The Case for the 'Right To Die'

Despite fears, Oregon has seen no signs of abuse


Credit: ZaldyImg / photo on flickr

Life is a gift that can also become an intolerable burden. For those afflicted with terminal diseases, the grim approach of death is accompanied by what, for some, is the unbearable prospect of pain, confusion and helplessness. If death can't be avoided, they would like to decide how and when it comes. 

With them in mind, the California legislature recently approved a bill to permit what supporters refer to as "right to die" and opponents call "assisted suicide." It awaits action from Gov. Jerry Brown, who hasn't said whether he'll sign it. 

The legislation came less than a year after the death of Brittany Maynard, a 29-year-old Bay Area resident who moved to Oregon after being diagnosed with incurable brain cancer. 

Oregon is one of five states that allow physicians to provide such patients with drugs to end their lives, which Maynard couldn't do at home. She made a video explaining her decision, and on Nov. 1, surrounded by loved ones, she carried it out, dying peacefully in her bed. 

Oregon was the first state to pass this kind of measure, authorizing fatal medications for terminally ill patients estimated to have six months or less to live. It grants access only after they request it orally on two separate occasions at least 15 days apart and once in writing, in the presence of witnesses. It requires the involvement of two doctors—who are supposed to confirm mental competency and inform patients of other options. The California bill is modeled on it. 

Before the Oregon law took effect in 1997, critics—I was one of them—feared it would put pressure on patients to kill themselves, warp the practice of medicine, dry up hospice care and put the poor in jeopardy. "It will lead to full-bore, active euthanasia," bioethicist Wesley J. Smith warned. "The consequences to the nation of passing Measure 16 would be devastating and far-reaching." 

But the fears have not been realized. The notable things about the Oregon law are its limited impact and the apparent rarity of abuses. Instead of being devastating and far-reaching, it appears to be modest but beneficial in its effects. 

To start with, not many people have made use of it. In a state with 4 million people and some 34,000 deaths annually, fewer than 80 patients a year have obtained prescriptions—and 39 percent of those never used them. 

The change had no apparent negative effect on palliative treatment. On the contrary, 93 percent of those who ended their lives were in hospice care. 

Those choosing the option typically have not been impoverished members of minority groups. Almost all are white, and college graduates are seven times more likely to do it than those with only a high school education. 

Abuses are not impossible. Critics discount the Oregon data because it comes from reports by the prescribing doctors, without independent verification. Irresponsible physicians may provide lethal drugs to patients who are not terminally ill or patients who need therapy for severe depression, and the misconduct might go undetected. 

But the state says doctors have a strong incentive to follow the law because it grants them legal protection only if they meet its requirements. An official of the Oregon Hospice Association testified, "Oregon is a very, very small state, and we have hospices all over, and they have big mouths. I think if there were any abuses in the law, we would hear about it." 

The broader consequences haven't materialized either. Active euthanasia didn't come to pass. Oregon hasn't given the option to people who are not terminally ill. 

"I really worried about abuse," New York University bioethicist Arthur Caplan, one of the original critics, told me, but he has changed his mind. "The evidence really swung me around." Caplan, no reflexive apologist for assisted suicide, has been critical of how it is practiced in Belgium and the Netherlands, which he regards as "very worrisome." 

Mistakes are inevitable in any system. But absent clear evidence of frequent harm, the presumption should be in favor of respecting the freedom of patients. Just as they have the right to hasten death by rejecting treatment, they should have the right to hasten it by taking lethal prescription drugs. 

Of course, terminally ill patients who can't endure what awaits them may also jump off bridges, step in front of trains, slash their wrists or blow their brains out. For those who want it, there should be a better way. 

© Copyright 2015 by Creators Syndicate Inc.

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  1. This article is way depressing. To counteract, we need more articles about rand paul because he is the bestest and makes me giddy with excitement. Why would anyone in the world want to put a gun in their mouth if he was our fearless leader?

    I’ve noticed the ratio of laudatory Bush-to-Paul Reason articles has gone up. Is he now our libertarian go to guy? If so, I’ll be sure to update my conscientious objector status muy pronto– as he might say– to get myself ready for another Bush War and the comcomitant ambivalence here amongst the true blue libertarian writers here at Reason.

    1. It doesn’t know what “libertarian” means, now does it?

      NAP, that’s the one and only essence of libertarianism. Someone who tells you different is attempting to sell you something.

    2. If people are terminally ill, they should have the power to end their own life. The government assholes need to stay out of other peoples business.

  2. schopenhauer wins this argument, hands down. “…it would be another example of the gross optimism of these religions denouncing suicide, in order to avoid being denounced by it.”

  3. this is THE most important political argument there is. does someone else have a higher claim to your life than you do? that seems to me to be extremely, extremely obvious nonsense. im still waiting for a coherent argument about why suicide is wrong…

    1. Oh, I think suicide is great. I just wish you conservatives would apply the same logic to abortion and women having the right to make their own decisions about their lovely vaginas. Remember, my name is VAGINA LOVER!

      1. im pretty sure i am a) not a conservative and b) applying exactly the same logic in both cases (im not sure where you got my views on abortion from, but regardless). what makes abortion different is it involves another life or proto-life. im actually too conflicted about abortion to have an opinion about it. i fully support a woman’s right to do what she wants with or to her vagina, but abortion could involve somebody else. i mean you could construe anything as someone just trying to be free, but i think there’s a pretty general consensus about swinging your fists and my nose or something

    2. Sheesh. The issue isn’t suicide. If you want to kill yourself, you can find the knowledge on the internet quite easily.

      The “right to die” issue is whether doctors – who take an oath “first do no harm – violate their oath when intentionally prescribing lethal medication. These people don’t want to commit suicide. They want physicians to kill them.

      1. okay that’s a good point. this issue frustrates me to the point of not thinking too carefully about it. my opinion on that would be if a patient wants a doctor to kill him/her and can find a doctor willing to do so, what’s the issue? the argument is inextricably tangled up in the way our culture treats suicide though, which is what’s fucked.

      2. Giving someone the means to kill themselves is not the same as killing them.

        And forcing people to choose between hanging themselves, or suffering with an incurable disease IS doing harm.

    3. Any part of a person that is truly ‘you’ is immaterial. Any part of you that is physical is a gift you didn’t create. Only freewill is ‘you’, if such a thing actually exists which is debatable.

      I think the “right to die” is good law, but the existential questions about identity don’t fall where you would like them to.

      You can’t be responsible for conditions which exist before you do. Cause-Effect-Responsibility.
      Since cause and effect are a function of time, and life “begins”, ppl can’t be responsible for being born poor or black or other uncontrollable things (leftists want to include homosexuality here too).

      This is the basis of the tolerance ideology.

      This creates an ontological problem for self-ownership however, in the strictest terms. We grant ppl self-ownership of their life and body, but only because no one else has a better claim. The truth is that its actually owned by whoever owned the first man. If you believe in non-ID evolution that can be difficult to determine.

      Suicide is a crime against your creator (whatever portion of you can or was “created”), but I don’t think the govt should be making it illegal.

      This is a self-correcting problem like severe child abuse, abortion, and divorce murder-suicides. These extreme cases are irrelevant to law because they are self-limiting and punish the perp in the process.

      1. Suicide is a crime against your creator? How fucking silly! Only if you buy into the religious bullshit that we should believe in a man up in the clouds, even though his existence can never be proven. I live in a real world where you need proof before making a confirmation of something. Suicide, unlike child abuse or murder, isn’t a crime because no one is hurt against their own will. By the way, my god that I worship is VAGINA.

        1. Suicide is a crime against your creator? How fucking silly! Only if you buy into the religious bullshit that we should believe in a man up in the clouds, even though his existence can never be proven.

          If God refuses to be “proven” (in the sense you mean) until his own good timing, then far be it from me to attempt it before he is ready!

          Actually, in this case belief is meaningless. Either there is a god or there isn’t. Our belief or lack of belief in him/her/it/them has any affect on existence.

          Again, if you are indeed right, and there is no god, then you aren’t committing a crime. And, as we don’t call for any use of FORCE OF ARMS against anyone for attempting the “crime”, why do you care what we believe?

          I live in a real world where you need proof before making a confirmation of something.

          Prove you exist. Do it now. Prove gravity. Prove dark matter. Prove grammar rules. (Ad nauseam.)

    4. does someone else have a higher claim to your life than you do?

      Well, yes, but He (God) isn’t in the business of enforcing it on you until you’ve made your final choice not to listen. At that point, he removes his life from you… leaving the “you” that is left. This is called “hell”.

      For the answer that is relevant to the political discussion, no, no human or group of humans has any authority to use force to keep you alive against your will.

      If you kill yourself, you’ve done wrong, but it’s not government’s job to make people do right.

  4. Right to die? As a LIBERAL ATHEIST, I’m 110% in favor. I just wish the idiots at Reason and Faux News (twins joined at the hip) would kill themselves. I’ll give them the gun to do it.

    1. no such thing as a liberal atheist, your religion is called statist, the most violent vicious superstition in the world accounting for 2 world wars, countless genocides, the crusades, slavery, oppression and the perpetual torture of humanity. YOU and those like you are directly responsible for supporting the bloodiest religion in all of human history; Statism.
      the only atheist is an anarchist first.

      1. good point. Very similar argument to “the discovery of freedom”. government is just one of the “pagan gods” some people believe in

        1. Complete with temples, rituals, commandments, prayers, and preists

          1. indeed. to be fair, being responsible for yourself is pretty terrifying.

          2. i have a “friend” on facebook (we’re actually friends in real life too, for whatever that’s worth) who every single damn day posts some bernie sanders propaganda. getting that excited about a politician is fucking insane. seems more like religious ecstasy than thoughtful consideration to me. maybe im just too blinded by capitalism or something to notice the second coming going on right underneath my nose, but i suspect it’s more likely he’s just pretty good at manipulating people. that’s so unlike jews in brooklyn though (im jewish, i can say that)

            1. Sounds to me like the relationship you people have with Rand “Faux Libertarian” Paul. He’s a hypocritical, lying phony and con man, but you WORSHIP him as if he’s “God.” And, by the way, “Stand With Rand” as a slogan is so lame; I thought you people hated slogans. Oh, I guess not when it’s your favorite POLITICIAN using it.

              1. You will find not many here support Rand Paul as anything other than an opportunity to not be fucked over so much by the government, which most of us do not believe in the superstition of a necessary government in the first place…. Its just a modern mythology that hasn’t yet been dispelled by the majority yet, but at least your side doesn’t slaughter the heretics as much these days.
                but i don’t expect a genuine conversation out of you because as all Anarchists know “Statists gunna hate”

              2. i do murmur “stand with rand” to myself every night (more like every four hours) while i masturbate, but i don’t see why that’s anyone else’s business

      2. Hey, DUMMY, with that stupid logic, there’s no such thing as a “religious conservative,” either. And we all know how religion has been used to justify the worst kind of evil; all those things you list were caused by people who thought their imaginary man in the sky was on their side

        1. Statism is the religion by which the government is god or held in as high of authority as god
          Basically, theocracy and democracy are identical in function in the minds of their followers, a quick HONEST examination of your own beliefs will hold this to be true, you are not an Atheist you are polytheistic; without eve talking to you i know you worship politicians, and pray to them each time you vote the thought going through your head when you pull that lever is the same as the man on his knees praying to the invisible skydaddy; and it goes like this “oh please (insert pol here) fix the woes of the world as i see them and force this opinion on all of the non-believers (conservatives) so that they may too be made whole in your righteous glory oh savior (insert pol here) we ask this of thee”
          You are not an Atheist, you must first not be beholden to any government before you can claim no allegiance to a god.
          conversely an Anarchist may be spiritual or atheistic but a person must first be an anarchist before they can claim to be of any other religion than statism.

          1. Man, you really are an asshole and an idiot. Don’t try to impress me with your faux intellectualism, and words like “statism” and “polytheistic” that you learned from this stupid, little rag Reason. You sound like you’re on drugs or one of those “liberal academics” you so loathe creating new terms to try to make your argument sound more convincing. You can’t admit that I’m a LIBERAL ATHEIST because you know that atheism IS the sane, rational view, as opposed to believing in that imaginary man in the sky that conservatives use as a crutch, and if you concede me that, you look like the fool. In other words, you want to change the definition to make your side–the right–look like the rational ones. Don’t try to redefine the word atheist, because I know what it is. Just ask the idiots at Faux News if they think most liberals are atheists. And, by the way, DUMMY, I’VE NEVER FUCKING VOTED IN MY LIFE. I don’t WORSHIP political assholes like Rand “Faux Libertarian” Paul, but I bet you’d vote for that little weasel. Drop dead, asshole. I’d love to knock your teeth out.

            1. nor have i. i have at least decisions to make that will have more of an effect on my life. like all the teeth i could be knocking out. why bother voting when you could be punching someone? civilization? pssh. you know what my type thinks of that idea

              1. the only theological position that actually makes sense is agnosticism. your belief in god not existing is just as facile as you imagine theists ideas are. i want to see something sorta resembling proof either way

  5. Oregon hasn’t seen abuse yet?

    key word is “yet”.

    Look at the Netherlands. Stuff that would make the Nazis glow with pride is occurring.

    1. Nazis? You want to see a Nazi? Go to my crazy Faux News-loving uncle’s house and listen to him spout off his list of every liberal and Democrat he wants put before a firing squad. By the way, Hitler and the Nazis killed Jews who DIDN’T want to die, and in extremely painful ways. For you to try to make that comparison is just idiotic.

      1. Nationalist Socialism is more closely related to 19th century democratic socialism, which ironically is what the modern democrat party represents, republicans are more like Itallian Fascism but both of the parties that make up the american oligarchy are at their core Fascist look up the definitions of words, they have meanings beyond what your high school teacher tells you.

    2. Citation needed

    3. too personal to go into on a comment board i suppose, but if my life had been left up to doctors id be dead. that’s actually not an exaggeration at all, multiple doctors told my mother, who was very very unwilling to just let me die, that she should just give up. and me being alive at all was an egregious misuse of resources. a lot of people with equally serious but less complicated medical issues could have been saved with that money (im worth almost a million insurance dollars). as unfair as that is, it makes me kind of averse to the whole “only a doctor can make that decision” mentality. science is fundamentally flawed in that it’s based on the assumption that what’s happened in the past will continue to happen in the future. that’s probably more true than not true, but it’s really not 100%

      1. What are you talking about? The article was about “assisted suicide”, not euthanasia.

        Look, if I don’t like my life, I can hang myself with a belt on a doorknob. The point is that doctors have access to drugs that make suicide much less painful and much more reliable. Since suicide is not illegal and not immoral, doctors should help you reduce the pain of that choice.

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  7. Did the Friday Funnies cash in on their right to die?

  8. Oregon hasn’t seen any abuse…yet. But how would we know? The majority of “assisted death” (or physician killing) is for cancer, but the “other” category is rising fast. Physician killing for ear ringing is coming. (It already happened in the Netherlands.) Only 3% of “assisted death” cases had psych evals despite one study showing the clinically depressed rate of 27% among those requesting it.

    And we also have a don’t know because we can’t know situation. How many of these deaths are coerced by family members wanting to speed grampa along so that we can divide up the inheritance? There is no mechanism to check for coercion.

    It’s like Obama saying there is no evidence of corruption in his administration.

    1. And we also have a don’t know because we can’t know situation. How many of these deaths are coerced by family members wanting to speed grampa along so that we can divide up the inheritance? There is no mechanism to check for coercion.

      This is paternalistic nonsense. The process for obtaining an assisted suicide is a lot more onerous than the one for say signing all of your assets over to your family, and yet we don’t presume coercion in the latter case either.

    2. They already have the right to kill themselves, they were kinda born with it. making it painless and clean is just a bonus of the government finally getting the point that it has no rights to dictate who should live or who should die. (i know it still doesnt understand this, and is still grasping at threads of control-thus the debate- but still i like to think that someone finally used common sense and said “how the hell can we force people to suffer til death when they can take their lives anyways, these laws are fucking retarded”)

    3. So what? If you’re truly a libertarian it won’t matter to you at all what reasons some other person for wanting to end their life, just as it shouldn’t matter to you what reasons someone wants to have an abortion or get a tattoo or do WHATEVER THE F THEY FEEL LIKE DOING WITH THEIR OWN BODIES. Why should someone have a psychiatric evaluation? What if they want to kill themselves so that they don’t have to suffer the indignity of living with mental illness anymore? Why is wanting to die necessarily symptomatic of irrationality, and moreover, what business is it of yours or of anyone else’s for that matter? Ear-ringing? Have you ever suffered with tinnitus? How can you say that there should be an objective threshold for what minimum level of suffering is acceptable to say you don’t have to endure it anymore?

      I thought libertarians were supposed to be for limited or no intervention in the personal lives of others as long as they aren’t harming anyone else. If someone wants to shoot another person that’s something to be intervened on, not because of the ten commandments but because of the secular philosophy of property rights and the body as a sovereign entity. But that doctrine also tells us that since the body is sovereign, no one has any right to intervene upon what another person wishes to do with his sovereign self. That means that if someone wants to dissolve their “government,” they can choose to do so no matter what paternalistic do-gooders might think is otherwise best.

  9. I can see the Faux News crowd is up and ready to go. I thought you people were supposed to be “libertarians?” I guess only when it applies to non-religious economic issues, huh?

    1. Yes, clearly MarioLanza (who is a drive by troll) represents the entire commentariat here. You are a moron.

      1. Hes not a moron, hes an Oxymoron “liberal atheist” LOL

        1. According to your buddies at Faux News like Chimp-faced Hannity and Asshole O’Reilly, all liberals ARE atheists, and all atheists ARE liberals. O’Reilly also likes to call us “secular progressives.” Rather be that than a CONSERVATIVE THEOCRAT at a so-called “news network” that peddles lies and propaganda, and wants to shut down any dissenting point of view. You people are just as PC as you claim the left is; you get all in a hissy fit when someone criticizes your side. No wonder you worship thin-skinned Trump The Hump (or for that matter, hypocrite Rand Paul) as if he were “God.”

          1. No, I vote for myself for all categories every election year, 2016 will be no different. Look up my old posts if you like and you will see I am an Anarchist and encourage others to vote for themselves as well.

            1. You’re an “Anarchist?” Just another word for “violent asshole.”

              1. And yet, he hasn’t aggressed against anyone.

                Unlike the thing you worship and support…

                1. How do you know for sure. He’s probably one of those anarchist idiots who riot.

                  1. You really don’t know what words mean, now do you?

                    To be more specific, if you see an “anarchist” riot, they are what I will call a “temporary anarchist”, the type who want massive government but realize that creating temporary anarchy is a good way to get it.

                    What you’re dealing with is anarcho-capitalists, who simply follow NAP, which means by definition they won’t aggress against you.

                    If you’re being aggressed against, it’s not by an “anarchist” (as we are using the term), by definition.

                    1. Man, you’ve really learned a lot by reading Reason’s talking points, haven’t you? You and the other “anarchist” have learned so much that you’re now guilty of what you claim others do, which is join a political party or movement (in this case, a bowel movement). You two WORSHIP the ideology more than anything else; it’s become YOUR god.

                    2. Man, you’ve really learned a lot by reading Reason’s talking points, haven’t you?

                      I don’t think any Reason writer claims anarchism. Maybe you should try reading it sometime.

                      You and the other “anarchist” have learned so much that you’re now guilty of what you claim others do, which is join a political party or movement

                      Political movements aren’t bad in and of themselves. Aggressing is bad. I can see why you’d confuse the two as all the political movements you’re otherwise aware of take aggression for granted.

                      You two WORSHIP the ideology more than anything else; it’s become YOUR god.

                      Nope, NAP was instituted by the LORD. Genesis 9:6

    2. I didn’t know Tony was a vagina lover… I thought Tony was one of those cosmopolitan gays who goes on and on about how gay he is.

      1. Who’s Tony, you idiot? My name is Steve, and I’m a vagina-loving, LIBERAL ATHEIST. I know that me saying that bugs the shit out of you CONSERVATIVE RELIGIOUS types. Ha. Ha. Ha.


          Atheist = without a god.

          You worship government (as long as “your guy/gal/thing” is in charge) as a god.

          Therefore, you are not an atheist. You are a “liberal” (modern, American sense of the term) though.

          I, however, am not a conservative, though I once was. You see, I’m a Christian (The LORD is my God) and I recognize that I cannot worship both God and government. Therefore, I am now a libertarian, one who doesn’t trust government to do anything good.

          1. Don’t try to redefine the word, idiot. You sound like that other asshole on here; he calls himself an “anarchist,” you call yourself a “Christian.” You want to change the definition to include a belief in government so you, who believes in a man upstairs whose existence can never be proven, sound like the rational one, when you’re not. How silly! Ask the religious nuts at Faux News if they think liberals are “God-less atheists.” By the way, I don’t even vote but, if I did, at least I’d be voting for a person that actually exists, whereas you put your faith in something equivalent to Santa Claus.

            1. The government religion is the biggest in the United States. Many, many “Christians” actually worship government first.

              you, who believes in a man upstairs whose existence can never be proven

              He will prove himself. Even you will recognize it. Until then, you’ll have to deal with the “proof” you’ve already been given, and ignore.

              I don’t even vote but, if I did, at least I’d be voting for a person that actually exists,

              I vote for people other than God. Once again, you prove my assertion about government worship by completely confusing the 2!

              whereas you put your faith in something equivalent to Santa Claus

              I wonder, do you believe that Alexander the Great lived and died? Because I have more proof that Jesus lived and died (and lived again) than you do…

              Also, I’m a Christian anarchist.

              1. “Christian anarchist.” Very funny.

                1. “Christian anarchist.” Very funny.

                  “In those days Israel had no king; everyone did as they saw fit.”

                  Combine that with 1 Samuel 8, and poof, Christian anarchist.

                  An Excerpt:

                  But when they said, “Give us a king to lead us,” this displeased Samuel; so he prayed to the Lord. And the Lord told him: “Listen to all that the people are saying to you; it is not you they have rejected, but they have rejected me as their king. As they have done from the day I brought them up out of Egypt until this day, forsaking me and serving other gods, so they are doing to you. Now listen to them; but warn them solemnly and let them know what the king who will reign over them will claim as his rights.””

  10. “The potential for abuse” is not a good argument for keeping physician assisted suicide illegal. There will always be abuse. But keeping the practice illegal will make it more likely abuse will occur because those who do not care about violating the law will continue to provide the services.

    1. Abusus non tollit usum

  11. ” I think if there were any abuses in the law, we would hear about it.”

    Apparently that is Chapman’s entire basis for concluding Oregon “has seen no abuses.”

    Reason‘s journalistic decline continues apace.

    1. If the state were not so heavily invested in the healthcare industry the subject of this article might not be a problem…

  12. I just discovered where “VicRattlehead” got that stupid moniker from. It’s the name for Megadeth’s cartoon mascot. Megadeath, of course, is that horrible, no-talent metal band led by idiot “born again Christian” Dave Mustaine. I bet “Vic” WORSHIPS Davey (as Davey apparently worships Rick Santorum), so much so that that’s where he gets his talking points. Not only are Vic’s ideas bad, his taste in music may be even worse. To cleanse his addled mind, maybe he should listen to some good rock. I’d suggest Yes, The Who, Cream, ELP, Jimi Hendrix, Traffic, Jeff Beck, Pink Floyd, The Doors and The Grateful Dead.

    1. Congrats. I’ve never seen an ad hominem attack go on for that many sentences before today.

      1. No? Really? Just listen to Psycho Mark Levin, Faux News or other GOP talk-radio ASSHOLES. Oh, sure, I’m not bound by the FCC as they are, but the sentiment is still the same. And stop whining, because you sound just like those thin-skinned PC liberals you so despise.

  13. Why shouldn’t the practice as it’s done in Belgium and the Netherlands be done the same way here? If people supposedly have a “right” to life, don’t they have the inverse, for whatever reason, just because they own their bodies and should be allowed to call it quits when they say so rather than when nature or “god” calls them “home”? A right is somewhere in the middle between a privilege and an obligation. A privilege can be denied; an obligation must be forced. A right is a choice. You can live if you want to, but if you don’t, so be it.

    On a further note, why shouldn’t people who have other sorts of illnesses which are not imminently “terminal” (a misnomer in a way because technically, life itself is terminal, it’s just a matter of when) but which are nonetheless chronic and debilitating? Parkinson’s, MS, fibromyalgia — and the elephant in the room, mental illness. Therein lies a catch-22: if wanting to die is itself symptomatic of mental illness, how can you be declared sane enough to want to die? And yet, what if you want to die so that you don’t have mental illness (or present with it) anymore? Aren’t these word games just cruel Kafkaesque ways of “playing God” with someone else’s life?

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  15. This article kills me.

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