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 17, 2012
I am a pastor and have been in around 150 end of life situations with folks and their families in the last ten years. Some pastors with longer careers have been there many more times. The problem with a "one size fits all" solution is that every situation I can remember is different. Take my own case; I am 52, the youngest of 4. My dad is 86 he is the youngest of 4 all living and doing well for being 90, 92 and 95. All have various things wrong but are comfortable. My two aunts aged 90,92, live together and take care of each other quite well. My point is; people do not respond the way you want, if "assisted suicide" is legal ... I am sure there will be family members who want them to "just do it" so they can inherit before the nursing home and doctors get all the money ... you cannot make a system that takes greed out of the equation and what you're setting up is lots of ways for people to commit murder "legally". I know that sounds very negative but I was in the financial business for 20 years prior to becoming a pastor and I witnessed many families acting very badly when it came to money issues, especially around elderly relatives. You would have to take "family" completely out of the situation and then you'd be leaving it up to strangers? Not a good solution for me or my family.

Dec 17, 2012
@Dilbro: don't worry guy - anyone who happily says "So, I told the son, if that guy can use half of his body it shouldn't be too hard for him to slit his wrists" clearly has no compassion in his body at all. He's certainly not a doctor I would want anywhere near me, whether for assisted suicide or a sore throat.

@EMU, yes, you are quite right. Someone who wants to die could, I guess, slit their wrists. Or they could drag themselves to the window and tip themselves out. Or stick a fork in the electric socket. But you know what? All those things bring the extremely high likelihood of dying in extended and extreme pain, and the chance that - if it doesn't work - you'll linger on for some time in still more pain. What people WANT from an assisted suicide is someone to help them go calmly, peacefully, and painlessly.

But I grok that a lot of doctor's wouldn't want to do it - that's why nobody is making it compulsory for them. But at the moment, doctors are the only people with ready access to the facilities that can GIVE that pain-free assistance, the only ones who can make sure that their last moments are a quiet and dignified slipping away, rather than anything more drawn out.

I'm truly sorry that as a doctor you seem not to grasp that people want help, want a release from pain and unhappiness. "How long a prison term would you voluntarily face when it's your wife you assist?" If I had to, I'd take the life sentence. And I'm sure my children would be thrilled that they'd lost their father as well as their mother, because there are people in the world so bereft of compassion that they'd use the Newtown shootings to make a point. I really wonder what it was happened to you that made you this way.
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Dec 17, 2012
I'm withdrawing from this discussion with you with the hope you never find yourself or a loved one suffering needlessly because the mercy and humanity we show our beloved pets isn't allowed for ourselves or our human loved ones.

My "credibility" on this topic is the extended pain and suffering of 3 close loved ones.

May you never have the credibility that I do.
-2 Rank Up Rank Down
Dec 16, 2012
Sorry, at 15 it's /not/ your life's choice. You have parents or guardians precisely because at that point your brain isn't developed enough to make such choices. (Naturally, I, too, entertained thoughts of suicide at that time. Who doesn't?)
One may make the case at 21, but obviously you're still alive, despite painless alternatives available to you today.
Would you be alive today if some professional offered you a happy and painless death at 15? Told you that it's okay, that even the fear you feel while looking at the syringe is okay and that you want it nevertheless and then gently set the injection?

Your country is just digesting yet another mass shooting of children. Consider the pain of slitting ones' wrist another form of gun control, preventing you from doing something you might regret later. (Figuratively speaking.)
-1 Rank Up Rank Down
Dec 16, 2012
"As for the glass shard, I think it was a perfectly valid means to figure out whether someone really wanted to die or was just talking. Slitting a wrist is by no means an exotic or untried suicide method, so one can reasonably expect that a would-be-suicidist would give this at least a try."

Yes, wrist slitting is universally known and considered by people like me.
No, I never chose that method (6 attempts from age 15 to age 21).
It isn't the valid litmus test you imagine.

Offer the person a quick painless alternative to agony and suffering.
It's their life, their choice.
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Dec 16, 2012
If the docter needs to hold you down, you're well enough not to need assistance in your suicide. The moment you rue it is when you lie in intensive care, unable to move or talk, your heart takes a break and you know that the automated alarm won't bring the nurse but the undertaker.

As for the glass shard, I think it was a perfectly valid means to figure out whether someone really wanted to die or was just talking. Slitting a wrist is by no means an exotic or untried suicide method, so one can reasonably expect that a would-be-suicidist would give this at least a try.

Just about everyone who wishes to kill himself can do so, in a few years possibly even locked in people. The fact that few people do it tells me that few people really want it. And this, in turn, leads me to treat any method of making suicide easier (or assistance more legal) as invitation for foul play. This includes letting relatives off the hook when their fingerprints are found on the syringe. The question here is, how long a prison term would you voluntarily face when it's your wife you assist? 2 years? Five and foregoing any inheritance? Surely that's something you could endure for the last favour to the love of your life? That's how I'd define the threshold for suicide assistance.

So far I've left the Alzheimer people. I've no idea how to deal with them but my guess is that a suicide wish is something requiring a very clear mind. Animals don't kill themselves, neither do kids. So, if a brain degenerates, I'd suspect that any death wish disappears pretty early. And killing one who does not clearly want to die, for, as Scott says, the saving of $100.000, is something I have a real problem accepting.
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Dec 16, 2012
"Yes, you might want to die in a certain situation. Today. You might even sign a paper to that effect. However, when that situation approaches, you may well curse yourself into the seventh circle of hell, out of fury for signing that paper that now kills you."

I'm pretty sure nobody is suggesting the doctors will be holding you down and administering a lethal injection while you scream that you've changed your mind.

As for your suggestion to allow the person to slit their wrist on a shard of glass, I think that's the reason for discussion of a compassionate humane solution rather than the pain and slow terror of cutting yourself open and bleeding out.

In Oregon you receive a prescription that you can take home, gather loved ones to say goodbye, pop it and drift off.
Dec 15, 2012
I took care of an aunt during the last 3 weeks of her life. She had a mass in her abdomen which she chose not to have surgically removed. We all assumed it was cancer, but since she wouldn't have surgery, there was no way to know what type or whether she could have lived longer with treatment.

She had taken care of her own mother for the last 10 years of her life as her mother lingered in alcoholic dementia. She did not want to go through this herself, so she chose hospice.

Hospice was wonderful to her, but in my opinion, hospice is, basically, assisted suicide. Once my aunt got the fentanyl patch she went downhill very fast. With the sedation and the lack of mobility, she quickly lost her appetite and stopped eating. The last 3 days she couldn't drink anything. Without the fentanyl patch, I think it would have taken her much longer to die. Her death was due to stopping eating and drinking, not the cancer.

I think it's shameful that we wait until someone is at death's door before we relieve their pain. No one who feels horrible in the moment can make a reasonable decision about the future. That's why depressed people kill themselves. My aunt basically chose a certain painless death over her fear of a longer and more painful life. I respected her decision. Above all else she feared losing control of her future like her mother did, so she opted to control her death via hospice.
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Dec 15, 2012
"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?"
In the last 20 years none of my family died.
A friend of a friend died of ALS. Actually he died of lack of air when he refused to have the breathing tube inserted one day.

As for "assistance", have you thought of what it does to the doctors? They study medicine and work impossible hours to heal. Are you asking them to kill their charges? It's one thing for /you/ to shoot your parents one day for being old and in pain and silly in the head, but a stranger where you have no idea what pressure he's under and what he really wants?

Furthermore, the one other case I've seen (father of a friend), the father was half side paralyzed and wanted to die. Yes, clear cut case for assisted suicide you might think. So, I told the son, if that guy can use half of his body it shouldn't be too hard for him to slit his wrists and if he wants to help in a non-prosecutable way, all he needs to do is drop a glass of water beside hs bed, put the shards on the bed-table, leave and "forget" to pick up the fragments til next morning. If he truly wanted to die he'd surely figure it out and do what he wants to do. What happened? Well, I got one ugly look and no answer from the son for suggesting it and that was it. And the old daddy died in pain half a year later.

There goes your "someone ought o agree".

There's something else:
Yes, you might want to die in a certain situation. Today. You might even sign a paper to that effect. However, when that situation approaches, you may well curse yourself into the seventh circle of hell, out of fury for signing that paper that now kills you.
+2 Rank Up Rank Down
Dec 15, 2012
"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."

Any attempt to include others in the decision could have horrible consequences for the person suffering. It's their life and it's nobody's business but their own when they decide to check out.

1. 2 family members approvals.
Problem: If you don't give me 80% of your estate, I'm letting you suffer forever.

2. 2 doctor approvals.
Problem: What are the odds that both doctors believe in assisted suicide and if so, what are the odds they both agree you've suffered enough? It has to be a non-zero percent.

If the decision is up to anybody besides me, I'm assuming trouble.
Dec 15, 2012
'None' is the answer to your question.
I am 'in the room' right now caring for my mother in law, 91 years old. These are the things she CAN'T do:
Watch TV
Listen to music
Converse with anyone
Feed herself
Use the toilet
Wash herself
Dress herself
Walk any distance

This is 'living'?

Also, Government's are attacking cigarette smoking and obesity, on the grounds it will save health costs later. It will, in terms of reducing the costs of the illnesses caused by smoking and obesity. But it will also prolong lives considerably without doing anything to attack the basic problem: the fact that for many of us, our bodies outlive our brains.
+11 Rank Up Rank Down
Dec 15, 2012
When my mom was diagnosed with advanced breast cancer, she did the most courageous thing...

She gave up.

She had just witnessed her best friend go through chemotherapy, and die inch by inch. Torturous. It was a miserable existence. My mom refused to suffer like that. She'd go out on her terms, in her way.

She told me, she had lived a good life. And she wanted to go in peace, at home.

She was only 55.

It's so contrary to everything I thought was right and wrong. It shook me. Why give up? I was mad, at first. But when I thought about it - it made sense. It made a lot of sense.

Roughly 3 months later she did. I was there, in my childhood home, when she left us. It was a beautiful thing. She left the world in such peace, surrounded by all the people she loved.

Why don't more people go out like that? Fear? Ignorance? Why?

When my cat was sick, I took him to the vet, and put him to sleep. It was a mercy. It was 'humane'. So why wouldn't I be able to do the same thing for my dad when it was his time, if that's what he wanted?

I think we look at life and death in the wrong light. It's not so bad. And frankly, we spend way too much time running from it.
+2 Rank Up Rank Down
Dec 14, 2012
Sadly...that system existed in the US in a previous generation. It was called smoking. People were relatively productive until their 50's or 60's, and then nobody noticed they had lung cancer until they only had months to live. They expired before they could take any of their Social Security, and before their heads psyches became blurred.

Most people thought there was a better way.
Dec 14, 2012
Thank you so much for writing about this topic. Full disclosure, I work for the organization which wrote the Death with Dignity Acts in the two states where assisted death is legal, Oregon and Washington, and we continue to work toward end-of-life care policy reform throughout the US.

These laws allow terminally ill adult state residents to request life ending medications from their doctor in the event of terminal illness. In order to receive the medication, the patient must be over 18, a resident of one of the states mentioned above, judged mentally competent by his or her physician, and have a terminal illness that will result in death in six months or fewer.

Oregon's law has been in effect for 15 years and Washingtonians approved their law in 2008. Use of these laws is carefully regulated and monitored, and state-issued reports show they work the way they're intended and without any incident of abuse.

I'm happy to answer any questions any of you might have about what is and isn't allowed under these laws and why they're written the way they are. Oh, and I highly recommend checking out the documentary "How to Die in Oregon" to learn more about the people who decide to request the medication allowed under the laws.

Melissa Barber
Electronic Communications Specialist
Death with Dignity National Center
Dec 14, 2012
It's interesting that the Netherlands came up. While it is legal there, most doctors do not want to perform the procedure out of dislike for the amount of paperwork involved, the legal liabilities if someone challenges them to whether the assisted suicide paperwork was proper and legal (think about relatives who might have disagreed with the choice), liability on ensuring that there was no pain during the procedure (think lethal injection capital punishment challenges), and their reputation as a doctor.

Disclaimer: I do not live in the Netherlands--I travel there 3-4 times per year on business and have staff who live there, and we've discussed this before. The opinions above are my synthesis of my staff's opinions.
Dec 14, 2012
Down voted for depressing nature of post.

Let's talk about other interesting things that are hopelessly morbid.
Dec 14, 2012
@ Anfauglir

I entirely agree with you.

The only point I was trying to make in my earlier post is that WHEN HE IS IN GOOD HEALTH a person should be able to make his wishes known in some sort of legal document and these wishes should be respected by the law, his doctors and his relatives.

If such a procedure was made legal, your mother could have made such a document that could have helped you take the proper decision for her.

In exceptional cases, like in the cases of minors, who have had no chance to make such a document their parents can probably be allowed to take the decision with certain safeguards incorporated.

I remember a case of a young girl who was in a coma since a few months. The doctors had sort of given up, but she was still alive. Nobody knew what her state of awareness with the outside world was. If at all she emerged from the coma later, it was certain it would be with severe brain damage. An additional fear of the parents was the safeguarding of her helpless body since she was a young woman (even though she was in a hospital) and there is no lack of perverts in this world. After waiting for a few months, the parents persuaded the doctors to put her to sleep.

In my mother's case, watching her slowly drift away was not so bad, primarily because she was not in any obvious pain. If not, I am sure I would be cursing the government for insisting that my mother die painfully rather than allowing her to die in peace a few months earlier.
Dec 14, 2012
I had a friend of the family who lived to be 91 years old. The last few years of her life were spent in an assisted-living facility in almost constant pain, despite the medicines the doctors were giving her, until, in the last few months, they hit upon a combination that kept her almost completely brain-dead. All of this was horrible to watch.

Another friend of the family was diagnosed with untreatable cancer in her 60s. With no assisted suicide option available, her options were limited to living in increasingly horrible agony for a few more years, or starving herself to death. She chose the latter option; she waited until her birthday, held a small celebration for her friends to say good-bye, and then stopped eating. She was dead in a couple of weeks, getting slowly weaker and less coherent over that time.

As horrible as starving oneself to death sounds, it looks infinitely preferable to me than the assisted-living facility. Of course, a proper assisted-suicide option would have been the best in that !$%*!$%*!$%*!
Dec 14, 2012

The trouble is opponents of assisted suicide won't let the argument be made in purely logical terms because that would weaken their position. Their main argument basically boils down to "Human life is sacred! Anyone who takes life, even their own, is a murderer!" And what Scott is saying is that you need to go through what he went through before you can make an argument like that to him.
Dec 14, 2012
My husband died with very much suffering. His hospital stay cost - or at least, charged to the BCBS $10,000 a day; I bet even having his slippers straightened by the bed was ab. $100 each time.
My mother's life was saved several times; although she suffered, she had time to say farewell to everybody (luckily, she was always in her clear mind); and all that wasn't even close to a fraction of what it was to my husband. The reason? She lived and died overseas. Here, there would be same $10,000 a day.
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