Comment by lopmotr | Hacker News Reader

Comment by lopmotr | Hacker News Reader

I have a pet theory that saving children from natural deaths is harmful to future generations. Surely by intervening so much, we're giving unhealthy people as much evolutionary advantage as healthy people. If the whole world reaches western standards of infant mortality and stays there long enough, will children eventually become dependent on even more interventions and be even more vulnerable to death without them? It might take a lot of generations, but aren't we supposed to value future humans higher than present ones because there will be more of them?

I would have died in childhood without modern medicine, and have a lifelong illness as a consequence of surviving. I may pass that on to my own children. That's a problem that never happened in all human history before about a 100 years ago when useful medicine started to exist, so maybe its effects will be disastrous for the human race. On the other hand, perhaps it's OK if we evolve more dependency on technology. We already need clothes, cooking, and shelter which helps us have advantages and flexibility that animals don't have.

> I may pass that on to my own children

A more palatable approach would be to treat you but not allow you to have children with the same condition. In the past this has been done in fairly barbaric ways but embryo selection offers a far more reasonable solution with minimal limitations on individual rights.

As for whether we should treat children and condemn them to a life of suffering, we already do this calculus with the elderly. Whether or not to perform a procedure depends on the chances of success and the number of quality years they can expect to have afterwards, procedures that will extend life by a year and result in a bedridden patient are routinely skipped, it's only applying the same to children that makes us squeamish.

My friends an ambulance driver and recently had to transport a blind, deaf and mentally retarded baby with a chronic heart condition. The question all the doctors and nurses in the hospital had to ask that night is whether they should treat the child if their heart fails. For me at least the answer is an obvious no in that case.

That's a slippery slope. Who gets to decide who lives and who dies? Who should we abort or sterilize? We all suffer to some degree, then we all die. It's the human condition.

At one point you could ask what the difference is between not treating a condition and euthanasia.

Ultimately the parents should get to decide, but we should make all means necessary available to them to give them the option so select, or engineer, a healthy embryo.

Yes, but it's an unavoidable slippery slope forced on us by nature, that we can affect with technology and that won't be going away until we can eliminate death and suffering. It's not a new slippery slope, doctors/parents/bureaucrats have to make decisions like this every day already and have for most of human history.

It's where we draw the lines on this slippery slope that constantly evolve.

> Who gets to decide who lives and who dies?

Doctors do all the time, they even have their own word for it: triage. When resources are insufficient to cover the needs of everybody, difficult decisions need to be made. Or as the case may be, easy decisions...

Is a decission reserved to parents, in this case. Triage is a term that aim to save the maximum number of people in disasters with many victims. Not to decide if somebody dies or lives.

People is classified in colors black, red, etc after its state. If you are in an accident and you cry and shout repeatedly you are classified in a lower priority than the quiet person that do not moves.

Between population growth not slowing anywhere near fast enough and rapid environment loss due to climate change, there is a good chance we'll see the mother of all triages. Not something to look forward to.

Yup, "lets kill the poor and all our problems will be solved" is a trendy old idea, trendy and deeply wrong also.

I thought this discussion was about prioritizing care to children that have a chance at a normal life (e.g. are not "a blind, deaf and mentally retarded baby with a chronic heart condition"), not killing the poor. My bad.

Well not just children. E.g. the proportion of women needing c-sections is increasing.

I don't think dependence on technology would improve human life in the long run, since the genetic maladaptation load would eventually overwhelm the ability of technology to keep up and we'd be back to where we started. But the key is that we're getting the ability to engage in genetic engineering, so realistically we should be applying technology to treat diseases to the best of our ability while we stall for time to get genetic engineering online so we can permanently stave off inherited diseases.

Isn't C-section for some people like a luxury to keep the body nice or something like that? Genuine question because I heard (yes, hearsay) that C-sections are for people in the USA like fashion? The again, I can't imagine any doctor, in my country at least, doing a C-section unless it is absolutely necessary.

> Isn't C-section for some people like a luxury to keep the body nice or something like that?

No, C-sections are (in normal conditions) more damaging to the body.

> Genuine question because I heard (yes, hearsay) that C-sections are for people in the USA like fashion?

I think the main non-medical reason for C-section preference is control of birth timing, but while it's definitely a thing, I don't know how common it is. Elective C-sections are more common in the US than most other countries, but usually that is based on medical indications prior to labor. I think I've heard that US practice tends to be more likely, all things considered, to view C-section as medically appropriate.

> The again, I can't imagine any doctor, in my country at least, doing a C-section unless it is absolutely necessary.

If it is only probably necessary, it may make sense to do an elective C-section rather than wait for the crisis where the mother and child are both in distress to switch to an emergency C-section.

This is a lie you have been told to prevent women getting medically necessary surgery. Probably told by the same people who tell lies about the abortion process.

There are lots of situations in which normal birth is unsafe for the baby - breech birth, cord strangulation, etc. There are also lots of situations where it is unsafe for the mother. It leaves a visible scar and requires a long recovery period.

Yes and no. C-sections are often medically necessary to ensure the health of the mother and baby. At the same time, elective C-sections are quite common as well, either for pain/recovery reasons or to lockdown the timing of the delivery.

OP's position is a bit extreme, but I wanted to share this as it's somehow related: forced sterilization under Japanese Eugenic Protection Law.

About 16,500 people, mostly women with disabilities, were targeted between 1948 and 1996 under a Japanese law that aimed to stop the birth of children described as “inferior”.

https://www.theguardian.com/world/2019/mar/18/victims-of-for...

Didn't UK and US have similar policies?

Humans are merely robots executing optimization process that benefits their genes chances of reproduction (and not for any explicit benefit to individuals themselves), but there is no reason we should go along with it. We have the tools to eventually break free.

If we ever lose access to technology, we'll die back to stone age anyway and only strongest and most ruthless will survive. What's a few more deaths because of genetic maladaptations as long as there is enough genetic diversity so some can survive and reproduce?

Genetic diversity is a main factor for survival of any species, as long as your children are functional to reproduce is fine.

Is unhealthy to have blue eyes, 100% round erythrocites and white skin in Africa. You have a much higher risk of develop skin cancer or Malaria. Is also unhealthy to have black eyes, curly hair and black skin in Norway. You lose more heat and have problems with vitamin D absortion... but both traits suppose an advantage in different areas.

Most mutations are entirely harmful. Those are included in the ones that we're promoting by saving young children. We've evolved to this point without saving children from them. So have all species. Surely the continual re-guiding of the evolutionary path is important to prevent a species from degenerating into something that's worse in every way? If we were to remove all selection pressures, the species would surely lose all kinds of qualities we like - not just less able to stay alive but less intelligent, more often deformed in painful ways, less tolerant to various foods, shorter life, less fertile, etc. I think some ever-present evolutionary pressure is needed to fight off entropy.

You're talking about specialization, which is quite different from random damage. Accordingly, we should keep the races distinct if we want to preserve those qualities, in the same way ecologists try to prevent closely related species from interbreeding and diluting their advantages. Though perhaps it doesn't matter anymore with housing, clothing, medicine, sun screen, etc. that allow blacks to safely live in Norway/etc.

I wondered when we'd get someone saying "but do we even want to prevent the avoidable suffering and death of children?"

If you're offended by questions, that suggests you have faith but not confidence. Sometimes the answer isn't so great like "shouldn't we use the most powerful antibiotics available in every case to maximize each patient's chances?" or any other utility maximization, really. It can all have negative consequences.

I don’t think this is something to worry about provided general healthiness is still being positively selected for, and we have every reason to believe that it is.

What makes you think that our ability to save (disease venerable children) is itself not an evolutionary advantage?

And then we can follow from there, if we stop saving them we do not develop our evolutionary advantage further.

Reply on news.ycombinator.com