On 'conscientious objection' in medicine again

'Regulars' on this blog will know that I have been railing time and again against a nebulous concept going under the guise of 'conscientious objection' in medicine. It gives doctors a license to pick and choose the types of medical services that they wish to provide, and, indeed, to whom they provide them. The 'rationale' for this sort of unprofessional conduct has always been that we should respect doctors and nurses who might be unable to provide abortions (or assist in the provision of abortions, respectively) when they believe abortion is akin to murder, as many monotheistic ideologies want to us to believe. Well, a LOT is wrong with this 'concept'. For starters there doesn't seem to be any test at all as to the truth of the conscientious objection. It seems sufficient to feel strongly enough about something (or someone) or other for a doctor or nurse to be excused. What would prevent a doctor belonging to the KKK to refuse to provide health services to black patients? Nothing much, as long as their belief is strong enough (and, as anyone will know who has had the doubtful pleasure of having to face racists, their beliefs are certainly strong). The result of legal provisions permitting 'conscientious objections' is that, for instance in South Africa women are unable to execute their legal right to have abortions in public sector hospitals because too many doctors and nurses (usually driven by strong fantasies to do with 'God') waive their hands (or slap the patient) and declare a conscientious objection. Backroom abortions remain common place, and human lives (real human lives, as opposed to cell accumulations called 'persons' by the Roman Catholic Church) are lost due to conscientious objections by medical 'professionals' who are more concerned about their private beliefs than about their professional service delivery during working hours.

The UK doctors' statutory body, the General Medical Council proposes that in future doctors should be entitled to refuse to provide any kind of professional service if their consciences tell them to do so. In a remarkable twist, the UK doctors' trade union, the British Medical Association (BMA) thinks that that goes too far, and that there must be strict limitations on the types of conscientious objections doctors are entitled to. It goes without saying that 'God' features again prominently, and abortion is the prime target. It goes also without saying that this is utterly arbitrarily a line that is drawn in the sand there. Why abortion and not PAS or IVF for lesbians? Your guess (or 'God' or 'culture') is as good as mine.

But then, in the UK today, like in the USA, religions are ever more pervasively infiltrating public life. The government is setting up ever more faith based schools to ensure an ever growing compartmentalization of, and segregation within society. If the GMC gets its way, us patients will soon need to know which religious beliefs a particular doctor or nurse subscribes to in order to ascertain which types of professional misconduct he or she is likely to get away with by means of reference (hands raised to the sky) 'conscientious objection'... - Seeing that there is no truth to the matter of religious beliefs, little should prevent a medical professional from setting up her own religion if her particular dislike of certain medical services isn't already covered by existing religious balderdash. After all, the numbers (in terms of other believers) are no indication of the truth of a religion, so a one-person religion should also work nicely. I wonder whether it soon will be OK in the country for taxi driver belonging to religion XYZ to refuse to take certain passengers to certain locations as they disapprove of such locations.

One can only hope that the GMC comes to its senses sooner rather than later.

South African government insanity on HIV/AIDS seems to continue

'Mbeki must be investigated'
26/09/2007 17:40 - (SA)

Cape Town - The Treatment Action Campaign (TAC) has called for a judicial investigation into the presidency and the health minister, as well as Christine Qunta.

In a press statement released on Wednesday, the TAC said there was prima facie evidence that illegal and unethical experiments were conducted on people living with HIV/Aids with a toxic and unregistered substance named Virodene.

The experimentation was for commercial benefit.

The statement claimed that the substance Virodene P058 was a derivative of the toxic, potentially lethal industrial solvent N dimethylformamide (DMF), which was never registered with a medicines regulatory authority of any state in the world.

There was evidence that the Office of the Presidency, President Mbeki and Minister of Health Manto Tshabalala-Msimang were involved in these trials after the Medicines Control Council and the University of Pretoria ruled them unethical and in contravention of the law, the TAC said.

President corrupt?

This led the organisation to call for the appointment of a judicial commission of inquiry to determine to what extent the president, health minister, government official had been involved and how much experimentation on people was being conducted.

The TAC also alleged that Christine Qunta, a practising attorney, was an investor and director in a company that profiteers from selling untested and unregistered cures and treatments for Aids.

Qunta was allegedly appointed by the health minister to a presidential task team on traditional medicines.

The TAC alleges that Qunta and her legal firm had earned tens of thousands of rands in fees profiteering from the unethical, unscrupulous and unlawful activities of Matthias Rath, the vitamin salesman.

The organisation believed that "at best it appears someone in the presidency acted unethically in 2000 and 2001. At worst, there is direct involvement of the president himself in corrupt, illegal actions with potentially deadly consequences for patients with HIV."

On euthanasia and slippery slopes

Colleagues at the Journal of medical ethics published research results this week indicating that the availability of voluntary euthanasia does not lead us down a slippery slope to all sorts of involuntary euthanasia. Here's a summary of the findings from eurekaalert.

No evidence physician-assisted death leads to 'slippery slope'

Legal physician-assisted dying in Oregon and the Netherlands: evidence
concerning the impact on patients in vulnerable groups

There is no evidence that legalised physician assisted suicide, results
in disproportionate numbers of vulnerable people having their lives
ended prematurely by doctors, finds research in the Journal of Medical
Ethics .

Opponents of legislation, which enables doctors to help people to die,
have claimed that it leads to a "slippery slope."

It makes it easier to end the lives of those who might be deemed a
burden to society or their families, such as those with disabilities,
stigmatised disease, or mental illness, they say.

But an analysis of figures from the Netherlands and Oregon, USA, where
physician assisted dying is legal, shows that this is not the case.

The authors assessed all cases recorded as physician assisted deaths in
Oregon, USA, between 1998 and 2006, as well as three independent studies
on the topic.

And they looked at end of life decisions in The Netherlands in four
government sponsored nationwide surveys conducted in 1990, 1995, 2001
and 2005, as well as specialised research.

The figures show that only a few people choose the option of physician
assisted suicide.

In Oregon, 292 people have taken advantage of the legislation since it
came on to the statute books in 1997. This amounts to 0.15% of all
deaths.

In The Netherlands, voluntary euthanasia and physician assisted suicide
have been tolerated since the 1980s, and legal since 2002, provided
strict guidelines are followed.

Advance directives, requesting euthanasia in the event of a coma or
dementia, are now also legal.

Around 1.7% of all deaths are categorised as voluntary euthanasia, and
0.1% as physician assisted suicide in The Netherlands.

The average age of people receiving help to die was around 70 in both
places. Most had cancer. There were higher numbers of people with AIDS
among those choosing to die with the aid of their doctor, the data
showed.

But there was no evidence of any excess bias towards race, gender, age,
socioeconomic status, disability, chronic illness or mental ill health
in either place.

No prosecutions related to illegal deaths have been brought in Oregon.
And of those brought in the Netherlands, there was no evidence that
those from vulnerable groups have featured more heavily.

"We found no evidence to justify the grave and important concern often
expressed about the potential for abuse," say the authors.

The evidence "does show that there is no current factual support for so
called slippery slope concerns about the risks of legislation of
assisted dying - concerns that death in this way would be practised more
frequently on persons in vulnerable groups," they conclude.

Ghost management and racial essentialism

Very interesting current issue of PLOS MEDICINE. There are several highly interesting pieces on the use and abuse of racial 'eye balling' of patients in medical practice, including papers by Ellison and Fausto-Sterling. Also, my colleague Sergio Sismondo has a piece on ghost management in medical research. He describes at length how pharmaceutical companies ghost manage medical research that they finance, all the way throughout the research process, from study design to the writ-up (for publication) of the results. So, as consumers of pharmaceuticals as well as health care professionals relying on published research results we have reason to be very concerned. All of this is well worth your time, and well worth reading.

Nazis and the US Navy

Weird story... but here you go, a US Navy complex in Coronado near San Diego, when looked at it from a bird's eye perspective, looks like the Nazi swastika. Bit unlikely that the architect and those who reviewed the design at the time were really unaware of this. Ein Schelm were boeses dabei denkt.

What is it about (white) men and beaches?

Oh well, Sunday again ... so, without further ado, on a not so serious note: I wonder what it is about (white) guys and beaches. Well, at least about me and beaches. Some time ago I went to India to attend a meeting on the island of Goa. So, on the day of my arrival from the UK, jet lagged and wearing somewhat odd clothes namely jeans and shirt, milling around among more appropriately dressed locals enjoying the same beach and the lukewarm sea water. Well, within minutes of me sitting there, pondering crucial questions to do with the upcoming dinner menu choices, two boys (best guess, they were anywhere between 5 to 7 years of age) approached me offering themselves for sex in return for money. I wasn't just mildly taken aback, but learned later that pedophile sex tourism is flourishing on the island. So the white guy in jeans and shirt seemed a perfect target for this sort of offering. Interestingly, women were not on the local sex trade menu - at least not on the one considered appropriate for me.

Well, yesterday I cycled on Grenada's world famous Grand Anse beach. The moment I stopped at one of the the far ends of the beach a Caribbean guy approached me trying to sell me women as well as offering unspecified special services. Well, my curiosity got the better of me and I asked what special services he had in mind. The good news is that kids were not on the menu, neither were men, mind you, but a rainbow concoction of drugs.

So, this and similar experiences in other developing countries make me truly wonder about my fellow (white) men. What is it about us that drives us to establish such markets in underdeveloped societies...

Another reason to go to Barbados

Incredible as it may sound, given the street robber like activities of other airports... there's free wireless at Barbados' international airport. Long live the providers of this service :). - Guess this is just another way of saying 'hi' from the Caribbean.

More on 'Faith' Schools

While the debate is raging in Canada about Mr Tory, the Conservative Party's aptly named leader's idea to pour more tax monies into faith schools, here's an interesting news item about these sorts of outfits in the UK. The Catholic Church, a known progressive force in international human rights circles, has issued a directive to 'its' schools in Northern Ireland to disband amnesty international support groups due to the human rights organisations support for abortion rights. So, if you ever had any doubt that these schools were truly about education first and not about ideology transfer.... think again.

Pink Shirt Revolution in rural Nova Scotia

Here's a kinda heart warming story from rural Nova Scotia. School kids have been standing up to schoolyard bullies with a truly innovative fashion statement! Check it out. I do think this is a truly remarkable story. Too bad things like this don't happen more frequently!

God business

Well, well, well ... weekend again. And so, on the usual not so serious note, let'sreturn to God business again. No stories today of the Christian variety of God popping in to create this wonderfully perfect planet with its wonderfully perfect Homo sapiens sapiens at the top of the food chain (are the believers really suggesting that we are the best our perfect creator was able to come up with? c'mon, you just got to be kiddin...)

So, without further ado then, and also to show that flat-eartherism isn't entirely the exclusive domain of creationists in the US educational establishment, here's a fun story from India.

India's culture minister offers to resign over a row re the question of whether the Hindu Gods are a mythical figures or whether they really existed. According to a report, 'Hindu devotees believe the area between India and Sri Lanka - now known as Adam's Bridge - was built millions of years ago by Lord Ram, supported by an army of monkeys.' Yep, Adam's bridge was built by Load Ram and his architecturally minded chimps. Well, the country's Archeological Survey determined that the edifice actually came about as a natural formation of sand and stone.

It goes without saying, much like many enlightened Muslims when given half a chance, Hindus started burning tyres, and blocked highways to make their point, namely that the scientists committed blasphemy and that the chimps and their Lordship really did it.

Now, you tell me, blasphemy... that's begging the question, because in order for us to commit blasphemous acts against any given deity, surely there must be proof of its existence, right? So, in the absence of that proof blasphemy may or may not have been committed, but almost certainly we cannot know for sure. Kinda cool though that the believers, always keen to see their relished fantasies 'respected' by agnostics like myself, think that the coolest way to establish the truth or otherwise of the matter at hand is to block highways and demonstrate in the streets.

In other God news, the religious leader of a sect supporting polygamy is on trial for having faciliated the marriage of an underage girl to an older man (funny, I have not yet come across a case where a really old woman would have been forced upon a teenage boy, but hey, such is the hard life of being a guy in polygamous religious outfits). Goes without saying that this is all in the name of the ever-elusive God of their's.

In Canada the leader of the Conservative party, the aptly named Mr Tory wants to spend more public funds on private religious schools, to the detriment of public school funding. So that we get more folks in this country burning tyres on highways in case sciences comes in the way of their religious beliefs.

Njoy the rest of your weekend.

On Greenpeace

We had a visitor here in Kingston, the Greenpeace MV Artic Sunrise was out here for a visit. It demonstrated both against nuclear power and coal fired power stations. Mind you, its engines:
Main engine: MAK 9M452AK 2495 IHP 1619kW
Aux engines: 2 x Deutz BF6M716 208hp (175 kva)
Bow & stern thrusters: 400 hp each
are most likely fired by sunlight and water as Greenpeace is all about renewable energy. I understand its all-metal hull is also constructed from ecologically harmless materials such as ... steel...?

Anyway, I have actually a lot of time for much of the work Greenpeace is doing. What irritates me is that it does so in ways that makes one wonder about the credibility of its message. Painting a steel based hull in green doesn't change the fact that the organisation's own mode of transport invalidates the very message it tries to convey. I mean, they could have cycled down to Kingston to tell the locals that coal based energy stations and nuclear power are bad, yet instead they transported themselves in a metal container weighing about 949 tonnes.

Which brings me to another gripe I have about Greenpeace, namely its consistency in terms of picking middle-class causes, some of which seem to be chosen not in terms of their objective priority but on aesthetic grounds alone. It's whales they're concerned about, and not pigs and other higher mammals that are being continuously tortured and eventually killed by the millions in our mass breeding factories. Surely reducing sentient beings to objects of meat production and keeping them in these factories of suffering and death is a greater moral evil than the killing of a few hundred or thousand whales in the open seas. I am not in favour of the latter, and I am glad that Greenpeace campaigns against whale hunting, but surely one has to wonder whether it's fundraisers who decide which cause (or animal) the organisation campaigns on (for)...

Dave Chappelle's Niggar Family

Check it out: Dave Chappelle's Niggar Family

Madeleine McCann -unGodly twists in the story

I guess, if you live on this planet, you had little choice other than to watch some (many) news item or other about the disappearance of the Scottish toddler Madeleine McCann. The poor girl disappeared miraculously from the parental holiday apartment in Portugal Algarve region. There were several twists to the story. For a start, due to the parents' religious view TV viewers were treated to an unprecedented media campaign showing them searching for the toddler in odd places, including the Vatican where they met the current Pope. The Pope duly prayed etc etc but equally, God (if it exists) didn't give a damn and nothing much happened. Madeleine didn't pop up again. The incredulous public was treated by TV anchormen and women to ever more bizarre stories such as the family priest flying over to Portugal to pray a bit more (but, given that his boss failed already, no surprise, God didn't listen to the family preacher either). Since Madeleine McCann disappeared, hundreds if not thousands of kids disappeared the world all over, most of which were not off-spring of well-to-do medical doctors as Madeleine McCann was/is. Indeed, most of these kids were not blond either. Surprise, surprise, their fate has proven to be of little interest to newsmakers the world all over.

Since this story broke, new developments added a more than macabre twist. The parents have officially been declared suspects in the case a day or two ago. The toddler's blood was found in a car they had rented several weeks after the girls disappearance. Makes one wonder what has really happened. - The McCann family declared duly that the evidence must have been planted by the Portuguese police. That explains things, of course. It would have never occurred to me that that could explain how the missing girl's blood pops up in a car the parents rented several weeks after the disappearance...

I guess what this story tells is as much about media bias (it had to be a pedophile, or an international ring of criminals selling blond young girls into sex slavery, it goes without saying, preferrably to Muslim perverts) as it tells us about how 'God' continues to be abused by those that invented the thing to begin with.

Madeleine McCann ... ungodly twists in the story

I'm sure at one point or other you either couldn't avoid vollowing or volunteered yopur time following the story of Madeleine McCann. The Scottish Toddler miraculously disappeared

Women's Lives Remain Expendable

The developing world all over microbicide trials take place designed to test whether various gels reduce the likelihood of women becoming infected with HIV and other STIs. That, undoubtedly, is a noble cause, except the execution is leaving frequently something to be desired. A number of trials have been stopped either because the gel didn't work, or because it actually increased the likelihood of an infection. This itself should make one wonder about the very concept that is underlying these trials. Either way, microbicide trials are a kind of poor sister of AIDS vaccine trials, so unlike HIV infected participants in AIDS vaccine trials, women who become HIV infected during microbicide trials do not receive AIDS clinical care from the investigators. In many developing countries this means in effect that they're left to die. Women's lives clearly remain expendable... no doubt bioethicists (many of whom busy themselves these days creating reasons for why such infected women are owed nothing by the investigators and their sponsors) will eventually condemn such trials as unethical. The question remains whether in that future time we will also see a return of that old 'different values and regulations were in place at the time' argument, that is usually wheeled out to justify such failures of ethicists to speak out.

The week that was ...

This week was kind enough to deliver - just in time for my not so serious weekend commentary - the resignation of US Senator Larry Craig. S(oon-to-be-ex-)enator Craig represents Idaho. Idaho is part of the flat-earth, bible belt of the USA, so Senator Craig has been busy saying no to most things civil rights, like gay marriage, gay hate crime legislation, access to abortion services, the basics that most of us living in liberal democracies take for granted. That, of course, isn't particularly funny, or even hilarious. US bible belt politics we usually wheel out in order to explain why we really are not overly keen to live in a country where behaving with basic decency toward women, and ethnic and sexual minorities is still a popular debating point.

What is funny, of course, is that S(oon-to-be-ex-)enator Craig was forced to resign this week. Not a great loss, of course, but what is hilarious is the reason for his resignation. It's not the usual kind of corruption, hiring a sex worker type of stuff that is standard operating procedure of the Republican Party in the US of A, no, arch-homophobe Larry Craig was caught cruising for gay sex by an undercover police officer in an airport toilet. Now, that is funny. It goes without saying that Mr Craig held various press conferences (holding hands with his wife) where - usually in a high-pitch, kinda hysterical, voice he pronounced that he isn't gay and that he never was gay. To be honest, being gay myself, I wish that was true. Trouble is, it doesn't look like it...

So, good riddance to yet another Republican hypocrite biting the dust. Mind you, I truly have little time for good looking young men hanging around in public toilets in order to entrap gay men, but that's another story altogether. This particular sting operation just happened to have caught to right bloke.

Oh, and in case you want to know how they do it in the US of A. Well, it seems you kinda tap with your shoe on the floor in your cubicle and somehow (weirdly) push it into the next cubicle to touch the bloke-next-door's shoe. If he doesn't shout at you to get lost (or shoots you, it's the US of A after all) it seems you drop a piece of paper outlining what your sexual interests are. Keep in mind the obvious limitations of the public mens room environment. Finally, according to what will enter gay history as the 'Craig move', you move your hand under the cubicle divider into the other bloke's cubicle. Quite conceivably this all sounds pretty ridiculous to you. If it does, you might just want to laugh out loud, as I did, when I watched interpretations of the Craig move on various evening talkshows on US cable during the last week. The truth is, it is pretty funny stuff.

Nuff said. Enjoy the rest of your weekend.