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My prediction is that assisted suicide will someday become legal in the United States for mostly economic reasons. We can already keep old bodies alive for decades beyond the expiration date for healthy brains. That's not a sustainable system, economically or otherwise. We're burying future generations in debt and burdening them with the responsibility of caring for our zombie bodies and rotted brains.

I understand all of the moral and social arguments against assisted suicide. Some people say life is sacred, and I respect that. I will also stipulate that if assisted living were legal, some people would attempt to pressure their grandmothers into early graves to collect the inheritance.

But let's assume that if assisted suicide were legal it would have a number of safeguards. Perhaps a person who wants assisted suicide services would have to get sign-offs from at least two direct family members, two doctors, and a psychologist. I would think you could devise a system to thwart all but the cleverest schemers.

In the past few years, several of my relatives and in-laws have shed their mortal coils under our current system. Each of them experienced a final year of life that was quite awful. If you haven't observed a close relative suffering for months, or even years, with dementia and illness, you probably shouldn't have an opinion on assisted suicide. You really need to be in the room. 

You might also want to walk down the hall of a medical facility that handles people in their final months of life. You won't see anything in the eyes of the patients that looks like happiness. It's truly horrifying. Our local facility is upscale and well-run, but it still feels like walking through a meat storage facility in which the meat feels pain and depression.

All of this makes me wonder if any economist has studied the economics of assisted suicide. My best guess is that assisted suicide could reduce a nation's healthcare costs by 20%. And that might be conservative. I'll bet it's not unusual for someone to consume $50,000 of healthcare service up to the final year of life then consume $100,000 worth in the final year. All of that is somewhat offset by the people who die suddenly. So I wonder what the net is.

A quick Google search found one study that says so few people would choose an assisted suicide option that it would have little impact on overall healthcare costs. In the Netherlands, where assisted suicide is legal, only 2.7% of people take that route. But I expect that someday science will keep bodies alive so long that up to half of all elderly people would want assisted suicide. And in my family, including in-laws, I believe only one out of seven died quickly. The other six had expensive and unpleasant final years.

Here's my question for today: Add up the number of people in your family who have died in the past ten years. How many of them went out quickly and inexpensively? I'll bet it's fewer than half.

 
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Dec 14, 2012
" If you haven't observed a close relative suffering for months, or even years, with dementia and illness, you probably shouldn't have an opinion on assisted suicide. You really need to be in the room. "
I don't think that is a valid starting point. I have experienced my grandmothers decent into dementia, but that experience should not be the starting point. Major decisions should be evaluated with facts and logic. Once all the options have been assessed and analyzed, then you have the big picture and then considering other factors can be considered. Factoring the emotional subjective points from the start is what we have now and just makes it difficult to get anywhere.

 
 
Dec 14, 2012
3 of 4 departed in that time were painful (on several levels) and expensive. The 4th? Unassisted suicide, in large part to escape that period of painful (on several levels) year and high medical bills.
 
 
Dec 14, 2012
Hbmindia - my mother (81) is currently in very severe stages of dementia, to the extent that at best she believes she is in her 20s, and at worst hallucinating people in the room with her. She regularly has no idea where she is or what is going on, closing her eyes and rocking and repeating the same word over and over. Despite excellent quality of care, she is almost always confused, and almost always scared and unhappy.

She, of course, can have no way of expressing what she wants, as there is zero chance she will be able to understand the question.

I had to fill out forms for the home to talk about end-life care and whether to choose DNR. I was quite aware at the time that - for me - it would be far easier to bear, easier to deal with, if she were to die quickly rather than linger on. Finances, thankfully, aren't a problem - her pensions are sufficient to pay for care as long as she lives.

My feeling was that as she had always been a strong Christian, she would prefer not to be resusitated. Her husband of 40 years had died the previous year, her daughter a few years before. What would she gain from lingering on in pain and fear and confusion, when death would reunite her with her family? She has no idea who I am, BTW.

Like others here, the experience has made me positive that when the end approaches, I want to be able to say "let it stop now" - I have no desire at all to linger on for what (as medicine advances) could enter decades.

Someone said "a cure may be around the corner - what if you choose to die the week before?". True, it could happen. But, statistically, over the centuries, what percentage of people would have chosen to die just before a cure was found? Very, very low %age, I'm sure. With no way of knowing what will happen tomorrow, you can only base your decision on what is happening TODAY. And if someone is sure, today and yesterday and yesterday and yesterday......that they have had enough, by what right can we say "no, because tomorrow may be better"?

Will assisted suicide reduce our compassion and lead to enforced euthenasia, the slippery slope? Perhaps. But if that argument DOES hold, then we'd better ban capital punishment all round for the same reason, and ensure we are never again in a position to kill anyone in combat, because both those things will desensitive people as well, no?

If and when the day comes when I decide I want to die, I want to be able to do it - or get help to do it - without its illegality causing further strife for my family.
 
 
Dec 14, 2012
My mother had Alzheimers for the last three years of her life. For the last one and half year she was almost in a vegetative state. Was she suffering? I guess so, but I cannot be sure as there was zero feedback from her.

But What I do know from her utterances when she was healthy is that my mother had an innate and strong desire to live as long as possible. She thought the best blessing that she could give to somebody is to wish him a long life of a hundred and twenty years. Paradoxically, she had not particularly enjoyed life. She had, in some ways, been through more pain and suffering than I would wish on my worst enemy but one thing that repeatedly struck me was her desire to JUST BE ALIVE (I do not mean alive in the sense of being active or enjoying life or doing something. I mean alive in the sense as simply not being dead).

Would she have been happier if the plug had been pulled a year earlier? I really have no idea. But assuming she could choose between life and death, I am quite certain that she would have preferred to remain alive and suffer rather than die.

I am sure that most people, myself included, would not value their own lives as much. I would gladly die a few years earlier while I am in full possession of my faculties. But given the above, I would like a person to be able to make the choice for himself, by making some sort of legal document that states his wishes. If the person has not indicated a preference, it should mean he prefers life. The choice should not be left to his relatives except in exceptional cases.
 
 
Dec 14, 2012
"a meat storage facility in which the meat feels pain and depression."

So ... a factory farm?
 
 
+8 Rank Up Rank Down
Dec 14, 2012
"I think any argument for assisted suicide should be based solely on quality of life and personal empowerment factors. Financial cost to society should not even enter into the discussion. There is more to life than economics. "

The economic gain is only incidental.

This will never happen in the USA though, because:
a) There's too many loudmouth voters who base their lives around 2000 year old fiction.
b) Big Pharma makes too much money off people's final year of suffering and they have a lot of lobbyists with good hair.
 
 
+3 Rank Up Rank Down
Dec 14, 2012
"For those of you who are Christians, suicide is not specifically stated as an abomination to God. Some consider it self-murder, and thus against the sixth Commandment, but there is mixed opinion on this. "

So....let the Christians opt out? This is optional, not obligatory.

I'm sure the extra year of pain they go through before dying will serve to strengthen their faith and the faith of those around them.
 
 
+10 Rank Up Rank Down
Dec 14, 2012
I can see your economic arguement; but I go more on the moral arguement. I've had two grand / great-grandparents who had protracted, unpleasant, unhappy, and seriously unwell final years. Both sincerely wished for death, and I couldn't disagree with them. I think it was immoral not to give them the option of a pain-free, peaceful, ordered exit, instead of prolonging the misery of an inevitable and irreversible deterioration.

I am incredulous that our "civilised" society allows people to suffer like this, and denies them the opportunity to make their own informed decision.
 
 
+8 Rank Up Rank Down
Dec 14, 2012
I am for; so this is a bit of topic, but relevant when considering the subject.

Both my grandpas died from cancer - after suffering huge pains - though not for very long. At home, because after nothing could be done to treat them, my father, a doctor (a good one) took care to eleveate their pain as much as possible - even in not so legal ways (too high doses of morfin).

When my mother's dad could no longer stand the suffering, in completely clear mind, he requested my father to administer a letal dose. The family discussed and agreed, albeit, of course, not easily.

When dad arrived at our house with the requested lethal dose, grandpa had died naturally already. I had never seen my dad cry, and have never since. Not because he loved my mother's father that much, but because he did not have to "assist suicide".

Of course, the law could make it a free choice, which doctors are willing, who are not. But think what impact such actions will have even on those, who choose voluntary, as my dad...

PS: as I am very interested in the topic, I read a lot. I have never seen a discusion on internet, where God and sin, and stuff is not brought into it. So cheers, dilbertblog readers.
 
 
Dec 14, 2012
This is a tough one. My mother had metastasized breast cancer that went into the bone. She was given an experimental drug that put her cancer into remission, and gave her about three more years of reasonable life. She finally passed due to sepsis from a chemo treatment that lowered her resistance to the point where a simple bed sore ended up killing her.

For those of you who are Christians, suicide is not specifically stated as an abomination to God. Some consider it self-murder, and thus against the sixth Commandment, but there is mixed opinion on this.

It is very hard to watch a loved one die, particularly from a painful and debilitating disease. At the same time, it is often the desire of those so afflicted to continue to live. America is primitive in the management of pain; we seem to think it's somehow wrong to give a terminally ill person drugs to alleviate their suffering; we wouldn't want them to become addicted, would we?

There's a difference between wanting the pain to stop and wanting to die. It is often the relative of the afflicted who wishes that the sick person would die, because of the suffering it causes the person who is watching the loved one go through the end of their time on earth. But as painful as it is to watch that happen, and believe me, I know, it is not the choice of the relative of the dying person to determine how the end will come.

Truly pain-managed hospice is, to me, a better choice than assisted suicide. It can greatly reduce the cost associated with extreme end-of-life healthcare. Assisted suicide can make one callous to life; the next step is euthanasia. Disrespect for life is not one giant leap; it's a series of small steps. I think there is enough disregard for the sanctity of life already. Having a relative say to the dying, "Wouldn't you like to end your suffering through assisted suicide?" is hardly an unselfish thing to say.

Put yourself in the dying person's shoes rather than in the shoes of the relative who will still be alive, and ask how you would feel if your loved ones suddenly became a cheering section for your quick demise. I would counsel being a sounding board for a decent end-of-life transition rather than a staunch advocate of pulling someone else's plug. It's more human that way.
 
 
Dec 13, 2012
Back in the bad old days, a chief coroner used to instruct his new doctors accordingly: " If you walk into a room and find an 82 year old man lying dead in bed, don't look under the bed for the gun."
 
 
Dec 13, 2012
"You might also want to walk down the hall of a medical facility that handles people in their final months of life. You won't see anything in the eyes of the patients that looks like happiness. It's truly horrifying. Our local facility is upscale and well-run, but it still feels like walking through a meat storage facility in which the meat feels pain and depression"

My wife works as a palliative care nurse in a terminal care unit. That isn't really the feeling I got there. I don't know, maybe it's different in Canada, where while assisted suicide isn't yet legal, there is no perverse incentive to keep people suffering as long as there is money - I mean life.

My wife talks about her work and I don't think I'd mind dying in such a place. The goal of a good palliative care facility is to ease pain as people die. In some cases this mean sedating them into a near coma and just letting them die in their sleep. Maybe that is considered assisted suicide in some places?

That said, I am in favor of right-to-die laws that allow able bodied/minded people facing dementia or paralysis to pre-empt their own suffering in a humane way.
 
 
Dec 13, 2012
Am I the only person who sees a certain sad truth about elder care in the typo here: "I will also stipulate that if assisted living were legal, some people would attempt to pressure their grandmothers into early graves to collect the inheritance."
 
 
Dec 13, 2012
Even taking the numbers we do have the amounts are large.
2.7% is a larger percentage than I would have expected, based on the fact that it's a pretty irrevocable decision.
Assuming that 2.7% of Americans who die every year (2,420,000) chose assisted suicide, that's 65,000.
Again, assuming, these are the ones with highest pain and suffering, therefore expense, let's put the cost savings per person at your 100K. 6,500,000,000 or 6.5B. Not going to solve the debt crisis, but a substantial number...per year.
 
 
Dec 13, 2012
The worst part of global warming is that there just aren't going to be enough ice floes to push granny off on.
 
 
Dec 13, 2012
I've had a family member die a long and horrible death from a terminal disease. They absolutely would have "pushed the button" if they could have. And, as you infer Scott, my opinion went 180 degrees on this topic because of it. Yes, of course we should have assisted suicide (including your stipulations).

@AtlantaDude, we make economic decisions on life/death every day. We could save tens of thousands of lives each year with one simple law change: the maximum speed limit in the U.S. is now 5 mph. Why don't we do that? Time and money.
 
 
+7 Rank Up Rank Down
Dec 13, 2012
I doubt that suicide will become a popular option (for religious and other reasons). Some of the hardest, saddest, cases involve dementia, Alzheimer's, etc., and probably wouldn't be fit to decide anyway.
But an easier approach is already possible: DNR (do not resuscitate), living will/health care proxy, palliative care, and hospice. Changing policy and education to encourage these would be a big step. Recent studies show that medical doctors rarely die in hospitals; they make other choices.
Why aren't the rest of us informed so we can make similar ones?

From a fiscal side, I've read that 80% of all Medicare expenses are incurred in the last year of life, and 50% in the final month! Of course, we don't always know at the time when that final year/month is beginning, but I suspect it wouldn't be difficult to halve those numbers. Suicide not required.

I've had a couple of family members who were wise/lucky enough to die at home in their sleep. Lucky, because not everyone gets the choice; but wise because most people don't make that choice anyway. After some period with various home health care workers helping out (at a fraction of the cost of a residential or medical facility), they grew weak, signed up for hospice, and we well attended to until they breathed their last. More of us should be so lucky.
 
 
Dec 13, 2012
@AtlantaDude

[I think any argument for assisted suicide should be based solely on quality of life and personal empowerment factors. Financial cost to society should not even enter into the discussion.

There is more to life than economics.]

Even as we speak societies everywhere are cutting health care spending or refusing to increase it, knowing this will result in some number of deaths. They are also allowing industry a certain level of pollution knowing that some people somewhere will die as a result. And making other, similar decisions. Like it or not economics is a part of life or death decisions and always has been.
 
 
Dec 13, 2012
I sure am glad that I won't have to concern myself with any of these issues after Dec. 21st, 2012. My only concern at that point will be thinking about how hard is it gonna be to learn to play this dang harp while I'm floating around on this cloud for the rest of eternity.
Thank you Mayan ancestors!!!!
 
 
0 Rank Up Rank Down
Dec 13, 2012
As it happens, the argument not from an economist, but from the Economist (http://www.economist.com/news/leaders/21564849-terminally-ill-people-should-have-right-gentle-death-right-should-not-be), is that assisted suicide should be permitted -- arguing from a purely ethical standpoint, rather than from some drearily Benthamesque 'cost to society' calculation.
 
 
 
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