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Culture War Roundup for the week of August 11, 2025

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When the clinic reportedly promised to “always contact a person’s family”, it may have been making a well-intentioned but practically impossible promise. What does a clinic do when a patient insists their family not be contacted, or provides false information for them?

If it is not possible to do what they advertise, they shouldn't be advertising it. False advertising doesn't cease to be false because the thing you advertised was impossible, but you really wanted to do it.

And if truthfully advertising what they actually do leads to bad publicity, so be it.

This is an isolated demand for rigor. Even the KYC protocols for banks don't have a 100% success rate at stopping identity fraud or impersonation. Out of N Pegasos clients, it hardly strikes me as worthy of damnation that one of them went to such lengths to throw them off. What if she'd hired an actor to come along with her? What if she brought forged legal documents? How easy is that to check from Switzerland?

  1. Your argument also included "What does a clinic do when a patient insists their family not be contacted" which is a much easier case. They should have a policy of dealing with such requests, and they should be able to describe this policy in advance of it actually happening.

  2. If she brought forged legal documents that can't be checked, they can have a policy that treats patients who show up with uncheckable documents as patients who have no documents. If legal documents are even an issue, the whole point of having them instead of taking someone at their word is so that they can be checked; if they cannot, they are useless.

If she hires an actor, you're probably stuck, but then, she didn't.

If she brought forged legal documents that can't be checked, they can have a policy that treats patients who show up with uncheckable documents as patients who have no documents.

I hate to break it to you, but most legal documents are basically uncheckable. Even a notarized document can likely be faked without too much trouble. Government-issued documents (id cards, passports, banknotes) are certainly harder to forge, but also require someone who is familiar with the safety features.

If legal documents are even an issue, the whole point of having them instead of taking someone at their word is so that they can be checked; if they cannot, they are useless.

That is not at all the point. The point is that verbal statements reported by third parties are notoriously unreliable. If Susan says: "Bob said I can sell his car", that is bound to create a he-said-she-said situation. Nobody will ever untangle if it was a honest misunderstanding or if one of them was lying.

This is why Susan needs a signed document to sell Bob's car. Can she easily forge Bob's signature? Sure. But that is now a serious criminal offense! If it is found that Bob never signed the paperwork, she is looking at jail time, and can not claim that she just misunderstood Bob's intention.

With assisted suicides, the difference is that nobody is going to put Susan's urn into jail.

I am sure that for every such sob story, there is also a sob story where someone could not get their next-of-kin to sign a paper stating that they were aware of the patient's intention to opt for MAID. A patient in Ireland would be hard-pressed to compel a relative to sign such a document through the court system. Likely, they would get themselves committed.

So I can totally understand that Swiss law does not require patients to provide a notarized genealogy with all the relevant death certificates to prove that whom they say is their next of kin is that.

With assisted suicides, the difference is that nobody is going to put Susan's urn into jail.

That reasoning proves a little too much--it's basically saying that because Susan can't be put in jail, legal documents aren't useful at all. In that case there's no point in even asking "what if she brought forged legal documents". And this also amounts to admitting that the whole system has a fundamental, unfixable, flaw in it--there's no way to verify that Susan is telling the truth.

The proper response to this is not to say "well, they can't verify the documents so that doesn't matter", it's to say "well, they can't verify the documents, so the system is unworkable". Making sure that they're not killing more people than the assisted suicide law allows is actually important; if they have no way to make sure, they shouldn't be doing it at all.

I am sure that for every such sob story, there is also a sob story where someone could not get their next-of-kin to sign a paper stating that they were aware of the patient's intention to opt for MAID. A patient in Ireland would be hard-pressed to compel a relative to sign such a document through the court system. Likely, they would get themselves committed.

The answer to this is "only take patients from places where they can legally get documents", not "stop asking for documents".

Making sure that they're not killing more people than the assisted suicide law allows is actually important; if they have no way to make sure, they shouldn't be doing it at all.

Suppose that you are a Swiss marriage registrar, and that Switzerland does not want to facilitate marriages where one or both partners a coerced into marrying. There are approaches with very different costs to filter these out. You could just keep a lookout for people who look unhappy or nervous. You could have a separate private chats with both the groom and the bride and mention that there are ways out for people who are coerced. You could require both of them to separately talk to a psychologist for an hour. You could require both to undergo psychotherapy for a year. You could just declare defeat and refuse to marry anyone, because it is not possible to know what motivations people have for sure.

In reality, you will probably not do that last thing generally -- even if you are fine with not having marriages, the same argument would also extend to employment contracts, loans, purchases, sex, etc. Or few people would argue that as you are quite likely to be able to smuggle a few grams of cocaine in a truck without it getting detected by customs, we either should abolish customs or stop international trade.

The assisted suicide case here was not even a matter of consent. But I will be sure that sooner or later, a case where consent is violated will appear. The chance that the evil family of some rich guy will kidnap their beloved pet and threaten to torture it horribly unless they opt for MAID is low, but not zero.

There is a conversion factor for violating the autonomy of those who would really want to live to violating the autonomy of those who really want to die. We probably disagree about the magnitude. From a utilitarian standpoint, I think that we should not minimize the suffering of those denied MAID.

Suppose a djinn offered you to prolong your life by a decade. If you accept, they will flip a coin. Heads, you get to live in the 98th percentile of happiness. Tails, you get to live in the second percentile of happiness (for your age cohort), with no way out. They also reveal that you will be 70 at the time your extra decade starts.

Personally, my answer would be fuck no. Sure, that decade in the 98th percentile would be sweet -- travelling, having sex with a great partner, enjoying life without being trapped in the rat race, playing with your grandkids. But the horror of the 2nd percentile would be much greater. You body failing, your mind fogging -- but not to the point where you do not notice any more, without social contacts, getting bedsores in some retirement home, in constant pain, waiting for a death which will not come for a decade.

In reality, we are not subject to the veil of ignorance imposed by the djinn. We can just ask the 70yo's what their quality of life is and if they want to die or not, and we will mostly get accurate answers. Nobody suggests randomly murdering elderly in the hope that they might welcome death.

So the next djinn offers their deal, which is the same as before, only you have a way to die before the decade is over -- say by stating your wish to die on seven subsequent days. They warn you that it is possible that someone will pressure you into taking that option even if you are in the happy branch.

This seems like a great deal to me. Sure, I lose some utility in the happy branch, but I also reduce the suffering in the pain branch by a factor of 5000.

The answer to this is "only take patients from places where they can legally get documents", not "stop asking for documents".

Luckily, this is not how liberal governments deal with foreigners whose governments are uncooperative. If you are a refugee from Iran, and the regime hates you and will not give you any ID documents, then a reasonable country would recognize your plight and try to work around it, not just ship you back to Iran because without ID you can not stay legally.

The Swiss people (or their representatives) have decided that humans in Switzerland should have a right to assisted suicide. Why should they deny this to foreigners just because their backwards government is uncooperative?

This is the same problem as I have with open borders proponents: If you want to have open borders, then make your case for it and get laws passed which say that we have open borders. But don't have laws which say that we don't have open borders, but then work to make it easy as possible to not follow the laws.

If you really want there to be no conditions for assisted suicide, then have policies (and laws if necessary) saying "there are no conditions for assisted suicide". But if you can't or won't do that, don't have policies that say that there are conditions, but then set things up so that they are trivial to work around.

Arguments like "what if we compare various possibilities a djinn might give you and what if we ask the 70 year old", etc. are arguments that there shouldn't be conditions, or at least not the conditions we have now. They are not good arguments for "we should have conditions but since conditions are bad let's make sure they don't work".

If you are a refugee from Iran, and the regime hates you and will not give you any ID documents, then a reasonable country would recognize your plight and try to work around it,

If you are a refugee from Iran, and Iran won't let you have documents, the other country should try to determine that you actually are a refugee and from Iran, even if it is not as easy to determine this as it would be if you had an ID. If the other country says "Iran doesn't give out IDs, so we'll just accept everyone who claims to be an Iranian refugee", that's a bad policy which is forseeably going to be abused. (In fact, similar policies are abused in real life by "refugees" that aren't really refugees.)

Also, it's a lot easier to revoke a bad refugee status (or a marriage, or your other examples) than to revoke a suicide.