I've just had a (distinctly utilitarian) piece on euthanasia published on openDemocacy.net ! Please read and share it, and any friendly comments there would be much appreciated

http://www.opendemocracy.net/thomas-ash/euthanasia-good-thing

Can you still edit it? I noticed a typo here:

'an irrational and short-lived suicidal desires'

also:

'contain suffering a genuine as'

Ah yes I can thanks - good catch. What did you think of it? (Comment here or there, though it's nice to keep the discussion in one place and have any comments at least duplicated there.) I see from the comments that the editor-in-chief has spotted its utilitarian leanings...

I think it's a good piece of persuasive writing for the OD audience, inasmuch as I can tell these things - what would persuade me on a subject like this is quite different to what would persuade the median reader. You can probably guess that I agree with the conclusions but don't think they go far enough (although I think I'm even more liberal/pro-euthanasia than most utilitarians on this issue).

I can't think of any comments at the moment that would be constructive to post on OD, since they'd likely give ammunition to the slippery slopers. I'll think about it a bit more.

Well that's very interesting - perhaps it'd be good to have a discussion about that here then, among us utilitarians?

About euthanasia? Sure...

Where I think I get more extreme than others seem to want to go is not liking the idea of treating 'temporarily' suicidal people as irrational. It seems to me that we get quite a skewed sense of how people in certain states are really feeling. If they're genuinely suicidal, they might kill themselves, so the ones we later interview are already slightly selected for being happier, or at least in a better mental state than the others.

Also, I think our happiness level has to drop well below net 0 before it can overcome our biological programming enough to make us actually seek to end our lives, but we seem to view anything better than suicidal as a 'recovery'. So I could be -10 suicidal, and pull myself back up/expect to pull myself to -2 quietly miserable, and current thinking would have it that because I've pulled myself out of suicide a) that's a better outcome than me having killed myself and b) that I've provided evidence that we should prevent people in comparable -10 states to hold off until things 'improve' - both of which, in this admittedly simplistic scenario, are clearly false.

I'm also up for disconnecting anyone in a permanent vegetative state asap, with or without their prior consent or their families. They don't lose anything, the other patients gain a lot.

In general I think we'd (both qua humanity and qua utilitarians) better to consider our collective fear of death as fear of fear of death. a) I think this is a more accurate description of our reaction to the thought of getting cancer tomorrow (which I think, though might well be wrong, most people find more disquieting than the thought of dying peacefully in our bed at around the same time that tomorrow's cancer would kill us). b) It means that rather than throwing huge amounts of resources at life extension for its own sake, we could use them them to improve our quality of life/allay our more irrational fears. Life extension research ironically becomes more worthwhile after we stop craving it so much, since the lives it's extending will be more likely to be happy ones.

That's interesting, I don't actually think it'd go down too badly at oD, so do post it there unless you'd really worried about that, and certainly post it at the version on my site.

You're right about suicide requiring a lot, and people changing their minds being no proof that that's the right decision for them. However I do still think suicide is often irrational, driven by emotion not in the sense that it's a judgement about one's subjective states but in the sense that it's not a judgement at all. Also my instinct is that most lives are or can be good, and you're missing out on what may well be a good life if you commit suicide young.

As to cancer, again speaking for myself I think I fear it because it'll cause death rather than feat-of-death and other suffering.

tog wrote:You're right about suicide requiring a lot, and people changing their minds being no proof that that's the right decision for them. However I do still think suicide is often irrational, driven by emotion not in the sense that it's a judgement about one's subjective states but in the sense that it's not a judgement at all. Also my instinct is that most lives are or can be good, and you're missing out on what may well be a good life if you commit suicide young.

There are almost 7 billion people on the planet, and more new ones are being created at any time than old ones die. Even if a number of individual lives were cut short if painless suicide became an easy option, this would hardly impact the total number of persons on the planet. It would destroy some societal value in the form of severed social relationships and associated pain of losing a person, and the value of previous education and experience of the suicider, but it would also reduce consumption of limited resources, and realize existential autonomy for all self-aware persons, which increases quality of life while you are living it, and which can also be seen as morally valuable in itself if you care for it axiomatically.

I think the social impact of suicide is overestimated, and from the perspective of individual autonomy it is invaluable as an option.

Hi Arepo, interesting points but I think some of them are built on a misconception about suicide:

Arepo wrote:Where I think I get more extreme than others seem to want to go is not liking the idea of treating 'temporarily' suicidal people as irrational. It seems to me that we get quite a skewed sense of how people in certain states are really feeling. If they're genuinely suicidal, they might kill themselves, so the ones we later interview are already slightly selected for being happier, or at least in a better mental state than the others.

Also, I think our happiness level has to drop well below net 0 before it can overcome our biological programming enough to make us actually seek to end our lives, but we seem to view anything better than suicidal as a 'recovery'. So I could be -10 suicidal, and pull myself back up/expect to pull myself to -2 quietly miserable, and current thinking would have it that because I've pulled myself out of suicide a) that's a better outcome than me having killed myself and b) that I've provided evidence that we should prevent people in comparable -10 states to hold off until things 'improve' - both of which, in this admittedly simplistic scenario, are clearly false.

As explained here (I can send you the full text if you are interested), unhappiness is strongly correlated with suicidal thoughts, not not as much with suicidal actions, much less successful suicide. "To intentionally end their own life, people need the will to carry out their plans. This resolve depends on factors such as fearlessness and being able to tolerate pain and to act impulsively... Poor impulse control, sometimes fueled by alcohol or other substances, may spur suicidal acts." In fact, one hypothesis about why anti-depressants sometimes lead to suicide (this is rare, but it has been observed to happen) is that severely depressed people are often too de-motivated to act on their suicidal thoughts. They lack the will-power or ability to take initiative needed to actually make an attempt. If they start on anti-depressants they may gain motivation before they have improved enough to stop thinking suicidal thoughts.

So while unhappier people probably have more suicidal thoughts, whether people end up committing suicide depends more on other factors. And to the degree impulsiveness is correlated with suicide, it seems like suicide is pretty irrational.

Finally, depression (and therefore suicidal thinking) is often associated with what psychologists call "cognitive distortions", which are extreme forms of general human cognitive biases. It is hard to see these as anything but irrational, and they can clearly lead to suicidal thinking. For example, "Catastrophizing – Focusing on the worst possible outcome, however unlikely, or thinking that a situation is unbearable or impossible when it is really just uncomfortable."Suicidal people may think that they will always feel as terrible as they do now, or not be able to see beyond their current situations or emotional states.

rather than throwing huge amounts of resources at life extension for its own sake, we could use them them to improve our quality of life

This I definitely agree with! Or we should focus on saving lives where it is actually cost-effective. In the US, there is a policy which states that a life-extending procedure should only be performed if it costs $50,000 to obtain 1 additional quality-adjusted year of life. That same amount of money could add dozens of years of life each to hundreds of people if it was invested in health interventions in the world's poorest countries.

Hi Brent,
It's good that we're putting some of the facts about suicide on the table, but I'd just like to provide some balance:

Yes, impulse control and motivation are contribute to suicide, and what you have described is the leading theory for the antidepressant effect on suicide. However, you've omitted to state that antidepressants do reduce risk of suicide in the long-term. People with clinical depression commit suicide because of their low mood, or at least this is the overwhelmingly common-sensical explanation, and convincing anyone otherwise will require a lot of evidence.

Granted, depression is associated with "cognitive distortions". Much of the happiness in one's past can be forgotten. One can forget which hobbies to enjoy. However, it is in the nature of psychology and psychiatry to study the abnormal. And just because cognitive distortions are present, doesn't mean we should ignore undistorted cognition. Put loosely, depressed people aren't always depressed about nothing. When you talk to their families and doctors and even visit them, you can see that there are often real problems. Of course, sometimes these are caused by the depression, although mostly they precede it. Distorted cognition is more interesting to research. It may even be more amenable to Cognitive Behavioural Therapy. But then again, it may never go away. From a utilitarian point of view, the permanence of the cognition is more important than its distortion. If low mood cannot be cured, it is no consolation that it is irrational.

Of course, I do agree with most of what you've said, though. I just hope I've provided some balance.

Hi Ryan,

Thanks for your comments! You added some important points, most of which I agree with.

Ta Brent, I hadn't taken that into account. Presumably unhappiness *is* correlated with suicide, though? (it's hard to imagine many people who'd consider themselves happy taking their own lives)

I also wonder if the mentality behind 'successful suicide' overlaps that behind voluntary euthanasia less than the mentality behind 'suicidal thoughts' would. After all, euthanasia is hopefully painless, and places responsibility for the final act in the hands of someone else, both making it physically easier and removing a possible mental obstacle to success. Is it possible even that the statistics you mention are skewed severely physically impaired people who would end their own lives but simply don't have the capacity to do so?

Either way (assuming any correlation at all), it seems like my argument still applies, but loses some of its weight. One further thing that occurred to me though, is that alive people are significantly more likely to reproduce than dead people, so preventing people who want to end their lives from doing so might increase the proportion of people who want to end their lives in the long run. This is only really relevant if there are physically capable people who're seeking VA rather than just killing themselves directly since I imagine people physically incapable of suicide don't have much reproductive success...

Arepo wrote:Ta Brent, I hadn't taken that into account. Presumably unhappiness *is* correlated with suicide, though? (it's hard to imagine many people who'd consider themselves happy taking their own lives)

Yes of course, I didn't mean to suggest otherwise, I probably didn't phrase it exactly right. What Ryan said about it is correct as far as I know. It is just that successful suicide requires more than just being unhappy, and it doesn't seem to be the case that the difference between people who just have suicidal thoughts and those who successfully committ suicide is that the latter are more unhappy.

I also wonder if the mentality behind 'successful suicide' overlaps that behind voluntary euthanasia less than the mentality behind 'suicidal thoughts' would. After all, euthanasia is hopefully painless, and places responsibility for the final act in the hands of someone else, both making it physically easier and removing a possible mental obstacle to success.

I think you are right, although that is getting at a different question. But yes, there was even a case of someone committing murder in order to get on death row because he wanted to die but wasn't psychologically able to committ suicide directly.

Is it possible even that the statistics you mention are skewed severely physically impaired people who would end their own lives but simply don't have the capacity to do so?

The article I cited and others that I have read mentioned things like resolve, fearlessness, impulsiveness, and ability to tolerate pain. They don't seem to be including cases where the person is physically incapable of committing suicide. I'm going to guess this isn't a major factor in these statistics.

The magazine I currently work for has a debate on assisted suicide and is looking for comments, which'd be highly likely to get printed in the next issue as they're aren't many so far:

http://www.newint.org/sections/argument/2012/03/01/assisted-suicide-dying-legalized-debate/

I posted this comment (that hasn't appeared yet):

Ilora seems to take it as read that the increase in physician-assisted deaths in Oregon is bad. Surely this is putting the cart (several miles) before the horse; if people who previously wanted something and were forbidden from getting it are given access to it without hurting others, we would normally celebrate the change.

The is basically the old argument that divorce should be illegal because legalising would (shock) mean more divorces. Imagine two people should rationally conclude that they want to separate, or that one person should rationally conclude that her own life is not worth living – God forbid! And that phrase seems to be the crux of this; one needs a quasi-religious view on the sanctity of life/marriage to object to the principle that some people could make such choices.

Certainly we might err on the side of caution when offering patients suicide – and any such law would surely do so – but we should temper this with perspective. Simply stating that people sometimes recover to the point that they’re grateful to continue living is disingenuous, unless we also hear how many don’t reach such a point. What proportion of people need to get better in order to justify Ilora’s ‘Dying Well’ group forcing thousands of them (by her own implication) to live a life of agony and humiliation?

If near half of them see such an improvement then perhaps she has a case - but if it’s much less then it seems barbaric to force people to extend such suffering for the sake of a lucky few.

It's primarily an exercise in trying to appeal to people's moral intuition rather than logic; if John's comment is representative of their readers I doubt anything more calculating would be well-received.

Btw Tom, if you can edit their website, it looks as though they're having a problem with smart quotes.

Hey Sasha, harleyotto's a spammer - see search.php?author_id=1005&sr=posts

(And thanks for the heads up about the quotes!)

Yeah, I've zapped him now. Btw, my post is still riddled with that formatting error - any chance I can pull some strings and get you to fix it?

I've passed on the problem with the quotes, and fixed your comment by hand - special treatment

Ta. Need some sort of imperial smiley

Sasha - I should say that your (very good) comment was printed in the following magazine.

Thanks. Which issue was it?