Proposals for some rather simple changes to Ground Warfare to make it more strategic

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Do you have proof that the game must always make sense?
This kind of counter-argument is prohibitive. If you assume that logic is out the window, then my biggest joy is roasting almonds while stalking prey, and I think the game should do nothing as the raccoon attacks the lady’s bag of food.
 
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Do you have proof that the game must always make sense?


You think that a population increasing in size 100-fold over the course of a few years without any immigration is reasonable?


Yes, but you haven't offered any proof that a colony ship is just one ship.


But there's no reason to think that different classes of ships are on the same scale as each other. There's no consistent scale at which things are depicted in the system view.

This kind of counter-argument is prohibitive. If you assume that logic is out the window, then my biggest joy is roasting almonds while stalking prey, and I think the game should do nothing as the raccoon attacks the lady’s bag of food.

MathyM got the right answer:



The story goes that Bertrand Russell, in a lecture on logic, mentioned that in the sense of material implication, a false proposition implies any proposition.

A student raised his hand and said "In that case, given that 1 = 0, prove that you are the Pope."

Russell immediately replied, "Add 1 to both sides of the equation: then we have 2 = 1. The set containing just me and the Pope has 2 members. But 2 = 1, so it has only 1 member; therefore, I am the Pope."



Also concerning the increase of people to 100-fold:



L'intento di Leonardo Fibonacci era quello di trovare una legge matematica che descrivesse la crescita di una popolazione di conigli.

Assumendo per ipotesi che:

  • si disponga di una coppia di conigli appena nati
  • questa prima coppia diventi fertile al compimento del primo mese e dia alla luce una nuova coppia al compimento del secondo mese;
  • le nuove coppie nate si comportino in modo analogo;
  • le coppie fertili dal secondo mese di vita in poi diano alla luce una coppia di figli al mese;
si verifica quanto segue:

  • dopo un mese una coppia di conigli sarà fertile,
  • dopo due mesi ci saranno due coppie di cui una sola fertile,
  • nel mese seguente, terzo mese dal momento iniziale, ci saranno 2+1=3 coppie perché solo la coppia fertile avrà generato; di queste tre, due saranno le coppie fertili, quindi
  • nel mese seguente (quarto mese dal momento iniziale) ci saranno 3+2=5 coppie
In questo esempio, il numero di coppie di conigli di ogni mese esprime la successione di Fibonacci.



Leonardo Fibonacci's intent was to find a mathematical law that described the growth of a rabbit population.

Assuming by hypothesis that:

you have a pair of newborn rabbits
this first couple becomes fertile at the end of the first month and gives birth to a new couple at the end of the second month;
the newly born couples behave in an analog way;
fertile couples from the second month of life onwards give birth to a couple of children per month;
the following occurs:

after a month a couple of rabbits will be fertile,
after two months there will be two couples of which only one is fertile,
in the following month, third month from the initial moment, there will be 2 + 1 = 3 pairs because only the fertile pair will have generated; of these three, two will be fertile couples, therefore
in the following month (fourth month from the initial moment) there will be 3 + 2 = 5 pairs
In this example, the number of pairs of rabbits each month expresses the Fibonacci sequence.


A colony ship is just one ship because it's one ship, it's simple logic, nowhere in the game a ship counts as more ships, so it follows logic that a ship is just one ship.


Planets and stellar object have a different scale than ships, and ships maybe be scaled differently than each other but it is unlikely to be much difference, except for titans, colossi, and juggernauts, but bigger ships are always represented bigger than smaller ships.
 
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MathyM got the right answer:



The story goes that Bertrand Russell, in a lecture on logic, mentioned that in the sense of material implication, a false proposition implies any proposition.

A student raised his hand and said "In that case, given that 1 = 0, prove that you are the Pope."

Russell immediately replied, "Add 1 to both sides of the equation: then we have 2 = 1. The set containing just me and the Pope has 2 members. But 2 = 1, so it has only 1 member; therefore, I am the Pope."
All very true. Allow me to withdraw my earlier question, and ask another in its place: Why do you think that a pop must correspond to a specific number of individuals for the game to make sense?
Also concerning the increase of people to 100-fold:



L'intento di Leonardo Fibonacci era quello di trovare una legge matematica che descrivesse la crescita di una popolazione di conigli.

Assumendo per ipotesi che:

  • si disponga di una coppia di conigli appena nati
  • questa prima coppia diventi fertile al compimento del primo mese e dia alla luce una nuova coppia al compimento del secondo mese;
  • le nuove coppie nate si comportino in modo analogo;
  • le coppie fertili dal secondo mese di vita in poi diano alla luce una coppia di figli al mese;
si verifica quanto segue:

  • dopo un mese una coppia di conigli sarà fertile,
  • dopo due mesi ci saranno due coppie di cui una sola fertile,
  • nel mese seguente, terzo mese dal momento iniziale, ci saranno 2+1=3 coppie perché solo la coppia fertile avrà generato; di queste tre, due saranno le coppie fertili, quindi
  • nel mese seguente (quarto mese dal momento iniziale) ci saranno 3+2=5 coppie
In questo esempio, il numero di coppie di conigli di ogni mese esprime la successione di Fibonacci.



Leonardo Fibonacci's intent was to find a mathematical law that described the growth of a rabbit population.

Assuming by hypothesis that:

you have a pair of newborn rabbits
this first couple becomes fertile at the end of the first month and gives birth to a new couple at the end of the second month;
the newly born couples behave in an analog way;
fertile couples from the second month of life onwards give birth to a couple of children per month;
the following occurs:

after a month a couple of rabbits will be fertile,
after two months there will be two couples of which only one is fertile,
in the following month, third month from the initial moment, there will be 2 + 1 = 3 pairs because only the fertile pair will have generated; of these three, two will be fertile couples, therefore
in the following month (fourth month from the initial moment) there will be 3 + 2 = 5 pairs
In this example, the number of pairs of rabbits each month expresses the Fibonacci sequence.
I am familiar with the ability of populations to increase over time and with Fibonacci's Sequence. But I don't see how any of what you've posted explains how a population of humans could increase in size a hundredfold over at most five years without any immigration.

A colony ship is just one ship because it's one ship, it's simple logic, nowhere in the game a ship counts as more ships, so it follows logic that a ship is just one ship.
Absence of evidence is not evidence of absense. Unless you can find some positive proof that a single in-game ship represents a single in-universe ship, it's possible that this proposition is not true.

Planets and stellar object have a different scale than ships, and ships maybe be scaled differently than each other but it is unlikely to be much difference, except for titans, colossi, and juggernauts, but bigger ships are always represented bigger than smaller ships.
Asserting your thesis does not constitute evidence for your thesis.
 
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Well time to ruffle some feathers...
I dont agree... your example is earth, a homeworld! Its silly to think that the most populated, industrialized and militarized planet inside a starfaring civilication is an easy nut to crack... you just cant give workers and peasants weapons and think they will win the day... the lack training and moreover if all farmer are pressed into the military, who shall grow the crops? If all workers are pressed into the military who shall work at the factorys?

Population: Even larger colonys... can be something between 100 million or 1 billion population that is something a space faring civilication should handle... the germans subdued in WW2 countrys that all in all where something like 100 million pops in the industrial age...

Technology: How much conquistadores where needed to conquer whole south america? Very very few compared to the manpower of the south american civs... if aliens would invade earth the death toll could be something like 1000 to 1...

Occupation: Just declare some corrupt natives to be the new ruling class under their new masters... and they will muster natives to oppress themselfes...

Most importent thing is: WHAT the hell does the invaders want? Sure the defender will defend... but what are the goals of the invaders?... do they want the planet?... do they want slaves?... do they want the infrastructure?... do they just love war like Klingons?... do they want food?

Iam not convinced that ground battles in the far future will be obsolete... or is the dude who made the video a militaria history expert??? He makes some good points althaugh...
 
Stellaris offers a simple reason why ground combat is a thing: The only way to be sure is locked behind Civics (Fanatic Purifiers/Determined Exterminators) and/or APs (Colossus Project, Become the Crisis). In short, most Galactic Empires would not even *consider* glassing planets. They absolutely *have* the technical capability, but unless they're explicitly Genocidal, they follow the maxim of "Orbital bombardment can obliterate, but only infantry can occupy.".
 
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A single pop was a billion people before the pop rework since earth in 2200 started with 8 pops, and after the rework 333 millions since it started with 24 pops instead.

Also colony ships don't bring a pop, they bring enough people to start a pop to grow in the times it starts to colonize to the time it ends colonizing, making a new pop like normal pop growth. Also they are clearly just one ship, since the ship is used as the colony reassembled shelter building, you're making stuff up:
Technically it never was 1 billion or 333 million per Pop. One, they never defined how large a pop was, and two, even if Earth is the effective starting point for population, the starting date using the faux-Gregorian calendar, is the year 2200, not 2021 (where the human population is 7.9B).

As someone else pointed out, reproductive growth doesn't work the way you are suggesting the game is handling growth of a colony ship's passengers. It would take many months, typically the greater majority of a year, for a human-analogue person to bring a baby to term, and then well over a decade to have them develop into a workable adult-equivalent. An early game stellar empire will not have the technologies necessary to supercharge that growth, certainly not enough for 1M adults to produce a population several hundred fold larger in 2-5 years.
Also they are clearly just one ship, since the ship is used as the colony reassembled shelter building, you're making stuff up:

Reassembled Ship Shelter

The remains of a Colony Ship, reassembled for planetside form and function.

Also the game says cruisers are based on colony ships.

Originally devised as an experimental next-generation colony ship hull configuration, the design's ample hardpoints made it ideal for carrying heavy weapons ordnance.
As for Colony "Ships" versus Colony "Fleets", uh yeah, I made that stuff up - that's why I said "head-canon".

I haven't seen anything in your posts to make me agree with your contention of just 1M initial passengers, so I'll continue to work off of my 250M number. If those are human-analogues, then the volume taken up just for the colonists' hibernating bodies' storage containers (2 x 1 x 1 meter box) is 500,000,000 cubic meters - a cylinder 2500m long and about 505m in diameter. That's the same internal volume as more than 37 copies of the Boeing Everett Factory in Washington state, or more like a 9x9 grid of One World Trade Centers.

We haven't looked at any of the life support systems, supplies, starting materials, equipment, and vehicles, nor any of the space-going aspects of the Colony Ship. All of that is going to land in one spot, unprepared for a massive structure sitting on it, and that structure perhaps not exactly designed to hold that entire mass in a gravity well, for decades until it is finally recycled and transitioned over to the new administration buildings. Good luck with that...

A Colony Fleet, while not at all specified in the Stellaris documentation, makes far more sense in terms of ease of building, piloting, landing, and stability once it's used as merely a planetary building. It allows for a minimal level of dispersal of colonization resources across a district or a portion thereof. Or do you honestly think that plopping down several hundred million people around a single point of materials is a good idea?

Lastly, the Cruiser being based off of either of those hulls means Evasion is going to be absolute nothing. This isn't really too big of a deal for the Cruiser, but the progression for all other significant systems from Corvette to Destroyer to Cruiser to Battleship is 1:2:4:8, meaning in many respects a Corvette is one quarter the volume/mass of a Cruiser, or about 2/3rds as long and wide. This means the Corvette is also laughably large and unable to accelerate laterally enough to displace its width in any reasonable amount of time (what Evasion is all about). Unless actual ranges (not the BS inflated values shown on the system map that are inflated to work alongside the "game clock = calendar" timeframe) are in 10's of light-seconds (versus at most single light-seconds, more likely under 1LS), NOTHING ever Evades. And I'd love to hear your definition of "strike craft"...
 
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Next, make it so that only L weapons and up can directly bombard a planet
So I can't usefully declare war until I have Destroyer tech, and I can't usefully profit from defensive war until I have Destroyer tech?

How about "no".
 
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All very true. Allow me to withdraw my earlier question, and ask another in its place: Why do you think that a pop must correspond to a specific number of individuals for the game to make sense?

I am familiar with the ability of populations to increase over time and with Fibonacci's Sequence. But I don't see how any of what you've posted explains how a population of humans could increase in size a hundredfold over at most five years without any immigration.


Absence of evidence is not evidence of absense. Unless you can find some positive proof that a single in-game ship represents a single in-universe ship, it's possible that this proposition is not true.


Asserting your thesis does not constitute evidence for your thesis.

A pop must represent a certain number of people because earth isn't inhabited by 8-24 persons.

It could increase 5 times though, and the starting fraction of pop might be enough millions, such as 80 millions people, to be enough to grow a new pop, or there is immigration because the tradition in the expansion tree that gives a second pop to new colonies talk about immigration so there must be a lot of immigration besides new births.

I didn't find the formal name yet, but anyway, you got a fallacy's fallacy, and you're wrong, and with that line of thought a ship could be a potato chip and when you disband it you eat it, ockham's razor. Also burden of proof to say that things are different as from represented is on you, because a juggernaut is just one juggernaut.

Neither do you.

Also again see what MathyM said:

This kind of counter-argument is prohibitive. If you assume that logic is out the window, then my biggest joy is roasting almonds while stalking prey, and I think the game should do nothing as the raccoon attacks the lady’s bag of food.
 
Technically it never was 1 billion or 333 million per Pop. One, they never defined how large a pop was, and two, even if Earth is the effective starting point for population, the starting date using the faux-Gregorian calendar, is the year 2200, not 2021 (where the human population is 7.9B).

As someone else pointed out, reproductive growth doesn't work the way you are suggesting the game is handling growth of a colony ship's passengers. It would take many months, typically the greater majority of a year, for a human-analogue person to bring a baby to term, and then well over a decade to have them develop into a workable adult-equivalent. An early game stellar empire will not have the technologies necessary to supercharge that growth, certainly not enough for 1M adults to produce a population several hundred fold larger in 2-5 years.

As for Colony "Ships" versus Colony "Fleets", uh yeah, I made that stuff up - that's why I said "head-canon".

I haven't seen anything in your posts to make me agree with your contention of just 1M initial passengers, so I'll continue to work off of my 250M number. If those are human-analogues, then the volume taken up just for the colonists' hibernating bodies' storage containers (2 x 1 x 1 meter box) is 500,000,000 cubic meters - a cylinder 2500m long and about 505m in diameter. That's the same internal volume as more than 37 copies of the Boeing Everett Factory in Washington state, or more like a 9x9 grid of One World Trade Centers.

We haven't looked at any of the life support systems, supplies, starting materials, equipment, and vehicles, nor any of the space-going aspects of the Colony Ship. All of that is going to land in one spot, unprepared for a massive structure sitting on it, and that structure perhaps not exactly designed to hold that entire mass in a gravity well, for decades until it is finally recycled and transitioned over to the new administration buildings. Good luck with that...

A Colony Fleet, while not at all specified in the Stellaris documentation, makes far more sense in terms of ease of building, piloting, landing, and stability once it's used as merely a planetary building. It allows for a minimal level of dispersal of colonization resources across a district or a portion thereof. Or do you honestly think that plopping down several hundred million people around a single point of materials is a good idea?

Lastly, the Cruiser being based off of either of those hulls means Evasion is going to be absolute nothing. This isn't really too big of a deal for the Cruiser, but the progression for all other significant systems from Corvette to Destroyer to Cruiser to Battleship is 1:2:4:8, meaning in many respects a Corvette is one quarter the volume/mass of a Cruiser, or about 2/3rds as long and wide. This means the Corvette is also laughably large and unable to accelerate laterally enough to displace its width in any reasonable amount of time (what Evasion is all about). Unless actual ranges (not the BS inflated values shown on the system map that are inflated to work alongside the "game clock = calendar" timeframe) are in 10's of light-seconds (versus at most single light-seconds, more likely under 1LS), NOTHING ever Evades. And I'd love to hear your definition of "strike craft"...

You can extrapolate since Earth started with 8 pops and then with the pop rework got to 24, and second, UN is pushing for population control, and there is a decision that does that, so they could have just activated for almost 2 centuries and then removed it with the discovery of FTL:

On September 24-25, world leaders will gather at the United Nations in New York to review progress toward the UN’s 2030 Agenda and its 17 Sustainable Development Goals. The SDGs, which aim “to end poverty, protect the planet, and ensure prosperity for all,” are commendable, and summarize the kind of world many of us wish to see in 2030. But if this vision is to have any chance of materializing, governments must now add an 18th goal: “Dampen population growth.”

Yet the huge projected increase in the world’s population this century is avoidable.
The size of the population in 2100 can be influenced now by international debate, government programs, and individual choices.

Changes in population policies and norms can reduce birth rates.


Also this:


I would've assumed 1 pop equals 1 billion people, you start of with what, 8 pops? That's a realistic number for a race that has global union, somewhat useable birth control and a good basis.

In 1920 the world population is estimated as having been 1.863 billion, and in 2020 the UN projects it as being 7.758 billion, so it's only an extra 84% growth relative to the past century's 416% (and we only had Earth to grow on.)

if a population has the space and the resources it can grow incredibly fast. So 100 years of prosperity driven by advanced agriculture, more potent food, higher life expectancy and so on could easily raise 10 billion to 50 billion or more, depending on whoever you're playing.



So realistic and logical.



I'm not sure where it said 1M, and it could be 80M and quintuplicate in 5 years, but even if they were 1M, they could start sending other ships with immigrants the moment the colony ship touches the ground.


There is no text that says there is a colony fleet, just a colony ship, so you're directly contradicting the game and the presentation:

colonization.png



Also keep in mind that colony ships carry a whole city inside them:



dTyl8hKRnvowNu4l5kznUyZebSVXLSGQ9nFg__yrNiE.jpg



I know the standard trope in most 4x games is the city ship that drops down, and people live out of it.


Also again, in stellaris you can plop down some million people on one point, it's a starting technology:
luxurious residences.png


As you can see you start the game with advanced zero-g technology so it shouldn't be a problem.


Also again the city is on top of a flat mesa:
colonization.png




Not sure about the ranges, can you use more numbers?

Also for strikecraft I'd like to make them progress to Titan lances just like a good shoot'em up:

 
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There are easy ways around that, as you pointed out. The army cap goes out the window by mid game.
Yes, and that's good, because when you get droids or cloning technology or bioengineering, why wouldn't a space civilization make unlimited efficient troops? Especially since you can also make dyson sphere and ringworlds in late game there is no real reason not to be more efficient.
 
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Yes, and that's good, because when you get droids or cloning technology or bioengineering, why wouldn't a space civilization make unlimited efficient troops? Especially since you can also make dyson sphere and ringworlds in late game there is no real reason not to be more efficient.

The point of the conversation was that making armies more impactful would also include adding a limit like Naval Capacity. Infinite army spam, especially for minerals, makes just about any ground assault a zerg rush.
 
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The point of the conversation was that making armies more impactful would also include adding a limit like Naval Capacity. Infinite army spam, especially for minerals, makes just about any ground assault a zerg rush.
But why limit them since xenomorph armies are basically zergs?
 
You can extrapolate since Earth started with 8 pops and then with the pop rework got to 24, and second, UN is pushing for population control, and there is a decision that does that, so they could have just activated for almost 2 centuries and then removed it with the discovery of FTL:

On September 24-25, world leaders will gather at the United Nations in New York to review progress toward the UN’s 2030 Agenda and its 17 Sustainable Development Goals. The SDGs, which aim “to end poverty, protect the planet, and ensure prosperity for all,” are commendable, and summarize the kind of world many of us wish to see in 2030. But if this vision is to have any chance of materializing, governments must now add an 18th goal: “Dampen population growth.”

Yet the huge projected increase in the world’s population this century is avoidable.
The size of the population in 2100 can be influenced now by international debate, government programs, and individual choices.

Changes in population policies and norms can reduce birth rates.

Also this:

I would've assumed 1 pop equals 1 billion people, you start of with what, 8 pops? That's a realistic number for a race that has global union, somewhat useable birth control and a good basis.

In 1920 the world population is estimated as having been 1.863 billion, and in 2020 the UN projects it as being 7.758 billion, so it's only an extra 84% growth relative to the past century's 416% (and we only had Earth to grow on.)

if a population has the space and the resources it can grow incredibly fast. So 100 years of prosperity driven by advanced agriculture, more potent food, higher life expectancy and so on could easily raise 10 billion to 50 billion or more, depending on whoever you're playing.

So realistic and logical.
If you want to run with the idea that Earth would absolutely maintain its population at early 21st century levels until the year 2200, after doubling in size every two generations for the last century, good luck with that. Most of the factors that increase population growth, including decreased infant/child mortality, decreased death in child birth, and longer adult lifespan, will both affect more of the world's population and improve in effect over the next two centuries. Birthrate controls only help so much, because they create diminished newer generations that are less able to support those that continue to exist into their unproductive years. You have to keep each new generation as large as each of the previous ones to maintain that production. The only way you keep overall populations stable (assuming you're keeping wars and disease in check) is to euthanize enough of the older generations or those that would be unable to contribute to society. That is a grim prospect, but if that's what it takes to keep your number stable, I guess that's what would happen.
There is no text that says there is a colony fleet, just a colony ship, so you're directly contradicting the game and the presentation:

Also keep in mind that colony ships carry a whole city inside them:

I know the standard trope in most 4x games is the city ship that drops down, and people live out of it.

As you can see you start the game with advanced zero-g technology so it shouldn't be a problem.

Also again the city is on top of a flat mesa:
Are you not picking up on me saying, "it's head-canon"? I run with the ideas in my head because those in the game are kinda schizophrenic and BS at times.

A "city" can easily be as small as 20,000-30,000 people, so not really definitive of anything, even if you post three separate copies of the same image.

Luxury Residences are made available to players following research into Idyllic Architecture, a Tier-3 Society technology; Anti-Gravity Engineering is likewise a Tier-3 Engineering technology. If you can show me a Tier-0 technology or its immediate options made available that offer a zero- or anti-gravity capability, I'd be interested to see it.

I just love the "hundreds of small tents and pre-fab shelters" for the potentially tens of millions of people on board...
__

The whole point of my initial response to the post from @fourteenfour was to point out that ships exist within the starting Stellaris environment that are capable of handling the loads required to move an Assault Army's worth of personnel, equipment, vehicles, material, and supplies. Whether the ships that justify that size requirement would carry 1M, 10M, 250M, or 1B colonists doesn't really matter, as even the smallest of them meets that requirement. And I have no interest in starting a whole other thread talking about that topic, which is where any further discussion on this tangent would need to take place.
 
If you want to run with the idea that Earth would absolutely maintain its population at early 21st century levels until the year 2200, after doubling in size every two generations for the last century, good luck with that. Most of the factors that increase population growth, including decreased infant/child mortality, decreased death in child birth, and longer adult lifespan, will both affect more of the world's population and improve in effect over the next two centuries. Birthrate controls only help so much, because they create diminished newer generations that are less able to support those that continue to exist into their unproductive years. You have to keep each new generation as large as each of the previous ones to maintain that production. The only way you keep overall populations stable (assuming you're keeping wars and disease in check) is to euthanize enough of the older generations or those that would be unable to contribute to society. That is a grim prospect, but if that's what it takes to keep your number stable, I guess that's what would happen.

Are you not picking up on me saying, "it's head-canon"? I run with the ideas in my head because those in the game are kinda schizophrenic and BS at times.

A "city" can easily be as small as 20,000-30,000 people, so not really definitive of anything, even if you post three separate copies of the same image.

Luxury Residences are made available to players following research into Idyllic Architecture, a Tier-3 Society technology; Anti-Gravity Engineering is likewise a Tier-3 Engineering technology. If you can show me a Tier-0 technology or its immediate options made available that offer a zero- or anti-gravity capability, I'd be interested to see it.

I just love the "hundreds of small tents and pre-fab shelters" for the potentially tens of millions of people on board...
__

The whole point of my initial response to the post from @fourteenfour was to point out that ships exist within the starting Stellaris environment that are capable of handling the loads required to move an Assault Army's worth of personnel, equipment, vehicles, material, and supplies. Whether the ships that justify that size requirement would carry 1M, 10M, 250M, or 1B colonists doesn't really matter, as even the smallest of them meets that requirement. And I have no interest in starting a whole other thread talking about that topic, which is where any further discussion on this tangent would need to take place.


Yes, it's a grim prospect, but did you keep up with the news? Euthanasia is gaining and has gained much ground in the last 40 years.

Rebutting the “after birth abortion” theory from the point of view of the Judeo-Christian tradition, Camosy [8] claimed that “all members of the species Homo sapiens are persons with an equal right to life”.
We will not mention any theistic argument against infanticide and will only discuss issues related to ethics of abortion as far as it is relevant to G&M line of argument and the flaws in it we perceive. Our strongest arguments concern G&M’s too narrow restriction to one concept of worthiness of protection (namely sentience) in the neonate – in a moral, medical and judicial sense – and the overly simplified restriction of “worthiness of protection” on the basis of that narrow conception of personhood.

Clearly, we do not believe that the implied practice of infanticide will truly become legalized anywhere on the basis of G&M’s arguments; yet, we believe that it is important to defuse the specific type of reasoning that lies at the basis of their arguments and conclusions, since, peer criticism is of the highest importance to protect the quality of academic reflection on an topic as important and controversial as abortion for social reasons. G&M’s views seem flawed on several levels: there are biological facts involved in the wording “after birth abortion”; there are important conceptual bioethical issues related to G&M adherence to a consequentialist approach; and practical medical ethics problems related to the lack of respect for well-established definitions in medicine, that have both a scientific and a moral historical background.
G&M did not build up their argument for mere rhetorical reasons, since their thinking is inspired by the views of philosophers like Tooley [12] and Singer [13], who take similar views. Tooley argues for a specific criterion for allowing infanticide, namely, the stages before an infant is able to experience complex desires, such as the desire for its continued existence. In a similar vein, Singer and his followers have taken the position that a person does not exist until sometime after birth, when sentience steps in. Sentience is defined by the Collins English Dictionary [14] “the state or quality of being sentient; awareness; sense perception not involving intelligence or mental perception; feeling”. On this basis, Singer defends the notion that a healthy great ape has more right to existence than a human newborn. Apart from moral objections, we have great difficulty in understanding biologically and conceptually how, using this definition, a newborn can be considered as not having “awareness”, “sense perception” and “feelings”.
In this paper, we will critically examine their “statement of fact”, namely that because a newborn is not sentient it therefore does not have a right to full moral status and legal protection. This will be done on the basis of an analysis of:
Biomedical conventions, practice and ensuing definitions.
G&M’s philosophical and bioethical type of approach with regard to the justification of sentience as an ethical absolute from which to derive moral criteria, and the deductive consequentialist methodology applied to this absolute.
The hypothetical practical outcome of their principles, specifically with regard to women’s rights.

Reconceptualizing infanticide as abortion is nothing more than a semantic trick that distorts current moral frameworks and the careful medical definitions on which these are based. Intrauterine life is a continuum. As stated before, morphologically, there can be little difference (except in size) between a fetus of 21 weeks and a premature baby of 25 weeks. But, if the first is delivered (after induction, or spontaneously) we have an abortion; if the second is delivered we have a pre-term birth. The medical and moral difference is enormous: the former is not viable, the latter is. In other words, in the case of an abortion, the fetus is either dead or dies immediately or soon after it is delivered (or extracted); with infanticide the baby is killed after delivery. If such practices would be allowed for on the basis of the argument that a newborn is not sentient (something we dispute, as mentioned earlier), and thus not worthy of protection, the same would be valid for any person in a coma (be it temporary or not) or indeed, any person sleeping. But, if one grants a perfectly viable human being the same moral status of a non-viable fetus, this should also be valid for such cases. The reality of countries where abortion is legally permitted during the second trimester and induced premature delivery even during the third one, far from contradicting this concept reinforces it, because the interruption of gestation is mostly carried out to save the life of the mother, or because the fetus is affected by important malformations. Since it renders all existing conventions invalid, the semantic move to equate abortion with infanticide sets into motion a slide down a slippery slope.

The irrelevance of whether a newborn is sentient: a philosophical and bioethical counter-argument
Our second counterargument deals with the justification of sentience as an ethical absolute and the deductive consequentialist methodology used to define practical moral guidelines for the new notion of infanticide. Debate over the legitimacy of abortion is widespread and gives rise to strong moral dispute. But neither pro- nor anti-abortionists consider abortion to be something that should become normalized. The termination of a pregnancy whether for medical or other reasons will always remain a sensitive issue. This is one of the reasons why even those with a liberal attitude towards abortion prefer to draw a line at late abortions. From both pro- and anti-abortionist perspectives, abortion remains a morally sensitive issue: the choice for abortion will never be an easy one.

Philosophers show large differences of opinion concerning the moral status of the embryo and the fetus [16]. Apart from theistic arguments [8], membership of the human community can be derived from sentience, the ability to suffer, or personhood (and potential to these). G&M opt for a criterion based on sentience, but they do so in a dogmatic embrace of “sentience” as fundamental criterion for moral status and their deductive consequentialist approach to its interpretation in practice.

A deductive consequentialist interpretation of sentience as a moral criterion renders it impossible to distinguish between the moral status of a human neonate and that of a great ape. Similarly, most animals have the ability to suffer, which, for society is not a sufficient reason to attribute animals the same moral status as a human being. Sentience, in our view, cannot count as a moral criterion. Sentience may be limited in those with a (severe) mental disability or Alzheimer’s disease, which – in most people’s eyes – is no reason to strip them of their basic human rights, although indeed, Singer cum suis would beg to differ.

The problem with consequentialist deductivism is that it starts from a dogmatic assumption (here, a specific and scientifically unsound definition of sentience) and, without regard for any moral intuition, deduces rules for practice from that position. The question should be posed whether the initial axioms are valid in the first place, and whether the argumentative method of deduction is morally sound. At least since the early 1990s, the problem of deductivism in bioethics has been acknowledged [17]; the problem is in the justification of a moral ground, such as, in this case sentience, as absolute on the one hand, and the methodology of deducing rules for practice from such ground on the other. The debate arose over the classical principle-based medical ethics approach developed by Beauchamps and Childress [18]. Their method posed an intuistic derivation of moral principles, but appeared handicapped in its deductivist application. On the one hand, the problem is why any person’s intuition for a moral grounding should be sufficient justification for their acceptance; on the other, is why would any counter-intuitive derivations for practical implementation of such moral ground need to be forcibly accepted [17].

In current medical practice, viability is taken as a guiding criterion for abortion, be it by pro- or anti-. Attempts to give more restrictive criteria are under pressure of not only moral criteria, but also of the consequences of advances in medical science. Other criteria have proven to be controversial: in the US there have been attempts – such as that of Mississippi – to pass legislation that simply declares “The term ‘person’ or ‘persons’ shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof” [19]. The attempt failed, but efforts in this direction continue. In theory, the concept that human life begins at fertilization is self-evident, but Mother Nature makes numerous errors and in the natural process of growing perhaps half of all fertilized oocytes do not become born babies because of major anomalies [20]. Such highly abnormal fertilized oocytes cannot and should not be protected: their elimination is part of the natural mechanism of safeguarding the species. Even for those zygotes that start “on the right foot”, there is a long process: initially all blastomers are totipotent; therefore, during these early stages there is no “individuality”, because several individuals can develop from one early embryo; then the container separates itself from the content and the germinal plaque begins to form; this is followed by organ and structure formation. Scientific evidence therefore cannot identify when in this continuum a “new human life” becomes a “new human person”. Yet, those who hold that even an embryo at its earliest stages deserves full protection, do so because they believe that it is a person [21].

Adhering to the consequentialist theories of authors such as Singer [13], G&M build-up their argument on the basis of a criticism of one very specific version of the potentiality argument. Derived from Aristotelian philosophy, the argument implies that if a subject is a person in potentiality, it has a right to protection. Aristotle stated: “… when we are dealing with definite and ordered products of Nature, we must not say each is of a certain quality because it becomes so, but rather that they become so and so because they are so and so, for the process of Becoming or development attends upon Being and is for the sake of Being, not vice versa” [22]. Today, not only fertilized human oocytes have the potential to become a baby, but any cell that can be made into a totipotent stem cell. Advances in science have thus complicated the frameworks and paradigms by which to decide on worthiness of protection. This presents major problems when dealing with the morality of abortion, as documented by the Hippocratic Oath.

In the context of G&M’s argumentation, what is important is whether it is viable, and likely to live a life without severe disabilities. Per se, determining when human life begins does not provide for specific moral guidelines, since what is at stake here is not when human life begins, but when this new human life requires protection. In this connection, the shifting of paradigms and cultural frameworks that affect people’s views on the protection of prenatal human life should not lead to an overly relativistic attitude in which new human life in general loses its right to protection and dismisses us from taking up responsibility for such protection.



The ethics of sex-selective infanticides; a pragmatic counter-argument
The third counterargument addresses the hypothetical practical outcome of G&M’s views, specifically with regard to women’s rights.

Exactly 20 years ago, the Nobel laureate for Economics Amartia Sen [23] carried out a comparative demographic analysis of actual sex ratios in various populations, versus the expected ratios if these societies had offered equal access to healthcare to both males and females; he then updated his calculations [24] and reached the conclusion that up to some 100 million females were “missing” in the world. Also Mahmoud Fathalla [25,26] has strongly denounced this widespread killing. He wrote: “In Europe, USA and Japan, there are 95–97 males for every 100 females, reflecting the biological advantage of females, while in Asia there are 105 males per 100 females reflecting the social disadvantage of the females”. Other demographers used different methods and got somewhat different numbers, but all very large. The reason is simple: the best known and most widely utilized (although illegal) “social reason” for “late abortion” and “infanticide” is a pregnancy with a female fetus or neonate. G&M do not provide for concrete examples of – in their view – legitimate forms of socially motivated infanticide, but on the basis of their criteria, the practice of gender-discriminatory infanticide should be considered legitimate. We believe this is the most obvious pragmatic argument against G&M claim.

Male preference currently probably comprises 90% or more of the cases of socially motivated infanticide, but G&B ignore the problematic nature of this consequence of their stating that killing a newborn could be ethically permissible in “cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk” [1]. Clearly, the birth of a baby girl in many parts of the world (especially, but not exclusively, in South and East Asia) represents a burden for her family and – given the legal and social pressure for small families – deprives them of the possibility of a male heir. Thus, whilst abortion is often defended on the basis of women’s right to self-determination, G&M’s extension of the concept of abortion to include infanticide may well lead to a condoning of practices that run counter to women’s very right to existence.


According to Eberstadt [27], sex-selective abortion is by now so widespread and so frequent that it has come to distort the population composition of humanity. He calls it a “new and medicalized war against baby girls”. According to the United Nations Development Programme [28] and the US Census Bureau’s International Programs Center [29] by the year 2010 there was a global excess of over 55 million males under the age of 20.

When not manipulated by human intervention, both the sex ratio at birth and the population sex ratio remain remarkably constant, with small imbalances occurring naturally under specific circumstances; for example, a small excess of male births has been reported to occur during and after war. The tradition of son preference, however, has distorted these natural sex ratios in several countries in East and South Asia, the Middle East and North Africa [30]. Paradoxically, technical advances, such as ultrasound technology, have exacerbated sex imbalance by allowing reliable prenatal sex determination. This phenomenon is particularly evident in the two most populous countries: China and India.

It is noteworthy that China, being one of the few nations where second trimester abortion on demand is available, should be the most visible “beneficiary” of the “new ethical stand”, making the situation even worse than it is today. Indeed, in some rural areas of China, up to 140 male births occur for every 100 females, thanks to the widespread utilization of prenatal sex determination, especially for second and higher-order pregnancies. Interestingly, in these areas, increased awareness that the practice would lead to a future marriage squeeze did not affect the demand for sex-selective abortion, at least up to ten years ago [31]. In China, this large surplus of young men is now reaching reproductive age, with consequences yet to be ascertained, because failure to marry and have children inevitably affects a man’s social status and acceptance in society. These young men have low self-esteem, feel marginalized, lonely, withdrawn and depressed [32], leading the government to make efforts to reduce sex selection with some degree of success, since – according to recent surveys – there is a significant decline in son preference in East Asia [33,34].


The United Nations have taken a strong stand against this detrimental practice. Indeed, a recent interagency document [35] stressed the negative consequences of practices associated with a systematic preference for boys, such as prenatal sex detection and selective abortion, infanticide and neglect of the girl child still rooted in many cultural traditions. The statement also reminded Member States of their obligation under human rights laws to respect, protect and fulfill the human rights of the infant girl; an obligation that exists for the more than 180 States signatories to the 1994 Programme of Action of the International Conference on Population and Development. These States have agreed to “eliminate all forms of discrimination against the girl child and the root causes of son preference, which result in harmful and unethical practices regarding female infanticide and prenatal sex selection” (paragraph 4.16) [36]. The joint interagency statement reaffirms the commitment of the UN to uphold these principles and to provide recommendations on how best to tackle this issue.

As it always happens, even when there is widespread rejection of a given practice, there is always someone who favors it. For instance, Williams [37] has argued that, those who favor a eugenic stand (selective abortion of disabled fetuses to ameliorate the perceived average genetic quality of our offspring), cannot consistently accept the prohibition of sex-selective abortion, since a woman's right to choose pregnancy termination should not be limited. From a feminist theoretical perspective, it would of course be paradoxical to allow women to terminate pregnancy to prevent the birth of a female neonate, but if one takes the point of view that women have a right to abortion whatever the motivation, Williams would be right.

In some countries and cultures, the selective abortion or infanticide of a girl is usually motivated by the socio-economic problems consequent to having a daughter: the birth of a baby girl in many parts of the world represents a liability for the family, because it will cost money and effort to bring her up and there will be no return from the social, economic and cultural investment in her education, since in these areas a girl gets married early and goes out to support her new family and her husbands’ parents, not her own. In addition, the girl’s parents have to find the money for the dowry, a sort of “double jeopardy”.




Abstract
Euthanasia or assisted suicide—and sometimes both—have been legalized in a small number of countries and states. In all jurisdictions, laws and safeguards were put in place to prevent abuse and misuse of these practices. Prevention measures have included, among others, explicit consent by the person requesting euthanasia, mandatory reporting of all cases, administration only by physicians (with the exception of Switzerland), and consultation by a second physician.

The present paper provides evidence that these laws and safeguards are regularly ignored and transgressed in all the jurisdictions and that transgressions are not prosecuted. For example, about 900 people annually are administered lethal substances without having given explicit consent, and in one jurisdiction, almost 50% of cases of euthanasia are not reported. Increased tolerance of transgressions in societies with such laws represents a social “slippery slope,” as do changes to the laws and criteria that followed legalization. Although the initial intent was to limit euthanasia and assisted suicide to a last-resort option for a very small number of terminally ill people, some jurisdictions now extend the practice to newborns, children, and people with dementia. A terminal illness is no longer a prerequisite. In the Netherlands, euthanasia for anyone over the age of 70 who is “tired of living” is now being considered. Legalizing euthanasia and assisted suicide therefore places many people at risk, affects the values of society over time, and does not provide controls and safeguards.


Keywords: Euthanasia, physician-assisted suicide

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1. INTRODUCTION
Euthanasia is generally defined as the act, undertaken only by a physician, that intentionally ends the life of a person at his or her request 1,2. The physician therefore administers the lethal substance. In physician-assisted suicide (pas) on the other hand, a person self-administers a lethal substance prescribed by a physician.

To date, the Netherlands, Belgium, and Luxembourg have legalized euthanasia 1,2. The laws in the Netherlands and Luxembourg also allow pas. In the United States, the states of Oregon and Washington legalized pas in 1997 and 1999 respectively, but euthanasia remains illegal 3. The situation in the state of Montana is currently unclear; a bill legalizing pas was passed by the state legislature in 2010, but was recently defeated by the state’s Senate Judiciary Committee.

In the Netherlands, euthanasia and pas were formally legalized in 2001 after about 30 years of public debate 1. Since the 1980s, guidelines and procedures for performing and controlling euthanasia have been developed and adapted several times by the Royal Dutch Medical Association in collaboration with that country’s judicial system. Despite opposition, including that from the Belgian Medical Association, Belgium legalized euthanasia in 2002 after about 3 years of public discourse that included government commissions. The law was guided by the Netherlands and Oregon experiences, and the public was assured that any defects in the Dutch law would be addressed in the Belgian law. Luxembourg legalized euthanasia and pas in 2009. Switzerland is an exception, in that assisted suicide, although not formally legalized, is tolerated as a result of a loophole in a law dating back to the early 1900s that decriminalizes suicide. Euthanasia, however, is illegal 4. A person committing suicide may do so with assistance as long as the assistant has no selfish motives and does not stand to gain personally from the death. Unlike other jurisdictions that require euthanasia or assisted suicide to be performed only by physicians, Switzerland allows non-physicians to assist suicide.

In all these jurisdictions, safeguards, criteria, and procedures were put in place to control the practices, to ensure societal oversight, and to prevent euthanasia and pas from being abused or misused 5. Some criteria and procedures are common across the jurisdictions; others vary from country to country 5,6. The extent to which these controls and safeguards have been able to control the practices and to avoid abuse merits closer inspection, particularly by jurisdictions contemplating the legalization of euthanasia and pas. The present paper explores the effectiveness of the safeguards and the “slippery slope” phenomenon.

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2. SAFEGUARDS AND THEIR EFFECTIVENESS
2.1. Voluntary, Written Consent
In all jurisdictions, the request for euthanasia or pas has to be voluntary, well-considered, informed, and persistent over time. The requesting person must provide explicit written consent and must be competent at the time the request is made. Despite those safeguards, more than 500 people in the Netherlands are euthanized involuntarily every year. In 2005, a total of 2410 deaths by euthanasia or pas were reported, representing 1.7% of all deaths in the Netherlands. More than 560 people (0.4% of all deaths) were administered lethal substances without having given explicit consent 7. For every 5 people euthanized, 1 is euthanized without having given explicit consent. Attempts at bringing those cases to trial have failed, providing evidence that the judicial system has become more tolerant over time of such transgressions 5.

In Belgium, the rate of involuntary and non-voluntary euthanasia deaths (that is, without explicit consent) is 3 times higher than it is in the Netherlands 8,9. (“Involuntary euthanasia” refers to a situation in which a person possesses the capacity but has not provided consent, and “non-voluntary euthanasia,” to a situation in which a person is unable to provide consent for reasons such as severe dementia or coma). A recent study found that in the Flemish part of Belgium, 66 of 208 cases of “euthanasia” (32%) occurred in the absence of request or consent 10. The reasons for not discussing the decision to end the person’s life and not obtaining consent were that patients were comatose (70% of cases) or had dementia (21% of cases). In 17% of cases, the physicians proceeded without consent because they felt that euthanasia was “clearly in the patient’s best interest” and, in 8% of cases, that discussing it with the patient would have been harmful to that patient. Those findings accord with the results of a previous study in which 25 of 1644 non-sudden deaths had been the result of euthanasia without explicit consent 8.

Some proponents of euthanasia contend that the foregoing figures are misrepresentative, because many people may have at some time in their lives expressed a wish for or support of euthanasia, albeit not formally. The counterargument is that the legal requirement of explicit written consent is important if abuse and misuse are to be avoided. After all, written consent has become essential in medical research when participants are to be subjected to an intervention, many of which pose far lesser mortality risks. Recent history is replete with examples of abuse of medical research in the absence of explicit informed consent.

2.2. Mandatory Reporting
Reporting is mandatory in all the jurisdictions, but this requirement is often ignored 11,12. In Belgium, nearly half of all cases of euthanasia are not reported to the Federal Control and Evaluation Committee 13. Legal requirements were more frequently not met in unreported cases than in reported cases: a written request for euthanasia was more often absent (88% vs. 18%), physicians specialized in palliative care were consulted less often (55% vs. 98%), and the drugs were more often administered by a nurse (41% vs. 0%). Most of the unreported cases (92%) involved acts of euthanasia, but were not perceived to be “euthanasia” by the physician. In the Netherlands, at least 20% of cases of euthanasia go unreported 7. That number is probably conservative because it represents only cases that can be traced; the actual number may be as high as 40% 14. Although reporting rates have increased from pre-legalization in 2001, 20% represents several hundred people annually.

2.3. Only by Physicians
The involvement of nurses gives cause for concern because all the jurisdictions, with the exception of Switzerland, require that the acts be performed only by physicians. In a recent study in Flanders, 120 nurses reported having cared for a patient who received life-ending drugs without explicit request 15. Nurses performed the euthanasia in 12% of the cases and in 45% of the cases without explicit consent. In many instances, the physicians were absent. Factors significantly associated with a nurse administering the life-ending drugs included the nurse being a male working in a hospital and the patient being over 80 years of age.

2.4. Second Opinion and Consultation
All jurisdictions except for Switzerland require a consultation by a second physician to ensure that all criteria have been met before proceeding with euthanasia or pas. In Belgium, a third physician has to review the case if the person’s condition is deemed to be non-terminal. The consultant must be independent (not connected with the care of the patient or with the care provider) and must provide an objective assessment. However, there is evidence from Belgium, the Netherlands, and Oregon that this process is not universally applied 10,13. In the Netherlands, for example, a consultation was not sought in 35% of cases of involuntary euthanasia 7. In 1998 in the Netherlands, 25% of patients requesting euthanasia received psychiatric consultation; in 2010 none did 16. Moreover, non-reporting seems to be associated with a lack of consultation by a second doctor 14.

In Oregon, a physician member of a pro-assisted-suicide lobby group provided the consultation in 58 of 61 consecutive cases of patients receiving pas in Oregon 17. This raises concerns about the objectivity of the process and the safety of the patients, and raises questions about the influence of bias on the part of these physicians on the process.

Networks of physicians trained to provide the consultation role when euthanasia is sought have been established in the Netherlands (Support and Consultation on Euthanasia in the Netherlands) and Belgium [Life End Information Forum (leif)] 18. Their role includes ensuring that the person is informed of all options, including palliative care. However, most leif physicians have simply followed a 24-hour theoretical course, of which only 3 hours are related to palliative care, hardly sufficient to enable a leif member to provide adequate advice on complex palliative care needs 19. The development of expertise in palliative care, as in any other specialty, requires a considerable amount of time. In the United Kingdom, it involves a 4-year residency program, and in Australia and the United States, 3 years.

Oregon requires that a patient be referred to a psychiatrist or psychologist for treatment if the prescribing or consulting physician is concerned that the patient’s judgment is impaired by a mental disorder such as depression. In 2007, none of the people who died by lethal ingestion in Oregon had been evaluated by a psychiatrist or a psychologist 20, despite considerable evidence that, compared with non-depressed patients, patients who are depressed are more likely to request euthanasia and that treatment for depression will often result in the patient rescinding the request 21–23. In a study of 200 terminally ill cancer patients, for example, the prevalence of depressive syndromes was 59% among patients with a pervasive desire to die, but only 8% among patients without such a desire 21. Despite that finding, many health professionals and family members of patients in Oregon who pursue pas generally do not believe that depression influences the choice for hastened death 24.

A recent Oregon-based study demonstrated that some depressed patients are slipping through the cracks 25. Among terminally ill patients who received a prescription for a lethal drug, 1 in 6 had clinical depression. Of the 18 patients in the study who received a prescription for the lethal drug, 3 had major depression, and all of them went on to die by lethal ingestion, but had been assessed by a mental health specialist.

There is evidence, therefore, that safeguards are ineffective and that many people who should not be euthanized or receive pas are dying by those means. Of concern, too, is the fact that transgressions of the laws are not prosecuted and that the tolerance level for transgressions of the laws has increased. Moreover, as the next section will explore, the boundaries of what constitutes “good” practices with respect to euthanasia and pas continue to change, and some of the current practices would just a few decades ago have been considered unacceptable in those jurisdictions that have legalized the practices.


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3. THE “SLIPPERY SLOPE” ARGUMENT
The “slippery slope” argument, a complex legal and philosophical concept, generally asserts that one exception to a law is followed by more exceptions until a point is reached that would initially have been unacceptable. The “slippery slope” argument has, however, several interpretations 26, some of which are not germane to the euthanasia discussion. The interpretations proposed by Keown in 2002 27 appear very relevant, however. He refers to these collectively as a “practical slippery slope,” although the term “social slippery slope” may be more applicable. The first interpretation postulates that acceptance of one sort of euthanasia will lead to other, even less acceptable, forms of euthanasia. The second contends that euthanasia and pas, which originally would be regulated as a last-resort option in only very select situations, could, over time, become less of a last resort and be sought more quickly, even becoming a first choice in some cases.

The circumvention of safeguards and laws, with little if any prosecution, provides some evidence of the social slippery slope phenomenon described by Keown 5,28. Till now, no cases of euthanasia have been sent to the judicial authorities for further investigation in Belgium. In the Netherlands, 16 cases (0.21% of all notified cases) were sent to the judicial authorities in the first 4 years after the euthanasia law came into effect; few were investigated, and none were prosecuted 5. In one case, a counsellor who provided advice to a non-terminally ill person on how to commit suicide was acquitted 29. There has therefore been an increasing tolerance toward transgressions of the law, indicating a change in societal values after legalization of euthanasia and assisted suicide.

In the 1987 preamble to its guidelines for euthanasia, the Royal Dutch Medical Association had written “If there is no request from the patient, then proceeding with the termination of his life is [juristically] a matter of murder or killing, and not of euthanasia.” By 2001, the association was supportive of the new law in which a written wish in an advance directive for euthanasia would be acceptable, and it is tolerant of non-voluntary and involuntary euthanasia 7,30,31. However, basing a request on an advance directive or living will may be ethically problematic because the request is not contemporaneous with the act and may not be evidence of the will of the patient at the time euthanasia is carried out.

Initially, in the 1970s and 1980s, euthanasia and pas advocates in the Netherlands made the case that these acts would be limited to a small number of terminally ill patients experiencing intolerable suffering and that the practices would be considered last-resort options only. By 2002, euthanasia laws in neither Belgium nor the Netherlands limited euthanasia to persons with a terminal disease (recognizing that the concept of “terminal” is in itself open to interpretation and errors). The Dutch law requires only that a person be “suffering hopelessly and unbearably.” “Suffering” is defined as both physical and psychological, which includes people with depression. In Belgium, the law ambiguously states that the person “must be in a hopeless medical situation and be constantly suffering physically or psychologically.” By 2006, the Royal Dutch Medical Association had declared that “being over the age of 70 and tired of living” should be an acceptable reason for requesting euthanasia 32. That change is most concerning in light of evidence of elder abuse in many societies, including Canada 33, and evidence that a large number of frail elderly people and terminally ill patients already feel a sense of being burden on their families and society, and a sense of isolation. The concern that these people may feel obliged to access euthanasia or pas if it were to become available is therefore not unreasonable, although evidence to verify that concern is not currently available.

In Oregon, although a terminal illness with a prognosis of less than 6 months to live has to be present, intolerable suffering that cannot be relieved is not a basic requirement (again recognizing that the concept of “intolerable suffering” is in itself ambiguous). This definition enables physicians to assist in suicide without inquiring into the source of the medical, psychological, social, and existential concerns that usually underlie requests for assisted suicide. Physicians are required to indicate that palliative care is a feasible alternative, but are not required to be knowledgeable about how to relieve physical or emotional suffering.

Until 2001, the Netherlands allowed only adults access to euthanasia or pas. However, the 2001 law allowed for children aged 12–16 years to be euthanized if consent is provided by their parents, even though this age group is generally not considered capable of making such decisions 5. The law even allows physicians to proceed with euthanasia if there is disagreement between the parents. By 2005, the Groningen Protocol, which allows euthanasia of newborns and younger children who are expected to have “no hope of a good quality of life,” was implemented 34,35. In 2006, legislators in Belgium announced their intention to change the euthanasia law to include infants, teenagers, and people with dementia or Alzheimer disease 36.

In Belgium, some critical care specialists have opted to ignore the requirement that, in the case of non-terminally-ill patients, an interval of 1 month is required from the time of a first request until the time that euthanasia is performed. One specialist reported that, in his unit, the average time from admission until euthanasia was performed for patients that seemed to be in a “hopeless” situation was about 3.5 days 37. Beneficence, this specialist argued, was the overriding principle.

Initially, euthanasia in the Netherlands was to be a last-resort option in the absence of other treatment options. Surprisingly, however, palliative care consultations are not mandatory in the jurisdictions that allow euthanasia or assisted suicide, even though uncontrolled pain and symptoms remain among the reasons for requesting euthanasia or pas 38. Requests by the Belgian palliative care community to include an obligatory palliative care consultation (“palliative filter”) were denied 19. From 2002 to 2007 in Belgium, a palliative care physician was consulted (second opinion) in only 12% of all cases of euthanasia 31. Palliative care physicians and teams were not involved in the care of more than 65% of cases receiving euthanasia. Moreover, the rates of palliative care involvement have been decreasing. In 2002, palliative care teams were consulted in 19% of euthanasia cases, but by 2007 such involvement had declined to 9% of cases. That finding contradicts claims that in Belgium, legalization has been accompanied by significant improvements in palliative care in the country 39. Other studies have reported even lower palliative care involvement 8,13. It must be noted that legalization of euthanasia or pas has not been required in other countries such as the United Kingdom, Australia, Ireland, France, and Spain, in which palliative care has developed more than it has in Belgium and the Netherlands.

The usefulness of a single palliative care assessment has been challenged—even when it is an obligatory requirement, as is the case at the University Hospital of the Canton of Vaud, Lausanne, Switzerland (the first hospital to allow, in 2005, assisted suicide in Switzerland 40) 41. Among U.K. palliative care physicians, 63% feel that a single assessment is insufficient to fully evaluate and address the needs of a person requesting euthanasia or pas 42. A similar number of U.K. psychiatrists have expressed similar concerns 43,44, and only 6% of Oregon psychiatrists are comfortable providing consultations for patients requesting pas 45.

Originally, it was the view of the Supreme Court of the Netherlands, the Royal Dutch Medical Association, and the ministers of Justice and Health that euthanasia would not be an option in situations in which alternative treatments were available but the patient had refused them. When this view conflicted with the accepted ethical principle that patients are allowed to refuse a treatment option, the law was altered to allow access to euthanasia even if the person refused another available option such as palliative or psychiatric care. One consequence of the change is that, the appropriateness of suicide prevention programs may begin to be questioned, because people wanting to commit suicide should, on the basis of autonomy and choice, have the same rights as those requesting euthanasia.

There are other examples that a “social slippery slope” phenomenon does indeed exist. In Switzerland in 2006, the university hospital in Geneva reduced its already limited palliative care staff (to 1.5 from 2 full-time physicians) after a hospital decision to allow assisted suicide; the community-based palliative care service was also closed (JP. Unpublished data). Of physicians in the Netherlands, 15% have expressed concern that economic pressures may prompt them to consider euthanasia for some of their patients; a case has already been cited of a dying patient who was euthanized to free a hospital bed 46. There is evidence that attracting doctors to train in and provide palliative care was made more difficult because of access to euthanasia and pas, perceived by some to present easier solutions, because providing palliative care requires competencies and emotional and time commitments on the part of the clinician 47,48. At the United Kingdom’s parliamentary hearings on euthanasia a few years ago, one Dutch physician asserted that “We don’t need palliative medicine, we practice euthanasia” 49. Compared with euthanasia cases, cases without an explicit request were more likely to have a shorter length of treatment of the terminal illness 10.

Advocates of euthanasia have largely ignored these concerns about the “social slippery slope” and have opted to refute the “slippery slope” argument on the basis that legalizing euthanasia and pas has not led to exponential increases in cases of euthanasia or pas or in a disproportionate number of vulnerable persons being euthanized 7,26,30. However, there is evidence that challenges those assertion.

The number of deaths by euthanasia in Flanders has doubled since 1998 30. Of the total deaths in this Flemish-speaking part of Belgium (population 6 million), 1.1%, 0.3%, and 1.9% occurred by euthanasia in 1998, 2001, and 2007 respectively 30 (about 620, 500, and 1040 people respectively in those years). The requirement of the law to report euthanasia cases (aided by laxity in prosecuting cases that fall outside the requirement) may explain some, but not all, of the increase 31. Chambaere et al. 10 reported in the Canadian Medical Association Journal that in Belgium, euthanasia without consent had decreased from 3.2% in 1998 to 1.8% in 2007. But a closer review of the original study shows that the rate had declined to 1.5% in 2001 and then increased again to 1.8% in 2007 30.

In Holland, the overall rate of euthanasia was 1.7% of all deaths in 2005, down from 2.4% and 2.6% in 2001 and 1995 respectively, but no different from 1990 when the rate was 1.7% 7. However, the Dutch government’s official statistics indicate a rise of 13% in 2009 compared with 2008; euthanasia now accounts for 2% of all deaths. Given the increasing numbers, interest in developing facilities that provide euthanasia (similar to those of the Swiss pro–assisted suicide group Dignitas) has recently been increasing. In Oregon, although the number of cases of pas remain very small relative to the population, the rate has been increasing: 24 prescriptions were written in 1998 (16 of which led to deaths by pas), 67 prescriptions in 2003 (43 of which led to deaths by pas), and 89 in 2007 50.

In Belgium, the rates of involuntary and non-voluntary euthanasia have decreased; together they accounted for 3.2%, 1.5%, and 1.8% of all deaths in 1998, 2001, and 2007 respectively (1800, 840, and, 990 people respectively in those years) 30. In the Netherlands, the rate decreased from 0.7% in 2001 to 0.4% in 2005 7. The actual rate is probably higher, given the large number of unreported cases. Notwithstanding the decrease, the rates are perturbing.

Battin et al. 51 examined data from Oregon and the Netherlands and concluded, as have others 30, that there was no evidence that vulnerable people, except for people with aids, are euthanized disproportionately more. “Vulnerable” was defined in that study as individuals who are elderly, female, uninsured, of low educational status, poor, physically disabled or chronically ill, younger than the age of majority, affected with psychiatric illnesses including depression, or of a racial or ethnic minority. Finlay and George challenged the study on the basis that vulnerability to pas or euthanasia cannot be categorized simply by reference to race, sex, or other socioeconomic status. Other characteristics, such as emotional state, reaction to loss, personality type, and the sense of being a burden are also important 52. Patients are also vulnerable to the level of training and experience that their physicians have in palliative care and to the personal views of their physicians about the topic. For example, one study showed that the more physicians know about palliative care, the less they favour euthanasia and pas 53.

Two recent studies further contradict the findings by Battin and colleagues. Chambaere et al. found that voluntary and involuntary euthanasia occurred predominantly among patients 80 years of age or older who were in a coma or who had dementia 10. According to them, these patients “fit the description of vulnerable patient groups at risk of life-ending without request.” They concluded that “attention should therefore be paid to protecting these patient groups from such practices.” In another study, two of the factors significantly associated with a nurse administering life-ending drugs were the absence of an explicit request from the patient and the patient being 80 years of age or older 15.


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4. THE RESPONSE
What can be done, then, when the best of palliative care is unable to address suffering?

Zylicz, a palliative care specialist who has worked extensively in the Netherlands with people requesting euthanasia and pas, provides a taxonomy to understand the reasons underlying the requests and provides stepping stones for addressing the requests. The requests can be classified into five categories (summarized by the abbreviation abcde) 54:

Being afraid of what the future may hold

Experiencing burnout from unrelenting disease

Having the wish and need for control

Experiencing depression

Experiencing extremes of suffering, including refractory pain and other symptoms

Strategies are available to begin to address severe refractory symptoms, to treat depression, and to deal with the fear that some people have of what the future with a terminal disease may hold. Approximately 10%–15% of pain and other physical symptoms (such as dyspnea and agitated delirium) cannot be controlled with first- and second-line approaches and become refractory. For these symptoms, there is the option of palliative sedation. Palliative sedation is defined as “the monitored use of medications intended to induce a state of decreased or absent awareness (unconsciousness) in order to relieve the burden of otherwise intractable suffering in a manner that is ethically acceptable to the patient, family and health-care providers in patients that are imminently dying” 55. Its intent is not to hasten death, which differentiates it from euthanasia. The goal is to achieve comfort at the lowest dose of sedative possible (usually with midazolam infusion, not with opioids) and at the lightest level of sedation. Some patients therefore achieve comfort at light levels of sedation, allowing them to continue interacting with family; in others, comfort is achieved only at deep levels of sedation.

Studies have shown that losing a sense of dignity and hope and taking on a sense of burden prompt some people to seek euthanasia and pas 21–23,56. Strategies to improve the sense of dignity, based on empirical studies that have explored the concept of dignity within palliative care, have been shown to work 57. Similar strategies need to be developed in the areas of hope and burden.

Given effective palliation, including palliative sedation for patients with refractory symptoms, the only remaining issue is that of legalizing “on-demand” euthanasia and pas when there is no terminal disease or when the person is tired of living or has a mental illness. Legalizing euthanasia and assisted suicide in these circumstances is most concerning and would have major implications over time, including changing a society’s values and making suicide prevention programs redundant because people wishing to commit suicide would then be entitled to do so.

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5. SUMMARY
In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and “tired of living.” Dutch euthanasia protocols have also moved from conscious patients providing explicit consent, to unconscious patients unable to provide consent. Denying euthanasia or pas in the Netherlands is now considered a form of discrimination against people with chronic illness, whether the illness be physical or psychological, because those people will be forced to “suffer” longer than those who are terminally ill. Non-voluntary euthanasia is now being justified by appealing to the social duty of citizens and the ethical pillar of beneficence. In the Netherlands, euthanasia has moved from being a measure of last resort to being one of early intervention. Belgium has followed suit 37, and troubling evidence is emerging from Oregon specifically with respect to the protection of people with depression and the objectivity of the process.

The United Nations has found that the euthanasia law in the Netherlands is in violation of its Universal Declaration of Human Rights because of the risk it poses to the rights of safety and integrity for every person’s life. The UN has also expressed concern that the system may fail to detect and to prevent situations in which people could be subjected to undue pressure to access or to provide euthanasia and could circumvent the safeguards that are in place.

Autonomy and choice are important values in any society, but they are not without limits. Our democratic societies have many laws that limit individual autonomy and choice so as to protect the larger community. These include, among many others, limits on excessive driving speeds and the obligation to contribute by way of personal and corporate income taxes. Why then should different standards on autonomy and choice apply in the case of euthanasia and pas?

Legislators in several countries and jurisdictions have, in just the last year, voted against legalizing euthanasia and pas in part because of the concerns and evidence described in this paper. Those jurisdictions include France, Scotland, England, South Australia, and New Hampshire. They have opted to improve palliative care services and to educate health professionals and the public.




The once subconscious, now blunt and vulgar, desire to murder one’s elders is the logical conclusion of a culture of perpetual consumerist youth. The elders of the tribe have long passed their usefulness and have become a burden on the economy.


Historians of the idea of “life unworthy of life” tell us that such thoughts as euthanasia would not emerge overnight but would be contingent on developments in biology, the behavioural sciences, ethics, law, and of course economics, that would have to facilitate such heinous practices. And it is precisely in the condition of the current coronavirus pandemic that we must be vigilant about such pernicious thoughts and practices.


In the case of this pandemic the world faces now we also need to trace the current murderous sentiments to much earlier developments. In my book, Corpus Anarchicum: Political Protest, Suicidal Violence, and the Making of the Posthuman Body (2012), I argued in detail how the phenomenon of suicidal violence is predicated on a far more pervasive transmutation of the human body into a disposable entity, evident in a wide range of contemporary practices ranging from genetic engineering to abortion, organ transplant, physician-assisted suicide, and ultimately eugenics and euthanasia.

In the 1980s the name of Dr Jack Kevorkian was synonymous with the phenomenon of physician-assisted suicide. In my book I argued that the deposition of elderly parents and grandparents in nursing homes away from their families was a prelude to this phenomenon of “mercy killing”, evidence of a culture of perpetual youth, as was the widespread practice of organ donation and organ transplants, all of which pointed to the formation of what in my book I have called “the posthuman body”.

The myth of perpetual youth
What we are witnessing in the heightened stages of COVID-19 here in the US is precisely this stage of marking dispensable bodies – bodies that have long since passed their economic usefulness, and as a result, are deemed to be disposable so “the economy” can resume feeding the fantasy of the perpetual youth.

This perpetual youth believes in nothing – especially no metaphysics of any certainty – but in the kind of “science” that can sustain this phantasmagoric eternity of now and here. Social Darwinism, Malthusian law of depopulation and the survival of the fittest have now coalesced in an existential belief in nothing. This is what I mean by the phrase “posthuman body”, or corpus anarchicum, a body that begins with genetic engineering, and ends with suicidal violence, or in the selling of one’s organs or else disposed of on the altar of Dow Jones in mass involuntary euthanasia.

Here predatory capitalism rules supreme, creates robotic consumers, and kills the superfluous like flies and viruses.
We had a premonition of this world in Neill Blomkamp’s Elysium (2013) which depicts a ravaged planet Earth from which rich people like Trump and his ilk have run away to a luxurious space “Trump Tower,” as it were, and in which they continue their parasitical existence.

It was precisely in this very world that in another film, Andrew Stanton’s WALL-E (2008), we had seen two robots modelled on rich girl meeting poor boy, emerging as the last vestiges of our anthropomorphic humanity, soon after the ravaged Earth had yielded to starship Axiom.


If you are binge-watching these days while sheltering at home, behold those two robots, Wall-E and Eve, as the premonition of our posthuman bodies – hopefully.



Also supplement:

Maintain humanity under 500,000,000 in perpetual balance with nature.
Be not a cancer on the Earth—Leave room for nature—Leave room for nature.


And relevant pic:

1446165273785.png



So yes considering current trends, it is logical and realistic that Earth UN in Stellaris could have enacted population controls with forced euthanasia of the elderly and those unable to contribute to society until FTL was invented.

GrimDark.




Moving on, I meant to say, that explanations that run contrary to what is on screen and what is expected, I managed to find the trope I was seeking before that explains everything:


The general assumption that all of the unstated details of the setting of a work of fiction that remotely resembles Real Life can be filled in by the audience's knowledge of the world in which they live, except in areas where the fictional world explicitly or by necessary implication deviates from Real Life.

So, for example, if the characters note that they've just gotten back from Paris, the audience can safely assume that this is the capital city of France complete with Eiffel Tower, even if this is never made explicit in the narrative.

Such assumptions are still expected even if the setting has obvious deviations from Real Life, such as the presence of superheroes, vampires, aliens, or a fictional President of the United States. The setting, after all, is Like Reality Unless Noted; the obvious fictional elements are the part that's been noted, and In Spite of a Nail the rest of the world is still assumed to be identical to Real Life.

When it becomes explicit that the setting is Like Reality Unless Noted in some aspect, that's Truth in Television. On the other hand, the audience's subconscious assumption that the setting is Like Reality Unless Noted may be suddenly and obviously disproven for The Reveal that it is actually an Alternate Universe or Alternate History, which may serve as a Tomato Surprise.

Even when stories are not set in the Present Day, they are still assumed to be Like Reality Unless Noted with the necessary adjustments. Historical settings are Like Reality Unless Noted with regard to their particular time period. Similarly, stories set in The Future are assumed to have at some point in the past been Like Reality Unless Noted and moved on from there. Even completely fantastic settings that have their own fictional history, geography, and culture, are probably assumed by the audience to be Like Reality Unless Noted with regard to a number of biological and physical facts — or at bare minimum, how people can generally be expected to behave. For that matter, even Alternate History stories that are explicitly set in a world not like our own may feature people and events that happened in reality to a far greater extent than mere chance would lead one to expect.


Many movies deal with, for instance, an attack on the United States government as if it happened in the present day. We can't really have a movie where the actual current elected president is killed or kidnapped (the majority of citizens on both sides would likely consider it too soon while they are in office), so a No Celebrities Were Harmed substitute or an outright fictional one will be in place so the story can take place in Real Life with the rest of our current culture intact.



Anyway, yes a city can be small as 20.000-30.000 people, but at least a colony ship has a cityscape inside, and it can be expected that there is not a colony fleet, that the ship is just one from the text, the trope of ark ships, the trope of like reality unless noted, and that actual immigration wtih people moving from the homeworld to the new people starting growth happens after the colony ship touches down on the planet and set its base up.

Plus there are expansions traditions that make more people go to colonies, and more people in colony ships:
Colonization Fever.png
A New Life.png





Also actually no, you have Luxury Residences at the start of the game, and those have advanced zero-g technology already, see here:

luxury residences starting date.png



Idyllic architecture is for the tier II of the building, the paradise dome, Luxury Residences are a starting tech.


Tier ITier IIRequirements
BuildingHousingAmenitiesBuildingHousingAmenities
Luxury Residences+3+5Paradise Dome+6+10
  • (No) Shared Burdens
  • Thrall World designation
  • Idyllic Architecture technology for tier II
  • Habitat Expansion technology to be built on Habitats


-----


So you were saying that transport ships are equivalent to colony ships at least? Just to make sure to understand what you're saying.


For completeness, assault armies should be big as defensive armies, and defensive armies are at least this big:

Hearts of Iron Age
Humans are Materialist and Fanatic Militarist, and have the industrial armies of Nazi Germany, the USSR, the US, the UK and Imperial Japan. In Ironman mode successfully invading at this time will unlock the Outside Context achievement. If they advance to Atomic Age they might start a nuclear war. The name is also a reference to Paradox's Hearts of Iron game series, set in World War II.
Present Day
Humans are Xenophile and Fanatic Egalitarian, and have the post-atomic armies of the US, China, Russia and the European Union. ISS II orbits Earth. If they discover FTL they will become the United Nations of Earth. They cannot start a nuclear war at this stage.


The U.S. Army​

During World War II about 16,000,000 personnel served in the U.S. Military. Approximately 11,200,000 or 70% served in the U.S. Army; 4,200,000 served in the Navy; and 660,000 served in the Marines.
 
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Also actually no, you have Luxury Residences at the start of the game, and those have advanced zero-g technology already, see here:

Idyllic architecture is for the tier II of the building, the paradise dome, Luxury Residences are a starting tech.


BuildingHousingAmenitiesBuildingHousingAmenities
Tier ITier IIRequirements
Luxury Residences+3+5Paradise Dome+6+10
  • (No) Shared Burdens
  • Thrall World designation
  • Idyllic Architecture technology for tier II
  • Habitat Expansion technology to be built on Habitats

-----
Fair enough on the starting techs - I'll have to point that out to someone on the Stellaris Wiki, as they have both Luxury Residences and Paradise Dome under Idyllic Architecture.

But I'll also point out to you that, in looking through the Research sections of the Wiki, the only techs that talk about gravity technology are at least Tier 2 (Gravitic Sensors and at least one other with that as a pre-req) and nothing that talks about applications using anti-gravity for ships, war or otherwise. It strikes me as odd that this "advanced zero-g" (BTW, should be "anti-gravity", as "zero-g" simply means an area where gravity or its effects don't effectively exist (e.g., freefall), not a countering of an existing gravitational "field") tech exists at the start of the game, yet the only mention of it is in keeping "outlandish terraces from collapsing." I think someone on the Dev Team just misplaced a reference to a technology in their fluff text, maybe something that used to exist later in the tech tree but was moved forward.
 
Fair enough on the starting techs - I'll have to point that out to someone on the Stellaris Wiki, as they have both Luxury Residences and Paradise Dome under Idyllic Architecture.

But I'll also point out to you that, in looking through the Research sections of the Wiki, the only techs that talk about gravity technology are at least Tier 2 (Gravitic Sensors and at least one other with that as a pre-req) and nothing that talks about applications using anti-gravity for ships, war or otherwise. It strikes me as odd that this "advanced zero-g" (BTW, should be "anti-gravity", as "zero-g" simply means an area where gravity or its effects don't effectively exist (e.g., freefall), not a countering of an existing gravitational "field") tech exists at the start of the game, yet the only mention of it is in keeping "outlandish terraces from collapsing." I think someone on the Dev Team just misplaced a reference to a technology in their fluff text, maybe something that used to exist later in the tech tree but was moved forward.
Maybe it was an older version of the game and they didn't update it, and I think the gravitic sensors was finding ships by their gravity or something, nothing about anti-gravity tech like primaris marines repulsor tanks for example.

That could be it, but then you can't be sure unless you find who actually did that tech.
 
Ground Battles are going to remain a meaningless tack-on until the devs get to actually overhauling combat entirely (ETA never), by introducing concepts such as tactics (beyond circling enemies in a lightshow of death) and manpower (because making planetary invasions actually cost something might enable actually designing interesting gameplay surrounding them).

But that's the kind of rework scope that simply won't fit in, especially now that half the team will work on fancy/DLC features, and the other half tackle the long overdue backlog. Whereas this kind of rework would need the full focus of the team, probably for the span of a whole expansion developement cycle, and then some.
 
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