domain:x.com
Throwaway05
15m ago
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.
Both sides understand that "protect women" is the only widely shared moral foundation.
Yes. Although this is not a stable equilibrium either. A society that enshrines "protect women" but doesn't enshrine "respect men" ends up becoming horribly biased against men.
Example #1: Ukraine. Women flee the country and are living their best life clubbing with rich Germans. Men are press ganged against their will and go die in a ditch somewhere.
Example #2: Men perform nearly all the dangerous jobs in the U.S. (Probably 99%+). These jobs, which have high rates of death and dismemberment, often pay more. However, any time men make more money than women, there is talk of a "wage gap" which must be corrected.
The recognition that sexes are different must come paired with the recognition that both sexes have special needs and duties. Women are not inherently morally superior, but we've evolved as a species to see them this way because of the intense demands and vulnerability of motherhood. In an anti-natal society women might as well just be weak men.
daguerrean
24m ago
Bathroom 1: For men, trans women, trans men, and any iffy dykes who freak the chicks out. Bathroom 2: For feminine women
I feel like this is the unofficial rule for everything, or at least it should be in our intuition. Like the NBA is not the men's basketball league, it's the open basketball league and no women are good enough to play there. So we have 2 leagues, open (NBA) and women (WNBA). At my college there were two kinds of recruiting events for computer science majors, job fairs for all and job fairs for women only.
I think it was Aella that wrote about how passing was actually meaningfully important in the whole trans issue, and I have to agree. If a man can successfully pass as a woman then he should be allowed to use women's restroom, although it seems like saying we "allow" that is pretty meaningless in that case. If we can't tell that it's a man how could we stop him? To me this basically feels like the norm thirty years ago, kind of an unofficial don't ask don't tell restroom policy. If you look like an absolute freak then yes women should be able to scream and shout at you and summon security to harass you for an hour or so.
Edit: In a way it reminds me of this classic. I feel like they both come down to "know your place" and act accordingly. Now how do we codify that into law? I'm not sure how, but I'm not sure it needs to be.
07mk
35m ago
Likewise if a woman is walking home alone at night and notices a lone male person walking some distance behind her, and begins to form a suspicion that said person may be following her. I doubt very much that she would be consoled if said male person yelled out "don't worry, I'm not a rapist!"
David Cross came up with a jingle to properly communicate this notion over a decade ago.
ControlsFreak
35m ago
You see a lack of consensus and a range of suggestions and think that this means that you must have an individual artisan. I see that and think, "Seems like there's kind of a range where most of the time, people will probably be okay-ish, so long as they're doing something plausibly in that range." At least until we have a more clear consensus. They can still go get advice, and if so, they'll get whatever doctor they trust, who thinks they should be in whatever part of that range. That's not killing them (at least not enough to form a clear consensus yet).
The rest of this is pretty much just paternalism. Like, I get it, many car owners are not equipped to handle the various minute considerations and the art of motorcycle car maintenance. We know car owners will insure themselves or get killed with poor decisions if left to their own devices (the number of bozos who get underneath a car that's just on a hydraulic floor jack, SMH; or maybe they'll screw up a brake bleed procedure and have a massive braking failure on the highway, etc.). But we don't ban it. Millions and millions of people still go to car repair experts, because they know they have zero knowledge. We don't ban auto repair experts, either! Sure, some people spend too much money on silly aftermarket turbos or whatever, and some of them even screw it up and blow up an engine, possibly causing death. But imagine if we took that and decided to ban people from buying their own car parts; do you think that "unnecessary car repair costs" (including the new cost of being required to go to a professional for literally every little thing) would decrease?!? I honestly do not have any idea what possible model of economics you could be using to get to this result.
BurdensomeCount
Apparently "BIPOC" is a racial slur now.
46m ago
I use Twitter basically for Cremieux content exclusively.
mrvanillasky
47m ago
I have a chronic masturbation problem and have always had runny cum. I'm most certainly alright, I didn't wanna hide any info.
Finasteride is safe, I just need to jack off less.
Throwaway05
50m ago
It's important to understand that medical stuff is more complicated than a layman is likely to understand, you see a lot of minimizing and belittling of the knowledge base of doctors these days and it leads to people not respecting the depth of complexity here. We do ourselves no favors in the process.
Consider a Statin. The benefits are pretty big...sometimes. But there isn't a lot of consensus as to who to give it and when. you have complex questions like "what number of rare debilitating side effects are appropriate for a moderate decrease in population risk. If you prevent 10 MIs is that worth one 30 year old getting an autoimmune issue and being unable to walk? What about 20? What about 50? What about 100? What do you do if the Family Med and Cardiology organizations disagree over what to do?
Medicine is both an art and a science and often lacks consensus. Standard of care is fuzzy and constantly being revised. We have to do ongoing education throughout our entire careers because a recommendation that was present from day one of my medical school is suddenly known to be wrong. Or maybe not, I have to read the paper and check.
Patients are not equipped to handle these considerations and don't realize how REAL they can be. We know patients will injure themselves or get themselves killed with poor decisions if left to their own devices so it's our job not to. Sketchy hormone replacement (testosterone), overprescription of stimulants and benzos, poor antibiotic stewardship...patients will do their best to do what feel is right with zero information and this can be extremely harmful to others or society (in the form of unnecessary medical costs and care).
SubstantialFrivolity
I'm not even supposed to be here today
52m ago
It's the old men who're the worst. Dude, don't spread your legs on the bench to clean your saggy balls, and what the fuck's up with being naked while having socks on !! Please No !
If it's any consolation, my wife has told me that old women are just as bad in their locker rooms. IDK what it is with old people and nudity, but it seems to apply to both genders.
ABigGuy4U
52m ago
A few hours ago, Russia fired an ICBM with a MIRV warhead at Ukraine. It looks like it was just the kinetic vehicle with no nuclear warheads.
SkoomaDentist
53m ago
Why use any social media aside from linkedin and a facebook/whatsapp account for messaging?
Conversely, I've never understood people who ragequit Facebook completely and then try to demand others to use some niche service to contact them. Just stop reading the feed (install a browser extension if you have to) but keep the messenger.
SubstantialFrivolity
I'm not even supposed to be here today
59m ago
Bro what.
self_made_human
Kai su, teknon?
1hr ago
I wish I was better informed about cholesterol, but statins do have minor risks and side effects, such as muscle pain and outright muscle breakdown in rhabdomyolysis. It's rare, but hardly unheard of.
There's always been debate about the benefits of statins, but at least in the UK they're usually prescribed to middle aged people with cardiovascular risk factors, or the elderly who have had heart attacks or strokes as secondary prevention. You're right that aggressive screening of prostate cancer is a net negative, especially in the elderly.
ControlsFreak
1hr ago
I'm sure all of that is very helpful to many people, but we're not talking about banning doctors. Remember, we are not stuck with just two possibilities of "banned" and "mandatory". For many, could you not just have massive warning labels that say, "This product is meant to treat specific conditions in specific ways; please consult a medical expert before use," in case someone has difficulty identifying the correct medication? They could still be sold by pharmacists, who can inform you of what you need to know about it (as they already do). If you show any uncertainty, they can say, "If you don't know, you should contact a doctor." The checking in sounds mostly paternalistic, basically just a verbal reminder; what's the real point here if you're not physically making sure they're doing as instructed?
Because remember, you're not actually making sure that they're not taking the medication incautiously. You're not actually going into their home and dispensing a precise dose at a precise time. You're an occasional verbal reminder that they need to comply with the instructions on the package of the TB drugs, another set of eyes to check if there are other medications that might interact. You're not actually stopping them from doing something dangerous.
Some medications have side effects that will very rapidly kill you that are rare enough patients wouldn't think of them
What do you actually do about that?
EDIT: The warning label can even say, "This product is dangerous if not used correctly," or even, "This product is dangerous even if used correctly," with another recommendation to consult a medical professional.
Folamh3
1hr ago
Clever. I wonder what the modern equivalent would be. Asking a woman if she's X, where X is an Instagram influencer famous for demonstrating self-defense techniques women can use to escape from dangerous men?
Have you explored the work of John Vervaeke? His YouTube series Awakening from the Meaning Crisis is a true masterpiece, seamlessly blending cognitive science, philosophy, and meditation. It’s probably the most well-thought-out lecture series I've ever come across online. Vervaeke himself identifies as a Buddhist, and I have a strong feeling that you would be the perfect audience for his insights - perhaps you’re already familiar with it. If not, I highly recommend giving it your full attention. Unfortunately, I don’t have the time or mental capacity to delve into the details right now, but I genuinely hope it might help you break free from any sense of apathy. By the way, what is your vision of Enlightenment? I believe in some form of Enlightenment, but not necessarily in Buddhist Enlightenment, more in gnosis - the knowledge that transforms the self.
I doubt very much that she would be consoled if said male person yelled out "don't worry, I'm not a rapist!"
As an aside, you reminded me of a lecture I once listened to about the brilliance of Odysseus' first words to Nausicaa after washing up on the beach naked.
He's an older male addressing a young girl, and he can't say something like, "Don't worry, I won't rape you," since that will just make her more worried by bringing the possibility out in the open. So instead he says, "I beseech thee, O queen,—a goddess art thou, or art thou mortal? If thou art a goddess, one of those who hold broad heaven, to Artemis, the daughter of great Zeus, do I liken thee most nearly in comeliness and in stature and in form."
This immediately does a few things:
- It puts him in a subservient position, as he is speaking respectfully to a superior.
- Comparing her to a goddess is a compliment, but comparing her to Artemis, a virgin goddess with stories of punishing men who try to see her naked, puts Nausicaa more at ease without having to say that he won't rape her directly.
HorthyMiklosKatonaja
1hr ago
That's right.
Nanugu
1hr ago
Your whole point was that the urban, educated, irreligious voters who switched from voting D to voting R are an uninfluential component of Trump's constituency. I'm saying that profile fits for a lot of the Trump admin, so your premise is flat out wrong. That RFK Jr, Musk, Vance, and even Trump are at different points of their conversion blue to red only shows that such a conversion is possible.
hooser
1hr ago
Alternatively, end all subsidies for tuition in private educational institutes. Those private institutes who provide a strong-enough return-on-investment to their students will remain, and those who don't will rightfully go under.
The main objective of many of the selective private colleges is to build and maintain a successful alumni association. They are therefore more akin to a private club. There's nothing wrong, I think, with a private selective club choosing among their perspective members based on criteria other than how good they were at school or how well they can score on various aptitude tests. But I don't see why taxpayer money needs to support selective private clubs.
As for the non-selective private colleges dependent on the tuition of current students rather than largesse of their alumni association: they are welcome to switch to Lambda School's model.
Chrisprattalpharaptr
Ave Imperaptor
1hr ago
In conclusion, for the moderates and centrists: Your signal is jammed, and only extremism will be boosted on either twitter or bluesky.
So why use it at all? Why use any social media aside from linkedin and a facebook/whatsapp account for messaging? There seems to be a broad agreement in the rat-diaspora that social media is a plague that wrecks attention spans, leads to skyrocketing teenage mental health issues and erodes any kind of political discourse, yet people still seem to use it.
Just read books and build community in meatspace instead of using Twitter/Bluesky. Whatever benefit you derive probably isn't worth the exposure to memes and toxic ragebait.
Throwaway05
1hr ago
Our role is to identify the correct medication, tell you what you need to know about it (which is later reinforced by the pharmacist), check in with you to make sure you are still doing as instructed, and so on.
Many medications are very dangerous if taken incautiously - TB drugs require a lot of instructions and very careful compliance for instance. Low dose Lithium is extremely safe but can easily interact with other medications, cause significant side effects, or cause problems in response to athletic activity and dehydration.
Some medications have side effects that will very rapidly kill you that are rare enough patients wouldn't think of them....the list goes on.
Throwaway05
1hr ago
I'm shocked that you thought even for a second that Bluesky would be better than Twitter - it's purpose is to be a new home for people who are upset that moderates and conservatives are being given a voice, any early adoption is going to be centered around that. Yes some of the media are trying to take mostly apolitical stuff over (like football) but its purpose is still "fuck Musk for platforming people we hate."
In some ways, I kind of want to reject the idea that all of our social policies should be aimed at minimizing female deaths like an autistic actuary.
As a simple example, I kind of don't care if the facts on the ground are maximally unfavorable to me in, say, the gun control debate because I am pro-liberty and am willing to bite the bullet on this. Even if an angel came down and gave me divinely inspired tablets that showed with 100% accuracy that we could reliably remove, say, all ~40,000 gun deaths per year in the United States by repealling the 2nd Amendment (and the vast majority won't convert to knife deaths or whatever), I would still say we should prefer 40,000 annual deaths to the infringement of liberty that would involve.
I don't want to empower the government to enforce any kind of bathroom policy, and so I'm willing to put up with a few women falling victim to men and ex-men in the name of liberty. My opinion wouldn't change if an angel came down and gave me divinely inspired tablets showing that such a policy reliably leads to X female victims of violence each year.
I feel the same way about casual sex with strangers, and a number of other issues. I'm willing to bite the bullet on the idea that freedom often comes with negative consequences for part of the population. I still think the government should enforce contracts that turned out to have been bad bets (which is why I was angry when Scarlett Johansson was succesfully able to cow Disney during the pandemic when they shifted movies to streaming where she got a worse deal - she made a bet, and it turned out to be a bad bet. If Disney wants to smooth things over with her, they can do that outside of the context of a contract dispute as a show of good will, but in an ideal world Scarlett Johansson should have been forced to live with the original bad deal, because that's what contracts are for.)
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