Thanks for posting this! I don't really know what EA is in an "ontological" sense, but it seems partly about branding and networking. I don't know what the best scope for these things is, but I appreciate a post like this raises these issues.
Maybe there could be multiple brands or submovements within EA (perhaps there are already) or numerous "sister" movements/communities with somewhat different values/priorities. Maybe it's good to have some solidarity between the more stereotypical radical EA-types and folks with more traditional views who want to make a difference in their community and stuff. The desire to make a difference in the world is, far from being peculiar to EA, basically a universal human trait, and I think it may be good to leverage and celebrate that. Or maybe it's better to stay smaller and more focused. Idk, but again, appreciate the post.
I like the general idea of local stuff.
I agree with much of what you said and so edited my post. I do have a few points to make in the abstract though.
Although patients are prone to make mistakes such as abusing drugs, the medical establishment is sometimes majorly wrong in predictable ways, and waiting for the establishment to fix itself through the official channels can take sometimes decades. If caffeine was just discovered today, I think it would be classified as a controlled substance and restricted to certain diagnoses. (No?) If so, I think that would be a huge loss for humankind.
The philosophy of clinical psychology/psychiatry as represented in the DSM strikes me as seriously flawed. They group things into discrete categories called "disorders" and eschew continuity and multidimensionality. As math (and its offshoots) becomes more wildly known, I think this will change, but it will take time. [I'm not saying that the concept of a disorder or diagnosis should be completely abandoned, but it has limitations].
Finally, the opioid comparison strikes me as strained.
FWIW: I think most people think of these things in terms of Putin getting what he deserves and in terms of moral imperatives to stand strong against injustice regardless of the consequences. Welfarist considerations are not the main thing for most people, though disincentivizing future aggregation via escalation is a legit welfarist consideration.
I suspect it's very similar to people's views on criminal justice.
That goes without saying.