9 ms·

My grandma always told me when she couldn’t go on her walks anymore she didn’t consider life worth living. When she got dementia she was placed in a closed hosp

by dathos 2y ago

My grandma always told me when she couldn’t go on her walks anymore she didn’t consider life worth living. When she got dementia she was placed in a closed hospice, to “protect her”. Now she only walks when I visit, and I only see a shell of the woman she was. Anecdotal of course, but why do people think it’s an ethics question when society is individualistic as can be? There is no choice in being born, why don’t we get a choice in when we leave?

InDubioProRubio 2y ago
Because half of society is a labour camp without guard towers- and if the slaves leave the camp it collapses in on itself.
amatecha 2y ago
Yeah, I knew someone who opted to have their dementia-suffering parent live with them until the end. That was tough, but... surely better than being left alone in a hospice/etc. as you mention. Unfortunately, yeah, you'll see the person just erode and ... it's really brutal as hell, ultra sad. Eventually the person is not even capable of consenting to euthanasia (nor any other medical procedure). Definitely something to discuss with family or closest friends especially upon getting diagnosed with an illness like that.
- 14 2y ago
  I have worked in hospice and would say typically the people who end up there are not what I would say left alone. But they are there to die. They usually end up there because the family who was looking after them is really struggling to do so any longer for various reasons like personal care or medication management being too much and they are approaching death. When there they get basically as much drugs to fight pain, anxiety and other symptoms as much as they need. The goal is to provide as much as possible a comfortable end to their life. Dementia patients are not candidates for MAID program here in Canada. You need to be of sound mind at this time. Perhaps in the future one can make a living will for future illness but currently if you are confused or suffering from dementia and can not understand what it is all about you can not consent to it.
- nradov 2y ago
  Caring for dementia patients at home is seldom better unless the family has the resources for 24×7 care. I know from personal experience that dementia patients will wake up in the middle of the night to wander out into the street or accidentally start kitchen fires. And if the family tries to do it all themselves it takes an enormous unsustainable toll. At some point everyone is better off putting the patient in a professionally staffed facility. Of course the prices for those create other challenges.
bleakenthusiasm 2y ago
One reason is religion. That aside, people are afraid that this could be abused. People could choose this purelyto avoid additional cost to their relatives. It could be used as an excuse why more costly options to avoid pain and suffering in old people might not be covered by insurance anymore. People could be talked into it for various reasons. Canada is a good example of a country where I think the base to make it work in a positive way is given. Their insurance covers a lot of treatments for basically everyone. The country cares about its citizens in a way that makes you believe they won't use euthanasia as a cop out to avoid paying for medical care. If these circumstances are not given, euthanasia can easily be seen as an easy way to get rid of people who are too expensive for society or too cumbersome to take care of.
- deleted 2y ago
  [deleted]
- Analemma_ 2y ago
  > People could choose this purelyto avoid additional cost to their relatives. Why is this a bad thing? If there's a choice between giving $100,000 to my descendants and using it to keep me intubated in a hospital bed for an extra 6 months, I find the former preferable by far. If someone else doesn't, that's fine, but I find comments like this both annoying and creepily authoritarian in saying that the correct choice is obvious and so they're going to make the decision for me.
  - karencarits 2y ago
    Not the op but I guess the idea is that questions of life and death should not primarily be economical questions. You are free to disagree, of course, and there is, at some level, economical considerations for all medical treatments. But at least I'm my country is there a sharp divide; an individual should receive the best available treatment without economical considerations. What treatments that are available for various conditions (not individuals!), however, are decided by comparing cost and utility. There is also an argument that can be made about the meaning of economy is to make lives better, but the opposite is not true
rich_sasha 2y ago
To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework? In a friend's family, there was a big rift as one family member in direct line of inheritance was accused of (successfully!) pressuring his mother to refuse medical care. She died sooner and more unpleasantly than she likely would have otherwise, leaving more money sooner to her children. And that wasn't even with euthanasia being legal. I have lots of sympathy for people so desperate they would rather kill themselves, but I don't know how you square that circle.
- 14 2y ago
  Well I am sure no system is perfect but the people that choose to end their life have to meet several criteria. They first need to be of sound mind when they make this decision (and this is one of the current issues being sorted out). So they talk with their doctor and express interest. They then are seen by other health care providers like psychologist who discuss it more. They are spoken to privately without the family present. It is their decision in the end and only theirs. Once they choose a time they need to still be fully alert and aware and they have to personally push the button that ends their life. And that is one of the issues, some people do not want to live if they become paralyzed or brain dead. But we can not euthanize those people even if they expressed that wish before. I have worked in hospice and they do MAID there all the time. It was a weird feeling to see a family and their loved one head into the downstairs where they would all sit around and tell them person how much they are loved and then that person would end their life. But I know it is the right thing.
- The_Colonel 2y ago
  > how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework? I would look into countries where euthanasia has been already implemented. It doesn't seem like it's a widespread problem, so apparently they made it work somehow. Does it mean it's absolutely bulletproof and no-one will ever be pressured to undergo euthanasia? No, but you can't ever achieve such certainty, and it's better to look at it from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.
stronglikedan 2y ago
> why don’t we get a choice in when we leave? Because dead folks don't pay taxes.
- barbazoo 2y ago
  So which one is it, the government assisting in deaths too often or not enough, it can't be both at the same time.
  - eru 2y ago
    Alas, actually, it can be. You can make both errors with false positives and false negatives at the same time.
- bawolff 2y ago
  Terminally ill people generally aren't paying taxes either. You have to make money somehow to owe taxes.
  - Sohcahtoa82 2y ago
    There are so many people that really have no idea how taxes work.
nashashmi 2y ago
> why do people think it’s an ethics question when society is individualistic as can be Because we disagree that society is individualistic. We are social creatures, not individualist creatures. And we need people around us. Including you needing your grandma. And she needs people like you. turn the question around: why do people feel easy escapes are ok? We came in this world and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?
- jncfhnb 2y ago
  What do you need from grandma, who is in constant pain and desires to die?
  - nashashmi 2y ago
    The touch, the voice, the eyes of love, the concern, the stories, the heart, the smile, ... shall I go on?
    - jncfhnb 2y ago
      Grandma doesn’t want to share those stories because it hurts to talk and she can’t see well and just generally she’s in a constant bad mood because her life sucks.
      - nashashmi 2y ago
        That would be the fault of those who are responsible for her happiness
        int_19h 2y ago
        There are quite a few medical conditions in which it is impossible to make it not hurt.
        jncfhnb 2y ago
        Ok. Even if we hold that ridiculous assumption true… so what? Let’s say grandma is explicitly suffering because others are failing her? Your proposed thesis still suggests she does not have justification for choosing death. What does she still owe us.

by dathos 2y ago

InDubioProRubio 2y ago

Because half of society is a labour camp without guard towers- and if the slaves leave the camp it collapses in on itself.

amatecha 2y ago

Yeah, I knew someone who opted to have their dementia-suffering parent live with them until the end. That was tough, but... surely better than being left alone in a hospice/etc. as you mention. Unfortunately, yeah, you'll see the person just erode and ... it's really brutal as hell, ultra sad. Eventually the person is not even capable of consenting to euthanasia (nor any other medical procedure). Definitely something to discuss with family or closest friends especially upon getting diagnosed with an illness like that.

14 2y ago
I have worked in hospice and would say typically the people who end up there are not what I would say left alone. But they are there to die. They usually end up there because the family who was looking after them is really struggling to do so any longer for various reasons like personal care or medication management being too much and they are approaching death. When there they get basically as much drugs to fight pain, anxiety and other symptoms as much as they need. The goal is to provide as much as possible a comfortable end to their life. Dementia patients are not candidates for MAID program here in Canada. You need to be of sound mind at this time. Perhaps in the future one can make a living will for future illness but currently if you are confused or suffering from dementia and can not understand what it is all about you can not consent to it.
nradov 2y ago
Caring for dementia patients at home is seldom better unless the family has the resources for 24×7 care. I know from personal experience that dementia patients will wake up in the middle of the night to wander out into the street or accidentally start kitchen fires. And if the family tries to do it all themselves it takes an enormous unsustainable toll. At some point everyone is better off putting the patient in a professionally staffed facility. Of course the prices for those create other challenges.

bleakenthusiasm 2y ago

One reason is religion. That aside, people are afraid that this could be abused. People could choose this purelyto avoid additional cost to their relatives. It could be used as an excuse why more costly options to avoid pain and suffering in old people might not be covered by insurance anymore. People could be talked into it for various reasons. Canada is a good example of a country where I think the base to make it work in a positive way is given. Their insurance covers a lot of treatments for basically everyone. The country cares about its citizens in a way that makes you believe they won't use euthanasia as a cop out to avoid paying for medical care. If these circumstances are not given, euthanasia can easily be seen as an easy way to get rid of people who are too expensive for society or too cumbersome to take care of.

deleted 2y ago
[deleted]
Analemma_ 2y ago
> People could choose this purelyto avoid additional cost to their relatives. Why is this a bad thing? If there's a choice between giving $100,000 to my descendants and using it to keep me intubated in a hospital bed for an extra 6 months, I find the former preferable by far. If someone else doesn't, that's fine, but I find comments like this both annoying and creepily authoritarian in saying that the correct choice is obvious and so they're going to make the decision for me.
- karencarits 2y ago
  Not the op but I guess the idea is that questions of life and death should not primarily be economical questions. You are free to disagree, of course, and there is, at some level, economical considerations for all medical treatments. But at least I'm my country is there a sharp divide; an individual should receive the best available treatment without economical considerations. What treatments that are available for various conditions (not individuals!), however, are decided by comparing cost and utility. There is also an argument that can be made about the meaning of economy is to make lives better, but the opposite is not true

rich_sasha 2y ago

To my mind the main obstacle is kind of orthogonal: how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework? In a friend's family, there was a big rift as one family member in direct line of inheritance was accused of (successfully!) pressuring his mother to refuse medical care. She died sooner and more unpleasantly than she likely would have otherwise, leaving more money sooner to her children. And that wasn't even with euthanasia being legal. I have lots of sympathy for people so desperate they would rather kill themselves, but I don't know how you square that circle.

14 2y ago
Well I am sure no system is perfect but the people that choose to end their life have to meet several criteria. They first need to be of sound mind when they make this decision (and this is one of the current issues being sorted out). So they talk with their doctor and express interest. They then are seen by other health care providers like psychologist who discuss it more. They are spoken to privately without the family present. It is their decision in the end and only theirs. Once they choose a time they need to still be fully alert and aware and they have to personally push the button that ends their life. And that is one of the issues, some people do not want to live if they become paralyzed or brain dead. But we can not euthanize those people even if they expressed that wish before. I have worked in hospice and they do MAID there all the time. It was a weird feeling to see a family and their loved one head into the downstairs where they would all sit around and tell them person how much they are loved and then that person would end their life. But I know it is the right thing.
The_Colonel 2y ago
> how do you protect the people who don't want to go, being pressured or manipulated. I agree that if someone is really, independently and committedly deciding to go, you shouldn't stop them. But how do you express that test in a bureaucratic, legalistic framework? I would look into countries where euthanasia has been already implemented. It doesn't seem like it's a widespread problem, so apparently they made it work somehow. Does it mean it's absolutely bulletproof and no-one will ever be pressured to undergo euthanasia? No, but you can't ever achieve such certainty, and it's better to look at it from the utilitarianism view - allowing euthanasia will prevent much more suffering than it will cause.

stronglikedan 2y ago

> why don’t we get a choice in when we leave? Because dead folks don't pay taxes.

barbazoo 2y ago
So which one is it, the government assisting in deaths too often or not enough, it can't be both at the same time.
- eru 2y ago
  Alas, actually, it can be. You can make both errors with false positives and false negatives at the same time.
bawolff 2y ago
Terminally ill people generally aren't paying taxes either. You have to make money somehow to owe taxes.
- Sohcahtoa82 2y ago
  There are so many people that really have no idea how taxes work.

nashashmi 2y ago

> why do people think it’s an ethics question when society is individualistic as can be Because we disagree that society is individualistic. We are social creatures, not individualist creatures. And we need people around us. Including you needing your grandma. And she needs people like you. turn the question around: why do people feel easy escapes are ok? We came in this world and were assisted in our upbringing and lived to old age, so why is it ok that we can feel like we can just get up and leave?

jncfhnb 2y ago
What do you need from grandma, who is in constant pain and desires to die?
- nashashmi 2y ago
  The touch, the voice, the eyes of love, the concern, the stories, the heart, the smile, ... shall I go on?
  - jncfhnb 2y ago
    Grandma doesn’t want to share those stories because it hurts to talk and she can’t see well and just generally she’s in a constant bad mood because her life sucks.
    - nashashmi 2y ago
      That would be the fault of those who are responsible for her happiness
      - int_19h 2y ago
        There are quite a few medical conditions in which it is impossible to make it not hurt.
      - jncfhnb 2y ago
        Ok. Even if we hold that ridiculous assumption true… so what? Let’s say grandma is explicitly suffering because others are failing her? Your proposed thesis still suggests she does not have justification for choosing death. What does she still owe us.