> He’s a bigoted right-wing conservative who doesn’t want to hear about interesting scientific developments that he views as benefiting people with lifestyles that he condemns.
Perhaps not here, but I think this is a view worth discussing. I'm moderately conservative, and some of that comment's criticism resonates with my own thoughts.
With cases like HIV/AIDS, I find myself pulled between several competing virtues:
One one side there's mercy and compassion; I'd like to minimize the suffering of hurting people. Even if someone is in dire straights because of actions that I view as unwise (extramarital sex, recreational drug use, etc.), I still want to want what's best for that person.
On the other side, there's justice. I live in a society where everyone pays, to some degree, for individuals' unwise behavior. E.g., Medicare/Medicaid for smokers' lung cancer or HIV treatment for persons who chose to indulge in risky behavior. I'm not okay with forcing the community at large to cover the costs of (what I view as) individuals' selfish actions.
I don't know what the right balance to this is. More generally, I'm not sure if there are any good principles for finding the right tradeoff between two virtues. I wish I knew. I want to do good, but the path is often obscure.
You can flip peoples' tribal affiliations on this topic by changing the disease to COVID. Do red-state antimaskers deserve treatment? Should responsible Americans pay for their reckless lifestyle?
> You can flip peoples' tribal affiliations on this topic by changing the disease to COVID. Do red-state antimaskers deserve treatment? Should responsible Americans pay for their reckless lifestyle?
Personally, I'm not sure. As I said above, I'm conflicted on the issue.
Regarding anti-maskers, I think it depends on the particular reason a person is anti-mask.
I'm working on the assumption that a lifelong smoker or someone who intentionally eschews safe-sex practices is generally aware of the risk they're courting. In my mind, this is "privatization of reward, socialization of risk" is similar to what we on HN often complain about regarding corporate bailouts.
In contrast, I could believe that at least some anti-maskers are genuinely misinformed about the risk posted by their behavior. I have less trouble feeling empathy for someone who's working from wrong beliefs, than someone who's knowingly being selfish.
You must be thinking about this in a weird way if you describe as selfish those people who have unsafe sex and contract HIV and who were fully aware of the risk. What do you think that they hoped to gain by becoming HIV positive? And if they thought it was an acceptable trade-in for some momentary pleasure, can they really have been fully informed in the first place? It seems that what you’re saying here is rooted in some kind of stereotype of crazy hedonism, rather than a more realistic understanding of the psychology of unsafe sex.
Believe me, there are idiots in all walks of life. There are plenty of people who are simply too dumb to practice safe sex, just as there are plenty of people too dumb to take trivial precautions against spreading COVID. I don’t think you’ll have much luck trying to formulate a coherent reason to regard the two groups in a fundamentally different light. Conservatives just have a bee in their collective bonnet about sex as compared to other comparably risky activities.
For some reason, any time there is any good news relating to HIV on HN, we have to have a thread where we seriously moot the question of whether HIV positive people deserve to die (or to put it in your bloodless terms, whether mercy is outweighed by justice). Have you considered just giving this a rest? Everyone already knows that many religious conservatives are in favor of denying treatment to HIV positive people belonging to social groups that they don’t like.
> Everyone already knows that many religious conservatives are in favor of denying treatment to HIV positive people belonging to social groups that they don’t like.
I'm sure there's malice, but I also get it. It's like --
Sometimes idiot hikers will set out into a wilderness with absolutely zero preparation, end up stranded in a life-threatening situation, and need to be helicoptered out of their plight for something like a million dollars of somebody else's money -- let's say the Park Service's.
No, I don't think they should be left to freeze to death, but if I'm funding the Park Service I have a right to be annoyed with them, especially if this isn't a one-off thing, but rather something that keeps happening.
In a world where antivirals cost a bajillion dollars, HIV can seem similar. "Get out of my risk pool."
But even from that perspective, this HIV vaccine is great. Give people the vaccine and now you aren't stuck paying for a lifelong prescription for Truvada or whatever else. Again, win-win.
Personally, when these vaccines get the kinks worked out, I will absolutely get them, even though I have zero intention of being at or of putting anyone at risk.
> It seems that what you’re saying here is rooted in some kind of stereotype of crazy hedonism, rather than a more realistic understanding of the psychology of unsafe sex.
If you delve into what has been written by radicals, you find all kinds of crazy shit, including the belief that STDs should be celebrated as a badge of courage. People as now-mainstream as Focault knowingly had unprotected sex, while HIV-positive, with anonymous men, wrapped it up (heh) in philosophical language, and sold it on to credulous academics. And there are other, slightly more fringe, characters whose names I forget; one guy I remember arguing that it was his political duty to "pos" people. To my ears this is batshit insanity and barely-disguised evil. Yet, though I know this thinking is not actually representative, it is often enough loudly defended (by trollish morons with no intention of living those values) for no reason other than that it's from "one of us". Conservatives are clearly reacting to that, in the age-old tradition of seeking out the worst crazy "the left" can provide.
> No, I don't think they should be left to freeze to death
Of course you don’t. But the OP would see this as a tricky ethical dilemma about balancing ‘mercy’ and ‘justice’. Or at least they should, if they’re not just selectively targeting groups of people that they don’t like.
> If you delve into what has been written by radicals, you find all kinds of crazy shit
You could say this about any group of people. No-one on this thread has defended any of these ‘radical’ ideas, and people have unprotected sex because they’re horny, not because Focault (who 99% of them have never heard of) told them to. So why are you even bringing any of this stuff up? It’s just muddying the waters.
> Yet, though I know this thinking is not actually representative, it is often enough loudly defended
No, deliberately giving people STDs is not an action that’s often loudly defended.
> No, deliberately giving people STDs is not an action that’s often loudly defended.
The action is not loudly defended, but the philosophy is. It's like when people from another part of the political landscape recommend "Industrial Society and its Future" but demur about the letter bombs.
> So why are you even bringing any of this stuff up? It’s just muddying the waters.
I was trying to explain the reaction. But, yeah, it's a waste of time. So here I stop.
There's an easy way to resolve that conflict that ought to appeal to religious conservatives: charity. If you donate to charities that help pay for people's HIV treatment, then no-one is being forced to pay and yet no-one is suffering unnecessarily either.
Oddly enough, despite being so deeply concerned with mercy and justice, religious conservatives do not appear to be among the leading donors to HIV-related charities.
That said, I don't see any kind of ethical dilemma here at all. It would clearly be a moral obscenity to systematically allow people to die of treatable diseases because they can't afford treatment. And if it's a question of 'blame' or 'risky behavior', then we should be refusing treatment to anyone who's ever eaten a donut.
> If you donate to charities that help pay for people's HIV treatment, then no-one is being forced to pay
If I feel you brought something on yourself why would I help you and not an innocent victim? And how would charity help resolve the issue of you dumping the cost on others, it would just be me instead of all of us, but still subsidizing.
> It would clearly be a moral obscenity to systematically allow people to die of treatable diseases because they can't afford treatment.
No, only if that money couldn't do greater good elsewhere.
> And if it's a question of 'blame' or 'risky behavior', then we should be refusing treatment to anyone who's ever eaten a donut.
In some proportion to the number of donuts, yes. Of course. Or at least they should go to the back of the line after we've helped people who didn't self-inflict.
I’m trying to look at this form the perspective of a religious conservative (presumably Christian, though I don’t know). “Only help others if you think they deserve it” is rather obviously not a precept that’s the basis of Christian charity. That is in fact why the OP says (quite despicably, in my view) that there is a conflict between justice and mercy in this case.
> how would charity help resolve the issue of you dumping the cost on others
OP objected to others being forced to pay. Charity is voluntary.
> Or at least they should go to the back of the line
What would this even mean in the case of the US. About 35% of adults are obese, and in almost all instances that’s due to their behavioral choices. Do we send a third of the population “to the back of the line”, or refuse to pay for their medical treatment?
I made my original post as an invitation to discuss my current views (which I admitted weren't settled). I was hoping to find any faults in my views' logic so I could replace them with something more logically consistent and, hopefully, loving.
The fact that you call my initial exposition "despicable" reminds me that HN isn't a good forum for this kind of discussion.
I regret posting a comment that elicited this kind of discussion.
Do you know of any first world countries where people are denied treatment for HIV depending on some assessment of whether or not it’s their fault that they’ve contracted it? E.g. we’ll pay for treatment if you get it from a blood transfusion but not if you get it sexually.
The proposal that you’re hinting at is very far outside the mainstream. I don’t think you’re likely to find any forum (that you’d want to be a part of) where it doesn’t elicit a strong negative reaction.
HN is probably one of few places that tolerates this kind of extremism enough to at least engage with your argument (such as it is) rather than just telling you to get stuffed.
> “Only help others if you think they deserve it” is rather obviously not a precept that’s the basis of Christian charity.
No, only help people if they didn't bring it on themselves and would probably be able to receive the help. There's no sense wasting a bunch of help on a junkie who won't use it, but once he's off the smack and willing to receive help then maybe. But only if a needy mother's kids don't need it more.
> Charity is voluntary.
Right, but you present it as an obligation. These people aren't being funded so you could just do it yourselves.
> About 35% of adults are obese, and in almost all instances that’s due to their behavioral choices. Do we send a third of the population “to the back of the line”, or refuse to pay for their medical treatment?
Oh boy, you're gonna hate this. Yes. And we already do. Try asking for an organ while you're a smoker. They give that sucker to someone who can use it and will take care of it.
What misguided sense of honor could force you to dispense treatment in the order people arrived in versus their need/ability to receive?
>No, only help people if they didn't bring it on themselves and would probably be able to receive the help.
You're suggesting that this is what Christianity has to say on the subject of charity?
>Right, but you present [charity] as an obligation.
No, I didn't. I pointed out that voluntary charitable contributions would be a good way to resolve the tension that the OP feels between 'justice' and 'mercy'.
>Oh boy, you're gonna hate this. Yes. And we already do.
In the case of organs there's an inherently limited supply, since people have to donate voluntarily and all sorts of other conditions have to be met. It's not as if we're throwing away livers rather than give them to alcoholics.
I'm sure you must be aware that we do treat all kinds of obesity-related conditions – and at great expense. In the case of HIV treatment, it's largely just a question of paying for drugs which can easily be manufactured in the required quantity.
But I guess at this point I'm wondering what your actual position is. Are you in favor of conditionally refusing treatment to HIV patients depending on the manner in which they contracted the virus? If so, why not just come out and say it? And if not, what exactly are you getting at?
> In the case of organs there's an inherently limited supply, since people have to donate voluntarily and all sorts of other conditions have to be met.
Yes, and charity spending on one person necessarily takes away from spending on another too. To support someone whose choice of behavior impacted them means you can't support someone who was injured entirely through 'acts of god'.
> It's not as if we're throwing away livers rather than give them to alcoholics.
No, but but they do go to the back of the line. Especially if they still drink.
> I'm sure you must be aware that we do treat all kinds of obesity-related conditions – and at great expense.
Sure. But thankfully we prioritize them to below children with heart defects, and non-obese adults with the same conditions.
> Are you in favor of conditionally refusing treatment to HIV patients depending on the manner in which they contracted the virus?
No more than I am for prioritizing treatment downward for everyone whose injuries were self-inflicted. That's only fair for the people whose were not.
I don't think you've really answered the last question. At the moment, in the US, how you contracted HIV makes no difference to your access to treatment. Do you think this should change or not?
As to the rest, you're obviously aware that in general, obese adults are not deprioritized for treatment as compared to non-obese adults.
> I don't think you've really answered the last question
That's pretty much a textbook example of sealioning. Why are you so anxious?
> HIV
Are they asking for charity? If not then their circumstances shouldn't be relevant, just their ability to pay.
> you're obviously aware that in general, obese adults are not deprioritized for treatment as compared to non-obese adults.
They are. If you're up for a contested treatment (a rare organ, a diagnostic machine that's always in use) you're given a score that represents your health and ability to benefit. Obesity isn't a total black mark but it absolutely is considered. However, we don't consider why you're fat, fat is just a health risk and we recognize that and don't waste effort where it won't be rewarded.
It seems you agree, then, that there is no ethical dilemma in insurers paying for HIV treatment regardless of whether the patient acted irresponsibly. But it would be easier to understand your answer if you’d just say whether or not you think that access to HIV treatment in the US should be more restrictive than it is at present.
We already covered the special case of contested treatments. It’s obviously irrelevant here as we are just talking about access to drugs for HIV patients, not access to an inherently limited resource. Either you pay for Truvda or you don’t. There’s no queue.
Similarly, if you are obese, no generally available treatment that could be of medical benefit to you will be denied merely because it’s expensive and you’re obese.
> Similarly, if you are obese, no generally available treatment that could be of medical benefit to you will be denied merely because it’s expensive and you’re obese.
Nope. There's a limit to everyone's insurance, beyond which they will not pay for more treatment. You won't get told that you're too fat but your treatments will cost more and consequently you'll get less of them. Your insurance contract is for a sum of money, not a specific set of life-saving actions.
But generally that limit is much higher than what you've paid so your expensive treatments take money from the pool.
> there is no ethical dilemma in insurers paying for HIV treatment regardless of whether the patient acted irresponsibly.
As long as their fees cover the payments. But if they're costing more than they're paying as a class, meaning that all other users are compensating them, then yes - dilemma.
> It’s obviously irrelevant here as we are just talking about access to drugs for HIV patients, not access to an inherently limited resource. Either you pay for Truvda or you don’t. There’s no queue.
Paying out of your own pocket, 100% fine regardless.
Just in case it adds clarification. I think the downvotes are due to equating HIV to justice. Smoking once it is well understood I guess kinda is, but HIV is really just a matter of luck like all infectious diseases. You can reduce your risk (eg masks for stopping flu or COVID), but to call it “justice” feels very callous to me.
Thanks for that. It sounds like I did a terrible job of expressing my thoughts.
Perhaps one of my mistakes was using HIV as an example. If someone only skimmed my post, they may have pattern-matched on the whole "AIDS is punishment from God" trope, which is 100% not what I was trying to say.
"religious conservatives do not appear to be among the leading donors to HIV-related charities."
Cite your sources please, because I've seen the opposite in my (limited) charity dealings.
Wow, this is the worst misinterpretation of conservatism I've seen... (let's say 'today')
Sex isn't wrong. It just so happens that it can lead to HIV infection. If you wish people get infected, you've created a moral loop that just punishes people because you enjoy watching people suffer. Congratulations, maybe you do have a handle of conservatism-as-practiced, after all.
It'd make just as much sense to threaten to kill anyone found in public without a blue towel: you'd get the satisfaction of righteousness indignation and the honour of killing lots of people for completely arbitrary reasons.
> He’s a bigoted right-wing conservative who doesn’t want to hear about interesting scientific developments that he views as benefiting people with lifestyles that he condemns.
Perhaps not here, but I think this is a view worth discussing. I'm moderately conservative, and some of that comment's criticism resonates with my own thoughts.
With cases like HIV/AIDS, I find myself pulled between several competing virtues:
One one side there's mercy and compassion; I'd like to minimize the suffering of hurting people. Even if someone is in dire straights because of actions that I view as unwise (extramarital sex, recreational drug use, etc.), I still want to want what's best for that person.
On the other side, there's justice. I live in a society where everyone pays, to some degree, for individuals' unwise behavior. E.g., Medicare/Medicaid for smokers' lung cancer or HIV treatment for persons who chose to indulge in risky behavior. I'm not okay with forcing the community at large to cover the costs of (what I view as) individuals' selfish actions.
I don't know what the right balance to this is. More generally, I'm not sure if there are any good principles for finding the right tradeoff between two virtues. I wish I knew. I want to do good, but the path is often obscure.