How Doctors die. It’s not like the rest of us (2016)(archive.cancerworld.net)
archive.cancerworld.net
How Doctors die. It’s not like the rest of us (2016)
https://archive.cancerworld.net/featured/how-doctors-die/
290 comments
> And not suffering, not being in pain was maybe what allowed her to begin to heal.
I think that is somewhat well known? I don't have good references about humans, but veterinarian James Alfred Wight (wrote books as James Herriot) has written about it, how lost cause lamb "miraculously" recovered after big dose pain killer (sorry, don't remember details, only his thoughs, how getting rest from pain helps).
I think that is somewhat well known? I don't have good references about humans, but veterinarian James Alfred Wight (wrote books as James Herriot) has written about it, how lost cause lamb "miraculously" recovered after big dose pain killer (sorry, don't remember details, only his thoughs, how getting rest from pain helps).
Pain -> stress -> cortisone -> body shifts to survival mode and shuts down longer term processes?
It’s definitely true for some muscle injuries - the painkillers allow you to relax enough to start loosening up an healing.
> how lost cause lamb "miraculously" recovered after big dose pain killer
this probably have to do with movement (which applies to other animals and humans) if they feel pain they don't move, that slows down the blood circulation and the healing process.
this probably have to do with movement (which applies to other animals and humans) if they feel pain they don't move, that slows down the blood circulation and the healing process.
Something, something, desk worker ...
This is ultimately what killed my mum. She stopped moving. Once that happens so many things in the body just don't work so well. Combined with her other ailments her body just didn't work properly any more.
She initially went down-hill after she was weaned off the steroids she had been on during treatment for a benign brain tumour. Obviously the tumour and the radiotherapy didn't help things, but her health dropped off a cliff when the steroids stopped, she lost all her strength. I often wonder if she'd still be around now if they had just kept her on them and worked on her mobility.
Keep moving. You don't have to run marathons or go to the gym for it to have a positive effect.
She initially went down-hill after she was weaned off the steroids she had been on during treatment for a benign brain tumour. Obviously the tumour and the radiotherapy didn't help things, but her health dropped off a cliff when the steroids stopped, she lost all her strength. I often wonder if she'd still be around now if they had just kept her on them and worked on her mobility.
Keep moving. You don't have to run marathons or go to the gym for it to have a positive effect.
I think this is a pervasive problem in hospitals today.
I was in the hospital 5 weeks at the end of 2020, and I was very aware of all the extra challenges that it brought to healing. Poor sleep due to lights/noise/interruptions, sleeping with a strange roommate who had their own sleep disruptions. Low quality food with few options, and very little fresh fruits and vegetables. On top of constant pain, boredom fear and isolation (despite all the people around).
I understand the hospitals are resource constrained, and have reasons for many of the things they do, but at the same time I feel like rest, nutrition and psychological elements are largely ignored when designing today’s hospital experiences.
For what it’s worth this was in Canada, so at least I didn’t have financial stresses in addition, but perhaps there are other countries more human in their approach to care.
I was in the hospital 5 weeks at the end of 2020, and I was very aware of all the extra challenges that it brought to healing. Poor sleep due to lights/noise/interruptions, sleeping with a strange roommate who had their own sleep disruptions. Low quality food with few options, and very little fresh fruits and vegetables. On top of constant pain, boredom fear and isolation (despite all the people around).
I understand the hospitals are resource constrained, and have reasons for many of the things they do, but at the same time I feel like rest, nutrition and psychological elements are largely ignored when designing today’s hospital experiences.
For what it’s worth this was in Canada, so at least I didn’t have financial stresses in addition, but perhaps there are other countries more human in their approach to care.
I was in the hospital for pancreatitis a few years ago, here in Austin. One thing that struck me was that they came around for their regular visits at least once every couple of hours, even with me being hooked up to all the machines. I never got to sleep more than one or two hours at a time for that entire period. And they screwed up my blood pressure medication and drove my Systolic up over 250, which lead to me learning a new level 10 of pain, and extended my stay in the hospital for a week. At least I learned that Morphine doesn’t work on me, but Dilaudid does.
Whatever else a hospital is, it is typically not a place that is designed for rest and recuperation and overall patient wellness. They want to push their curatives on you as quickly as possible and without a lot of regard for your mental well being, so that they can get you out quickly and move on to the next patient. Think of it more like a MASH unit, where you’re only supposed to be there for a short period of time before they stabilize you and ship you out somewhere else.
I grew up spending a great deal of my life in hospitals, because of my dad and his medical problems. And then my mom and her medical problems. But until recently, I never really understood things from their perspective. I hope I don’t develop hospital psychosis like my dad did, but I am definitely very wary of checking into a hospital unless there is no choice.
Whatever else a hospital is, it is typically not a place that is designed for rest and recuperation and overall patient wellness. They want to push their curatives on you as quickly as possible and without a lot of regard for your mental well being, so that they can get you out quickly and move on to the next patient. Think of it more like a MASH unit, where you’re only supposed to be there for a short period of time before they stabilize you and ship you out somewhere else.
I grew up spending a great deal of my life in hospitals, because of my dad and his medical problems. And then my mom and her medical problems. But until recently, I never really understood things from their perspective. I hope I don’t develop hospital psychosis like my dad did, but I am definitely very wary of checking into a hospital unless there is no choice.
I also think that people underestimate good nursing, both for sick people and children. Hospitals are not necessarily great places to live. May be the care at the hospice actually gave her something to live for.
> I don't think exactly that her doctors were wrong in believing that her death was imminent
This is the crux of it. It's hard to predict exactly when people will die. Spend enough time with palliative care physicians and the phrase "if I had a crystal ball" is burned into your memory
This is the crux of it. It's hard to predict exactly when people will die. Spend enough time with palliative care physicians and the phrase "if I had a crystal ball" is burned into your memory
The important difference between physicians and non-physicians in relation to death is not that doctors understand disease mechanisms.
It is that doctor's are familiar with death.
Ordinary people aren't as familiar with death, and don't have a wide range of responses to it because society hides it and pretends it doesn't exist.
The main place regular people encounter death is on the news as a statistic of war and crime. Then when it visits their family and friends, they are unprepared, except for what they know of death, which is a calamity.
Sitcoms don't include death because they exist to take your mind off work, and provide a platform for advertising consumer goods.
Friends and acquaintances don't often talk about death in expansive terms. They only offer a cliche one liner - sorry for your loss - because that's the only response they've learnt. It's a well intentioned sentiment, and also one that's constrained by a fear of death that is unwarranted.
That's a shame because death is an expansive part of life. It's the point at which a life becomes whole, and we can see someone in their entirety. Death, along with birth, is the context for life.
It's going to happen to all of us, no matter how we try to deny it or hide it. Doctors know this and so they let it in. They do this before life descends into the shadows.
It is that doctor's are familiar with death.
Ordinary people aren't as familiar with death, and don't have a wide range of responses to it because society hides it and pretends it doesn't exist.
The main place regular people encounter death is on the news as a statistic of war and crime. Then when it visits their family and friends, they are unprepared, except for what they know of death, which is a calamity.
Sitcoms don't include death because they exist to take your mind off work, and provide a platform for advertising consumer goods.
Friends and acquaintances don't often talk about death in expansive terms. They only offer a cliche one liner - sorry for your loss - because that's the only response they've learnt. It's a well intentioned sentiment, and also one that's constrained by a fear of death that is unwarranted.
That's a shame because death is an expansive part of life. It's the point at which a life becomes whole, and we can see someone in their entirety. Death, along with birth, is the context for life.
It's going to happen to all of us, no matter how we try to deny it or hide it. Doctors know this and so they let it in. They do this before life descends into the shadows.
Due religious reasons I'm contemplating my death quite often. Not daily but I try to do it at least weekly. I don't say it has made me comfortable about being mortal but compared to people around me I seem to have more casual relationship to it. Like the other day my boss asked me if I'll come to the office next week and with smile on my face I answered, that yes I'll come if I won't die during weekend. He got quite confused.
Remembering that you'll die someday, and not just some distant day far away but literally any day or moment gives a good perspective to everything in your life and makes you focus on things that truly matters.
Remembering that you'll die someday, and not just some distant day far away but literally any day or moment gives a good perspective to everything in your life and makes you focus on things that truly matters.
I have the same thing. I often contemplate my death, and how I am going to die. And yes, I derive some comfort from it - knowing I have lived my best life and done the best I could at it. There are things I haven't achieved yet that I want to experience, so I don't want to go just yet. But if it happens, then I'm good with that.
But I'm an atheist, and firmly believe that this is all we get, and death really is the end of everything for us. I'm not sure I'd be so accepting if I was facing some kind of afterlife. Even ignoring the possibility of an eternity being tortured in heck, I'm much happier with the thought of everything just stopping than with the thought of it somehow continuing on another level.
It's interesting, how our fear of death drives us. Yet (as gp says) we never talk about it.
But I'm an atheist, and firmly believe that this is all we get, and death really is the end of everything for us. I'm not sure I'd be so accepting if I was facing some kind of afterlife. Even ignoring the possibility of an eternity being tortured in heck, I'm much happier with the thought of everything just stopping than with the thought of it somehow continuing on another level.
It's interesting, how our fear of death drives us. Yet (as gp says) we never talk about it.
What often brings me joy is thinking about my life before birth, I like to think death will be just the same. If so life after death can't be so bad.
Yeah, you'd think so. I thought so. But I can't get myself to die. After death, there's nothing.
And I understand now why some people say it's terrifying. Between decades of suffering or eternity of nothing, what would you choose?
Don't half ass the answer, go on a bridge with a heavy backpack zip tied to yourself, put a loaded gun to your head or have a fistful of TCA pills in your hand, whatever, then answer it.
I don't want to live, but I ain't keen on dying either, to paraphrase Robbie Williams.
I really wouldn't mind being killed by something out of my control, though.
And I understand now why some people say it's terrifying. Between decades of suffering or eternity of nothing, what would you choose?
Don't half ass the answer, go on a bridge with a heavy backpack zip tied to yourself, put a loaded gun to your head or have a fistful of TCA pills in your hand, whatever, then answer it.
I don't want to live, but I ain't keen on dying either, to paraphrase Robbie Williams.
I really wouldn't mind being killed by something out of my control, though.
I was depressed for a lot of the last ten years. I thought about ending it all a lot. Part of my calm acceptance now is because of facing it so much back then.
If you're seriously contemplating it, because life is suffering, know that it's not always like that. This too shall pass. There are good times too. My life now is something I could not have imagined achieving back when I was depressed and couldn't see any future for myself. Life is also randomly wonderful. I'm incredibly grateful to my past self for struggling on through, not ending it, and getting us to here. Here is good.
Of course, this too shall pass. Enjoying the good times in full is important, because they won't last. I hope I have the courage to face my next set of bad times with the same fortitude as my past self faced them.
If you're seriously contemplating it, because life is suffering, know that it's not always like that. This too shall pass. There are good times too. My life now is something I could not have imagined achieving back when I was depressed and couldn't see any future for myself. Life is also randomly wonderful. I'm incredibly grateful to my past self for struggling on through, not ending it, and getting us to here. Here is good.
Of course, this too shall pass. Enjoying the good times in full is important, because they won't last. I hope I have the courage to face my next set of bad times with the same fortitude as my past self faced them.
Don't worry, other lives will end before mine.
that sounds more ominous than comforting ;)
Quite so. Lots of people worry about the time they'll "spend" not being alive after they die, but nobody ever seems to worry about they time they spent not being alive before they were born. In the context of the wider universe, "not being" is what you are doing the vast amount of time. The century or so that you are alive is the exception.
I like the fact that we are made of atoms. Even if we die they will remain, even if it is only energy. So, for me its very comforting to think that sure i will stop exisiting as this configuration of tiny particles, however its not the end, its just a reconfiguration and i will become one with the universe, a tiny part of everything.
I like the "wave" metaphor for this. We are just waves in the surface of existence. When we stop being a wave the water remains, ready to be part of the next wave.
What you said to your boss is actually a common expression in my country. To say "I hope so" about some event in the future, we say "If we live".
Which country?
Tunisia, North Africa
I have always found the humility of Muslims saying "In sha'Allah" admirable. It's a beautiful way to remind ourselves that our fate -- and our life -- is not entirely in our hands.
This was also commonplace in Spain, traditionally. Some people, especially old ones, will say "si Dios quiere" literally every time they refer to any event in the future, even if it's just "see you tomorrow". Not doing so would be considered a "challenge" to God, or Fate, more generally.
Curiously, from "inshallah" Spanish got the word "ojalá", a very common term for expressing hope of something happening (and with no religious or any other "deep" connotation anymore; just like you'd use "I hope").
Curiously, from "inshallah" Spanish got the word "ojalá", a very common term for expressing hope of something happening (and with no religious or any other "deep" connotation anymore; just like you'd use "I hope").
In Poland we have a saying "jeżeli Bóg pozwoli". "If god allows" which funyly shows that deep down people "understand" (as their pre-monotheistic ancestors "understood") that the God is the malevolent being that messes up your plans and ultimately kills you.
In parts of the UK the equivalent is 'if we're spared'. Some people may decide this means that the person saying it is probably a miserable old codger, the sort of person who says "mustn't grumble" when asked "How's things?"
In America I sometimes hear a similar saying of "Lord willing" which is a shortening of a verse from James: "If the Lord wills, we shall live and do this or that."
My mom used to sometimes say “Lord willing, and the creek don’t rise”.
He wasn't expecting you to be suicidal or terminal ill or this being the weekend a bus ran over you.
And the phrase "if we're alive", is used for longer time periods like next year or more.
And the phrase "if we're alive", is used for longer time periods like next year or more.
Memento mori.
I think about my own death, or some disability, at about the same frequency.
What would I do if I lost my hearing, or my sight.
It is one of the reasons I try to live this life, instead of waiting for some future rewards in an uncertain afterlife.
Yes, I am not religious, and I think being religious has little to do with thinking about death. Death is the great equalizer.
I think about my own death, or some disability, at about the same frequency.
What would I do if I lost my hearing, or my sight.
It is one of the reasons I try to live this life, instead of waiting for some future rewards in an uncertain afterlife.
Yes, I am not religious, and I think being religious has little to do with thinking about death. Death is the great equalizer.
Yes, ironically enough, physicians don't pathologize death the same way most of our culture does. They see it enough for it to lose the quasi supernatural grip that it has in a culture that doesn't talk about it, and so they're just able to make much more measured decisions about quality of life at the end of life than other people.
>Ordinary people aren't as familiar with death, and don't have a wide range of responses to it because society hides it and pretends it doesn't exist.
I relate to this so much. I had a period of staring my potential death in the face and there is nothing in modern society that prepares you for that. I was completely rudderless for a while because I had literally no social context in which death could be faced without making people intensely uncomfortable.
There's many things I think our society is pretty crap at, but the subject of death in general has to be one of the worst offenders by far. We shouldn't be sweeping death under the carpet as a taboo subject and pretending it doesn't exist, it should be something people talk about. Death is the one thing that unites us all, it would be a far less unpleasant thing to face if people could have a sensible conversation about it without fear or grimaces.
I relate to this so much. I had a period of staring my potential death in the face and there is nothing in modern society that prepares you for that. I was completely rudderless for a while because I had literally no social context in which death could be faced without making people intensely uncomfortable.
There's many things I think our society is pretty crap at, but the subject of death in general has to be one of the worst offenders by far. We shouldn't be sweeping death under the carpet as a taboo subject and pretending it doesn't exist, it should be something people talk about. Death is the one thing that unites us all, it would be a far less unpleasant thing to face if people could have a sensible conversation about it without fear or grimaces.
We forgot to memento mori.
"Sitcoms don't include death"
Ricky Gervais isn't afraid of it...Have you seen After Life?
https://www.imdb.com/title/tt8398600/
Ricky Gervais isn't afraid of it...Have you seen After Life?
https://www.imdb.com/title/tt8398600/
> Sitcoms don't include death
UK sitcoms beg to differ - just look at Coronation Street or Eastenders - they cover pretty much every category of death you can think of (except, I suppose, by wildlife.)
UK sitcoms beg to differ - just look at Coronation Street or Eastenders - they cover pretty much every category of death you can think of (except, I suppose, by wildlife.)
My mom struggled with lung cancer for two terrible years with cutting edge treatment, and died badly. My dad cared for her through that, and when his turn came five years later, he had no doubts. He refused all but palliative care and died in two months. What he saw once, a physician will see over and over ad nauseam. Having seen one of each, I'm not conflicted over which path I'd take.
Was it small cell lung cancer?
edit: for the remarkably special downvoters (stay classy HN) - that's the type of lung cancer my mother died from, in about 20 months time. You generally can't surgically remove small cell lung cancer. It was particularly brutal, with endless treatment attempts that were physically grueling and minimally effective. It's a highly aggressive cancer with a very low survival rate and few good treatment options. Accordingly, having watched her go through that, I can very much relate to what the parent said.
edit: for the remarkably special downvoters (stay classy HN) - that's the type of lung cancer my mother died from, in about 20 months time. You generally can't surgically remove small cell lung cancer. It was particularly brutal, with endless treatment attempts that were physically grueling and minimally effective. It's a highly aggressive cancer with a very low survival rate and few good treatment options. Accordingly, having watched her go through that, I can very much relate to what the parent said.
While I don't usually comment on downvotes, my guess is that the downvotes are because your question can come off as being insensitive. After someone tells you about the tragic death of both of his parents, maybe don't start a guessing game of what his mother died of even if your loved one died of that same disease.
adventured(3)
Small cell lung cancer is what got my mom. She did chemo, radiation therapy, you name it.
In the end, she went into the bathroom, threw up a lot of blood, and never woke up. They didn’t do an autopsy, but the assumption was that the cancer had just gotten too widely distributed throughout her system.
But, since she had spent much of her adult life helping my dad with one or the other of his medical problems, and she had been an HR director at Norman Regional Hospital for many years, she did focus on trying to keep the best quality of life that she could, right up to the end.
The irony was that she had quit smoking thirty years earlier. It was her sister that did her in. Since the sister was in stage 4 of stomach cancer, they let her smoke in her hospital room. And my mom was the primary caregiver who slept in that room and was there pretty much 24x7. So, her second-hand smoke is what got my mom.
Definitely focus on quality of life. Whatever you’ve got left, you should try to make those your best days, weeks, months, or years yet.
In the end, she went into the bathroom, threw up a lot of blood, and never woke up. They didn’t do an autopsy, but the assumption was that the cancer had just gotten too widely distributed throughout her system.
But, since she had spent much of her adult life helping my dad with one or the other of his medical problems, and she had been an HR director at Norman Regional Hospital for many years, she did focus on trying to keep the best quality of life that she could, right up to the end.
The irony was that she had quit smoking thirty years earlier. It was her sister that did her in. Since the sister was in stage 4 of stomach cancer, they let her smoke in her hospital room. And my mom was the primary caregiver who slept in that room and was there pretty much 24x7. So, her second-hand smoke is what got my mom.
Definitely focus on quality of life. Whatever you’ve got left, you should try to make those your best days, weeks, months, or years yet.
On the other hand, my sister was told to put her affairs in order. She did the major surgery and the chemo, and just passed 10 years cancer free.
Odds of her outcome were something like 5%. She's well aware of how lucky she is.
Odds of her outcome were something like 5%. She's well aware of how lucky she is.
the age of your sister at the time of sickness should factor in, right?
And the type of treatment
Multiple operations to remove metastasized tumors followed by conventional chemo.
Posted article doesn't seem to be accessible right now so apologies if I'm repeating something it says, I couldn't RTFA.
"Being Mortal" by Atul Gawande talks about this. He mentions Stephen Gould's essay, "The Median Isn't The Message," in which Gould says:
> For most situations, however, I prefer the more martial view that death is the ultimate enemy—and I find nothing reproachable in those who rage mightily against the dying of the light.
Which is an idea I think meshes very well with the strategy of chasing low probability , high reward outcomes. Gawande's response makes a lot of sense to me personally:
> There is almost always a long tail of possibility, however thin. What's wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that's vastly more probable. The problem is that we have built our medical system and culture around the long tail. We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near certainly that those tickets will not win. Hope is not a plan, but hope is our plan.
He also talks about several patients he treated through the years who suffered through futile treatments while trying to become one of the lucky ones and lost what quality of life they might have had in their dwindling time.
I'm glad your sister was one of the lucky ones who had a good outcome as opposed to going through the major surgery and chemo and being one of the 95%. It also seems to me that a different mindset in these sort of situations that educate patients on palliative options and try to make their remaining time as good as it can be would reduce much unnecessary suffering.
"Being Mortal" by Atul Gawande talks about this. He mentions Stephen Gould's essay, "The Median Isn't The Message," in which Gould says:
> For most situations, however, I prefer the more martial view that death is the ultimate enemy—and I find nothing reproachable in those who rage mightily against the dying of the light.
Which is an idea I think meshes very well with the strategy of chasing low probability , high reward outcomes. Gawande's response makes a lot of sense to me personally:
> There is almost always a long tail of possibility, however thin. What's wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that's vastly more probable. The problem is that we have built our medical system and culture around the long tail. We've created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near certainly that those tickets will not win. Hope is not a plan, but hope is our plan.
He also talks about several patients he treated through the years who suffered through futile treatments while trying to become one of the lucky ones and lost what quality of life they might have had in their dwindling time.
I'm glad your sister was one of the lucky ones who had a good outcome as opposed to going through the major surgery and chemo and being one of the 95%. It also seems to me that a different mindset in these sort of situations that educate patients on palliative options and try to make their remaining time as good as it can be would reduce much unnecessary suffering.
The family and her all realize how lucky she is to be alive today. I don't disagree with people who make the choice to just do palliative care, and I don't disagree with those who choose to fight.
My parents had a very similar experience. I feel your pain, and I agree with your choice
The point is you don’t know which path you’ll go down until you go down it.
Look at any cancer drug trial and there is a massive spread in outcomes. Some people take a drug and die with horrible side effects in 2 months, others live 10 years with mild side effects.
Look at any cancer drug trial and there is a massive spread in outcomes. Some people take a drug and die with horrible side effects in 2 months, others live 10 years with mild side effects.
There's a lot of comfy middle ground between "I do not want any medications; I will go home and wrap myself in a linen shroud" and "please break my nonagenarian ribs then barely sustain me in purgatorial discomfort as long as technology allows". And yet one of those endpoints has become the legal/social default.
What ticks me off no end is the folks who (often successfully) fight against physician assisted suicide. Dementia is the interesting test case, but I think should still be allowed.
With all the talk about 'controlling our bodies' in terms of abortion, and I can see both sides of that one, your own life is the one thing you really own. To have that control taken away is the worst kind of insult by the state.
With all the talk about 'controlling our bodies' in terms of abortion, and I can see both sides of that one, your own life is the one thing you really own. To have that control taken away is the worst kind of insult by the state.
Yeah, I know someone who said for basically their entire adult life "if I ever get like that, just shoot me" and meant it quite seriously. Unfortunately, they indeed spent their last few years gradually degrading in the throes of dementia. Very sad to see, and even more sad to know they would have absolutely hated being left to "rot" in such a way. The only consolation is the person hopefully didn't "know"? Who knows? :\
People say all sorts of things, but if they don't commit to writing directions down, how are people supposed to know what the person really wanted? Also, someone might say one thing, until death becomes immanent, and then they realize they want something else.
I have written a formal, witnessed statement of my wishes, in the event that I'm unable to utter them. My physician has a copy; there's a copy in my desk-drawer at home, with my will.
I understand that different health authorities here have different policies on the registration and application of such "living wills". I have no confidence that if I get sick in the wrong place, my statement will even be noticed, let alone respected. Also, there's no reason why a paramedic coming to my home would know to look in my desk-drawer (I live on my own), and so discover that I don't want any CPR, ever.
And ultimately, these living wills are advisory only; medics can't be sued for ignoring them.
It's a bloody mess. I really hope I don't ever get demented.
I understand that different health authorities here have different policies on the registration and application of such "living wills". I have no confidence that if I get sick in the wrong place, my statement will even be noticed, let alone respected. Also, there's no reason why a paramedic coming to my home would know to look in my desk-drawer (I live on my own), and so discover that I don't want any CPR, ever.
And ultimately, these living wills are advisory only; medics can't be sued for ignoring them.
It's a bloody mess. I really hope I don't ever get demented.
There are organisations in the EU that will assist suicide in certain circumstances.
Sir T Pratchett wrote extensively about being on the wrong end of dementia. He didn't have much to say about abortion when he was dealing with cognitive decline.
Sir T Pratchett wrote extensively about being on the wrong end of dementia. He didn't have much to say about abortion when he was dealing with cognitive decline.
I think the core problem is giving out a "free pass" to kill people. Very few people (at least in my experience) think that assisted suicide itself is bad, but the abuse potential is massive. And the action is, by definition, irreversible.
Plus, the people that need this are (quite obviously) unable to make this happen on their own. So this comes with the additional moral qualms of whether this is really what the wanted and if their mental state clear enough to make a decision like this.
Lastly, not killing these people is the "safe choice" - you're not getting sued for not killing a person. In the end, it probably boils down to this.
Plus, the people that need this are (quite obviously) unable to make this happen on their own. So this comes with the additional moral qualms of whether this is really what the wanted and if their mental state clear enough to make a decision like this.
Lastly, not killing these people is the "safe choice" - you're not getting sued for not killing a person. In the end, it probably boils down to this.
And we see how this has worked out for abortion. The 0.10% case of either saving a woman's life or in cases of rape and incest as turned into the justification for aborting 189 babies for every 1000 live births -- or in the african american community 487 babies for every 1000 live births.
Once you open the flood gates, you will have plenty who kill themselves who otherwise wouldn't with just a little bit of extra support.
Once you open the flood gates, you will have plenty who kill themselves who otherwise wouldn't with just a little bit of extra support.
And a lot better societal outcomes. Unwanted babies suck and end up having bad lives, negatively affecting their parents’ lives as well.
Too bad we can't ask unwanted babies if they would rather have been born into a bad life.
This isn't directed at you, but I have had countless conversations about this very topic. The detriments are greatly overstated. I've found usually people are talking of these things outside looking in in an ideological vacuum, and not an experiential one.
Let's take societal outcomes for african americans, as an example. What people don't realize is, when people speak of abortions in a vaccuum (and lets be frank -- it's usually white liberals who champion it the hardest), the elephant in the room is with african american women carry out the disproportionate volume of abortions, and the the overwhelming majority of Planned Parenthood locations being located in poor and black neighborhoods. There is a large argument now that is catching on in many african american communities that maybe if we had the estimated 11 million more black babies born in this country, black representation would be much better off in all matters of the socioeconomic and political spheres, resulting in better lives overall for the general population. In 2015, in association with National Black Pro-Life Coalition, Protecting Black Life, and National Black Pro-Life Union met with CURE to deliver a congressional report detailing all of these facts, and making the strong case that the economic and societal impact of all the abortions in the black community is far greater. I encourage everyone to read it: https://www.congress.gov/115/meeting/house/106562/witnesses/...
This isn't directed at you, but I have had countless conversations about this very topic. The detriments are greatly overstated. I've found usually people are talking of these things outside looking in in an ideological vacuum, and not an experiential one.
Let's take societal outcomes for african americans, as an example. What people don't realize is, when people speak of abortions in a vaccuum (and lets be frank -- it's usually white liberals who champion it the hardest), the elephant in the room is with african american women carry out the disproportionate volume of abortions, and the the overwhelming majority of Planned Parenthood locations being located in poor and black neighborhoods. There is a large argument now that is catching on in many african american communities that maybe if we had the estimated 11 million more black babies born in this country, black representation would be much better off in all matters of the socioeconomic and political spheres, resulting in better lives overall for the general population. In 2015, in association with National Black Pro-Life Coalition, Protecting Black Life, and National Black Pro-Life Union met with CURE to deliver a congressional report detailing all of these facts, and making the strong case that the economic and societal impact of all the abortions in the black community is far greater. I encourage everyone to read it: https://www.congress.gov/115/meeting/house/106562/witnesses/...
If society wants more babies, the path is easy: provide financial help for couples and single mothers. The way it currently is, abortion is very attractive.
Yep. Carlin had this right; it's not being pro-life, it's being pro-birth. From birth until they turn 18 and can join the military, fuck 'em.
Exactly. People seem to forget why birthrates were so high in the past. It is not just lack of abortion (which happened), but the fact that more children would provide additional help in the daily farm work. In other words, it was very cheap ho have children and the financial benefit existed. In a post-industrial society, these incentives are reversed. It is very expensive to have children, and there are no financial incentives. That's why we have the declining birth rates everywhere we have an economically developed society.
Financial help is not all it takes to stop abortions.
There are welfare states such as scandinavian ones where the financial help for having children and/or being a single mother is very generous.
A single mother with 6 children can receive financial aid to the equivalent of a senior software engineer salary without having to work at all. Source: https://www.expressen.se/gt/gt-granskar/shukri-hade-fatt-lik...
Even with these levels of financial support, abortions are common - https://en.wikipedia.org/wiki/Abortion_in_Sweden#Trends
There are welfare states such as scandinavian ones where the financial help for having children and/or being a single mother is very generous.
A single mother with 6 children can receive financial aid to the equivalent of a senior software engineer salary without having to work at all. Source: https://www.expressen.se/gt/gt-granskar/shukri-hade-fatt-lik...
Even with these levels of financial support, abortions are common - https://en.wikipedia.org/wiki/Abortion_in_Sweden#Trends
I'd just like to point out that raising 6 kids is very much hard work, even if you're a bad parent I find it hard to describe it as no work at all.
Your data shows that the trend of abortion in Sweden is stable since the 70s. So, no, there is no correlation between abortion and a decrease in birth rates.
It’s not just about money, raising children well is time expensive, hence why most couples who have a choice stop a 2-3.
So basically your solution to racism is "force black women to have more babies"? That's... pretty disgusting if so.
There are other reasons people want to get abortions, such as knowing they can't provide for the child or give them a safe/stable household. Adoption is rare, and the foster system in most countries absolutely ruins kids. So those aren't good alternatives.
This goes along with my thesis that if given the proper support, we would avoid the majority of them.
I'm not certain there is a level of foster care that could provide good outcomes. I think that's a bit of a pipedream. If your argument is instead that a shitty life is better than no life at all, I couldn't really disagree. But I think it's somewhat inhumane to bring a new life into the world knowing it will be suffering.
I think the main reason kids in foster care suffer is that the kids are already old and have been through a traumatic situation that caused them to have to be put into foster care. That trauma plus the transition can leave emotional scars. Another problem is the foster parents cannot fully take in the kid. The kid can be taken away from them by the government and given back to the kid's original parents.
Putting a newborn up for adoption is different, it doesn't have either of those problems. There are 2 million families in the US waiting to adopt a newborn.
Putting a newborn up for adoption is different, it doesn't have either of those problems. There are 2 million families in the US waiting to adopt a newborn.
We should provide free birth control and better sex education. Morning after contraception should also be free -- a fertilized, un-implanted egg is not a human -- it's a potential human.
>a fertilized, un-implanted egg is not a human -- it's a potential human.
Is there a scientific reason for that idea? I don't see how implantation can really be considered a transition from potential human to human. I think with enough scientific advances a human could be raised entirely outside the womb, and in that case there would be no implantation.
Is there a scientific reason for that idea? I don't see how implantation can really be considered a transition from potential human to human. I think with enough scientific advances a human could be raised entirely outside the womb, and in that case there would be no implantation.
I think the way GP phrased it is a shorthand for "egg just after fertilization" - because today, fertilized eggs either get implanted early or rejected by the mother's body. When science and technology advances to the point of making it possible to gestate humans entirely outside of the womb, the way we talk about this will have to adjust to be more precise.
(Implantation itself doesn't feel like the transition point either, but it's just the last obvious discrete step before the continuous progression all the way to birth.)
(Implantation itself doesn't feel like the transition point either, but it's just the last obvious discrete step before the continuous progression all the way to birth.)
I don't see why we can't try to adjust to be more precise now.
It seems strange to say that our current definition is not the correct long-term definition, but we'll keep using the current one. To me that's basically saying our current definition of human is wrong, and I don't see why it's acceptable to use a wrong definition.
It seems strange to say that our current definition is not the correct long-term definition, but we'll keep using the current one. To me that's basically saying our current definition of human is wrong, and I don't see why it's acceptable to use a wrong definition.
In countries with a good safety net (including parental leave and child care help), comprehensive sex education, free access to contraception and abortion and general health care, abortion rates are often lower.
I'm not sure it avoids the majority since a decent amount of folks have the knowledge and tools to simply avoid the pregnancy in the first place, but it does lower it.
I'm not sure it avoids the majority since a decent amount of folks have the knowledge and tools to simply avoid the pregnancy in the first place, but it does lower it.
I'd hope someone would know fairly early in the pregnancy if they will be able to provide for a child or not. (i.e. before the baby can feel pain, is basically a complete human being, etc.)
That's why there's so much interest in defining limits around abortions. Late term abortions are pretty much described as horrific by the vast majority. There should be room for political agreement here.
That's why there's so much interest in defining limits around abortions. Late term abortions are pretty much described as horrific by the vast majority. There should be room for political agreement here.
My understanding is that late term abortions are almost always cases of extreme tragedy already.
I know it's relevant because it's the politics that are setting the rules right now, but political agreement isn't really the crux of the discussion for me. It's about minimizing suffering and the ethics of controlling someone else's body.
That said, I don't think there will be political agreement because it's not 100% about the rules around abortions anyway. It's a political instrument at this point. Either side is trying to win, not do what's right, and that's how things have gotten so extreme.
That said, I don't think there will be political agreement because it's not 100% about the rules around abortions anyway. It's a political instrument at this point. Either side is trying to win, not do what's right, and that's how things have gotten so extreme.
Most abortions are as soon as the woman knows she's pregnant. Very, very few are late term, and, as a sibling mentions, those are almost universally due to health risks (possibly also a major change in financial status, relationship, etc).
To be clear, you are right that a late term abortion is pretty horrific. They're also -traumatic-. No one is -intentionally- waiting around to get an abortion; there isn't room for political argument here because anyone who finds themselves pregnant at a late stage and doesn't want to be is already in the case of "reasonable exception". A medical complication, a change in financial status to where she can't support it (when before she thought she could), etc.
No one is finding out they're pregnant in the first trimester, and then just can't make up their mind until the third, and we as a society need to set a date she has to make up her mind, or force her to keep it against her will. That's a made up justification, and as we continue to see, the same forces that make that justification don't even stop there.
To be clear, you are right that a late term abortion is pretty horrific. They're also -traumatic-. No one is -intentionally- waiting around to get an abortion; there isn't room for political argument here because anyone who finds themselves pregnant at a late stage and doesn't want to be is already in the case of "reasonable exception". A medical complication, a change in financial status to where she can't support it (when before she thought she could), etc.
No one is finding out they're pregnant in the first trimester, and then just can't make up their mind until the third, and we as a society need to set a date she has to make up her mind, or force her to keep it against her will. That's a made up justification, and as we continue to see, the same forces that make that justification don't even stop there.
>those are almost universally due to health risks
>But data suggest that most women seeking later terminations are not doing so for reasons of fetal anomaly or life endangerment.
https://onlinelibrary.wiley.com/doi/epdf/10.1363/4521013
>“[t]here aren’t good data on how often later abortions are for medical reasons.”
>“Based on limited research and discussions with researchers in the field, Dr. Foster believes that abortions for fetal anomaly ‘make up a small minority of later abortion’ and that those for life endangerment are even harder to characterize,” the report stated.
https://www.washingtonpost.com/us-policy/2019/02/06/tough-qu...
>But data suggest that most women seeking later terminations are not doing so for reasons of fetal anomaly or life endangerment.
https://onlinelibrary.wiley.com/doi/epdf/10.1363/4521013
>“[t]here aren’t good data on how often later abortions are for medical reasons.”
>“Based on limited research and discussions with researchers in the field, Dr. Foster believes that abortions for fetal anomaly ‘make up a small minority of later abortion’ and that those for life endangerment are even harder to characterize,” the report stated.
https://www.washingtonpost.com/us-policy/2019/02/06/tough-qu...
For perspective, note that the studies you're referring to are studying a rare occurrence. https://en.wikipedia.org/wiki/Abortion refers to CDC statistics that 1% of abortions may be at 21+ weeks, but even that is with the caveat that what they're really looking at is medical procedures, and thus that "According to the CDC, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the dead fetus is accomplished by the same procedure as an induced abortion." Additionally, 56% of women declined to participate in the study, and there will surely be some correlation between that choice and the cause for the termination.
Of course that doesn't invalidate the findings; but it is a a fairly small number of events they're talking about here, that's all.
Of course that doesn't invalidate the findings; but it is a a fairly small number of events they're talking about here, that's all.
Not to mention the reply left out my original "possibly also a major change in financial status, relationship, etc", since my entire point was that late term abortions, while for a variety of reasons, are not simply people taking the most expensive, most traumatic, most controversial option as a form of contraceptive. It's for a variety of nuanced, complex reasons that aren't "for convenience", as the convenient path is always to abort or prevent the pregnancy earlier. Which is why pro-choice advocates say it should be between the woman and her doctor, -not- government; the fact the situation is arising at all means it is exceptional.
I did see that, but since it was in parentheses I interpreted it as you saying that was lower likelihood.
The general way I interpret the meaning of parentheses is that it's a part of the sentence that provides extra information, but the sentence would still be correct if it was removed.
The general way I interpret the meaning of parentheses is that it's a part of the sentence that provides extra information, but the sentence would still be correct if it was removed.
>Additionally, 56% of women declined to participate in the study, and there will surely be some correlation between that choice and the cause for the termination.
I think you're misunderstanding how the sentence I quoted relates to the study. The study I linked to actually only studied women who had abortions unrelated to fetal anomalies or life endangerment. So none of the 56% who declined to participate in the study nor any of the 44% who accepted to participate in it had abortions related to fetal anomalies or life endangerment.
The quote I quoted was basically an offhand remark that the paper made to justify its relevance, not backed up by evidence in the paper, but instead backed up by a citation to a different paper that I found hard to understand in a quick skim.
I think you're misunderstanding how the sentence I quoted relates to the study. The study I linked to actually only studied women who had abortions unrelated to fetal anomalies or life endangerment. So none of the 56% who declined to participate in the study nor any of the 44% who accepted to participate in it had abortions related to fetal anomalies or life endangerment.
The quote I quoted was basically an offhand remark that the paper made to justify its relevance, not backed up by evidence in the paper, but instead backed up by a citation to a different paper that I found hard to understand in a quick skim.
>Adoption is rare
What you mean by that? There is extremely high demand to adopt newborns, which is why parents desperate for children adopt from other countries. There is currently a waiting list of 2 million families willing to adopt newborns.
Children in foster care are different story - people are much less willing to adopt older kids.
What you mean by that? There is extremely high demand to adopt newborns, which is why parents desperate for children adopt from other countries. There is currently a waiting list of 2 million families willing to adopt newborns.
Children in foster care are different story - people are much less willing to adopt older kids.
I mean that most kids who end up without a home were never up for adoption anyway, for whatever reason the child was taken away from a home that couldn't take care of it and as you mentioned, they're too old now.
> children adopt from other countries
Maybe finish adopting all those kids who exist and need families right now, regardless of where they’re from, rather than force people to give birth to more babies that need adoption.
Maybe finish adopting all those kids who exist and need families right now, regardless of where they’re from, rather than force people to give birth to more babies that need adoption.
Many people would like to adopt a newborn. Various laws and other barriers make it essentially impossible to adopt a newborn from another country.
https://adoptionnetwork.com/types-of-adoption-options/domest...
> Domestic – If you are looking to adopt a newborn or young infant, you are looking at a domestic adoption. It’s that simple.
> more babies that need adoption.
That's a strange way of looking at it. When you say it like that, it sounds as if a new baby will create an imbalance between supply and demand. There's 2 million families waiting to adopt a newborn, so a new baby will help balance that, not imbalance it.
Fertility is dropping, so I wonder if there will be an even higher demand for newborns in the future.
https://www.bbc.co.uk/reel/video/p09k7qw5/how-modern-life-is...
https://www.theguardian.com/us-news/2021/feb/26/falling-sper...
https://adoptionnetwork.com/types-of-adoption-options/domest...
> Domestic – If you are looking to adopt a newborn or young infant, you are looking at a domestic adoption. It’s that simple.
> more babies that need adoption.
That's a strange way of looking at it. When you say it like that, it sounds as if a new baby will create an imbalance between supply and demand. There's 2 million families waiting to adopt a newborn, so a new baby will help balance that, not imbalance it.
Fertility is dropping, so I wonder if there will be an even higher demand for newborns in the future.
https://www.bbc.co.uk/reel/video/p09k7qw5/how-modern-life-is...
https://www.theguardian.com/us-news/2021/feb/26/falling-sper...
Most folks in the US are too poor to adopt and it doesn't matter how well they'd care for the child: It isn't exactly a free process just looking out for the needs of the child. (I'd argue that if we were just looking out for the child, the legal costs would be covered by taxes and eligibility wouldn't be put on finances at all. We'd have to use tax money to support the child without adoption, after all).
My parents looked into adopting from another country - it was a program they were introduced to through church. It cost $20,000 plus travel... in the 1990s.
My parents looked into adopting from another country - it was a program they were introduced to through church. It cost $20,000 plus travel... in the 1990s.
Well he did qualify the reasons he provided as being only 0.1%. So obviously there are 99.9% more reasons.
But then here you come with the ~93% of reasons that boil down to convenience. It's more convenient to murder this baby than to not murder it so murder it is.
There is a very important and overlooked 7% of abortions that are medically related that save the whole concept of legal abortion for me. Mothers who want babies but, because literally everything in biology can go wrong in ways that make abortion the only humane option, those poor women can't. And they don't need police investigating their terminations in the middle of unimaginable grief.
But then here you come with the ~93% of reasons that boil down to convenience. It's more convenient to murder this baby than to not murder it so murder it is.
There is a very important and overlooked 7% of abortions that are medically related that save the whole concept of legal abortion for me. Mothers who want babies but, because literally everything in biology can go wrong in ways that make abortion the only humane option, those poor women can't. And they don't need police investigating their terminations in the middle of unimaginable grief.
My understanding is that prior to abortion being legalized, attempted abortion was not an uncommon cause of death. If someone is so willing to avoid pregnancy that they kill themselves, I don't know if it can be reasonably described as convenience anymore.
> But then here you come with the ~93% of reasons that boil down to convenience.
It is absolutely not convenience. To flip it another way, these are often homes you would never allow to adopt a baby, or homes where the child is inevitably taken by child services due to abuse or incapacity of the parent(s). Then they end up in foster care, far too late to be adopted by the nice well-to-do family with a white picket fence, and they bounce around the foster system.
The foster system can't even handle all the kids that aren't adopted, and some kids end up too broken to stay in care. What happens then? At some point they just throw a bunch of broken kids into a shitty house together and have a child services worker come check in on them every day or so.
It is absolutely not convenience. To flip it another way, these are often homes you would never allow to adopt a baby, or homes where the child is inevitably taken by child services due to abuse or incapacity of the parent(s). Then they end up in foster care, far too late to be adopted by the nice well-to-do family with a white picket fence, and they bounce around the foster system.
The foster system can't even handle all the kids that aren't adopted, and some kids end up too broken to stay in care. What happens then? At some point they just throw a bunch of broken kids into a shitty house together and have a child services worker come check in on them every day or so.
You're right. Those homes are too difficult, too far gone. They have no hope anyway. There's no point in giving them an opportunity when killing is easier.
Do you have citations for the numbers you provided? Thanks! (I’m genuinely asking because it never occurred to me that you can track the amount of a private medical procedures occurrence across states and stuff…)
https://www.cdc.gov/mmwr/volumes/69/ss/pdfs/ss6907a1-H.pdf
Although the numbers are a bit different here, maybe he’s referencing a newer data set. Still it’s shocking:
> non-Hispanic Black women had the highest abortion rate (21.2 abortions per 1,000 women) and ratio (335 abortions per 1,000 live births)
Although the numbers are a bit different here, maybe he’s referencing a newer data set. Still it’s shocking:
> non-Hispanic Black women had the highest abortion rate (21.2 abortions per 1,000 women) and ratio (335 abortions per 1,000 live births)
No sorry, it is my numbers that are outdated. I was referencing a 2015 congressional report. Abortion rates have been declining sharply over the past few years, so that's good news at least.
Depends on why. If rates have been declining because people are more educated about birth control and family planning, that's good news indeed. If it's because of new restrictions on access to abortion, that's not fixing the problem at all.
> kill themselves
Many would disagree with that characterization.
Many would disagree with that characterization.
potato potatoe -- it's ending a life.
At week 4 the embryo is the size of a poppy seed. It's technically alive, but it's not an actualized being.
Your concern may be genuine but it is misplaced.
Your concern may be genuine but it is misplaced.
Unless you're vegan, you participate in the ending of life as well.
At the stages of development when most abortions are performed, the life that is being ended is much less of a life than that of a cow, or pig, or chicken, or even fish, that ends up being killed for food.
If people truly believe that ending abortion is a moral and ethical issue, then the only consistent stance is to also be vegan and push for laws requiring everyone else be vegan.
At the stages of development when most abortions are performed, the life that is being ended is much less of a life than that of a cow, or pig, or chicken, or even fish, that ends up being killed for food.
If people truly believe that ending abortion is a moral and ethical issue, then the only consistent stance is to also be vegan and push for laws requiring everyone else be vegan.
Eh, spurious reasoning. The 0.10% case is not the underpinning for the right to abortion in the United States. In our jurisprudence the right to abortion is guaranteed by the constitutional right to privacy. So, your argument starts from a false premise, and the facts that happen to be true don't redeem it.
> The 0.10% case of either saving a woman's life or in cases of rape and incest as turned into the justification
...for nothing. The right to abortion isn't premised on any of those, in general. The only one that is particularly relevant as a justification is protecting the life of the mother, and that mostly has to do with abortions later in pregnancy, Cobstitutionally.
Otherwise, the justification of abortion is bodily autonomy.
...for nothing. The right to abortion isn't premised on any of those, in general. The only one that is particularly relevant as a justification is protecting the life of the mother, and that mostly has to do with abortions later in pregnancy, Cobstitutionally.
Otherwise, the justification of abortion is bodily autonomy.
Bodily autonomy? Is that a thing in the law? What's the justification for the drugs laws then?
Bodily autonomy means you shouldn't be forced to do something with your body, not allowed to do everything with it.
That would cover forced conception/abortions, but how does it cover the right to an abortion?
It's not like becoming pregnant is "being forced to give birth";
if it is the distinction is meaningless since not allowing <x> is forcing you to not do <x>, and forcing you to do <x> is disallowing you to not do <x>.
It's not like becoming pregnant is "being forced to give birth";
if it is the distinction is meaningless since not allowing <x> is forcing you to not do <x>, and forcing you to do <x> is disallowing you to not do <x>.
Becomming pregnant is not being forced to give birth but being forced to carrying pregnancy to term and giving birth is being forced to give birth.
But you are right. This distinction is meaningless by itself.
What actually has meaning is if what we are forcing/forbidding you to do with your body puts your health and life at risk for some other benefit, for example for benefit of a single new other human.
Forcing someone to carry pregnancy to term to save the life of this new human is like forcing someone to giva a kidney to save some other person's life.
It's commendable but it shouldn't be obligatory.
But you are right. This distinction is meaningless by itself.
What actually has meaning is if what we are forcing/forbidding you to do with your body puts your health and life at risk for some other benefit, for example for benefit of a single new other human.
Forcing someone to carry pregnancy to term to save the life of this new human is like forcing someone to giva a kidney to save some other person's life.
It's commendable but it shouldn't be obligatory.
But it's a little different - I'm not responsible for someone needing a kidney, but a person who becomes pregnant is (in most cases) responsible for that. That doesn't mean anyone should be "forced to carrying pregnancy to term", but it also doesn't mean they shouldn't be punished for not doing so.
Being punished for not doing something is the same as being forced to do this.
And being responsible for getting pregnant shouldn't be automatically punished with being forced to risk your health and life for benefit of human that is not you. Unless pregnancy is a crime there should be no punishment at all. Let alone the corporal punisment.
And being responsible for getting pregnant shouldn't be automatically punished with being forced to risk your health and life for benefit of human that is not you. Unless pregnancy is a crime there should be no punishment at all. Let alone the corporal punisment.
> And being responsible for getting pregnant shouldn't be automatically punished with being forced to risk your health and life for benefit of human that is not you.
Why not? Those are the stakes of sex and we all know it going in. I'm a man, but I know that if I accidentally get a woman pregnant one of the consequences will be being forced to monetarily support the resulting child. She knows going in that pregnancy is a potential consequence. Neither of us is "innocent" here, we both took a gamble and lost. The question is, if one believes that a fetus is a person with a right to life, do we not also believe that those who knowingly engaged in its creation have a responsibility towards it?
> Unless pregnancy is a crime there should be no punishment at all. Let alone the corporal punisment.
Having children is not a crime, yet we routinely force people to be responsible for their children. One could say that the crime is being irresponsible, but then one could just as easily say the same about terminating a pregnancy.
Why not? Those are the stakes of sex and we all know it going in. I'm a man, but I know that if I accidentally get a woman pregnant one of the consequences will be being forced to monetarily support the resulting child. She knows going in that pregnancy is a potential consequence. Neither of us is "innocent" here, we both took a gamble and lost. The question is, if one believes that a fetus is a person with a right to life, do we not also believe that those who knowingly engaged in its creation have a responsibility towards it?
> Unless pregnancy is a crime there should be no punishment at all. Let alone the corporal punisment.
Having children is not a crime, yet we routinely force people to be responsible for their children. One could say that the crime is being irresponsible, but then one could just as easily say the same about terminating a pregnancy.
> Why not?
Because getting pregnant is not a crime so it shouldn't be punished.
> Those are the stakes of sex and we all know it going in.
You can say that about crimes as well. Knowing the stakes doesn't mean that something that follows is not a punishment. And we should be punishing only crimes. And we shouldn't be using corporal punishments at all.
> I'm a man, but I know that if I accidentally get a woman pregnant one of the consequences will be being forced to monetarily support the resulting child.
That's a horrible idea too unless you are voluntarily choosing to do it.
> Neither of us is "innocent" here, we both took a gamble and lost.
That doesn't mean either of you should suffer any punishment.
> The question is, if one believes that a fetus is a person with a right to life, do we not also believe that those who knowingly engaged in its creation have a responsibility towards it?
Even if you believe a fetus is as much of a person as adult human you still can't compel other human to risk her health and life for that person even if not risking it means this person dies. Even if she's responsible for giving this human life.
Human that needs a kidney also has the right to live but you can't ensure that right is fulfilled by taking involuntarily kidneys of other people.
What's more, even if your child needs a kidney to survive you are not obliged to provide it and punished for not doing so.
An yet if somebody needs a uterus (and the rest of your body with all it's fragile systems) you are forced to provide it if it's your kid.
> Having children is not a crime, yet we routinely force people to be responsible for their children. One could say that the crime is being irresponsible, but then one could just as easily say the same about terminating a pregnancy.
When the child is born, you don't have to take it with you from the hospital. If you did, you voluntarily assumed the rights of a parent with all the responsibilities. When you neglect a child you are punished for violation of this voluntary agreement.
You don't voluntarily agree to getting pregnant and giving birth unless you are planning it and wanting it. Having sex is not acceptance of being forced to deliver a child. Acceptance could be assumed if having children was the only reason people have sex. But people use sex as communication and bonding tool.
Because getting pregnant is not a crime so it shouldn't be punished.
> Those are the stakes of sex and we all know it going in.
You can say that about crimes as well. Knowing the stakes doesn't mean that something that follows is not a punishment. And we should be punishing only crimes. And we shouldn't be using corporal punishments at all.
> I'm a man, but I know that if I accidentally get a woman pregnant one of the consequences will be being forced to monetarily support the resulting child.
That's a horrible idea too unless you are voluntarily choosing to do it.
> Neither of us is "innocent" here, we both took a gamble and lost.
That doesn't mean either of you should suffer any punishment.
> The question is, if one believes that a fetus is a person with a right to life, do we not also believe that those who knowingly engaged in its creation have a responsibility towards it?
Even if you believe a fetus is as much of a person as adult human you still can't compel other human to risk her health and life for that person even if not risking it means this person dies. Even if she's responsible for giving this human life.
Human that needs a kidney also has the right to live but you can't ensure that right is fulfilled by taking involuntarily kidneys of other people.
What's more, even if your child needs a kidney to survive you are not obliged to provide it and punished for not doing so.
An yet if somebody needs a uterus (and the rest of your body with all it's fragile systems) you are forced to provide it if it's your kid.
> Having children is not a crime, yet we routinely force people to be responsible for their children. One could say that the crime is being irresponsible, but then one could just as easily say the same about terminating a pregnancy.
When the child is born, you don't have to take it with you from the hospital. If you did, you voluntarily assumed the rights of a parent with all the responsibilities. When you neglect a child you are punished for violation of this voluntary agreement.
You don't voluntarily agree to getting pregnant and giving birth unless you are planning it and wanting it. Having sex is not acceptance of being forced to deliver a child. Acceptance could be assumed if having children was the only reason people have sex. But people use sex as communication and bonding tool.
if you decide to for example continually give blood to another person to keep them alive, you are allowed at any point to revoke your consent for this procedure even if it makes the other person die.
it doesnt matter that the women entered the pregnancy knowing the consequences, she is allowed to revoke the babies privilege to use her body whenever she wants.
it doesnt matter that the women entered the pregnancy knowing the consequences, she is allowed to revoke the babies privilege to use her body whenever she wants.
Jesus Christ "revoke the babies privilege"
When did that baby consent to being conceived?
When did that baby consent to being conceived?
another human doesnt have a right to leech off your body.
Obviously the law isn't consistent. Doesn't mean we should race to the bottom though, expanding everyone's bodily autonomy should be a goal.
> Bodily autonomy? Is that a thing in the law?
By name, no. It’s a popular term which I think maps pretty well to a large and significant subset of “privacy” law under the Supreme Court’s 5th (as applies to the federal government) and 14th (as applies to the States) Amendment “due process” jurisprudence.
> What's the justification for the drugs laws then?
Arguably, none. The only case which has reached the Supreme Court in which I ama aware of the relevant Constitutional argument was kind-of considered against the Controlled Substances Act used it as an argument in the lower courts for Constitutional avoidance (a doctrine under which the courts read ambiguity in laws to favor an interpretation which does not violate the Constitution), and the Court refused to apply it because the law was not ambiguously crafted so as to permit the reading preferred, even if it was Cobstitutionally necessary; because invalidity of the law itself was not argued at the lower court, the Supreme Court declined to consider it for the first time on appeal. United States v. Oakland Cannabis Buyers' Cooperative, 532 U.S. 483 (2001).
By name, no. It’s a popular term which I think maps pretty well to a large and significant subset of “privacy” law under the Supreme Court’s 5th (as applies to the federal government) and 14th (as applies to the States) Amendment “due process” jurisprudence.
> What's the justification for the drugs laws then?
Arguably, none. The only case which has reached the Supreme Court in which I ama aware of the relevant Constitutional argument was kind-of considered against the Controlled Substances Act used it as an argument in the lower courts for Constitutional avoidance (a doctrine under which the courts read ambiguity in laws to favor an interpretation which does not violate the Constitution), and the Court refused to apply it because the law was not ambiguously crafted so as to permit the reading preferred, even if it was Cobstitutionally necessary; because invalidity of the law itself was not argued at the lower court, the Supreme Court declined to consider it for the first time on appeal. United States v. Oakland Cannabis Buyers' Cooperative, 532 U.S. 483 (2001).
> the justification of abortion is bodily autonomy
then why do so many pro-choicers also hate vaxxers? And please don't say "that's different, it affects other people!"
then why do so many pro-choicers also hate vaxxers? And please don't say "that's different, it affects other people!"
> And please don't say "that's different, it affects other people!"
Preempting the flaw in your strawman doesn’t invalidate it. A woman choosing to abort a pregnancy has no bearing on anyone but her. In contrast, the anti-vaccine crowd both directly, and indirectly, contribute to the propagation of disease.
Your right to bodily autonomy stops at society’s doorstep, which is broadly agreeing that the unvaccinated don’t get to participate in the non-essential aspects of society, otherwise furthering the risk to everyone else without reason.
Preempting the flaw in your strawman doesn’t invalidate it. A woman choosing to abort a pregnancy has no bearing on anyone but her. In contrast, the anti-vaccine crowd both directly, and indirectly, contribute to the propagation of disease.
Your right to bodily autonomy stops at society’s doorstep, which is broadly agreeing that the unvaccinated don’t get to participate in the non-essential aspects of society, otherwise furthering the risk to everyone else without reason.
"has no bearing on anyone but her."
Isn't the baby also affected by that choice?
Isn't the baby also affected by that choice?
> Isn't the baby also affected by that choice?
Legally, zygotes, embryos, and fetuses (like spermatazoa and ova, and unlike babies which are not involved in this) are not persons.
Legally, zygotes, embryos, and fetuses (like spermatazoa and ova, and unlike babies which are not involved in this) are not persons.
Legally (currently). But...
A zygote, an embryo, and a fetus are genetically fully human, and are distinct individuals from the mother. So saying "has no bearing on anyone but [the mother]" is... legally correct, but morally much more grey. And saying "it only affects one person" is also pre-empting the objection to the strawman.
A zygote, an embryo, and a fetus are genetically fully human, and are distinct individuals from the mother. So saying "has no bearing on anyone but [the mother]" is... legally correct, but morally much more grey. And saying "it only affects one person" is also pre-empting the objection to the strawman.
> A zygote, an embryo, and a fetus are genetically fully human, and are distinct individuals from the mother
Define “genetically fully human” and “distinct individuals” and provide an argument as to why each is ethically relevant.
Define “genetically fully human” and “distinct individuals” and provide an argument as to why each is ethically relevant.
"Genetically fully human": having 2x23 chromosomes with the full complement of DNA that normal human cells contain; that is, not haploid like spermatozoa or ova.
"Distinct individual": Genetically different from the parent, and not just different with a transcription error.
Why it's relevant: Because "it's her body" and "it affects nobody else" aren't relevant arguments when it's not just her body, when there's another individual there. Now we have to have a real moral/ethical discussion, and we can't short-circuit it with dismissive strawmen.
But I'm fairly sure you knew all of that. I suspect that you just want to keep using the strawmen to avoid having the actual ethical/moral discussion.
"Distinct individual": Genetically different from the parent, and not just different with a transcription error.
Why it's relevant: Because "it's her body" and "it affects nobody else" aren't relevant arguments when it's not just her body, when there's another individual there. Now we have to have a real moral/ethical discussion, and we can't short-circuit it with dismissive strawmen.
But I'm fairly sure you knew all of that. I suspect that you just want to keep using the strawmen to avoid having the actual ethical/moral discussion.
Can you clarify what you mean by:
> like spermatazoa and ova, and unlike babies which are not involved in this
Do mean some fetuses are people aka babies, or all fetuses are distinct from babies and hence not persons.
> like spermatazoa and ova, and unlike babies which are not involved in this
Do mean some fetuses are people aka babies, or all fetuses are distinct from babies and hence not persons.
So what's the strawman? That many pro-choicers also hate vaxxers?
> then why do so many pro-choicers also hate vaxxers? And please don't say "that's different, it affects other people!"
Er, why not? The fact that it affects what is legally a non-person entity in whom the State has a legitimate interest is why abortion rights have different parameters later in pregnancy, so why wouldn't it be the consistent that vaccination having public health impacts that affect the life and health of other actual people is relevant?
Er, why not? The fact that it affects what is legally a non-person entity in whom the State has a legitimate interest is why abortion rights have different parameters later in pregnancy, so why wouldn't it be the consistent that vaccination having public health impacts that affect the life and health of other actual people is relevant?
since we are arguing about what the law should be, some(thing/one) being "legally a non-person entity" would be circular.
At what point is a person a person? "at birth" seems arbitrary.
At what point is a person a person? "at birth" seems arbitrary.
> At what point is a person a person? "at birth" seems arbitrary
All lines dividing up creation into named categories and entities are arbitrary.
That one is arbitrary is not an argument against it and in favor of a different (and equally arbitrary) one.
All lines dividing up creation into named categories and entities are arbitrary.
That one is arbitrary is not an argument against it and in favor of a different (and equally arbitrary) one.
Can you explain what you mean? Are zygote, embryos, foetus and various categorisations of foetal development arbitrary? Or do you mean "arbitrary" specifically in terms of personhood (i.e. there might be a clearly distinguishable stage where the heart starts beating, but this bears no obvious relationship to personhood)
> That one is arbitrary is not an argument against it and in favor of a different (and equally arbitrary) one.
True, but that's not my aim. I am instead attacking the notion of personhood, which was a dependency of your own argument, not mine. If there are no meaningful indicators of personhood, the only way to avoid aborting a person is to set a limit at a point where a foetus is still likely to be a non-person, because detailed gauges of personhood are otherwise unavailable.
I think a better direction for this argument would be to burden you with the question; why aren't we allowed to terminate once a child is born? pre-empting the argument "but then there are no health risks / autonomy considerations" - does that mean all abortions are done for purely health-risk reasons?
> That one is arbitrary is not an argument against it and in favor of a different (and equally arbitrary) one.
True, but that's not my aim. I am instead attacking the notion of personhood, which was a dependency of your own argument, not mine. If there are no meaningful indicators of personhood, the only way to avoid aborting a person is to set a limit at a point where a foetus is still likely to be a non-person, because detailed gauges of personhood are otherwise unavailable.
I think a better direction for this argument would be to burden you with the question; why aren't we allowed to terminate once a child is born? pre-empting the argument "but then there are no health risks / autonomy considerations" - does that mean all abortions are done for purely health-risk reasons?
Holy crap those numbers are awful. Personally I'm slightly on the side of pro-choice, but we really need to educate people more on birth control.
Bafflingly, the same political forces that oppose abortion also oppose both birth control and sex education.
And homosexuality, despite it not resulting in children. And welfare. And mandatory paid maternity leave. And...basically everything that would actually ensure children are not a burden on the parent.
Hmmmm, maybe abortion for those people isn't about protecting babies but is really about subjugation of women?
> but the abuse potential is massive.
How so? We don't have to create a system in which it is legal to shoot someone in the head and then claim they asked you to do it. Have it be a medical procedure that must be done in a hospital by government certified doctors. You can even require a psych evaluation before it becomes an option.
I can understand there being some gray area in which it isn't clear that the person has all their faculties to the point they can request it, but that shouldn't stop us from creating a system that works for all the obvious cases.
How so? We don't have to create a system in which it is legal to shoot someone in the head and then claim they asked you to do it. Have it be a medical procedure that must be done in a hospital by government certified doctors. You can even require a psych evaluation before it becomes an option.
I can understand there being some gray area in which it isn't clear that the person has all their faculties to the point they can request it, but that shouldn't stop us from creating a system that works for all the obvious cases.
... then the psych evaluator gets sued by kin, etc.
Well the first problem is that it's not legal. Lets fix that problem for fixating on the secondary issue of the American legal system exacerbating principal-agent problems
Family members can pressure the patient to give up.
Family also pressure to give birth even in cases where the potential child leads a terrible life and it's abused too.
This is the reverse case, though. Plus, child abuse can in principle be found out and mitigated. Death is irreversible.
Incentives are different too. Outside of highly fundamentalist cultures, there isn't really a strong benefit to a family from pressuring someone to keep a child. In developed countries, children are a huge liability for the first ~20 years of their life. Meanwhile, with assisted suicide, there are strong incentives around cessation of ongoing medical care (costs), and obviously inheritance.
Between that and possibility of presenting some murders as assisted suicide, I think if the idea is to be implemented, it really needs to be done extra carefully.
Incentives are different too. Outside of highly fundamentalist cultures, there isn't really a strong benefit to a family from pressuring someone to keep a child. In developed countries, children are a huge liability for the first ~20 years of their life. Meanwhile, with assisted suicide, there are strong incentives around cessation of ongoing medical care (costs), and obviously inheritance.
Between that and possibility of presenting some murders as assisted suicide, I think if the idea is to be implemented, it really needs to be done extra carefully.
Child abuse is just one thing. There are people who don't have the capability to give proper physical and mental care, they don't even know anything, just wanted a cute thing because they don't have anything else to do. Then there genetical disease. Many just wanted a boy, so they play gamble and give birth to 3 girls. These kids are here for someone's selfish wish, may live miserable life in 3rd world countries. Bring someone to life, but don't let anyone escape unless going through huge suffering whole life.
Car kills many, doesn't stopped that from banning cars completely. Yes do it carefully, but no. Even people who live alone, doesn't have anything valuable, are not able to die with dignity. Must suffer.
Car kills many, doesn't stopped that from banning cars completely. Yes do it carefully, but no. Even people who live alone, doesn't have anything valuable, are not able to die with dignity. Must suffer.
Sure, but they also pressure folks into marriage and birth and organ donation and all sorts of things. It is definitely possible to do it in ways that help minimize this.
And even then: We already allow families to decide to take folks off of life support.
And even then: We already allow families to decide to take folks off of life support.
There's a system in india where mercy killings are normal and there are plenty of stories of families plotting to kill their elders. It could end up like that if normalized.
> Very few people (at least in my experience) think that assisted suicide itself is bad, but the abuse potential is massive.
Many terminally ill people receive substandard palliative care, and want assisted suicide – it seems likely that at least some wouldn't want it any more (or might never have sought it in the first place) if their palliative care was better.
What are the ethics of saying to people "we aren't going to do anything to fix the substandard palliative care you are receiving, but we are happy to help you kill yourself"?
Many terminally ill people receive substandard palliative care, and want assisted suicide – it seems likely that at least some wouldn't want it any more (or might never have sought it in the first place) if their palliative care was better.
What are the ethics of saying to people "we aren't going to do anything to fix the substandard palliative care you are receiving, but we are happy to help you kill yourself"?
This isn't how it works, though - they are two separate issues.
Of course we shouldn't have substandard care, palliative or not. Of course we should try not to let people suffer. It isn't like palliative care is at all affected by whether or not we have assisted suicide, as we can obviously have good palliative care without allowing assisted suicide at all (or the opposite, but we aren't that cruel yet).
But not matter how much we try to make folks comfortable, it simply doesn't always happen and not everyone wants to die slowly, even if they are comfortable in the meantime. Even the most comfortable care we can muster for the majority of folks doesn't result in a good quality of life, after all. (Of course, some folks are more comfortable than others just because of income and situation, which we can lessen but not get rid of entirely).
Assisted suicide shouldn't always come from the folks receiving palliative care, either. I'm fine with folks having plans in place to die if they have dementia, for example, or if their wish for a decade has been to kill themselves, despite getting are. Or heck, even if someone wants to die at x age, if they live that long. Well-planned assisted suicide should be available.
Of course we shouldn't have substandard care, palliative or not. Of course we should try not to let people suffer. It isn't like palliative care is at all affected by whether or not we have assisted suicide, as we can obviously have good palliative care without allowing assisted suicide at all (or the opposite, but we aren't that cruel yet).
But not matter how much we try to make folks comfortable, it simply doesn't always happen and not everyone wants to die slowly, even if they are comfortable in the meantime. Even the most comfortable care we can muster for the majority of folks doesn't result in a good quality of life, after all. (Of course, some folks are more comfortable than others just because of income and situation, which we can lessen but not get rid of entirely).
Assisted suicide shouldn't always come from the folks receiving palliative care, either. I'm fine with folks having plans in place to die if they have dementia, for example, or if their wish for a decade has been to kill themselves, despite getting are. Or heck, even if someone wants to die at x age, if they live that long. Well-planned assisted suicide should be available.
You are a person who has never been in the very unfortunate position of needing to die. That’s why suicide will never be accepted. Because so few people ever get stuck in that situation.
The "potential for abuse" GP is talking about could be rephrased as: with assisted suicide, many more people would find themselves in the very unfortunate position of needing to die, just for reasons external to them.
I'm very on the fence on this topic; I've watched family members/friends pass in varying degrees of pain, and at least in those cases I'm not sure having assisted suicide would have helped that much. What _definitely would_ have helped would have been better end of life care.
> who has never been in the very unfortunate position of needing to die.
Defining that line is very, very, tricky. People only reach this point at a desperate time, when they are potentailly very vulnerable. There's a huge difference between two people in an end-of-life situation, one who is willing to die and one who isn't, yet both may "need" to die, and we have the meansright now to provide an easier transition from "terminally ill" to the former, but yet people end up in the second bucket all the time.
> Because so few people ever get stuck in that situation.
Yet we have many many people who have suicidal thoughts, and who commit suicide (arguably needlessly), when we have methods of helping. We should have the same methods of helping people who are terminally ill.
(That's not to get into the mess of what do the family of the patient want; things get messy _really_ fast when money is on the line as I've unfortunately witnessed, and it tears families apart.)
> who has never been in the very unfortunate position of needing to die.
Defining that line is very, very, tricky. People only reach this point at a desperate time, when they are potentailly very vulnerable. There's a huge difference between two people in an end-of-life situation, one who is willing to die and one who isn't, yet both may "need" to die, and we have the meansright now to provide an easier transition from "terminally ill" to the former, but yet people end up in the second bucket all the time.
> Because so few people ever get stuck in that situation.
Yet we have many many people who have suicidal thoughts, and who commit suicide (arguably needlessly), when we have methods of helping. We should have the same methods of helping people who are terminally ill.
(That's not to get into the mess of what do the family of the patient want; things get messy _really_ fast when money is on the line as I've unfortunately witnessed, and it tears families apart.)
It is very tricky to define the line for terminally ill people. But the reality is that if you ended up on the wrong side of the line you would welcome the choice.
It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success.
Something like locked-in syndrome after a bad stroke, or late-stage Alzheimer's - potentially a vegetative state that can last a decade - isn't.
The real problem is making sure the choice is free and informed - not being "encouraged" by other family members for personal gain, revenge, or some other unacceptable motivation. Possibly after a person is no longer considered legally competent, but may still be signalling a current desire to avoid death even though they left a living will stating they would welcome it.
It does indeed get messy very, very quickly.
Open legalisation complicates all of that and turns it into a much harder problem than it is already. The courts would spend a lot of time dealing with those cases.
It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success.
Something like locked-in syndrome after a bad stroke, or late-stage Alzheimer's - potentially a vegetative state that can last a decade - isn't.
The real problem is making sure the choice is free and informed - not being "encouraged" by other family members for personal gain, revenge, or some other unacceptable motivation. Possibly after a person is no longer considered legally competent, but may still be signalling a current desire to avoid death even though they left a living will stating they would welcome it.
It does indeed get messy very, very quickly.
Open legalisation complicates all of that and turns it into a much harder problem than it is already. The courts would spend a lot of time dealing with those cases.
I think once we figure out depression, assisted suicide will become uncontroversial. If you understand what dying means (end of everything you have and will ever have) and don't have depression, but you want to die then we should let you make that decission. You must have good reasons.
> making sure the choice is free and informed - not being "encouraged" by other family members
How would you do this?
One way or the other, I think you would end up attempting to create a metric for QoL. Some people, for example, might want death after losing their limbs, or their sight - a difficult life, but not a painful one, some people are born without these facilities and manage to live fruitful lives. If you allow death for those cases, why not evaluate regular suicides the same way?
How would you do this?
One way or the other, I think you would end up attempting to create a metric for QoL. Some people, for example, might want death after losing their limbs, or their sight - a difficult life, but not a painful one, some people are born without these facilities and manage to live fruitful lives. If you allow death for those cases, why not evaluate regular suicides the same way?
The line is not difficult to draw. Again, you’ve never experienced it. There are states of existence where it becomes a simple and plain object in your mind that you must die because of the objective and real factors of your circumstances and not because of a feeling or notion. Until you experience that, it will all be fuzzy, grey, wushu washy fluff in the sky. Because it’s never been real to you.
You know how people will sometimes change their mind when confronted with reality? You know how some men scoff at a dangerous activity until they are pushed out from the crowd to do it themselves? The reality of the situation sets in. All of a sudden your mind is revealing to you things that you had not considered before. Revealing intuitions and details that it had not performed for you because your brain doesn’t consider things in detail until they are perceived as important to you — until they are in front of you. This also happens for death. All of a sudden, details fill in that have never been emphasized in the idiot internet threads. All the details of how a suicide attempt can go wrong, where the line of death really is, all the ways that you might feel pain. It’s completely overwhelming if you are suddenly in desperate need of death. It’s the experience of the most marginalized and abused group of people to ever exist. Forced to die in gruesome and terrible ways and in horrific home made contraptions that very often create a huge amount of pain before fulfilling their purpose.
You know how people will sometimes change their mind when confronted with reality? You know how some men scoff at a dangerous activity until they are pushed out from the crowd to do it themselves? The reality of the situation sets in. All of a sudden your mind is revealing to you things that you had not considered before. Revealing intuitions and details that it had not performed for you because your brain doesn’t consider things in detail until they are perceived as important to you — until they are in front of you. This also happens for death. All of a sudden, details fill in that have never been emphasized in the idiot internet threads. All the details of how a suicide attempt can go wrong, where the line of death really is, all the ways that you might feel pain. It’s completely overwhelming if you are suddenly in desperate need of death. It’s the experience of the most marginalized and abused group of people to ever exist. Forced to die in gruesome and terrible ways and in horrific home made contraptions that very often create a huge amount of pain before fulfilling their purpose.
There are lots of things that are abused but still not illegal, like cars, giving birth. If people can bring someone without their consent to have poor life, there should also a way to exit if one wants. Otherwise life is a prison for many.
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The problem is the possibility that physician assisted suicide will be abused to clear out people who are costly to treat by gently urging them to take the option, or other similar scenarios like a family urging someone to take the option so they can get early inheritance.
It's one of those things that I might support in idealistic principle but where I develop serious reservations when I factor in how ugly people can be in real life.
It's one of those things that I might support in idealistic principle but where I develop serious reservations when I factor in how ugly people can be in real life.
Then perhaps we should ban inheritance. It seemed unfair anyway.
Especially since current practice when it comes to dementia is waiting till the patient forgets how to swollow food and then let him/her starve to death.
Several of my grandparents spent way too long in ICU and hospice care and ultimately it wasn't worth it. I feel terrible about how their final days went, but other family members were adamant about 'throwing everything they could at it.'
But the family members making that choice weren't footing the bill and they didn't have to lay in bed all day, so why wouldn't they try? I also feel they had a gross misunderstanding of the capabilities of modern medicine.
In each case the doctor's asked, "do you want to give him/her a fighting chance?" Of course, no one wants to say 'no' to that question, because they don't really understand what's possible and don't understand what "winning" actually looks like.
But the family members making that choice weren't footing the bill and they didn't have to lay in bed all day, so why wouldn't they try? I also feel they had a gross misunderstanding of the capabilities of modern medicine.
In each case the doctor's asked, "do you want to give him/her a fighting chance?" Of course, no one wants to say 'no' to that question, because they don't really understand what's possible and don't understand what "winning" actually looks like.
> In each case the doctor's asked, "do you want to give him/her a fighting chance?" Of course, no one wants to say 'no' to that question, because they don't really understand what's possible and don't understand what "winning" actually looks like.
Right, and people don't generally think to ask those questions because, at that point, they're not in an emotional state that is conducive to stopping and asking questions. That said, the phrase "fighting chance" is absolutely terrible here. It's far too loaded to convey what would actually be meant here.
Right, and people don't generally think to ask those questions because, at that point, they're not in an emotional state that is conducive to stopping and asking questions. That said, the phrase "fighting chance" is absolutely terrible here. It's far too loaded to convey what would actually be meant here.
Yeah, some might describe it as something more like "drawing it out as long as possible", from what I've observed of some people in their last days/weeks/months.
"But the family members making that choice weren't footing the bill"
That appears to be the crux of the problem: "footing the bill". It may sound counter intuitive but I have found that when cost is removed from the equation, then better decisions may arise or at least a few extra distortions are removed.
When money is directly involved then there are several potential, and in my view damaging, extra approaches that might arise. There's the: "we've spent so much and achieved [something] so let's go all in." Or "we've only spent this much so let's go for gold" Or: "We are paying for this anyway and so let's give it a go".
Health care systems that are funded by taxation ie pre-paid, in my view, escape those problems and encourage end of life scenarios that are more likely to be better (for a given value of better)
I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax". The NI rate is: https://www.gov.uk/national-insurance/how-much-you-pay - nominally 12% but is only levied on the first £x. It gets a bit complicated because employers also pay NI for their employees.
The thing about an organisation like the National Health Service is that if you have one and you get hurt, you get it fixed without thinking about it too much. We do pay quite a lot for it but it works and the cost is not so noticeable compared to Income Tax. My dad had a few heart related snags a few years ago that involved a three week stay in Exeter General, then a helicopter flight to London and a six month stay in the Royal Brompton, mostly in their intensive care unit (ICU) which would have been horrendously expensive. One of the docs described how he massaged my Dad's heart in his hands when the bloody thing decided to get a bit weary of being fiddled with too much.
The UK's NHS is not perfect or anywhere near perfect. It's a whopping great organisation with some good and some not so good staff and some horrendous bureaucracy. That said, I would prefer it to any other medical system. It works eventually and often works surprisingly well and often preemptively. Dad would be dead without it. Dad's GP practice missed a few clues. When his doc went on holiday, a Hospital Registrar (as it turns out) was drafted in to cover. Dad presented and his feet didn't touch the floor until he was in a hospital bed.
Again, I have to emphasise that the UK's NHS is not perfect but I don't worry about what to do if my arm fell off or something. I get to A&E and they fix me up.
I have also been at the far end of palliative care (Mum). Again the NHS did the business and did its best (cancer) but it had to accept defeat. That's when Hospice Care cuts in alongside the NHS. St Margarets were absolutely fantastic.
In the end it is taxation that pays for this thing but the fact that you can forget about money when dealing with health care issues is quite important, I think.
That appears to be the crux of the problem: "footing the bill". It may sound counter intuitive but I have found that when cost is removed from the equation, then better decisions may arise or at least a few extra distortions are removed.
When money is directly involved then there are several potential, and in my view damaging, extra approaches that might arise. There's the: "we've spent so much and achieved [something] so let's go all in." Or "we've only spent this much so let's go for gold" Or: "We are paying for this anyway and so let's give it a go".
Health care systems that are funded by taxation ie pre-paid, in my view, escape those problems and encourage end of life scenarios that are more likely to be better (for a given value of better)
I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax". The NI rate is: https://www.gov.uk/national-insurance/how-much-you-pay - nominally 12% but is only levied on the first £x. It gets a bit complicated because employers also pay NI for their employees.
The thing about an organisation like the National Health Service is that if you have one and you get hurt, you get it fixed without thinking about it too much. We do pay quite a lot for it but it works and the cost is not so noticeable compared to Income Tax. My dad had a few heart related snags a few years ago that involved a three week stay in Exeter General, then a helicopter flight to London and a six month stay in the Royal Brompton, mostly in their intensive care unit (ICU) which would have been horrendously expensive. One of the docs described how he massaged my Dad's heart in his hands when the bloody thing decided to get a bit weary of being fiddled with too much.
The UK's NHS is not perfect or anywhere near perfect. It's a whopping great organisation with some good and some not so good staff and some horrendous bureaucracy. That said, I would prefer it to any other medical system. It works eventually and often works surprisingly well and often preemptively. Dad would be dead without it. Dad's GP practice missed a few clues. When his doc went on holiday, a Hospital Registrar (as it turns out) was drafted in to cover. Dad presented and his feet didn't touch the floor until he was in a hospital bed.
Again, I have to emphasise that the UK's NHS is not perfect but I don't worry about what to do if my arm fell off or something. I get to A&E and they fix me up.
I have also been at the far end of palliative care (Mum). Again the NHS did the business and did its best (cancer) but it had to accept defeat. That's when Hospice Care cuts in alongside the NHS. St Margarets were absolutely fantastic.
In the end it is taxation that pays for this thing but the fact that you can forget about money when dealing with health care issues is quite important, I think.
12% is a pretty good deal.
Many religious organisations want something similar and deliver approximately nothing in return.
Many religious organisations want something similar and deliver approximately nothing in return.
The tithe was abolished hereabouts a few years before the NHS was formed.
I think we got a good deal in the end.
I think we got a good deal in the end.
> Health care systems that are funded by taxation ie pre-paid, in my view, escape those problems and encourage end of life scenarios that are more likely to be better (for a given value of better)
It remains a serious criminal offence in the UK to assist in suicide (suicide itself hasn't been a crime for decades).
> I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax".
That is utterly incorrect. National Insurance is not ring-fenced; the money goes into the government's revenue pool, same as Income Tax. It can then be spent on weapons, wars, or subsidies for fossil-fuel industries.
NI is just a wheeze to allow governments to increase taxes on income without appearing to raise the rate of Income Tax. There's a reason the rate of NI has never gone down.
[Edit] I appear to be wrong: NI income doesn't go into the "general pool", at least not directly (it seems to be complicated).
NI is an obnoxious tax. It is capped; earnings over about £900 pw are untaxed. Pensioners are untaxed. So the burden falls most-heavily on less-well-off working people (the less you earn, the greater proportion of your earnings goes in NI).
It remains a serious criminal offence in the UK to assist in suicide (suicide itself hasn't been a crime for decades).
> I think that I am very lucky to have the UK's NHS to care for me. We pay for it nominally via a second income related tax called "National Insurance" - we also have a country wide "Income Tax".
That is utterly incorrect. National Insurance is not ring-fenced; the money goes into the government's revenue pool, same as Income Tax. It can then be spent on weapons, wars, or subsidies for fossil-fuel industries.
NI is just a wheeze to allow governments to increase taxes on income without appearing to raise the rate of Income Tax. There's a reason the rate of NI has never gone down.
[Edit] I appear to be wrong: NI income doesn't go into the "general pool", at least not directly (it seems to be complicated).
NI is an obnoxious tax. It is capped; earnings over about £900 pw are untaxed. Pensioners are untaxed. So the burden falls most-heavily on less-well-off working people (the less you earn, the greater proportion of your earnings goes in NI).
My sister kept fooling with my father's palliative care meds? Why? She claimed it was so he could spend more time with her kids. My father thought he kids were spoiled.
What could be the other reason? Was she naieve? I do know she loved him, but it seemed he needed to do things for her love? She messed with his meds so she could more inheritance. Just American greed.
It's not like she even needed the money. She had two shoe stores in LA, and was a shoe designer.
She got all his cash. She had a lawyer on speed dial according to my brother. My mother got nothing. (We are not a litigious family for the most part.)
She spent part of the money on a Yurt in the backyard of her beautiful home, after a world trip staying in fancy hotels.
She wonders why her brothers, and mother, don't return calls.
One more thing. My father had a huge liver tumor. He had great insurance (Union Cadillac policy). Because modern doctors do not palpitate anymore, he went decade with the tumor. We all knew something didn't look right, but he was told by a doctor it was just scarring from a hernia operation. Not one doctor felt his abdomen, except interns at the hospital. (After the third different intern pushed on his stomach, I said enough. He's not a learning tool for you.)
He left the hospital with an incurable diagnosis. Many specialist looked at him.
This doctor affiliated with the hospital kept dragging my sick father in for appointments. He told him he would operate, after this sanctimonious speech about drinking.
My father was naturally elated.
The doctor called a couple of weeks later, and said he couldn't operrate.
It was all those unnessary office visits that irritated me, along with getting a guy's hope up.
(Sorry about the ramble. I once said, I didn't understand why Steve Jobs didn't use western medicine to cure his Pancreatic tumor. What I didn't know is how low the cure rate of that cancer was. I didn't know what kind of cancer (I hear their are basically two types, and one is somewhat kinda curable. The other is not.). I never should have said anything. When my day comes, I'm using that Right to Die option. I'm glad CA has that now. Oh boy, I am now depressed.)
What could be the other reason? Was she naieve? I do know she loved him, but it seemed he needed to do things for her love? She messed with his meds so she could more inheritance. Just American greed.
It's not like she even needed the money. She had two shoe stores in LA, and was a shoe designer.
She got all his cash. She had a lawyer on speed dial according to my brother. My mother got nothing. (We are not a litigious family for the most part.)
She spent part of the money on a Yurt in the backyard of her beautiful home, after a world trip staying in fancy hotels.
She wonders why her brothers, and mother, don't return calls.
One more thing. My father had a huge liver tumor. He had great insurance (Union Cadillac policy). Because modern doctors do not palpitate anymore, he went decade with the tumor. We all knew something didn't look right, but he was told by a doctor it was just scarring from a hernia operation. Not one doctor felt his abdomen, except interns at the hospital. (After the third different intern pushed on his stomach, I said enough. He's not a learning tool for you.)
He left the hospital with an incurable diagnosis. Many specialist looked at him.
This doctor affiliated with the hospital kept dragging my sick father in for appointments. He told him he would operate, after this sanctimonious speech about drinking.
My father was naturally elated.
The doctor called a couple of weeks later, and said he couldn't operrate.
It was all those unnessary office visits that irritated me, along with getting a guy's hope up.
(Sorry about the ramble. I once said, I didn't understand why Steve Jobs didn't use western medicine to cure his Pancreatic tumor. What I didn't know is how low the cure rate of that cancer was. I didn't know what kind of cancer (I hear their are basically two types, and one is somewhat kinda curable. The other is not.). I never should have said anything. When my day comes, I'm using that Right to Die option. I'm glad CA has that now. Oh boy, I am now depressed.)
Do not be resigned, the day may not come. When you ultimately die, you may not have to make any choice at all, you might never even know it happened, you will never even know you lived.
This is a pretty popular topic, and discussed previously:
https://news.ycombinator.com/item?id=3313570 (2011)
https://news.ycombinator.com/item?id=5104430 (2013)
https://news.ycombinator.com/item?id=9260286 (2015)
https://news.ycombinator.com/item?id=13122408 (2016)
https://news.ycombinator.com/item?id=3313570 (2011)
https://news.ycombinator.com/item?id=5104430 (2013)
https://news.ycombinator.com/item?id=9260286 (2015)
https://news.ycombinator.com/item?id=13122408 (2016)
those 4 HN links refer to these 2 articles:
http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...
http://www.theguardian.com/society/2012/feb/08/how-doctors-c...
http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...
http://www.theguardian.com/society/2012/feb/08/how-doctors-c...
These are all derived from the original 2011 Zocalo article.
The bottom of the Cancerworld article says:
> This blogpost was first published in 2011 on Zócalo Public Square
The bottom of the Guardian article says:
> Taken from an article originally published at Zócalo Public Square.
The bottom of the Cancerworld article says:
> This blogpost was first published in 2011 on Zócalo Public Square
The bottom of the Guardian article says:
> Taken from an article originally published at Zócalo Public Square.
I long ago decided that if I got a terminal disease, I would refuse any treatment that would extend my quantity of life at the expense of my quality of life.
I've seen what chemo does to people. No thank you. If I get cancer, I'll just self-medicate with whatever opioids I can get my hands on until either the cancer kills me or the pain gets bad enough that the opioids stop being able to do anything for it, at which point I'd just intentionally OD by a massive amount while alone in a remote location.
(and on top of all the debilitating, crippling effects of chemo, I am also, for multiple reasons, particularly attached to my hair... it's one of the only parts of my body I like, and I would literally rather die than lose my hair)
I've seen what chemo does to people. No thank you. If I get cancer, I'll just self-medicate with whatever opioids I can get my hands on until either the cancer kills me or the pain gets bad enough that the opioids stop being able to do anything for it, at which point I'd just intentionally OD by a massive amount while alone in a remote location.
(and on top of all the debilitating, crippling effects of chemo, I am also, for multiple reasons, particularly attached to my hair... it's one of the only parts of my body I like, and I would literally rather die than lose my hair)
Don't be so quick to decide this now -- consider your options at the time, if such a thing arises. It may not be so cut & dry as "terminal" and there's a huge amount of variability in how cancer diagnoses go. In the meantime, take the best care of your body you possibly can :)
If you don't decide it now and write it down in a living will, you may be unable to make that decision when you need to.
Even if the cancer has a very high survival rate following chemo, if the only way to save my life involves losing my hair I will refuse treatment and let myself die.
I mean, first - the loss of hair is temporary, second - not all cancers are that vicious. It might be worth it if the probability of survival after treatment is high. This article was about almost certainly incurable cases, treatment or not.
Whether or not it grows back is irrelevant. I will not stand to be without my hair for even a single millisecond.
The only way I would even remotely accept chemo is if I could get a 100% guarantee in writing—with an agreement to immediately kill me if I wake up early—that I will be put in an induced coma before chemo and not taken out of the coma until after my hair has completely grown back and surpassed its previous length, and I want the anaesthesiologists legally obliged to err on the side of me not waking up ever over the possibility of me waking up before my hair has fully grown back.
The only way I would even remotely accept chemo is if I could get a 100% guarantee in writing—with an agreement to immediately kill me if I wake up early—that I will be put in an induced coma before chemo and not taken out of the coma until after my hair has completely grown back and surpassed its previous length, and I want the anaesthesiologists legally obliged to err on the side of me not waking up ever over the possibility of me waking up before my hair has fully grown back.
Cancer survivor here. I did chemo. My oncologist says I had the worst go of this treatment she’s ever see .
My hair grew back. After just a couple months I felt great again. It was worth it.
My hair grew back. After just a couple months I felt great again. It was worth it.
Whether or not it grows back is irrelevant. I will not stand to be without my hair for even a single millisecond.
The only way I would even remotely accept chemo is if I could get a 100% guarantee in writing—with an agreement to immediately kill me if I wake up early—that I will be put in an induced coma before chemo and not taken out of the coma until after my hair has completely grown back and surpassed its previous length, and I want the anaesthesiologists legally obliged to err on the side of me not waking up ever over the possibility of me waking up before my hair has fully grown back.
The only way I would even remotely accept chemo is if I could get a 100% guarantee in writing—with an agreement to immediately kill me if I wake up early—that I will be put in an induced coma before chemo and not taken out of the coma until after my hair has completely grown back and surpassed its previous length, and I want the anaesthesiologists legally obliged to err on the side of me not waking up ever over the possibility of me waking up before my hair has fully grown back.
Years ago, Charlie, a highly respected orthopaedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds – from 5% to 15% – albeit with a poor quality of life.
Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
I am guessing that he had testing which determined it had spread and was terminal. It seems implausible that an otherwise healthy person would just pass up on a 15% chance of survival.
Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
I am guessing that he had testing which determined it had spread and was terminal. It seems implausible that an otherwise healthy person would just pass up on a 15% chance of survival.
If I were given a 15% chance of survival (at best) where the most I could hope for was having a poor quality of life, I wouldn't be interested either. Even it at 2:1 it'd be a tough decision for me.
As a doctor, he'd understand more than most what a "poor quality of life" means.
[deleted]
With a major bowel surgery? You’re looking colostomy bag combined with a tough recovery. That means pressure sores, painful chemo or radiation, substandard care in rehab, etc. Plus, pancreatic cancer usually comes back in force once you run that gauntlet.
My dad went through some of that post-stroke. No way.
My dad went through some of that post-stroke. No way.
15% for 5 years of unpleasant survival. Basically 0% chance for a “long” “normal” life after that.
My mother (who worked in medicine and was very healthy) was diagnosed with a GBM and had a brief course of radiation to try to shrink it without a ton of luck.
She stopped working and went home and had an OK year then an awful 4 months and then fell out of bed and broke her hip and never woke up.
She could’ve maybe had 2 or 3 pretty bad years if she’d “fought” and was “lucky.”
My mother (who worked in medicine and was very healthy) was diagnosed with a GBM and had a brief course of radiation to try to shrink it without a ton of luck.
She stopped working and went home and had an OK year then an awful 4 months and then fell out of bed and broke her hip and never woke up.
She could’ve maybe had 2 or 3 pretty bad years if she’d “fought” and was “lucky.”
Pancreatic cancer has a notoriously low survival rate, and undergoing pancreatic cancer treatment is a horrible way to die.
Thats the only way the patient discovers pancreatic cancer. It is only discovered earlier and treatably when a coincidental different test finds something. Sadly nobody even knows how fast pancreatic cancer grows so even increasing the frequency of tests doesn’t give you any recourse.
If it were 15% chance with a good quality of life, I'd take that treatment. But having seen several relatives live through a 'poor quality of life', I would not want that.
Given a long enough time horizon the chance of survival for anyone approaches 0%. At a certain point we got to come to terms with the inevitability of death. It really does not make sense to be performing elaborate, expensive proceedures on the elderly.
I'm seeing a lot of people sharing very personal and very difficult anecdotes here, and I am worried that that would make someone decide to reject chemotherapy outright, or recommend a loved one to reject it.
Yes, chemotherapy has very adverse side-effects. But it's also the best course of action we currently have for a lot of cancer patients. It varies depending on the type, grade and stage of the illness, as well as the patient's overall health [1]. It should not be rejected outright.
Now for my personal anecdata: My sister in law was in her 30s when they detected her breast cancer, and got chemo for some time. It was a very difficult time for her, but it worked - the cancer receded. She kept having to do get periodical checks to keep tabs on it.
Unfortunately her cancer came back, and this time it was more aggressive - it resisted all treatments and eventually metastasised. They took her off chemo, but her health deteriorated very quickly anyway. She died 1 and a half years ago, at home.
On average, chemotherapy gave her and my brother around 7 years of life, in exchange of some very shitty quality of life moths due to side effects. They definitively made the right choice in taking chemo the first time, and not taking it the second time. A lot of people's cancers never come back.
I am not saying that chemotherapy is worth it in all cases. I am painfully aware that it isn't. But it is worth in a lot of cases. Don't reject it outright.
PS: I should mention that we live on a country with a civilized health care system where her treatments were paid for by the state's Social Security. No one in this story had to deal with "can we afford this treatment" problems. If you are in that situation, I am sorry for you.
[1] https://www.medicalnewstoday.com/articles/326031
Yes, chemotherapy has very adverse side-effects. But it's also the best course of action we currently have for a lot of cancer patients. It varies depending on the type, grade and stage of the illness, as well as the patient's overall health [1]. It should not be rejected outright.
Now for my personal anecdata: My sister in law was in her 30s when they detected her breast cancer, and got chemo for some time. It was a very difficult time for her, but it worked - the cancer receded. She kept having to do get periodical checks to keep tabs on it.
Unfortunately her cancer came back, and this time it was more aggressive - it resisted all treatments and eventually metastasised. They took her off chemo, but her health deteriorated very quickly anyway. She died 1 and a half years ago, at home.
On average, chemotherapy gave her and my brother around 7 years of life, in exchange of some very shitty quality of life moths due to side effects. They definitively made the right choice in taking chemo the first time, and not taking it the second time. A lot of people's cancers never come back.
I am not saying that chemotherapy is worth it in all cases. I am painfully aware that it isn't. But it is worth in a lot of cases. Don't reject it outright.
PS: I should mention that we live on a country with a civilized health care system where her treatments were paid for by the state's Social Security. No one in this story had to deal with "can we afford this treatment" problems. If you are in that situation, I am sorry for you.
[1] https://www.medicalnewstoday.com/articles/326031
This doctor clearly has a vision for how he feels end of life should be, and then implies all (most) doctors share this and non-doctors should follow and doctors should be more vocal about the implied belief.
I'm a bit warey of his assertion that all doctors think the same way as him though. He relies pretty heavily on his experience and a few anecdotes. I wonder if there is any actual data on how doctors view "futile" care and end of life.
I'm a bit warey of his assertion that all doctors think the same way as him though. He relies pretty heavily on his experience and a few anecdotes. I wonder if there is any actual data on how doctors view "futile" care and end of life.
Here’s some actual data:
“Most physicians would forgo aggressive treatment for themselves at the end of life, study finds” https://med.stanford.edu/news/all-news/2014/05/most-physicia...
“Most physicians would forgo aggressive treatment for themselves at the end of life, study finds” https://med.stanford.edu/news/all-news/2014/05/most-physicia...
Take it with a grain of salt just like any self reported study. Their preference may very well change when they become the patient.
Especially with something as heavy as "here's your choice of the last two calendar dates you can expect to be alive"
“Everybody has a plan until they get punched in the face.” -Mike Tyson
My dad was a physician who always was very clear that he did not want to live in an incapacitated sate. When he had the stroke that killed him, he tried to keep my mom from calling 911 till after he was dead.
Some people are expecting to get punched in the face.
Some people are expecting to get punched in the face.
Anyone with this opinion will have DNR orders on file. Their preference is already locked in.
Most of my family are physicians or nurses. They are all of this opinion.
My mom was an ER and ICU RN and NP. She’s to the point where I have a written protocol for when and how I am to call 911 in the event of an emergency for her.
Nobody wants to die, but few who understand want to live in the purgatory between life and death that futile care entails.
My mom was an ER and ICU RN and NP. She’s to the point where I have a written protocol for when and how I am to call 911 in the event of an emergency for her.
Nobody wants to die, but few who understand want to live in the purgatory between life and death that futile care entails.
It's all ancedotal, but my dad is a doctor and, in talking with him, he agrees with the author and says every other doctor he knows concurs. He is in his 70s and not in the greatest of health (he was in a car accident years ago that seriously led to a decline in his health). He hasn't changed his mind at all as he has gotten older.
As a physician, I think it comes down to circumstance and goals of care. If I was in my forties and had several young children, I'd want everything done to be able to see them again. Even if I knew it was "futile".
This is why palliative care is so important. All of our goals in life are vastly different all the time, even cycling every week.
This is why palliative care is so important. All of our goals in life are vastly different all the time, even cycling every week.
I once worked with a cardiovascular surgeon who was possibly one of the most brilliant people I'd ever met. His wife was a neurosurgeon, and she was diagnosed with some rare form of brain tumour, and they both knew the prognosis. They ended up selling their little farm and all their cars and equipment, and bought a little float plane to travel the world with for her final years. I believe he passed away shortly after she did, but they got to spend the last of their time together with a very relaxing lifestyle.
I took two psych classes in University. One was "Death and Dying". Perhaps a morbid class to take in your 20s, but it was a full class. The professor happened to be dying herself as she taught it. Very useful and enjoyable. It's one of the few textbooks I've kept since the long-ago graduation. A very useful course to take.
in one view, most everyone is dying, while they read this.. a colleague did some hospice volunteer work for a while, and I made sure to quietly mention to her that I found it commendable and important.
The author implies (by omission) that palliative care results in a peaceful, pain-free death. You can't rely on that!
I wonder how often physicians die as a result of taking a drug such as Nembutal - the drug recommended by Exit International. Civilians can't buy this drug - not even illegally, e.g. on the Dark Web, as far as I can see. But physicians can.
I don't want to get caught. I don't want the kind of "palliative care" that amounts to death-by-dehydration. If I get throat cancer and can't swallow, no amount of pain-killers will make my death pleasant.
I want a stash of Nembutal, so that I can do myself in, if the prospect I'm facing is a nest of wires and tubes or untreatable pain. It's an ethical disgrace that it's illegal for me to manage the end of my own life.
Apparently any relative that accompanies me on the plane to Switzerland risks prosecution for assisting a suicide. So if I want to die quickly and peacefully, I'll have to do that on my own.
The amount of humbug that swirls around this subject makes my head swim.
I wonder how often physicians die as a result of taking a drug such as Nembutal - the drug recommended by Exit International. Civilians can't buy this drug - not even illegally, e.g. on the Dark Web, as far as I can see. But physicians can.
I don't want to get caught. I don't want the kind of "palliative care" that amounts to death-by-dehydration. If I get throat cancer and can't swallow, no amount of pain-killers will make my death pleasant.
I want a stash of Nembutal, so that I can do myself in, if the prospect I'm facing is a nest of wires and tubes or untreatable pain. It's an ethical disgrace that it's illegal for me to manage the end of my own life.
Apparently any relative that accompanies me on the plane to Switzerland risks prosecution for assisting a suicide. So if I want to die quickly and peacefully, I'll have to do that on my own.
The amount of humbug that swirls around this subject makes my head swim.
Wasn’t this one of the things the “death panels” (as so expertly branded by Republicans) were supposed to help with? Helping people on Medicare decide on how they wanted to approach these kind of issues and what they wanted for advanced directives?
Unfortunately so much of this is decided at the last minute as people are terrified or just desperate for any lifeline no matter the consequences. Choices that, had they made them without those immediate pressures they may have made differently and had time to truly think through.
Unfortunately so much of this is decided at the last minute as people are terrified or just desperate for any lifeline no matter the consequences. Choices that, had they made them without those immediate pressures they may have made differently and had time to truly think through.
> Wasn’t this one of the things the “death panels” (as so expertly branded by Republicans) were supposed to help with? Helping people on Medicare decide on how they wanted to approach these kind of issues and what they wanted for advanced directives?
No. A death panel does not decide when someone is to die but when treatment is to be stopped due to mounting costs, regardless of the wishes of the patient.
No. A death panel does not decide when someone is to die but when treatment is to be stopped due to mounting costs, regardless of the wishes of the patient.
There never was a death panel in the ACA
https://en.wikipedia.org/wiki/Death_panel
This was the definition of the death panel:
> Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options.
This was the definition of the death panel:
> Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options.
Today's medicine is focused to treat the diseases, refusing to admit that people at 70-80 years old die not from disease, but from the old age.
Everybody but a few enthusiasts refuse to treat ageing instead of cancer or heart diseases. People in general refuse to treat ageing as a disease, thinking it is something natural.
I would not want a couple more miserable years on earth, I want a few million years of a healthy young life.
Everybody but a few enthusiasts refuse to treat ageing instead of cancer or heart diseases. People in general refuse to treat ageing as a disease, thinking it is something natural.
I would not want a couple more miserable years on earth, I want a few million years of a healthy young life.
> People in general refuse to treat ageing as a disease, thinking it is something natural.
Aging is not natural? I certainly understand why someone would not consider it a disorder.
> I want a few million years of a healthy young life.
I would avoid literal genies if I were you.
Aging is not natural? I certainly understand why someone would not consider it a disorder.
> I want a few million years of a healthy young life.
I would avoid literal genies if I were you.
Aging is natural the same way heart disease and cancer are natural. Some people get unlucky and develop cancer at a young age, but we don't throw up our hands and say whelp it's just nature.
We should treat aging the same way. Some people's bodies fail them at 80, but others live to be 100+. If we develop good treatments there's no reason that everyone can't live to be 100 in relatively good health.
We should treat aging the same way. Some people's bodies fail them at 80, but others live to be 100+. If we develop good treatments there's no reason that everyone can't live to be 100 in relatively good health.
> Aging is natural the same way heart disease and cancer are natural
How are heart disease and cancer not natural?
Aging is also slightly different in that it's how our bodies are supposed to work as far as I understand it, which is not very well (Possibly as a cancer prevention mechanism).
Telomeres and Aging: https://en.wikipedia.org/wiki/Telomere#Association_with_agin...
Telomeres and Cancer prevention: https://en.wikipedia.org/wiki/Telomere#Telomerase
How are heart disease and cancer not natural?
Aging is also slightly different in that it's how our bodies are supposed to work as far as I understand it, which is not very well (Possibly as a cancer prevention mechanism).
Telomeres and Aging: https://en.wikipedia.org/wiki/Telomere#Association_with_agin...
Telomeres and Cancer prevention: https://en.wikipedia.org/wiki/Telomere#Telomerase
> How are heart disease and cancer not natural?
The parent isn't claiming that; they are pointing out that heart disease and cancer are just as natural as aging. We spend a lot of effort to cure heart disease and cancer, so why not do the same with aging?
The parent isn't claiming that; they are pointing out that heart disease and cancer are just as natural as aging. We spend a lot of effort to cure heart disease and cancer, so why not do the same with aging?
Because aging is not a disorder. No one expects heart disease or cancer. everyone expects to get older… regardless if you’d like this or not.
Ageing is natural and harmful. Hunger is natural and harmful. Earthquakes, hurricanes, plaque are natural and harmful. We should mercilessly fight all of those, and ensure either of those maladies cause people to die.
Just yesterday there was an article on Hacker News attacking Bezos for having the pride and selfishness to attempt to cure aging: https://news.ycombinator.com/item?id=28440348
"Be fine with dying of old age or else you're a villain" is this weird, fundamental, Christian part of our common mythos/ethics/stories. The evil villain seeks immortality. The kindly old witch or wizard or Pope dies peacefully because it is right.
Aging is bad. We might be able to fix it. There are a thousand downsides and challenges that come with a solution to old age, but that doesn't mean leaving aging in place is better.
"Be fine with dying of old age or else you're a villain" is this weird, fundamental, Christian part of our common mythos/ethics/stories. The evil villain seeks immortality. The kindly old witch or wizard or Pope dies peacefully because it is right.
Aging is bad. We might be able to fix it. There are a thousand downsides and challenges that come with a solution to old age, but that doesn't mean leaving aging in place is better.
I never understood people who defend death
If there is a tiger chasing you, wouldn't you try to escape or fight? Or just give up and let the tiger eat you? It is natural, tiger also want to eat, right?
If there is a tiger chasing you, wouldn't you try to escape or fight? Or just give up and let the tiger eat you? It is natural, tiger also want to eat, right?
If your mental image of people who support the notion of death is people who are just apathetically suicidal, then you're missing the point.
No, my point is that I personally am very afraid of death, and would fight death from the selfish reasons.
People who support the notion of death seem not to constantly fear it themselves, but view it as something hypothetical, that they wouldn't have to face themselves in the near future (likely several decades).
People who support the notion of death seem not to constantly fear it themselves, but view it as something hypothetical, that they wouldn't have to face themselves in the near future (likely several decades).
I don't think I particular fear death. Fear of death is a monkey brain thing. I don't want to die because I enjoy living. But if I had the choice between dying immediately or living for a few more minutes while being pushed through a meat grinder, I think I, and everyone alive, would choose to die immediately. It's not too difficult to imagine torture and pain so horrific that even monkey brain prefers death.
Human brain can make that judgment wherever it wants. I think the general case that shitty medical routes are just not worth it is often true.
Human brain can make that judgment wherever it wants. I think the general case that shitty medical routes are just not worth it is often true.
They're not suicidal. But they have this big inconsistency in their ethical framework.
I mean, if an elder gets into a car accident, shouldn't we try to save them? If a fire starts in a nursing home, shouldn't the residents be evacuated and the fire put down? How come that everyone understands the importance of saving lives, but some flip 180 degrees on it if the cause looks "natural" enough and the victim is old enough?
I mean, if an elder gets into a car accident, shouldn't we try to save them? If a fire starts in a nursing home, shouldn't the residents be evacuated and the fire put down? How come that everyone understands the importance of saving lives, but some flip 180 degrees on it if the cause looks "natural" enough and the victim is old enough?
> people who support the notion of death
Isn't that a bit like supporting the notion that there is a sky above us?
Perhaps you are referring to people who reject the notion that death is to be avoided in all circumstances, whatever the consequences.
Isn't that a bit like supporting the notion that there is a sky above us?
Perhaps you are referring to people who reject the notion that death is to be avoided in all circumstances, whatever the consequences.
> There are a thousand downsides and challenges that come with a solution to old age, but that doesn't mean leaving aging in place is better.
Sure, not by default, but on the merits of those downside, you probably should conclude that it is in fact better to have people age. Especially if it serves to only be available to the rich and powerful. That's just a shortcut to utter dystopia.
Sure, not by default, but on the merits of those downside, you probably should conclude that it is in fact better to have people age. Especially if it serves to only be available to the rich and powerful. That's just a shortcut to utter dystopia.
Should you?
I think most people would think that a poor person under the rule of a despotic king is still better off alive than dead. So how come that, if the king were to live for hundreds of years, that poor person would suddenly be better off dead?
I feel this line of reasoning boils down to, "if we can't have perfect equality, everyone should die".
I think most people would think that a poor person under the rule of a despotic king is still better off alive than dead. So how come that, if the king were to live for hundreds of years, that poor person would suddenly be better off dead?
I feel this line of reasoning boils down to, "if we can't have perfect equality, everyone should die".
You're assuming that the poor person gets immortality too. That's generous. Or even if they do, that they live in conditions that don't result in them dying from unnatural causes. Or just kill themselves because life is awful.
Better 100 good years than 500 bad ones.
Better 100 good years than 500 bad ones.
Why did you feel the need to slam this as “Christian?” There’s nothing in Christianity that speaks against medicine or trying to extend life. The only thing that is different for Christians is they believe death is not the final end, and thus have less reason to be afraid. They still don’t want to die.
Would you be comfortable slamming other religions in the same causal way? If not, why not?
Would you be comfortable slamming other religions in the same causal way? If not, why not?
Hacker News is US-centric. The US is Christian-centric (religiously and culturally). And there has been a truly bizarre push almost entirely among evangelicals recently to just accept mortality where its absolutely not needed (e.g., during the pandemic).
[deleted]
Well, particularly early Christianity hero-worshipped martyrs, and seeing as how death brought about union with Christ, there is no tradition of prizing life in the body above death.
There's a long tradition of wealthy people with various delusions of having the secrets to defeat death, from Steve Jobs to Howard Hughes and beyond. The Christian tradition scoffs at that because it always fails, and exposes the fragility of even massive earthly wealth, where the Christian priority would be to reject the riches of this world in order to build wealth in the next. That doesn't seem so weird to me.
From its earliest days, following the edicts of Jesus, Christianity encouraged its devotees to tend the sick. Priests were often also physicians. According to the historian Geoffrey Blainey, while pagan religions seldom offered help to the infirm, the early Christians were willing to nurse the sick and take food to them, notably during the smallpox epidemic of AD 165-180 and the measles outbreak of around AD 250; "In nursing the sick and dying, regardless of religion, the Christians won friends and sympathisers".[6]
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
https://en.wikipedia.org/wiki/History_of_nursing
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
https://en.wikipedia.org/wiki/History_of_nursing
You could achieve more life by reactivating more regeneration, but DNA replication is costly when you do it over and over again, damaging telomeres.[1]
And uncontrolled regeneration can give you tumors [citation needed], so there is no easy path other than your own genetics or having a good lifestyle.
[1] https://en.wikipedia.org/wiki/Telomere
Even rivers and stars have an end...
And uncontrolled regeneration can give you tumors [citation needed], so there is no easy path other than your own genetics or having a good lifestyle.
[1] https://en.wikipedia.org/wiki/Telomere
Even rivers and stars have an end...
Telomeres are only one part of the equation, and they likely natural mechanism for controlling the cell differentiation. My understanding they resemble natural breaks that prevent cells to divide uncontrollably where they shouldn't.
I doubt they are the primary cause of ageing.
I prefer the theory explaining ageing as an epigenome misregulation that David Sinclair describes.
I doubt they are the primary cause of ageing.
I prefer the theory explaining ageing as an epigenome misregulation that David Sinclair describes.
Is it fair to future generations who are yet to be born to write off the possibility of their ever being born because we're selfish and want to live forever? There is some limit to the number of humans we can support on earth, so if everyone is living millions of years (or more realistically let's say hundreds of years) we would have to drastically cut the world's reproduction rates.
Maybe I'm overthinking it, but I feel like that is the classic hubris of mankind to aspire to become gods. We want to control nature and life, yet our limited knowledge prevents us from understanding the ramifications of our actions until it is too late. (Under a White Sky is an interesting read on the subject)
Maybe I'm overthinking it, but I feel like that is the classic hubris of mankind to aspire to become gods. We want to control nature and life, yet our limited knowledge prevents us from understanding the ramifications of our actions until it is too late. (Under a White Sky is an interesting read on the subject)
So you would rather die, and let everybody who live now die, for the sake of the potential future generation?
> I feel like that is the classic hubris of mankind to aspire to become gods
Gods were invented by people who refused to admit their ignorance of things they couldn't understand or explain.
Every year the list of unexplainable things gets shorter and shorter. Maybe we'll never be able to explain everything, but I do believe it's within reach to understand the aging process to the point of being able to reverse or even halt it. It may not happen in our lifetimes, and the society that figures it out may not be able to deal with the ramifications properly, but they will learn over time. Just as we've done with scientific and technological advancements in the past. Sometimes you can't figure out how to deal with something until you have to deal with it.
Gods were invented by people who refused to admit their ignorance of things they couldn't understand or explain.
Every year the list of unexplainable things gets shorter and shorter. Maybe we'll never be able to explain everything, but I do believe it's within reach to understand the aging process to the point of being able to reverse or even halt it. It may not happen in our lifetimes, and the society that figures it out may not be able to deal with the ramifications properly, but they will learn over time. Just as we've done with scientific and technological advancements in the past. Sometimes you can't figure out how to deal with something until you have to deal with it.
> I feel like that is the classic hubris of mankind to aspire to become gods. We want to control nature and life, yet our limited knowledge prevents us from understanding the ramifications of our actions until it is too late.
But we are becoming gods. The problem isn't with the aspiration, the problem is that we currently suck at being gods and need to get better at it.
But we are becoming gods. The problem isn't with the aspiration, the problem is that we currently suck at being gods and need to get better at it.
Dude. Nobody has the slightest idea how to effectively treat "aging". The billionaires that engage in that fantasy might be pushing the state of the art a little bit, sure, but they do it from a starting position of absolute ignorance, and their efforts are mostly in vain.
It's like that old joke about a group of PMs that have "invented the general AI". Now all that's left to do is for some researchers and engineers to create it.
It's like that old joke about a group of PMs that have "invented the general AI". Now all that's left to do is for some researchers and engineers to create it.
There are some ideas, in fact. They are not very well developed, though, because such research is very expensive, and even the very educated people on this side fiercely fighting the idea that extending people's life is a good thing.
Until the general public accepts the necessity of the age-related research, there won't be any effective mechanism for age reversion.
NIH yearly budget is 35B dollars. Half of that they spend on cancer research, the other half divides between the other diseases. Age research is a tiny fraction of this budget.
Until NIH spends at least 1/3 of their annual budget on fighting aging, there won't be any significant progress.
Until the general public accepts the necessity of the age-related research, there won't be any effective mechanism for age reversion.
NIH yearly budget is 35B dollars. Half of that they spend on cancer research, the other half divides between the other diseases. Age research is a tiny fraction of this budget.
Until NIH spends at least 1/3 of their annual budget on fighting aging, there won't be any significant progress.
My wife and I feel the exact same way - we have it legalized in our will and in statements of health (I can't remember the legal name for them - but documents about what we want to have happen if we are very sick/near death and can't speak for ourselves). Basically neither of us want anything done for us, at all. Just let us die. Please do not try to prolong things through chemotherapy, intubation, tube feeding, etc.
I don't know how much this still applies, but in the 80s and 90s it also seemed like doctors and nurses smoked a lot more than the average population. Maybe it just seemed that way because you just saw them outside hospitals smoking in groups, but I remember driving by a childrens hospital once, and my father, an ex-smoker, saying they were all out there because they were accustomed to seeing death and weren't afraid of it.
To me, this reveals the Christian roots of modern medicine.
To me, these weeds are to be uprooted: Christians willingly inflict suffering unto others, as they believe it is the natural state of human being and must be increased in servitude of their God, especially near death.
To me, these weeds are to be uprooted: Christians willingly inflict suffering unto others, as they believe it is the natural state of human being and must be increased in servitude of their God, especially near death.
Christians are more generous than the general population, so your tripe makes no sense.
https://www.hoover.org/research/religious-faith-and-charitab...
> The differences in charity between secular and religious people are dramatic. Religious people are 25 percentage points more likely than secularists to donate money (91 percent to 66 percent) and 23 points more likely to volunteer time (67 percent to 44 percent).
https://www.philanthropyroundtable.org/philanthropy-magazine...
> In study after study, religious practice is the behavioral variable with the strongest and most consistent association with generous giving. And people with religious motivations don’t give just to faith-based causes—they are also much likelier to give to secular causes than the nonreligious.
https://givingusa.org/just-released-giving-usa-special-repor...
> People who are religiously affiliated are more likely to make a charitable donation of any kind, whether to a religious congregation or to another type of charitable organization.
> Religiously affiliated households give as much or more to other types of charities as non-religiously affiliated households do.
https://www.hoover.org/research/religious-faith-and-charitab...
> The differences in charity between secular and religious people are dramatic. Religious people are 25 percentage points more likely than secularists to donate money (91 percent to 66 percent) and 23 points more likely to volunteer time (67 percent to 44 percent).
https://www.philanthropyroundtable.org/philanthropy-magazine...
> In study after study, religious practice is the behavioral variable with the strongest and most consistent association with generous giving. And people with religious motivations don’t give just to faith-based causes—they are also much likelier to give to secular causes than the nonreligious.
https://givingusa.org/just-released-giving-usa-special-repor...
> People who are religiously affiliated are more likely to make a charitable donation of any kind, whether to a religious congregation or to another type of charitable organization.
> Religiously affiliated households give as much or more to other types of charities as non-religiously affiliated households do.
I’m not referring to giving or philanthropy, I’m referring to the ”suffering erases sins” mindset perpetuated by Christians.
It is Jesus’ final message.
Sin does not exist, they made it up to make themselves and others suffer.
Have you considered that some people are so keen on giving away their fortunes because it makes them suffer more, and thus makes them think they are now cleaner in God’s eyes?
It is Jesus’ final message.
Sin does not exist, they made it up to make themselves and others suffer.
Have you considered that some people are so keen on giving away their fortunes because it makes them suffer more, and thus makes them think they are now cleaner in God’s eyes?
Have you considered basing your characterization of 2.5 billion people on reality, rather than your own twisted mental gymnastics and fabrication of their beliefs?
I am basing my characterization on hundreds of associates, acquaintances and encounters, as well as second-hand anecdotes, from a time span of three decades.
None other than the founder of EWTN, as well as Mother Teresa agreed with him.
They made her a SAINT!
So 2 people out of billions? And can you prove your claim for both?
See also https://news.ycombinator.com/item?id=28475407.
See also https://news.ycombinator.com/item?id=28475407.
Based on the content your earlier comment, it's abundantly clear that you're lying.
See also https://news.ycombinator.com/item?id=28475407.
See also https://news.ycombinator.com/item?id=28475407.
Are you saying that "suffering erases sin" is Jesus' final message?
The Christian message is that there's nothing we can do in our own power to erase sin, including suffering, hence the need for Jesus in the first place.
Death in Christianity is the final release from sin and its consequences, e.g. suffering, and into eternal joy...and being released of the weight of the consequences of sin eternally is supposed to bring joy and love in this life.
So I have no idea what you're talking about.
The Christian message is that there's nothing we can do in our own power to erase sin, including suffering, hence the need for Jesus in the first place.
Death in Christianity is the final release from sin and its consequences, e.g. suffering, and into eternal joy...and being released of the weight of the consequences of sin eternally is supposed to bring joy and love in this life.
So I have no idea what you're talking about.
Explain Mother Theresa, as well as the flagellants and other penitents.
What about them?
You know perfectly well what about them.
No, I don't. Why don't you answer the question?
Well, I'm a protestant so there might be a different belief system in the Catholic church. "Grace by faith alone", which is the basis of what I commented above is a reformation doctrine and is mostly a protestant thing (some Catholics I have met believe it, but officially not the Roman Catholic Church), and penitence is entirely a Catholic thing, and was a primary cause of the reformation.
There are actually a LOT of different belief systems within Christianity and the related cults surrounding it, so you can't entirely sum them up by saying "Christianity". How I would respond to anyone stating that suffering is required to pay for sins is that it is un-Biblical and they've warped the message of Jesus, and are adding to/complicating the gospel.
This is possible in the Catholic church because edicts of the Pope and Councils have had equal (or at least near equal, I'm not a Catholic historian or theologian) weight with scripture, which of course have no weight at all to Protestantism as the Pope is just another person. Mother Theresa and penitents have such a drastically different belief system, that while I would not go so far as to call them non-Christian as I think only God alone determines that, I would say that their teachings are not the same religion as mine. Saints again are a purely Catholic thing, so to me and other protestants, Mother Theresa is just another person, and "Saint" is a worthless designation from the Catholic Church. In addition, individual adherents of what is classified as "Christian" can teach and believe (or fail in their belief) of the core doctrines and cease to become what I would consider Christian, despite doing things in the name of Christ. The church during the time of Paul's letters and Acts were dealing with the same thing, people using the name of Christ who were not what Luke or Paul considered Christians.
It sounds like a no-true-Scottsman argument, and perhaps it is, but the argument that I'm making is that you are lumping billions of people together, when #1 they don't lump themselves together (Catholics have considered protestants and the reformers heretics as well), and #2 they believe and practice drastically different things. You will likely hear Protestants hedge when asked if Roman Catholics are Christian, and the reason is because on an individual basis, there are Christians within the Roman Catholic church. But what they teach is not what we consider the Christian gospel.
There are actually a LOT of different belief systems within Christianity and the related cults surrounding it, so you can't entirely sum them up by saying "Christianity". How I would respond to anyone stating that suffering is required to pay for sins is that it is un-Biblical and they've warped the message of Jesus, and are adding to/complicating the gospel.
This is possible in the Catholic church because edicts of the Pope and Councils have had equal (or at least near equal, I'm not a Catholic historian or theologian) weight with scripture, which of course have no weight at all to Protestantism as the Pope is just another person. Mother Theresa and penitents have such a drastically different belief system, that while I would not go so far as to call them non-Christian as I think only God alone determines that, I would say that their teachings are not the same religion as mine. Saints again are a purely Catholic thing, so to me and other protestants, Mother Theresa is just another person, and "Saint" is a worthless designation from the Catholic Church. In addition, individual adherents of what is classified as "Christian" can teach and believe (or fail in their belief) of the core doctrines and cease to become what I would consider Christian, despite doing things in the name of Christ. The church during the time of Paul's letters and Acts were dealing with the same thing, people using the name of Christ who were not what Luke or Paul considered Christians.
It sounds like a no-true-Scottsman argument, and perhaps it is, but the argument that I'm making is that you are lumping billions of people together, when #1 they don't lump themselves together (Catholics have considered protestants and the reformers heretics as well), and #2 they believe and practice drastically different things. You will likely hear Protestants hedge when asked if Roman Catholics are Christian, and the reason is because on an individual basis, there are Christians within the Roman Catholic church. But what they teach is not what we consider the Christian gospel.
From its earliest days, following the edicts of Jesus, Christianity encouraged its devotees to tend the sick. Priests were often also physicians. According to the historian Geoffrey Blainey, while pagan religions seldom offered help to the infirm, the early Christians were willing to nurse the sick and take food to them, notably during the smallpox epidemic of AD 165-180 and the measles outbreak of around AD 250; "In nursing the sick and dying, regardless of religion, the Christians won friends and sympathisers".[6]
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
https://en.wikipedia.org/wiki/History_of_nursing
Following the First Council of Nicaea in 325 AD, Christianity became the official religion of the Roman Empire, leading to an expansion of the provision of care. Among the earliest were those built ca. 370 by St. Basil the Great, bishop of Caesarea Mazaca in Cappadocia in Asia Minor (modern-day Turkey), by Saint Fabiola in Rome ca. 390, and by the physician-priest Saint Sampson (d. 530) in Constantinople, Called the Basiliad, St. Basil's hospital resembled a city, and included housing for doctors and nurses and separate buildings for various classes of patients.[7] There was a separate section for lepers.[8] Eventually construction of a hospital in every cathedral town was begun.
Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals after the end of the persecution of the early church.[9] Ancient church leaders like St. Benedict of Nursia (480-547) emphasized medicine as an aid to the provision of hospitality.[10] 12th century Roman Catholic orders like the Dominicans and Carmelites have long lived in religious communities that work for the care of the sick.[11]
Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation.[12] Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.[13]
Medieval hospitals in Europe followed a similar pattern to the Byzantine. They were religious communities, with care provided by monks and nuns. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrims: not all cared for the sick.
When and where the first hospital was established is a matter of dispute. According to some authorities (e.g. Ratzinger, p. 141), St. Zoticus built one at Constantinople during the reign of Constantine, but this has been denied (cf. Uhlhorn, I, 319). But that the Christians in the East had founded hospitals before Julian the Apostate came to the throne (361) is evident from the letter which that emperor sent to Arsacius, high-priest of Galatia, directing him to establish a xenodochium in each city to be supported out of the public revenues (Soxomen, V, 16). As he plainly declares, his motive was to rival the philanthropic work of the Christians who cared for the pagans as well as for their own. A splendid instance of this comprehensive charity is found in the work of St. Ephraem who, during the plague at Edessa (375), provided 300 beds for the sufferers. But the most famous foundation was that of St. Basil at Cæsarea in Cappadocia (369). This "Basilias", as it was called, took on the dimensions of a city with its regular streets, buildings for different classes of patients, dwellings for physicians and nurses, workshop and industrial schools. St. Gregory of Nazianzus was deeply impressed by the extent and efficiency of this institution which he calls "an easy ascent to heaven" and which he describes enthusiastically (Or. 39, "In laudem Basilii"; Or. fun. "In Basil.", P.G., XXXVI, 578-579).
https://en.wikipedia.org/wiki/History_of_nursing
The book When Breath Became Air by Dr. Paul Kalanithi tells the story of his dying. I found it very liberating to learn more about the process from a trauma expert. I'm also slowly making my way through a more medical book currently called How We Die that outlines the actual body processes of the ways we die. I cannot recommend it highly enough.
https://www.goodreads.com/book/show/49286.How_We_Die
https://www.goodreads.com/book/show/49286.How_We_Die
The problem with euthanasia is that the certainty of it defies all human survival instincts so it’s psychologically very difficult to press a button that ends our existence. What would be better if you could legally hire a service, while healthy, that would sneak up on you and kill you painlessly if you were in a terrible condition with nothing but pain and misery to look forward to. You could cancel them at anytime, but if you didn’t, they’d bump you off mercilessly when you needed it.
Perhaps we could devise some kind of medical implant to do it. Although no doubt somebody here would offer it as a SaaS that triggered when you failed to renew your subscription.
Laughed a little bit too hard at this, 10/10, good joke.
My heart really goes out to those of you who went through long battles. Today would have been father’s birthday, sadly he passed away last year aged 61. I often anguished over how quickly he left us, two weeks from the day I found out he was sick to the day he died, I now realise that although I was robbed of time, he and I were both saved a lot of pain.
It is a personal story, is there any evidence that this is a rule? Like, maybe a research that compares costs and/or procedures rendered to terminally ill patients, doctors vs non-doctors. I also heard, that doctors themselves are horrible patients.
Related and very interesting read: https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay...
Far, far, far down in the blog post at section III., the author says this:
> I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay.
> My big fear, though, is that I won’t get a terminal disease.
> I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay.
> My big fear, though, is that I won’t get a terminal disease.
Why would that be the big fear?
I'm guessing something like e.g. Alzheimers or some other quality of life degrading, but not lethal, disease that makes life (not as) worth living, at least past a certain point in the progression of the disease. But because its not lethal, it won't take you out of your misery.
A quick death can be a mercy.
Answered in the subsequent paragraph after the end of the quotation...
It's ambiguous but maybe they mean a chronic disease instead? i.e. constant suffering but no end date.
I think it means you get something like a degenerative COPD that just grinds you into the ground one suffering day after another while you’re in and out of hospitals, lose your mobility, and lose your basic organ functions; no chance to recover, just withering away neither quickly or slowly.
In most places assisted dying laws only apply to people suffering a terminal disease. If you are suffering something non-terminal, you lack choice and will continue suffering. The best hope some people have is that loved ones let them starve to death.
Assisted dying, where it is allowed, is universally conditioned on the subject having a diagnosed terminal condition. If your diagnosis isn't "death within 6 months", then you're stuck with tubes, wires and chemicals, or waiting for it to happen.
So I also hope that if I get an incurable and unpleasant condition, it's a terminal one.
So I also hope that if I get an incurable and unpleasant condition, it's a terminal one.
Everybody wants to go to Heaven but nobody wants to die.
https://youtu.be/Lb-EJEWRxlM
"A free man thinks of nothing less than of death, and his wisdom is a meditation, not on death, but on life." ― Baruch Spinoza
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Why did she recover after she was switched to hospice care? The best explanation I have is that in the hospital, her access to opioids had been limited. Letting a patient have too much can be risky. But in the hospice, where death is regarded as impending, those risks don't matter and she could have as much as she needed to actually be comfortable. And not suffering, not being in pain was maybe what allowed her to begin to heal.
I don't think exactly that her doctors were wrong in believing that her death was imminent and that a hospice was the right place for her. But what if we created a healthcare system where clinging to life is so exhausting for the patient that embracing the inevitability of death is the most healing option?