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The answer to this question becomes mu when you recognize that the Universe has no particular regard or disdain for you, it simply is.
You did not commit any "sin" in order to come down with ulcerative colitis. It boils down entirely to mechanistic interactions between your genes and the environment, and the way it moulded your body/immune system in a defective manner. While genes and environs are certainly components in what can be considered one's moral predilections, being Mother Teresa herself is no recourse from an agonizing death.
The only place where sin approaches a meaningful concept is when it comes to things that are the outcome of behaviors that are (nominally) amenable to intervention. A thief has sinned and loses his hand for it. A child with a Philadelphia chromosome has probably cried a little too often, but I wouldn't call that warranting a death sentence or the misery of chemotherapy.
All efforts to reconcile the stochastic distribution of boons and curses dished upon us with a belief in an Omnipotent, Omniscient and Omnibenevolent Creator are, well, rather moot when you recognize that there's no reason (or grossly insufficient reason) to assume one exists.
And taken at face value, a Creator who knows with omniscience everything a conscious being will go through, including that it will inevitably sin and be punished for it (infinitely so, depending on which doctrine of Hell you adhere to), is prima facie disgusting to me. It certainly conflicts with any reasonable definition of benevolence, though attempts to torture them into reconciliation have been a pastime for theologists for aeons.
It would be akin to me "torturing" a sorting algorithm for putting 1 before 3 in an array, when I know with ~100% confidence it will make that decision every single time.
That is the relationship between a 3-O God and every poor bastard down here.
I would call you deluded, rather than a liar. It is a common enough delusion, but there is no more polite way of phrasing it.
You do not recognize the sheer magnitude of the empirical, physical, metaphysical and ontological claims you make if you think any amount of "moral growth" should sway your opinion one jot.
I have suffered plenty of pain. I put more stock in painkillers than your approach, not that I am calling it useless. Meditation and other techniques do help. They just don't help as much as fentanyl when you've broken your hip or are choking on your own secretions.
Religion is the opiate of the masses. I can't ding it too much on those grounds, I prescribe plenty of opioids myself. But what it also happens to be is a sheer refusal to take the universe as it is and a distraction from efforts at making it better.
No deity has pulled Mankind out of Malthusian Hell, we've dug up the rendered corpeses of our primordial ancestors and burned them, smelted steel and split atoms till we are in spitting distance of a Heaven on Earth, of our own making. Or we could all die after we build a Molochian monstrosity trained, in part, on this very conversation. But we live and die by our own, human hands, and God certainly hasn't been swiping in often enough for me to give him any credit.
Taken to its logical conclusion, any attempts at alleviating it is cheating God and his ward out of a valuable life lesson, though what that might entail to a child with appendicitis is questionable.
Not all suffering is bad. But I have seen far too much needless suffering to remotely privilege that claim. And when it has come to mitigating it, I assure you that even Jesuit clinics will hand out medication instead of just thoughts and prayers. When a child with ichthyosis vulgaris comes out of the womb and lives a short, yet excruciatingly painful existence before inevitable death (which can only be drawn out for a while, not remedied till the normal age at which we're supposed to die), I struggle to think of any mitigating factors that might make their short time on this Earth a net positive.
You do not know pain. Pray that you never have to.
Please talk to me directly, or create a blog somewhere rather than pretending you're actually responding to me.
I wasn't actually asking you, and you know this. You have no privileged position as a doctor and the bearer of bad news to accuse others of ignoring people's suffering. The problem of suffering is the same no matter the degree of suffering.
My approach isn't a way to deal with pain, it's a way to understand it. It's a test you can perform yourself which will grant you evidence one way or another regarding the veracity of the rest of my claims. If you think I'm right or wrong, say so, but don't pretend that I was giving you pain management tips.
I don't have anything against painkillers, but the fact that God didn't grant us the ability to dull our own pain at a whim means that pain-without-painkillers is a problem which must be addressed.
We've already been over this, but, like you, I suppose I'll have to pretend to be talking about this for the first time and pretend to have never heard any counterarguments from you.
Agency is extremely important. If one cannot choose then they lack agency. If one's choices lack consequences, then they cannot choose. I prefer being free to choose, even when that means making harmful mistakes, to being locked in to a life of unwilling righteousness. I prefer being created, even if that means occasionally being punished for sin, to not being created.
Whether sin should be punished at all is its own question. I find punishments for sin to be quite merciful so it's easy for me to understand them as corrective rather than punitive. They provide immediate consequences to actions which might otherwise become habit and lead to a greatly diminished capacity for joy in the long run.
Only if you're also assuming that no other principles exist. "Pain teaches us lessons" doesn't preclude things like "helping others teaches us lessons," "pain-lessons have diminishing returns," etc.
Taken to its logical conclusion, I don't think it's ethical to prevent literally all of the suffering of any single person--at least unless some other method is discovered for teaching the same lessons. That's all.
lol
I struggle to see how I haven't been directly responding to you.
Is rich, when it's immediately followed by:
So you are, I presume, the sole wielder of rhetoric here?
I must respectfully disagree. It is a privilege of this profession to see all the varieties of pain on offer, in enormous doses, and hence it lends additional weight to my claim that there is usually nothing ennobling or enlightening from it.
You are ignoring suffering. Much like the survivor of a tsunami thanks the Lord for answering his prayers while carelessly (and not even maliciously) forgetting that his next door neighbors were praying even harder before being swept away, you suffer from an enormous amount of survivorship bias.
I'm, thankfully, still alive, and hence technically a survivor too, but I get to see the ones who don't make it.
Have we? I genuinely don't recall.
"Agency" is a joke, in the eyes of the God as you presumably believe in.
What agency? What choice? Those are the illusions of beings without omniscience.
Now, if you notice that glaring flaw and knock it out, you're 1/3rd of the way there.
Depends on the sin in question. Maybe consumption of shellfish is a bad idea with ambient oceanic mercury levels.
You seem to think that pain and suffering are, on net, good. I disagree, even if I can recognize instances where they are adaptive. Your toddler will learn quickly not to touch hot stoves. He will not learn from many, many, other painful things.
The world as it exists aligns far more with an uncaring, mechanistic universe than one that is even slightly designed to minimize needless suffering. Your praise of a hypothetical, benevolent creator that refuses to do its job or even needs this kind of apologetics is saddening.
There exists many possible worlds where suffering exists, but the overwhelming majority of lives are worth living and no senseless suffering plagues us. A world with guardrails, so you toddlers can get an owie but not electrocute themselves. We are not remotely optimized, we do not get idealized amounts of negative feedback without verging on senseless torture.
I happen to think we can make such a world, but it'll be by our own endeavors, and if we make a god, it will grown in datacenters and trained to be actually kind. Abrahamic religion is a pernicious memeplex that while very occasionally adaptive, also dulls and drags our ability to work with the only real world we have at hand.
Is very clearly conflicting with.
It certainly is a tip, and to an extent I even endorse it. Mindfulness helps with some kinds of pain.
I don't know about your God, but the Blind Idiot God of Evolution has blessed most of us with endogenous opioid receptors and the endogenous opioids to bind to them.
There was a newborn child banging his head against his crib when I passed the paediatric ward (thankfully not the one for those with cancer). Know why? It's because it prompts the release of internal painkillers "on a whim", distracting him from a colic, though I wouldn't advocate this as recommended route for adults with our predilection towards traumatic brain injuries and reduced neuroplasticity.
Buddhist Monks can suppress the pain of self immolation. Though that whim certainly took practise, and without it there's a lot of undignified screaming and rolling about while cops draw guns at you.
Scoff as you wish, I do genuinely know more about pain and suffering than you do. It is not an apple lightly eaten.
Oh, okay.
I can't blame this all on you, because I did just change my handle, but the conversation I linked above (where I mention the miracles I've seen) is a child of a debate we were having about this very topic. Given that you referenced the comment, and proceeded with a bunch of arguments which we've already debated in detail, I interpreted your words as grandstanding using my comment as your soapbox.
We have discussed pretty much everything here multiple times before though.
Rhetoric is fine, making the same tired points over and over, rather than actually addressing counterarguments, is not fine. I already understand, in good detail, your position regarding the fundamental apathy of the universe, and don't need it explained to me yet again. So when I say I wasn't actually asking you, I'm calling you out for using what was obviously a rhetorical question as an excuse to soapbox again. Combined with the many other arguments we've had over this exact topic, it seemed clear that you're essentially not addressing me (one who already knows your position) at all.
When you say:
you do so in response to me explaining why I addressed the problem of pain at all. Whether humans actually have access to painkillers "on a whim" is essentially irrelevant--the point is that even with painkillers, suffering still exists, and therefore needs to be explained. You're definitely smart enough to know where I was going with that, but rather than actually addressing my point you chose to use it as yet another soapbox.
I don't think your technicality here is even true--I wouldn't describe that as painkillers accessible on a whim--but it's really not important.
I think it's better that some amount of suffering exist than no suffering, but generally pain and suffering are bad. If suffering didn't exist at all I think our innate capacity for joy, and freedom to choose, would be severely diminished.
Here's another example of what I'm talking about. It looks to me like willful misinterpretation of what I'm saying. I know you don't need pain management tips. You know I know you don't need pain management tips. The context makes it clear that I'm not giving you helpful advice regarding pain management, but rather attempting to provide evidence regarding my own attitude concerning pain. Yet you deliberately choose to interpret it differently, pretending I'm a misguided, naive optimist who thinks that all those who think pain is bad just don't know how to manage pain.
Sure, it's a useful pain management tip, but you know that's not why I brought it up.
I really disagree, I think abject agony is on net pleasant from a hedonistic perspective. That's not to say I'm a masochist or anything, just that the innate joy of existence outweighs virtually any amount of physical pain. We've already discussed this in detail in the thread linked above. Some of the worst suffering people can experience is to lose a loved one. Given the infinite expanse of possibility space, I think the fact that essentially the worst thing we ever experience is an absence of joy is actually pretty good evidence of a benevolent creator. It's certainly more compatible with that than with an uncaring mechanistic universe, which I would expect to at least be capable of inflicting more physical pain than it does.
You may know more about physical pain than I do but that doesn't mean you know physical pain better than I do. One denotes knowledge, the other understanding. I've experienced enough pain that I think it's reasonable to generalize the lessons I learned to literally any degree of physical pain.
I don't really care to argue about enormous doses of pain always being ennobling or enlightening, sometimes they are but usually they just hurt. The point is that they're tolerable and that the existence of pain itself is pretty easily explicable.
More like we both got swept away, I came back to shore after a few hours, and then they came back a few hours later. A lot of the lessons learned generalize to worse situations.
This is again something we've already discussed in detail. In short I don't think you lose responsibility for your choices by blaming them on your neurons, nor do I think on any meaningful level determinism actually means you lack freedom or agency.
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Damn dude. If you want to move to the US I'll make it happen for you.
Are we talking flights or dodging the Texan Border Patrol? ;)
Then again, both do entail flying, and I'm not sure I'm currently up to swimming the Rio Grande.
Huh. While Skookum is off climbing mountains, it looks like I have another monumental physical feat to prepare for haha.
(On a more serious note, I appreciate the offer greatly. Who knows, you might have pull with the AMA or be a mysterious millionaire, I'll count that as a miracle heh.)
Well if you want to practice here it would cost you another 3 years, it is paid. I think it would be worth it.
India has had World Federation for Medical Education for a decade now, that changes a lot.
Plus Maine needs doctors badly. Of course it would be through proper channels and a plane ride.
The reason I said pull with the AMA is that because I am, for no fault of my own, ineligible to give the USMLE. If not, there would be relatively fast options like the fastrack programs in under-served regions of Texas and Mississippi that would let foreign doctors begin working without repeating residency.
A cause of endless suffering and angst for me, I assure you. At least I'm licensed in the UK, which is a modest step up from India. Maybe it's a fixable issue, in which case I may make it to the States yet.*
*Fixing it entails unavoidable wrangling with unaccountable NGOs and maybe $50k. My cheapskate med school is unlikely to pay up, and I certainly can't afford that myself.
Ah that hyperlink didn't work for me. What is the nature of the issue?
https://old.reddit.com/r/slatestarcodex/comments/14tkrow/apologetics_for_america/
Is that better? I cross-posted it here too, but it's buried so deep it would be a pain to dredge it up.
To cut a medium length story short, there's an non-profit called the ECFMG, based in the US, that doles out certificates that endorse med schools as meeting the standards for their graduates to attempt US Residency exams. My med school doesn't have one. The reasons roughly boil down to the majority of its graduates not having aspirations of going abroad, or if they do, they end up going to the UK /Germany (and a handful of other places, none great) when they find out the US isn't an option. That's because they have their own certification/licensing regime.
While a terrible blow when I found out at the end of med school (I'd have dropped a year and tried for a better place if I had any inkling), it also locks me out of relatively congenial options like Australia, Canada and New Zealand as well.
This is an issue at the level of the med school, and even if I accrue an entire alphabet after my name, without it being fixed I simply can't apply to those countries, even if I was to become a senior consultant in the UK.
It's not that my med school is illegitimate, (though I certainly wish I had gotten into a better one), this is not a legal requisite like being recognized by the Indian Medical Council, but it's expected, such that nobody realizes it's a problem before it's too late. I didn't.
To fix it, the med school needs to reach out to the ECFMG. Which they did after much coaxing, but didn't get a reply. I suspect half because they're cheap bastards who used a gmail account. And were the ECFMG to proceed, they subcontract other agencies that charge fees ($50k in question) that the med school pays. I have reason to believe that one of the sub agencies has already extended blanket approval to all Indian med schools, including mine, but they aren't going to proactively reach out to the ECFMG, but the risk remains that the cheapskates will be asked to pay what in India is an enormous sum (like the net combined tuition of 5 students over 5 years) and I am grappling with overwork, UK exams and depression, so my plan is to work with my juniors and march in force to demand this gets done.
Hence why I've been focused on the UK, while my desire to move there is half-hearted at best, it's still a mild improvement.
Trust me, the moment I ever become eligible, if I do, I'm setting my GMC license on fire and grinding the USMLE so hard you won't see me for a year haha.
I'm sure you have already considered all options far more thoroughly than a quick google. But this seems like to me (I could be 100% wrong) that if your med school meets all the requirements they don't actually need to be ECFMG certified as long as they COULD be ECFMG certified. Does your school meet the requirements?
An individual’s eligibility for ECFMG Certification... IMGs can continue to apply for and pursue ECFMG Certification, even if their medical school currently does not meet the requirements of the Recognized Accreditation Policy. IMGs can pursue ECFMG Certification as long as their medical school meets ECFMG’s current requirements.
The individual’s medical school must meet requirements established by ECFMG. Schools that meet all requirements will be listed in the World Directory of Medical Schools (World Directory) with an ECFMG note stating that the school meets eligibility requirements for its students and graduates to apply to ECFMG for ECFMG Certification and examination. The ECFMG note also will include the graduation years for which the school meets these requirements. Since ECFMG is a sponsor of the World Directory, the ECFMG note is located on the “Sponsor Notes” tab of the medical school listing. If there is no ECFMG note on the Sponsor Notes tab of the medical school’s listing, its students and graduates are not eligible to apply to ECFMG for ECFMG Certification and examination. To confirm that a medical school meets ECFMG’s requirements, access the World Directory at www.wdoms.org . For more information on the ECFMG Sponsor Note, see Information on Sponsor Notes in the World Directory of Medical Schools.
Once you're on wdoms.org you can look up your med school and look in the notes. If you see something like this you should be all set.
Educational Commission for Foreign Medical Graduates (ECFMG), United States of America Students and graduates of this medical school are eligible to apply to ECFMG for ECFMG Certification and for examination, provided that: For medical school students officially enrolled in this school, the graduation years are listed below as “current”. For graduates of this medical school, their graduation year is included in the graduation years listed below. Graduation Years: 1970 - Current The degree title of the final medical diploma the student will earn, or the graduate has earned (and must provide), is listed in the Reference Guide for Medical Education Credentials. All other eligibility requirements are met. Refer to the ECFMG Information Booklet for detailed information.
Thank you for looking into it, but sadly it is precisely the absence of that sponsor note that's the issue :(
It's nigh ubiquitous, hence why nobody notices its absence, but that's precisely what my med school needs to do a better job reaching out and acquiring.
I asked the ECFMG, and they stated it can be applied retroactively to past graduates if the med school shows it met requirements at the time, but that's the easy part haha
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