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Would you say the same about the sale of heroin between a dealer and a buyer?
If your answer is anything but yes, doesn't that suggest there are at least some cases where making the option of something available is a net negative to at least one of the individuals in question, even when they are able to consent?
Yes. I'd legalize the sale of heroin from a buyer to the seller. I'd be okay with heavy taxes on it, and would absolutely be for imposing strict penalties on all the negative externalities it would cause.
If someone buys heroin and does it in their home without hassling anyone else, that's their business. If they become addicted and commit crime, then they should face punishment. If they lose their jobs and need to be bailed out, that should be conditional on a good faith attempt at seeking medical treatment and adhering to the treatment regime prescribed.
You won't catch me going on the street protesting for it to be legalized, because I have better things to do, but I wouldn't stand in the way.
After all, I am in the business of occasionally needing to prescribe fentanyl and morphine, and given that the patient pays for it directly, or indirectly through taxes or insurance, that counts as selling it. Doctors are, among other things, fent dealers. If that can be done without causing society to collapse in flames, other alternative arrangements might well work.
Both doctors and society in general has a duty of care that extends in not providing people heroin. Now there is a balance to this that means that fredom tm and other considerations might matter with certain less harmful substances enough, but there is a line.
I think we had a discussion about this before, but that you don't care about the line doesn't mean that you aren't breaking clear good ethical norms here that a doctor especially shouldn't break. Doctors are especially the kind of people who ought to think about what is their patient's best interest and not what their patient might be requesting at the moment.
It is in fact immoral and parasitic to profit from selling what is harmful to others. There can be a debate about some more grey areas, but there is a line above which it becomes pretty clear that you have activity that is just harming people.
But aren't addicts morally culpable on a significant level? Of course. Although there might be some more sympathetic stories. But so are people selling heroin and to a lesser extend those allowing them to do so. You discourage and condemn all three to get a society without the malaise of significant drug addiction and death due to it. While you allow, encourage, and side with all three to get the society with these problems. It is a choice that will end with the different outcomes with a clear right and wrong side.
I'd like to point that there's a distinction between a random person selling someone else heroin, and me doing the same thing. I would, of course, hold myself to a higher standard and not disburse it if it wasn't a necessity. That's what I would do if ever had to prescribe diamorphine, the term used not to scare the hoes.
Even in a setting where the usual legal and ethical constraints I'm obliged to follow (if I wish to keep my license) were waived, if someone came up to asking heroin, and it wasn't in the context of overwhelming pain in a hospital, I'd politely tell them I'm not comfortable doing that, and that they should look elsewhere.
I am okay with letting other people do things that might harm them, especially if they know what they're getting into, that doesn't mean I want to make things worse myself.
Sure. I'm happy to concede that. I don't think that changes my overall stance that blanket illegality shouldn't be the means of regulating this.
If I'm allowed to daydream, everyone old enough to vote takes a Rational Adult exam, potentially one that's subdivided into multiple ascending tiers of difficulty. The more you pass, the more you are allowed to do, because the presumption is that you've proven yourself intelligent enough to be responsible for yourself. For an existence proof, look at driving tests.
Maybe have people pay for bonds. Maybe allow insurance companies to charge them more for risky behavior. Tax negative external ties and strongly punish anything that spills out of personal bounds.
I don't really care about moral culpability, at best I consider it an occasionally useful fiction. You get a pass if you've got a brain tumor or something, that's the way people look at things.
I don't condone giving heroin away to school children. I am willing to look away when an adult buys it off another adult with no coercion involved. If it's a situation where coercion is the default assumption, have them sign a legal contract first. I see liberty that extends only to doing things that society deems are Good For You a pale imitation of the real deal, and I accept the consequences.
So, you don't like "blanket illegality" for heroin, but you are totally ok with a kind of authoritarian state evaluation (with follow on coerced financial behavior) of your intelligence, psychology, and ability for self-determination.
Yes?
Have you ever had to take a driving test? Do you want to legally prescribe heroin? You'd have to sit for a medical licensing exam after med school. This isn't a massive deviation from normality.
Nowhere does it say that these have to be particularly onerous exams, except potentially at the most extreme end. Basic franchises should be accessible by someone who doesn't have a learning disability, a reversal of the situation where we extend blanket permission for non-illegal acts, and only then restrict freedom for those, such as the mentally retarded or grannies with dementia, who can't be expected to take responsibility for their own safety and well-being.
Who would approve the questions and composition of your "Rational Adult" exam? State legislatures? The Federal government?
I'd like to request a straightforward answers. Are you saying that bureaucrats and/or elected politicians will be granted authority to prepare an exam that deems be sufficiently "rational"?
Anything works as long as the general public voted it in place. I don't particularly care about whether it would be managed at the state or federal level. They'd probably negotiate treaties and recognize equivalent tests if the need arose.
As for their content:
A combination of IQ test and general knowledge for core franchises.
If you want to just be eligible to vote? Name the 3 largest political parties and their public policies. Score above the threshold IQ where you'd have been deemed Special Needs or outright lacking capacity. In other words, don't be an imbecile.
You want to drive? Take the same driving test we do today.
Want to drink? Show you understand how many drinks it takes to take your BAC to the legal limit. Take a simulated driving test while drunk, so you get a visceral understanding of its effects.
Do strongly addictive drugs without a medical prescription? Display a clear understanding of the dangers involved, the signs of toxicity and overdose, the longterm side-effects. Clearly state you understand the risks, you're releasing the state of liability for any expenses you incurr that you can't personally cover, buy insurance, or optionally post a bond that will be returned if you don't fall afoul in a fixed period of time. Optionally a cool-down period of a month, so anyone not strongly motivated doesn't bother. Perhaps have seminars by ex-addicts warning of the dangers.
Want to sell that shit? Don't want to go through med school? All of the above, with the same level of detail and knowledge you'd see in a geeky member of /r/Psychonauts. A clear understanding of customer protection laws, truthful advertising, quality control. Liability if not strictly vetting that your customers are licensed to buy too. It would probably look like a version of a pharmacy exam but much harder.
Want to gamble? I'd prefer no licensing at all, but if necessary, demonstrate basic understanding of probability and that the House always wins in the end.
Yes, with strict checks and balances, and mandatory consultation with domain experts. If you trust the systems in place that license doctors, lawyers and accountants, envision more of the same, but open to anyone who can pass the tests.
Alternatively, for people who have passed the hardest core tests, extend them the ability to buy any service, from anyone regardless of qualifications. If you trust some rando on the internet to be your doctor, then you can take his medical advice while discharging him of the liability normally involved.
Edit:
The simplest solution I can endorse is Robin Hanson's idea of a Store That Sells Banned Things.
https://www.lesswrong.com/posts/PeSzc9JTBxhaYRp9b/policy-debates-should-not-appear-one-sided#fn1x15
Add in an exam to be able to access said store, and then I accept this factual consideration, and consider it to be positive on balance.
At this point, we're just living in a "light all of the tax dollars on fire" fantasy land with a ballooning bureaucracy to boot (who else administers all of these very involved exams).
I can't think of a worse hell for personal liberty.
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Surely the same duty that applies to you, applies to others. Doctors are probably going to be a source of the drugs.
It isn't just something that you simply aren't comfortable of doing but a moral obligation that extends to other doctors and people in general. It is a duty not to do it and such an important duty that they ought to be restricted from selling what is essentially addictive poison.
It is not a fiction however but central to morality. Someone who is selling heroin to others is a terrible person who engages in what is correctly treated as a criminal activity.
In this case, it isn't about what society deems to be good for you but what is genuinely good for you.
Which heroin definitely is not. The freedom to take and sell heroin is not a worthy one. It also hardly the case that liberty is enshrined here when the end result is someone who becomes an addict. There is a higher liberty that is satisfied by not selling and not buying heroin, morally condemning the practice, and restricting it as well.
It is also about what kind of society you want and will get. Your hiding a refusal to do the pro social duty behind liberty.
Another analogous case would be making it illegal to put poison in food even if there is a willing buyer who is unaware.
Allowing selling your self or one's dependents to slavery, or selling your eyes, would also be the kind of thing that reduces liberty, and doesn't enshrine it. I don't see liberty but slavery when looking at drug addicts.
I would agree however that any moral obligation and any paternalism towards addicts and others who make poor decisions should be limited or else it becomes pathological altruism and parasitical at expense of more productive citizens.
Noblese oblige and paternalism only so far but it does include having a society that tries not to take advantage of these kind of people.
What you are proposing would be a betrayal to the principle of no regulation = liberty.
Plus smart people even though less than others, do stupid self destructive things too. Having a country that restricts heroin and has policies that lead to less drug abuse would result in a country that some of the people who were to become addicts would have lead successful lives. Avoiding having places that are notoriously filled with "zombies".
Maybe this makes sense for something like crypto but makes less sense for heroin. Your proposal would surely lead to more restrictions than just banning the worst things.
It does make sense for some industries to limit them in some capacity when it comes to gambling, porn ,etc. Still, the fact that you are willing to support something much more restrictive does undermine the claim that liberty to sell and buy heroin is an important principle. It is not. The duty of caring about the end result of heroin being sold and bought is a much more important consideration.
Why? If we're restricting ourselves to what seems to be a rather minarchist AnCap Utopia, why is it that only doctors would be licensed to sell it?
Once again, my own views, and not representative of current reality:
Anyone can get a license to prescribe anything. They go to a government body that makes them pay a recurring sum that is a fair estimate of expected negative externalities, or what would have come out of the public purse. For highly addictive drugs, this would certainly be an enormous sum. It might even be legally required to buy insurance on the free market. Think of this as a more generalized form of malpractice insurance as paid by doctors, if you don't show proof of funds then too bad for you.
It might be framed as a bond, due to be returned with interest after X years, but any violations would be deducted from it. If they sold to someone with an Adult Card, then they'd be cleared of much of the liability.
Good luck on getting people to come to a true consensus on what is "good for you". A stable equilibrium is allowing people to choose for themselves, as long as they don't abuse the privilege by hurting others.
As far as I'm concerned, the State should not be in the business of being a nanny, and if it insists, then people should be allowed to opt out or form enclaves of like-minded people.
I re-iterate that I'm not a monomaniacal zealot. This counts as a concession, a mild step back from Absolute Freedom (or outright anarchy). I think your right to swing your fist ends where my nose begins.
I am willing to trade away a non-zero amount of freedom for other terminal values I have. I just value freedom more than most.
I disagree. We currently do something maybe sorta kinda like what I propose, but in a half-baked manner without underlying guiding thought more than the whims of the Current Year.
That is your opinion. I express my love and sense of duty towards my "fellow man" by hoping I can treat them like intelligent adults who can decide for themselves, and ask the same in turn.
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Would do you think of the ability to bring back to life basically people who overdose? I forget the name of the drug but it starts with an N if memory serves. Maybe Narcan or something like that.
You're correct, though Narcan is a brand name.
What about it? I mean, I feel like most people have no objection to its existence, and consider it a very good thing to have around. You might have a few junkies start whaling on you because you ruined a perfectly good high as far they were concerned (they don't care about the fact that they stopped breathing).
You talked about making junkies internalize their costs whilst narcan seems to be the opposite.
I'm not a zealot, you won't see me holding a copy of Atlas Shrugged while putting a padlock on a public park.
In the UK, I've never seen Narcan dispensers in public. I presume only paramedics would carry them.
In the US? I've heard of them being in half the stores, people carrying them just in case, and so on.
If someone feels morally obliged to whip it out when they see an addict ODing, why on earth would I condemn the kindness of strangers? If they weren't carrying anything, and didn't do more than call 911 and walk away, I won't condemn them either.
Don't get me wrong. I think the opioid epidemic in the US needs addressing. I'm all for rounding up junkies and making them take their meds and go through a rehab program, but because they're criminals, a public nuisance and causing social chaos, not because they're drug-users.
I also think that in countries with publicly funded healthcare, states should have the right to deny coverage to those who refuse to address behaviors that impose exorbitant costs. You might be saved and treated free of charge the first time, but if you don't comply with further advice, then I don't object to the public washing their hands of you as a lost cause.
Some diseases are unavoidable, it's not like anyone asks to develop Type 1 diabetes or schizophrenia. I'm far more sympathetic to such cases, but not sane people who know the risks of addiction and show no signs of stopping, while expecting the rest of us to pick up after them.
Because their kindness results in more unkindness directed at others by the addicts they save.
I do not think, from a proper consequentialist position that considers n-th order effects, that holding people liable for saving strangers is a good idea. In fact, I'd say it's a terrible idea.
If a cardiologist operates on, and saves, someone who goes on to conduct a genocide in Angola, would you hold him liable? Assume he didn't know the fellow beyond hearing he was a rich African who had flown into London for surgery, and paid for the best. Do you want us doing background checks on patients, as extending this line of reasoning would entail?
For the average bleeding heart: If they don't Narcan someone, I don't hold them responsible. If they do, then I think their general desire to be pro-social should be recognized, even if in this particular case, the person wasn't worth saving. That is not always a given, someone who is a recreational drug user but isn't a homeless junkie might easily OD on fent accidentally contaminating their coke. Far too many members of net productive members of society would be caught in the crossfire. Nary a day goes by when you hear of some young yuppy dying in a fancy club or house party from the same.
Does he have any reason to believe this will be the result?
The result of saving some random street addict from his own overdose are pretty predictable: with high probability, more petty crime, maybe some major crime, until the addict manages to overdose again.
As for the yuppies, I'm not crying for them either.
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