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PaperclipPerfector  5d ago (text post)   24140 thread views

Culture War Roundup for the week of February 24, 2025

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Look, you're being too harsh on me.

When I say I had active suicidal ideation, I meant it. The barrier between suicidal ideation and an attempt is tenuous at best.

I wasn't very far at some points. I never actively planned things, but at certain points, if someone had come up and put a gun in my hand, I can't say for sure what would have happened.

Public attitude prior to about the 90s was suicide is wrong. Flat out wrong. Then euthanasia become a cause for terminal patients suffering from incurable cancers and the like, people in constant suffering. But it would never go past that the medical establishment insisted, and it would certainly never be trivialised by being offered to the depressed. 25 years later and the depressed can get assisted suicide. It is an example of the concept creep pusher_robot mentioned.

Norms change over time, and we're talking 30 years. The people who might have made the original claims could easily be dead or retired.

Governments have changed multiple times since. Culture would have changed even without strong pushes. It's not the same set of people making promises and breaking them the moment backs are turned.

I strongly disagree that there's any "trivialization" involved in offering it to the incurably and severely depressed. They're living miserable lives, even if we can't clearly and legibly figure out what's gone wrong with them. That's just the state of psychiatry today.

I would strongly push back against it being offered to people who hadn't exhausted the treatment options for their depression. What else can I say?

This pretty much sums it up for me. Yeah bud, I know it's unavoidable, that's been my point from the beginning. The fact that you would level it back at me as if that somehow excuses it is the core problem with the modern world. It's the death of a thousand cuts, responsibility is diffused so nobody has to own the psychological consequences of their actions and we say 'hey they have the freedom right? You aren't opposed to freedom are you? I didn't hand them a gun!' Sure you knew you were taking actions that would result in their deaths, but they could have just spent 700 pounds to ask a doctor to promise to never kill them during one of the infrequent periods when they could even see something resembling a future for themselves! How is that on you?

I am a consequentialist. I seek to maximize my values, finding compromise where they conflict with each other.

I strongly value personal liberty and freedom, including control of one's life. I also value other people living on, preferably as happy and satisfied as they can be.

I'm not lying or denying that there are clear downsides and tradeoffs involved. I just think that they're worth it.

You offer me a bullet, and I'm biting it.

You might value things differently, and that's your prerogative.

I would be willing to perform the kinds of roles my envisioned system would require. It would be difficult and emotionally taxing work, but most doctors eventually understand, through bitter experience, that not all patients can be saved. Sometimes everything that can be done had been done, and you're keeping a corpse hooked up on life support. Sometimes it's not that clear cut, but they consistently report that their life is misery while being otherwise physically well. If I can't save them, then prolonging their life against their wishes is as bad as putting a confused elderly woman with dementia on the ventilator so she can spend another week in pain and terror before her inevitable death.

Well you're right, it's not. Congratulations on winning the argument.

I guess it's on me for expecting you to actually grapple with the issue because you claim to have suffered depression. I should have realised you wouldn't be able to empathise when you explained that you had never been suicidal.

I never came into this with the desire to win an argument. If this passes as a victory, I want it even less than you do.

I'm doing my best to explain why I hold the views I do. That I am aware of your values and concerns, and the downsides of my own desires. I still think the price worth paying, and not because I'm not empathetic. I wouldn't be a psychiatrist if I didn't want to help people. I some rare circumstances, that help would be for them to no longer live on.

You're right, I flew off the handle, I'm sorry. I certainly didn't mean to imply I didn't believe you suffered depression, although I do think suicidal as a descriptor should require planning - if it's at the wanting to die level the whole of Denmark is suicidal.

But this subject is uniquely tilting me, I am trying to have empathy but it does feel like you are being deliberately obtuse. I believe you are not, and I appreciate you saying what you just did, and I have been trying to figure out another way to explain myself but I can't do it without tilting further.

I understand, and I won't press the point.

It can be frustrating to confront someone with the same set of observed facts, and find that they take away entirely different messages. Some of that is miscommunication, and common ground can be found if you hash things out long enough.

Sometimes, it can be genuine differences in what we value, and I wish I had a solution to that. I do not expect that there is, beyond letting the brute force of reality sort out a victor, though hopefully not with bloodshed or permanent acrimony. I've been there, when talking to someone who accepts what I find unacceptable, and I'd be lying if I said I'd never lost my temper in the process.

If you wish to continue the conversation, I'll be here. If not, then I did appreciate the opportunity to discuss our beliefs and ideas.

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