The last 24 hours were monstrous to inflict on anyone. Torture. Evil.

Hours and hours of faltering breathing, often restarting with what was plainly a panicked adrenaline-pumping response. It looked like they felt like they were about to drown every few minutes, hour, after hour, no relief. No IV fluids (terminal anyway, so no trying to keep them alive with techniques like that) and unable to drink, so certainly terribly thirsty the whole time. Unable to communicate or really engage with surroundings, and quite high on pain meds anyway (the closest thing to a mercy in all this). It’s fucked up that that’s a fairly normal way for dying people to make their exit. I’m sure there are all kinds of problems with trying to provide a way out when someone can’t make the choice for themselves, without opening it up to abuse, but damn, I hope this isn’t the best we can do because it’s terrible.

I know people that work in hospice, and they say this is a big misconception (the article hints at it too). they patients don't die from lack of water, they don't want water because they are dying, and their body can't process it. In fact, as you kind of touched on at the start, giving them IV fluids can cause them to drown since their body can't process the water.

Death is pretty ugly thing, that comes for us all. I got to learn the fun way that in the state of Oregon, it is illegal to disable a pacemaker. Even when the person has a DNR, and it is really the only thing keeping them alive. The best the doctors can do is turn the pacemaker down as low as possible, and hope its not enough to keep the person artificially alive. Which seems kind of really weird, when its also the first and one of the only states that allows medically assisted suicide..

I was once helping take down a 10-foot weather balloon full of helium, and took in two breaths in a row of pure helium. I started to get tunnel vision, said "whoah", sat down when I realized I was about to lose consciousness, fell down, and twitched just long enough for my friend to realize I wasn't joking around before I woke up. From my experience, hypoxia from pure helium is slightly pleasant all the way to loss of consciousness. I presume pure nitrogen would be nearly the same.

Let my last words be something witty in a high-pitched helium voice.

(Side note: pure nitrogen hypoxia would not be a particularly humane form of execution because the condemned would likely fight it by holding on to their last breath.)

I fully understand why this has been done, to stop people who only intermittently get the urge, but for someone like me it's a major bloody inconvenience, so inert gas it most likely is.

(The above is not an opener for a discussion, it's an FYI for a different perspective. Please don't respond).

Obviously for many people it's still very scary - it is death after all. But the self-administered morphine drip has been around for ages and is relatively uncontroversial.

They care about your relatives who are burdened not “accidentally” holding that button for you when somehow you would still like to live.

It’s just not a great hill to die on since most people that actually care strongly about the issue are the ones bed ridden in the hospital.

That’s almost always a financial incentive though; if you remove that you can see who really cares. I have an open will for my friends and family; everything goes to charity with the taxes and tangible assets worked out so they don’t have issues; they get a net amount of a few million. Everyone else knows they don’t get 1 cent; helps with the accidental button holding.

Several in-patients that opted for medical assistance in dying were refused that treatment by administrators of the hospital on religious grounds, and their families are sueing based on the additional suffering inflicted by having to transfer to other facilities.

Neither of those matter because they don’t hold massive, disproportional influence over a huge part of the US political establishment.

He got pneumonia at the stage where he was having to use an oxygen machine at home. At the hospital he asked the doctors if he'd be able to go home, and they said it was highly unlikely.

So, he asked them to turn off the oxygen, which they did. He passed peacefully a few hours later.

Sure, we might have gotten a few extra months with him, but I'm so glad the doctors respected his wishes. My worst fear was him having to endure something like what you describe.

The reality is there comes a point where the doctors can only prolong the dying--and in an awful lot of such cases that's a negative for the person.

All in all it’s a tragic thing the only constellation is that I guess after 24 hours in that, one welcomes death with open arms.

Sadly, this is just one of millions of descriptions of why the phrase "Slow as death" exists. Generally, life really does not want to give up, and the process is indeed terrible.

Edit: I feel a bit dumb now, I hadn't actually read the article yet, went straight for the comments. Seems like I'm just reiterating what it says.

When I'm in that shape I just wanna go in peace. Preferably at home, in my own bed, surrounded by loved ones. No tubes down my throat, no shots to keep me alive at any cost, with no end in sight.

Here's some good discussion on the topic between two doctors that I watched recently: https://youtu.be/O0YIGAUDlzQ?t=242

for example, nobody plans to go on a ventilator. But if you need one (like severe pneumonia), you’re already pretty messed up and you’re going to have a painful death with or without the tubes.

But I feel that was the main point at the start of the thread: if death is certain and going to be painful, why must we drag it out? Why is that additional lifespan (measured in days) so much more important than comfort?

Is it really worth trading away that opportunity just to not accidentally die on a ventilator? I'm not sure.

I never wanted to go into medicine. Thus I do not believe the preferences of a typical older doctor represent my preferences in this respect.

I read an article once of a nurse who kept CPR going on her husband for somewhere around 2 hours until they could get him to a hospital that was able to restart his heart. I believe he ended up okay. CPR obviously isn't invasive tubing, but it's still kind of hard on the body.

"some" is doing a lot of work in this sentence. Recovering enough to have "at least some" independence after several months is not a great outcome. That very likely means lifelong daily care is required.

I wonder what 'go in peace' means if you explain it medically. Possibly abrupt heart failure?

From the deaths of older relatives that I've (sort of) witnessed, if any other part of your body fails it's going to be slower and a lot more unpleasant.

I have often wondered why he was chosen to carry such a burden, a harmless and kind person.

France does the same but has nationalized healthcare, so it does not seem motivated by profits. It puts pressure on the healthcare system and only brings additional suffering. We could change that, but implementing assisted death needs careful consideration and defeating politically the small subset of people that think life with extreme suffering is precious.

Yes.

> and defeating politically the small subset of people that think life with extreme suffering is precious.

You don't need to defeat us. All you need is a clear-cut agreement between the patient and the doctor, preferably in advance for those who are physically unable to decide at the end, similar to a DNI. Between the patient and the doctor, and possibly the patient's family, it's no one else's business (though I still think second-party euthanasia of non-terminal persons is disgusting, and that they should commit suicide without involving a second party). It's when government or other third parties start getting involved that everyone should have an issue with euthanasia.

Then you are not part of the group of persons I was pointing out. Is was thinking of people against it regardless of the conditions. Some form of consent is needed for euthanasia. How strong this consent should be (written agreement before? Or must explicitly tell the doctor right before the injection?) needs to be decided after thinking carefully about how to keep the law being useful while avoiding abuses. But right now euthanasia is fully illegal; the best one can get is starving to death.

I actually am probably one of the one's you are pointing out. In that I don't want a government sanctioned process for this (it leads to a slippery slope in the countries it has been enacted in[1]). At best I'm basically in favor of decriminalization, not legalization, and not a standardized process that can be altered over time.

"By establishing a social policy that keeps physician-assisted suicide and euthanasia illegal but recognizes exceptions, we would adopt the correct moral view: the onus of proving that everything had been tried and that the motivation and rationale were convincing would rest on those who wanted to end a life.

Ezekiel Emanuel"

[1] - see point 6: https://haase.org.uk/history-of-euthanasia/

Also this case in Canada of a woman with MCS who couldn't get better housing away from the chemicals. It was easier to give her medical assistance in dying than to get her to a house or apartment free from other people's smoke and cleaning chemicals: https://www.ctvnews.ca/health/woman-with-chemical-sensitivit...

She's not the only Canadian case of it being easier to grant MAID than to get functioning health and welfare services. One person was granted it because he was about to become homeless.

When it came to it, she didn't. It still wasn't petty because death-by-cancer never is. She was extremely weak and thin and tired. But on her last day she spoke to everyone in the family, gave weak hugs, said goodbyes. I guarantee you that guy took away days (at least) of suffering. We all knew that. He knew that. She knew that. Nobody said it though.

And I think that's better than someone who can't afford to deal with a disability being asked if they're prefer to die than cost the state lots of money. Horror stories both sides of the nuance.

I have CRPS, one of the contenders for worst chronic pain you can have. It's a "suicide disease", because if it advances to stage 3/4, there's a suicide rate of about 70%. It sucks a lot. I've had well over 200 spinal procedures over the last 30 years to try to mitigate the pain, with dozens of other surgical procedures in less tricky spots.

I also have Brugada Syndrome, a "drop dead suddenly without warning" disease. When diagnosed, I wanted to take my time before consenting to having an implanted defib. The doctors announced that "Mr Foster, we believe you are not rational at the moment", fortunately I had a friend with me who assured them I was probably the most rational man in Brisbane.

I was threatened with an ITO (Involuntary Treatment Order) if I didn't go ahead with having an internal defibrilator put in me. I went ahead with the procedure.

So I can't even die by refusing treatment, as "sane" people resist dying at all odds. If I don't want invasive, painful procedures that take over a year to recover from, then the courts will claim I'm suicidal and issue an order to the hospitals to proceed with more bloody cutting.

No, sane people say "I've had enough". Fortunately my current GP understands, as he says "Sometimes people feel they've had enough medicine".

Did this threat come from a doctor? What an astounding lack of empathy.

I would switch medical providers in a heartbeat if at all possible.

Also, in the moment, it's entirely possible that somebody who is otherwise completely rational who just had a life-altering experience is temporarily less than completely rational and you're only hearing that one side of the story.

Why does society refuse to allow people to have mental and physical autonomy in matters like this? Sure, they pay lip service to it, but when it comes down to the hard moments, we almost always end up erring on the wrong side.

Perhaps this is a US vs. other countries thing, but I live in Germany and was born in the UK, and I'm quite shocked that you are surprised by unempathetic (or downright evil) doctors

I think I’ve had an unusual number of people close to me choose that option, including my father recently so I guess I’m still trying to reconcile it all. Their pain vs mine, what could have played out differently, etc.

I sincerely wish the best outcome for you and yours.

Chronic pain changes you, and rarely for the better. It's nigh impossible for someone who hasn't had to deal with 24 hours a day, 7 days a week, for months or years on end pain that's up on the extreme end of the scale. We try to hide it, to protect our families and loved ones for what we live, but sometimes it's too much.

Suicide is natures' rational solution to unending torment. Christian teachings and traditions try to say that suffering is holy, and it is righteous to endure. How come it makes people into assholes then?

Between knowing I have the option, and the amazing power of venlafaxine, I do not need to either fixate on or commit suicide though. At least for a while now.

I will never judge anyone who intentionally kills themselves as I don't know how painful their reality was.

It is terrifying transitioning from seeing health as innate to viewing it as something you need to carefully nurture or it will slip away.

End game is not pretty. My ex wife didn't do any fitness stuff at all and she's walking with a stick while I'm doing 30km hikes at 3000m...

Hell, I fell off my bike from a stop a few weeks ago, and landed on my knee, and it took a week and a half before I felt like I could trust my leg to hold weight.

Whatever you do my advice is if it's high impact join the 'old man's league'. They better understand everyone's limits.

It is a tough sport and one bad day grappling or boxing and I'm in pain for weeks which limits training. It's not a easy sport to do half-way.

Check and see if your local rink has an intro to hockey class and use that to get a feel for hockey.

Hockey does have risks of course, but playing in a non checking league takes the risk down to manageable levels in my opinion.

I don't know what specific injuries you're suffering from but I've suffered from back pain and really improved my situation a lot. I'm physically stronger than I've ever been in my life. I've worked through some knee injuries. I've even recently improved my gum health (in a way someone said wasn't possible). It takes more work and more focus but our bodies are amazing machines and 37 ain't old.

> Most people your age can still exceed any physical accomplishment they've had in their lifetime if they really want to. E.g. they can play sports better than they ever had and they can achieve personal bests in any physical ability.

So not people who were at the peak of their ability/potential in their 20s – most people, however, do not perform at their limits in their 20s, simply because that isn't their priority, they don't train for it, etc.

The two of them together have changed my life. A lot of acute injuries of mine had healed, but had left my muscles extremely tight and essentially kind of frozen, which then creates problems with movement and posture and which then generates other kinds of pain. I too thought I'd never get back to "normal", and then was shocked to discover that I basically could, after a couple of years of undoing all the muscular tightness and "frozenness" through myofascial release and Alexander Technique. (Basically, the myofascial release gets rid of it, while Alexander teaches you how to prevent immediately re-forming it.)

It's funny that myofascial release is only just starting to gain awareness among the medical community, while Alexander Technique still mainly only has awareness in the acting and musical performance communities.

This year I got a personal trainer for the first time.

I’m really trying to fight to get in shape and stay in shape.

I spent my 20’s working and for the last 5 years I work remotely, largely ignoring my health.

Sitting in a home office all day is really bad for you.

If you've never done strength training before, you may be pleasantly surprised to learn how much extra mass you can add, while remaining on a typical diet, with zero chemical assistance. Your trainer will be able to help you.

Only because it requires you to create a major new habit after 30 years on earth of not doing it, not because it's difficult physically. If you are putting in the time and especially the effort, it should be easy.

That said, the common mistake in the gym is when people just kinda do reps at some easy weight and then stop short with a bunch more reps left in reserve. Never really pushing themself. I guarantee that describes anyone finding it extraordinary difficult to build muscle.

As someone with chronic back pain since my late teens, this is... a nice perspective. My friend group isn't old enough yet for it to come up very often but I feel like I can relate.

With that said, my better half can't bend her arm past a certain part on her body, however, b.c of a really small/stupid collision/fall coming down a Tahoe MTN ski run. It always depends on the problem.

If you switch to safer kinds of sport/workout, you still can have a chance to be very active for many years until old age.

Medically-assisted suicide ought to be available to anyone (not only of sound mind and not only with a terminal condition), and at any time. People ought to have the right to die, just like they have the right to water, food, and shelter. In most countries it is currently easier to take other people's lives than to take one's own.

People ought to be able to step into a hospital, ask 'hey, I'd like to die', sign a couple of forms saying 'yes, I'd really really like to die', step into an anoxic chamber, and be put into hypoxia and brain death in a matter of minutes. Obviously, an emergency stop plunger ought to be available in case the person in question changes their mind.

The belief that life is a gift from a god is a highly Christocentric, Western view that I disagree with. We are brought into the world without any real consent; we should at least be able to easily choose the date, time, and manner of our passing if we so desire.

Related: Majority of gun deaths in the USA are suicides. In the gun control debate you might want to exclude those, right? But actually having ready access to a way to die increases the total number of suicides - it's not that all of those people taking their own lives would use different methods of suicide - some would but some would never die from suicide at all. So it's used as a argument against having easy to access firearms, and generally an argument against an easy way for suicide.

The point is, the mind changes constantly; it's its nature. What should one do?

Personally, I'd rather avoid the rollercoaster of "I'm happy I didn't die" and "I should've died."

I believe that depression should be treated seriously as a mental illness. But treat the depression, and not the choices made while depressed (i.e. suicidal ideation, suicide attempts), which are symptoms of depression. It's not like we treat so seriously any of the other choices made while depressed like over/under-eating, alcoholism, impulsive purchases, etc.

> So it's used as a argument against having easy to access firearms

Personally I believe in restricting access to firearms because they are usually used to kill other people. If someone wants to use their gun to take their own life, rather than take their guns away, I'd like to spare them and their family the mess, and give them a way to die peacefully and quietly in a supine position.

You don't have to, it's not your business, it's their right to make that choice and no one else's. "My body, my choice" applies to suicide even more than abortion, if you don't control your own life and body you can't call yourself a free man.

I disagree with dismissing someone's decision because they have a mental illness like depression too. Depression and other issues don't always respond to treatment, and even when they do it's often after trying different treatments for months! I've been through very dark times with depression, OCD, and much more. I live a life of luxury now that most of the country would envy with a wonderful wife. If I knew I had to face a year or too of my past issues again and I would get to spend the last 40 years in my wonderful life again afterwards I don't think it would be worth suffering like that for a year. Some issues like OCD really are that bad. If someone with a mental illness wants to die, offer to help, but respect their decision if they don't accept.

But the truth is that I'm not convinced that death is the "the winning move is not playing it". You see death is life: in order to die you must be alive first.

That's why lately I'm thinking unconsciousness is the way out, but I'm not sure about that too.

I told him - "She suffers from migraines, and for 3 out of 4 weeks in an average month she must spend the entire day immobile in a dark room. There are no treatments in the near term which are expected to improve her outlook. The pain is debilitating. Doctor, who is "insane" - the person who wants a way out of the constant agony, or the person who says "More, please!""

I believe that the right to life as enshrined in the Constitution (and endowed by my Creator) must, inherently, also include the right to end that life, if a man (or woman) so chooses.

Why have people here who don't want to be here?

You're at a party. You politely say goodbye to everyone and start heading for the exit.

You are restrained and drugged.

Nice party, bro...

You are referring to an incident where a caseworker mentioned that MAID is an option to a permanently disabled veteran suffering from pain, and it was deemed out of scope for their job. The policy has now changed so that caseworkers are not allowed to even bring up MAID. No one was coerced into the option.

The outcome of the incident you are citing is that it is now less accessible for people to learn about the option.

Meanwhile there are cases across Canada where people have been blocked from getting MAID because of religious hospitals, outside objectors, and debates about what kind of permanent illness qualifies even if two doctors and the patient have all agreed.

The process is not fast, requires psychological assessment, and must be signed off by a doctor.

There is precisely no evidence that anyone has ever undergone MAID when they weren’t 100% consenting and having made there own decision.

1) Is the patient of sound mind when the decision is made? (Not necessarily carried out. I have no problem with someone saying "kill me when my mind is gone.")

2) There should be a medical evaluation of whatever the problem is with an eye to what can be done to make life more palatable.

3) There should be a waiting period. (I would, however, say that if the person is no longer capable of confirming it that should count as confirmation.)

Suicide should only be for when one's remaining life is of negative value, not because of temporary bad things.

I always ask: for how long? What is the ultimate goal? If you don’t know, it's time to seek answers before pushing society forward carelessly.

The impulse to die being eliminated from the gene pool is a good thing ? Or rather the characteristics to fight for life at all costs is what one would want in the gene pool ?

If what you assume is true, at some point people will want to die less and the problem will self correct .

Death is important tool in evolution delaying it is not argument for it .

Not many, probably, but the option should be available to those who need it.

> Nihilism was quite popular in the 19th century and led us to two world wars already

I'm sorry, but this is rubbish. Firstly, I'm not nihilistic, but practical. Not everyone who wants to die is suffering; sometimes they just want out of a pointless and meandering life. They don't want to put in the effort to up themselves, and frankly, why should they? What right do other people have to impose their views on someone who's feeling like this?

Sometimes one is suffering, but can't be bothered to, or might suffer more while trying to convince the state and a medical team that they deserve to die. It's 2024, and we have increasing acceptance of the gender spectrum, of the autism spectrum, of recreational narcotics, and more. Why is dying so marginalised? Like I said, this is a Christocentric view. A modern society must allow its citizens to die quietly, peacefully, and cleanly, whenever they choose.

Next, what led to the two world wars was not 'nihilism', a very loaded single word, but rather a bunch of overly-complex defence pacts, treaties, and arms races in 1900s Europe that eventually collapsed into a bloody shit show. The second world war happened because of a feeling of revenge, anti-semitism, and Slavophobia on the part of the Germans, and imperialism on the part of all the Axis powers. Nothing more, nothing less. Depending on who you ask WW2 began as early as 1910 with the invasion and occupation of Korea by Japan.

> your opinion will be eliminated from the gene pool

Wanting to die is not (only) passed down in someone's genes. It is highly environmental and depends on what people do, who they talk to, and where and how they live.

Nihilism is only just now having an impact in the academy as it is the intellectual foundation of post modernist and critical theory.

IMHO it's a combination of low wages, high cost of living, and scrolling/gaming/streaming/porn addiction. we don't know how to talk about it yet but it's fucking people up. human brains were not ready for what the internet has become

I'm thinking of a book whose title eludes me at present. It's by a doctor, talking about their ER experience. One of their frequent fliers--and one time he talked a bit about why. He had been a sniper in Afghanistan (Afghani, fighting the Russians), he drank to keep from killing himself because of the horrors he had experienced.

I don’t know if this was specific to that (large, household name) company or if that’s emblematic but it sounded like a very bad idea (they had more stories of excessive drinking but that was the one I recall off the top of my head).

It is. Just flick the blade open on a switchblade and stab into your temple. You don't need a fricking second or third party to help you with this.

Some of us atheists view life as more precious than many religious people do because this is it.

> fricking

Do you really have to be so violent in response?

There exist supervised injection sites for narcotics. You bring the drugs, the healthcare workers give you clean syringes/needles/paraphernalia and help you with the injection. As a society we have decided that it is OK for people to potentially wreck their own lives with narcotics.

Why not a similar concept for dying, where the end is only eternal oblivion? Step into a room, step inside a pod, press a button, pod closes, press another button to replace the air with nitrogen, done.

> life as more precious

I'm sorry, but 'life is precious' is a religious view, even if you call yourself 'atheist'. Life is just life, it is an emergent property of chemical and physical processes and laws. It is interesting, to be sure, but precious? Sorry, no. Humans have killed each other since they evolved from Australopithecus, and have only found more efficient, violent, and deadly ways to do so in the intervening five million years.

I was trying to meet your request for an option that came as close as possible to just flicking a switch.

> Step into a room, step inside a pod, press a button, pod closes, press another button to replace the air with nitrogen, done.

I know of a friend of a friend who did this on his own. If you are of sufficient capacity to step into some place and press a button then you are able to buy or make this equipment on your own and do it yourself.

> I'm sorry, but 'life is precious' is a religious view, even if you call yourself 'atheist'.

And some religious people also believe that taking care of Earth's natural environment is also a religious duty. That doesn't make it a religious view, it makes it a general moral view that is shared between some religions and some atheists. The justification for a moral view is what makes it religious or secular.

> Humans have killed each other since they evolved from Australopithecus

And how many of these deaths have been because of religious beliefs? I think enough of them to say that killing people for moral reasons is a religious view, even if you call yourself 'atheist'.

https://www.airgas.com/medias/Airgas-Compressed-Gas-Cylinder...

The have a volume in cubic feet specified, multiply by the 165 bar that's what's typically used to see how much space it will fill. Looking around our house there's a very odd-shaped closet under the stairs that would be difficult to measure. Of the more typical places the smallest room in the house is a closet. 6' x 5' (minus a 1' x 1' chunk that I believe contains an air duct) x 8' = 232 cubic feet. Suppose you dump 232 cubic feet of material into it--you'll displace half the air which gives a time of useful consciousness of 20-30 minutes. Not good enough. Let's try doubling that, now we end up with a time of useful consciousness of 30-60 seconds. That's probably enough. That's 2 cylinders at 137 pounds each. Or if you use aluminum, 3 cylinders of 90 pounds each.

There are of course some very positive side effects like beautiful architecture and music, and plenty of philosophical debate, but I wish it came without the baggage. But then again, I feel the two Abrahamic religions are philosophically scarce—can't have debate when everyone who disagrees with you is killed or converted.

None of us have a pathological desire to live at all costs, but as it turns out, figuring out when to say “yeah I’m done, see yah” and halt treatment is way more complex than it first seems, especially when making the decision for someone else. Things can happen very fast, and there’s a bunch of things that basically require a job in the industry to know ahead of time.

If anyone knows of some comprehensive resources for helping define reasonable limits, I’d love to hear it.

https://www.orderofthegooddeath.com/

They also do a lot of advocacy around green burial, alkaline hydrolysis, and whatnot as well.

Caitlin Doughty (who founded the Order of the Good Death) Ask a Mortician channel on youtube covers this stuff too, but the older videos might be out of date.

I also discovered that my home state has ZERO listed green burial sites, which is shocking to me because... I live in VT. I would have guessed it would be the leader in green burial, it is right up our wheelhouse!

They've got template letters for sending to politicians on the topics of greener death options and other related stuff. Maybe you can help your politicians know that it's an option that people want.

I want to be composted, personally. I hate those 'put your cremains in a seedling pot and turn into a tree' things because cremains can't nourish anything. Skip the cremation, have a green burial or be composted, and ACTUALLY nourish a tree! I'd have thought green burials and human composting would be an easier sell because of the popularity of those cremains tree things, but apparently not.

Soapbox time: you (almost certainly) do not have to have your loved one embalmed. Bodies are safe and clean and won't smell if kept appropriately. If you are utilising the services of a funeral home and they tell you they won't (or can't) let you have an open casket or other viewing without the person being embalmed, it will be a policy of the funeral home at highest authority. It almost certainly is not the law, as much as some of these homes may try to convince you it is. If it is the law, make them explain which law it is and check. Bodies do not have to be embalmed for viewings. You can take your loved to another funeral home who doesn't pull that rubbish and they will have to release the body. Death is not an emergency and you can take a little time to know your rights and the law before being strong armed into an expensive and unnecessary procedure like embalming. Do it if you want to do it. Don't do it because you've been pressured into it in a time of grief.

This gets additionally terrible when it's for someone else whilst handling the wishes of everyone else with significant ties to them.

Had a relative die a while back who was going through absolute hell the final few days; some family members still have a massive grudge towards the hospice for what they feel like were moves done to ensure they died quicker. I've absolutely no clue why they seemed to think dying in massive pain over a longer span of time seemed better but they did.

No. The cancer was everywhere and it was aggressive. Try what harder? There was nothing to do. Someone close to them felt my mother was being evil and incompetent in not pushing him to eat more. While he lost a lot of weight the cause of death was when it got his kidney (one had already been removed when it was thought to be stage 1.)

https://www.uclahealth.org/patient-resources/support-informa...

Imagine a pain scale of 1-10; pretend 10 is so high that you die from the pain.

Is it worth living at a 7-8 at every moment continuously, to extend your life for 2 months? How about living at a 9 for just 2 more weeks?

If you say "no" that just means you're not hooked up to a machine where that's your living experience (not like someone is actively killing you).

I think, when you put it that way, it becomes easier to set some rules around it. Btw I'm pretty close to someone who would always choose to live longer, but even I would say no to, for example, living at a 10 of pain for just 1 more week of life.

This is overly simplistic. There is little to debate about your example of living at a 7/8 for 2 months. What is more realistic is some hypothetical situation where the average patient has an expected survival of 6 to 18 months, with the hope that the 7/8 pain can be reduced to a 4/5, and with acknowledgement that some days may be a score of 5, some days may be a score of 9. Then what?

As a provider on the other side of it you witness two similar patients take two different paths. Perhaps the first patient lives 36 months with pain score averaging a 3. The family will often appreciate the intervention and effort. The other patient experiences a string of complications and dies after 2 weeks, living at a pain score of 10. Their family paints you as an evil torturer who should have never been listened to.

In fact you can see both types of opinions in this very thread.

This is another common misunderstanding of why people so commonly struggle to get a convincing diagnosis. The problem isn't a clueless doctor robotically listening for keywords. It's that the doctor has 10 minutes to dedicate to you and if it's not in the 80% of straightforward cases for them, the patient gets the bare minimum and then becomes someone else's problem. To solve that you need to fix provider shortages and (in the US) remove the corporate overlords constantly applying pressure on the little worker bees beneath them.

> out doesn't mean you can't look at the patients and see how things are turning out. And recognize that things are not static--your first patient doesn't exist. Things don't just sit there at three for three years and then kill you.

It's becoming clear to me you have a really odd sense of what doctors generally know and don't know. I don't really have an interest in exploring the left side of the Dunning kruger curve with respect to how medicine works.

My entire family has been suffering over the past 18 months watching my 88-year-old grandmother slowly pass away from age-related deterioration and AD.

I worked with mice during my PhD training in the US. If a lab was caught with lab mice suffering like my grandmother is without euthanizing them, the lab would be liable to be shut down.

So I ask: why am I forced to sit and watch my grandmother suffer slowly to death? Why can't there be assisted suicide/euthanasia protocols in place to prevent this suffering?

> Why can't there be assisted suicide/euthanasia protocols in place to prevent this suffering?

Even most religious people believe in mercy killing. The issue is the slippery slope, and the fact that various people have slid down this slope in every country with legal assisted suicide or euthanasia. Whenever you are going to have a third party, or even just a second party, involve itself in someone's death, you have to figure out how to deal with issues every bit as serious as letting someone suffer to death.

https://www.pewresearch.org/short-reads/2015/10/05/californi...

This sounds appealing in the abstract but one thing to consider is the impact on other family members. My parents had a neighbor who chose to remain at home. However that meant his wife also had to stay at home to look after him (yes there were nurses who came in a couple of times a day, but a lot of the burden was still on the wife.) This meant her own life basically shut down. She never went out, and spent at least a year fully housebound for his care.

Once he died, she was able to go out, reconnect with friends, kickstart her life again. Couldn't help feeling the husband's choice here was a selfish one.

* Spouse has dementia, does not recognize you, abuses you for being an intruder in the house, constantly shouts for help all times of day and night.

* Feeding, cleaning (double incontinence).

* Can't go out except for a few minutes when nurses are present.

The above goes on for months and even years with no end in sight. No chance to go out for exercise, hikes in nature, meeting friends. Isolation. At home carers have significantly reduced life expectancy for good reason.

Having hospice care where they can be well looked after is not a bad option, and is not a sign of weakness or failure for a partner.

I'm seeing this right now with a close friend and her 83yo mother.

It's seriously damaging to my friend, and no amount of my reasoning with her seems to help her process her mother's cognitive decay...

...and it leaves me defeated also, I don't have the tools to really be of true help.

I've found that usually the people who said that to me were the least prepared for what that meant.

I'm not saying that we need to get rid of medical advances that prolong life, it's just that these things have created new problems that we aren't dealing with and that not many people are really talking about.

It gets even more dicey when you start talking about things like "well, the 20% chance is you'll survive this. The 80% chance is you'll die". Almost everyone is going to want to roll the 1/5 chance of living rather than taking the "you do nothing and you die" path, even if the 1/5 path is horribly terrible.

the longer you keep someone with medical needs and decent insurance the more you can milk the their insurance or whatever wealth they may have accumulated.

self-absorbed closed ones can also easily dismiss the sick person desires and needs.

I see no incentive for this to change.

We have humans, who can clearly assert a particular desire when of sound, lucid mind. Yet we do not allow them to have any control over one of the most personal experiences their life will ever offer them, when in a medical establishment. We don't allow people to assert a desire to be euthanized gently. We force them to die on their own (by being unwilling to do anything more than remove care), no matter how much they may be suffering. Of course, we always have the option of taking matters into our own hands, with all the potential stumbling blocks that provides.

In contrast, we have pets, who can not verbally assert any particular desire, due to the lack of common language. We can't ask them if they want to stay with their loved ones, or if they're suffering and want to be free. Yet we make the decision to actively end their lives every single day in the world.

Logically, this seems completely backwards to me. It seems like we should err on the side of not ending a pet's life when they don't want us to, and that we should allow people of sound mind to articulate a self-aware desire to have a more dignified, gentle death as much as possible.

As a survival-happy species, our successes are calculated in the number of years we have extended our lives, with the reduction of suffering being only incidental to this aim. To stay alive under almost any circumstances is a sickness with us. Nothing could be more unhealthy than to “watch one’s health” as a means of stalling death. The lengths we will go as procrastinators of that last gasp only demonstrate a morbid dread of that event. By contrast, our fear of suffering is deficient.

The book is very pessimistic but that’s the point, I quite enjoyed it.

As for the premise of the article, it is definitely getting easier to die. We had the plumbers and the rubbish collecting workers clear up our communicable chronic diseases, we de-industrialised and cleared up the air, we quit smoking, put on our seat belts and reigned in the alcohol. So far so good.

But, if you look at the physiques of people, the levels of car dependency and the predominance of the Standard American Diet, it seems that people are going the way of Joe Biden in old age, to have what you might call a loss of cognitive abilities, yet able to be preserved near indefinitely. The President isn't unalive, but he isn't really there. Millions are in the same boat, functionally alive but only from the eye-sockets down, and probably with bits of their colon or bladder removed due to cancer that they have bravely fought with a diet of highly processed food and a sedentary lifestyle.

When it comes to how to live a healthy life, there is so much misinformation that we are all an experiment of n = 1. There is no realm of information that is anywhere near as confusing as diet. Really you are forced to join one tribe or another if longevity is your game. Either you are going to go all in on 'everything in moderation' or go fully ketogenic meat only carnivore, or the other way, full on vegan.

The Google confirmation bias is strong with the whole topic, and I am sure that I could look up 'can I get omega three fatty acid things from eating goat hair' and somewhere there will be an article or 'scientific paper' promoting the eating of goat hair, with a study from some goat herders living in Outer Mongolia, thousands of miles away from any fish, with excellent omega three things going on. There will also be an 'adsense' advert for where you can get goat hair online and Reddit threads on whether you need yak shavings instead.

If I can continue in my career at 80, let alone run one of the biggest countries in the world, I’ll be pretty happy. Car dependence, the SAD and obesity are going to bring back heart attacks in ones 60’s - not a generation of hard working octogenarians.

The stances on death, the reactions when people died… it all matched what you’d do if you believed death was the end and none of it matched what you’d do if you believed people went on to eternal paradise.

I assume that by "stances on death" you mean that Christians generally believe that it is immoral to allow people to die. That is because we believe that the life of humans has a fundamental moral worth, such that it is wrong to kill them no matter the circumstances. Many Christians would agree that the patient of some terminal illness would be better off dead, but that doesn't give us the right to do the deed. We aren't consequentialists, we are deontologists. If something (i.e. killing people) is wrong, then it is wrong no matter if it leads to a better outcome.

As far as "reactions when people died", it should be obvious but it sucks to lose your loved ones no matter what. Even if you felt completely certain that someone's soul was in heaven (and few would claim to be that certain, more on that in a bit), it's still very painful to have to be separated from them. It's comforting to believe that someone is (or will be) in heaven, but that comfort does not just erase the pain that you have to endure in the here and now. People aren't Vulcans, who can shrug things off through logical reasoning. They have feelings that are sometimes irrational but no less real because of it.

Furthermore, nobody can have complete certainty of the future. If I were to lose my job, I would be upset and worried because of how that might impact my family. By your logic, this would mean that I don't actually believe that I'll be able to find a new job. But no, it just means that I know that the future isn't certain. I believe I could find a new job if I lost my current job today. But I'm not certain, and that means I would be upset if I did lose my job. In a similar way, Christians believe in heaven but we can't be certain, so we still fear death sometimes. I mean, Jesus himself was afraid of his impending torture and death at the hands of the Romans! It's just part of being human.

Assuming that people being kept alive by modern medicine are better at procreation, they are indeed the fittest.

Of course most of the people being kept alive by modern medicine are old as hell, though, so they are hardly the childbearing or rearing type.

So now I'm confused as to why you brought it up?

Just means that the survey would ask that question. I'm guessing that GP wants to check whether those who believe in the Darwin awards as well as the moral justness of evolutionary pressure killing certain people earlier that other people, would be more opposed to using modern medicine to keep people alive.

Maybe? It really depends because modern medicine is part of social Darwinism, even though it is against evolutionary biological survival of the fittest. So I could see this going multiple ways among this subset of people. I'd expect the richest of them to believe both in medical extension of life (and fertility treatments) as well as believing that only those who can personally, or societally, afford such intervention should get it. This may be the dissonance GP is mentioning.

If you are saying that modern medicine keeps some people alive through to parenthood who would otherwise have perished: yes, that’s true. We have made our environment less challenging.

There must be some ultra-high-risk test pilot jobs available for 75 year olds with inoperable diseases. Go out with a bang!

That's what calluses are for.

: without painkillers

And poppies, and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9785912/ . Even animals know what plants to eat to help with pain.

: or healthcare

Someone in the tribe knew how to make a splint and what herbs or foods were best for what ailment.

: or a guaranteed source of water that does not carry those roundworm parasites that love to swim inside your eyes

In general I expect that there would be few enough people, and they'd be sufficiently knowledgeable of the water sources among the areas they frequented, that this usually wouldn't be a problem.

https://askdruniverse.wsu.edu/2018/08/31/dr-universe-people-...

https://www.theatlantic.com/science/archive/2020/01/how-did-...

> One group of students decided to put this method to the test. They hoisted their water-filled deer hide directly over a fire, and they planned to let it go as long as the hide stayed intact. The hair on the outside singed, but the skin itself held up just fine. So the students waited and waited and waited. Four hours later, the hide was still intact. It did get very hard, but neither sprung a leak nor burned.

: or anti polar bear sprays so they didn't tear you off and eat alive?.

I'm pretty sure that by the time some of us migrated to where polar bears live we had some pretty good spear technology.

What’s your point here?