civil service

As weak signals go, recent press about the differential conditions in the public and private sectors is as good as they get. People in the private sector see their conditions worsen year on year, with pensions being hit hard over the last few years, and now the threat of widespread redundancies in every sector, bonuses slashed and real terms pay cuts. In stark constrast, the public sector has grown enormously, and with the populations in some consituencies heavily dependent on public sector jobs, government has treated them very well to maintain popularity. Doctors and nurses have seen their salaries increase enormously, as have many other roles, and many new nonsense jobs have been created to indulge political correctness of all flavours, especially in local government. People in the civil service receive an average of 4% more pay than their equivalents in the private sector, but that is on top of far better pension provision, far greater job security, far less stress,lower workloads, more tolerance of sick leave, early retirement, and virtually guaranteed career progression.

Such disparity of terms and conditioons between public and private sectors is clearly not sustainable. Government has realised this for years, and has made some feeble efforts to confront the situation, only to immediately retreat in the face of possible industrial action by civil servants wanting to keep their privileges. 

The next year will see the showdown. Oridinary people struggling hard in the face of recession will not tolerate their public service counterparts carrying on as if nothing has happened. The nature of the confrontation remains to be seen. Government might take on the unions and force through changes, but they are unlikely to do so voluntarily, so people are likely to take to the streets and demonstrate, along with media campaigns, until government is forced to act. But some sort of action to fix the disparity is inevitable, and it is hard to believe that it won't begin next year.

NHS deaths

I am very reluctant to get any medical treatment that involves going to hospital. I don't mind needles, the smell of antiseptic, and don't mind looking at the sight of blood, even my own, I've even watched a few minor operations being performed on me before. What worries me now is that there is such a high chance of catching a potentially fatal hospital-induced infection from a filthy ward, or having a doctor or nurse kill me through negligence or incompetence. I know they are taught not to build emotional bonds with their patients in case they kill them (or they die for other reasons) so they mightn't even feel any more guilty than I will if I make a typo while writing this. So I would only go to hospital for stuff that is in itself life threatening. Doctors bury their errors, and many nurses have become lazy and arrogant on the back of misplaced public worship.

The Times today quotes a figure of 40,000 deaths a year attributable to mistakes by doctors. I've seen previous figures of up to 70,000 so it sounds reasonable to me. Additionally, between 5,000 and 10,000 more deaths are reputed to arise from hospital acquired infections due to inadequate hygiene. My personal experience of filthy hospital wards, doctor errors, and nurse negligence makes me perfectly happy to accept such figures, or worse.

So why are we spending so much on trying to reduce road deaths from already the lowest in the world, when the best that could ever be achieved that way is a few lives saved per year? Or better still, why waste billions on health and safety outside hospitals when it would save far more problems if spent improving the NHS. Surely, it would be far better to spend the same amount cleaning wards, or encouraging doctors and nurses to be a little more professional, or even to train them better? Given that public funds are limited, it would be better to spend them where they can achieve the best result. It is normally difficult to compare expenditure, e.g. health with social security, but where the motive is a straightforward one of reducing deaths, then it shoul,d be a very simple decision indeed. A 5-10% drop in deaths caused by the NHS would more than make up for all UK road deaths, numerically speaking at least (though of course not necessarily on an individual basis). 

And the future? Well, if we can't spend money sensibly now, even where evidence is abundant, we can only expect more waste, more unnecessary deaths, more incompetence and negligence, and more targetting of any area that can distract people from the real problems. Not much to look forward to, but any real change will need major changes at government level first.

The future of suicide

Today's UK papers are full of commentary on the law on assisted suicide, after a Swiss-enabled suicide was shown last night on Sky TV.

I used to be involved in fundraising for the Samaritans, a wonderful organisation that helps people who are in despair, some of whom may be thinking of ending it all. Apparently, the worst time of the year is Christmas, when people really feel the pinch of loneliness. With current economic problems, it is likely to be even worse than usual this year. But what of the future?

The very long term (2050 and beyond) will bring technology that allows people to link their brains to the machine world, perhaps using nanotech implants connected to each synapse to relay brain activity to a high speed neural replica hosted by a computer. When this technology has matured, it will allow people to do wonderful things such as using machine sensors as extensions to their own capabilities. They will be able to use android bodies to move around and experience distant places and activities as if they were there in person.

For people who feel compelled to end it all because of disability, pain or suffering, an alternative where they could effectively upload their mind into an android might be attractive. Their quality of life would improve dramatically at least in terms of capability. We might expect that pain and suffering could be dealt with much more effectively too if we have a direct link into the brain to control the way sensations are dealt with. So we might see a big drop in the number of people who want to die.

But the technology options doesn't stop there. If a person has a highly enhanced replica of their own brain/mind, in the machine world, people will begin to ask why they need the original. The machine world could give them greater sensory abaility, graeter physical ability, and greater mental ability. Smarter, with better memory, more and better senses, connected to all the world's knowledge via the net, able effectively to wander around the world at the speed of light, and being connected directly to other people's minds when you want, and doing so without fear of ageing, ill health of pain, this would seem a very attractive lifestyle. And it will become possible this century, at low enough cost for anyone to afford.

What of suicide then? It might not seem so important to keep the original body, especially if it is worn out or defective, so even without any pain and suffering, some people might decide to dispose of their body and carry on their lives without it. Partial suicide might become possible. Aside from any religious issues, this would be a hugely significant secular ethical issue. Updating the debate today, should people be permitted to opt out of physical existence, only keeping an electronic copy of their mind, timesharing android bodies when they need to enter the physical world? Should their families and friends be able to rebuild their loved ones electronically if they die accidentally? If so, should people be able to rebuild several versions, representing the deceased's different life stages, or just the final version, which might have been ill or in decline?

And then the ethical questions get even more tricky. If it is possible to replicate the brain's structure and so capture the mind, will people start to build 'restore points', where they make a permanent record of the state of their self at a given moment? If they get older and decide they could have run their lives better, they might be able to start again from any restore point. If the person exists in cyberspace and has disposed of their physical body, what about ownership of their estate? What about working and living in cyberspace? Will people get jobs? Will they live in virtual towns like the Sims? Indeed, in the same time frame, AI will have caught up and superceded humans in ability. Maybe Sims will get bored in their virtual worlds and want to end it all by migrating to the real world. Maybe they could swap bodies with someone coming the other way?

What will the State do when it is possible to reduce costs and environmental impact by migrating people into the virtual universe? Will it then become socially and politically acceptable, even compulsary when someone reaches a given age or costs too much for health care? People thinking aboiut changing the law now should keep the long thin wedge of social attitude change in mind. It can take as little as two decades to reach a full 180 degree reversal (e.g. attitudes to gays, abortion, genetic modification). The far end of the wedge might not look so appealing.

So perhaps suicide has an interesting future. It might eventually decline, then later increase again, but in many very different forms, becoming a whole range of partial suicide options. But the scariest possibility is that people may not be able to die completely. If their body is an irrelevance, and there are many restore points from whihc they can be recovered, friends, family, or even the state might keep them 'alive' as long as they are useful. And depending on the law, they might even become a form of slave labour, their minds used for information processing or creativity whether they wish it or not. It has often truly been noted that there are worse fates than death.