History Does Not Repeat Itself

History does not repeat itself. We can learn from historical events, but we cannot use them to predict future occurrences. And that is because yesterday is never the same as today and today is never the same as tomorrow. Things change. Facts affecting events change. Players participating in events change. Situations affecting events are ever changing. Change fuels the world and does not permit the retrospective analysis of history to be the sole decider in decision making. Such an analysis can serve only as a background for decisions affecting today.

Has history helped us avoid conflict? Is the world a better place because of the lessons of history? I think we would all agree that the answers to both questions are a resounding "no!"

History seems to cycle rather consistently. That is the one, if only, true historical fact. Wars, man-made disasters, non man-made disasters, financial crises, crises of thoughts and ideas - ever constant, but never the same.

Programs instituted to stem the depression of the '30s cannot be the answer to our present financial debacle. Early 20th century is not early 21st century: trading in the stock market is different, corporate management is different, the value of currency is different, the population is different, the people in control are different. The world is different.

Ahmadinejdad's antisemitism is not Hitler's antisemitism: the situation is different, the world is different, weapons are different, spread of information is different, the organization of countries is different, the population is different, the people in control are different.

Slogans echoing a reference to a past occurrence, such a "Don't forget Munich!" (vis-a-vis the Iran issue) should serve only to remind us of the event, but never to intend for us to respond to today's issue as we feel we should have to yesterday's. Remember history. Learn from history. But do not become a prisoner of history! The world of today "resembles" but does not "mirror" the world of the past.

Should We Control Aging?

A recent New York Times article described a scientific battle being waged between researchers studying the aging process and how to control it. Why is science dedicated to the lengthening of life by prolonging it "artificially" instead of concentrating its efforts on allowing life to reach its limit "naturally" by controlling the conditions (diseases, disasters, etc.) that tend to end it prematurely. Why do we bother with uncovering the aging process?

Stemming the aging process would give one the opportunity to live forever, and to live forever without the effects of biological aging! One could have the appearance and the energy of a 30-year old (pick your age) "forever!" Would you opt for this - or opt out of this?

Every living thing undergoes an aging process. There are evolutionary and cultural memes that support this reality. Aging isn't always pretty; as a matter of act it's often quite ugly. It can be emotionally ugly and physically ugly. It is often, if not generally, unwelcome.

We should clearly attempt to make the process less difficult to accept. But should we really be in the business of trying to stop it altogether? I don't know - maybe we should. Perhaps a world where biological aging no longer occurs would be an improvement. Using the evolutionary principle, I guess it would have to be considered an inevitability in the unceasing process of biological alteration. There is no stopping science in its constant drive to answer the never-ending questions about our natural world.

As for me, I'd opt not to tamper with our current march towards the senior years. Aging seems not only purposeful - but has its poetry. However, in its teleologic eternal efforts to understand, science has no bounds and should have none. It may trample on poetry in the process -- but new poetry always follows.

The Troy Davis Case - What's Right and What's Wrong

Troy Davis was executed by the State of Georgia on September 21, 2011. Davis was indicted for murdering a police officer in 1989 and convicted of this crime in 1991. He was sentenced to be executed ten years ago. Between sentencing and execution his attorneys had numerous appeals and reviews by various jurisdictions including the Georgia Supreme Court, The United States District Court, The United States 11th Circuit Court of Appeals and the United States Supreme Court, and a at least two special review panels. I counted 11 reviews during the past 10 years.

There had been multiple appeals for new trials and for more evidentiary hearings from notables that include Pope Benedict, former president Jimmy Carter, former FBI director William Sessions, and even Al Sharpton.

First of all, no judge and no court decisions should be influenced by external pressure, whether it comes from Al Sharpton or even Pope Benedict. If the purpose of the demonstrations was for new trials or new hearings, these appeals were in keeping with what actually occurred. There were multiple new judiciary and evidentiary hearings - none of which apparently led to an overturning of the original conviction and sentencing.

None of the notables were present in the courtroom. None of the notables were present for evidentiary argument during the many appeals. I wasn't there, and I would contend that none of the readers of this entry were there.

I am not arguing for the death penalty. I am very opposed to the death penalty. But I firmly support our judicial process, which I believe to be as fair and unprejudiced as possible. Davis's case was considered by many courts on a myriad of occasions. And unless we suspect some form of judicial conspiracy among the various levels of review, it is reasonable and right to conform with their decisions.

Were this not a death penalty case, I wonder if anyone would even have heard of it. Unfortunately Georgia (one of 34 states) supports the death penalty - a form of punishment that has been judged to not be "cruel and unusual."

Yes the death penalty is harsh and, to my way of thinking, wrong. Demonstrations against it are in order - as a matter of fact there should be more of them! But to demonstrate and chastise those committed to the law and its interpretation is unreasonable.

We should not be questioning guilt or innocence here. That is not our place. We were not present in the courtrooms. We should, however, be taking a stand against execution even when the evidence for murder is overwhelming; and even for the most callous of murderers.

On the same day that Davis was executed, Lawrence Russell Brewer was executed in Texas. Brewer was convicted of chaining a man to the back of a pickup truck in 1998 and pulling him along a bumpy road to his death. Protestations and demonstrations against his execution were either non-existent or not publicized. Why?

Israel-Palestine. A Public-Relations War

Last night I attended a presentation by a member of AIPAC (American-Israel Political Action Committee) dealing with the Palestinian statehood issue which will shortly be coming up for discussion at the United Nations. Most of you are aware of this matter. It is the latest approach that the Palestinian "government" is taking to strengthen its position vis-a-vis Israel - a position, which the speaker maintained, has no chance of passing because of an assured United States veto as a last resort. There is, however, the strong possibility that the status of Palestine will be upgraded to what is termed "state without membership" - similar to the Vatican, or Switzerland prior to its joining the United Nations.

The speaker went to to discuss other options relating to a Palestine-Israel accord, seeming quite confident that a negotiated settlement will eventually be reached, because, in fact, there is no alternative solution.

I wonder.

At present Israel is losing a public relations battle. Palestinians are gaining ground, gaining sympathy, gaining allies - to the point where an application to the United Nations is actually going to occur! They are winning the war of words, photos, videos, and headlines. They are an "occupied" people who have been "ejected" from their homeland and are existing in "refugee" status in other countries. If it were a decision left to the General Assembly of the UN, Palestine would be granted official statehood and membership. According to the AIPAC speaker, the vast majority of UN members would vote it so.

The Israel-Palestine problem reminds me a little of psychotherapy. After some 60 years, no real change.

Israel has offered many negotiation-points - but to no avail! Has the time come to believe that this just won't work? If I were winning a war of public relations and sitting in the so-called "catbird's seat," why should I negotiate? If the world is moving in my direction, why change tactics? Time? I have all the time in the world? No reason to hurry. It can only get better for me and worse for the other side. And I have a whole group of potential "fifth columnists" ready to jump in and help.

I find it difficult to share AIPAC's optimism regarding a future negotiated settlement given the present circumstances. Somehow Israel must find a way to gain an advantage in this public-relations war. It has to somehow rid itself of its "oppressor" image - an image which, unfortunately, has come to represent the face of Israel to much of the world.

Israel is not an oppressor!

Israel is not an occupier!

Israel is not a slaughterer of civilians

Israel is merely trying to exercise its right to exist. It has been physically attacked numerous times over its period of existence and all Israel has done is to respond - to protect its citizens and its geographical integrity. In being forced to do so Israel has, somehow, taken on the face of oppression. This image must be changed.

Shopping for Medical Care

A recent article in the highly-regarded New England Journal of Medicine began with the following sentences: "Most physicians want to deliver 'appropriate' care. Most want to practice 'ethically.'" (N Eng J Med, Aug 18, 2011)

Isn't it interesting how the author divides the medical profession into two groups: Group 1 - those who practice appropriately and ethically and Group 2 - those who apparently do not. The author does not give us any indication as to where the dividing line lies. Is the Group 1/Group 2 ratio around 90/10, or is it closer to 60/40? I hopefully and candidly believe he is alluding to the first ratio rather than the latter.

Today physicians are frequently referred to has "health-care providers" and their patients as "consumers." Merely the use of these terms has, rightly or wrongly, helped move this encounter from "doctor-patient" to "product-shopper." When one "shops" one considers a number of possibilities before purchasing. Hence the "second opinion" and sometimes even "the third (or more) opinion."

Not that there is anything wrong with that!

As some products are better than others, so are some doctors better than others. In calculating the cost of medical care, I have seen no data that speak to the cost of such "shopping." When such costs are discussed, it is assumed that one family practitioner or specialist is no different from another. We physicians know, in fact, that this is far from factual, and so do our patients. And so the "consumer (patient) shops."

But in doing so, our consumer-patient must recognize that this, too, will necessarily add to the general expense of medical care - whether it is governmentally or privately provided. Controlling health care costs is very difficult for a society that will shop for the best and the brightest who deliver appropriate care in an ethical manner!

"Ethical Boundaries" in Multiple Pregnancies

A recent article in the New York Times Magazine discussed the issue of reductions in cases of multiple pregnancies (twins, triplets, etc.) This has become an issue because of the high incidence of such pregnancies when in vitro fertilization is performed - a process necessitating the implantation of multiple eggs into the uterus of the recipient. Physicians seem to have no difficulty in agreeing to reduce a resultant quadruplet or triplet pregnancy to a twin pregnancy, but ethical issues have arisen when the mother expresses the desire to reduce twins to a "singleton." In the past twin pregnancies carried an increased risk to a normal outcome, but this is no longer the case.

Many physicians perfectly willing to perform a routine choice abortion are not amenable to reduce below twins in cases of in vitro pregnancies. One obstetrician was quoted as saying that reduction to singletons "crosses the line between doing a procedure for a medical indication versus one for a social indication." Apparently a standard singleton abortion for a "social indication" is somehow different. Another, after consultation with his staff, similarly decided against such reductions because of the lack of medical justification. One could conclude that such lack of justification is immaterial when considering a routine choice abortion

Isn't it interesting, in our world of "choice," that how a fetus is regarded is dependent on the conditions of his existence. A physician who would readily abort a product of a normal conception, is not willing to abort the product of an in vitro conception because, as one obstetrician put it: "We were in the business to improve pregnancy outcomes" and reductions of twin in-vitro pregnancies "didn't fit the criteria."

Somehow an abortion intended to reduce a twin to a singleton in an in vitro pregnancy is said to bring on a new "ethical boundary." Is there really an ethical boundary between a woman choosing to abort a single normal pregnancy and a woman choosing to abort one of a normal twin pregnancy conceived in vitro?

It is altogether possible that with future medical advances, triplets, or perhaps even quadruplets could have an outcome no different from that of a singleton or a twin. What then?

When the medical indications disappear, will the physicians quoted above refuse to reduce four to two or three to two if it be solely for "social reasons?"

It seems to me that the choice to abort either belongs to the woman, or it does not. It is black or white - there can be no gray. A woman choosing to abort or reduce a twin pregnancy, or a triplet pregnancy should be regarded no differently from one choosing a routine abortion of a single pregnancy, no matter the manner of conception. The existence of a product of conception is being terminated in both cases. Why should it make any difference whether it be one, or two, or three, or four, or what the style of conception was?

The so-called ethical boundary can not be conditional on the "style" of conception or on the number of fetuses contained in the uterus. The ethical boundary, if it exists at all, must continue to lie between "pro-choice" and "pro-life."

The "Nanny State", Taxes, and "Bad Behavior"

In a recent New York Times article, food columnist Mark Bittman advocated a tax on " bad food." He argues that such a tax would result in "billions of dollars annually" which he feels should be used to support the consumption of "healthy food." He also advocates that the taxes take the form of an excise tax, not a sales tax, in that the former are included in the price, whereas the latter are added at the check-out counter. There is little doubt that such tax manipulation would have some of Bittman's desired effects, but of course the burden would primarily be borne by low-income families and individuals - those who must carefully watch their dollars - whereas the rest of us would hardly bat an eye at the Bittman-estimated extra $1.44 per six-pack of Pepsi.

This raises two interesting issues - the rise of the "nanny state" and the taxing of "bad" behavior or "bad" habits, or "bad" foods as a means of generating government revenue.

The "nanny state" dictates behavior. Usually, via some form of tax, it strongly discourages certain behavior which is considered generally harmful to a person's health and welfare, thereby having a major negative economic impact on society. In its race to do so, however, it treads on individual rights that are not directly detrimental to others.

One could argue that the government, as the major underwriter of health care and general welfare, has not only the right, but the fiscal responsibility to impose "good behavior," "good nutrition," etc. on its citizens for the benefit of the country's interests and security. By virtue of its capacity as the principal provider of health care, the government acquires the right to impose regulations on how a citizen's health care should be managed. Should this be the case, the government ("nanny state") could influence not only our nutritional behavior, but the scheduling of mammograms, colonoscopies, genetic evaluations, etc. and other preventive initiatives.

Governments always need money. Our representatives are constantly searching for new revenue sources. So why not tax "bad behavior," "bad food," etc. as a means of raising dollars? This is a tax plan which is targeted to eliminate itself. If one actually terminates the taxable "bad behavior," etc. then the tax dollars would disappear! If these dollars are dedicated solely to eliminating the taxable "bad behavior," and this behavior is, in fact, eradicated, then we have a beneficial outcome. On the other hand, government may become dependent on these " behavior" taxes as a source of general income - income that was originally intended for a dedicated purpose, but in time of fiscal need, may be "borrowed" to meet pressing obligations.

Should taxes be punitive and be levied as a means of raising income? If certain behavior is deemed "bad for the nation" then shouldn't it be eliminated rather than taxed, and participation in such behavior be a misdemeanor or a felony? Bad food shouldn't be taxed - it should be removed. Cigarettes shouldn't be taxed - they should be illegal.

Where should a society draw the line between individual rights that have no direct effect on others, and societal rights imposed on all members for the general welfare.