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VoiceOfRa comments on [Link] Death with Dignity by Scott Adams - Less Wrong Discussion
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Scott Adams strikes me as being really bad at actually using rationality despite the name. I think the commenter PhantomPhlyer was spot on:
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?
Some of the modern versions of the oath don't say that.
http://guides.library.jhu.edu/c.php?g=202502&p=1335759
The way it was phrased to my by a doctor who spent many years caring for people with terminal illnesses:(from memory)
I'd recommend the The Richard Dimbleby Lecture by Terry Pratchett "Shaking Hands with Death"
https://www.youtube.com/watch?v=90b1MBwnEHM
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.
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.
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.
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.
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.
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.
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".
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.
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.
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.
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.
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.
Drugs for euthanasia are sugar pills with 100% occurrence of lethal side effects.
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.
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.
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.
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.
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.
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.
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.
I have no problem with saying that doctors shouldn't be able to use moral reasons to refuse to prescribe other prescription drugs, either.
What kinds of non-moral reasons should they use, then? Or should people be able to legally buy and use all legal medicine freely?
"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
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.
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.
Legalizing euthanasia doesn't force any doctor to engage in it. It just removes punishment when a doctor engages in it.
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.
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.
Surgery requires a lot more skill then giving someone a lethal dose of something.
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?
"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.
Performing abortions requires special skills. Thus it would make no sense to force doctors who aren't trained for the procedure to perform it.
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.)
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.
Not really, at least giving someone an overdose of pain meds requires a lot less skill then performing an abortion.
It doesn't. That's why the government is forcing bakers to do it.
I've just noticed that the great-great grandparent comment was explicitly about that one country, so I'm retracting the parent.
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.
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.
I agree that the laws in question are different, I would argue that the passing of those laws aren't independent events.
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.
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.
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 :(
The issues are already muddied, I'm merely acting on the basis of this fact.
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.
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.
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.
So, how does this apply to your comment here?
That's why the wedding cake example doesn't make sense in this context. You need special laws to regulate euthanasia.
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.