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Corvos 6m ago

Yeah, I guess. I hate it. But in particular I feel like I was around for most of this one and so I feel more jerked around by it.

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OliveTapenade 22m ago

That's an interesting, because it is very alien to my intuitions. Is a pleasure more morally worthy if it is more subtle or complex, or takes more intellectual capacity to appreciate? That doesn't seem obvious, to me. That would imply that, for instance, a young child's pleasure at a bowl of ice cream for dessert is among the unworthiest of all pleasures. Or that my pleasure at a fresh breeze on a beautiful day is particularly contemptible. It seems to be that the complexity or subtlety of a pleasure does not reliably correlate with its moral worthiness. There are some very simple, even child-like pleasures that strike me as paradigmatically worthy (a beautiful sunset, a tasty meal, a smile from someone you love), and some very complex pleasures that strike me as worthy (contemplating advanced mathematics, stellar physics), and some that I struggle to rank (meditating on the nature of God, say). Likewise, however, I can think of very simple pleasures that seem obviously unworthy (wireheading is the classic example), as well as complex pleasures that seem unworthy (anything you've ever been tempted to call intellectual masturbation).

When I judge particular pleasures or joys as worthy or unworthy, my intuitions do not seem to clearly correlate with its complexity, or the intelligence required to enjoy it. It seems like other criteria are involved.

More important than that, though, is the question of, regardless of the quality of the pleasure sought, whether pleasure-seeking by itself is sufficient to make a life morally good. Enjoying pleasures is definitionally going to be more pleasant than doing boring office-work, but the defence of office-work would presumably be in terms of its flow-on effects. Office-work, assuming it's a real job and not just make-work, is aimed at in some way serving others or producing something for others - self-gratification is not the goal, as it is with entertainment. Does that make a difference? We might also ask about character formation. Filling in expenses reports may not be as fun as playing your favourite game, but it may have different impacts on one's character.

Ultimately my position is not that pleasure is inherently unworthy or bad to experience, or that humans should not enjoy pleasurable activities, but it is that a life dedicated wholly to seeking pleasures is morally empty and contemptible. It even strikes me as something unlikely to successfully produce great pleasures, in many cases; I tend more to the school of thought that says that pleasures come alongside or as the byproducts of other endeavours, which must be sought for their own sake. I wouldn't want to follow that principle off a cliff - I don't think there's anything wrong with, say, going to see a film because you want to enjoy yourself - but in terms of the overall direction of a person's life, I think it is helpful.

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Capital_Room rather dementor-like 1hr ago

People significantly choose what side they're on by considering the effects of what they believe to be facts beyond subjective self-interest or family ties. They demonstrably spend time researching "the facts" and the "science."

We apparently know very different sorts of people, because that's not my experience with most people IRL, unless by "researching "the facts" and the "science"" you mean watching Fox News.

Most people I know determine their positions on "ethnicity have to contribute to considering the effects of certain economic policies like price controls, or law regarding the environment, or political and institutional design" by "what does the Republican party support" or "what does the Democrat party support."

IIRC (I don't recall where I saw the data) most Americans partisan identities develop in their early 20s, and then generally just keep voting for the same party the rest of their lives.

What you describe as how "people" behave is simply alien to my experience.

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Capital_Room rather dementor-like 1hr ago

This is not 1955.

Yes, Americans have gotten softer, weaker, fatter, and far more pacified since then.

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Crowstep 1hr ago

Poland hasn't liberalised its laws, Czechia did in 2021 but then tightened them again last year after the Charles University mass shooting. Austria and Sweden have recently tightened their laws, as has Switzerland.

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GBRK 1hr ago

I might eat a lizard but its never come up.

I've had alligator nuggets before. Tastes just like chicken.

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GBRK 1hr ago

We should ban guns below a certain size limit for everyone except police/government agents/licensed bodyguards but otherwise legalize larger guns, including crew-served and mobile weaponry. Most crimes and accidents happen with smaller, easier-to-conceal, easier-to-misuse weapons. Most legitimate uses (hunting, home defense, overthrowing a tyrranical government) are equally or better served by larger weapons, or similarly prevented by less lethal weapons (defending against an assailant who doesn't have a gun of his own.) And of course if someone pulls a gun on you, trying to brandish your own weapon is possibly the stupidest thing you can do. The only two downside to this policy is the specific edge case where A pulls a pistol on B and good samaritan C has no choice but to pull out their concealed weapon and shoot A before A realizes that C has a gun-- but the amount of time C successfully saves A would probably be far outweighed by the amount of times where A doesn't pull out a weapon in the first place because everyone saw the guy carrying an assault rifle from a mile away and everyone already put their shotguns on the table to dissuade any funny business.

"But muh terrorism."

What did you think fighting against a tyrannical government looked like? Essays? Papers? Any measure intended to let agreeable people fight a disagreeable government will equally allow disagreeable people to fight a disagreeable government. The only way to stop a bad guy with a HIMARs is a good guy with a suicide drone.

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DaseindustriesLtd late version of a small language model 2hr ago

One of the weird quirks of LLMs is that the more you increase the breadth of thier "knowledge"/training data the less competent they seem to become at specific tasks for a given amount of compute.

just pure denial of reality. Modern models for which we have an idea of their data are better at everything than models from 2 years ago. Qwen3-30B-A3B-Instruct-2507 (yes, a handful) is trained on like 25x as much data as llama-2-70B-instruct (36 trillion tokens vs 2, with a more efficient tokenizer and God knows how many RL samples, and you can't get 36 trillion tokens without scouring the furthest reaches of the web). What, specifically, is it worse at? Even if we consider inference efficiency (it's straightforwardly ≈70/3.3 times cheaper per output token), can you name a single use case on which it would do worse? Maybe "pretending to be llama 2".

With object level arguments like these, what need to discuss psychology.

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DaseindustriesLtd late version of a small language model 2hr ago · Edited 2hr ago

There's an argument in favor of this bulverism: a reasonable suspicion of motivated reasoning does count as a Bayesian prior to also suspect the validity of that reasoning's conclusions. And indeed many AI maximalists will unashamedly admit their investment in AI being A Big Deal. For the utopians, it's a get-out-of-drudgery card, a ticket to the world of Science Fiction wonders and possibly immortality (within limits imposed by biology, technology and physics, which aren't clear on the lower end). For the doomers, cynically, it's a validation of their life's great quest and claim to fame, and charitably – even if they believed that AI might turn out to be a dud, they'd think it imprudent to diminish the awareness of the possible consequences. The biases of people also invested materially are obvious enough, though it must be said that many beneficiaries of the AGI hype train are implicitly or explicitly skeptical of even «moderate» maximalist predictions (eg Jensen Huang, the guy who's personally gained THE MOST from it, says he'd study physics to help with robotics if he were a student today – probably not something a «full cognitive labor automation within 10 years» guy would argue).

But herein also lies an argument against bulverism. For both genres of AI maximalist will readily admit their biases. I, for one, will say that the promise of AI makes the future more exciting for me, and screw you, yes I want better medicine and life extension, not just for myself, I have aging and dying relatives, for fuck's sake, and AI seems a much more compelling cope than Jesus. Whereas AI pooh-poohers, in their vast majority, will not admit their biases, will not own up to their emotional reasons to nitpick and seek out causes for skepticism, even to entertain a hypothetical. As an example, see me trying to elicit an answer, in good faith, and getting only an evasive shrug in response. This is a pattern. They will evade, or sneer, or clamp down, or tout some credentials, or insist on going back to the object level (of their nitpicks and confused technical takedowns). In other words, they will refuse a debate on equal grounds, act irrationally. Which implies they are unaware of having a bias, and therefore their reasoning is more suspect.

LLMs as practiced are incredibly flawed, a rushed corporate hack job, a bag of embarrassing tricks, it's a miracle that they work as well as they do. We've got nothing that scales in relevant ways better than LLMs-as-practiced do, though we have some promising candidates. Deep learning as such still lacks clarity, almost every day I go through 5-20 papers that give me some cause to think and doubt. Deep learning isn't the whole of «AI» field, and the field may expand still even in the short term, there are no mathematical, institutional, economic, any good reasons to rule that out. The median prediction for reaching «AGI» (its working definition very debatable, too) may be ≈2032 but the tail extends beyond this century, and we don't have a good track record of predicting technology a century ahead.

Nevertheless for me it seems that only a terminally, irredeemably cocksure individual could rate our progress as even very likely not resulting in software systems that reach genuine parity with high human intelligence within decades. Given the sum total of facts we do have access to, if you want to claim any epistemic humility, the maximally skeptical position you are entitled to is «might be nothing, but idk», else you're just clowning yourself.

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durdenhobbes 2hr ago

I laughed at both episodes quite a bit, even as a twice-voter for Trump. This guy summed up a lot of my internal thoughts though. For a show that famously "goes after everybody", they were suspiciously hands off the low-hanging fruit that was the Biden administration.

I really hope they don't make the entire season about Trump. It's already way overdone and feels beneath them.

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jkf 3hr ago

I guess you could contrast it with other causes of death in Canada?

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SubstantialFrivolity I'm not even supposed to be here today 3hr ago

I agree with you, although I've never seen double white lines and thought any solid line was "do not cross". Still, I know that white lines separate traffic going the same way and yellow lines separate traffic going the opposite way, and the significance of dashed versus dotted lines.

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cjet79 3hr ago

Firing squad is the way to go. That or ground zero of an explosive with enough force to instantly destroy your brain.

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cjet79 4hr ago

I don't know if I've ever seen double white lines outside of an airport runway.

I recently just went on an 11.5 hour road trip.

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cjet79 4hr ago

You joke, but the underwater rugby team is much more successful at recruiting and in that sport you can hold people underwater.

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cjet79 4hr ago

Going out after practice is difficult, but I try to make it happen. The main options are Hooters or Denny's.

My own charisma as a coach is hard to judge. People thank me for the coaching and give me compliments, but that could just be politeness.

The people that play are often eclectic. Usually smart people, it's an interesting team sport because you can't easily communicate underwater, but it's absolutely essential that you help your teammates.

Being in shape and able to swim well helps a lot. If you can't do those things but keep playing you will become a good swimmer and at least a little in shape. I've seen and coached people up from 'cant reach the bottom of a 7foot pool with flippers' to 'can swim most of the pool length underwater on the bottom'.

There are three different learning curves for the sport:

Fitness and water agility. Being an athlete and good swimmer helps this, but coming out to practice consistently also helps
Positioning and team play. Being in the right spot for passes or stealing the puck from others. People that have played other team sports like basketball, or soccer pick up on this stuff better. But just being smart helps a lot.
Stick/puck handling. It's possible to do drills and rush to get much better at this. It is very satisfying when you have these skills. They are the least important of the skills though. You can be pretty bad at these and still be a great player. If you are good at these skills you can be a lazier player. They allow you to maximize the benefits of the other two skills.

With a new player I teach them these things:

How to get down to the bottom easily
Pushing the puck along in a straight line
Turning around with the puck
A simple push pass.

There are usually a few things to correct with each of those. If someone can get to the bottom easily the other items are pretty simple to teach.

We are short on players so just last week we had a brand new player being legitimately useful and scoring a goal against people that were trying to stop him. He is somewhat of an exception. Almost like a track star that played soccer for the first time in a rec league and just ran past everyone even while they sucked at dribbling.

A good athlete or swimmer can be ok at the sport within a few practices. They can be good at it in a year. A person could find the sport their freshman year of college and be selected for an international U23 team by their senior year. That is not an outlandish tale, that is one of the guys I play with.

The learning curves are there. It can take time to get good at the sport. As much time as it takes to get good at any sport, and in some cases less time, because there is less competition. But no one has ever heard of the sport or played it. Meanwhile everyone learns other sports in elementary school. Where they can get the boring basic stuff out of the way. By the time they get to highschool they can choose to play on a team where everyone has a minimal level of good fitness, understanding of the sport, and a basic to intermediate level of experience in the specialized skills of that sport.

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thrownaway24e89172 Death is the inevitable and only true freedom 4hr ago

You may think this, it might actually be true for you. That is not why the meme exists. Nybbler is correct. The meme exists for 2 reasons: 1) The "Hello HR" meme is true to life; and 2) Reality produces approximately 1 Marie Curie a century, whereas it produces dozens of her male equivalents. I was once an engineering student. Lady engineering students, as a rule, just flirt to get their work done by the men.

The "Hello HR" meme is only true to life in the sense that there do exist a small minority of women who fit it. Likewise "lady engineering students" who "just flirt to get their work done by the men" do exist, but they are a small minority of female engineering students. Those that do stand out a lot more however due to the relative lack of social skills in the type of people who typically become engineers making them more vulnerable to such social aggression.

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aldomilyar 4hr ago

Bunch of Monasteries carved into tall solitary cliffs. It's one of the most incredible visual spectacles in the world.

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EverythingIsFine Well, is eventually fine 4hr ago

Definitely worth a larger discussion! Good post.

First I think it might be helpful to quote my full original comment:

In principle I think I agree with assisted suicide and adjacent arguments like you propose. However, in practice I think suicide legalization in almost any form is super vulnerable to misaligned incentives all over the place, and could become a legitimate slippery slope with ever more lenient standards and criteria. Mostly I don't want to live in a society where e.g. old people are pressured by the government, their loved ones, or doctors to commit suicide for partially selfish reasons at vulnerable times, which seems like a recipe for societal decay that I'm not confident we could avoid becoming should we crack open the door too far. Those kinds of subtle and not-so-subtle pressures can be pretty strong. Depressed people, old people, and sick people already have a hard enough time without people suggesting that maybe everyone would be better off without them. In that light, the US laws that focus almost exclusively on imminent or near-certain death type cases seem like as far as is prudent to go because it doesn't tempt us down that road.

I advocate for staying within a framework where we draw the line at imminent or near-certain death cases. I'm fine with assisted suicide there. I'm not fine with anything more flexible than that, and the direction I believe most societies that relax suicide legalization will end up going is a bad one. There are essentially two competing rationales here. If you draw your justification from the idea that "adult decision-making fundamentally should include suicide" that's one idea, but the one I like better is "if someone's going to die, you might as well grant them control over the method". Those are not interchangeable, and should not be conflated. Let's call the first a suicide right and the second a terminal death right for clarity.

My argument, to be clear, is that as a practical matter whatever the philosophical truth of the suicide right, not only is it controversial, implementing it is very vulnerable to abuse, to a degree that the terminal death right is not; therefore, we should not implement anything beyond a terminal death right. Some people still disagree with a terminal death right, but the scope of abuse is inherently limited. The major concern is that the diagnosis is wrong. If the suicide is done too early, frankly they were going to die anyways, so while there might still be harm to the family or others, they were going to have to cope with it at some point (and as we all know, the normal method of death is often worse for them). I think the evidence is clear enough on that point we can just all agree. So we're just left with the concern about misdiagnosis, and we can discuss that if someone objects, but structurally the incentives mostly run the other way: people don't like to be told their death is certain, the medical system both doctor and insurer prefers to keep them alive (and paying bills), etc. Of course, the government does not, they'd rather do whatever is least costly overall, and the individual doesn't have enough say on policy to matter, even if theoretically affected by the premium increase. Ironically despite 2010 opposition to an ACA addition for Medicare coverage of voluntary end-of-life consultations and decision-making (so-called "death panels"), we ended up with something slightly worse, where we ended up with coverage but the decisions are usually made ad-hoc, last minute, and influenced by hidden coverage decisions by bureaucratic panels. Still, despite the imperfection, I don't think people who could have lived longer but were misdiagnosed is a large group, and I am not worried about that group growing too big over time.

By contrast, a suicide right has a much larger scope of potential harm. The most notable one being that you might getter 'better' in some way. So a death cuts off that entire potential. After all, that's one of the main and more general moral objections to death, is that is robs an individual of potential. Because of this scope enlargement, some issues that were previously irrelevant suddenly become very relevant. Because of this scope enlargement, the potential pool of people expands by an order of magnitude at least. Some examples include the mentally ill, those in chronic pain, those with "bad quality of life", and also the elderly themselves as a whole category. Even, potentially, people who aren't mentally ill in a traditional sense but find low overall "meaning" in life. In addition to the possibility that you might exit one of these groups (get 'better' in the relevant way), there's also the possibility that one or more of these groups shouldn't philosophically deserve a death right at all. We might call that last opinion, where you like some but not all of those groups, a limited suicide right for clarity of language.

Now again I want to say that I'm agnostic or even slightly in favor of a broad suicide right (for example on the autonomy grounds you mentioned). I simply don't trust the incentives to align in a way where that right, insofar as it exists, is meaningfully and rigorously defined and enforced. In other words, I don't want to give it the full legal status as a "right" because of side effects. Does that mean I don't actually believe in a suicide right as an traditional right? I leave that to the philosophers, but I feel similarly about the death penalty, if it's relevant. I think a death penalty is highly natural, even desirable, but practically the legal fight and bills and guilt certainty and political controversy and all that isn't worth bothering over, so if the "right" goes unimplemented, I'm not too bothered.

So let's talk evidence. As you say, my argument can be disproved or disputed seemingly simply based on the evidence (is abuse so common as to become inevitable). I agree that it is sensible to do so, and hopefully we have enough data. However, I think it's telling that despite agreeing here you then spend most of your post in speculation mode despite the stated intention to spend it in evidentiary mode. I don't mean that as any kind of attack and enjoyed your post quite a bit as a thought experiment, but think you settled the evidence too quickly and glossed over the details of the system as it currently works abroad. Yes, that does mean we get plenty of good elucidation of your ideas on the subject more broadly, which is neat, but I don't find it a satisfying response to my actual original claim, and that's what I'm going to focus on in my response here. With that said, it's possible I'm wrong about this and you are admittedly in a slightly better spot to asses it (?) than I am. I also want to caveat this with the point where I notice that all the examples are by definition foreign examples. America has a unique health care system, very infamously set up differently than how almost everyone does it, and so it's probably true that the American risks take on a slightly different form than those abroad! I'm American and admittedly American-centric in most of my comments here (sorry).

You basically present the following pieces of evidence:

"The countries that have legalized assisted dying are not, generally speaking, ruthless capitalist hellscapes where human life is valued purely in economic terms"
Netherlands, Belgium, Switzerland, and Canada have all had assisted dying for 1-2 decades and do not "pressure vulnerable populations into premature death" and serve as good evidence.
- There are rigorous oversight systems and multiple safeguards, and furthermore these have neither decayed/weakened nor been peeled back in scope or rigor
- The absolute numbers remain "low"
- The families of those killed have "better outcomes"
- There is "no significant evidence of systemic coercion"
- People like the policy overall

(I find the last point irrelevant. Sometimes people like bad policies. That doesn't make them good policies, and doesn't make them good for society either. This is a common fallacy and I don't think it merits inclusion, my belief in the wisdom of the masses notwithstanding.)

Before I go further, let me clarify a few things. A suicide right, remember, can be applied to the mentally ill, those in chronic pain, those with "bad quality of life", and also the elderly, not just terminally ill people. Some of the common failure modes to a suicide right that I had in mind:

Government pressure to kill yourself early/without sufficient cause, saving money
Misdiagnosis risks for non-terminal categories
Family pressure to kill yourself early/without sufficient cause, saving them trouble or money
Self-pressure to kill yourself early/without sufficient cause. The reasons are myriad but might prominently include three: fearing being a burden, making a poorly reasoned/rushed decision, or finally a subjective claim that your life lacks sufficient function and/or meaning [implied: which might be inaccurate or morally objectionable].
Well meaning doctors pressure you to kill yourself early/without sufficient cause, but use poor judgement in doing so
Insurers pressure you indirectly to kill yourself early/without sufficient cause to save money
"Society" provides a background pressure to kill yourself early/without sufficient cause, and this distorts all of the above in more subtle ways
Safeguards become lax, toothless, ineffective, confusing, or counterproductive

To be clear, I will acknowledge as true that safeguards, waiting periods, and smart policy might potentially mitigate many of these worries simultaneously without needing to address root causes, and that might be fine. This admittedly makes evidentiary examination a little tricky to tease out, but also potentially easier, as in theory we can simply examine end-states instead of going point by point. However, examining end states is not an exhaustive reply to all of my concerns.

I have a few doubts about your evidentiary claims here more specifically.

A lot of the studies you cite (and performed) are about terminally ill patients. This completely misunderstands my original point, as I hope is clear above. Terminally ill patients don't give us near the same information about the slippery slope that I worry about, they aren't the problem. You cite a study about cancer patients who were terminally ill. Then you cite a study about Canada's first two years of MAID, which is a mixed-methods examination of medical end providers and families but seems to my eyes to be more an examination of how the implementation was rather than an examination of the process itself (e.g. the survey questions and methods all baked in an assumption of patient autonomy, i.e. a suicide right, as a good thing, and some moral objections as a bad thing, things like that). Furthermore, as I'll detail, the Canadian process in the first two years is much different than it is today.

You bring up the Dutch report, and I'd say on the whole the Netherlands offers moderate evidence against a slippery slope. This study summation from 2009, though dated, states there is no slippery slope almost word for word, though in the decade and a half since rates have doubled again (the trend overall is definitely not exponential and has reversed itself at times). A few more words about the Netherlands: The Dutch report refutes point 7, yes, finding that notable instances of protocol noncompliance are rare. In a sense, point 7 and point 2 are pretty similar, and maybe not justified. Maybe it bears on points 1, 5, 6, or 7, but what about the others? Anyways, it appears the Dutch protocol is designed to confirm that the to be due care, a request was "voluntary and well considered", suffering was "unbearable with no prospect of improvement", well-informed, with "no reasonable alternative", an independent physician's confirmatory opinion (including psychiatric expertise if relevant), and a well-executed death. It does seem like a legitimate system overall, with reasonable stability, and no significant evidence against, although I'm interested in what the next 10 years will have in store.

Note those requirements. While technically more expansive than strictly terminal cases, in practice it seems pretty similar. Physicians are instructed not to encourage it, only to permit it, trust is high, and the requirement that it is "unbearable with no prospect of improvement" and "no reasonable alternative" is pretty strong. No prospect of improvement and unbearable! This is not the language of an elective suicide right. Also, "the general structure of the Dutch health care system is unique. The Dutch general practitioner is the pivot of primary care in the Netherlands", so we have the generalizability issue, and I'd furthermore call out of some language from the foreword: "As in previous years, 2024 saw a significant rise in the number of euthanasia cases" and "I am therefore pleased to see the public debate on euthanasia for young people with a psychiatric disorder... debate leads to reaffirmation or adaptation of social norms... [it] helps prevent euthanasia for being taken for granted". Now, the report conflates assisted dying with terminal death care, but there is some cause of worry: institutions declaring it a right without distinction, that anyone disagreeing is against that right rather than a reasonable moral viewpoint, and explicitly stating that social change is happening. It's moral regulatory capture of a sort? Though yes, absolute numbers are in a certain sense downstream from the pressures, so if we aren't seeing supermassive increases maybe it's decent evidence against. That's however the extent of your evidence as presented.

Implied to be similar are the cases of Belgium and Switzerland. This basically also agrees against slippery slopes in Belgium despite modest increases year on year. However we should also note increasing references to a suicidal right in legislation proposed, which was on initial adoption (via decriminalization without mandatory reporting, notably, so there's reason to distrust their official numbers) explicitly said not to be a right at all. Belgium also expanded the law to cover minors, though I don't think this is a big deal by itself. Belgium also displays something interesting: an increasingly large group with a "polypathology" justification: a combinations of conditions that are not sufficient on their own but combined are bad enough to qualify. That's something to keep an eye on. And yes, the numbers we have also continue to rise, albeit slowly, and in part due to demographic changes, and mostly as that link says due to more "complex" health conditions, not psychiatric stuff, and remains mostly terminal case stuff. Overall I'd consider Belgium moderate evidence in your favor.

Switzerland is weird. It's basically self-administration only, legally unbanned with the only requirement being that it's "nonselfish"... but in practice it's administered by nonprofits or by doctor discretion which do their own gatekeeping and there's a parallel medical system that takes care of it. Frankly I think this is fertile ground for investigation, especially socially, but my post is feeling too long so I'm going to ignore it for now because those effects seem pretty unique and difficult to tease apart to my satisfaction.

Finally, but more relevantly, the Canadian example could hardly be more different than the Netherlands. Notably the best comparison for the US in particular, we see a dramatic expansion of terminal suicide rights to outright suicide rights, in all sorts of areas which trigger nearly every one of my concerns. Initially the issue is forced due to a court case that I'm not qualified to explain. It's framed in 2016 as terminal care: adults, consent-capable, "end of life", "serious and incurable illness" (in legislation softened to add "or disability"), "advanced state of irreversible decline", and "constant or unbearable physical or psychological suffering with cannot be relieved in a manner the patient deems tolerable" (in legislation softened from tolerable to "acceptable"). Seems mostly in line already, but see some cracks? The patient deems what is a tolerable remedy, and the end of life assessment is if it's "reasonably foreseeable". It's implemented, but the next development is a 2019 court case strikes the end of life bit, though, citing the Canadian modern bill of rights equivalent (!) and requests some vague changes.

The new ensuing legislative response (after some delay, in 2021) is startling. We get almost a wholesale shift from terminal-right adjacent claims to suicide-right language. More specifically, there's an expansion from terminal to "grievous and irremediable" only (though non-terminal get their own set of different requirements), the patient's own judgement remains enshrined, they expand to "mature minors", they allow limited "advance" consent, they even allow an eventual automatic time-gated clause to expand to purely mental conditions (currently on pause, it was extended). Terminal patients are given their own track, but even the existing safeguards are notably weakened, with fewer witnesses required, a removal of the waiting period, etc. The non-terminal patients admittedly get a nominally more strict set of requirements, like a 90-day reflection period. But critically, the patient must be informed about other options, but is not even required to attempt such! The witnesses need only agree that the person "given serious consideration" to the alternatives presented.

It's my understanding that this was partly based on an assertion stemming from the court cases in the early 2010s outside Quebec that suicide is in many cases itself ethically valid, and thus the physician might as well participate. I will say overall "bioethicists" come off quite poorly: see for example this impassioned and personalized narrative of the situation dressed up as a formal paper, and with a clear and controversial agenda accompanied by a disdain for any who disagree (outright abuse of credentialism, false consensus, and laundering of opinions as fact, normally things I am skeptical of when accusations are made, are pretty notable and pervasive here).

Some reporting on this issue may lead to you think that Canada, even once it allows purely mental health cases, will only be up to par with the Netherland model. I can't emphasize enough how this seems not at all to be the case. The latter model basically requires all avenues to be exhausted or likely not to work; the former only makes vague gestures at such, and although to some extent all judgements about assisted suicide have an element of subjectivity to them, Canada's model takes this way too far and almost leapfrogs terminal death rights to arrive at something pretty close to full suicide rights almost cold turkey. The narrative and impetus is driven by court cases rather than a normal bottom-up democratic process.

Data is a little sparse especially for the newer non-terminal track patients, but the numbers are much more potentially exponential looking overall than we saw in either European nation we looked at, see here for an example. Although in those cases we saw increases in the earlier years of the program, Canada has seen continual tweaking and also what appears to me to be steeper increases. We've also started to see some abuse. Non-compliance is plainly very rarely reported, see here for an example, allegedly up to a quarter of all total MAID cases, and requiring legwork the government did not even attempt to do. This examination flatly concludes that "The Canadian MAiD regime is lacking the safeguards, data collection, and oversight necessary to protect Canadians against premature death." A Wikipedia page relates several examples of exactly the kinds of pressures I worried about: doctors telling patients not applying for MAID is selfish, considering homelessness an inherently valid reason for suicide, offering MAID as a suicide intake risk assessment tool, offering MAID as an alternative to installing a wheelchair ramp, etc. to name a few. There are MAID teams at pretty much every major hospital in Canada, and my understanding is that they sometimes advocate their services under the guise of awareness, rather than keep shop open for last-resort style care.

I speculate that the Canadian method of implementation makes it uniquely vulnerable to these pressures, and I further speculate that if implemented in the United States, it would be a disaster. Maybe there's a cultural element to it as well. And before you say it, Oregon and similar states are also terminal illness only models. The US system especially has already quite a problem and unique situation with insurers and other layers in the medical system that make the incentive structure go crazy.

So hopefully you see my point. Terminal suicide rights are fine. An independent individualized suicide right based purely on conceptions of autonomy is a different ball game. I furthermore think that when considering suicide rights as such, the European examples aren't actually of nearly the same utility as they first present themselves to be (they are mostly presented in the language of terminal rights despite technically being more broad). And yes, wording and systems matter. I ran out of steam here so apologies if this didn't fully address the points that you made, but as I see it the actual evidence that I see is pretty weak for a right to suicide rooted purely in principles of autonomy. The only nation to most closely attempt such has shown very worrying signs that should be red lights for all advocates, and I predict these issues will only worsen. It's quite possible that better-designed legislation can prevent or mitigate these issues sufficiently, but that's mostly untested.

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George_E_Hale insufferable blowhard 4hr ago

Patmos is off the beaten path, accessible by ferry, and for me at least had some religious significance. The small shrine of St John is pretty touristy, or seemed so 35 years ago. Of course I'm not sure how the recent fires have affected the island.

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ArjinFerman Tinfoil Gigachad 4hr ago

You know how everyone was freaking out over that dude that got sent to El Salvador? It's this times 622.

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cjet79 4hr ago

Northern Virginia, USA.

But the sport is international. Best place to be is New Zealand, where its a high school sport. Best place to be in US is Lake Tahoe where Elon Musks' billionaire cousin is building a super team and paying people to live and play there. That last part might sound like a joke, it's not.