Taro Aso, Japan's Finance Minister who had a serious problem with foot-in-mouth disease says Let Elderly People 'Hurry Up and Die'

Taro Aso said on Monday that the elderly should be allowed to "hurry up and die" to relieve pressure on the state to pay for their medical care.

"Heaven forbid if you are forced to live on when you want to die. I would wake up feeling increasingly bad knowing that [treatment] was all being paid for by the government," he said during a meeting of the national council on social security reforms. "The problem won't be solved unless you let them hurry up and die."

Aso's comments are likely to cause offence in Japan, where almost a quarter of the 128 million population is aged over 60. The proportion is forecast to rise to 40% over the next 50 years.

To compound the insult, he referred to elderly patients who are no longer able to feed themselves as "tube people". The health and welfare ministry, he added, was "well aware that it costs several tens of millions of yen" a month to treat a single patient in the final stages of life.

In 2008, while serving as prime minister, he described "doddering" pensioners as tax burdens who should take better care of their health.

In 2001, he said he wanted Japan to become the kind of successful country in which "the richest Jews would want to live".

He once likened an opposition party to the Nazis, praised Japan's colonial rule in Taiwan and, as foreign minister, told US diplomats they would never be trusted in Middle East peace negotiations because they have "blue eyes and blond hair".

Shades of Dr. Kevorkian

Judging from the insensitive nature of comments on health issues on top of all his previous gaffes, Aso is clearly unfit for office.

However, a couple things he stated make perfect sense. For example "Heaven forbid if you are forced to live on when you want to die."

That is the way I personally feel as well. It brings to mind Dr. Jack Kevorkian

Jacob "Jack" Kevorkian commonly known as "Dr. Death", was an American pathologist, euthanasia activist, painter, author, composer and instrumentalist. He is best known for publicly championing a terminal patient's right to die via physician-assisted suicide; he claimed to have assisted at least 130 patients to that end. He famously said, "dying is not a crime".

In 1999, Kevorkian was arrested and tried for his direct role in a case of voluntary euthanasia. He was convicted of second-degree murder and served eight years of a 10-to-25-year prison sentence. He was released on parole on June 1, 2007, on condition he would not offer suicide advice to any other person.

Dr. Jack Kevorkian's "60 Minutes" Interview

Please consider Dr. Jack Kevorkian's "60 Minutes" Interview which contains a video of Dr. K. himself injecting a patient who suffered from Lou Gehrig's disease, with a dose of lethal drugs.

Of all the interviews he conducted for "60 Minutes," Mike Wallace often said none had a greater impact than this one.

Dr. Jack Kevorkian had long been a public advocate of assisted suicide for the terminally ill. From 1990 to 1998, he claimed to have helped end the lives of some 130 willing subjects. In September of 1998, Dr. Jack Kevorkian videotaped himself injecting Thomas Youk, who suffered from Lou Gehrig's disease, with a dose of lethal drugs.

Whose Decision Is It?

To me this is a decision best left between an individual and a doctor, or an individual (and their family), and a doctor. I have signed papers saying I do not want to be artificially kept alive in certain situations.

When my mother died of cancer, my father was asked by the doctor "do you want us to try and revive her?" I faced a similar setup myself, when my wife Joanne died.

Terri Schiavo Case

Let's not forget the Terri Schiavo Case. By any practical measure, Terri Schiavo was dead. She had no functioning brain. Yet it took a 7 year battle for her husband to get the right to remove her feeding tube.

George Bush signed legislation to keep her alive. in 2003 Florida Governor Jed Bush signed "Terri's Law" forcing the state to keep a dead woman breathing against the wishes of her husband.

Many of the statements by Taro Aso are of a different nature but some reflect attitudes regarding interference by government that we have seen in the US.

What About Costs

Finally, there is an issue with costs. Even if someone wants to be kept alive, what are the bounds on costs? Does it make sense to spend millions of dollars to keep someone alive for another year?

At what point do we say "you get food, comfort care, and pain relievers" but that's it?

I do not have a precise answer but I can precisely say we need to have a serious discussion on the topic.