169 Comments
Jun 10Liked by Richard Hanania

This article hits me really hard right now. My dad is in his late 70s and has Parkinson's, and my mom is in her mid 70s and has Alzheimer's. Both, as you know, are neurodegenerative diseases that will only get worse and worse over time. Both parents require a lot of care right now, and it's eating up a lot of resources and time on the part of both my brother, his family, and myself.

My dad has signed a bunch of end of life documents, indicating that he doesn't want any lifesaving or life prolonging interventions. He's already so weak that his balance is unstable, which led to a fall last week and he broke 4 ribs. He can still feed himself, but barely because he's too weak to lift a regular fork (has to use a plastic one). He has to have help to get on the toilet.

My mom's short term memory is basically gone at this point, and she is constantly asking about her folks and where they are (they've been dead for over 40 years), and when you tell her this, she asks why no one told her, then 2 minutes later asks the same question again (and over and over) You can't reason with her, you can't argue with her, and you can't correct her recollection of anything really because she doesn't remember and therefore can't make mental connections. Sometimes she remembers her husband, sometimes she claims she's never been married, sometimes I think she thinks he's her father. At this point she still remembers me, but I know that day is coming too. We can't leave her alone anymore because she will literally decide she wants to go "home" (from the house that she's lived in for the past 15 years) and walk down the driveway and down the road. There is no cure, and this will only get worse and worse, forcing us to eventually put her into a memory care facility. If you've never visited a nursing home or memory care facility, you really should just to get a sense of how sad and depressing those places are (in addition to expensive).

I have owned animals and horses for many years. and I will say that we would never subject an animal to living the kind of life the elderly have to endure. I've defended friends and clients who've put their horses down upon retirement or some sort of major injury that would've left them pasture sound but basically unusable. I do know a client who retired a horse at age 20, then proceeded to fund that horse's retirement in a pasture for the next 20 years to the tune of $400/month, time and funds that could've been spent on another, younger horse or pretty much anything else.

Anyway, there are no easy answers here. I do agree with Richard though, that I would not want to be such a burden on my family at the end of life and I think euthanasia should be a more socially acceptable option.

Expand full comment
author

Thanks for your comment Heather. I’m sorry about what you’re going through but I’m glad you shared it because stories like this show people what is at stake in terms of suffering and human dignity. The opponents of euthanasia focus on the extremely rare case of the mentally ill young person who kills himself, while ignoring that forcing people to spend years undergoing pointless and degrading suffering is the norm for a huge percentage of the population.

Expand full comment

You need society’s permission to die?

Why?

Expand full comment

You don't. Nobody can stop you from blowing your brains out with a gun if you plan appropriately. If you wish to delay the end until you are no longer capable of doing it yourself, then the person you ask to do it does need permission to kill you if they want to avoid prosecution.

Expand full comment

People are so used to do whatever the doctors say that they ask the doctors permission to die. To be fair, the conditioning is strong and I myself somewhat fell for it when my daughter was born. It is hard to go against an authority figure in a stressful moment.

That be instead, if you stop and think, the absurdity in a situation like this becomes readily apparent.

Expand full comment
deletedJun 11·edited Jun 11
Comment deleted
Expand full comment

As a Catholic I am obliged to oppose euthanasia, and I do consent to that teaching. That being said, I think the current way we handle cases such as your own is a horror show that benefits no one but the insurance and medical practitioners. Prolonging life because we are terrified of death instead of viewing it as reality which is fearful, but also a release from the vale of tears. Imbibed nihilism combined with the ego's of doctors.

People should be allowed to die the old way, that is, naturally. Yes it is painful, often slow and unglamorous, but the end will always come when it is meant to. Never late or prevented by someone else. It is good for the soul of the one dying, and good for those who witness the stark reality of life and death. Memento mori. This also has an added benefit. It is totally free.

It is ironic, that in this culture of death, we have screwed up dying. It should be the easiest thing ever as it requires no effort to die, one simply has to let it happen. Insane.

Expand full comment

The fear of death costs everyone affected way too much. If we calculate who benefits, clearly it is doctors, hospitals, insurance companies and Big Pharma, all benefitting from people's personal terror of entering the unknown. They hang on to life tenaciously, regardless the cost. I have Jesus so death holds no fear; I would rather not go painfully but we do not get to choose. Dignity is facing life, and death, courageously. It has nothing whatsoever to do with dependency. There is much to be learned, including humility, from the process of being dependent. That is what this article is really about; our culture reviles humility and it is clear what that has led to. Oh wait; what month is this??

Expand full comment

Pride month was cancelled at my house. We fly the Sacred Heart flag

Expand full comment

Unfortunately I don't think insurance Companies benefit from this, I've read of insurance companies offering terminally ill people money to avoid the costly process of prolonging their death, and read arguments that government should spend money on young people instead, while claiming that old people are past their usefulness to the society ( it's true but life being commodified is something I can't stand, because where does it end). My pressing concern is the slippery slope where companies and government might compel ethunasia on those that don't want it. But there's absolutely no reason an elderly person should be compelled to go through the dehunamising experience of losing their minds and slowly withering away.

Expand full comment

Have you considered the legalities of deciding to die vs life insurance? No payouts for voluntary death.

Expand full comment

I have already lived this and it is no fun; but it is the norm now. Funny, no one seems to remember that these stories are NOT how it used to be. At no time in history did the care of the elderly become what it is today; they died at home, with family, after old age or disease ran it's course. This "prolonging" is not natural. The "medical" field makes a fortune, literally, from draining the bank accounts of the elderly at the end of their lives. The "care" they receive, which may gain them a few months at best, while many are literally unable to recognize those whose love they poured into, is cruel as it is not really life. Euthanasia is for animals. It seems to me that people need to accept death and dying as nature intended; at home, with loved ones around, as it has been for millennia. It would be better for everyone.

Expand full comment

I understand what you are going through. I am very sorry. Having both parents need so much at the same time must be hard. Make the most of sharing memories with your Dad since you still can. Love on your Mom as best you can. Once they are really gone, it is forever. That is honestly worse in many ways, believe it or not. Speaking from experience. It is not easier to lose your parents just because you know they are finally at peace. You still lose them.

I often wonder how it is we can grow up and not tealize how hard it will be to lose our parents. No one talks about it. Or as youth, we cannot comprehend.

Expand full comment

The young healthy Dutch woman killing herself is the best argument against euthanasia. Young healthy people should not be killing themselves, period. To not only allow that they do so, but to even actively approve of and assist in the suicide, is surely a sign of a deeply sick society and culture. If you want euthanasia for old people who are suffering, you should be arguing as vehemently as possible against letting anyone else who isn't severely ill access it, because seeing young healthy people using it to kill themselves is going to turn people off of the idea really fast.

Likewise, the concern with telling people to kill themselves so that they won't be a burden is what happens when this shifts to become the standard. You can portray it as noble for someone to kill themselves for this reason in a culture which is otherwise telling them to live, sure. What about the opposite situation? If everyone adopted your view, the social norm would quickly change such that people are expected to kill themselves at a certain point, and those who desire to live may face social sanction for daring to "be a burden."

You say that it's bad for the state to have a say in this, but the state must always have a say in matters of literal life and death. What kind of policies will the state adopt with the shifting of euthanasia into common practice for the elderly? Will the government decide that perhaps people should lose all of their benefits, such as social security, at a certain point, under the logic that they are now enough of a burden that they should just kill themselves? Hopefully nothing that drastic, but I would expect 100% that the government would begin looking for ways to encourage the elderly to hurry up and die and stop costing the taxpayer so much money.

As with abortion, I think you are leaning too heavily into simply insulting the other side, and not doing enough to engage with their actual concerns.

Expand full comment

So what if a young healthy person experiences their life so negatively they want to end it? Is life such a hard sell you have to coerce people into staying alive? People are brought into existence without their permission, the least you can do is let then say no thanks.

Expand full comment

"People are brought into existence without their permission." What an insane ideology you must believe in. Shall we just go ahead and collectively off ourselves, drive the species extinct, so that no more people will suffer the horrible fate of being "brought into existence without their permission?" After all, this course of action would be the surest way to prevent all future human suffering!

Expand full comment

Ideology? Not sure how that statement is an ideology. I think perhaps you have the ideology you took from that statement that I think we should all off ourselves. 1)A life not worth beginning may well be worth continuing, partially because part of the suffering is becoming attached to things that decay and end and 2)Plenty of people are fine with having been born and at least for now see the tradeoffs as worth it. I'm not talking about what people should do, I'm talking about what people should be allowed to do. I've found no topic that makes people angrier than suggesting that life isn't in comprehensive terms, a gift. But we have so much evidence far beyond substantial suicide rates that show some people go to some effort to absent themselves in ways short of killing themselves. How many empty chambers does their need to be in the gun and how high the prize for an empty chamber to not have at least some misgivings about playing Russian Roulette with the gun pointed at someone else's head? Especially if you are going to refuse them the dignity of assessing their own situation? Hanania should get David Benatar on the show to discuss this. The angry response to this line of antinatalism thinking reminds me much of woke responses to the potential for natural group differences - a thought that can't be entertained for fear of an entire house of values predicated on it being false and irrational fear of what wide acceptance might cause. We shouldn't pretend that plenty of sane people might not look at their life and declare it no longer worth it, especially as they age.

Expand full comment

I'm generally contemptuous of the term "culture of life," but go on, keep talking. I think seeing some more of what you're selling would be the fastest way to convince people that the tradcaths actually have a point when they talk about the need to support a "culture of life."

Expand full comment

Agree. By definition, a depressed person cannot see future happiness. They aren't capable of knowing that they might be happy. In this particular example, the Dr the who told the woman that "he couldn't do anything more for her"--he's the one causing the damage, imo. The sheer conceit and vanity to think that if you the knowledge you hold at that moment is all that can be done is evil. The psychiatrist could have asked someone else to take a look at her. This reminds me, slightly, of the "Witch Trials of JK Rowling" podcast, and one very pleasant KID talks about transitioning as a logical choice because his psychiatrist had told him they had tried everything else to cure his depression. These people are small minded--there is always more to try than what's on the checklist, and if they aren't feeling it they can ask someone who can.

In both cases, and I think most of life, we feel better/our depression lifts/we get a hit of dopamine when we move towards a goal. I believe the depressed woman in her twenties had a goal, and also found meaning in her belief that she could move the euthanasia movement forward. In the second case the kid is offered meaning and accomplishing a series of steps to become trans.

I think what depressed people need is a harmless goal that can be filled by following steps that will allow them to make a difference in the world.

It's not up to doctors and mental health practitioners to tell people that they've done all they can, so life (or gender) has to be changed.

Expand full comment

The idea that once we become a burden on others, we should kill ourselves is the moral position a smart 12-year old might make. We are all a burden on others at times, and other times we are the ones to bear that burden. That's life. (I've had to put relatives in long term care, and that's not great, and I was the in-home caregiver for my mother the last 6 years of her life as she died from Alzheimers)

I'm in favor of euthanasia too, and I plan to die by suicide myself. Things like advance directives should be used and honored. But the problems addressed in the journal article are real. If hospitals facing budget problems have the incentive to kill rather than treat patients, we could end up with a completely amoral system.

Expand full comment
Jun 25·edited Jun 25

> If everyone adopted your view, the social norm would quickly change such that people are expected to kill themselves at a certain point, and those who desire to live may face social sanction for daring to "be a burden."

This common slippery slope anti-euthanasia argument is already demonstrably false. There are many countries from Switzerland to Norway to Canada that allow easy access to euthanasia—have done it in some cases for decades—and many of these countries are also countries whose citizens report the highest levels of well-being and happiness. There is no evidence that suggests that people in these countries feel increasing social pressure to end their lives before they’re ready.

To the people who continually make this particular anti-euthanasia argument, you need to demonstrate through evidence that this as of yet unobserved response to accessible euthanasia is actually something that happens, which to date, it isn’t.

However, a very real problem worth talking about is the millions upon millions of people currently living in chronic and uncurable agony who no matter how much they may beg to be released from it are forced against their will to experience it.

Expand full comment

>This common slippery slope anti-euthanasia argument is already demonstrably false. There are many countries from Switzerland to Norway to Canada that allow easy access to euthanasia—have done it in some cases for decades—and many of these countries are also countries whose citizens report the highest levels of well-being and happiness. There is no evidence that suggests that people in these countries feel increasing social pressure to end their lives before they’re ready.<

The young healthy Dutch woman killing herself over "depression" is in fact evidence of changing attitudes. Is that something that has been happening for decades in these countries that you name? I doubt it.

My comment speculates on what would happen if everyone adopted Richard's viewpoint. We don't have any real-world evidence of what that would be like because, in the real world, there are still countless people like me standing in the breach saying "this is a bad idea." We do however have some real-world evidence on the reality of slippery slopes once you remove those troublesome nay-sayers and really give people free rein to run wild with certain ideas; as Exhibit A, I would present the freefall into insanity of the "LGBT community."

Expand full comment

>The young healthy Dutch woman killing herself over "depression" is in fact evidence of changing attitudes. Is that something that has been happening for decades in these countries that you name? I doubt it.

Actually millions of young people have killed themselves all over the world for thousands of years, even before the word euthanasia was ever coined. Denying people euthanasia doesn’t prevent suicide. If euthanasia is an option, then some of these young suicidal people will be far more likely to talk to medical professionals about their problems and these medical professionals then have the opportunity to suggest other viable solutions to their problems. Once all these other viable solutions are exhausted, usually over many months or even years, some of these young people may elect to still end their life, though very few do. I don’t think this one woman you continually point to as evidence that euthanasia obviously works for no one, decided she wanted to die because euthanasia happened to be available under the right circumstances where she lived.

You also put depression in quotations, as if it isn’t a real health issue.

All this is besides the fact that the one woman you reference time and again as evidence that euthanasia options lead to widespread social pressure to kill oneself for the betterment of the community did not indicate at all, ever, that she felt such pressure. There is simply no evidence of this fantasized social pressure in countries that offer euthanasia.

Expand full comment

>Actually millions of young people have killed themselves all over the world for thousands of years, even before the word euthanasia was ever coined.<

Obviously, the difference at issue here being that they never did it with explicit government approval and assistance. Your willful conflation of these two things demonstrates bad faith.

Expand full comment

If there had always been an officially sanctioned channel that these young people could have entered, where they could have expressed the severity of their concern to professionals who could evaluate the source of their problem and recommend alternative treatments thereby buying time for these young people to reconsider, I think lives would’ve been saved. If the experts could not find a viable solution, then the suffering party could’ve at least died in a peaceful, self-determined manner.

Why are you convinced that the young woman you reference wouldn’t have attempted suicide if euthanasia had been illegal? Everything she did and said indicated she was suffering to such an extent that she wished to die and likely would’ve attempted to take her own life.

Today my 80-year-old dad with severe dementia lies in a hospital bed. Dozens of times today he will discover as if for the first time that he has a catheter inserted through his penis into his bladder. He will panic and try to remove it but the restraints on his hands and wrists and the belt around his waist will prevent him. He will try to attack the nurses and staff who try to care for him. He will scream and scream. He will continue to do this the rest of his life as the catheter is permanent. He has no other options because people like you forbid him—and millions like him—to end their suffering, based on false premises and misapplied principles.

The potential suffering you are worried about from accessible euthanasia is hypothetical while you dismiss the actual unimaginable misery of millions as a necessary evil. I beg you to reconsider.

Expand full comment

>Why are you convinced that the young woman you reference wouldn’t have attempted suicide if euthanasia had been illegal? Everything she did and said indicated she was suffering to such an extent that she wished to die and likely would’ve attempted to take her own life.<

No it didn't lol, she stuck around for *3 years* going through all the bureaucratic bullshit instead of just taking the matter into her own hands. That absolutely suggests that she had some kind of attachment to the idea of government-sponsored euthanasia that she did not have for "regular" suicide, that she clearly didn't view the latter as an acceptable alternative to the former.

The idea that we're somehow going to "save lives" by encouraging suicide is insane troll logic. This is like saying that people are going to commit rapes anyways, so we might as well make it legal and even get the government involved in helping people with them, because if we just let the rapists talk about their issues with government therapists then maybe they won't want to rape anymore, and if they still want to do it anyways well hey the state overseeing the whole process can make it less traumatic for everyone involved, right?

No, if you do that shit, *of course you're going to get more rapes, not less.* The same is true of suicide, or any other human activity. This is Human Nature 101, it's so basic a five year old could probably understand it and explain it to you. Like what even. It's one thing to argue that suicide is A Good Thing, Actually, but the idea that you're going to somehow prevent it by legalizing it is just beyond cope.

>He has no other options because people like you forbid him—and millions like him—to end their suffering, based on false premises and misapplied principles.<

By definition, I can't forbid anyone from killing themselves. I'm just refusing to give it my stamp of approval. If you're going to do it, you can obviously just do it. But you can't make me go along with it.

Expand full comment

I am 100% pro-euthanasia for all the reasons you say but I think you misrepresent the arguments against. Being kept alive in diapers and assisted suicide are not the only two options.

I have a terminal illness and I will die before too long. I live in the UK where assisted dying is not allowed. But there's an NHS form you can fill in ("Advance decision to refuse treatment") where you specify whether or not you want to be hooked up to a machine and under what circumstances you want to be fed or helped to breath artificially (I chose 'never' on all counts). You don't last that long if they are not feeding you.

Unassisted suicide is also an option and you can buy the necessary equipment at Bass Pro. You can also catch a train to Switzerland and get your assisted suicide there. You can't take anyone with you unfortunately (or to buy your gun or morphine for you) because they will be arrested when they get home. I think this is cruel but I am sure there are ways around it.

I think you also misrepresent the "don’t want to be a burden" argument. The fear is not so much that grandma will become a burden. It's that nefarious grandchildren will persuade grandma that she is a burden whether she is or not. You might not be persuaded by arguments like these but a lot of grandmas will, unfortunately.

The UK will almost certainly allow assisted dying in the next parliament as have 11 states in the USA already. I imagine more will approve it soon. As I say, I am with you on the merits of assisted dying, but I think your case will be stronger if you properly acknowledge the arguments against.

Expand full comment
author

“But there's an NHS form you can fill in (‘Advance decision to refuse treatment’”) where you specify whether or not you want to be hooked up to a machine and under what circumstances you want to be fed or helped to breath artificially (I chose 'never' on all counts).”

It’s insane that the case against euthanasia is in some places you have a right to be starved to death. That is not a good or humane outcome and not something we should force people to go through.

Expand full comment

Like I said, I think euthanasia is the right choice but it's unfair of you to pretend that those other options don't exist. Starving to death when you are in a coma is not as bad as you think it is. It is what I have chosen, for example.

Expand full comment

That's like saying I don't support abortion but we should acknowledge women do have options like using coat hangers!

Expand full comment

Is it like that?

Expand full comment

Here’s a study on PubMed on withholding nutrition that you might appreciate. In particular, it might correct your impression that it is “not a good or humane outcome”.

In addition, no one is forced to go through it — not in my country at least. It has to be chosen by the patient. In the absence of explicit instructions from the patient, the next of kin or person with Power of Attorney can choose to withdraw life-sustaining care but they need court approval first.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041738/

No one is forcing this option on anyone. But is is an option and I would choose it anyway, even if assisted dying were an option.

Expand full comment

I think at some level RH thinks that if your grandchildren want you dead, you don't deserve to live, similar to how if you are not alpha enough to become a millionaire in a society with crumbling social capital because of immigration you are a loser who should get lost.

Expand full comment
Jun 10·edited Jun 10Liked by Richard Hanania

I agree with you 100% Richard. I am now watching my dad die slowly of Alzheimers. He asked to die while he was still capable of asking once he realized he would be in diapers for the rest of his life. He now is too far along to know to ask and is too incapacitated and depressed to do anything but lay in bed looking at the ceiling all day except mealtimes. He is medicated to a point that makes the depression tolerable but I think it makes his mind even more fuzzy.

He will soon run out of money for the Board and Care home that he is in. My sister and I are both low income and must work so we can't do the 24 hour care he will require. The next step for my Dad will be a Medicaid nursing home which is the most depressing place I have ever seen and I hate thinking about the day we will have to move him.

Since Alzheimers runs in families, should I ever get this diagnosis, I fully intend to go to Switzerland so that I never live this way. Our country is so backwards by not allowing people to make an Advanced Care Directive to end their own lives should they choose to do so. I follow the news about MAID in Canada since they are way ahead of us about treating people with dignity and respect at the end of life. I started following your newsletter the last time you wrote on this subject and I really appreciate you continuing to write on this topic.

Expand full comment
author

Thanks for the comment, it hopefully moves others. I'm sorry about your dad's situation.

Expand full comment

Many people have a phase of life when they are depressed, some to the point of wanting to kill themselves. Then they get better and lead good lives.

Would the author really want depressed people in their twenties having access to euthanasia when we know many of them will l recover, at least to the point of not wanting to end their lives?

Expand full comment
Jun 10Liked by Richard Hanania

This is the article where you and I agree 100%. I've told my family to move to anywhere that allows it, I've got a DNR on file, I've made my wishes known to everyone who will listen, and I've begged someone to murder me if I can't do it myself. I watched someone suffer for 13 years in a condition I wouldn't force on a dog. It's immoral. If I can no longer do for myself and especially if I can't think or speak, I do NOT want to be here any longer. And, the fact that we ask our family members to decide is atrocious. No one wants to kill "mom." So, instead they go into debt and the doctor and hospital continues to make money? Not no, but hell no. I know suicide is legal but not always possible and why shouldn't a person get to go out peacefully on their own terms?

Expand full comment

You're conflating the use of medical interventions with euthanasia. It's not euthanasia to withhold treatment. "DNR" requests are not euthanasia. You certainly have the right not to be a consumer of anything, including medical intervention; but you have no right to ask society to not only condone your actions but to help you end your life "on your terms."

Expand full comment

I'm not conflating anything. I'm signaling that I have put in place everything legally available to me at this time. I believe that people have a right to end their lives when and where and how they deem fit. I am not asking society to condone anything. There is no difference to me between society condoning alcohol usage or death if it's mine. What I dont understand is a society that condones watching suffering. Neither of them is anyone's business, especially the government's. What I am hoping is that if I am willing to pay for end-of-life services and there are humane doctors who don't believe people should be made to languish in their shell, the law will eventually allow this. Being allowed some dignity in death doesn't seem too much to ask. People who would rather see others go into the streets and buy the means necessary on their own only allows the same outcome, but messier. I can't understand why any human being would look at someone suffering and say, "No. My morality doesn't allow me to watch you die this way. You must do it the way I say and if that means you have to blow your brains out, so be it." My grandfather, two months ago, a Marine, was given a bad bill of health. He was 86. He went home, got dressed in uniform, walked into his backyard, removed his shirt, and shot himself in the liver, though he meant it to be the heart, I'm sure. Was that better? When his family came home? I guess it makes him a hero because he didn't ask anyone for permission.

Expand full comment

You had an 86 year old grandfather just two months ago, and you've already got a DNR order in place? Perhaps you have your reasons, but, you know, plenty of people have made full recoveries after having CPR in a medical emergency.

It's not that one's morality does not allow them to watch you die one way versus another; it's that suicide itself is immoral, even if the situation around certain suicides feels more sympathetic, like your grandfather's for instance. We can all understand the desire to avoid personal suffering and humiliation, but let's not pretend that it's courageous or dignified. To normalize suicide to a degree in which there is actually a third party profiting by willingly ending the lives of others is terrible for society; and you are, indeed, asking for society to condone it when you want to see it legalized, hence the argument to convince people that it is a compassionate and dignifying action.

I've been involved in the care of multiple dying loved ones. One of my closest family members endured months in hospice before passing, and I am thankful everyday for her willingness to suffer the pain and humiliation of disease. I saw what it truly means to die with dignity...and it's not toasting to your life with all your loved ones while you still can before letting someone put you down like a dog.

Expand full comment

I think we will just have to agree to disagree here. I appreciate your opinion. Thanks for the discussion.

Expand full comment

One last thing, for the record, I have been far more sympathetic to euthanasia in the past. I worked with kids who were so disabled, both physically and mentally, that they constantly needed phlegm suctioned out of their throats just so they wouldn't choke to death. But when I considered that much of their suffering was the result of societal pressure to take advantage of costly medical intervention (you alluded to this in your first comment) which artificially extended their lives, I shifted my focus away from euthanasia and onto the right to refuse medical intervention and found that fixing this would go a long way to allowing people to "die with dignity." Our society's incredible lack of stoicism when facing death is based on a sales pitch. To create a business for euthanasia won't fix the problem; it'll only change the sales pitch.

Expand full comment

My nephew was born with only the ability to breathe and scream when in pain. He couldn't even suck a bottle. He was on a feeding tube from day one. By age 13, he had undergone surgeries to fix his spine. He would wail and his body ended up outgrowing parts of itself. His spine had him bent into a position that was unnatural. My sister, his mother, wheeled him in and out of showers, never left the house because it would hurt him, and cried day in and out for 13 years until he finally took his last breath. There was nothing they could do short of starcing him to death which wasn't an option. He was not someone who had hope of getting better. Ever. I will never understand why that's okay. I understand that we shouldn't try to make an industry out of death, but we need something more than we have.

Expand full comment

I think the assertion that suicide itself is immoral illustrates Richard’s point about the vast gulf in value systems here, and overshadows the other arguments about greedy hypothetical doctors who’d start indiscriminately knocking off patients for a few bucks.

On one side is the deeply held belief that suicide is inherently immoral, and on the other is the deeply held belief that nobody should be condemned to spend the rest of their days in horrifying agony to satisfy somebody else’s abstract philosophical beliefs. One side sees the preservation of human life, in its strictest biological sense, as the only acceptable factor in the moral calculus, and the other side believes this principle is morally incoherent (and selectively applied to suicide). One side says it is dignified to accept a life of terminal misery, and the other side asks: why?

And I agree with him that it is almost impossible to bridge this gulf. Especially when the first position comes from a fundamentally theological place.

Expand full comment

They ALL come from fundamentally theological places.

"The only true evil is pain" is a doctrine, a religious concept.

"Life is not ours to take" is also a doctrine, a religious concept.

Sometimes they collide. And that's when things get difficult.

Expand full comment

This really isn't true though. I mean sure some people are making the argument you describe. But plenty more are raising concerns about where the acceptance of widespread euthanasia might lead, rather than claiming that it is always wrong in all circumstances as an absolute moral axiom.

Expand full comment

I don't agree with your framing of the two sides, and I think there could be a bridge in the recognition that society should not condemn anyone for refusing certain life-extending medical interventions for themselves or their loved ones; however, it's already legal to refuse medical intervention. And it is already socially acceptable to give strong painkillers that could hasten an already dying person's death. In other words, one can certainly believe suicide is immoral while concurrently believing that preserving life at all costs can also be immoral.

Everyone, regardless of beliefs, should be able to recognize that here is no real objective measure for "pain" or "suffering." I know of a person who killed himself after suffering what he found to be unmanageable pain from shingles. A Christian can believe that suicide is immoral but also recognize that the conditions that drive any individual to suicide can be severe and perhaps relieve one of culpability; God is the perfect judge. Atheists can believe that suicide is never immoral, that their life is a chance happening that is completely theirs to do with what they want, but also recognize that it may be dangerous to legitimize and socialize suicide as a means of escaping suffering, as suffering is not only subjective but a basic part of the human condition.

I don't think one needs to be particularly religious to be able to imagine how throwing off taboos regarding suicide could negatively impact society. And I wouldn't downplay the inevitability that you will have doctors who are more than willing to put people down for less-than-noble reasons. This is hardly a side argument but a very realistic consequence that anyone should be able to anticipate; and, indeed, abuses have already been documented in places where euthanasia is legal.

Expand full comment

It's important to clarify that refusing medical treatment and euthanasia are indeed different actions, but they both stem from the fundamental right of individuals to have autonomy over their own bodies and lives.

Withholding treatment, such as through a DNR order, allows a patient to avoid unwanted interventions that might prolong suffering without improving quality of life. Similarly, euthanasia is about respecting a person's choice to end their suffering on their own terms when facing a terminal illness or intractable pain.

While it's true that euthanasia involves actively ending a life, it is done with the same respect for autonomy and compassionate intent as respecting a DNR order. Those who seek euthanasia are often in situations where their quality of life has deteriorated to a point where continuing to live is more about enduring suffering than experiencing life. In these cases, the individual is not asking society to condone arbitrary death but to recognize their right to a dignified and humane end to their suffering.

Furthermore, the argument that society should not help someone end their life on their terms overlooks the compassionate and ethical considerations at play. Allowing euthanasia can be seen as an extension of palliative care—providing relief from suffering when no other option remains.

Legalizing euthanasia involves stringent safeguards to ensure that it is a well-considered decision made voluntarily by a competent individual. It is not about encouraging death but about providing a humane option for those who are suffering unbearably and have no hope of recovery.

Expand full comment
RemovedJun 10
Comment removed
Expand full comment

Is the idea here that anyone who costs more in healthcare resources than they can generate in taxes should simply be put down? Because that's not just a slippery slope, it's a sheer drop-off into insanity.

Expand full comment
RemovedJun 11
Comment removed
Expand full comment

That's not what you wrote originally. You wrote:

"if you spend money on medical interventions for yourself after age 75, you should be considered kind of an asshole, or at the very least a distasteful, neurotic pussy."

This implies that even if you spend your own money that you earned earlier in life to keep yourself alive longer, there's something morally wrong with you, which seems pretty insane to me. But we really don't have to take it that far. Let's say I'm in a car accident that leaves me paralyzed from the waist down. I am now permanently disabled and will, from this day on, be a net drain on society's resources. Am I "kind of an asshole" if I want to keep on living? Am I obligated to kill myself now? If not, what is the difference between this situation and a 75 year old who would like to enjoy a few more years on Earth?

Expand full comment
RemovedJun 11
Comment removed
Expand full comment

You didn't answer my question at all. I take from this that you didn't think your position through before posting, and realize now that it's utterly ridiculous.

Expand full comment
Jun 10·edited Jun 10

I'm generally a supporter of euthanasia for people who request it (particularly if they have a terminal illness or chronic pain), although I admit to a certain amount of unease about the MAiD model in which doctors offer it proactively to people just seeking treatment for a curable condition (or hell, just people who are homeless, as in the case of Amir Farsoud).

I remember seeing a discussion about that depressed Dutch woman on a forum, and one user described the visceral disgust he felt about that case. Not because a depressed woman killed herself, but because she decided to kill herself by *going through the proper channels*. You're an able-bodied adult! There is literally nothing stopping you from hanging yourself in private, or drowning yourself, or overdosing on paracetamol etc. If you're in such a state of unbearable psychic misery that you want to end it all, why prolong your agony by sitting on a euthanasia waiting list for three years when you could top yourself TODAY? "I want to kill myself, but I'll only go through with it if the teacher signs my permission slip"? Pathetic. The hypoagency is real.

Expand full comment

She actually explained it: she wanted to avoid the potential traumatic effects of for example finding her body on her family/partner. I also think that in case of legal euthanasia you can spend your last minutes with people you're close with instead of having to do it alone and in secret or exposing someone who might decide to stay with you/help to criminal charges.

You could argue that only the brave have the right to choose death on their terms and outsourcing this to state agents to soften the process is wrong, and I have some sympathy to this position, tho it does feel unnecessarily cruel.

Expand full comment

It's not cruel to demand people who kill themselves suck it up instead of requiring all of us through elected government to praise them as brave. "Dying is hard on people around me, so it's not fair" is a childish answer.

Expand full comment

I'm not suggesting praising them as brave (or, for that matter, condemning as cowardly). The whole "brave cancer patient" routine sucks as much as the "social worker facial expression" nearly every woman and many men make when someone says they're feeling depressed/ otherwise miserable.

I'm suggesting that, if we can agree that someone being in a situation that feels unbearable enough for them to want to die is an at least unfortunate, and maybe even tragic (can we agree on that?) then adding extra pain to the whole rigmarole feels inhumane. I don't think aiming for humane policies is childish, and I don't think "suck it up for the sake of sucking it up" is desirable. Yes, dying can be hard and euthanasia laws aim to make it a bit easier. I agree with this goal.

Obviously it's a value position and thus not subject to argument based on data.

Expand full comment
Jun 10·edited Jun 10

>then adding extra pain to the whole rigmarole feels inhumane

But that's exactly my point: by her own account, this woman was experiencing such profound and unbearable pain that she felt her life wasn't worth living, and yet she voluntarily added three years of extra pain to the whole rigmarole by insisting on going through the "proper channels" to end her own life, when she could have finished herself off three full years earlier if she so chose. Even if she insisted on employing a suicide method which would allow her to spend her dying moments with her loved ones (i.e. getting her hands on a lethal dose of morphine, explaining to her loved ones that this is happening and she isn't going to be talked out of it, gathering her loved ones around her bed) - that's going to take her, what, six months max?

Expand full comment

I'm always a bit confused when people say with such an ease that one could just get a good dose of morphine. I wouldn't know how to get such a dose of morphine if my life depended on it..

Expand full comment

I assure you, if you live in a large Western city and your life depended on it, you could.

Expand full comment

Yes, I think if your movement has to prop up people behaving this way, and to be clear, the right to death people absolutely have to do this and will have to do more of it in the future, it's a sign you're just pretending to be a Nietzschean to scandalize socially conservative Christians. Any movement that wants the government to promote suicide is going to have to pretend a young woman spending years doing interviews about her brave choice is a hero. They don't have a choice; this is their vanguard! Or I guess the government employee heroically pinning down the confused 80-year-old woman. With so many impressive heroes like these to pick from, the Christians will surely be humiliated into defeat.

Expand full comment

You know I've seen you throw the word "Nietzchean" or some variant around a lot in these comments and I really don't know where it's coming from or what it's meant to mean in this context.

Expand full comment

>>it's a sign you're just pretending to be a Nietzschean

I'm probably missing something, but where's this Nietzschean part coming from? The OP? My comment? If the latter, I'm not feeling particularly Nietzschean here at all. I'm making what feels like a pathetic appeal to merciful authority for my own hypothetical, cancer ridden and/or dementia addled self. I certainly hope that if I started to feel that my psychic pain got bad enough to really want to jump off the bridge I'd be able to do just that.

So, the argument from that Dutch woman is really strawmanning this whole conversation. The vast majority of people who take advantage of euthanasia are NOT young women with BPD.

As to the 80yo, yes please. I want someone to do that for me if I get there.

Expand full comment

No, the government of Canada has decided (not due to any legislative vote, but the wisdom of progressive judges, naturally) that the people of Canada will sanction and uphold suicide as a dignified choice. They can't help themselves, they really believe it's important to stress this is good. It's not like having legal alcohol markets where you're still allowed to not pay for other people's beers if they're an alcoholic. It's something *YOU* must underwrite and therefore accept as a good thing.

All I am saying is, no thank you. I don't want to pay taxes to endorse mentally ill girls and young women destroying themselves, and I don't care if you need a gender chakra aligned, or your brave shooting up of heroin affirmed, or dignity in suicide granted to try and guilt me into it. It's nonsense, I won't have a part of it, and if you want to do it as an adult, the least you can do is stop trying to demand my moral and fiscal approval of your bad behavior. Stop making me pay for your bad behavior is about the most libertarian thing anyone has ever said; I don't understand siding with progressives on this.

Expand full comment
author

You seem very very passionate about young girls with mental illnesses not killing themselves, which is in all systems so rare that it is almost nonexistent. So rare that individual cases become international news. Meanwhile you focus a lot less attention on the norm, which is the miserable conditions under which many people spend their last days in advanced countries.

Expand full comment

I mean, this is the same thing that happens with abortion, in reverse. 98% of abortions are elective, but abortion advocates focus in on the occasional extreme outlier of a raped 12 year old or what have you in order to justify that 98%. Having to defend the most extreme form of something is par for the course when making policy, because people who are anxious about something are always imagining the worst case scenario. People who think "whatever it'll probably be fine" aren't likely to chime in one way or the other, they aren't the ones who need to be convinced or placated.

Expand full comment

What is the evidence that most suffering in advanced societies is due to either of these groups? I don't think either of us has actually run the numbers and made the point, but my recent point (in this thread) wasn't even a utilitarian one.

Expand full comment

I feel like it wouldn't have been THAT difficult for her to get her hands on a lethal dose of morphine, explain to her loved ones what she wants to do and have them gather around her bed while she presses down on the plunger. Then once the deed is done, one of them can call an ambulance and tell them "we had no idea, we just found her like that" (winking to the paramedics is optional).

It's not even that I don't sympathise with her desire to avoid traumatising her loved ones: I just resent the entitlement of "I don't want to have to deal with this problem, therefore it's the state's problem and they have to pay for it (even if it would cost me nothing to deal with it personally)".

In a weird way, it sort of reminds me of gay men demanding that PrEP (€400 for a bottle of 30 pills) be made available free of charge. You can get condoms for next to nothing. If having bareback sex is so important to you, pay for your goddamn PrEP yourself. Not everything that inconveniences you is a problem the state is required to solve and subsidise.

Expand full comment
Jun 10·edited Jun 10

"I'm generally a supporter of euthanasia for people who request it (particularly if they have a terminal illness or chronic pain), although I admit to a certain amount of unease about the MAiD model in which doctors offer it proactively to people just seeking treatment for a curable condition (or hell, just people who are homeless, as in the case of Amir Farsoud)."

I agree with this. It doesn't seem like an "undue burden" that state sponsored euthanasia should pass the rock bottom requirement of "the patient should at least ask for it first."

Expand full comment

It's like "gender-affirming" surgeries. Just because some people will castrate themselves anyways, doesn't mean I want to legalize and pay for it and mandate that some medical provide do it, so it will be done more safely.

Expand full comment

Allowing euthanasia could lead children to pressure their sick elderly parents to end their lives, a reality many would find shocking. The right often views bad incentives as worse than a bad situation with reasonable incentives. Therefore, their cautious stance on euthanasia makes sense.

Expand full comment

While I agree that it is a worry, what about the status quo? In the US at least, sick elderly parents often impose huge costs on their children, therefore a very large incentive already exists for children to pressure their parents to end their lives. How often do we see this occurring? Obviously not true data, but in the cases I've encountered, it is far more common that the sick elderly parents wish to end their lives - or more commonly, sign documents saying that they don't want painful/expensive/undignified last resort treatments, which is the same thing - and it is the children who oppose that.

We already have hospice care - which for sick, elderly patients contains the exact same incentives and results as euthanasia. I agree that hospice is morally different than actively ending one's life, but you're talking incentives. Shouldn't we already see "children pressuring their sick elderly parents into hospice?" I admit there might be, but it seems like something we should check.

Expand full comment

I am pro-euthanasia but the one thing I would change is to make cryonics mandatory with it at least in those cases where it's not the obvious ethical imperative (as it would be with a painful terminal illness).

This would instantly transfer it from the category of death/assisted suicide to medical treatment, thereby entirely bypassing the usual tired bioethical debates; as is the point of cryonics, the option to revive in the event that it becomes feasible and a cure to the original ailment is discovered; last but not least, it would lower cryonics costs thanks to bigger economies of scale and accelerate cryonics research.

Expand full comment

My father just committed suicide after a terminal lung cancer diagnosis. He said that his treatment was "human torture". I totally agree with the point of this article. Good job Richard.

Expand full comment

The most committed partisans on both sides of this debate seem to want to avoid a key factor here, which is that often people in the market for assisted suicide could do it themselves if they wanted to.

The 'pro euthanasia' people prefer to surreptitiously move the goalposts of the debate to 'should people in terrible pain be allowed to kill themselves' when the real question here is 'should our highly regulated and government-subsidized medical system facilitate people in killing themselves.' Meanwhile the anti euthanasia crowd tend to be religiously motivated and, since their religions ban suicide, they won't embrace the argument 'let them just do it themselves.' But 'let them just do it themselves' is the appropriate resolution for the vast majority of edge cases where RH thinks we need to just err on the side of allowing euthanasia because it's like distasteful speech.

The person dying and in horrible pain whose mind is gone or who is too weak to lift a fork probably has no option for suicide without help. But no such impediment applies to the edge cases where someone depressed but not in morbid physical health. In those cases, the state/medical establishment should do everything possible to make the person better and discourage suicide. If despite this help the individual still kills himself, that's a tragedy but not one that the state/medical authorities need to be a part of.

Expand full comment

The same argument could be said for abortion. Anyone could get an abortion. The argument was that it should be done in a "highly regulated and government-subsidized medical system.'' The coat hanger was always there, but that wasn't good enough.

Doing it yourself isn't fool proof. People survive jumping off a bridge, or bungle hanging themselves. Getting a gun isn't exactly easy depending on where you live. I tried overdosing on pills once and it didn't work. If public funds are going to abortion, they should go for this too. But at a minimum, the state shouldn't get in the way of a private facility offering this service.

Expand full comment

The analogy doesn't hold water. Yes, killing yourself can be messed up but it doesn't require medical expertise to get right. And in any event the basic debate is not whether abortion is publicly funded (a secondary issue) but whether it should be legal to begin with.

Expand full comment

It's surprising, in light of "gender-affirming care", that you seem to underestimate the power of opening up a "human right" to market forces and social contagion. There will be specialized euthanasia accessories, like candles, bedsheets and mementos, fancy euthanasia retreats and increased demand for funeral services. Participating in and supporting euthanasia will be a social justice cause, seen as a way to reduce racial disparities and save the planet from climate change. You will not only be able to unburden your family, but also provide them with a week's worth of food. AI chatbots and hordes of indoctrinated counselors will help spread and support the social contagion. Your problems are too difficult and outweighed by the benefits of ending your life now, on your own terms. Just do it.

Expand full comment

Exactly. The edge case becomes the base case.

Expand full comment

As I see religion being introduced into the other comment threads, things are coming into sharper focus: Refusing euthanasia and burdening society with your mental and physical suffering will associated with far-right, Christian Nationalist sympathies, just as refusing an experimental mRNA vaccine was looked askance at. Don't be a religious fanatic or white supremacist, kids. Drink the Kool-Aid. Literally.

Expand full comment

Reflecting on it, I think the reason why you are able to be so clear cut about the matter (aside from your autism) is because of your extreme libertarianism. However, if we accept the premise that large numbers of people are morally obligated to kill themselves, and we are not strict libertarians (so, 98% of people), then we pretty quickly get to somewhere dark.

Expand full comment

I don't see how it is libertarian to get the government involved in running assisted suicide. The libertarian position would be that the government simply leave people to do as they please, including with regards to suicide, which is already more or less the case. If assisted suicide is truly so popular, perhaps pass a law authorizing private medical providers to provide the "service," and let the market do as it may.

Now of course that isn't how any of this plays out in real life, which is par for the course when it comes to libertarianism. Libertarian theory almost never matches reality. But it's important to clarify what the libertarian take would actually be, so that people clamoring for a state-sponsored suicide industry aren't allowed to falsely claim the mantle of "libertarian."

Expand full comment

Strange, I'm neither autist nor libertarian, yet I still hope for euthanasia to win. My emotional reason for this is severe fear of horrible prolonged unnecessary suffering that can easily strike me or my child or anyone. Can't even bear to imagine it. The moral obligation of being left to die when too old to keep walking has been in use in many very poor societies. I'm not afraid at all that it will become a dark reality in very rich societies. Even if it would it would feel slightly less dark to me compared to the unnecessary prolonged suffering that is the current reality.

Expand full comment

I am absolutely convinced that the opponents of voluntary euthanasia are people who are motivated by a very deep terror that no one loves them, indeed no one even likes them, and that people would have reason to want to get rid of them, if they could do so legally.

To address this fear, they COULD simply resolve to become a more likeable person that others might actually want around. But instead, they double down in their endeavors to control everyone else (which ironically is likely one of the traits that makes other people prefer that they not be around).

I would love for someone to do a survey and see what the correlation is between policy position on legally assisted suicide and how much one agrees with the statement "there are probably at least a few people who wish I was dead".

Expand full comment

You don't think it's possible that some people have a legitimate difference in preferences or values--instead it must be the case that they fear that they personally will somehow be targeted for elimination if euthanasia is allowed?

Very strange viewpoint.

Expand full comment

They can have their own preferences and values, but we are talking about telling OTHER people -- people one doesn't even know -- how they're allowed to die...and not just that but telling them they have to do it in the worst, most drawn-out, expensive, and humiliating way.

That's an extremely authoritarian position to take, to elect oneself as being in charge of how complete strangers choose to die, and preventing them from doing so as they see fit. I find it to be a shockingly offensive level of interference and control over other people's lives at their most intimate and vulnerable end-of-life moment.

So yes, I think one has to have an incredibly strong fear to be comfortable asserting such an overwhelmingly intrusive power over others, to try to tell millions of strangers: no, you're not allowed to die the way you want to die, only the way *I* say you get to die. I mean, that's just a straight up tyrannical impulse. I full understand why Richard has such a strong reaction to someone that comfortable trying to control other people's lives.

It is just a simple fact that end-of-life issues are horrific (in the US at least) leaving confused, mentally-gone people to languish and be kept alive FOR YEARS, literally in diapers, in a care home somewhere charging hundreds of thousands to keep a person alive who would never choose that. Preventing people who want to avoid that from being able to have more peaceful end of life is a tyrannical and cruel impulse that can only be borne of great fear because it makes no sense otherwise. If someone is religious and thinks it's wrong to commit suicide, that's fine for them, but why do they get to tell everyone else what to do? Let their god judge them in the afterlife, if that's what they believe, it's not up to them to make end of life decisions for other people.

Expand full comment

It's just so lazy to dismiss opposing views as "actually, you are personally motivated by X." I could just as easily sit here and claim that all the euthanasia supporters ACKCHYUALLY just don't want to have to take care of their parents and are hoping to use euthanasia as an easy cop-out.

As far as the idea that this is somehow about "telling other people how to die," no, in fact suicide has been de-criminalized in the United States, although I think there may be some states which still criminalize *attempted* suicide. Anyways, while I guess I'd make suicide illegal if I could, it's still a pretty ridiculous and oxymoronic thing to complain about. You obviously do not require anyone else's approval to kill yourself. You can just go do it, and quite literally, no one can impose any consequences on you afterwards. I'm all for the Second Amendment, so in fact I'm very much in favor of making suicide widely available to everyone!

I'm just not going to sign off on it and tell you that I think it's okay or that it's a good idea. If anyone ever speaks to me who is suicidal, I will never tell them to commit the act. I might understand their reasons if they do it anyways, but it will never be done with my approval. Asking me to support state-sponsored suicide is asking me to approve of suicide as an official societal standard. Again, I will not do this, and the nature of the act of suicide makes it absurd to contend that this somehow makes me "authoritarian." You are obviously free to kill yourself however and whenever you want, generally speaking. What you are asking is for the government to help you do it and approve of your decision, which is not something you are entitled to.

If you felt this passionately about the issue, there is *a lot* that you could go out and do about it, right now. Go and start spreading the message to people that they should plan ahead of time when, where and how they are going to kill themselves. Make sure it really sticks--down a bottle of pills and *then* put a large-caliber firearm to your head. Go out deep into the woods where your body will trouble no one. Have a plan to do it well before you become demented and bed-ridden--that is obviously the surest way to avoid being a burden, after all. If suicide is truly so noble, go ahead and make a movement out of it. If you succeed, it would be a powerful statement in favor of your beliefs.

Instead of doing that, supporters of euthanasia seem content to whine about it on Internet forums, and do nothing more. I am not impressed.

Expand full comment

As morbidly psychologically offensive as this is, I absolutely agree. This is one of those truths that you can be publicly crucified for saying, but anyone with any sense would quietly agree with.

And good for you for saying it.

Expand full comment

This seems like weak-ass Bulverism, and I say that as someone who supports euthanasia.

Expand full comment

No one has the right to demand that society condone suicide and that medical professionals who take vows to do no harm (as laughably idealistic as that sounds) administer life ending drugs. It seems that the pro-euthanasia advocates are more interested in forcing their beliefs on society, that, even to their last breath, they, not God, are in charge. What they appear to desire is approval from those around them, which would be a damnable thing if they truly have to answer to their creator for their actions. If one wants to kill himself, let him take sole responsibility. We all know there are plenty of painless ways to do it.

People also seem to forget that they have the right to refuse medical treatments that will unnaturally prolong life. If you prefer a more dignified death, avoid hospitals and don’t be a consumer of modern medicine. Even then, there are no guarantees in this life; you may die on the toilet.

Expand full comment

Richard, I follow your logic to a point. What makes me uneasy is when it is the government that controls the agency and the money that both provides healthcare and is willing to actively assist in one's death. Governments, and the workers comprising the government, have an almost unblemished track record of manipulating even the most well intended of laws and regulations to the benefits of the bureaucracy rather than the citizen. It just feels like this is the unfortunate end state of rationing healthcare which, admitted or not, is already happening daily in most western countries.

Expand full comment