It's about to become easier to die
October 19, 2023 8:50 PM Subscribe
Canada Will Legalize Medically Assisted Dying For People Addicted to Drugs (Vice).
Substance use disorders fall under the rubric of mental illness and will be included in the Medical Assistance in Dying (MAID) program under regulations expected to go into effect in March. But Parliament's MAID committee will reconvene to provide "oversight" before the expansion.
Substance use disorders fall under the rubric of mental illness and will be included in the Medical Assistance in Dying (MAID) program under regulations expected to go into effect in March. But Parliament's MAID committee will reconvene to provide "oversight" before the expansion.
This strikes me as a really bad idea for two reasons:
1. People going through withdrawal often want to kill themselves, but many of them will reach the other side and feel much better.
2. In essence, this is a policy which will encourage social undesirables to kill themselves, and is far down the path to outright fascism.
posted by jamjam at 9:18 PM on October 19, 2023 [64 favorites]
1. People going through withdrawal often want to kill themselves, but many of them will reach the other side and feel much better.
2. In essence, this is a policy which will encourage social undesirables to kill themselves, and is far down the path to outright fascism.
posted by jamjam at 9:18 PM on October 19, 2023 [64 favorites]
This is horrible. They are throwing away human lives under the guise of compassion.
posted by nestor_makhno at 9:26 PM on October 19, 2023 [14 favorites]
posted by nestor_makhno at 9:26 PM on October 19, 2023 [14 favorites]
I think this is eventually going to produce a backlash. When MAID is given out to some sufficiently photogenic teenaged girl, and her family raises hell about it, the Conservatives will suddenly have their cause, along with the anti-immigrant backlash from the Palestine-Israel conflict and the killing of Sikh nationalists.
I could easily see this becoming the rallying point for Canadian Christian Conservatives/ Evangelicals.
It's going to be a 'this is why we can't have euthanasia' example in 20 or 50 years time. There will be horror stories about otherwise perfectly healthy persons steered and pressured into death. There will be official apologies and memorials.
posted by LeRoienJaune at 9:31 PM on October 19, 2023 [12 favorites]
I could easily see this becoming the rallying point for Canadian Christian Conservatives/ Evangelicals.
It's going to be a 'this is why we can't have euthanasia' example in 20 or 50 years time. There will be horror stories about otherwise perfectly healthy persons steered and pressured into death. There will be official apologies and memorials.
posted by LeRoienJaune at 9:31 PM on October 19, 2023 [12 favorites]
I mean, the headline focuses on medically assisted dying for those addicted to drugs, but what it actually is is medically assisted dying for those with illnesses, NOW INCLUDING MENTAL ILLNESSES, NOT EXCLUDING DRUG ADDICTION.
I'm not sure I disagree with expanding the eligabilty/critera for medically assisted dying to include mental illnesses, and I think to DISCLUDE addiction from the "mental illness" category would be a step backwards in our understanding and treatment of addiction.
posted by Grandysaur at 9:31 PM on October 19, 2023 [27 favorites]
I'm not sure I disagree with expanding the eligabilty/critera for medically assisted dying to include mental illnesses, and I think to DISCLUDE addiction from the "mental illness" category would be a step backwards in our understanding and treatment of addiction.
posted by Grandysaur at 9:31 PM on October 19, 2023 [27 favorites]
This is clickbait, basically. It's a horribly written article that's an absolute mess and does not really explain much and what it does it explain is explained poorly.
posted by dobbs at 9:34 PM on October 19, 2023 [40 favorites]
posted by dobbs at 9:34 PM on October 19, 2023 [40 favorites]
and is far down the path to outright fascism.
This kind of phrasing is way too loosely used these days-- what does it even mean, in this context? There is not a singular path to a destination called Outright Fascism. Is it different from regular fascism?
At any rate, as a Canadian creaking towards my seventh decade, I am beyond grateful for MAID, and so are the many older adults I have known (a man who I looked up to as a kind of second father; a beloved teacher) who made use of it. We can argue about whether its use is "justified"--is chronic pain a reason for death (a friend's partner of many years) or must it be reserved for incipient death, requiring the six-month terminal deadline (a friend who made of her last months a kind of performance piece)? Even so, I am very relieved that I will have the option, should I need it.
But I do fear the creep towards allowing an easy exit for mental health reasons, for depression that resists all medication, and, as in this case, addiction. What about addiction makes the sufferer a candidate for death? What about depression?
posted by jokeefe at 9:41 PM on October 19, 2023 [23 favorites]
This kind of phrasing is way too loosely used these days-- what does it even mean, in this context? There is not a singular path to a destination called Outright Fascism. Is it different from regular fascism?
At any rate, as a Canadian creaking towards my seventh decade, I am beyond grateful for MAID, and so are the many older adults I have known (a man who I looked up to as a kind of second father; a beloved teacher) who made use of it. We can argue about whether its use is "justified"--is chronic pain a reason for death (a friend's partner of many years) or must it be reserved for incipient death, requiring the six-month terminal deadline (a friend who made of her last months a kind of performance piece)? Even so, I am very relieved that I will have the option, should I need it.
But I do fear the creep towards allowing an easy exit for mental health reasons, for depression that resists all medication, and, as in this case, addiction. What about addiction makes the sufferer a candidate for death? What about depression?
posted by jokeefe at 9:41 PM on October 19, 2023 [23 favorites]
Yeah, this is clickbait. Speaking as someone who has a mental illness that is known to get both worse and more drug-resistant as I get older I would be very glad to live somewhere that has a social construct for me exiting rather than having to leave a surprise corpse for someone.
The framing of the article as being directed at drug addiction is rather pathetic. They could just as well called out anorexics or people with Generalized Anxiety Disorder. "Canada declares open season on DSM!"
posted by Tell Me No Lies at 9:50 PM on October 19, 2023 [24 favorites]
The framing of the article as being directed at drug addiction is rather pathetic. They could just as well called out anorexics or people with Generalized Anxiety Disorder. "Canada declares open season on DSM!"
posted by Tell Me No Lies at 9:50 PM on October 19, 2023 [24 favorites]
2022 CMAJ: There is little evidence describing the technical aspects of medical assistance in dying (MAiD) in Canada, such as medications, dosages and complications. Our objective was to describe clinical practice in providing MAiD in Ontario and Vancouver, Canada, and explore relations between medications used, time until death and complications. [...] The sample included 3557 patients. The medications most often used were propofol (3504 cases [98.5%]), midazolam (3251 [91.4%]) and rocuronium (3228 [90.8%]). The median time from the first injection until death was 9 (interquartile range 6) minutes. Standard-dose lidocaine (40–60 mg) and high-dose propofol (> 1000 mg) were associated with prolonged time until death (prolonged by a median of 1 min and 3 min, respectively). Complications occurred in 41 cases (1.2%), mostly related to venous access or need for administration of a second medication.
--
Since people addicted to drugs (opioids, benzos, cannabis) often develop tolerance to these medications, this may not be an *easier* way to die.
posted by Iris Gambol at 11:16 PM on October 19, 2023
--
Since people addicted to drugs (opioids, benzos, cannabis) often develop tolerance to these medications, this may not be an *easier* way to die.
posted by Iris Gambol at 11:16 PM on October 19, 2023
Also unfabulous: the embedded "related article" is last month's People Experience ‘New Dimensions of Reality' When Dying, Groundbreaking Study Reports.
posted by Iris Gambol at 11:17 PM on October 19, 2023 [1 favorite]
posted by Iris Gambol at 11:17 PM on October 19, 2023 [1 favorite]
A friend of mine lives in Canada and has physical disabilities. When she tried to get help for her support needs - accessible rental accommodation; physical therapy; mobility equipment; continence supplies, and she pointed out that the Disability pension was woefully inadequate for her essential needs, the authorities told her "well, if you can't afford your basic needs on the Disability pension, there is always Medically Assisted Dying."
I support voluntary euthanasia for people with conditions like terminal cancer, but the way that Canada is pushing people with normal or near normal life expectancies towards Medically Assisted Dying rather than adequately funding appropriate support for chronically ill/Disabled Canadians is very concerning.
posted by chariot pulled by cassowaries at 1:27 AM on October 20, 2023 [58 favorites]
I support voluntary euthanasia for people with conditions like terminal cancer, but the way that Canada is pushing people with normal or near normal life expectancies towards Medically Assisted Dying rather than adequately funding appropriate support for chronically ill/Disabled Canadians is very concerning.
posted by chariot pulled by cassowaries at 1:27 AM on October 20, 2023 [58 favorites]
Legalize drugs for people addicted to drugs. (And offer treatment.)
posted by Horace Rumpole at 2:55 AM on October 20, 2023 [18 favorites]
posted by Horace Rumpole at 2:55 AM on October 20, 2023 [18 favorites]
This is clickbait; this feels like reading the Toronto Sun or similar.
MAID is controversial all around. No one is marching people to death camps. I doubt it will even get passed because there is just too much controversy about its application.
Clickbait like this only serves to further the Cons and PPC.
posted by Kitteh at 4:38 AM on October 20, 2023 [12 favorites]
MAID is controversial all around. No one is marching people to death camps. I doubt it will even get passed because there is just too much controversy about its application.
Clickbait like this only serves to further the Cons and PPC.
posted by Kitteh at 4:38 AM on October 20, 2023 [12 favorites]
If a non-Canadian is gonna post about Canada, find better sources. We have them.
Might I, as a non-Canadian unaware of these sources (being a non-Canadian), ask you - presumably a Canadian - to suggest a couple of these sources simply as a for-instance, since (as has been established) you, as a Canadian, have heard of them and I, being a non-Canadian, likely have not?
posted by EmpressCallipygos at 4:42 AM on October 20, 2023 [3 favorites]
Might I, as a non-Canadian unaware of these sources (being a non-Canadian), ask you - presumably a Canadian - to suggest a couple of these sources simply as a for-instance, since (as has been established) you, as a Canadian, have heard of them and I, being a non-Canadian, likely have not?
posted by EmpressCallipygos at 4:42 AM on October 20, 2023 [3 favorites]
CBC. The Star has been linked too. But Vice shouldn’t be one of them.
(I amended my comment because it’s too early to be snarky and I’m on vacation without a laptop.)
posted by Kitteh at 4:44 AM on October 20, 2023 [1 favorite]
(I amended my comment because it’s too early to be snarky and I’m on vacation without a laptop.)
posted by Kitteh at 4:44 AM on October 20, 2023 [1 favorite]
I really supported MAID because I think people deserve to die with the same dignity we literally allow our dogs but my God the idea that anyone suggests MAID as a solution to anyone who isn't clearly terminal is gross and awful. That poor disabled people are ever hearing it as an option instead of, say, making disability supports enough to actually live on, is grotesque.
posted by jacquilynne at 4:46 AM on October 20, 2023 [27 favorites]
posted by jacquilynne at 4:46 AM on October 20, 2023 [27 favorites]
And the Liberals aren’t pushing that; there are outside groups who have asked them to consider it, so they are. I suspect they won’t pass it because it’s too fraught. It’s easier to accept terminal illness as the primary use and should be reserved for that. I know there have been occasional news stories—the woman who was suffering from severe anorexia was one—about folks who don’t qualify in the original intent who wanted access to assisted dying too. Again, it’s a very touchy topic and I don’t think they could expand without pushback. Especially since Trudeau would like to stay in office.
posted by Kitteh at 4:52 AM on October 20, 2023
posted by Kitteh at 4:52 AM on October 20, 2023
The numbers don’t show how many people who opted for a medically assisted death were living in poverty, but Dr. Dosani says it’s not acceptable for anyone to choose to die for lack of financial and social support.Yup. I have a chronic, degenerative, and incurable neurological illness. I am in pain every day. Like a lot of social supports, disability payments are based on what one has paid into it over the years; I was able to work full time for thirty years so my disability support is near the maximum. As well, recipients are allowed and encouraged to work… up to a point. If you pass a certain amount in income annually, the government decides that you are not all that disabled, despite what a doctor says, and your support is ended. Even the maximum allowable extra income plus the disability payment still puts me well below the low income cutoff.
So: I am required by law to live the rest of my days in poverty.
Bill C-22 passed in June and within one year, the disability payments will increase, but it will still be well below anything like what people working minimum wage jobs will make, and that figure itself is of course well short of a living wage. It’s great.
posted by ricochet biscuit at 5:02 AM on October 20, 2023 [20 favorites]
Speaking as someone who has a mental illness that is known to get both worse and more drug-resistant as I get older I would be very glad to live somewhere that has a social construct for me exiting rather than having to leave a surprise corpse for someone.
I wish I could favorite this a bajillion times. Speaking as someone who has lived a lifetime of severe and debilitating treatment-resistant depression, I feel that there should be a compassionate exit available for people.
I watched helplessly as my mother succumbed to Alzheimer’s. It was horrible to watch, and horrible to deal with as a caretaker. If I found myself heading down that same path, I would very much like to be able to compassionately exit on my own terms.
posted by Thorzdad at 5:28 AM on October 20, 2023 [21 favorites]
I wish I could favorite this a bajillion times. Speaking as someone who has lived a lifetime of severe and debilitating treatment-resistant depression, I feel that there should be a compassionate exit available for people.
I watched helplessly as my mother succumbed to Alzheimer’s. It was horrible to watch, and horrible to deal with as a caretaker. If I found myself heading down that same path, I would very much like to be able to compassionately exit on my own terms.
posted by Thorzdad at 5:28 AM on October 20, 2023 [21 favorites]
the idea that anyone suggests MAID as a solution to anyone who isn't clearly terminal is gross and awful
I understand that you’re speaking more about the economic side, but in the general case: there are things far far worse than death and telling people they have to suffer indefinitely because those things aren’t fatal is not a very good policy either.
posted by Tell Me No Lies at 6:01 AM on October 20, 2023 [20 favorites]
I understand that you’re speaking more about the economic side, but in the general case: there are things far far worse than death and telling people they have to suffer indefinitely because those things aren’t fatal is not a very good policy either.
posted by Tell Me No Lies at 6:01 AM on October 20, 2023 [20 favorites]
Yeah this is wrong-headed in so many ways. Assisted suicide should be available for those who are in a drug-free, lucid state of mind in which they can reasonably make that decision, which is the ultimate decision. People under the thrall of addiction aren't in a position to make that decision, because they're on drugs and "not in their right mind," for lack of a better term. I don't know if the makers of this genuinely have compassion in their hearts, but it doesn't really look like they do.
posted by zardoz at 6:28 AM on October 20, 2023 [1 favorite]
posted by zardoz at 6:28 AM on October 20, 2023 [1 favorite]
there are things far far worse than death and telling people they have to suffer indefinitely because those things aren’t fatal is not a very good policy either.
I'm not saying that people who aren't terminal shouldn't have access to MAID at all. But I don't think anyone, especially someone who is meant to be assisting people with their living needs, and super extra especially someone who is meant to be assisting people with their living needs but isn't because there's not enough money to help them, should be suggesting it to them.
posted by jacquilynne at 6:36 AM on October 20, 2023 [5 favorites]
I'm not saying that people who aren't terminal shouldn't have access to MAID at all. But I don't think anyone, especially someone who is meant to be assisting people with their living needs, and super extra especially someone who is meant to be assisting people with their living needs but isn't because there's not enough money to help them, should be suggesting it to them.
posted by jacquilynne at 6:36 AM on October 20, 2023 [5 favorites]
I am overall in favour of MAID. I've been around people who are dying who have wanted it to be over. They had lost their sense of agency during the dying process, and had MAID been available at the time they would have availed themselves of it.
But I really think that we need to hit pause on expanding MAID here in Canada because right now because it is being used to fill the holes in our failing social safety net. And that is, to me, so very very wrong.
That said, we basically have the choice of three flavours of neo-liberalism to choose from up here, so I don't hold out much hope in much other than lip service being paid to social programs in my lifetime.
posted by eekernohan at 6:46 AM on October 20, 2023 [11 favorites]
But I really think that we need to hit pause on expanding MAID here in Canada because right now because it is being used to fill the holes in our failing social safety net. And that is, to me, so very very wrong.
That said, we basically have the choice of three flavours of neo-liberalism to choose from up here, so I don't hold out much hope in much other than lip service being paid to social programs in my lifetime.
posted by eekernohan at 6:46 AM on October 20, 2023 [11 favorites]
I believe everyone has the right to die on their own terms, when they want to, ("sound mind" is not something I really think exists), no questions asked. I really believe that if you persistently want to die, you should have a right to die.
But real compassion would be offering solutions to the poverty and social despair that is at the root of many people's addiction. Sure, not all addicts are poor and live in hopeless circumstances, but for many of them, lifting them out of poverty and giving them a better prospect for their lives would help them avoid relapse once they've kicked in treatment. I think we have medicalized addiction and come to believe it is a permanent personality trait that once acquired will always be with us. This is nonsense AA bullshit. I've never met an addict who was not suffering from another affliction of the soul, unbearable anxiety, depression, despair, post traumatic stress. And poverty amplifies all our afflictions. I believe addiction is a response to these problems, and you should get a chance to come to terms with those problems, including just being given money to lift yourself out of poverty, before you resign yourself to never getting the monkey off your back.
All the same despair is a legitmate reason to die...
posted by dis_integration at 7:26 AM on October 20, 2023 [9 favorites]
But real compassion would be offering solutions to the poverty and social despair that is at the root of many people's addiction. Sure, not all addicts are poor and live in hopeless circumstances, but for many of them, lifting them out of poverty and giving them a better prospect for their lives would help them avoid relapse once they've kicked in treatment. I think we have medicalized addiction and come to believe it is a permanent personality trait that once acquired will always be with us. This is nonsense AA bullshit. I've never met an addict who was not suffering from another affliction of the soul, unbearable anxiety, depression, despair, post traumatic stress. And poverty amplifies all our afflictions. I believe addiction is a response to these problems, and you should get a chance to come to terms with those problems, including just being given money to lift yourself out of poverty, before you resign yourself to never getting the monkey off your back.
All the same despair is a legitmate reason to die...
posted by dis_integration at 7:26 AM on October 20, 2023 [9 favorites]
People under the thrall of addiction aren't in a position to make that decision, because they're on drugs and "not in their right mind," for lack of a better term.
Treatment should be a mandatory part of the process, but if a person has it together enough to say "I wish to die" once a month for a year then I don't know that I'm doing them any favors by forcing them to live in misery.
posted by Tell Me No Lies at 7:29 AM on October 20, 2023 [3 favorites]
Treatment should be a mandatory part of the process, but if a person has it together enough to say "I wish to die" once a month for a year then I don't know that I'm doing them any favors by forcing them to live in misery.
posted by Tell Me No Lies at 7:29 AM on October 20, 2023 [3 favorites]
From a quick google search this Vice article seems to have popped up today on metafilter, slashdot, reddit, ycombinator, the Daily Mail, and Daily Caller. I wonder if there's some astroturfing going on to push this slanted take over other coverage.
posted by allegedly at 7:32 AM on October 20, 2023 [10 favorites]
posted by allegedly at 7:32 AM on October 20, 2023 [10 favorites]
I think MAID is a good thing when it's used appropriately, but there have been at least two publicised cases of people turning to MAID because of poverty and a lack of supports and that is inexcusable. One woman died, the other was saved by kind private citizens. There was also an incident where a government support worker recommended MAID to four veterans.
https://www.ctvnews.ca/health/woman-with-chemical-sensitivities-chose-medically-assisted-death-after-failed-bid-to-get-better-housing-1.5860579
"She died after a frantic effort by friends, supporters and even her doctors to get her safe and affordable housing in Toronto. She also left behind letters showing a desperate two-year search for help, in which she begs local, provincial and federal officials for assistance in finding a home away from the smoke and chemicals wafting through her apartment."
https://www.ctvnews.ca/health/woman-with-disabilities-approved-for-medically-assisted-death-relocated-thanks-to-inspiring-support-1.5921893
"A 31-year-old disabled Toronto woman who was conditionally approved for a medically assisted death after a fruitless bid for safe housing says her life has been "stabilized" by an outpouring of support after telling her story."
https://www.cbc.ca/news/politics/veterans-affairs-maid-one-employee-1.6774645
"On Friday, the department released the results of what it called a months-long investigation. The department launched the probe last year after a veteran told them an employee suggested they consider MAID."
posted by Stoof at 7:34 AM on October 20, 2023 [7 favorites]
https://www.ctvnews.ca/health/woman-with-chemical-sensitivities-chose-medically-assisted-death-after-failed-bid-to-get-better-housing-1.5860579
"She died after a frantic effort by friends, supporters and even her doctors to get her safe and affordable housing in Toronto. She also left behind letters showing a desperate two-year search for help, in which she begs local, provincial and federal officials for assistance in finding a home away from the smoke and chemicals wafting through her apartment."
https://www.ctvnews.ca/health/woman-with-disabilities-approved-for-medically-assisted-death-relocated-thanks-to-inspiring-support-1.5921893
"A 31-year-old disabled Toronto woman who was conditionally approved for a medically assisted death after a fruitless bid for safe housing says her life has been "stabilized" by an outpouring of support after telling her story."
https://www.cbc.ca/news/politics/veterans-affairs-maid-one-employee-1.6774645
"On Friday, the department released the results of what it called a months-long investigation. The department launched the probe last year after a veteran told them an employee suggested they consider MAID."
posted by Stoof at 7:34 AM on October 20, 2023 [7 favorites]
I have to echo the concerns voiced here about non-Canadian coverage of medically-assisted dying policy in my country. The vast majority of it has been hand-wringing, fear-mongering, "it starts with this and it ends with your children!" scare-coverage that reveals far more about the perspective of the reporting outlet than it does how this policy integrates into and is perceived by Canadian society.
David Brooks' coverage in The Atlantic has been particularly onerous in this regard.
posted by jordantwodelta at 7:59 AM on October 20, 2023 [11 favorites]
David Brooks' coverage in The Atlantic has been particularly onerous in this regard.
posted by jordantwodelta at 7:59 AM on October 20, 2023 [11 favorites]
MetaFilter is so so hypocritical in what is allowed for an adult to do whatever they want with their life.
posted by zengargoyle at 8:08 AM on October 20, 2023 [13 favorites]
posted by zengargoyle at 8:08 AM on October 20, 2023 [13 favorites]
No Other Options: "[T]hose close to the system have long talked openly about red flags that many people are choosing euthanasia because they’re not getting the “supports and cares” they need. The physicians in charge of the process not only know that this is happening, but they have discussed it in seminars, collected evidence, and then kept it quiet in public."
posted by Paddle to Sea at 8:10 AM on October 20, 2023 [3 favorites]
posted by Paddle to Sea at 8:10 AM on October 20, 2023 [3 favorites]
As a Canadian who have been living in the US for a long time, I find that the only times I hear about MAID it always feels very sensationalistic and designed to push a conservative agenda on the subject (eg this post). I hope it's talked about with more nuance inside Canada? Or it is really so bad?
posted by 3j0hn at 8:13 AM on October 20, 2023 [10 favorites]
posted by 3j0hn at 8:13 AM on October 20, 2023 [10 favorites]
i don't have a lot of time today when not glancing at my phone while waiting for something to run but some of what's happening may well be a case of "good intentions, bad policy." I recommend this article from The Walrus (yes, Canadian source), this essay, also in The Walrus, and this episode of The Current.
posted by warriorqueen at 8:19 AM on October 20, 2023 [4 favorites]
posted by warriorqueen at 8:19 AM on October 20, 2023 [4 favorites]
Also if anyone is recommending MAID to people who are just asking for disability supports they should be fired. I hope that anyone who encounters that from a worker reports it immediately. That's horrific.
posted by warriorqueen at 8:20 AM on October 20, 2023 [13 favorites]
posted by warriorqueen at 8:20 AM on October 20, 2023 [13 favorites]
if you make the world horrible enough for the disabled and ill and offer them a way to conduct a form of self-perpetrated eugenics then that's compassion right
addressing the root causes of a capitalist-driven material reality where one of the major criteria of mental illness is whether or not one can support themselves financially ie whether or not one is okay with being exploited for profit while never funding critical social welfare programs is so much more expensive than just individually assisted suicide
listen if the people on the tracks want the trolley to run them over having no choice in whether or not they remained tied to the tracks in perpetuity, never able to escape, then it's only ethical to provide them access to the lever, right?
under our neoliberal paradise this is not coercion, this is simply good intent and moral solvency
posted by paimapi at 8:31 AM on October 20, 2023 [7 favorites]
addressing the root causes of a capitalist-driven material reality where one of the major criteria of mental illness is whether or not one can support themselves financially ie whether or not one is okay with being exploited for profit while never funding critical social welfare programs is so much more expensive than just individually assisted suicide
listen if the people on the tracks want the trolley to run them over having no choice in whether or not they remained tied to the tracks in perpetuity, never able to escape, then it's only ethical to provide them access to the lever, right?
under our neoliberal paradise this is not coercion, this is simply good intent and moral solvency
posted by paimapi at 8:31 AM on October 20, 2023 [7 favorites]
Also if anyone is recommending MAID to people who are just asking for disability supports they should be
The only people who should legally have the authority to even broach the topic in the course of their job are caregivers. For everyone else there should be strict liability with the same penalty as bullying and harassment with the intent to cause a suicide.
posted by tclark at 8:31 AM on October 20, 2023 [2 favorites]
I am generally in favour of MAID and for expanding it, but when it was first started, I said to some colleagues that it couldn't be in place of appropriate care/treatment/support for people who don't want MAID; in other words, it couldn't become a way for our systems of care to avoid actually providing the care they are supposed to. For it to be a true choice, both MAID and appropriate care need to be on the table.
I'm worried about the direction its heading, because it does feel like its becoming the default option, but I honestly don't know if my perspective right now is because of some news stories, or if there's a trend. Regardless, I need to do some digging and maybe its time for a bit of a pause to consider what's happening and how to better handle expansion of criteria as well as ongoing care options.
posted by nubs at 8:32 AM on October 20, 2023 [2 favorites]
I'm worried about the direction its heading, because it does feel like its becoming the default option, but I honestly don't know if my perspective right now is because of some news stories, or if there's a trend. Regardless, I need to do some digging and maybe its time for a bit of a pause to consider what's happening and how to better handle expansion of criteria as well as ongoing care options.
posted by nubs at 8:32 AM on October 20, 2023 [2 favorites]
Welp, lemme tell ya, I'm here in the U-nited States, dealing with a disability that's too bad to let me work a job that would let me afford health insurance, but that's not quite bad enough to qualify for any help. As my funds run out and I contemplate homelessness, having a nice suicide booth around the corner would at least be a reassuring option to have, you know?
I mean, if part of a society's basic foundation is that a given percentage of citizens are homeless at any time, if that's an accepted part of our daily existence, we've gone way past the point at which we have any claim to the moral high ground. We're forcing these people to live in hell, to live in our sewage and our waste, to support our economic system.
How is giving them the option of a peaceful death more cruel?
posted by MrVisible at 9:29 AM on October 20, 2023 [10 favorites]
I mean, if part of a society's basic foundation is that a given percentage of citizens are homeless at any time, if that's an accepted part of our daily existence, we've gone way past the point at which we have any claim to the moral high ground. We're forcing these people to live in hell, to live in our sewage and our waste, to support our economic system.
How is giving them the option of a peaceful death more cruel?
posted by MrVisible at 9:29 AM on October 20, 2023 [10 favorites]
It feels like a lot of the controversy is about people feeling pressured into MAID due to ableist bias and a lack of meaningful alternatives like decent financial assistance, accessible treatment options, affordable housing, palliative care, and so on. I worry that when this stuff gets framed as a problem with "MAID going too far," the solution won't be to address any of those other things, it will be to deny people access to MAID -- a hard-won right to autonomy over your own life. I think that would be a bad outcome.
posted by Gerald Bostock at 10:06 AM on October 20, 2023 [11 favorites]
posted by Gerald Bostock at 10:06 AM on October 20, 2023 [11 favorites]
whoa. I am generally pro-euthanasia for the terminally ill, I think the right to die with dignity is very important. but this...this seems like a really bad idea.
posted by supermedusa at 10:43 AM on October 20, 2023
posted by supermedusa at 10:43 AM on October 20, 2023
I think there is a world of difference between feeling for yourself that you would like the option, for whatever reason, vs a person seeking options for life, being told "hey have you considered just dying?" ugh.
posted by supermedusa at 10:51 AM on October 20, 2023 [6 favorites]
posted by supermedusa at 10:51 AM on October 20, 2023 [6 favorites]
A close acquaintance who is very disabled was hospitalized with pneumonia and not only did the doctors try to encourage him to just die, they talked to his wife and tried to get her to persuade him. Until that kinda shit stops, I'm very dubious.
posted by The otter lady at 11:01 AM on October 20, 2023 [16 favorites]
posted by The otter lady at 11:01 AM on October 20, 2023 [16 favorites]
How would they know about the option unless they're told?
If the people who are in charge of helping them can't help them, don't have the budget to help them, and have nothing else to offer, how is it humanitarian to withhold the information that there's an alternative to living in endless suffering?
I mean, there are two endings to a meeting with a (social worker/disability worker/government employee designated to deny benefits) who's denying you the benefits you need to survive. Either you leave with the option to off yourself, or you leave with no options at all.
Yes, it'd be better to offer people what they need to live. We've been trying to do that for my entire existence, more than half a century. But we don't seem to be on the verge of achieving that anytime soon, and in the meantime there are a whole lot of people who are suffering horribly in order to keep the economy running.
If you're well off, you can do a bit of research, do a couple of errands, and have yourself a peaceful, painless suicide (well, probably) for a few hundred dollars. The more economically disadvantaged you are, the further that's out of reach. Is a peaceful death a privilege reserved for the wealthy?
In a country where people, even disabled people, are forced into homelessness for economic reasons every single day by the hundreds, where homelessness is incredibly difficult, degrading, dangerous, terrifying, and subject to brutal oppression, offering people the option of a peaceful death for economic reasons seems like a mercy.
posted by MrVisible at 11:13 AM on October 20, 2023
If the people who are in charge of helping them can't help them, don't have the budget to help them, and have nothing else to offer, how is it humanitarian to withhold the information that there's an alternative to living in endless suffering?
I mean, there are two endings to a meeting with a (social worker/disability worker/government employee designated to deny benefits) who's denying you the benefits you need to survive. Either you leave with the option to off yourself, or you leave with no options at all.
Yes, it'd be better to offer people what they need to live. We've been trying to do that for my entire existence, more than half a century. But we don't seem to be on the verge of achieving that anytime soon, and in the meantime there are a whole lot of people who are suffering horribly in order to keep the economy running.
If you're well off, you can do a bit of research, do a couple of errands, and have yourself a peaceful, painless suicide (well, probably) for a few hundred dollars. The more economically disadvantaged you are, the further that's out of reach. Is a peaceful death a privilege reserved for the wealthy?
In a country where people, even disabled people, are forced into homelessness for economic reasons every single day by the hundreds, where homelessness is incredibly difficult, degrading, dangerous, terrifying, and subject to brutal oppression, offering people the option of a peaceful death for economic reasons seems like a mercy.
posted by MrVisible at 11:13 AM on October 20, 2023
IME, there will always be tension around how to give MAiD information sensitively and how it is heard. No matter how many researchers and focus groups judge training/video/pamphlet to be appropriate for general use, there will always be multiple ways it comes across, most commonly, (a) I didn't know that; (b) I'd forgotten about that (c) I've already rejected that, don't you keep records? and (d) this is poorly done, why do you want me to die?
Staff and clients both need kindness in this situation. And staff especially needs training and permission about when NOT to have this discussion, if that's the greater client benefit.
posted by beaning at 11:27 AM on October 20, 2023 [5 favorites]
Staff and clients both need kindness in this situation. And staff especially needs training and permission about when NOT to have this discussion, if that's the greater client benefit.
posted by beaning at 11:27 AM on October 20, 2023 [5 favorites]
And if staff aren't even trying to give this info sensitively, that's a whole another issue.
And yes, better societal support is needed tho I'd expect the usual amount of complaints about increased taxes from the usual crowd that also limits the funding/education/healthcare that would have helped in the first place.
posted by beaning at 11:33 AM on October 20, 2023
And yes, better societal support is needed tho I'd expect the usual amount of complaints about increased taxes from the usual crowd that also limits the funding/education/healthcare that would have helped in the first place.
posted by beaning at 11:33 AM on October 20, 2023
Another link, about Oregon rather than Canada, but I think it illuminates some of the issues around MAID for mental illness: Some anorexia patients want the right to die. A few doctors are willing to listen
posted by praemunire at 11:43 AM on October 20, 2023 [2 favorites]
posted by praemunire at 11:43 AM on October 20, 2023 [2 favorites]
I fully support MAID. I worked for over a decade on the front line of disability rights. It's MAID or its Robert Latimer. Who should be pardoned.
MAID in Canada is a whole system with checks and balances to try, imperfectly, to provide humans dignity and decency at the end of their lives. Yes more resources are needed to assist people who need and want help, but it's a core conservative politic to underfund any form of assistance and then use that to deny MAID, or abortions or recognize your full rights. I have unreserved and unwavering support for the right to abortion or MAID.
There is no pipeline of people getting euthanized because of cost. The "authorities" aren't telling folks to get dead, mainly because the M in MAID stands for Medically and those are actual professionals. While still fallible they are not "encouraging" MAID, and that's because the A stands for assisted. So some medical folks, and certainly not all of them, are available to enable people to exercise their right to die as an informed choice.
posted by zenon at 11:53 AM on October 20, 2023 [9 favorites]
MAID in Canada is a whole system with checks and balances to try, imperfectly, to provide humans dignity and decency at the end of their lives. Yes more resources are needed to assist people who need and want help, but it's a core conservative politic to underfund any form of assistance and then use that to deny MAID, or abortions or recognize your full rights. I have unreserved and unwavering support for the right to abortion or MAID.
There is no pipeline of people getting euthanized because of cost. The "authorities" aren't telling folks to get dead, mainly because the M in MAID stands for Medically and those are actual professionals. While still fallible they are not "encouraging" MAID, and that's because the A stands for assisted. So some medical folks, and certainly not all of them, are available to enable people to exercise their right to die as an informed choice.
posted by zenon at 11:53 AM on October 20, 2023 [9 favorites]
My only personal connection to MAID involves a friend who chose this option after suffering years of debilitating pain due to a chronic neuro-muscular condition. From what I can tell, his experience very much aligns to what we'd hope would happen with this type of legislation: dignity, choice.
I'm am not in the least surprised that this end-of-life arrangement is running into fierce debate given the nature of the stakes, and the convergence with what appears to be increasing social pressures and reduction of cares and supports for others. I have little faith that we'll salvage anything once the Cons sink their teeth into this and emotions are whipped up some more. It's a shame.
posted by elkevelvet at 12:30 PM on October 20, 2023 [3 favorites]
I'm am not in the least surprised that this end-of-life arrangement is running into fierce debate given the nature of the stakes, and the convergence with what appears to be increasing social pressures and reduction of cares and supports for others. I have little faith that we'll salvage anything once the Cons sink their teeth into this and emotions are whipped up some more. It's a shame.
posted by elkevelvet at 12:30 PM on October 20, 2023 [3 favorites]
MAID isn't out there killing the cripples and impoverished. MAID isn't solving societies woes and balancing the CPP budget.
I've been to where Robert Latimer is from, way out in the grasslands in western Saskatchewan. Because it's exactly the sort place I was born and raised up. I know what poverty and disability are because I've lived it. I know what augers and industrial planers do to puny humans. I know what plastic looks like melted into most of your skin, because my cousin was helping burn brush piles. And they used gasoline to speed things up. The pain. The misery. The drugs.
I know why poor people will turn to MAID. I know why disabled people will lose all hope, why they will feel like a burden. Why they would choose death over living in our society. Because it's our society that strips some of its people down. It's our shared morality, the judgement that some people aren't just without value, but that some people degrade the community simply by existing as they were born. The politics that splits people only into takers and makers.
As a society we choose, every day, to turn away from supporting people. People in total despair are dying in staggering numbers of alcohol, drugs and suicide, but somehow MAID will be abused, its process bent to end peoples lives unnecessarily. So the conversation around MAID is dominated by edge cases and we will just keep the social policies that reinforces structural inequalities, perpetuate poverty and ignore disability.
posted by zenon at 12:46 PM on October 20, 2023 [13 favorites]
I've been to where Robert Latimer is from, way out in the grasslands in western Saskatchewan. Because it's exactly the sort place I was born and raised up. I know what poverty and disability are because I've lived it. I know what augers and industrial planers do to puny humans. I know what plastic looks like melted into most of your skin, because my cousin was helping burn brush piles. And they used gasoline to speed things up. The pain. The misery. The drugs.
I know why poor people will turn to MAID. I know why disabled people will lose all hope, why they will feel like a burden. Why they would choose death over living in our society. Because it's our society that strips some of its people down. It's our shared morality, the judgement that some people aren't just without value, but that some people degrade the community simply by existing as they were born. The politics that splits people only into takers and makers.
As a society we choose, every day, to turn away from supporting people. People in total despair are dying in staggering numbers of alcohol, drugs and suicide, but somehow MAID will be abused, its process bent to end peoples lives unnecessarily. So the conversation around MAID is dominated by edge cases and we will just keep the social policies that reinforces structural inequalities, perpetuate poverty and ignore disability.
posted by zenon at 12:46 PM on October 20, 2023 [13 favorites]
> And staff especially needs training and permission about when NOT to have this discussion, if that's the greater client benefit.
THIS. In general, I think it might be best for a patient's regular care team to not initiate conversations about MAID, especially when it comes to mental health issues or non-terminal illnesses.
It's one thing to know that there is a process you can use to seek MAID. It's another to have your doctor or social worker recommend it to you. Someone who is supposed to be working to improve your health or help you access social services shouldn't be the one telling you (in effect), "This is hard, and I don't think you're worth fighting for. Consider suicide." It would leave me wondering if that provider was trying to undermine my care.
I don't know what the best way would be to present information about MAID (a brochure? a conversation with a counselor who isn't otherwise involved in their care? a "I would like to learn about medical assistance in dying" checkbox in the pre-appointment paperwork?). But patients shouldn't feel like it's being pushed on them by the very people who are supposed to be keeping them alive. Let them know it's an option, but let them be the ones to initiate that conversation with their doctor.
posted by threecolorable at 12:47 PM on October 20, 2023 [5 favorites]
THIS. In general, I think it might be best for a patient's regular care team to not initiate conversations about MAID, especially when it comes to mental health issues or non-terminal illnesses.
It's one thing to know that there is a process you can use to seek MAID. It's another to have your doctor or social worker recommend it to you. Someone who is supposed to be working to improve your health or help you access social services shouldn't be the one telling you (in effect), "This is hard, and I don't think you're worth fighting for. Consider suicide." It would leave me wondering if that provider was trying to undermine my care.
I don't know what the best way would be to present information about MAID (a brochure? a conversation with a counselor who isn't otherwise involved in their care? a "I would like to learn about medical assistance in dying" checkbox in the pre-appointment paperwork?). But patients shouldn't feel like it's being pushed on them by the very people who are supposed to be keeping them alive. Let them know it's an option, but let them be the ones to initiate that conversation with their doctor.
posted by threecolorable at 12:47 PM on October 20, 2023 [5 favorites]
(By the way, I'd say that that first case was someone who got MAID for mental illness, compounded by the malpractice of doctors telling her she had a disease that doesn't exist ("MCS") instead of working on resolving what I'm sure was genuine physical and emotional distress--persuading her that she was going to be forever in misery because the government wouldn't build her an [unattainable] "chemical-free" residence.)
posted by praemunire at 3:20 PM on October 20, 2023 [3 favorites]
posted by praemunire at 3:20 PM on October 20, 2023 [3 favorites]
a conversation with a counselor who isn't otherwise involved in their care?
I think the best thing would be to have people who are actually trained and specializing in presenting this information, perhaps the same specialists who manage palliative care, which comes closest to implicating the same issues, instead of expecting every harried GP to present the option in a sensitive, nuanced, non-coercive way in a 15-30 min. appointment.
posted by praemunire at 3:22 PM on October 20, 2023 [1 favorite]
I think the best thing would be to have people who are actually trained and specializing in presenting this information, perhaps the same specialists who manage palliative care, which comes closest to implicating the same issues, instead of expecting every harried GP to present the option in a sensitive, nuanced, non-coercive way in a 15-30 min. appointment.
posted by praemunire at 3:22 PM on October 20, 2023 [1 favorite]
I’ve witnessed the way MAID (or rather the “end-of-life option”) works in California, which is similar to how it works in a number of other U.S. states - you pretty much have to be a terminal patient, a couple of doctors have to sign off, they prescribe you a massive overdose of drugs which you have to take orally of your own volition - and I came away very much in favor of it. I think most other people would, too. My experiences also sharply illustrated some of the limitations of this model, particularly the reasons that it might be desirable to allow doctors to administer euthanasia directly, but that seems to multiply the ethical questions. Making the option available to people without a directly terminal condition does so more drastically. I don’t know what else to say about it.
posted by atoxyl at 5:28 PM on October 20, 2023 [2 favorites]
posted by atoxyl at 5:28 PM on October 20, 2023 [2 favorites]
The Canadian Association of MAiD Assessors and Providers (the influence of which I have no idea) has a guide for health care workers on how the topic should be broached.
The guideline argues that the topic must be broached with eligible patients as part of informed consent, but is clear that the obligation is to inform, and categorically not to suggest or encourage the option.
It also has a training curriculum for nurses and doctors.
posted by senor biggles at 4:55 AM on October 21, 2023
The guideline argues that the topic must be broached with eligible patients as part of informed consent, but is clear that the obligation is to inform, and categorically not to suggest or encourage the option.
It also has a training curriculum for nurses and doctors.
posted by senor biggles at 4:55 AM on October 21, 2023
This article made me understand why that old-school, Nazi-style fascism was attractive--you can't have a society constantly proclaiming that every life is precious yet putting down the poor and inconvenient just like sick dogs or cats. You're going to have to either provide more supports or just come out and say that certain people deserve to die, so it's less emotionally stressful to euthanize them.
posted by kingdead at 6:04 AM on October 21, 2023 [3 favorites]
posted by kingdead at 6:04 AM on October 21, 2023 [3 favorites]
Once again, I want to point out that American society has accepted that a certain population of American citizens has to be homeless in order for the economy to continue functioning as it is.
We have accepted that.
Knowing how dangerous being homeless is, knowing that it will drastically shorten peoples' lives, knowing it will traumatize them, knowing how incredibly awful it is. Knowing some of them are children.
We have accepted that.
The idea that we don't believe that some people deserve to die is pretty ridiculous. We prove every day that we believe that. We just don't say it out loud.
We've already cast them out of society to die. How is offering them the opportunity for a peaceful death worse?
posted by MrVisible at 7:03 AM on October 21, 2023 [4 favorites]
We have accepted that.
Knowing how dangerous being homeless is, knowing that it will drastically shorten peoples' lives, knowing it will traumatize them, knowing how incredibly awful it is. Knowing some of them are children.
We have accepted that.
The idea that we don't believe that some people deserve to die is pretty ridiculous. We prove every day that we believe that. We just don't say it out loud.
We've already cast them out of society to die. How is offering them the opportunity for a peaceful death worse?
posted by MrVisible at 7:03 AM on October 21, 2023 [4 favorites]
Most societies aren’t euthanizing the poor as a matter of course, unless the lack of supports now constitutes putting them down. Also, every first world nation has homeless people - this social problem has not been solved by anyone, as far as I know.
posted by Selena777 at 7:07 AM on October 21, 2023
posted by Selena777 at 7:07 AM on October 21, 2023
MAID is also not "euthanizing the poor" and it is incredibly problematic that people are talking about it in those terms.
posted by Gerald Bostock at 8:31 AM on October 21, 2023 [5 favorites]
posted by Gerald Bostock at 8:31 AM on October 21, 2023 [5 favorites]
Metafilter is so hypocritical in what is allowed for an adult to do whatever they want with their life.
I never understand why some people choose one side of a list of comments and then apply a characterization to the mythical monolith “Metafilter”. I see multiple people on both sides of this conversation.
posted by Glinn at 8:52 AM on October 21, 2023 [1 favorite]
I never understand why some people choose one side of a list of comments and then apply a characterization to the mythical monolith “Metafilter”. I see multiple people on both sides of this conversation.
posted by Glinn at 8:52 AM on October 21, 2023 [1 favorite]
I understand that that’s not what this is, Gerald Bostock, I believe that this program is sort of under attack. I was responding to kingdead’s comment.
posted by Selena777 at 9:33 AM on October 21, 2023
posted by Selena777 at 9:33 AM on October 21, 2023
The MAID discussion revisits conversations I've heard down here in the States. The greater bureaucracy never handles this sort of thing well. Remember the Kevorkian trials? So the conversation begins with, "If they no longer want to live, let's help them die." It's only downhill from there.
MrVisible mentioned how American culture conglomeration has resolved specific humanitarian issues. A related issue not mentioned is how some male American movers and shakers seem to think they know more about American women's healthcare needs than women do, and they have the Bible verses to prove it. Sort of.
As I approach my eighth decade, I undergo yet more bouts of chemo, this time for a different cancer than the one whose ass I kicked via a stem-cell transplant about twenty years ago. My current treatment is incredibly expensive (as was the last one). One item on my last blood test cost $12,000. I have another three months of chemo before the docs decide whether they may successfully excavate my innards without killing me. Even then, odds are one in ten that I'll survive the mythical 5-year period afterward.
Why is this relevant? I have probably the best healthcare plan available in America. That's why I'm alive today. Any lesser plan would not have provided for frontline treatment. Soon enough, I'll likely be offered palliative care. I will have options, one being that I get to pull my plug if I want to do that. If you make a bell curve of my situation (options for treatment), I believe you'll find that I'm on the small end of the small end of the curve.
There's the rub. In short, the problem is not with a reasoned opinion--we should have a legal right to choose our manner of death; it's with the details: who gets to have the authority to usher us into the great void.
In a perfect world, intelligence will inform compassion to elevate the universal human condition. I won't hold my breath for that eventuality. For now, I would rather have the decision to kill or let die left to the patient with an incurable disease or to caregivers to whom the patient has granted the decision.
Canada: I'm not trying to speak for you. Or anybody else.
posted by mule98J at 10:01 AM on October 21, 2023 [2 favorites]
MrVisible mentioned how American culture conglomeration has resolved specific humanitarian issues. A related issue not mentioned is how some male American movers and shakers seem to think they know more about American women's healthcare needs than women do, and they have the Bible verses to prove it. Sort of.
As I approach my eighth decade, I undergo yet more bouts of chemo, this time for a different cancer than the one whose ass I kicked via a stem-cell transplant about twenty years ago. My current treatment is incredibly expensive (as was the last one). One item on my last blood test cost $12,000. I have another three months of chemo before the docs decide whether they may successfully excavate my innards without killing me. Even then, odds are one in ten that I'll survive the mythical 5-year period afterward.
Why is this relevant? I have probably the best healthcare plan available in America. That's why I'm alive today. Any lesser plan would not have provided for frontline treatment. Soon enough, I'll likely be offered palliative care. I will have options, one being that I get to pull my plug if I want to do that. If you make a bell curve of my situation (options for treatment), I believe you'll find that I'm on the small end of the small end of the curve.
There's the rub. In short, the problem is not with a reasoned opinion--we should have a legal right to choose our manner of death; it's with the details: who gets to have the authority to usher us into the great void.
In a perfect world, intelligence will inform compassion to elevate the universal human condition. I won't hold my breath for that eventuality. For now, I would rather have the decision to kill or let die left to the patient with an incurable disease or to caregivers to whom the patient has granted the decision.
Canada: I'm not trying to speak for you. Or anybody else.
posted by mule98J at 10:01 AM on October 21, 2023 [2 favorites]
Post edit: I meant to say one of the bags they hung on my infusion pole cost $12,00.
posted by mule98J at 10:08 AM on October 21, 2023
posted by mule98J at 10:08 AM on October 21, 2023
It's nice you have that insurance, and those options.
Did you know, we don't even count how many homeless people have cancer?
This is from Navigating the Homeless Patient Through Cancer Care from Oncology Nurse Advisor. It's the conclusion of the article.
Did you know, we don't even count how many homeless people have cancer?
Although information on homelessness and cancer is limited, research on the veteran population provides some foundation for data. Hwa, Dua, Wren, and Visser (2015) found that, of 90 veterans with hepatocellular cancer, 30% were homeless and 21% lived with a family member, with a friend, or in a trailer; the others were able to rent (26%) or own (23%) a home, with 15% receiving housing assistance. Hepatocellular cancer was the second most commonly occurring cancer in Baggett, Hwang, et al.’s (2013) research.So, is a peaceful death a privilege to be reserved only for the wealthy? If you have the choice, why shouldn't they?
Historic documents have noted that adequate housing affects health outcomes. In general, the mortality rate is three times higher for homeless veterans than for those who live in a home (Gabrielian, Yuan, Andersen, Rubenstein, & Gelberg, 2014).
...
When oncology nurses think of palliative care, the concept of people with cancer living their lives comfortably in their homes, surrounded by loving support from their family, friends, and healthcare team, may emerge. Unfortunately, people who are homeless do not have this experience (Biedrzycki, 2017).
This is from Navigating the Homeless Patient Through Cancer Care from Oncology Nurse Advisor. It's the conclusion of the article.
As a healthcare community, we must anticipate treating patients who are homeless. Some will remain homeless throughout the course of treatment, whereas others may intermittently have temporary shelter. Some may eventually have better community support engagement or even reach out to an estranged family member for help, and others will choose to limit contact. Realizing that there may not be an ideal solution, and that we may not be able to fix the problem are important considerations.posted by MrVisible at 11:13 AM on October 21, 2023 [1 favorite]
It's nice you have that insurance, and those options.
I bought that insurance with eight years of my life in the US Army, and a medical discharge for a blood disease that didn't even have a name at the time. When the myeloma kicked in twenty years ago, the VA fortuitously listed it under one of their Agent Orange events. The chain of care in the VA system snapped taut, and I was saved. There's no way the jobs I liked to work would have provided me with that level of care.
My parents, siblings, and most of my nephews and nieces were not so lucky about the insurance end of that particular shit sandwich. We lived well below the poverty level until I joined the Army. People like us don't have good insurance plans, and I know very well that we were not quite at the bottom rung as classes were evaluated.
I am lucky because the more or less random life choices I made let me have six or eight of my nine lives free. Had I actually been entitled (as I understand the way this word is used nowadays) I would have been too "entitled" to join the Army, but not quite entitled enough to work at any but a wage earner's job. As it was, the VA let me go to school and get too smart for my own good, but I am not complaining about never having fitted into the mainstream.
posted by mule98J at 5:04 PM on October 22, 2023 [2 favorites]
I bought that insurance with eight years of my life in the US Army, and a medical discharge for a blood disease that didn't even have a name at the time. When the myeloma kicked in twenty years ago, the VA fortuitously listed it under one of their Agent Orange events. The chain of care in the VA system snapped taut, and I was saved. There's no way the jobs I liked to work would have provided me with that level of care.
My parents, siblings, and most of my nephews and nieces were not so lucky about the insurance end of that particular shit sandwich. We lived well below the poverty level until I joined the Army. People like us don't have good insurance plans, and I know very well that we were not quite at the bottom rung as classes were evaluated.
I am lucky because the more or less random life choices I made let me have six or eight of my nine lives free. Had I actually been entitled (as I understand the way this word is used nowadays) I would have been too "entitled" to join the Army, but not quite entitled enough to work at any but a wage earner's job. As it was, the VA let me go to school and get too smart for my own good, but I am not complaining about never having fitted into the mainstream.
posted by mule98J at 5:04 PM on October 22, 2023 [2 favorites]
I'm very sorry that you're having to go through this, but I'm very glad you don't have to worry about your medical care as you do.
I've never quite fit into the mainstream myself, which is why joining the service was never in the cards; queer people weren't particularly welcome back in the 80s.
I'm curious as to why you believe that the option of a peaceful death should be limited to people with incurable diseases. Would drug addiction qualify? What about depression? Psychological conditions which cause enormous distress? What about chronic diseases which cause immense pain and distress, but won't kill you for decades?
And now the worst one... why is it wrong to offer a painless death for economic reasons? We've made poverty stunningly awful, deliberately, in this country. I've expressed my outrage about that a few times here. Why is offering the option of a peaceful death worse than what we've already done to people?
For the past seventy years, suicide statistics have been pretty steady: men kill themselves at a rate of 17 to 23 per 100,000, and women at between 5 and 7 per. And the way we do it now, nearly every one of those involves traumatized bystanders, pain, awfulness... well, you know.
I think I was heavily influenced as a youth by the thanatorium scene in Soylent Green. That's how I want to go out, right there. Death in an IMAX pleasure dome.
posted by MrVisible at 7:33 PM on October 22, 2023 [1 favorite]
I've never quite fit into the mainstream myself, which is why joining the service was never in the cards; queer people weren't particularly welcome back in the 80s.
I'm curious as to why you believe that the option of a peaceful death should be limited to people with incurable diseases. Would drug addiction qualify? What about depression? Psychological conditions which cause enormous distress? What about chronic diseases which cause immense pain and distress, but won't kill you for decades?
And now the worst one... why is it wrong to offer a painless death for economic reasons? We've made poverty stunningly awful, deliberately, in this country. I've expressed my outrage about that a few times here. Why is offering the option of a peaceful death worse than what we've already done to people?
For the past seventy years, suicide statistics have been pretty steady: men kill themselves at a rate of 17 to 23 per 100,000, and women at between 5 and 7 per. And the way we do it now, nearly every one of those involves traumatized bystanders, pain, awfulness... well, you know.
I think I was heavily influenced as a youth by the thanatorium scene in Soylent Green. That's how I want to go out, right there. Death in an IMAX pleasure dome.
posted by MrVisible at 7:33 PM on October 22, 2023 [1 favorite]
This is clickbait; this feels like reading the Toronto Sun or similar.
MAID is controversial all around. No one is marching people to death camps. I doubt it will even get passed because there is just too much controversy about its application.
This is a terrible article and it is clearly written for shock value. The fact is that Canada already has in place legislation that will extend MAID availability to those with 'only' mental illness from March 2024. Nothing needs to be passed for this to happen.
I'm very much in favour of medically-assisted suicide, but there's a whole minefield around informed consent for someone who has a mental illness serious enough that medical professionals would agree death is their best option.
posted by dg at 7:56 PM on October 22, 2023 [1 favorite]
MAID is controversial all around. No one is marching people to death camps. I doubt it will even get passed because there is just too much controversy about its application.
This is a terrible article and it is clearly written for shock value. The fact is that Canada already has in place legislation that will extend MAID availability to those with 'only' mental illness from March 2024. Nothing needs to be passed for this to happen.
I'm very much in favour of medically-assisted suicide, but there's a whole minefield around informed consent for someone who has a mental illness serious enough that medical professionals would agree death is their best option.
posted by dg at 7:56 PM on October 22, 2023 [1 favorite]
I have orbited the gravitational pull of PTSD for about fifty years. Some of my veteran friends have committed suicide. They made that choice. I can't help but think that rather than wanting to die, they just wanted "IT" to stop. At some point, mental anguish over the fucking internal movie intersects with the soul-draining and sheer fatigue of struggling with physical pain.
But here's the difference I see. A person's agency is always compromised by bureaucratic oversight. I have seen providers manipulate hospice care to favor a continuing infusion of Medicare (or other insurance providers). Please allow me to avoid trying to describe these details. We understand the concept of "being in one's right mind" the same way that we understand how the universe came into existence: lots of theories in a constant state of flux. I remain skeptical of the bureaucracy's role in such a decision.
The exchange here on the Blue has run me aground. I realize the bureaucracy can push uniformly on all of us. My friends' suicides cleared my head of objectivity. They just wanted it to stop. After grief comes anger and guilt over the anger, and the rollercoaster ride begins again. In my distant past, I seriously considered suicide, but I changed my mind after a lengthy period of painful introspection. I am grateful that a bureaucracy wasn't involved during my lowest cycle, even if it was trying to be helpful, wanting to help me out the door.
The difference between "Finding a place for Mom" and depositing her in a low-budget warehouse is too depressing to imagine. How does the MAID theory navigate those waters?
posted by mule98J at 9:40 AM on October 23, 2023 [2 favorites]
But here's the difference I see. A person's agency is always compromised by bureaucratic oversight. I have seen providers manipulate hospice care to favor a continuing infusion of Medicare (or other insurance providers). Please allow me to avoid trying to describe these details. We understand the concept of "being in one's right mind" the same way that we understand how the universe came into existence: lots of theories in a constant state of flux. I remain skeptical of the bureaucracy's role in such a decision.
The exchange here on the Blue has run me aground. I realize the bureaucracy can push uniformly on all of us. My friends' suicides cleared my head of objectivity. They just wanted it to stop. After grief comes anger and guilt over the anger, and the rollercoaster ride begins again. In my distant past, I seriously considered suicide, but I changed my mind after a lengthy period of painful introspection. I am grateful that a bureaucracy wasn't involved during my lowest cycle, even if it was trying to be helpful, wanting to help me out the door.
The difference between "Finding a place for Mom" and depositing her in a low-budget warehouse is too depressing to imagine. How does the MAID theory navigate those waters?
posted by mule98J at 9:40 AM on October 23, 2023 [2 favorites]
And now the worst one... why is it wrong to offer a painless death for economic reasons? We've made poverty stunningly awful, deliberately, in this country. I've expressed my outrage about that a few times here. Why is offering the option of a peaceful death worse than what we've already done to people?
I think the disconnect here is that people are actually afraid of something different - they are afraid that such a peaceful death would not be offered. It would be compelled, or at least encouraged. The fear is not of assisted suicide just itself, the fear is that assisted suicide would be recommended to people who are seeking other solutions; that people who would very much like to keep on living, and are seeking solutions for difficulties, might be encouraged to not live any more instead of anyone trying to help them with those difficulties. And I think I am inclined to agree.
I think I was heavily influenced as a youth by the thanatorium scene in Soylent Green. That's how I want to go out, right there. Death in an IMAX pleasure dome.
Yes, but even here, Ernest Borgnine was CHOOSING to go to the thanatorium. He brought himself there, he had made that decision himself, he had considered the alternatives and chose that for himself. No one was compelling him or persuading him to make that choice.
Meanwhile - compare that scene to a similar scene from Cloud Atlas. One of the plot threads in that film also deals with the future; a future in which cloning is possible, and these clones perform the minimum-wage jobs like Fast Food Servers and such. The clones all live "in the shop", and are told that after twelve years all clones get to retire and are given a free trip to a retirement home in Hawaii. But one of the clones discovers that instead, they're killed and processed into this cheap goop that they feed to the clones. In the scene where we see this, we follow a bunch of clones into the "processing station" where they're told their paperwork for their retirement just needs to be processed - but it's actually a slaughterhouse and they're killed, thinking until the very last that they are about to head off to Hawaii.
You're thinking of the thanatorium - others are thinking of the Xultation scene from Cloud Atlas. That's why we have a disconnect.
posted by EmpressCallipygos at 10:34 AM on October 23, 2023 [1 favorite]
I think the disconnect here is that people are actually afraid of something different - they are afraid that such a peaceful death would not be offered. It would be compelled, or at least encouraged. The fear is not of assisted suicide just itself, the fear is that assisted suicide would be recommended to people who are seeking other solutions; that people who would very much like to keep on living, and are seeking solutions for difficulties, might be encouraged to not live any more instead of anyone trying to help them with those difficulties. And I think I am inclined to agree.
I think I was heavily influenced as a youth by the thanatorium scene in Soylent Green. That's how I want to go out, right there. Death in an IMAX pleasure dome.
Yes, but even here, Ernest Borgnine was CHOOSING to go to the thanatorium. He brought himself there, he had made that decision himself, he had considered the alternatives and chose that for himself. No one was compelling him or persuading him to make that choice.
Meanwhile - compare that scene to a similar scene from Cloud Atlas. One of the plot threads in that film also deals with the future; a future in which cloning is possible, and these clones perform the minimum-wage jobs like Fast Food Servers and such. The clones all live "in the shop", and are told that after twelve years all clones get to retire and are given a free trip to a retirement home in Hawaii. But one of the clones discovers that instead, they're killed and processed into this cheap goop that they feed to the clones. In the scene where we see this, we follow a bunch of clones into the "processing station" where they're told their paperwork for their retirement just needs to be processed - but it's actually a slaughterhouse and they're killed, thinking until the very last that they are about to head off to Hawaii.
You're thinking of the thanatorium - others are thinking of the Xultation scene from Cloud Atlas. That's why we have a disconnect.
posted by EmpressCallipygos at 10:34 AM on October 23, 2023 [1 favorite]
The Big Story: Will MAiD changes give drug users access to assisted death?
posted by ignignokt at 4:28 PM on October 31, 2023 [1 favorite]
Substance use disorders may qualify under mental illness, so ... yes, drug users may be able to apply for MAiD. But that's a long way from saying their application will be granted. Today, a trip through the subtlety often missing in discussions of this controversial policy.If you're worked up about this, this is a good listen.
GUEST: Jocelyn Downie, Professor Emeritus at the Faculties of Law and Medicine, Dalhousie University; works at the intersection of health care ethics, law, and policy
posted by ignignokt at 4:28 PM on October 31, 2023 [1 favorite]
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posted by ivan ivanych samovar at 9:05 PM on October 19, 2023 [23 favorites]