Please don’t slap my penis in any way similar to the way you’d slap a tennis ball. Also, I was unaware that most women liked it when you “volleyed” their breasts from side to side. Pro-tip.
The answer is, don’t use Facebook in the first place - or any other web site.
Over the last couple of days I’ve seen links to Fox (and quoting a different study (I’ve not read) on slightly different matters, IIRC by the same authors, the Fail) and elsewhere talking about a lack of consent in euthanasia carried out in Belgium, where it’s legal, citing this study (of which the full text is freely available). Most quote “66 out of 208” cases or “30%” carried out without consent.
Since I’ve gone to the effort to type this up for a friend on Facebook, let’s reprint this here in case it interests any of you. Maths time.
In this particular case, media spin is heavy on the numbers. The study’s authors make it clear they’re talking from the point of view only of what constitutes legal consent (strictly defined as written instruction from the patient and the opinion of 2-3 doctors that their condition meets the standard set), as opposed to a reasonable understanding of the patient’s wishes and wellbeing. In actual fact, in the figures, the decision was discussed with the patient in 22% of those 30% “non-consensual” cases, or else the patient had previously expressed a wish to die (in 40%), leaving only 38% of that original 30% still unaccounted for (or ~10% of the overall figure) in terms of never broaching the subject.
Of that remaining chunk, the decision wasn’t discussed with the patient in 70% of those cases (the 38% of the 30% overall; with me so far?) because the patient was in a coma and therefore couldn’t give their written consent to anything. The thornier side comes in in the 21% (of that chunk; 21% of 38% of 30%, or ~2% of overall cases) where it wasn’t discussed with the patient due to dementia, or the 8.5% where talking about it was thought to be harmful to them (for unstated reasons).
Dementia is one of the things people fear most - and believe you me, I’d be happy to be quietly killed if I’d totally lost my marbles - and it’s that, IIRC, that Terry Pratchett is facing with the form of Alzheimer’s he’s suffering. But it also makes it impossible to get a reliable after-the-onset consent, which is bound to complicate things (and yes, I’m aware of the concept of ‘living wills’, but there’s always a ‘what if there were second thoughts’ argument to those cases).
So that’s one thing. But in 80% of all cases, relatives were consulted, as well as in almost all cases, other caregivers and other medical professionals. Only in (a slightly worrying) 6.5% of the 30% who didn’t give express consent was there no consultation at all, although for all we know these might well have been in the worst-affected of the comatose patients (there’s no cross-referencing of that sort in the figures).
And don’t forget that’s 6.5% of 30%, or ~2% of the overall total. I would suspect - at least, I’d like to believe - that these are people with no family, comatose and with such failed health that there’s no chance of them ever recovering. With cross-referencing of figures it’d be clear to see, of course. There’s no suggestion in the study that doctors might be going death-crazy, indeed that’s 208 cases total out of nearly 7,000 responding doctors so it’s hardly commonplace in any event, and response to the survey was entirely voluntary, so I doubt there’s much there that’d be too unreasonable.
It’s a difficult thing to balance, but I don’t know that it’s too hard to legislate for: the Belgian standard actually seems pretty good, it’s just enforcement of that standard that maybe needs tightening.
The study is, to say the least, rather more nuanced than recent reports on Fox and elsewhere, and paints a very different picture of the Terrible Belgian Death Industry and all its delicious organ harvesting. The second study, in the Fail, would I suspect show a similar pattern; in terms of the strict Belgian legal definition of consent the figure is higher, but there’s a world of difference between failure to meet that definition and murdering the elderly and the ill.
Edumacashunal, that’s me.
// fiction, sample, the razor gate, trg
Since Elizabeth’s review and the commenters on it made mention of floating city-within-a-city Port Blackwater in THE RAZOR GATE, I figure I might as well throw up the entire chapter I mention in my guest post, the one where we see the Port properly for the first time (the first actual visit there happens quite early on, but this is the real intro to it).
See below the cut for the entirety of Chapter 22 of TRG. Enjoy.
Maya left her car a half-mile from the waterfront and took a cab the rest of the way. The river district was usually safe, but even if no one stole it there was no guarantee she’d be able to navigate the cluttered streets that radiated out from Port Blackwater like fat-clogged arteries. The lights of the harbour settlement gleamed in dull Technicolor projection on the heavy night clouds, orange and yellow flecked with just about every other tint imaginable, a shadow play of a disco somewhere in hell. Thin trails of smoke drifted up into the few lazy flakes of snow still falling. A couple of times she caught glimpses of the Murdoch River running sluggish, black and cold. No ice on its surface. Not yet.
“First time in the Port?” the cab driver said. “You picked a good time; rest of the city might be shutting up, but the Port’s open all day every day, right?”
“No,” Maya said. She could smell, or imagined she could smell, grilled fish, gritty acrid black coffee. Algae, river mud, photochemical pollution. See the slowly decaying drifts of packing waste and plastic netting and the shrieking clans of gulls that lived on them. “No, it’s not my first time there. I grew up in Port Blackwater.”
“Haven’t been back in years.”
“How come you’re going back now? Going to see the old place, huh?”
She hadn’t gone back because there was nothing to go back for. Her dad dead and gone, and she’d taken so long and worked so hard to escape the place’s gravity well that even going near it now made her wary, afraid of falling back in. The scent of whatever her dad had managed to pick up cheap from the market that morning, grilling in the tiny galley. The regular Sunday treat of lunch at old Thierry D’ Croix’s place, and the stew he always swore, in his broken mix of English, Spanish and some obscure Haitian dialect, was made from river rats, and maybe it had been. Sitting on mismatched plastic stools on the deck of Thierry’s ancient tug, its surface protected from his customers’ feet by tightly compressed strata of newsprint, a Burroughs cut-up catalogue of five years of history in half a dozen languages. Something she could feel, but was too young to understand, between her dad and Thierry. She knew then that her father had worked for the Argentinian government, knew now that he’d been in intelligence, but what that had to do with Thierry or why he’d ended up living in a floating refugee ghetto in America had been, and remained, a mystery to her.
“What was it like being a kid in the Port?” the driver said. “I can’t imagine it. Hell, I didn’t even learn to swim till I was twelve.”
“It was different, but kids are kids, you know? Maybe it was smaller then, too. Grown over the last few years.”
Afonso Cassinelli and his baby daughter had arrived in the Port a handful of years after its ‘founding’. A ramshackle flotilla of refugee boats fleeing civil war in West Africa and apparently aiming for Canada had made a navigational error somewhere crossing the Atlantic and showed up in Newport City harbour instead. Fishing boats, a couple of old tugs, a rusting freighter ten years past the date it should have been scrapped. This wasn’t two hundred Cubans squeezed together in a Zodiac, or a cargo container with three dozen families who’d paid thousands of dollars for the privilege of suffocating to death at sea, but an organised flight to a better world. Conditions aboard were generally tight, but not inhumane. The authorities moved the boats to the storm-protected anchorage at Resolution Bay in the estuary, and gave the refugees the choice between staying on their boats after health inspections, or placement in block housing ashore while they decided what to do with them. Most stayed.
A few months later, more boats began to arrive. Refugees from Central America and Haiti, trying to avoid the camps of Miami by making the much longer and more dangerous trip up the coast to Newport. The city berthed the newcomers alongside the original arrivals. By the time they were given the right to stay, a certain critical mass had already been reached and the jetties between the clusters of boats and the shoreline were increasingly busy thoroughfares. Other, unofficial connections between vessels had sprung up, and the floating village had become a fixture. Botched city planning in the decades before, plans that spawned disasters like the building of the Levels, had left the city short on cheap housing and dangerously close to bankrupt. Newport City ran utilities out to the shoreside, gave incoming vessels basic sanitary and structural inspections, arranged a food stamp programme and quietly left the refugees be. Some managed to succeed in permanent visa applications or citizenship claims, but most stayed in limbo, stuck between a choice of menial illegal work in the city or making a living for themselves in the crowded confines of the Port. Maya held US citizenship thanks to the mother she’d never known, and even then it had been a struggle to escape. An address – such as they were – in the Port was death on an application for a regular job or a bank account.
“Sometimes I wonder,” she said, only partially to the driver, “how many of us made it out. If I go back there now, how many of the kids I knew will still be there, or dead already.”
“I didn’t think the Port was that dangerous. I never have trouble there.”
“It’s not, usually, not in that way. My room, my cabin, was four feet wide and just over six long. In winter, in weather like this, condensation used to freeze on the inside of the little window I had, coat the glass with a sheet of ice. The nearest piped water was a standing tap at the shoreward end of the jetty, two hundred yards away. Some people boiled river water.”
“My dad built a rainwater collector on the deck. It was cleaner, so long as we stopped birds getting into it. I was fourteen when I had my first hot water shower in a proper bathroom; my dad took me on vacation to Wheeler Forest. Our boat had a chemical head. Others just flushed straight into the water. Some people set up micro-treatment systems in old plastic tanks. There was a city waste barge, but that was just for trash. I learned to swim in the river. And to fish. There was no licensed medical care, and no emergency services in the Port. So if someone got sick - which happened a lot, and everyone lived so close together that any disease always spread bad - or had an accident, they might die when anywhere else they’d be OK. You see?”
It had been illness that finally took her father. Something long and slow and deadly that he’d done his best to hide from Maya. He’d refused to see a doctor onshore, insisting that crazy ‘Brass’ Velasco could do anything a city hospital could, short of surgery. “And if I need surgery,” her dad had said, shaking his head, “it’s something that’ll probably kill me anyway.”
Brass was a decent doctor, even if he only had one eye. He’d promised Maya he’d do what he could. Antibiotics, painkillers, other drugs she didn’t know the names of, for something that looked like maybe it was tuberculosis, except it wasn’t because nothing shifted it. Her dad had died in his own bed, on a cool spring night, breath faltering but, she’d thought, happy, and maybe that was OK.
Maya stopped the cab a quarter of a mile from Copeman Fisheries and walked the rest of the way. The air was cold and spiked with the smell of charcoal smoke and kerosene. The noise of conversation, competing traders’ shouts in half a dozen languages, the rattle of metal and the soft low creak of mooring lines, washing across the water in waves like breaking surf. Along the jetties and the narrower steel and wooden walkways that criss-crossed between individual boats, clusters of people moved in streams, winter-wrapped shadows drifting through the scattered billowing smoke and steam blowing from cooking pots and fire cans. Maya’s foot hit the wood of the jetty, left the concrete wharf behind, and she felt herself pass through the strange invisible barrier that separated the Port from the rest of the city, from the rest of America.
Old, long-dormant pathways in her brain stirred at snatches of conversation she heard as she passed, words in languages she remembered from her childhood, phrases and accents that made up the fluid, ever-changing dialect of the Port. Unconsciously adjusted her stride, adapting to the narrower confines and the abandonment of personal space. Like crowded Japan, hundreds of unwritten rules and customs had arisen in the Port, codes of conduct and politeness to provide the illusion of privacy and isolation when the physical reality was lacking. Planes of codified behaviour overlaid on the bustling chaos like an invisible web, steering and guiding the occupants, and instantly marking out outsiders.
She saw the turn on to the pontoon at which her father’s boat, her childhood home, had been moored, and made sure she cut the other way, across the deck of a former fishing vessel. Told herself it was the most direct route across the bay to Copeman Fisheries, but in reality she just didn’t want to deal with the inevitable disconnect between her memories and the present. That boat would be part of someone else’s life now, repurposed and reclaimed, the past gone and forgotten.
She wondered why Jason Blake had asked her to come to the wharf for this meeting. Sure he worked at the fishery, but if he wanted to keep the rendezvous quiet surely there were better ways than inviting her to a place she obviously didn’t belong. There must be a hundred bars or cafes in the Port or ten minutes’ walk inland of the place. It was low tide, too; the air was muddier, the boats a little lower at their anchorages, the river running harder now it was no longer fighting the ocean. Not a time when boats would be unloading their catch. She hunkered further into her coat, walked faster.
Copeman Fisheries was a snow-covered two-tier corrugated steel warehouse unit on the edge of a cluster of other run-down commercial buildings that looked either abandoned or like they should have been. The painted logo over the doors by the waterside loading dock was lit by a single fizzing halogen spot that highlighted the letters COPE and very little else. Three more lights seemed to have burned out. There were scores of footprints in the slush by the doors, wheel tracks leading into the cargo entry.
There was a guy waiting inside the door when she pushed it open. Stocky, huddled in a woollen hat and a bomber jacket. He looked like a thug for the Russian mob. Stamped out a cigarette as she shut the door. Said, “I’ll take you to Mr Blake.”
He had an hourglass tattoo on the back of his hand.
In The Razor Gate, author Sean Cregan has created an intense, intelligent, engaging thriller. The near-future Newport City is brought vividly to life under Cregan’s skillful hand, with the setting being familiar enough to feel real, but just foreign enough to feel exotic. Blackwater Port, a floating city within the city, is particularly intricately laid out, and its unique location and culture give it a decidedly ominous presence, making it almost a character itself. On its face The Razor Gate is a straight-up thriller, but there are also larger societal issues being addressed just under the surface, particularly the never-ending struggle between the rich and poor. And while none of us want to die anytime soon, you should definitely want to take a trip through The Razor Gate.