifeless bag of meat. Then, of course, very few Christians actually ascribe to the ascetic life as laid down in their scripture. Sorry for your loss.

JshWright 13y ago
I realize it's our own doing, but there is nothing 'right' (or 'left') about Christianity. That being said... your post is completely accurate (in my experience), and speaking as a Christian, that infuriates me (likely even more than it does you...)
- lostlogin 13y ago
  In a 2 party system it pretty much is right or left. As a foreigner I'd argue that its far right and right though.
  - Samuel_Michon 13y ago
    > I'd argue that its far right and right Amein, that is my view as well. I was born in the Netherlands but have lived in the US for 8 years and I still spend 3 months out of the year there. My opinion is that US voters don’t really have choices. It’s right or far right. There are some fringe parties (like various socialist and green parties) but there’s no chance they’ll gain any power. In both the democratic party and the GOP there are conservatives and progressives, but it seems to me that the conservatives always win out. As a member of Left Turn and the League of Young Voters, I volunteer to register people to vote. I know it’s not enough, but I don’t know what else to do.

dsego 13y ago

I suggest watching Terry Pratchett's thought-provoking and humbling documentary Choosing To Die (http://www.youtube.com/watch?v=slZnfC-V1SY http://www.youtube.com/watch?v=slZnfC-V1SY). It covers the topic of assisted suicide and towards the end of the film we can witness a man ending his life in a Swiss clinic. It is also a very personal subject for Terry, as he was diagnosed with Alzheimer's and is afraid to live without being able to use his mind and write books.

stickhandle 13y ago

Please HN don't disappoint me with "slippery slope" and "it's too complicated" arguments. I want to continue to believe the level of discourse here is better than that. Its not just do-able ... doctor-assisted suicide is right.

eitland 13y ago
Yes, because slippery slopes doesn't exist. Or because we should not discuss the implications of a possible slippery slope? Note I'm not telling you what is right or wrong but I insist on the right to discuss relevant issues, in ethnic as well as in technical questions.
- stickhandle 13y ago
  Slippery slopes certainly exist. However, the use of "slippery slopes" as a counterpoint is not useful. In fact, its harmful as it is posed as an end to the argument. We can certainly all agree its a complicated issue that requires a complicated solution, but our discourse should be on the solution, not simply stopping calling it slippery.
alan_cx 13y ago
Ooooooh, this really makes me angry.............. How dare you? Those two arguments are very valid and absolutely need to be included in any serious discussion about this. Just because you so arrogantly dismiss them, does not mean that other people wont, worse still cant have those concerns. To suggest that mentioning these two issues means one is not "better than that", what ever you mean by that but clearly it is intended to put down and dismiss any one who is concerned about them, is frankly vile. You have loaded your statements outrageously.Especially in such a fundamental question of life, where people will be at their most vulnerable. Essentially you are saying that unless people agree with you, they are some how stupid. Worse still, the idea that some how doctors are so special that they can be wholly trusted alone with this is insane. Heh, here in the UK, one of our most frighting and notorious serial killers was a family GP. Oh, and one of the London bombers was also a doctor. Doctors are a flawed as the rest of us. BTW, I fully support the idea that in some cases ending life humanely is the best thing to do. I would want such for me, and any one else who wants it. I too think that is right. However, with such a serious fundamental issue like this, we almost have to be guided by the serious concerns people have first. We must get people who are deeply worried by the implications to also go along with any solution. Its like drilling for oil with the consent of environmentalists. We need solution that satisfies all, or all we will have is a god almighty mess. We much not have such a mess when it comes down to legally killing people. I can accept people being divided on war, welfare, economics, which programming language is best, etc, etc, fine. But the sanctity of life is a little more important than that. Its too fundamental to humanity. Its about how we regard life it's self. This is one debate no one gets to lay down the rules on. (Deep breaths............ calm.............hmmmmmmmmm happy place......)

everettkhurst 13y ago

While it is illegal for Scott to kill his father, or allow the doctors to kill his father, it is not illegal for his father to engage in highly dangerous behavior. If this were my dad, I would leave him alone in a house with lots of clearly marked poisons, and warn him explicitly not to drink any of them because I absolutely do not want him to drink any of them, and then I would go for a really long walk. It would be a shame if I were to come home and find that he had accidentally taken a drink of poison instead of his beer. A shame.

badman_ting 13y ago

Sorry, but I am getting really tired of this form of discourse. A million interests prevent you from doing a million things every day, but apparently it's only objectionable and worth remarking about when it's the government. And it's not even like I disagree with him -- yes we should allow assisted suicide. But boy oh boy is it hard not to notice that he wastes no time thinking about why things are this way, or which interests specifically may be preventing things from changing. Nope, it's just THE GOVERNMENT. Short circuit, do not pass go, no further critical thinking necessary. "The Nanny State Didn't Show Up, You Hired It" http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt_show_up.html http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt...

mturmon 13y ago
I agree with you. The post highlights a problem, but tantrum-like blaming of "the government" is counterproductive. There are a lot of interests (some legitimate, some not) and gotcha's (it's no accident that "they killed her for the inheritance" is a staple), and inertia (people don't seem to like to rally around assisted suicide as a cause).
rodgerd 13y ago
If he wants to blames someone, he'd to better to blame usually religious-based lobby groups. But that wouldn't fit into his usual narratives, so I guess the government it is.
- burntsushi 13y ago
  Religious based lobby groups don't force politicians to create and enforce particular laws. Politicians do it voluntarily.
  - kabdib 13y ago
    They do it for votes and contributions. They do it for hire. I guess that it is also voluntary, but only in the sense that if they don't do it, they don't paid. [I know, politicians are salaried, too. Let's make a distinction...]

FrankenPC 13y ago

Any form of suffering on the helpless scale is especially painful. There's something hellish about helplessness that can't be described, you just have to experience it. Anyone who goes through months or years of helplessness without committing suicide is a warrior. The particularly insidious part of this kind of trauma is the intense PTSD that is the result of this mental torture. Reading the S.Adams blog entry, you can just see the PTSD dripping off every word. I feel for him. I feel for anyone who has gone through this because there is no justice at the end of the bullst rainbow that the Christians describe.

spacecowboy 13y ago

So sorry to hear about the current situation, found myself filled with a lot of emotion as I read through it. Reminds me of a talk I had with a good friend of mine where we basically acknowledged that we're not afraid to die but that we're more afraid of the dying process.

altero 13y ago

Follow the money Today patient has to pay lot of money to be kept alive. Also deciding about death is expensive and this burden would be on government. In a few decades elderly people will be 40% of population. Government will probably have to pay bills for most of them. Only then will this become norm, but in really hideous way.

burntsushi 13y ago
> Also deciding about death is expensive and this burden would be on government. Why? The burden should be on the person.

IanDrake 13y ago

Reminds me of a good C.S. Lewis quote: Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.

JshWright 13y ago
C.S. Lewis had a lot to say that is germane to this conversation. The pain so clearly reflected in Adams' words reminded me quite clearly of A Grief Observed.
loup-vaillant 13y ago
Note that this quote only apply to human tyrants. As a Christian apologist, I'm sure C.S. Lewis didn't object to the benevolent tyranny of God. (I would, but I too have my own exception: Friendly AI).
- olefoo 13y ago
  And where does your "friendly-AI" draw it's moral template from? I mean, I'm OK with an AI that works tirelessly in the background keeping the air clean and the habitat habitable. However I don't want a computer, no matter how smart; telling me what I and consenting partners choose to do. Or deciding whether or not we must or can use birth control. Or any of a thousand other forms of infringing on human agency.
  - FBT 13y ago
    You raise good points. In fact, that is the very problem of so-called "Friendly" AI. Note the capital F. It's a confusing term, I know, but the basic idea is an AI that "does what we want", in the most general sense. The idea behind FAi is the exact idea you present here. The point is that it is a bad idea to just throw together an AI and hope that it is friendly (lower case f), but rather the big important problem of our time is to generate a mathematical model of Friendliness, so that we can explicitly define to the AI how we don't want all the bad things you mentioned or any other besides. [Edit] Here are some relevant links: http://intelligence.org/files/CEV.pdf http://intelligence.org/files/CEV.pdf http://commonsenseatheism.com/?p=14047 http://commonsenseatheism.com/?p=14047 http://www.acceleratingfuture.com/michael/blog/2009/08/a-nice-and-meaty-introduction-to-friendly-ai/ http://www.acceleratingfuture.com/michael/blog/2009/08/a-nic...

tunap 13y ago

They should have pinned a medal on him, instead they threw him in jail. Thanks for trying, Jack. https://en.wikipedia.org/wiki/Kavorkian https://en.wikipedia.org/wiki/Kavorkian

jl6 13y ago

I don't wish to minimise his situation but it seems like he considers his father's suffering not quite as bad as his own suffering were he just to do the killing himself and take the jail sentence.

Houshalter 13y ago
That's a good point actually. Especially if you could do it with low risk of being caught/convicted. Which should be possible with someone who is dying anyways and you have full access to them in the hospital and could just slip some poison or something into them. I don't blame the author for not doing that though. Maybe it didn't even occur to him. But it's a good point that if you truly thought it was so terrible you should want to try to stop it even if it's illegal.
- PavlovsCat 13y ago
  But there is also the risk of inflicting even more suffering. Even killing (instead of, say, crippling) oneself with all the time and resources in the world to do it is not an easy task; but killing someone you love, without inflicting even more pain and without getting caught, in a hospital of all places, now that seems near impossible for a layperson.
  - Houshalter 13y ago
    Depends on the method of killing. And even a painful one is still probably preferable than long drawn out suffering. I assumed the poisoning would be easy and doctors wouldn't look for it but that may not be trivial. But if you actually cared it would be worth a few hours of research at the very least.
- unethical_ban 13y ago
  Doctors can tell when someone has been suffocated or poisoned.
billmalarky 13y ago
Scott wants what he believes his father wants (since his father can no longer make decisions Scott must decide in a way he believes his father would want him to decide for him) and is best for his father. To kill his own father and risk prison (not to mention the devastation it would cause to Scott's immediate family) is simply not an option. What kind of man would want his own son to risk life in prison in order to end their own suffering?

ahi 13y ago

Fortunately, doctors can still fiddle around the edges. My 96 year old grandmother went into the hospital last Thursday. After some tests it was concluded she would have a couple more months with rehab or maybe a couple weeks without. We decided to just have her loaded up with morphine and she passed on Sunday surrounded by her children. The morphine didn't kill her, her heart was mush, but it likely knocked some time and suffering off the end. It's unfortunate that we dont all get to die so gracefully. I dont forsee euthanasia ever being legal in the US given the absurd response to medicare requiring just basic end of life planning with a doctor.

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fernly 13y ago

Very important: by law in most states, you can control the conditions of your end of life care. State laws vary but if you are in California, this[0] is the form you print out, fill out, have notarized, and give copies of to your regular physician and the person(s) holding your medical power of attorney. Every person should do this, because without this clear and legally binding statement of your wishes, medical people are compelled to do everything possible to preserve your life. Part 1 establishes who can act for you when you can't act for yourself (i.e. in a coma). Unless you are legally married or a minor (when your spouse or parent can act), nobody can intervene to make medical choices for you. Under privacy laws, nobody can even ask about your condition. So your live-in lover or best friend is helpless to change how you are cared for -- unless they are named in a document like this one. Part 2 expresses your wishes on how you want to be cared for at end of life. If Scott Adams's father had filled out this form and checked 2.1(b), none of that tragedy would have happened! And you can add more conditions. On my form, for example, I specified that if I was unable to read, to watch TV, or listen to audio with comprehension, and had no reasonable prospect of regaining those abilities, my life was over and I wanted to refuse all medical interventions except pain management. My idea being, to die quickly of pneumonia is nearly as good as assisted suicide. However you fill it out, do fill it out, and encourage your loved ones to do so as well. A stroke or fall or collision can wipe out your consciousness at any age, and this form relieves your survivors of a lot of horrible choices. [0] http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCareDirectiveForm-fillable.pdf http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCare... (PDF)

hrjet 13y ago

To avoid the slippery slope, couldn't there be a jury system that could decide the genuineness and applicability of a case of euthanasia? Leaving it only in the hands of a single person, be it the patient, or doctor or relative is bound to attract criticism. But if a jury can sentence one to a life-sentence in a crime case, they could arguably be trusted to deal a similar sentence for someone terminally ill.

eip 13y ago

Breathing pure nitrogen is a quick and painless way to die.

srean 13y ago
Indeed and I wish this was closer to the top than here at the bottom.

lmg643 13y ago

i am wondering if i am the only person who read this, who felt the piece was a very strange way to consecrate his father's passing. "i wish i could have put him down like a cat, and if you disagree with me, i hope you die a horrible death." there is a good case for euthanasia, and there is a case against it, it just seems inappropriate to approach a dialogue with this piece as a starting point. in the end, i'm sorry he lost his father in a painful and ugly way and felt captive to a hospital. the end of life situations in my family were also pretty gnarly but involved hospice care. i'd love to know the circumstances here, and how the situation could have been improved. but you'll never win over your opponents starting from a place like this.

dxm 13y ago
I lost my grandfather (father really, he raised me) and I felt the same way, I signed his DNR and if nobody was looking, I would have turned off all measures to keep him stable myself. Watching somebody you love pass is entirely heartbreaking, it's satisfying to see them cross the line into the unthinking. If I had the talent of Scott Adams, the words I would have emitted would have been similar.
x0x0 13y ago
look, when your opponents are the sick pieces of human shit who exploited Terri Schiavo, there is no common ground to be had. Republicans like people to die as painfully as humanly possible, and the medical industry will cooperate. My experience was my father dying from cancer. There was no question he was going to die, and the only remaining questions where how soon -- tomorrow or in a month or two -- and how painfully.

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bashcoder 13y ago

I if ever become so weak as a man that I would vote someone else's conscience instead of my own, then on that day, Mr. Adams, be my guest: Kill me.