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It has been a generation! In some cases, multiple:
If this a slippery slope, then at the current rate of progress we might have Dyson Swarms before the Netherlands breaks double digits for proportion of deaths conducted by MAID.
Switzerland has octogenarians
runninghobbling around who don't remember a regime before euthanasia. It also has a rather high proportion of the elderly, which suggests they're not being culled when inconvenient.Can I make guarantees that societal norms won't change, and in a direction either you or I will disapprove of? Who can? The legalization of gay marriage hasn't, as far as I'm aware, causally produced a legalization of pedophilia or beastiality as some feared. I consider my claims very strong evidence, it's harder to get stronger.
You can't launch many rockets if your standard for rocketry is that we must perfect the design before putting a single nozzle on the pad. You will not enact any social change at all, out of an overabundance of caution. I consider this regrettable.
I mean it’s been generations in Europe. Like everything else context matters. American healthcare is not anything like European healthcare— ours is a private, for-profit system designed to cut the costs of healthcare and to ensure profits for hospitals and insurance companies. In a taxpayer funded system like NIH, I’d agree that the slippery isn’t that steep, it’s probably a little steep depending on who’s caring for the patient, how difficult that care is, and the ability of the family to either provide it or pay someone to do so. In America, everything is mediated through health insurance, and as for-profit companies, those companies have every incentive to not cover treating elderly patients who might not live long anyway. Treating cancer is expensive: hospital stays, chemotherapy, pain management, in home care between visits, blood work. Giving an elderly cancer patient an overdose of morphine is cheap. Few extended families in the US can afford to pay out of pocket for cancer treatment, it’s simply too expensive, so if the insurance company refuses to cover it because the cancer treatment is expensive, there aren’t any options, either the extended family spends themselves into poverty to pay for granny’s chemotherapy, or they let her get her OD of morphine and convince themselves that she — and they — chose “death with dignity.”
Oh no. You're taking the claims about the American healthcare system at face value.
I'm going to dial @Throwaway05 for backup/moral reassurance. I'd say *page */bleep but the US is a more enlightened regime:
The American healthcare system is incredibly socialist. Is there a better word for a regime where you can walk into any hospital clutching your gut, and they legally must treat you, even if you look and smell like a hobo and throw feces at them? Where the hospital isn't allowed to throw you out, or means test you for such trifling things as the ability to pay for care? Where hospitals, and by extension, actual paying customers, must subsidize/swallow losses in case their patient wanders out and says fuck you to collections? Assuming you even got an address or ID to send those?
Buddy, that's socialism masquerading as capitalism, with only the polite and respectable actually going through the whole charade. You should see what happens in India, where we're not quite so keyed into the kayfabe - despite having both entirely free public care as well as a booming private sector. We'd laugh at the softness. They'd kick your ass to the curb, and the cops would come and laugh.
The government, and by extension, the humble net tax-payer, faces the same dilemma in the UK. We do not kill people just to save money. To the extent that mere prioritization of finite funds kills people, it's in the name of saving more lives than we let die. My bosses do not get a raise or a cut of the savings. To murder anyone would take the collusion of, at minimum, the nurses and resident doctors on the ward. Worst case you rope in the family and pharmacy. It takes working here to truly grok how ridiculous such a proposition is, the nurses will throw you under the bus for looking at the patient wrong, let alone killing them.
Yeah, OP has bit (and I cannot blame him given the amount of poor reporting and understanding out there) on a lot of the popular misconceptions about U.S. healthcare.
Your mention of EMTALA and how the ED works is super instructive. Supposedly during the recent strikes in South Korea hospitals would just post up guards outside the ED and not let people in and they would wander off to another hospital, get better on their own, or just die on the street. Not an option here and EMTALA violations are one of the few ways a physician can get truly screwed.
But yes the U.S. isn't really a private system, it's not really for-profit (or non-profit - it's a mix of both in surprising ways). It is super complicated but is part of where the confusion comes from a lot of time.
Things in the U.S. are more expensive than the rest of the world but part of that is cost of living part of that is poor health of the population part of that is the fact that the U.S. can actually afford it and subsidizes everyone else...
Usually expensive cancer treatments in the U.S. end up discounted, or insurance will cover them (but not fast enough), and they might not be available at all in other countries or it takes too long to get an appointment to get delivered them.
You know, now that I think about it, I think 50% of this was going off the memory of an AAQC of yours. Had to be you.
I suppose that means I remembered enough of it not to bring dishonor upon your name. And thank you for being polite enough not to point that out first.
Lol, well "no actually it is quite a bit more complicated than that and the popular presentation and imagining is grossly inadequate" is like the central lesson of The Motte. Internalizing that and putting it to use is YOUR credit.
For the issue at hand - it's worth noting that most Americans can be signed up for Medicare or Medicaid and hospitals will do that in an attempt to deal with some of the cost of mandatory care.
Illegals become more problematic and can easily end up sucking up hospital level resources for a year and a half while waiting for a charity care dialysis placement or something like that.
Incidentally I write with - transitions all the time. Is that materially different than that em-dash thing all the kids are complaining about? Do I look like an AI??????
You write far fewer long-form essays than I do, thought they are almost always a treat to read. I'm sure if you keep it up, someone will come get your ass too.
See, it's a if she floats/if she sinks situation. If it sits still, it's probably an AI. If you see 'em make a dash for it, then it's definitely an AI. Or so the logic goes.
(People think that someone who can come up with that pun, while dying of heatstroke and quasi-manic from sleep deprivation on a bus, needs AI? Hardly. The AI is lucky to have me. This post is only 90% a joke)
The most cynical will, like in my case, assume that - transitions are a search-and-replace. That is despite me swearing on Scout's honor that I never put one em-dashes put in, or had to take one out at any point (and I actually was a Scout). It is trivially easy to launder AI written content. If I was making an intentional effort to disguise entire tracts of the stuff, I promise nobody would ever tell.
On a more general note, em-dashes are noteworthy because very few people used them before ChatGPT did. Think journalists, researchers (or their editor), pretentious literary types etc. They were often difficult to type on most devices, leaving aside most people didn't really conceptualize them as a separate thing from normal dashes, let alone finer considerations like the en-dash vs en-dash.
Yes! Destroy, the, grammatical, patriarchy.
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Human or LLM: Yes—no—maybe (em dashes)
Lazy human: Yes--no--maybe (pairs of hyphens as ersatz em dashes)
Idiosyncratic human: Yes – no – maybe (en dashes plus spaces)
Lazy and idiosyncratic human: Yes - no - maybe (hyphens as ersatz en dashes, plus spaces)
Insane human: Yes- no- maybe
Insane human: Yes — no — maybe (em dashes plus spaces)
squints
nods
Em dash big? En dash small?
Small brain human use small dash?
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I'll grant you Switzerland. Netherlands and Belgium are still too recent imo. Marriage developments also took decades, as well as multiple specific law changes, to fully take effect.
And as I said, it's not that I want to outlaw it; But I just want to make the slope a little bit less slippery. It's notable that in Switzerland, it's merely legal by omission, it's illegal for organizations or people to earn any money or get any other benefits through it, and the substance can only be provided, but it has to be administered by the person themselves. All of these seem like sensible limitations to me. And there have been almost no changes to either practice or law since then. Contrast Canada, where it has only become legal recently, is explicitly legalized as a service by the health care industry, it already got extended significantly only a few years in, and is in the process of getting extended yet again. At least to me, it seems like it's reasonable to worry about a slippery slope being possible if it's done the wrong way; That doesn't mean it's impossible to find a correct way, though.
I will note that this is a concern I have intentionally and prominently addressed. I am personally okay with euthanasia as a cost-saving measure, keeping someone on the verge of brain death in the ICU is both expensive and futile. Doubly so if the savings are used to extend more lives on net.
As it stands, I am willing to compromise on my fantasy of euthanasia booths next to children's parks if that's the cost of making it available in more jurisdictions. What I proposed is a version specifically designed to appease the squeamish, while still being something I am content with myself. This involves removing or minimizing financial incentive to individuals or even most parts of the system.
To the extent that this calls for amendments in places with legal euthanasia, well, it does do that. It's just not as pressing as elsewhere.
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