This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
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.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Two case studies in government waste:
As you can likely imagine right now a lot of people in medicine are sharing tales and taking sides in the great DOGE debate. Two that popped up on my radar and stuck out to me:
Some problems: -As an emergency room most of their patients have no insurance or Medicare or Medicaid, meaning the facility often get paid less than cost. They only stay open at all because of their state grants.
-Many of the patients are drug addicts or malingering (because of homelessness for example). Every day you’ll hear something like “you’ve been here every day for the last three weeks” or “have you considered stopping using PCP? You always seem to fight with the police when you do” and “here’s your follow-up appointment, will you go? No? Fuck me? Okay thank you have a nice day.”
-Many of the patients who do actually have mental illness are in denial about it, or have some sort of limitation that prevents them from attending aftercare appointments.
-The “best” solution is probably to violate patient rights and involuntarily commit them to make someone else be on the hook for making sure they go to their aftercare.
-In the meantime, the hospital has hired several additional staff to manage some of the administrative complexities associated with this change (for example hammer calling the patients to remind them to come to the appointment). They have also hired night staff whose job is to sit in an office overnight purely to schedule appointments with an outpatient program (otherwise no patient could be discharged overnight because they wouldn’t have an appointment to go to…).
Anyway, he dutifully completed his requirements in a timely fashion (which were all pointless! Ex: what is the motto of the VA???). So, months later his rotation is starting soon. He begins the process of emailing the education team once every 2-4 business days. You have to email them multiple times before they respond. The conversation goes something like this over the course of multiple weeks, “I think I’ve completed my onboarding do I have to do anything else?” “no” “okay is my onboarding done” “no” “okay when can I pick up my ID card” “when your onboarding is done” “I thought my onboarding was done” “yes” “okay what I am waiting on” “nothing.” I have seen the emails; it really looks like this.
At this point his program tells him to CC the chief of medicine at the VA hospital, at which point the person responds with “okay we put in a ticket for this a month ago, your training is complete but your training is marked as incomplete.” A screenshot has been attached that shows the request and an automatic response that says something about high ticket volume and that they will get to it at some point. The chief of medicine replies “….does the trainee need to do anything?” (we are here).
The resident will be able to rotate but will not be able to do any work without computer access.
It’s worth noting that the VA is paying for this resident to be there, despite the fact he will in fact not be able to do anything. At his last VA rotation (yes they go through this for every resident every time) he was six weeks into an eight week rotation before he got access.
Widespread narcan use is surely one of the biggest disasters in the history of modern America.
Imagine if tomorrow, a new medicine called Dementiolab or whatever comes out. It doesn’t prevent or cure Dementia, it doesn’t even slow its progression while someone still has a personality and life to hold on to. But, at the second-to-very-last-stage of the disease, the “giant violent baby” phase, the nightmare phase, Dementiolab prolongs life by 10x, keeping patients alive for many years. American hospitals rush to prescribe this new treatment, after all it literally prolongs the lifespan of dementia patients by a huge amount.
But for insurers, the public purse, families of patients and (I would argue) the patients themselves, it would of course be a disaster. It even further fuels the drug market because when customers don’t die, they come back to buy another day.
Narcan is like this for hard drug addicts. For generations, addicts who got into a really bad way, the kind you can’t really recover from (in 99% of cases), just died. But in Narcan, we invented a Dementiolab, a means to keep people alive in a horrific condition, resurrected again and again to keep suffering, and to keep making everyone else’s life worse.
Humanity, decency, even empathy requires that we stop giving addicts Narcan. If a 7 year old accidentally ingests some fentanyl then sure, otherwise no.
I am skeptical of any plan that involves causing large numbers of people to die on the basis that the world would be better off without them. What if it isn't? You would have just caused a bunch of deaths for no reason.
It'd be pretty embarrassing if you wiped out all the heroin addicts, then a few months later someone came out with a new AI-devised wonderdrug that can cure all addictions with a single pill.
Your framing of the problem is wrong.
In a suicide, the fault for the death ultimately lies with the one who pulls the trigger.
Overdose deaths are suicides.
That was their choice to make, and an isolated demand for rigor: if we actually cared about this for human beings more generally, cryopreservation would be a much larger industry.
Philosophy question: to what extent do we as people owe each other to stop suicide attempts? Discuss.
On one hand, we've put up nets and installed phones and nationwide hotlines and circulated narcan. On the other, some Western states have legalized euthanasia for increasingly minor medical issues. To me, the former feels reasonable (although I find OPs argument about narcan to be at least darkly intriguing), and the latter feels like it starts reasonably but quickly slides down the slippery slope. I know some moral codes (Catholicism, for one) are blanket-opposed to aiding suicide.
I'm interested to hear other opinions on where the line should be.
Suicide is a form of murder: self-murder. We make efforts to stop murders, we should make efforts to stop suicide. Overall, society must signal disapproval of suicide. Cultures that honor or otherwise approve (even the implied approval of not bothering to do anything about it) fall into failure modes that our current society doesn't, without much obvious benefit. See Imperial Japan, for instance, which continued fighting long past the point where there was no hope of victory because their culture venerated honorable death over defeat. It did their society active harm. Their suicide rate remained high up until around 2010, when it began to drop and has continued to drop until today, where the suicide rate is actually a little less than the United States (it went from a high of 25.6 per 100K people in 2003 to around 12.2 today, compared to the US's 14.5).
Why did suicide rates drop so significantly in Japan? Well, in 2007 the government released a nine-step plan to lower suicide rates. Since then they funded suicide prevent services, suicide toll lines, mental health screenings for postpartum mothers, counseling services for depression, and in 2021 created a Ministry of Loneliness whose job is to reduce social isolation. In other words, when the Japanese government tried to make a societal effort towards preventing suicide, suicide rates dropped.
Which is good, because Japan needs every citizen it can get. Population is still dropping, and everyone who kills themselves can no longer contribute to society nor create and raise society's next generation.
Those people don't owe Japan their lives. Maybe if Japan wants them to contribute to society or create and raise society's next generation, it can make doing those things seem better than literal oblivion.
People owe the societies they live in, actually. If you want to go live in the woods with wolves and bears for neighbors then more power too you, that’s the condition for opting out.
Giving someone a service they never asked for, then claiming they owe you for it, is a classic scam. And this isn't the 16th century. There is nowhere you can run that a government won't find you. They own everything.
More options
Context Copy link
If the world owes you nothing, you owe nothing to the world.
More options
Context Copy link
Why is living in the woods a valid way to opt out, but killing yourself isn't?
More options
Context Copy link
No. Commun
istsitarians tend to think this because it allows them to demand infinite sacrifice for zero benefit, but the social contract is continually and constantly renegotiated.In this case, society isn't holding up its end of the bargain- the "owes its members a future that's at least as good as it was before" part- and as a result, the individuals that make up society will under-deliver in TFR until it starts delivering.
More options
Context Copy link
More options
Context Copy link
Kind of seems that that is exactly what they are doing: providing mental health services, attempting to find ways to reduce social isolation, trying to change social norms so that literal oblivion does not look like such a nice choice in comparison to social disgrace, etc.
No, they're trying to convince them not to choose oblivion despite not actually changing the conditions. That is, they're trying to get some marginal people from "life sucks so bad I'd rather be dead" to "life sucks almost bad enough I'd rather be dead", not generally improving conditions.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link