Author Topic: Restricting Someone's Rights Under Extraneous Circumstances  (Read 892 times)

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Offline j

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #35 on: January 22, 2016, 09:15:32 PM »
My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.

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Since it's always easier to discuss things without having to get into the racial aspect, howabout maturity? Seems to me that the people best targeted for such a program are the people not really mature enough to make long term decisions such as this to begin with.

Long term decisions such as...having a kid?

Half-kidding, but we as a society consider 21 year olds "mature" enough to do a hell of a lot of things (and 17 year olds can legally do almost as many) that can have *devastating* negative effects on them in the long term.  The goal ought to be to educate and equip them as best we can to help them make good, informed life decisions, but the micromanagement can only go so far.  In my mind, personal responsibility is paramount in a lot of scenarios, but people can and do make decisions that seriously impact society, and thus society has a vested interest in those decisions.  We legally restrict all kinds of things; reproduction happens to be a unique and fascinating topic to consider in that regard, because there are so many different angles.

For the record, I'm not arguing that this should be implemented or anything of the sort, or even that it is ethical.  I just thought it was a relatively plausible idea, unlike most plans to limit people's reproductive rights, and would make for good discussion.

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If I'm not mistaken, most doctors don't even want to discuss sterilization with anybody under 30. Do we really want to start rewarding tubal ligation for 20 year olds? I know that a big part of the appeal here is to prevent the immature from spawning in the first place, but this is an inappropriate cure to the problem.

The first statement is absolutely true, and you're probably right on with the rest of it as well.  The "appropriate cure" is education, which is another interesting topic, and the barriers to which are many.  I tend to agree with whoever (Chino maybe?) was recently saying that the biggest obstacle is shitty upbringings and home lives.  And ironically, I'd speculate that a significant contributor to such situations is--wait for it--parents having numerous kids they don't want or can't care for!

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And while it wasn't directed at you, I'm serious about the kidney thing, which I consider a very related tangent, and I always value your takes on medical ethics.

If what you're getting at is that similar socioeconomic disparities to those we're discussing above would come into play if there were a market in non-vital organs, I agree.  The poor and less educated would get the shaft, as the sick ones wouldn't be able to afford an organ if they needed one, while the healthy ones would be more likely to sell 'em, be it due to ignorance, financial burden, or manipulation by a third party.

I'm still not sure that makes it unethical, because as it is there are an absolute shit ton of people in need of donor organs, and far too few to go around.  Part of the reason has to be that there is little incentive for the less saintly among us to part with our organs or assume the risks associated with harvesting them.  The economic benefits would be significant too: dialysis costs a hell of a lot more than renal transplantation.  But I'd think any ethical organ trade would have to be tightly regulated, maybe a system where the state is the only buyer of organs or something.  I honestly don't know.

To circumvent sounding any more like an idiot on that subject which I know little about, here are a couple of alternatives:
1) Change to an "opt out" or assumed consent for organ donation post mortem.  Can't see much downside to this.
2) Diabetes prevention/management.  This brings us back to education, but diabetes accounts for the vast majority of the end-stage renal disease here in the states.

-J

Online El Barto

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #36 on: January 22, 2016, 10:55:44 PM »
My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.
Well, I'd hate to interrupt a perfectly nice buzz by doing statistical research, so I'll just speculate on my own that the numbers would look very different. The current birth control paradigm requires paying money up front to incur any one of a number of short term annoyances for long term gain. The suggestion being bandied about would be to suffer that annoyance up front to earn a paycheck; something we all do every day. The long term outcome would be a crapshoot. All of this points towards the poor and uneducated taking the quick payout.


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Since it's always easier to discuss things without having to get into the racial aspect, howabout maturity? Seems to me that the people best targeted for such a program are the people not really mature enough to make long term decisions such as this to begin with.

Long term decisions such as...having a kid?


Half-kidding, but we as a society consider 21 year olds "mature" enough to do a hell of a lot of things (and 17 year olds can legally do almost as many) that can have *devastating* negative effects on them in the long term.  The goal ought to be to educate and equip them as best we can to help them make good, informed life decisions, but the micromanagement can only go so far.  In my mind, personal responsibility is paramount in a lot of scenarios, but people can and do make decisions that seriously impact society, and thus society has a vested interest in those decisions.  We legally restrict all kinds of things; reproduction happens to be a unique and fascinating topic to consider in that regard, because there are so many different angles.

For the record, I'm not arguing that this should be implemented or anything of the sort, or even that it is ethical.  I just thought it was a relatively plausible idea, unlike most plans to limit people's reproductive rights, and would make for good discussion.
The irony certainly wasn't lost on me. And I actually agree that it's a fairly plausible proposal. I just think people would view it as mind-bogglingly evil, and I'd have a hard time telling them that they're wrong.


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If I'm not mistaken, most doctors don't even want to discuss sterilization with anybody under 30. Do we really want to start rewarding tubal ligation for 20 year olds? I know that a big part of the appeal here is to prevent the immature from spawning in the first place, but this is an inappropriate cure to the problem.

The first statement is absolutely true, and you're probably right on with the rest of it as well.  The "appropriate cure" is education, which is another interesting topic, and the barriers to which are many.  I tend to agree with whoever (Chino maybe?) was recently saying that the biggest obstacle is shitty upbringings and home lives.  And ironically, I'd speculate that a significant contributor to such situations is--wait for it--parents having numerous kids they don't want or can't care for!
:tup

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And while it wasn't directed at you, I'm serious about the kidney thing, which I consider a very related tangent, and I always value your takes on medical ethics.

If what you're getting at is that similar socioeconomic disparities to those we're discussing above would come into play if there were a market in non-vital organs, I agree.  The poor and less educated would get the shaft, as the sick ones wouldn't be able to afford an organ if they needed one, while the healthy ones would be more likely to sell 'em, be it due to ignorance, financial burden, or manipulation by a third party.

I'm still not sure that makes it unethical, because as it is there are an absolute shit ton of people in need of donor organs, and far too few to go around.  Part of the reason has to be that there is little incentive for the less saintly among us to part with our organs or assume the risks associated with harvesting them.  The economic benefits would be significant too: dialysis costs a hell of a lot more than renal transplantation.  But I'd think any ethical organ trade would have to be tightly regulated, maybe a system where the state is the only buyer of organs or something.  I honestly don't know.
My hunch is that the insurance folk would be the ones making the decisions, since as you said dialysis is far more expensive than transplantation. The state would have to regulate it. Fortunately, when it comes to these things practicality governs profit. There's little benefit giving a newly purchased kidney to somebody that isn't a particularly good fit for it. The current transplant waiting list is based on necessity and compatibility, and I see little reason to change that if supply suddenly exploded. Basically, this seems like an easy one to sort out (if you consider the whole thing ethical in the first place).

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To circumvent sounding any more like an idiot on that subject which I know little about, here are a couple of alternatives:
1) Change to an "opt out" or assumed consent for organ donation post mortem.  Can't see much downside to this.
2) Diabetes prevention/management.  This brings us back to education, but diabetes accounts for the vast majority of the end-stage renal disease here in the states.
-J
I really like number 2. Not sure it could be pulled off, but it's a pretty good idea. Also unsure it'd help all that much, but this is a situation where all help is, well, helpful. I'm just really not sure how many people croak leaving usable organs. In the end I suppose I'm just intrigued by the notion of people having to put onto paper their unwillingness to donate.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline j

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #37 on: January 24, 2016, 08:38:44 PM »
My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.
Well, I'd hate to interrupt a perfectly nice buzz by doing statistical research, so I'll just speculate on my own that the numbers would look very different. The current birth control paradigm requires paying money up front to incur any one of a number of short term annoyances for long term gain. The suggestion being bandied about would be to suffer that annoyance up front to earn a paycheck; something we all do every day. The long term outcome would be a crapshoot. All of this points towards the poor and uneducated taking the quick payout.

So, part of a subset of people who otherwise would use no contraception might utilize this option if it were available?  Isn't that the point?

A quick google search brings up a few interesting stats:
From the Guttmacher Institute: "Among American women who use contraceptives, the largest proportions use the pill (28%), tubal sterilization (27%) and the condom (16%). However, sterilization is the most common method among black and Hispanic women, while white women most commonly choose the pill." (emphasis mine)

The CDC reports that ~23% of women aged 15-44 currently use either female or male sterilization as their method of contraception.  Sterilization is currently performed after 10% of all births.

I guess that stuff is less related to what we were talking about, but to bring it back to the topic at hand, what if we incentivized IUD placement instead of sterilization?  It's just as effective statistically and is less invasive, more easily reversible, etc.  Or are you saying that ANY publicly funded contraception will be utilized more by certain racial groups than others, and that is what you find problematic?


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To circumvent sounding any more like an idiot on that subject which I know little about, here are a couple of alternatives:
1) Change to an "opt out" or assumed consent for organ donation post mortem.  Can't see much downside to this.
2) Diabetes prevention/management.  This brings us back to education, but diabetes accounts for the vast majority of the end-stage renal disease here in the states.
-J
I really like number 2. Not sure it could be pulled off, but it's a pretty good idea. Also unsure it'd help all that much, but this is a situation where all help is, well, helpful. I'm just really not sure how many people croak leaving usable organs. In the end I suppose I'm just intrigued by the notion of people having to put onto paper their unwillingness to donate.

Yeah...but post-mortem.  Cadaver organs don't typically last quite as long or have as high graft success rates as those from live donors, probably because of injury from inflammatory processes prior to death.  But they are a huge potential source of donor organs and there is currently a huge deficiency of donor organs.

As for diabetes prevention, yeah, it's an uphill battle.  The crux of it is getting people to change daily habits that have been ingrained into them over their entire lives.  From the perspective of the family practice physician (whose job I don't envy), this must be done in a 10 minute office visit during which you meet them for the first time, explain the horrors of the complications of advanced diabetes, make it hit home that yes this will happen to them if something doesn't change, then ensure that they remain disciplined throughout the following 6 months or a year until you (possibly) see them again.  The best family docs I know are excellent communicators and can quickly build a great rapport with their patients, and even they admit to almost zero success at this.

I digress.  Education is again the key, because our drugs for treating diabetes kinda suck, and once somebody is insulin dependent, there's usually no coming back.  How do we educate people adequately to make them understand these things and choose to turn their lives around?  I have no idea.

-J

Offline Stadler

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #38 on: January 25, 2016, 09:50:30 AM »
My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.
Well, I'd hate to interrupt a perfectly nice buzz by doing statistical research, so I'll just speculate on my own that the numbers would look very different. The current birth control paradigm requires paying money up front to incur any one of a number of short term annoyances for long term gain. The suggestion being bandied about would be to suffer that annoyance up front to earn a paycheck; something we all do every day. The long term outcome would be a crapshoot. All of this points towards the poor and uneducated taking the quick payout.


Why is that last thing bad?  Why are we willing to assume that because someone is poor or uneducated that the decision they will make is de facto flawed?  Why doesn't that apply to other aspects of life (not least of which is the having of the baby to begin with)? 

I think the essence of choice is paramount here; that doesn't mean that anyone can do whatever they want, when they want, how they want, and for free.   The fact of the matter is, our society is such that some choices come with a financial burden.   I think we ALWAYS have trouble when we separate the responsibility from the choice, and that includes fiscal responsibility.  Just like healthcare is skyrocketing in part because we have doctors/patients prescribing tests because "insurance will pay for it!", we need SOME tie between the choice and the responsibility.  The question then becomes, what is more important for society?  Where is the line between "choice" and "responsibility"?   For this reason, it's sort of a paradox:  the more you have society pay for the choices of the individual, the more you have standing to say "society has a say in those choices".

It's really a large part of my criticism of the ACA; it's wrecking havoc with the idea of "cost-benefit" and "risk-reward". 

Online El Barto

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #39 on: January 25, 2016, 11:15:03 PM »
Sorry for quoting you gents out of order, but it makes more sense this way.

My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.
Well, I'd hate to interrupt a perfectly nice buzz by doing statistical research, so I'll just speculate on my own that the numbers would look very different. The current birth control paradigm requires paying money up front to incur any one of a number of short term annoyances for long term gain. The suggestion being bandied about would be to suffer that annoyance up front to earn a paycheck; something we all do every day. The long term outcome would be a crapshoot. All of this points towards the poor and uneducated taking the quick payout.

So, part of a subset of people who otherwise would use no contraception might utilize this option if it were available?  Isn't that the point?
Indeed it is the point. My concern is that the subset will be disproportionately black. The numbers you cited (which surprised the hell out of me) refer to people already going out and obtaining some form of contraception of their own accord. We're wanting to increase the number, but by monetarily incentivizing it you're bringing in the people more concerned about short term needs than long term considerations; i.e. the poor and uneducated.

My concern isn't coercion. Though it is voluntary, I think it very likely to be an option utilized disproportionately by blacks (and avoided by Hispanics).

Maybe.  My guess is the numbers would look similar to the data on current usage of various methods of birth control, which I'd have to look up.
Well, I'd hate to interrupt a perfectly nice buzz by doing statistical research, so I'll just speculate on my own that the numbers would look very different. The current birth control paradigm requires paying money up front to incur any one of a number of short term annoyances for long term gain. The suggestion being bandied about would be to suffer that annoyance up front to earn a paycheck; something we all do every day. The long term outcome would be a crapshoot. All of this points towards the poor and uneducated taking the quick payout.


Why is that last thing bad?  Why are we willing to assume that because someone is poor or uneducated that the decision they will make is de facto flawed?
I'm not saying that it is a bad thing, and as usual you offer up a pretty nice bit of counter-intuitive reasoning. What I am saying is that people are going to claim that you're targeting the black communities and that it's outright evil, and I'd have a hard time telling them that they're wrong.

I guess that stuff is less related to what we were talking about, but to bring it back to the topic at hand, what if we incentivized IUD placement instead of sterilization?  It's just as effective statistically and is less invasive, more easily reversible, etc.  Or are you saying that ANY publicly funded contraception will be utilized more by certain racial groups than others, and that is what you find problematic?
Temporary sterilization is certainly a much better way to go (although it would be completely unworkable in practice). However, the problem still remains. It'll be viewed as racially motivated and generally evil. Just somewhat less so in this case.





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To circumvent sounding any more like an idiot on that subject which I know little about, here are a couple of alternatives:
1) Change to an "opt out" or assumed consent for organ donation post mortem.  Can't see much downside to this.
2) Diabetes prevention/management.  This brings us back to education, but diabetes accounts for the vast majority of the end-stage renal disease here in the states.
-J
I really like number 2. Not sure it could be pulled off, but it's a pretty good idea. Also unsure it'd help all that much, but this is a situation where all help is, well, helpful. I'm just really not sure how many people croak leaving usable organs. In the end I suppose I'm just intrigued by the notion of people having to put onto paper their unwillingness to donate.

Yeah...but post-mortem.  Cadaver organs don't typically last quite as long or have as high graft success rates as those from live donors, probably because of injury from inflammatory processes prior to death.  But they are a huge potential source of donor organs and there is currently a huge deficiency of donor organs.
My understanding is that they don't last as long because they've spent some time dead. I suppose if you pull one out of somebody before that you're in the process of pulling the plug on, then it'll be fine, but the longer it's outside of a warm, oxygenated body the less use you'll get out of it. Or at least so I've heard.

But what I was wondering was just how many people die in a condition where their organs are viable. A ton of stiffs will be ruled out from the get go. Trauma. Toxicity. Cancer. Anybody who dies before they make it to an ER. While I love your idea about making people intentionally opt out, and it'd definitely up the number of donors, I'm not sure how big of an improvement it'd be. I think the circumstances surrounding the average death are the bigger factor here.
Argument, the presentation of reasonable views, never makes headway against conviction, and conviction takes no part in argument because it knows.
E.F. Benson

Offline Stadler

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Re: Restricting Someone's Rights Under Extraneous Circumstances
« Reply #40 on: January 26, 2016, 10:16:37 AM »
Indeed it is the point. My concern is that the subset will be disproportionately black. The numbers you cited (which surprised the hell out of me) refer to people already going out and obtaining some form of contraception of their own accord. We're wanting to increase the number, but by monetarily incentivizing it you're bringing in the people more concerned about short term needs than long term considerations; i.e. the poor and uneducated.

But, and not totally devil's advocate, but not entirely free of advocacy for Beelzebub, why is that bad IF it is a product of their choice?  Why do the choices of all people have to be the same?  There are, unavoidably, difference in the demographics of race; isn't it to be expected that those differences - whether causal, correlated, or coincidental - might lead to different decisions? 



I'm not saying that it is a bad thing, and as usual you offer up a pretty nice bit of counter-intuitive reasoning. What I am saying is that people are going to claim that you're targeting the black communities and that it's outright evil, and I'd have a hard time telling them that they're wrong.

Well, I understand that; I expect the claim regardless.  But I'm not sure that the obligation IS to show they're wrong.  Why isn't the obligation for THEM to show they are RIGHT?