@Hyolobrika@berserker.town

A devil's advocate take on your approach (I don't know what I agree with here, but am willing to discuss from this POV):

There are situations when it's generally believed that the person with the skin in the game makes worse choices than someone without. I think the medical field believes that strongly: treating one's family or oneself is considered unethical in most circumstances and always discouraged. Performing noninvasive "fishing expeditions" for problems that show no symptoms is generally discouraged (except some cases where we encourage it for patients from some demographic), lest false positives cause patients to strongly wish for treatment.

All these examples suggest that people with more skin in the game might be over-eager to do something instead of nothing when a choice with unclear calculus of benefits appears. However, we are in a more confused situation regarding war: conscripts have much more skin in the game of war than in the game of suffering from consequences of not entering a war. From a purely selfish point of view, if a war can be avoided by means that cause the same amount of suffering by means other than military, all the conscripts should vote against it, because the suffering will be distributed among the whole population.

I don't think these two problems cancel each other. Each of them is a problem of biased noise, and even if the magnitudes of both are similar, they are likely far from anticorrelated.

@icedquinn @dhfir

@robryk separating someone for the purpose of objectivity is a little different. a doctor refusing to take a case because he doesn't think he can do a good job due to personal ties means the patient goes to a new doctor.

in the case of wars the doctor is deciding on what procedures he's going to get paid for and the patient has basically no say in any of it.

@Hyolobrika @dhfir
@robryk @Hyolobrika @dhfir it probably helps to think in the functional components at work.

when the deciders who profit have to share also in the risk -> skin in the game
when the deciders have no benefit nor risk in the decision -> objectivity
when the deciders who profit do not suffer any risk -> pump and dump, military industrial complex, investment bankers who get bailed out, etc

sometimes the feedback is artificial. like malpractice suits are an artificial way to tie the doctor back to the downside of side effects for drugs he prescribes.

as far as i'm aware it's not considered unethical to give medical advice to your own family. it's forbidden to prescribe pills to *yourself* though, which if i recall has more to do with the prevalence of doctors and nurses becoming drug addicts and it adds at least a basic layer of protection for somebody to stop you from giving yourself a fentanyl addiction.
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@icedquinn

> when the deciders who profit do not suffer any risk -> pump and dump, military industrial complex, investment bankers who get bailed out, etc

Agreed about this part, thinking about previous two still.

> as far as i'm aware it's not considered unethical to give medical advice to your own family.

An AAFP journal recommends to do this only as a last resort: aafp.org/journals/fpm/blogs/in

AMA says that one should not do that except in limited circumstances, albeit giving many more reasons not to do so: ama-assn.org/delivering-care/e

> it's forbidden to prescribe pills to *yourself* though

I don't think it's actually forbidden, except maybe for things that are known to be addictive when used normally. IIRC doctors in Poland are allowed to write a prescription for themselves. I don't know what the medical board says about ethics of doing so, though.

@Hyolobrika@berserker.town @dhfir

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