I made that point because I argue that patient autonomy is important. Further, I argue that in order to protect patient autonomy, information should not be withheld from the patient. Accordingly, the patient should be given everything necessary to enable them to make optimal choices as a rational agent. Not providing low-cost, minimally-invasive screen tests to the patient, under the premise that the patient is an irrational agent, reduces their autonomy insofar as it limits their decision-making capacity. I argue that there is no compelling justification to do this for low-cost, minimally-invasive screenings. Furthermore, assuming that the patient is rational and finding ways to advance the rational patient's well-being protects patient autonomy. Therefore, the only justifiable factors that should be considered when screening patients that preserve patient autonomy is what I stated here: https://news.ycombinator.com/item?id=31450997
Does the position seem clear now? I apologize if this line of reasoning was not clear earlier.
> If your goal is to actually help people, you should base your arguments on how things are in reality instead of some idealized dream world.
That's a fair position (you seem to be a utilitarian), and probably quite defensible. But, one could argue that patient choice is an important feature for our medical systems to have. I certainly want to be able to refuse medications that my doctor recommends (e.g. opioids) or seek alternate advice/second opinions. My cost-benefit analysis equation is probably not the same as my doctor.
To be clear, I'm not talking about an "idealized dream world", as you put it -- I'm talking about patient autonomy in the real world, even if it means allowing patients to make what seems like a suboptimal decision.
> Your entire argument here seems to require patients to be rational agents.
Yes, my argument does rely on patients being rational agents.
> They aren't.
That may be true, but it's certainly paternalistic (in the formal, definitional sense) to act as if they are not rational agents and withhold information/reduce autonomy. This is a case of pure paternalism (again, in the formal philosophical sense).
Different ethical systems, of course, make different judgements on whether this behavior is moral. It's also up for debate whether this is a desirable feature of the medical system.
No. Not all screenings/tests are done, even when it's super low cost and non-invasive. For example, one factor that is used to determine whether to screen for certain types of cancer is "Possible harms from follow-up procedures". [1] Another factor that is taken into account it the chances of a false positive. [1] Both of these factors are irrational, since more information is strictly optimal given a rational agent. They should not even merit consideration in choosing whether to undertake a screening (this information should only be used after a screening is done, to determine follow-up action).
In my opinion, the only justifiable factors are probably along the lines of:
- invasiveness (e.g. if it's non-invasive or minimal cost)
- benefit to the patient if detected
- cost relative to other screenings/actions that can be done for the patient
One slightly reasonable common argument I hear for reduced medical diagnostics is: “we don’t have the resources; it’d overwhelm the medical system”. While this may be the case for some tests, there are probably a great number of tests that could be scaled to be done yearly on the whole population.
That's cool -- I didn't know that! Imo, the more effective and cheaply we can store energy and smooth out supply/demand curves, the more attractive solar and wind becomes.
Perhaps one way of encouraging a "greener" grid is to first encourage the development of cheap energy storage solutions, and then letting the market figure out the best way to utilize such storage (rather than the other way around). Might lead to more efficient/creative green energy solutions.
I think it’s very promising/exciting as a method of smoothing out the demand curves of the electric grid. Plus, it’s fairly straightforward to modify existing dams/hydro infrastructure to have this capacity.
Since some dams are already used as water reservoirs for drinking/agriculture, this could be quite viable if the desalination can be done cheaply and efficiently at scale (not sure if this is even possible on the scales required for this idea to make sense, though).
The anecdotes about the propagation of the mannerisms of Wittgenstein are a gem.
Here’s a particularly nice one about David Foster Wallace:
> James Wallace, who was a graduate student in
philosophy in 1959-1962, not only learned philosophy at Cornell but also picked up
a gesture of Wittgenstein. The gesture - hitting himself in the back of his head, to
indicate what a fool he was
was then passed on to his son, David Foster Wallace,
who eventually figured out its origin.
Fastmail. It just works and does everything I need, without bloat (I've got it on a custom domain). It also seems reasonably likely to last "a decade or two".
> This seems like not a sound argument to me....is it not tautological, or, simply an observation that perception of reality does not necessarily match actual reality?
The argument is trying to say that the distinction from "actual reality" (whatever that means) and perception of reality doesn't make much sense. One cannot break free of their perceived reality in order to see/compare/reason about "actual reality".
> And if the counter-argument is that the perception of the outsiders is what causes those objects to exist ...
As I understand it, this is Berkeley's position.
> ... if we then killed all of those outside observers (say, just a few researchers who are aware of what is in the room surrounding the child's room), would the objects in that room then cease to exist (and if so, by what mechanism that we reasonably know exists)?
Yeah, basically -- assuming you, the experimenter/person who is observing this thought experiment, is also killed.
I think the issue with some of these thought experiments is that they assume there exists some omniscient perspective who can see every part of the experiment (i.e. the person running the experiment).
> To me, the obvious flaw here is that there seems to be an implicit "only" perceived within the conclusion: "Ordinary objects are [only] ideas [and nothing else]." This is an extremely common error that the human mind makes, but you'd think that a philosopher would catch it in review of an idea (or the reviewers, who say: "The argument is valid, and premise (1) looks hard to deny."), so I feel like I must be missing something in the argument.
Yeah, I think the link I sent doesn't sum up Berkeley's point well. Perhaps it'd be better to take a look at the original argument. [1]
> > Does it really make sense when materialists argue that unobservable, undetectable, totally unperceivable and uninferrable things in this world actually exist?
> It makes complete sense to me (and I typically disagree with materialists)!
Interesting! How do you reconcile this with the belief that "reality is contingent on our minds"?
The original text is the best, I think (maybe look at Stanford's Encyclopedia of Philosophy's treatment of the subject [1]).
The way I like to think of Berkeley's position is like an equivalence argument. Suppose one is arguing that mind-independent objects exist (that is, there are things out there that cannot be perceived, but one claims to exist). Berkeley's conception of the world (in which such undetectable objects do not exist) is equivalent, at least from the perspective of any observer. Any mind/observer in the world, by construction, cannot perceive or detect (even indirectly) mind-independent objects. If they could, then those objects wouldn't be mind-independent. So a world in which mind-independent objects exist is indistinguishable from Berkeley's world.
Does it really make sense when materialists argue that unobservable, undetectable, totally unperceivable and uninferrable things in this world actually exist?
So, Berkeley argues that reality is actually contingent on our minds (and he tries to show that this isn't as big of a deal as it sounds).
Berkeley's real argument goes a bit differently (as I understand it), but I think a claim of functional equivalence may be more convincing for people with a math/CS background.
If you’re interested in learning about other metaphysical possibilities, George Berkeley’s works could be worth a read. One of his big statements is that “to be is to be perceived” — that is, anything that cannot be perceived doesn’t actually exist. Berkeley makes a pretty decent argument for this and his work is fairly influential in the realm of metaphysics (UC Berkeley is named after him).
I interpreted the original comment to mean that the mind is necessary for reality (i.e. there is no meaningful reality outside the mind), which is very close to what Berkeley is gesturing at.
Either way, the questions you’re asking (which all themselves presuppose a certain metaphysical interpretation of the world) have interesting implications (it seems like what you’re driving at is similar to the mind-body problem).