Bodily integrity vs moral responsibility

[C C]

Slightly different question. Is it reasonable to have ANY prerequisites for such procedures (even as little as a three-day waiting period to contemplate their decision)?

A minimal ethical canon (call it "Abel-ism") that stresses "Not being the keeper of others" and also somehow manages to escape amoral classification, could at least dismiss prerequisites. But if the physicians are still holding onto their oaths, then...

Does bodily autonomy alone completely absolve the surgeon from moral responsibility? It certainly doesn't in law, but I'm asking about the ethics here. [...]

Personal autonomy indeed could not dictate everything in the empirical world, even if it's heavily acknowledged in the decision / planning process. But if all is constricted to the idealized / formal world of ethics.... It's difficult to say since there's essentially multiple views competing there. The contingent and practical moral schemes (which are receptive to local situations, particular events, consequences, etc) might be culled-out by insisting that they must be properly general or universal in order to qualify for and inhabit that abstract landscape. Such would arguably banish body autonomy just via its focus on the discrete individual, though defenders might still contend that its centerpiece "body" is a generic placeholder that a real, particular person is merely plugged into.

[...] Or is wanting to hold the surgeon accountable, to any extent, just a way to allow the person seeking the procedure to have a scape goat for a poor outcome (and a way to absolve them of the consequences of their own choices)?

In the real world both the opportunity for a lawsuit (patient POV) and the fear of litigation (medical staff POV), and having a preparatory accountability in place that satisfies insurance companies and risk management... Would be among the contributors in kick-starting morality at the idealized / formal level into play for whatever involvement it has in crafting prerequisites.

Unlike backstreet surgery in the days when abortion was illegal and where the off-duty practices of a mob doctor go undocumented, "respectable" agencies have to contend with the scrutiny of the public eye and its arena. Which is not to say that a good old country doctor back in the day wouldn't have set special rules for the welfare of special patients without needing a kick-start. But the interacting, complicated systems of today will coerce physicians, medical workers and formulators of requirements to address that territory, regardless.

[Syne]

Personal autonomy indeed could not dictate everything in the empirical world, even if it's heavily acknowledged in the decision / planning process. But if all is constricted to the idealized / formal world of ethics.... It's difficult to say since there's essentially multiple views competing there. The contingent and practical moral schemes (which are receptive to local situations, particular events, consequences, etc) might be culled-out by insisting that they must be properly general or universal in order to qualify for and inhabit that abstract landscape. Such would arguably banish body autonomy just via its focus on the discrete individual, though defenders might still contend that its centerpiece "body" is a generic placeholder that a real, particular person is merely plugged into.

In general, personal and bodily autonomy are considered ethical rights. The surgeon shares these rights, and is free to exercise his autonomy to accept or deny any patient. But the surgeon is not trained in mental health evaluation, so he is ill-prepared to ensure his acceptance of a patient abides by informed consent of a mentally competent person. If the person is incompetent, then it does fall on the competent surgeon to restrict access, as an elective operation on the mentally incompetent would be unethical. But if the person is competent, the responsibility is wholly their own. Ethically, the surgeon does have a right to ensure his own ethically behavior, by any reasonable means.

And if the surgeon feels he must consult a therapist, the therapist too has a right to ensure his own ethical decision. So ultimately, is there a way to involve more people than the individual without restricting the individual's freedom by the ethical obligations of the others involved? I would say no, and that any laxity of the prerequisites would indicate a laxity of some professional's own ethics.

[Secular Sanity]

Slightly different question.

Is it reasonable to have ANY prerequisites for such procedures (even as little as a three-day waiting period to contemplate their decision)? 

I never disagreed with certain prerequisites or guidelines as long as they’re flexible.  A diagnosis and a preoperative evaluation doesn’t seem unreasonable, but living a "true life" for a minimum of one year does.  What if you wanted breast implants and were required to live a "true life" for a year?  

I'm much more interested in an objective view of the ethics than I am subjective, anecdotal opinion from those most biased. Where does our obligation, as society, end and the individual's autonomy begin?

But here's the reason I'm asking. If society has any ethically justifiable obligation to restrict, or place prerequisites on, irreversible body alterations of healthy tissue, shouldn't those ethics apply universally?

Whenever there's a conflict of moral duties, e.g., lying, murder, civilian casualties, etc., most deontologists will immediately turn to consequentialism, i.e., lesser of two evils.  As you have, most of them condemn subjective feelings, and all forms of subjectivism, or moral relativism.

I think you’d be hard pressed to find an atheist that would agree with duty-based ethics and absolutes.  It’s a mistake to think that a set of absolute standards can be applied universally and withstand the test time.  

Right or wrong; our emotions determine both.  Joseph Fletcher said that love and justice are one in the same.  Justice is love distributed, nothing else.  

Any meaning or value is external.  Our lives would be void of values without emotions.  Our feelings inform us on what supports our survival or detracts from it.  Jaak Panksepp said that the physiology of motherhood is the physiology of love.

As Ernest Becker asked in regards to sacred values, "what is the best illusion under which to live?  Or, what is the most legitimate foolishness?  He thought that the whole question would be answered in terms of how much freedom, dignity, and hope a given illusion provides."

If love is an illusion, it is, in my opinion, the best illusion, the most legitimate foolishness.  Love can spur individuals to spend themselves for our sake.  Love can transform self-interest into devotion.

Will you risk your life for me?  Will you die for me?  Will you live for me?


"Man does not now and will not ever live by the bread of scientific method alone."—Allen Wheelis

[Syne]

Slightly different question.

Is it reasonable to have ANY prerequisites for such procedures (even as little as a three-day waiting period to contemplate their decision)? 

I never disagreed with certain prerequisites or guidelines as long as they’re flexible.  A diagnosis and a preoperative evaluation doesn’t seem unreasonable, but living a "true life" for a minimum of one year does.  What if you wanted breast implants and were required to live a "true life" for a year?  

I'm much more interested in an objective view of the ethics than I am subjective, anecdotal opinion from those most biased. Where does our obligation, as society, end and the individual's autonomy begin?

But here's the reason I'm asking. If society has any ethically justifiable obligation to restrict, or place prerequisites on, irreversible body alterations of healthy tissue, shouldn't those ethics apply universally?

Whenever there's a conflict of moral duties, e.g., lying, murder, civilian casualties, etc., most deontologists will immediately turn to consequentialism, i.e., lesser of two evils.  As you have, most of them condemn subjective feelings, and all forms of subjectivism, or moral relativism.

I think you’d be hard pressed to find an atheist that would agree with duty-based ethics and absolutes.  It’s a mistake to think that a set of absolute standards can be applied universally and withstand the test time.  

Right or wrong; our emotions determine both.  Joseph Fletcher said that love and justice are one in the same.  Justice is love distributed, nothing else.  

Any meaning or value is external.  Our lives would be void of values without emotions.  Our feelings inform us on what supports our survival or detracts from it.  Jaak Panksepp said that the physiology of motherhood is the physiology of love.

As Ernest Becker asked in regards to sacred values, "what is the best illusion under which to live?  Or, what is the most legitimate foolishness?  He thought that the whole question would be answered in terms of how much freedom, dignity, and hope a given illusion provides."

If love is an illusion, it is, in my opinion, the best illusion, the most legitimate foolishness.  Love can spur individuals to spend themselves for our sake.  Love can transform self-interest into devotion.

Will you risk your life for me?  Will you die for me?  Will you live for me?


"Man does not now and will not ever live by the bread of scientific method alone."—Allen Wheelis

What? I thought you were done with this thread? So what does your minimum "diagnosis and a preoperative evaluation" entail?

Atheists? Why would there be a certain ethical view more common among atheists? Would it just be that atheism is a kind of rebellion, so obligatory ethics is eschewed? What is ethics if it doesn't address moral obligation? Doesn't that just become social contract? Again, I've already said absolutes are unachievable.

You're really quick with the quotes (I assume from someone you believe an authority), but you've yet to offer compelling argument, even just parroting others.

As a man, I will tend to risk my life to save a woman. It has nothing to do with emotion. It's a biological imperative justified by my earlier reasoning that the strong have a moral obligation to protect the weak.

The problem with choosing between illusions is that it relies on the validity of the assumption that those are the only options.

[Secular Sanity]

First, do you think that we could drop the personal attacks and just have a discussion?

I’ll answer your questions, if you’ll answer mine.

As a man, I will tend to risk my life to save a woman. It has nothing to do with emotion. It's a biological imperative justified by my earlier reasoning that the strong have a moral obligation to protect the weak.

Will you answer the second question?  Would you die for a woman that you didn’t know?  How about one that you were married to?  Many people risk their lives to save others, some have training, and many die in the process, but if you knew for certain that you’d die, would you?

Let’s say you had child and a man with a gun gave you a choice.  He’d kill your child or two children that you didn’t know?  What would you do?  If you saved your child, what if the numbers were to increase?  How many stranger’s children would have to die before you’d sacrifice your own?

Do you remember the man that left his girlfriend and his two children during the movie theater shooting?

How do you feel about what he did?

You know the so-called code of conduct, "women and children first"?  Guess where it first appeared.  In a true love story.

"So this notion of chivalry at sea is a myth?

Yes. It really is every man for himself."

https://www.newscientist.com/article/dn2...irst-myth/

[Syne]

First, do you think that we could drop the personal attacks and just have a discussion?

I’ll answer your questions, if you’ll answer mine.

As a man, I will tend to risk my life to save a woman. It has nothing to do with emotion. It's a biological imperative justified by my earlier reasoning that the strong have a moral obligation to protect the weak.

Will you answer the second question?  Would you die for a woman that you didn’t know?  How about one that you were married to?  Many people risk their lives to save others, some have training, and many die in the process, but if you knew for certain that you’d die, would you?

Let’s say you had child and a man with a gun gave you a choice.  He’d kill your child or two children that you didn’t know?  What would you do?  If you saved your child, what if the numbers were to increase?  How many stranger’s children would have to die before you’d sacrifice your own?

Do you remember the man that left his girlfriend and his two children during the movie theater shooting?

How do you feel about what he did?

You know the so-called code of conduct, "women and children first"?  Guess where it first appeared.  In a true love story.

"So this notion of chivalry at sea is a myth?

Yes. It really is every man for himself."

https://www.newscientist.com/article/dn2...irst-myth/

As long as you have the intellectual honesty to refrain from treating subjective emotion as a refute/dismissal of actual argument. And don't pretend you haven't played tit for tat.

"Risk my life" means the very real possibility of dying. But for a stranger, with the certainty of death, in most cases the threat to the woman would persist, so my death would not remedy the situation. So no, certain death requires more. The individual's life is worth more than a futile gesture. In an active shooter situation, I would certainly fight rather than run, because I would likely save lives (by giving them more time to flee) whether I died or not. Personally, I wouldn't be able to live with myself if I didn't do everything I could to protect my wife or children.

Hypotheticals are highly dependent on the details. Is the man present with me and my child? How will he kill these other children? Etc., etc.. In reality, most dilemmas have more than two possible solutions.

In the case of the Titanic, my certain death would certainly save at least one woman or child. The rationale is that, on the off chance someone not in the lifeboats can be saved, the average man can typically survive longer in the freezing water. No matter how slim, the potential for two survivors outweighs the certainty for only one.

Oh yeah: So what does your minimum "diagnosis and a preoperative evaluation" entail?

Atheists? Why would there be a certain ethical view more common among atheists? Would it just be that atheism is a kind of rebellion, so obligatory ethics is eschewed? What is ethics if it doesn't address moral obligation? Doesn't that just become social contract?

[Secular Sanity]

Oh yeah: So what does your minimum "diagnosis and a preoperative evaluation" entail?

The motivations of those seeking GRS would be self-servingly biased, to the exclusion of concern for the mentally ill.

A mentally ill patient would not be diagnosed with BIID or Gender Dysphoria . Vilayanur Ramachandran said that they show no signs of mental disturbance.  Their intelligence is normal, they’re emotionally intact, and they’re obviously not hysterical or mentally disturbed in any way.  Preoperative evaluations are self explanatory.

Atheists? Why would there be a certain ethical view more common among atheists? Would it just be that atheism is a kind of rebellion, so obligatory ethics is eschewed? What is ethics if it doesn't address moral obligation? Doesn't that just become social contract?

We don't believe in moral absolutes.  We’re animals.  "You’re nothing but a pack of neurons."  Even you said that it's your biological imperative, but for Kant, a will that operates through biology is not responding to reason.  Kant's claims of universal laws stem from his belief in only one true religion.  The religion of morality.  The recognition of all duties as divine commands.  God as an ideal of human reason.

I would die for my children, but not because it’s my duty.  Like you, I couldn’t live with myself.  Life would become unbearable.  Is this rational?  Probably not.  It’s how I feel because I’ve developed a strong attachment.  I love them.  I can't imagine life without them.

Kant encourages us to put aside our feelings, even those derived from empathy and love.  He claims that emotions are irrelevant.  That a sense of duty is the only appropriate motive.  

A mother does not collapse upon hearing of her child’s death because of her failure to carry out her moral obligation.  I do not help others because it’s my duty.  I help them because I have empathy.  I feel their pain.  Their pain causes me pain.  My emotions are my primary motive.

Duty, honor, respect, and glory are worthy of discussion.  Maybe we should start a new topic.

[Syne]

Oh yeah: So what does your minimum "diagnosis and a preoperative evaluation" entail?

The motivations of those seeking GRS would be self-servingly biased, to the exclusion of concern for the mentally ill.

A mentally ill patient would not be diagnosed with BIID or Gender Dysphoria . Vilayanur Ramachandran said that they show no signs of mental disturbance.  Their intelligence is normal, they’re emotionally intact, and they’re obviously not hysterical or mentally disturbed in any way.  Preoperative evaluations are self explanatory.

If you insist on citing an authority, you should at least cite a source for the specific assertion. What would a person considered psychologically unfit for GRS be diagnosed as?

So, this is enough?
"The purpose of a preoperative evaluation is not to “clear” patients for elective surgery, but rather to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery. Pre-operative outpatient medical evaluation can decrease the length of hospital stay as well as minimize postponed or cancelled surgeries.1 To effectively provide this consultative service, the physician should understand the risk associated with the particular type of surgery planned and relate this risk to the patient's underlying acute and chronic medical problems. The complete consultation should include recommendations for evaluation and treatment, including prophylactic therapies to minimize the perioperative risk." - http://www.aafp.org/afp/2000/0715/p387.html

Atheists? Why would there be a certain ethical view more common among atheists? Would it just be that atheism is a kind of rebellion, so obligatory ethics is eschewed? What is ethics if it doesn't address moral obligation? Doesn't that just become social contract?

We don't believe in moral absolutes.  We’re animals.  "You’re nothing but a pack of neurons."  Even you said that it's your biological imperative, but for Kant, a will that operates through biology is not responding to reason.  Kant's claims of universal laws stem from his belief in only one true religion.  The religion of morality.  The recognition of all duties as divine commands.  God as an ideal of human reason.

I would die for my children, but not because it’s my duty.  Like you, I couldn’t live with myself.  Life would become unbearable.  Is this rational?  Probably not.  It’s how I feel because I’ve developed a strong attachment.  I love them.  I can't imagine life without them.

Kant encourages us to put aside our feelings, even those derived from empathy and love.  He claims that emotions are irrelevant.  That a sense of duty is the only appropriate motive.  

A mother does not collapse upon hearing of her child’s death because of her failure to carry out her moral obligation.  I do not help others because it’s my duty.  I help them because I have empathy.  I feel their pain.  Their pain causes me pain.  My emotions are my primary motive.

Duty, honor, respect, and glory are worthy of discussion.  Maybe we should start a new topic.

Why this strawman that seems to assume I wholly agree with Kant?

Your emotions may very well be plenty justification for you, but we are discussing ethics. If that's just not a topic you're prepared to discuss, admit that to yourself and move on. Social evolution ties your emotions in different degrees to different groups; community, family, spouse, etc.. The morals derived from such emotions only serve to bind those groups. They have no rigorously reasoned justification beyond that, and no basis to evaluate their own ethical merit. Ethics is useful because it offers a means to evaluate right and wrong without these social/emotional biases.

[Secular Sanity]

If you insist on citing an authority, you should at least cite a source for the specific assertion. What would a person considered psychologically unfit for GRS be diagnosed as?

So, this is enough?
"The purpose of a preoperative evaluation is not to “clear” patients for elective surgery, but rather to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery. Pre-operative outpatient medical evaluation can decrease the length of hospital stay as well as minimize postponed or cancelled surgeries.1 To effectively provide this consultative service, the physician should understand the risk associated with the particular type of surgery planned and relate this risk to the patient's underlying acute and chronic medical problems. The complete consultation should include recommendations for evaluation and treatment, including prophylactic therapies to minimize the perioperative risk." - http://www.aafp.org/afp/2000/0715/p387.html

He said that in this video that I linked earlier.

Like you said, my personal, internal beliefs are irrelevant.  You’re asking for an objective view, not a subjective one.  If morals are internal and subjective, and ethics are external and objective, then a request for my personal opinion is utterly pointless.    

While a physician should always act in a patient’s best interest, improving self-image is socially acceptable.  They can decline, if they do not believe that a surgery is in the patient’s best interest.  However, they are not responsible for changes in social attitudes or the demands for their intervention.

Why this strawman that seems to assume I wholly agree with Kant?

Your emotions may very well be plenty justification for you, but we are discussing ethics. If that's just not a topic you're prepared to discuss, admit that to yourself and move on. Social evolution ties your emotions in different degrees to different groups; community, family, spouse, etc.. The morals derived from such emotions only serve to bind those groups. They have no rigorously reasoned justification beyond that, and no basis to evaluate their own ethical merit. Ethics is useful because it offers a means to evaluate right and wrong without these social/emotional biases.

You're views seem to align more with Kant's.

Ethics are moral assessments, right, Syne?

Hume argued that moral distinctions are not derived from reason. Moral distinctions are derived from the moral sentiments: feelings of approval (esteem, praise) and disapproval (blame) felt by spectators who contemplate a character trait or action.

Kant argued that emotions may influence out conduct but that true moral action is motivated only by reason when it’s free from emotions and desires.

Syne, what do you think the meaning of this quote is?

"Feelings are not supposed to be logical. Dangerous is the man who has rationalized his emotions." -David Borenstein

[Syne]

If you insist on citing an authority, you should at least cite a source for the specific assertion. What would a person considered psychologically unfit for GRS be diagnosed as?

So, this is enough?
"The purpose of a preoperative evaluation is not to “clear” patients for elective surgery, but rather to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery. Pre-operative outpatient medical evaluation can decrease the length of hospital stay as well as minimize postponed or cancelled surgeries.1 To effectively provide this consultative service, the physician should understand the risk associated with the particular type of surgery planned and relate this risk to the patient's underlying acute and chronic medical problems. The complete consultation should include recommendations for evaluation and treatment, including prophylactic therapies to minimize the perioperative risk." - http://www.aafp.org/afp/2000/0715/p387.html

He said that in this video that I linked earlier.

Like you said, my personal, internal beliefs are irrelevant.  You’re asking for an objective view, not a subjective one.  If morals are internal and subjective, and ethics are external and objective, then a request for my personal opinion is utterly pointless.    

While a physician should always act in a patient’s best interest, improving self-image is socially acceptable.  They can decline, if they do not believe that a surgery is in the patient’s best interest.  However, they are not responsible for changes in social attitudes or the demands for their intervention.

Who said anything about changing social attitudes? I'm only talking about protecting the mentally ill from irreversible consequences.
And I don't have the time to watch a 20min video. If you want me to take any reference seriously, don't link to a TV show (or at least give me time codes for pertinent arguments).

Why this strawman that seems to assume I wholly agree with Kant?

Your emotions may very well be plenty justification for you, but we are discussing ethics. If that's just not a topic you're prepared to discuss, admit that to yourself and move on. Social evolution ties your emotions in different degrees to different groups; community, family, spouse, etc.. The morals derived from such emotions only serve to bind those groups. They have no rigorously reasoned justification beyond that, and no basis to evaluate their own ethical merit. Ethics is useful because it offers a means to evaluate right and wrong without these social/emotional biases.

You're views seem to align more with Kant's.

Ethics are moral assessments, right, Syne?

Hume argued that moral distinctions are not derived from reason. Moral distinctions are derived from the moral sentiments: feelings of approval (esteem, praise) and disapproval (blame) felt by spectators who contemplate a character trait or action.

Kant argued that emotions may influence out conduct but that true moral action is motivated only by reason when it’s free from emotions and desires.

There are moral judgments and then there are ethical assessments (evaluations). Judgments, like those in law, really only rely on precedent. Your personal (and society's) history and experience are the major basis for moral judgments. Morals are not a mean to assess anything. OTOH, ethics are an reasoned evaluation which can be used to assess morals.

It is true that "moral" distinctions are not derived from reason. Approval/disapproval of the group is typically paramount. Kant's "true moral action" probably refers to morals that have been ethically validated by objective reason. Some morals will be ethical, almost by happenstance considering how much of the individual's reason survives to influence group conduct, but only ethical reasoning can objectively determine if they are.

Syne, what do you think the meaning of this quote is?

"Feelings are not supposed to be logical. Dangerous is the man who has rationalized his emotions." -David Borenstein

Morals, like mob mentality, can be almost anything, justified by whatever people agree to allow...for any motivation. Using reason to justify emotional choices is like a scientist twisting the facts to fit his preconceived outcome. You don't arrive at the truth.