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Rationality Engine for Assisted Dying - Prep Phase - Dilbert Blog

Rationality Engine for Assisted Dying – Prep Phase

Update 4/7/15: New questions added from comments. I will ask Jimmy Akin to add any questions of his own and begin responding.

This post is strictly to prep for an upcoming “verdict” from me on the topic of assisted dying, using the Rationality Engine I have been testing in this blog. 

The Rationality Engine attempts to turn the uninformed and irrational opinions of the public into a coherent verdict via a system that has the following features:

Rationality Engine

1. Public debate, with comments that can be up-voted, and no end to the debate. It is a living document.

2. Curator who explains his/her biases.

3. A format that includes simple claims, usually in one sentence, followed by the curator’s verdict and reasoning. Relevant links will be cited so the reader can check the reasoning for the verdict.

4. The curator updates the living debate as new and useful links, arguments, and insights occur on all sides.

5. The curator can not be a member of an organized political group because it would taint credibility. Ideally, the curator’s livelihood should benefit more from being unbiased than from holding a particular view. 

6. Phase one is a call for links and arguments that the curator can sort and summarize to get the conversation started.

The Rationality Engine has been tested successfully on two topics in this blog. The first topic was the gender pay gap, in which all sides viewed the resulting verdicts as balanced. (Based on comments.) To my knowledge, this has never before been accomplished.

The second test was on the question of whether Democrats or Republicans are more “anti-science.” The question is silly and subjective, but the Rationality Engine worked again to show beyond any doubt that ignorance of science is not limited to one of the parties. Nor is it obvious which party is “worse.”

The question of assisted dying will be the third test of the Rationality Engine. In phase one I will seed the topic with the opinions of one well-informed and well-placed opponent of assisted dying in California. I will provide the other side of the issue because it is fairly simple in this case. Your comments will further shape the final verdict that comes later.

At this point you should be thinking I am not unbiased. And you already know what my verdict will be. But you would have said that for the first two debates tested with the Rationality Engine and you would have been wrong. The Rationality Engine is designed to squeeze out the curator’s bias in the glare of public scrutiny. This will be a good test of whether that is possible.

So let’s agree that in this case the curator (me) is super-biased. If the Rationality Engine still works, we learned something useful. If my super-bias ruins the debate, we learned something else. So let’s learn something.

Background: California is considering legislation similar to Oregon’s assisted dying law. I asked for a volunteer to “debate” (but really just explain) opposition to the law because I have never met anyone who opposed it. Organizations such as the AMA, the Catholic Church, and disabled rights groups oppose assisted dying. But organizations have motives slightly different from individuals. For example, an individual would be happy for an organization to disappear when its mission is accomplished. But organizations tend to develop a life of their own as soon as money starts changing hands. So an organization can never win and can never admit losing because both situations mean an end to the organization and the paychecks of people who support it. For an organization, the fight is more important than the outcome. Individuals prefer a good outcome over a perpetual fight.

Jimmy Akin, a prominent and outspoken Catholic, (see his website) volunteered for this discussion and I accepted. 

To be clear, this does not test my “unicorn” hypothesis that there is no such thing as a normal, ordinary citizen of California who opposes the proposed law once it has been explained. Jimmy is professionally aligned with the Catholic church, so the Rationality Engine will have all sorts of bias as input (his and mine). But the Rationality Engine should still work if you readers keep us both in line.

I will start with a list of questions for Jimmy. Please add to the list if you see something missing. With Jimmy’s answers in hand, which will take some back-and-forth by email, I will put the debate into claim-verdict form for your review.

Here are the questions I propose for Jimmy so far.

Questions for Jimmy Akin

1. What standard would you use to deny me the right to a painless death at the time of my choosing?

[Note: From prior email exchanges I know that Jimmy’s answer is “the common good.”]

2. Explain what you mean by the “common good” in the case of assisted dying. And can you give an example from real life (as opposed to a thought experiment) where you see the common good standard applied to the satisfaction of society’s majority?

3. Explain how the common good is achieved by making my grandmother suffer, against her will, for an extra month before death. How did that make things better for others?

4. Oregon already has an assisted dying law. What problems have you seen with Oregon’s experience? 

[Note: I assume a California law would be essentially similar to Oregon, maybe with some upgrades.]

5. Do you think the folks in Oregon would agree with you that their law allowing assisted dying has not worked for their common good? If not, what can you point to as an example of why they don’t understand their situation?

6. Do you believe psychological anguish is “pain” in the context of end-of-life decisions about reducing pain? For example, if you are trapped in a broken body that will never improve, slowly going mad, strapped to a hospital bed, with no end in sight, do you consider this pain?

7. There is legitimate concern that some elderly and disabled folks will be pushed into making an assisted death decision by caretakers seeking their own convenience, or an inheritance. Given that concern, if the law said you could include in your Health Directive an absolute ban on assisted dying options, would that reduce your concerns?

For example, I would gladly accept the risk of my family encouraging me to die early because once my family wants me dead it is time to go anyway. You, on the other hand, could put in your Health Directive that no assisted dying option can be contemplated should you become mentally feeble. You would have nearly zero risk of an unwanted assisted death at that point.

[Note: My assumption is that even if the new law in California is silent about your Health Directive, the current law would let you ban assisted dying in that document.]

8. Do you believe physical pain can be nearly eliminated by drugs at the end of life, and that doing so is already the common practice? 

[Note: I will be providing my numerous first-hand observations that while it seems like such a thing is easily possible, it is almost never done unless you want the patient in a coma. In the real world, pain management at the end of life is a myth.]

9. In the United States alone, and in your lifetime, how many people do you think will be in terrible pain and wishing they had an assisted dying option? 

[Note: My estimate is 100 million people over my remaining lifetime.]

10. In the United States alone, and in your lifetime, how many people do you think would choose an assisted death only to learn their disease has a cure just around the corner? 

[Note: My estimate is 100 people.]

11. In the United States alone, and in your lifetime, how many disabled people do you think would be successfully persuaded to end their lives early for the sake of someone else’s convenience should assisted dying be the law everywhere? 

[Note: My estimate is nearly zero. Too many eyes watching. I would be interested in Oregon’s experience, if known.]

Personally, I prefer living in a world where the AMA, The Catholic Church, and disabled rights groups fight for the value of life. That creates a powerful counter-force against slipping toward a culture that is casual about life and death matters. That said, would you be comfortable with the law allowing assisted dying as an option while the major opposition groups hold to their legitimate concerns about the process? 

And let’s say the groups I mentioned encourage people to opt out of the assisted dying option in their Health Directives. One could further imagine the law in California requiring Health Directive instructions to include opposition opinions from the mentioned groups.

Would that scenario meet the common good standard, given that everyone gets heard, everyone gets the option they want, and the value of human life is always put center stage in the process?

12. Some have argued the slippery slope case. If you share that view, can you give examples in which the slippery slope actually happened for the worse? [Note: I will be arguing that the slippery slope argument is not credible in any debate.]

[Update: The following questions added from comments.]

13. How do you weigh the elements of “common good”? When something is good for one and bad for another, how do you compare?

14. What does “Do no harm” mean in an era when medical science can keep you alive and imprisoned in your own body indefinitely? Is that not harm?

15. If someone is brain-dead, would you keep them alive for the common good?

16. My personal observation, and that of others, is that pain management at the end of life is a myth unless you want the patient unconscious. Old people are not good at advocating for their own pain relief. Do you believe pain relief is achievable for all people in the real world?

17. Does the Catholic Church teach the sanctity of life or reverence for life? The latter would suggest that you could end your life in a dignified fashion. The former does not.

18. If people choose assisted death often enough, could it reduce the amount of efforts that go into curing those problems?

Okay, smart readers. Time for you to suggest questions to include. And if anyone feels inclined to collect a list of links (pro and con), that would be great for seeding the discussion.

Scott

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In other news, tiny bio-sensors smaller than your blood cells might be coming to a body near you. Cheap weather stations can be printed with 3D printers. And bring on the electric spaceship.

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Scott

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