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Comment by llm_nerd | Hacker News Reader

"If you're undecided about this"

As with many things, it's a very slippery slope and it is far more nuanced and not easily "decided".

MAiD for someone in the final stages of a terminal illness is a far cry from government workers suggesting MAiD to a healthy paralympian veteran asking for a wheelchair ramp (https://www.cbc.ca/news/politics/christine-gauthier-assisted...). And of course we have expanded MAID to people suffering from mental illnesses, and it's something people are pursuing now because they can't afford rent. Oh and the government is recommending that MAiD be expanded to minors.

And FWIW, we've long had MAiD - people with terminal illnesses usually got ever escalating doses of painkillers until their body gives up. It's more formalized now, but as with almost everything people with "good intentions" push it to the point where something simple becomes hugely contentious.

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> MAiD for someone in the final stages of a terminal illness is a far cry from government workers suggesting MAiD to a healthy paralympian veteran asking for a wheelchair ramp

Yeah, this has pushed me from being roughly in favor of allowing it to considerable caution. It may or may not be OK for people to make the decision for themselves, but it absolutely is wrong to push people to it.

Don't overweight rare examples. This is basically the only one that I ever see brought up too because it was a fuck up. Plus it's not like there's any force to offering it.

I fairly frequently encounter wildly incorrect statements made by public-facing roles. While this is the famous human-euthanasia-related headline example of "WTAF were they thinking?", I've got a few more of that ilk in various cases:

• Doctors refusing abortions and the mother dying as a result, even though the law allowed abortion in such cases

• The entire public discourse (shouting match) over the various covid vaccines, and of course the lockdowns — as HN has a broad audience, I should note that regardless of which group any reader of this message thinks was "right", both sides were very loudly convinced the other was risking lives, and that necessarily means that a lot of people were very loudly, very forcefully, wrong

• The UK's DWP telling loads of people they were considered "fit for work" when they were gravely ill and died shortly after

Outside of fatal cases, but still medical:

• I've also noticed that almost every discussion where women share experiences of doctors, regardless of group size, there's women who report doctors ignoring evidence and these women having to solve their medical issues on their own

• I've personally had a GP tell me something was impossible when it had actually happened — In my case, food ending up in nasal cavity, which was very easy for me to know had happened as the food exited about an hour later via a nostril, but the GP thought it was impossible

• Unnecessary surgeries (and I don't mean purely cosmetic surgery) are a thing

• Retained surgical instruments are a thing: https://en.wikipedia.org/wiki/Retained_surgical_instruments

Between unfeeling bureaucracies and emotional but flawed humans, there's a lot of room for people to end up pressured into unwanted euthanasia.

Figuring out how to minimise suffering given all that? Well, even without that it would be beyond me. But it does make it harder.

My main point is that the MAID vs wheel chair ramp is basically the only example of that happening I've ever seen where someone with a minor ask was 'pushed' towards MAID instead. There's rare but recurring then there's 'we have one extreme example' in the case of the vet wheel chair ramp.

> Doctors refusing abortions and the mother dying as a result, even though the law allowed abortion in such cases

Depends on what law you're talking about in the US some have quite unclear provisions and doctors and hospitals are wary of stepping into unclear water and having to litigate exactly how in danger the life of the mother was at that exact moment.

> Depends on what law you're talking about

Multiple. Ireland was a case I knew had happened, precipitating liberalisation of the law. In the US stories, I couldn't immediately recall if the discussions I have seen were actual cases or hypotheticals.

There have been several cases in the US where the mother wasn't given miscarriage care due to their anti-abortion law not having a clear enough exception. Even where there are if the criteria are too tough the wait can damage the woman's future chances of successfully having a kid too.

One example there's several more out there. https://www.theguardian.com/us-news/2024/oct/30/texas-woman-...

Which is why MAID requires two independent doctors and a cooling off period, and a bunch of red tape. There's a lot of red tape for a reason. It takes a lot more for it to happen than a single degenerate case manager who has since been fired.

https://www.ctvnews.ca/health/article/woman-with-chemical-se...

In that case a woman with chemical sensitivities was killed by the state.

Again, the premise is good. But as always it gets expanded and cases like this become normalized. And soon there is talk about more cases. Rinse and repeat. It's how good ideas become destroyed and hugely contentious.

Basically no one has a problem with MAiD for the final stages of a terminal illness. But people just can't stop themselves.

But you’re just describing the slippery slope. It’s a real problem, and the solution is continual vigilance against sliding too far and a simultaneous pushing to the desirable point. How can we do better?

What's your conclusion on this then? That it should be completely off the table because of these edge cases? I think finding these problems and patching them out as they're discovered could work. Giving the whole thing up would be like banning all airplanes after the first plane crash. The aviation industry instead put in thorough and rigorous checks to prevent future incidents (which sadly has degraded somewhat recently, but I digress). I think the same could be applied here.

I was simply replying to the "if you're undecided consider this scenario" take. As with many conversations, the situations are often more complex and nuanced than the example case, and as with many initiatives, good intentions can get co-opted until it isn't remotely what people want it to be. People might be onboard with the government assisting someone in the late stages of a terminal illness to end their life with dignity, but find it grotesque if not criminal for the government to be assisting in ending the life of someone who isn't happy with their current apartment.

So yes, it's a good program for some cases, but it is a very ugly topic that is not something that people should be "decided" on.

I guess I just assumed that it goes without saying that most everything is nuanced.

> killed by the state

Really loaded phrasing there especially given she wasn't even living in government housing but in housing provided by Salvation Army of Canada. Not sure about Canada but in the US most housing assistance is in the form of vouchers so there's not much control the government would have over the exact conditions in any place they might have found for her, she essentially needed a house of her own with no shared public spaces to be able to avoid all smoke or cleaners that might trigger her MCS. That kind of public housing is pretty rare to nonexistant anywhere.

The biggest thing is that there's no coercion going on in these cases it's simply an option she chose to take and without MAID there's a high chance she takes on her own.

>Really loaded phrasing

The government provided MAiD to this person, facilitating their death, and the phrasing was correct. The circumstances don't rise to the level where the government should be assisting a suicide, at least not in the way that the vast majority of the Canadian public sees it. And per your other comment, there have been a number of extremely dubious cases.

https://www.theguardian.com/world/2024/oct/17/canada-nonterm...

They currently estimate that 2% of cases don't meet the criteria, which is 100s per year. I support MAiD for its original intention (grievous and irremediable medical condition in an advanced state of decline that cannot be reversed), but any discussion about this topic without noting the Overton window is myopic.

>there's a high chance she takes on her own

While this is speculative[1], let's pretend and say...okay? That is something every person has available to them. Having the state provide the tools, with intention, is not the same.

In multiple comments you have talked about force or coercion, yet not only are we often talking about compromised people, when your government and healthcare workers and social workers are saying "You know what...you should kill yourself", if you don't find that unbelievably dangerous grounds that is a form of coercion, I think you really need to rethink things. There is an implication that is there that is just beyond consideration.

And yes, if this government was willing to end this woman's life, they should have been willing to find appropriate housing.

[1] - It is notable that many people who want MAiD go to long-lived (irony) extraordinary efforts to get MAiD. It would have been so much easier to take many, many other options to end their time among us, but the battle for MAiD basically gave a reason for living.

> And FWIW, we've long had MAiD - people with terminal illnesses usually got ever escalating doses of painkillers until their body gives up. It's more formalized now, but as with almost everything people with "good intentions" push it to the point where something simple becomes hugely contentious.

With my mom's experience, the old informal system was horrible and undignified. I'm glad we have this new system in place.

> people with "good intentions"

The road to hell is paved with good intentions.

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