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The troubled 29-year-old helped to die by Dutch doctors (bbc.co.uk)
19 points by gadders 5 months ago | hide | past | web | favorite | 50 comments

This specific case aside, I don't understand what the big deal with euthanasia is in more clear-cut cases. Why is it not possible for terminal cancer patients (or similar terminal diseases) abroad? It seems we have run this long enough to prove that, yes, it is possible to run this system without apparent abuse.

And in this specific case, please keep in mind that it is so exceptional that it made international news. Both the Netherlands (RTL, as mentioned) reported on it as well as apparently the BBC. It's not as if we go along with every teen's death wish, and as the article says, "the process can take years". It's on the long side rather than short, as you have all the time in the world to reconsider, but also all the time in the world to suffer more. My grandfather had it finally arranged and was looking forward to it, but it was scheduled for a week after he died naturally. Poor man. This really is not about giving up on someone or saying someone doesn't deserve to live.

The main argument I've heard against euthanasia (excluding religious ones) is that it may induce an obligation or pressure for terminally ill people to die. People with terminal diseases can be a financial and emotional burden on their family and society, which may cause family members or doctors to coerce patients to be euthanized.

So far, in places where euthanasia is legal, this isn't the case. I doubt it ever will be, but I can understand how people can fear widespread euthanasia for that reason.

Worse than that, it can provide an avenue for people who commit crimes to ... shall we say encourage what, for them, would be a solution.

> It seems we have run this long enough to prove that, yes, it is possible to run this system without apparent abuse.

Careful extrapolating successes/failures across cultures. Different peoples and different societies are much more amenable to abuse than others. It's less about their innate humanness and more about the societal structures in which they live and justified/unjustified faith (or lack of) in institutions and oversight bodies.

> I don't understand what the big deal with euthanasia is in more clear-cut cases

Is it avoided/discouraged because it is an irrevocable act.

Many people believe that murderers "deserve" death and yet are reluctant to systemically end the lives of convicts even in "clear cut cases." What if the process, despite it being slow and deliberate and involved still gets it wrong?

Forcing someone to die slowly in agony is also an irrevocable act. There's more than one way to get it wrong.

Yeah, same with making someone rot in prison for a lifetime.

I understand that.

"How could I know - how could anybody know - that her death wish was not a sign of her psychiatric disease? The fact that one can rationalise about it, does not mean it's not a sign of the disease,"

Words cannot express how grateful I am that suicide was not an endorsed or approved option for me in my younger years.

What was it that helped you?

Rather than pretending suicide isn't an option, putting it in its rightful last place is helping me manage my emotions. I'm a conscientious objector. If someone gives me a gun and tells me to shoot someone else, I'd rather turn it upon myself than kill another person.

Life sucks. Right now I'm going through a really tough time. So bad that I wanted to Shut Down. But instead I chose to Reboot. Got a plane ticket, flew on Wednesday, and now I'm 10,000 km from the problems and very relieved. I really, really hope that I can find a new job and restart life soon - my savings won't last more than a couple of months. But this is an emergency.

If it doesn't work out, becoming a monk is another possibility to retreat from the world. And if that doesn't work out, then perhaps prison. And extremely dangerous career choices, such as war zone photography. Bad circumstances will drive me to those first, before I'd hurt myself. If you're not afraid of death, you're fearless! You're free! That courage can be used to help people. Please try that first.

For people wanting to help, don't ask "What happened?" - that focuses on the problem. Say "Are you OK?", "What can I do to help you?" if you care about the solution.

I didn't get the chance to reboot, it was more like a hard reset. Good luck, friend. :)

I have 5 chronic diagnoses all considered separate (physical and mental) but in truth there is some underlying correlation between them.

The first thing I tackled was my sleep disorder, followed by being aggressive about reducing the stresses in my life that I could control. The sleep bit was more controlling routine than medicine- pretty much ever sleep pill was worthless for one reason or another.

It took a few years, but finally I was art a point where I could comfortably cope with everything but any sort of long term stress would bring back depression and anxiety. Lexapro has been amazing in that regard.

Ultimately, friends, family, and the private shame of how selfish my thoughts were kept me going, forcing a discipline, reducing stress, a few months of therapy and now medicine, and I feel like I haven't in 15 years.

I know someone who has survived multiple suicide attempts, BPD, Bipolar, Clinical Depression, etc. They went through hell, had convulsive shock therapy, a decade of therapists and experimental drugs that could kill you. They now live a perfectly normal happy life.

There is light at the end of the tunnel. There is so much good in this world it is worth all that and more to hang on and see it through.

We should have headlines that read "Troubled 29-year-old helped to live by Dutch doctors" We should not embrace euthanasia we should embrace every individuals inherent worth, they deserve love not poison.

I know exactly how people feel for them and say it is their right. Indeed it is the open door. It is always available, you need to simply walk through it. I would hope that we on this side of it would be begging people not to go rather than shoving them through it. It is no great thing to put someone to death, no matter how it makes us feel about it they will never have the chance to feel anything.

Yet for every story akin to this there is one of someone who's unable to get desired help, despite years of trying. Of mental health services that are unavailable or under-funded, or go through shit for most of their life. All the while living in countries that don't have euthanasia available, even for terminal cases.

We are already "begging" people not to go - that leads to the efforts to turn it into a huge guilt trip as often practised by church dignitaries when discussing euthanasia - both in the specific or abstract. Also, as described in the article, they have to validate their state of mind with others first.

Neither should we be shoving them through it.

Can't we just accept that sometimes someone has actually had enough and let them make their own minds up? Their life might actually be shit, and it is they that have to live it.

The fact that it rare enough to be headline worthy, yet the thousands of cases who go through a temporary acute crisis and hang or shoot themselves aren't speaks volumes don't you think?

I know exactly how you feel, I get that argument. I choose to disagree on moral grounds. I know it is so easy to disregard my position. But here is just one thing to consider.

It is far cheaper to provide assisted suicide than to provide social support, medical support and guidance. When we have all these baby boomers headed for infirmity and assisted living lacking the funds to pay for it, make no mistake. You will see suicide made out to be heroic, it will be lifted up. Death with dignity will be promoted with unassailable stories. But you will never hear of the lives, of those silenced ultimately because of an economic reality. We should choose to lift up life even when it hurts to affirm the great dignity of each person. Because an emotional story can become the authorization in a bureaucratic system to wipe people away to save money.


No disregard of your personal position - I respect your right to choose your own outcome and hold life sacred for you and yours.

I get uncomfortable when it's others imposing the belief that a life is "sacred". I might then be forced to die slowly, and extremely painfully, over some years having been diagnosed with terminal cancer. Having seen that with my father, though he received superb palliative care, no thank you.

I've heard the killed for cost argument many times over the thirty or so years since it became a regular media topic in the UK. It;s roughly 20 since Netherlands legalised euthanasia, maybe more. The reality doesn't seem to bear any resemblance to your predictions; the vast majority in the Netherlands are still in favour of the law (over 90% I think), yet the numbers taking euthanasia are still low. The requirement for medical second and third opinions should prevent unpleasant relatives pushing granny under the bus or the state seeking to save cash. A universal healthcare system undoubtedly helps distance the patient from the cost implications.

Even having passed all the the hurdles, with an advance directive completed beforehand, it's not guaranteed euthanasia will result. If you haven't completed an advance directive and are not in sound mind, it's simply not available. In other words it's not a policy decision, it's a personal and medical one.

It's been just over a year since my last suicide attempt that left me in a coma for under a month and subsequently left me unable to use my legs. It's been a hard journey learning to walk again, and I did my first 20k steps this morning. My left pinky is a little numb, and I'm not sure if it's placebo but some of the feeling is coming back. And I'm excited to get back to playing Holdsworth licks again.

Life is what it is. But I would prefer it if there was an easy and painless means to end one's life. Human right means nothing without the right to die without pain, and with dignity.

I find that many if not most people on HN are atheists. I was for 35 years. No longer, that is long story for some other time but I will pray for you and hope that by the grace of God you recover and find true joy and peace in this life.

Thank you, friend.

I've always felt that euthanasia gives people a better chance by potentially turning a suicide attempt into a chance for medical intervention before it happens. How do you know that this is a net negative?

With all sincerity it is based on logic and reason enlightened by faith. http://www.usccb.org/issues-and-action/human-life-and-dignit...

That page is just full of links, so I'm not sure what I'm supposed to be getting from it. Are you saying that you don't care whether the availability of euthanasia increases or decreases the death rate for people with psychological problems?

How did you get better? Please be detailed.

I can't completely speak for this person, a close relative. I don't and maybe she does not either, know exactly what it was that worked. It took a long time, many steps forward and backward. I would simply say seek professional help.

Did they credit any particular treatment with their recovery?

It is not worth getting into the details. CT did make a big impact. Ultimately it is very complicated and every case is unique.

Edit: I would also add Cognitive Behavioral Therapy and group and talk therapy as well as ongoing engagement with professionals in general was essential.

What is and is not a psychiatric disease seems as subjective as what is and is not a crime. A growing understanding of psychiatric illness has yielded at least some good. But claims of psychiatric disease have also been abused for great evil. What constitutes mental illness will continue to evolve. Perhaps if the future is dystopian, suicidal tendencies will be treated as a normal, healthy reaction to everyday life. What should and should not die will remain a difficult question, but maybe suicide will be treated as a liberty. The human condition is far more than the labels we place on kinds of people and the kinds of lives they live.

> but maybe suicide will be treated as a liberty

It is a liberty, it's the closest thing we have to a truly inalienable right, mostly by virtue of being un-punishable. Short of strapping someone to a bed permanently it's impossible to forcibly prevent.

As a non-lethal alternative, couldn't we have a "social suicide"? Maybe some mechanism to erase all non-criminal records of a person and restart them on a different place, with a different name? Perhaps it couldn't cover cases of severe mental disease, but it could help many.

Saying "yes ok lets kill you" just says "yes you are not worth saving"

I see and feel your point. As a doctor who has worked with people with severe mental health issues I can imagine nothing worse than experiencing what they do. This must be especially agonising for someone so young, who will have to experience this her whole life.

That said, I'm not sure I could be part of euthanasia in a case like this. This one is very tricky with the mental state to consider. Also, what if a new treatment for some of her conditions arise within a few years? Unfortunately, progress in psychiatry is slower than probably all other medical fields.

I agree this is very difficult. But saying "Also, what if a new treatment for some of her conditions arise within a few years? " is not fair to the person who is suffering at the moment.

After seeing some old people have miserable lives during their last few years I think we should give people the option to leave life in diginity if they want to.

> After seeing some old people have miserable lives during their last few years I think we should give people the option to leave life in diginity if they want to.

In my way of thinking, a person is not "old" until they have lived past their "expiration date". Everyone reaches their expiration date at a different time. One woman told me she immediately thought of her first husband when the idea of people having expiration dates came up: he'd died from getting electrocuted while working on a ceiling fan. At the time they had young kids and losing her husband was traumatic, but retrospectively she realized he actually had very little drive to live.

Both my grandfathers lived past their expiration date, as they were kept alive by artificial means for an extra 5-10 years. But once those pacemakers were installed, it was easier to keep them running than to turn them off.

Conservative care is much kinder for old people than modern medicine. Since doctors don't have to care about cost, it's easy to use any measure to keep their patient alive, even when it's not very appropriate.

is not fair to the person who is suffering at the moment

No, it's not fair. I don't have a good answer.

After seeing some old people have miserable lives during their last few years

Absolutely. Some people suffer terribly at the end of their lives. This is the type of euthanasia I support.

Please don't post unsubstantive comments, especially on a difficult topic like this one where emotions are guaranteed to run high.

Although I'm pro-euthanasia in a medical sense, I don't think it's fair to dismiss GP's comment like that. There was definitely substance to it, and that substance is worth thinking about, even if you sit on the other side of the fence.

If you disagree, say why you disagree. Don't just say "your viewpoint has no substance".

I agree. Maybe I’m ignorant, but I’d never thought about the topic that way, about the bind it puts the doctor in when you say you want to die, and how that interplays with the impact on mental health. I also think the comment was a succinct way to communicate that insight.

I'm particularly fond of succinct insights. It gives you time to think. Paragraphs of disclaimers and apologies distract from insights IMHO.

It's not a question of disagreeing. That comment was glib and reductionist. People need to do better than that here, especially on divisive topics. The replies to my objection were far more substantive than the original comment, proving that this is easy enough to do if people want to.

My rephrasing of the insight took about 3x as many words; it's generally a good thing when you can convey the same insight with fewer.

I get what you mean about trite, inflammatory comments, but I don't think the one you're objecting to qualifies. It points out a non-obvious implication of accepting someone's request to die. I see a clear difference between that and something like, "sure, let everyone who feels hopeless die, that sure saves money on people who aren't worth saving!".

Those replies also appreciated that "glib and reductionist" comment.

I think that's a very valid point by the GP. It's true that it's easier to kill someone when they want to die, rather than help them.

For some reason, mental/emotional problems are not treated differently from physical ones here, it's perverse. Some physical problems we don't have the technology to heal, allowing people relief from the pain they suffer from them is reasonable. But I'd wager the large majority of mental and emotional problems can be healed, given enough care, time and love.

But love is in short supply already, so may be that's not reasonable.

I have had psychiatric care for over half my life. The medicine I get do not work and I have tested everything the doctors have prescribed to me. None of the medicines work. I have had the feeling of hopelessness and the will to die for a very long time. If this was an option in my country I would jump at the chance. When an animal suffers you put it down. You do not keep it alive for as long as possible. That is barbaric. The indifference the doctors have is not helping either. That the nurses treat you as a child is infuriating. Nurses come as close to going over to baby speech as possible. I would love to know the drugs she drank.

https://www.nami.org/ is a great organization there are chapters in every state, lots of programs like peer-to-peer https://www.nami.org/Local-NAMI/Programs?classkey=7b7ca6ea-b...

Please please do not act on those thoughts. Continue on with therapy. Find others who have gone through similar experiences. Find joy in life despite the presence of all the hopelessness. It can be done! I want you to know even if it matters nothing to you I will be praying for you.

I understand if you choose not to answer this. You say you would jump at euthanasia. Why do you not just take your own life in a more "conventional" way?

I think most of us have this idea that if we don't take a drastic attempt like jumping off a bridge or hanging from a ceiling fan, we aren't suffering enough. In my case, I suppose I was looking for something painless hence a bottle of pills.

Perhaps our biological instinct for survival simply kicks in and whereas many people all throughout history have taken direct/bloody route to an exit, some of us just can't seem to do it.

Things are usually structured to prevent suicides. For example windows in tall buildings are locked, helium gas for balloons is now mixed with oxygen.

Most methods have non zero chance of survival and consequences.

You weren't built to kill yourself, you were built to survive. That makes it difficult to harm yourself even if it would allow escape.

The world has too many people, why not let those who want to leave leave

The more guaranteed conventional ways tend to leave a body for someone to be traumatized by.

Was she killed because she was incompatible with society?

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