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PaperclipPerfector  1yr ago (text post)   27509 thread views

Culture War Roundup for the week of November 6, 2023

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They is currently an 8 month old baby in the UK with a mitochondrial disease which is almost definitely terminal. The babies name is Indi: https://abcnews.go.com/International/wireStory/italy-grants-citizenship-terminally-ill-british-baby-after-104666139

A UK judge has ordered that that the baby be killed. Her parents have protested this, saying that they don’t think the government should kill their baby.

The Catholics have said: give us the baby and we will put the baby in our pediatric Vatican hospital, and the Italian government has said they would cover the medical bills. The Italian government has also said that the family can have Italian citizenship.

The UK has said no, you can’t leave, you need to keep the baby here so we can kill it.

I know this sounds hyperbolic, but…I don’t think it is. Read the article. Absolutely deranged behavior.

I understand that in socialized medicine countries there is some calculation about how much life support will cost, and famously in Canada sometimes this means the government just tries to get you to kill yourself, but that doesn’t seem to be the case here. The Catholics are being pretty Catholic about this and just trying to save the baby. The UK government won’t let them and insists that they should just kill her.

Insanity.

mitochondrial disease which is almost definitely terminal.

I would like to hear your justification for the use of the word "almost" in this sentence - so far as I can tell this baby is doomed, and has nothing in her short future but suffering (insofar as she is even capable of feeling suffering at this point) and death.

The Catholics are being pretty Catholic about this and just trying to save the baby.

And the protestants are just being protestant about this and acting under pragmatism rather than dogma.

Look, I'm sure the folks at Bambino Gesu are operating with only the best of intentions, but good intentions don't heal babies with broken genomes. The Vatican would have better odds building a colony on Titan than of saving this child.

Indi is a British citizen. As such the court is bound to act in her interests. Not her parents, hers. It is blatantly obvious to me (and the judge, apparently) that any sentient creature with zero capacity to do anything but suffer is better off in a state of inexistence. Prolonging her life for the sake of, what, her parent's feels? Not justifiable.

And the protestants are just being protestant about this and acting under pragmatism rather than dogma.

Discontinuing care would be pragmatic. Preventing the child from going somewhere else, were care will be given is just as dogmatic.

I think the point is UK courts will rule that letting a child die might be best for the patient and override parental wishes, but they will also override parental wishes to save a child if they deem that best for the patient (With Jehovahs Witnesses and blood products most commonly I think).

So they don't have a, "always preserve life as much as possible" rule, or a "always end life early" rule, but they choose depending on the circumstances.

Papal infallibility is a dogma, even when what the pope says is pretty nuanced. This is just "healthcare system infallibility".

I don't think that makes sense,because we don't allow doctors to make the choice on their own. And multiple witnesses and doctors were called before multiple judges, including up to the ECHR which isn't even British.

When we lock up a criminal after a trial is that dogma because we're assuming "justice system infallibility"? Or that we know its not infallible but decisions have to be made in the best interests of people anyway, even though it could be incorrect?

Sure, if a jurisdiction outlaws, say, gender affirming care, it would be a claim on infallibility if you not only prevented people from providing it within the jurisdiction, but also prevented the from going where it's legal.

No, I think you're wrong there. You don't have to think you are infallible to stop someone doing X, you just have to think you are more likely to be right than they are. It might be a claim that you know better than them, but that's not the same thing as thinking you are infallible.

If I forbid you to take cocaine (assuming I am in a position to do so, and care about you), and when you tell me you are going round to your friend's house to do coke and I lock you up instead, I can freely acknowledge that it is possible that it will be a positive healthy experience for you with no downsides. I just have to think the cost/benefit is tipped too far into the negatives. But it isn't a claim to infallibility. You can ask me "Isn't there a chance you are wrong SSCReader?" and I will say, "Yes, I might be". Yet I still won't open the door. I know I am not infallible, yet, if I think your judgement is (for whatever reason) too badly compromised, I just have to trust it MORE than yours.

It's comparative, not absolute in other words.

Sorry, can you stay within the bounds of my hypothetical instead of changing it so that it no longer applies to the situation?

More comments

Normally people are free to take their baby to Italy if they want though -- the UK health system choosing not to treat the baby due to hopelessness seems fine, but actively preventing the family from seeking other options is a bit nuts. (and reflects a high degree of egotism on the part of the UK justice/health system, if not quite 'infallibility')

It's not just due to hopelessness, the treating specialists claimed that treatment was not just useless but causing pain and therefore further treatment was not in the best interests of the patient. As long as you accept that is on the balance of probability true, then the choice is allowing further torture. You don't have to think you're infallible for that. Indeed it went to what, at least 4 different courts (one of which was the ECHR and not controlled by the UK), all of which are checking the work of the other.

It may still be wrong of course. But if you have double checking built into the system, it seems clear the system has at least taken some steps to try to minimise mistakes.

It's the extension of jurisdiction to Italy that is key here -- if Italy (or Vatican City I guess) thinks that the treatment is literal torture, they could ban it.

What even are the mechanics of this -- is the state taking over custody of this kid? ie. if the parents show up with an ambulance and a bunch of Vatican doctors, the police will prevent them from moving the child?

More comments

What struck me as dogmatic is the prolongation of life as the highest priority, the greatest possible good, regardless of anything. There is no consideration given to the possibility that maybe prolonging Indi's life is not a good thing for her.

It's in your comment too. If you'll pardon me trying to guess your thought processes, the only negative you can even consider is the economic cost of keeping Indi alive. If someone else is covering that then there is literally no downside.

This is only true if treatment is an unalloyed good, which, of course, it isn't.

What struck me as dogmatic is the prolongation of life as the highest priority, the greatest possible good, regardless of anything. There is no consideration given to the possibility that maybe prolonging Indi's life is not a good thing for her.

I find that absolutely backwards. Even if the UK healthcare system ran some advanced calculus on whether it makes sense to keep her alive, they are the ones failing to consider that someone else might come to a different conclusion. Actually, failing to consider wouldn't even be that bad, the issue is that they are so absolutely certain, that they believe they have a right to stop, by force, other people from prolonging her life. A non-dogmatic person does not act this way.

It's in your comment too. If you'll pardon me trying to guess your thought processes, the only negative you can even consider is the economic cost of keeping Indi alive. If someone else is covering that then there is literally no downside.

This is only true if treatment is an unalloyed good, which, of course, it isn't.

Usually we let the patient decide whether or not to undergo treatment, and if they are in a state where they cannot make that decision, we lave that to their family. You're so certain about being right, that you think it gives you the right to override the parents, and you're calling others dogmatic?

I really don't think it is the place of a judge to ever order a cessation of treatment, except to settle a dispute over power of attorney or something similar.

The article doesn't make it clear what mitochondrial disease is responsible, but the UK is probably the world leader in treating it. The caveat: It has to be done via in-vitro fertilization.

This would have to be a defect in mitochondrial proteins that are coded for in nuclear DNA, right? The mother obviously doesn't have the disease, or she would never have lived long enough to reproduce. Since mitochondrial DNA is inherited from the mother without recombination, then it can't be carried in mitochondrial DNA, unless it's a de novo mutation.

Many (most?) mitochondrial genes have migrated into nuclear DNA, so an autosomal recessive disease could explain how she was able to inherit the disease without either of her parents having it.

From the topic text:

Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:

  • 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.

Please don't post things like this.

I think I crossed out the parts you didn’t like. Is that what you meant?

Those are definitely the worst parts, but the rest of it ain't great either - it appears the entire point of this post is to complain about someone doing a thing you don't like. What's the point? Why are you posting it? If it's "these people are doing a bad thing", then it's not a good post; if there's some other reason, go into that.

Why are you posting it? If it's "these people are doing a bad thing", then it's not a good post; if there's some other reason, go into that.

He did. The ethics of euthanasia are an interesting topic, and discussing a general topic through a recent example is a very common thing here. You might as well ban the Gaza megathread, if that's you interpretation of the rule.

The ethics of euthanasia are an interesting topic

Then write something about that, not just "look how bad these people are".

and discussing a general topic through a recent example is a very common thing here

Then start a discussion, instead of just dropping "look how bad these people are".

This particular rule isn't new, it's existed before this branch of the forum has.

https://www.themotte.org/post/757/israel-gaza-megathread-iv/158907?context=8#context

Three most recent posts in the Gaza megathread:

Someone writing about an event

A specific set of four questions to people

A specific single question to people

If anyone's just posting "boy look at how bad these people are" then report them, please.

If anyone's just posting "boy look at how bad these people are" then report them, please.

The thing is, I'm not really bothered by people doing that, and I don't think it's possible to not do it while discussing certain events. For example from the CW of the week of the Gaza attack:

Hamas has just attacked Israel en-masse, overwhelming the Iron Dome with 5000 rockets and even sending raiding parties into Israel.

Sure sounds like "boy look at how bad these people are" to me!

I get it, it's a judgement call. Some things are just The News, and others you kind of have to go out of your way to find, I was just taken aback that describing in plain terms what occurred in this event has made the cut for mod-worthy.

From the article, it seems like the government merely ruled that (government-provided, in the UK) life support should be withdrawn, which does not register as "ordered to be killed" any more than I would consider the government refusing to subsidise plane tickets for unemployed people to amount to imprisonment. The weird part only begins at the point where they also arrogate to themselves the right to prohibit transferring the baby to a different hospital - but this is part of a general tendency towards legal paternalism in medicine. I was under the impression that the appetite for making it illegal to go do something that is not authorized locally (including recreational drugs, experimental treatment, and especially medical interventions that touch upon ethically touchy topics such as abortions, embryonal selection, cloning...) is generally high, and people get away with it it is only due to the inattention of the legal system.

There's a very high amount of authoritarianism and arrogance found in senior medical professionals. They don't like to be disobeyed or disagreed with. Look at the "Take Care of Maya" case that just finished.

Another interesting example is that now there are several countries that ban drugs like ketamine, psilocybin, or MDMA for treatment of severe mental disorders. But they allow assisted suicide in those cases. Because a dead patient happens all the time, but to be proven wrong would be truly horrendous.

This contradiction doesn’t hold if the people banning the drugs aren’t the same people in charge of treating severe mental disorders or carrying out euthanasia. Maybe I’m wrong and medical professionals do have a right to use prohibited drugs which they’re not exercising.

t. The weird part only begins at the point where they also arrogate to themselves the right to prohibit transferring the baby to a different hospital - but this is part of a general tendency towards legal paternalism in medicine.

It seems to me most of these stories concern the UK. I don't recall such a story - prohibit privately funded transfer of a hopeless baby - from any other country.

The government is also preventing the parents from taking the child out of the country to get treatment. So, no, the government has specifically decided the child needs to die because keeping it alive or trying to treat it is cruel.

Yes, I understood that (see second half of the post). But in that interpretation, isn't any legal prohibition of experimental or perceived-to-be-unethical medical interventions still similarly equivalent to "deciding someone needs to die"?

But in that interpretation, isn't any legal prohibition of experimental or perceived-to-be-unethical medical interventions still similarly equivalent to "deciding someone needs to die"?

YesChad.jpg

Seriously, I'm perfectly willing to bite that bullet. Even in the case of treatments almost certainly being useless, denying people the option of trying to do something for themselves in the face of a terminal disease is telling them that they must learn to die on the state's terms.

for themselves

If this were true, it would be a very different situation.

Government telling adult citizens what to do is very fraught.

Government protecting the interests of dependent minors in limited cases where parents are not acting in those interests is well-established law and a sad but necessary institution.

This is just a weird mind worm that Catholics have. They’ve lost control of society, of culture, Francis is on the verge of allowing gay marriage, Vatican 2 has been in place for 60 years, divorce is commonplace, but one brain-dead infant needs to be pumped full of drugs and kept alive as a vegetable for the longest possible time. Maximizing the number of deformed, disabled, unwanted, underclass or critically sick babies appears - in the 21st century perhaps along with supporting large scale immigration - to be the guiding principle of the Catholic Church.

This isn’t even opposition to euthanasia, because as others have suggested, she wouldn’t survive for any period naturally (which is the traditional threshold), but rather must be artificially kept alive in what amounts to a gruesome and morbid Frankenstein-esque medical experiment.

I will respect Catholic trads when they actually fight for for something that might improve civilization in a material way for people currently alive and their healthy descendants instead of kvetching endlessly about irrelevancies. Until then, for God’s sake if for nobody else’s, they ought to let this deeply unfortunate child rest in peace.

The sanctity of human life as a bright line between good and evil is an important load bearing principle of our civilization that is much too often taken for granted.

It's easy to call Catholics idealistic and impractical, but you're the one who lacks foresight if you think it isn't worth fighting tooth and nail on this particular battlefield.

Consider carefully the horrors that we know lie beyond the door of the State deciding who lives and dies. And remember it isn't you who controls it at the moment.

The sanctity of human life as a bright line between good and evil is an important load bearing principle of our civilization

Are you a staunch pacifist? Do you believe that no human being can ever kill any other human being under any circumstances? Even if your answer is yes, surely you can acknowledge that nearly no other person on earth, including in any nation you consider civilized, holds this belief. The vast majority of people believe that it is completely permissible to take another human life in at least some circumstance. That means that the line you are pointing at is not actually very bright at all, and is certainly not foundational to our civilization.

I am not. However I believe killing is only appropriate in cases where other options are exhausted such as self defense and war. And that it is not something that can be applied to people who did nothing wrong.

I entirely condemn it as a means of administrating a society, which is why though I am sympathetic to the idea of a death penalty for serious crimes, I am against it in practice. The State can not be trusted with the power to kill outside of the regimented confines of necessity. Death panels do not qualify.

And yes this is foundational to Western civilization in general and English civilization in particular which both place a lot more value on individual life than their contemporaries. Which is why the English, who like their rights, have historically not been very fond of the continental style of planned society. And why communism took root in the east and not in the west, contrary to Marx's predictions.

Again, it was England that had the Bloody Code, one of the most punitive and authoritarian legal regimes in European history. Any talk of “the natural rights and liberties of Englishmen” needs to grapple with that. It turns out that actually England does have a robust history of state institutions - such as secret police - that have intervened substantially into the lives of their citizens, no different from any other European state. So, if you’re going to make an argument about why state violence against citizens is a priori wrong, rather than trying to appeal to an extremely contentious and revisionist model of English history.

There’s a difference between a war and the state deciding that one of its own must die. I don’t think the line is death qua death but the line is certainly the inalienable rights of life liberty and the pursuit of happiness of those citizens who live within the borders of the state. The concept of human rights is absolutely foundational to the west and I think this is the line that must be defended.

Are you suggesting that the death penalty - something eagerly practiced by every single country you would consider part of “the West” until practically yesterday, is “anti-Western”? Again, if you do, then you’re applying a definition of “Western Civilization” that didn’t exist until about forty years ago at the earliest.

It seems that you have an extremely progressive understanding of Western history, in which the West only started at the exact point in history in which your exact values became solidified. No Western person three hundred years ago cared about or believed in “human rights” in the way you’re using the phrase. Western countries were all totally fine with slavery at that point. Were they “not Western” at that point? England at least was executing thousands of people per year for even petty crimes. Was England not “Western” until it stopped doing so?

I’m suggesting that killing somebody outside of a state of war without due process (with the exception of self-defense) isn’t part of the enlightenment western tradition. It took a long time to get there, and we’re still working to get there.

Are you suggesting that the death penalty - something eagerly practiced by every single country you would consider part of “the West” until practically yesterday, is “anti-Western”? Again, if you do, then you’re applying a definition of “Western Civilization” that didn’t exist until about forty years ago at the earliest.

I don't think that they were saying that "the state should never decide that one of its own should die." It seems that we can draw distinctions between a convicted child murderer and a child, for example.

However, I agree that human rights, in the modern sense (secular nonlegal rights that one holds because of being human) is extremely recent. The traditional Western view (going back to the days of the Roman Empire) was that one's extra-legal entitlements vs. others came from God. There were other Western ethical systems that worked differently (Stoicism, Peripateticism, Epicureanism) but these weren't based on the legalistic model that Western civilizations inherited from the Ancient Hebrews.

It was certainly abolished by appealing to Western principles. Much like slavery.

There's always a distance between the principles people hold and what they actually do.

But this is precisely the shell game I’m accusing you of. “Western countries happily lived one way for hundreds of years, and then very recently they decided to do things a different way. That means the original way they did things, which lasted for much longer than the more recent thing, was never actually Western at all.”

I don't see the enlightenment as a divergence but simply a continuation of the principles that have guided western civilization since it's foundation.

I suppose we might simply disagree there.

There’s a difference between a war and the state deciding that one of its own must die

The death sentence, while slowly dying itself (or being strangled through lawfare and regulations) still exists in many Western states.

Further, there are plenty of cases where the state summarily executes people outside a state of war, try and shoot a police officer, or in the case of the UK, attempt to stab one and see how far the sanctity of life gets you.

Holding human life as sacred/uncomprisable simply doesn't work, at most you can argue that a high premium should be put on it, which is already true in the West, unless people are willfully blind to the historical state of affairs or the misfortunes of the rest of the globe.

Further, one can easily (and correctly) argue that this particular case lies at the confluence of a conflict between multiple different "rights", such as a right to medical care, a right not to be tortured, the right to die, or parental rights over their offspring. No matter how you slice it, someone's sacred ox is getting gored.

States can and will kill people, it's how they perpetuate themselves, and necessary for their very existence until we manage to eliminate violence altogether (hah).

try and shoot a police officer, or in the case of the UK, attempt to stab one and see how far the sanctity of life gets you.

Seeing how regular police officers don’t carry firearms in the UK (aside from in Northern Ireland), you’ll probably get pretty far.

but one brain-dead infant needs to be pumped full of drugs and kept alive as a vegetable for the longest possible time

Yes, the better answer is to turn it into ragouts and fricassees since then they would get some return for their time and expenditure.

I don't think you can piously mutter about "this deeply unfortunate child" after characterising it at the start as a brain-dead vegetable. You've shown your real opinion, no need to pretend to care about the child as such. And indeed sick children in general; you explicitly mention "healthy descendants" so - diabetic babies should die? blind babies are a hobble around the ankle of the healthy? At what stage does one reach a sufficient level of "not a healthy descendant" to be for the scrap heap, and at what point is "sufficiently healthy to be allowed live" reached?

I think barring cases where therapy would likely involve growing a new brain for them, such as microcephalic infants, in an ideal world everyone should be kept alive until we have the medical treatment to heal them, which I wager is easily within the current nominee life expectancy of most people reading.

Unfortunately, we live in a far from ideal world and budgets aren't infinite, so I have no qualms about letting die those who are an onerous burden.

For a more formal/object assessment criteria of how much a year of one person's life is compared to the average, we have QALY and DALY which adjusts for "quality" and disability respectively, to formalize the intuitive notion that a year of a doddering dementia patient's life is not worth as much as one of a healthy 20 yo.

A baby that no amount of money would save today before they die would certainly qualify for someone who should be allowed to die, or at least be cryogenically preserved in the hopes of resuscitation in a more enlightened age.

Regardless of earnest hand-wringing about the sanctity of life and how it's beyond such loathsome things as cost-benefit analysis, you don't see the global GDP diverted to help an orphan that fell down a well, or the Pope emptying the church's coffers for the sake of any old malarial infant.

Since it must be done, then it's best done as intelligently as we can manage, instead of letting moral outrage do all the work.

Diabetic babies aren't particularly expensive to rear, the Indian government, impoverished as it is, can give insulin away for free, and even the blind are being cured with reproducible therapies that promise to end the disease once and for all, no need for miracles not of our own making.

Sure, but our friend didn't make any fine distinctions when talking about "healthy descendants". So what level of health counts as 'healthy' for his purposes?

we live in a far from ideal world and budgets aren't infinite, so I have no qualms about letting die those who are an onerous burden.

If the cost is being borne largely by private actors, what cost is it to the government? Surely, if a private individual or charity group is able and willing to direct their funds to keeping those children alive, they should be allowed to, no?

Regardless of earnest hand-wringing about the sanctity of life and how it's beyond such loathsome things as cost-benefit analysis, you don't see the global GDP diverted to help an orphan that fell down a well

You do see people expend hundreds of thousands, if not millions of dollars, to save kids trapped in a cave or save an individual diver who went into a cave, however. Much of that is almost always from the national coffers. To say nothing of charities who's entire goals are to save such people, regardless of said cost.

If society can forward cash from its coffers toward elderly patients at nursing homes, it can spend some money keeping some kids alive. Especially if a society-- hell, an individual- chooses to shoulder that burden, keeping most of the cost of the existence of that child out of a country's own economic burdens. It's one thing to say "the state will not fund this any more" - it's another too deny access and use of private resources.

If the cost is being borne largely by private actors, what cost is it to the government? Surely, if a private individual or charity group is able and willing to direct their funds to keeping those children alive, they should be allowed to, no?

I have no objection to this at all. By all means, people should be allowed to make hail mary attempts as long as they're taking the financial burden upon themselves.

You do see people expend hundreds of thousands, if not millions of dollars, to save kids trapped in a cave or save an individual diver who went into a cave, however. Much of that is almost always from the national coffers. To say nothing of charities who's entire goals are to save such people, regardless of said cost.

This does not change the fact that the willingness to pay is not infinite, far from it.

Refugee is just a modern euphemism for illegal immigrant. Hence why thousands of Albanian men who wash up on the southern shore of England are called 'refugees' by the open border crowd.

Refugees is basically the NGO way to enable large scale immigration.

If you count the millions of asylum seekers pouring across the southern border, than refugee resettlement is at all-time highs surely.

It seems like you are playing semantic word games, using some technical definition of refugee that isn't the common sense definition.

Conflating the number of asylum seekers with the number of *refugee resettlements is itself semantically dubious, isn't it? Especially given that most of those asylum applications will be denied

The application may be denied, but that doesn't force them to go home. They can just disappear into the US.

Well, voluntary departure is a much smarter move, since it avoids having a removal order issued, But I am sure you have data on how many rejected asylum seekers stay illegally.

In Germany, at least, the standard operating procedure is for an illegal immigrant to falsely claim asylum, have his application rejected, and then not be deported.

The Catholic Church and Bishops Conference (ie the leadership body of American Catholicism) also lobbied extensively for Hart-Cellar and for amnesty for all illegal migrants whenever it’s been an issue in American politics. The Sanctuary (city/state) movement evolved out of steps that largely Catholic churches took to harbor Central American migrants in opposition to Reaganite immigration policy in the early ‘80s.

That being said, the historical record shows that in 1965 very few people who supported Hart-Celler envisioned that the level of demographic change would be what it turned out to be.

But how many civil society groups, including the Church, have changed their minds at all, knowing what we know now?

Canada already proved euthanasia is a slippery slope, so I don't buy all the talk about how this isn't an important issue.

I will respect Catholic trads when they actually fight for for something that might improve civilization in a material way for people currently alive and their healthy descendants instead of kvetching endlessly about irrelevancies

All the misery of modernity was brought upon us by people obsessed with material improvement, so I'm happy respecting Catholics now.

Canada has proved that conservatives will meme about euthanasia being a slippery slope given the slightest provocation.

It's not like every hospital ward is flooded with sarin gas once a week, I haven't heard any actual horror stories beyond 'someone mentioned to someone that this was one of their many options' or 'someone who was probably a high risk for suicide anyway got to do it painlessly'.

Let me know if you know of something more substantial than that, it's admittedly not something I follow closely but I don't ever remember being impressed by this narrative when I've seen it and gone to read the original source.

Offering euthanasia for anything other than a terminal illness is breaking of the original promise for what it would be used for, and thus a vindication of the slippery slope. If you want to shift the goalposts even more, go ahead.

I don't know what you mean by 'original promise', whether that's a single specific document or a general sense that most of the public got from reading hundreds of politicians and pundits talk about the matter, or what.

Not that I'm totally disagreeing, I'm sure there are some specific groups involved who were either lying or mistaken about what course things would take and didn't project it looking exactly like it does today. Which isn't teh same thing as the whole enterprise being deceptive from the start, I don't know enough of how it was proposed to judge that either way, would be interested to learn more if you are thinking about a specific document or speech.

I think there should be a principled difference between 'this is a slippery slope' and 'this was sold using deceptive rhetoric'.

If so far nothing crazy has happened, and nothing that the original proposers wouldn't have been happy with has happened, and it's only been a short time since it was implemented, then I'm not sure that's evidence that it will slide into crazy things that the original proposers would not want.

It just sounds like original proposers were downplaying how big the change would be, which is bad because it's dishonest, but not strong evidence of an ongoing trajectory.

Anyway, if the proposition is 'Canada has proven that the government can't be trusted with medical decisions involving life or death', then I think I'd have to see the Canadian government do something objectionable before it was strong evidence of that. Not just 'it's being used in sensible ways that weren't originally specified'.

(of course, maybe you believe the current way Canada is using it is objectionable in and of itself. That's something I'd be interested to hear more about, but it's a different argument than the slippery slope argument)

I don't know what you mean by 'original promise', whether that's a single specific document or a general sense that most of the public got from reading hundreds of politicians and pundits talk about the matter, or what.

The latter, and I think it's disingenuous to imply only the former should be relevant in a democratic society.

Which isn't teh same thing as the whole enterprise being deceptive from the start,

"Slippery slope" does not mean an enterprise is deceptive from the start. It's possible for people to really honestly believe it will not go further than the point discussed when pushing through a policy. I actually was on the pro-euthanasia side until recently, and it is because I believed they will be limited to people suffering from a terminal illness.

However given the history of policies growing beyond the originally discussed scope, I think it's justified to assume most enterprises put forward today are deceptive from the start.

I think there should be a principled difference between 'this is a slippery slope' and 'this was sold using deceptive rhetoric'.

One is a subsection of the other. If you asked me for a definition of "slippery slope" it would boil down to "selling a social change through a type of deceptive rhetoric, where the scope of the planned change is much larger than originally discussed".

If so far nothing crazy has happened

(of course, maybe you believe the current way Canada is using it is objectionable in and of itself. That's something I'd be interested to hear more about, but it's a different argument than the slippery slope argument)

Yes, I do believe that. Crazy things have already happened. Even crazier things would have, were it not for public backlash. They're also scheduled to relax the rules even more next year, which will again, ensure even more crazy things happening.

I don’t have any issue with Canada’s euthanasia system, and the only flaw people seem to note is that they get upset when someone they don’t think should choose to kill themselves does so. But again, depressives, people dealing with extreme loneliness etc have always killed themselves at disproportionate rates, I don’t consider it morally abhorrent to ease their pain more painlessly.

But again, depressives, people dealing with extreme loneliness etc have always killed themselves at disproportionate rates, I don’t consider it morally abhorrent to ease their pain more painlessly.

As someone who has suffered from bouts of depression and loneliness in my life, I’m glad that I had people around me who cared enough to check in and look after me. They didn’t simply refer me to a government euthanasia program. That would be morally abhorrent. I hope you would never suggest that to one of your own friends or family members.

I wouldn’t, but if after a long time it seemed intractable that they wanted to kill themselves, and they were in great pain, and I didn’t want them to suffer horrifically in e way in which people so often do in suicide [attempts], I would accept their decision to go to Dignitas or whatever. Would I raise it as a possibility? I don’t know, but it certainly isn’t inconceivable that I would.

Canada already proved euthanasia is a slippery slope, so I don't buy all the talk about how this isn't an important issue.

Slippery slope? Canada is doing absolutely the right thing when it comes to Euthanasia. It is not being forced upon anyone, merely given as an extra option in addition to the normal healthcare system for those who's diseases are really bad.

Offering to euthenize veterans when they have the temerity to complain that their wheelchair ramp is taking a long time to install is not what I'd call "who's diseases are really bad".

Ah, you mean that grand myth about an offer that was “made verbally” and for which the veteran in question was unable to provide any evidence for whatsoever, that one?

Someone claims they want to die but were refused: we must believe them, don't ask for proof!

Someone claims they want to live but were told to die: where's the proof? oral only? it's a myth!

This is reminding me of #MeToo and 'believe (all) women' - when the accusations were against the guy we hate, it was mandatory to believe them and no doubt could be cast on the claims; when it was against our guy, of course the bitch was a lying, politically motivated, fabulist.

I don’t see why a verbal referral, possibly made sarcastically to a “squeaky wheel”, would have been recorded.

This is one of the reasons American conservatives don’t trust a large, central, bureaucratic government: “The part of the government which oversees the government states they couldn’t find anything in the files of the part of the government which works with citizens who served the government in fighting another government to indicate there was a referral to the part of the government which kills its own citizens to prevent them using excess government resources which could be used for more productive citizens.”

Well it’s relevant becuase in the Canadian bureaucracy (as in most bureaucracies) most things are recorded in writing, including offers of this kind of assistance apparently. Almost nothing in a Western bureaucracy when it comes to interaction between some government body and the citizen would ever happen ‘verbally’, even minor stuff requires 7 forms and a bushel of letters sent to the citizen about everything that relates to anything to do with an issue.

So while the government may have conveniently lost its copy, it’s much more suspicious that the veteran did, especially when she went directly to the press to complain about it.

Well hon, I've worked in a Western bureaucracy implementing government grants and policies, and we often communicated with the public over the phone or face-to-face at the enquiry window. And didn't write down every single word we and the client uttered.

So "interaction between some government body and the citizen" did "happen ‘verbally’". The 7 forms came later in the process.

More comments

Almost nothing in a Western bureaucracy when it comes to interaction between some government body and the citizen would ever happen ‘verbally’, even minor stuff requires 7 forms and a bushel of letters sent to the citizen about everything that relates to anything to do with an issue.

None of this is true, and bureaucrats know perfectly well that if they want to get something done, but it's not really up to code, they need to handle it over a phone call, or a face to face meeting, instead of via email for example.

More comments

I definitely have an issue with how you present the findings of the article. No one wants to kill the baby. They withhold care and not even on cost base, but because there is no benefit. Second - the article is preciously light with details about the treatment that the Vatican hospital proposes. I doubt that the UK doctors wouldn't recommend the baby to be moved to Italy if there was even a shred of evidence that their treatment there would potentially lead to permanent improvement. Or even to advancement for the medicine as a field.

No one wants to kill the baby. They withhold care and not even on cost base, but because there is no benefit.

If you are refusing to hand it over to someone who wants to give them care, how is that not killing them? If you're in an ambulance, is it ok if I block your way to the hospital?

If that care is almost certain to be ineffective, then it's not, regardless of the good intentions of the would be saviour. Suppose my baby was dying and a charlatan offered to exorcise it of the demon that was surely killing it. It would not be murder for me to ignore this claim, or the claims of anyone else who proffered some dubious miracle cure.

Again, I am yet to hear anyone make the claim that the care of the Vatican hospital is qualitatively different from that of the UK system, so if they're charlatans, so is the UK healthcare system.

I am also yet to hear anyone claim that the kid cannot be kept alive for a while longer, people are only claiming that it's ultimately futile. While it maybe true, it is also true that actively preventing people from delivering the child to a place that offers to keep the child alive for a while longer is equal to murder.

The UK healthcare system at least had the decency to desist when it became obvious that the treatment didn't work or, if the diagnosis was made later, couldn't work. A charlatan is someone who knows that their cures don't work, and very much keeps plying them after that becomes obvious.

While I certainly support the right of the parents to take their child to the Vatican hospital since it's not on the dime of the UK taxpayer (beyond presumably airfare and the logistics of getting them there), I still only have disdain for those who demand that a life worse than death be continued at any cost.

And I don’t think anybody claims that the parents or the UK have the obligation to continue treating the child indefinitely(certainly the majority opinion of theologians in the Catholic Church does not require medical treatment to continue when there is no chance of recovery- although it does require ordinary caretaking[feeding, diaper changing, etc, but not ventilation]). However the parents have the right to make medical decisions for their own children, especially when making the ‘wrong’ one doesn’t make the kid worse off or cost more money(because the Italian government is paying for it).

It's not the government's right to feel disdain that's in question, it's their right to get in the way that is.

What makes a charlatan a charlatan is claiming to have miracle cures, not being unable to produce them (which is true of all of them). That said, I don't know if the Vatican is making this claim, so I couldn't say if they are charlatans or not.

The Vatican hospital has one of the top icu’s in the world, so I don’t think the treatment plan being vetoed is ‘I dunno, will incense and holy water work?’

It seems like what’s actually happening is that UK government bureaucrats- probably someone in the NHS’s cost effectiveness department- doesn’t like being reminded of not owning other people’s children.

If there was actually a credible plan to treat this baby, it would be produced. But so far all I've heard is to keep the baby alive in the hope for a miraculous recovery.

Such a bureaucrat would have no power to issue an injunction. Injunctions like this are handed down by judges, not NICE, which doesn't have power to do anything of the sort or even intervene in individual cases.

Would it be murder to stop you from trying it at gunpoint, were you so inclined?

No. Obviously, it is not murder to prevent someone from performing an exorcism. The premise is faulty, that an offer to save someone's life instantly creates an obligation not to do anything to interfere, regardless of how incredible that claim is.

I disagree. I think prisons have a duty to allow for medical care and that armies that close humanitarian corridors are guilty of war crimes.

Bad analogy. Anyway look at the facts - the baby is with major brain damage, needs constant life support, it may not survive the trip, the logistics of the trip themselves are not trivial, and that care is terribly vague. All of the first were could be taken out of consideration if there was some serious data on the last. It is not blocking the way to the hospital, it is blocking the way to a quack.

Your analogy is the bad one, the Vatican hospital aren't quacks.

Everything you brought up is also irrelevant. Can I block your way to the hospital, if I'm sure you will die anyway? That's what your arguments boil down to.

In that case they are - otherwise they would have provided details what magic they would do that the UK doctors won't. No but I can block your way to the torture chambers - and invasive treatment without chance of improvement is exactly that.

IIRC the Vatican hospital(which are not random quacks but a very highly ranked institution in a first world country) wants to try an experimental procedure that the NHS won’t authorize because it’s very expensive and has a low chance of working. It’s fair for the NHS not to want to do it, but it doesn’t seem like they should be able to stop the parents from taking their child to a hospital that wants to do the procedure.

In the article itself is mentioned that the Vatican hospital is quite short on details about what this procedure is.

If the Vatican hospital is a torture chamber, and what they're doing is no different than what the UK hospital did at this point, than the UK hospital is a torture chamber, and all people involved in it must be punished.

I think it's ok for the government to make utilitarian decisions on behalf of children when the stake are high enough and the outcome clear enough.

I don't know for sure if this case meets that standard, I'd need to both be a doctor and read an unbiased account of the situation (and no one without a biased take would bother reporting on this case from either side).

But the pitch is: this infant will die shortly no matter what, it's already suffered severe neurological damage that would prevent it from appreciating any potential positive experiences it might have during that time, keeping it alive on life support for a few months is gaining it absolutely nothing except torturous pain and suffering.

Again, I don't know how well the actual case fits that hypothetical, but in a hypothetical like that I do believe that it's in the infant's best interests to have life support suspended, and I would be ok with the government enforcing that. Children need something to protest their interests in cases where parents are acting against those interests starkly enough (even if they do so out of misguided love), and it's possible to invent a stark enough scenario to justify this intervention.

Of course, aside from what it would be right for the government to do in theory, is the question of what powers and policies we want to government to have in the real world, where it's run by often stupid people and we have to live with the full variance of its actions. In a case like this I am cheered by the fact that the judge is just siding with the doctor's strong recommendations rather than judging the merits of the case on his own; I feel like there's probably some system of relying on expert advocates that produces good outcomes in expectation. But I'd be very sympathetic to someone arguing that the government can't be trusted with these types of decisions, and we just have to accept whatever child suffering denying them that power incurs as the cost of preventing even more suffering if we gave them that power.

This is one of those horrible situations where I could see myself making this call, and would sympathize with anyone who was in that position... except agents of the british government.
There are legitimately "injuries incompatible with life" that should cause a physician to cease all but palliative treatment; it's almost obscene to go through the motions of treating bisection, brain destruction, and other unsurvivable conditions as if you're seriously trying to save the patient, and every cell in your body being unable to function due to an innate and permanent defect is one of those cases.

On the other hand, people in the US have now started surviving bisection thanks to a tradition of unlimited care in the most hopeless cases, while Canada has slid down the slope of euthanizing patients like a Krieg medic faster than anyone ever imagined. Even if it's a decision I'd make, it's not one I would trust anyone else to.

In a sane world the baby would be cryopreserved until the singularity.

In a sane world the baby would be cryopreserved until the singularity.

Do you happen to be dath ilan citizen shipwrecked on this planet of apes? I mean, another one?

Didn’t they eventually have to scoop up a decomposed human as bio-goop sludge from the bottom of one of the earliest cryopreservation capsules?

A lot of people died attempting to fly before we figured out how to do it.

The earliest version of a lot of things didn't work /shrug.

Most of the early cryo-patients didn't survive, the most notable incident being the Chatsworth disaster.

Cryonics has learned from those mistakes. In particular, cryonic orgs now absolutely refuse to preserve a patient unless he has already provided enough money to cover both his preservation and his upkeep, in perpetuity. This is important, because most cryonics failures happened partly or wholly due to financial problems.

From "Suspension Failures: Lessons from the Early Years", first published in Cryonics, February 1992:

One important lesson to be drawn from this tale of woe is that cryonic suspensions should only be maintained by those who have a strong personal interest in being cryopreserved themselves and have made arrangements. This includes the financial backers as well as those in charge of daily care. Those who are personally committed generally have superior judgment and realize the advisability of the neuro option (head-only preservation) in cases where funds are limited. Such people will fight hard to maintain even someone they hardly knew, who is not a relative, as happened at Alcor during the Dora Kent crisis for instance. They are not afraid to take measures others squeamishly shun, when a patient’s survival is at stake. Neuroconversions carried out by such people have saved several patients whose funding ran out [28]. Not one of the many suspension failures was a neuro.

Of seventeen documented freezings through 1973, all but one ended in failure, while maybe five or six later cases, some of them privately maintained, were later terminated (or were continued under questionable circumstances, such as attempted permafrost interment). In most of these cases, finances were a factor.

And from "Don’t Ask, But Do Tell" by Mike Darwin:

Your statement “(CSNY) underestimated the costs associated with maintaining the leaky Cryo-care capsules (sound familiar?)” is incorrect. The estimates for the cost of cryopreservation presented to the public ranged from $8,500 posited by Bob Ettinger in THE PROSPECT OF IMMORTALITY in 1964 to the $10,000 widely quoted by the media as being the cost of indefinite cryopreservation at both CSC and CSNY during the period from1969 to 1972. Of that $10,000 no less than $8,000 was to be invested for long-term care. $8,000.00 in 1969 had about the same buying power as $44,561.80 in 2006, or roughly twice what CI currently budgets for long-term storage for Option One Members ($23,000 per patient). The problem was that this money was never set aside, and indeed never existed in the first place. What’s more, with the exception of Paul Hurst, Sr. (and later Herman Greenberg), CSNY was not consistently paid, or in the case of Steven Mandell, paid at all. Steven’s life insurance was applied for after he was already (terminally) ill and did not pay out. Pauline Mandell never paid Cryo-Span for the CC dewar, the charges for “encapsulating” Steven, or for liquid nitrogen or facility floor space (rent). The $4,500 for the CC dewar, the $1,100 for the Sergeant-Welch vacuum pumps, and the costs of welding, transportation, and miscellaneous hardware were paid for by Curtis Henderson.

Didn’t they eventually have to scoop up a decomposed human as bio-goop sludge from the bottom of one of the earliest cryopreservation capsules?

You probably mean Chatsworth scandal, this was indeed one of more embarrassing failures of early cryonics.

Normie introduction

Cryonicist-transhumanist introduction

"The stench near the crypt is disarming, strips away all defenses, spins the stomach into a thousand dizzying somersaults."

If the improbable case anyone is interested in in-depth analysis what went wrong with cryonics, see "Cryonics: An Historical Failure Analysis" series.

When the long awaited ‗freezing‘ of the first man took place on 12 January, 1967, the man in charge was Robert F. Nelson, aka Frank Bucelli, a Santa Monica TV repairman. Bucelli was much more than a TV repairman; he was a convicted felon with a long criminal record beginning in his youth; including violent offenses such as assault and battery as well as numerous charges, and several convictions for fraud and theft.

Yes, freezing people is not easy.

I'm not sure, but this shouldn't be an issue with modern preservation techniques.

Modern preservations techniques are virtually the same as they were back then; build a human-sized thermos, fill it with liquid nitrogen, stick the patient inside, and occasionally top it off with liquid nitrogen to keep it full as it boils off. The biggest difference is that they now pump a patient full of cryoprotectants to prevent freezing damage from ice crystals, a process called vitrification.

The big changes that were instituted as a result of the early disasters were institutional, not technological. Cryonics companies will refuse to touch you until you have paid them cold, hard cash, or given them ownership of a life insurance policy with a reputable life insurance company. Patients are stored upside-down so that their heads are protected longest in the event of liquid nitrogen boil-off. Cryonics orgs are prepared to convert their whole-body patients into neuros if that is the only way to keep them suspended.

These are all bitter lessons that had to be learned the hard way. Family members would arrange to cryopreserve their relatives, then lose interest in paying for their upkeep as the grief faded. Patients used to be stored upright for optics reasons. Patients that could have been saved were never converted to neuro, usually because of family objections.

It’s not about preservation techniques, it’s about organizational continuity and goal rigidity. Unless the freezing capsules are buried in the Antarctic permafrost, they aren’t passively safe for the occupants and cryopreservation must be actively maintained.

Under British law, the primary issue in such cases is whether a proposed treatment is in the best interests of the child. Judges have repeatedly upheld doctors’ decisions to end life support even when that conflicts with the parents’ wishes.

So, for some reason, it is up to the doctors and judges whether the baby should receive life support, and not the parents, and furthermore, somehow that means they can prevent a child from leaving the country if they're going to get medical treatment they consider to not be in the best interests of the child, which in this case is undergoing painful treatment instead of letting her die? Do I have that right?

Why isn't it up to the parents why can't they take their child out of the country? What's the legal basis for this?

It makes a little more sense in custody disputes where the parents can't decide something so then a judge intervenes and picks a side, but in this case, both parents want the child treated. So why don't they get to make the decision?

Usually parents have autonomy over their children's treatment. If doctors believe that the parents are acting massively against their child's best interest, then they'll take it to the courts. This is because under law the doctors have a duty of care for the child, otherwise the doctors would be deemed negligent. So here it is a case of doctors vs parents.

In these case, the court will act in the child's best interest. So here, you might think paradoxically, the best interest is to withdraw care and allow the child to die. Modern medical technology can prolong death and make it a long and painful process. See Scott's blog for more on this.

If two parents wanted to let their baby die instead of receive care, would you defer to their judgement in the same way?

Because it can amount to torture, and we don't generally allow parents to do that. Parental rights are not unlimited.

I lost a child myself, so I understand the pain and grief the parents are going through. But if the child is in significant pain and is not able to be treated ( which doctors seem to agree on), then its a choice of a long drawn out painful death or a quicker painful death. The parents in this state may not be able to make objective choices about what is best for their child.

or a quicker painful death

Why isn't pumping the patient full of heroin never an option? Hell, keep the little bugger on a cocktails of joy drugs or whatever until it dies of RNA related malnutrition ( You can guess I'm not a doctor ).

I have a doctor story about that. My aunt was in pain and dying of a quick cancer, and I asked a doctor why they couldn’t give her morphine, and he told me that they couldn’t because it would increase her tolerance. I give doctors some slack for their high intelligence to open-mindedness ratio because they have to deal with so many lying idiots, but I still find them insufferable. It’s like they’re not talking to you, they’re just reciting you your miranda rights.

Is the bureaucracy with all its political biases the best place to make that call?

In the average case, parents with consultation from doctors are the best persons to make that call, and that's why they do make that call (I'm guessing) ~99.999% of the time.

But sometimes that process doesn't work for whatever reason, and the government steps in.

This isn't weird, it's approximately how things are supposed to work with the legal system. 99.999999% of the time, men choose not to rape or murder or rob anyone; when one of them is an outlier who makes the wrong choice, the government has to step in to correct it.

I don't think it's inconsistent to say both 'Citizens make their own choices' and 'The government fordbids a small corner of decision-space with extremely bad outcomes for other people'. Lots of things constrain a person's choices, including brute physical reality, capitalism, social policing, etc; we're right to worry and fight over how much an individual's choices are restrained and guided, but I don't think it's right to say they're not making them.

You mean doctors? Then a judge? Yes probably.

Good thing that it's not just some nameless bureaucracy making the choice here but all the involved doctors also agree with it.

As someone with lots of personal & professional experience with doctors (working as a postdoc in medical science and helped the father of a close friend navigate his own cancer diagnosis), I have to take the opposite position. Doctors have a very strong tendency to groupthink, to defer to the leading doctor and to generally behave in such a way as to maximize ass-covering as opposed to the best interest of the patient. They can and will manipulate and keep secrets from you for the purpose of their own convenience. Don't misunderstand me, they do so since they're extremely overworked and just try their best to do good with limited time and resources, but they will frequently miss the mark especially in unusual cases.

Why is the pain necessary? Just put the baby on powerful enough painkillers to risk brain damage if necessary, then go for the long drawn out chance of life.

At 8 months, that will just kill them, which doctors are not allowed to do. They have to follow things like the Liverpool pathway which is withdrawal of support or feeding etc.

No, it will not kill them. We routinely sedate 8 month old children for various medical procedures. It can even be done for a long time as long as the risk of long term complications is acceptable.

Infants can't be sedated or given strong painkillers?

Yes, they can most definitely be sedated or be given very strong painkillers. They can cause permanent harm if done for extended periods of time, but it can be done. Speaking from a related expertise- I'm an anaesthetist.

Not if it will be harmful to them, in the UK at least. A compromise between a doctors moral and legal duty to do no harm and the cruel reality that some people can't be treated and death might be a kindness. They are allowed to withdraw life saving care but not give treatment that itself causes harm. The idea being that not saving someone is not the same as killing them.

Its been an ethical debate for a long time, Google Liverpool Care pathway for more (though it isn't called that any more i believe).

The UK is bad like this. I don't know why or how it got to be this way. But this is not an isolated example. The case of Charlie Gard got some attention a few years back, and the situation was basically the same.

Which is to say that if something in the laws or regulations is not changed, these awful situations will happen again and again.

Alfie Evans as well, nearly identical. That case shocked me. Absolutely brutal and senseless

Wasn't he brain dead basically?

A UK judge has ordered that that the baby be killed. Her parents have protested this, saying that they don’t think the government should kill their baby.

Now wait a minute, the order is to stop actively keeping the baby alive, which seems pretty different from killing the baby, even if the end result is the same.

The court point of view is that they're ordering the parents to stop torturing their child, and that they can't condone the parents moving the baby to a different country that is willing to torture it. Obviously there's clear disagreement over whether the medical care is comparable to torture.

I don't think the court is obviously right here, but I think you're being unreasonable in claiming they're obviously wrong.

When there are available other ways to provide resources and methods to keep the baby alive, and the court and hospital refuse and actively fight against it, that is exactly the same as killing the baby.

It would be more honest if the court and hospital directly argued in your manner that the parents are torturing the baby in keeping the baby alive. The have chosen instead to argue that more treatment is not in the baby's best interest, and just leave conclusions obvious but nebulous.

I don't agree with the parents here, but I think it would be monstrous and unjust to prosecute the parents for torturing their baby. Even if you think it's dishonest to do otherwise.

If the issue is pain, that's easy to fix with enough painkillers and sedatives. Of course, that probably has terrible side effects on babies, but the alternative is death. Even if the medical care is literal torture there are ways to make it humane.

Seems pretty clear the underlying motivation to end care really is about money, and forbidding the family from leaving is more about control and optics than about the wellbeing of the child.

Do you believe that every human, no matter how unviable, has to be kept alive at any cost?

If someone wants to try to do that and use their own legitimately acquired ressources to do it, trying to stop them seems monstrous.

No, but I think if the parents are willing to pay the price, and it's possible to do so without causing too much suffering (e.g. by using tons of painkillers), then it's usually immoral to step in and stop them.

Not the person you replied to, but here's my opinion - no, every human does not have to be kept alive, and certainly not at public expense. However, if the parents are willing to pay out of their pocket for a chance at keeping their baby alive, I don't think anyone else should have a say in it. Probably a more moral use of their money than buying a sports car or having a destination wedding.

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