Reflecting on Assisted Suicide and Daniel Kahneman

A lot of what I’ve written about suicide comes from my childhood experiences that I’ve written about in The Revolutionary Ketamine, my SPEAK EVENT talk, and my recent IHMC Ocala talk. I recently read a Wall Street Journal article about the death of Daniel Kahneman titled "The Last Decision by the World's Leading Thinker on Decisions" by Jason Zweig sparked my interest and prompted another article I wrote: The Controversial Trend: Are Younger Generations Embracing Euthanasia.

Zweig reflects about Daniel Kahneman’s death last year, in March 27^th, 2024 where he traveled to Switzerland clinic and paid for his assisted suicide to leave this world. Zweig, was obviously close to Kahneman and emotional about his death.

Daniel Kahneman

He was born March 5, 1934, was an Israeli-American thinker who won the Nobel Prize in Economic Sciences in 2002 for his work on prospect theory, a rare feat for a psychologist. Kahneman is also famous for his groundbreaking work in behavioral economics, particularly for developing Prospect Theory with Amos Tversky. This theory transformed how we understand decision-making under risk, showing that people aren't the rational calculators traditional economics assumed. Instead, they're driven by psychological quirks—most notably loss aversion, where losses hurt more than gains feel good.

He's also widely known for his 2011 bestseller, Thinking, Fast and Slow, which popularized his ideas about two mental systems: the fast, intuitive System 1 and the slow, deliberate System 2. This framework explains why we make snap judgments or cling to bad investments. Until his death in March 2024 via assisted suicide at age 90, Kahneman remained a towering figure, celebrated for making economics more human.

Human Euthanasia

The article is about why Kahneman chose to end his life through euthanasia. My past articles have addressed human euthanasia and how it can divide rooms, especially with what’s currently happening in Canada with its Medical Assistance in Dying (MAID) program, where they're killing nearly 15,000 people a year through healthcare-assisted suicide. Canada’s decision to include mental health situations was recently delayed until 2027. In the next 20 years, dying on a prescribed date could be a normal occurrence. However, the way Kahneman did it was different and raises important ethical questions.

A Hint at Why Kahneman Chose Death

He was in relatively good health and sound mind leading up to his decision—or so it seemed, though this may only be partly true. In his goodbye letter, he reveals he was grappling with severe kidney problems, during which he experienced a period of lost lucidity. He wrote, “I am still active, enjoying many things (except the daily news), and will die a happy man. But my kidneys are on their last legs, the frequency of mental lapses is increasing, and I am ninety years old. It is time to go.”

He was also fearful about how his mother died: "During her last illness, my mother lost her remembering self…she could not tell you much about her current stay in the hospital because she remembered so little of it. To my dismay, I discovered I knew much more about what she had gone through than she did."

End-Stage Kidney Disease

Chronic renal failure leads to various neurologic disorders affecting both the central and peripheral nervous systems. These complications—such as diffuse encephalopathy, seizures, and stroke—could account for Kahneman’s condition. His mention of a temporary lapse in lucid thinking suggests a possible link to hepatorenal syndrome (HRS), a serious condition where kidney failure arises, typically as a complication of advanced liver disease. Once a patient develops HRS, successful treatment becomes unlikely. I’ll always remember my first HRS case: the patient remained strikingly alert all night, babbling incoherently with trembling lips, seemingly unaware of person, place, or time. She passed away days later. However, we can’t confirm whether Kahneman’s liver was failing. This is purely speculation, and his mental lapses could have had numerous other causes.

This makes me wonder why he didn’t consider a kidney transplant. It’s not impossible for a 90-year-old to undergo a kidney transplant, but certainly with the difficulties of getting on a kidney transplant list, he would have been at the bottom of the list at his age and condition.

Dying Happy

This article raises the question of how to leave or be good with dying. Was Seneca right two thousand years ago that "We suffer more often in imagination than in reality"? Kahneman also once told Zweig: “Self-delusion helps sustain most people.” At least Kahneman appears to have created a happy ending for his 90-year life. His personal reflections on life and death are deeply moving and make us feel a connection to his journey.

As I mentioned in an article, when most of us reach our 90s, our spirit and vitality slip away rapidly, like sand escaping our hands. No biohack can overcome that reality (see the Bryan Johnson article). Think of former President Jimmy Carter just before he died at 100—he was a mere shell of a human being. Kahneman’s death certainly raises profound philosophical questions about how we should approach extreme longevity and the nature of a good death

Is our death ours alone to own?

That’s a great question as the article ends. I surmise that most commenters here would say yes, in keeping with the Western ideal of self-autonomy. But the problem is that when to end autonomous life is subjective, and those who take their lives in a "rational way" will influence others to take their lives much earlier.

Studies have revealed that people with religious faith struggle less with the process of dying. The article doesn’t mention God, who created Kahneman and blessed him with many gifts. Several religious entities and groups have historically opposed assisted suicide, whether or not assisted. The Catholic Church has thought about suicide for over 2,000 years, and views it as a grave offense against the love of self and one that also breaks the bonds of love and solidarity with family, friends, and God.

Also, The American Medical Association (AMA) has summed up the case against assisted suicide well: Physician assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would provide serious societal risks.

Make The Best Of It

As death approaches, should we make the best of whatever time we have left, or should we spare those loved ones around us and hang on as much as possible to our inevitable decline? Certainly, our death is ours alone.

People are less concerned with dying than with the process of dying. We must accept that life will end one day. That makes us uniquely human. But, as Woody Allen once said, "I don't mind dying; I just don't want to be there when it happens." To achieve Allen’s words, one must have a lot of resources and connections, much like what Kahneman had. No one wants to linger in pain or cognitive decline. It shows that those with a lot of wealth can use it to travel and "not be there when it happens." Alternatively, inherent wealth is having good family around you at the time of your death can make it a beautiful process. I recently witnessed one such death, and it was sad, but beautiful at the same time. No matter what, this quote stuck with me: “quitting on time usually feels like quitting too early.”

Substack article: The Controversial Trend: Are Younger Generations Embracing Euthanasia

https://johnathanedwardsmd.substack.com/p/the-controversial-trend-are-younger-ec9?r=1j3a1i

IHMC Ocala talk: Anesthetic to Healer.

https://www.ihmc.us/lectures/20250123/

The Revolutionary Ketamine

https://www.amazon.com/Revolutionary-Ketamine-Effectively-Depression-Prevents-ebook/dp/B0BTZ6Q9KY

Visit Website

https://johnathanedwardsmd.com/

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