Wednesday, January 10, 2024

Advance Decision template (Celia Kitzinger)

 

ADVANCE DECISION

 

To Health Care Professionals: 

 

I, [YOUR NAME], of [YOUR ADDRESS], have the capacity to make the decisions set out in this document.  I have carefully considered how I wish to be treated if, in the future, I lose the capacity to consent to medical treatment, or the ability effectively to communicate my refusal or consent. 

 

Date of birth:  [YOUR DOB]

NHS number:  [YOUR NHS NUMBER]

National Insurance Number:  [YOUR NI NUMBER]

 

REFUSAL OF TREATMENT

To avoid any doubt, and unless stated to the contrary below, I confirm that the following refusals of treatment are to apply even if my life is at risk or may be shortened by virtue of such refusal.

 

In the event that I am no longer competent to make decisions on my own behalf, these are the decisions I have made in advance.  If I lack mental capacity and also have an advanced disseminated malignant disease, advanced degenerative disease of the nervous system (including MS, motor neurone disease and Parkinson’s disease), moderate or severe brain damage due to injury, stroke, disease or other cause, senile or pre-senile dementia, severe difficulty in breathing (dyspnoea) that cannot be cured, or any other condition of comparable gravity, I refuse any medical intervention aimed at prolonging or sustaining my life.

 

In the event of any of the above conditions applying, I refuse all life-prolonging treatments, including but not limited to: cardio-pulmonary resuscitation, artificial ventilation, specialised treatments for particular conditions such as chemotherapy or dialysis, antibiotics when given for a potentially life-threatening infection, and artificial hydration and nutrition.  I also refuse all life-sustaining treatments including but not limited to therapies whose purpose is to maintain or replace a vital bodily function and without which death would most likely occur as a result of organ or system failure.

 

I recognise that I am unlikely specifically to have included all possible current or future treatments for whatever health condition may lead to the applicability of this AD. Nonetheless I wish to refuse them.  Furthermore I am unable to anticipate all possible circumstances under which this AD might become applicable but believe that any such circumstances would be extremely unlikely to alter my decision had I anticipated them.  I am very anxious that new treatments or unpredictable circumstances might be used by my healthcare team to argue that this AD is not applicable and not binding.  I wish so far as I can to pre-empt any such arguments.

 

CONSENT TO TREATMENT

I do consent to any medical treatment to alleviate pain or distress (including any caused by lack of food or fluid) aimed at my comfort.  I do consent to palliative treatment for incurable vomiting or feeling sick (but not for treating any underlying condition causing these symptoms).  I maintain this request even in the event that it may shorten my life.

 

Upon my death I wish to donate all usable organs and I consent to any treatment which is designed to make this possible and to optimise the process.

 

 

I have deposited this advance decision with:

 

1.  My GP: [GP NAME, GP ADDRESS]

 

 

Signed:  ______________________    Date: __________________

 

 

 

----------------------------------------------------------------------

 

Witness 1   

 

Witness Name :  _________________________

 

Address:            __________________________

 

 

I witness that this advance decision was signed or acknowledged in my presence.

 

 

Signature:   _________________     Dated:    _________________

 

 

 

Witness 2

 

Witness Name :  _________________________

 

Address:            __________________________

 

 

I witness that this advance decision was signed or acknowledged in my presence.

 

 

Signature:   _________________     Dated:    _________________

 

 

 

Tuesday, January 09, 2024

Nothing worse than elderly relatives bearing advice


Hi fellow comrades-in-arms for justice,

Let me introduce myself. I'm a student, a radical and passionate for change. I despise the tired establishment of this country which only ever presides over failure. Everything’s broken; nothing gets fixed; I'm terminally bored.

And that's why I’m wired for action.

Get outta the way, Grandpa!

Speaking of that, my dad gave me a copy of a letter my granddad wrote to me years ago - before he died. It was kept for me until I was eighteen! How condescending is that? I hate all that advice from beyond the grave stuff.

So here's an extract of what I have to put up with - just hear the pompous pontification, the smug condescension!

---

“... It is the destiny of teens and twenty-something's to yearn for a cause, to join a movement of like-minded people fighting for a better future for all, as they see it. The activist tribe is intoxicating: self-righteous events follow one from other; there is no shortage of parties and romantic partners. Loneliness is banished, life is collective, active, exciting and seldom boring.

“The cause is seldom analysed too closely or too seriously. Christianity once promised Salvation and Heaven-on-Earth; Marxism promised a radical equality, the end of oppression, the unlocking of all the forces of progress; climate activism fights clear enemies to save a biosphere fit for all the people.

“But it takes years of immersion in the esoteric doctrines of the cause before its objectives, strategies and tactics can be properly understood and deployed. Rebuttals which are compelling rely upon complex analyses spanning several disciplines with which you will not, at this stage of your life, be familiar. During your period of apprenticeship you will be emotionally committed to the movement, chained to the induction process … and immune from outside criticism which you will find either tribal nonsense or too sophisticated for easy comprehension.

“And here is a meta-critique to which you are also immune.

“It is in the nature of young people, particularly those in somewhat elite institutions such as the universities, to believe they are owed a pathway to future success. In advanced economies, however, the pyramid is steep - and narrow at the top. Few aspirants will make it, and those few will generally owe their success to their family connections (in a very few cases, outstanding talent may hack it).

“The struggle therefore is bogus. It cannot deliver you what is promised. The Kingdom of God on Earth will not happen; the Communist Revolution will require an evolution to a world utterly different from your own; the Green movement's strategy is utterly decoupled from actually solving the problems it purports to address.

“So enjoy the struggle while you remain starry-eyed. Then enjoy it in retrospect as a fulfilling coming-of-age. Unless you were born with silver spoon in mouth (you were not!) - or you get very lucky indeed - you will need to readjust your objectives as you leave your twenties. We live in a complex society: hopefully you didn't trash your studies, your CV or your reputation in ways that prevent you from finding a life trajectory which really does work for you in future.

“Have fun - I wish you well...”

---

Easy for him to dump all over us, isn't it. He's dead.

Monday, January 08, 2024

"Our Posthuman Future" by Francis Fukuyama

Francis Fukuyama's "Our Posthuman Future" swings a now-rusty axe at advancements in biotechnology, its edges dulled by two decades of scientific progress following its publication in 2002.

At its core, the book muses upon a disingenuous morality play: technology mutates our "absolute human nature". The remedy? A state-guided ethical framework to restrain its monstrous potential.

So much for libertarianism.

Fukuyama's high-mindedness is crafted to appeal to both sides of the political aisle – leftists who fear technological disruption of their cherished shibboleths, and conservatives wary of moral relativism – but ultimately it only highlights his own personal  preferences.

Fukuyama needs a fantastical portrait of human nature, a static essence woven from language, consciousness and "spiritedness". This convenient Nietzschean fiction ignores the messy reality of evolution, whereby our biological and cultural landscapes constantly reshape what it means to be human.

His pronouncements on the dangers of genetic engineering are quaintly outdated, riddled with assumptions about heredity that have been thoroughly debunked by subsequent research. Fukuyama, at time of writing, was unaware for example of the polygenic formation of most complex traits - such as personality and intelligence - which feeds his convenient skepticism as regards the genetic component of their heritability.

The book's real agenda emerges in its calls for stringent regulation, its subtext tinged with suspicion both of scientific inquiry and individual autonomy. By invoking a static, nebulous and absolute "shared humanity" as the foundation of morality, Fukuyama unwittingly empowers the very state he claims to fear, entrusting it with the delicate task of policing human evolution. Sadly, this is what reactionary looks like, dressed in moderate, progressive clothes.

Such politically-convenient triangulation ignores the vast ethical complexities of biotechnological advancements, reducing them to a convenient bogeyman that justifies increased state control. That would be self-defeating for any state which unilaterally tried it. One thinks of the calls for unilateral nuclear disarmament echoing across the decades.

"Our Posthuman Future" may have sparked conversations at the margins two decades ago, but its attempt to impose an absolute Platonic morality on the contingent protocols of an evolved social primate is just an empty exercise in reification.

Sunday, January 07, 2024

No-one cares about your digital clone

 From the Revelation Space Wiki:

“Beta-level simulations were sophisticated computer programs designed to mimic a person in appearance, mannerisms, and thought-patterns. While capable of successfully impersonating a human mind down to their most minute idiosyncrasies, they were not in fact self-aware -- they were just near-perfect imitations of life. As such, they enjoyed no legal rights or protections.

… it was considered a most egregious social faux pas to allow someone to believe a beta-level simulation was in fact alpha-level; however, mistaking someone for their beta-level was itself an insult …
”

Alastair Reynolds’ digitised-human concept is fast approaching reality. 

Today I read about a company which will set up your digital clone (with avatar) if you simply submit as few as four pages of notes, penned by yourself.

Better results are expected if you grant delphi.ai access to your entire corpus of Google Docs and hopefully your memoirs too.

In pitching to your vanity, no-one mentions the use-case. How often will your grandchild (or generic loved one) choose to chat with a shallow personality model - without emotions or empathy - formed from a dataset fossilised in deep time?

Forget about it. In 10-15 years there will be an unbounded collection of Internet friends and advisors, all a lot smarter, more empathic and wiser than you or I could ever be. 

Hope to be remembered fondly, if only dimly.

Saturday, January 06, 2024

The Breakdown of the Bicameral Mind

"The rain lashed down on the cobblestones, a cold, insistent lullaby against the slick flagstones. Jacques huddled deeper into his threadbare overcoat, its collar a damp cage against a wind whispering secrets of the Seine. Beside him, the hulking silhouette of Pierre was an impassive monolith, the silence that clung to him as thick as the Parisian smog. Lutte Ouvrière's newest recruit was draped in shadows, shadows which whispered under flickering street lights - tonight the shadows seemed to writhe with a life of their own.

It all went to hell faster than a bar brawl on Bastille Day. One minute they were hauling crates into a grimy Parisian cellar, the musty air heavy with the ghosts of revolutions past, the next, the cobblestones were erupting in blue flashing strobes, steel claws of spotlights ripping through the night. Sirens wailed a mournful aria as armoured vans disgorged gendarmes, their faces like gargoyles in the harsh neon glare.

The interrogation suite was a slap in the face. Pastel walls, plush carpeting, armchairs that swallowed you whole like overstuffed confessionals. Jacques felt like a stray, an alley cat catapulted into Versailles, his knuckles white against the polished veneer of the interrogation table. The video screen on the wall flickered to life, displaying Pierre in all his granite-faced glory, shackled to a chair in a cell that wouldn't have looked out of place in a mediaeval oubliette. Yet, even under the harsh fluorescents, Pierre's eyes were unwavering, a stoic statue in a concrete landscape.

Then she walked in. Céline. A whisper of smoke and ink, wrapped in a dress the colour of midnight, her dark hair a cascading waterfall against skin like alabaster. She smiled, a flash of white teeth against crimson lips, and Jacques's pulse skipped a beat. This was no gendarme in sheep's clothing, no gruff inspector with a dossier smelling of stale Gauloises. This was a femme fatale straight out of a Simenon novel, and she was playing him like a Stradivarius.

She slid into the chair opposite him, the scent of vanilla and expensive perfume hanging in the air like a promise. Instead of barking orders, she spread documents on the table, the top his long-forgotten university thesis, "The Reconstruction of the Standard Model from Loop Quantum Gravity." Céline, a goddess of intelligence fluent in the arcane language of physics? It was enough to make a man question reality.

Her questions were velvet-coated barbs, her flirtations calculated manoeuvres. She spoke of his research, his dreams, her gaze lingering on his exposed chest. He found himself drowning in her eyes, those emerald depths promising secrets, his guard slowly dissolving like salt in seawater.

Then, the revelation, sharp and sudden. 

"You're on our side, Jacques," she purred, the controller in her hand a tiny silver sceptre. 

Memories, dammed for months, burst through the sluice gates of his mind. He wasn't Jacques, the idealistic firebrand of Lutte Ouvrière. He was Agent Duval, deep cover, tasked with monitoring Pierre, a viper in the folds of the French Left, a serpent working for a foreign intelligence service with his fangs already sunk into the nation's security.

The flood of memories was agonising, a kaleidoscope of clandestine meetings, whispered codewords, the ever-present fear of exposure. And Pierre, ever the stoic mask, his loyalty as impenetrable as the granite of the Alps.

Céline's smile was bittersweet. Relief, triumph, and a tinge of sadness that made her eyes even more luminous. Tonight, they would celebrate a stolen moment of normalcy in the quicksand of espionage. Tomorrow, Duval would vanish, another layer of memories carefully excised, leaving behind a bruised and bewildered Jacques, convinced he had withstood brutal interrogation by the very forces he secretly served.

But as they slipped into the Parisian night, hand in hand, Jacques couldn't shake the feeling that somewhere, beneath the fabricated memories, a shard of truth remained. A whisper in the dark, a ghost at the corner of his vision, reminding him of the man he once had been, the life he had led, and the choices he had made in the cold embrace of shadows. And he knew, with a chilling certainty, that the shadows would always be there, waiting, ready to reclaim him the moment his guard slipped. For in the labyrinthine world of espionage, loyalty was a fickle flame, easily extinguished by the coldest of winds.”

---

The Breakdown of the Bicameral Mind written by Bard from this...

---

Bard Prompt: Write a short story of around 2,000 words in a breathless, pulp-noir style based on the following synopsis.

“The setting is the dark, rainy street in an ancient, run-down arrondissement of Paris. The hero is a young man, Jacques, who is a political activist. His left wing organisation, Lutte Ouvrière, has sent him out this late night with a new comrade, a large taciturn man whom Jacques has never met before. The comrade takes charge and directs Jacques to help set up a mysterious assignment. However, the mission is quickly interrupted: lights, police vans. The two of them are arrested.

“The scene shifts to an interview room, which to Jacques’s surprise is very pleasantly furnished with pastel walls and stuffed upholstery with sumptuous cushions. Jacques is seated at a small table in the centre of the room, expecting a rough interrogation to come. He notices a video screen on the wall to his right. It shows an image of his large comrade shackled to a steel chair in a filthy cell. The large man sits as impassively as ever.

“Jacques doesn't know it but he's in a special DGSI interrogation suite. The DGSI is France's interior intelligence agency.

“A charming, petite, dark haired woman about his own age enters the room. She introduces herself as Céline. She pulls a chair up beside him and puts some papers on the table. Jacques recognises the top paper as his university thesis, ‘The reconstruction of the Standard Model from Loop Quantum Gravity’.

“Céline’s manner is respectful and flirtatious. She seems to want to talk about his scientific research, not about his political activism. Jacques finds himself attracted to Céline, hé can't help noticing her bare arms, her enticing outfit. Soon he's letting her steer the conversation as she wishes. Suddenly he realises the truth: she's just flattering him, getting under his guard. ‘You’ll get nothing from me,’ he says, ‘I’m telling you nothing!’

“Céline smiles at him and tells him he is completely wrong. Jacques is actually on her side although he doesn't know it. His bulky companion, still visible on the wall screen, is an agent of a foreign intelligence service, infiltrated into the French Left. Jacques has been keeping him under surveillance. ‘Now do you remember?’ she asks, as she does something with a small controller in her hand. Jacques's memories come flooding back. He is a deep cover DGSI agent.

"Céline is really Jacques's girlfriend and tonight they are going to celebrate a brief but joyous reunion. Tomorrow though, Jacques will have all these memories erased and will be released with a cover story of a brutal police interrogation which he successfully resisted, believing he is a true revolutionary and a loyal member of Lutte Ouvrière.”

----------------------------

Coming along, isn’t it, this drafting of stories by LLMs? A fifty percent word count expansion here from my outline-prompt. The short-range narrative cohesion is good, the long-range story cohesion still not quite there for me. But for a pedestrian pulp tale, not bad at all. AC.

Wednesday, January 03, 2024

The End of History and the Last Man

Reading Francis Fukuyama's book (in the 2020 reissue of this 1992 published book) is an exercise in head-scratching perplexity and fist-on-wall-banging frustration.

Making Hegel's thymos (the Homeric/Platonic quest for status and recognition) a motor for historical change is certainly an improvement over basing your theories of history on that poor, selfish, solitary creature, homo economicus, with its purely consumerist motivations.

But that's like going from crass to merely poor.

In his 1975 book, "Sociobiology: The New Synthesis", Edward O. Wilson expressed a strong belief that the future of social sciences lay in their integration with evolutionary biology, specifically through the lens of sociobiology. Surely Fukuyama might have noticed this? We have advanced our understanding of human nature quite a bit since Hegel, who was writing only twenty years after the French Revolution of 1789.

Still, as a clear and coherent philosophical introduction to Kant, Hobbes, Locke, Nietzsche and Hegel, Fukuyama's chosen intellectual resources, this book could hardly be bettered.

Such a clever man, Mr Fukuyama. One could almost believe his attempts to stay Overton Window-adjacent might be… Straussian?


---

Substantively, Fukuyama argues that capitalism - in its ‘bourgeois democratic‘ form - is truly the stable endpoint in human social organisation (an attractor in dynamical systems jargon). In his 2020 afterword he observes that militant Islam and system-busting populism have, despite widespread fears, not proven to be existential threats to the democratic order.

I am sure he is correct: a strong civil society composed of decentralised and fragmented economic elites welcomes a relatively weak, malleable centre of governance - one which won't get out of control.

Russia and China are examples of strongly-autonomous state structures pursuing nationalistic (thymos-driven?) projects to the detriment of their economic interests. It's tough being an entrepreneur in such countries: avoiding being 'disappeared' or worse.

The real (and long-term) threats to Fukuyama’s somewhat optimistic trajectory are twofold: (i) the massive expulsion of the mass of the population from social and economic life by elite-owned total automation; (ii) the entrenchment of a hereditary elite class by genomic engineering - a tech-constructed version of India's caste system (still covertly operational).

I would like to know more about Fukuyama's views on total automation. Meanwhile, his take on bioengineering, “Our Posthuman Future”, is on my reading stack.

---

The short-term stability of 'liberal democracy' has its limits. It is worth emphasising just how ultimately fearful capitalist elites are of the masses - and how little they really care for their welfare. Unlike the lords of feudalism, economic and state-apparatus elites are not armed and are relatively few in numbers.

The military, not recruited from the elite in their mass, is not necessarily to be relied upon.

Fukuyama observes in the final chapters of his book just how much degradation and contempt politicians have to suck up in managing and defusing disgruntled mass movements and their cynical demagogue leaders.

It's therefore often the case that key government figures are not themselves socially or economically members of the top elite. No recent British leaders have been scions of the billionaire class; Trump is viewed with disdain by the truly well-off.

As in Tom Wolfe's essay, "Mau-Mauing the Flak Catchers", politics is theatre and the real stuff happens elsewhere. That's what Fukuyama's ideal of liberal democracy ultimately comes down to.

Wednesday, December 27, 2023

A Ukrainian Soldier (via Le Monde)

 « A force de franchir tous les paliers de la peur, j’ai compris que je ne suis rien, juste un corps en vie. »

 “By pushing through all the levels of fear, I finally understood that I am nothing, just a corpse in motion.”

Tuesday, December 26, 2023

Thought for the Day

 Some arguments have visceral force because they are true; others because large numbers of people believe in them.

Wednesday, November 29, 2023

How to design an exterminator AI


From OpenArt.ai

Posted here as a service to those misanthropists who wish to exterminate the human race, but lack the necessary strategic vision.

---

First, don't go the pure AI route. You'll find that it's orders of magnitude easier to engineer a bunch of gain-of-function viral pathogens and let them loose. In fact, lose the idea of the dangers of high-intelligence entirely. Plenty of highly-intelligent people died in prison cells or death camps. An enhanced capacity for abstract thought only takes you so far.

To make humanity, or any species, extinct, you have to change the parameters of that species’ environment to ensure subsequent reproduction tends to zero.

A simple approach is to drop a sufficiently large rock on the planet. But sometimes the introduction of a new, invasive species is enough to do the trick - rats introduced onto a hitherto-pristine island is a well-known case study. 

Could you use advanced AI to enable a lethal threat to humanity? Create a new species to occupy our human niche, preventing humans in their totality from continuing?

Some of you will say that the TFR data shows that capitalism and contraception are already taking us way down that path. But not all humans will be affected: those who disdain such will inherit the Earth - a future paradise for the Amish (h/t Robin Hanson).

Putting both viruses and progressive antinatalism to one side, what people really want to hear about, it seems, are killer robots.

They're hard. 

It's easy to design a substantial point-threat: AI autonomous weapons for example. It's another thing to design a universal, all-consuming threat which prevails over any and all human countermeasures.

All existing AI systems - all our technological products - are strictly parasitic on our existing human global economy. Without that they can't power themselves, repair themselves or reproduce themselves. 

In principle, we can imagine a totally self-reproducing robot community-economy. If it had sufficient means of military aggression and defence, then we're simply positing a species like ourselves (in some possibly improved variant) implemented in metal/silicon or protoplasm depending on the engineering pros and cons.

Since we would be competing in-niche for land, resources and sources of energy, we would have to fight these aliens for our survival. But defeat is not foredoomed, not if we were paying attention all along.

In any case, I say to the misanthropes out there, we are centuries away from that future. You won't live to conceptualise, let alone design, that possible road to human extinction.

My advice? Stick to the viruses. 

Or go design the irresistible (but sterile) android life-partners - trust me, no one will stop you there.

Thursday, November 23, 2023

What we think of when we think of death


The soldier: the first one can be hard; after that it's pretty easy.

The dualist: there may be some connection between the person I feel myself to be and the squidgy mass of cells-in-soup inside my skull - but the same thing?!

The neuroscientist: it's process - the mind is what the brain does; I concede we don't know how that could work.

The evolutionary biologist: natural selection has favoured the complex human nervous system. It supports sophisticated social behaviour in challenging, dynamic but mostly predictable environments. What's the problem?

The philosopher: to explain consciousness is categorically different to experiencing it. We both know you're in pain and why, but you're the one screaming.

---

Me:

Sometimes when I think of dying I feel that a complex organ (my brain) will stop functioning and its constituents disperse into the biosphere. No big deal.

Sometimes I think that human subjective experiences are extraordinarily similar. Millions of people have sensations, feelings, thoughts and consciousness just like mine. My personal deletion in death is not dissimilar to me falling asleep and waking up next morning as a… slightly different person: someone very like me who is not me.

The human race (or successor conscious beings) may advance in times to come - or may become extinct. We all feel that to secure the former is worth any sacrifice (most of us!) but there is no evidence the universe is the kind of entity which could care either way.

The process of evolution ensures that we have to care - selection bias - so that's really no surprise. We each live within our individual consciousnesses, so structured that we have to care about ourselves and those others we take to constitute our mutually supportive community. If you like, those are the boundary conditions for being a socially adjusted human (not sociopathic, schizophrenic, psychotic, etc).

When we die, a universe may die with us and within us, but let's not be precious. The flow, the continuity of the collective consciousness of humanity gives me reassurance. Just like I'll not be too concerned about falling asleep tonight - as someone will likely awaken tomorrow morning with whom I identify.

Like most people trained in physics, I happen to accept the block universe concept in which the passage of time is a psychological construct, a product of local spacetime interaction between our bodies and the environment. In this sense the past and the future are equally existent and our lives exist in entirety - just as a DVD contains the whole movie, all at once.

(Maybe the universe is really some complex multiverse structure in Hilbert space - who knows?).

Anyway, because I'm a reasonably adjusted human being, I'm a fan of sensual, emotional, smart, prosocial consciousnesses having an indefinite, fulfilling future. I'm reassured by progress so far - at least in this branch of the universal wavefunction. These emotions are conditioned by my future-ignorance, of course.

And for reasons mentioned, I'm not too scared about the eventual unavoidable extinction of the personal consciousness of this author.

You, dear reader, will take up the torch.

---

Greg Egan's short story "The Walk" in his collection "Axiomatic" uses this approach as setting. 

Roger Scruton in his book "On Human Nature" makes the distinction between being conscious and having a theory of consciousness.

And I wrote a short piece about this - 'Live Forever' - at sciencefiction.com.

See also Adam Carlton's short story, "Doppelgänger": memory discontinuity hangs heavy.