Sunday, August 24, 2008

Thank goodness the farce is over: Olympic World Doping Orgy has successfully concluded

Ok folks, fair enough, I am a NERD, you could not pay me to watch sports events. I tried, but truly, any third rate crime caper is more likely to catch my attention than athletes high on chemicals running faster than their compatriots hundred years ago who were not able to access similarly undetectable hi-tech stuff.

I mean, the French Tour de Farce has long ceased to be taken seriously by anyone other than pharma reps trying to sell anabolica to farmers.

Just look at some of the Olympic outcomes...

  • 51 gold medals for the PR of China - the Chinese anti-doping folks claim that 99.5% of all athletes were not doped, seems China benefited neatly from this clearly delusional assessment.
  • The same Jamaican bloke broke three world records in three days - overall the runners form that island state managed to grab 6 gold medals and nothing much else
  • A US American bloke broke 7 world records among his 8 gold medals in 8 days

How likely is it, even if we grant top fitness and - in the case of Chinese athletes a lot of local support - that this happened without pharmaceutical ... ummm ... sponsorship?

Wouldn't it be fairer if the sponsor also received - in retrospect - a medal for concocting chemicals that propelled athletes ahead of the more naturally inclined crowd without the doping tests detecting anything? I think it would be so much fairer to celebrate the chemists, too. Why can't we have a separate competition for chemists supplying drugs to Olympic athletes? I would like to know what makes them faster, so next time I go on a bike trip I can grab some of that juice, too!

I won't event talk much about the civil rights violations committed by China so the world could have its sporting farce. Some of those folks who had a life and their own little houses were made homeless in the process of building those pompous architectural monstrosities conjured up by some architect suffering likely from penis envy or some other inferiority complex. Reportedly many of these people still live under bridges and the like. They will never be able to return to their homes as they have been bulldozed into the ground so doped athletes could have nice shower facilities. But hey, even this pales in comparison to the PR of China's international track record: it supports dictators and mass murderers in Zimbabwe and Sudan, it executed about 10,000 of its own (Chinese) citizens during the last year alone... and I could go on. Still, at least we know now that they're capable of building giant ugly things (no surprise in this really: give an architect a pile of dosh and she will invariably come up with something giant or other - gives em an opportunity to pass by their legacy every other day and say 'I did this - world, admire me!') and conjuring up nice fireworks on the land stolen from those folks now 'housed' under bridges. I still think it's remarkable how happily well-paid engineers and architects rose to the challenge of building giant chunks of concrete and steel on land they knew was stolen from its original owners by a totalitarian regime. No questions asked, as long as the pay is right. Professionalism in action... - Great games. Thank goodness it's over.

And now, go, flame me, I don't care :). I'm just glad these days there's cable and one can choose to watch something else. When I was younger we had the choice between Olympic games and Olympic games on our tellie (chosen by our dad for the rest of the - otherwise bored - family).

Voices of Disbelief - Sunday PM Marketing

I am all fired about about a really cool book Russell Blackford and I have been working on during the last couple of months. Wiley-Blackwell will publish it some time next year. It's great for us to have found such a large and prestigious international publisher for the book as this will give us quite a bit of marketing muscle to deploy!

Basically what Russell and I decided to do is to ask people on our respective electronic rolodexes why it is that they don't believe in an omniscient, omnipotent 'good' God running the universe. Call it a humanist/atheist coming out party if you wish. And you know what, I am well and truly thrilled about what we've got so far (which is 27 chapters out of about 50 or so - with some time to go for our deadline). Remarkable philosophers, science fiction writers, medical doctors, newspaper columnists, political activists from around the globe have gathered to tell the world in a way not only why they don't believe in God, but arguably also why you shouldn't buy into that clap-trap either. Very moving personal accounts, entertaining stories, philosophical analyses and so on and so forth will result in a most enlightening, entertaining and challenging book. I'm truthfully over the moon, seeing how great this project is coming together. I won't be mentioning any of the names of the contributors yet, but rest assured, most of them are household names in their respective fields of work.

Saturday, August 16, 2008

Viva California

Both houses of the Californian legislature have passed a resolution that requests

all relevant California agencies to notify California-licensed health professionals (doctors, psychologists, and others) about their obligations under international law relating to torture,

those health professionals to be notified that if they participate in
torture they may be subject to prosecution,

the Department of Defense and the Central Intelligence Agency to remove all California-licensed health professionals from participating in prisoner and detainee interrogations.

This comes in the wake of uncontrovertible evidence unearthed by US medical doctor Steve Miles, a bioethicist at the University of Minnesota, that health care professionals were involved in torturing prisoners in Guantanamo Bay. Here's a brief excerpt from an article Miles wrote in a bioethics journal, describing the torture of one detainee in Guantanamo Bay (based on heavily censored US army records):

The Interrogation of Prisoner 063

Two government documents detail medical and psychological participation with the interrogation of Prisoner 063, Mohammed al-Qahtani, at Guantanamo Bay between November 23, 2002 and January 11, 2003 (Zagorin and Duffy 2005). The first is an 83-page interrogation log (ORCON 2003). The second is an Army investigation of complaints of mistreatment of prisoners at Guantanamo Bay, including Prisoner 063 (United States Army 2005, 13–21). The third and fourth are notes taken in relation to that Army investigation (CTD Fly Team 2006; GITMO Investigation 2004). The second set of these notes extensively describes medical collaboration with one or more interrogations but the record is so heavily redacted that it is not possible to determine which, if any, of this material described the interrogation of Prisoner 063 (GITMO Investigation 2004).

According to the Army investigation, the log covers a period in the middle of al-Qahtani’s interrogation that began in the summer of 2002 and continued into 2003. For eleven days, beginning November 23, al-Qahtani was interrogated for twenty hours each day by interrogators working in shifts. He was kept awake with music, yelling, loud white noise or brief opportunities to stand. He then was subjected to eighty hours of nearly continuous interrogation until what was intended to be a 24-hour “recuperation.” This recuperation was entirely occupied by a hospitalization for hypothermia that had resulted from deliberately abusive use of an air conditioner. Army investigators reported that al-Qahtani’s body temperature had been cooled to 95 to 97 degrees Fahrenheit (35 to 36.1 degrees Celsius) and that his heart rate had slowed to thirty-five beats per minute. While hospitalized, his electrolytes were corrected and an ultrasound did not find venous thrombosis as a cause for the swelling of his leg. The prisoner slept through most of the 42-hour hospitalization after which he was hooded, shackled, put on a litter and taken by ambulance to an interrogation room for twelve more days of interrogation, punctuated by a few brief naps. He was then allowed to sleep for four hours before being interrogated for ten more days, except for naps of up to an hour. He was allowed 12 hours of sleep on January 1, but for the next eleven days, the exhausted and increasingly non-communicative prisoner was only allowed naps of one to four hours as he was interrogated. The log ends with a discharge for another “sleep period.”

Medical Treatment during Interrogation

Clinicians regularly visited the interrogation cell to assess and treat the prisoner. Medics and a female “medical representative” checked vital signs several times per day; they assessed for dehydration and suggested enemas for constipation or intravenous fluids for dehydration. The prisoner’s hands and feet became swollen as he was restrained in a chair. These extremities were inspected and wrapped by medics and a physician. One entry describes a physician checking “for abrasions from sitting in the metal chair for long periods of time. The doctor said everything was good.” Guards, medics and a physician offered palliative medications such as aspirin to treat his swollen feet.

Intravenous fluids were regular administered over the prisoner’s objection. For example, on November 24, the prisoner refused water. A Captain-interrogator advised him that the medic “can administer IV [sic: the log’s contraction for intravenous fluids of an unspecified volume is used throughout this article] fluids once the Captain and the Doctor on duty are notified and agree to it.” Nine hours later, after taking vital signs, medical personnel administered “two bags” of intravenous fluids. Later that day, a physician evaluated al-Qahtani in the interrogation room and told him that he could not refuse medications or intravenous fluids, and that he would not be allowed to die.

The next day, interrogators told the prisoner that he would not be allowed to pray if he would not drink water. Neither a medic nor a physician could insert a standard intravenous catheter, so a physician inserted a “temporary shunt” to allow an intravenous infusion. The restrained prisoner asked to go the bathroom and was given a urinal instead. Thirty minutes later, he was given “three and one-half bags of IV [sic]” and he urinated twice in his pants. The next day, the physician came to the interrogation room and checked the restrained prisoner’s swollen extremities and the shunt. The shunt was removed and a soldier told al-Qahtani that he could pray on the floor where he had urinated.

From December 12 to 14, al-Qahtani’s weight went from 119 to 130 pounds (54 to 59 kilograms) after being given six IVs. On December 14, al-Qahtani’s pulse was 42 beats per minute. A physician was consulted by phone and said that “operations” could continue since there had been no significant change. Al-Qahtani received three more IVs on the December 15 and complained of costophrenic pain. A physician came to the interrogation cell, examined him, made a presumptive diagnosis of kidney stones and instructed the prisoner to take fluids. The next day blood was drawn in the cell.

Of course, treatment such as this is prohibited by the Geneva Convention which requires that prisoners be treated at all times humanely, not be tortured, and so on and so forth. While one can argue whether ot not the described actions of health care personnel constituted torture (they did not, to my mind), they did at a minimum enable the continuation of torture by means of keeping prisoners sufficiently fit to be able to be tortured again. They also enabled torture by way of declaring the prisoner fit enough to be tortured again.

Is it not remarkable that the American Medical Association has not come out with a strong statement condemning the participation of US medical doctors in the torturing of prisoners of war in Guantanamo Bay? Perhaps this is due to the fact that the AMA is always a little bit slow. It took the organisation only more than a hundred years to apologise for institutionalised racism that it practised for many years.Local AMA chapter had rules discriminating against black doctors as recent as the late 1960s. To be fair, it is not only the AMA that is dragging its feet on the issue, the American Psychological Association also can't decide where it stands on the issue. Very much unlike the American Psychiatric Association (ie medical professionals) which regulated against the participation of US psychiatrists in such activities in 2006. Since then the US military has replaced psychiatrists with psychologists to assist them in developing sound torture techniques. The US military is one of the the largest employers of psychologists in that country.

Friday, August 15, 2008

Correlation and causation

Just a correlation or possibly causation? Neither South Africa nor Canada, both countries I lived in, have managed so far to grab an Olympic medal. The wailing about their failing national teams is great in both these great nations. Let us hope that not too many people will commit suicide due to Olympic failures. Let us also hope that nobody thinks that there's more to this then just a correlation.

Hey, come to think of it, perhaps causality related suspicions might be the underlying rationale for the theft of my bike yesterday. Perhaps someone tried to punish me for the Canadian failure. I kind of doubt it, after all, had I not left it unlocked under a tree outside my house, quite likely it would still be there.

Tuesday, August 12, 2008

Does correct spelling matter?

There's an interesting debate raging in the UK currently, between a 'new' university lecturer, a Dr Smith and an 'old' university professor, a Dr Grayling. It is probably not entirely unfair to say that 'new' universities in the UK are organisations that are traditionally weak on the research side of things and strong on the teaching side of things. Equally, 'new' universities (ie usually ex polytechnics) tend to be less competitive institutions, attracting more often than not academically less gifted students or students coming to universities through less traditional routes (eg they mid attend university mid-career).

Well, the 'raging' (I am exaggerating!) debate is about the question of whether or not we as academics should punish students for spelling errors and such or whether we should accept those as legitimate 'variants' of English as 'new' university Dr Smith suggests. 'Old' university Dr Grayling duly makes a mockery of Dr Smith's views by producing a coherent commentary relying on proper English that rapidly disintegrates into incoherent ramblings and random accumulations of letters that don't make sense at all anymore. His point: proper English matters. In a way you'd say that probably he is a snob, albeit a leftish one (writing for the GUARDIAN). Surely there is a big difference between someone who ignores minor spelling mistakes students make (yes, there's plenty of them in 'new' and 'old' universities alike) and someone who passes essays even though they are incomprehensible because the words can't be made sense of any longer as they do not resemble existing words; or someone who passes essays where the sentence structure is such that the meaning cannot be ascertained any longer.

Mind you, this is not just a problem in English speaking countries. Long suffering colleagues in Germany tell similar tales. German language instruction that focuses these days more on 'interpretation' of poems and 'critical thinking' skills then grammar and spelling seems to have wrecked many students ability to express themselves properly in that language.

Difficult one: I have to be honest, with English not being my first language, it annoys me hugely having to read essays by students whose first language is English, yet whose English is MUCH worse than mine. And yes, I have come across essays by students whose first language is English that were to a large extent incomprehensible, because the English was so terrible. - I have no idea how those folks managed to get through high-school, and indeed how they managed to sail through their undergraduate years, but yes, such students do exist! - My take on this has always been to ignore mistakes that do not impact on content, but I can see that that might be problematic. After all, prospective employers of our graduates have every reason to assume that students we graduate have a proper command of the language of instruction that we use in our teaching, or don't they? On the other hand, should I really give a higher grade to a native English speaker over an English-as-second language speaker just because the latter's English is worse, while the actual critical content of both essays is of fairly comparable quality?

What's your take on this?

Saturday, August 09, 2008

Intl AIDS Conference Calls for Decriminalisation of HIV Transmission

Various activists, academics and politicians during the International AIDS Conference criticized that many countries these days criminalize HIV transmission. The argument is essentially that the law is a bad means to deploy in order to achieve public health objectives. One reason for criminalizing HIV transmission is of course the hope that one might be able to deter some infected people from having unsafe sex. The folks wanting to decriminalize HIV transmission believe that the deterrence effect doesn't work. Frankly, I cannot see how that could be demonstrated one way or another. The deterrence effect of the criminal law has been demonstrated time and again, so I wonder why we should buy into the claim that in the case of sex it doesn't work.

Hey, perhaps it doesn't, but if that is so, what's so terribly wrong with society deciding to punish someone who knowingly subjected someone else to the risk of catching a serious chronic illness? I could see that an argument could probably be made for sexual encounters among consenting adults that, say, pick each other up in a bar some night, where both volunteer to have unsafe sex, no deception re one's HIV status takes place, no questions are being asked and a transmission takes place. I think here we'd probably have a case of harm to self. At the very least we have a case where someone arguably consented to the risk of catching a sexually transmitted illness (as AIDS is). These sorts of happenstances seem to make up the bulk of transmissions and I have not yet seen anyone running to police in order to get their one-night-stand encounter prosecuted. By and large people accept responsibility for their conduct in such circumstances, and so they should.

Truth be told the few cases that have been prosecuted across the world had to do with folks who behaved overwhelmingly truly appallingly to their partners (and not in the sense of one-night stand partner, but in the sense of husband, wife, long-term boyfriend, long-term girlfriend). You know, stories like a 25 year old guy who knew to be HIV infected and insisted on not using condoms with his 15 year old girlfriend. I am at a loss why human rights types folks think that it is a bad idea to criminalize such conduct. For the sake of the argument, even if the deterrence effect of such punishment would really fail, why would it be so unjust to punish such conduct? What's so different about HIV and AIDS that we should not aim to police such harm to others?

One thing I find truly annoying about these campaigners: With a straight face they'd pronounce variously that we shouldn't 'criminalize HIV' or we shouldn't 'criminalize people with HIV'. It goes without saying that nobody anywhere in the world has as yet attempted to either criminalize HIV or people living with the virus. What people in most countries have been saying is this: if you got the bug and you behave in harmful ways towards uninfected people by means of subjecting them to unreasonable risks through reckless behavior, we will punish you. So, what is punished is the harmful conduct, not the virus itself or anyone who happens to be infected but behaves sensibly.

African Union at it again and again and again

That useless outfit of African diplomacy, the African Union is at it again. It has put on hold Mauritania's membership due to the coup that took place there. Any wild guess why the coup (plural, coups) that took place in Zimbabwe never led to a suspension of that country and its kleptocratic leadership? Same ol same ol I'd think...

Don't buy anymore Random House (US) books and products

The US based publishing house Random House (owned by German conglomerate Bertelsmann) has just pulled the book 'The Jewel of Medina' by Sherry Jones off the shelves. It's essentially a story about the Prophet Muhammad's child bride A'isha. As with all novels (as opposed to history books) the author reportedly described some sex scenes between M and A'isha. Of course nobody as been there when/if it happened, so nobody could possibly know. It's a novel after all. For what it's worth the bits and piece that I have seen seemed innocent enough, but then, I'm a small 'l' liberal when it comes to matters sex. The reason given for withdrawing the book is not that it's a bad novel, but that it could (sic!) be (according to Random House) offensive to some (sic!) Muslims, and that it "could incite acts of violence by a small, radical segment".

One wonders ... most atheists probably couldn't publish with Random House any longer either, after all, there could always be a small fanatic minority of believers that could react violently. If that is sufficient these days for a mainstream publishing house to execute censorship, we might as well call it a day as far as freedom of expression in liberal democracies is concerned!

Worse in a way, the impact of this decision on writers surely must be some kind of self-censorship. After all, if you know that your content covering religions or religious figureheads could be controversial, you also know that likely you won't be able to sell it to mainstream publishers - well, at least you'd have to be stupid trying to sell it to Random House. My conclusion: for the time being I won't be buying any Random House products (ironically, Rushdie's stuff is still among them - well, I assume that his work could not possible incite violence among a small minority of religious fundamentalists ... or something like that).

Wednesday, August 06, 2008

An HIV Vaccine and Big Pharma

Wow, 22,000 AIDS scientists, operatives and activists are gathering in Mexico to celebrate their disease. Well, good on them, of all the jobs that they could have chosen, AIDS is not an entirely worthless kinda thing, and yet, ain't it odd the role that big pharma plays in it all? Many, if not most AIDS NGOs are to a significant extent (or entirely) funded by big pharma. All sorts of panelists are flown in by big pharma to speak. Scientists' research more often than not is funded by big pharma. You might say that that's bothersome, but not such a big deal, given that big pharma and the activists have a lot in common these days. Initially big pharma was hated because it priced drugs out of many peoples' research, today it offers cheaper drugs that in turn are guaranteed huge sales thru programmes such as PEPFAR. Still, about 70%of people who could clinically benefit from AIDS medicines have no affordable and reliable access. It is entirely unclear whether the roll-out of medicines in developing countries will be sustainable over generations to come. In a way this l ooks like a win-win situation for big pharma, ever more people get on their medicines, many of them in the global south, funded by taxpayers in Western countries. All is well then, or isn't it? Well, it only looks like it.

There is one area where big pharmas investment has been negligible: HIV vaccine and microbicide research. There's no big surprise in that. You can't seriously expect these companies to produce an HIV vaccine, given that they know full-well that that would rob them of millions of customers requiring life-long care. No way they will ever meaningfully contribute to HIV vaccine development. It's a bit like asking OPEC to invent an alternative to oil for us . And so it's left to the haphazard activities of the Global Fund, the two Bill's and their friends and other such groups. We neither have a serious concerted global effort funded by the governments of the world (our representatives...) nor by big pharma.

No wonder the participants of the international AIDS travel circus can look forward to many more such events to come. Courtesy of government and industry inaction we won't be seeing a vaccine any time soon. Even better, with treatment activists mostly in the backpocket of international organizations and funded to a large extent by industry, don't expect too much pressure from them either. Hey, and while I'm at it, the same holds true for plenty of other ailments that could be prevented efficiently if a vaccine was around. Serious rethinking is required as far as drug R&D financing is concerned.

Sex between strangers

Here's a true story my friend Anita Kleinsmidt kindly forwarded to me... enjoy

Was it rape or was it not? That was the question the Pretoria High
Court had to deal with.

But as it turned out, it was in fact a case of mistaken identity, says a report in The Star. The 'victim' is a Pretoria woman in her 20s. The man had received a 10-year jail sentence for the one night of passion he had with her, but the High Court intervened and acquitted him of any wrong-doing. About three years ago a man in a car asked the woman for her telephone number. Without looking at him, she gave him her number and walked on. This was the start of a phone relationship. They eventually agreed to meet and the man, known as Jacky, arranged to pick up his new love. She in turn - without knowing what Jacky looked like as they had never met - waited for him at the restaurant with her overnight bag in tow. It emerged during the trial in the Pretoria Magistrates' Court that a man walked towards her and hugged her. She testified that they later had repeated sex that night and when she switched on her phone the next morning, she discovered a message from the 'real Jacky'. Kenneth Vilakazi (30) was subsequently arrested and later convicted for the rape in the lower court. He received a 10-year jail sentence, but turned to the High Court to appeal his conviction.

Vilakazi maintained that they had consensual sex. The woman said he was not the man she thought he was. She claimed he misrepresented himself to her, but the court disagreed. Judge Cathy Satchwell and Acting Judge JC Labuschagne found that the 'victim' had made the
mistake herself. The court found that they were all strangers and it was a case of one stranger having sex with another stranger.

Monday, August 04, 2008

AIDS Talkfest on the Road

The International AIDS Conference is again on the road, this time in Mexico City (watch carefully whether the surplus sero-conversions that go with that event match those resulting from the last AIDS conference, or whether they're higher or lower - funny counting game). Anyway, more seriously, there are some interesting issues the talk fest crowd is going on about.

For starters, 150+ HIV vaccine trials crashed not exactly without a trace, rather in quite a few of them those participants randomized into the active arm were becoming more (instead of less) susceptible to picking up HIV. So, both HIV vaccine and HIV microbicide trials have hit a wall of sorts.

Interestingly, however, there's possibly some light at the end of the tunnel. A few months back a team of HIV specialists in Switzerland announced that in their opinion people on antiretrovirals are no more likely to transmit HIV than are people who use condoms. The reason for this is that the medicines reduce an infected person's viral load to such low levels that it's next to impossible to pass the bug on to sexual partners. There's all sorts of caveats, but this matters in the face of rising STI rates among people in high HIV prevalence groups in a whole bunch of countries, including Germany, the USA and many others.

Well, fascinating ethical questions abound: Should one tell people on HIV medicines that their risk is that low or would that mean that they would take unreasonable risks - eg by having more unsafe sex with more people than they would otherwise have? Should we put people very early on in their infection on HIV medicines, for public health reasons as opposed to reasons to do with their medical care? What should we do if there ever arose a conflict between public health interests and patient care? Considering that a substantial number of people on medicines are not as compliant in terms of how they should be taking them, and considering that this leads to more drug resistant mutations of the virus, at what point in time would the early introduction of drugs be outweighed by these undesirable consequences? What are the implications for the criminalization of HIV transmission? If someone duly takes her anti HIV drugs and her partner - not knowing about her infection -picks up the bug anyway, would it be acceptable to punish her?

Difficult new questions to ponder.

Sunday, August 03, 2008

Help - Hilfe - Hannes Wader

I'm sure outside German speaking countries nobody has ever heard of an old unreconstructed Communist German folk musician by the name Hannes Wader. Well, for better or worse, being the hopeless romantic that I am, I have been trying forever to get my hands on a digital copy of one particular song 'Leben einzeln und frei', but I am seemingly unable to download the thing. Anyone able to help?