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Talk of "institutionalized perverse incentives" (even while well argued) is a strawman defense to block personal self-determination, because the thesis "Legal suicide is incompatible with social medicine" is disproven by simply studying the working model in the Netherlands, done in practice, not just in thought. Point me at medical excesses, or steadily increasing rates of euthanasia, and I can reconsider.

A Dutch patient doesn't easily get into the position before euthanasia is a legal option. I need to strongly underline that we are talking about terminally ill people.

For those people there rests little difference between terminal sedation and euthanasia, except that the first is often imposed through medical staff - unless specifically ruled out by the patient. The second is a determined choice only available when specifically requested by the patient. The choice of dying in this situation is crystal clear - either you drift out in an opiod induced stupour, or with a self-determined choice. That is, simply, the right to die - people who want to face their death themselves. That does not make it an easy choice. And not many choose for it, as Dutch numbers unambiguously reflect.

As it is, I'm proud to live in a country where citizens are granded that final important right of self-determination.

by Nomad on Thu Feb 11th, 2010 at 05:30:25 AM EST
[ Parent ]
my mother died in a london hospice, and it's basically the same approach, comfort and cessation of pain are prioritised over length of life, and if they are helped to the point of accelerating their demise, no-one will be anything but grateful, as their existence is no longer any benefit to anyone, least of all themselves.

the staff there were angels of mercy, and the atmosphere anything but sombre.

sounds like the dutch don't see a need to sequester this from normal medical practice, and why should they?

~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~

by melo (melometa4(at)gmail.com) on Thu Feb 11th, 2010 at 06:44:42 AM EST
[ Parent ]
Well, it's pretty far from "proving" anything on this topic, but it is true that the Dutch evidence shows a decrease in the proportion of deaths attributed to euthanasia and assisted suicide since peaking in the mid-1990's when euthanasia was a hot topic in public discourse.  The evidence is somewhat different in Oregon, but there is a reporting controversy there and the policy is more recent as well, and I don't know what it is in Belgium.

I think a better argument in favor of legalization of suicide is related to something In Whales mentioned elsewhere in this thread. Euthanasia and suicide happen anyway, so perhaps legalization provides a degree of transparency which helps to mitigate the perverse incentives at least where they involve direct encouragement of others to choose death.  (It wouldn't help the larger issue of presenting suicide as a morally superior option to continued treatment in order to avoid inconveniencing others.  This isn't refuted by the Dutch experience and data either, because it doesn't show what the Dutch experience would have been if suicide and euthanasia were not already established parts of Dutch discourse by the 1980's when data on such things became available.)

by santiago on Thu Feb 11th, 2010 at 12:42:29 PM EST
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