I think a case might be made that would prefer a world in which doctors were like that caricature. Not from the perspective of someone about to be harvested, but ex ante you are probably not that person.
That would be a world in which no-one would got to hospital or trust a doctor for anything serious... Even going in for an organ transplant, you'd be more valuable dead and your functioning organs sent off to others...
How could there be any value in giving organs to others if those others won't trust a doctor for anything serious?
"That's why you carry a blood donor card, too, so they think if you stay alive they'll keep getting blood from you!"
I don't think this argument works. Blood is cheaper.
Whole blood isn't typically paid for here. Some private companies will buy plasma, but while the Red Cross will often give donors presents from businesses that want to show off their charitable cred, you don't walk away with cash.
Isn't donating blood necessary to get the right, or at least priority, to receive donated blood should you need it? I'm pretty sure that's how things work here in Israel. I seem to remember they also waive some kind of payment for blood recipients who donated enough blood in the past.
While they'll let you bank blood specifically as a contingency for your own use later (because getting your own blood back is safer than getting someone else's), I'm almost positive they don't check to see whether you've donated before giving you a transfusion. They just make sure you aren't a Jehovah's Witness and give it to you. There are a lot of constraints on who can donate blood - I have a couple of friends who can't on account of being on medications that would make it impossible for others to use their blood, for instance - so if people who donated blood had priority, I'm sure there would be an uproar from such individuals.
Actually, I can't donate blood due to medications (and possibly also due to being at elevated risk for complications due to blood loss). So yeah, if I'm in a big accident and a lot of people need blood transfusions at once, I'll probably be at the end of the line (I haven't tested this though). I haven't heard of any uproar, though.
Anyway, in a situation where they have to ration blood and to prioritize people, what other way is there to decide? First come first served? The ordering of who came first isn't that precise. In a big accident a bunch of people would come in all at once. I can accept that "he donated blood so he gets it back first" is at least as fair a rule as "he was on the outer ambulance bed, so he came into ER twenty seconds before you, and gets it first".
That article lists an interesting variation for Israel:
A simplified but effective description of the S.T.A.R.T. is taught in the Israeli army to non-medical personnel: the injured who are lying on the ground silently should be prepared for immediate transportation; injured lying on the ground but screaming are injured whose transportation can be delayed; and the walking wounded need help less urgently.
Take-home lesson: if you're injured in the Israeli army, don't scream for help, because that will make us stop helping you. Just play dead instead. :-)
"But even if we grant that falsehood, she still does not have adequate reason to withdraw her consent for organ donation, as long as she can present proof to evil consequentialist doctors that she's worth more alive than dead. And she can."
I don't see how this follows. If the doctors already have organ-needing patients to whom they are attached, and she is out-cold, then she strictly can't prove she's worth more alive than dead. The fear that doctors won't work as hard to save an organ donor is based both on ignorance of doctors' motivations and on a hint of awareness that docs aren't as above-board, righteous people as they want us to believe. This combination leaves open the doubt, 'But how corrupt are they?", and not having an easy way (that they know of) to check this, their imaginations run wild.
I don't think this fear is prima fascia absurd, as there have been several well publicized cases (including one written up by Gwande in the book Complications) in which organ donors going into prep for transplant were found to be alive. Statistically it's minor, and one could argue that if they hadn't been donors, they would have been left to die, but you know what they say about rats in NYC...
It's not just a matter of doctor's motivations. It's also that the doctors who'd save a patient hit by a cement truck aren't the same ones who'd be looking for organs or even, likely, know about any particular patients needing organs. And that matching organs takes care and is a little hard to do on the sly while trying to make it look like you're making an effort to save the patient from injuries. And that her concern wasn't that she'd be butchered for any specific patients to whom her doctor was attached, but that she thought that they'd save the extra lives in strict consequentialist fashion if she had several organs that could each save a different recipient.
"It's not just a matter of doctor's motivations. It's also that the doctors who'd save a patient hit by a cement truck aren't the same ones who'd be looking for organs or even, likely, know about any particular patients needing organs."
Not obvious to people who don't know hospital departmental structure.
"And that matching organs takes care and is a little hard to do on the sly while trying to make it look like you're making an effort to save the patient from injuries."
Not obvious to people who don't know how transplantation works- you can blame popular shows like House and soap operas for this.
"And that her concern wasn't that she'd be butchered for any specific patients to whom her doctor was attached, but that she thought that they'd save the extra lives in strict consequentialist fashion if she had several organs that could each save a different recipient."
She didn't express this thought (at least not in your post), and I doubt she was thinking there was an actual calculation that her organs might save 6 people and 6 lives > 1 life, so much as fear that the hospital was already looking for donors, and voila, one pops up.
Said person might know more than she is considering and agree with you if you made these points, but she might be very ignorant, like most people.
Not obvious...
Yes- which is exactly Alicorn's point. If she had had more time, she could have persuaded the girl to carry on being a donor by pointing out these facts, but she didn't, so she resorted to this 'light art'.
Alicorn's point seems to be that since she didn't have time to explain everything to this woman, she used arguments "which use premises you don't hold that your opponent does", in order to persuade her that her POV was absurd. She says that even if we grant this woman the falsehood that doctors are consequentialists, the woman's own reasoning will show that doctors will not sacrifice her for her organs, "as long as she can present proof to evil consequentialist doctors that she's worth more alive than dead. And she can."
I don't see how someone can present this proof if she's out cold, and I don't think that the woman's beliefs about organ donation are necessarily absurd unless you grant that she has a certain amount of factual knowledge about the process. I also don't see how Alicorn's joke would persuade anyone in this woman's position that being an organ donor was safe, unless they actually believed that blood was a sufficiently valuable commodity that doctors would keep them alive in order to take it (this would involve a very large time horizon on the doctors part). As such, I don't believe this anecdote was a very good illustration of the 'light arts' Alicorn was trying to advocate, though I would agree that her general point is valid.
I don't see how someone can present this proof if she's out cold
By - as I said - carrying a blood donor card. Card-carrying is also how they find out if you're an organ donor.
But even if we grant that falsehood, she still does not have adequate reason to withdraw her consent for organ donation, as long as she can present proof to evil consequentialist doctors that she's worth more alive than dead.
From what she said "she'd heard that doctors don't try as hard to save donors in hopes of using their organs to save other lives.", it isn't that they actually kill her if she has an organ donor card, just that they don't put in as much effort. Which implies the following beliefs:
The conclusion she should draw is that she should carry just a blood donor card, to demonstrate that she is really useful alive, and not at all useful dead, so they should try really, really hard to save her.
See my reply to cousin_it re: expense, but I think it's harder to find a match for organs than it is to find one for blood. So there's a good chance that if she were hit by a cement truck, nobody needing a transplant of any organs left intact would match her - but that's not something the operating doctors would be able to test for while she was actively on her way to bleeding out in the ICU.
It wouldn't kill you to admit that you didn't consider the relative value of blood and organs in the heat of improvising a joke ;)
Unless the author saw this post, found it inspiring, and dashed that comic off at the last minute - yes, coincidence.
Inconsistency is a general, powerful case of having reason to reject something. Inconsistency brings with it the guarantee of being wrong in at least one place.
I would agree if the laws of the universe or the system, political or material are also consistent and understood completely. I think history shows us clearly that there are few laws which, under enough scrutiny are consistent in their known form - hence exogenous variables and stochastic processes.
We don't have to understand the universe completely to be very confident that it contains no contradictions. If the laws as we understand them are not self-consistent, then we have reason to reject them - we just might, until we have better alternatives, have stronger reason to keep them around.
If the universe "contained contradictions", what would it look like? What does this property mean, and how could it be observed?
It wouldn't look like anything, doesn't mean anything, and couldn't be observed. You can't speak counterfactually about universes with contradictions in them without being incoherent, because no possible world contains contradictions.
Yes, but given that we're not logically omniscient, it seems like it would be awfully useful to also have a weaker concept of coherence for discussing practical affairs. Otherwise I fear we wouldn't be allowed to talk about counterfactuals at all, for who among us is wise enough to prove that a purported possible world doesn't contain any hidden contradictions?
'Descriptions' that claim to describe possible worlds can contain contradictions. But such descriptions don't describe anything, they're just words.
'Descriptions' that claim to describe possible worlds can contain contradictions. But such descriptions don't describe anything, they're just words.
Maybe they don't describe anything, but that doesn't make them "just words." To be concrete, QED is, to the best of my ability to wrest information from physicists, inconsistent; yet it remains "the most accurate physical theory."
In defense of the consistency of the universe...
You don't have to go as exotic as QED to derive inconsistencies from the assumption of the continuum. When physicists encounter these inconsistencies, I suspect the continuum (or another source of infinity) is behind them. Singularities, for example, can be handled using discrete cut-offs.
(Later edit: Why down-voted?)
Indeed, there is something about the phrase that doesn't mean anything. Perhaps because contradiction exactly means 'not possible' (thus 'not contained'). So that if there ever was a 'contradiction' actually realized in reality, then we would just need to look to reality to see how the 'contradiction' was possible after all.
A contradiction comes about when you have a list of things that are true (A=B, B=C, ...) and somewhere in the list you find something (A~=C) that reduces to B=~B for some B.
Can a universe be possible where B and ~B are both true for some B?
Sometimes I feel like this is the universe we live in already, for exactly the kinds of things where "true" doesn't mean anything. The 'contradictions are impossible' rule doesn't apply to them. So, circularly, that's why true doesn't mean anything for them. So we might deduce something along the lines of truth and logic have meaning for a statement B IFF B and ~B are not simultaneously true/possible.
"Things" in reality aren't "true" or "false" outside the context of specific logical tools. In particular, consistency is a property of (some of the) logical systems, considered as a good heuristic for developing ones that are interesting (formally, consistency alone doesn't make a system "good": indeed, a consistent system may even prove false formulas!). For logical systems, it does make sense to talk about which ones are consistent and which ones are not.
tl;dr: It is worthwhile to convince people that they already, by their own lights, have reasons to believe true things, as this is faster, easier, nicer, and more effective than helping them create from scratch reasons to believe those things.
This is not part of the problem-solving sequence. I do plan to finish that, but the last post is eluding me.
Related: Whatever it is I was thinking of here (let me know if you can dig up what it was).
Today, while waiting for a bus, I heard the two girls sitting on the bench next to mine talking about organ donation. One said that she was thinking of ceasing to be an organ donor, because she'd heard that doctors don't try as hard to save donors in hopes of using their organs to save other lives.
My bus was approaching. I didn't know the girl and could hardly follow up later with an arsenal of ironclad counterarguments. There was no time, and probably no receptivity, to engage in a lengthy discussion of why this medical behavior wouldn't happen. No chance to fire up my computer, try to get on the nearest wireless, and pull up empirical stats that say it doesn't happen.
So I chuckled and interjected, at a convenient gap in her ramble, "That's why you carry a blood donor card, too, so they think if you stay alive they'll keep getting blood from you!"
Some far-off potential tragic crisis averted? Maybe. She looked thoughtful, nodded, said that she did have a blood donor card, and that my suggestion made sense. I boarded my bus and it carried me away. I hope she's never hit by a cement truck. I hope that if she is hit by a cement truck, a stupid rumor she heard once doesn't turn it into as complete a waste as it would have to be without the wonders of organ transplant.
And even maintaining those twin hopes and feeling I'd done something to improve their conjoined chance of realization, I began to feel like perhaps I'd done wrong. I could conjure up a defense - hey, I laughed first, and I'd used the exact same words before as a mere joke (with people better-informed than this who I'd expected to get it on their own). It's not strictly my fault that she didn't take it as a joke too. And hey, I would have gone ahead and had the whole knock-down drag-out argument with her if there had only been time, if I could only have had her ear for long enough to spit out more than a soundbite, if only she hadn't been a complete stranger I'll never see again.
But even without time and social pressure preventing you from having a great long knock-down drag-out argument, it can be devastatingly ineffectual to present the reasons you think are the right ones to believe some proposition P or take some action A. And presenting other reasons seems dishonest, somehow - just lining up soldier-arguments in favor of P or A because they're well-equipped against this opponent, and not because they're the best and soundest and strongest according to objective (read: your) standards.
Here's a related story: in my midterm paper for my Plato's Republic class, my thesis statement was "Plato's position on falsehood in the kallipolis is inconsistent". Bam! Plato would have a heart attack! Dreaded inconsistency! But after I got comments back, I agreed with the professor that what I'd really shown was something weaker: "Plato has good reason, by his own lights, to reject the Noble Lie". No utter logical malady infects his city so thoroughly that I can demonstrate a rejection of modus ponens on the subject at hand. But the revision... is still pretty strong. Inconsistency is a general, powerful case of having reason to reject something. Inconsistency brings with it the guarantee of being wrong in at least one place. But so too, in a gentler and narrower way, does having reason to reject something by your own lights, even if it's not an airtight reason. And this gentleness is more non-threateningly persuasive, and this narrowness demands less background from your interlocutor in logic, and beginning from this preexisting background saves more time, than beginning with a priori principles and proceeding from there to proposition P or action A.
The girl at the bus stop began by having nasty suspicions that doctors are twisted creatures who all walked straight out of an ethics textbook, evil consequentialist plots devoid of professionalism or commonsense morality fully-formed in their minds, and who would see her ambulance-borne self as a sack of valuable organs they could use to salvage numerous other lives if only they made the slightest wrong twitch with a scalpel. But even if we grant that falsehood, she still does not have adequate reason to withdraw her consent for organ donation, as long as she can present proof to evil consequentialist doctors that she's worth more alive than dead. And she can.
Offering arguments like this - ones which use premises you don't hold that opponent does, and which aren't reductios in form - is only dishonest if your conclusion is meant to be, "Objectively and all things considered, you should perform action A or believe proposition P." Those arguments (assuming the premises your opponent holds and you don't are false) show nothing of the kind. But pointing out that people have reasons by their own lights to believe P or perform A - concluding instead "given these premises which you accept, A or P is reasonable" - is not, I contend, underhanded. Conveniently, it's also not slow, mean, or difficult. And maybe these light arts saved a life today.