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1 minute ago, pawnman said:

I didn't answer them because I'm tired of playing the game where you poke a hole in every answer.

There is a limit to hospital capacity.  I'm with you...help as much as we can, for as many people as we can.  But at some point, we're gonna have more sick people than we have capacity.  What's your answer to increasing hospital capacity in an area over-run with Covid?  Where do you get additional bed space, doctors, nurses, ventilators, medication...?

It sounds great to "just increase capacity".  Hell, why didn't the President think of that?  Just put more people in hospitals, problem solved!  While we're at it, why don't we just increase capacity in Afghanistan until we've airlifted everyone?  Why are we making decisions about who gets refugee status - just increase the capacity!  It's so simple!

I didn't poke any holes in your answers. They were already there.

You say you're getting tired, so I won't run this into the ground. I could you if you like, but you seem like you don't.

You don't have to do it here, but let this thought roll around in your head a while:

"I am so secure in my convictions that would take one person off a ventilator and give it to another over their vaccination status."

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11 minutes ago, torqued said:

I didn't poke any holes in your answers. They were already there.

You say you're getting tired, so I won't run this into the ground. I could you if you like, but you seem like you don't.

You don't have to do it here, but let this thought roll around in your head a while:

"I am so secure in my convictions that would take one person off a ventilator and give it to another over their vaccination status."

Yes, I am.

And you're so secure in your convictions you'd let a vaccinated person die over an unvaccinated one.

 

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1 minute ago, pawnman said:

Yes, I am.

And you're so secure in your convictions you'd let a vaccinated person die over an unvaccinated one.

 

No, I am not. I am simply admitting I do not have enough information to take a life.

Therein lies the fundamental difference between us. You would kill over vaccination status. I would not.

In just a few posts, we've reached the impasse that all of society will soon face. Words don't solve it.

 

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https://www.wired.com/story/would-it-be-fair-to-treat-vaccinated-covid-patients-first/

Some salient points on the topic in this article, despite being published in Wired.

There is already an established triage hierarchy in medicine, and adding vaccination status into it introduces a whole new wave of other ethical decisionpoints that are unwelcome to the medical profession writ large.

Bottom line: by the time someone gets to the point where they need to be admitted to inpatient hospital treatment, they certainly medically "deserve" that level of care just as much as any other patient.

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4 minutes ago, torqued said:

No, I am not. I am simply admitting I do not have enough information to take a life.

Therein lies the fundamental difference between us. You would kill over vaccination status. I would not.

In just a few posts, we've reached the impasse that all of society will soon face. Words don't solve it.

 

Applaud your indiscriminate empathy but you cannot hide behind "my action is no action/I don't know" if you are a leader. If there were to be another harsh outbreak, and hospital were to be over run, decisions have to be made. Do you save someone who at least tried to save themselves? If you had two car crash victims come in, identical traumas, your the only surgeon on staff, do you save the one who wore a seatbelt or the one who did not? 

I do want to point out that there are two "no shot" groups. I think there is a group who is legitimately scared about the shot not being tested enough. I empathize heavily with these people, they are just trying to stay safe and make the correct call like anyone else. 

The other group is trying to prove some political point/live up to some tough guy ethos/fvck covid I ain't no bitch. Some people are just difficult for the sake of being difficult and it has complicated this entire process.  

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3 minutes ago, Hacker said:

https://www.wired.com/story/would-it-be-fair-to-treat-vaccinated-covid-patients-first/

Some salient points on the topic in this article, despite being published in Wired.

There is already an established triage hierarchy in medicine, and adding vaccination status into it introduces a whole new wave of other ethical decisionpoints that are unwelcome to the medical profession writ large.

Bottom line: by the time someone gets to the point where they need to be admitted to inpatient hospital treatment, they certainly medically "deserve" that level of care just as much as any other patient.

Thanks, I wish I could have articulated my points as well as this article does.

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On 8/26/2021 at 9:36 PM, frog said:

Somewhere on the internet, there is a forum of virologists arguing about how to fly fighter aircraft. 

Numerous forums I participate in have hilariously uninformed but spicy debates about military aviation between individuals of every other profession besides military aviation.

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3 minutes ago, hockeydork said:

Applaud your indiscriminate empathy but you cannot hide behind "my action is no action/I don't know" if you are a leader. If there were to be another harsh outbreak, and hospital were to be over run, decisions have to be made. Do you save someone who at least tried to save themselves? If you had two car crash victims come in, identical traumas, your the only surgeon on staff, do you save the one who wore a seatbelt or the one who did not? 

I do want to point out that there are two "no shot" groups. I think there is a group who is legitimately scared about the shot not being tested enough. I empathize heavily with these people, they are just trying to stay safe and make the correct call like anyone else. 

The other group is trying to prove some political point/live up to some tough guy ethos/fvck covid I ain't no bitch. Some people are just difficult for the sake of being difficult and it has complicated this entire process.  

As I told pawnman, it's really easy to set up a hypothetical scenario that allows you punt the football out the stadium. As I did earlier, I could introduce a few complications and complexities to your example and you, also, wouldn't be able to create such an obvious answer.

You're not a surgeon, pawnman is not a surgeon, and neither of you have been faced with these false dilemmas, nor do you know of anyone who has. I know that's sort of blunt, and I risk raising your ire by pointing that out. However, I can be reasonably certain that you will never be in that situation or have the ability to comprehend all the nuances and variables required to make such a decision. So... for you to profess that you have the knowledge and moral authority to make a life-death decision in a this unrealistic hypothetical is more than a little off-putting.

You don't get to decide who lives or dies in the ER and, thankfully, you never will.

 

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7 minutes ago, torqued said:

As I told pawnman, it's really easy to set up a hypothetical scenario that allows you punt the football out the stadium. As I did earlier, I could introduce a few complications and complexities to your example and you, also, wouldn't be able to create such an obvious answer.

You're not a surgeon, pawnman is not a surgeon, and neither of you have been faced with these false dilemmas, nor do you know of anyone who has. I know that's sort of blunt, and I risk raising your ire by pointing that out. However, I can be reasonably certain that you will never be in that situation or have the ability to comprehend all the nuances and variables required to make such a decision. So... for you to profess that you have the knowledge and moral authority to make a life-death decision in a this unrealistic hypothetical is more than a little off-putting.

You don't get to decide who lives or dies in the ER and, thankfully, you never will.

 

My asthmatic GF is a soon to be nurse. Nothing hypothetical about that. She'll be exposed to the hospital environment all this fall, nothing hypothetical about that. So for me it isn't just a keyboard warrior issue. Should I send her into work to care for COVID patients, vax or unvaxxed? What if she gets it and can't pull out of it? Am I going to feel responsible? Would I feel better if she got sick trying to save a vaxxed person over an unvaxxed one? 

Not a surgeon, neither is pawnman, neither are you I'm assuming. And guess what, you aren't the CDC or the FDA who are telling you the shot is safe and effective. Nice appeal to a surgeons technical authority while also blindly ignoring the ones that are inconvenient for you. And nope, won't decide who lives or dies. At least I could decide tho. You'd just sit there with your "I don't know, let's help everyone" pants on. Let's open the borders than, every South American is a human just like you, let's help all of them get the American dream. 

Also...way to go with the condescending tone, nice civil debate turned hostile.

 

 

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25 minutes ago, hockeydork said:

My asthmatic GF is a soon to be nurse. Nothing hypothetical about that. She'll be exposed to the hospital environment all this fall, nothing hypothetical about that. So for me it isn't just a keyboard warrior issue. Should I send her into work to care for COVID patients, vax or unvaxxed? What if she gets it and can't pull out of it? Am I going to feel responsible? Would I feel better if she got sick trying to save a vaxxed person over an unvaxxed one? 

Not a surgeon, neither is pawnman, neither are you I'm assuming. And guess what, you aren't the CDC or the FDA who are telling you the shot is safe and effective. Nice appeal to a surgeons technical authority while also blindly ignoring the ones that are inconvenient for you. And nope, won't decide who lives or dies. At least I could decide tho. You'd just sit there with your "I don't know, let's help everyone" pants on. Let's open the borders than, every South American is a human just like you, let's help all of them get the American dream. 

Also...way to go with the condescending tone, nice civil debate turned hostile.

First, I apologize if it seemed I am being hostile and condescending. I know I'm being direct, but I'm trying not to make it personal. I've had this debate with a few friends and although we get charged up over it, we remain friends.

I'm assuming your girlfriend is vaccinated. If so, what's the problem? Why do you worry?

The specific issue in this debate that I might seem passionate about is the logical leaps one must make to justify actively taking one life in the belief you're saving another on the basis of vaccination status.

You're talking about what kind of pants I'm wearing and open borders. Your argument is a mess.

What is the goal of vaccines? Is it to create antibodies to fight COVID? If that is the result you are trying to achieve, why would you differentiate the method by which it was achieved?

Again, I'm being direct. Don't take it personally. I often don't have time to disarm my language with delicate words and subtle suggestions. I don't think you're an idiot.

CS Lewis, circa 1948:

 

 

ERUNRuOU0AAIPMs.jpg

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If we have vaccinated people needing ventilators en masse… Something has seriously gone wrong, as the whole point of the vaccine is to at least prevent that outcome.

Do we have any data showing such a hypothetical is even happening in small samples? How many vaccinated people are being hospitalized?

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27 minutes ago, Kiloalpha said:

If we have vaccinated people needing ventilators en masse… Something has seriously gone wrong, as the whole point of the vaccine is to at least prevent that outcome.

Do we have any data showing such a hypothetical is even happening in small samples? How many vaccinated people are being hospitalized?

No the argument is mute.  A dilemma for a MD to choose between a vaxed or un-vaxed patient?  If that is a true scenario the vax has failed.

We are being told that 99% of all patients are un-vaxed.  Israel is hte most vaxed population on earth but pushing a booster now?  

The US is about 50-60% vaxed now not factoring in hte under age 12 group.  So a huge chunk of hte population has the needle.  Therefore the pool of ppl to be infected should be pretty small at this point.  Considering 60% would show no symptoms, 28% would be mild and 12% would need hospitalization.  

This is why some ppl are questioning the shot in the first place.

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Just now, torqued said:

First, I apologize if it seemed I am being hostile and condescending. I know I'm being direct, but I'm trying not to make it personal. I've had this debate with a few friends and although we get charged up over it, we remain friends.

I'm assuming your girlfriend is vaccinated. If so, what's the problem? Why do you worry?

The specific issue in this debate that I might seem passionate about is the logical leaps one must make to justify actively taking one life in the belief you're saving another on the basis of vaccination status.

You're talking about what kind of pants I'm wearing and open borders. Your argument is a mess.

What is the goal of vaccines? Is it to create antibodies to fight COVID? If that is the result you are trying to achieve, why would you differentiate the method by which it was achieved?

Again, I'm being direct. Don't take it personally. I often don't have time to disarm my language with delicate words and subtle suggestions. I don't think you're an idiot.

 

We're cool, not trying to offend you either man. Sorry if it feels like I am saying someone who didn't get the shot's life would be easy to cast away/is worthless, that's not what I am intending to say.  

1) So I am onboard with you on the argument if she's vaxxed, what is the problem than? She should be protected if the shot is so good like the drug companies/CDC/FDA supposedly say it is. We have talked about this, travel nurse salaries are insane right now. If she get's her booster (if it is recommended) I am fine with her going to work and taking care of vaxxed/unvaxxed people with the same level of care. The issue is only if there is a mutation that renders the shot ineffective, do I send her in to work? Am I going to send her into a hospital that is getting lit up with some new form of COVID to care for people who did not at least try to proactively defend against COVID? It's a crummy thought but it is very possible scenario. For humanity's sake let's hope this winter isn't a shit show regardless of anyone's vax stance. I am sure both you and I would rather be talking about anything else besides this issue.  

2) I don't think saving/taking a life boils down to just vax status. Like you said...there are so many factors. But if all else is equal and hospitals are full, who do you save? Now if someone verified HAD COVID, and didn't get the shot, yes I concur that person is no different than a vaxxed person, so if you are a reinfected vaxxed person vs. a had actual COVID before the shot was available and got reinfected, same difference to me when you show up in the hospital. I think we're on the same page here. If you have never had COVID and won't get the shot, I think you're making a poor call. 

3) What isn't the same difference is saying that getting REAL COVID is a "better" first time way to get the antibodies than the shot. This is very much a YMMV situation I guess. My friends mother in law didn't get the shot, ended up in rough shape in the hospital. Her Dad had already died from a heart attack too when his wife was little and was an athlete (heart defect), mother is fit. I got the shot, and was tired for a day. Was it worth her maybe not making it just to get the antibodies the natural way? Was it worth a 24 year old daughter potentially having no parents left because her mothers first exposure to COVID was the real deal? I don't think so, thankfully she recovered but damn, what if she hadn't? At the end of the day tho that was her decision, and I respect her rights, even tho I think it was still a bad decision. 

Immunity drops off over time, seems to be agreed upon not matter if you had the shot or real COVID. The difference is getting the antibodies by the shot isn't nearly as risky as getting them by going out and getting real COVID, at least per the FDA/CDC. Her getting real COVID landed her in the hospital. I sat in my bed and watched Netflix. 

If the damn thing didn't mutate I don't think there'd be anything wrong with stamping COVID out long term via a combo of natural immunity and vax. But it seems to me like in order to get rid of it you gotta squash it real quick by having everybody immunized at the same time. If it's only half the population that's immunized at a time, be it natural immunity or vax, the virus will just keep festering and mutating. 

Could we get everyone immunized naturally at once by spreading COVID rapidly? Sounds nuts, but I do think that would work, but we might lose some people. The shot seems like a better/safer way to do it. 

The border thing was just an analogy...that sometimes we cannot save everyone, even if we want to/they deserve it. 

 

Handshake. 

 

 

 

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1 hour ago, ecugringo said:

No the argument is mute.  A dilemma for a MD to choose between a vaxed or un-vaxed patient?  If that is a true scenario the vax has failed.

We are being told that 99% of all patients are un-vaxed.  Israel is hte most vaxed population on earth but pushing a booster now?  

The US is about 50-60% vaxed now not factoring in hte under age 12 group.  So a huge chunk of hte population has the needle.  Therefore the pool of ppl to be infected should be pretty small at this point.  Considering 60% would show no symptoms, 28% would be mild and 12% would need hospitalization.  

This is why some ppl are questioning the shot in the first place.

Moot. 
 

 

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2 hours ago, torqued said:

As I told pawnman, it's really easy to set up a hypothetical scenario that allows you punt the football out the stadium. As I did earlier, I could introduce a few complications and complexities to your example and you, also, wouldn't be able to create such an obvious answer.

You're not a surgeon, pawnman is not a surgeon, and neither of you have been faced with these false dilemmas, nor do you know of anyone who has. I know that's sort of blunt, and I risk raising your ire by pointing that out. However, I can be reasonably certain that you will never be in that situation or have the ability to comprehend all the nuances and variables required to make such a decision. So... for you to profess that you have the knowledge and moral authority to make a life-death decision in a this unrealistic hypothetical is more than a little off-putting.

You don't get to decide who lives or dies in the ER and, thankfully, you never will.

 

Hey, by that token, none of us except @stuckindaytonare doctors, so this is all just a giant circle-jerk to feel good about our own arguments.  

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5 minutes ago, hockeydork said:

We're cool, not trying to offend you either man. Sorry if it feels like I am saying someone who didn't get the shot's life would be easy to cast away/is worthless, that's not what I am intending to say.  

1) So I am onboard with you on the argument if she's vaxxed, what is the problem than? She should be protected if the shot is so good like the drug companies/CDC/FDA supposedly say it is. We have talked about this, travel nurse salaries are insane right now. If she get's her booster (if it is recommended) I am fine with her going to work and taking care of vaxxed/unvaxxed people with the same level of care. The issue is only if there is a mutation that renders the shot ineffective, do I send her in to work? Am I going to send her into a hospital that is getting lit up with some new form of COVID to care for people who did not at least try to proactively defend against COVID? It's a crummy thought but it is very possible scenario. For humanity's sake let's hope this winter isn't a shit show regardless of anyone's vax stance. I am sure both you and I would rather be talking about anything else besides this issue.  

2) I don't think saving/taking a life boils down to just vax status. Like you said...there are so many factors. But if all else is equal and hospitals are full, who do you save? Now if someone verified HAD COVID, and didn't get the shot, yes I concur that person is no different than a vaxxed person, so if you are a reinfected vaxxed person vs. a had actual COVID before the shot was available and got reinfected, same difference to me when you show up in the hospital. I think we're on the same page here. If you have never had COVID and won't get the shot, I think you're making a poor call. 

3) What isn't the same difference is saying that getting REAL COVID is a "better" first time way to get the antibodies than the shot. This is very much a YMMV situation I guess. My friends mother in law didn't get the shot, ended up in rough shape in the hospital. Her Dad had already died from a heart attack too when his wife was little and was an athlete (heart defect), mother is fit. I got the shot, and was tired for a day. Was it worth her maybe not making it just to get the antibodies the natural way? Was it worth a 24 year old daughter potentially having no parents left because her mothers first exposure to COVID was the real deal? I don't think so, thankfully she recovered but damn, what if she hadn't? At the end of the day tho that was her decision, and I respect her rights, even tho I think it was still a bad decision. 

Immunity drops off over time, seems to be agreed upon not matter if you had the shot or real COVID. The difference is getting the antibodies by the shot isn't nearly as risky as getting them by going out and getting real COVID, at least per the FDA/CDC. Her getting real COVID landed her in the hospital. I sat in my bed and watched Netflix. 

If the damn thing didn't mutate I don't think there'd be anything wrong with stamping COVID out long term via a combo of natural immunity and vax. But it seems to me like in order to get rid of it you gotta squash it real quick by having everybody immunized at the same time. If it's only half the population that's immunized at a time, be it natural immunity or vax, the virus will just keep festering and mutating. 

Could we get everyone immunized naturally at once by spreading COVID rapidly? Sounds nuts, but I do think that would work, but we might lose some people. The shot seems like a better/safer way to do it. 

The border thing was just an analogy...that sometimes we cannot save everyone, even if we want to/they deserve it. 

 

Handshake. 

 

 

 

Great post, I appreciate the thoughts. I can sort of follow your train of logic, but I still have problems with it.

When, not if, the mutation of the virus turns up in the hospital where your girlfriend works and she is at risk because her vaccine is ineffective against it, being vaccinated/unvaccinated has no longer has any meaning. My point being, once a variant exists, everyone is effectively unvaccinated, so it shouldn't be factor in determining who gets treated. There are currently an untold number of variants, and we're told Delta is the predominant one. Let's add that there is no way to know which variant anyone has unless an individual sample is genetically sequenced. That's not happening.

The obvious solution is to prevent variants, right? (I'm probably rehashing someone else's argument in another thread here, but I don't know.) Many of us are led to believe that getting everyone vaccinated prevents the mutation and spread of variants.

Is that how it works? No.

Do vaccines destroy the virus? No.

Do vaccines create antibodies? Yes.

Do antibodies improve an individuals immune response and perhaps lessen the viral load? I think so.

Do vaccines prevent mutations from occurring? No. https://www.npr.org/2021/02/09/965703047/vaccines-could-drive-the-evolution-of-more-covid-19-mutants

Are natural antibodies more robust and longer lasting than those resulting from vaccines? Who am I to say? https://www.bloomberg.com/news/articles/2021-08-27/previous-covid-prevents-delta-infection-better-than-pfizer-shot

Check out the phylogenetic tree lineage for viruses. Coronaviruses are distinct from influenza viruses, which are distinct at a higher level than, say, the Polio virus. Until recently, coronaviruses have always been known as the "Common Cold", for which a cure or a vaccine has never before been found. One major reason is because they can never be eradicated from animal reservoirs. We do have annual influenza shots, but how effective have they been in eliminating the flu? The point being, coronavirus variants will always exist because they will always lead the cure.

None of this is about curing the virus.

 

 

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10 minutes ago, pawnman said:

Hey, by that token, none of us except @stuckindaytonare doctors, so this is all just a giant circle-jerk to feel good about our own arguments.  

I guess... if it's even possible to feel good about your argument to jerk someone's breathing tube out of their throat.

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Just now, pawnman said:

Sick burn, bro.  Musta been captain of your debate team.

I wasn't trying to burn you or score a point. I'm honestly conveying my disgust for a truly despicable and indefensible position.

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4 minutes ago, torqued said:

I wasn't trying to burn you or score a point. I'm honestly conveying my disgust for a truly despicable and indefensible position.

Sure...must be nice to live in a fantasy land where every person has everything they need and no one is ever constrained by resources.

 

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15 minutes ago, torqued said:

Great post, I appreciate the thoughts. I can sort of follow your train of logic, but I still have problems with it.

When, not if, the mutation of the virus turns up in the hospital where your girlfriend works and she is at risk because her vaccine is ineffective against it, being vaccinated/unvaccinated has no longer has any meaning. My point being, once a variant exists, everyone is effectively unvaccinated, so it shouldn't be factor in determining who gets treated. There are currently an untold number of variants, and we're told Delta is the predominant one. Let's add that there is no way to know which variant anyone has unless an individual sample is genetically sequenced. That's not happening.

The obvious solution is to prevent variants, right? (I'm probably rehashing someone else's argument in another thread here, but I don't know.) Many of us are led to believe that getting everyone vaccinated prevents the mutation and spread of variants.

Is that how it works? No.

Do vaccines destroy the virus? No.

Do vaccines create antibodies? Yes.

Do antibodies improve an individuals immune response and perhaps lessen the viral load? I think so.

Do vaccines prevent mutations from occurring? No. https://www.npr.org/2021/02/09/965703047/vaccines-could-drive-the-evolution-of-more-covid-19-mutants

Are natural antibodies more robust and longer lasting than those resulting from vaccines? Who am I to say? https://www.bloomberg.com/news/articles/2021-08-27/previous-covid-prevents-delta-infection-better-than-pfizer-shot

Check out the phylogenetic tree lineage for viruses. Coronaviruses are distinct from influenza viruses, which are distinct at a higher level than, say, the Polio virus. Until recently, coronaviruses have always been known as the "Common Cold", for which a cure or a vaccine has never before been found. One major reason is because they can never be eradicated from animal reservoirs. We do have annual influenza shots, but how effective have they been in eliminating the flu? The point being, coronavirus variants will always exist because they will always lead the cure.

None of this is about curing the virus.

 

 

Long term you may indeed be right. There is something to be said for from an immunity standpoint would we have been better off all catching the same variant of COVID quickly with natural immunity. Like you said, who knows. The problem with that plan of action tho was the hospital capacity isn't/wasn't available. If this was just the common cold people wouldn't be stuck in the ICU due to COVID. Maybe from a population standpoint this was indeed the better move, but from an individual stand point not so much if you were the one who ended up getting rocked by the virus. 

If it was possible, it isn't, maybe the best thing would be to have every human lock themselves in a room for a few weeks. 

I don't know either dude, if there's a variant that starts cracking through the current vaxs defenses significantly, that is going to really suck for everybody. Let's both hope it doesn't happen. 

 

 

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17 minutes ago, pawnman said:

Sure...must be nice to live in a fantasy land where every person has everything they need and no one is ever constrained by resources.

 

It's not as nice as the feeling of moral superiority when you pull the plug on someone's life support, I'm sure.

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