Comment by lordnacho

It is not really a shift. The slippery slope is the heart of the debate. Once assisted suicide is allowed, the line between respecting autonomy and others making that decision blurs. Safeguards may help, but asking where to draw the line is the central problem.

It's not that simple. Once the option is there, there is incentive to encourage people to take it when their continued existence would be a burden.

I've wondered about this for my hypothetical future self.

Currently? I'd say that I wouldn't want to live with dementia, but what if my "demented self" (kinda hate the phrasing, sorry) in the future wants to live, or doesn't remember they don't want to live?

Do I have a say over the life of someone who doesn't remember they were me?

The entire issue they're pointing to is that deciding that someone's existence is sufficiently tormented is difficult and morally fraught.

But do people who have dementia or say a mental illness have the capacity to make that decision?

It sounds like Daniel Kahneman was suffering from depression after his wife's death and all he saw in the rest of his life was sadness. He had no hope. What day was the best day to die? What if the next day his hope came back?

No, you'd let them decide if they want to die.

I've known at least 2 old persons who were literally looking forward to their death because of chronic pain and general boredom and frustration of requiring 24h/7 assistance and not being able to live the way they used to.

They would have likely used assisted suicide if it had been an option back then.

On the contrary, I urge you to consider whether it is your statement that is overly dismissive. Is there perhaps some existing conditioning, maybe in the form of religious upbringing that is driving your reaction to this? Many of us in fact find OP's a very thoughtful comment than a "silly statement".

> By your logic we should kill everyone at their peak.

No, they suggested that the old and ailing whose quality of life has deteriorated to the point where there is no hope or no more joy in living, ought to be given the choice.

Let me end by quoting my favourite lines from the HN guidelines:

"Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith."

In medical research on treatments the outcome is often measured in quality adjusted years of life, because just keping people alive at any cost is a bad metric.

3 years of living in constant pain - not saying it’s the case here - is not better than being dead to some people.

That's literally a one-dimensional analysis. Are you sure you're not missing any other relevant factors?I find it hard to believe you uncritically think 'more = better' in every context.

A beautiful woman dies twice as the old saying goes.

While what you say is extreme there is a point in the decline past which there is no point of living. If you have something worth living for - cling to life and to 107 if you like. But if the only thing that waits you is to slowly decay and fade and lose yourself - what is the point?

I am left wondering. Can’t people (in general) understand that Alzheimer’s changes a person fundamentally, irreversibly and forever until death follows? Many positive traits of personality disappear, the negative starts to dominate, I think mainly from fear and a subconscious awareness of what is being lost. That’s pretty much 101 of grieving when a loved one is struck with Alzheimer’s. The person has left. You continue caring for a body / a different person because of the relation you have to a former them. But please don’t connect the persons past deeds and being to the actions with Alzheimer’s.

For myself: I hope for assisted suicide before Alzheimer’s. I value me for me. Not-me I don’t value, and Alzheimer’s does not improve not-me over me. But people who cannot separate me from not-me (with whom not-me loses status for me)… I don’t care about them! (Philosophical mood.)

Either and or both?

I don’t want to go that way either. If I start losing my mind to Alzheimer’s or dementia I don’t want to slowly turn unrecognizable to those who love me, fuck that shit. Give me something suitable and I’ll do it my damn self if needs be.

There are lots of degenerative diseases particularly striking the various biological systems of the body. But neurodegeneration, whether Glio, ALS or dementia are especially cruel and horrific in that they attack and erode the patient's personality, a fundament of individuality and self.

To me both those things are basically the same.

The definition of good is probably the closest to doing the opposite of inflicting pain on others. There’s very little chance that you will be hated by being good. So definitely behaving or being good is not so different than behaving in a way that other people don’t hate you.

> It is absurd because it places subjective opinions over objective goods.

Care to name even a single objective good, and explain how exactly it is objectively good?

There is no such thing as objectivity in human experience. Every single thing, even attempts to be objective, are all filtered through the subjective experience of life. Our brains interpret objective reality and provide us a subjective translation.

You were so close to genuine self-ownership in this post, especially with decrying slave morality - than you ended by getting spooked all over again.

You might enjoy “the unique and its property” by Max Stirner. An excellent philosophical book and especially relevant given that Alzheimer’s takes away the self…

The point is he deserved to be remembered well but due to recency bias and the severity of whatever he did during the end stages of his disease he will not be. I personally suffered immense trauma in my early 20s when I moved to a really cheap place. My parents refused to believe me that there was a black mold and general mold problem in the place I was living and that it was causing me psychological distress and flaring up my eczema. Despite all evidence that I had they dismissed it because I had told them I was depressed beforehand. They are not very in touch with empathy or compassion or mental health. Very old-fashioned view that these things are character flaws which are not to be spoken of. Anyways they dismissed my concerns did not read my messages or view my pictures of personal property being destroyed and the landlord not responding to me, the whole rental was illegitimate and I had identified that early on they even ignored that I got a scalp infection which I had to take oral anti-fungal medication to get rid of. The preponderance of evidence was so overwhelming, but for whatever reason they could not admit I had been right and that they were wrong and refused to help me and actively discouraged me from taking legal action or even to move home for months. Eventually I was blessed with an extended relative who gave me shelter. During one of the worst parts of this period my parents even went so far as to assert that what was actually happening to me was the onset of paranoid schizophrenia. I was close to the right age and sex for it to happen. I knew that paranoid schizophrenics often become homeless and violent and the general awfulness of the condition. If it was not for my own investigation that there was no family history of it and a friend who believed what I was saying and told me that I needed to leave the house and then finally extended family I had a plan to no longer exist. This was partially out of not wanting to be remembered badly, but also so many other things like; not wanting to hurt my loved ones, not wanting to hurt strangers, not wanting to slowly degrade into an unstable and potentially dangerous person and of course the median life expectancy for that condition is so low. I lacked the constitution to allow myself to become someone who would likely damage the world and severely damage those close to me so my logical conclusion based on a false premise during those couple days was to nip it in the bud so to speak as it's a progressive condition. My relationship with my parents has not been the same since, but how could it be. I am forever indebted to a friend and extended family... they quite literally saved my life.

The end point being that with the parents I have there was nearly a guaranteed outcome of only objectively bad things happening for me, for them, for people around me. During that state I saw my plan as honorable and wrote it down in what I was to leave to explain my actions.

A god need not concern himself with the opinions of men

I’ve had a lot of people suffer in my life from health conditions, ranging from mental illness, heart disease, and cancer. And I’ve had to take care of them all at different times. Did I consider this a burden or a gift? Oh, it was hard, but does that mean it’s a burden?

If you think you’ll be a burden on your loved ones can we really say they’re your loved ones? This is a serious question. If you’re thinking that you’ll be a burden do you think that these people really love you?

At least I would want to let them use experimental drugs, or do anything to further the cause of curing Alzheimer’s.

But again, this is all far from the original article about an old man who decided to die because well, we don’t really know, he just didn’t see the point of living anymore.

Yup. Ask me if I want to live. If I'm unable to answer and it's not reasonably expected that I will be able to answer in the future then the answer is no. I am the mind inside, not the body outside. If the mind is gone that's it, the body is worthless.

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The alternative being when someone becomes inconvenient to others we should encourage their death? What good is compassion or empathy when the lesser in society could just go off and die, right? Why stop at incurable diseases? Political opponents, coworkers, nasty service workers, double parkers, lawyers, and many other groups cause a lot of anguish and suffering.

Ancient and immortal? So eternal return?

That’s irrelevant here. What is relevant is that we have a contempt for human life and a lack of charity. The teacher was not at fault for his condition. We should learn magnanimity.

Sure, we can think about how the burdens of caring for our family can be lessened as they age, or how we may help reduce that burden for our family, but family does have the duty to care for its members, and to place such considerations above the intrinsic value of human life is very sad indeed.

The idea is the tree is not too far from camp. It should hours not days to return. And I suspect they would check on them.

I always think of that scene from Donnie Darko - where he says when his dog got sick, she went to hide under the porch. “To die?” His therapist prompts him. “To be alone” he corrects her pointedly. [0]

That’s kind of what I want when I die too - I don’t think I want to be around other people when it happens. I want to have my final moments to face death on my own, without feeling like I have to perform for other people.

… that said, give me another 60 years to chew on it and maybe I’ll feel different.

[0] https://youtu.be/8j1IMBM-QyE?si=jfCe9YUvKW_t5m5e

I think people tend to underestimate the risks in allowing suicide —- here’s a blurb from the linked article:

However, social acceptance may lead to more egregious abuses: the issue gained a higher profile in early 2010, when an 80-year-old man escaped after discovering his intended fate and heard his family members discussing how they were going to "share" his lands, and took refuge in a relative's home.

Fascinating that you think someone with dementia would be suffering more from hunger then from their condition sapping away at them.

You can create one with LegalZoom for very little money.

It includes a one hour zoom session with an actual attorney to explain things.

They make it so easy.

Unfortunately some people refuse to prepare because they don't want to think about death.

Same as with other similar agreements. A doctor needs to declare your mental fitness. When in doubt, a court gets involved. As a rule of thumb, if you are able to understand enough to getter law involved you’re likely still mentally fit.

You express it in writing in an advance medical directive.

The same argument would apply to any other kind of will or testament. You need to update it frequently. It’s not uncommon for people to change their mind quite late, and (at least in Germany) that’s perfectly possible even until late. If people dispute this later change of mind a judge needs to get involved, and being married to one I can tell you that they treat each case differently and with the appropriate care.

Arguably the best qualified person to decide what to do with Future You is Present You.

Uh, new years resolutions are not exactly what I would call the ideal metaphor for assisted suicide.

Plenty of people here who reacted negatively to OP's suggestion seem to not have had to deal with a loved one who dealt with Alzheimer's or other forms of dementia. It's not hard like taking care of a toddler is hard. It's hard like, "this is not the same person I know for my whole life, they don't recognize me, they say and do mean things to me and their grand-kids and neighbors all the time, and require 24x7 supervision to not hurt themselves or break everything in the room."

Oh, and remember that in the US, all nursing homes for this kind of thing are for-profit companies backed by venture capital, meaning they are expensive as hell. Take your current middle-class apartment, shrink the size to just a bedroom (that you now have to share with someone else), and then quadruple the rent. Just a few years of that can decimate the life savings of the average retiree and/or their children's.

I speak with some authority here because all of this happened to my father. He was "alive" in the last few years of his life, but not what anyone would call "living." I absolutely do not want that to happen to me. If it were legal in the US, I would absolutely opt for an assisted suicide plan for myself.

There are ways to handle it that avoid all the "whatabouts" that you and others have already brought up. One rough draft of an example: 1) Have a lawyer write up a kind of will expressing my wishes. 2) Get three unbiased negative diagnoses to show I am of sound mind prior to signing the will. 3) Go in for regular testing (every year, maybe two). After each negative diagnosis, add another (witnessed and/or notarized) signature to the will. The will is not valid if testing or a signature is missed. 3) If there is ever a positive diagnosis, it must be confirmed by two other clinics. 4) If three years pass with doctors and clinical tests confirming increasing dementia symptoms along the way, the assisted suicide clause is invoked and I get to pass peacefully surrounded by loved ones instead of being a stressful burden on them for years or decades to come.

Yes, there are details and unintended consequences that neither me nor anyone else can see ahead of time. Like everything else, they are dealt with as they come up. No, you won't convince me that your favorite corner case means the entire idea is invalid.

https://www.google.com/amp/s/www.bbc.com/news/articles/c3wxq...

Huh, wow. Reading the Wikipedia page [0], I had forgotten about the term "direction via indirection"; seems to me like the first documented case of a dog whistle.

[0]: https://en.wikipedia.org/wiki/Will_no_one_rid_me_of_this_tur...

It's really up to them, not you. If you're pro assisted suicide you have to be pro other people making the decision in ways you disagree with.

I don't see what that has to do with my comment, but okay: A lot less than are unwillingly bringing undue burden and stress to their family and neighbors because there is no legal mechanism to avoid it. Even fewer if we acknowledge that assisted suicide should be an option with a very high bar for those who would qualify. I wrote another comment about one way it might work.

Do you also not care how people think of you now?