The philosophical underpinning is giving up of materialness. The practicality of the 5 instances that I witnessed over the past year - typical terminal individuals choose this. They pass away surrounded by loved ones (they typically medicate for any pain, and the body starts shutting down when food and water stops). This is observed with somberness, but celebrated as very positive act.
When someone starts this process, it's a unique experience speaking with them, as there's usually nothing that comes up, and the moment does not really lend itself to small talk :)
During his final days, he became unresponsive, only sleeping. The doctors gave us the option of feeding him through a tube. We made the hard decision of not doing it. Gave him all the medicine to help his body heal, but no invasive procedures.
We stayed by his side for the next 5 days. Playing songs that he enjoyed. Audiobooks that he loved. And just taking care of him.
Finally, his breath became slower and slower until it stopped and he passed away. I had the opportunity of being beside him during his last breath.
The passing of loved ones is always difficult, but I am grateful for how he went. He lived a full life and was incredibly healthy until the end.
Without knowing, we decided on a sallekhana-like process for him. It was the right thing to do.
Thank you for showing me this.
I'm surprised that someone can be killed in this way. Is it the electrolyte imbalance? There's a lot of potassium in coconut water.
On the one hand according to the wiki this is more progressive removing food by degrees which would make the process a lot longer.
On the other hand being a mostly ascetic practice I'd assume it's done by people who have a lot less reserves (body fat and muscle) which would shorten the process significantly (the 207kg Angus Barbieri famously fasted continuously for 382 days[0] breaking his fast at 82kg, although he supplemented his liquids — water, tea, and coffee — with vitamins, electrolytes, and yeast extract, the latter for essential amino acids).
[0]: technically he was put on a recovery diet of salting then sugaring his water for 10 days, so ate no solid food for 392 days, breaking his fast with a boiled egg and a slice of buttered bread
> Kahneman used the services of Pegasos in the village of Roderis in Nunningen, Switzerland. In the death room with a view over green hills, wearing a suit and tie, he lay on the bed and turned on an infusion of sodium pentobarbital himself. A companion held his hand and told him they were holding it on behalf of his loved ones. Kahneman's last words were "I feel their love."
[1]: https://www.aargauerzeitung.ch/schweiz/suizidhilfe-weltstar-...
> Pegasos, a non-profit based in Basel, Switzerland, believes that it is the human right of every rational adult of sound mind, regardless of state of health, to choose the manner and timing of their death.
I found this bit "regardless of state" really interesting.
I wonder what their views would be for someone who wouldn't have a family and nothing much to do or explore after a certain age? Does it matter what nationality they are from? What if someone's reason is - they had savings and now they have run out of it and area already 55-60 or more and have no intention or plan to work anymore and don't want to go through the struggle of life? (Of course they would have had paid the euthanasia fees)
How does it all happen?
Great guy, very sociable, knew everyone in the little town he lived in. Kept in touch with a lot of students. Good neighbour, friendly guy who'd talk to everyone.
He got Alzheimers. He started forgetting stuff, and it frustrated him. He got caught driving dangerously, and cursed the doctor who took away his license.
He argued with me about the state of some chicken he wanted to cook. I told him "this is pink all over, you have to cook it more". He got angry. I understood he'd become like this to everyone.
He pissed off everyone on his street, and all police, medical and social workers sent to help him. The disease made him blow up every relationship he had with anyone that he didn't know well, like me and a couple of colleagues.
He got found in his house, having left the gas on, endangering the whole street. He ended up in a care home, not knowing who he was, or who I was.
If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
You even literally show that he isn't solely remembered for those last 3 years of his life. We owe people like that care and understanding, not murder framed as mercy.
It's always so painful to see old people around who are clearly living alone, forced to do everything themselves, having to ask strangers for help because they're afraid of being a burden, and their actual children can't find time for them. Only to now see people actually supporting murder because old people become a burden for a couple of years near the end of their life.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
I don't think I've read a wilder defense of euthanasia in my entire life.
This is a "great guy" who committed his life to teaching kids, being a good neighbour, and his reward is one of his former pupils arguing he ought to be killed because he's grown unwell, he's unable to maintain his optics, and the community he gave his life to has therefore 'soured' on him. How very inconvenient for you, that this man is unwell.
What message is this supposed to send to anyone? "Don't get invested in trying to be nice to the neighbours, they're all ghouls who'll have you shipped to the glue factory as soon as you stop seeming useful." And once everyone internalises this level of social atomism, where do you expect these 'great guys' to keep coming from?
This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
There may be others reading in the thread who also can relate to the personality of the teacher and may care about their affect on others when they are "not themselves".
I'm grateful for this story - it's powerful to see examples of autonomy at end of life - and contrasts starkly with the experiences many of us have with aging parents. End of life, at least in the US, can be deeply flawed and misery for all.
> Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
Yes, this is the focus. Science has stalled when it comes to neurological disorders. But the response is love and understanding. I do not understand how someone would "sour" on a person because they have an illness. A very absurd conclusion indeed.
you don't want dementia because it damages and hurts you and everything and everyone around you
(my grandpa physically attacked grandma multiple times in his last year)
They do matter.
Being concerned with how your behavior affects your family or your community, and the opinion they have of you, above your own self-interest, is how good parents, good friends, good citizens, and so on, are made.
Whether we should care about that or not is a philosophical conversation, I suppose. I would take the side of if we care about what people think about us when we are alive, surely we should care what they think of us when we are dead. Otherwise, we only value their opinion of us as a function of what they will do for/to us, which seems not great.
I really don't want my family's last memories of me to be that. Yeah my wife remembers when her grandma was of sound mind, and has some good memories with her back then, but they stopped due to the disease.
Everyone should be entitled to their own opinions on how they want to be remembered. I would rather be allowed to pass in sane mind.
But even at aface value, more rational long-term approach would be to treat it, surely
As Barbara Tversky, who is an emerita professor of psychology at Stanford University, wrote in an online essay shortly after [Kahneman's] death, their last days in Paris had been magical...
One afternoon, according to her online essay, she asked what [Kahneman] would like to do. "I want to learn something," he said.
Kahneman knew the psychological importance of happy endings. In repeated experiments, he had demonstrated what he called the peak-end rule: Whether we remember an experience as pleasurable or painful doesn't depend on how long it felt good or bad, but rather on the peak and ending intensity of those emotions. "It was a matter of some consternation to Danny's friends and family that he seemed."
Maybe in a different city, or with different friends.
If he did “learn something new”, could he have incrementally improved upon it, using his brilliant mind? Could he have made one more wise observation?
It seems he likely left something on the table.
It sucks. It's so easy to forget who they were before the disease. This is them now and it's hard as hell.
Simple things that take 1-step for us take 50+ steps for her. She doesn't readily communicate that she's hungry or thirsty or needs to use the bathroom, we have to constantly ask. She's always exhausted and walking around in circles but reacts aggressively to most suggestions to go to bed or take a nap (no matter how we word it). She can't focus for more than a few seconds, so she has no hobbies to occupy her time, and even the TV loses her interest after a minute at most. Her speech is one unbroken babble, and she gets annoyed if someone starts a conversation near her but doesn't let her interject.
Not sure how much more my dad and I have left in us. The disease stripped everything from her and it's stripping everything from us. In-home care is the likely course but she hates all strangers and is always paranoid about anyone other than us being in the house. There's no good solution.
Tell your parents you love them.
If you ended back in camp you’d be welcomed. If you didn’t, that was your end. I found that remarkably comforting and peaceful.
You don’t. You try to take care of yourself before you’re gone. If you miss that opportunity, you and your loved ones suffer. Same as it is for everyone now.
As we're currently seeing happen: whatever is left unsaid in the body of the law can and will be abused by evil people to concentrate more power (even if the spirit of the law advocates for something kind).
So, we have to normalize some sort of stress tests for laws... because you sure don't want to be dragged against your will because you're poor.
Isn't the point of eugenics to influence population genetic trends? Not a very effective strategy to kill people when they already have probably 2 generations of descendents.
You don't consider years of mental trauma on the individual and years burden and stress on loved ones to be suffering?
I completely agree that the disease is horrible, but your conclusion is bizarre. When you are in that condition, how anyone views you is the least of your worries.
That's just as much failure of everybody as it is of him. This was dementia speaking and society needs to learn that.
You wouldn't tell somebody with a broken leg to get it together and it's just their personality that they can't walk. Nor should you treat dementia like that. Yes, people seem to shift personalities and anger others. But those others need to understand that it's a medical condition, an untreatable and fatal one, so should have even more sympathy than with somebody who broke a leg (cause that will likely just be temporary). Not alienate the person and speak ill of them.
No animal other than man would consider perpetuating that state of decline. An elephant would simply wander away to die, freeing their community from their struggle to simply keep breathing.
I agree with Kahneman, at least that we all should seriously consider the cost of allowing that level of degeneration to consume us -- and more, the pain it inevitably will inflict on our loved ones -- and plan for it while we're still compos mentis.
It's certainly a failure point within us and something to be aware of to make effort towards understanding our own impact as you suggest. Sadly a problem with no full solution over long enough time periods.
Folks I know who have passed on also wanted to be remembered when they were strong, not when they were ill.
I've really thought about this a lot after seeing a number of family members and friend's family members go through dementia, and it seems like it can go two ways: like this, which is how it went with my grandmother (whose hoarding behavior increased aggressively, and she started slapping people), or how it went with my grandfather on the other side (he became quieter and quieter, watched tv every day while understanding less and less of it, and when you caught his eye would repeat how much he loved you and how much seeing you "made an old man feel good.")
It has something to do with how you feel about the nature of people in general, and whether you feel they are all suspicious and possibly conspiring against you, or that you think they are basically good and want the best for you. When you have all of your mind, you can beat the demons or the angels back with your reasoning enough to have the personality that you want. My grandmother was very loving, and my grandfather was very shrewd and practical. But when that higher function can't regulate you, what shows is if you were someone who taught yourself how to see the good in people, or someone who taught yourself how to see the bad in people.
I suspect I'll end up like my grandfather, as much as I think of myself as like my grandmother. Deep down, I've always been crippled by the feeling that everyone is a wonderful person. My aggression and judgemental nature on a lot of things can really, embarrassingly, be interpreted as me looking for excuses for everyone's behavior.
I find the people who remember him as this guy somewhat contemptible though, so I guess my theory would be he wasn't remembered badly by anyone whose opinion mattered.
But on the other hand I guess that's the way the world works.
Yes, the sixty-fifth worst thing about degenerative brain disease. Good observation.
I don't think this is fair. I know several people who died with Alzheimer's and although their final years were very difficult for them nobody has a bad opinion of them. It's certainly a strain on the family but intimating that if you have dementia you better kill yourself or your legacy will be ruined is not ok.
We, the loved ones, made the decisions to keep them going and I wonder how fair that was to them. We tend to not want to let people go, choosing to sacrifice quality of life for the sufferer and those around them for, what, a few fleeting moments of possible clarity? The opportunity to say goodbye to someone who may or may not even understand what is happening?
The events I went through with my family hurt us in ways that will not likely ever heal, despite effort on at least a few of our part, and it did leave me wondering if I would put my son or wife through that should something similar ever happen to me. I decided against it, seeing as I am at the age where these are very real possibilities. In the US, we have DNRs ("do not resuscitate") and living wills that offer prior directives, but something like assisted suicide is not allowed here unless some very extreme circumstances are met, because insurance companies and hospitals make more money from suffering people than dead ones. I'm a strong advocate of the right to die, but it is a decision that needs to be made some extensive consideration and documentation before one actually needs it.
Parent comment doesn’t say this, does it?
But my personal anecdata puts that man in a minority. None of my older relatives with Alzheimer’s have become aggressive or troublesome. Worry, anxiety and confusion seem to be much more common states of mind, which admittedly also doesn’t seem like such a fun way to spend your days.
I disagree it’s up to you to conclude it would have been better if he had been killed 3 years earlier (which you imply).
In general you don’t have the right to such a statement.
Now, if you were discussing _your own_ condition this would be a totally valid consideration IMHO. But you (almost) _never_ have the right to conclude from someone elses part when it’s their time to go.
Assisted suicide is a humane option but ”I hope he had died with some dignity years ago instead of pissing everyone off” tarnishes the entire concept and is exactly the type of argument which stops assisted suecide becoming a more widely accepted option.
Many countries hesitate to execute criminals despite very clear criteria that could be used to justify it. (Many countries banned entirely.)
Why would we have a lower bar for someone who hasn’t committed any crimes?
I’ve never been close to anyone who had dementia. My grandparents on both sides died with their mental facilities in tact and my parents who are 83 and 81 are independent and just as of 6 months ago passed a cognitive test. I can imagine if they started acting out of character and being mean to me or forgot who I was that I would be hurt, overwhelmed etc. But not pissed.
*no data though, just observing my village
I am pro assisted suicide. Not sure about Switzerland but some countries allows it for young people with mental health problems. That I can't accept that.
That's the part that doesn't matter at all. Your life isn't contingent on others having a specific view of you - the rest of the world can, for lack of better words, go fuck themselves.
What matters is if you want to live a life where you can't drive a car, you might poison yourself with your cooking, you lose your mental facilities, etc. That is the relevant choice here.
Think about what is happening from his point of view. The condition has fundamentally changed his perception of reality. You are trying to tell him that this perfectly cooked chicken is pink all-over when it clearly isn't. Everyone else has gone mad and he doesn't know why.
The real issue is our broken systems for handling dementia and underfunded homes, overworked staff, no real community nets. Fixing that honors the full life someone led, instead of saying their value drops when they need help. Assisted suicide opens doors to abuse, like pressuring people who feel like burdens.
We owe better to people like your teacher.
https://ourworldindata.org/life-expectancy
Because dementia and other neurodegenerative diseases take decades to manifest they've been especially hard to diagnose early and prevent or treat early, while cognition is still intact. Alas, I think that hasn't changed much in recent years, despite many scientists and businesses working toward that end.
Partly that's because few academic researchers can pursue a theory long enough in time to fully assess its potential, especially in combo therapies. Nor can the big pharma corporations who not only suffer from the same difficulty in long-term funding, but prefer the ROI of continuing treatments for disease to that of quick cures (or lifestyle advice). These are nowhere near as profitable a pill the patient must take for decades.
All I can say is that I didn't, and thank you for implying that it was so well written that it could only have been authored by a machine that has all of humanity's cultural output to hand.
If you apply at scale the same logic with more sensibility you will also be able to rationalize a genocide because someone felt bad about something.
What defines demonic inspiration?
And here I don't say "demonic" metaphysically but philosophically.
At some point everything indirectly leads to euthanasia and society is not built for that at all. Everything you do might or might not lead to someone's euthanasia, which means you are liable for their death.
Let's say we can predict school shooters before they shoot and give them an euthanasia to save lives. If bullying or encouragement causes someone to start shooting up a school, then the latent shooter will die before they do their shooting, but it also means that the instigator is a murderer themselves, because in the absence of instigation, no crime would be committed and no euthanasia would be necessary.
Since it is probably not possible to assign liability of a euthanasia to a single individual, because multiple people contributed to the outcome, the liability will be shared. Ten people being involved means each has committed 10% of a murder, meaning that they should receive 10% of a life sentence. Are you ready to serve a cumulative year in prison spread throughout your life to account for indirectly causing euthanasia?
Note that this problem isn't necessarily unique to euthanasia. The problem applies to any cure all solution. (Think of series like "Common Side Effects")
If you punch someone's face in, but cure it with a blue mushroom, was it really a crime, since their face is intact? And yet, more punching happens as a result of the existence of the panacea, which is why there needs to be a punishment for making someone dependent on the panacea.
You will be missed! Sad to hear he passed, but glad he was able to go out on his own terms.
A later analysis[55] made a bolder claim that, despite Kahneman's previous contributions to the field of decision making, most of the book's ideas are based on 'scientific literature with shaky foundations'. A general lack of replication in the empirical studies cited in the book was given as a justification.
I just could not digest it. I understood the words but I couldn't make whatever message he was trying to convey... it felt too "dense" for me. Maybe im just stupid, but I could not get past I think the first two chapters.
It’s best use is to be announced your favorite book among undistinguished company. Some people need such books. Such as those from Smith and Keynes.
That said, there is a problem in at least some places where assisted suicide is available where it keeps getting recommended to disabled people who don't want to die. That needs to be solved. Seems like an easy solve. Just don't do it.
There is a cost reduction incentive, though, which is why it happens. Costs can be reduced for abled people by convincing them to exercise and eat more fiber, so the same pressure can do good instead of evil. At some point we have to decide to care about people.
Where? This is a thing which always pops up in these debates because it is a deep-rooted fear, but are there countries where this is a thing?
I don't think things are as bad, but I also think that old age in poverty is a valid reason for euthanasia if there is no alternative. If the society is cruel to the poor, holding poor elderly as hostage to improve situation is cruelty on top of the cruelty.
https://thewalrus.ca/assisted-dying/
https://www.ctvnews.ca/politics/article/doesnt-line-up-mps-c...
>Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.
>What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.
Randy Stroup [2]:
> Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide.
Stephanie Packer [3] (although in this case she inquired herself):
> Then her doctors suggested that switching to another chemotherapy drug might buy her time. Her medical insurance company refused to pay. She says she asked if the company covered the cost of drugs to put her to death. She was told the answer is yes — with a co-payment of $1.20.
T. Brian Callister, MD, FACP, FHM [4]:
>When I spoke with the insurance medical directors of the patients' insurance companies by telephone on separate occasions, both of the insurance medical directors told me that they would approve coverage for either hospice care or assisted suicide but would not approve the life saving treatment option.
> Neither the patients nor I had requested approval for assisted suicide, yet it was readily offered.
[1] https://abcnews.go.com/Health/story?id=5517492&page=1
[2] https://www.foxnews.com/story/oregon-offers-terminal-patient...
[3] https://nypost.com/2016/10/24/terminally-ill-mom-denied-trea...
[4] https://www.cga.ct.gov/2018/phdata/tmy/2018HB-05417-R000320-...
I had a friend that decided to stop treatment (dialysis), when he realized that he'd never get off it (he couldn't get a transplant). He was in his late 60s.
It was both a sad, and joyous experience. He took about a month to pass (renal failure). He was Catholic, and wouldn't do assisted suicide.
During that month, a bunch of us would go over to his house, almost on a daily basis, and we'd just hang out. It was actually a great experience.
https://www.nyswritersinstitute.org/post/hunter-s-thompson-s...
I thought Jain the perspective shared in this comment is valuable: https://news.ycombinator.com/item?id=45548178
Well, not just the comment, but also the wikipedia article linked to in the comment.
Obviously, Jainism isn't Catholicism, but this part of the wikipedia article got me thinking:
>It is not considered a suicide by Jain scholars because it is not an act of passion, nor does it employ poisons or weapons.
Catholics are probably never going to think suicide is ok, but I wonder if they could come around to a definition of suicide that is more narrow and which excludes death-with-dignity. If they did make that adjustment, I would personally agree with their stance.
There is plenty of precedent for this legislation through definitional scoping in history in general, though I'm not an expert on Catholicism. The book "Legal systems very different from ours" talks about it, and gives examples. It's really the only option for any sort of change when you're dealing with decrees from a supernatural entity or an unchangeable part of a constitution.
That’s my biggest concern about assisted suicide for an otherwise healthy person who just wants to avoid the inevitable decline (as in this case). There is a direct financial incentive for families to push people into this.
The only way I can see to remove that would be to require that your estate can’t go to anyone who potentially has influence over you in the case of assisted suicide for with no terminal illness.
What financial incentives are there in killing someone?
Imagine you're poor, your family is poor, and your friends are poor too. You spend 2 years in and out of inpatient care, and then die. Your family is now saddled with a debt they will never be able to pay. Your medical bills could make them homeless. Now imagine choosing between that, and MAID. MAID is obviously a cheaper "out."
Now remember the demographics of poor people in this country. If poor people end up being more likely to choose MAID, that necessarily means MAID would be used disproportionately on ethnic minorities and disabled people. So you end up with eugenics again, just because of the sorry state of our medical system and class demographics.
Not all assisted suicide is eugenics, to be clear. There's a discussion of Jain practices elsewhere in this comment tree.
But man did I lose sleep at the thought that we could have people volunteering to kill themselves solely because they're poor. You could argue that it's wrong not to give someone the choice to die sooner, given that dying later could cause so much strife for their family. But I hold that the right solution isn't making people die sooner, it's building a medical system where people never have to grapple with this choice in the first place.
And did you just go to eating more fibre from euthanasia in the same few sentences? :D
In Germany, it was illegal for doctors to recommend or advertise abortion, and that worked pretty well. You could do the same for assisted suicide.
I don’t do it, but I’m not sure how that solves the problem of other people doing it.
Some of its wording is weird, like mentioning his wife dying in the same context of two other partners with no explanation. The original is a much better read.
In particular, the physician must "be satisfied that the patient’s suffering is unbearable, with no prospect of improvement", which from this article sounds far from the case here.
[1] https://www.government.nl/topics/euthanasia/is-euthanasia-al...
1. Administer the medication yourself
2. Be of "sane" mind at the time you do it.
3. Have a doctor certify that at the time you choose to do it, you are in unbearable pain/suffering, and there is no realistic relief from it.
This rules out dementia (especially item 2). So people here who are in early stages of Alzheimers go to Switzerland as well.
^ Yes, it's "illegal" but it's effectively nulled if the means to it are made legal.
Every assisted suicide is then investigated by the police to ensure no profit motives exist.
Sorry, but your comment smells rather about peddling fakery, especially as you have provided heaps of reliable references.
Should assisted dying be legalised?
Philosophy, Ethics, and Humanities in Medicine volume 9, Article number: 3 (2014)
Thomas D G Frost, Devan Sinha & Barnabas J Gilbert
https://peh-med.biomedcentral.com/articles/10.1186/1747-5341...
Abstract
When an individual facing intractable pain is given an estimate of a few months to live, does hastening death become a viable and legitimate alternative for willing patients? Has the time come for physicians to do away with the traditional notion of healthcare as maintaining or improving physical and mental health, and instead accept their own limitations by facilitating death when requested? The Universities of Oxford and Cambridge held the 2013 Varsity Medical Debate on the motion “This House Would Legalise Assisted Dying”. This article summarises the key arguments developed over the course of the debate. We will explore how assisted dying can affect both the patient and doctor; the nature of consent and limits of autonomy; the effects on society; the viability of a proposed model; and, perhaps most importantly, the potential need for the practice within our current medico-legal framework.
> It is difficult to reconcile that citizens may have the right to do almost anything to and with their own bodies– from participating in extreme sports to having elective plastic surgery– yet a terminal patient cannot choose to avoid experiencing additional months of discomfort or loss of dignity in their final months of life.
If you’ve already made it to 90 with no major issues, you’re expected to make it to 95 and you could make easily live to 100. My wife’s grandad is 90 and he still lives alone, drives, plays golf nearly everyday, and regularly sees his 12 grandchildren and many great grandchildren. He even made the 9 hour trip to come see us last year.
I’m very wary of making it legal for doctors to euthanize an otherwise healthy person who just wants to avoid an eventual decline.
It’s relatively common for families to push people into nursing homes, but in this case there’s an even stronger direct financial incentive. I don’t trust the system to adequately prevent this.
Counter-anecdote, my partners Granddad is 93. Age 90, we said the same as you. Now he's an old, rude, obnoxious liability - he's still great, and I don't hold it against him, he's earned the right. But I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
From the article:
> Kahneman knew that many would see his decision as premature. But that was exactly what he intended, he wrote: If you wait until a life is "obviously no longer worth living", it is already too late.
I personally wish my partners final memories of her Granddad were him at 90, and not at 93. I've known for a good 5 - 10 years I will take the same route as Kahneman. I feel the desire to stay alive long enough to be a liability for yourself and those around you is a decision motivated by ego and fear, rather than compassion or logic.
Everyone becomes a liability at some point. By that logic we should just go full Logan’s run and kill people as soon as they stop being productive.
There nothing wrong with saying that you aren’t going to take extreme measures to preserve your life past a certain age.
But I don’t want this attitude of “you should kill yourself so you don’t burden your family” to become the norm either.
What if your partner’s grandad heard you calling him a rude obnoxious liability and felt pressured into killing himself?
>I've never known anyone naturally age and die without losing their ability to be civil in some way towards the end.
But many people die suddenly with no serious mental decline at all. That can happen at 95 or 100 the same as it happens earlier.
If you rule out everyone who didn’t die of some nebulous cause as the result of a slow decline you are selecting for people who mentally decline.
She couldn't look after herself was was forced into care by the courts. Since going into a home she's physically never been fitter, but mentally she's not the person she was 10 years ago -- it's not that she's changed personality, it's as if her memory of the last 80 years was wiped.
Many people die suddenly with no decline at all.
There is no financial incentive. No-one is making any money from assisted suicide in Switzerland.
This is obviously an outright falsehood. Nonprofit doesn't mean that no one gets paid.
> It’s relatively common for families to push people into nursing homes,
So you are rejected by your family and punished even more by taking away a dignified exit strategy?
You can argue that more countries should grant that right. But if you’re going to do so, you need to have an answer for the incentives it creates.
Robin Williams had to hang himself.
There should be easy medical options in the US.
The instinct for self preservation is strong. Knowing what will come requires foresight and clarity. You may lose the capacity for informed decision making before the point where it's clear that there's not much to live for.
Many of us lack the insight that Kahneman perhaps had that in order to take control of the end you may need to leave some good days on the table.
I do not know if this was ever widely practiced, but I think the ancient Indian ritual of going to the forest and starving to death in your last days is basically fine. It gives a dignified, sacred end to a life, while the modern medical sciences constant battle against the inevitable ends up distorting and deforming the last days of your life and forces you to leave without dignity clinging to the last vestiges of your humanity that’s left.
You can get into a state of living death where the brain is mush and who you were is completely destroyed. That's hell for the family.
I saw my grandmother forget her daughter (my mother) it was heartbreaking. Seeing my mom realize her mom forgot everything about their life together was just painful.
It was just a sad existence to observe as well. Grandma lived for quiet a while with dementia and spent years trying to return to her childhood home. We'd constantly have to trick her into accepting help from us "strangers". Re-convincing her to come inside that these "strangers" wouldn't mind having her for a bit. Watching her read over the same page of a book for hours on end.
That's not an existence I want for myself or my family.
Mentally she is still pretty clear and she often says it would be best if she doesn't wake up in the morning.
I think it would be better for everybody if we had a way to have a ceremony where we all say goodbye and then end it.
Sorry mate.
Don't have an exact word to describe how I feel after reading above. Find it beautiful that such an accomplished person wanted to learn something even towards the end of his life.
He said that alone made life worth living, for him and them, but once any deteriorating conditions rendered him permanently unable to participate in this weekly activity then he felt it was time to go.
Maybe having a pre-set condition like this is less arbitrary, and also allows everyone involved to understand as the time comes closer.
Of course, even if you lack legal permission, suicide doesn't strictly _require_ legal or medical assistance. An autonomous exit is always an option, though generally less painless than assisted.
In the cryonics community, it's a common complaint that they have to wait until the patient is legally dead in order to cryopreserve, which can make it difficult to cryopreserve under ideal circumstances.
I like the idea of allowing individuals to opt for cryopreservation over end-of-life care. End-of life care costs so much money, it could even be neutral from a financial perspective.
Since cryopreservation lacks the finality of other forms of death, it could also address some of the ethical dilemmas around assisted dying. After all, a lot of end-of-life care seems to be motivated by a futile attempt to somehow delay the inevitable. From my perspective, cryopreservation seems slightly less futile.
If medical technology continues to advance, maybe in the year 2500 there will be people walking around who were born in the 1900s and can give talks about their experiences. Wouldn't that be cool? It would help a lot if just a single country to made it possible to get cryopreserved before you're legally dead.
And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
I don't believe that. I do believe it is a hair less futile than delaying the inevitable and then burying yourself 6 feet underground.
>it doesn't work and is widely considered to be pseudoscience.
The cryonicist claim is something like: "If we save your brain in a way that preserves its information content, it may be possible for future technology to reconstruct that information content, and effectively revive you." No cryonicist is claiming that cryonics "works" with existing technology.
Consider the state of medicine in the year 1925 vs the state of medicine in the year 2025. Now extrapolate that advancement trend forwards until 2525. Is extrapolating trends forward a form of pseudoscience? If so, what do you say about global warming?
>And mentioning the cost of end-of-life care is risible when your alternative is paying paying indefinite rent to a company for freezer space to keep a corpse frozen.
Keeping a closed canister filled with liquid nitrogen is not especially costly.
Alcor charges $80K out of pocket for neuropreservation: https://www.alcor.org/membership/pricing-and-dues/
The Lancet says a typical American accumulates $155K in healthcare costs during the last 3 years of their life: https://www.thelancet.com/journals/lanam/article/PIIS2667-19...
Long-term care costs are rising fast: https://www.nytimes.com/2025/05/24/business/retirement-long-...
(BTW, I appreciate that you made a falsifiable claim here, since that helps readers evaluate the credibility of your other claims. A sort of within-comment Gell-Mann effect.)
Assessing how well cryonics might in the future at different scales is a prediction. So, yes, cryonics is speculative; it is making a bet that future technologies will somehow bring a brain back to life, in some form. Digital: a brain scan followed by whole-brain emulation. Biological: physical repair at the molecular level. If/when some kind of revival works, the question of consciousness remains.
The current edition of Wikipedia's entry on cryonics writes: "It is generally viewed as a pseudoscience" which is attributed to Jens Karlsson saying "Cryonics ... is generally viewed as a fringe pseudoscience." [3]
I don't care for this characterization. When I think of pseudoscience (such as a homeopathy and astrology) makes claims that are unfalsifiable, often by design. On the other hand, cryonics is falsifiable. Scientists are trying to figure out scales where it can work: it has far to go, and it may not get there.
I personally can't speak to the degree of lies, hucksterism, or fraud swirling around cryonics. I won't defend any such practices.
Will future history show cryonics to be impossible, not dependent on the currently-available technology, but as a provable claim based on the laws of the universe? Maybe. Maybe cryonics is a long-shot worth trying. I'm not an expert, but I lean towards the latter: allocating a small fraction of resources towards exploring it seems wise.
[1]: https://www.smithsonianmag.com/smart-news/scientists-revive-...
[2]: https://www.scientificamerican.com/article/46-000-year-old-w...
[3]: https://www.chicagotribune.com/2002/09/29/mainstream-science...
I'm often reminded about a case in my own country: a young person had decided it was time to end her life after struggling for many years, without a sign of improvement. She was denied the right to euthanasia. After multiple failed suicide attempts, she went for the nuclear option and jumped in front of a train.
Everyone deserves to die in a dignified and humane way, not in multiple pieces or with a mind deteriorated beyond recognition. Forcing prolonged suffering is unnecessarily cruel. I wish more countries were as progressive with euthenasia as Switzerland.
Euthanasia has some strict rules in Belgium, especially for cases involving psychological suffering. In 2014, the age restriction was dropped (except for psychological suffering). Since then, 6 minors have received euthanasia.
Seems like we should close this thread to honor these wishes
Assisted suicide sounds like a fine option until you think of its impact on your loved ones. Imagining putting my wife and kids through my deciding to die, and the process of them bringing me to the place where it happens - or imagining one of them doing the same thing - just fills me with horror
> If you wait until a life is "obviously no longer worth living", it is already too late —- Kahneman
Live your life in a way that it is worth living until you no longer can, I suppose. To exist is hard, do your best.
He kept to himself, so I didn't know him well. I did know that he was an independent and thoughtful man who hated that his tremor got so bad he couldn't feed himself. I remember talking with his family about if those self-balancing Google spoons might help.
There are two kinds of people for whom suicide sounds appealing: those in poor health who don't want to experience it getting poorer, and those for whom the difficulty of being alive outweighs the joy of it. If you're in the former camp, that pain is coming for them anyway. If you're in the latter camp and still make the decision, maybe you don't have those close bonds that make you want to persevere.
I “retired my wife” at 46 in 2020, eight years into our marriage so she could enjoy her passion projects and I have turned down more lucrative jobs that would have required me to work harder and be in an office so I could work remotely from anywhere - but realistically in US time zones.
Everyone who knows me, knows that I would die with no regrets. As far as my wife who loves me and my grown (step)kids who I know also love me, I don’t owe physical suffering to anyone. Assisted suicide because of Alzheimer’s is more tricky than something like cancer though. What can you do? Sign something in advance where once you can’t pass a cognitive test three months in a row - kill you?
That said, I think the same, and there are some non-obvious second-order effects around it being the menu, especially regarding life extension incentives and if people started to feel guilt-tripped by it.
The first thing that comes to mind is a reduction in commitment to the elderly. As soon as health care costs ramp up, people will start to make more decisions based on the economic aspect of the people's support instead of thinking in life extension mechanisms as a natural first choice.
Second, it is related to the public health services. From my experience in some parts of EU/America, if you have a disease until your 50s, you will get treatment. However, after that, there are probably some parts of the public/private health system that throttle down the treatments.
The 2-week interval between a return if you are 30s/40s, will become 6 weeks if you are over 60s.
The next one, the "inheritance social contract," will be changed. As long as folks know that assisted suicide will be placed on the menu, I do not doubt that folks terrified with the possibility of loved ones "not doing enough to keep them alive" will dilute everyone who lifts the gas.
And as a second-order, I can see the securitization and life insurance industry will demand insane premiums to cover elderly persons, given that potentially people can lift and coast the treatment for their loved ones, and this can break part of their actuarial models, which, yes, expect people to exhaust resources to keep their elderly alive and not to choose together to pull the plug in a single-digit number of years before.
And maybe a third-order effect (in Germany there are some cases) where people with resources (single-digit million real estate + assets) exercise liquidity on it and live the best of their lives after 70 or in some cases, legally marry 30+ nurses to take care of them in the last 3 years and offer a chunk of inheritance, post-death pension, or insurance premium.
We're opening up tremendous abuses of power by allowing the state to kill people for non-criminal behavior.
Sure the first iteration is presented as "voluntary", but the next edition will be for the greater good. And how about sinister / malevolent abuses of "voluntary" suicide -- similar to abuses over guardianship.
at least with guardianship the person can be set free, because they are still alive.
I'd like to quote from the HN guidelines:
> Don't be curmudgeonly. Thoughtful criticism is fine, but please don't be rigidly or generically negative.
With that said I urge you those who disapprove to ask whether you are being "rigidly negative" about this.
1. Is this disapproval perhaps coming from your religious context? If so, please pause and consider why that may not apply to the rest of us. And also whether you really think that your religious beliefs must be forced on the rest of us.
2. Is this disapproval coming from a sense of deep unease that this post causes? If so, know that this unease is shared by most of us. But try and muster the fortitude to go past that unease and consider the decision from a place of compassion.
Many/most of the nursing staff are Filipino and strongly Roman Catholic.
As she lay dying and unable to speak, one of the nurses undertook to convert her at this last minute to their religion. At night, alone, after all visitors had left, she would come into mum's room and press mum, a very committed atheist, to pray for her salvation.
It's hard to describe how vulnerable someone is who is stuck in their bed and dependant on the nursing team for everything, even sips of water.
I will say this was not representative of her care, but it opened my eyes to the lengths religious believers will go to to push their views on others.
I guess we are all Dying, Fast and Slow.
So you could say it was more system 1 thinking rather than system 2.
I would've expected the opposite given our survival instincts.
I don't think it's a link to an assisted suicide/dying with dignity center.
Society's relationship with intentional end of life decisions is fraught, to say the least.
It's less likely to be "a certain age" and more surrounding factors: if most of your friends have passed and you don't have much chance to do things that interest you because you could pass at any moment yourself there comes a point where life has limited worth.
Essentially, hope runs out, and when it's run out entirely you either wait for death, or ... don't wait.
> It's fascinating that even for very ill or injured people the will to survive is so strong
Sometimes. Chronic illnesses are a massive contributing factor to suicide rates for instance: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
For physical illnesses.
What is the point of living your last 10 years of life bed ridden? This is how I will go.
I want every second. Even if it’s painful.
I am still alive.
You didn't mention Belgium so I'm pleased to hear that Belgium is doing well according to you (4000 cases of euthanasia per year of which 80 are for psychological suffering, 1 child per year).
> οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε
In English:
> Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.
Now he could have been depressed after his wife died and was just lying to himself that this was his own, autonomous, decision. Depression can do that to you, it can make you think suicide is the most rational decision.
The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
Ironic is the opposite of what you mean, don't you think? By your explanation, Kahneman acted according to his life's work.
> The guy who spent his life researching how to live rationally chooses suicide at age 90, upon seeing “increasing metal lapses”, presumably in order to not ever live irrationally.
That was possibly part of his motivation. But also the pain, suffering (goes broader than physical pain), confusion, and cost -- to him and his family.