Monday, December 22, 2014

"All Lives Matter"

The ongoing controversies regarding the Ferguson and Staten Island issues of white-on-black police brutality have reached new heights (or maybe the proper word would be "depths).  A current article describes a recent incident at Smith College concerning a campus-wide e-mail circulated by Smith's president, Kathleen McCartney.

Dr. McCartney's e-mail announced her concern, and the concern of the Smith community about not "losing faith in the quest for racial equality, and how you fear for people of color."  It went on to speak about how violence of this nature serves as a reminder of the existence of racial injustice.  The president ended her note with the following:

"We are united in our insistence that all lives matter."

Apparently some Smithies interpreted this phrase as racist.  They argued that it "minimizes the anti-blackness of this current situation."  It was felt that McCartney, in using this phrase, was not sensitive to the problems that specifically befall African-Americans.

McCartney apologized for "drawing attention away from the focus on institutional violence against Black people......" and went on to commit herself to "learning from the lived experiences of people of color....."

We really have a problem when a statement proclaiming the equal value of all human life is considered insensitive and biased - and results in an apology.

Thursday, December 11, 2014

The Usefulness of Medical Data in Managing Disease

Dr. Sandeep Jauhar (Op-Ed NY Times, Dec 11) questions the use of standard accepted medical guidelines in the management of patients.  He is correct in pointing out that there have been such treatment guidelines published by a myriad of medical specialty organizations, outlining what current evidence indicates is the best method of evaluating and treating various conditions.  These organizations have committees of recognized experts in their respective fields who review all available published data that may pertain to a particular disorder/procedure.  Their conclusions are then published in the medical literature - not only as guidelines, but with "guidelines" as to how to evaluate the recommended guidelines.

The "guidelines" to evaluate the guidelines look at the statistical validity of the populations studied:  (A)were multiple populations studied,  (B)were there limited populations studied, or (C)were there only very limited populations studied.  Based on the data analyzed, the experts then classify procedures/treatments according to apparent benefits v. possible risks.  Class I indicates that the data clearly indicates that the procedure/treatment is very beneficial and is highly recommended.  Class II concludes that benefits are not conclusive, may indeed be worthwhile, but suggest additional studies.  Class III is comprised of treatments/procedures that have not been shown to be helpful or may actually be harmful.

Evaluating these criteria, and then following the suggested treatment/procedure outline is what is called evidence-based medicine.  This is the way to manage patients - this is the way to manage disease.  When a treatment/procedure is found to work in a significant majority of people (evidence-based), physicians should use it!  Denying the validity of such recommendations, is to deny the validity of using properly collected statistical data.  On what else can conclusions and recommendations be based?

Dr. Jauhar argues that such "homogenized health care" is not always the best treatment.  Of course not.  There are always times when any one individual will react negatively to a recommended course of therapy, or where it might be contraindicated for one reason or another.  He concludes that personalizing care is better.  Of course it is.  But until individual genomic analysis allows medicine to personalize care (and it is moving in that direction), so called "homogenization" is not to be denigrated.

Remember - what works well for the significant majority of a population will, in the vast majority of instances, work well for you too!  Though you are an individual and have your own personal genetic makeup, your genetic similarities to others is vastly greater than any differences - and you are  far more apt to have the same benefit/risk result to a recommended guideline as your neighbor.

Monday, December 1, 2014

Government and Ebola

Physicians may not always be unbiased when it comes to issues such as the Affordable Care Act and similar subjects that govern how they work and how their incomes may be affected. The non-medical community may certainly and rightly differ with their points of view.   But when it comes to evaluating the facts regarding science-based health issues, physicians whose medical and scientific expertise is well recognized should be listened to, and their recommendations generally followed.

A recent editorial in the highly regarded New England Journal of Medicine (Nov 20) discusses the matter of Ebola virus and quarantine.  It points out how the 21-day quarantine on health care workers returning to the United States from West Africa is "unfair and unwise, and will impede essential efforts to stop these awful outbreaks....."  Government should listen to the presentation of the facts and not "drive a carpet tack with a sledgehammer."

1.  Ebola is transmitted via contact with bodily fluids.
2.  Viral transmission occurs only when the viral load is very high, which is why asymptomatic individuals are not considered contagious.
3.  Fever precedes the contagious stage.
4.  The blood test for Ebola only becomes positive 2-3 days after the onset of fever or symptoms, supporting absence of contagion prior to that time.

It is important to remember that only those individuals caring for Thomas Duncan (the American who died in a Texas hospital from Ebola) at the time of hospitalization, when he had a very high viral load, became infected, while his family members, exposed during the very early start of his illness, were unaffected.

Government officials who ignore the facts and follow their "instincts" in order to achieve what they believe to be "the greater good" for their constituents, must provide the public with some evidence to support these unscientific and unsubstantiated programs which, in fact, are more harmful than helpful.

Monday, November 17, 2014

Is Israel a Democracy?

The meaning of democracy is equality before the law.
How can Israel say that everyone is equal before the law – that you’re equal before the law – when the law defines Judaism as the cultural, national and legislative basis for the state?

These are the words of Yair Lapid, Israeli Finance Minister, as reported in a recent issue of The Jerusalem Post.

Israel isn't going to be a democratic what?

These are the words of American Jewish philanthropist Sheldon Adelson.

I believe they are both saying similar things, though the tenor of the two quotes differs dramatically.  Adelson is rather blunt.  Lapid is more diplomatic.

Can Israel truly be regarded as a democracy?

Israel may be a democracy, but perhaps a "democracy" with certain provisos.  David Kretzmer, a law scholar at Hebrew University has pointed out the peculiarly Israeli dichotomy between nationhood and citizenship.  In Israel these are not interchangeable terms.   You can be an Israeli citizen, but, if not Jewish, you are not a member of the "nation-state of the Jewish people," which, after all, is how Israel defines itself.

Can you imagine a non-Jewish Prime Minister or President?  Could such an official deal with the religious laws and religious officials of the state?

Yes, one man, one vote - but a clearly defined difference among its citizens - some included in the nation-state, some not.

Wednesday, October 29, 2014

"Klinghoffer Re-visited"

The Metropolitan Opera has posted the libretto of "Death of Klinghoffer" on it web site.  Here is a piece sung by one of the terrorists.  Do you really believe that these words are not anti-Semitic (though, admittedly, they are the ravings of an outraged, angry and hateful terrorist)?  If similar disparaging words had been used to denigrate blacks or Muslims - do you think an opera including such words would have been written, no less performed?

You are always complaining Of your suffering
But wherever poor men Are gathered they can

Find Jews getting fat.
You know how to cheat
The simple, exploit
the virgin, pollute
Where you have exploited, Defame those you cheated, And break your own law With idolatry.
Is one big Jew.
What did you say?
You are old and ugly.
Not for one day
Will your children miss you. I hear a belly growl;
The voice of your soul.
Go on then, kneel,
Beg me, beg me to permit You something to eat
And a chance for a piss.
I see you cross
Your swollen legs.
Nobody begs?
That was your last chance. Just this once
You can befoul yourselves. You are all wolves,
Wolves without teeth.
You should think of death, But you meditate
On dirty meat,
And your own unclean flesh. Are you English?
Your Balfour Declaration Led to the partition
And the dissolution
Of the Palestinian nation.

Where English is spoken You will find perversion And all kinds of filth Not practised by stealth Late at night,
But on the street
During the day.
You wink at sodomy. You laugh at blasphemy. You give no charity

To the oppressed.
What did your watch cost?
Is it solid gold?
How many mouths could be filled If this were sold.
Your wrists are thick
But I can make
Bigger ones crack.
There. You may have it back. 

Tuesday, October 21, 2014

Considering a Sexual Encounter? - Bring Along the Required Documents

There has been much written about sexual harassment and rape accusations at colleges.  I thought it would be interesting to share portions of a 44-page document on sexual conduct and misconduct issued by California's Claremont College for its students (as reported in The Weekly Standard  Oct 20)

Effective consent consists of an affirmative, conscious decision by each participant to engage in mutually agreed upon (and the conditions of) sexual activity.  

The Essential Elements of Consent:
1.  Informed and Reciprocal
2.  Freely and Actively Given
3.  Mutually Understandable
4.  Not Indefinite
5.  Not Unlimited

All parties must demonstrate a clear and mutual understanding of the nature and scope of the act to which they are consenting, and a willingness to do the same thing, at the same time, in the same way.

Withdrawal of Consent can be expressed 'no' or can be based on an outward demonstration that conveys that an individual is hesitant, confused, uncertain, or is no longer a mutual participant."

Don't forget to bring signed documents and lawyers along on your next date!

Saturday, October 11, 2014

There Is Only One Holocaust - Stop Making Comparisons!

Godwin's law is an observation made by attorney and author Mike Godwin in 1989.  It states: "As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1." In other words, Godwin believes that given enough time, all online discussions end up being about Hitler and the Nazis.

In fact the Holocaust, to which these so-called comparisons relate, is, in fact, not subject to comparison.  It is "incomparable!"

Yes, there have been ethnic cleanings.  Yes, there have been mass killings.  Yes, there have been atrocities of significant magnitude throughout ancient and recent history.  Yes, there has been slavery.  Yes, there has been the forced movement of peoples from their traditional homes.  Yes, there have been outrageous examples of discrimination.  And even more.

But there has been only one Holocaust.  Unique.  Incomparable.  Defined by what it represented.

It is mass killings. It is ethnic cleansing.  It is slavery.  It is forced movement of peoples.  It is the utmost form of discrimination.  It is all of these and much more.  It is a cold, calculated, engineered affair.  It is extermination as a business, in part analogous to pest control, - efficient, cost-conscious, scientific, and yes open to competitive bidding.  It was unique in the evaluation and commercial uses of its byproducts.  Products of the ovens were converted to energy.  Corpses were provided to medical schools.  Gold from teeth was extracted and melted down.  Skin and hair was re-cycled.  People were used as human guinea pigs in medical research.  It is an atrocity of such magnitude that, without records or witnesses, it could be regarded as unbelievable propaganda (as it was by many political leaders of the time.)  It is an unequaled barbarity of major proportions - cold, logical, unemotional, efficient, effective and productive.

It is the industry of human extermination.

Time to render Godwin's Law obsolete.  Time for a new law.

The Holocaust is unique
No comparison to other atrocities applies