Comment by torben-friis | Hacker News Reader

Comment by torben-friis | Hacker News Reader

Parent Full thread

> Even if we ignore the consequences, it's simply wrong for anyone to override a consenting adult's choices over their body.

It is a pretty evident fact that, in the modern world, a person can not possibly have enough knowledge, understanding, and available time to make enough informed choices for their own survival.

Quick! you're in a shop looking for shampoo and it contains ammonium lauryl sulfate. Is it a valid surfactant, or a ticket to an early grave? No idea? Tough luck buddy.

What I described above is not an absurd exaggeration, is the world we once lived in. See https://en.wikipedia.org/wiki/William_J._A._Bailey

Behind the tempting ideal of personal responsibility lies the flip side of leaving people unarmed and open to manipulation. Everything has tradeoffs, and our system might harm some people when access to reviewed products doesn't come soon enough for them. This damage is far counterweighted by not having your daughter's jaw fall off because she chose the wrong brand of lipstick.

That's frankly a ridiculous straw man. A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival. The difference is that when someone makes the wrong choice about their own survival, they die. When someone makes the wrong choice about other people's survival, other people die.

Nobody is arguing against listening to experts or using processes to make safety decisions. I'm just saying that you should not enforce your judgement on other people. I don't object to the state or anyone else making recommendations or to other people following them. Everyone is ultimately responsible for deciding whom to trust. If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same. The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct. Might dosen't make right when it comes to science or individual trade-offs.

If I'm in the shop buying shampoo, I can look for the name or logo of an organization that I trust to determine the safety of products. If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom?

[0]: https://www.cato.org/commentary/end-fda-drug-monopoly-let-pa...

>A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival.

Sure, but surely you'll agree that a body of experts trained and given full time dedication to make the choice will make better decisions than an average person encountering the problem without previous preparation.

> If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same.

That brings us back to the original situation, with extra steps. Being unable to make informed choices includes being unable to choose the right source of truth to delegate your choices to. People that can't tell the difference between psychology and psychoanalysis won't be qualified to choose between believing a psychologist or a psychoanalyst either.

> The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct.

The defining characteristic of the state in this situation is not its monopoly on violence, it's its nature of representing the collective will and interest of the people. A state agency that regulates products is not created to be profitable nor to have any interest other than the wellbeing of the people it represents.

> If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom?

It is not a matter of ideology. It is a matter of tradeoffs.

The situation you describe is not strictly impossible, but the number of times a person is able to correctly diagnose its own needs and how to solve them better than a whole professional system is a rounding error, compared to the amount of times people will be harmed by incorrectly believing they know better. Since no system can't solve both of those problems, you have to choose the lesser evil.

You choose to identify more with the person who correctly knows what he needs, rather than with the person that in desperation is fooled into believing an incorrect 'expert'. That's understandable, but its human bias, and you're statistically far, far, far more likely to be the second than the first.

Sure, a group of experts is generally more likely to make a good decision when an objectivity good decision can be made (which is often not the case because individual preferences vary). If however, that group is able to enforce its will by violence, it will probably make worse decisions because it has no incentives to make good decisions, and corruption can give it incentives to make bad ones.

The defining characteristic of the state in this situation is undoubtably it's capacity for violence. That is what creates the entire situation. If it were not for the state's superior capacity for violence, it would not be able to enforce its decisions by violence, and everyone would be free to decided whom to trust. To describe the state as "representing the collective will and interest of the people" is simply incorrect. Even if the state represented the will of the majority, it would be wrong to equate the majority of people who live in a particular place with all the people who live in that place. Just as might doesn't make right, neither does being more numerous. In reality, the state doesn't even represent the interest of the majority of people, but only a tiny fraction of people with sufficient wealth to lobby effectively.

Even if you had a hypothetical state that only existent to enforce the will of the many on the few, such a state would probably be wrong more often than an individual because while the wisdom of the crowd can work, it can be easily undermined under conditions I think would be inevitable in such a scenario[0]. A million people who can't tell the difference between psychology and psychoanalysis won't be able to choose between electing a psychologist or a psychoanalyst, any more than they can choose between believing a psychologist or a psychoanalyst. The only difference is that under the majoritarian model, everyone is forced to accept the choice of the majority.

The situation I described happens all the time. It's the rule, not an exception. The link I posted includes several examples. The FDA has become a little better in the last few years, but it continues to kill people by refusing to allow them access to drugs and medical devices. Here is a more recent article specifically about the delay in approving the covid vaccines: https://www.theatlantic.com/ideas/archive/2021/08/fda-delays...

This is not primarily about people who diagnose themselves, although they should have the right to do that as well. It's about people who are diagnosed by a doctor who knows how to help them, but would go to prison if they tried. Often the drug has been used in other countries for years, and the company has simply not paid the FDAs exorbitant licence fees. One example from the link I posted in an earlier comment:

> Pharmacologist William Wardell concluded that the five year delay in allowing the hypnotic Nitrazepam to be used in America (after Britain’s approval) cost 3,700 lives. He believed that the FDA also cost thousands of lives by preventing the sale of the first beta‐ blocker Propranolol for three years after it was available in Europe, and another seven years before it could be used for its most useful purposes. Sam Kazman of the Competitive Enterprise Institute (CEI) figured the annual beta‐ blocker toll at 17,000. Overall, he wrote, “as many as 100,000 people may have died waiting for FDA to act.”

[0]: https://www.pnas.org/doi/pdf/10.1073/pnas.1008636108

Reply on news.ycombinator.com