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Alabama health system pauses IVF treatments after court embryo ruling (thehill.com)
60 points by santaz01 3 months ago | hide | past | favorite | 22 comments



Why can't the states rights people do something to expand rights, not shrink them?


Because the people who claim "states rights" only ever do so when they're being forced to treat other people equally.

Recall they vigorously opposed any state allowing same sex marriage, and even got DOMA passed so that if a couple got married in a state that allowed same sex marriage, the marriage would not be recognized anywhere else.

You know, standard bigot stuff.

Anyway, the overlap between people shouting "states rights" and people claiming the south did not start the civil war, and that the civil war was not about slavery, is large enough that anyone who comes out with "states rights" as their presumptive argument is automatically suspect to me. If you can't come up with an argument for your position beyond "because I [believe I] can", that's a BS position.


I don't think that's quite fair, I think there are reasonable reasons to be for state rights.

Or, in my own words, it's less than I favor state rights and more that I disfavor federal rule.

Federal rulings are winner-take-all. It doesn't matter if 49.9% of the country disagrees, everybody is now bound by the new rule. There is no fallback for them; they can't move to a city or state that has the rules they want.

Being bound by rules that you don't agree with, that your city doesn't agree with, that your state doesn't agree with breeds resentment and culture wars.

We're a country of 300 million people with vastly different backgrounds and beliefs. We are unlikely to reach a national consensus on contentious issues. We can either rule by tyranny of the majority and piss off everyone that disagrees, or give people more self-determination by running things state-by-state where their vote is worth like 50 times more than at the national level.

I won't pretend it's a panacea. Terrible things have been done in the name of state's rights. I don't agree with what Alabama is doing, but I do understand this outcome is important to the people of Alabama. They should have as much of a right to direct their government as anyone else. Even if they want to do things I don't agree with.

California or New York are likewise free to do what they want. Frankly, they could probably offer some kind of publicly funded "state relocation" program to give people from conservative states the funds to relocate, and they'd probably profit off of it.

I also think most of the federal rights crowd is disingenuous. I didn't hear anyone complaining about state rights when California legalized weed or gay marriage. Many states are still defying the federal government with legal weed.

Really, I think whichever side has a majority in the federal government supports federal rights, and the loser supports state rights. Federal rights are popular among liberals because they've been successful at getting the rules they want (for the most part until very recently). Everything is well and good when the tyranny of the majority is on your side.

I think if that flips and conservatives become dominant at the federal level, state rights will become much more important to liberals.


I don't generally see widespread support for federal rights as an ideal in the same way. I rarely see the argument "the federal government should be able to do whatever it wants within it's domain" which is the analog to states rights. Typically people just want individual legislative efforts and for the federal government to accomplish it. The result may be similar in terms of focusing power but it's not really coming from the same place. The extremes of state's rights folks would happily tell you the federal government should be abolished outside of a standing military. There really isn't an opposing side that believes state governments have no place at all. Diminished power sure, but it's not quite the same.

Apart from gun legislation and social programs to some extent, most people on the left don't seem to be pushing for illiberal policies from the government that would amount to forcing their views on others if they succeed. Many leftists support a federal government simply because it's the only reasonable method to do such things as protect the environment at scale, and provide social programs like medicare for all and UBI.

And it's all tyranny of the majority at any level. How else would you describe this ruling and the legislation that allowed it? That's how democracy functions. Even at states rights it's the elites in the big cities deciding how the people in the rural counties live. The only other options are tyranny of the minority (read: bad) or a lack of any governance at all. And it's fine if you believe in the sole dominion of the individual, but lets not pretend that states rights is some sort of ideal rather than a step on the spectrum towards the desired state of the dissolution of any effective government.


> I rarely see the argument "the federal government should be able to do whatever it wants within it's domain" which is the analog to states rights.

You don't see that argument because it's the status quo, there's no reason to argue for it. Through some combination of the 3 federal branches, they literally can do whatever they want. There is unambiguously no higher power in the US to tell them no, short of the states calling a constitutional convention and agreeing to stop it, and even that is subject to Supreme Court interpretation.

The broad interpretation of the Commerce Clause leaves virtually nothing that isn't within the federal domain.

> The extremes of state's rights folks would happily tell you the federal government should be abolished outside of a standing military. There really isn't an opposing side that believes state governments have no place at all. Diminished power sure, but it's not quite the same.

This view absolutely exists, they're just quieter about it. Those arguments take the form of "if state X won't do what I want, we'll make a federal law and take the power to legislate that away from them". There's no need to overtly disenfranchise the state when you can just overrule them whenever they disagree.

That's the insidious part of broad federal power. States only have nominal power and domain, because the feds have asserted that virtually everything could potentially be in their domain. States no longer have unilateral authority over... basically anything. California can't really legalize weed all on its own because the feds have jurisdiction over intra-state sales of goods for... reasons. Abortion is only legal/illegal until the feds make a rule one way or the other.

> Apart from gun legislation and social programs to some extent, most people on the left don't seem to be pushing for illiberal policies from the government that would amount to forcing their views on others if they succeed. Many leftists support a federal government simply because it's the only reasonable method to do such things as protect the environment at scale, and provide social programs like medicare for all and UBI.

This is kind of what I'm talking about, though I don't mean to imply it's primarily a liberal problem (conservatives would likely make similar plays if they had the ability). Europe seems to get by OK with socialized healthcare at roughly the size of a state; they don't need to do socialized healthcare at the EU level (roughly the size of the US).

Some variants of UBI can also work at the state level; hell, they could even work at the city level for cities with wide enough income inequality.

That's not to say that there aren't advantages to doing it at the federal level, but I don't see anything that fundamentally requires the federal government (presuming the feds get out of the way and don't prevent your state from doing it).

> And it's all tyranny of the majority at any level. How else would you describe this ruling and the legislation that allowed it? That's how democracy functions. Even at states rights it's the elites in the big cities deciding how the people in the rural counties live.

Scale makes a massive difference in the tyranny of the majority, because of the impact a single person can have and the resultant hope or despair. Lets say you hypothetically decide to spend all of your time campaigning on your own for some cause, doesn't matter what. In a group of 10 people, you can talk to every person to try to convince them, and likely swing the vote. In a city, you could reasonably reach every person in the city with footwork and a reasonable ad spend. In a state, it starts to look very hard to do, but you could maybe grassroots a movement. At the federal level, you might as well give up before you start. Without an absurd level of funding and hundreds of other people, you're not going to reach even 1% of the population.

The tyranny of the majority is never good, but it gets much worse at scale. Imagine a global government of some sort; the US would be where Idaho or Vermont are now. China and India combined would have nearly half the votes; no one would care what the US wants. Imagine if the US wanting to allow gay marriage hinged on cowtowing to other countries. That's how many US states feel now; they're not allowed to do what their people vote for, so they either suck it up or bow down to a more populous state.

I would generally prefer that power was concentrated where the people most affected by it have the most ability to change it. In an ideal world without realistic constraints, I would prefer that cities had the most power, but that's not realistic for a variety of reasons.

> And it's fine if you believe in the sole dominion of the individual, but lets not pretend that states rights is some sort of ideal rather than a step on the spectrum towards the desired state of the dissolution of any effective government.

I do believe strongly in personal self-determination, but frankly if I were trying to dissolve effective government, I just wouldn't change anything. I'd let things keep going the way they are. The ever-growing culture war and divisions between the sides will dissolve effective government far faster than any kind of legislative action I could encourage. So long as we pursue winner-takes-all solutions at the federal level, there will be bitter fighting between the sides until it erupts in some kind of violence or revolt.

Arguing for state's rights is, to me, a way of preserving effective government. Let the liberals do liberal things, let the conservatives do conservative things, and very sparingly force a consensus via the federal government when we absolutely have to.

I don't even really see how state's rights dissolve effective governance. I'm not proposing we get rid of all the things the fed does, just that we give that power over to the states to do what their people want. California is free to make their own Medicare or Social Security, and Alabama is free to get rid of them.

I suspect a few red states would promptly wreck themselves for a while, and eventually steady out. I suspect a few blue states would have to re-evaluate their budget a decade or two in, but they'd steady out as well. There'd be some things that might have to be re-federalized because they just don't function at the state level. In the end, though, I think everyone would feel far more in control of the laws surrounding them, and be more likely to chuckle about Florida's or California's shenanigans than to let it fuel a vitriol against them.


> You don't see that argument because it's the status quo, there's no reason to argue for it. Through some combination of the 3 federal branches, they literally can do whatever they want. There is unambiguously no higher power in the US to tell them no, short of the states calling a constitutional convention and agreeing to stop it, and even that is subject to Supreme Court interpretation.

What I mean by that is that when someone says we should federally allow abortion, they don't do it from a mental framing where they feel that it is the sole right of the federal government to decide to do such a thing. They do it from a position where the outcome they desire is for everyone to have access to abortion and the federal government is a tool to enable it. Like you say, it may only be possible to think in those terms because it is the status quo everywhere the supreme court hasn't deemed it not to be, and maybe if it weren't these people would be calling for it to be, but that's not an argument many are people are making right now as far as I see. It seems to be more about a desired result than a principled position regarding the role of state vs federal government.

> This is kind of what I'm talking about, though I don't mean to imply it's primarily a liberal problem (conservatives would likely make similar plays if they had the ability). Europe seems to get by OK with socialized healthcare at roughly the size of a state; they don't need to do socialized healthcare at the EU level (roughly the size of the US).

I don't typically think of programs like with UBI and M4A as a states rights issue, though I can certainly see how that is likely be a gap in my own perspective. I do agree such that programs runs contrary to my above statement about framing as these are typically presented as baseline necessities granted to all members of our country. Outside of the ideological aspect though, programs of these types almost invariably perform better at larger scales, similarly to how larger insurance almost invariably perform better than smaller ones. Remove bureaucratic messes like means testing and there's simply no way for a state run M4A or UBI to be as effective as a federal one.

>Scale makes a massive difference in the tyranny of the majority, because of the impact a single person can have and the resultant hope or despair. Lets say you hypothetically decide to spend all of your time campaigning on your own for some cause, doesn't matter what. In a group of 10 people, you can talk to every person to try to convince them, and likely swing the vote. In a city, you could reasonably reach every person in the city with footwork and a reasonable ad spend. In a state, it starts to look very hard to do, but you could maybe grassroots a movement. At the federal level, you might as well give up before you start. Without an absurd level of funding and hundreds of other people, you're not going to reach even 1% of the population.

I do agree this is a massive problem with our current representation at the federal level. I haven't given it enough consideration to have a firm idea of how to address it but having 1 representative to almost million voters is not tenable. The population has tripled since the last time we increased the number of house reps. At the founding a US house rep had as many constituents as a modern state rep does.

> Arguing for state's rights is, to me, a way of preserving effective government. Let the liberals do liberal things, let the conservatives do conservative things, and very sparingly force a consensus via the federal government when we absolutely have to.

That's not a stance I agree with but it's not unreasonable. I frequently find that people advocating for that level of state's rights can be pushed to reveal that they think governance itself is morally wrong, that taxes are violence, and that disempowering the federal government is only the beginning. Somewhat similarly to how some advocating for M4A do so without arguing their real agenda of nationalizing everything under the sun.


> What I mean by that is that when someone says we should federally allow abortion, they don't do it from a mental framing where they feel that it is the sole right of the federal government to decide to do such a thing. They do it from a position where the outcome they desire is for everyone to have access to abortion and the federal government is a tool to enable it.

This is an interesting interpretation, I feel like that gave me a better understanding of your position, well argued :) I also want to thank you for taking the time to engage in a friendly and genuinely interesting conversation.

This isn't really an ideological Constitutional perspective on my end either. I'm not entrenched in the concept of states so much as that I think "rules for everyone" are contentious and typically a bad idea. Eg I'd be open to the idea of granting the greatest power to counties if I could be convinced that it wouldn't confuse the hell out of everyone because of the varying jurisdictions.

States are, to me, also just a useful abstraction. They feel like about as small of a unit of jurisdiction as we could feasibly have without completely ruining any kind of cohesion or economy.

> Outside of the ideological aspect though, programs of these types almost invariably perform better at larger scales, similarly to how larger insurance almost invariably perform better than smaller ones. Remove bureaucratic messes like means testing and there's simply no way for a state run M4A or UBI to be as effective as a federal one.

In an ideal world, I would definitely agree. In the real world, I think I still agree, but less strongly. At the federal level, you'll have to deal with Alabama or Florida constantly trying to ruin it, the same way Medicare currently is.

Some states are likely incapable of running UBI at all on their own, because their populace is too poor. There isn't enough wealth to redistribute.

> I haven't given it enough consideration to have a firm idea of how to address it but having 1 representative to almost million voters is not tenable. The population has tripled since the last time we increased the number of house reps. At the founding a US house rep had as many constituents as a modern state rep does.

This is basically where I started, and ended up with my current views. Expanding the House and/or Senate sounds good, because your rep cares more what you think, but it also waters down how much influence your rep has.

I.e. you get more influence over a less influential person.

In a similar statistical tract, there were only 2.5 million people in the US in 1776. That is to say that at it's founding, the federal government ruled a populace that was 6.25% the population of just California (the voting population in 1776 would have been even lower because of the rampant disenfranchisement).

Early citizens had more individual control of the federal government than modern CA citizens have over their own state.

The city I live in has almost half the population of 1776 US.

I do think the nature of government has changed as these mechanisms have been stretched to population levels their creators probably never imagined.

> That's not a stance I agree with but it's not unreasonable. I frequently find that people advocating for that level of state's rights can be pushed to reveal that they think governance itself is morally wrong, that taxes are violence, and that disempowering the federal government is only the beginning. Somewhat similarly to how some advocating for M4A do so without arguing their real agenda of nationalizing everything under the sun.

I empathize with some of those views, but also recognize they're just not feasible.

I don't think governance is morally wrong. I do find it less than ideal that people are effectively coopted into a government at birth, and subject to rule by an entity that they never have the opportunity to reject. I would support a primarily ideological measure to allow people to revoke their citizenship and go live in the woods and grow mushrooms or whatever they want to do the government won't let them do. Something similar to the arrangement with Native American tribes.

That sentiment is largely intertwined with the reality that basically all habitable land is claimed at this point. You can't ride off into the wilderness to found your own civilization anymore. I do think there should be some kind of escape hatch for people who find governmental rule oppressive. They might be nutjobs or wrong about what they want, but I do think they deserve the right to bow out of society (both the bad and the good) if they do choose.

I do think there's an aspect of violence to taxes (primarily due to the above compulsory membership), but it's unfortunately unavoidable. If there were a way for the government to function without compulsory taxes, I would support it, but there isn't. Things have to be paid for, and asking people to voluntarily donate would be a budgeting nightmare and destroy the government.

To me, those issues really stem from governments being founded on the monopoly on violence. I would prefer a world where our governments aren't bound together by violence, but by a genuine desire of every citizen to keep them going. Where people don't pay taxes because they're afraid of going to jail, but because they're proud of what those taxes enable. Where people join a government because they want to contribute to what that government stands for.

Sadly, I don't think we're there, nor are we particularly close. The monopoly on violence has historically been the only real means to maintain social cohesion and a functional government. Perhaps one day far in the future.


The term "states rights" is carefully coded. It doesn't "more rights". It means "The state has rights, and you don't".

It's not a path to "individual rights"; it's exactly the opposite. The term gets bandied about most often when the federal government wants to guarantee an individual right, and a local majority doesn't want the individual to have it.

The poster child for "states rights" is the Lost Cause mythology. What rights were the states demanding to have? They were very explicit about it: the right to own human beings, and ensure that they had no rights whatsoever.

https://www.battlefields.org/learn/primary-sources/declarati...


Stuff like this is why all of my friends and peers are leaving Alabama. I would love to leave but my wife refuses to leave while my MIL is still alive and living near by.

Of course all of the stats say that plenty of people are moving to Alabama. But not the kind of people you want as neighbors. Thanks, Fox News.


It's wild watching half the country gleefully roll itself back to medieval times.


from the article, worth discussion right?

The Wrongful Death of a Minor Act “applies to all unborn children, regardless of their location,” wrote Alabama Supreme Court Justice Jay Mitchell.

In a concurring opinion, Chief Justice Tom Parker quoted scripture to note that divine law recognizes all human life as sacred.

“Even before birth, all human beings have the image of God, and their lives cannot be destroyed without effacing his glory,” Parker wrote. “We believe that each human being, from the moment of conception, is made in the image of God, created by Him to reflect His likeness.”


divine law. as per what and who again?


As far as "replacement theory" goes, this'll be sure to increase the already-declining (rapidly) fertility rate /s...


The census will have to add lines for "unborn people (metabolically active)" and "unborn people (metabolic stasis)". /s

IVF is the domain of the upper middle-class and the rich. So around 80% of Alabama IVF users are likely to be Republicans in agreement with white nationalist lite, Christian fundamentalist patriarchy. Complaints will be ignored by the self-righteous triumphalist legislature proud of ramming through their anti-freedom agenda.


I was right there with you on the outrage, having read a few other articles on the subject. But a few details in this article made me look at the actual decision, and the specific outcome is much less obtuse than has been implied. Bad facts make bad law, as they say.

Basically two couples went through IVF, created embryos, and those embryos were frozen. Some other patient at the hospital gained access to the lab through an "unsecured" door, opened up the frozen storage container, pulled the embryos out, and promptly dropped them (extreme cold), destroying them. The plaintiffs are looking at the hospital for civil damages, due to the negligence of not securing the storage.

The court's decision seems like a straightforward application of how Alabama's constitution was previously amended regarding the unborn. Philosophically, I do not agree with that amendment - especially as its main aim is as a wedge for preventing straightforward women's medical care in favor of more lethal options.

But I've also got a hard time brushing aside these would-be parents' desire for accountability from the hospital for the deaths of what they had hoped would be their children. In this case the "rights of the unborn" and the rights and desires of the parents were aligned (rather than being in conflict as in most situations of this topic). The hospital should not be allowed to hide behind the standard disclaimers about medical outcomes not being assured, or the vanishing "market value" of tissue samples, to shirk basic responsibility that would have easily prevented the plaintiffs' horrible losses.

I do agree the implications of the decision being available as a precedent aren't great on a few fronts, but that responsibility rests on the constitutional amendment itself.


My latest newborn has to have two bracelets and never leave the room. I understand the concern, but would like to push back on the increase in cost and restrictions.

Safety-maximalism will maximize expense, we agree on that?

As a customer can I opt into a safety/cost ratio from 20 years ago? With today's technology and medicine that would result in affordable abundance.


I agree with your general point. I just went through something similar myself with a "locked ward" that basically meant I had to precariously balance the cafeteria trays I was carrying to put a disease-ridden phone up to my ear, while seemingly like a trivial speedbump for anybody wanting to get in surreptitiously.

But here we're talking about access control for a staff-only area that's being used for longer term storage, which doesn't seem onerous at all. Especially with IVF where they should be taking identification/labeling seriously because people understandably don't want to end up carrying someone else's baby due to mix ups.


Much like the abortion bans these states are enforcing today, and just as was the case in the past, these laws do not impact the rich.

The rich could get abortions before roe v wade, they can get them today. The same applies to IVF, but now even if you were middle class with health insurance that did cover IVF (it's unclear whether this is mandatory or not), health insurance does not cover travel or accommodation needed for treatment.


>domain of the upper middle-class and the rich ... Christian fundamentalist patriarchy

Agreed. If they're anything like my favorite voted-for-Reagan construction clients, they'll scream "Build the wall!" in front of their non-citizen housekeeperS; while Mr. goes to strip clubs and Mrs. has vibrators (Reagan campaigned against both, as obscene).

----

Only so much time in the day for such hypocracy!!!

----

I read here on HN, just this morning, something to the effect of:

>>Our global economy has become an amalgamation of the worst parts of both capitalism and communism

And the above example (from my favorite client) is spot-on(-true).


>> Our global economy has become an amalgamation of the worst parts of both capitalism and communism...

and religion


[flagged]


get therapy.


Oh no, honey. No.




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