Many people in our society are now living into their late 80's and 90's, but it is also apparent that a large percentage of them have chronic illnesses, injuries and conditions that make life miserable and often virtually intolerable. Then you factor in the massive and heroic utilization of resources for their care, the dramatic toll taken upon the caretakers, family and person in care. I know from personal experience that people are bankrupted, suffer from mental distress and illness, are "stuck" in facilities which provide a low standard of minimal care, and express a desire to end their lives, praying not to wake up the next day. Would it not be more humane to allow euthenasia and release those who suffer the most intensely from their pain and torment? What would you prefer if you found yourself in this situation? Unfortunately many of these human beings are in our society deemed legally disabled from making such a decision for their own care.
There are "problems" with them.
Finding a physician that will allow this, and write the prescription is difficult.
Seeing a therapist is also a requirement.
And the BIG hurdle is that the person is the one that has to physically take the medication.
That means the person must be aware and able to make the decision when to take the medication. NOT going to happen if the person has dementia.
That means the person must be physically able to ingest the medication. NOT going to happen in the case of a person is incapacitated with ALS or with any paralysis that limits the use of the hands..
And if a person is not able to take the medication by mouth that limits as well.
Signing a POLST (goes by other names in some States) limits what can be done to keep a person alive. You can elect to not have CPR done. You can elect no intubation or IV's, or Tube feeding.
The kicker here is that you must appoint a person as Health Care POA that is in agreement with your wishes and they can not let family members step in and prevent them from following through on your wishes.
The one argument I haven't seen, but has crossed my mind, is at what point does it become a narrative about what it is costing the insurance companies to keep treating patients? If there is an option for a medically assisted "out"? "Sorry, Mr. So-and-so, we will no longer treat your chronic condition, because there is no hope for improvement, but we WILL spring for MAiD...so your choice is to continue treatment on your own dime or ingest medication to commit suicide".
You would like to think that sort of thing won't happen, but as MAiD becomes more commonplace and acceptable in the medical profession, I can see the insurance companies considering their bottom-line profits to the exclusion of any other considerations. You are already seeing Medicare Advantage programs denying treatments and procedures that traditional Medicare would approve; is it such a leap to envision a world in which all treatments are denied to a patient with an incurable condition because the patient now has the "out" of a medically assisted (and presumably pain-free) death? And how many of those patients would accept the medically assisted suicide, not out of fear of a painful death, but out of concern of financial ruin of their families should they try to continue treatment that is now being paid for out of their pocket?
I don't enthusiastically support euthanasia as the answer. Often, the person suffering is unable to make this decision, and a loved one must play God and decide, basically, to kill someone.
I think we need to seriously review how the medical community treats every illness, with the goal of keeping a person "alive", but without consideration for what the result will be. We've been conditioned to think "being alive" is the most important thing; more important than quality of life.
100 years ago, when an elder (or young person) became seriously ill, they were kept in their bed, with family around, until they died. They weren't rushed by ambulance to a hospital to be operated on, medicated, have breathing tubes shoved down their throat or nose, and kept barely alive, even when unresponsive. When the heart rhythm slows or stops beating, we add more medication or crush their ribs trying to pump and re-start the heart. Doctors automatically try and "fix" everything. But everything should not be or can not be fixed by medicine.
There have been times when I regret the decision I made 11 years ago, to take my husband to the emergency room when he suffered a stroke. I had no idea at the time what was wrong and just wanted to make him better.
I decided after he came home, bedridden, partially paralyzed, unable to communicate, unable to eat, in diapers, the man I knew and loved was already gone. It was the saddest time in my life. I cried every day wishing he would come back. I knew if he were to suffer another stroke, in his current condition, I would not rush him to the hospital, but would instead hold him and let him know how much he is loved, as nature takes its course.
Ironically, now removed from all the stressors in his life, his body is remarkably healthy. No pain, good blood pressure, no sign of disease. He just can't do anything. He lays in bed watching TV, or I get him out to his recliner in the living room, which is a major feat for me, to watch TV in a different room.
He still can't eat, can't walk, his only verbal communications consist of one or two word mumbled commands to indicate he wants something. He often says a word un-related to what he actually wants. I have to guess. Mostly, he just yells repeatedly for "help" or calls my name. I recognize it could go on like this indefinitely. He could out-live me.
We have a DNR in place, and he is on Hospice. I worry about losing hospice care for him. I worry I will have a heart attack, or fall and break something, and a week or more will pass before anyone comes to check on us. Our life is a very sad situation. We are simply surviving. We are not living. Not meaningfully.
The only reason why our elderly get poor care is plain old money-grubbing and greed on the part of insurance companies and care facilities. Care homes do not have to be the disgusting, miserable places they are and get top-dollar at that. Homecare workers should be considered professionals and they are not. Most homecare agencies will hire anyone and send them into a client's home flying blind with zero training and zero agency support. These problem could be easily remedied, in fact every problem with American healthcare could be easily remedied if all healthcare became non-profit. No investing in nursing homes where shareholders getting a pay day. No ripping off Medicare and Madicaid. If all of it was non-profit they wouldn't cut every possible corner from care quality to food quality to housekeeping, if there was no profits to be made.
I can't say if whether or not people are living too long because every person is an individual. If greed and profit was taken out of old age, the elderly would not be a bankrupting burden to themselves, their families, and our Medicare and Medicaid system.
Take the profit-making out of healthcare and you take the problems out of it too. In past times when many women didn't work outside the home, they would have the care of an elder put on them and that kept many out of care homes. This wasn't fair or right, but it's a fact. What can happen is our government and insurance companies need to make a different approach towards a willing family caregiver. Not a family caregiver program where family member becomes a 24 care slave to a needy elder for tiny monthly stipend that's a joke really. Pay a family caregiver half of what a nursing home collects per resident. Insist that they complete CNA homecare training (that the state will pay for) before they can become a paid family caregiver to an elder. Offer paid respite to them.
There are so many ways aging can be a kinder and easier that don't include killing the person.
Too many suffer for too long . Modern medicine can be great or cruel at times .
There is a crisis of how to care for the number of elderly who need help ,
When I graduated college my first nursing job was at a rural hospital . It was during a nursing shortage. We had a number of nurses for a while from the Philippines. They were paid a lot of money to come to the US and their rent was paid for as well . I wonder if that will happen again as well as bringing CNA’s from other countries to fill the gaps . It will raise the costs .
My problems with the medical profession are more about medicating to keep people alive, with no hope of improvement and no enjoyment in life. In earlier times, it was easier for people to fade away without medication. For families with limited finances, it was common for bed-ridden grandma to turn down being spoon fed so that there was more for the children, and just gently fade away.
This is a complex issue that is not just about costs or corporate greed keeping people alive, or a labor shortage, or a religious/spiritual issue, or a legal liability issue. It's a combo of all that and more.
Once we start down a path of "who should be kept alive" can easily turn into Utilitarian thinking, which is a slippery slope. Who would be next after the terminally ill and very elderly? People with disabilities who can't hold a job? People who can hold a job but require all sorts of assistance just to live "independently"?
I'm with lealonnie1, that we stockpile our own meds, chug some of our favorite booze and do it on our own when we are ready. However -- being "ready" is the tricky part. We all talk a big game about shutting down our lives on our own terms and timing, but even Alva didn't do it when she got the 2nd breast cancer diagnosis at 83. People naturally want to live and it takes a lot to change that and by then it is often "too late" for us to put it into play. Much like in the movie, "Still Alive".
His plan was take a pile of pills , he waited too long , couldn’t open the bottles . So his daughter ( the nurse ) opened all the bottles for him and left the room .
Obviously he is getting good care or he would not be entering year four of his nursing home life. His body refuses to shut down but it is time for him to finally go.
I really don't know what the solution is because it is a slippery slope. I just wish he'd just stop eating already.
As far as I am concerned, I hope to be able to take my own life when I'm ready.
FIL and MIL had their major crisis in 2020 but thanks to well over 1.5m in Medicare, they are still here
I think one of the "problems" is that doctors are not honest with patients and families and they continue to "treat"
I do not think doctors are taught how to accept that death in inevitable and that continuing to treat no longer does the patient or the family any good.
I think the doctors are taught to "heal /cure" and to acknowledge that there is noting more that can be done may be seen as a "failure". No one likes to fail.
I think a rotation in Hospice care, Hospice referral and Palliative Care should be included in the Medical School Rotation just as ER, Surgery and other disciplines are.
Part of the problem is people like my in laws think there is no end to what can be done . My MIL would be shocked when a 96 year old friend would die of pneumonia . No matter how many times I explained to her that even with antibiotics the immune system has to fight off the infection . Old immune systems can fail . So I think doctors feel they have to offer everything , especially to that generation that saw such rapid advances in health care in the last century .
On one hand we would like our LOs to live on other side we want their suffering to end. Constant suffering for us as well, I know sometimes I wish for end then when my husband was in hospital I prayed to keep him alive.
I know my husband’s pain is becoming worse and irreversible.
He was extremely healthy until 60 and for the last five years going down and for last year with increased speed.
He really does not want to live anymore.
Now he has so many health issues, advanced Parkinson’s, spinal stenosis, pain not controlled even with morphine, heart, kidneys and other issues, the
last Saturday I am pretty sure now he had TIA, which may lead to major stroke. I am sure he won’t want to live and I am struggling with what if as it did happen to his father and hubby was the one to make decision to pull the plug, which he did. He knew his father would not want to live like that and hubby repeatedly saying he does not want to either. I don’t know if I am able to do it. I am not particularly religious, rather agnostic, I just think of valuing living but knowing rationally it is better to end it, yet I know I cannot face it. Hopefully sometime else happens.
He is seriously considering MAID, I am against it, although I understand how he feels. The struggle is tremendous.
It looks we will have options for people with mental diseases.
Medical Assistance in Dying (MAID) has been legal in Canada since June 2016 for eligible adults with serious, incurable, and irreversible medical conditions causing enduring, intolerable suffering. It is a legally regulated service administered by physicians or nurse practitioners, with 16,499 cases in 2024.
Key aspects of MAID in Canada as of 2026:
Eligibility: Individuals must have a serious/incurable illness, be in an advanced state of decline, and have enduring, intolerable suffering. A natural death does not need to be foreseeable.
Excluded Conditions: Currently, mental illness as the sole underlying condition is not eligible, though this is expected to change in March 2027. But if there is serious illness in combination of mental then people qualify based on first condition.
Safeguards: Two independent assessments are required. The process requires a written request and a 90-day assessment period if death is not reasonably foreseeable.
Process: It can involve a doctor-administered injection or a prescription for self-administration.
Data: 16,499 people received MAID in 2024, a 6.9% increase over 2023.
My HEAD
My HEART
I only hoped that when it came to the tough decisions the right organ would win any argument there was.
I like you knew my Husband would not want to live the way he was, just a shell existing. That is not "living"
Luckily I never had to make a tough decision that would have caused me an inordinate amount of stress.
As tough as it is you follow his wishes.
🙏
The fact is that many of us will end up this way the longer we journey through life. Many heart attacks and strokes are not fatal, but debilitating. Alva always said she wanted her daughters 1000 miles away but for right now it’s her daughter who flew out to manage things including presumably liaising with Alva’s partner and his children. The days of them hopping on Muni are likely over. The days of facilities are now looming.
Back in the 1990’s I worked in a rural hospital . There was a surgeon who was from Russia . He had been in the US over 20 years with his wife who was also from Russia . Not sure how they had gotten out back in the 1970’s but he was a citizen and his kids were born here. He was the best . His patients were up and walking quick , He was so nice too , to all the nurses .
Anyway , he was the on call surgeon one night when a 98 year old very frail woman came into the ER with a ruptured appendix .
The surgeon told the family she would not live . The family insisted on surgery anyway. So the surgeon did the surgery , the woman lived for about another day or two after the surgery . She was septic BEFORE the surgery from the ruptured ALREADY infected appendix . This is the reason she died . The family then was attempting to sue the surgeon .
The surgeon had been honest and told the family she would not live. The surgeon went out in his backyard and shot himself dead. He left a page long note . The note was printed in the newspaper along with supportive comments from other doctors regarding this doctor’s innocence . In the letter the surgeon spoke about how happy and grateful he was to be in the US , but he could not understand being sued for this woman dying . He described other parts of our culture he could not understand either . He could not understand our overly litigious society. He felt deeply betrayed and shamed for no reason other than someone trying to gain money , and in the process damage his reputation . It was very sad .
I had a friend when I was in my twenties. He invited me to one of his AA meetings. We were sitting there and he recognized a friend in the row of seats in front of us. He tapped him on the shoulder. His friend turned around and half his face was missing from a failed suicide attempt.
So, yeah take pills and drink whiskey but make sure you do it right.
Plus as a Christian woman there is always that moral dilemma regarding suicide. Please, don't hate me for bringing that up. But these are the thoughts that go through my mind when I ponder this topic.
You used a lot of de-humanizing language in your carefully thought out question, like the sarcastic use of the term 'human being'.
Canada's Medical Assistance in Dying (MAID) law allows eligible, consenting adults with grievous, irremediable, and intolerable suffering to receive assisted death. It is a voluntary, patient-driven process—not a "ward of state" system—requiring mental capacity, independent assessment by two practitioners, and, for non-terminal cases, evaluation of alternative care options.
So I am not sure what you state is accurate.
The way I see it MAID is a reasonable option for those who want it and meet the criteria to do so. The government of Canada is not euthanizing people.
I totally agree about the spiritual element of suicide. This is each individual person's issue as they stand alone before God. God is a perfect judge.
And then there is the whole issue with mental illness. At what point will mentally ill people (or those who advocate for them) want to be given the same option? Is not allowing them access to MAID, in effect, telling them that their suffering is somehow less terrible than those who suffer from physical illness? If the quantifying requirement is a terrible quality of life, then who is to say that someone suffering from severe bipolarism or schizophrenia isn't suffering as much as, say, a terminally ill cancer patient? To say (or even imply), by not allowing them access to MAID, that their suffering is not as bad because it is mental rather than physical - well, is that attaching yet another stigma onto those suffering with mental illness, albeit inadvertently?
And what about the mental toll on the doctors who would be making the determination? There are already studies that vets suffer from some of the highest rates of depression and anxiety among medical providers, mostly due to euthanizing beloved pets and the emotional fallout from witnessing it on a daily basis...how long until these doctors and nurses are in the same position?
And to touch on a point that is far more disturbing, how long is it until we hear stories about family members who encourage their elderly LO's to take "advantage" of MAID, not because they are suffering, per se, but because the family can't manage care of them - or worse, to get their hands on an inheritence? Because there are no doubt people in this world who would absolutely do that, sad to say. And then use the excuse of "oh, they were old and suffering, why prolong it for no reason?"
But to focus on one problem , the refusal of doctors to assign a dementia diagnosis is real. My FIL had a minicog test with a low score as well as other very obvious signs of dementia . He refused to follow up with neurology . The primary at his assisted living would not officially diagnose on his record . This caused problems obviously for my husband to be POA . My husband had to do some stealth like things behind a computer screen to manage his Dad’s finances and pay his Dad’s bills .FIL was no longer able to do any of that .
Hospitals no longer will diagnose either . So ER dumps are failing to lead to placement . They also send home and tell the family to follow up with neurology which many elders refuse .
My own sister who was diagnosed with Lewy Body dementia and vascular dementia had some temporary improvement taking the med Aricept .
Last May She successfully strong armed the PA that she sees at a neurologist office to take dementia diagnosis off her record despite scans that prove it . He also wrote in his notes that she was not showing enough reasons in his office that day or the visit a month prior to keep her from going back home to her previous legal residence , which was her son’s home . She showtimes well , in truth she is not safe home alone when her son goes to work . She also won’t let a companion in the home . Her son has cameras up but he can’t watch them constantly at work either .
My sister won her way out of her board and care home and back to her son’s house . My sister thinks her only problem was metabolic encephalopathy that she had and almost died from prior to being placed and she believes she is cured .
The truth is she was having dementia symptoms prior to the encephalopathy . Before the encephalopathy sis even told me she thought she had dementia and made me promise to support her son in placing her when necessary .
My nephew ( her son ) is literally back to square one with her living with him and her Lewy Body and vascular dementia symptoms are increasing again . The Aricept is no longer working .
And now she refuses to go back to the neurologist to be diagnosed . That PA caused her to be emboldened and she will never go back to a neurologist . She says she was misdiagnosed . She clearly has anosognosia. She thinks there is nothing wrong with her now. She is also clearly not in early stage , she’s in middle at least . She’s also having trouble walking and at times feeding herself. So nephew is stuck waiting until she gets worse and he says he will now just wait until she can’t walk and place her in SNF .
My other pet peeve is when the doctor won’t tell a person with dementia that they can’t drive .
He watched his father being kept alive for a decade or more, simply because the rest of the family was able to live in a small mansion due to dad's retirement and veterans pension. Couldn't walk, talk, or eat. Had to have a suction machine to clear his throat because he couldn't swallow. Wore diapers and had a catheter. The primary bedroom was turned into a hospital suite, for all purposes. It was disgusting to see them keep him alive for their benefit!
However, I'm not going to play "God" either. That, I could never resolve the guilt for which I would feel.