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Culture War Roundup for the week of August 4, 2025

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Am I severely miscalibrated? Over 5% of total deaths sounds like a massive amount to me.

Who am I to tell you what's massive or not? When you see how the elderly, who make up a very large chunk of all deaths these days, actually go out, it really doesn't surprise me. I would start raising eyebrows past 20%, and be alarmed past 30. This is implying business as usual, not something like the Culture's post-scarcity, where people almost never die natural deaths, and euthanize themselves when they're bored. We'll figure that out if/when we get there.

Who am I to tell you what's massive or not?

The person using the number as part of an argument that there's no cause for concern?

I would start raising eyebrows past 20%, and be alarmed past 30.

That's pretty wild numbers, imo, and reduces my ability to take your general judgement of risk, safety, acceptibility, etc on this topic as particularly calibrated toward anything persuasive. I think burying your own calibration in a p.s. is kind of dishonest when you are trying to lay out a defense of something.

Really? Okay? What if I say 5% is massive, or not massive? You can make the same fuss either way. There are people who are categorically against the euthanasia of even a single person, and people who think that every human should be euthanized. What do you have to say to them?

Do you have an intuitive or even an intellectual understanding of how miserable the average death is? Did you remind yourself that euthanasia is meant to replace that inevitable, often painful and undignified death, with one that doesn't draw out the inevitable and lets people go out on their own terms?

Please, if you accuse me of being miscalibrated, then produce your own ISO calibrated standards. I remain in earnest anticipation, and until then, this is probably the queerest objection in the thread.

Reading iprayiam's post, I was originally in agreement with him, but now, I am not sure. If euthanasia was legalized, I would expect a spike as all the olds with terminal illnesses and low quality of life euthanized themselves, and then a stabilizing as the rate of them would be the rate of people entering those low quality of life stages of their life for the first time. Are there really 5% of people right now with terminal illnesses and low quality of life? I hadn't really ever thought about it.

A major issue:

Terminal illness is not strictly defined, and neither is low quality of life. It's more of a know it when you see it kinda deal.

If you're willing to settle for proxies -

How many people will need palliative care in 2040? Past trends, future projections and implications for services

Current estimates suggest that approximately 75% of people approaching the end-of-life may benefit from palliative care. The growing numbers of older people and increasing prevalence of chronic illness in many countries mean that more people may benefit from palliative care in the future, but this has not been quantified. The present study aims to estimate future population palliative care need in two high-income countries.

My quick trawl of the literature suggests that ~95% of all deaths in the Anglosphere are due to illness and not external factors. I mean, if a disease kills you, I'd certainly call it terminal at some point. Most of these patients have some combination of cardiovascular disease, respiratory disease, cancer and so on.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2023#leading-causes-of-death

This is illustrative. I manually added all the leading causes:

Dementia and Alzheimers disease continued to be the top leading cause of death, continuing the pre-pandemic trend. There were 66,876 deaths with an underlying cause of dementia and Alzheimers disease, accounting for 11.6% of all deaths registered in 2023.

Following dementia and Alzheimers disease, the remaining leading causes of death in England and Wales were:

ischaemic heart diseases (57,895 deaths; 10.0% of all deaths, and a 2.5% decrease in deaths from 2022)

chronic lower respiratory diseases (32,106 deaths; 5.5% of all deaths, and a 7.7% increase in deaths from 2022)

cerebrovascular diseases (29,474 deaths; 5.1% of all deaths, and a 0.7% increase in deaths from 2022)

malignant neoplasm of trachea, bronchus and lung (27,923 deaths; 4.8% of all deaths, and a 2.3% decrease in deaths from 2022)

influenza and pneumonia (24,240 deaths; 4.2% of all deaths, not a leading cause in 2022)

4.2+4.8+5.1+5.5+10+11.6 (the big 6) add up to 41.2%. That leaves every other thing that kills people.

Note that is not exhaustive, and this kind of data is a pain to collate. I hope that even just going by the biggest causes makes it clear that a 5% MAID rate is nothing to write home about. @iprayiam3 is, to out it bluntly, terribly miscalibrated. People can just say things, and be wrong on the internet, while bringing no facts to the table themselves.

My own figures of 20-30% are hardly perfect, but they're certainly closer to plausible figures for people undergoing rather unseemly and painful deaths. They came from a strong hunch, and it's clear that working in medicine makes that gut feeling more accurate.

Now that I know more accurate values, I can see a plausible case for much higher rates.

Dementia and Alzheimers disease

ischaemic heart disease

Forgive the aside, but what is the meaning of the word 'disease' in medical parlance? I suppose in the back of my mind I was aware of 'heart disease' but I would normally think of 'disease' as synonymous with 'infection'.

Disease is defined somewhat tautologically, since we usually define health (or the WHO does) as:

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Google tells me that they haven't bothered to define disease. Well, a disease is anything that impacts you negatively and isn't something like a car crash or a bullet to the head.

Wikipedia goes for:

A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury

This has plenty of room for arguments, even if I find some deeply stupid or misguided. Some deaf and autistic people claim that trying to cure their conditions, or that of their children, is medicalizing a "normal" or equally valid state of being, and tantamount to genocide.

I have no sympathy for such a position, sure, mild autism isn't that bad, but if they're non-verbal and low-functioning, almost everyone wants them cured. At best, I support individual autonomy enough that if a deaf person insisted that they wished to remain deaf, they have the right to refuse treatment. I begrudgingly concede that they should have the right to make that decision for their children, even if I think it's a really dumb one.

Fortunately, the sufferers of most diseases seek cures. There's no movement to redefine psoriasis, fungal feet infections or heart attacks as a manifestation of the human condition that shouldn't be eliminated. Doctors just nod at the dumb stuff, and keep doing what seems sensible. Or at least I do.

I see, thank you.