Daniel Kahneman opted for assisted suicide in Switzerland
bluewin.ch560 points by kvam 2 days ago
560 points by kvam 2 days ago
I had an old teacher who died almost a year ago.
Great guy, very sociable, knew everyone in the little town he lived in. Kept in touch with a lot of students. Good neighbour, friendly guy who'd talk to everyone.
He got Alzheimers. He started forgetting stuff, and it frustrated him. He got caught driving dangerously, and cursed the doctor who took away his license.
He argued with me about the state of some chicken he wanted to cook. I told him "this is pink all over, you have to cook it more". He got angry. I understood he'd become like this to everyone.
He pissed off everyone on his street, and all police, medical and social workers sent to help him. The disease made him blow up every relationship he had with anyone that he didn't know well, like me and a couple of colleagues.
He got found in his house, having left the gas on, endangering the whole street. He ended up in a care home, not knowing who he was, or who I was.
If he'd been run over by a car, or died of a heart attack at the age of 80, people he knew would remember him as that nice old guy who had a dog and made a lot of art, and was friendly to everyone. Instead he was that 83 year old guy who pissed off everyone, nearly blew up the neighbourhood, and drove like a maniac.
You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
> You really don't want to end up with dementia and related illnesses, it totally sours everyone's view of you.
This seems like such an absurd conclusion to this, as though the opinions of other people of you are what matter when you functionally lose your personhood and then die.
Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
The parent described someone who went above and beyond the norm of other members in his community in his constant positive interaction with his neighbors, collegues, and former students. It is highly likely this kind of person would give a considerable shit if he knew he would become a nightmare for the same community.
There may be others reading in the thread who also can relate to the personality of the teacher and may care about their affect on others when they are "not themselves".
There's a difference between "I don't want the disease because I don't want to become a menace to others" (what you're saying) and "I don't want the disease because it would make me lose social status" (what the original commenter said).
I am left wondering. Can’t people (in general) understand that Alzheimer’s changes a person fundamentally, irreversibly and forever until death follows? Many positive traits of personality disappear, the negative starts to dominate, I think mainly from fear and a subconscious awareness of what is being lost. That’s pretty much 101 of grieving when a loved one is struck with Alzheimer’s. The person has left. You continue caring for a body / a different person because of the relation you have to a former them. But please don’t connect the persons past deeds and being to the actions with Alzheimer’s.
For myself: I hope for assisted suicide before Alzheimer’s. I value me for me. Not-me I don’t value, and Alzheimer’s does not improve not-me over me. But people who cannot separate me from not-me (with whom not-me loses status for me)… I don’t care about them! (Philosophical mood.)
Very few people would choose to be unpopular, and unfortunately this type of behavior is decided by brain function, things like depression, from the beginning.
There are lots of degenerative diseases particularly striking the various biological systems of the body. But neurodegeneration, whether Glio, ALS or dementia are especially cruel and horrific in that they attack and erode the patient's personality, a fundament of individuality and self.
Either and or both?
I don’t want to go that way either. If I start losing my mind to Alzheimer’s or dementia I don’t want to slowly turn unrecognizable to those who love me, fuck that shit. Give me something suitable and I’ll do it my damn self if needs be.
FWIW I agree with you. I want to go out on my own terms if I get that sort of diagnosis. The only major health-related concern I have is that I'll some day experience a traumatic health event that immediately disables me and stops me from making that decision, whether legally (competency) or extralegally.
I know there are medical directives that can be put in place but they don't cover everything and they can't compel anyone to end my hypothetical misery, the most they can do is withdraw care.
In my experience having had a parent suffer this way, you lose them before they are dead and you grieve along the way. I can understand the "souring" phrasing - in that there is less affection for the altered person in the present even while feeling a duty for their care and a deep love for who they were.
I'm grateful for this story - it's powerful to see examples of autonomy at end of life - and contrasts starkly with the experiences many of us have with aging parents. End of life, at least in the US, can be deeply flawed and misery for all.
Valuing how others remember you is definitely a motivation in life for many. I respect that it is not your own, respect that it may be mine. It is by no means "absurd".
It is absurd because it places subjective opinions over objective goods. This is the vice of “human respect”. Human beings do not have a final say about others. They can opine, but opinions are like buttholes, everyone has one.
Sure, it is nice to be remembered well, if you deserve it, but I do not live for the opinions of others. This is slave mentality and pathetic. I care about being good, and if I am hated for that, then so be it. Sad, but better to be hated for being a good person than loved for being a mediocrity or a knave.
And to off yourself out of concern with how people remember you is a condemnation of our society, our lack of charity, our lack of magnanimity, and our selfish prioritization of convenience. Full throttle consumerism.
The definition of good is probably the closest to doing the opposite of inflicting pain on others. There’s very little chance that you will be hated by being good. So definitely behaving or being good is not so different than behaving in a way that other people don’t hate you.
> There’s very little chance that you will be hated by being good
Jesus, Socrates, anyone who stands up against an immoral hierarchy. Rethink your thought
To go down this rabbit hole, presumably someone is hating somebody in this immoral hierarchy though? If everyone is happy with everyone, where's the immoral part? I do think the OP is right that in many circumstances of everyday life, being good usually correlates with being appreciated by people you actually have relationships with. Of course, this being real life, there are exceptions. However, while a child may complain and claim they hate you for not letting them have too much candy, they do love and appreciate you in a deeper way for taking care of them.
Jesus, Socrates, et al, are extreme examples that clearly debunk the comment made above. There are much more mild versions of that everywhere and everyday. Being ‘good’ in no way guarantees you will be loved. In fact, if you have integrity you will probably end up butting heads with people who are ‘not good’, and those folks will likely not hesitate to do underhanded and manipulative things to make you hated by others and not just them. Thankfully that is not everyone, but it is childish to believe that somehow being ‘good’ will make you beloved. If that were the case, being ‘good’ would be the easy choice that everyone makes. It is not.
> It is absurd because it places subjective opinions over objective goods.
Care to name even a single objective good, and explain how exactly it is objectively good?
I would posit that caring for helpless infants is an objective good. It’s not clear to me how I’d explain that to someone who doesn’t inherently understand it.
What does "care for" mean, precisely? Is circumcising or baptizing them objectively good, so that they don't burn in hell for all eternity? What about shaping their skull in a more pleasing form? If they have ambiguous but otherwise working genitals, should you do surgery to assign them a clear sex? Or unto more mundane affairs, is it objectively good to give them baby formula instead of mother's milk, or maybe the other way around? Is it objectively good to take them from their parents and care for them yourself if the parents are not caring for them? How do you objectively determine if the parents are caring for them?
That's a bit contradictory, isn't it? If caring for helpless infants is an objective good only for those who inherently understand why that is, then that's a dependence on the observer's understanding and so it is subjective.
There's a world of difference between something being objectively a certain way, and between feeling really strongly some way about something and thinking that everyone else reasonable would feel the same way too. There are things that are encoded into (most of) our very instincts, things we (for the most part) find absolutely common sense, but this doesn't make them objective. I wish language was able to succinctly express these different levels of "being on the same page", but alas I don't believe it does at the moment, and abusing the word "objective" I can't say I love as an alternative.
I agree with you that it is good to care for helpless infants. The fact that this cannot be clearly explained to someone who doesn’t inherently agree indicates that this is not an objective good, though.
The devil’s advocate would probably also ask how it would be objectively good to protect baby Hilter, knowing that protecting his innocent infant life would lead directly to the deaths of millions.
Is caring for a helpless infant objectively good if it is infected with an extremely virulent plague that will undoubtedly kill any human who comes in contact with it, or a human who comes into contact with them, or them, many layers deep? What if that infant has 2 days to live no matter what, but millions of people will die if it's cared for?
Objective good does not exist, context is king.
You were so close to genuine self-ownership in this post, especially with decrying slave morality - than you ended by getting spooked all over again.
You might enjoy “the unique and its property” by Max Stirner. An excellent philosophical book and especially relevant given that Alzheimer’s takes away the self…
The point is he deserved to be remembered well but due to recency bias and the severity of whatever he did during the end stages of his disease he will not be. I personally suffered immense trauma in my early 20s when I moved to a really cheap place. My parents refused to believe me that there was a black mold and general mold problem in the place I was living and that it was causing me psychological distress and flaring up my eczema. Despite all evidence that I had they dismissed it because I had told them I was depressed beforehand. They are not very in touch with empathy or compassion or mental health. Very old-fashioned view that these things are character flaws which are not to be spoken of. Anyways they dismissed my concerns did not read my messages or view my pictures of personal property being destroyed and the landlord not responding to me, the whole rental was illegitimate and I had identified that early on they even ignored that I got a scalp infection which I had to take oral anti-fungal medication to get rid of. The preponderance of evidence was so overwhelming, but for whatever reason they could not admit I had been right and that they were wrong and refused to help me and actively discouraged me from taking legal action or even to move home for months. Eventually I was blessed with an extended relative who gave me shelter. During one of the worst parts of this period my parents even went so far as to assert that what was actually happening to me was the onset of paranoid schizophrenia. I was close to the right age and sex for it to happen. I knew that paranoid schizophrenics often become homeless and violent and the general awfulness of the condition. If it was not for my own investigation that there was no family history of it and a friend who believed what I was saying and told me that I needed to leave the house and then finally extended family I had a plan to no longer exist. This was partially out of not wanting to be remembered badly, but also so many other things like; not wanting to hurt my loved ones, not wanting to hurt strangers, not wanting to slowly degrade into an unstable and potentially dangerous person and of course the median life expectancy for that condition is so low. I lacked the constitution to allow myself to become someone who would likely damage the world and severely damage those close to me so my logical conclusion based on a false premise during those couple days was to nip it in the bud so to speak as it's a progressive condition. My relationship with my parents has not been the same since, but how could it be. I am forever indebted to a friend and extended family... they quite literally saved my life.
The end point being that with the parents I have there was nearly a guaranteed outcome of only objectively bad things happening for me, for them, for people around me. During that state I saw my plan as honorable and wrote it down in what I was to leave to explain my actions.
the conclusion is true, though obviously the worst part is that this guy spent at least a year in varying states of despair, anger, and even worse psychological terrors.
you don't want dementia because it damages and hurts you and everything and everyone around you
(my grandpa physically attacked grandma multiple times in his last year)
My brother had schizophrenia. No one thought well of him. I guess he should have killed himself as well by the logic some are professing on here. Oh, he tried, but he ended up dying of heart disease.
> Maybe a better focus would be that there often isn't a good way for a community to manage a person who suddenly becomes irrational because of an illness.
Yes, this is the focus. Science has stalled when it comes to neurological disorders. But the response is love and understanding. I do not understand how someone would "sour" on a person because they have an illness. A very absurd conclusion indeed.
Dementia and Alzheimer is not something that can simply be managed throught treatment. It is an inexorable descent into suffering for both the person and its entourage with absolutely zero hope of getting better. At best in the last stages you get very short glimpses of normality within hours of confusions, frustrations, anger and pain.
If I am ever diagnosed with one of those, I absolutely want the chance to end my life before I reach a stage I become a burden to my loved ones and can't give a trustable consent. I'd rather go too soon than too late.
I’ve had a lot of people suffer in my life from health conditions, ranging from mental illness, heart disease, and cancer. And I’ve had to take care of them all at different times. Did I consider this a burden or a gift? Oh, it was hard, but does that mean it’s a burden?
If you think you’ll be a burden on your loved ones can we really say they’re your loved ones? This is a serious question. If you’re thinking that you’ll be a burden do you think that these people really love you?
At least I would want to let them use experimental drugs, or do anything to further the cause of curing Alzheimer’s.
But again, this is all far from the original article about an old man who decided to die because well, we don’t really know, he just didn’t see the point of living anymore.
Have you ever cared for someone with late stage Alzheimer or other forms of severe dementia? The reality of it is that a person who suffers from this is simply not the person you knew, by any measurable definition. They don't remember you, they may well fear and hate you. They change moods at a moment's notice, they live in a state of either lethargy or accute anxiety, suddenly waking up in a place that they don't recognize or remember ever living in, nor remembering how they got there. Their life essentially becomes a series of TikTok reels in which they are the main actor, or a vivid dream. Not only are they not the same "self" that you loved, they are usually not even a coherent "self" beyond a few tens of minutes.
And, just to make everything as heartwrenching as possible, in this series of short reels their mind is swiping through, they occasionally become the person you had loved, for some minutes. And you know that these moments will never get more common, only rarer, but you can't help but think that they're "still in there".
It is my firm belief that any sense of "me" would be long dead by this time. Keeping my body and scraps of my consciousness alive only to torment my loved ones, caregivers, and neighbors would be a cruelty that would serve no purpose. I hope that I don't ever have to make this choice, but I also hope that, if I am ever diagnosed, I will have the chance to make this choice and avoid such suffering.
> Have you ever cared for someone with late stage Alzheimer or other forms of severe dementia?
Yes.
Did I say that it was easy? Did I say that the spiritual way through all this was just pretending like everything is OK? No, it’s a very difficult process.
Avoiding suffering is impossible. Choosing to die to avoid suffering does not guarantee non-suffering. Only understanding suffering and where it originates can get rid of suffering, and you don’t do that by avoiding it.
You are not replying to my core point. Do you believe that a person with severe late stage Alzheimer is the same person they were before the disease reached that point? Do you believe that their old mind and personality still exists at that point? If so, why?
For many other neuro-psychiatric diseases, we know that moments of psychosis are reversible, at least to some extent, with drugs and therapy and the kindness of others. The same is manifestly not true, tragically, for dementia: everything lost is gone forever.
You are not the same person you were when you were nine years old are you? Literally all your cells that you had then are gone and replaced. You’ve also had new experiences and that’s changed self-concept as well. We are not one continuous person that something like Alzheimer suddenly changes.
It’s because we associate so much with our experience as memories that makes us think that that is what we are. Are people with Alzheimer’s the same person? No, they’re different people. This is why we’re not allowed to just go around killing people with Alzheimer’s and dementia.
The thing that makes us alive is the constant change and activity in the body. If you say, someone does not change, that someone is the same throughout their whole life. That amounts to calling something dead, still, unchanging, lifeless.
These people with dementia, they still have a personality don’t they? I know my friend’s mother does. And my friends, father who died a few months back with Alzheimer’s. Yes, he was angry and had outbursts that were 100% uncharacteristically not like his old behavior. But behavior does not dictate who you are is signals that we still have a consciousness. And that is who we are. We are not our memories. We are not our current form of expression. We are our consciousness. Because our consciousness loses the function of accessing memories does not make us any more us.
You are not your memory. You are consciousness. You are the thing that reads memories.
But again, this drifted so far from the point of the article. This man killed himself not for his current suffering, but for his perceived future suffering. He was afraid of change he was afraid of what that change meant. He wanted people to see the same dead person That people saw him in life. A constant unchanging perception.