Freakonomics Radio

678. Who Gets to Choose a “Good Death”?

58 min

This episode of Freakonomics Radio explores the complex and evolving landscape of medical aid in dying (MAID). It features conversations with economist Al Roth, New York Governor Kathy Hochul, and physician Daniel Sulmasy, delving into the ethical, personal, and policy dimensions of choosing when and how to die. The episode examines the growing legality of assisted dying, the philosophical tensions between individual autonomy and societal ethics, and the role of death doulas in transforming end-of-life care.

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✨ Key Takeaways

1

Daniel Kahneman, Nobel laureate, chose assisted suicide in Switzerland, believing that the miseries of late life are superfluous, prompting debate on personal vs. societal value.
2

Governor Kathy Hochul signed New York's Medical Aid in Dying Act with strict guardrails, including a mandatory mental health evaluation and a five-day waiting period, to prevent coercion.
3

Al Roth discusses 'repugnant transactions,' comparing the stigma of assisted dying to historical bans on same-sex marriage, and notes that many doctors secretly practice it even where illegal.
4

Doctor Daniel Sulmasy argues against MAID, calling it 'bad medicine, bad ethics, and bad public policy,' and warns it reflects a culture obsessed with control over life and death.
5

Hospice nurse Suzanne O'Brien advocates for death doulas as a complementary, non-medical support system to help people face death with education and presence, rather than fear-driven decisions.

💬 Notable Quotes

"I have believed since I was a teenager that the miseries and indignities of the last years of life are superfluous, and I am acting on that belief. — Daniel Kahneman (via email read by Al Roth)"
"If being in control is the most important thing, it's a pretty paltry philosophy. You can't control who your biological parents were, you can't not die, and you can't make somebody love you. — Daniel Sulmasy"
"I cannot live my life to the extent of fullness until I make friends with death. — Suzanne O'Brien"