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The state should stop judging who gets to die

Published on 49 Comments on The state should stop judging who gets to die

Shadi Hamid says that liberalism is simply unable to cope with the idea of assisted dying:

A political philosophy built around individual autonomy eventually runs into questions it can’t answer. Why should we preserve life if someone doesn’t want to live? Should the state have the right to facilitate the death of its own citizens? These aren’t just abstract philosophical puzzles — they’re questions that real bureaucrats are answering every day in countries such as Canada, the Netherlands, Belgium and now Britain.

I'm a liberal and I can answer this question just fine. The problem is not with liberalism, the problem is only that Hamid disagrees with the liberal answer.

The question he should be asking is not why the state should have the right to "facilitate" a desire to die. It should instead be why the state—as it does—has the right to get in the way. We spend millions on netting under bridges to keep people from jumping off. Helium tanks are partially filled with oxygen to prevent it being used as a way of ending life. Lethal medication is tightly regulated to prevent "unauthorized" use. Right to die legislation often restricts medical assistance to those with less than six months to live.

But why should the state should have any opinion one way or the other about this? My family? Sure. My pastor? Sure. But in the end, legal "assisted" suicide is misnamed. It's really just a narrow exception to the otherwise nearly universal prohibition against ending your life if you want to.

I don't understand why anyone—and certainly not the state—should be intent on forcing people to continue living against their will. Nor should the state care why someone wants to die. What could possibly be a more personal decision?

Should we be worried about a slippery slope if we take this attitude? I don't think so. There have always been a small number of people who want to end their lives, but it's never become widespread and it never will. We are powerfully programmed by evolution to continue living even under horrific conditions.

That said, I favor minimal state assistance for ending life. There are two reasons for this. First, it allows the state to continue taking vigorous steps against accidental or spur-of-the-moment suicide (bridge netting, restrictions on lethal meds, etc.). Second, it requires a person to affirmatively choose to die, and I guess I'm enough of a squish to think that at least a few soft barriers should be in place.

And this is for adults only. The problems with extending this to minors are pretty obvious, I think.

49 thoughts on “The state should stop judging who gets to die”

  1. drfood4

    I used to think there was no problem with medical assistance in death (MAID) until I heard some of the stories coming out of Canada. So I agree that state assistance should be minimal, (well, actually I think it should be nil).

    Someone in England floated the idea of rewarding the family financially if their loved one chooses to die instead of running up big hospital bills. I'm in favor of hospice care, but I find financial incentives to be creepy, especially if it involves active euthanasia.

    1. shapeofsociety

      Doctors should not be allowed to discuss or even mention assisted suicide unless the patient initiates a conversation about it. Vulnerable people can be talked into killing themselves, and financial incentives to use it as an alternative to real care are a huge ethical problem. Only adults of sound mind whose lives are nearing the end should be allowed to do it.

    2. Leisureguy

      I don't know the stories coming out of Canada, perhaps because I live in Canada. Could you possibly describe or link to some of the stories to which you refer. (And consider also the stories coming out of the US.)

        1. Crissa

          MacAulay said the four instances, which took place between 2019 and May 2022, were "all related to one single employee and it's not a widespread or a systemic issue,"

          That sounds like a single person being a problem.

            1. Solar

              This is a case of one asshole VAC employee doing something they are not supposed to be doing. Not an issue with how the process is supposed to work, which is the point of contention.

              1. shapeofsociety

                If you bothered to do real research on this you would know that it is not an isolated issue. There is a widespread problem in Canada of doctors pushing MAID on patients who didn't ask for it, on patients who are mentally ill and vulnerable, and even on minors. Much of it seems to be driven by hospitals wanting to save money. It's a horrendous abuse and it needs to be reined in. Instead of demanding that others do your research for you, please crack open your preferred search engine and find it yourself.

                I'm not opposed to all assisted suicide. For people who are terminally ill and suffering, who have made a rational decision that they would rather euthanize themselves than let nature take its awful course, it's entirely reasonable and ought to be legal. But safeguards are needed to prevent vulnerable people from being manipulated into killing themselves to save someone else money.

                1. ScentOfViolets

                  Instead of demanding that others do your research for you, please crack open your preferred search engine and find it yourself.

                  Instead of demanding that others prove you wrong, do your own research and bring it on with links, cites, sources. What is it with these assholes who always always always want to put the burden of proof for their claims on other people? Besides being lazy, dishonest gits, that is.

                2. Coby Beck

                  "Much of it seems to be driven by hospitals wanting to save money."

                  This statement is consistent with someone who does not quite get the whole socialized medicine thing. Hospitals in Canada are not for profit and therefore do not need to kill their patients in an effort to save money..

            2. Solar

              Read it again. It had a single story that claimed malfeasance or abuse of the system and 2 brief (as on literally a couple of lines) of two cases of people who were presented the option.

              It's also worth mentioning that in the main case of the article, the police and everyone the asked the family to investigate concluded there was no wrong doing and the person met the requirements for MAID.

              Also that the family is talking if both sides of their mouth. On the one hand they argue that their relative had no other issues other than hearing loss but otherwise was perfectly fine living alone. And on the other hand for their complaint they argue their relative did not had the capacity to understand the process. So which is it? Was his capacity impaired or not. All points from what is described suggest no, since he was living alone before this, so perhaps if his family had been more attentive to him beforehand he might have not decided to make this choice.

              1. Crissa

                Also, he wrote to them asking for help, and they didn't respond for over a month.

                Like, did he? Seems like they should have done more.

              2. MF

                I begin to see echoes of the left wing approach to sex change surgery. Perfecting attacks on MAID so important that no one should ever admit that there may be issueS.

  2. damgo2

    Like Kevin I think this should be legal but at the same time as difficult as possible. For the vast majority of people, it's easy to die if you really do want to. The state should aim to make it LESS convenient and simple to discourage spur of the moment suicides. People who truly want to die still can in a million ways.

    For the bedbound or seriously disabled this isn't true, so I support something like MAiD for those (and only those) people. But even there the goal should be to make it difficult and a hassle. That way we discourage social pressure to die, and ensure only those truly determined to die use it.

    For example, the bureaucracy in charge of MAiD requests should just drop 80% of all requests into the shredder. Doctors should be prohibited from mentioning or suggesting MAiD on their own.

    2. ScentOfViolets

      Heh. That got me to thinking of those unmarked suicide booths Fry almost enters in S1 E1 of FuturamaA vastly underrated show with some really great science snark.

  3. D_Ohrk_E1

    I think the larger point he's trying to make is that it's easier for a government to allow people to choose death rather than rescue them from the social ills that place many of them into the position of wanting to choose death.

    In a Dystopian world, conservatives eliminate most welfare and safety net programs. People, such as a permanently disabled person or someone with a congenital mental illness, might just line up for the Death Chamber when the money runs out and they're about to become homeless or the treatments are going to stop.

    In essence, this is not so much of the freedom of choice -- of Liberalism -- but of being forced into picking the least worst option.

    Perhaps this is a false choice, but the question inevitably will be, should governments facilitate people into picking the least worst option, or should they focus on improving the lives and protecting people?

    2. painedumonde

      +1.

      I would also posit that the urge to prohibit this is couched in religious dogma; the programmed beliefs of ancient thought. And in this country, Christianity is the predominate religious thought - which if I'm not mistaken - the central character definitely chose to end his life. For others of course, but it was his choice, facilitated by the government.

      That might sound flippant, it is intended to be a little anyways, because the stance against the practice to release somebody from unimaginable agony is obscene and should be ridiculed. Especially since its origin is from legend.

  4. eannie

    My experience as a dual citizen who lived in the Netherlands for several decades is that it is complex. People who are terminally ill…sometimes feel the hurdles are too high and wish to make it easier….there was a documentary years ago…telling the gut wrenching story of parents of a young women…with intractable pain who opted for euthanasia…needless to say it was horrendous for the parents….but that’s a reality …death is dealt with on a very open and mature manner…but it’s not easy either

  5. bouncing_b

    Why aren't guns mentioned?

    I thought guns are the main method Americans use to kill themselves (I think about half of gun deaths are suicides; could look this up if needed: CDC). This is especially the case for impulsive suicides.
    The government in most states certainly isn't working very hard to prevent this.

    Does anyone know what people do in states and countries where guns aren't so absurdly available?

  6. Heysus

    My opinion only, we need to learn about dying and letting go. Many times we are doing a great disservice to those who are suffering by not ‘letting them go’. I worked with terminally ill for some time.

    1. MF

      There us a big difference between hospice care for the terminally ill and euthanasia for deafness, depression, etc which is what Canada now has.

      1. Solar

        Canada has a policy of let the person decide for themselves, as long as they meet certain criteria. Of course, letting people choose about their own body and life is anathema to conservatives like you, hence you oppose it. In your eyes, it is just one more life to control and to squeeze out every dollar possible.

      2. jdubs

        MF gets all giddy and excited at the thought of controlling the lives of others. He alone can deem how deserving you are of whatever action you may wish to take. He has an important interest in your body and your decisions. More of an interest than you!

  7. peterh32

    Sadly in the last year I had a relative who opted for MAID. She had a terminal and fast-moving cancer. I was initially horrified but ended up very grateful that she had that option, here in California.

    I thought that WaPo article was pretty bizarre. A challenge to liberalism? Gimme a break

  8. msobel

    Not true, the state preserves the right to possess effective methods used in half the self-terminations.

    ChatGPT: In the United States, firearms are the most common method used in suicides. According to data from the Centers for Disease Control and Prevention (CDC), about 50% to 60% of all suicide deaths involve a firearm. This varies slightly from year to year, but guns consistently account for the largest proportion of suicide methods in the U.S.

  10. ScentOfViolets

    Jesus. I have a terrible, deep, abiding fear of dementia. Speaking only for myself, that's got to be the one most horrible ways to go, a slow irrevocable erosion of self that the afflicted will never be able to see by the very nature of the process. My mother went that way and my brother-in-law is already at the point in the curve where the decline is noticeable from month to month. It doesn't help that he absolutely refuses to undergo any neurological evaluation. Scared as shit to see the results come back, I guess, and I don't blame him one bit for being scared.

    I'm offering up a very personal, very concrete example as to why people in otherwise good health would want the option to terminate their own lives. I will _not_ leave behind a thing that isn't me to suck the life out of those I love the most.

  11. Dana Decker

    KD: "Helium tanks are partially filled with oxygen to prevent it being used as a way of ending life"

    That's news to me, and I cannot find instances of on the Internet. There is heliox, but that's to facilitate deep diving. And anyway, what about the propellant in whipped cream canisters? It's almost pure nitrous oxide. People will find a way.

  12. Justin

    Yah, I’m a liberal and quite uninterested in preventing suicide. Although, I do support repealing the 2nd amendment and confiscating all firearms. The government surely doesn’t care about that kind of suicide so it’s all a bit inconsistent.

    This is the part I don’t like.

    2 days ago — A 45-year-old man is believed to have killed his high-school-aged daughter, then himself in Washington County, Oregon, deputies said.

  13. SnowballsChanceinHell

    For whom the Bell Tolls

    No man is an island,
    Entire of itself.
    Each is a piece of the continent,
    A part of the main.
    If a clod be washed away by the sea,
    Europe is the less.
    As well as if a promontory were.
    As well as if a manor of thine own
    Or of thine friend's were.
    Each man's death diminishes me,
    For I am involved in mankind.
    Therefore, send not to know
    For whom the bell tolls,
    It tolls for thee.

  14. BriPet

    I don’t get why Kevin consistently ignores the fact that people with disabilities have been pushed and pressured into agreeing to that option where available.

    1. johngreenberg

      I strongly support the right of an individual to decide to die.

      But having said that, I also recognize the larger principle behind BriPet's comment: individuals do not exist in a social vacuum. They are surrounded by others whose interests may and often do differ from theirs.

      THAT, not the question of whether or not suicide is ever justified, is the role which governments can and do play, as they should. Governments should insure that any decision to commit suicide is being made by the individual him or herself and not because others have determined what they believe is best for him or her.

      Governments must also insure that palliative care is available and affordable so that unnecessary suffering does not motivate anyone who need not suffer.

      In short, there IS a legitimate role for government, beyond those Kevin lays out.

      1. johngreenberg

        Is this addressed to me? If so, the answer is everyone should get to decide for themselves. I think both BriPet and I said so pretty clearly.

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