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I agree with this first claim, but I imagine that the "suicidal and paralyzed from the neck down" crowd is pretty small. My arguments so far have not accounted for that one situation, but I think a good rule is "Follow their instructions, even if they request something which will kill them". You cannot really implement this legally, so this should be one of those things which are technically illegal but which everyone pretends that they don't see when they happen.
This is basically the right to give away some of your agency, which could lead to consequences which harm your rights. Tricky situation, but I don't think it's bad from this direction. Having the right to ask somebody to end your life isn't the issue - the issue is that, if we make institutions which can legally end your life, then your environment could systemically pressure you to make this decision.
To give an example, you're not forced to marry anyone. Being able to marry is a freedom you have. But there may be economic benefits to marriage, and this is where the problem starts. Do you know why I'm not an organ donor? It's because it seem that some doctors don't really do their best to save you if you're an organ donor and they're short on whatever organs you have. I haven't looked into it much, but it's not hard to imagine how this incentive might come into being.
This is how it should be. For instance, I could grab a hammer right now, run out of my apartment, and start bashing random people with it. I won't make this choice, but you cannot deprive me of the ability to make it without depriving me of my fundamental human freedom (the ability to use tools, the ability to open my front door, the ability to move my body, and the ability to interact with other people). My neighbour has the same freedom. This is exactly how it should be, every alternative is worse.
I'm alright with temporarily putting suicidal people under watch, since they might be acting on impulse. But if they continue being suicidal for longer periods of time, it becomes apparent that it's their genuine will.
Here's what will happen: Millions of old people will be considered a drain on society and made to kill themselves. There's a million paths leading to this, and number 13215 is "Accidentally give older people medicine which has the side-effect of increased risk of suicide". An AI will A/B test medicine, and then look at the results. Would you look at that, medicine X leads to greener numbers: Lower costs, and less complaints about pains. The reason you don't see: The lower costs are due to less old people remaining alive, and the lowered complaints are because those who suffered the most have died. Another possibility is that they're given medicine which is stronger but accelerates their death, this also leads to less pain, and thus less complains, and it also makes other numbers on the spreadsheet look green in that more deaths mean lower costs. Did you know that "we don't know" how most modern algorithms actually work? It's just a blackbox with an input and output. Well, that's why we won't see that we're just killing old people faster, all our metrics will show "improvements".
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