Thursday, October 27, 2011

Corporate ethics: the Xigris example

Howard Brody has a post up about Eli Lilly's pulling the sepsis drug Xigris from the market and, of particular interest, the story (if the reports are accurate) of how the corporation had maneuvered to get it used:
The part of the Xigris story that especially caught my attention was how some of my colleagues in bioethics were caught up in the company's PR campaign without apparently realizing it--or else taking the money and not caring. As one prong of the marketing strategy, Lilly decided that since Xigris cost so much, and since so few ICUs were purchasing it (since the studies had been so equivocal), then there must be rationing of life-saving treatment going on. Of course one solution would have been to lower the price, but perish the thought. So Lilly instead forked over $1.8M to fund an "ethical" study of rationing in the ICU, with the intent of bringing pressure to bear on recalcitrant units with the dreaded "R word."

The part of the story that I did not cover in HOOKED, as Williams reminds us, was actually addressed in a 2006 commentary in the New England Journal (subscription required) by Eichacker and colleagues. Having managed to get the FDA to approve Xigris despite iffy data of efficacy and safety, Lilly bankrolled a big PR firm to do three things--set up the rationing "ethics" inquiry, and get major medical societies to write guidelines for sepsis care that included the use of Xigris (by funding the guideline panels and making sure that numerous docs with Lilly money in their pockets served on the panels). The third thing however was what made Eichacker and company worried. It was Lilly's subsequent effort to lobby the organizations that create quality indicators for hospitals and insurers to include those guidelines in their quality measurements. That is, if an ICU did not use Xigris, because they deemed it insufficiently useful and overly dangerous (a reasonable evidence-based position at the time), the hospital might get a lower score for quality of care and then have problems with insurance reimbursement as well as the bad publicity. Eichacker et al. very reasonably said this was a blatant hijacking of these quality indicators for commercial purposes.

...Why bother sending drug reps into thousands of doctors' offices if you can buy off the people who write the guidelines and the people who ding the hospitals for bad quality of care?
To reiterate: They hired a PR firm to portray the non-use of their drug as rationing, lure ethicists - ! - and guidelines developers into going along with this framing, and work to get the quality-rating organizations to favor the use of their drug and penalize those hospitals that weren't using it. For a drug with little evidence of efficacy and which in the end was withdrawn for a lack of it.

Brody quotes David E. Williams' advice to the drug companies:
--Industry: Feel free to market your products and services aggressively, but don’t take things too far. If you do you’ll end up killing the goose that lays the golden eggs. No one will trust doctors, guidelines or journals anymore
First, the idea that it's morally acceptable for corporations making medications to put the interests of their shareholders above those of the people taking the medications is a huge problem. Of course, that's to be expected in a corporate-capitalist system. They've been getting away with it, and indeed escalating, for decades, and moreover have other means of attaining their goals. They're not going to worry about this alleged long-term risk to reputations. Nor are doctors and medical organizations - in a situation in which these corporations are free to pursue their interests aggressively - going to counter them. Regulations, if they were passed and enforced, would make some difference,* but the real meaningful solution is to separate corporations from medicine entirely. Or, at the very least, to take out the worst offenders by revoking their corporate charters or holding their executives personally criminally responsible.

* In this specific case, a report on the drug's withdrawal notes that the study showing a lack of effectiveness was "ordered by European regulators in 2008 as a condition of the product's continued approval there."

The orca slavery lawsuit: a plea to avoid reflex ridicule

Strangely enough, none of my usual sites (including the Orca Coalition) mentioned the orca slavery lawsuit before I learned of it on the Colbert Report last night:

PETA has a link to the suit, "asking a federal court to declare that five wild-caught orcas forced to perform at SeaWorld are being held as slaves in violation of the 13th Amendment to the U.S. Constitution," on its site. It involves some of the orcas that have been discussed here, and appears to have received its impetus from the Morgan case (Ingrid Visser is one of the Friends).

I can already imagine the hostility and mockery that will greet it: it's just another kooky stunt from PETA, rights isn't the appropriate framework in which to discuss the ethical status of animals, it's an offense to humans who've been enslaved to suggest that nonhuman animals are, everyone knows the Constitutional basis doesn't exist, and so on. I fervently hope, though, that people will take some time to read the suit and consider the case within a longer historical framework, and will not dismiss or reject the struggle of and for these orcas because of a dislike of PETA or animal rights arguments. (You can read some of the background by clicking on the "whales" tag below.)

I also hope people will consider the point made by Colbert - that we live in a country in which the argument that nonhuman animals can be "people" who can be enslaved is ridiculed but corporations are granted the legal rights of people:

Wednesday, October 26, 2011

Brave women: Tunisia and Uganda

Tunisia is at a crossroads. Fresh off of elections and embarking on writing a constitution, the country still has an opportunity for a (relatively) democratic secularism. Reading a call from HRW for the dropping of criminal charges against a TV station for airing a film claimed to "defame" religion, I learned that more than one determined filmmaker is critically commenting on religion there:
Laws that criminalize the “defamation” of religion or religious groups are not compatible with norms of freedom of expression, Human Rights Watch said. The United Nations Human Rights Committee, in its general comment on article 19 of the International Covenant on Civil and Political Rights, which Tunisia has ratified, stated that it is not permissible for “prohibitions of displays of lack of respect for a religion or other belief system, including blasphemy laws … to be used to prevent or punish criticism of religious leaders or commentary on religious doctrine and tenets of faith.”

Since the ouster of President Zine el-Abidine Ben Ali on January 14, there have been other attacks on artistic expression by groups claiming to act under the banner of protecting Islam. On September 26, protesters forced their way into the Afrikart Cinema in downtown Tunis to protest its screening of Secularism, If God Wills, a film about atheism shown as part of a cultural evening.
Intrigued by this description, I checked the link and discovered the following:
Online commentators, including on Facebook, have vilified the documentary under its former title, Neither Allah Nor Master (Ni Allah ni Maître) and its director, Nadia al-Fani, a Franco-Tunisian, largely because al-Fani has openly declared her atheism in interviews on Tunisian television and made it the subject of her film. Al-Fani has received numerous online death threats.
I found this interview with al-Fani, in which she argues: "I think in order to live together there must be this concept of secularism. I already had this position before the fall of Ben Ali, that to ask for democracy, is to ask for secularism."

In Uganda, Kasha Jacqueline Nabagesera, who recently won the Martin Ennals Award for Human Rights Defenders, is leading a different but related struggle - for LGBT rights. Here's a short video about her:

Martin Ennals Award Laureate 2011 Kasha Jacqueline Nabagesera from True Heroes Films on Vimeo.

Saturday, October 22, 2011

Interlude - Ella

Interlude - yay cats

That is all.

Because after the tear gas, there's nothing you need like acupuncture

This is really a celebratory post about professionals involving themselves in social-justice movements. Social Medicine has run a few posts the past two weeks about medical workers at the Occupy protests, both as activists and as volunteer medics:

  • "Doctors for the 99%: Physicians Participate At the Wall Street Occupation"

  • "Doctors for the 99% out in force on October 15th"

  • "How to be a Street Medic (updated)"

  • The first two highlight the organized activism of professional medical groups fighting for just health care systems. The last is an updated version of a 2004 article describing the activities of street medics - professionals who attend to the medical needs of protestors. Overall, it's fine and informative. However, it includes this bit:
    Who are street medics?

    Street medics come from a variety of health care backgrounds including herbalists, nurses, EMTs, NPs, health educators, physicians, medical students, and acupuncturists. In fact, a medical background is not actually necessary to be a street medic as most receive additional training in first aid, the management of activist-specific injuries and such topics as scene control and pre-hospital assessment. A large amount of formal medical training is not applicable to street medic work [?], so additional training is always necessary.

    Being a street medic requires more than just medical knowledge. The ability to work in non-hierarchical affinity groups, value non-western medical knowledge and work in stressful, and at times dangerous, situations are all equally important to street medic work. For many physicians and nurses, developing these skills will be the focus of their street medic experience. [my bold]
    There is no such thing as "non-western medical knowledge." There is no such thing as Western medical knowledge. There is only medical knowledge. Acupuncture is placebo. This is an insult to the medical professionals participating in the protests, who are working to make the fruits of medical science accessible to everyone.

    Developing a just system of health care means abolishing the corporate model of health care. That is entirely in keeping with, and in fact truly captures, the spirit of this movement. It is to create a system in which the powerful tool of medical science is participatory and serves human needs instead of corporate profits. Developing a just system of health care does not mean opposing science-based medicine in favor of woo. To throw the scientific baby out with the corporate bathwater is to unintentionally hand more power to corporations and their efforts at obfuscation in every sphere.

    As I said, this one point irked me but this post is really a cheery one about how professionals can lend and are lending not just their voices but their skills and talents to movements for social justice. And it's not just medical professionals. I posted a little while ago about the National Lawyers Guild's web site for cyber-activists. They've now initiated a large-scale Occupy legal support program:
    “We know from decades of experience in defending free speech rights that law enforcement agencies, absent competent and aggressive legal pressure, tend to run roughshod over the rights of those engaged in dissent,” [Carol Sobel, co-chair of the Mass Defense Committee] said. “We are taking a proactive approach to the defense of demonstrators.” “We don’t want to just defend protesters who have been falsely arrested—we want to head off the false arrests at the outset and send a message to local police agencies that suppression of free speech will not be tolerated,” Sobel said.
    The page at my link provides contact information and a listing of the cities in which they're already operating.

    This is all very exciting. So many people, it seems, think of activism as marches and protests only, and don't realize how their skills and talents - as artists, nurses, graphic designers, legal professionals, social workers, IT experts, scientists,... - can contribute to social movements, and in turn how their participation can expand their own consciousness and lead them to push for change within their profession.

    Thursday, October 20, 2011

    Make Mine a Double

    "I found my first real home during my second year in New York, at a bar in the East Village. Maybe it was the kind of bar you've loved, if you've loved a bar." - Kristen Dombek

    Gina Barreca once happened into the book store where I worked. She was truly pleasant and gracious enough to sign all of our copies of her books, which left me with good feelings towards her. So when I read about a new collection of pieces about women and drinking - Make Mine a Double: Why Women Like Us Like to Drink (Or Not) - I was happy to discover that she was the force behind it.

    I immediately added it to the large mix of books I'm reading at the moment. It's a delight. I'm only about a third of the way through, and already the essays have hit on drinking and feminism, religion, gender, race, class, and families. I laughed aloud several times reading Sarah Deming's "Against Mixology." Perhaps I'll post about it again when I finish them all, but I'd recommend it on the strength of the first several alone.

    Interlude - Vineyard, fall

    Radioactive Wolves!

    This was fascinating.

    I want to take pictures there.

    Orca Coalition set to appeal Morgan decision

    I reported last week that the decision had been made to send Morgan to Loro Parque in the Canary Islands. Encouragingly, the Orca Coalition quickly raised funds to initiate an appeal. There's hope yet!
    “International regulations for the care of a protected animal have still not been followed. Only if rehabilitation is deemed impossible, other options are allowed to be considered. But the Dolfinarium has so far not been able to mention one action that shows that they are trying to prepare Morgan for a life in the wild”, according to Marq Wijngaarden, lawyer of the Orca Coalition. Because of the court ruling in August the Dolfinarium has to wait at least five more weeks before they are allowed to export Morgan. The Dolfinarium appears to have no intention to uphold this term, and again wants to violate the rules.

    The Orca Coalition is still open for a meeting with the Dolfinarium. “We are supported by a group of international orca scientists who have experience with rehabilitating these protected animals in the wild. Their knowledge and experience is available for Morgan, and also for future stranded orcas. For a year now a detailed plan to return Morgan to her family has been available”, says Barbara van Genne, marine biologist and spokesperson for the Orca Coalition. The Orca Coalition continues to take efforts to implement this step by step release plan in order to return Morgan back to her family under expert guidance, according to international regulations.

    Monday, October 17, 2011

    Rorschach's post about the ERV comments

    It's great that so many people have donned their hazmat suits and waded into the ERV pit to protest the threatening, misogynistic language by saying "No." Rorschach has posted about the matter, including email addresses for ScienceBlogs and National Geographic. He notes:
    [T]his and other comments in that and the previous threads on elevatorgate hosted by Abbie Smith on her blog in the last 3 months seem to be in breach of Scienceblogs’ Code of Conduct :...
    An understatement. They appear to have reversed the Code and used it as an instruction manual.

    If any of the other remaining ScienceBloggers are still unaware that this is happening on the site they share, they should probably be informed as well.

    Saturday, October 15, 2011

    The skeptical-atheist community needs to say: NO THREATS

    This has gone on more than long enough. We don't have immediate influence on those outside our community, but we need to stand together against veiled threats of the sort directed at Ophelia Benson.

    Let's give them the Geraldo treatment.

    Two sex queries

    So...I have two questions related to my post yesterday:

    First, just after I saw Orgasm, Inc., I heard on the car radio an ad for some sort of herbal supplement for men (I wish I'd written down the name). The product was alleged to mimic or promote testosterone or something. The commercial acknowledged that the "condition" it supposedly treated was merely normal changes associated with aging, but focused - in addition to boosting vigor generally - on maintaining or increasing sexual desire.

    I recalled at least one Roman writer* reflecting upon declining sexual desire with age and calling it a positive and enjoyable experience: men (I think they were writing specifically about men) are less likely to behave stupidly, and the weakening of those overwhelming physical drives frees them to focus on other aspects of their lives, especially their work. Now, I can see a specific situation in which a man's partner has a problem with his lack of interest in sex (not that this silly supplement would do anything for that beyond, potentially, the placebo effect). But I see the Roman writers' point, and don't really understand why people would want to artificially create desires in themselves, even if these can be satisfied. Why are some men interested in doing this?

    Second, both PZ and Dan Savage have written recently about the mystery of the female orgasm, both leaning toward the "by-product theory" which sees the female orgasm as an evolutionary by-product of the male orgasm. This makes sense, but I've been confused about why the female orgasm is seemingly assumed to have no adaptive function because it's not needed for ejaculation. I could well be missing something important here, but I would think that the pleasure of orgasm, like other sexual pleasure, would incline women to have more sex. Is the assumption that female sexual interest/desire has played no evolutionary role whatsoever? If so, that assumption doesn't seem defensible in light of primate and human anthropological research.

    With regard to the specific case Savage is commenting on, I think his advice to relax about it is good. We know that this can be strongly affected by psychological states, and being wound up about it can't be helping, even if it's not hurting. At the same time, cultural beliefs (and the feelings of shame that stem from them) and ignorance about sex (on both partners' parts) shouldn't be dismissed as possible factors because of an evolutionary hypothesis.

    *(if anyone can remind me which specifically, please do)

    CFI to take legal action against Wyndgate; O'Reilly to respond to Dawkins cancellation

    The Center for Inquiry reports that they plan to take legal action against the Wyndgate Country Club for cancelling Richard Dawkins' talk after the club's owner saw Dawkins interviewed on The O'Reilly Factor and learned of his atheism.

    O'Reilly is expected to comment on the matter on his show on Monday night (8 PM EST).

    Friday, October 14, 2011

    Media on media: a contrast

    Today, I learned of three new books about media history. The first works featured in the New York Times' upcoming book reviews, under the title "Dynasts of the Daily Press," are about the Medill family, media tycoons: The Magnificent Medills: America’s Royal Family of Journalism During a Century of Turbulent Splendor by Megan McKinney and Newspaper Titan: The Infamous Life and Monumental Times of Cissy Patterson by Amanda Smith. Also, yesterday's Democracy Now! offered an interview with Juan Gonzalez (Democracy Now! co-host) and Joseph Torres, authors of News for All the People: The Epic Story of Race and the American Media, which looks at how the media has historically shaped views about race in the US and the role of technological changes and government policy, bringing to light the work of minority journalists and media activists in fighting for a more democratic media.

    This is from the Times review:
    Megan McKinney’s “Magnificent Medills” and Amanda Smith’s “Newspaper Titan” between them expend more than 1,000 pages chronicling the escapades of Joseph Medill and his family. McKinney’s book includes accounts of Joseph Medill and his offspring, on to the great-­grandchild Alicia Patterson Guggenheim, who came to own and run Newsday. Smith (the editor of Joseph P. Kennedy’s letters), at much greater length than Mc­Kinney, concentrates on Cissy Patterson, who was Joseph Medill’s favorite grandchild and led the gaudiest life of the Medill ­grandchildren.

    ...Contra McKinney, the Medills were not magnificent but neurotic, alcoholic, megalomaniac and inordinately unpleasant generally. Far from being a titan, of newspapers or anything else, Cissy Patterson was, in Smith’s own showing, capricious, spoiled, headstrong, snobbish, litigious, anti-­Semitic, a mean drunk and vindictive. Not, as we should say today, a fun family, Joseph Medill’s offspring.

    They did spend grandly, though chiefly on themselves, living more like Medicis than Medills. They called on Stanford White to build them mansions on Astor Street in Chicago, on Dupont Circle in Washington, and had other architects build them mansions elsewhere. Vast sums went on clothes, jewels, luxurious travel, liveried servants, private railroad cars, horses, fox hunting and buying off ex-husbands and -wives....

    ...The Medill grandchildren viewed journalism as purveying entertainment while enhancing their social positions and spreading their political views. “Never overestimate the intelligence of the American people” might have been their motto, and in their newspapers they rarely did. They gave their readers what they thought they wanted. This included large photo spreads, stories of sex and violence, advice columns, lots of gossip, strong opinions, contests and comic strips. (Joe Patterson was especially adroit at developing new comic strips for The Daily News.) The formula worked. At one point the family owned and controlled the three largest-circulation dailies in the three most important cities in the United States.
    From Gonzalez' description of News for All the People:
    So we’ve tried to outline how that developed, from the early Post Office for newspapers; the rise of the telegraph, that gave rise—that really made possible the wire services that dominated news throughout the late 19th century; the rise of radio, then of cable television, because television was really just an extension of radio, the rise of cable television; and finally the rise of the internet. Each of these new technologies has created a huge debate over what is the role of the media in a democracy and what is the role of the government in establishing the rules of operation by which all the different groups in society will be able to have access or be heard or produce news.
    They talk about the work of several minority journalists, and then media reform movements:
    JUAN GONZALEZ: ...We point out in the book that between 1970 and 1973 there were more than 340 license challenges to the licenses of television and radio stations across the country. As thousands of African-American and Latino community leaders—forgotten—people like William Wright in Washington, D.C., Emma Bowen in New York, Lonnie King in Atlanta—all marched into the television stations and the radio stations and said, "We are fed up with your failure to cover our communities. We want you to hire more African Americans and Latinos. We want you to have shows that speak to our communities." And they launched a massive movement all across the country challenging licenses. And as a result of that movement is when you had the newsrooms opened up to people like Ben Bradley—I’m sorry, to Ed Bradley—

    AMY GOODMAN: 60 Minutes.

    JUAN GONZALEZ: —and to Geraldo Rivera*—


    JUAN GONZALEZ: —and to all of these first generations—Gil Noble, Gloria Rojas. The first generation of African-American and Latino journalists came into the newsrooms as a result of this massive community movement of media reform in the 1970s....
    The contrast between the Times' and Democracy Now!'s assessments of the interests of their respective audiences is pretty stark: for the former, the fox hunting, backstabbing, and marital problems of narcissistic media magnates; for the latter, an analysis of the history of media democracy, racism, and reform movements, taking us through the net neutrality struggles of today.

    *I admit I have another motive for quoting this particular portion of the interview, and that is to show this video (the segment leading up to this, also at the link, has Cornel West referring to "our atheist and agnostic brothers and sisters"...on Fox):

    Cuttlefish should like it. :)

    Diagnostic expansion and Orgasm, Inc.

    Duncan Double last month made a call (or, I should say, joined the call) for "No more psychiatric labels." I was struck by the extremity of the demand, but its reasoning and subtleties become more clear if you read his longer piece about it and this piece by Allen Frances about the DSM-V. A recent article in Society and Mental Health, "Creating an Age of Depression: The Social Construction and Consequences of the Major Depression Diagnosis," also gives a sense of the validity problems faced by these diagnoses as well as their consequences.

    I happened to read Double's post just after I saw the film Orgasm, Inc.

    As a documentary, it's not spectacular, often seeming unfocused and employing some unnecessary gimicks and misplaced humor. (It would have been a better film, I think, had it centered around Leonore Tiefer and the Berman sisters.) But the story and the issues the movie addresses carry it along.

    One aspect that caught my attention was the film's engagement with diagnosis, stigma, and shame. A claim I frequently hear in discussions of mental problems is that their medicalization has removed - or, more typically, is in the course of removing - some alleged stigma. I've never been much convinced of this, particularly at a time when the number of psychiatric diagnoses continues to rise, enveloping more and more areas of life and ordinary difficulties that had not previously been stigmatized. In the particular case of "female sexual dysfunction" it would be a hard sell: the label plainly redefines (at least some) regular life experiences as problems in need of treatment. The larger story concerns the frightening power of corporations and other groups to transform,* in their own interests, the way people think and feel about their most intimate experiences and problems and their causes.

    Thursday, October 13, 2011

    Success at SourceWatch!...and a request

    I posted just yesterday afternoon about the terrible condition of the Alternative Medicine page at SourceWatch, which had, undetected, come to be a site of woo-promotion and, worst of all, HIV-AIDS denialism. I checked the page this morning and found this:
    Alternative medicine refers to alternative approaches to healing and wellness which do not decisively fall within the professional realm of conventional and orthodox (predominately drug and surgery based) medicine. Complementary and Alternative medicine (CAM) is an umbrella term for alternative, complementary and integrative medicine.

    Note: This article has been placed under review. Its contents will be preserved on the talk page until that review is completed. ~~
    Lisa Graves, Executive Director of the Center for Media and Democracy/SourceWatch, left the following message in my comments:
    Dear Sir or Madam:

    I received this alert about the SourceWatch article discussed above.

    Based on your note, I have placed the article under review. Its contents have been re-located to the talk page of the article, pending that review. If you have edits to that page that you would like to make or suggest, while this review is pending, you can make them there.

    Without the Google alert, I might not have discovered your criticism of one of the tens of thousands of articles on the site. If you have future suggestions for correction or improvement, please help us in updating the article at issue or alert us to the issue. We are a small ngo with a small staff of editors along with some who volunteer on SourceWatch.

    Lisa Graves, the new Executive Director of the Center for Media and Democracy/SourceWatch
    I'm extremely impressed and pleased by the rapid response, which just strengthens my trust in SourceWatch, and regret not having contacted them directly as well.

    So I ask for the help of the science-based community in making a better page. I'll be coming up with some ideas for topics that should be covered and references, but I would appreciate any suggestions, or better yet people can make them there directly. Please keep in mind that the audience of SourceWatch tends to be critical of corporate distortions of medicine and medical research, and that a factual presentation of CAM merely requires good science and accurate history, not corporate cheerleading. (In this vein, discussions of CAM as an industry and its political influence are completely appropriate and important information for SourceWatch readers.)

    Wednesday, October 12, 2011

    sCAM invades SourceWatch!

    I've often used SourceWatch in investigating people and organizations. The information can be dated and incomplete, and you have to follow up on the references, but overall it's an extremely useful resource. So, after reading posts about the ACS' rejection of atheists, I was following a link trail there originating at the American Cancer Society page (there are, of course, several legitimate criticisms that can be leveled at the ACS) and becoming increasingly disturbed. I reached the Alternative Medicine page and couldn't choke back the outrage.

    Most of it is taken up with attacks on "mainstream" medicine. Now, I've never been shy about my opinions of health care in the contemporary US and elsewhere. I believe a comprehensive and fully functioning clinical trials database is important, but only one of the radical changes that need to happen for medicine to serve people rather than profits. But even if every claim about mainstream medicine made on the page were accurate, which is not the case, this would in no way validate CAM. The article suggests, for example, that randomized clinical trials can be twisted and suppressed, which is true.* However, in arguing this, the article's editor(s) are saying nothing to challenge RCTs scientifically, and in fact implicitly accepting the RCT rationale. The discussion of rigged, cherry-picked, and dubious trials is followed immediately by:
    Orthodox practitioners and various related and profitable industries, may also spin facts to make the strong and solid features of a minority practice appear strange and eccentric. For example, the very small doses used in homeopathy must be ineffective. Also, the fact that they have employed medicines for over 200 years as evidence that the field has not "progressed". However, another interpretation might be that these 200 year old remedies (along with other non pharmaceutical, toxic and surgical remedies) still work and have not led to serious injuries and deaths. Incredibly, the fact that homeopaths conduct detailed, personal patient interviews has been portrayed as "quirky" because it revels in "inane facts" about a patient.
    This is ridiculous enough, but it's the section on HIV-AIDS that had me fuming. A few excerpts:
    Since the first hypothesis by Robert Gallo of the National Institutes of Health (NIH) at an April 23, 1984 press conference, there has never been any proof that HIV caused AIDS. In fact, Gallo only announced that he had discovered the virus which probably caused AIDS. Others claimed that he had discovered the “AIDS virus” and he never corrected them.

    ...[T]here has been no well-funded, empirical research regarding the true cause of AIDS. In spite of this, evidence exists to conclude that HIV is not the cause of AIDS, according to critics of the orthodox HIV/AIDS paradigm. Furthermore, the HIV test is so inaccurate and misleading, it has never made a real connection between HIV and AIDS.

    ...After his challenge to the the AIDS orthodoxy in 1997, Dr. Duesberg was ridiculed, marginalized and denounced. Years later, other medical practitioners and scientists are realizing the inherent fallacies in the HIV/AIDS paradigm. The most obvious is the lack of scientific documentation.
    And most eye-spittingly infuriating:
    In November of 1999, President Thabo Mbeki publicly questioned the HIV/AIDS paradigm, causing intense domestic debate in South Africa. It was the first challenge to the paradigm that the HIV virus caused Aids. Most people in U.S. and global "markets", were healthy and alive prior to their HIV positive death certificates and died within a year of taking prescribed medications. Like most contrary “AIDS” debates, it was largely ignored or censored by U.S. media.**
    Needless to say, the citations are utterly ridiculous. This CAM SourceWatch invasion might be the work of just a few individual cranks, but it can't be allowed to stand. People visiting the site for information about the doings of ALEC or the Koch brothers should not also find these lies.

    *The various techniques for doing so are described in detail by Ben Goldacre in Bad Science and Irving Kirsch in The Emperor's New Drugs.

    **Goldacre's Bad Science is also the best source on this.

    Sad news about Morgan

    She's going to Loro Parque. This is so depressing. How anyone could think it's in any orca's interests to be sent to this place is beyond me. And how can this process be legal?

    Tuesday, October 11, 2011

    Don't buy a ticket

    Famine and epidemics

    This is an interesting post from Contagions, the first in a series about the link between malnutrition and epidemics and the vicious cycle that can be created.* Ziegler writes, "Today this cycle can be mitigated and eventually broken by international food relief and even limited modern medical treatment." This is an overly optimistic expectation. Patchy mitigation can be achieved, but what is needed is a revolution in food production and distribution.

    *The 2007 article on which it's based is open access.

    Great reporting on Honduras

    This 25-minute video provides a solid overview of Honduras from the coup to the present, focusing on violence against resistance journalists and activists. It ends on a hopeful note. There are some brave people in Honduras.

    (via Quotha)

    Monday, October 10, 2011

    Lobo in Washington: the political jenny spins on

    Pepe Lobo, Honduras' coup president, visited Washington last week in the latest chapter in the Obama administration's bloody betrayal of the Honduran people and Honduran democracy. (And no, foolish people, this utter moral failure has had nothing to do with Obama's parental responsibilities or alleged sleep habits, and nor, it shouldn't have to be pointed out, has it occurred despite some imaginary objections from Hillary Clinton.) The visit was of course accompanied by the endless parade of lies and spin, as Adrienne Pine and Free Speech Radio report.

    Ag gag laws and other environmental, animal rights, and food news...

    First (via Climate Change), as this article in, of all places, Forbes, reports, environmentalists joined the Occupy Wall Street protests last week.
    Wednesday’s march was also buoyed by another group of rabble-rousing upstarts: environmentalists. Fresh off their own nonviolent stand outside the White House — where they spent two weeks protesting the proposed Keystone XL oil pipeline — the re-energized U.S. environmental movement has now found an even bigger, broader stage. And like most factions of Occupy Wall Street, it seems perfectly happy to share that stage with other interests.

    ...McKibben and now hope to conjure some of that mojo in Washington (which also held its own “Occupy D.C.” march Thursday) for “ Occupy State Department,” a protest to stop lobbyists from dominating Friday’s final public hearing on Keystone XL. The State Department will rule on the proposed pipeline by year’s end, and critics have accused it of “bias and complicity” in favor of the project. On top of that, Haigh says, many hearings so far have suspiciously become pro-pipeline pep rallies.
    The inclusion of organized environmentalists, as the story points out, should come as no surprise:
    Occupy Wall Street’s first “official” statement lists an array of grievances with corporate America, many of which are at least indirectly related to environmental and public health. Referring to corporations in the third person, some of its most clearly environmental grouses include:

  • “They have poisoned the food supply through negligence, and undermined the farming system through monopolization.”

  • “They have profited off of the torture, confinement, and cruel treatment of countless nonhuman animals, and actively hide these practices.”

  • “They have deliberately declined to recall faulty products endangering lives in pursuit of profit.”

  • “They continue to block alternate forms of energy to keep us dependent on oil.”

  • “They have purposely covered up oil spills, accidents, faulty bookkeeping, and inactive ingredients in pursuit of profit.”
  • Second, on the other side, corporate interests and their political lapdogs continue their offensive against animal rights and environmental organizations that interfere with their profiting through destruction.* As Food & Water Watch reports:
    Today, the vast majority of animals raised for meat, milk and eggs live in extreme conditions where they are unable to express their most basic instinctual behaviors. Many of these animals never once feel grass under their feet or the sun on their back.

    Numerous organizations are committed to exposing the reality of what factory farming means for animals welfare. This has always been a challenging task, but it may soon become even more difficult. With the help of several state legislators, the meat industry is working harder than ever to ensure they maintain exclusive control over their public image by banning unauthorized images from their facilities.

    Over the past year, representatives in four states (Florida, Iowa, Minnesota & New York) have introduced legislation that would make it illegal to record any image or sound inside a farm without the owner’s permission. The Iowa and Minnesota bills would also criminalize the re-broadcasting of these images by the media.

    Proponents say the legislation is necessary to protect private property from theft and vandalism and to ensure bio-security. But all of these concerns are already well covered under current laws. The real motivation behind this legislation is unmistakably clear—the videos recorded on these farms confirm the worst fears of conscientious consumers and severely damage the industry’s carefully crafted public image.
    I suspect ALEC ghostwriting...

    Finally, The Nation last month ran a set of pieces about social justice and the food movement, kicked off by Frances Moore Lappé's essay.

  • Frances Moore Lappé, "The Food Movement: Its Power and Possibilities"

  • Raj Patel, "Why Hunger Is Still With Us"

  • Vandana Shiva, "Resisting the Corporate Theft of Seeds"

  • Eric Schlosser, "It's Not Just about Food"

  • Michael Pollan, "How Change Is Going to Come in the Food System"

  • They're quick reads; the quality varies. My favorite line is from Vandana Shiva: "That is why we have to make food democracy the core of the defense of our freedom and survival. We will either have food dictatorship for a while and then a collapse of our food systems and our societies, or we will succeed in building robust food democracies, resting on resilient ecosystems and resilient communities. There is still a chance for the second alternative."

    *I've finished Green is the New Red,

    and highly recommend it. It moves, in two important senses - touches the reader (through substantive reporting and without heroizing activists) and zips along. The best aspect is the way Potter situates the environmental and animal rights movements and the onslaught against them within a historical context, particularly with reference to the McCarthy era. Also important is the discussion of the special "terrorist" prisons that have emerged in the US in recent years.

    Saturday, October 8, 2011

    More percentages - this time, orca sounds and certainty

    I'll be posting more in the next few days about the reported percentages of HPV-positive oropharyngeal cancers, but there was another percentage reported that caught my eye recently and made me wonder. While I made an argument about the use of percentage in the previous articles, in this case I simply have a question.

    The news last week from the Orca Coalition contained a happy announcement that Morgan's family had likely been located. If so, this is significant, since her prospects for returning to the ocean are much improved if she can rejoin them. The announcement read "Family of Morgan found with 77% certainty." The text reads:
    Independent scientists have now found that there is a match of at least 77% between the sounds that orca Morgan makes and specific orca families residing in the North Atlantic Ocean including around Norway.
    So my percentage-related question is: Does finding a minimum 77% sound match translate into 77% certainty of having found her family? (I'm not necessarily saying there's less certainty - in fact, there could be more - but this direct translation of percentages sounds odd to me. Could be correct, though...) Also, how is the sound match determined? It's all very interesting, and brings into even greater relief the rich social life these whales are deprived of in captivity. Listen!:

    Strangely beautiful. (Unfortunately, I can find little to no information about the people listed as having taken the pictures or recorded the sounds, which is odd.)

    Fun with Wiley and Wikipedia

    Speaking of Wikipedia, in reading Dan Vergano's article before my quick post about the latest in the Wegman scandal on Wednesday, I neglected to click on the link to Andrew Gelman's "Wiley Wegman chutzpah update," with its guide to choosing between WP and WIREs Computational Statistics. It's good.

    It's not louche! It's literate!

    I mentioned the other day that the ABC series Revenge has become a guilty pleasure. After posting about it, I became curious enough to look into its critical reception. One of the reviews mentioned that it's based on The Count of Monte Cristo (it's even listed in the novel's Wikipedia entry under adaptations), which I didn't know because I hadn't read it. That error is now being rectified. I'm enjoying the original in precisely the same way, which is making me feel much less guilty.

    Thursday, October 6, 2011

    Peter Singer, making me angry

    Pretty much every time the subject of differences in the abilities and interests of “races” or sexes comes up online, there are a few people (not always the same people) ostensibly on “my side” who chime in to repeat the same basic line. It goes something like, “Anyway, group differences are merely statistical averages, so we can’t make assumptions about any individuals; moreover, people should have equal opportunities or treatment regardless of such differences.” These comments have always annoyed me, as the argument always seems to rest on the assumption that these differences do in fact exist. They’ve also bothered me because this line of thinking is so formulaic that I was sure it must trace to a common source, but didn’t know what it was.

    It’s evidently Peter Singer. Chapter 2 of the latest edition of Singer’s Practical Ethics

    is, quite simply, a scholarly nightmare. It’s also…(ironically) kind of unethical. I was a bit worried going in, since his discussion of Marxism in the previous chapter was simplistic and that chapter had hinted at some problems. The basic contention of the chapter at issue, one with which I generally agree, is that while people are not really all “equal” on every criterion, our treatment of each other has no business being based on people's capacities or characteristics other than the fact that they have interests. We all have the same fundamental interests, and any true ethics is democratic in the sense that everyone is considered a moral equal; everyone’s interests are given equal weight under the principle of equal consideration of interests.

    Singer concludes the chapter with a discussion of disabled people, of whom he says
    When we ask how such people ought to be treated, there is no argument about whether their abilities are the same as those of people without disabilities. By definition, they are lacking at least some ability that normal people have. Their disabilities will sometimes mean that they should be treated differently from others… The fact that a specific disability may rule a person out of consideration for a particular position does not, however, mean that that person's interests should be given less consideration than those of anyone else. Nor does it justify discrimination against disabled people in any situation in which the particular disability a person has is irrelevant to the employment or service offered (pp. 44-45).
    Of course, as he notes, “people with intellectual or physical disabilities,” like the “gifted” or “geniuses” of whatever stripe at the other extreme, is a huge umbrella category, and anyone disabled in one way can be perfectly average or even immensely gifted in others. In fact, Singer could simply have written entirely about individuals. He could have spoken of people who are not bright, or talented, or who lack abilities considered important in a particular culture or area, or their opposite – people with extraordinary abilities on any particular scale. His fundamental argument is that none of this has anything to do with the moral consideration we grant any of these beings.

    Singer doesn’t focus on individuals, though. Instead, the chapter is taken up with a discussion of alleged race and sex differences, and this analysis is, frankly, dreadful. Again, there’s really no reason for this discussion. His point could be made easily with reference to individuals. Singer repeatedly notes that it doesn’t really matter whether racial or sex differences in intelligence or other capacities or propensities exist. He’s only, he says, discussing them hypothetically because he wants to show that even if they do exist they should have no ethical ramifications. His arguments, he argues, “give no comfort to racists.”

    Throughout the chapter, though, he shows his hand: it’s clear that he does believe these differences exist. It’s all there - The Bell Curve, the unspecified black US Olympic team, mental object-rotation, Greater Male Mathematical Variation, female verbal ability and recognition of emotional states, aggression, live faces vs. mechanical mobiles, evo psych just-so stories… And it’s all presented as if the scientific evidence is overwhelming, and social inequalities a result of differences in ability. For example,
    [T]he fact that there are more males at both extremes of ability in mathematics, whereas females tend to cluster more around the average level, does support Lawrence Summers’ ill-fated remark about the relative scarcity of suitable female candidates for Harvard positions in those areas of science and engineering in which mathematical ability plays a key role. Only those with exceptional ability become professors, and even within that select group, only those among the very best have any prospect of becoming a professor at an elite institution like Harvard. It isn't difficult to see that males are likely to be overrepresented among those at the extreme upper end of the scale of mathematical giftedness.(p. 32).
    Ay. Where to start? This is remarkably ignorant, on so many levels. I’m reading, and I’m fearing, but I’m thinking, “No, he wouldn’t possibly go there…”

    And then…
    In addition, the preferences young females show for playing with dolls, and young males for playing with toy trucks, have even been shown to hold for vervet monkeys! No wonder that parents continue to give their children the toys that they most desire and with which they are most likely to play (p. 30).
    Veeeeeeeeeeeerveeeeeeeeeeeets! In the annals of racist and sexist “research” it has a lot of competition, but this may in fact be the stupidest article ever. (And so much for mere alleged statistical averages – now it’s “the toys that they most desire.”) Someone so deeply concerned with animal rights should stand with vervets against their use in research so profoundly dumb and pointless.

    But this is just the most egregious element in a chapter that, without honestly acknowledging it, takes on board much of the range of racist and sexist contentions that have characterized the past several years. It’s almost as though Singer read one or two of the popular “difference” books and just swallowed it all whole. Throughout the discussion, he makes no effort to take seriously or engage with the extensive criticisms of the research he cites or the equally extensive counterevidence. He writes:
    It would be inappropriate for me to attempt to assess the scientific merits of biological explanations of human behaviour in general, or of racial or sexual differences in particular. My concern is rather with the implications of these theories for the ideal of equality. For this purpose, it is not necessary for us to establish whether the theories are right (p. 25).
    But then follows a lengthy discussion, after which:
    ...These are the major psychological differences that have repeatedly been observed in many studies of females and males (p. 29).
    Followed by:
    Adopting the strategy we used before in discussing race and IQ, I shall not go further into the evidence for and against these biological explanations of differences between males and females (p. 31).
    Oh, of course not. This, again, given what he actually does write, is completely disingenuous. He presents the alleged scientific foundation for these differences (he never does even define “race” or point to any scientific basis for this concept) as though it were scientific fact. But of course these “theories” have no implications as such if they’re incorrect (as I discuss below, their existence as “theories” taken seriously has very real implications, but that’s something very different).

    Indeed, as Singer sees it, antiracists and feminists – those dumb feminists never seem to understand! – are at fault for making a big deal of these beliefs, which we should all just admit to because they’re really not a problem at all. The (so ‘70s) opposition of these groups to the plain findings of science can only reflect ill-founded political sensitivities, fears, and feelings. “The opposition to genetic explanations of alleged racial differences in intelligence is only one manifestation of a more general opposition to genetic explanations in other socially sensitive areas,” he writes.
    It closely parallels, for instance, the hostility of 1970s feminists [I love that it’s about the “1970s feminists”] to the idea that there are biological factors behind male dominance in politics and business. (Today's feminists are more willing to entertain the idea that biological differences between the sexes are influential in, for example, greater male aggression and stronger female caring behaviour. [???]) The opposition to genetic explanations also has obvious links with the intensity of feelings aroused by evolutionary explanations of human behaviour. The worry here is that if human social behaviour is seen as having evolved over millions of years and having links with the behaviour of other social mammals, we shall come to think of hierarchy, male dominance and inequality as part of our evolved nature, and thus unchangeable. Nevertheless, evolutionary explanations of human behaviour are now much more widely accepted than they were in the 1970s [?] (p. 25).
    One of my biggest pet peeves is the formulation of explanations for allegations. Hypothetical explanations should be for actual, defensible findings. How do you have an explanation for something that’s simply alleged? Related to this is the charge that feminists – well, those clunky, outdated ‘70s feminists – have no arguments or empirical challenges to these contentions, only fear and irrational hostility. Regardless, the claim of blanket opposition to any "evolutionary explanations of human behavior" is a straw man.

    And of course those 1970s feminists were so ignorant to think that biological essentialist arguments were a problem:
    Although this question of origin is important in some special contexts, it was given too much weight by the 1970s feminists who assumed that the case for women's liberation rested on acceptance of the environmentalist view. What is true of racial discrimination holds here too: discrimination can be shown to be wrong whatever the origin of the known psychological differences (p. 29).
    Singer’s views are amazingly clear in the following:
    Some years ago an American sociologist, Steven Goldberg, built a provocatively entitled book, The Inevitability of Patriarchy, around the thesis that the biological basis of greater male aggression will always make it impossible to bring about a society in which women have as much political power as men. From this claim, it is easy to move to the view that women should accept their inferior position in society and not strive to compete with males or to bring up their daughters to compete with males in these respects. Instead, women should return to their traditional sphere of looking after the home and children. This is just the kind of argument that has aroused the hostility of some feminists towards biological explanations of male dominance. As in the case of race and IQ, the moral conclusions alleged to follow from the biological theories do not really follow from them at all. Similar arguments apply (p. 32).
    Great! The actual consequences that those dumb feminists think might follow from the acceptance of arguments in books like The Inevitability of Patriarchy really don’t! Peter Singer said so, or at least that they shouldn't, and the conclusions of philosophy books are binding. (Don’t even get me started on his ignorant claims about capitalism.)

    This all rests on so many nonsense assumptions. Here’s my view:

    1) The vast majority if not all of these shifting but resilient essentialist claims about race (not to mention the idea of biological race) and sex are wrong. They need to demonstrate their scientific worth in the face of challenges, and they haven’t.

    2) The fact that so many, including so many in the media, are so willing to readily accept notions of difference that are based on garbage research and/or actively contradicted by the evidence makes me angry. It also makes me angry that distinguished scholars not only buy into this nonsense but go out of their way to include it in their otherwise intelligent books.

    3) The idea that we – women and minorities - shouldn’t be concerned about these “scientific” racist or sexist claims is shockingly wrong. It’s a naïve notion that could only be held by the powerful. The effects of these claims aren’t determined or ameliorated by an ethics book. Their consequences are well established. (The same is true of nonhuman animals: The facts about orcas and people’s knowledge of them, for example, make a difference to how orcas are treated. If people believe that they’re generally unintelligent and asocial, they’re going to be treated as such.) This is reality, and it’s irresponsible - and therefore immoral - to ignore it. This doesn’t mean social realities are unchangeable, but that it’s unethical to write as though they don’t exist and one’s claims don’t fall on a fertile ground of racism and sexism.

    I think the ethical course of action, given modern history and demonstrated social effects, for anyone writing or talking about racial or sexual differences in abilities/capacities/interests would be to

    A) Not assume the biological reality of race, and in fact regard the notion critically.

    B) Not make or repeat claims about these differences unless these claims are supported by solid and extensive scientific evidence.

    C) Consider alleged evidence critically. This means not just critically evaluating this evidence but seeking out and taking seriously critical perspectives and opposing evidence.

    D) Consider alleged evidence historically. This means learning the history of racist and sexist “science” – and this goes well beyond eugenics - and viewing contemporary “findings” in this line. We need to appreciate both contemporary and historical variation, and go out of our way to learn of examples that contradict our notions of what’s natural, aware that our ideas of human nature are bound to reflect the prejudices of our own times. This epistemic ethics is part of the practical ethics Singer talks about.

    Singer says:
    It is easy for us to criticize the prejudices of our grandfathers [ahem], from which our fathers [ahem] freed themselves. It is more difficult to search for prejudices among the beliefs and values we hold (p. 49).
    Yes. Let’s all do this.

    UPDATE: I wrote this post a few days ago, and at the time I assumed that I’d have few problems with the later chapters. I was wrong. This surprised me given that, as with the chapter I talk about here, I agree with him on the most central points. I’ll probably post about his childbearing and abortion sections soon.

    Now the History of Vaccines Blog, too

    I can't believe they did it, too:
    A study published in the October 3, 2011, issue of the Journal of Clinical Oncology reveals a startling rise in the rate of throat cancers related to human papillomavirus (HPV). The study looked at specimens from 271 throat cancers (specifically oropharyngeal squamous cell carcinomas, or OPSCC) collected over 20 years. The researchers found that HPV prevalence in the cancers increased from 16.3% during 1984 to 1989 to 71.7% during 2000 to 2004. They note that "The overall rise in OPSCC incidence during 1984 to 2004 is largely explained by the increasing incidence of HPV-positive cancers, whereas incidence of HPV-negative cancers declined.”
    As I pointed out yesterday, these percentages are absolutely meaningless in detecting an increase in HPV-associated OP cancers or OP cancers in general. The only figures of significance in this determination are incidence rates. From the article's abstract:
    Population-level incidence of HPV-positive oropharyngeal cancers increased by 225% (95% CI, 208% to 242%) from 1988 to 2004 (from 0.8 per 100,000 to 2.6 per 100,000), and incidence for HPV-negative cancers declined by 50% (95% CI, 47% to 53%; from 2.0 per 100,000 to 1.0 per 100,000). If recent incidence trends continue, the annual number of HPV-positive oropharyngeal cancers is expected to surpass the annual number of cervical cancers by the year 2020.
    Ignore the percentages here, too, as they're useless and misleading. In terms of the actual (estimated) incidence, we're talking about an increased incidence of HPV-positive OP cancers from 0.8 to 2.6 per 100,000 and a decreased incidence of HPV-negative OP cancers from 2.0 to 1.0 per 100,000 in the US over the period 1988-2004. This resulted in an overall increase of 0.8 per 100,000 - from 2.8 per 100,000 to 3.6 per 100,000. This results from a +1.8 change in HPV-positive OP cases and a -1.0 change in HPV-negative OP cases. I questioned in my previous post about this whether an increase of 1.8 cases per 100,000 of a disease over a 16-year period constitutes a "dramatic" rise in HPV-associated OP cancer, and I would ask the same about the overall increase. I find it difficult to imagine that an increase of less than one case per 100,000 over 16 years, even for a rare disease, is a "startling" increase.

    The changing HPV-positive and -negative proportions of OP cases (from 16% to 72% HPV-positive) can in some sense be seen as 'good' news. First, the fact that it partially results from a decline in smoking-associated cases reflects a decline in smoking, and smoking causes a gamut of other health problems. Second, as the abstract notes,
    Median survival was significantly longer for HPV-positive than for HPV-negative patients (131 v 20 months; log-rank P < .001; adjusted hazard ratio, 0.31; 95% CI, 0.21 to 0.46). Survival significantly increased across calendar periods for HPV-positive (P = .003) but not for HPV-negative patients (P = .18).
    So HPV-positive OP cancers are much more survivable than HPV-negative OP cancers, and treatments for the former have improved while those for the latter have continued to be less successful. The bad news is that the number of cases of HPV-positive OP is expected to grow as the virus (especially HPV 16) spreads further through the population.

    And of course there are HPV vaccines that could help to prevent against infection with the strain (HPV 16) responsible for almost all HPV-positive OP cancers. The HoV Blog reports:
    We spoke with Paul A. Offit, MD, chief of Infectious Diseases at The Children’s Hospital of Philadelphia, about the new study and its implications for HPV vaccination for boys. When asked whether we have evidence that HPV vaccination prevents throat cancers in males, Offit said, “What we do have is evidence that HPV vaccination can prevent infection. And since we know that a cell cannot become cancerous [with HPV-related cancer] unless it was infected with HPV, then the vaccine will protect against oropharyngeal cancers in men.”

    Moreoever, Offit noted that we do not have direct evidence that HPV vaccination prevents cervical cancer in girls; what we have is compelling evidence that the vaccine prevents the cervical intraepithelial neoplasias that are requisites for cervical cancers. “So, for boys, we have the same thing: a cell can’t be transformed unless it is infected with HPV. And we have data that the vaccine prevents infections.”
    I have a couple of questions about this: Can "infections" be talked about in this general way? Can we assume that the vaccine would prevent oral HPV infection exactly the same as genital HPV infection? Are these entirely the same? I read one report that suggested that Maura Gillison (one of this study's authors, incidentally) successfully pilot-tested an indicator for HPV throat infection, so it seems like this could be used in determining efficacy in preventing infection... In any case, as I've said, it's a highly plausible assumption. The post continues:
    Offit thinks that the recommendation HPV vaccination for boys will come soon, possibly at the end of this month when the Advisory Committee for Immunization Practices meets. The topic is on the committee’s agenda for Tuesday, October 25.
    If the most optimistic hopes for the long-term efficacy and safety of the vaccine are realized, and if combined with other preventive measures, it will be a valuable addition (given to girls and boys pre-exposure) to the preventive arsenal against a number of diseases, including OP cancer. I trust the CDC will make its decisions based upon all of the existing knowledge (including knowledge of the uncertainties involved) and not meaningless percentages or media hype.

    Wednesday, October 5, 2011

    My guilty pleasure

    ...of the moment (and that of several people I know) is Revenge:

    Suspend disbelief,* forget all notions of social and political justice for an hour, and revel in the telenovelal silliness of it all.

    *Really. I hear you saying, "But why would he...? There's no way she wouldn't..." Shut up and look at the beach.

    A good movie that isn't a documentary

    It's "foreign,"* unless you're in Argentina, so I suppose I should call it a "film." Haunting.

    But why the hell do so few films pass the Bechtel test?

    *Won the 2010 Best Foreign Language Academy Award.

    That's just dumb.

    Via Rorschach's blog I learned of a new study about HPV-associated oropharyngeal cancers. Apparently, the story's all over the place. Some of the stories are decent, if insufficiently critical. But several present the study in ways that are just...dumb.

    In a typical example, the headline from Medical News Today reads "HPV Linked Oropharyngeal Cancer Rates Rise Dramatically." The first paragraph:
    In the 1980s just over 16% of patients with oropharyngeal cancers tested positive to HPV, compared to over 70% during the last decade, researchers reported in the Journal of Clinical Oncology. The authors add that if the rise in incidence continues at its present pace, the incidence of oropharyngeal cancers will overtake that of cervical cancer.
    Oh, good grief. Regarding the latter claim, whether it will overtake cervical cancer is irrelevant. They're both rare in the US, and cervical cancer is rare and its rates have declined dramatically due to screening which is extremely effective in prevention. That trend will continue as long as women can get and follow up on Pap tests, are educated about the need for regular screening, and are not led to a false sense of protection by the hype about the vaccine.

    The only information relevant to the rise in HPV-associated oropharyngeal cancers - aside from where and over what time period you're talking about, which I'd think would be obvious but seems to be lacking in several articles - is the actual incidence of HPV-associated oropharyngeal cancers. The MNT and other articles imply that if the percentage of HPV-associated OP cancers has increased dramatically, this reflects a dramatic increase in the incidence of HPV-associated OP cancers. But that's just dumb. OP cancers are also caused by smoking and alcohol use, so changes in smoking or drinking rates leading to a lower incidence of OP cancers caused by them will change the percentage of OP cases caused by HPV regardless of changes in their actual incidence. (Indeed, the incidence of HPV-associated cancers could decline and its percentage still increase: Say there were 100 cases of OP cancer one year, and 50 each are caused by smoking and HPV. The next year the number of cases caused by smoking drops to 10, while the number of cases caused by HPV drops to 40, for a total of 50 overall. The percentage of HPV-associated cases will have risen from 50% to 80%.)

    We know that these changing percentages reflect to some extent declining smoking rates in the US and the resultant decline in smoking-related OP cancers. But the authors of the study (I don't unfortunately have access, though the accompanying editorial is available, as is the supplementary data) did find an increase in the incidence of HPV-associated OP cancers over the period studied. The presentation of this increase in the media reports has also been fairly misleading, though. The "225% increase" is repeatedly reported, but it's harder to see the "dramatic" rise when you consider that the increase is from .8 cases per 100,000 to 2.6 cases per 100,000 over a 16-year period. I don't have the knowledge to fully put this in perspective, but the actual numbers are significantly less dramatic than the trumpeted percentage increase, and it's still rare.

    But of course even if there are "just" several thousand cases of HPV-associated OP cancer per year in the US, and even if it's more treatable than the other kind (the most interesting aspect of the article, from what I was able to gather from the editorial), that's several thousand too many, especially if the increase continues. I can understand people suggesting a broad HPV vaccination of men as well as women.

    The HPV vaccines are approved in the US for boys 9-26 for the prevention of genital warts and some cancers, though they aren't currently recommended for boys by the CDC. Some have said that this study should push the CDC in the direction of recommending the vaccines for boys as well, or even mandating them. The problem with this is that there is no evidence that the vaccine is effective against OP cancer. There's no evidence against it, as far as I know - there's no evidence at all. Merck and GSK haven't done the research, and they're apparently not going to. I was suspicious about Merck's dropping it, but the argument made in this article is plausible: there's no equivalent to Pap smears for OP precancers, so any clinical tests of vaccine effectiveness would be expensive and take a good deal of time, and tests that screened only for oral HPV infection wouldn't necessarily convince the FDA of effectiveness against precancerous lesions.

    But the fact remains that the evidence doesn't exist, even if a plausible rationale does. So "I can't see the harm of [mandatory] vaccination of boys for OP cancers" remains problematic. For families making the decision, the financial costs are known, the long-term risks aren't, and the effectiveness (in this case, either short- or long-term) isn't. As a public health measure, the same considerations apply, and additionally there are concerns about the best use of resources in terms of this disease and other related diseases. If I were being cynical, I would say that Merck is in a great position here. They're not going to spend the money to find out if the vaccine is effective in preventing OP cancers, but people will push for public funds to be used for the purpose. Meanwhile, plenty of people are urging, on the basis of this research, that the vaccine be given to or mandated for as many boys as possible, and it's already approved for boys, so sales will increase.

    Even if I'm not being cynical, I would simply argue that the decisions need to be made on the basis of the available evidence and on a cost and risk vs. benefit ratio.

    The same disclaimer I attached to my earlier post about this applies to this one: I'm not trained in medicine, and some of my facts or analysis could well be wrong. If they are, I would appreciate corrections. A note that shouldn't be necessary: I'm not anti-vaccine, as anyone familiar with my writing should well know, and anyone who does a search for "health" on this blog can easily discover. I'm anti-thinking-every-disease-and-vaccine-profile-is-the-same, because that's just dumb.

    Victory settlement for Amy Goodman and others for 2008 convention arrests

    A final settlement has been reached in a federal lawsuit challenging the police crackdown on journalists reporting on the 2008 Republican National Convention and protests in St. Paul, Minnesota. Democracy Now! host and executive producer Amy Goodman, along with former producers Nicole Salazar and Sharif Abdel Kouddous, filed the lawsuit last year against the Minneapolis and St. Paul police departments, the Ramsey County Sheriff and United States Secret Service personnel. The lawsuit challenged the policies and conduct of law enforcement during the 2008 RNC that resulted in their arrests. They were among dozens of journalists arrested that week in St. Paul. The settlement includes $100,000 in compensation paid by the St. Paul and Minneapolis police departments and the Secret Service. The settlement also includes an agreement by the St. Paul police department to implement a training program aimed at educating officers regarding the First Amendment rights of the press and public with respect to police operations, including proper procedures for dealing with the press covering demonstrations.
    Here's their press conference, appropriately enough from near the Occupy Wall Street encampment in lower Manhattan:

    Papist gangs of Nebraska

    The story:
    Students at a public school in Fremont, Nebraska, have been told they can't wear a rosary to school because it's also considered a gang symbol.

    Elizabeth Carey, 12, told Omaha television station KETV her elementary school adopted the policy last year.

    "The principal said I couldn't wear my necklace at all because gangsters were wearing it," she said.

    Superintendent Steve Sexton told the television station the policy is for student safety.

    "We had information from law enforcement that there were documented instances of gang activity in the area and we had information that states that the rosary was being used as a symbol of gang affiliation," Sexton said.

    But the move has raised the ire of the American Civil Liberties Union of Nebraska....
    Here's the ACLU-Nebraska press release, "That gang of nuns looks pretty dangerous":
    ...Amy Miller, ACLU Nebraska Legal Director, said "Students have the right to express their faith in public schools. Whether a student wants to wear a crucifix, a rosary, or another symbol, it is wrong for school officials to interfere. We understand the serious concerns about gangs in schools, but Fremont Public School should demonstrate there is a concrete gang connection before shutting down a student’s free speech and religious rights. ACLU Nebraska has and will continue to support the constitutional rights of religious people”...*
    I agree that this is a real issue and fully support the kid's right to wear a crucifix to school, but I can't help but find this funny. A girl is prohibited from wearing a crucifix to school because of its alleged association with gang activity. In an elementary school. In Fremont, Nebraska. It's funny.

    ...Hmm... Perhaps I'm primed by the segment about Al Smith's presidential campaign in Prohibition last night, but could it actually be anti-Catholic bigotry? I'm not finding anything about the town's religious make-up, but Wikipedia did offer "Fremont gained national attention in 2010 when residents approved a referendum that would ban illegal immigrants from renting and working in the town." (Here's the article at the WP link.) So there appears to be strong anti-Hispanic sentiment which could be behind this, and a recent history with the ACLU... Hmm...

    *They should of course support the constitutional rights of nonreligious people as well.

    Wegman: Another installment in the 'dismal chronology'

    Dan Vergano reports on Deep Climate's newest analysis.

    Copying from Wikipedia. For shame.'s that investigation going, George Mason?