61% of people who legally obtain end-of-life medication under MAID laws never use it. O'Brien argues this reveals the real driver: people want the option, the sense of control, not necessarily the act itself — which raises the question of whether addressing fear is a better intervention than prescribing lethal drugs.
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At 50:30 · chapter starts 46:30
The conversation reaches its most layered moment as Dubner asks O'Brien how her work intersects with MAID. She doesn't offer a simple answer. In her experience at the bedside — with ALS patients, cancer patients, people terrified of suffocation or becoming a burden — she hears fear underneath the demand for assisted dying. Her approach is to address the fear directly: educating patients on what medications are available for breathing difficulties, on what the dying process actually looks like, on how their families can be supported. She recounts an ALS patient who said early on 'when the time comes, I'll take care of it' — code for a plan to take his own life — and how building trust and providing education changed that calculus. O'Brien's most revealing data point: 61% of people who legally obtain end-of-life medications under MAID laws never use them [1] — Suzanne O'Brien "61% of people who legally obtain end-of-life medication under MAID laws never use it. O'Brien argues this reveals the real driver: people w…" 50:30 . What they want, she argues, is the sense of control — the option in their back pocket — not the act itself. She stops short of calling MAID unnecessary, acknowledging cases of intractable pain where it may be the right answer. But she argues that a massive education gap means people are fighting for laws when they already have tools they don't know about.
Suzanne O'Brien noted that the average cost of a funeral in the United States is between $7,000 and $11,000, far more than what a fraction of that sum could provide in end-of-life care.
Predictions that AI would eliminate radiologists were spectacularly wrong. Since those predictions, Mayo Clinic's radiology staff grew 55% and the specialty became the second-highest paid in medicine. The reason: AI automated scan-reading, but only 36% of a radiologist's time was ever spent doing that.
Self-help fails because people are sold one universal cure by the hyper-responders who had a transformative result from it. The real problem is context: every method works for the right person at the right time, which is almost never you just because the author says so.
Spencer Greenberg was once so socially anxious his heart pounded just approaching a stranger. His therapist gave him homework: go to a bar alone, talk to 5 strangers. Starting with asking for the time, he worked up to asking men for hugs — and his anxiety fell dramatically in 6 months.
A person who flies regularly but obsessively checks weather forecasts before every flight is not doing exposure therapy — they're teaching their brain that flying is only safe with the ritual. Safety behaviors prevent the brain from ever learning that the feared thing is actually fine.
The worry-time technique assigns all worries to one scheduled slot (e.g. 5 PM). Every time a worry surfaces, you write it down and ban yourself from engaging with it until that time. When 5 PM arrives, most worries feel trivial and the act of batch-worrying exposes how little it actually accomplishes.
In a randomized study of 20 habit techniques, 'habit reflection' stood out: recall a past habit you successfully built, write down what helped you succeed, then apply those same strategies to your new habit. It works because it's self-adapting — it uses whatever worked for YOU.
The tiny habits technique — always having a minimal version of your habit you can do when life gets in the way — keeps the mental machinery of habit formation from breaking. Paradoxically, people given a tiny-habit fallback option were MORE successful at the full habit, not less.
Fears and worries act like playground bullies — they want to ambush you. But when you deliberately seek them out and choose the time of engagement, they lose their power. The volitional act of starting the fight on your own terms is one of CBT's most underappreciated insights.
Most downtime defaults are things you regret immediately after — phone scrolling, binge TV. 'Glad you did it' activities meet the same need for rest but leave you feeling like you spent your time well. The switch from a bad screen to a documentary, a book, or a walk costs almost no extra effort but compounds into identity over time.
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