[ExI] Medical power of attorney for cryonicsts

[John Clark]

On Sat, Dec 6, 2014 at 3:18 PM, Anders Sandberg <anders at aleph.se>

>> > Medical ethics at its simplest typically runs the issue past the
> Beauchamp principles. Does the treatment respect the autonomy of the
> patient? (this is where informed consent comes in, as well as the right to
> withdraw for any reason)
>


> That one is pretty uncontroversial and pretty obvious; I don't have a PhD
> in ethics but nevertheless I figured that one out all by myself.
>


> Ha! Autonomy easy and uncontroversial? It is a nightmare. What about the
> autonomy of Pro Ana people to starve themselves to death?


What about them?

>  What about trepanationists who want a hole in their head?


A hole in the head is not a fashion statement I personally am 'likely to
imitate anytime in the near future, but different strokes for different
folks.

> What about forcing medication on incarcerated mentally ill people to
> become autonomous enough so they can be executed?


Forget about morality, insisting that a malfunctioning machine be repaired
before anyone is allowed to throw it away is just stupid.

 > Suicides?


As I've said before, in my opinion making somebody live who wants to die is
as immoral as making somebody die who wants to live, and my opinion is just
as good (or as bad) as that of a medical ethicist.

> When is an Alzheimer patient capable of making decisions, and when should
> we overrule them?


That indeed is difficult, at what exact point does impaired turn into too
impaired? But do professional ethicists have a solution to this problem
that is provably correct? Of course they don't nor will they ever have such
a thing because morality isn't like geometry where you can prove all sorts
of amazing things starting from nothing but a few self evident axioms. The
difference is the geometry was invented by humans and was designed my them
to be as logically consistent as possible,  but morality was invented by
Evolution as thus is a tangled mass of compromises make-dos and kludges
with little need for consistency.


> > Most of the time ethics is easy: don't be a dick. Ask before you do
> something to somebody. Stop if they ask you to stop.


Yes.

> It is the 1% of the time when this doesn't work that keeps medical
> ethicists busy.


But in those difficult cases do the opinions of medical ethicists end up
being better than the opinions of those who didn't write a PhD dissertation
on morality? I see no evidence that they are.

 > do you amputate a really bad limb, or try to rehabilitate it? Is
> reduction of pain worth a health hazard?


Those questions are none of a ethicists business, they can only be answered
by the person with the bad limb and the pain. Maybe he will make good
decisions and maybe he will not, but either way it will be his decision and
his limb and his pain.

>> All treatments have risk and specifying how much risk is in the
> scientific domain. And there is no one objective number that divides
> acceptable risk from the unacceptable, it is entirely the patient's
> decision not mine because it's his life not mine.



> Science can in theory give you probability distributions for risk, yes.
> In practice this is often infeasible: we do not know the probability
> distribution of how *you* will respond to a drug, since we only have
> population data - data which we know is biased, often from small samples,
> and have unknown errors too.


Then we need more science to reduce the uncertainties, and more ethicists
will not be of the slightest help.

>>> Does the treatment cause injustice? (This is why I think reporting is
> important: it spreads the benefit of the experiment even if it doesn't work
> out. And this is also why super-expensive treatments might be problematic. )
>


> > This is where my opinion on morality differs from the opinion of
> medical ethicists.  Apparently Mr. Beauchamp feels that if you can't cure
> everybody you shouldn't cure anybody, I disagree.
>


> Sorry, but you fail at ethics 101 here.


That's OK, if I had to fail one course ethics 101 would be the one I would
pick. But I just can imagine what possessed me to sign up for such a course
in the first place.

> You have presumably not read a word by Beauchamp,


That is true I've not read one word, in fact I've never even heard of
Beauchamp until you mentioned him.

> and yet jump to strong conclusions about what he thinks (and no, he
> doesn't think that).


All I know about the man is what you told me, if Mr. Beauchamp wasn't
worried that treating a disease will cause injustice and didn't say
"super-expensive treatments might be problematic" then who did?

> In fact, medical ethicists have a lot of views on what is unjust: there
> are libertarian ethicists and there are communist ethicists (and even
> nuanced mainstream ethicists).


If they all cancel out to zero then what use are they? I don't need the
help of a gaggle of ethicists giving me contradictory advice, I am
perfectly capable of becoming confused by myself.

  John K Clark
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