Life-and-death choices III

In a text on life-and-death choices ([1]), I noted:

For instance, over the last few months, I have heard repeated claims of excessive pushing of “assisted suicide” (likely all relating to Canada). Assisted suicide might seem like an increase in one’s own self-determination. When done correctly, it might even be so.* However, when suicide becomes a “solution” actively offered by e.g. the government or a hospital (as opposed to something requested by the patient), maybe even one pushed as “the best option” (or similar), this fast ceases to be the case—especially, when the concerns of others are given priority.**

*[…]

**Consider thinking like “if this patient dies, we have a free bed for someone else and maybe an organ or two to transplant”, “if this pensioner dies, there is more pension money to go around”, “if this prisoner dies, society is free from the costs of keeping him incarcerated and he is guaranteed not to commit further crimes” (also see excursion), and note the fate of Boxer in “Animal Farm” and many in “Soylent Green”. (Also note how often the dystopic works of old appear to be used as instruction manuals today—not as deterrents.)

Today, I encountered claims that Doctor endorses idea of suicide through organ donation ([2]). Some quotes:*

*Here and below with reservations for formatting, etc.

A recent bioethics paper raises some age-old arguments around an issue that strikes at the heart of ethical organ donation: organ donation euthanasia or ODE.

The Dead Donor Rule (DDR) is cornerstone to the public trust and ethics of organ donation. But for some, including Dr. Didde B Anderson, limiting the donation pool only to those actively dying or dead violates a principle of personal autonomy and is “paternalistic.”

As summarized in Psychology Today (PT), Anderson argues that healthy people who wish to donate an essential organ — a heart, for example — to save the lives of others should be allowed to do so, at the cost of their own lives.

Here something very similar to my original points apply, in that this might superficially seem like an increase in self-determination, but that the net-results could be very negative. This especially once the interest of others, utilitarian principles, and similar enter the equation. Apart from what is discussed in the remainder of [2], I note how easily this could move us towards exactly one of those Boxer or “Soylent Green” situations, especially when combined with coercion, economic incentives, reductions in medical services, etc.

One of Anderson’s main arguments is that allowing someone to choose to commit suicide for organ donation would lead to better organ viability. Yet this is a calculating, utilitarian argument that has no place in a society that values both individual rights and human dignity. […]

[Dr. Jonah Rubin of Harvard Medical School] says that creating a system that ignores the DDR — where an otherwise physically healthy person could request euthanasia for the purposes of organ donation — would inevitably create perverse incentives and unintended social consequences. If killing oneself for organ donation becomes a praiseworthy act, the mere mention of organ donation on a suicide-minded patient increases psychological pressure and starts to erode their autonomy.

Yet another issue in the same family, which could soon turn into guilting e.g. those in pain,* the elderly,* the poor, or the already suicidal into death, maybe in combination with claims that “You will no longer be a burden on your family!”, “You will no longer be a burden on society!”, “You have a civic duty to [whatnot]!”. (Note the difference that organ donations make to the situation: hospitals and the like now have incentives to push such a line in order to get organs for other patients and/or make more money.)

*In these cases, with reservations for organ viability, which can vary greatly depending on the cause of pain, how elderly, etc.

In a follow-up ([3]), I wrote:

[…] we have issues like where to draw the border between assistance and murder/manslaughter/whatnot, what level of encouragement (to go ahead) is tolerable in what setting,* when there should be an obligation to provide alternatives, when an offer to assist and/or a request for assistance should require a “cooling off” period, etc. […]

*That such encouragement can and often should be illegal is clear. Consider e.g. a deeply unhappy high-school student who is exposed to “encouraging” bullies. Even in a more medical setting, a case can often be made, as seen by how many who experience gender-dysphoria have been prematurely encouraged to take irrevocable steps. An analogous, “suicide affirmative”, approach could lead to a great many unnecessary deaths—maybe including that someone who engaged in a “call for attention” pseudo-attempt is encouraged to try again and with professional help to guarantee success.

Coincidentally, this matches up well with another recent article from the same source as [2]: Plan would let kids seek euthanasia … without telling parents! ([4]). This article discusses a potential horror, in light of the above, how easily manipulated today’s youths appear to be,* the gender-dysphoria epidemic, etc. Note, in particular, that youths who commit suicide and donate their organs would be a gold mine for an unscrupulous hospital.

*Whether the youths of yore or the adults of today were/are better, I leave unstated.

Assisted suicide and euthanasia have become rapidly accepted in Canada under the government’s Medical Aid in Dying (MAiD) program, but there are still efforts to expand it even further. A new government report on MAiD was recently presented to Parliament, urging the inclusion of minors in the eligibility for physician-assisted death — without parental consent.

The committee then made the recommendation that Canada should begin, within five years, funding research and consulting “with minors on the topic of MAID, including minors with terminal illnesses, minors with disabilities, minors in the child welfare system and Indigenous minors.”

Here an interesting potential drift is present: while the current first effort seems to be focused on the terminally ill (cf. other parts of [4]), this continuation points to the mid- or long-term inclusion of those with disabilities, on welfare (burden to society!), and, for some reason, the “Indigenous”*.

*How they plan to get away with that one is unclear… I suspect that it is a case of a horrifyingly unfortunate formulation, e.g. with the intent to give the “Indigenous” preferential treatment in consultation, as a quasi-DIE measure and as opposed to a go-die measure. (Note a recent similar blunder where pushers of that absurd and linguistically nonsensical “people first” language made a claim along the lines that “the poor”, “the disabled”, and … “the French” would be insulting labels.)

Additionally, the report recommended that minors be able to be euthanized, even if their parent doesn’t approve […]:

That the Government of Canada establish a requirement that, where appropriate, the parents or guardians of a mature minor be consulted in the course of the assessment process for MAID, but that the will of a minor who is found to have the requisite decision-making capacity ultimately takes priority.

So, minors are supposed to be allowed to kill themselves, in addition to undergoing sex-change procedures, without parental consent—but they do not have the right to enter a binding contract on their own, to have sex, to get married, to drink, whatnot.* Indeed, such acts are often illegal even with parental consent…

*With reservations for what applies in any given jurisdiction for the age at hand. The laws can vary considerably.

Now, I am open to discuss what should and should not be allowed at what age, with or without parental consent, but any sane system must have a consistency of principle. Such a consistency would not be present here. (And tends to be absent, more generally, when politicians are present.)

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