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Culture War Roundup for the week of October 10, 2022

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In 2016 ISIS attackers bombed the airport in Brussels killing over a dozen people. A seventeen year old girl was present but uninjured. This May she chose to be euthanized because of her psychological trauma. She was 23 and she had no physical injuries. The news of her death was just announced recently.

https://www.lemonde.fr/en/international/article/2022/10/10/2016-brussels-attacks-victim-granted-euthanasia-after-years-of-ptsd_5999805_4.html

This seems absolutely insane to me. I don't doubt she was suffering but she was only 23. A lot could have changed over the next 70 years. She wasn't terminally ill, she didn't have cancer, she wasn't paralyzed from the neck down. She was very sad and very scared and had attempted suicide twice. But I know that at least some people who have survived suicide attempts have gone on to lead happy lives.

I used to disapprove of euthanasia but wasn't strongly in favor of making it illegal, even though it was never a choice I would make myself or approve of making for a relative. But cases like this have made me strongly opposed to it. It seems like the medical establishment can't be trusted to restrict it to only the most extreme cases. The people saying that allowing euthanasia is a slippery slope have been proven right in my opinion.

I really don't understand the near-unanimous outrage here. Does no one believe the suffering from a psychiatric condition can be so terrible as to make the person want to die?

Another comment interpreted her two suicide attempts as calls for help or attention. If this were true, would she not have stopped short of actually killing herself in the end?

If euthanasia had been illegal, she would have just committed suicide with a different method – I mean, she clearly wanted to die – and it would have been a brief sentence or two in an article about the terrorist attack. "Shanti De Corte, who was 17 at the time of the attack, was set to testify, but committed suicide after suffering from PTSD following the bombing. She is regarded as the 33rd victim of the attack." or something to that effect.

But I know that at least some people who have survived suicide attempts have gone on to lead happy lives.

And there are others who attempted again and were successful.

Why does everyone here think they know better than the woman herself, a panel of doctors and a public prosecutor, all of whom must have known far more about the case than was shared in this one news article?

know better than the woman herself, a panel of doctors and a public prosecutor,

The woman has been, factually, mentally unwell, so it's not hard to understand why one may think they "know better". If we allow the idea that psychiatric illnesses exist, and some of them may move persons to an action which is not to their best interests, and it is possible to fix these conditions and they should be fixed - which is, admittedly, not an obvious proposition and is fraught with edge cases, but if we still allow it - then the reason for such thinking becomes clear. As for "a panel of doctors and a public prosecutor", unfortunately, many of us observed, some more recently than others, as public figures and medical professionals acted out of considerations other than the best of their patients and the pure factual truth, and there is no reason to assume it could not happen again. Of course, it's not easy to conclusively prove that's what happened in each particular case, but there's nothing outrageous in assuming it might have happened, and "the doctor knows best" not always works, and "government employee knows best" works even less frequently.

I suppose we'll have to agree to disagree, then.

In my view, a panel of doctors, plus a public prosecutor who reviews possible abuses, is sufficient in terms of scrutiny.

Yes, people entrusted with power are sometimes malicious or incompetent, but this argument can be directed at virtually every institution in existence. Unless you have actual evidence of abuse, my priors are firmly on the side of trusting that the people who are familiar with the details and whose job it is to review these cases (and who have years of experience in doing this) have made the right decision.

but this argument can be directed at virtually every institution in existence.

And it should be. If you see something, say something. If something the institution does looks wrong for you, your responsibility, if you ever want to have good (or at least better) institutions, is not to say "well, they are the institutions, they know best" but apply scrutiny to what they do. That's the only way to make sure any institutions work at all for us, and not for their own sake. If you ignore all the evidence of institutional failures, contenting yourself with "well, they have years of experience, surely it's ok somehow in some way unknown to me, just trust the experts and everything will be ok" - nothing will be ok, because there's no motivation for the institutions to serve you - you abdicated all your claims on that.

My point is that, in the absence of actual evidence of institutional failures, we should assume they're working properly. "Something looks wrong" is not evidence. If something does look wrong to someone, they can investigate. Maybe they'll find evidence of wrongdoing, but if they don't find anything after a reasonably thorough investigation, the matter should be dropped. "Something looks wrong" is unfalsifiable.

There's evidence of euthanasia being over-promoted by the same doctors who are supposed to be guardians of it, I posted it on this thread and so did others. So there's definitely not "the absence of actual evidence of institutional failures", quite the contrary.

If something does look wrong to someone, they can investigate.

Not really. Only if someone is a DA or similar person in power, and they have motivation to intervene for some reason. Otherwise, there won't be any investigation at all, let alone "reasonably thorough" one.

"Something looks wrong" is unfalsifiable.

We're not talking here about scientific paper and abstract scientific pursuits, where "we still don't know whether theory X is true or not" is an OK outcome and in general we're fine with waiting for conclusive evidence one way or another. When we're talking about killing people, "you can't scientifically prove there's something wrong here, therefore we're fine to assume it's ok and not knowing one way or another is completely OK too" shouldn't be the bar it has to clear. It should be much, much higher than that. If something looks wrong, there should be an overwhelming and obvious proof it's not, and "if something were wrong, somebody would investigate it" shouldn't cut it too. When we're talking about irreversible actions of this magnitude, we can't approach it in the same way as we manager parking tickets - "this officer has been issuing tickets for 20 years, so if you can't conclusively prove she was wrong, we assume it's ok". We have to erect a higher bar on this.

There's evidence of euthanasia being over-promoted by the same doctors who are supposed to be guardians of it, I posted it on this thread and so did others.

I assume this is the comment to which you are referring. It talks about Canada. As I have noted elsewhere in the thread:

Canada is unique among countries that have legalized euthanasia in permitting doctors to bring up the possibility to patients who haven't even mentioned it. In other countries, the patient must bring it up first, unprompted.

In other words, this particular failure mode is trivially preventable.

And as far I know, this is true for Belgium.

Not really. Only if someone is a DA or similar person in power, and they have motivation to intervene for some reason. Otherwise, there won't be any investigation at all, let alone "reasonably thorough" one.

It is my understanding that in continental European legal systems, public prosecutors don't have any discretion in choosing whether or not to prosecute a certain crime, as American DAs do. Hence, the prosecutor must have investigated the case thoroughly enough to conclude that no crime took place. As I said, this seems like enough scrutiny. If you added, say, an ombudsman who reviews the prosecutor's actions, and they concluded that the prosecutor had done nothing wrong, you could just say the ombudsman is in on it. And this can go on indefinitely, which is why I said the claim was unfalsifiable.

Oh and, I forgot to mention: according to the article, in addition to the panel of doctors and the prosecutor, the woman was "supported by her friends and family" in making the decision. I agree that we have to have a high bar for cases like this; I just think the bar was met in this case.

Public prosecutors do in fact have considerable discretion here in what cases they choose to prosecute. Possibly the most obvious example of this being the decriminalised (but not quite legal) status of cannabis in the Netherlands.