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Culture War Roundup for the week of November 6, 2023

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Funny you should say this, since about an hour back, I was woken from a much needed nap by a panicked nurse in order to attend to a cancer patient, and arrived to see her grossly decompensating, with particular issues that made most of the initial resuscitation measures I'm in a position to provide useless.

I lost a bit of hair over how I was supposed to treat her, but was incredibly relieved to discover that, despite the nurses losing their shit, she was a palliative patient who had just had her End of Life and DNR forms filled by her family after the consultant in charge had informed them that all hope was lost as the brain mets gradually ate away at whatever made her human.

No amount of medical care any ICU could provide would save her or make her whole, at most we could prolong the process by keeping a living corpse hooked up to a ventilator at ruinous cost and taking space better served with the living. That calmed me down, even if this was the first time I had to deal with a dying patient entirely alone with nobody to back me up, I've read the guidelines, I know the drugs, and after some faffing around because apparently the oncology ward of the fanciest hospital in my part of the country didn't have syringe drivers capable of providing subcutaneous meds (utterly ridiculous, but they almost certainly have them in the ICU, but she was categorically forbidden from being transferred there), I managed to figure out a protocol that would ease the pain, or at least any residual discomfort someone who hadn't been conscious for days and never would be again might feel till her lungs filled with fluid and her heart became fitful and her ribs were no longer a cage for her soul.

So there you have it, I'm complicit in killing someone today, and I think it was a good decision, or at least the least bad of the options at hand. That's euthanasia for you, the modal case, representative of the end of suffering for millions.

It still hurt, at least for me, you'd think that working in an Onco ward would dissipate delusions that you can make sure your patients always walk out hale and hearty, but I did enter the profession because I'm proud to heal people. If that's not possible, may they pass gently into the good night, rage is more appropriate for the living who must deal with the banal, apathetic cruelty of an unfeeling world.

The problem is that very, very many people are flaky and short-sighted. Death is a one way trip, with no ability to undo a mistake.

Speaking very broadly, since practised and legal norms vary so grossly, euthanasia for the atypical cases where they're "physically" healthy involve lengthy periods of consultation and various opportunities to back out, though I think Canada has a more streamlined process, for better or worse.

So it's typically the case that multiple earnest medical professionals and social workers will repeatedly inquire as to the continued choice of the person to continue on the course. Even then, in my opinion, if someone who doesn't have a lack of capacity earnestly tells me they want to die, I wish to do my best to accommodate them promptly, even if I won't literally pull out a gun the moment they say so. This decision is obviously dependent on factors like acute pain or a severe bout of acute depression, where I can reasonably expect that treating them or will reasonably make the patient desist from their demands, but there's nobody who just kills people who have acute pain that I'm aware of, usually it's chronic and refractory to treatment.

People make plenty of decisions that they might vacillate on before death, the act of dying isn't special in that regard even if I agree it's rather terminal. They might want to adjust their will as they succumb to dementia and lose capacity to do so, they might want to feel the arms of a lover estranged for decades, it's the very lucky few who get to leave with no regrets at all.

Should their be due process and a period of waitful watching? I would certainly endorse that, but if someone over a span of weeks, months or even years keeps asking to die, I'm going to live and let die. That's how I address:

Do we really want to kill people who are edge cases and who may just be going through a bad period?

As for-

Excessive worrying might be improved through mental health care or altering people's news diet.

I can only chuckle ruefully at the idea that the majority of people who opt for euthanasia haven't had "mental health care" and oodles of it. They're usually refractory to treatment in the form of drugs, therapy and even physical interventions like ECT. They've failed to work.

I doubt the average neurotic woman with Trump Derangement Syndrome or even those who become anti-natalists or anti-humanists are lining up to kill themselves.

Shouldn't we try to fix society instead of killing the people who are unhappy because of societal pathologies?

That's a false dichotomy in my eyes. We can do both, and should do both.

That the group with a desire to die is disproportionally poor, urban and single, suggests a strong societal component is at play.

All associated with severe unhappiness and poor life outcomes and for good reason. Being poor, "urban" and single against your wishes sucks.

If you have a means of turning such people into rich, rural and married individuals, then I'm willing to hear it, but I doubt anyone does short of waiting for the world to get much wealthier.

That's a false dichotomy in my eyes. We can do both, and should do both.

But in my society we are not actually doing both. At least some of the issues are caused by choices that people are doubling down on, if anything. Loneliness is now only on the agenda because it is becoming such a huge issue, but no one is undoing the cultural and political changes that caused it, or coming up with any real, new solutions. Unless you count euthanasia as a solution.

What I see is a pathological unwillingness to even face facts and instead, everything gets viewed from extremely dogmatic viewpoints, like the idea that all problems will be solved if we achieve things like inclusivity, gender equality, racial equality, etc; despite a completely lack of a rational analysis of what we would actually need to achieve such things; let alone an honest analysis of the up- and downsides of the policies being implemented (politically, culturally, etc).

In the face of such irrationality, 'solving' issues by getting rid of the evidence as much as possible by killing the victims of modern culture and modern policies, seems like a logical outcome that will lessen the pressure to recognize or fix the pathologies of modernity.

All associated with severe unhappiness and poor life outcomes and for good reason. Being poor, "urban" and single against your wishes sucks. If you have a means of turning such people into rich, rural and married individuals, then I'm willing to hear it, but I doubt anyone does short of waiting for the world to get much wealthier.

And yet people of modest means seemed to have an easier time in the past of actually getting the main things that most people want, a house, a partner, children and a decent level of respect (which may have just been 'successful while knowing your place,' but that is a lot better than just a bare 'loser'). And they were poorer than today, so this idea that wealth can fix a broken society seems false, as things have become increasingly broken despite increased wealth.

In my country even the progressives have woken up to the reality that people increasingly see lower education as a path to failure. Of course, their solution is foolish, to rename it to 'practical education,' due to their post-modern belief that words create, rather than reflect reality.

And rural living is itself failing as well. Rural women get convinced that they need to find a leftist yuppie and be part of city life, so they leave for the city, leaving a large gender imbalance, forcing men to leave as well and to become yuppies, but those men often fail, since the official messaging is sabotaging. So many boys don't see this as a path to success. Again, the progressives seem to have finally woken up to this too, but of course their answer is to vilify and censor people like Andrew Tate, rather than fix their own messaging or even just giving a shit about boys/men.

And it is not just sabotaging for men, but also for women, many of whom now seek out parasocial, dysfunctional substitutes for real friends and a real partner, for instance by streaming (although men do that too).

And of course, globalist culture stimulates breaking physical bonds with family and the friends you grow up with.

I could go on, but I think you get the point that I disagree very strongly with sentiments like 'of course the poors/urbans be sad' or with ignoring that society has a big influence on how successful people are at finding and maintaining relationships (romantic, but also friendships and family relationships). I see your beliefs as part of the pathological culture that refuses to learn from the cultures of the past and pretends that its dysfunctions and problems are inevitable.