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I am skeptical of any plan that involves causing large numbers of people to die on the basis that the world would be better off without them. What if it isn't? You would have just caused a bunch of deaths for no reason.
It'd be pretty embarrassing if you wiped out all the heroin addicts, then a few months later someone came out with a new AI-devised wonderdrug that can cure all addictions with a single pill.
Your framing of the problem is wrong.
In a suicide, the fault for the death ultimately lies with the one who pulls the trigger.
Overdose deaths are suicides.
That was their choice to make, and an isolated demand for rigor: if we actually cared about this for human beings more generally, cryopreservation would be a much larger industry.
Philosophy question: to what extent do we as people owe each other to stop suicide attempts? Discuss.
On one hand, we've put up nets and installed phones and nationwide hotlines and circulated narcan. On the other, some Western states have legalized euthanasia for increasingly minor medical issues. To me, the former feels reasonable (although I find OPs argument about narcan to be at least darkly intriguing), and the latter feels like it starts reasonably but quickly slides down the slippery slope. I know some moral codes (Catholicism, for one) are blanket-opposed to aiding suicide.
I'm interested to hear other opinions on where the line should be.
I think euthanasia should be legal. I think there should be quite a lot of oversight of the process, but I'm not against governments doing cost-benefit analyses of who gets care.
By revealed preferences, it's impossible to care infinitely about a given life. If that wasn't the case, then the entire global economic output would be spent on the first kid who showed up with terminal cancer. Not even those who claim that Life Is Priceless act like that's true. The Pope isn't selling his mobile to save one more starving child in Africa. Even the Dalai Lama has personal possessions, and expensive ones.
Once you accept that (and no population on earth could function without doing so) , all that remains is figuring out how much society implicitly or explicitly values life and making it legible. Yes, it sucks. But we're not gods with unlimited resources.
(If you wish to spend your own funds on your care, then I have no objection to you spending as much as you can afford, your money, your choice. But if you're spending my money, through taxes..)
I also think that anyone who can prove they possess capacity (in the medicolegal sense) should have the right to end their lives.
I'd be open to that being a difficult process, you'd need doctors to sign you off as sane and not suffering from a disease that impairs judgement (and can be cured).
No, I avoid tautology by not claiming that just wanting to die is sufficient grounds to be diagnosed with a mental illness and hence lack capacity. I think there are philosophical reasons that are consistent with wanting to die, for reasons other than depression.
(Severe depression that is resistant to all treatment is, IMO, a terminal illness)*
I hold this position despite being severely depressed, with occasional suicidal ideation. I recognize that I don't want to be depressed or suicidal, and want that part of me excised. I'm quite confident I would never act on that (and doctors know how to make it quick, painless, and irreversible), and if my disease somehow overwhelmed my true volition, I would want to be saved.
I think that unless someone has formally applied for a Suicide License, the default presumption should be that something is wrong with them, and they don't actually want it. This allows us to try and save people who jump off bridges or take paracetamol after a bad breakup. I differ from most people in that I would accept people wanting to die for more considered reasons.
Of course, in the Real World, my hands are tied by laws and code of conducts that physicians must agree to if they want to stay out of jail and in their job. But that's my stance on the matter.
*I haven't exhausted all options, far from it. I even expect that we'll have a generalized cure for depression in my lifetime. I still am not comfortable with telling someone with depression so bad life has lost meaning that they must hold out in hopes of a cure, suffering all the way.
But how confident are you that you would never act on that if you had been raised in a society that not only tolerates suicide but excuses and justifies it? In the depths of despair, when the abyss swallows your vision and knowing that doctors could do it quickly, easily and painlessly, then are you confident you would never go through with it?
Quite confident. If my heterodox views are any indication, I'm not someone particularly susceptible to conformity or peer pressure. How many people do you think were born and raised in my circumstances and turned out the way I did? I defy neat classification.
If society was unchanged in terms of medical technology and overall technological progress, but actively encouraged suicide, I still don't think I'd opt for it. I'd demand that every possible treatment be tried first, then possibly ask for a legal document put in place that debarred me from applying for a lengthy period of time, no matter the cause. I'd spend the rest of my life hoping for a cure, and wouldn't give up until I was dying of other causes. If I really wanted to die, I already have more opportunities than I can count (not that the average person doesn't, bridges and busses aren't rare objects).
Do note that I would prefer that even if euthanasia on demand was an option, that there were multiple safe-guards in place to minimize impulse decisions. That would include medical review for reversible causes, counseling with therapists paid a bonus for every patient they talk out of it (to align incentives), and a wait time of a few months. If at any point someone has second thoughts, the wait time gets pushed back another few months.
Hell, keep it a secret under NDA that the first time they put you in the suicide pod, it's actually a drill. If you start screaming and want to be let out, that's when they tell you and swear you to secrecy. Even during the real thing, leave a big red button that would stop the process, if it's a lethal drug, have a bottle of antidote by their side when they're given it.
There was an incredibly poignant video of an elderly francophone lady taking her euthanasia meds for a terminal illness. She was lucid and in absolute control, and speaking till she went to sleep and never woke up. That's what I want the average person who takes this route to look like.
At that point, I'd be content that we're looking at people with incurable illnesses who can't be talked out of their intent. My confidence in an eventual cure for almost all disease isn't so strong that I would demand people hold out for it, that's their choice to make. My choice, at every point in the 10+ years I've been depressed, is to live for a better future.
Those are good measures, although like pusher_robot I would expect them to scope creep a lot. Rules or laws with any ambiguity seem to inevitably fall victim to the death of a thousand cuts. We've already seen euthanasia for a depressed 29 year old in the Netherlands.
But I'm not so worried about patients requesting assisted suicide as I am about the people with access to buses and bridges who suffer in silence and don't have educated medical professionals to help them. It's not really peer pressure, I'm talking more about a society where the emotional valence of suicide is not negative and how that will impact the depressed in general. A world where the water we breathe says 'suicide is an option actually' instead of 'suicide is a tragedy'. I am strong enough in this world to not submit to despair, but I don't know if I would be strong enough in that world. Not when that black dog has me and suicide seems like the only chance for something resembling relief.
It genuinely seems to me that the case you linked to is the system working as intended. I'm 100% serious:
...
She has a point. If you're not familiar with the management of severe depression, then by the time you reach ECT, you've exhausted all the options. I don't know if she tried things along the lines of ketamine or psychedelics, but those don't work for everyone.
She's tried everything, it didn't work, and she's clearly suffering immensely.
This woman, the purported victim, seems entirely lucid and defending the medical establishment that's carrying out her wishes. What more can you possibly ask for? It is clearly not spur of the moment decision, she's engaged with the options that the medical field can offer her.
The only thing that I would (personally) say that strikes me as untrue is that there "there's no hope". I think I have strong reasons to hope got a cure for depression, but that isn't a certainty, and could take decades even for myself.
If someone doesn't have the same degree of confidence in future medicine or a technological singularity, then I think that's acceptable shorthand. Strictly speaking, there's always a possibility that someone might just develop a brain tumor that makes them not depressed (or at least makes them manic), but that's not particularly reliable.
Suicide is always an option, regardless of what the law has to say in that regard. It is also often a tragedy. The two aren't mutually incompatible statements!
In the UK, we have things called living wills or advanced care plans. In your case, since you're afraid that you might make the wrong call during a depressive spiral, in my described world, I would advocate that you draft something along those lines so that any doctor who isn't malevolent (in a manner that breaks the law at that point) would note that you don't you don't want to die, and stymie it then.
Yep that's because while editing my post I seem to have dropped the words that should have followed the linked text. My point was supposed to be that we had previously been assured that assisted suicide would never be used for anything except terminal illness and certainly never for depression, and yet here we are.
It feels like you are deliberately missing the point of my argument. When society is more permissive of something it happens more. Not just in medically approved settings, everywhere. And suicide is already considered less of a tragedy than it used to be. The valence is changing in front of us.
You live in a world where you see doctors all day every day so talking to one is nothing, hell you can do all that shit yourself if you like, but otherwise your buddy will bang it out for you as a favour after work. I live in a world where every fifteen minutes I spend with a doctor costs me $90, I can address one issue and if I bring up another it will cost me another $90 even if the last one only took two minutes to address. I do not go to the doctor unless I have no choice and I am incapacitated. And in my working class social circles I am considered a hypochondriac. I am regularly told that I trust doctors too much. That is the world I live in about half the time, and those people are not going to the doctor to ask him or her to promise not to kill them if they ask. I don't think you or @Throwaway05 understand how shot trust in medicine is amongst the working class. It's kind of terrifying.
Fake edit:
In case this is the point of confusion, I'm not concerned about that, I'm not concerned about me at all, I have the perspective of age now. I am worried about the young adults out there like me when I was a young adult, the undiagnosed schizophrenics (and the undiagnosed bipolars and major depressives) who would never give strangers power of deciding their fate, believe suicide is a personal decision and only hold back because of a sense of wrongness. Those people are going to die in your world before a doctor even knows there is something wrong.
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