Freakonomics Radio

Podbit · Freakonomics Radio

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

Explore episode Jun 19, 2026
Business
The Economics of Assisted Dying in Canada

678. Who Gets to Choose a “Good Death”? · Jun 19, 2026 Business

Shortly after Canada's court ruling requiring MAID legalization, health economists were already publishing papers on how much the cash-strapped Canadian healthcare system would save. Sulmasy's counter: if your healthcare system isn't giving people good end-of-life care, fix the system — don't prescribe death.

Where this was said

Sulmasy on Autonomy, Free Will, and the Philosophy of Control

At 33:42 · chapter starts 31:10

Dubner pushes back on Sulmasy with the autonomy argument: if free will is a cornerstone of Catholic doctrine, how can the Church oppose the free choice to die? Sulmasy's answer is precise: free will is what makes morality possible — without it, there's no praise or blame, no ethics at all. But free will doesn't mean every choice is right; it means we are capable of choosing, and capable of being wrong. The exchange escalates to Sulmasy's most memorable observation: American culture has elevated control to its highest value, but control can't account for the three most important human experiences — birth, death, and love. You can't choose your biological parents, you can't avoid death, and you can't force love without negating it. Sulmasy also raises the economics of the Canadian case: health economists were publishing financial savings analyses for MAID even before the ink on the court decision was dry. His colleague's counter: if your healthcare system doesn't provide good end-of-life care, fix the system — don't prescribe death as the cost-effective alternative.

Society & Culture
Control Can't Account for Birth, Death, or Love

678. Who Gets to Choose a “Good Death”? · Jun 19, 2026 Society & Culture

The American demand for assisted dying is rooted in a cultural obsession with control. But control, Sulmasy argues, is a philosophically bankrupt foundation: you can't control who your parents were, you can't avoid death, and you can't force someone to love you. A value system built on control excludes the three most important things in human life.

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