I'm very on the fence on this topic; I've watched family members/friends pass in varying degrees of pain, and at least in those cases I'm not sure having assisted suicide would have helped that much. What _definitely would_ have helped would have been better end of life care.

> who has never been in the very unfortunate position of needing to die.

Defining that line is very, very, tricky. People only reach this point at a desperate time, when they are potentailly very vulnerable. There's a huge difference between two people in an end-of-life situation, one who is willing to die and one who isn't, yet both may "need" to die, and we have the meansright now to provide an easier transition from "terminally ill" to the former, but yet people end up in the second bucket all the time.

> Because so few people ever get stuck in that situation.

Yet we have many many people who have suicidal thoughts, and who commit suicide (arguably needlessly), when we have methods of helping. We should have the same methods of helping people who are terminally ill.

(That's not to get into the mess of what do the family of the patient want; things get messy _really_ fast when money is on the line as I've unfortunately witnessed, and it tears families apart.)

The line is not difficult to draw. Again, you’ve never experienced it. There are states of existence where it becomes a simple and plain object in your mind that you must die because of the objective and real factors of your circumstances and not because of a feeling or notion. Until you experience that, it will all be fuzzy, grey, wushu washy fluff in the sky. Because it’s never been real to you.

You know how people will sometimes change their mind when confronted with reality? You know how some men scoff at a dangerous activity until they are pushed out from the crowd to do it themselves? The reality of the situation sets in. All of a sudden your mind is revealing to you things that you had not considered before. Revealing intuitions and details that it had not performed for you because your brain doesn’t consider things in detail until they are perceived as important to you — until they are in front of you. This also happens for death. All of a sudden, details fill in that have never been emphasized in the idiot internet threads. All the details of how a suicide attempt can go wrong, where the line of death really is, all the ways that you might feel pain. It’s completely overwhelming if you are suddenly in desperate need of death. It’s the experience of the most marginalized and abused group of people to ever exist. Forced to die in gruesome and terrible ways and in horrific home made contraptions that very often create a huge amount of pain before fulfilling their purpose.

It is very tricky to define the line for terminally ill people. But the reality is that if you ended up on the wrong side of the line you would welcome the choice.

It's not the same line as "Life is wretched and miserable (because of depression, bankruptcy, relationship breakdown...) and therefore I'd like to check out." Those are all at least potentially fixable with reasonable odds of success.

Something like locked-in syndrome after a bad stroke, or late-stage Alzheimer's - potentially a vegetative state that can last a decade - isn't.

The real problem is making sure the choice is free and informed - not being "encouraged" by other family members for personal gain, revenge, or some other unacceptable motivation. Possibly after a person is no longer considered legally competent, but may still be signalling a current desire to avoid death even though they left a living will stating they would welcome it.

It does indeed get messy very, very quickly.

Open legalisation complicates all of that and turns it into a much harder problem than it is already. The courts would spend a lot of time dealing with those cases.

> making sure the choice is free and informed - not being "encouraged" by other family members

How would you do this?

One way or the other, I think you would end up attempting to create a metric for QoL. Some people, for example, might want death after losing their limbs, or their sight - a difficult life, but not a painful one, some people are born without these facilities and manage to live fruitful lives. If you allow death for those cases, why not evaluate regular suicides the same way?

I think once we figure out depression, assisted suicide will become uncontroversial. If you understand what dying means (end of everything you have and will ever have) and don't have depression, but you want to die then we should let you make that decission. You must have good reasons.

The "potential for abuse" GP is talking about could be rephrased as: with assisted suicide, many more people would find themselves in the very unfortunate position of needing to die, just for reasons external to them.