Problems with Assisted suicide

Andrew4Handel

I don't think assisted suicide reflects autonomy because it requires someone else to assist in your death and societal structures and values to change for everyone. It devalues life by ending it.

The case of Nathan Verhelst raises various relevant issues here:

"Nathan Verhelst was born Nancy into a family of three boys. The newspaper, which said it had spoken to him on the eve of his death, reported that he had been rejected by his parents who had wanted another son. He had three operations to change sex between 2009 and 2012.
"The first time I saw myself in the mirror I felt an aversion for my new body," he was quoted as saying."

https://www.bbc.co.uk/news/world-europe-24373107

This person had mental health problems after being rejected by their mother and felt the solution was a sex change but they were unhappy with the result and had an assisted suicide. His mother even reported she wasn't sad after their death in an interview. It is o clear that "She" identified as "He" other than as a means to please her parents.
Essentially this person was pushed to suicide by others and failed medical interventions.
Other people can make your life unbearable and then solve the problem they created by assisting in your suicide.
So I don't see the autonomy in being pressured by circumstance into taking your own life or in allowing someone's death to be a solution for societal problems.

Jack Cummins

↪Andrew4Handel

This is a particularly unusual story because it involves a transgender person and assisted suicide. I am startled that the person was given an assisted suicide, unless it was the mother. Assisted suicide is particularly complex and controversial, just as euthanasia is. Part of this may be because people may be pushed into it with others as a way of rejection, especially the elderly and people who unable to look after themselves. In this particular case it seems like there were critical family dynamics which needed experience and, perhaps, some professional family therapy interventions could have been offered to work with the various family members as opposed to the focus being on the one individual in isolation. I am not sure where this took place because it seems an extreme story.

Suicide itself is a very tricky area. I have worked in psychiatric nursing and it is often the opposite to this scenario. People are often wishing to kill themselves and if a person is viewed as a suicide risk they are often placed on close levels of observation, such as having a member of staff at arms length 24/7. I have known people being nursed in this way for over a year. Of course, it is not as if anyone can be on such observations permanently and often the people who do kill themselves don't tell anyone their intent and plans.

As far as needing assistance, some people try to kill themselves and don't succeed, and may even end up disabled in the process. Others may make what is believed to have been most likely a gesture for help, such as an overdose, and die accidentally.

Andrew4Handel

This is a particularly unusual story because it involves a transgender person and assisted suicide. I am startled that the person was given an assisted suicide, unless it was the mother. — Jack Cummins

It was the Mothers child who was euthanised because of botched sex reassignment surgeries.
There is a lot of details about it online.

Here is another controversial case:

Shanti De Corte was waiting for a plane to Rome on March 22, when she stood just a few meters away from one of the two suicide bombers who detonated high-powered bombs. Miraculously, Ms. De Corte, who was 17 years old at the time, was not injured, but she never recovered from her post-traumatic distress disorder. The young woman suffered years of psychological pain. Supported by her friends and family, she requested euthanasia in April. It was performed on May 7, but her death was announced only a few days ago.

This young woman had an assisted suicide due to mental distress:
ttps://www.lemonde.fr/en/international/article/2022/10/10/2016-brussels-attacks-victim-granted-euthanasia-after-years-of-ptsd_5999805_4.html

Apparently at at 23 she knew her life would never improve and everyone else seconded this opinion.

This seems like a win for terrorism to me that people can terrorise us into losing the will to live.

Andrew4Handel

People are often wishing to kill themselves and if a person is viewed as a suicide risk they are often placed on close levels of observation, such as having a member of staff at arms length 24/7. I have known people being nursed in this way for over a year. Of course, it is not as if anyone can be on such observations permanently and often the people who do kill themselves don't tell anyone their intent and plans. — Jack Cummins

As someone who has attempted suicide in the past I was deemed not mental ill enough to be sectioned.
I am not sure how one gets oneself sectioned these days.

Despite having had suicidal feelings over the years I don't want the state to aid in my death because since prior attempts I have found some enjoyment in life. I got a degree and learnt a new musical instrument after feeling really suicidal but then I think new medication may have initially increased suicidal feelings as can be the case until it started having positive effects.

The psychiatric, psychologic and philosophical stance on suicide is confusing but nowadays it has been gone from a criminal act and taboo to being seen as divorced from mental illness and a valid choice.

I always want to stop someone from committing suicide and suggest a reason for them to live.

Vera Mont

I don't think assisted suicide reflects autonomy because it requires someone else to assist in your death — Andrew4Handel

Only in the final stages of illness, when the patient is incapable of doing it alone. And that's the only time that assistance is legally available. Therefore, many of us plan our exit strategy while we are still physically able. The problem with that approach, of course, is that we die sooner than we want to, so as to escape being forced to endure months or years of pain and to spare our loved ones months or years of hardship - which, incidentally, also causes some relatives and caregivers to take pity on a patient and help them illegally, risking prison themselves.
Nobody is forced to choose suicide; nobody is forced to assist; it's entirely voluntary. Quite often, all the assistance a patient needs is not to deprived of the means to do it themselves, but that, too, is illegal under theocratic jurisprudence. That's the difference in pro- and anti- policy: the use of force and threat of punishment.

Vera Mont

This seems like a win for terrorism to me that people can terrorise us into losing the will to live. — Andrew4Handel

Yes. They can also murder and maim, enslave, torture, rape and imprison us. No anti-suicide law ever stopped a terrorist, an assassin, a revolutionary, a dictator or a plain old criminal.

Despite having had suicidal feelings over the years I don't want the state to aid in my death because since prior attempts I have found some enjoyment in life

Then don't ask for help. And if somebody offers, refuse.

Andrew4Handel

Yes. They can also murder and maim, enslave, torture, rape and imprison us. No anti-suicide law ever stopped a terrorist, an assassin, a revolutionary, a dictator or a plain old criminal. — Vera Mont

An anti assisted suicide law would have meant this young woman would still be alive and there would be decades left of her life in which to truly and improve her mental health.

We need ill people to stay alive to try and cure illness. There are all manner of drastic interventions for mental disorders but now this young woman is completely gone. They could have removed part of her brain as they have done with some people or put in implants for deep brain stimulation tried all manner of legal and illegal drugs.

By her own account she was severely mentally distressed so how can someone in that position give informed consent?

But relating to my wider point we should be preventing, terrorism and mental illness and distress. If I had successfully committed suicide when I was a teen, the school bullies, the local bullies, the church I grew up in and my parents would never have been held accountable now I can advocate on the dysfunctional issues that lead to my suicidal ideation.

Andrew4Handel

Then don't ask for help. And if somebody offers, refuse. — Vera Mont

The mental health services should be there to help improve a mentally ill persons life.

They should in no way sanctioning suicide or rationalising it. But they have been compromised.

They found people are more likely to commit suicide after seeing a mental health professional. From my experiences the services can leave you feeling more hopeless.

Vera Mont

The mental health services should be there to help improve a mentally ill persons life. — Andrew4Handel

Of course.

They should in no way sanctioning suicide or rationalising it. — Andrew4Handel

They are staffed by people and people have their own ideas about what they 'should'. That's autonomy.

But they have been compromised. — Andrew4Handel

They have changed. Everything changes.

They found people are more likely to commit suicide after seeing a mental health professional. — Andrew4Handel

Which "they" is this that have found? And where did "they" find it? This does not appear to me a cause-effect relation. It doesn't seem to me unreasonable that troubled people try to get help, and only when it fails to provide the relief they seek do they choose the final option.

From my experiences the services can leave you feeling more hopeless. — Andrew4Handel

Of course health care services could be improved - not only in mental health, but all areas - if a society devoted enough resources to it. (Or refrained from driving so many of its members to despair.)
Forbidding yet another expression of personal volition doesn't improve them. Mental illness was not more effectively treated when anti-suicide laws were universal than they are now.

180 Proof

↪Vera Mont

:up:

↪Vera Mont

:up:

Andrew4Handel

↪Vera Mont

Another issue I had was that I wasn't diagnosed with autism spectrum disorder until my early 40's and it caused me a lot of problems before then including suicidal ideation and despair.

So why offer assisted suicide when you don't know what underlying issues or conditions a person may have and when you may not have explored all options and diagnoses?

Along with this my older brother died a couple of years ago from Multiple sclerosis that left him unable to communicate except through blinking and essentially paralysed. When he was in a coma twice we had to advocate to keep his life support on on his behalf but if he didn't have relatives to do this they wouldn't have known his wish because of his increasing communication issues over the years. After he survived pneumonia twice he met his wife and got married which he always wanted to do.

He had a quality of life that seemed objectively horrible in some respects but always wanted to be kept alive until, it was impossible to do so. My dad worked in Geriatrics (Care of the elderly) and he found people there were not eager to die even ill and in their 90's.

I think you can create a cultural that doesn't value life/longevity. I personally don't like any form of suffering but I don't think death is alleviating suffering it is ending existence.

There is extensive forms of end of life palliative care that try to reduce suffering to the minimum

Andrew4Handel

Forbidding yet another expression of personal volition doesn't improve them. — Vera Mont

I think autonomy does not make sense if you are going to kill yourself. You can't express autonomy once you are dead.

Have you got an argument for autonomy? We don't chose to be born, we don't chose our parents, our religious upbringing, schools etc.

I don't think we can have consistent autonomy without undermining many process in life including creating children.

People think we have a responsibility to those we create, a responsibility to others etc. If a man or woman has young children or even older children killing themselves can create a burden for them, for surviving relatives and friends and even lead to another suicide through grief and loss.

Vera Mont

So why offer assisted suicide when you don't know what underlying issues or conditions a person may have and when you may not have explored all options and diagnoses? — Andrew4Handel

I haven't. As far as I know, no Canadian doctor under the new law does. And it's not as if compassionate caregivers haven't been assisting terminal patients all along - it's just they had to do it in secret or be punished by the self-righteous authorities.

If he didn't have relatives to do this they wouldn't have known his wish because of his increasing communication issues over the years. — Andrew4Handel

Hence the need for a living will. Relatives very often do the opposite of what the patient wants.

I think you can create a cultural that doesn't value life/longevity. — Andrew4Handel

Sure, and that's coming, when overstressed societies, besieged with one calamitous event after another, can no longer support their increasingly aged and infirm populations. But it won't be because I've opted out.
The values of this society haven't changed. I and a large minority never shared the Abrahamic religions' values: they were just foisted on us. When we became the majority, we finally shook them off.
But your values haven't changed because of that, and we're not forcing our choices on you.

There is extensive forms of end of life palliative care that try to reduce suffering to the minimum — Andrew4Handel

Forms, yes - mainly pain relieving drugs, which are effective to some finite degree for some finite length of time, and sedation, which is not very much like living. Available beds, nowhere near as many are required. Elder care and long-term care facilities are already in crisis

current elderly care systems worldwide are already unable to address the soaring demand from fast growing numbers of older people, even in higher-income countries. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60463-3/fulltext

which would be somewhat lessened if everyone could choose. But they already can't: far too many old people are crammed into overloaded, understaffed, poorly run - and often horrific - facilities. Out of sight, but still a huge drain on the health-care system.

I think autonomy does not make sense if you are going to kill yourself. You can't express autonomy once you are dead. — Andrew4Handel

I'll settle for until. Of-bloody-course no rights or freedoms continue beyond death. Not even in heaven, which, from all I've heard, is an absolute dictatorship.

Have you got an argument for autonomy? We don't chose to be born, we don't chose our parents, our religious upbringing, schools etc. — Andrew4Handel

...until we attain the age of majority, whereupon we choose our studies, work, friends, lovers, homes, lifestyles, purchases, government representatives, churches, hobbies, entertainments, clothing, modes of transport, even down to the herbs in our kitchen window.
Everyone who lives in a society is bound by laws - and can choose to break those laws and risk punishment. The more restrictions lawmakers impose on citizens' personal lives - whom you may marry, where you may live, what institutes of learning you may attend, what you may read, what you may smoke, which water fountain you may drink from - the more oppressive that society is and the more law-breakers it has to deal with, and then the criminal justice system is as overburdened as the health care system.

I don't think we can have consistent autonomy without undermining many process in life including creating children. — Andrew4Handel

Oh, yes, and forcing people to create children they don't want and can't support, but the forbidding society won't, either: more burden for the social services.

If a man or woman has young children or even older children killing themselves can create a burden for them, for surviving relatives and friends and even lead to another suicide through grief and loss. — Andrew4Handel

Also conversely, a lingering illness can - does - create burdens of entrapment, helpless pity, self-sacrifice, guilt, resentment and material hardship for the family. The terminally ill parent was going to die anyway, only the children didn't first go through a long period of waiting, watching them suffer. And the spouse who can't stand that any longer and helps the patient die, often commits suicide, too, rather than go to prison.

Animal flesh is subject to the vagaries of nature; disease, injury, malfunction, debilitation and dementia. Being in this world is dangerous and ultimately fatal. All endings are inevitable; some are more gruesome and protracted than others. I just want to be allowed to make my ending no more awful than it has to be.

Andrew4Handel

This is from a British medical association (BMA) document:

Arguments against Physician assisted suicide.:

1. Laws send social messages. An assisted dying law, however well intended, would alter
society’s attitude towards the elderly, seriously ill and disabled, and send the subliminal
message that assisted dying is an option they ‘ought’ to consider.
2. So-called ‘safeguards’ are simply statements of what should happen in an ideal world.
They do not reflect the real-world stresses of clinical practice, terminal illness and family
dynamics. It is impossible to ensure that decisions are truly voluntary, and that any coercion
or family pressure is detected.
3. For most patients, high-quality palliative care can effectively alleviate distressing symptoms
associated with the dying process. We should be calling for universal access to high quality
generalist and specialist palliative care, rather than legalising physician-assisted dying.
4. Licensing doctors to provide lethal drugs to patients is fundamentally different from
withdrawing ineffective life-sustaining treatment, and crosses a Rubicon in medicine. The
role of doctors is to support patients to live as well, and as comfortably, as possible until they
die, not to deliberately bring about their deaths.
5. Currently, seriously ill patients can raise their fears, secure in the knowledge that their doctor
will not participate in bringing about their death. If doctors were to have the power to provide
lethal drugs to patients to end their lives, this would undermine trust in the doctor-patient
relationship. Some patients (particularly those who are elderly, disabled or see themselves
as ‘a burden’) already feel that their lives are undervalued and would fear that health
professionals will simply ‘give up’ their efforts to relieve distress, seeing death
as an easy solution.
6. Once the principle of assisted dying has been accepted, the process becomes normalised
and it becomes easier to accept wider eligibility criteria or to widen eligibility through the use
of anti-discrimination legislation.
7. In modern clinical practice many doctors know little of patients‘ lives beyond what the busy
doctor may gather in the consulting room or hospital ward. Yet the factors behind a request
for assisted dying are predominantly personal or social rather than clinical. Assisted dying is
not a role for hard-pressed doctors.

https://www.bma.org.uk/media/4394/bma-arguments-for-and-against-pad-aug-2021.pdf

Andrew4Handel

Arguments for Physician assisted suicide.:

1. Even with universal access to specialist palliative care, some dying people will still experience
severe, unbearable physical or emotional distress that cannot be relieved. Forcing dying
people to suffer against their wishes is incompatible with the values of 21st century
medicine.
2. Physician-assisted dying is a legal option for over 150 million people around the world. In
jurisdictions where it is lawful, there are eligibility criteria, safeguards and regulation in place
to protect patients.
3. Guidance in the UK for end-of-life practices, such as the withdrawal of life-sustaining
treatment, already contains safeguards to ensure decisions are made voluntarily, coercion
is detected and potentially vulnerable people are protected. There is no reason why these
safeguards could not be used effectively in assisted dying legislation.
4. The current law is not working. UK citizens travel to Switzerland, to facilities like Dignitas, to
avail themselves of physician-assisted dying, but this option is only available to those who
have the funds to do so. This often leads to people ending their lives sooner than they would
have wished because they need to be well enough to travel. There is no oversight under
UK law about who travels abroad for an assisted death; anyone who provides assistance –
doctors, family or friends – is breaking the law, which can lead to criminal investigations.
5. There is widespread public support for, and tacit acceptance of, physician-assisted dying
within society. Given this, it would be fairer and safer to have a properly controlled and
regulated system within the UK.
6. Some people, knowing that they are dying, want to be able to exercise their autonomy and
determine for themselves when and how they die, but need medical advice and support
to achieve this. Doctors should not be able to impose their personal beliefs on competent,
informed adults who wish to exercise this voluntary choice. Legislation would contain a
conscientious objection clause to protect those healthcare professionals who did not want
to participate.
7. The existence of legislation allowing assisted dying brings reassurance and peace of mind for
many people with terminal illness and their loved ones, even though only a small percentage
actually use it when the time comes

https://www.bma.org.uk/media/4394/bma-arguments-for-and-against-pad-aug-2021.pdf

180 Proof

Animal flesh is subject to the vagaries of nature; disease, injury, malfunction, debilitation and dementia. Being in this world is dangerous and ultimately fatal. All endings are inevitable; some are more gruesome and protracted than others. I just want to be allowed to make my ending no more awful than it has to be. — Vera Mont

:death: :flower:

You’re on earth. There’s no cure for that. — The Unnameable

Andrew4Handel

Also conversely, a lingering illness can - does - create burdens of entrapment, helpless pity, self-sacrifice, guilt, resentment and material hardship for the family. The terminally ill parent was going to die anyway, only the children didn't first go through a long period of waiting, watching them suffer. And the spouse who can't stand that any longer and helps the patient die, often commits suicide, too, rather than go to prison. — Vera Mont

I would need examples of this "And the spouse who can't stand that any longer and helps the patient die, often commits suicide, too," can you cite one case or more. I would wager that there are far more cases of one suicide triggering another.
Suicide contagion is well documented in history.

https://en.wikipedia.org/wiki/Copycat_suicide

You seem to be working under the false premise that assisted suicide is only being used on terminally ill persons or will stop their.
I was talking about how suicide in general affects others and that it is not just purely autonomous act because it has consequences for others.
Even in cases of seriously ill people having an assisted death relatives often don't want it to happen. (And most terminally ill people don't use assisted suicide in places like Canada)

I felt trapped in my brothers care when I started to care for him. My own mental health had improved so i started to get involved in with his care and moved in with him. Over the years I moved out and he got married etc but it went one for a couple of decades but people want to make sacrifices for other peoples well being. In some ways I also benefited from my involvement in my brothers care.

Andrew4Handel

...until we attain the age of majority, whereupon we choose our studies, work, friends, lovers, homes, lifestyles, purchases, government representatives, churches, hobbies, entertainments, clothing, modes of transport, even down to the herbs in our kitchen window. — Vera Mont

The would be great if it was true but it probably isn't. Peoples childhood probably profoundly effects their adulthood (that is another debate topic) and peoples attitudes correlate with their the society they grew up in and your picture is of a Western capitalist, individualistic model. Culturally situated so to speak.

In some societies married couples live with their parents or a parent moves in with a married couple. Society is less individualistic and has stronger notions of duty. Independence from others is not viewed as a good thing. Some types of dependence are seen as positive.

In the case of Nathan Verhlest in the opening post she was neglected by her parents leading to a need for complete emotional self sufficiency
but she/he tried to transition to male to win her parents approval which didn't work unethical surgeons experimented on her body to try and make her look as male as possible because surgeons can now apparently do anything to your body that you ask for
and then society provides the poison for her to exist life after a litany of abuse neglect and medical malpractice.

Cuthbert

I would say I have the right to end my own life. But I am not sure that I can place an obligation on anyone else to help me do it. There may be people who are under obligation to hinder me, if they can, because of other duties they have, e.g. to preserve life. I'm not sure that I can remove that obligation, if it exists. Unfortunately, the consequence of this view is that if I am unable to end my own life then I shall be left helpless and in avoidable suffering. So I don't have an answer. But I think those are the main outlines of the problem.

Manuel

↪Andrew4Handel

Because one often needs help in such circumstances then the issue no longer reflects a person's autonomy? Well, if that is the case, we have no autonomy in almost anything - because we get assisted in all aspects of life.

Nevertheless, if one does not have a say in what you do with yourself, I don't know what should count as having a say in something.

As for circumstances, many, notably cases of enduring and not-relieveable pain, severe mental disorders and, sometimes, very bad luck. If a person really wants to die, they will find a way - often a quite horrible one at that. Better to allow these things to occur with empathy, instead of moral grandstanding.

And sure, we should be careful in cases in which what's going on is no more than a temporary depression.

Vera Mont

n some societies married couples live with their parents or a parent moves in with a married couple. Society is less individualistic and has stronger notions of duty. Independence from others is not viewed as a good thing. Some types of dependence are seen as positive. — Andrew4Handel

How does that relate to torturing people too feeble to defend themselves?
Yes, modern western people are free to and expected to make their decisions, which is why they are also held to account for their decisions. A 40-year-old never gets away with the plea: I was raised in a family of mobsters; it's my heritage."

Making a cultural issue of degrees of independence doesn't alter the issue of suicide. Cultural attitudes to suicide also vary. In the Old testament, all you had to do to be put out of your misery is "curse god and die" - no punishment, no afterlife. In Islam, suicide in the cause of furthering a national aspiration is not only allowed, but laudable, as it was for Sampson, and as it is for American soldiers. An ancient Roman was expected to fall on his sword, rather than dishonour his family, and of course, we all know about the Japanese tolerance of suicide.

In the case of Nathan Verhlest in the opening post she was neglected by her parents leading to a need for complete emotional self sufficiency
but she/he tried to transition to male to win her parents approval which didn't work unethical surgeons experimented on her body to try and make her look as male as possible because surgeons can now apparently do anything to your body that you ask for
and then society provides the poison for her to exist life after a litany of abuse neglect and medical malpractice. — Andrew4Handel

This is a bizarre situation. I have no reason to doubt your veracity, or the existence of unscrupulous and callous people, doing cruel and illegal things.
But why I should I be made to pay for their sins?

Vera Mont

"And the spouse who can't stand that any longer and helps the patient die, often commits suicide, too," can you cite one case or more. — Andrew4Handel

https://www.washingtonpost.com/archive/lifestyle/1983/03/12/the-koestler-suicide-pact/0e322224-2438-4b89-8e10-34564a557d67/

For more than a decade, Dr. Daniel and Katherine Gute of Milwaukee, both approaching 80, had been planning their deaths, should one or both of them be forced to live in a nursing home or need extraordinary medical care.

‘Inseparable’ pair were reportedly ‘determined’ not to go on in life after suffering health issues...[url=http:///home-news/peter-diana-couple-suicide-pact-b1872340.html].Peter White, 72, and his wife Diana, 74,[/url] were found dead in their flat in Altrincham in January this year

He killed her and made a serious attempt on his own life but called police in desperation 12 hours later when he woke up still alive. He begged paramedics to let him die and admitted from the first 999 call that he had killed Dyanne.

You seem to be working under the false premise that assisted suicide is only being used on terminally ill persons or will stop their. — Andrew4Handel

That is the legal position in Canada, yes.

I was talking about how suicide in general affects others and that it is not just purely autonomous act because it has consequences for others. — Andrew4Handel

How's that relevant to the assisted suicide law? People were killing themselves when it was illegal, and when it was legal, and whenever they felt it was their only escape from a fate they could not face.
Of course it affects others. Of course, everything one person does is disapproved of by some other persons. People disagree about all kinds of things, but they keep doing the things they disagree about, and nosy parkers dip their oar in , too.

The Euthanasia Prevention Coalition has stepped up to bankroll the man’s wife in her effort to have the courts stop her husband from using Canada’s assisted-suicide system to take his life.

.

The coming of each person into the world affects the world in some way. The way each person lives in the world affects the world, for better or worse. The time and manner of each person's departure from the world affects the world. Nevertheless, we keep doing all three.

Vera Mont

But I am not sure that I can place an obligation on anyone else to help me do it. — Cuthbert

It isn't necessary. There are plenty of people ready to help voluntarily. Many of the strongest advocates of legalizing assisted suicide have been health-care workers who had too watch too many patients suffer through terminal illness that no decent person would allow their pet to endure.

Jack Cummins

↪Andrew4Handel

I am replying mainly to your reply saying that you always wish to help people from committing suicide. I come from that angle too, because apart working with suicidal people in mental health care I have experienced suicidal ideas and known people who committed suicide. It was while I was a student that I knew 3 people who committed suicide when I was a student that led me to train in mental health care.

In ethics, there is the ongoing issue of autonomy of choice and this may be related to the legal issues surrounding capacity to consent which is often seen as the benchmark of the ethics involved in psychiatry. Critical psychiatry may have taken over in the aftermath of the decline of the antipsychiatry movement.

On the subject of suicide, one book which I found useful is, ' Suicide and the Soul", by James Hillman. What he looks at is the way in which while suicide comes amidst despair it may also contain a hope or wish for transformation. To some this may appear as idealism but it may also involve the tightrope of the suicidal person's existential predicament as a search for choices which may go deeper than the surface of autonomy as theory bringing it more in line with the quest for authenticity.

Cuthbert

There are plenty of people ready to help voluntarily. — Vera Mont

That means they would be happy to receive the obligation, if I place it. But they may not take the initiative. They may not volunteer, in that sense. I must take the initiative by requesting them to kill me. Of course many kind and humane people will be happy to receive the obligation and accede to my request.

The question is: do I have the right to place such an obligation on someone, even if they would be ready to take it on? For health workers: do they have the right to accept the obligation, when they have a duty to preserve life and not to take it?

It's inhumane to stand by and watch people suffer, as you say. It is outrageous that the law punishes the humane alternative of assisting suicide. And it is outrageous of me to expect someone to end my life when their general and sometimes professional duty would be to hinder me from suicide. There's outrage all round and all of it has some justification.

Andrew4Handel

How does that relate to torturing people too feeble to defend themselves? — Vera Mont

What are you referring to? Palliative care is not torture. Prolonging someone's life is not the definition of torture.

Your position seems to contain a lot of hyperbole. Once enacted assisted suicide laws affect everybody. They affect attitudes towards life and death, palliative care, treatment and value of the disabled the treatment of mental illness.

You cited the example of Arthur Koestler and his wife. I will deal with the different cases you gave separately.

Arthur Koestler took his own life without assistance. His healthy wife committed suicide in her fifties as part of a suicide pact. Suicide pacts are ethically problematic and indicate an unhealthy relationship. Peoples life should not end when a loved one dies. It is reminiscent of Suttee where a wife was immolated or immolated herself on the funeral pyre of her husband in India. It is a recipe for abuse and coercion

"Controversy arose over why Koestler allowed, consented to, or (according to some critics) compelled his wife's simultaneous suicide. She was only 55 years old and was believed to be in good health. In a typewritten addition to her husband's suicide note, Cynthia wrote that she could not live without her husband. Reportedly, few of the Koestlers' friends were surprised by this admission, apparently perceiving that Cynthia lived her life through her husband and that she had no "life of her own".[75] Her absolute devotion to Koestler can be seen clearly in her partially completed memoirs.[76] Yet according to a profile of Koestler by Peter Kurth:[77]"

https://en.wikipedia.org/wiki/Arthur_Koestler#Final_years,_1976%E2%80%931983

Koestler was a long time advocate of assisted suicide and was Vice-President of the Voluntary Euthanasia Society. It is not clear like in other cases of suicide advocates that he tried palliative care.
His suicide and others like this that have happened can be viewed as political acts.

Vera Mont

But they may not take the initiative. — Cuthbert

They're not even allowed to. But, in a sense, they already took the initiative on all our behalf when they petitioned and testified before one court after another to get the law changed. And, as I mentioned before, it was tacitly understood in the health care community that both physicians and nurses occasionally succumbed to a patient's pleas for release, even while assisting was illegal. Taking that risk was initiative enough to convince me.

The question is: do I have the right to place such an obligation on someone, even if they would be ready to take it on? — Cuthbert

I don't know about you; I trust them to make a decision they believe to be right.

For health workers: do they have the right to accept the obligation, when they have a duty to preserve life and not to take it? — Cuthbert

They may well consider their first duty to the patient, rather than an abstract concept of 'life'. they may consider "do no harm" to include refusing to shove tubes and needles into someone who does not want to undergo a treatment, or who has explicitly refused artificial life support. DNR orders have been in effect for a long time and generally followed - unless the family too charge and countermanded the patient's wishes.
Nothing about life is as cut-and-dried as the words 'give' 'preserve' and 'take' could begin to encompass.

And it is outrageous of me to expect someone to end my life when their general and sometimes professional duty would be to hinder me from suicide. — Cuthbert

And was the authority that laid that "duty" on them more moral, better justified than the person's own case-by-case judgement?
I used to work at the coroner's office. We had bodies come in from hospitals and nursing homes of people who finally succeeded after many such well-meaning or legally enforced interventions. The agonies they endured just to end their lives demonstrates just how agonizing those lives must have been. I can't believe anyone has a duty to prolong such a life.

Vera Mont

Palliative care is not torture. — Andrew4Handel

You keep pretending that's a viable option for everyone in terminal distress.

In developed countries, cancer patients are relatively well provided for, with good access to palliative care units and hospices, at least in urban centers. Community hospitals and rural areas are, however, less well served, and people living with chronic noncancer diagnoses have much poorer access to specialist palliative care programs.

And of course, if you add the depredations of covid et al, plus rapidly aging population... it's not looking like an option for everyone.

Prolonging someone's life is not the definition of torture.

Not your definition. It is the definition of many a professional torturer.

His suicide and others like this that have happened can be viewed as political acts. — Andrew4Handel

Fair enough. Political acts are required to effect political change. If changing archaic laws eventually changes social attitudes, that's all to the good for ex-slaves, children and atypical genders.

Andrew4Handel

Here is some issues with the Canadian assisted suicide program. From The Guardian Newspaper.

"Are Canadians being driven to assisted suicide by poverty or healthcare crisis?"

https://www.theguardian.com/world/2022/may/11/canada-cases-right-to-die-laws

"After pleading unsuccessfully for affordable housing to help ease her chronic health condition, a Canadian woman ended her life in February under the country’s assisted-suicide laws. Another woman, suffering from the same condition and also living on disability payments, has nearly reached final approval to end her life."

"In February, a 51-year-old Ontario woman known as Sophia was granted physician-assisted death after her chronic condition became intolerable and her meagre disability stipend left her little to survive on, according to CTV News.

“The government sees me as expendable trash, a complainer, useless and a pain in the ass,” she said in a video obtained by the network. For two years, she and friends had pleaded without success for better living conditions, she said."

Andrew4Handel

For more than a decade, Dr. Daniel and Katherine Gute of Milwaukee, both approaching 80, had been planning their deaths, should one or both of them be forced to live in a nursing home or need extraordinary medical care. — Vera Mont

There is a lot about this case here:

https://www.milwaukeemag.com/tender-is-the-night/

"In 2002, they were visited by Anne Wanzer, one of Kitty’s college classmates, and her husband, Dr. Sidney Wanzer."

"Wanzer published a booklet through Hemlock Society USA called The End of Life: How to Deal with the System – A Practical Guide for Patients and Families. In it, he outlines how to make a living will and do-not-resuscitate orders, and details methods of “hastening” the end of life: physician-assisted suicide, stopping aggressive medical treatments, not eating and using helium."

So this is apparently not a case of suicide through desperation.
.........

“If Dan had a bible, it was Wanzer’s book,” says Dr. Bruce Wilson, the Gutes’ doctor and friend. Wilson says he had “hundreds” of conversations with Dan and Kitty about end-of-life issues. “Both of them said to me, ‘We feel very strongly about how we want to go out, when it’s time.’ ”

Daniel intended to kill himself because he didn't want to live without his wife not because he assisted in her suicide. Her having dementia has the ethical dilemma of her not being able to consent.

This is different then the cases faced by people with poverty, poor healthcare access, mental illness, family pressure and other issues people are faced with when AS becomes nationally legalised.

There is a lot more relevant information in the linked article that I will come back to in later posts.

Vera Mont

There is a lot more relevant information in the linked article that I will come back to in later posts. — Andrew4Handel

So, the burden of your argument is that every case of suicide researched and planned by persons of sound mind fail to meet your criteria for good reason?
The fact they were not yet terminal and helpless points to the premature suicides of people determined to die on terms in countries where that's against the law.
You're right that I was not thorough enough: didn't find enough spouses who had actually done their partner in, but merely collaborated in a suicide, before killing themselves. So we don't know, except for one, what would have happened to them if they were discovered to have collaborated or conspired in the spouse's death; can't be sure they would have prosecuted and convicted.
True. I concede, since I'm prepared top ferret out cases whether the spouse did kill the other, then recorded the fact, clearly stating that they were reluctant to face legal consequences and only then killed him or herself.

Problems with Assisted suicide

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