[pdonis]

> I would rearrange your brain if you had cancer and I was capable of removing it.

With my consent, or without it?

Does that make a difference to you? It does to me. If it does to you, we probably agree more than it seems like we do from this discussion.

But if consent doesn't matter to you, we have a fundamental disagreement that I don't think any amount of discussion will resolve.

[Layke1123]

Theoretically, if I could fix your brain without you even being aware of it so that you don't die from brain cancer, I would.

If I had to physically do it via surgery like our best attempts in science can do today, I would operate if you came to the hospital for the procedure.

When it comes to altering your brain so that you like vanilla instead of chocolate, I would not do that. Some things require consent absolutely. Some things do not, like resuscitating a person if you are an EMT and sworn to do no harm. Consent isn't the end all be all of the debate, not by a long shot.

For example, do you ask the murder to consent to going to jail or do you put the murderer in jail against their will?

[pdonis]

> Theoretically, if I could fix your brain without you even being aware of it so that you don't die from brain cancer, I would.

Am I not even aware of it because I'm unconscious and incapacitated, and you're asking the consent of someone else who is empowered (say by my medical power of attorney) to give consent on my behalf?

Or am I not even aware of it because you have a stealthy way of doing it that I can't perceive even though I'm conscious?

I suspect it's the latter, but I'd like you to confirm.

> If I had to physically do it via surgery like our best attempts in science can do today, I would operate if you came to the hospital for the procedure.

Is this because you think it's important that I consent to the procedure, or just because our limited technology of today won't let you do it in a way I can't perceive at all?

Again, I suspect it's the latter, but I'd like you to confirm.

> When it comes to altering your brain so that you like vanilla instead of chocolate, I would not do that. Some things require consent absolutely. Some things do not, like resuscitating a person if you are an EMT and sworn to do no harm.

Oh, so you do think consent is important in some cases? Then where do you draw the line? I get the EMT resuscitating a person, that's an easy case--but it's an easy case because there is a default presumption that if the person were able to consent to being resuscitated, they would. But you are also saying (I think--see above) that you would cure my brain cancer without my consent if you could. Where's the line between that and you not being willing to alter my brain so I like vanilla instead of chocolate?

> do you ask the murder to consent to going to jail or do you put the murderer in jail against their will?

The murderer has already harmed others. That's where I am drawing the line about when consent is no longer required to imprison them.

[Layke1123]

The later for both, yes, and the line is when you make a judgment for what is likely to happen as a result of current events. If you have the power to make a better outcome happen 90 percent of the time versus 80 percent of the time, you choose 90 percent even if you are wrong some of the time. No ones has perfect information, yet we still make decisions that alter things despite perfect information. We just do the best we can, and sometimes that means we get ot wrong but should be moving in the better direction whenever possible.

[pdonis]

> If you have the power to make a better outcome happen 90 percent of the time versus 80 percent of the time, you choose 90 percent even if you are wrong some of the time

I don't see how this leads to your having to get my consent to make me like vanilla instead of chocolate. If you believed making that change in me would "make a better outcome" with 90 percent probability, by your logic as stated above, you would be justified in doing it without my consent. But you said that case requires consent "absolutely". I don't see how your stated rule does that.

Perhaps I should describe my position on this in more detail. My reason why you should not change my brain without my consent, whether it's to cure my brain cancer or make me like vanilla instead of chocolate (actually in my case it would be the other way around), is that you are not the one who has to live with the consequences; I am. So I should be the one to make the choice whether or not to do it. The only exception, which I have already stated, is if someone has already done harm to others and we are imposing consequences as an alternative to whatever the natural consequences of what they did would be (for example, trying someone for murder and imprisoning them if convicted, instead of letting the victim's family and friends take private vengeance). I'll assume we are not talking about a case where that exception applies in the rest of this post.

(Technically, there is a second exception, cases like the EMT resuscitating a person, since the person is incapable of giving consent. But I've already addressed that: there is a default presumption that the person would consent to being resuscitated if they could. And note that in our current legal system, a person can override that presumption by, for example, having a do not resuscitate order on file with their doctor.)

In the brain cancer example, I suspect you are imagining a case where you have some treatment that can be done easily from a distance without my perceiving it and without any side effects--it just makes the cancer vanish and leaves everything else the same. I have commented elsewhere in this discussion that I don't think such a thing is a real possibility; there's no way you could ever know that there are no side effects with such certainty. (And if you don't, if you're only 90 percent sure that there will be no side effects, then my rule above applies and you should let me make the choice since I'm the one that will suffer the side effects.) But let's assume for the sake of argument that you are certain there will be no side effects; let's say you have a mountain of evidence from past usages of the treatment, easily available and easily understandable by anyone.

But if that's the case, you have no need to do the treatment without my consent; you could just, you know, get my consent. After all, the treatment is a slam dunk from what you're saying; you have this mountain of easily understandable evidence that says it works great and has no side effects. So why not just show me the evidence? After I've seen it I have no reason not to consent, so I'd just consent. And then you wouldn't even have to worry about making a judgment and possibly being wrong. You wouldn't be making the judgment at all; I would.

In other words, your rule, which appears to be something like "if you're at least 90 percent sure that it will lead to a better outcome, you can do things to other people without their consent", requires you to make a judgment whose consequences you won't have to live with, someone else will, and all history shows that that is a very bad idea. What gives you the right to judge on my behalf that, say, 90 percent odds of curing my brain cancer is good enough? That's a judgment for me to make, not you, because I'm the one who has to live with the results. And in the truly slam dunk cases where the results are certain to be good ones, getting consent is also a slam dunk, so "always get consent" still covers those cases.

In short, "always get consent" (in cases where the exception I gave above doesn't apply) is a simpler rule that leads to better results than yours--it does the same thing in the easy cases, and puts the judgment in the hard cases where it belongs, with the person who will have to suffer the consequences of the judgment.

[Layke1123]

"Always get consent" (except here, here, and here)

This if not a simpler rule than to act if the outcome is judged to improve the situation. My rule is that a 90 percent chance is better than an 80 percent chance. It has no exceptions, no caveats.

I could convince you 90 percent of the time to "consent" to brain cancer surgery. If I can fix your brain without you even being aware of the problem 95 percent of the time, I would choose the later not the former, even if you happened to be the 5 percent. It's the same reasoning why we REQUIRE vaccines even though a small percentage of people can die from the vaccine itself. There are no exceptions in my system, it's simply the laws of probability applied precisely rather than some semantic argument you twist and turn at every exception to every case.

[pdonis]

Sorry, we disagree. And I see no point in continuing to argue about it.