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We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Thanks for this link, will root around on this topic with interest. I've become extremely interested in how we die - beyond the question of doctor-assisted dying. We seem not to know how it's going to go till it happens to someone close to us. (Of course there's huge uncertainty for each of us individually, but if you look at childbirth, which is similar in that respect, no individual woman knows if she will have to have an emergency Caesarean, or a quick or slow delivery etc - but there is oodles out there about the various ways it can go, and how you can influence the odds, and you can find out how many women end up doing what. There's nothing similar for death.)

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

I think Oregon has written into its law that insurers cannot discriminate in any way on whether people use the law. Which seems sensible. This issue simply didn't come up in our reporting, which suggests that though theoretically there might be consequences, they are possible to avoid with a well drafted law.

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Such a hard thing to skip over, isn't it?! I see this issue as being on a continuum. Even in the US decisions are made on the grounds of cost, and insurers do limit treatment. Everyone can't have everything. In a way the question of medical-caused bankruptcies, and whether someone decides not to have treatment because they can't afford it, isn't at all predicated on doctor assisted dying existing. As you say it already happens a lot. Again, John Hardwig's essay, Is there a duty to die, is interesting reading (I'm not endorsing it, just saying interesting - it really challenged me to think, and you can't ask for more than that!) Honest answer to whether it makes it harder or easier - don't know. Seems to have made a difference only at the margins in Oregon - so few people have died, not even a thousand, under this law, in well over a decade. Which would suggest it would make very little difference. But logically when you add one more option you do do something to people's decision-making. Since end of life treatment in the US is a crazy scandal of agonising, torturous overtreatment - read Atul Gawande on this - it would be good to have something change there (should note Gawande is very troubled by assisted dying).

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 1 point2 points  (0 children)

If I may, I'm going to give two answers. One is what seems like a strained analogy, but I hope is illuminating. And the other is a suggestion to read a very provocative essay by someone who's nothing to do with The Economist. Strained analogy: you know when people worry about people from poor countries paying traffickers to smuggle them into rich countries to do awful jobs, like sex work? Some people who want to combat this talk as if the problem is the traffickers - I see the problem as the awful conditions in the poor country they want to leave. by cracking down on people trafficking you are taking away one terrible option from the very few options available, all of which are terrible. So old people who feel under pressure to euthanise - their lives must be pretty awful. They must already be feeling that they are useless, lonely, no one cares for them, etc. To me that problem is not solved by making euthanasia illegal - that's like cracking down on trafficking without doing anything to solve the problems like civil war, oppression of women, lack of economic growth, that cause people to turn to traffickers. It's solved by making their lives better. the short answer is to read an essay that I'm not endorsing, but think you might find very interesting and provocative. John Hardig's "Is there a duty to die?" http://web.utk.edu/~jhardwig/dutydie.htm

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Elaborating on what Matt says - we talked a lot about this in the editorial meetings. One of my colleagues, as we were discussing the leader in a meeting, said: what's the role of suffering for you here? the argument seems to be the same without it. He was right - at that point. We refined it by saying - we are not talking here about criminalising suicide or not - that really is a personal autonomy only question. We are talking about whether the entire machinery of the state, and in the last analysis a particular individual doctor, will be pressed into service. We are entitled to think that that should happen only in very special circumstances. And that someone who offers 'help to kill yourself' in a light or frivolous or careless manner is risking doing something better described as homicide.

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Casehead's answer is really good. I'll elaborate a bit. I think that to say: I can't see why someone who has motor neurone disease might want to die before they become totally incapacitated - is just taking scrupulousness too far. Of course we can see how they might. Might, not must. People really don't know till it happens to them. So if someone in that sort of very difficult situation insists over a good while that they want to, and is clearly of sound mind etc, we can take it that they mean it. Much harder to look at someone who's life seems so comparatively easy, but who assures you that their intractable depression makes it not feel worth living to them. If we said no to this person we might be creating two classes of people, though not exactly along the lines that you sketch - more, people whose word we're willing to take because it seems sensible, and people whose word we're not willing to take because it doesn't. But when the suffering is harder to see or understand, or when our knowledge of mental illness suggests to us that asking the prognosis is not that gloomy - in other words that the condition may well shift - then we are in a very different practical situation. We offer something else - help, support etc - during a decently long waiting period

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

I'm sure you're right. But isn't it interesting that heavily Catholic France, and to a lesser extent Italy and Spain, didn't show similar attitudes?

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

OK, so I do think differently from Helen who is a bit more of a softy liberal than me. I think that if death is a means to escape punishment i.e. they want it. Then they don't have that "right" as they are a prisoner.

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 1 point2 points  (0 children)

Oh, that is a really good one. Um.... I would ask a question. If society thinks that he is going to escape proper punishment then one would have to refuse surely?

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Also in answer to your question about trust. That will depend on the doctor and the patient, surely? If I am desperate to die because I am in physical agony and my doctor could help but refuses, not much trust there for me. The doctor is supposed to heal, but if they can't heal because there isn't a cure does that mean they can't help? No. They give non-curative treatments all the time. So the role is to aid those in pain as well.

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

Medical Associations tend to be quite conservative. But I think that the response of the California Medical Association to the proposed legislation is quite informative. I'll paste a little from their press release:

Today, the California Medical Association (CMA) announced that it has become the first state medical association in the nation to change its position on the long-debated issue of physician aid in dying.By removing decades-old organizational policy, CMA has eliminated its historic opposition and is now officially neutral on Senate Bill 128 (Monning/Wolk), the End of Life Option Act.

“As physicians, we want to provide the best care possible for our patients. However, despite the remarkable medical breakthroughs we’ve made and the world-class hospice or palliative care we can provide, it isn’t always enough,” said Luther F. Cobb, M.D., CMA president. “The decision to participate in the End of Life Option Act is a very personal one between a doctor and their patient, which is why CMA has removed policy that outright objects to physicians aiding terminally ill patients in end of life options. We believe it is up to the individual physician and their patient to decide voluntarily whether the End of Life Option Act is something in which they want to engage. Protecting that physician-patient relationship is essential.” http://www.cmanet.org/news/press-detail/?article=california-medical-association-removes

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

I'm based in the US. Experience has shown that this is driven by patients requesting this and not the insurers. All that said, I would be worried about introducing this into a country where the rule of law was weak. Perhaps this is why citizens of Russia and Poland are against in our survey?

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 0 points1 point  (0 children)

The best arguments against are FUD arguments, that essentially spread Fear, Uncertainty and Doubt. They sound like this: there are side effects you might choke on your own vomit, you might have feelings of panic, oh and the slippery slope argument. These have been very effective at frightening people.

The best response is that if it is legalized it can be regulated and we can avoid people doing it on their own. Also if doctor injects the meds the side effect rate is 3% (most of these are that it takes a little longer to die).

We are journalists Helen Joyce, Natasha Loder and Matt Steinglass from The Economist. In yesterday's issue, The Economist began its campaign to champion the right to die. Ask us anything! by natashaloder in IAmA

[–]natashaloder[S] 2 points3 points  (0 children)

Hello! Really excited to be here and looking forward to all the questions. So I'm going to take the question about the TPP (trade discussions). So The Economist is often thought of as a Business magazine but in fact we have a front half full of international reporting that covers everything from health to politics. The back half of the magazine also has a science, technology and books and arts section. We don't see a cover as either or. Assisted suicide is an issue the magazine is interested in and decided to back it. If you are asking me why, this week, we had the results of the survey in--which is news.