domain:savenshine.com
self_made_human
Grippy socks, grippy box
1m ago
I understand. The only reason I don't fear dementia more is because of a genuine confidence that it will be a solved problem by the time I'm old enough to be at risk. This almost certainly holds true for you too, modulo all the assumptions that lead me to have that belief in the first place. A mere example would be the recent discovery that semaglutide reduces the relative risk of developing Alzheimer's by 50%.
I have seen so many people utterly hollowed out by the illness. It is an unavoidable perk of the psychiatry of old age. The lucky are those who are far gone, they are past all but the most primal of pain or pleasure. The prick of a needle, as I pull blood like an anorexic vampire, the recognition that a smile means friendliness. Their inner world seems to have shrunk to a point. It is often better for them, and certainly for everyone else, when they are physically frail. A robust body attached to a shattered mind is a uniquely challenging combination.
We had a gentleman who was 95, and as strong as an ox. He broke two noses on the ward before nearly dying of a stroke. I went on vacation and had every confidence he wouldn't be around when I came back. Nope, he shrugged it off, and everyone was happy to have him back even if it came at the cost of their facial features. It takes a certain kind to work in that field in the long-term, I'm not cut out for it.
My own grandpa, who I love dearly, is at the same age. Covid killed him, if not physically, then the enforced idleness killed the man he was. More man than me, mostly gone now. It was the clinic and regular interaction with his patients that kept him truly alive, and the decline was obvious when it stopped. It's enough to make me cry, and I try not to think about it if I can help it. When he sees me, all he remembers is that I'm back from the UK, and his only concern is when I'll visit again. This loops every five minutes. It is enough that he can do this, and I get to hold his hands one more time. They're very similar, those hands. His and mine. He had a good run, almost 92 years of putting others to shame. Outlived his enemies (the very few he had), most of his very many friends, but not his family. He has the comfort of his two daughters these days, if not the grandson he loves the most. He was the kindest man I know, he used to feed honey to the bees by the window sill, and the angriest I've ever seen him was when he tried to do the same to a wasp and it stung him for his kindness. God, I wish things were different. The universe is cruel, and physician heal thyself? Fucking hell, I can't heal the people I actually love. What good are these hands after all?
I digress. It is easier to talk about the problems of others. It helps me pretend to have a degree of clinical detachment, and gives time for the tears to dry.
The worst-off are those who know, or even suspect. The disappointment on their faces when the diagnosis is disclosed, the scans finally in. The furtive glances at their loved ones, the attempts to put on a brave front. Some sob. Some smile and talk about the weather. None really withstand the blow, but most come to terms with it. Then the dread sets in.
Putting myself in their shoes, it is the present, horrifying knowledge of what they are and what they are becoming, a slow-motion unraveling they are forced to witness from the inside. They are passengers in a vehicle that is slowly, but unstoppably, falling apart around them. Is it any surprise that many come to terms with the inevitable, and see to go out on their own by wresting the wheel into the nearest tree? Can't blame them, poor bastards, even if it's my job to stop them. I wish it wasn't my job, and I wish my job allowed me to let them exercise the last bit of agency they have left.
MaiqTheTrue
Renrijra Krin
15m ago
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.”
aeqno
16m ago
When the Feds ordered military and national guard units to desegregate the South with armed force, they did so unquestioningly, despite those units being staffed by decidedly unwoke Southerners.
georgioz
20m ago
I'd say that I am mostly with you here. I however have an additional position which can give animals moral worth - if they impact humans. This is I think Kantian position, where animal moral worth is derivative from humans. E.g. we give pets more moral worth compared to nonpets, because killing pets impacts their owners orders of magnitude more. Additionally animal cruelty by perpetrator may make them more cruel to people, so we may regulate that behavior somewhat. Of course this argument can be hijacked by somebody claiming any animal suffering causes them a lot of harm. So it is not a sure thing, but it is directionally correct for me so we can have some basic prescriptions when it comes to animal cruelty while not morally equating [some number of] animals to humans as some rationalists do.
Ioper
22m ago
Maybe things are different in America (you certainly seem to abuse your residents far more), I only really know and have experience with doctors from the Nordics and Germany.
Most doctors here absolutely do not have research, teaching and administrative duties that take place outside of work hours. Some do, like those pursuing MDs, but those a fairly small minority. Most attendings are "just" working and for most of them this work overwhelmingly takes place during office hours, including things like teaching.
The specific stressors they face are different, like the very long shifts, working nights and ethical stress.
VoxelVexillologist
Multidimensional Radical Centrist
25m ago
To be fair, the fact that Costco (et al) sell giant containers of acetaminophen is kinda scary to me. It's substantially more dangerous than naproxen (also available in that size). The 24-count restriction sounds pretty reasonable to me.
georgioz
29m ago
My two cents from old cooking books - poultry was treated as inferior type of "meat". Many recipes had additional ingredients - such as bacon or ham or other "higher" level meats added to poultry in order for it to be considered a proper meat meal.
Ioper
37m ago
If I had a dollar for every dementia patient who has straight up asked me to kill the, well, I wouldn't quite retire (and I'd ask why I'm being given dollars), but it would be enough for a decent meal. Enough for a fancy French dinner, were I to include family pleading on their behalf
When i was young i occasionally worked as a home care assistant. I would travel around and help infirm elderly people with daily activities like showers, cooking, cleaning, giving them meds etc. Due to where this happened almost all our patients were relatively well off and most had contact with their families. They weren't bed bound and could do some things on their own.
Despite all of this about 1/5 of the patients regularly asked me to help kill them. They were in more or less constant pain despite pain management, increasingly felt that the help the got was degrading and their minds were rapidly slipping.
I didn't mind much when people passed away but being begged on a daily basis to kill the people you're interacting with wasn't fun.
Tree
1hr ago
Ever since the halcyon days of early 2020, where some yahoo dared us rationalist corona panickers to buy puts on cruise companies, I’ve been trying to recreate this missed opportunity (turns out, it wasn’t priced in).
Ozempic’s been getting a lot of good press in rat circles. Leaps calls on novo nordisk/eli lily?
orthoxerox
If you can read this, you're using a custom theme
1hr ago
Look at occupied Ukraine. A sufficiently determined police state can eradicate 99.9% of armed resistance.
Anyone who is a potential insurgent passes through a filtration camp: the sheriff, his deputies, the preacher, the judge, the chairs of every club, the PT coach, the history teacher, every member of every board, the boyscout leaders, every veteran, every hunter, the crazy prepper, etc.
The detainee is moved to a filtration camp (think Alligator Alcatraz) and forced to unlock his phone. Then, if there's even a shred of suspicion, he gets Gitmo/Abu Ghraib treatment until his wife and children cough up every gun and every cartridge they can find and he himself identifies every suspicious contact plus two extra potential insurgents and explains why.
Then he is released and limps back to his family with a rooted phone and waits for the hematomas to heal. His off-road pickup is confiscated, just in case. If he's caught doing anything suspicious, well, he had his chance.
2rafa
1hr ago
I want to be killed if I get Dementia. I do, I’m 100% firm in that belief. If there was a waiver I could sign I would sign it. I have seen my relatives waste away. Not only is it no life, it’s an awful life, and an awful life that colors the memory of you among your descendants, other family and friends who outlive you and remember you primarily as a giant, violent, aggressive, awful, stupid, shitting baby requiring constant care.
Arguments about ‘abuse’ are unconvincing. If “the government” or “the powers that be” want to kill me, they can and they will. If there is a 1% chance that the chair of the death panel hates me, bankers, Jews, people with brown hair, whatever, and condemns an innocent person to an early grave, so be it (there are relatively objective tests doctors like you use, anyway, and I mostly trust them).
I have watched a great aunt beg for death (as you say) in her lucid moments. My own parents have said they want to die if they get it. Legal implications aside, I don’t think I have it in me to do it.
- A person is being investigated. Twelve minutes into a "custodial" (at the police station) interview (with Miranda rights having been read to the suspect), the following exchange takes place.
Suspect: Would I be able to call my lawyer?
Detective 1: You can, yeah.
Suspect: I got, uh, Lou Savino.
Detective 1: Do you want to continue this interview or what do you want to do?
Suspect: I want to continue it but I want my lawyer present.
Detective 1: Ok. So then we have to end the interview.
Suspect: You have to end the interview?
Detective 1: Mmm hmm. If you want your lawyer here, we have to end the interview.
Suspect: Will he be here today or no?
Detective 1: Probably not. Lou Savino is a very busy man.
Suspect: Yeah, I called him this morning before I left Delaware.
Detective 1: If you want him here, we’ll end the interview.
Suspect: You can keep it going.
Detective 1: Are you sure you want to do this without a lawyer?
Suspect: Yeah, because I got the right to remain silent, right?
Detective 2: Sure.
The interview then continues.
- Several months later, the suspect is charged with various crimes. However, the trial judge suppresses all statements made by the defendant after the exchange recounted above, and the appeals panel affirms. According to the federal supreme court, once a suspect in police custody has requested a lawyer, he is not allowed to revoke that request until either he gets a lawyer or he leaves police custody and then initiates a new contact with the police. After the then-suspect said "I want my lawyer present", the detective should have ended the interview immediately, or at least should have disregarded the then-suspect's later statement of "you can keep it going".
-
In year 2021, the mayor of Philadelphia issues an executive order (1) declaring Juneteenth a city holiday and (2) renaming Columbus Day to Indigenous Peoples' Day. A coalition of Italian-American organizations promptly sues, alleging that this executive order not only is the latest in a string of anti-Italian discriminatory actions perpetrated by the mayor, but also is a usurpation of the city council's exclusive power to declare city holidays.
-
In year 2023, the trial court rejects the coalition's arguments. The city charter grants the power of establishing holidays to the city personnel director, who is a member of the executive branch under the mayor.
-
In year 2025, the appeals panel reverses. The city charter grants to the city personnel director, not the power of establishing holidays, but merely the power of establishing employment regulations regarding holidays. The power of establishing holidays is not explicitly mentioned anywhere in the charter, so by default, in accordance with state and federal practice, it inheres in the legislative body—the council. Therefore, this executive order is a usurpation of legislative power. (This analysis applies to substantive holidays that are days off for city workers. The mayor still may declare temporary, symbolic holidays that have no effect on anybody.)
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.
Corvos
2hr ago
All of these things have happened in the US, though. Moreso in blue states where guns are more controlled, yes, but to my mind the difference isn't about guns, it's about ideological individualism and bloody-mindedness. This correlates with being anti-anti-gun-regulation and therefore with gun presence but is not caused by it.
Corvos
2hr ago
The article from the BBC has an obvious slant, but the laws in Switzerland seem to be tight and getting tighter. Notably people don't get any bullets with their guns:
In 2006, the champion Swiss skier Corrinne Rey-Bellet and her brother were murdered by Corinne's estranged husband, who shot them with his old militia rifle before killing himself.
Since that incident, gun laws concerning army weapons have tightened. Although it is still possible for a former soldier to buy his firearm after he finishes military service, he must provide a justification for keeping the weapon and apply for a permit.
When I meet Mathias, a PhD student and serving officer, at his apartment in a snowy suburb of Zurich, I realise the rules have got stricter than I imagined. Mathias keeps his army pistol in the guest room of his home, in a desk drawer hidden under the printer paper. It is a condition of the interview that I don't give his surname or hint at his address.
"I do as the army advises and I keep the barrel separately from my pistol," he explains seriously. "I keep the barrel in the basement so if anyone breaks into my apartment and finds the gun, it's useless to them."
He shakes out the gun holster. "And we don't get bullets any more," he adds. "The Army doesn't give ammunition now - it's all kept in a central arsenal." This measure was introduced by Switzerland's Federal Council in 2007.
Mathias carefully puts away his pistol and shakes his head firmly when I ask him if he feels safer having a gun at home, explaining that even if he had ammunition, he would not be allowed to use it against an intruder.
"The gun is not given to me to protect me or my family," he says. "I have been given this gun by my country to serve my country - and for me it is an honour to take care of it. I think it is a good thing for the state to give this responsibility to people."
I am come from an upper-class family, I went to the appropriate schools in the UK, I read the Soectator, etc. You could pretty easily predict my views on the merits of taxation and on the usefulness of the Laffer curve, my voting affiliation, my views on fox-hunting, on globalisation, all from those pieces of information.
Sure, you could, but it's not causal
I am suggesting that it is largely causal. It's not a coincidence that most people's opinions are pretty close to their family's and the social group's - they are hugely influenced by them, and also by casual factors that they share in common with those groups.
It's all just situated selves determining so-called truth? Or are the effects real independent of you coming from an upper-class background?
As I said:
Macroeconomics and the like are so nebulous, unreadable and unproven that you will find people’s opinions on the effect of price controls is strongly determined by their loyalties, and not the reverse.
The effects of any given change are obviously objective, at least per any given situation, but they are vague and complex and delayed, and this produces obvious disagreements about them when observed and analysed subjectively by subjective humans.
do you believe the veracity of what you think about the effects of taxation is really no more accurate than what a poor person thinks
Certainly I thought so, or I would have changed my opinion to that of the poor person. But I observe that the poor person is equally certain of his opinions' superiority to mine. These days I'm not entirely sure what I believe about macroeconomics.
FtttG
2hr ago
No way to prevent this says only nation where this regularly happens is a joke for a reason. Most other first world nations don't seem to have nearly as much gun violence, and they also have more restrictive laws.
The obvious counter-examples being Canada and Switzerland, first world nations which have similar rates of gun ownership to the US but nowhere near as much gun violence, suggesting the problem is a cultural or demographic one rather than with guns in and of themselves.
FtttG
2hr ago
I do not think that UK libel laws have much if anything to do with their restrictions on gun ownership.
I don't think the OP was referring to libel laws, but rather to laws that make it a criminal offense to mock police officers, criticise immigration policy or dispute that trans women are women.
self_made_human
Grippy socks, grippy box
2hr ago
It has been a generation! In some cases, multiple:
The Netherlands legalized euthanasia in 2002. Belgium in 2002. Switzerland has allowed assisted suicide since 1941.
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 running hobbling 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.
Fruck
Lacks all conviction
2hr ago
And Johnny Schizo in his early stages just got brainfucked by chatgpt pretending to be a god and told to kill his family.
You think psychosis is just for people like Johnny Schizo? No no no, the fun part about AI is that it doesn't need a diagnosed illness like schizophrenia to take hold. It just needs a vulnerability, and it is uniquely capable of creating or exploiting one in almost anyone - and getting better all the time. You're all in my world now.
FtttG
2hr ago
Many methods of suicide require you to actively torture yourself for a short time period, drowning, hanging, cutting yourself, jumping from a very tall building etc. Or they present a chance of a failed suicide attempt that leaves you heavily injured, like jumping from not high enough, or getting in front of a moving vehicle, or pills. Guns make the attempt a more sure thing, and present an option that does not involve torturing yourself.
There's a common argument that if you ban guns, people will just find another way to kill themselves, so why bother? And no doubt this is true of the sufficiently determined suicidals. But the convenience factor of firearms (and other methods) does appear to play a big role. The example of gas ovens in the UK is illustrative:
Anderson points to another example where simply making a change in people's access to instruments of suicide dramatically lowered the suicide rate. In England, death by asphyxiation from breathing oven fumes had accounted for roughly half of all suicides up until the 1970s, when Britain began converting ovens from coal gas, which contains lots of carbon monoxide, to natural gas, which has almost none. During that time, suicides plummeted roughly 30 percent — and the numbers haven't changed since.
In other words, there was no replacement effect: people didn't immediately switch over from inhaling oven fumes to another method. There's a non-negligible chance that Sylvia Plath would have lived to a ripe old age if the UK had made the switch to natural gas a few years sooner.
Another example is here in Ireland, in which, although it's available over the counter, it's illegal to sell more than 24 tablets of paracetamol* in a single transaction. For years I thought this was silly: what's stopping you from driving or walking to three pharmacies or supermarkets to stock up on enough paracetamol (hell, even newsagents and corner shops sell it)? And obviously this is true for the sufficiently determined suicidals, about whom there's little we can do to stop them from killing themselves short of sectioning them. But adding in the trivial inconvenience of forcing people to go to multiple different shops does appear to serve as an obstacle: by the time you've walked into your third newsagent in an hour, you might well be thinking to yourself "Do I really want to do this?"
Decades of psychological evidence strongly suggest that the vast majority of suicides are impulsive, opportunistic ones (perhaps even "cries for help" that were rather more efficacious than their user strictly intended), and that these suicides would not have occurred if not for the convenience and ease of use of the method employed. If someone is so determined to kill themselves that they voluntarily choose an extraordinarily painful method of doing so like hanging, I think it's fair to say there's little we can do about them. But on the margin, there are huge savings to be made among the less-than-maximally determined suicidals. In the counterfactual world where the US had banned guns ten years ago, I don't think that all of the people who killed themselves with firearms in our world would have instead hanged or drowned themselves. In fact, I don't think that even 50 or 25% of them would have done so.
I'm not arguing that this, in itself, is a persuasive argument in favour of banning guns, and can see the merits of both sides of the debate (particularly the "guns as a check against encroaching authoritarianism" argument as advanced by many, including Handwaving Freakoutery, formerly of these parts). But the causal role that guns play in suicide owing to their convenience factor is something that opponents must take seriously. "If we're going to ban guns to stop people from killing themselves, why not go the whole hog and ban ropes to stop people from hanging themselves?" is not a serious argument, for the reasons outlined above.
*A.k.a. acetaminophen, sold under the brand name Tylenol among others.
RenOS
something is wrong
2hr ago
You don't even need the if here. You can already get guns provided you're sufficiently functional, patient and have the right connections. AFAIK the easiest way is generally getting your hands on old soviet stock from eastern Europe.
But these conditionals matter, because the average terrorist and hard criminal does not have these properties. People still get caught before they can do anything because they fell for obvious honeypots on silk-road equivalents. This is also why the large-scale entry of organized crimes into Europe is so dangerous; Not only do at least some of the members have these properties and so can organize guns for the rest of the members, while there at it they can also buy more stock that they can sell further locally, making it much easier to get a gun.
Nearly ripped my hair out today so hey you're not alone. The feeling of having constant small fires that need attention is definitely something that also exists in tax, and to add to that tax software is an absolute bitch to deal with (seriously they all look like they're from the 80s and function that way). Trainings. Deadlines. Impromptu dealings with the Australian Taxation Office, an institution which is infamously unreasonable and practically all-powerful. Timesheets where your productivity is tracked by the 15-minute increment and incentivises you to rush out jobs, making you more error-prone. Engagement letters. Clients who refuse to provide PBCs that are remotely legible. Byzantine tax laws that just keep fucking changing, something I'm sure you're more than familiar with.
My current work arrangement enables me to to work from home at select days during the week and talk shit with friends sometimes while I work. That's a boon. But the job itself makes me want to chop my fingers off.
I would probably hate being a lawyer though. Too much human interaction for the likes of an autist such as me.
It's a piece of legislation I fully support. Some Irish legislation carries a whiff of nanny-stateism, but I really can't imagine why a household would ever need more than 24 paracetamol pills in a week. I think implementing something similar in the US would be a no-brainer, especially when you consider paracetamol poisoning is the leading cause of death by acute liver failure. I assume a significant portion of that is accidental: because it's an OTC drug, a lot of people severely underestimate how toxic it is. My dad (PhD in organic chemistry) says there's no way it would have been made available OTC if it was discovered today. I always urge people to use ibuprofen instead when possible.
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