The Economist has an interesting story on laws allowing for physician assisted dying for people with certain health conditions. The first such law was passed in Northern Australia back in 1995. More recently, many other jurisdictions have adopted similar laws. This map caught my eye:
With the exception of Hawaii, every single state with assisted dying is also a state where pot is legal. Notice that these states tend to be in the western US. (Canada also allows both pot and assisted dying.) All but Montana are “blue” states.
The politics of marijuana legalization is quite interesting. Support for legal pot is far higher among the public than among politicians (of either party.) According to the Economist, the same is true of assisted dying:
In Britain, an Oregon-style bill passed its second reading in the House of Lords in October. But to become law it would also need the support of the House of Commons and the government, which looks unlikely. Three-quarters of Britons support a right to die, but only 35% of MPs do.
Perhaps this reflects the fact that elites don’t like the idea of ordinary people being able to decide for themselves how to live (or die). Elites like to be in control.
On the other hand, for at least one type of assisted dying, support is actually higher among the old than the young (at least in Canada):
This is the exact opposite of the case with marijuana, where the young are more in favor of legalization. I wonder what explains the difference? One possibility is that young people tend to have milder forms of mental illness, which they don’t see as being severe enough to justify terminating a life. Or perhaps older people with mental illness have just given up hope:
John Scully, who has lived with severe depression and ptsd for decades, agrees. At home at night in Toronto, Mr Scully, who is 80, is haunted by the horrors he witnessed as a war correspondent: the dead torn apart by vultures, the AK47 scoped to shoot him. He also experiences physical pain. “There is no cure,” he says. Nineteen shock therapies, countless medications and six stints as a psychiatric patient have failed to bring him relief. The “only help available”, he believes, is assisted dying. He sees it as a far more dignified choice than suicide, which he has attempted twice, and he thinks it would be less painful for his family.
Perhaps if you are 30 years old then you can still envision a better future.
PS. You don’t know how depressing it is for me to see Boomers listed as the very oldest group in that chart.
READER COMMENTS
steve
Dec 4 2021 at 1:48pm
Having a majority who want to pass right to die laws is not the issue. The issue is that the support is fairly soft and for those who oppose it there is very strong opposition. Those who oppose will make more noise and donate more to politicians who will not support right to die laws. I am not sure what you mean by elites (I never know what people mean when they use that since I think it is mostly a pejorative now) but if you mean politicians then it comes down to money and votes. They will get more donations if they oppose right to die and they will get more votes in the primaries where turnout is small and dominated by those who feel most strongly about the issue. This seems to be dominated by religious groups.
Steve
Scott Sumner
Dec 4 2021 at 2:58pm
I recall the issue was on the ballot in Massachusetts, and the Boston Globe came out against the idea right before the election. It lost narrowly. I’d consider the Globe to be part of the “elite”.
Rajat
Dec 4 2021 at 4:25pm
Whether young people have ‘milder’ cases of mental illness, I’m not sure, as I think their symptoms might feel very severe to them due to their lack of experience with managing emotions. My guess is that of young people who have survived adolescence (aged 18-23), many would have either experienced depression themselves or known people who had and may have formed the view that many young people experiencing depression or other mental illnesses ‘come out of it’, perhaps with medication or therapy, or otherwise ‘grow out of it’ after a few years. Perhaps this is when they can leave a bad familial, schooling or economic situation. By one’s 60s or 70s, those who are mentally ill or know those who are know that their symptoms are unlikely to improve. Either therapies don’t help them or people do not or cannot stick with them.
Scott Sumner
Dec 5 2021 at 12:48pm
Good point.
Andrew_FL
Dec 4 2021 at 6:36pm
“Right to die” meaning in this case “right to be murdered by a physician”
Michael Hammock
Dec 4 2021 at 10:26pm
In the same sense that the right to choose to undergo surgery is “the right to be stabbed by a physician.”
Mark Brady
Dec 4 2021 at 11:01pm
There are many cases of physicians putting extreme pressure on people to choose assisted suicide. Andrew_FL makes a serious point.
I invite readers to check out one or more of the articles here: https://www.spiked-online.com/?s=euthanasia
Brent Buckner
Dec 5 2021 at 11:34am
Given regulation, I much prefer a separate designation for those performing (and counseling) the homicide than physicians.
Scott Sumner
Dec 5 2021 at 12:51pm
I read several of the articles you linked to, and didn’t see any evidence to support your claim.
Mark Brady
Dec 5 2021 at 2:10pm
Here is one that is specific to what I’m talking about.
https://www.spiked-online.com/2021/10/21/assisted-dying-a-warning-from-canada/
And check out the website notdeadyet[dot]org.
Jon Murphy
Dec 5 2021 at 2:22pm
Mark:
I don’t see anything in that article to suggest that folks were “putting extreme pressure on people to choose assisted suicide.” The only empirical complaint I see is that MAID expanded assisted suicide to more groups.
Scott Sumner
Dec 5 2021 at 9:28pm
I agree with Jon. That was one of the articles I read the first time around. Can you quote the specific passage from the article you are referring to? I don’t see it.
Jon Murphy
Dec 5 2021 at 10:22am
That some freedom might be abused is insufficient to justify forbidding it. That a physician may unduly pressure someone into assisted suicide is no more grounds for forbidding assisted suicide then saying that someone may speak inflammatory words is grounds for forbidding free speech.
steve
Dec 5 2021 at 12:25pm
I agree with Jon here. Would suspect that most of this is actually families or patients misunderstanding what was said when they were under stress and/or poor understanding of medical issues. Also, the other side, which we see way too often, is physicians performing heroic procedures that have almost zero chance of actually helping a pt. Some of this is poor judgment by the individual doctor but some is also financially motivated. In general we have not been especially good at handling end of life issues though I do think it is much better than it was 20 years ago.
Steve
Jose Pablo
Dec 4 2021 at 7:23pm
“You don’t know how depressing it is for me to see Boomers listed as the very oldest group in that chart. “
Depressing and unfair, I think, more than 30% of the Canadian population is represented in that group. Only around 8% in the Generation Z (18-23) group.
Mark Brady
Dec 4 2021 at 10:56pm
I’ve now read the article in The Economist, and contrary to the impression the reader might receive from Scott Sumner’s article, the editorial doesn’t specifically focus on the “mentally ill.” Indeed, they write, “The trickiest questions arise when an individual’s capacity to make an informed choice is in doubt. Some people with mental disorders have suicidal thoughts that come and go. For them, the bar should be very high. Doctors must be sure they can distinguish between a temporary mental-health crisis and a sustained, considered wish to die. If in doubt, they should offer treatment aimed at helping the patient to live.”
Jon Murphy
Dec 5 2021 at 4:47pm
That’s what mentally ill means. They are incapable of acting in their own best interests.
Mark Brady
Dec 5 2021 at 8:16pm
Two thoughts.
It is clear that The Economist views the “mentally ill” as a subset of all those cases where advocates of assisted dying believe that the procedure should be legalized. Hence the editorial speaks of “the trickiest questions,” which implies that the other cases do not involve questions of “mental health.”
“That’s what mentally ill means. They are incapable of acting in their own best interests.” But those are not synonymous expressions. For example, we may agree that young children do not always act in their own best interests, but we don’t say that the kids are “mentally ill.”
Jon Murphy
Dec 5 2021 at 8:36pm
Yeah, I think you’re making a distinction without a difference here.
Mark Z
Dec 5 2021 at 1:11am
I imagine for an older person, assisted suicide means an opportunity available as an alternative to suffering, whereas to a younger person, it mainly means the possibility of losing a parent or older family member who chooses it. For younger people, its legality may be more likely to lead to a net loss to them precisely because they’re less likely to make use of it.
Richard T
Dec 5 2021 at 4:17am
I’m 63 and can still envisage a better future. But fast forward 25-30 more years and that will change. Judging by what happened in previous generations of my family, I shall already be dying, peacefully, in slow motion. Talk of “saving” or “taking” my life will be, well, misplaced. The question will simply be whether it is mine in fact or just in name.
I long ago chose what I would live off and where I would live. Later, I chose who would live with me. We chose when to engender children and live for them. I shall choose when to stop living off my work and start living off my savings. I’ll also choose how hard I try to keep myself healthy, so I’ll have imprecise control over how much longer I live. But my first degree was in mathematics, and I don’t like such imprecision, nor will it do anyone else much good. So assuming I suffer no unforeseen illness, I still want to make one last choice. Tell me, will this life be truly mine, to hold or discard?
Jon Murphy
Dec 5 2021 at 10:26am
It seems to me simple economics can explain the difference:
The older one gets, the expected benefits of one’s remaining years generally diminishes while the marginal costs of staying alive increase (as you say, mental issues, pain, outliving loved ones, etc). At some point, MC>MB, and thus death becomes optimal.
john hare
Dec 5 2021 at 2:12pm
I have various thoughts on the issue, many that conflict. I think people should have the legal right to choose even while strongly disliking that the choice should ever be necessary. I would want the legal right to choose, especially via a living will in a situation where I am brain dead. OTOH, I would hate to give up just prior to a cure being available. Third hand I would rather leave some legacy to my grandkids than spend everything on a futile effort that I am barely aware of. And so on….
Jon Murphy
Dec 5 2021 at 2:41pm
Just sell your soul to the Devil for immortality and make the whole point moot 🙂
In all seriousness, I get your point. And the choice is so incredibly personal. That’s why I support making assisted suicide legal
MarkW
Dec 5 2021 at 6:10pm
Support for legal pot is far higher among the public than among politicians (of either party.)
There was an interesting route to legalization in my state of Michigan. Enough signatures were collected to put the issue on the ballot. But the (Republican majority) legislature had the option of voting to pass it immediately at that point (and without requiring the (D) governor’s signature). So, they passed it — not because they actually favored it, but because the public support for it was such that they feared it would increase Democratic voter turnout in the Fall. The nice thing was that the law was not crafted by legislators, lobbyists, and bureaucrats and therefore is a relatively permissive clean, simple bill with low taxes (very much unlike California where cannabis is so heavily taxed that it has trouble competing with the black market).
Phil H
Dec 5 2021 at 9:05pm
I have to admit to some confusion over this issue. For the disabled, I understand that it’s a huge problem. But for the rest of us… how hard is it to google “carbon monoxide generators”? Or “what combination of booze and pills will stop my heart”? Everyone has the right to end their own life, but why do the poor doctors have to be dragged into it?
“Three-quarters of Britons support a right to die, but only 35% of MPs do.” There’s quite an easy explanation for this: most Britons don’t think someone wants to kill them (and they’re probably right); most MPs, in the course of their research, read about cases where the right to die gets abused. And then a significant proportion of them decide that carving out (more) exceptions to the murder law is not worth it.
Matthias
Dec 6 2021 at 1:42am
Nah, empirically there’s plenty of bungled suicides. If something is ok doing, then we might as well offer professional help.
I’m not sure whether doctors should offer that help, or perhaps some other (new?) group?
Jon Murphy
Dec 6 2021 at 6:35am
To Matthais’s point, there are lots of bungled suicides, and often those lead to some form of involuntary incarceration in the United States.
Besides, I fail to see why you find it odd that people would want to seek medical advice for a medical procedure.
Matthias
Dec 6 2021 at 1:48am
About the issue of people being pressured, or changing their mind etc:
I thought about this before. Also in the context of eg taking drugs.
One mechanism I found interesting is the following:
If you want to end your life, you register that, say, a year in advance. If at anytime you want to change your mind, the deal is off, and another registration starts the clock afresh.
If you make it through the year without changing your mind, you are free to go.
A similar mechanism could be used instead of banning potentially addictive drugs like heroin, where people might want to commit themselves to not succumbing to the temptation:
Anyone who wants to take the drug, needs to register some time in advance, and any canceling of the registration resets the clock.
(In a more abstract context, this idea deals with people having inconsistent preferences over time, and privileges the more socially acceptable preference, but also allows determined, consistent people to get what they want.)
Aladdin
Dec 6 2021 at 9:22pm
It is reasonable to … for me, I don’t support the right for doctors to kill people, even voluntarily, but I do support doctors allowing a patient to die naturally by not providing treatment that would unnecessarily prolong suffering.
I fully understand the logical issues with that, as well as the logical mistakes that makes. But … I don’t know. Suicide is a touchy subject, and that is the only way I can square it in my mind.
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