Scott Alexander has a thoughtful piece about who gets to set the default in disagreements about what is reasonable. He describes a couple therapy session where one member is bored with his sex life and goes kinky clubbing, to the anger of his strongly monogamous partner. Yet both want to stay together at least for the sake of the kids. Assuming the answer is an either-or situation where one has to give up on their demand (likely not the ideal response in an actual couple therapy setting), the issue seems to boil down to who has the unreasonable demand.
It resonated with another article I came across in my news flow today: What It’s Like to Be Chemically Castrated. This article is an interview with a man who wanted to be chemically castrated in order to manage his sex addiction and save his 45-year marriage. Is this an unreasonable intervention?
Suppose you want to enhance your cognition. A scientist hands you two drugs. Drug X has at least 19 controlled studies on the healthy individual showing it is effective, and while a handful of studies report a slight increase in blood pressure, another dozen conclude it is safe and non-addictive. Drug Y is also effective, but it increases mortality, has addiction potential and withdrawal symptoms. Which one do you choose? Great. Before you reach out for Drug X, the scientist warns you, “I should add, however, that Drug Y has been used by certain primitive communities for centuries, while Drug X has not.” Which one do you choose? Should this information have any bearing on your choice? I don’t think so. You probably conclude that primitive societies do all sort of crazy things and you would be better off with actual, double-blind, controlled studies.
Now what if I told you that, regardless of your interest in cognitive enhancers, you have been choosing Drug Y over and over, day after day, for several years? Continue reading