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I appreciate the effortpost, but I don't think we're really disagreeing about the same thing.
I'm not arguing we should accept everyone's self-evaluation of their internal mental state at face value, and I am ambivalent about allowing state-assisted suicide under any circumstances. All your concerns about the failure modes of the system, even with supposedly rigorous safeguards and checkboxes, are valid. As are the concerns about the mental health of adolescent girls in particular.
All I am saying is that, "all in their heads" or not, "social contagion" or not, some psychological conditions are, for the sufferer, as "real" as anything we can definitively trace to a biological origin. I say this as someone who knows (multiple) people with severe, sometimes crippling depression. I do not think they are faking, I do not think their condition would be fixed by some good therapy and hitting the gym, and it's kind of dismissive to say their suffering isn't real. Because I know these people, I would absolutely oppose any move towards giving them an Easy Button to kill themselves with the state's help. But at the same time, not being in their heads (but believing what they say about their own experience), I don't buy the argument that what they feel can't be compared to physical pain. It doesn't really matter if it's 100% psychological and they just need to go outside, or if there is a pill that would help them, it's still as real as any other pain. To the degree that the comparison to teenage girls catching Tourette's from social media is relevant, it's kind of like saying those girls don't really have uncontrollable tics that make them miserable and which they wish they could stop. Are some of them totally faking, and they really could stop any time they want to? Maybe, but I think most of them are suffering as much as someone with real Tourette's Syndrome.
I think it's saying that there's no way to know what they feel like. It could feel like genuine Tourettes, an upwelling of neurological energy that moves the body like a puppet, or it could feel like a strong case of muscle memory, like reaching into the bag of potato chips for one more chip even though they aren't appealing anymore and there's no remaining rational reason to do so. I say the same for clinical depression: is the sobbing and screaming caused by genuine pain, in the way that one responds to a kidney stone or the unexpected death of a loved one? Or is it a learned reflex, the body and mind moving on autopilot, stuck in a rut, acting in the way that they have collectively learned to act to reconcile their circumstances with the expectations of the people around them? We don't know! Presuming to understand what it feels like to be another person is a delicate endeavor in the best of circumstances, and I posit that it's hopeless with respect to delusional disorders that are situated entirely within the mind.
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