This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
We require people to get car insurance because we know they will make the wrong decision (not getting insurance) if left to their own devices. Some people try this anyway.
We know that people will make the wrong decision with medicine also. Some of this is objective - people would prescribe themselves substances that are controlled (for a reason, for instance opiates), people will ask for treatments where the benefits are clearly outweighed by the risks. Consider all the people who use marijuana when they clearly are not supposed to,* or try and get Addy as a performance enhancing drug, or use illegal substances. What do you think would happen if you could just Dilaudid at the pharmacy? It would be a catastrophe.
The classic non drugs of abuse example is antibiotics. People will ask for antibiotics every time they get sick. Even when it's clearly viral and therefore the abx won't help. They will demand abx, they will write reviews complaining about it and bully the prescriber into giving them abx - even though they won't do anything helpful. Zero benefit.
And the costs can be high to the individual (side effects can be very bad), and to society (antibiotic resistance is increasing greatly). If someone becomes disabled because they took an abx of their own recognize society will pay the cost. This is not theoretical, people kill their kidneys with NSAIDs for example (that's OTC).
If left to their own devices patients will make objectively shitty decisions. The regulatory state exists to prevent this, you don't want people on the road without insurance.
When it comes to the more subjective stuff it does get a bit fuzzier but the fundamental problem remains, no layman has the knowledge and experience to make these judgements, just googling a pubmed article is not enough, smart and educated people think they can figure it out but this requires training and experience. The average person has no chance and society needs to be organized around protecting average and below average people.
The regulatory state has its problems but we require building codes because people will elect to live in a poorly built slum if given the choice because it's cheap. We have to protect people from themselves.
People will take a gamble on "it's fine I have a 1% change of a bad side effect from this antibiotic but society will pay the cost and even though this infection is viral maybe its not."
This is stupid.
People do not like being told what they can do and put in their bodies, but little in the world is as important to get correct as human lives. I remember what it was like before I was a doctor, I thought I knew what I was doing I did not.
*I'm not saying nobody is allowed marijuana, it's complicated.
What type of car insurance do we require people buy? Hint: it's not the type that compensates them if they screw up their own car. It's for a different purpose. What do you think that is?
Most of the rest of your comment appears to be just additional restatements of the things I've already responded to. Yes, car owners lack knowledge, and they'll make mistakes sometimes when they don't use the services of a professional. I don't see where you've made any further advancement on the argument.
I do think that this part is a slight refinement. At least one that I only obliquely addressed, not directly. When it comes to the subjective parts of auto repair, it gets fuzzier, but the fundamental problem remains. Laymen aren't going to have the knowledge and expertise to make those judgments, and the Chilton guide isn't enough, either. They need training and experience. Average person has no chance... of that last few percent that is still probably within the realm of the basic guidance where there might not even be a consensus, anyway.
This is just tripling down on paternalism, and it's one that is soundly rejected in most rationalist spaces. YIMBY is currently reigning supreme, haven't you heard?
People don't like being told what they can/can't put in their cars, but nothing is more important than thousands of pounds of steel hurling down the road at high speed, where lives are at stake. We can't possibly let people work on their own cars. ...or at least, that's the conclusion of your logic.
If you are okay with putting a bullet in the head of anyone who uses medical care without expert opinion in any way that causes a societal cost then sure.
But we don't do that.
If you become disabled, or end up on dialysis, or increase the risk of a multi drug resistant organism other people subsidize you.
The cost with which we subsidize you is immense. Hundreds of thousands to millions of dollars per person. Society cannot afford to pay that more than necessary, and ethics prevent us from euthanizing people for their ineptitude.
Paternalism is good to some extent it's why we have building codes and financial regulations and you know....laws. Where you draw the line is a point of discussion but drug libertarians don't know anything about medicine and have zero idea what they don't know.
More options
Context Copy link
More options
Context Copy link
Specifically, though, people are forced to get third party liability insurance, because there the costs of their wrong decisions is very much borne by others (the argument could be made that ultimately wrong medical decisions could end up like that, but it's a greyer matter).
Antibiotic stewardship is something that impacts others, but the bigger problem is that people will ignore their own health as much as possible and then society pays the costs by caring for them after their mistakes. With obesity and some other lifestyle things accept this because you do need to limit how much you impact people's rights, but throttling of medical care is almost universally considered reasonable due the complexity in making informed decisions.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link