[HN Gopher] Medical aid in dying, my health, and so on
       ___________________________________________________________________
        
       Medical aid in dying, my health, and so on
        
       Author : homebrewer
       Score  : 132 points
       Date   : 2025-06-11 16:33 UTC (6 hours ago)
        
 (HTM) web link (blog.the-brannons.com)
 (TXT) w3m dump (blog.the-brannons.com)
        
       | daedrdev wrote:
       | > Another slim possibility is a heart transplant. I am not
       | interested. I've explained my reasons more fully to people who
       | are close to me, but they basically boil down to the fact that an
       | organ transplant requires a full commitment to the process, and
       | I'm not willing to make that commitment.
       | 
       | Seems a little strange to not want to try to commit to the
       | requirements for transplant and instead just die.
       | 
       | Perhaps they (arguably justifiably) fear the trauma that further
       | interventions will bring.
        
         | jrvarela56 wrote:
         | I always ask not to be snarky but because our culture seems
         | fixated on living forever: what's so bad about dying?
        
           | ian-g wrote:
           | I can't speak for anyone else, but it feels like there's more
           | to do. More to learn, to see, to visit, etc...
           | 
           | When you're ready, you're ready, but people should have the
           | option of continuing if they want.
        
           | nancyminusone wrote:
           | If you're a big fan of doing nothing forever, I'm sure it's
           | fine.
        
             | jf22 wrote:
             | Better than getting shocked all day or feeling shitty after
             | a transplant because of the drugs you have to be on
             | forever.
        
               | mrguyorama wrote:
               | For some people yes, for others no.
        
             | the_af wrote:
             | I get what you're saying, but continued existence has to be
             | balanced against the quality of said existence. If it's
             | agony, pain or extreme disability that prevents enjoyment
             | of life, life seems less compelling.
        
             | SoftTalker wrote:
             | Same as before you were born. How traumatic was that?
        
             | wat10000 wrote:
             | Doesn't matter, it's not like there's a choice.
        
           | jvanderbot wrote:
           | I would be horribly sad about missing my kiddos' milestones.
           | It's an absolute joy watching them grow up.
           | 
           | But if my health made me feel like I was going to miss them
           | (or worse: derail them), then I would be forced to admit it
           | wasn't for the best for me to keep going as is. If I was sure
           | that was the case, it would be easy.
           | 
           | Conversely, it's easy to examine "from the outside" someone
           | else's situation and say they should keep on going. I'm not
           | so sure I could endure what TFA describes either, especially
           | since it's probably hopeless, and especially after watching
           | my own father sit dying for days in a hospital after his
           | heart attack while the doctors poked him to make him move to
           | show my mom he was still alive. It was gruesome and he died
           | anyway.
        
           | daedrdev wrote:
           | Nothing is bad about dying, its a part of life, but his
           | insistence on giving up despite a major medical option
           | remaining feels illogical even though they may have good
           | reason to not want it.
        
             | vjvjvjvjghv wrote:
             | The decision may be more logical once you experience the
             | same situation
        
         | the_af wrote:
         | My take from reading the blog post is that this person is
         | understandably disappointed, scared and traumatized by past
         | treatment failures. He described being scared to even try
         | sleeping, always fearing the next shock or heart attack. Also
         | some of the treatments seem to have been exploratory or "just
         | in case", and then failed. That leaves a psychological scar.
         | 
         | It's very difficult for someone who hasn't experienced this
         | (like me and, I guess, you) to put themselves in the other
         | person's shoes. I think I can understand the decision he's
         | making, and it doesn't seem to me to have been taken lightly.
        
           | daedrdev wrote:
           | Well said, I think you put up a reasonable answer. And at
           | some level their situation will not change, they still will
           | have heart problems while waiting and may go through all that
           | to not even get a transplant
        
           | weatherlite wrote:
           | I get it but can't a transplant actually work well for him ?
           | I've just read the statistics and they seem really decent.
           | Perhaps he "needs" anti depressants and go for a transplant.
           | It's not clear to me he is in a completely lucid state of
           | mind - he is saying himself he thinks he has PTSD, plus he
           | has a bunch of stuff to live for it's not like he hates life
           | - he just hates this shitty medical mess he is in. However,
           | it looks like his family is on board with him going through
           | with this so what can I say.
        
             | gusmally wrote:
             | When reading the rest of his posts, I think you are right
             | to ponder how his mental health is negatively impacting his
             | outlook. He seems to be more ready to accept death than I'd
             | expect, given how young he is. I wish him and his family
             | the best; an unimaginable situation.
        
             | finaard wrote:
             | A transplant always is a life altering change. You'll be on
             | immunosuppressants for the rest of your life which has a
             | massive impact on your quality of life - and that's _if_
             | you get a transplant before you die.
             | 
             | I have no idea how I'd react in that situation - but I can
             | understand people who'd rather not. Especially considering
             | that you might not want to take one of the few organs from
             | a person who might be willing to fully commit to that.
        
             | the_af wrote:
             | I do think he has some (understandable) PTSD, indeed.
        
         | nancyminusone wrote:
         | This is at least the second time I've heard someone say that
         | the defibrillator implant shocks are so bad, they would rather
         | be dead.
        
           | the_af wrote:
           | I never thought about the uncertainty of it all. If the
           | shocks are very painful and can come at any moment, without
           | notice, they must be terrifying. The author of the article
           | describes being fearful of even trying to sleep...
        
             | Modified3019 wrote:
             | It's literally like those experiments that test the effect
             | of electric shocks in rats for avoidance of something, and
             | there's a control group of rats that are just shocked
             | randomly. The randomly shocked rats become highly stressed
             | and neurotic.
        
           | nneonneo wrote:
           | If the defibrillator has any kind of warmup period before it
           | fires, I wonder if that interval could be used to send a
           | signal to the patient, e.g. to their phone.
           | 
           | The most "usable" form of this would be to allow the patient
           | to agree or disagree to the shock (maybe defaulting to agree
           | if no response is given in time); this would place the agency
           | in the hands of the patient and allow them to be mentally
           | prepared. Missing that, at least a couple seconds of warning
           | would be better than nothing.
           | 
           | (Disclaimer: I don't know much about these devices or the
           | latency requirements between detection of an abnormal
           | condition and treatment; these suggestions only work if the
           | heart can tolerate a few seconds of delay. It seems plausible
           | since the detection itself is based on monitoring of heart
           | rhythms over some period of time, but I am not an expert.)
        
             | alwa wrote:
             | I can only speak for myself, but, assuming it's feasible to
             | implement as you describe, that sounds awful. In full auto
             | mode, unpleasant experiences happen, but at least without
             | specific anticipatory distress. I don't see that you
             | alleviate the overall existential state (of the possibility
             | of shocks constantly looming over you forever) by offering
             | individual instances of temptation to choose comfort over
             | lifesaving intervention.
             | 
             | Now the unpleasant experiences become something that I'm
             | doing to myself, and that my animal brain in the moment has
             | the power to prevent. Every intervention becomes a test of
             | my willpower: I know that I need this, I know I don't want
             | to do it in the moment... What's the harm in rolling the
             | dice this one time, in exchange for avoiding just this one
             | painful episode? The parallel that immediately comes to
             | mind is "well, just this _one_ cigarette won 't kill me..."
             | 
             | I'd much, _much_ rather pre-commit than have to face that
             | aversive decision time after time and day after day.
             | Knowing that my life is on the line if I 'm caught in a
             | moment of weakness. That calculus is much too important to
             | me to leave to the whims of my reactive brain.
        
               | nneonneo wrote:
               | Maybe that works for you, but in the case of the article,
               | the random shocks were bad enough to make him literally
               | choose death over the shocks...
        
         | NoMoreNicksLeft wrote:
         | >Seems a little strange to not want to try to commit to the
         | requirements for transplant and instead just die.
         | 
         | You just have different values than the OP. I have values
         | different from yours as well that would have me turn down a
         | transplant... and it's not that I wouldn't want to live longer.
         | There are just some measures I'm unwilling to take.
        
           | vjvjvjvjghv wrote:
           | This is not a matter of values. It's more like you can only
           | be sure what you would do in a situation when you are
           | actually in it. There are plenty of people who claim "if I
           | was in situation X I for sure would do Y" but will reevaluate
           | this when they are actually in it.
        
             | reverendsteveii wrote:
             | They'll do _what_ when they 're actually in the situation?
        
               | vjvjvjvjghv wrote:
               | They will take another look at the available options and
               | pick what they think is the best option. This may be
               | different from the one they proclaimed they would take.
        
             | NoMoreNicksLeft wrote:
             | Np, I actually have values. It's difficult to believe, most
             | of the people around you apparently have none. First off,
             | my own organs are spare parts for those in my family who
             | are younger than I am... children, nieces, nephews, etc.
             | They're never to donate to anyone in a generation older
             | than them (lateral's sometimes ok). And I wouldn't accept
             | donor organs from someone not in my family. I've got other
             | people to think about than myself, so staying alive at any
             | cost (financial or moral) isn't a consideration at all. Not
             | saying I wouldn't hesitate if facing the end, but I've
             | thought about this alot over the years and I've already
             | made the choice.
        
         | reverendsteveii wrote:
         | Yeah, my thought on reading this line was that dying also
         | requires a pretty irrevocable commitment. I can't make this
         | decision for this person and its ultimately going to be the
         | kind of decision that defies so-called rational analysis but I
         | was caught by the inconsistency in this particular piece of
         | reasoning.
        
           | pseudosavant wrote:
           | Slight oversimplification, but dying is a one-time
           | commitment, and the transplant requires continual commitment
           | (or re-commitment) over a very extended period of time (the
           | rest of his life).
        
             | reverendsteveii wrote:
             | again, and this may really just be sophistry but it
             | deserves acknowledgment, I wanna zoom in on the phrase "the
             | rest of his life"
             | 
             | Let me be clear: I understand the difference and I agree
             | with you. The reality is that a transplant would probably
             | be a lot of work and suffering and I can definitely
             | understand opting out of it. All three of the grandparents
             | I actually got to meet ended up doing this same math and
             | getting the same result: sometimes life-extending care
             | isn't worth what you have to go through to get the
             | extension of life. I guess what I'm interested in playing
             | with here is the language we use to abstract the reality,
             | and how it doesn't really hold up once death is accepted.
             | Treatment is a commitment. So is dying. Treatment will go
             | on for the rest of his life. Without treatment, dying will
             | go on for the rest of his life. A lot of the things we do
             | and ways we look at things assume that dying is
             | 
             | 1) very far off 2) to be avoided at all costs
             | 
             | If either of these things becomes untrue the calculus we do
             | to determine reasonable courses of action goes flying out
             | the window. Neither of these things is true for this
             | person, but it's true for all (for a given value of all) of
             | us trying to talk about it and I see throughout the thread
             | this interesting disconnect that basically boils down to
             | people saying "You can't kill yourself! You'll die!"
        
           | wat10000 wrote:
           | The dying happens with either course of action. The
           | transplant is in addition to it, not an alternative.
        
         | leoxiong wrote:
         | I think this view is needlessly reductive and lacks compassion
         | and understanding for their suffering. Not every problem should
         | be approached with an engineering mindset.
        
         | SoftTalker wrote:
         | Everybody dies. It's not something to fear, if you have come to
         | terms with it.
        
         | roxolotl wrote:
         | I agree with the other comments but one thing that's also
         | missed is that by accepting a heart transplant you're likely
         | also taking a heart transplant from someone else. It is
         | incredibly altruistic to be honest enough with yourself about
         | what you're willing to live with.
        
         | vjvjvjvjghv wrote:
         | People aren't a science experiment. At some point they have had
         | enough and it's something we should respect.
        
         | TrackerFF wrote:
         | I just want to chime in here.
         | 
         | Getting a heart transplant doesn't necessarily mean buying
         | yourself 40 more years. Could be 5, 10, 15. If I recall
         | correctly, the average is around 10-15 years.
         | 
         | You also have to be on immunosuppressants for the rest of your
         | life, with all the added risks that come with that (infections,
         | cancer, organ damage, etc.).
        
       | hypeatei wrote:
       | I wasn't aware that Oregon had a "death with dignity" program for
       | terminally ill people. It was enacted in 1997! Do other states
       | have similar ones?
       | 
       | I'm a huge proponent for assisted suicide in general, even if
       | you're not terminally ill. Regardless, these types of laws are a
       | step in the right direction.
        
         | altairprime wrote:
         | Between the timber wars and assisted death, it was a hell of a
         | decade. They introduced statewide vote by mail I believe around
         | then as well.
        
         | bufordtwain wrote:
         | Yes, other states have it you can Google for a list.
        
           | hypeatei wrote:
           | Hah, yeah, I could. I guess it was more of an invitation for
           | people to discuss specific state programs and their
           | experience with them (e.g. if they had relatives who used it)
        
         | gadders wrote:
         | I don't know why people are so for it. The process is "cruel
         | and unusual" when it's done to criminals but the same process
         | is fine when you request it.
        
           | pseudosavant wrote:
           | The question of choice/agency is probably at the heart of the
           | difference. One, the state is taking someone's life against
           | their will. The other is allowing someone to exercise their
           | own agency to end their own life.
        
           | aradox66 wrote:
           | It's a different chemical cocktail, but more importantly
           | consenting to it makes a bit of a difference in terms of how
           | it registers morally.
        
           | maxsilver wrote:
           | > The process is "cruel and unusual" when it's done to
           | criminals but the same process is fine when you request it.
           | 
           | Because consent matters.
           | 
           | Many things work this way, they're wonderful or useful or
           | helpful _when you request /consent to it_, but are despicably
           | evil when done _against your will_.
        
             | noworriesnate wrote:
             | Children are incapable of consent. In the same way, people
             | who are having big mental burdens are not capable of
             | consenting to this. It's a system as ripe for abuse as
             | allowing children to consent to sex.
             | 
             | I've had my dark moments, but I learned to deal and I'm
             | sooo glad I didn't end it.
             | 
             | You know, you always hear about people who survive a
             | suicide attempt often find out after they've jumped that
             | they really didn't want to die! It's an irreversible
             | choice, and something about realizing that changes people.
        
               | qualeed wrote:
               | > _You know, you always hear about people who survive a
               | suicide attempt often find out after they've jumped that
               | they really didn't want to die_
               | 
               | You don't just walk into a building and say "I would like
               | to die please" and then get assistance on the spot.
               | 
               | The two people I know who chose assisted death both had
               | to go through various evaluations (over a period of
               | several months) to determine that they thoroughly
               | understood the decision they were making and that they
               | had the mental capacity to make the decision.
               | 
               | The comparison to a child 'consenting' to sex is
               | completely nonsensical.
        
               | noworriesnate wrote:
               | Of course that's not how it works. People will doctor
               | shop. If one doctor rejects them, they go to the next and
               | learn the right things to say to get the doctor to say
               | yes. It's just ripe for abuse.
               | 
               | What they really need is help, not death.
        
               | qualeed wrote:
               | Someone who is determined enough to go through several
               | years of doctor shopping to kill themselves will find a
               | way to kill themselves whether there are assisted death
               | programs or not.
               | 
               | I agree that those (hypothetical) people need help.
               | Though, to be honest, I'm not really convinced this is a
               | real issue. Some of these programs have been around for
               | multiple decades, and I've not seen _any_ evidence that
               | there is a pattern of abuse. Let alone the programs being
               | apparently  "ripe for abuse".
               | 
               | Disallowing assisted death programs is not help, though.
               | It is a punishment to people who deserve a death of
               | dignity instead of months or years of unbearable
               | suffering.
               | 
               | If abuse of the medical system is a concern of yours, I
               | feel like a much more prominent cause ( _millions_ more
               | preventable deaths) worth fighting is over-prescription
               | of opiates. That 's just my opinion, though. (And, for
               | all I know, you're already fighting that fight too. If
               | so, godspeed)
        
               | threemux wrote:
               | You are sharing an important perspective. 1 in 20 people
               | die from assisted suicide in Canada today. You can't tell
               | me the process is sound every time. That's a huge number.
               | 
               | It's false dignity, and false compassion. Dignity does
               | not come from control over one's life, and it does not
               | come from the absence of suffering. Dignity comes from
               | being made in the image and likeness of God. If anyone
               | reading does not agree, well, that's fine, but I feel
               | compelled to say it that someone might read it.
               | 
               | How many people will we lose to despair that could have
               | been helped? I say this both as a Catholic and someone
               | that has suffered and recovered from mental illness.
        
               | qualeed wrote:
               | I had a lot to say to this comment. I think your comment
               | is gross. But it will just end up in a debate about god,
               | so I'm editing it out.
               | 
               | However:
               | 
               | > _How many people will we lose to despair that could
               | have been helped?_
               | 
               | Assisted death is not something reserved for mental
               | illness, and it's dishonest to frame your comment like it
               | is. Terminal, painful diseases are the leading reason for
               | assisted death. In fact, many assisted death programs do
               | not consider mental illness alone to meet the criteria of
               | acceptance.
               | 
               | The whole point of these programs is that there is no
               | other help possible. Except, maybe, enough drugs to make
               | the person basically dead anyways. Which, in my opinion,
               | is not "help".
        
               | threemux wrote:
               | This is an age-old question. All I can do is share the
               | Catholic perspective on this which you may or may not
               | like or agree with.
               | 
               | God allows suffering to bring about a greater good, His
               | plan. He endows us also with free will, which sometimes
               | means we make choices that cause suffering for ourselves
               | or others. Free will doesn't mean all or even most
               | suffering in a given life is because of our choices.
               | Sometimes it is though.
               | 
               | Satan's playbook is all about denying these things,
               | denying the cross, denying redemption. Satan is the one
               | whispering that life isn't worth it, that it would be
               | easier to end it, come down from the cross.
               | 
               | For a even better discussion of these things, I always
               | recommend Life is Worth Living which is an old program
               | hosted by Bishop Fulton Sheen. It is as relevant today as
               | it was when he recorded it. Many of the episodes are on
               | YouTube.
               | 
               | EDIT: many seem to be taking this as an anti-painkiller
               | stance which it is not. Reducing pain until natural death
               | is a great kindness.
        
               | throwaway173738 wrote:
               | I think that's an entirely reasonable stance to take if I
               | can reframe my anguish as in the case where I've been
               | dumped and am feeling sad. But if my heart is dying and
               | my life can only be prolonged through great and endless
               | suffering, I think choosing death is entirely reasonable,
               | and demanding that someone live a few more miserable
               | weeks is cruel. And I don't think those parables about
               | Satan considered the difference between those two
               | situations. What lesson is there to absorb to become a
               | better person?
               | 
               | If tomorrow I invented a machine that could keep us all
               | alive indefinitely but also required us to be immobile
               | and in great pain, who would choose that outcome?
        
               | threemux wrote:
               | Not against reducing pain for terminal patients - I made
               | an edit above because it seems I was unclear on this
               | point.
        
               | threemux wrote:
               | I'm leaving my other comment despite your edits, as I
               | believe it represents an answer to an important question.
               | 
               | Nothing in my comments is dependent on assisted suicide
               | being available or not for any purpose or another. I am
               | arguing against it in all cases to be clear.
        
               | qualeed wrote:
               | > _I am arguing against it in all cases to be clear._
               | 
               | Yes, reading your other comment, I now understand that
               | you truly believe that suffering is a good thing and
               | that, if you had it your way, my father would have had to
               | be bedridden, in extreme agony, for several more months
               | than he had already suffered. A cruelty beyond
               | imagination.
               | 
               | We will never, ever agree on this, so I wish you a good
               | day.
        
               | threemux wrote:
               | I am not against painkillers. I am against suicide.
        
               | footy wrote:
               | MAiD is not available for people whose only condition is
               | a mental illness [1]. I'm saying this not for you but for
               | anyone who may read this, particularly non-Canadians.
               | It's not about "despair".
               | 
               | [1] https://www.camh.ca/en/camh-news-and-stories/maid-
               | and-mental...
        
               | threemux wrote:
               | Yes that is the official stance. I do not believe that is
               | being followed on the ground and is in any case a
               | temporary condition. In 2027 it will be officially
               | available with only a mental health issue.
        
           | strongpigeon wrote:
           | > The process is "cruel and unusual" when it's done to
           | criminals but the same process is fine when you request it.
           | 
           | You seem to be saying that as this is inconsistent. I'm
           | curious why do you think that is? Whether someone agrees to
           | have something done to them or not is a crucial factor in
           | whether doing said thing is OK.
        
           | hypeatei wrote:
           | Well, the death penalty is certainly a different discussion
           | since the government is deciding to take your life. I don't
           | support it, personally.
           | 
           | Assisted suicide, in my view, is more like an escape hatch
           | for people who don't want to participate any longer
           | regardless of how much "potential" they may have. Making it
           | available for terminally ill patients is good, but it misses
           | the mark for people who struggle with more "invisible"
           | illnesses like ones in their own mind or lifelong ones like a
           | physical deformity.
        
           | Nextgrid wrote:
           | My understanding is that the death penalty process is kind of
           | a hack job and can't be done properly because no medical
           | personnel will participate in it due to the Hippocratic oath.
           | This is not a concern in consensual euthanasia.
           | 
           | There's also an issue with the death penalty process
           | seemingly _requiring_ suffering, as evidenced by the lack of
           | use of inert gas which appears to be painless considering
           | accidents with poorly-ventilated spaces where people
           | unknowingly pass out (and sadly those who go help them suffer
           | the same fate). Even in states where the  "gas chamber" is a
           | thing, cyanide is used instead of just inert gas despite it
           | making the post-execution cleanup process _safer_ (so would
           | make sense even if you did not care one bit about the
           | suffering of the condemned).
        
             | baseballdork wrote:
             | Even if the death penalty was perfectly humane, there are
             | so many other considerations that this comparison is
             | clearly in bad faith. The GP doesn't understand why the
             | state murdering people is a different consideration
             | entirely from doctor assisted suicide?
        
               | Nextgrid wrote:
               | Absolutely, I'm not defending the death penalty in any
               | way. But even if you _do_ support it, my response tries
               | to bring up how bad and _intentionally_ cruel the current
               | implementation is.
        
           | noworriesnate wrote:
           | I think it should be an option for the terminally ill but
           | nobody else.
           | 
           | There are people who are suicidal who don't feel they deserve
           | help and feel that assisted suicide is an option for them. We
           | should not give them that option. Instead, we should spend
           | that effort as a society helping them deal / get better.
        
           | qualeed wrote:
           | > _The process is "cruel and unusual" when it's done to
           | criminals but the same process is fine when you request it._
           | 
           | Yes, of course. This is a concept called "consent", and it
           | drastically changes the context and morality of various
           | situations.
        
           | jvanderbot wrote:
           | Is it unreasonable for you to imagine any of the following
           | scenarios?
           | 
           | * A person believes that choosing to die is different than
           | having that forced upon you
           | 
           | * A person disapproves of assisted suicide _and_ capital
           | punishment?
           | 
           | * A person approves of assisted suicide _and_ capital
           | punishment?
           | 
           | * The process is quite different for criminals vs voluntary
           | medical participants?
           | 
           | etc etc?
           | 
           | Seems to me you're twisting things pretty hard to find a
           | false equivalence.
        
           | os2warpman wrote:
           | Because I am practically alone in having avoided addiction,
           | felonies, poverty, becoming handicapped, and/or morbid
           | disabling obesity over the course of my life I have become
           | the "responsible adult" in my family.
           | 
           | Over the last six years it has been my responsibility to
           | oversee the end-of-life care for three people: my paternal
           | grandfather and grandmother, and maternal grandmother.
           | 
           | My grandfather died at home of congestive heart failure. He
           | spent a week on hospice in a medical bed in the living room
           | staring at the ceiling, barely conscious due to the morphine
           | and pain, pissing and shitting himself, as he slowly
           | suffocated to death.
           | 
           | My paternal grandmother lingered for two weeks in the
           | hospital due to an embolism after falling and breaking her
           | hip. Again, two weeks bedridden staring at the ceiling barely
           | conscious due to the morphine and pain, with a machine
           | breathing for her, until diffusion/perfusion stopped enough
           | that no mechanical or pharmaceutical intervention could
           | oxygenate her blood enough and she died.
           | 
           | My maternal grandmother was the worst. Having fought off COPD
           | for the last 20 years it finally became too much. After a
           | year of coughing fits that led to torn muscles and spine/rib
           | fractures leading to her being in a near-constant state of
           | opioid-induced stupor the oxygen and albuterol stopped
           | working and she very slowly and painfully drowned to death.
           | She had been aware of her impending death for about two years
           | and constantly expressed her desire to die on her own terms,
           | but she had made the mistake of moving into an assisted
           | living facility. So she spent the last few years of her life
           | in a recliner hooked up to oxygen as the albuterol treatments
           | got more and more frequent until the point that she would
           | have to wake up every couple of hours 24 hours a day to do
           | them, with coughing fits between them to the point that she
           | would paralyze herself due to neck or back pain and spend six
           | weeks on pain killers, unable to urinate or defecate or dress
           | or eat without assistance, as it became harder and harder to
           | breathe until she mercifully slipped into unconsciousness and
           | died.
           | 
           | We already have medical aid in dying, it's called "giving a
           | little more morphine every time the patient starts gurgling
           | in order to 'soothe their pain'".
           | 
           | In a just world the patient has the choice to accelerate the
           | process.
           | 
           | All men must die.
           | 
           | I will not die suffocating to death as I stare at a blank
           | ceiling, blasted out of my brains on drugs, while a TV blares
           | in the background to cover up the sobs of my family.
           | 
           | In my late sixties I am going to start going to the doctor
           | complaining of back pain, stockpile enough Percocet to kill
           | me, and when the time comes (with good fortune many many
           | decades later) I am going to settle my accounts, write a note
           | with some directions, have a party, and say goodbye.
           | 
           | That's why I'm "for" MAID.
        
           | InitialLastName wrote:
           | Me borrowing your car is also very different, morally
           | speaking, depending on whether you agreed to it or not.
        
         | NoMoreNicksLeft wrote:
         | It's had it ever since the Kevorkian blowup 35 years ago, I
         | think.
         | 
         | >Regardless, these types of laws are a step in the right
         | direction.
         | 
         | What direction would that be?
        
           | hypeatei wrote:
           | > What direction would that be?
           | 
           | Providing people with options on how/when they leave this
           | world and making suicide less taboo. You could say most
           | technically have this option already but I think it's more
           | humane if we provide reliable methods to do so via medical
           | professionals. Leaving it up to individuals can be messy and
           | violent.
           | 
           | On the cultural side, I guess I'd like to see less
           | sanctioning of suicide so that we don't make people's lives
           | more complicated for merely expressing their desire to do so
           | (e.g. getting the police called and being held for days)
           | 
           | All of that to say that death is sad regardless of what time
           | you leave and I'm not advocating for people to do it. Just
           | that we should have the option like any other healthcare
           | service with guardrails of course.
        
             | wat10000 wrote:
             | The status quo is that the people who are most able to
             | avail themselves of non-medical means tend to be the ones
             | least in need of it. A healthy, able-bodied person can
             | pretty easily off themselves in all sorts of ways. A person
             | no longer able to care for themselves will find it
             | impossible unless they can somehow secure the cooperation
             | of a helper.
        
               | ty6853 wrote:
               | Non able bodied people can commit suicide via dehydration
               | within a couple days (longer if they are healthy),
               | provided they can avoid getting treated for it.
        
         | gusmally wrote:
         | The NYT recently did an interesting review of Canada's program:
         | https://www.nytimes.com/2025/06/01/magazine/maid-medical-ass...
        
           | dralley wrote:
           | I read that article a few weeks back - it was a great read.
           | Incredibly complex topic both legally and ethically, but I
           | thought they did a good job with it.
        
           | alexpotato wrote:
           | > Wonnacott had met Paula once before, and he found her to be
           | a fairly accurate narrator of her own medical history.
           | 
           | This line reminded me of a lecture from my Psych 101 class
           | back in college:
           | 
           | There are three "views" of ourselves
           | 
           | 1. Reality
           | 
           | 2. What we wish we were
           | 
           | 3. Where we think we are
           | 
           | If 2 and 3 match but are far from 1: we are happy but
           | "delusional"
           | 
           | If 1 and 3 match but we are far from 2: this is VERY often
           | found in people who have depression.
           | 
           | And, ideally for long term happiness, 1 and 3 are close
           | together and 2 is a "reasonable" distance away or close to 1
           | and 3.
        
       | fnord77 wrote:
       | it's terrifying to me all the medical cases that cannot be
       | adequately treated with the current state of medicine.
        
         | morkalork wrote:
         | The body is a complex system and sometimes you're dealing with
         | the hand you've been dealt.
        
         | hondo77 wrote:
         | There is no treatment for death.
        
       | strongpigeon wrote:
       | I'm incredibly grateful that medical aid in dying is an option
       | and that one can have agency not only in how they live but also
       | in how they die.
       | 
       | I had someone close to me opt for it. They were greatly suffering
       | and had no chance of their condition getting better. Having a
       | planned final date allowed us to say farewell and thank each
       | other for all the great moment we shared without feeling ominous.
       | The last phone call I had with them will stay with me forever.
        
         | pseudosavant wrote:
         | I've been grateful that a couple of loved ones were able to
         | choose to end their suffering. Both times, it was a sad, but
         | very rational decision. I do wish there was a lot less stigma
         | about it. People said some genuinely awful things to my aunt
         | about her choice before she passed especially.
        
         | gusmally wrote:
         | It must be hard to say one last permanent goodbye.
        
           | vjvjvjvjghv wrote:
           | It beats seeing them suffer over years.
        
           | lurking_swe wrote:
           | on the bright side, at least you don't need to worry about "i
           | wish i told them __ before they died." It's a good way to
           | have closure i suppose.
        
         | antisthenes wrote:
         | It's a mercy we allow our pets.
         | 
         | No reason we shouldn't allow it to ourselves.
        
           | koolba wrote:
           | Pets are legally property. You may love your pet, but it's
           | not human.
           | 
           | The risk with allowing humans to do this is that it's
           | possible for someone not of sound mind to come to this
           | conclusion.
        
             | EvanAnderson wrote:
             | People who aren't of sound mind can come to this conclusion
             | regardless of the law. Giving people who are of sound mind
             | a way to control their death with dignity (and in a
             | minimally burdensome way for those who they leave behind)
             | is the point.
        
             | qualeed wrote:
             | > _The risk with allowing humans to do this is that it's
             | possible for someone not of sound mind to come to this
             | conclusion._
             | 
             | It seems like lots of people think you can just go to your
             | doctor and be prescribed a cocktail of death because you
             | feel down today. That's not what assisted death programs
             | are like, at all.
             | 
             | There's waiting periods, evaluations by independent doctors
             | and psychiatrists, interviews, etc. to determine your
             | capacity and understanding of the decision. Someone who is
             | not of sound mind is not getting approval for assisted
             | death.
             | 
             | Anyone sufficiently determined enough is going to find a
             | way to die, regardless of what laws or programs are there.
             | These programs don't change that, and they aren't meant to.
        
               | koolba wrote:
               | > Someone who is not of sound mind is not getting
               | approval for assisted death.
               | 
               | For many of us, this is a classic catch-22 as requesting
               | such approval demonstrates the lack of a sound mind.
        
               | ty6853 wrote:
               | IMO it's purely a liability debate. The other concerns
               | are philosophically interesting but on a practical basis
               | mooted: anyone of sound or almost anyone of unsound mind
               | and two nickels to rub together can reliably off
               | themselves without asking anyone for approval.
        
               | qualeed wrote:
               | > _requesting such approval demonstrates the lack of a
               | sound mind._
               | 
               | This is wild to me.
               | 
               | I watched my father, who had a life expectancy measured
               | in months, live in unbearable pain 24 hours a day. And
               | you believe that him wishing to end that nightmare
               | demonstrates a lack of sound mind? The sound decision, in
               | your opinion, is to suffer in pain, knowing that there is
               | no treatment nor cure coming, just pain for some number
               | of months until death's release?
               | 
               | I find it particularly cruel that you (seemingly?) think
               | that he should have had to continue to suffer. And, by
               | extension, myself and the rest of my family, should have
               | had to continue to watch him suffer.
               | 
               | (Before we get too far into it, I will say upfront,
               | there's not much in way of argument that will sway me
               | from this opinion. I am certainly open to hearing your
               | opinion, though.)
        
               | avgDev wrote:
               | Please remember this if you ever get diagnosed with a
               | painful terminal illness.
        
               | lurking_swe wrote:
               | tell me you haven't been around old suffering people
               | without telling me. I literally think your comment is
               | crazy. Like batshit crazy.
               | 
               | Go into a nursing home in the U.S. sometime and walk the
               | halls. Tell me if you think the majority of those people
               | are waking up with something to look forward to? Some of
               | them are sitting in their own shit for hours because the
               | nurses are too short staffed. I'd rather be dead than sit
               | in my own shit for hours while being in chronic pain, and
               | abandoned in a nursing home.
               | 
               | There are other reasons to choose death too of course.
               | But i digress. I'm not in the mood to make an exhaustive
               | list.
               | 
               | If you're old and in okay-ish health, and have
               | _something_ to look forward to (hobby, seeing grandkids,
               | reading, etc), then it's a different story.
        
               | Noumenon72 wrote:
               | When I volunteered at a nursing home an attendant
               | complained to me about a guy who wouldn't make the effort
               | to go shit but expected staff to dig it out for him. Why
               | bother choosing to live if you don't find it worth even
               | that much effort.
        
               | footy wrote:
               | the amount of implied privilege in this mindset is mind-
               | boggling.
        
               | martinpw wrote:
               | Appalling comment. You have clearly not been around
               | extreme end of life suffering.
        
             | phoe-krk wrote:
             | Yes, it is indeed a risk. It is much better to only allow
             | people "not of sound mind" to kill themselves the way they
             | currently do - via brutal, goresome, and unexpected
             | methods, which also often endanger others as well.
             | 
             | /s
        
             | wat10000 wrote:
             | Why isn't it considered a risk that someone not of sound
             | mind might decide on a course of action that causes them to
             | live in agony for months with an incurable condition? Why
             | is the argument always "what if a particular death is bad?"
             | and never "what if a particular staying alive is bad?"
        
             | scotty79 wrote:
             | > someone not of sound mind
             | 
             | We are already risking someone not of sound mind owning a
             | gun or operating heavy machinery and ludicrous speeds in
             | public places.
             | 
             | Do we really think the benefit doesn't outweigh the risk in
             | case of medically assisted death?
        
             | wizzwizz4 wrote:
             | No, the _actual_ risk is that there are larger bureaucratic
             | barriers to _treatment_ than to the assisted dying
             | programme, so it 's easier for somebody suffering to die
             | than to get treatment, _when effective treatment is
             | available_ and (in the absence of those daunting
             | bureaucratic barriers) preferable.
             | 
             | Assisted dying is a horrifying, but probably overall good
             | idea; however, we need to reform our medical bureaucracies
             | before it's something that they can ethically provide.
        
             | MiscIdeaMaker99 wrote:
             | What constitutes a sound mind?
        
               | swat535 wrote:
               | Isn't this what we have psychologists for ?
               | 
               | Surely you don't think an 18 year old claiming to be
               | endlessly suffering due to failing a math test sound
               | enough to terminate his life?
        
         | wat10000 wrote:
         | A centenarian relative did this. But it's not actually legal
         | where they lived. So instead of doing it properly, it was done
         | by withholding food and water and they slowly faded over the
         | course of a few days.
         | 
         | It is absolutely insane the way we do this stuff.
         | 
         | I understand why people are concerned about medically assisted
         | death, but this is the sort of thing that happens without it.
        
           | dachris wrote:
           | I've also seen elderly people whose time was past (very old,
           | bed-ridden, lost their partner) go into into what's basically
           | hunger strike in the nursing home. They said "I'm not really
           | hungry today", eating very little, getting thinner and
           | thinner until the end.
           | 
           | It's now legal here, but family, religion and tradition can
           | be obstacles to assisted dying.
           | 
           | In case you don't want to leave that way, you have to prepare
           | ahead of time. There's different legal means in different
           | countries, e.g. advance directive covers the case where you
           | can't decide yourself anymore.
        
           | Yeul wrote:
           | I think doctors have always pumped people full of painkillers
           | to the point of death long before it was legal. Who would
           | know?
           | 
           | Besides with modern technology it has become debatable what
           | death is. You can plug someone to a machine and keep their
           | heart going for years.
        
             | wat10000 wrote:
             | I've heard lots of stories of that being done, anyway. Oh,
             | that much morphine is dangerous, but they're in a lot of
             | pain....
        
         | BrandoElFollito wrote:
         | Unfortunately not everywhere. In France the parliament is
         | passing half-assed laws to praise all kinds of religious
         | authorities and call it progress.
         | 
         | Luckily we have our neighbor countries that are way more
         | civilized than we are.
        
       | scottcha wrote:
       | Maybe I'm a statistical anomaly or maybe I just don't know the
       | baseline occurrence rate for this stuff but I have 3 close
       | acquaintances two of which are this persons age or younger with
       | similar symptoms (tachycardia, though to a lesser degree) going
       | on. Is there data on the incidence rates for this stuff and has
       | it been increasing since 2021?
        
         | georgeburdell wrote:
         | Not tachycardia, but I had frequent heart palpitations for a
         | few months after contracting Covid the first time in late '21.
         | Did not notice anything in subsequent times. Maybe it was a
         | placebo effect, as I had knowledge of Covid's effects on the
         | heart, maybe not.
        
           | throwanem wrote:
           | I doubt it was placebo. I had the same for about a year after
           | a wild-type covid infection in early 2020.
        
       | gadders wrote:
       | I wonder if those implanted defibrillators would be more
       | manageable if they gave you (say) a 15 or 30 second audible
       | warning so you could prepare yourself?
        
         | luka598 wrote:
         | Perhaps they would, but I would guess that you would still get
         | scared when hearing the warning instead of the shock it self.
         | 
         | For example if you would get stabbed 15 seconds after hearing a
         | beep I think you would develop pavlovian like response to the
         | beep itself.
        
           | Nextgrid wrote:
           | Counterpoint: a warning may not avert the fear but still be
           | beneficial in cases where the person needs to prepare
           | themselves to avoid a sudden fall/etc.
        
             | dawnerd wrote:
             | Could see it very useful if you're driving. Might even save
             | other peoples lives in the case of a crash.
        
               | closewith wrote:
               | Depends on the jurisdiction, but in most places it is
               | unlawful to drive in the 6-18 months following implant or
               | a shock from an ICD.
        
               | zirgs wrote:
               | If I had a disease like that - I would not want to drive
               | at all.
        
           | BriggyDwiggs42 wrote:
           | What if it had the user press a button to trigger the shock?
           | Would it help them prepare for it?
        
         | vjvjvjvjghv wrote:
         | What are you going to do once you get the warning?
        
           | layer8 wrote:
           | Mentally prepare.
        
       | jollyllama wrote:
       | I'm completely ignorant on this topic, but if the defibrillator
       | was shocking him so frequently, but he has survived having it
       | turned off, doesn't that imply the patient was being shocked far
       | too frequently? I can't imagine that has a positive effect.
        
         | EA-3167 wrote:
         | So the issue here is that overly rapid beating (Tachycardia) in
         | the lower two chambers of the heart (Ventricles) can be
         | harmless, but left alone it can lead to dangerous heart rhythms
         | (Such as Ventricular Fibrillation aka VFib) and arrest. The
         | cardioversion is there to prevent it, but it's true that the
         | fast beating of the Ventricles (VTach) is most likely to
         | resolve without killing you.
         | 
         | Still in a patient like him it will eventually lead to VFib and
         | then death, so you implant a device that prevents that cascade.
         | There are settings for these devices about the threshold of
         | when and how to shock, but ultimately it's still going to err
         | on the side of caution because any sustained VTach is
         | dangerous.
        
       | BXLE_1-1-BitIs1 wrote:
       | Perhaps the question is how much misery are you willing to
       | tolerate to prolong your life for how long?
       | 
       | Certain treatments take weeks to recover from while giving you
       | months, years, even decades of life expectancy with good quality.
       | 
       | Other treatments of late stage terminal cancer only give you a
       | few more weeks in the hospital.
        
         | smeeger wrote:
         | my life is miserable even though im not sick. i would not
         | qualify for assisted suicide. what does that mean? but if i got
         | a terminal illness i would. so my life is motivated by the idea
         | that i will someday achieve something that will make it worth
         | it... and if i became terminally ill then i would no longer be
         | able to achieve that goal... so i should end it. maybe i should
         | reorganize my life so that i am not miserable. im not sure
         | thats possible. i had a little early retirement before and i
         | was still miserable. i am miserable dealing with people in this
         | country. everyone is petty, mean and ready to stab you in the
         | back
        
       | sandworm101 wrote:
       | I ran into a stat recently that gave me pause. Medical air in
       | dying, what canadians call "MAID", is now a significant cause of
       | death. It's roughly 1 in 20 of all canadian deaths. That is far
       | higher than I would ever have expected.
       | 
       | https://www.canada.ca/en/health-canada/services/publications...
       | 
       | >>> In 2022, there were 13,241 MAID provisions reported in
       | Canada, accounting for 4.1% of all deaths in Canada.
        
         | ian-g wrote:
         | i don't think it's honestly that startling. extrapolating that
         | number gets you to a total of 323k deaths, probably under a
         | percent of canada's complete population based on their 2021
         | census population of about 37 million.
         | 
         | in 2021 there were 305k deaths in 2023 there were 326k deaths,
         | and we learned that one sixth of MAID requestors died before
         | they were deemed eligible or ineligible
         | 
         | and 70% were in pallative care
         | 
         | a lot of people die slowly and painfully, and a lot of people
         | think long and hard before making that request.
        
         | mrguyorama wrote:
         | It's almost certainly better for the vast majority of humans to
         | die on their preferred schedule from something that wont cause
         | them to suffer. The old joke goes:
         | 
         | "I want to die like my grandfather, peacefully in his sleep
         | with no pain, unlike his passengers who all died screaming and
         | in agony"
         | 
         | Most "natural" deaths are just various forms of suffering. You
         | decay while still technically alive, your body stops working,
         | your brain turns to pudding despite your physical fitness and
         | healthy life.
         | 
         | Why WOULDN'T more people choose to die peacefully, if they
         | don't have religious or moral problems with suicide?
         | 
         | I would expect, in an imaginary utopia, that the vast majority
         | of non-accidental deaths would be by choice.
         | 
         | The alternative is laying in an expensive bed for an
         | indeterminate time while a doctor pumps you so full of opioids
         | that you are barely you anymore anyway. Or like my Memere, you
         | die by choking on your own vomit, alone in your home, with
         | everybody coming to see you for your birthday in a few days but
         | miss you, because you die first. She probably would have
         | preferred to schedule it.
        
         | raydev wrote:
         | What gives you pause about the number?
        
       | j-krieger wrote:
       | > I've explained my reasons more fully to people who are close to
       | me, but they basically boil down to the fact that an organ
       | transplant requires a full commitment to the process, and I'm not
       | willing to make that commitment.
       | 
       | I can't imagine being that indifferent to life. I would give all
       | I could to live just one more day if I were in that position.
        
         | scotty79 wrote:
         | Nobody knows what would they do in extreme circumstances until
         | they end up in those circumstances.
        
         | qualeed wrote:
         | From the post: " _I want to live [...]_ "
         | 
         | I am saying this completely honestly, with no sarcasm:
         | 
         | I truly hope that you never have to experience (or witness a
         | loved one experience) the kinds of illnesses/injuries/diseases
         | that would make someone consider assisted death. It is a
         | blessing that you can't imagine the situation. Because the
         | situations that make you consider assisted death are _awful_.
        
         | eptcyka wrote:
         | The heart transplant will have them live in a state of
         | uncertainty, most likely having to use a defibrillator until a
         | suitable heart is found, if it is found. It is risky, with many
         | points of failure. As such, a certain death of their own terms
         | might be more valuable than a chance of a life with the
         | certainty that they will have to go through the suffering that
         | has already driven them to disable the defibrillator mixed in
         | with some more risk and pain. It would be a rollercoaster ride
         | for the hungover, except they don't know id they will get to
         | step off. And the loved ones get to watch on from the side
         | lines. Even with all that, it is tough to imagine not opting
         | for the transplant, but this should just serve to help you
         | empathise with pain they are going through.
        
         | nancyminusone wrote:
         | I think the same as you, but I recognize that those in such
         | circumstances now are literally experiencing horrors beyond my
         | comprehension. However bad you think it might be, it would have
         | to be unspeakably worse, which for some, it evidently is.
        
       | BrandoElFollito wrote:
       | I seriously wonder why a state (France in my case) preggers to
       | have people jumping from buildings on into a train than to have
       | them terminate their life peacefully.
       | 
       | I know that when I have Alzheimer or ALS out similar stuff I will
       | commit suicide, quickly. I will have to prepare early to have
       | some poison or jump into a train (something I would like to avoid
       | to not traumatize the driver).
       | 
       | Why not simply helping me when this is what I want, in the name
       | of who knows what.
        
         | martinpw wrote:
         | > I know that when I have Alzheimer or ALS out similar stuff I
         | will commit suicide, quickly.
         | 
         | One of the common features of dementia is that you don't know
         | you have it. It is just that everyone else around you seems to
         | start behaving weirdly while your own reality is unchanged. It
         | is both a blessing and a curse, but it does mean you may not
         | ever have that moment where you can make the choice.
         | 
         | My mother has been bedridden for a year, completely helpless,
         | on a daily drug regimen, recognizes nobody, would absolutely
         | not want to continue living in this state, but is no longer
         | capable of making that choice and so will stay in this
         | condition for potentially several more years until she finally
         | dies. It's a horrific final chapter.
        
           | BrandoElFollito wrote:
           | I thought about that too, and was hoping for a diagnosis
           | before I am incapacitated.
           | 
           | I actually wondered about a dead man switch, where poison
           | would be released into the bloodstream if I do not
           | acknowledge that I am fine. This would also manzge comas and
           | lock-in. Technically it is quite complicated though.
           | 
           | I pity you, and this is exactly the reason I want to quickly
           | end it so that my family does not suffer for a long time.
        
       | blindgeek wrote:
       | I am the OP. Surprised to see this at the top of HN.
        
         | croisillon wrote:
         | Good luck!
        
         | delichon wrote:
         | "All lives are the same length, Lazarus. They're all just one
         | moment long. It's the moment we're in. The rest is memory or
         | imagination." -- Dora, in Time Enough for Love by Robert A.
         | Heinlein
        
         | soulofmischief wrote:
         | https://news.ycombinator.com/item?id=44251900 just thought I
         | would leave this comment here in case it makes you reconsider.
         | Don't let sunk cost fallacy make you commit to something so
         | permanent just yet if it turns out this therapy is within reach
         | after all. Either way... Good luck. Hug your loved ones tight.
        
         | couchdb_ouchdb wrote:
         | Best to you OP.
         | 
         | I always think of the Five Remembrances:
         | 
         | I am of the nature to grow old. There is no way to escape
         | growing old. I am of the nature to have ill health. There is no
         | way to escape having ill health. I am of the nature to die.
         | There is no way to escape death. All that is dear to me and
         | everyone I love are of the nature to change. There is no way to
         | escape being separated from them. My actions are my only true
         | belongings. I cannot escape the consequences of my actions. My
         | actions are the ground upon which I stand.
        
       | A_D_E_P_T wrote:
       | > "A few months ago, a friend sent me a link to a university
       | doing clinical trials using stem cells to repair the heart. It
       | seemed really promising. Unfortunately, they are in Germany, and
       | they only accept German residents. So that wasn't an option."
       | 
       | It's not _that_ tough to gain German residency. There 's even a
       | "Freelancer Visa" that gives you a residence permit. If you pay
       | an immigration consultant a few thousand bucks, and don't have a
       | criminal history, it can be done rather quickly.
        
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