Jan 3·edited Jan 3

I am Dutch so this is a familiar topic for most of my life :-( A large part of my life when I was part of the what was then called left, I supported your line of reasoning enthusiastically. However, some cases in Holland changed my mind. The taboo on killing is imho a Chesterton fence, it is sacred for a reason. Once you remove this fence, I fail to see why your eloquence and logic reasoning skill could not take it further. Where is the next fence?

I strongly believe that our moral intuition evolved to develop successful offspring. It does not have logic, it is not scientific, it is just a tool of the evolution to let us do the heavy work for the next generation. It motivated us quite well for many eons and brought us in a time where we're extremely prosperous by historic standards.

Alas. In the last decades your kind of logic reasoning and eloquent style brought our prosperous societies on a glide slope; I blame the universities. Agree, I am often seduced and charmed but if we take a step back and see how well we do on the next generations, both quantitatively and qualitative then it is hard to deny that we seem to be failing in our most basic task. Many of our girls seem to have given up on having kids (and their mothers were already quite reluctant) and now you seem to want to give up on our old, sick and disabled because they are a nuisance.

I agree that I lack the eloquent reasoning that fatally destroys your argument; I stand here with only my moral conviction. A believe that some fences attacked by your arguments actually have a reason. Even if they are hard to articulate now.

I remember a comparable situation with Haidt's moral story about incest. If it is consensual, legal, surefire prophylactics, and safe, why not? Liberals tend to answer (reluctantly) that it should then be OK, conservatives reject it out of hand. However, feeling torn for some time on this topic I realized one day why we have this taboo. If it was a normal practice, there were bound to be cases where younger siblings mimicked it and then the prophylactics might be missing. In this case, my intuition just warned me for something that was not obvious in the problem description.

I believe there is a good reason why actively killing people feels so morally repulsive for humans; I could never ask a doctor to do this for me. I think we should tread very carefully in this area.

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I’m disgusted by the long winded arguments on assisted suicide in many variations, this one MAiD. The folks who have the luxury of time and health go on and on about the morality, politics and expense or damage to society. For those of us facing the reality of needing options these arguments are ludicrous.

Who among us would deny the justice of facilitating the euthanasia for a suffering animal? Yet it changes entirely for a human. I’ve got a severely disabled adult son with chronic pain. My goal is to relieve his intractable extreme suffering and thus honor his dignity. At some point I’ll have to make decisions as his guardian and I’ve always known there are limits to any options for him.

Quality of life is most important to him, daily. Just as important is a “good death”. It all is part of HIS existence. I fight for his “good life” and I’ll fight for his “good death” when inevitable and the only way for him to stop unbearable, severe and excruciating suffering.

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You write about this often, yet you still haven't explained why do these people need doctors to kill them? Why don't they just kill themselves? Suicide is one of the most common causes of death, so a lot of people figured it out.

"Yes, for most people you can always kill yourself by jumping off a bridge, but I don’t think people should be tortured because they lack the courage to do that.“

What happened to revealed preferences? People who "don't have the courage" to kill themselves do not, in fact, want to end their lives. It's like saying "I really like to practice violin, but someone please force me".

"And many are of course disabled and unable to commit the physical act of suicide."

An overwhelming majority of euthanasia patients are not disabled to the point of not being able to commit suicide through multiple means. Even terminal neurological patients typically know months ahead what is in store and can act on their supposed preferences.

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I think you're getting the right-wing antipathy towards COVID restrictions completely wrong - they don't feel that way because they have less care for the value of life. They feel that way because they believe that people should be able to choose their own level of risk in living (on this issue - same cannot be said for drug use, premarital sex, etc.). Euthanasia is the opposite of that self chosen risk - it's an end to risk and suffering made in the belief that there is no more hope on this earth for a good life.

I'm ambivalent. Suicide has a social contagion effect, and I could easily see this becoming the next gender dysphoria, with autistic/mentally ill kids being told that the real road to the happiness is through the gas chamber rather than hormone treatments.

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Let start with two caveats: 1) I am generally a big fan of Richard's and 2) I am quite torn on the topic of MAID.

With those two notes out of the way, his philosophical arguments in favor of MAID are quite weak and actually might have pushed me further to the anti-MAID side. Let's review:

"A moment’s thought, however, reveals that “doctor shopping” is an inevitable part of any but the most totalitarian healthcare systems. When one doctor refuses to carry out euthanasia and another does, Raikin simply assumes that the one who chooses the outcome he likes is correct. Doctors disagree on treatments all the time. Dentists often can’t agree on whether the same tooth needs a root canal, and that doesn’t even involve the complex psychological judgments necessary to decide whether someone is “really” allowed to end their life. To demand complete consistency in the application of a euthanasia program is holding it to an impossible standard, one we do not apply anywhere else in medicine."

-Here Richard compares doctor shopping for state-sponsored suicide to <checks notes> if someone needs a root canal. I hope I don't need to explain to anyone why this comparison is ludicrous. Further, we don't apply this unanimity standard anywhere else in medicine because there is no other procedure in medicine with this degree of dire circumstances. Should the standard for this "care" be higher than any other... particularly a freaking root canal?

"If your standard for accepting euthanasia is “the healthcare system can never make mistakes and should have 100% consistency in its applications,” you will never be satisfied."

-So what should the standard be for this program? 90%? So if 10% of people are killed by the state's hand, who otherwise shouldn't have been, Richard chalks that up to an oopsie? Sorry, not good enough. Not even close.

"I’m not going to lie to you and say Canada, or any other country, never makes mistakes. But one has to also worry about cases where people are forced to live decades in miserable conditions. Yes, for most people you can always kill yourself by jumping off a bridge, but I don’t think people should be tortured because they lack the courage to do that. “Grandma doesn’t need state-sponsored euthanasia, she should have the balls to blow her brains out on the carpet” isn’t a humane approach."

-To Richard, since the above is inhumane, the 10% oopsies are the humane option?

"I don’t think we need many safeguards in a euthanasia program because the best safeguard is that people usually want to live, and despite what MAID opponents say, our culture generally discourages suicide."

-Culture can change, and it can change rapidly, especially in the days of social media. Has Richard seen the increase in LBGT kids in the last 5-10 years? The fact that in our culture today people "usually want to live" (his words not mine) should not be good enough justification for anyone especially since if the tide turns, stopping it will be a major lagging indicator that something as gone haywire.

"Those who don’t want to continue living are very rare, and since no one can truly understand the mental state of another person, I will defer to their own judgments about their condition."

-Remind me to never ask Richard for a recommendation to a physiatrist. I'll just say this, as someone with family members who have severe mental illness...deferring judgement to everyone about their own mental condition is so incomprehensibly stupid, it's hard to believe it was written. Using this logic, why should people even have to see a doctor before using MAID? Why can't they just walk into a clinic and be killed right there on the spot, since "no one can truly understand the mental state of another person." Simply nuts.

"One could just as easily say that people who want to kill themselves after becoming disabled are seeing things more objectively, and when they accept their condition they’re coping and living under a kind of false consciousness."

-Adapting to a difficult circumstance is "living under a false consciousness?" Please also remind me to never ask Richard for recommendations on a motivational coach.

"The data from the Netherlands and Belgium stresses something that really should be obvious and go without saying, which is that most people do not want to put children to death except to alleviate the most extreme and pointless suffering."

-Again, five years ago you'd say that "something that really should be obvious and go without saying, which is that most people do not want to cut the healthy breasts, testicles, and uteruses, off of and out of young boys and girls..." but yet, here we are.

"If you think that Canadian medicine is turning out psychos who want to start slaughtering children in their offices, and they’d be able to get away with it, we have much bigger problems then any deficiencies in MAID."

-One more time for the people in the back...they're turning out people who cut the various organs out of children, so is it so crazy to think this evolution could happen in the near future because it is the "humane" thing to do?

This was more I was planning to cover, but these are the highlights. Richard's logic on a wide array of his arguments is severely deficient and his hand waving away of people who have serious concerns about the program does nothing to help is cause. These are serious issues which need to be addressed and his weak thought process here actually dissuades me from his side.


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Jan 3Liked by Richard Hanania

God bless you for this post! (recently I read that hit-piece by Ross Douthat and was taken aback.)

2 "references" to add: - the 2004 Clint Eastwood movie Million Dollar Baby

- and MD Scott Alexander, the greatest blogger of'em all, about "culture of life" in one of his top-posts (his choice) https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/ :

I work in a Catholic hospital. People here say the phrase “culture of life” a lot, as in “we need to cultivate a culture of life.” They say it almost as often as they say “patient-centered”. At my hospital orientation, a whole bunch of nuns and executives and people like that got up and told us how we had to do our part to “cultivate a culture of life.”

And now every time I hear that phrase I want to scream. 21st century American hospitals do not need to “cultivate a culture of life”. We have enough life. We have life up the wazoo. We have more life than we know what to do with. We have life far beyond the point where it becomes a sick caricature of itself. We prolong life until it becomes a sickness, an abomination, a miserable and pathetic flight from death that saps out and mocks everything that made life desirable in the first place. 21st century American hospitals need to cultivate a culture of life the same way that Newcastle needs to cultivate a culture of coal, the same way a man who is burning to death needs to cultivate a culture of fire.

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Jan 3Liked by Richard Hanania

I'm in fully agreement about everything you've written here, but consider assisted suicide a small issue in the general end of life care situation.

The number one way people kill themselves is they give up receiving treatments and go on hospice, not that they actively commit suicide.

This tends to kill people pretty fast in most of these cases. While there are probably cases where you would need assisted suicide its not the #1 issue at end of life.

Having just been through this with my father I would say these are the main problems:

1) It's much harder then it should be to get a DNR enforced at a hospital. My Dad was revived against his will multiple times.

Through some kind of miracle this worked out and we were able to bring him home with his mind in tact for his last week at home, but that was a statistical outlier.

A big issue for end of life would be reforming the DNR process across the board. Also, you want to make it as easy for the family to get the person out of the hospital.

2) Once you lose your mind its very difficult to die. Even if you mentioned in the past that you wanted to die if you lost your mind, once you've lost it doctors will keep asking your questions until you murmur something about wanting to be alive.

It needs to be easier to pre-commit to cutting off medical care if you lose your mind and not having that changed by yourself or relatives.

3) The #1 issue is of course the cultural attitude of the people involved. My father and my family generally have never been fixated on mere life, but this is an attitude I wish I could see more broadly.

4) There really is no incentive for the family to cut off medical care. The government is paying for it all. The hospital is making money off you. The best way to get people to accept hospice care is to just pay their descendants money to do so. I'm not going to game out the entire formula here but this seems sensible to me.

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"The state’s interest in saving costs, as long as it’s going to pay for healthcare, is also legitimate, although I won’t dwell on that here."

I think this is the central issue that people are going to have a fundamental divide on, and which you should perhaps be talking about more instead of all this other stuff, although to be fair I doubt you could change many minds on it. You say that you are completely okay with the idea of the state encouraging suicide simply to save money on healthcare costs. But to many people, perhaps most, that is an abhorrent concept on a deep first-principles level, and you're just not going to reason and logic your way past it.

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Jan 3·edited Jan 3

You made a quite good argument about euthanasia, but not about MAiD.

You almost got the point when you correctly state "If the state is going to provide healthcare, it should acknowledge that suicide is a legitimate choice for people to make." but in your first instance you openly state that "The state’s interest in saving costs, as long as it’s going to pay for healthcare, is also legitimate, although I won’t dwell on that here.".

In fact, under a truckload of rethoric, the true argument for Canandian MAiD is to cut the healthcare public spending: i frankly find nothing "free" in a poor guy that the government push to suicide not to pay for his healthcare bill.

Funnily enought, one of the strongest argument for lockdown and forced administration-of-a-serum-never-tested-for-immunization-so-not-labellable-vaccine-without-definition-manipulation is to cut healthcare pubblic spending: "save the NHS" is the most reknown.

So, i find your argument "“Dying of Poverty” as Emotional Manipulation" a strawman at best: i want you to argue how "The state’s interest in saving costs through euthanasia, as long as it’s going to pay for healthcare, is also legitimate".

P.s. to attack Raikin because "he’s against all euthanasia no matter what condition a patient is in [so] Complaints about shortcomings of MAID should be understood from this perspective" is an ad hominem fallacy: otherwise, i should dismiss your whole argument as anti-elderly bigotry, because you made clear you are against the gerontification of the modern world.

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Have you read Helen Dale's "Kingdom of the Wicked" series? She sets up an alt-hist technologically advanced Roman Empire in part to contrast its morality with Judeo-Christian morality, and show us that the Roman alternative, though flawed, had its attractions. I bet based on this and your other writing that you will sympathize more or less completely with the Roman worldview Dale portrays, more than the vast majority of people would and even more than I would-- and I view the book as making a pretty compelling pro-Roman case. In any case it'd make a fascinating review post for your newsletter.

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Look you can delete comments and put “pressured” in scare quotes, but MAID is a moral disgrace, and getting the state to kill grandma is a proper nazi style slippery slope, no matter how many 1000 words you write

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Jan 4Liked by Richard Hanania

You have definitely shifted my view on this topic. I’m still a little worried about some slippery slope scenarios, but overall I’m pro MAID now. Thanks.

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While I had a vague sense of disagreement with you going into this article, I'm now open to being persuaded. Wondering if aesthetics is the main problem here again. Thanks for that.

I am VERY happy to see you bring up Nuclear Power & the Death Penalty--as I am very much in favor of both. However, I noticed you seemed more focused on what people on Twitter were saying as opposed to the article Kass wrote. I realize that responding to a philosopher like Kass would be a huge article in and of itself--but I think we might benefit from a critique of the other side's "best to offer." Or maybe a link to someone who has a good case against Kass?

One point I'm not seeing addressed by either side in this debate is this: Both California and Canada have similar-sized populations, and both are pretty "woke" and secular. Yet, I believe the per capita use of MAID is much higher in Canada than California. Not that it would affect the moral argument you put forward--but I really wonder if there's a good explanation for that? Is there any data point we can look at and say, "THIS is why Canadians are more comfortable with MAID than Americans?"

Related Topic: Forgive me as I meant to post this on a previous post of yours (congrats on having a wonderful daughter this year!) but I was wondering if this article might shift your stance on abortion somewhat:


I'm starting to do just that.

Thanks and Happy New Year! Can't wait to read the new book on Civil Rights.

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I'm Canadian, and I'm not interested in the general question of euthanasia for terminal conditions; I'm interested in my government expanding the criteria so it can kill people who have depression and "fibromyalgia," which is usually depression. The second-order question is how this national psychology affects everyone else. There are already multiple friends of friends who are considering it, despite having no terminal issues.

Negative psychology is a loop. It causes problems that cause problems. Whiplash doesn't exist in places where people don't know about whiplash. People don't kill themselves due to fibromyalgia in cultures where fibromyalgia isn't accepted as a thing or as a valid reason to kill yourself.

Killing yourself is like divorce: we make it difficult for a reason.

This is also occurring in an environment where the government is desperately flooding the country with immigrants to prop up housing values for Boomers, flushing out the poor and vulnerable (and making new people poor and helpless). Our housing costs have increased 500% in 20 years due to government policy. This country is becoming the epitome of despair. I'd be interested to hear someone from Toronto or Vancouver who doesn't own property roll in here holding the opinions expressed in this essay.

I'm sure you know that thing about survivors who jumped from the Golden Gate bridge mostly regretting the jump. I'm not going to break the bank trying to stop them, but I hate this government that will steal your life's work and then push you.

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Is this a Swiftian satire? "A Modest Proposal"?

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Jan 14Liked by Richard Hanania

First time reading a post on a substack and interrupting my reading to go and find the "subscribe" button. I've encountered your writing from time to time (most recently in the comment section at ACX) and liked it, but absolutely loved this. Higher agreement-per-word for me reading this than almost anything other than reading back over something I wrote myself. Back when the MAID fake news was heating up I irritated friends on both sides of the political aisle with my constant debunks. I wish I'd just had this link to send them.

Now, this comment comes too late for anyone ever to be likely to read it, but despite my complete agreement with it I have an additional angle on the motivations of those who oppose assisted suicide. I needn't duplicate any of Robin Hanson's talking points -- it is obvious that there is tremendous signalling value in proclaiming our willingness to support at any expense those who are too disabled to do so themselves (even if we have to force them to stay alive so that we can do so). No, rather I would like to comment on other, [post]Christian motivations. It will be offensive to objectors from the right and left that I lump them together, but I do so for good reason, likely nobody will ever read this, and my own authentic thoughts are apparently classified as 'trolling' so what the hell.

One lens (like all lenses it is imperfect and is best used in conjunction with other lenses) with which to understand what this looks like from the inside (for objectors) is to consider shifts in thinking in/with/around the rise of Christianity. Rather than one's life belonging to one's paterfamilias, one's polity, or one's (democratic) peers, it belongs solely to the Lord God, who alone can dispose of it justly (sometimes through [tacitly] divinely-approved kings). This coincides with and helps explain the preciousness of the individual: each person is like a coin that even if minted of base metal is stamped with the face of the one King of Kings. Thus when (according to legend) St. Lawrence (of the grid-iron) was told to hand over the ill-gotten gains he was presumed to have as chief deacon of Rome, he gathered up all the beggars (mostly crippled, blind, and lame) and proclaimed, "here are the treasures of the church". Islam, though obviously different, continued this new ownership-relation: one's life is not one's own, but belongs rather to Allah. Centuries later, Marxists were not facetitious in referring to the Acts of the Apostles in saying "from each according to his means, to each according to his needs". However changed might have been the frame, within even the worst times under communism we see a similar dynamic -- every person stands in relation not to God but the People, and if comrade Stalin has the power to dispose of a human life it is because he is merely a pawn of this People. "But this is a facile and obvious fraud!" one might respond. Sure, but so was the divine right of kings -- that doesn't mean neither expressed and augmented the underlying ideology. Consider the gulag practice of having prisoners send birthday well-wishes to comrade Stalin. Though literally dying of mistreatment yet even still they were (symbolically-only) regarded as part of the People and part of the political process.

Any descendant of this kind of thinking regards a human life as something outside ordinary disposal (however thirsty for exceptions or excuses any particular person who holds this view may be). The simple statement "your life is your own to dispose of as you will" at a stroke undercuts a primary value on either side. Thus freed, individuals might have premarital sex, get tattoos or abortions, publically blaspheme, kill themselves, or make decisions with economic consequences beyond the State's duty to ameloriate.

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