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Morally Acceptable Behavior - Dilbert Blog

Morally Acceptable Behavior

According to this poll, a majority of Americans now find physician-assisted dying to be morally acceptable behavior.

That doesn’t mean the practice should be legal, obviously. There are lots of practical considerations. But the majority no longer sees it as a moral failing.

On a related matter, I have been noodling on the question of how best to reduce the number of coerced physician-assisted deaths in places where it is legal. There is no perfect solution, but I think social media could someday be part of it.

Coercion in this context means an unscrupulous family member or perhaps a rogue medical professional manipulates grandma into choosing death over a chance of recovery. How would that sort of bad behavior be detected?

One potential avenue for a solution could be Facebook. Let’s say I am worried about being coerced someday after my mind declines. I could put into my health directive today that physician-assisted death is off the table for me unless I have advertised it for sixty days on Facebook. In other words, everyone close to me has to hear of it in advance. Shine the brightest light on it.

The idea, poorly formed at this point, is that the more people who are watching, the less likely the bad people will have full control. And let’s say the doctors involved have to review your Facebook comments before agreeing to anything. 

I would expect dissent in most situations. Family members could have lots of reasons for being opposed. But if the objections are based on morality or dignity, the doctor would be free to align with the patient’s view. If the objections look like “I think the daughter is trying to kill grandma to get the inheritance” then doctors would be able to opt out or require a more rigorous third-party review.

As someone here pointed out, a relative can coerce grandma to change a health directive too. But I think health directives should always show the chain of decisions, not just the current document. Any change to the physician-assisted dying directions should be automatically reviewed by third-parties for signs of coercion.

There is no way to drive the risk of coercion to zero. But the biggest risk is a rogue relative or two operating in the shadows. A Facebook requirement could fix some of that.

I think the coercion risk is real, and it might increase over time as more seniors enter the final years and overload the system. But I also think we could be more clever about reducing that risk with these two tweaks:

1. Flag any changes to a person’s health directive.

2. Post on Facebook your intent to pursue physician-assisted dying, 60 days in advance.

3. Automatic third-party review if the directive on physician-assisted dying has changed, the Facebook option is ignored, or there are questionable comments from friends and family.

I believe anyone could put a Facebook requirement on their health directives today. All it needs to say is that you want the doctor making the decision to review the relevant posts to look for evidence of coercion. 

This idea is slightly less than half-baked. I’m hoping you can improve it. 

Scott

@scottadamssays

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