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I agree with your point. These are practical matters with practical consequences. However I do not believe you take your reasoning far enough.

It's worse than that. As you know, many times effects can be randomly distributed. So ingesting substance X may kill or maim 70% of the people, do nothing in 29% of the people, and cure incurable cancer in 1%. So who gets to decide whether granddad, who is dying of this cancer, gets to take the substance or not?

The problem the western democracies have been struggling with for decades is that at some point somebody has to say "no". No, I will not pay for the consequences of your choice to smoke every day. No, I will not provide a treatment that may only work in 1% of cases. Somebody has to be an adult. Instead we hold conflicting ideas: I want to make my own choices vs. I want to live in a world where I do not have to worry about anything. Unfortunately the universe does not feel obliged to play along.

From historic experience, I don't think criminalizing things we don't want to pay for as a society is workable. How about providing some kind of long-term healthcare insurance that would cover people in a vegetative state for many years? Or just making it all open and informing people as much as possible what's going on around them? Because there's also a perverse aspect of the relationship you describe: by giving healthcare providers sole discretion over these things, we're also putting them in a position to define deviancy down.

I fear the real problem isn't making yourself into an addict for the rest of your life -- it's that the rest of us want a more homogeneous society in which fewer and fewer outliers are tolerated. That worries me from a statistical and evolutionary standpoint. We need our Edgar Allan Poes, our General Grants, our Gonzo Journalism. Yes, 99.9% of junkies are basically walking dead people. Then you run into a Freud. We can't sacrifice the Freuds in our empathy towards the others who are suffering.

Would I sacrifice 10% of the population on an ongoing basis to keep that kind of chaotic, creative, evolutionary potential? I don't there's even a question about it. It's an existential question, not a moral or philosophical one. This has been the natural state of our species for eons, and it's what brought us out of the savannah. The real question is why we would want to deviate from it.

I don't want to live in a totally-controlled world where I am unable to make capricious decisions affecting the rest of my life -- and I hold that opinion for purely pragmatic reasons. It does not sound like any kind of future state for mankind that we ever imagined (aside from dystopian fiction) It also does not sound like the species has much of a future if it keeps heading this way.

Freedom and natural variation sucks. Let's have more of it.




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