[Link] Death with Dignity by Scott Adams

post by Gunnar_Zarncke · 2015-05-12T21:34:49.246Z · score: 5 (5 votes) · LW · GW · Legacy · 92 comments

Over at Scott Adams' Blog you can find a very fine example of using the 'Rationality Engine' to solve the social problem of assisted dying.

 

92 comments

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comment by shminux · 2015-05-12T22:45:09.876Z · score: 10 (10 votes) · LW · GW

Also note that, if you are a cryonics subscriber, deciding when and where to legally die is likely to increase the odds and reduce the cost of an optimal preservation procedure being used. Subject to the usual caveats, of course. Still beats starving yourself to death.

comment by [deleted] · 2015-05-17T07:24:32.800Z · score: 2 (2 votes) · LW · GW

Makes paying for cryopreservation via life insurance rather difficult however.

comment by shminux · 2015-05-18T01:02:33.637Z · score: 1 (1 votes) · LW · GW

Depends on whether assisted departure counts as a suicide by life insurance companies. Maybe someone should check with Alcor.

comment by Douglas_Knight · 2015-05-24T20:26:46.298Z · score: 1 (1 votes) · LW · GW

Suicide does not usually block life insurance.

comment by shminux · 2015-05-25T04:41:45.946Z · score: 0 (0 votes) · LW · GW

A standard policy tends to give a year or two waiting period before covering it.

comment by Viliam · 2015-05-13T08:28:11.677Z · score: 6 (6 votes) · LW · GW

I got the impression that the anti-euthanasia guy is mostly repeating one argument -- that you can always remove pain, therefore the argument of killing people to prevent them from feeling unnecessary pain is always false.

My opinion is that this argument sounds nice and kinda convincing, but is completely unrelated to reality in healthcare. From what I have seen, hospitals for terminally ill patients are more or less torture chambers. There are countries where people are not even allowed to take marijuana to alleviate their pains, even when it is fucking obvious they only have a few days of live remaining. Yeah, there are legal pills that remove the pain for maybe 1 hour, and they are allowed to take one pill every two days, or something like that.

I would respect the opinions of the religious people more, if at the same time they would fight with the same strength for legalization of medical marijuana. Otherwise... fuck them, they are just making other people suffer, so they can feel better about their own righteousness. (Also, some of them are sick people who believe that suffering brings you closer to Jesus, but I hope those are only a small minority.)

comment by Jiro · 2015-05-13T14:38:40.945Z · score: 1 (11 votes) · LW · GW

Medical marijuana is predominantly a scam used as an excuse to have non-medical marijuana and call it "medical". The cases of people who actually need it for medical purposes are very non-central examples of how medical marijuana gets used in reality.

comment by Viliam · 2015-05-13T19:33:11.313Z · score: 2 (2 votes) · LW · GW

Maybe, but what would you recommend instead?

The usual painkillers are more addictive, have worse side effects (which is why they cannot be used as frequently as the patients would need), and they also get stolen by people working in medicine for recreational purposes.

comment by Jiro · 2015-05-13T20:56:17.635Z · score: 0 (2 votes) · LW · GW

One possibility is medical marijuana, with sufficient precautions that it stays medical. I don't know exactly what level of precautions would be optimal, but you could do a lot better than we have now.

comment by waveman · 2016-06-24T10:41:48.128Z · score: 0 (0 votes) · LW · GW

precautions

Always try to keep in mind that precautions are not free. Precautions stop a lot of people now from getting enough pain killing medication. I have experienced this myself, for 6 hellish weeks.

comment by NancyLebovitz · 2015-05-14T17:19:58.281Z · score: 1 (1 votes) · LW · GW

Why do you say that? I keep seeing things by people with serious medical problems who say that marijuana helps a lot with their symptoms.

comment by Jiro · 2015-05-14T19:09:24.368Z · score: 0 (2 votes) · LW · GW

"I see lots of X" and "it is predominantly not X" are not contradictory.

comment by OrphanWilde · 2015-05-13T20:17:42.204Z · score: 1 (5 votes) · LW · GW

Try mentally tabooing the word "medical" and review your positions on medical marijuana. My impression here is that you have strong cached thoughts about what does and does not qualify as "medical", and the difference between medical and non-medical reasons isn't as large as you think.

For one hypothetical example, if there was a drug that made average people into geniuses, would its use qualify as "medical", or "performance enhancing"? What about a drug that made below-average people average? What's the difference, except expectations about what constitutes normality?

comment by Jiro · 2015-05-13T20:54:31.389Z · score: -1 (3 votes) · LW · GW

"Medical" here means "matching what the average person would think of when told it is medical". That is, the word is intended to communicate, and what it communicates is misleading to a large portion of the intended audience.

comment by Gurkenglas · 2015-05-14T10:31:35.142Z · score: 1 (1 votes) · LW · GW

Tabooing Your Words has the purpose of removing a disagreement about word definitions from these discussions. The substitution you made does not help, since now the discussion could continue in the direction of arguing about what the average person thinks of the word (which is pretty close to the definition of definition). (This feels close to Fighting the Hypothetical.)

(Am I intuiting this right that you're not sure you could find a proper substitution that the others could not prove bad at capturing what you wanted to say by using it to prove your point wrong?)

(At this point I'm half expecting a reply from someone along the lines of "This kind of psychological analysis isn't going to make you many friends.")

comment by Jiro · 2015-05-14T15:51:55.018Z · score: -1 (1 votes) · LW · GW

Tabooing Your Words has the purpose of removing a disagreement about word definitions from these discussions.

Tabooing your words is used when you personally are disagreeing with someone and you and them may not mean the same thing by the word. Tabooing your words is not used when discussing whether the word they use is misleading an audience. It doesn't actually matter that the proponents may think that "medical" means "relieves anxiety" thus qualifying recreational marijuana (as well as tobacco and alcohol) as medical; they know very well that the audience won't interpret it that way.

Am I intuiting this right

No.

comment by Jiro · 2015-05-13T20:59:24.530Z · score: 0 (0 votes) · LW · GW

Is there a reason why I keep getting moderated down here?

comment by hairyfigment · 2015-05-13T22:44:53.716Z · score: 2 (2 votes) · LW · GW

I downvoted you because Viliam claimed medical marijuana prevents a great deal of pain, and you responded with - an argument that fails to even assert it causes pain elsewhere. Perhaps you could start by showing that what you call the "central" use of medical marijuana does not displace other recreational drugs.

comment by Jiro · 2015-05-13T23:36:03.031Z · score: 0 (2 votes) · LW · GW

He didn't just claim that medical marijuana reduces pain, he claimed that it reduces pain, and therefore people who oppose euthanasia should support it. This argument implicitly assumes, not just that medical marijuana prevents pain, but also that there are no other reasons (including non-pain related reasons) which outweigh the benefit from preventing pain.

In other words, given his argument, any argument that medical marijuana is in general bad--including claims that it is misused for non-medical purposes--is responsive. So is any argument that asserts that pain relief is relatively infrequent, because he is (implicltly) balancing pain relief against other reasons, and the other reasons affect the result more if pain relief is infrequent. Just because his claim is that it reduces pain doesn't mean that counter-arguments must be limited to asserting that it causes more pain elsewhere.

comment by hairyfigment · 2015-05-14T02:50:02.160Z · score: 0 (0 votes) · LW · GW

Viliam:

I got the impression that the anti-euthanasia guy is mostly repeating one argument -- that you can always remove pain, therefore the argument of killing people to prevent them from feeling unnecessary pain is always false.

...From what I have seen, hospitals for terminally ill patients are more or less torture chambers.

But sure, if you had argued that we should view marijuana use as approaching torture in badness, or even that the opposition takes this view, that would be responsive.

Now the Catholic Church does in fact seem to oppose marijuana across the board. As an outsider I find this ludicrous (will they treat it more like wine once someone claims it can become the breath of Christ?) but certainly I would not have downvoted you had you presented your claim as an explanation of the (specifically Catholic) opposition and not implied that I should share your objection.

comment by Jiro · 2015-05-14T04:13:18.821Z · score: -2 (2 votes) · LW · GW

I'm not Catholic and not specifically trying to explain a Catholic position. I am trying to justify it, however (without claiming that the justification is the one used by Catholics).

But sure, if you had argued that we should view marijuana use as approaching torture in badness, or even that the opposition takes this view, that would be responsive.

I find it difficult to imagine what pieces of evidence one could give for hospitals being like or not like a torture chamber. I also find it difficult to imagine that he's seen or measured pain levels in many actual torture chambers in order to be able to meaningfully compare hospitals to them. In other words, calling it a torture chamber is an applause light, and doesn't actually say anything more than just "there is unnecessary pain", which as I've pointed out, I did respond to.

Will you now retract the downvote?

comment by NancyLebovitz · 2015-05-14T17:23:17.533Z · score: 1 (1 votes) · LW · GW

Have some evidence-- medical professionals refuse end of life care

comment by Jiro · 2015-05-14T19:08:32.204Z · score: 0 (0 votes) · LW · GW

That is evidence for there being unnecessary pain, which I don't deny.

Edit: I suppose that's too strong. If the pain is part of a tradeoff against worse consequences it might be necessary. So change that to "that is evidence for there being pain that produces negative utility to the patients, which I don't deny".

comment by waveman · 2016-06-24T10:39:42.213Z · score: 0 (0 votes) · LW · GW

There is a large body of work in religious traditions that sees suffering as good.

Here is the soon to be Saint Theresa

From wikiquotes

"One day I met a lady who was dying of cancer in a most terrible condition. And I told her, I say, "You know, this terrible pain is only the kiss of Jesus — a sign that you have come so close to Jesus on the cross that he can kiss you." And she joined her hands together and said, "Mother Teresa, please tell Jesus to stop kissing me".

comment by ChristianKl · 2015-05-18T14:50:13.063Z · score: 0 (0 votes) · LW · GW

Morphium is also capable as a painkiller. I'm not aware that there pain for which marijuana is the only possible way to stop the pain.

comment by Viliam · 2015-05-19T07:39:07.695Z · score: 1 (1 votes) · LW · GW

It may depend on country, but in situations I have seen, the patients were not able to receive enough morphium to stop the pain most of the time. There were limits on how often they can get a pill, and if I remember correctly, it was once in a few days, but the pill only worked for a few hours.

The limits on how much morphium one can get are probably motivated by trying to (a) minimize the risk of addiction, and (b) avoid health damage. Both of that is nonsense if we speak about a person who obviously only has a few weeks of life left and zero chance to recover.

If we could ignore these limits, I don't really care whether morphium or marijuana or anything else, as long as it works. But currently, those limits exist.

comment by ChristianKl · 2015-05-19T13:04:23.861Z · score: 0 (0 votes) · LW · GW

Higher doses of morphium aren't given per pill but intravenously.

As far as I understand in Berlin where I live a patient who's in the hospital and in pain usually get's more morphium if he asks for it.

From a medical perspective it's much easier to dose morphium than to dose marijuana smoking.

comment by VoiceOfRa · 2015-05-13T02:47:50.490Z · score: 1 (5 votes) · LW · GW

Scott Adams strikes me as being really bad at actually using rationality despite the name. I think the commenter PhantomPhlyer was spot on:

Is it just me, or did Scott's conclusion not really conclude anything? It just said that, according to Scott's poll report (I haven't seen any poll, and consider one on emotional a topic such as this depends on how the question is worded), that 'most' Californians would favor death by doctor.

Was that the point of this whole tedious exercise? To repeat the same assumption he made at the start of this debate?

I also think this tome concentrated too much on 'dignity' and not enough on 'death at the hands of another.' Scott appeared to brush over the idea that you're asking a doctor to violate his oath and kill another human being. I think that's at the crux of the debate.

This whole agonizing journey, to me, is based on the following truism: he who frames the debate controls the outcome. But maybe I missed something in his conclusion.

comment by HungryHobo · 2015-05-14T10:27:17.020Z · score: 4 (4 votes) · LW · GW

Some of the modern versions of the oath don't say that.

http://guides.library.jhu.edu/c.php?g=202502&p=1335759

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty.

The way it was phrased to my by a doctor who spent many years caring for people with terminal illnesses:(from memory)

"Drugs have side effects, some of them have serious side effects. This is acceptable. When someone is dying you treat the pain with whatever dose is needed to treat the pain. Many drugs and painkillers can cause side effects such as damage to the patients internal organs and even death but death can be an acceptable side effect of a treatment for extreme pain. When there is no hope of recovery you treat the pain, you don't refuse to treat extreme pain for fear of side effects."

I'd recommend the The Richard Dimbleby Lecture by Terry Pratchett "Shaking Hands with Death"

https://www.youtube.com/watch?v=90b1MBwnEHM

comment by Jiro · 2015-05-15T14:27:11.490Z · score: -2 (2 votes) · LW · GW

Terry Pratchett wanted to die because he had Alzheimer's. As far as I know, Alzheimer's doesn't cause physical pain, so this dodge would not work in euthanasia for Alzheimer's.

comment by HungryHobo · 2015-05-16T16:56:27.010Z · score: 1 (1 votes) · LW · GW

Dodge?

How does that statement imply that pain is the only acceptable case? There are many other horrible, distressing and unpleasant things in life and not all of them involve pain. Pain is just a simple case.

comment by Jiro · 2015-05-17T01:24:17.100Z · score: -3 (3 votes) · LW · GW

It's a dodge because it tries to use a loophole in the rules about killing. You can't intentionally kill, but the people who you want to intentionally kill suffer pain, and you're allowed to incidentally kill in the course of relieving pain. So you just characterize the killing as incidental rather than intentional and presto, you can now morally kill them.

The loophole doesn't work for Alzheimers because it doesn't cause pain like that.

comment by HungryHobo · 2015-05-17T13:46:42.178Z · score: 1 (1 votes) · LW · GW

That's not a loophole, that's literally just a description of doing things how you're supposed to do them.

It's like describing rightlyfully claiming simple tax deductions you're entitled to as a "tax loophole" or winning a game by scoring the most goals against the other team as using the "goals loophole".

Read more than the first word of my post.

There are many other horrible, distressing and unpleasant things in life and not all of them involve pain. Pain is just a simple case.

Pain is just another form of distress, people with only a childlike understand of ethics might ignore anything except pain but relieving other forms of significant suffering can also perfectly ethically involve death. There are things in life worse than death and that doesn't just include pain.

Having literally everything you are slowly erased can be massively distressing to people.

comment by Jiro · 2015-05-17T17:10:02.751Z · score: -2 (2 votes) · LW · GW

Having literally everything you are slowly erased can be massively distressing to people.

And by your own reasoning, doctors are not allowed to kill them, because they're only allowed to kill people in pain and only by using physically damaging painkillers.

comment by HungryHobo · 2015-05-18T00:24:31.016Z · score: -1 (1 votes) · LW · GW

Yet again. You seem to lack a basic understanding of the difference between if and iff (if anf only if).

If does not imply iff.

comment by Jiro · 2015-05-18T14:24:10.480Z · score: 1 (3 votes) · LW · GW

I have a basic understanding of implicature. Saying that you are permitted to kill patients if you are doing it incidentally in the process of alleviating pain also implies, in normal conversation, that you are not allowed to do it otherwise. It is a "limiting implicature".

comment by HungryHobo · 2015-05-18T16:19:31.369Z · score: 2 (2 votes) · LW · GW

Outlining how in some jurisdictions you're allowed to drive drunk in some situations and giving the example of escaping a kidnapper may imply that driving drunk is normally disallowed. Absolutely.

On the other had it in no way shape or form implies that similar rules of thumb do not apply if you're escaping a rapist or murderer.

Talking about a specific case where it's ethical to relieve a particular kind of distress through death implies that using death as a treatment isn't the usual case but it in no way shape or form implies that it's the only case.

comment by Jiro · 2015-05-18T17:30:01.611Z · score: -2 (2 votes) · LW · GW

It implies that causing death isn't the usual case in similar situations. Saying that it's permitted in circumstances related to particular fatal illnesses implies that it is not permitted for other fatal illnesses that don't meet the same criteria.

comment by HungryHobo · 2015-05-19T10:09:24.853Z · score: -1 (3 votes) · LW · GW

You're not actually reading any of my replies are you?

It doesn't matter what I write here, you're going to ignore it utterly like the last 3 posts and just repeat your same basic misunderstanding.

comment by waveman · 2016-06-24T11:24:37.902Z · score: 2 (2 votes) · LW · GW

you're asking a doctor to violate his oath

Why this reification of a 2500 year old trade union membership oath? That doctors no longer actually use, for reasons which will become obvious below:

Should we also ban women from the practise of medicine, as the oath requires. And ban doctors from performing surgery?

comment by DanielLC · 2015-05-13T19:41:23.394Z · score: 2 (2 votes) · LW · GW

Scott appeared to brush over the idea that you're asking a doctor to violate his oath and kill another human being.

The oath doesn't matter. You can change the oath. If the oath is stupid, I'd go so far as to suggest outright violating it. If there are reasons behind the oath, then you shouldn't violate it willy-nilly, but you also can only argue based on the oath in the near term. On large scale things, you argue based on the reasoning, and if the oath doesn't match up with the right thing to do, you alter the oath.

comment by Jiro · 2015-05-13T08:44:17.481Z · score: 2 (6 votes) · LW · GW

Scott appeared to brush over the idea that you're asking a doctor to violate his oath and kill another human being. I think that's at the crux of the debate.

You have reasons for not wanting to kill another human being. Promoting "don't kill" to a terminal goal and forgetting that you have reasons for not wanting to kill, and therefore that you should be willing to kill when those reasons don't apply, is a lost purpose. (I'd link you to the post here about lost purposes but it is horrible.)

Also, in this specific case, the doctor has a legal monopoly. Getting and administering euthanasia drugs without a doctor is illegal, even where physician-assisted suicide is legal. If you want the doctor to be able to opt out of killing, then you should also remove the legal monopoly which forces the patient to use a doctor in order to be killed.

comment by Silver_Swift · 2015-05-13T10:49:50.214Z · score: 2 (2 votes) · LW · GW

Moreover (according to a five minute wikipedia search), not all doctors swear the same oath, but the modern version of the Hippocratic oath does not have an explicit "Thou shalt not kill" provision and in fact, it doesn't even include the commonly quoted "First, cause no harm".

Obviously taking a person life, even with his/her consent, may violate the personal ethics of some people, but if that is the problem the obvious solution is to find a different doctor.

comment by DanArmak · 2015-05-13T16:45:11.851Z · score: 0 (0 votes) · LW · GW

Getting and administering euthanasia drugs without a doctor is illegal, even where physician-assisted suicide is legal.

This isn't specific to euthanasia but applies to all prescription drugs. As long as the law doesn't let people decide to take even minor mostly-harmless medications without a doctor's approval, it will certainly not make an exception for drugs designed to kill people. Changing these laws is far harder yet than changing the laws prohibiting suicide and (non-medical) assisted suicide in general.

comment by DanielLC · 2015-05-13T19:36:19.346Z · score: 1 (1 votes) · LW · GW

There are lots of drugs people can take without doctor's approval. It's just ones with harmful side-effects that are a problem. Drugs for euthanasia are, for all intents and purposes, 100% effective with no side-effects.

comment by DanArmak · 2015-05-14T08:35:19.837Z · score: -1 (1 votes) · LW · GW

Drugs for euthanasia are sugar pills with 100% occurrence of lethal side effects.

comment by DanielLC · 2015-05-14T21:00:08.816Z · score: 1 (1 votes) · LW · GW

A side effect is something other than the intended effect. If you used it as a placebo, then it would have a 100% occurrence of lethal side effects, but as it is it has none.

comment by DanArmak · 2015-05-15T12:38:48.844Z · score: 0 (0 votes) · LW · GW

That's true. I'll amend my statement: the law forbids harmful (eg lethal) medicine, not just harmful side effects. A deliberately lethal medicine is simply a poison. The law forbids both killing and suicide, so deliberate poisons are obviously illegal.

I'm not saying this is a good state of things; just that there's no hope of it changing. People will not be allowed to buy euthanasia drugs without a doctor's approval, because it will be seen as legalizing both suicide and poison that could be used to murder someone.

comment by Lumifer · 2015-05-15T14:52:47.149Z · score: 0 (2 votes) · LW · GW

A deliberately lethal medicine is simply a poison.

The dose makes the poison and that has been known for ages. You can kill a man with water.

"Euthanasia drugs" only make death pleasant and painless. Often they are just an overdose of opiates.

comment by DanielLC · 2015-05-15T19:48:59.384Z · score: 0 (0 votes) · LW · GW

They are a poison. The fact that they can do other things is irrelevant if you're using them as directed for a poison. Although I suppose there might be problems if someone claims to be suicidal so they can underdose and use it for opiates.

comment by Lumifer · 2015-05-15T20:07:07.608Z · score: 1 (1 votes) · LW · GW

They are a poison.

I don't think you get it. Everything is poison in the appropriate dose. What usage is "as directed" is irrelevant if you can freely acquire the necessary amounts.

comment by DanArmak · 2015-05-15T18:41:25.960Z · score: 0 (0 votes) · LW · GW

Which is one reason most opiates, and most other drugs you can easily overdose on and die (as opposed to water), are not legal to buy without prescription.

comment by Lumifer · 2015-05-15T19:42:03.062Z · score: 0 (0 votes) · LW · GW

Actually, no, the reason why you can't buy opiates without a prescription is because they are addictive psychoactives.

You can very easily overdose on Tylenol (acetaminophen, paracetamol), but it will take you a while to die from liver failure. You can buy unlimited amount of Tylenol in every pharmacy.

comment by DanArmak · 2015-05-16T00:47:15.175Z · score: 0 (0 votes) · LW · GW

Actually, no, the reason why you can't buy opiates without a prescription is because they are addictive psychoactives.

Like I said, dangerous overdoses and side effects are one reason, not the only reason.

Which drugs are legal, and which don't require prescriptions, is in large part a matter of historical contingency, lobbying and politics. But there are other reasons too, and dangerous side effects or overdose effects are among the more important ones.

comment by Jiro · 2015-05-13T16:51:24.519Z · score: 0 (0 votes) · LW · GW

This isn't specific to euthanasia but applies to all prescription drugs.

I have no problem with saying that doctors shouldn't be able to use moral reasons to refuse to prescribe other prescription drugs, either.

comment by DanArmak · 2015-05-13T18:05:19.979Z · score: 0 (0 votes) · LW · GW

What kinds of non-moral reasons should they use, then? Or should people be able to legally buy and use all legal medicine freely?

comment by Jiro · 2015-05-13T21:12:00.374Z · score: 2 (2 votes) · LW · GW

"Non-moral reasons" is shorthand for reasons that do not involve morality that is not intrinsic to performing the duties he is being paid for. For instance, "I refuse to give the patient drug X, because drug Y will cure the patient and drug X will not" is a moral reason insofar as wanting the patient to be cured is a question of morality, but it would be okay. "I refuse to give the patient drug X because God tells me not to give people drug X" would be an unacceptable reason. This actually happens for contraceptives.

One solution is to prohibit such doctors from practicing medicine. Another solution is to permit them to opt out for moral reasons, but only if

  1. There is some reasonable way for the patient to know in advance, and
  2. Circumstances are such that the doctor's opting out doesn't make it too much harder for the patient to see another doctor who will provide such prescriptions

Letting people buy all medicine freely has its own problems because the doctor's refusal to prescribe also implies the doctor refuses to use his expertise to tell the patient what medicine he needs.

comment by ChristianKl · 2015-05-18T15:05:24.274Z · score: 1 (1 votes) · LW · GW

Legalizing euthanasia doesn't force any doctor to engage in it. It just removes punishment when a doctor engages in it.

comment by VoiceOfRa · 2015-05-19T04:33:00.633Z · score: 0 (2 votes) · LW · GW

In theory you are correct. In practice, the way similar issues have played out in the US is that regulators start applying reasoning like Jiro exhibited elsewhere in this thread.

comment by ChristianKl · 2015-05-19T12:51:42.025Z · score: 0 (0 votes) · LW · GW

No doctor is forced to operate his patients. A doctor might be forced to inform his patients that it's possible cure his illness by surgery.

There no need to argue for slippery slope, it's quite possible to write laws that allow doctors euthanasia but make clear that they are not forced to do so. Additionally you can also put other restriction on it like marketing bans.

comment by VoiceOfRa · 2015-05-19T16:01:32.766Z · score: 1 (3 votes) · LW · GW

Surgery requires a lot more skill then giving someone a lethal dose of something.

There no need to argue for slippery slope, it's quite possible to write laws that allow doctors euthanasia but make clear that they are not forced to do so.

It's also possible to right laws that allow for gay "marriage", but don't force, say bakers, to bake cakes for gay weddings. The way things actually play out suggests this isn't actually possible in practice.

Also I have a question. Do you actually not want doctors forced to perform euthanasia or are you just trying to alley my concerns? If the latter, you are being disingenuous. If the former, why did you reply to me but not to Jiro?

comment by Good_Burning_Plastic · 2015-05-22T08:05:15.958Z · score: 1 (1 votes) · LW · GW

It's also possible to right laws that allow for gay "marriage", but don't force, say bakers, to bake cakes for gay weddings. The way things actually play out suggests this isn't actually possible in practice.

"In one of a dozen or so countries where X was done, Y also happened" isn't even terribly strong evidence for "it's not possible in practice to do X without Y also happening", let alone "it's not possible in practice to do anything in some reference class including X without something in some reference class including Y also happening".

For another data point, there is at least one major European country where doctors are both allowed to perform abortions and allowed to refuse to perform abortions and the situation hasn't changed much in either direction for decades.

comment by VoiceOfRa · 2015-05-24T01:21:08.886Z · score: 0 (0 votes) · LW · GW

Performing abortions requires special skills. Thus it would make no sense to force doctors who aren't trained for the procedure to perform it.

comment by Good_Burning_Plastic · 2015-05-24T08:33:19.211Z · score: 0 (0 votes) · LW · GW

Performing abortions requires special skills.

Performing euthanasia (or, as in your other example, cooking kosher meals) doesn't? Baking cakes for gay weddings does?

(FWIW, I don't think that bakers should be forbidden by law from refusing to bake cakes for gay weddings.)

Thus it would make no sense to force doctors who aren't trained for the procedure to perform it.

The fact is, I heard that in said major European country you sometimes get the same doctor refusing to perform abortions in public hospitals ostensibly for moral/religious reasons but who has no trouble whatsoever with them in their own private practice.

comment by VoiceOfRa · 2015-05-25T05:19:13.128Z · score: 0 (0 votes) · LW · GW

Performing euthanasia doesn't?

Not really, at least giving someone an overdose of pain meds requires a lot less skill then performing an abortion.

Baking cakes for gay weddings does?

It doesn't. That's why the government is forcing bakers to do it.

comment by Good_Burning_Plastic · 2015-05-23T20:34:07.538Z · score: 0 (0 votes) · LW · GW

"In one of a dozen or so countries where X was done, Y also happened" isn't even terribly strong evidence for "it's not possible in practice to do X without Y also happening", let alone "it's not possible in practice to do anything in some reference class including X without something in some reference class including Y also happening".

I've just noticed that the great-great grandparent comment was explicitly about that one country, so I'm retracting the parent.

comment by ChristianKl · 2015-05-19T18:08:39.765Z · score: 1 (1 votes) · LW · GW

I don't want doctors to be forced to perform euthanasia in the sense of giving a dosis of a drug with the direct intention to kill.

There are cases where I think it could be argued that a doctor shouldn't be able to put a patient without that patients consent on life support. I can imagine forbidding a doctor from engaging in life lengthening actions without the consent of the patient even if the doctors feels a moral obligation to lengthen the patients life.

There are cases where not given a patient valium and morphium means that the patient is in huge pain. A obligation on the part of the doctor to give valium and morphium to the point where the patient doesn't suffer even when that shortens life is debatable.

It's also possible to right laws that allow for gay "marriage", but don't force, say bakers, to bake cakes for gay weddings. The way things actually play out suggests this isn't actually possible in practice.

When I look at your link it doesn't seem to be the case that this is about laws enabling gay marriage. It's about a law called the Oregon Equality Act of 2007 that prevent businesses to discriminate against gay people. Whether or not the government has a law recognizing gay marriage that law would prevent bakers who fall under the "Public accommodations" section from baking those cakes. Given that only in 2014 Oregon seems to have returned to legalized same-sex marriage. That gives 7 years without a government having legalized same-sex marriage where as far as my understanding goes a baker should be banned to refuse selling wedding cakes to gay couples.

Apart from that I don't think it makes sense to have special regulation about baking cakes that specifically speak about the freedom of bakers to choose whether or not to bake cakes for certain purposes.

Cake backing doesn't seem to me an activity that deserves special legislation. I do think that euthanasia is a subject that deserves issues based legislation.

A good example might be how we regulate prostitution in Germany. You can legally make a contract in Germany to engage in prostitution. If two people however make such a contract and then the prostitute decides they don't want to have sex with that person, there no way to enforce the contract and force the prostitute to have sex.

I think that euthanasia is in that class of activities that shouldn't be forbidden but that also shouldn't be able to be enforced.

comment by VoiceOfRa · 2015-05-19T23:41:41.226Z · score: 0 (2 votes) · LW · GW

When I look at your link it doesn't seem to be the case that this is about laws enabling gay marriage. It's about a law called the Oregon Equality Act of 2007 that prevent businesses to discriminate against gay people. Whether or not the government has a law recognizing gay marriage that law would prevent bakers who fall under the "Public accommodations" section from baking those cakes. Given that only in 2014 Oregon seems to have returned to legalized same-sex marriage. That gives 7 years without a government having legalized same-sex marriage where as far as my understanding goes a baker should be banned to refuse selling wedding cakes to gay couples.

I agree that the laws in question are different, I would argue that the passing of those laws aren't independent events.

Apart from that I don't think it makes sense to have special regulation about baking cakes that specifically speak about the freedom of bakers to choose whether or not to bake cakes for certain purposes.

Except that's just what we have here. If say the KKK asks for a cake that depicts a black being lynched the baker is likely to refuse and is likely to be able to get away with refusing. What the law, as interpreted in practice, says is that baking a gay wedding cake is something that bakers specifically cannot refuse to do.

comment by ChristianKl · 2015-05-20T06:20:17.972Z · score: 0 (0 votes) · LW · GW

I agree that the laws in question are different, I would argue that the passing of those laws aren't independent events.

The laws share a similar motivation and as such aren't independent but here the core question is whether the government can forbid private businesses that operate publically from discriminating based on sexual orientation.

In a partisan environment where everyone is mindkilled most people have likely the same opinion on that question as the question about gay marriage but that doesn't make them the same question.

If I get treated differently at the door of a nightclub because of my gender, I don't think that's basis for suing the nightclub. On the other hand I expect to be treated by the government in a way that doesn't discriminate based on gender.

By muddling those issues together, you prevent rational political discourse.

Except that's just what we have here.

No. The law doesn't speak about baking cakes.

Laws as supposed to be written as simple as possible.

Writing a law that says (among others): "Public businesses aren't allowed to discriminate against homosexuals. The expectation are bakers that are asked to bake cakes for homosexual weddings."

That's crappy law making. If laws get written that way their complexity rises. Baking cakes for homosexual weddings isn't important enough to be written about in a law. On the other hand euthanasia is.

In case you think I'm arguing irrelevant technicality, the fact that most people don't understand that simple laws are good is on of the core reasons why we have so much complicated bureaucracy.

Nobody cares about low bureaucracy when debating how to solve ideological charged issues :(

comment by VoiceOfRa · 2015-05-21T03:34:31.887Z · score: 1 (1 votes) · LW · GW

By muddling those issues together, you prevent rational political discourse.

The issues are already muddied, I'm merely acting on the basis of this fact.

The laws share a similar motivation and as such aren't independent but here the core question is whether the government can forbid private businesses that operate publically from discriminating based on sexual orientation.

Except that's not how the law is being applied. A law against discrimination against gays would forbid bakers from kicking out patrons who happen to be gay. (Granted "anti-discrimination" isn't exactly a coherent concept to begin with.)

This is similar to the difference between forbidding restaurants from putting up signs saying "no Jews allowed" and requiring all restaurants to serve kosher meals.

comment by [deleted] · 2015-05-21T13:40:34.388Z · score: 1 (1 votes) · LW · GW

Granted "anti-discrimination" isn't exactly a coherent concept to begin with.

It is a "targeted concept". This is a term I came up with as I don't know of any better. People who defined the legal murder did not have any idea of who could be the typical murderer and who the different victim. It was not targeted for special people or special motivations, it was solely about the act. Discrimination is a targeted concept, it is targeted for the kind of behavior that arises from sentiments like racism. It does not have a really coherent definition because the kind of definition they would like to give it, "don't do any actions motivated by racism, sexism etc." is not appropriate in law. Note that targetedness is not inherently a right-wing critique. For example a Marxist could also try to argue that theft is a similar targeted concept because it is aimed at specific kind of situations, poor people stealing from each other or the rich, and not targeted on rich people stealing surplus value from workers. This is a bit of an artificial example though. The textbook targeted concept is Lèse-majesté, an inherently righty one. So it depends.

comment by Jiro · 2015-05-20T07:34:36.413Z · score: 1 (1 votes) · LW · GW

I don't think the idea is that laws specifically need to prevent people from being forced to make wedding cake. Rather, wedding cakes are a single example of the more general idea "lwas have to prevent people from being forced to do things in general". Each individual item in that category isn't important by itself, but cumulatively they are important.

comment by VoiceOfRa · 2015-05-21T04:00:40.561Z · score: 1 (1 votes) · LW · GW

Rather, wedding cakes are a single example of the more general idea "lwas have to prevent people from being forced to do things in general".

So, how does this apply to your comment here?

comment by Jiro · 2015-05-21T04:19:22.997Z · score: 1 (1 votes) · LW · GW

Doctors are an unusual case because doctors have a legal monopoly over prescribing drugs. If the available doctors refuse to prescribe a drug, nobody else can do it instead without violating the law. There usually aren't legal monopolies over cake-baking.

comment by ChristianKl · 2015-05-20T08:27:14.352Z · score: 0 (0 votes) · LW · GW

That's why the wedding cake example doesn't make sense in this context. You need special laws to regulate euthanasia.

Rather, wedding cakes are a single example of the more general idea "lwas have to prevent people from being forced to do things in general".

The law that forces here is the Oregon Equality Act. It prevents businesses from discriminating. It's not a law that legislates gay marriage that's the issue.

If you want to have effective laws than you have to target the right law. If you try to fix things at the wrong spot you add additional complexity.

When it comes to doctors there are laws about malpractice that do force doctors to do certain things. I think malpractice laws do have a right to exist but they shouldn't be too restrictive on what doctors can do. I think euthanasia laws should be written in a way that doesn't make it malpractice to avoid applying euthanasia.

comment by Jiro · 2015-05-20T15:04:07.275Z · score: 1 (1 votes) · LW · GW

The law that forces here is the Oregon Equality Act. It prevents businesses from discriminating. It's not a law that legislates gay marriage that's the issue.

A law which says that a gay marriage has to be treated like a straight marriage in one particular way is a gay marriage law. The law is just being made piecemeal and not labelled with "Gay Marriage Law" in the title, but it's still a gay marriage law.

comment by ChristianKl · 2015-05-20T15:09:09.265Z · score: 0 (0 votes) · LW · GW

By the same token you could say it's a gun sales law as it forbids people from refusing to sell guns to gay people based on them being gay.

comment by Jiro · 2015-05-20T15:21:14.109Z · score: 1 (1 votes) · LW · GW

The original law isn't a marriage law, it's a gay marriage law. So you would have to describe your hypothetical as a "gay gun ownership law". But laws other than the one being invoked already allow gay people to own guns.

Furthermore, while you describe the original situation as refusing to do business based on being gay, it's not. It's refusing to do business based on it being about a gay marriage. If a straight person wanted a cake celebrating a gay wedding, they wouldn't be served either, and if a gay person wanted a cake for something else, they would; the refusal is based on the content of the message, not the identity of the customer.

comment by ChristianKl · 2015-05-20T15:50:34.899Z · score: 0 (0 votes) · LW · GW

Furthermore, while you describe the original situation as refusing to do business based on being gay, it's not. It's refusing to do business based on it being about a gay marriage.

You make a major mistake when you focus on the situation that the case is about instead of focusing on the law.

If you want feel free to argue, that the court made a mistake when it's treated the bakery as violating the prohibition of discriminating against gay people. Then your problem is not with the law but with the judge for interpreting the situation differently than you.

Other laws do allow gay people to own guns but a single gun salesman can refuse to serve a customer. There's no law that requires a gun salesman to serve every customer. This law prevents him from not selling him the gun because the customer is gay.

If you want to have a reasonable discussion about politics and which laws to pass, argue about the actual laws.

comment by VoiceOfRa · 2015-05-21T03:58:17.159Z · score: 2 (2 votes) · LW · GW

If you want to have a reasonable discussion about politics and which laws to pass, argue about the actual laws.

No, the relevant discussion is about the consequences of passing the laws, and if the consequence is that the judiciary will interpret it to mean something different from what it says, that's relevant to the discussion.

Note: part of the misunderstanding here may be that you will in a civil law country whereas the US is a common law country, and thus the judiciary here has a lot more power to interpret (or even make up) laws.

comment by Jiro · 2015-05-20T15:53:44.678Z · score: 1 (1 votes) · LW · GW

If you want feel free to argue, that the court made a mistake when it's treated the bakery as violating the prohibition of discriminating against gay people. Then your problem is not with the law but with the judge for interpreting the situation differently than you.

Law is law whether it is made by writing a statute or whether it is made by judicial fiat. If anything, the fact that the judge's ruling didn't match the law on the books makes it especially obvious that the judge is actually making law.

comment by ChristianKl · 2015-05-20T16:27:55.574Z · score: 0 (0 votes) · LW · GW

To have a productive discussion it's worthwhile to be able to clarify which political decisions one agrees with and which one accepts.

Do you think that the law itself is reasonable and it's just the judge who's the problem?

comment by Jiro · 2015-05-20T16:46:17.047Z · score: 0 (0 votes) · LW · GW

In practice, there is no "the law" which is separate from a judge's decisions, so that's a meaningless question.

comment by ChristianKl · 2015-05-20T16:55:47.108Z · score: 0 (0 votes) · LW · GW

That's only true if you don't care about law making. Societies that don't care about the laws on the books usually get pretty messed up.

comment by VoiceOfRa · 2015-05-21T04:03:57.495Z · score: 0 (2 votes) · LW · GW

Yes, and unfortunately in the contemporary US the idea that judges should base their decisions on what the law actually says is considered an extreme right wing position.

comment by [deleted] · 2015-05-21T13:29:14.606Z · score: 0 (0 votes) · LW · GW

This is interesting. From the Wiki it sounds a bit like, when judges in the US exercise judicial activism, they tend to come up with leftier decisions than those who take the laws literally. So that this activism goes left but rarely or never right. For example, more religioius or more authoritarian or more private property oriented judicial doesn't really exist, this is what these Wiki articles suggest. That the written law is always righttmost wall and they go only left from that. Is this a correct interpretation?

If yes, what could cause this?

For example, there was about 2-3 years ago the opposite kind of scandal in Hungary, that a female judge used language in the explanation of a decision that was more racists against the Roma minority than what is usually accepted. It is fairly logical for me that right-wing people should become judges and it is weird for left-wing people to choose such careers. It is a highly authoritarian role, you better like authoritarianism if you want to do this.

I would imagine the champion-of-le-oppressed lefties become defense attorneys and respect-mah-authority righties become judges...

comment by VoiceOfRa · 2015-05-21T23:03:03.860Z · score: 0 (0 votes) · LW · GW

If yes, what could cause this?

I think part of it is that the law is interpreted by judges after it is written by legislators. Thus conservative judges are likely to respect the existing law. On the other hand "progressive" judges are like to consider the written law "old-fashioned", "obsolete", or "unacceptable in this day and age" by virtue of the fact that it was written in the past.

It is a highly authoritarian role, you better like authoritarianism if you want to do this.

It also works if you have a totalitarian "punish the class enemies" mindset.

I would have expected someone from a former Soviet satellite to be aware of this.

comment by [deleted] · 2015-05-22T07:02:13.797Z · score: 0 (0 votes) · LW · GW

Yes, a but a lot of laws are already pretty liberal! Such as this anti-discrimination thing. Why doesn't a conservative judge interpret it a way that it allows more discrimination than the liberal lawmakers wanted?

IIt also works if you have a totalitarian "punish the class enemies" mindset.I would have expected someone from a former Soviet satellite to be aware of this.

I think the Old Bolsheviks and The New Left (post-1968 "hippies") are/were entirely different people. Consider how being gay in the Soviet Union meant 5 years GULAG. They wanted nothing of the hedonistic, permissive, autonomous, individualistic approaches of the New Left. In fact their criticism of the West sounded often similar to a religious conservative criticism, dressed up in Marxist lingo. For example I remember terms like "drugs are a symptom of the decadence of bourgeois soceties". Translation: virtues Commie proletarians should not experiment with their brains, nor try to have exstatic fun, just worky work work and marry and have kids roughly like a good Puritan Protestant. Another slogan I remember "let's leave pornography as the opium of the decadent West, we don't need this". Same logic. The root reason is that this ideology worked a lot like a pseudo-religion, see Voegelin. Of course there are aspects of a quasi-religious mindset in the New Left as well - as well as on the Right, because it is a human universal, the brain evolved so that it needs, likes, something like a religion. Sanity waterline and all that.

Irving Kristol said an interesting thing. Building on Voegelin's idea that it all is a form of secularized Gnosticism, he said let's look at how old Gnostics had approached sexuality: basically it was one of the two extremes: either complete chastity all life long, or orgias. The common ground is they did not care about its biological function: making kids. He said conservative orthodoxies tend towards the biological function, and thus endorse married reproductive sex as it is generally the best environment for raising children. This is a way to deal with reality while the other two extremes are to deny or change it.

But Kristol's important idea is that a Gnostic drive can go both ways, it can be either incredibly stiff and strict or incredibly permissive. And of course Gnostics of these two types will not like each other much and are really different people! The strict Gnostic, the Cromwell-Calvin-Lenin type, will love being in a position of authority, the permissive Foucault-Marcuse-Lennon type not.

Thus back then in Soviet times the Lenin types really disliked the Lennon types and tried to keep them and their habits and ideas outside the border or inside the GULAG. This worked similar the other way around too, I remember an older British guy telling me that they had back in the 1980's a big demonstration against Thatcherism in Cambridge. Cambridge being Cambridge, it was full of young radicals, anarchists to Trotskytes. And a girl showed up with a Soviet flag. And then a guy just walked up to her and quite simply spit on her blouse. And this shockingly rude behavior did not surprise anyone. That was how the Lennonites in the West felt about the Leninite flag.

comment by VoiceOfRa · 2015-05-22T08:31:14.666Z · score: 0 (0 votes) · LW · GW

I think the Old Bolsheviks and The New Left (post-1968 "hippies") are/were entirely different people. Consider how being gay in the Soviet Union meant 5 years GULAG.

On the other hand their attitude towards divorce and abortion (especially in the early days after the revolution) was very similar to that of the new left. Furthermore, their reasoning was that women were the oppressed proletariat of the family, which sounds remarkably like modern social justice rhetoric.

They wanted nothing of the hedonistic, permissive, autonomous, individualistic approaches of the New Left.

On the other hand, they were perfectly willing to work with the politically. And to this day the more readical elements of the new left believe the "good guys" won Vietnam. In fact members of the new left love supporting any strict Gnostics as long as they themselves aren't currently being subject to them. Heck these days they tend to support Islamic conservative quasi-Gnostics for lack of any actual strict Gnostics to support.

comment by Lumifer · 2015-05-21T15:34:39.011Z · score: 0 (2 votes) · LW · GW

what could cause this?

You know Cthulhu's swimming habits, yes? X-D

In general, it's common for both sides to complain about "judicial activism" (see e.g. the left about the SCOTUS decision in Citizens United).

comment by VoiceOfRa · 2015-05-21T23:07:14.952Z · score: 0 (0 votes) · LW · GW

Of course, they complain about different types of decisions. Rightists complain when judges make decisions that ignore or greatly stretch the plain meaning of the law (either regular law or the constitution). Leftists complain about decisions that use the plain meaning of the law.

comment by waveman · 2016-06-24T11:55:16.720Z · score: 0 (2 votes) · LW · GW

Some criticisms of this piece

  1. He generally assumes that the only form of suffering in death is pain. There are also nausea, vomiting, weakness and fatigue, restlessness, feelings of dread, feelings of humiliation, feelings of intense disgust (google "malignant wound" if you dare), severe shortness of breath, feelings of asphyxiation, and delirium.

  2. Short of putting the patient into a coma, not all pain is treatable. Pain from nerve compression and bone compression are very hard to treat. Pain medications have side effects (eg delirium from morphine), and paradoxical effects (eg intensification of pain from metabolites of morphine). The circumstances of the terminally ill are unstable. A person can be pain free one moment and then be in pain again. Experimentation ensues, and continues until the person is again "reasonably comfortable". Also there is suffering from being aware of the anguish of your family as they watch you suffer. The overall stats on residual suffering are in the tens of percents for the above (except malignant wounds, which are mercifully not common)

  3. His quotation of the web site http://www.patientsrightscouncil.org/ several times concerns me. One of the luminaries on the site Rita Marker is author of the book "Deadly compassion", and is described in the blurb of the book as director of the "International Anti-Euthanasia Task Force". I therefore question their credibility as a source of objective data on the topic. In this debate the use of "front" organisations is rampant, and typically disguises motives and/or beliefs of those behind them and often misleads people as to their objectivity - as appears to have happened in this case.

  4. He fails to make a sufficiently clear distinction between the view that "I do/do not want euthanasia for me" and "I do/do not want to ban euthanasia for anyone".

  5. I also don't see much evidence he has researched issues in depth, looking at actual data. He overvalues speculation over data IMHO.

  6. He assumes that the opposition of the AMA is entirely motivated by medical considerations, without investigating how representative the organisation's views are of doctors in general and the role of religious based activism in their position.

  7. While in some sense not relevant to a rational argument, it is useful to understand the motivations and tactics of the organized opposition to voluntary euthanasia. Overwhelmingly the opposition is religiously motivated, though most religious people in polling do support voluntary assisted dying. You can read e.g. the Catholic Encyclical on euthanasia for details of their actual beliefs, which revolve around a) the notion that God owns your life, not you b) failing to submit to God's will - as to when you die - is a form of selfishness, arrogance and narcissism http://www.catholicherald.co.uk/news/2016/06/11/pope-francis-euthanasia-is-triumph-of-selfishness-not-compassion/ and c) the notion that suffering is part of God's plan (look up "redemptive suffering") and that suffering is often a very good thing.

    When these people raise arguments like slippery slope, killing granny for the inheritance, and the loss of respect for people with disabilities, it helps to understand that these are not their primary concerns. They are typically using these arguments because they work, not because they are true. They appear to feel morally justified to bend facts, make things up, exaggerate, use front organisations with misleading names, etc because it is in a good cause of stopping euthanasia which they regard as a moral evil.

    If you are unaware of this, you may fail to be on guard for the kinds tactics that are unfortunately rampant in this debate.