Here is a specific anecdotal example of how a “slippery slope” argument can be quite valid. It might not be inevitable that every change or compromise invites a fall down a slippery slope, but there are cases where the first step does start the change.
Twenty years ago a treatment facility for mentally handicapped people had a policy that mechanical restraint was an unacceptable practice, and could not be used in any situation except drastic need for medical reasons to prevent injury, or allow treatment of life threatening conditions. It required a specific order from a physician for each use of the device, one hundred percent monitoring of the individual restrained by two people and a very strict schedule of release and exercise during the period of restraint. It could not be ordered for more than 24 hours for any reason, could not be immediately reordered without personal review by the facility director. The real life result was that it was never even suggested except in extreme conditions, and every possible alternative had already failed.
At that time it was decided at the state level that the cost of implementing and monitoring such practices in the medical facilities serving prison populations was to high. The regulations were changed, and that change applied to all state medical facilities, including the treatment of non-criminals. The changes eliminated the necessity of the second person in attendance, and allowed extended time periods during which the procedure could be repeated without new authorization. No other changes were suggested, it was simply a “bureaucratic reform” to eliminate unnecessary paper work.
The use of mechanical restraint was not frequent in the first few years at this particular facility. However it went from zero to several times a year. In the next few years the need for immediate review before repeated reliance on the procedure was relaxed to a quarterly review by staff, rather than an immediate personal review by the director. A few years later the responsibility for such orders was expanded to include non-medical clinical practitioners. The use of mechanical restraint became infrequent but routine in specific cases.
In the last decade the use of Mechanical restraint at this facility has become routine and frequent in many specific cases, is reviewed along with ordinary treatment plans by teams of providers, and requires only a standing order describing the circumstances under which it can be used. The actual facts are that it is often used inappropriately, is seldom monitored even at the level that the relaxed standards require, and is often ordered by assistants to clinical specialists who sign the orders after the fact.
Two months ago a restraint was used inappropriately at least three times as a convenience by staff members who have no particular reason to believe that such a thing is not completely ordinary. Two of these cases included “orders” given by unlicensed people to execute the procedures, and no one even questioned the right of those people to make the decision. The facts of real life are that it happens all the time now, and most folks don’t even think that is a bad thing. It saves time and money.
I told the director twenty years ago that we would be slapping cuffs on people for no reason, and doing it regularly if they changed the rules. He said that was not possible, and that my argument was unrealistic, there was no slippery slope. Two people facing dismissal on charges of ignoring rules they didn’t know existed are wondering what the hell the fuss is over; it was only a few minutes that they used a procedure that they have seen used for hours. No one even wonders how it got to be this way.
There isn’t always a slope, and it isn’t always slippery, but you ought to check it out, because you can’t slide back up the hill.
Tris
“I believe in general in a dualism between facts and the ideas of those facts in human heads.” ~ George Santayana ~