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DavidOdden

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  1. Coercive School Photos

    You should carefully scrutinize your contract with the photographer, in particular the part where you promised to return photos that you didn’t want and pay for the one you did. Oh, wait, there was no such contract. In other words, they took pictures, gave them to your child, and hoped that by handing it to a minor, they could get a binding contract with an adult. It’s not clear to me exactly which part you’re objecting to (there is plenty to object to). Obviously the fact that the pictures were taken can’t be changed, nor can you change the fact that the school allowed / encouraged this activity. If this is a government school, there is no contract between you and the school so no implicit “you agreed”. It is marginally possible that a private school contract would have some clause about school photos and your obligations therein. So you have no legal obligation to return the pictures or to pay for them. Is there anything that you actually want from them? For example, do you want better photos? Do you not want to pay? I suggest that you write a simple letter to the photographer acknowledging receipt of the photos, reminding them that they did not have your permission to take the pictures, and pointing out that you did not agree to return the photos or to pay for them: handing them to a minor child is a risk that they have to assume. It may be worth saying what you do not like about the pictures, though be clear that you are not interested in a retake (if that is the case). You could also mention (if it is true) that you will be separately raising questions with the school board, regarding the legality of taking your child’s picture without permission. You might mention that your understanding is that when one takes a non-public picture of a person for profit, they are legally required to obtain consent from the subject (or the parent, in the case of a minor). This is known as the "right of publicity" or "personality right". Then I would express my objections to the school board, or the state board of education. There may be specific laws surrounding photographing a student on school property (I haven't looking into that for Utah). Bear in mind that you may have unwittingly signed a release form earlier in the year, so they may respond with a copy of a form that you signed that has "school pictures" included in it. Unfortunately, there is nothing effective and immediate that you can do about the juvenile culture that you find yourself embedded in. If schools (at the adult institutional level and at the juvenile student level) “want” everybody to participate, then everybody either participates, or faces social opprobrium for not complying.
  2. Given the principle that force may not be initiated to override the choices of another, even when those choices are irrational, then there is clearly no room to use force to prevent suicide, eating lamb or cow, being naked, or jumping off a cliff. There is room in an emergency to use force to defend yourself against the initiation of force, and there is room to seek protection via government force of your rights under the law, which includes your property right to control your property. Your right to be irrational is precisely and narrowly circumscribed: you may be irrational up to the point of violating my rights. I understand the problem that “I don’t like X” easily turns into a law “You may not X”. Within the past 50 years, the concept of individual rights and limited government have substantially eroded in the US. The solution to this problem is not to prohibit persuasion, it is to try to restore the concepts of limited government and individual rights. So if a half a million people want to forego the joy of a good lamb kebab, that is their right. It is likewise my right to try to persuade them to lighten up. Or, to put the matter the other way, it is also the right of the vegan down the road to try to persuade me that animals have the same rights as humans and we should only interact with them if they give informed consent. Even though ethical veganism (or vegetarianism) is irrational, that irrationality is their right. So let me recapitulate: Objectivism does not support using force to prevent irrational behavior.
  3. The reason why rationality is being thrust into the discussion is because this pertains to the fundamental identification of man’s nature made by Objectivism: it is man’s nature to survive by reason. That means, quite literally, that to survive qua man, you must act rationally. I’m afraid that your interpretation of Objectivism in in error. Rationality is more important than “selfishness”, because selfishness is in fact rational self-interest. The philosophy that says you should do whatever you feel like doing, that philosophy is hedonism, not Objectivism. To quote from “The Objectivist ethics”, In choosing one action over another, one need principles and especially a purpose: you make a particular choice as a means of achieving your ultimate purpose. Again to quote from “The Objectivist ethics”, As to the question of whether Objectivists universally “care” about some random other person, they do not. Although we are a decent and charitable bunch, we don’t have the insincere universal “caring” attitude that recognizes neither vice nor virtue. Whether or not many Objectivists would support a person’s decision to jump off a cliff depends on the nature of that person. Probably most Objectivists would support Kim Jong-Un’s decision to jump off a cliff, and would oppose Yaron Brook’s decision to do likewise (assuming that it was indeed an irrational choice). Generally, the attitude would be “That’s stupid”, “it’s no skin off my nose”, and “I have more important concerns”. All Objectivists would, however, support a person’s right to choose to jump off a cliff.
  4. The definition of irrationality is “not following reason in chosing actions”. How to determine if you or someone else is following reason is a separate problem. I think the first step that you have to take is to mentally get rid of everybody else on Earth, so that your postulate “Let everyone do as they choose, rational or not” doesn’t make any sense, because there isn’t anyone else, there’s just you. So why should you be rational? Why should you follow logic, in chosing your actions? Why for example should you not jump off a cliff and scream “Fly!” in the hopes that you will actually soar like an eagle (which would be objectively cool)? Because in fact you will hurtle down to the rocks below and kill yourself. You would have made an identification that is contrary to reality, and any identification that contradicts reality is illogical, and irrational. Having resisted the temptation to leap off a cliff, you eventually discover that choices can and must be evaluated, with reference to your primary choice, which is to exist. Lamb kebab is good, and cliff-jumping is bad. These are objective facts, conclusions reached by integrating all of your knowledge of reality. Please note that things themselves are neither good nor bad, the only thing that is good or bad is a choice made by a man. Sheep and cliffs simple are. Now you can add some people. Adding people adds something special to the mix, that man’s actions must be chosen. Because of man’s nature, cliff-jumping is always bad, and lamb kebab is generally good (save for unfortunate allergy cases, which an individual must discover). There can be variations in what is objectively good and bad that pertain to the fact that nobody is an exact duplicate of anybody else. Waking up before dawn may be good for you and bad for me. I will massively abbreviate the discussion and simply point out that overriding another person’s choices by force is bad, indeed bad enough to be called evil. In a social context, this fact of man’s nature is recognized, and we reject the credo “Let everyone do as they choose”, because that is bad. It is bad for me if you beat me up or steal my lamb. That moral principle is so important that we have the institution of government which recognizes and protects people’s rights. Initiation of force is the greatest evil, and the worst irrationality. It is an irrationality because it willfully sets aside your knowledge of reality and the use of logic, and allows you to treat another being contrary to his nature and, additionally, contrary to your nature (man is not a parasite: but by nature, a remora is). Eventually we get to annoying forms of irrationality, such as the belief in gods. Such beliefs are potentially dangerous, because they can and have very frequently overridden valid moral principles regarding the rights of others – in their place, we get corrupted irrational pseudo-principles like “Only Muslims have rights”, or “Only Christians have rights” or “Only Hindus have rights”. But even if religionists suppress the urge to violate the rights of others, they are still being irrational in believing in a four-armed blue dude whose body is the universe. A person who believes that is not practicing the art of non-contradictory identification of the undeniable (that which he can perceive). A person who denies logic at such a fundamental level on that one issue will deny logic on any number of other issues, and they cannot be trusted. We generally care, because every man is a potential trade partner, offering something of greater value. Irrational people make lousy trade partners. As for how you deal with an apparently or actually irrational person, one solution is for you to take your nature to define the standard of reality by which you judge others’ actions. That, b.t.w., is irrational (I hope that is obvious). You may find that all of the butchers in your town pursue a particular religion, and all of the butchers are somethat irrational. You have to decide whether your anti-religionist principles are so high that they override your recognition of the objective value of a good kebab. Likewise, you have to decide whether your desire to be nude is so compelling that you are willing to trade in your job or your flat, in case your employer or landlord are prudish. Your hedonism may have consequences for you, which you need to rationally consider, and which you should not rationalistically dismiss. If those people are not a value to you, then they don’t deserve your consideration. I don’t care if you don’t care to be educated on your beliefs: I don’t want you imposing your intolerant tolerationist belief on me. So now we have a stalemate: you don’t want to be judged, and I don’t want to be told not to judge. Who wins? Should I give in and not point out the error in your ways, or should you give in and consider my advice? I think the answer to this comes in each of us evaluating the other as a potential trade partner. In the final analysis, my way is conducive to existing in a social context, and your way is only conducive to living alone on a mountaintop. I conjecture that you don’t actually want to live the mountaintop hermit lifestyle, because if you did, you’d head for the hills right now.
  5. Why follow reason?

    I'm a little puzzled that anyone is still bothering to interact with the troll.
  6. Most people do or believe something that I wish they wouldn’t do or believe, and this includes being irrational even when it doesn’t directly affect me (e.g. people who just can’t stand the color yellow). I would like to live in a world where everybody is as rational as I am. Most of the time, however, it would be irrational for me to rant about other people’s irrationality, primarily because most people don’t actually have the rational response “Oh my God, was I really that irrational!? I’ve gotta change my ways”, when confronted with their irrationality. In other words, getting up in people’s face about their irrationality as a way of encouraging rationality is itself irrational. I am not suggesting that irrationality should be tolerated, instead, particular instances of irrationality have to be judged on their demerits, so you have to decide whether it’s worth getting a divorce because your spouse doesn’t like your favorite musician. “Tolerance” implies a complete lack of judgment, whereas “temperance” means that you have judged and decided that the costs outweigh the benefit (“breaking point” likewise implies a judgment, and in this case the benefit outweighs the cost). Let’s take a clearer case, such as a person publically advocating a racist and statist Nazi agenda: it would be well worth countering this person. How can you counter them? Shooting them, for one: but that’s clearly irrational; so is throwing rotten tomatoes, or threatening their life. So is trying to shout them down. In fact, prancing around with counter-protest signs saying “Say No To Nazis!” is at best a minimally rational response. The rational response is to argue against them, perhaps in the hopes of changing their mind (as though they had somehow been misled by some factual error), or more likely, to persuade someone in the audience who is undecided. Throwing tomatoes might “persuade” a member of the audience, and you don’t want to appeal to such irrrational low-lives, so always take the high road. Strolling in public in the nude, in the hope of offending some person, is not a rational response. It does not appeal to reason, it appeals to emotion, and what you will most likely do is simply anger the anti-nudity person, and possibly embarrass others who might be more or less on your side. It is actually perfectly reasonable to have an ideology about nudity where it is a highly personal and intimate thing, as sex is. If your goal is to educate society, use your mind, and not your naked butt. There is zero debate among Objectivists over whether it is okay to be naked at home (it is), or to be naked at someone else’s home (it is not unless you have permission). The only discussion is over the problematic notion of public nudity, that is, projecting your nakedity at others, against their will, when (a) you’re on a dispassionate third party’s property – a business – and that property owner sets the rules; or (b) when you’re on government property, e.g. a government park. But as you know, the government shouldn’t be running a park service. There is one final problem area, namely the case where A and B have adjacent lots, and A like to prance nude on his property, where B can see him from his porch while enjoying the sunset. If B is offended at seeing A, does B’s interest (in not seeing A nude) create a duty for A to erect a screen? Or should B erect a screen on his property, to shield himself from seeing A. Indeed, what if A is offended at B seeing him? Does A’s offendedness impose a duty on B? Let he who is offended build the screen on his property, in conformity with his values.
  7. A theory of "theory"

    I think it may well be that "theory" in physics is different from "theory" in other sciences, owing to the fact that physics is significantly advanced. Not being a physicist, I don't have a specific exemplar of "theory" to contemplate. A lot of what I vaguely know about modern physical theories is not about anything empirical, it's about alternative mathematical descriptions. I suppose I need to find a geologist or virologist, to see what examples of "theory" are in those disciplines.
  8. Why follow reason?

    So if you think there is an inconsistency, you presumably can identify it from the subset of OE that I extracted for you. Where is the inconsistemcy? Incidentally, you misquoted Rand from PWNI: the text actually says "His metaphysical attitude and guiding moral principle can best be summed up by an old Spanish proverb..." Context-dropping comes with a price.
  9. Why follow reason?

    While I agree with my colleagues, I might add a bit glued together from Rand’s essay “The Objectivist Ethics” (this is pieced together, you have to supply the page numbers and ellipses). What is morality, or ethics? It is a code of values to guide man's choices and actions–the choices and actions that determine the purpose and the course of his life. The first question that has to be answered, as a precondition of any attempt to define, to judge or to accept any specific system of ethics, is: Why does man need a code of values? Is the concept of value, of "good or evil" an arbitrary human invention, unrelated to, underived from and unsupported by any facts of reality–or is it based on a metaphysical fact, on an unalterable condition of man's existence? In ethics, one must begin by asking: What are values? Why does man need them? "Value" is that which one acts to gain and/or keep. The concept "value" is not a primary; it presupposes an answer to the question: of value to whom and for what? It presupposes an entity capable of acting to achieve a goal in the face of an alternative. Where no alternative exists, no goals and no values are possible. Only a living entity can have goals or can originate them. And it is only a living organism that has the capacity for self-generated, goal-directed action. An organism's life depends on two factors: the material or fuel which it needs from the outside, from its physical background, and the action of its own body, the action of using that fuel properly. What standard determines what is proper in this context? The standard is the organism's life, or: that which is required for the organism's survival. No choice is open to an organism in this issue: that which is required for its survival is determined by its nature, by the kind of entity it is. The goal of that action, the ultimate value which, to be kept, must be gained through its every moment, is the organism's life. An ultimate value is that final goal or end to which all lesser goals are the means –and it sets the standard by which all lesser goals are evaluated. An organism's life is its standard of value: that which furthers its life is the good, that which threatens it is the evil. The pleasure-pain mechanism in the body of man– and in the bodies of all the living organisms that possess the faculty of consciousness –serves as an automatic guardian of the organism's life. The physical sensation of pleasure is a signal indicating that the organism is pursuing the right course of action. The physical sensation of pain is a warning signal of danger, indicating that the organism is pursuing the wrong course of action, that something is impairing the proper function of its body, which requires action to correct it. The simpler organisms, such as plants, can survive by means of their automatic physical functions. The higher organisms, such as animals and man, cannot: their needs are more complex and the range of their actions is wider. The physical functions of their bodies can perform automatically only the task of using fuel, but cannot obtain that fuel. To obtain it, the higher organisms need the faculty of consciousness. A plant can obtain its food from the soil in which it grows. An animal has to hunt for it. Man has to produce it. The range of actions required for the survival of the higher organisms is wider: it is proportionate to the range of their consciousness. The higher organisms possess a much more potent form of consciousness: they possess the faculty of retaining sensations, which is the faculty of perception. Man has no automatic code of survival. He has no automatic course of action, no automatic set of values. His senses do not tell him automatically what is good for him or evil, what will benefit his life or endanger it, what goals he should pursue and what means will achieve them, what values his life depends on, what course of action it requires. His own consciousness has to discover the answers to all these questions-but his consciousness will not function automatically. Man, the highest living species on this earth–the being whose consciousness has a limitless capacity for gaining knowledge–man is the only living entity born without any guarantee of remaining conscious at all. Man's particular distinction from all other living species is the fact that his consciousness is volitional. The faculty that directs this process, the faculty that works by means of concepts, is: reason. The process is thinking. Consciousness–for those living organisms which possess it–is the basic means of survival. For man, the basic means of survival is reason. Man cannot survive, as animals do, by the guidance of mere percepts. A sensation of hunger will tell him that he needs food (if he has learned to identify it as "hunger"), but it will not tell him how to obtain his food and it will not tell him what food is good for him or poisonous. \
  10. A theory of "theory"

    I do understand the words: Bunge's position this is more or less the approach to theory which I am arguing against. For example, a theory is not a deductive system, it is an inductive system. Deduction may play some role in validating a theory: a theory does not contain logical consequences, it implies them. A theory does not contain assumption (conjectures), it contains truths which are the generalized product of research. The idea that “theory is assumptions” is the credo of that approach to theory which allows arbitrary statements to be put out there, and we don’t do that. A theory is not an infinite set of propositions (if it were, nobody could know a theory, probably not a distressing conclusion to folks of that ilk). An infinite set of highly specific propositions could follow from the few propositions that comprise a theory (the problem is that there is not an infinite set of existents, so infinitely many of those “propositions” would be based on an invalid premise “If only it were true that X152,349 existed”). I don’t accept his claim that a theory is harder to confirm or falsify than a hypothesis, largely because I don’t know what it would even mean to be “hard” to confirm or falsify, and making bad analogies to nets does not clarify the logic of the statement. I would counter that it is vastly easier to refute a theory than to refute a hypothesis (if we take “hypothesis” to be about a very specific instance, within the domain covered by a theory). A theory entails very many specific hypotheses and if any of them are false, the theory is false (100,000 true values is highly unlikely). A hypothesis entails basically one of two logically possible outcome, where falsification is comparatively very unlikely –50-50). The characterization of hypothesis as “A statement that embraces more than the data that suggest or confirm it” fails to distinguish theory from hypothesis (this definition is also true of “theory”). Again, “All the empirical generalizations and law-statements, even the well-confirmed ones, are hypotheses” is also true of theory. The guy seems to be confused about standard of proof vs. cognitive function. This is a useful source, where I can show that I'm not arguing against a straw man.
  11. A theory of "theory"

    I don’t have an account of “hypothesis”, because the concept is outside my comfort zone. We mostly don’t deal in “hypotheses”, and my encounters with the concept come from allied areas of psychology and education. I am reasonably confident that a hypothesis is specifically about things that you do not know, and the standard of proof is a way to exclude hypotheses from being mistaken for theories, which was my intent. I think that a hypothesis is also specific to an individual, so it amounts to saying “this instance will have these properties”, on the grounds that “this instance” is a concrete example of a theoretical concept. If that is correct, then a hypothesis is just a prediction applied to an instance. Alternatively, a hypothesis may be even less grounded in reason and could just be a conjecture. But, as I say, my profession generally doesn’t talk that way, so I’m not comfortable with the term.
  12. I have a fairly simple problem / question / or need (let my need become a demand on your attention!): what is a theory? From experience, I know a number of specific theories, but I do not know what the proper definition of “theory” is, and what its properties are. My ultimate goal is to say something about a particular scientific theory (to identify flaws stemming from a misunderstanding of what a theory is). To show this, I need to say what the essence of a “theory” is. By analogy, I know what the concept “concept” is. Knowing the nature of a “concept”, I know that “1967 Dodges, black cats and the act of running” –excluding all other things – cannot be a concept, since those things have no similarity. I confess that I have a draft of a theory of “theory”, in the more literal scientific or philosophical sense (thus excluding uses where someone says that they “have a theory that X”, when they mean that they “feel that X is so” or they “have an idea that X may be true”). A theory is (defined as) a system of identifications which allow man to grasp the nature of a (conceptualized) subject. It presumes a definition of the subject concept, thus “theory of gravity” presumes a concept “gravity”, which implies a definition of “gravity”. Likewise “theory of mammals” presumes a concept “mammal” (and therefore a definition of “mammal”). A theory of a subject is a set of (highly) probable propositions which state the essential properties of that subject. The underlined parts here are my theory of “theory”. I need to clarify a few points. A “property” of a thing is a fact about its composition that determines what it does, which is not the same as “an observation” or “a correlation” true of the thing. For example, Android is the most popular OS for smartphones, but this is not a property of Android. Plutonium is used in reactors and making nuclear weapons, but this is not a property of plutonium. As for “essential”, I first want to disclaim any connection to discussions of essential vs. accidental properties in professional philosophy, which gets bogged down in proper names as opposed to concepts, and “possible worlds”. What I mean is those properties that characterize the subject, and which are not already implied by some other property. For example, being warm blooded is a property of man, but it is not an essential property of man, since man is a mammal (etc.), and “mammal” implies “warm-blooded”. An obvious essential property of man is having the faculty of reason, also having free will. I stop short of requiring that the identifications which constitute a theory have to be proven to the point of certainly; a fairly high standard of proof is necessary, to distinguish a theory from a hypothesis. And finally, an explanation about “subject”: this is basically shorthand for “the existents subsumed by a concept”. Here are a couple of corollaries of this meta-theory. Because of the defining nature of “theory” – it is cognitive (it is created for a cognitive purpose) – theories inherit the economy requirements of concepts and their definitions. This derives various Occamite principles such as Aristotle’s “We may assume the superiority ceteris paribus of the demonstration which derives from fewer postulates or hypotheses”, and so on. “Grasping the nature of” an existent summarizes the Objectivist epistemology: it is a proper and objective relationship between a consciousness and reality. As a form of knowledge, there must be proper evidence for the claim, and a theory cannot be arbitrarily stipulated. I would appreciate any criticism of this meta-theory directed at whether it does correctly describe what a theory is. It is irrelevant to me whether contemporary science teaching sees “theory” as a social construct. It is likewise irrelevant that most explanations of “theory” insist on adding stuff about repeated testing, standardized protocols or “testable”, since these are non-essential consequences of more basic concepts such as “knowledge”, “non-arbitrary”, or “probable” which the concept “theory” depends on. In other words, I’m trying to say what a theory is, and I am not trying to recapitulate what others have said about theories. I had hoped that How We Know would have a pre-packaged answer, but it does not seem to. Of course, alternative theories of theory important, since any claim has to be evaluated against reasonable alternatives.
  13. Race Realism

    As you think about this topic, I suggest that you keep in mind the possibility that “race” is simply a mistaken concept, a mis-identification. It’s not like “gremlin”, “unicorn” of “free lunch”, being purely fictitious, but is is sufficiently detached from reality that it needs to be consigned to the intellectual trash heap that also contains phlogiston and epicycles. In its place would be some concept pertaining to human evolution and genetics. The genetic concept of “haplogroup” is based in objectively measurable fact, and the study of Y-DNA and mtDNA haplogroups has produced some interesting results pertaining to population genetics. (The reason for these 2 groups is that they do not recombine, so Y-DNA gives you good information about the patrilineal line and mtDNA is about the maternal line). In tracing shared mutations, you can come up with something resembling a “family tree” of humans. There are geographical correlates of haplogroups, where for example haplogroup A appears in parts of Africa especially among the San, who have probably been hanging on in the same spot for tens of thousands of years. Haplogroup A represents the “original situation”, lacking any of the subsequent Y-DNA mutations. And then you start adding mutations, and you check the geographical distribution of that mutation. (Geographical distributions have to be controlled by knowledge of history, for example the Siddi in India were transported from East Africa about 1500 years ago; obviously, Europeans only appeared in the New World a few hundred years ago). There are some surprises there, for example haplogroup B is high frequency in Africa, but also among the Hazaras of Afghanistan, which is surprising since usual racial classifications would have them be Mongoloid. Eventually you will get to haplogroup L-M20 which has high frequency among Tamils and I assume Malayali. It is also frequent (though not as frequent) among Pashtuns. Again, Dravidians can be racially classified in lots of ways, depending on what morphological features you’re attending to; Pashtuns are pretty much standardly classified as Caucasian. So the problem is that there is a physical reality (a genetic fact, which refers to your ancestry) which however doesn’t match well with any extant theory of “race”. The reason is, simply, that the theory of “race” is based on a false premise of absolute and instantaneous separation of humans – as though God split the human race into 6? groups and instantly transported them to their ancestoral homelands. Instead of race, we have a better concept of haplogroup, which is actually related to genetics. There are very many haplogrops: it is a hierarchical concept.
  14. My statement that a patient does not and cannot know what they have agreed to is not a statement of absolute principle about contracts, it is an assessment of general current medical practice, YMMV. I agree that it is possible to craft a limit on liability, but the thing that you e-sign is not negotiated. Part of the problem is that most people don’t know about the chargemaster (I myself didn't know that there was such a thing until a couple of months ago), and I’m not even sure that the thing that you theoretically agreed to has framed the question of liability in terms of that document (e.g. “the charges you will be billed for come from the chargemaster, attached”). The other part is that, setting aside to-the-penny omniscience, you can’t necessarily get a binding reasonable estimate. These ostensive agreements don’t say much about what you’re getting. This problem is most acute in emergency surgery situations, where the answer almost certainly will be “it costs what it costs”, and it should be the least serious in routine office visits. If you can directly deal with a private physician, you are essentially dealing with a classical craftsman contract, where you can ask for an estimate which then implies some limit on your liability (at least a ballpark). But in a typical large medical facility arrangement, classical concepts of “agreement” as underlie contract law are stretched to their limit. This lack of actual agreement and meeting of the minds is really what (properly) underlies the concept of unconsionability. Some practices may be misleading, for example if the mean cost of a procedure is $X but the standard deviation on this is really high and the actual range encompasses 1000 times that, then an honest answer about the cost would be either "I have no idea", or "The average is $1,000 but it can go as high as a million". Suggesting "I would think about $1,000" is misleading. As far as I know, there is no independent profession of “patient financial advocate”, which is basically a contract-law trained professional who negotiates on behalf of a more specific commitment from the care-provider. This is of little use in the emergency surgery context, but would be very useful for expensive, important, but non-emergency treatments. Were I uninsured and needed a heart-lung transplant, I would seek the services of such a professional, because I bet I would not be spiritually or technically able to negotiate, or even inquire competently. There does seem to be such a profession, but they appear to be presently limited to post-hoc remedies, and are not focused providing a patient with better up-front information so that they can decide whether to go elsewhere or forego a procedure.
  15. I don’t think “pay or die” is a realistic summary of the medical profession’s actions: rather, it is “don’t worry about the details, we will take care of you”. That is, they offer something, but you have to agree to it. If you don’t agree to it, you may die (this much is the informed consent part). You know that agreeing to what they offer means that someone will pay. The real-world issue, IMO, is that a patient does not and cannot know what they have agreed to. There is a real question as to whether patients actually have a properly-formed contract with a hospital, in the typical case. Their theory is that if you pick up a electro-pen and sign on a box when told to, this signifies agreement to something (they may print a copy if you request it). Classically, in contract law, a person signs the actual piece of paper where it is clear what the terms are that they have agreed to. The agreement is more than just some list of statements on a server somewhere, it also includes representations by agents. If an agent says “your insurance covers this”, that is a representation that you can rely on. A fundamental doctrine of contract law is that the terms of the contract have to be reasonable, in the sense that a reasonable person, made aware of the terms, would agree to those terms. Open-ended liability is not a reasonable contract term, meaning that your liability to pay may be mitigated by an objective estimation of whether or not you would have agreed if you had known the actual cost of the product. Put simply, your intuition “I would have never agreed to that hangnail treatment if I had known you were going to charge me $100,000” is correct, and a contract with such a consequence would not be enforceable. I don't know about cancer treatment, I'm just identifying a general principle. The full set of contract terms are usually vague and/or ambiguous: as a principle of law, these communicative defects are construed against the maker of the contract in contracts of adhesion ("pay or die", non-negotiable agreements). There are relevant legal provisions regarding auto repairs in most states, and while they often involve improper intrusions of government into business, they also do also encode proper concepts regarding the concept of “agreement”, effectively saying that while you don’t have to give a precise commitment as to the cost of a repair, you have to be within a certain range and receive further consent if you go over that range (the shop cannot recover beyond a certain degree of overage). Again, the question is: is it reasonable to think that a person would agree to this, if they understood the facts? This same concept is applicable, in principle, to all agreements: it recognizes that agreeing to one implied price does not entail agreeing to any price. In a market-based health system, limits on customer liability would be quite prominent. in these agreements.
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