Saturday, March 31, 2007

Pope cures Parkinson's sufferer and my sadness

Pretty amazing! Pope John Paul II, the recently deceased arch conservative CEO of the Roman Catholic Church, is said to have cured miraculously one of his staff members from Parkinson's. Amazingly, he did this two months after he had died. The nun in question prayed to him for help, and the miracle occurred. I heard about the story yesterday on the BBC News. And guess what, something truly amazing, in fact another miracle, occurred, and again it was linked to Pope John Paul II. So, here's what happened. I was quite down, if not slightly depressed yesterday when I heard about the nun-related miracle. Incredibly, the moment the story was reported on the news program I burst into laughter, in fact I laughed so hard I started crying. Praise the Lord, umm Pope. A miracle. On hearing of the dead man's capacity to heal Parkinson's (triggered by something as innocent as a prayer), my sadness was rapidly replaced by roaring laughter, and I was full of joy.

I understand that this miracle production is due to the perceived need for the ex church CEO to become a 'saint'. I don't know what 'saints' are, but it seems many Catholics are quite keen to get their ex CEO made a 'saint' (may be the church equivalent to an OBE?). For John Paul (mark II) to get that honor he needs to be 'beatified' (beats me what that is), and that in turn requires a miracle.

The good news is that he's getting ever closer to the church OBE, because there's not one but two miracles: first, of course, the healed nun (can't beat that one), and then I was alleviated of my sadness. I'm sure if there's a few more such miracles a lot more laughter could be produced in a fairly cost-effective way. So, if your tummy itch disappeared when you saw John Paul II on the telly, give me a shout. I will collect all the necessary miraculous evidence to ensure he gets his church OBE quickly. Least one can do for that old sod.

Friday, March 30, 2007

Voting for the Scottish Christian Party? - You got to be kidding!

photo to the left:
Superman and his disciples

In most places other than Iran and the UK pluralistic societies since the enlightenment have understood that it is important that the state and the various churches operating in it should be separated. The state should remain institutionally neutral with regard to the values held by churches. It might well adopt some of the values expressed by such organisations, but there should never be a causality of the sort that whatever value is expressed by church A will become law in state A. There are all sorts of good reasons for this, but this is not the topic of today's posting. Nope, I want to tell you a bit about a smallish political sect called the Scottish Christian Party. They decided that they want Christian values to determine government policies in Scotland. Scotland will see elections to its devolved parliament some time in May this year.

Here, for the humanist and reasonably enlightened religious reader of this blog some gems from the party's website:

Bob Handyside, a retired music teacher and one of its candidates says: 'Traditional Christian family values have been undermined while minority groups are privileged and preferred before the majority.' Bob is, of course, referring to civil rights legislation saying that religious adoption agencies may not discriminate against same sex prospective adoptive parents.

A guy by the name Revd J. Hargreaves explains to visitors of the party's website what the real name of the Scottish Christian Party is: 'Our full name is in fact the Scottish Christian Party “Proclaiming Christ’s Lordship”.' So, the real government in Scotland then or in the UK, for that matter, is not the democratically elected government appointed by the citizens but some Lordship by the name Christ. Well, looks like the end of democracy is ever edging closer as da Lord is moving in on us.

Makes you wonder how they see themselves representing the people of Scotland, seeing that Scotland is the most strongly non-religious country in the whole of Europe. Explains da Lord's representative Mr J. Hargreaves: 'Furthermore, just as you would not expect to find a Conservative in the Scottish Socialist Party, those of other faiths and none cannot join the Scottish Christian Party.' So, there you have it, the Lord's crowd doesn't want you, and will almost certainly not represent your interests unless you are a Christian. Shame they haven't picked Allah as their leading light, as otherwise all they'd have to do is to move on to Iran and enjoy its version of 21st century civilisation (if they're really lucky they might even be able to participate in the public stoning to death of people alleged to be gay).

As the old Romans say in Asterix and Obelix cartoons: 'Caveat emptor' or 'Let the buyer beware.' These people are really out there, even though one can't help but think that some comedian might be behind this party and its activities. They can't be for real, or can they?

Wednesday, March 28, 2007

Pandemic Influenza - A Vague Policy Document Guides Us Nowhere

Resource allocation decision-making is not only a pleasurable pastime for bioethicists, it has also serious consequences for real people (yes, people like you and me). In bioethics and health economics academics have been arguing for a long time what criteria are just criteria for determining who is inside, and who will be left to fend for herself outside the life boat. One of the big theoretical arguments has been whether we should aim for the number of life years saved or whether we should aim for the number of lives saved. Crudely put, is it acceptable, in emergency circumstances, to discriminate against the elderly? Should a 90 year old person who has lived most of his or her life be entitled to the same level of (scarce) resources as a 12 year old person? The main, and to my mind, convincing arguments in favour of discriminating in favour of the young person are:

  1. We should try to maximise the number of quality life years with the resources available. There doesn't seem much point in throwing our resources at adding another few months or even a year or two at a 90 year old when with the same resources we could guarantee a teenager to live basically her whole life. [Note: It would be nice, of course, to do both, but the empirical premise of this argument is that we cannot do both due to a lack of resources.]
  2. The second argument seems somewhat related. It's the fair innings argument, suggesting that the 90 year old had his fair shot at life and that he is not entitled to be kept going if that means that a person who hasn't had that fair shot at life would have to forgo living her own good life (eg our teenager).
Well, in the US a policy maker consensus has formed along the lines that these arguments are not good enough and that we should aim for lives saved instead of life years. In the UK the Department of Health has just issued a draft policy document inviting public comments.

This document in the section on 'Fairness' proposes that 'people with an equal chance of benefiting from health or social care resources should have an equal chance of receiving them.' The guidance document was written by a largeish group of mostly substantially beyond the age of 40 luminaries in ethics, theology, public health etc. It's misleadingly labelled an ethics framework when really it's a policy document. As with many such consensus driven documents it's a failure in that it is both vague and minimalistic (I owe this terminology to an insightful paper David Benatar published on another such document in Developing World Bioethics recently.) In the crucial resource allocation case it is sufficiently vague as not to give any guidance at all. The statement can effectively and legitimately be read in two ways, each leading to diametrically opposed practical conclusions.

Firstly, it can be read as saying that an elderly person would not have an equal chance of benefiting from a health resource, given that she wouldn't benefit from survival as long as someone much younger. Ergo it would be acceptable to discriminate in allocation decision making against the elderly.
Secondly, it can also be read as saying that an elderly person would have an equal chance of benefiting from a health resource, given that she would survive as a person, as much as someone much younger would survive as a person. Ergo it would be unacceptable to discriminate in allocation decision making against the elderly.

Until we know what the unit is that we are supposed to utilise to measure 'benefit', flipping coins is roughly as useful as this guidance document.

So, we find ourselves in a situation where, regardless of which policy option we prefer, we would and would not be able to identify with what is proposed, subject to how we interpret the fairness related statement above.

This, arguably, renders this policy guideline useless as there would be no uniform policies resulting from it.

We can't even have a decent argument about it as we cannot be certain what it wants to convey... - Makes you wonder about those luminaries and their capacity to produce a guidance document for a crisis situation such as pandemic influenza.

Tuesday, March 27, 2007

Irresponsible governments - accountability for acts and omissions

The South African Health Minister Manto Tshabalala - Msimang and Treatment Action Campaign's Zackie Achmat have frequently crossed swords in the past. He was asked by a local paper whether he could ever be friends with her. Achmat replied "no", and explained: "Almost a million people have died and for that I don't think that I could ever establish a friendship with her."

Forget the question of whether or not anyone would want to be friends with such an egotistical, petty character as the South African Minister for Health Prevention and the country's similarly deluded President. There's a more interesting issue, and that issue is this. Consequentialist ethicists (among others) have made much of rejecting the acts and omissions doctrine. They claim, essentially, that all other things being equal, you are as responsible for the consequences of your actions as you are for the consequences of your omissions to act when you could have acted. I think that this makes perfectly sense.

Here then is an interesting challenge: Remember a mass murderer like Slobodan Milosevich, the Christian slaughterer or anything not Christian/Serbian during the civil wars in former Yugoslawia? Many people died as a direct consequences of his actions (read: policies). Well, if we really believe that the acts and omissions doctrine doesn't make much sense, we surely need some international court of justice that holds governments responsible for policies that omit to act when they could have acted to prevent significant harm to their citizens. Thabo Mbeki, Manto Tshabalala-Msimang and the ANC government are responsible for up to 1 million of preventable deaths in Southern Africa due to their refusal to provide medication to these people when they could have.

I am still flabbergasted that nobody in South Africa seems keen on holding these liberation politics apparatchicks responsible for the preventable deaths of more than a million poor Black South Africans. Just imagine such genocidal policies had been enacted by a white government. The world would have been up in arms, and quite rightly so. Surely, holding a Black run government to lower standards of performance, competence etc is in itself racist, isn't it?

... or am I missing something?

Monday, March 26, 2007

'God'less Europe - or so :)

Quite interesting. Secular folks like myself have supported a document called the 'Brussels Declaration'. This document, published a few weeks ago, was meant to influence European Union debates on our commonly shared values in Europe. We were concerned that the Pope and his minions in the EU parliament might sneak in 'God' in some incarnation or other. Well, I am pleased to report that the official declaration of the European citizen's values makes no mention of 'God' ... and the Pope is reportedly not pleased at all. Here then the Berlin Declaration

The Berlin Declaration

Europe was for centuries an Idea, a hope for freedom and understanding. This hope has been fulfilled. European unity has enabled us to live in peace and prosperity. It has created a community and overcome differences. Every member has helped to unite Europe and to strengthen democracy, the rule of law. We have to thank the love of freedom of the people of central and eastern Europe that Europe’s unnatural divisions are today finally overcome. With European unity, we have learned the lessons from our bloody conflicts and painful history. We live today together in a way that was never previously possible. We citizens of the European Union are united in our good fortune.

Section 1

In the European Union we realise our common ideals: for us the individual is central. His dignity is inviolable. His rights are inalienable. Women and men have equal rights. We strive for peace and freedom, for democracy and the rule of law, for mutual respect and responsibility, for prosperity and security, for tolerance and participation, justice and solidarity. We live and function together in the European Union in a unique way. This expresses itself in the democratic co-operation of member states and European institutions. The European Union is based on equal rights and solidarity. That is how we make possible a fair balance of interests between the member states. We uphold in the European Union the individuality and the diverse traditions of its members. The open frontiers and the lively diversity of languages, cultures and regions enrich us. Many goals cannot be achieved independently but only through common action. The European Union, the member states and their regions and local communities share these tasks.

Section 2

We face great challenges which cannot be confined to national frontiers. The European Union is our answer to them. Only together can we preserve our European social model in the future to the benefit of all citizens in the European Union. This European model unites economic success and social responsibility. The common market and the euro make us strong.

That is how we can shape the increasing worldwide interdependency of the economy and ever expanding competition on international markets according to our values. Europe’s wealth lies in the knowledge and abilities of its people; this is the key to growth, employment and social cohesion. We will jointly fight terrorism and organised crime. We will also defend our freedom and civil rights against their enemies. Racism and xenophobia must never again be given their chance. We will act to ensure that conflicts in the world are solved peacefully and that people do not become victims of war, terrorism or violence.

The European Union will promote freedom and development in the world. We want to push back poverty, hunger and disease. In doing so, we will continue to play a leading role. In energy policy and protection of the climate we want to go forward together and make our contribution to heading off the global threat of climate change.

Section 3

The European Union will continue to live in the future on the basis of its openness and the will of its members to strengthen together the inner development of the European Union. The European Union will continue to promote democracy, stability and prosperity beyond its frontiers. European unity has made reality out of a dream nurtured by earlier generations. Our history warns us that we have to protect this good fortune for future generations. We must continue to renew and update the political shape of Europe. That is why, 50 years after the signing of the Treaties of Rome, we are today united in the goal of achieving a renewed common foundation for the European Union before the elections to the European Parliament in 2009.

Because we know: Europe is our common future.

HIV dissidents - continuing crackpottery causes untold harm in Africa

I have written before about the unprofessional conduct of a small group of scientists insisting that HIV isn't the cause of AIDS, that AIDS isn't an infectious illness and importantly that medication proven to keep people with AIDS alive actually causes AIDS.

Well, these folks pretty much lost their battle for the professional and public opinion in the developed world, so they shifted their lunatic campaign to the developing world. You can find a pretty detailed analysis of their activities in Southern Africa here. South Africa in particular carries one of the highest HIV disease burdens in the world. I don't want to spend too much time dwelling on the reasons for that, except to say that this is caused by a mix of poverty, education and importantly a government propagating these minority views until very recently. The ANC government as a trusted source of information spent years sending out misleading, confusing and outright false information on HIV/AIDS.

A few days ago I received this message from an outfit in Kwazulu Natal:

The subject heading of the email ... 'HIV not a real problem its [sic!] the sugar'

The spam-type email continues:

'Dear friends,
You believe in HIV because you did not know the real facts.
We make a juice (UMLINGO WAMANGCOLOSI) that lets any one start their life again, strong and healthy.
All you have to do is stop the following food, drinks and stress:
2. Chemicals
Visit us every monday and thursday between 9 and 16.00pm at the KwaNgcolosi Court House and you will be healthy with in weeks.
KwaNgcolosi is under Hillcrest/Waterfall by the Inanda Dam just 40Km from Durban.'

I wonder how many, mostly Black, South Africans will fall for this nonsense and die a preventable death from AIDS due to this quackery!

Sunday, March 25, 2007

Access to Essential Drugs

By way of promoting a book I co-edited, here's a review of said product in this week's medical journal THE LANCET.

The Lancet 2007 24 March

Book Review

Access to essential drugs and the pendulum of power

The Power of Pills: Social, Ethical and Legal Issues in Drug Development, Marketing and Pricing
Jillian Clare Cohen, Patricia Illingworth and Udo Schuklenk, eds.
Pluto Press, 2006, ISBN 0-745-32402-9.

Pp 320. £19·99, US$35·00

Many factors have influenced my commitment to campaign for access to essential medicines, but two immediately leap out. When I was working in Bangladesh I witnessed a certain drug company promote the virtues of a sugar-coated vitamin pill as the most important factor in helping children grow and stay healthy. Families spent a day's wages on these useless tablets when they could have been buying bananas, spinach, and dahl instead. As I watched parents make sacrifices to pay for these pills, I realised that I was obliged to do something about this profoundly unjust situation:

I knew what was going on, doing nothing would make me complicit in the drug company's actions.

Years later, in my role as a medical editor, I accepted an invitation to lunch with the Association of the British Pharmaceutical Industry. It was just after the South African Government had won their landmark court case against the pharmaceutical industry, in April, 2001, and I wanted
to hear the association's view of the outcome. It was in London's Grosvenor Hotel and everyone apart from me was tucking into a three-course meal under the chandeliers. I felt alone in my disapproval of drug companies' evangelical zeal to uphold patents, and uncomfortable about the way those present were talking about African people. After I said my piece, I left the dining room and a Brazilian waiter came running after me to thank me for what I had said.

And here lies the problem. The activities of drug companies that put patents before public health—encouraged by the World Trade Organisation's rule on Trade-Related Intellectual Property Rights (TRIPS)—places the pharmaceutical industry and campaigners on different sides of an impasse that is so wide there seems to be no possibility of meeting in the middle. In the real world, the outcome of this polarised debate depends on who has the most power, which unfortunately for now is the drug companies. But if there is any hope of making progress, there has to be some mutual recognition and acknowledgement of each other's point of view. Will I find any thought-provoking reasoning in The Power of Pills to help me appreciate the
position of drug companies?

The Power of Pills explains the social, ethical, and legal issues involved in drug development, marketing, and pricing and has contributions from an eclectic mix of academics, activists, economists, ethicists, health-care professionals, lawyers, and philosophers. There is one contributor from the pharmaceutical industry. Most of the essays are beautiful examples
of moral, philosophical, and economic reasoning at its best. For example, Michael Selgelid and Eline Sepers argue that drug companies should be "incentivised" to research diseases in developing countries. The need for governments in the south to implement a comprehensive public-private policy that sets the agenda is the focus of Joao Carapinha's essay. Steve Miles suggests that the socioeconomic gap between rich and poor countries is likely to grow unless
developing countries establish their own research capacity that prioritises the health needs of their populations. The case for abolishing the patent system is made convincingly by Adam Mannan and Alan Story. And Brook Baker argues that access to essential medicines is a human right and proposes that the international community should put it firmly on the human rights agenda.
The drug industry is represented by Robert Freeman, a pharma veteran. He offers a predictable defence arguing for "strong intellectual property rights, a stable regulatory, pricing and reimbursement environment, and the recognition that pharmaceutical innovation is a major contribution to the health of nations." We are back at the impasse. I am not convinced.

Another prime example of pharma dogma is in the 2005 report from the Millennium Project Working Group on Access to Essential Medicines, one of the Millennium Development Goal targets, which discusses the way forward.
The report's authors come up with similar solutions to those outlined in The Power of Pills, such as fair pricing of essential medicines and innovative methods of research and development that are not led by the pharmaceutical industry. However, at the back of the report is a statement of dissent by representatives of the research-based pharmaceutical industry and signed by
Eli Lilly, Merck, and Pfizer. Although representatives for the industry were part of the working group they refused to sign the report, "because of the enormous visionary gap between ourselves and the working group in identifying root causes of the access challenge". Their reasons are so important in understanding why there is a stand-off position when it comes
to access to essential medicines that I think their response is worth quoting. They state, "We do not believe that the main problem in barring medicines to the poor is patent protection, nor do we accept that individual pricing practises are fundamental to explaining why one-third of
the world's poor lack access to basic, low cost essential medicines." They conclude, "In short, the report fails to provide the balanced and accurate perspective necessary to stimulate fresh policy approaches that could make a real difference to the lives of the poor. To allow these inaccuracies and misinterpretations to become accepted truth and as the basis of moving policies forward does no one any service, least of all patients who rely most on the commitments we have made. It would significantly diminish our ability to fulfil commitments to current and future partnerships—most importantly—our capacity to produce new drugs, diagnostics, and vaccines."

I am left wondering how much more evidence and reasoning it will take for the drug industry to meet somewhere along the impasse. Is there any way forward? A WHO Intergovernmental Working Group on Public Health, Innovation and Intellectual Property may offer some hope. The group's aim is to help devise a global strategy to boost research and development for neglected diseases, including looking at new ideas such as patent pooling, to address the barriers posed by patents for individual drugs. But experience to date shows that drug companies will do everything they can to cling on the status quo where they hold all of the power. The pendulum of power will need to swing to the other side before there is any reasonable progress.

So imagine this: after deciding to diversify and invest in its own research and development, a former Indian generic drug company has come up with a new compound that could be of major benefit to people with lung cancer—the leading cause of death from cancer in rich countries. The company has tested its drug in clinical trials, it has been approved for use, and as is within the company's rights, according to TRIPS, the company patents it and charges a premium so that the cost for treating one patient for 1 year with the new drug is £50?000. Can you imagine the response to this situation, including the tabloid headlines? Now why should the response to access to life-saving treatment, such as antiretroviral therapy, for people in developing
countries be any different? Is it because they are poor? Is it because they are powerless? Or is it because, on the whole, the international community just does not care? The power is not with the pills. It is with the pill makers.

nathan ford < >

Saturday, March 24, 2007

Royal Bank of Scandalous (aka Scotland)

Regular readers of this blog will know that I made atrocious experiences with the Royal Bank of Scotland. For the record, the stuff-up the bank caused months ago during a stay in San Francisco has still not been rectified. Even my branch manageress thinks that the organisation's conduct has been shameful at best.

Having declared my personal conflict of interest, I should probably also mention that I continue to monitor this record profit making organisation for further evidence of truly scandalous conduct. And indeed, given half a chance, the Royal Bank of Scandalous (as a reader of this blog renamed the organisation) will almost certainly jump at it.

Well, here's what's happening. Just like other organisations, the company requires that its staff also buy its products. Any of its staff members caught not having a bank account with the Royal Bank of Scotland will be subject to disciplinary procedures. I don't understand why the company's staff would be so recalcitrant. Is it because they know better than most of us how crappy the bank's customer (dis-service) really is? May be they don't want to wait months to see an apology for bad service and some kind of compensation? After all, the bank pretty much instantly charges the living hell out of you if you overdraw your bank account. If they (by their own admission) mistakenly drain your account of money, they quite happily charge you (yes, you!) instantly. They then fail, months after having punished you for overdrawing an account that they accidentally drained, to compensate you or fix the mistake.

Of course, I shouldn't be unfair. There are plenty of other companies requiring their staff to buy their products. Rolls Royce for instance demands that its staff drive only Rolls Royce, and so do Bentley, Jaguar and Mercedes Benz. Come to think of it, thousands of Lufthansa staff were recently disciplined for flying other airlines. Worse, McDonald's staff seen with a Burger King burger in their hand will be shot on the spot by McDonald's Staff Monitoring Services. - OK, I guess you realise that I made these stories up. I also hope you get the point that I am trying to make. Take the opportunity to cancel your account with the RBS when you have a minute. As a bank it fails to provide decent customer services, and as an employer it undoubtedly sucks big time. Move on while you can.

Friday, March 23, 2007

Some good news from South Africa - at long last

Here's good news from today's BRITISH MEDICAL JOURNAL. It's a copy-paste job really. I am tempted to go on raving again about human lives lost due to the unimaginable incompetence of the current South African minister for health prevention, Dr (Beetroot) Manto Tshabalala-Msimang, and, of course, the country's slightly paranoid President Thabo Mbeki, but what's the point... readers of this blog will know. So, here's the BMJ item:

South Africans to get AIDS plan

Pat Sidley


The South African government has finally introduced a full and far reaching plan to deal with its HIV/AIDS epidemic. But it will cost the country some 14bn rand (£970m; {euro}1.4bn; $1.9bn) over the next five years. This amount was not planned for in the present budget for the year ahead.

The plan aims to give antiretroviral treatment to up to 80% of people with AIDS who need the treatment; to halve the new infection rate by 2011; and to ensure that all pregnant women who are HIV positive have access to treatment to prevent transmission to their babies. The plan envisages better spending of the large donations that pour into the country, with the intention of strengthening the health system and using health staff more efficiently. The whole process will be properly evaluated and monitored.

Less than a year ago, Mr Mbeki's government followed the president's view that AIDS was a syndrome and that "a virus could not cause a syndrome." Mr Mbeki thought that the extent of disease in the country could be attributed to poverty. He voiced misgivings about white Western experts who claimed that AIDS originated in Africa as though Africans were dirty and immoral. And he presided over a cabinet which approved a product as a cure for AIDS that was later found to contain an industrial solvent (BMJ 1997; 314:450).

The health minister Manto Tshabalala-Msimang, who had a liver transplant earlier this month (15 March), has previously advocated the virtues of beetroot and garlic over antiretrovirals and appealed against court decisions fought for and won by the Treatment Action Campaign to compel the government to provide treatment (BMJ 2006,333:167)

Thursday, March 22, 2007

Complementary medicine - a contradiction in terms

Can't believe that more and more cash-strapped UK universities resort to teaching degree courses in complementary medicine. It's a contradiction in terms. The only reason why this kind of stuff is called 'complementary' is precisely because it isn't tested medicine to begin with. If it had been tested and was known to work we would stop calling it complementary. So really this pseudo-medicine attaches itself to medicine (hence 'complementary medicine') to gain credibility.

Here is a nice exchange between a scientist and a teacher of gobbledigock, check it out:

Wednesday, March 21, 2007

German Justice - Postmodern relativism at its best

Here's a story to think about. A female German national, born in Morocco, suffered serious physical abuse at the hands of her husband, a male German national, also born in Morocco. She files for urgent divorce, seeing that her husband is also threatening to kill her. Well, a female German judge ruled against her request, arguing that both parties to the dispute were Muslims, and that allegedly the Quran doesn't rule out this sort of violence. Therefore, when considering the cultural background of the two parties in the dispute, so argued the judge, there was no unreasonable harm done by the husband (after all, we know from watching TV on the odd occasion, that women get killed by irate Muslim husbands and/or their families occasionally in places like Pakistan, Afghanistan, Iraq, and Iran). The argument essentially was that we should be respectful of the cultural difference that expresses itself in such actions.

Well, this kind of postmodern hogwash was quickly and sensibly dealt with in Germany. The judge in question was removed from the bench and someone else is hearing the woman's request for an urgent divorce.

Tuesday, March 20, 2007

Virgin vs Sky vs ... us the paying subscribers

I feel stupid. The UK's 'free market' system which is supposed to guarantee low prices due to 'real' competition is more often than not a pseudo-free-market. One duopoly is probably the British Airways / Virgin Atlantic control over London's Heathrow Airport. No big surprise that Richards Branson (image to the left), the greedy ex-hippie trying to line his pockets with our hard earned cash, didn't much like the idea of an open skies agreement with the US as it would have brought competition into the market and the prices down.

No big surprise when this self-appointed hero of the small man (read people like you and me), was recently at it again. After taking over NTL (a pretty terrible US cable company selling cable packages to UK TV audiences) his Virgin group refused to pay anylonger for a number of Sky channels. This is partly because a bun-fight has broken out between two billionaires, Rupert Murdoch (aka Darth Vader of the media world) vs Richard Branson (aka ... well, I don't know, nothing complimentary, that much is certain). Sky lost a million or two viewers from the Virgin cable customers who can't tune into its channels anylonger. Advertisers want some of their cash back, of course. And here's an interesting twist in the story. Sky has already budgeted for this loss of advertising earnings and will return money to its advertisers due to its loss in audience share. Compare this to the consumer hero Richard Greed Branson. I wrote to Virgin demanding a reduction in subscription fees seeing that some of my favourite programmes have disappeared without much of a warning. There's been no reply. Richard Greed Branson declared that subscribers would receive no reduction in their subscription fee and people who didn't like that could go to Sky.

I am pleased to see that these operators' activities are currently being investigated by the UK's media regulator. After all, this has been scandalous... and it has been a direct result of a serious lack of competition. These two organisations essentially hold the viewing audience for ransom.

Monday, March 19, 2007

Scottish Nationalist (aka Bigotry) Party ...

You may or may not recall this item on this blog. I posted it awhile ago, arguing that the Scottish Nationalist Party is essentially lowering itself to a gutter driven political party. One of its MSP's proposed at the time that religious adoption agencies ought to be allowed to discriminate against same-sex potential adoptive parents. This was a clear attempt by the Catholic Church and its minions in parliament to undermine legislation designed to prevent unjust discrimination based (among other things) on sexual orientation. Despite public demands that the party take a stance on this issue, there was silence from the organisation's leadership.

I am 'pleased' to say that the party's efforts have finally paid off. It received a 500,000 GBP cheque in support of its election campaign from Brian Souter, a fundamentalist Christian and owner of transport company Stagecoach. Not a big surprise then that the party refuses to reply to queries from civil rights organisations demanding to find out what its stance is on equality related matters. This (very local, I know - apologies to readers slightly further afield...) is not completely insignificant as the SNP is set (according to virtually all opinion polls) to become the biggest party in the next Scottish parliament. So, a win for bigotry is quite possibly on the books. As the Romans said: Let the Buyer Beware.

Friday, March 16, 2007

Boycott Reed Elsevier

The British Medical Journal enjoins academics and others, to boycott the publisher Reed Elsevier. Its main reason is that Elsevier (publisher, among other things, of the medical journal THE LANCET and the Encyclopedia of Applied Ethics) organises international arms trade fairs, and is therefore partially responsible for sustaining an industry that thrives on the suffering of others. The BMJ argues that academics should withdraw their support for Elsevier to express their disagreement with its involvement in the arms trade, and its profiteering from the suffering of others.

So, for better or worse, as of today and until the matter is resolved, I will not be submitting manuscripts to Elsevier published journals or books. Least one can do, I guess, and good on Richard Smith, the former Editor in Chief of the BMJ, for blowing the whistle on this one. Find the current BMJ Editorial on the issue here.

Those slippery slopes - cloning babies

The reproductive cloning debate was undoubtedly 'won' by Luddites. You can tell already that I do believe that the other side of the argument deserves our support. What interests me in this context is how a slippery slope argument has been deployed by my learned Luddite friends against therapeutic cloning research. Of course, the Luddites have long been railing against therapeutic cloning research because it relied on the destruction of human embryos. Virtually all of these embryos are surplus IVF embryos (ie they would have been flushed down the sink anyway). I never understood the logic of this argument, because the embryos in question were at a developmental stage of about 10-14 days after conception. There is no central nervous system, brain, suffering, nothing in other words that should make us pause and ask whether the destruction of such an embryo is something to be concerned about.

I digress. What I really meant to focus on in today's commentary is a slippery slope argument. Those against therapeutic cloning research argued that if we permitted therapeutic cloning research we would slide down the slippery slope to the reproductive cloning of human beings.

There are two problems with this argument:
  1. There is no straightforward slippery slope from therapeutic cloning research to reproductive cloning research. Those using this kind of argument consistently fail to provide evidence for their claim. - So, really the word 'cloning' has been deployed here as a bogey woman in the Luddite fight against progress in biomedical research.
  2. Secondly, the Luddite rhetoric also begs the other question, namely what would be wrong with reproductive human cloning if we were capable of doing it? Surely the argument against reproductive cloning needs to succeed first in order to deploy the slippery slope related concerns against therapeutic cloning. To my mind, there are no serious reasons against reproductive cloning. It would simply give a few hundred or a few thousand people worldwide another means of non-sexual reproduction (eg infertile couples for whom IVF failed could access cloning to have a genetically linked child). In fact, there could be a good medical reason for this. What if a loving couple with a desire to have their own genetically linked child runs a serious risk of passing a genetic illnes on to their off-spring. Reproductive cloning would permit to eliminate that risk by using only the healthy parents genetic material. Good news all round, I would think, but then, hey, my initial isn't 'L' for Luddite.
Of course, none of this suggests that reproductive cloning should be a research priority (there is bigger fish to fry on the health front, just think TB, Malaria, HIV). In fact, considering the millions of orphans in need of loving homes, this pre-occupation with having our 'own' genetically linked kids has always struck me as obscene. However, from this observation it doesn't follow that therefore we should outlaw reproductive cloning.

Thursday, March 15, 2007

Business is business - ethics is ethics is something else altogether

UK arms manufacturers, pretty much beyond reasonable doubt, bribed their way into getting multi-billion pound contracts from Saudi Arabia. The current UK government, which is pretty close to or has beaten the governmental sleaze factor introduced during the disastrous Major years, has ended an official investigation into the issue on the grounds that it would not be in the 'national interest' to investigate the matter. The reason (ie the 'national interest') is that the Saudi government threatened to stop buying any further arms from the UK if the investigation continued. They were upset that their cosy little corrupt world was just about to be opened up to the glare of the public eye (mass media, the lot). No wonder that high-flying ethical governance principles were discarded in an instant by Tony Blair and his governmental cronies.

In Germany Siemens managers admitted to having paid kick-backs to secure contracts from Italy's state owned energy company Enel. Goes without saying that they insist that they didn't 'offer' the dosh, but that those Italians demanded it out of the blue - what choice did they have other than to pay up. It goes also without saying that Siemens has an ethics structure (mission statement, compliance staff etc etc) that's second only to Enron.

Which brings me back to 'business ethics'. I am almost certain that all the business ethics activities in the universe won't make a difference to companies' real-world behaviours, unless there's a severe threat to a company's reputation and business, in case its ethical failing is discovered. So, at the end of the day it's about CONTROL, CONTROL, CONTROL, and almost certainly not about voluntary codes of conduct.

In the case of democratically elected governments that back corruption, at the end of the day it's about ELECTING A NEW GOVERNMENT. We, the electorate must hold them accountable and remove them as soon as is feasible.

Wednesday, March 14, 2007

TB is coming our way again... -

An interesting article was published recently in a free online medical journal. Academics from Southern Africa and Canada discuss the question of whether or not it is necessary to quarantine tuberculosis sufferers in South Africa in order to stop the development and spread of a drug resistant variety of the bug. Part of the man-made problem of XDR-TB is that instead of staying in hospital voluntarily in order to receive proper care patients leave as quickly as they can, because otherwise their welfare benefits would be cut by government. This is a serious problem obviously. While proper care cures about 98% of TB sufferers in developed countries, this figure comes down to 50% in South Africa. One consequence is that ever more dangerous variations of TB develop. The reason is that people out of hospital are less compliant when it comes to taking their medication as they should. A paper worth reading.

Tuesday, March 13, 2007

Torture and political assassination in Zimbabwe - the ANC is silent...

Morgan Tsvangirai, the leader of the Zimbabwean movement for democratic change, has reportedly been nearly beaten to death by Zim security forces during recent demonstrations his organisation staged against the kleptocratic rule of one Bob Mugabe. There is nothing really newsworthy with regard to that collapsing country and its corrupt ruling class. What remains very worrisome is that there isn't a word of criticism from neighbouring South Africa's ANC. The organisation's tacit approval of what is happening in Zim makes one wonder what the future might hold for democracy in South Africa itself.

Israeli diplomacy in action - sort of

I am sure you will have seen ambassadors in action. Suit, style, eternal boredom - most of the time. In recent years a bunch of Israeli diplomats have made it worthwhile looking out for nocturnal activities undertaken by senior Israeli diplomatic missions' staff. Tsuriel Raphael, for instance, was until very recently the Israeli ambassador to El Salvador. 'Until very recently' because he had to be recalled a day or two ago because he was found bound, gagged, and naked outside the diplomatic mission, wearing sado-masochistic paraphernalia. Guess, as long as he didn't hurt anyone against their wishes and he was only hurt because he wanted to, one should probably not bother too much about this case. One can understand, though, why he was recalled. Imagine him going to a reception with other ambassadors... no doubt he would not be able to handle the bickering behind his back - well, I couldn't.

Then there was that Israeli diplomat who was found dead in a Parisian hotel room with a woman who probably wasn't his wife. He suffered a cardiac arrest during a sex romp. Exciting times, no doubt.

And yes, there was also that comedian version of a diplomat who explained during a reception that Israel and Australia have much in common, as both are located in Asia, yet their peoples don't have the Asian characteristics of “yellow skin and slanted eyes.

Looking at this track record, it doesn't seem overly demanding to succeed as a diplomat. The challenges in terms of tactfulness and such things seem actually remarkably low.

Monday, March 12, 2007

More on Abdelkareem Soliman

Here's the latest on Kareem Soliman's case. I reported earlier about this 22 year old secular Egyptian blogger who has been sentenced to jail for criticising al-Azhar university and allegedly denigrating the Egyptian President.

Sunday, March 11, 2007

The Empire of the Flat Earth Strikes Again

The Observer newspaper in the UK reports today that flat earthers are highly incensed about a pilot scheme tested in some of the country's schools. Kids ages 4-11 receive booklets featuring a prince who's turning down a couple of princesses before finally falling in love with his prince. Goes without saying that this isn't about sex but about love. Educationalists have pointed out that the power of children's books in terms of shaping future social values is very substantial. Omitting gay people from such literature likely contributes to homophobic societal values. I have no idea whether these factual claims are correct, but they do not sound utterly implausible.
Of course, the empire of the flat earth is pretty horrified. Says the education spokesman (of course a spokesman) of the Muslim Council of Britain, 'This is not consistent with Islamic teachings and from our point of view many parents would be concerned.' Other flat earthers have suggested that these books 'promote' homosexuality. Leaving aside the question of whether or not that would be a bad thing (if it was possible to promote some sexual orientation to such an extent that people change their's), the same could probably be said for the prince-meets-princess type children's literature. So, unless one thinks there's something inherently wrong about homosexuality one would probably have to worry about any kind of sexual orientation bias in children's books. Quite arguably children's booklets showing the diversity of relationships we have in modern societies (of course, the Vatican, Iran and similar oddities are not, strictly speaking modern, civilised societies :) are desireable.

Some Good Ideas from the Conservatives in the UK

It's been reported that the Conservatives are issuing a policy document on green taxes today. Among the policies proposed is a tax on all too frequent airtravel. From what I understand they're punishing airlines that fly inefficient old planes that are heavier polluters than more recently build ones. They also propose that each of us gets a kinda green frequent flier account whereby we - sort of - fly one long-distance flight per year and one short-distance flight per year on a reasonably low tax rate. However, someone flying from Glasgow to London several times per week will find herself paying a very substantial and increasing tax rate per flight. The logic behind this is pretty obvious: the Tories aim to discourage us from taking too many short-distance flights. That probably is a good idea. The airlines usually counter this by saying that their pollution is small fry compared with other polluters. However, it is also true that their contribution to overall emissions is rapidly increasing due to the fact that more and more of us fly for short-distance travel. The airlines have also argued that such tax policies would hit mostly the low-income traveller who would then be precluded from travelling (thereby losing valuable freedoms). The fact is though, that most of those travelling on low-cost carriers in the UK are actually business people and middle- to upper-income folks.
Of course, while this initiative aim to get us to take trains, is commendable, there is also the fact that trains remain - at best - an unreliable luxury activity in this country. The amount of delayed, cancelled etc trains in this country is probably only matched by South Africa's useless rail network. Just last week I needed to attend a meeting in Oxford. I planned the trip quite carefully in such a way that I would be able to go by train... only to discover that someone or other has decided to go on strike and that very severe disruptions were forecast. So I flew down to London on BA. No hassles, an obscene price (like 200 GBP one way...) - but I got where I needed to get in time for my meeting.

The table to the left shows a ranking of what the German news magazine SPIEGEL calls climate sinners (ie polluters). O course, this is in absolute terms as opposed to relative to population size.

Friday, March 09, 2007

German Logic

My German passport is running out some time in May this year. So, realising that in our globalised world we still have to keep local membership cards (passports), I went to one of the country's Consulates. I brought dutifully two passport photos along, cash, as well as my old passport. Not entirely unexpectedly, in this age of bitterly fighting terrorist's images, they were unhappy with my mugshots as they didn't fit exactly into the predetermined slot (I think there's too much space on both the left- and the right-hand side). So I had to go to a photographer who produces mugshots according to the book. Then I learn that I need my birth certificate, too. It's here where I kinda lost it. In order for me to have currently a valid German passport I must have a birth certificate to begin with. It's a conditio sine qua non. So, why ask me again? Beats me. Of course, it goes without saying that I didn't have it with me and needed to fax a copy the next day. Goes also without saying that the Consulate's fax line didn't work the next day etc etc.

The amount of time wasted by people making up such rules just defies belief (just scroll down to the KLM related item as their airport security operations are another case in point).

Wednesday, March 07, 2007

Incest just isn't a good idea - unless you stop breeding

This German couple (brother and sister) has been living together for six years. They managed to produce a number of children, some of which are seriously disabled. There's a harrowing nasty family background to the story, but that's the gist of it. No doubt many Germans will bicker when they hear that the couple lives in the former East, but truth be told, that's neither here nor there. Incest is illegal in Germany and there's up to three years in jail on the books for the couple. The main reason for such draconian measures is, of course, that reproduction between brother and sister has a 50% chance of serious disability caused by genetic abnormality.
So, no doubt, legally and ethically, what they did was bad. Well, I should be a bit more precise, their decision to reproduce was clearly wrong. There's several things worth thinking about, though.
For starters, why should a sister-brother couple be prosecuted and possibly jailed if they decided to live together, engage in sexual intercourse but do not reproduce (in the case under consideration the 'husband' has undergone a vasectomy and won't therefore be able to impregnate his 'wife' and sister again). They, quite possibly so, should be punished for producing disabled children, but I am less certain that they should be prevented from living together if that is what makes them happy - as long as they do not reproduce any longer.
The other issues is that we do not punish parents whose off-spring suffers similarly high risks of genetic illness (ie a genetically not linked couple whose kids suffer a 50% or higher risk to develop cystic fibrosis will not be threatened with jail if they go ahead and reproduce anyway).
It seems to me that we are not consistent, as a society, in our response to the issue under consideration. If the primary reason against incest is that we're concerned (rightly so) about genetic abnormality and disease among the off-spring of a sister-brother couple, we should deploy the same yard stick in other cases where the risk of genetic illness is similarly high. We are not doing this at this point in time. This strikes me as inconsistent.

Monday, March 05, 2007

Support academic freedom in Iraq

Here is a link to a Petition asking that the UK government support Iraqi academics. Colleagues in that country are currently under threat from more or less medieval forces. They're being kidnapped, tortured and murdered by sectarian barbarians in the country. The consequences for development are dire if teachers of medicine, nursing, architecture etc are leaving the country in order to save their lives and the lives of their loved ones.

Stem cell research - cultural wars continued

You will probably know of the never-ending ideological battles between pro-lifers and the rest of us. Main bone of contention is the moral status of embryos. Particularly viciously fought over was (well, is) the issue of embryonic stem cell research. For better or worse, embryonic stem cell research requires the extraction of embryonic stem cells around 10-14 days after conception. The embryos are destroyed in this process, much to the chagrin of pro-lifers. The cell accumulation they're concerned about has, of course, no central nervous system, no brain, no capacity to suffer, nothing in other words that would justify ascribing moral status to such embryos.
Comes scientific research 'demonstrating' that the same kind of therapeutic stem cell research can be undertaken without the destruction of embryos. In fact, so claims the research by Dr Catherine Verfaillie, we should also be able to use adult stem cells. Of course, if you can avoid fighting over nothing (with pro-lifers and others), that's what you should aim for. So, even if one subscribes to the view that the embryos in question do not deserve moral status of any kind, one should be relieved to see that valuable research can continue while cultural wars over moral standing can be avoided altogether by using adult stem cells.
Dr Verfaillie (that time of University of Minnesota affiliation) published her work in the prestigious peer reviewed journal NATURE. It has since turned out to be the case that some of the data she published was significantly flawed. Quite possibly her conclousions might not be sustainable in light of the serious mistakes she made. Perhaps, in light of the cultural wars just mentioned, it is not that insignificant that Dr Verfaillie since moved on to a Catholic university in Europe.
In case you're interested in good background information on stem cell research, check out this site at the US National Institutes of Health.

Sunday, March 04, 2007

Drug, drugs, and drugs

Interesting article in today's OBSERVER newspaper. The word is that a research group established by Colin Blakemore, CEO of the UK Medical Research Council, proposes to re-classify drugs according the to harm they are likely to inflict on those taking them. They propose to de-link drug classification from the legal system's response to them and rely entirely on their direct harmful consequences. This means, for instance, that alcohol would receive a higher (ie more dangerous) ranking than for instance the party drug ecstasy. All perhaps unremarkable, except that it makes one wonder how any other system could possibly have ever been used. Surely, if one goes for drugs prohibition at all, one would want to deal with drugs in order of dangerousness to health as opposed to other criteria. But then, fighting drug abuse has long been code for fighting drug users (and occasionally those benefiting from the drugs trade). Of course, if ecstasy turns out to be a lower risk to our health than is alcohol, this begs the question why alcohol is not an illegal substance but ecstasy is. Here's the top 20 list:
  1. Heroin
  2. Cocaine
  3. Barbiturates
  4. Street methadone
  5. Alcohol
  6. Ketamine
  7. Benzodiazepine
  8. Amphetamines
  9. Tobacco
  10. Buprenorphine
  11. Cannabis
  12. Solvents
  13. 4-MTA
  14. LSD
  15. Methylphenidate
  16. Anabolic steroids
  17. GHB
  18. Ecstasy
  19. Alkylnitrates
  20. Khat

Saturday, March 03, 2007

Sleeping thief

Nice story in today's online MAIL & GUARDIAN. A burglar in a Zimbabwean town went on gathering his loot in a small store that he broke into... and then fell asleep. He then went on to charge the store's owners with using 'magic' to protect their store from his activities...

Friday, March 02, 2007

Lottery ethics in British education

In the UK children are usually admitted to schools subject to their families living in close proximity to a given school. On the face of it this makes sense. After all, you avoid travelling long distances to get to school, etc. The problem begins when you realise that there are huge disparities in terms of school quality. Ever since it has become common practice that rich (well, even middle-class) people buy themselves houses close to desireable schools in order to give their children eventually a competitive advantage over other kids whose parents have to make-do with a not-so-good school.
Enter Tony Blair and his education secretary. The government has decided to do away with these so-called catchment areas and instead has opted that whenever there are more applicants for admission to a particular school there will be a lottery determining which children would be admitted. The result is that all children have an equal shot at getting into a better school, regardless of their parents' wealth. Likely that house prices in former school catchment areas will fall as living in such a catchment area will not increase the likelihood that a kid will get into a better school.
To me all of this makes perfect sense (equality of opportunity is one of the fundamental tenets of justice), but not, of course, to the TELEGRAPH newspaper, a conservative UK broadsheet.
Of course, a different issue altogether is, why there are better and worse schools, and why there are significant disparities to begin with. This, of course, is due to the fact that this country affords itself both private and public schools. Under Blair's reign the number of privately run schools has actually increased.

Thursday, March 01, 2007

Why not sell your wife's kidney?

DIE WELT, a conservative German broadsheet, reports that a Pakistani national sold his wife's kidney so that he could pay for the purchase of a new tractor. His cunning plan (successfully executed, mind you) involved beating her to pulp in order to have a pretext for having her admitted into hospital. Once there she was quickly put to sleep by medical staff and the relevant organ extracted. Of course, she was the only one not knowing about this until a medical check-up some 18 months later revealed what had happened. Remarkably, relatives of the couple were in it as well as the medical staff.

So, while we go on about informed consent in biomedical research and health care practice... there's also the Pakistan version of the same.

Here's a pretty good documentary about organ sale in Pakistan.

COVID19 and the ethics of hospital triage decision-making

There is a lot of talk these days about the predicted coming wave of COVID19 patients needing ICU beds and ventilators in particular, and th...