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PaperclipPerfector  10d ago (text post)   33712 thread views

Culture War Roundup for the week of November 11, 2024

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Generally we allow people to refuse treatment, even if that will have negative consequences for them.

When an adult refuses medical care for themselves, the negative consequences fall on the person making the decision. When an adult refuses medical care for a child, the adult does not experience those consequences.

We also generally recognize children lack the maturity to make long-term decisions, so we grant the power to make medical decisions about them to their parents (or whoever has custody of them).

And there are many examples of that going wrong, usually from parents who think of their children as their property and refuse to distinguish between 'my child's long-term interest/coherent extrapolated volition' and 'my personal preferences/non-universal ideology'.

Even with adults, if someone is unconscious, it's their next of kin that generally make medical decisions for them, not the doctors. None of that implies owning another person as property.

Because the next of kin is expected to make the decision based on 'what the patient would decide if conscious' and not 'what the next of kin wants'.

Also how consistent are you with "rightness" overruling parental authority[?] If the evidence for pediatric transgender care is determined to be very poor, are you ok with a blanket ban on transgender care, even if the child, parents, and a bunch [of] their doctor[s] agree that it's right?

  1. Overruling parents in the case of 'parents and child agree; we think both are wrong' should be a higher bar to clear than 'parents disagree with child; we think child is right and parents are wrong.'
  2. The case for giving any authority to parents rests on the assumption that they are usually right, for a value of 'right' that can be falsified, i. e. not defined as right a priori by dint of their status as parents. In cases where parents are often wrong, I believe society currently gives them too much unchallenged authority, and there need to be more checks and balances.
  3. What do you mean by 'the evidence for paediatric transgender care is determined to be very poor'? A literal reading would be 'the evidence seems to support it, but we have low confidence in that assertion.' akin to the evidence for ivermectin vs. COVID-19, or aducanumab vs. Alzheimer's disease. In that case, where we cannot predict long-term effects, we should do what results in the least immediate suffering. If you meant 'the evidence shows with strong confidence that it is harmful', akin to the evidence regarding 31 g of aspirin vs. the 1918 influenza, then I could be convinced to support a moratorium until experiments on adults show that they have found a less harmful method of changing genders.
  4. 'Blocking transgender care that is desired by a minor patient and approved by both parents and doctors' is not the mirror image of 'allowing transgender care that is desired by a minor patient and approved by doctors but opposed by the patient's parents'; the mirror image of that is 'blocking transgender care that is desired by the parent(s) but opposed by the patient and the doctors.' e. g. the often raised spectre of the blue-hair-and-pronouns parent attempting to transition their cisgender child in order to gain the status of 'ally to the trans community'. (I am not sure whether this has ever happened, but it would certainly justify overruling the parent's wishes, even in a society in which gender transition is instant, perfect, side-effect-free, and reversible.)

When an adult refuses medical care for themselves, the negative consequences fall on the person making the decision. When an adult refuses medical care for a child, the adult does not experience those consequences.

Not directly, but usually parents go through suffering of their own when something bad happens to their children.

And there are many examples of that going wrong, usually from parents who think of their children as their property and refuse to distinguish between 'my child's long-term interest/coherent extrapolated volition' and 'my personal preferences/non-universal ideology'.

Sure, but I don't think that's enough to have doctors override the decisions of the parents outside of extreme circumstances.

The bit about personal non-universal ideology is interesting. How is your idea on who should decide the child's treatment not based on your non-universal ideology?

Because the next of kin is expected to make the decision based on 'what the patient would decide if conscious' and not 'what the next of kin wants'.

And we give it to parents because we expect them to make the decision the child would have, if they were mature.

1. Overruling parents in the case of 'parents and child agree; we think both are wrong' should be a higher bar to clear than 'parents disagree with child; we think child is right and parents are wrong.'

So in a case like this, if the parents managed to convince the child that this treatment will help, would you say the state has no right to intervene?

2. The case for giving any authority to parents rests on the assumption that they are usually right,

I disagree. For one, it's an impossible standard to go by, because I don't know if we can agree on what's "right" between the 2 of us, let alone between a country of millions of people. But to the point, personally I'd say they have that authority by default, and you need a strong positive argument if you want to take it away.

3.What do you mean by 'the evidence for paediatric transgender care is determined to be very poor'? A literal reading would be 'the evidence seems to support it, but we have low confidence in that assertion.' akin to the evidence for ivermectin vs. COVID-19, or aducanumab vs. Alzheimer's disease. In that case, where we cannot predict long-term effects, we should do what results in the least immediate suffering. If you meant 'the evidence shows with strong confidence that it is harmful', akin to the evidence regarding 31 g of aspirin vs. the 1918 influenza,

I kind of see it as both. To the extend positive evidence exists it's low-confidence, and for many metrics it's just inconclusive / not enough to form any opinion. As to the harm, the problem here is that the intervention itself is inherently harmful - surgeries remove healthy body parts, hormones have many side effects, etc. The rationale here is that the benefits of addressing "dysphoria" are balance out the downsides, but I think that's the claim that needs to be justified, rather than skepticism of it.

4. 'Blocking transgender care that is desired by a minor patient and approved by both parents and doctors' is not the mirror image of 'allowing transgender care that is desired by a minor patient and approved by doctors but opposed by the patient's parents';

It might not be a mirror image, but if we're going by "they are usually right" I feel confident in my arguments that such treatment should be denied - children don't know what the hell they're talking about, normie parents mostly trust authority figures like doctors, but some doctors I can only describe as completely ideologically captured (they explicitly say dysphoria is not necessary to transition, and that transition is about expressing yourself authentically rather than treating any ailment) or certifiably insane (one go to example of mine was involved in the Satanic Panic back in the 90's, and now writes / gives talks about "gender angels" and hands out blockers to non-verbal autists), and the most prominent world-wide association of gender-care specialists has been caught red-handed hiding evidence that doesn't go their way.

I personally feel very strongly that treatment under these circumstances is wrong, but I don't know if I have the authority to step in here and tell people what treatment is right for their child. But since we're not living in the libertarian utopia where parents decide for themselves, I see no reason why I shouldn't lobby that my values are implemented.

Not directly, but usually parents go through suffering of their own when something bad happens to their children.

That's not the same thing.

And we give it to parents because we expect them to make the decision the child would have, if they were mature.

But often they don't make the same decision their child would have if mature. Many parents attempt to override their child's decisions even after their child is mature.

So in a case like this, if the parents managed to convince the child that this treatment will help, would you say the state has no right to intervene?

No, I think that clears the higher bar.

On the other hand, if a child, upon finding out that meat is made out of dead animals, desires to adopt a plant-only diet, and their parents approve, I would not override their decision, even though many non-Adventist-influenced experts doubt that it is wise.

personally I'd say they have that authority by default, and you need a strong positive argument if you want to take it away.

They said the same thing about kings once....

We hold these Truths to be self-evident, that all ... are endowed by their Creator with certain unalienable rights ... that to secure these rights, governments are instituted ... that whenever any Form of Government becomes destructive of these Ends, it is the Right of the People to alter or abolish it....

As above, so below.

libertarian utopia where parents decide for themselves

But they aren't deciding for themselves! They are deciding for another person! In the purest form of libertarianism, the child would decide everything for themselves.

I am not advocating for pure libertarianism, but that is what I mean by 'your children aren't your property.' The base state isn't parents having absolute power over their children, it's them having no authority whatsoever. All power accorded to parents is a creation of society.

That's not the same thing.

Yeah, that's why I said "not directly". Point remains if a parent makes a mistake they'll usually by wrecked with guilt, for the doctor it's tuesday.

But often they don't make the same decision their child would have if mature. Many parents attempt to override their child's decisions even after their child is mature.

If you mean something more than disagreeing with them and putting some social pressure, than I agree it crosses a line. Luckily the law is on the adult child's side in such cases.

No, I think that clears the higher bar.

Cool. So it just so happens that this blog post was talking about the exact same drug - down to the brand name - that gender clinics sell as "puberty blockers", the first line of medical intervention that they recommend for the youngest children, and claim is completely reversible. Funnily enough data from UK's Tavistok indicates that as many as 48% of kids referred to a gender clinic are autistic, so this is giving the exact same drug to a largely the same cohort. The only difference is the disorder they aim to cure, but both disorders are wishy-washy and not objectively verifiable (I guess autism might be, in the more extreme cases, but that's a point against gender affirming care).

If there's an argument for the government forbidding the doctor to administer it in one case but not the other, I'm not seeing it.

They said the same thing about kings once....

What can I say? If you want to live in platonic / marxist utopia where all children belong to the state, you're free to want it. I even wish that you get to live in the society you desire, as long as you don't go full Jihadi, and claim that this is the one true way for all of the world to live. This is why asked how are your ideas not based on your non-universal ideology.

We hold these Truths to be self-evident, that all ... are endowed by their Creator with certain unalienable rights

If you actually believed that this means parents have no authority over their children, you'd be quoting Rousseau, not the American founding fathers.

But they aren't deciding for themselves! They are deciding for another person! In the purest form of libertarianism, the child would decide everything for themselves.

I am not advocating for pure libertarianism, but that is what I mean by 'your children aren't your property.' The base state isn't parents having absolute power over their children, it's them having no authority whatsoever.

Yes, that's my point. If you were advocating pure libertarianism, I could consider your idea of removing all authority from parents, and ensuring the child's autonomy. But since you don't, the idea is completely absurd to me. If parents have no authority over their children, than an adult has even less authority over another unrelated adult.

Point remains if a parent makes a mistake they'll usually by wrecked with guilt

I'm not talking about mistakes but conflicts of interests; 'parent has ideology with which child does not agree, makes decision based on that ideology, causes suffering to child, refuses to consider that they may have been wrong.'

So it just so happens that this blog post was talking about the exact same drug

That'll larn me to skim the article -- I thought they were talking about surgery!

In the case of puberty blockers, I would only intervene insofar as to ensure that the child and parents had at least heard the counterargument to their proposal; I could see applying the same argument to gender transition.

If you want to live in platonic / marxist utopia where all children belong to the state

Again, children aren't property. Not belonging to their parents doesn't mean that they must belong to someone else, it means that they belong to themselves; whatever authority we give to parents starts from zero even if it doesn't stay there.

If you actually believed that this means parents have no authority over their children, you'd be quoting Rousseau, not the American founding fathers.

I was quoting the Declaration as opposition to the divine right of kings.

"As above, so below" was the extrapolation to the divine right of parents.

Yes, that's my point. If you were advocating pure libertarianism, I could consider your idea of removing all authority from parents, and ensuring the child's autonomy. But since you don't, the idea is completely absurd to me.

The idea of something between 'pure libertarianism' and 'status quo' is absurd to you?

If parents have no authority over their children, than an adult has even less authority over another unrelated adult.

A having authority over Bs personal decisions is not the same thing as A having authority over B's authority over C. A parent has every right to forbid their child from making unreasonable demands of their younger sibling.

In the purest form of libertarianism, the child would decide everything for himself.

I feel obligated to point out that, according to one prominent libertarian, under an ideal libertarian framework (1) the parent would have absolute authority over the child, but (2) the child would have the option to assert self-ownership and emancipate himself at any time by leaving the parent's household.

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