The Genetically Modified Food Controversy

Gene Transfer

[From Deardra MacDonald - Based on a presentation at the Philosophy Club in The Villages, FL, 25 March 2011. Powerpoint charts are available on video at the end of topic. The proprietor of this Blog does not necessarily agree with this material.]

My main reason for doing this topic at the Philosophy Club was to become familiar with the controversy surrounding the Giant Chemical Corporations, Small Farmers, Activists, and the Consumers. Three months ago I was like most Americans and had absolutely no idea that over the past couple of decades, giant Chemical Corporations has achieved a virtual monopoly on some of the most important seed markets in the United States and the world. So I started with the basic question, “What is a genetically modified seed?" The section that started my education was Wikipedia’s “Genetically Modified Food Controversies”. My research started by just reading this website and trying to absorb, or should I say struggling to understand genetically modified organism controversy! From that point my research took on over 100 website from Universities, Independent Research Centers, Lawsuits, Monsanto vs. Small Farmers, White House Involvement, on and on and on… to many to write in this article.

Consumer’s Fear That No Independent Research Done On Humans

An article by the Center for Research on Globalization Stated, “One of the great mysteries surrounding the spread of genetically modified plants around the world since the first commercial crops were released in the early 1990’s in the USA and Argentina has been the absence of independent scientific studies of possible long-term effects of a diet of GMO plants on humans or even rats. The real reason has now come to light. The genetically modified agribusiness companies like Monsanto, BASF, Pioneer, Syngenta and others prohibit independent research.

An editorial in the respected American scientific monthly magazine, Scientific American, August 2009 reveals the shocking and alarming reality behind the proliferation of genetically modified products throughout the food chain of the planet since 1994. There are no independent scientific studies published in any reputed scientific journal in the world for one simple reason. It is impossible to independently verify that GMO crops such as Monsanto Roundup Ready Soybeans or MON8110 GMO maize perform as the company claims, or that, as the company also claims, that they have no harmful side effects because the GMO companies forbid such tests! They are covered by the US constitution patent protection, allowing a monopoly of that invention for 20 years. The Internet is the places to go to find out about the research and risks.

The Revolving Door Policy George H. W. Bush, Bill Clinton, George W. Bush, Barack Obama

The support between Monsanto and White House is unprecedented in the history of corporations. Monsanto is an American company; its headquarters is located in Saint Louis, Missouri. “ A statement was made by our President in 1992 proclaimed that genetically modified seed is “substantially equivalent” to non-GMO seeds”. The genetically modified seed was approved in the United States beginning with our President George H.W. Bush in 1992, and supported by Bill Clinton, George W. Bush and Barack Obama. High Level Connections.

Small Farmer and Monsanto Contract

The contract has been call by activist and farmer An Ironclad Contract. It is a contract that profits Monsanto. This contract is fundamentally unfair to farmers. Ironclad Contract What needs to be understood is that it is also fundamentally unfair to society, we the consumers are the third unrepresented party to such because we end up consuming the products of this agreement.

People have said if working with Monsanto is so difficult, farmers should just plant conventional seeds. That sounds like an easy fix, but where are they going to get the seed? The Center for Research on Globalization explains why Monsanto keep farmers and everyone else from having any access at all to buying, collecting, and saving of NORMAL seeds. Monsanto has bought up the seed companies across the Midwest. They’ve written Monsanto Seed Laws and gotten legislators to put them through, that make collecting and storing of seeds so onerous in terms of fees and paperwork and testing and tracking every variety and being subject to fines, that having normal seed becomes almost impossible. Monsanto is pushing the law that remove community’ control over their own counties so farmers and citizens can’t block the planting of GMO crops even if they can contaminate other crops.

Small Farmer vs. Monsanto Lawsuits

Whenever you see the words Small Farmer and Monsanto in the same article, it is describing a lawsuit against small farmer by Monsanto. Monsanto is filing lawsuits around the world. See what Vandana Shiva from India says about small farmers. Vandana Shiva: The Future of Food-Part 1 Vandana Shiva Video.

Monsanto's efforts to prosecute farmers can be divided into three stages: investigations of farmers, out-of-court settlements, and litigation against farmers Monsanto believes are in breach of contract or engaged in patent infringement. Monsanto has set aside an annual budget of $10 million dollars and a staff of 75 devoted solely to investigating and prosecuting farmers.

Activist rally for labeling all genetically modified.

This is where the Activist and consumers have rallied together and have signed petitions to label all foods that have been genetically modified. Allergic reactions are a real concern of genetic engineering because it may transfer new proteins into foods, causing allergic reactions and many other symptoms in human. Since law does not regulate labeling genetically engineered food, those who have known allergies will have no way of identifying the contents of their food. The first Taco Bell crisis and the mixing of genetically altered corn not approved for human consumption into the nation's corn supply reveals how poorly government regulators have been doing their job. It was biotech opponents, not the FDA, who discovered that Taco Bell brand taco shells -- made by Kraft and sold in grocery stores -- was contaminated with animal seed Cry9C corn, marketed by the French biotechnology company Aventis under the name StarLink. The U.S. Environmental Protection Agency approved StarLink in 1998 for use in animal feed or non-food industrial purposes only.

Where does the American Medical Association Stand on Genetically Modified Food

When I talk about the giant Chemical Corporation and genetically modified food, the first response I get back from other people always centers on a similar comment. People say that doesn’t make sense? Why would the American Medical Association support a corporation that produces a product that could be potentially harmful to humans? Then I patiently… remind people of the support that both the doctors and American Medical Association sided completely with the Giant Tobacco Corporations. The Journal of the American Medical Association published it advertisements of the safety of smoking in the early 1930’s. In medical journals and in the popular media, one of the most infamous cigarette advertising slogans was associated with the Camel brand: "More doctor smoke Camels than any other cigarette." The campaign began in 1946 and ran for eight years in magazines and on the radio. They are still bills in the House and Senate today trying to pass stronger wording against tobacco. Tobacco Regulations

When I put in “American Medical Association and Monsanto” using Google search engine, the first 3 websites on American Medical Association and Monsanto are on Monsanto’s letterhead? After the first 3 website then came the flood of websites reporting negative information. I selected this video under the topic American Medical Association and Monsanto: Video.

Summary

It is up to each person to decide what side of the “Controversy” they support. It is mandatory that consumers have a good understanding of “both sides” of this controversy because over 60% of what you buy in the grocery store is genetically modified food and ends up on your dinner table. This new genetically modified organism in our food has not been tested on humans. It will take generations to determine which side of this controversy is right?

Deardra MacDonald

Press for full screen.

Nuke Tsunami Makes Clean Coal Look Better

I've just published this over at Watts Up With That?

The recent Japanese earthquake and tsunami, which shut down several reactors at the Fukushima Dai-ichi complex in northeastern Japan, followed by a failure of the backup cooling systems that resulted in hydrogen gas explosions and fires, has me re-evaluating my support for nuclear power.

Don’t get me wrong, I still favor nuclear power as part of what Sen. John McCain called an “all of the above” energy policy. We need all the energy we can get to power a vibrant, growing world economy. Our energy future should include nuclear along with clean coal, gas, oil, and renewables, as well as improved energy efficiency and usage. I welcomed the recent resurgence in interest in building more nuclear power plants in the US, a policy supported by both Presidents George W. Bush and Barack Obama. Obama re-iterated that support a day ago.

Read the rest HERE and please comment here or go over there to join what will soon be many dozens of commenters and hundreds of page viewers. (Click here to see all my Watts Up Topics).

Ira Glickstein

Golf and Philosophy: Lessons from the Links

[from Andy Wible]

I enjoyed giving a talk at the Villages’ Philosophy Club on February 25th on some of the issues raised in my new book Golf and Philosophy: Lessons from the Links. I have been a lifelong golfer and I currently teach philosophy at Muskegon Community College. So, I decided to bring my two lifelong passions together in the book. I don’t think any other sport affects fundamental philosophical issues in our lives like golf. Golf affects where we live, such as the Villages and often who we our friends are. Also, unlike most other sports, we can play it nearly all our lives. The Power point presentation that on the book I gave is available at: http://www.muskegoncc.edu/PDFFiles/C&P_Arts/Wible_Villages.pdf The narrative below is a sketch of the lecture that accompanied the slides.

I started the talk by explaining a common theme that runs through the book and philosophy in general. The theme is the importance of finding the essence of a concept. The essence is what makes something what it is. Let’s look at a simple example. There are many different tables in the world, but what makes them all tables? One might say it is a flat surface with four legs. But four legs do not seem to be necessary for being a table. So, “four legs” should not be part of our definition of table. A flat surface is not enough for being a table for we know the floor is a flat surface and is not a table. To get the full essence of a concept, we are looking for the necessary (required) conditions that are jointly sufficient (enough). A better answer might be that a table is an elevated flat surface (this is close to what the dictionary says). This definition is closer to the truth but still does not seem to be sufficient for some things like buildings fulfill this definition.

We can use this conceptual framework to look at the essence of golf. The Casey Marin court case was an examination of the essence of golf. The question was whether giving Martin a cart would change the nature or essence of the game. If it did, then the cart legally did not need to be given. Is walking a necessary condition of golf? Many argued it was. Of course, many people use carts and are still playing golf. So, on the surface it seems that he should be given the cart given his disability (the majority on the Supreme Court agreed). It is a tough issue though, because we might argue that walking is an essential part of “professional golf” where greater excellence is demanded.

A similar issue is whether golf is a sport. Some have argued that it is not because there is not as much of a physical requirement as sports such as football or basketball. A cart clearly would change the nature of those sports. Running though does not seem to be a necessary condition of playing a sport. A tennis player who walks to her shots is still playing tennis. So, what makes some games qualify as sports? In chapter 15, Holt and Holt suggest that a sport be defined as a competitive game of inclusively gross physical skill. Do you think that this definition provides the necessary and sufficient conditions of the concept “sport?” If they are on the right track, then we can safely say golf is a sport.

We next turned ways golf can teach us about big issues in life. The first way golf can help us to understand personal identity or who we are. What makes me who I am? Why am I the same person as five years ago even though I have changed? If I change and yet remain the same, then whatever changed in me is not who I am essentially. That quality that changed was not a necessary condition of who I am. For example, many people say that their jobs make them who they are. “I am Joe the Plumber.” It is true that many peoples’ identities are influenced by their work, but we are not essentially our work. If someone changes his job he is still that person. We are also not our body or our soul for we could change our body or soul and still be the same person.

Golf helps us to get a better understanding of who we are by noticing the importance of memories when playing. If we remember a bad short putt, then that memory causes our current self to shiver over the next short putt. The reason is that we largely are our memories. I am who I am because of the memories that I have. If you lose all your memories, then you are no longer the same person (we often say that Alzheimer’s patients are not the same person, but cancer patients are the same person.). This theory of personal identity is not perfect for I could have false memories of something that I never did. I might remember playing golf with my Grandfather at Doral, but there could be good evidence that I never did.

Nonetheless, it does seem closer to the truth. Philosophy does not always give us the right answer, but attempts to get us closer to the truth.

We next turned our discussion to the meaning of life (chapter 16 of the book). I asked whether living a happy life is sufficient to living a meaningful life. One problem with saying that happiness if sufficient for a meaningful life is that a happy immoral person could be said to have a meaningful life. I think most of us would think that he does not for a generally moral life is necessary to live a meaningful life. Golf can again help see this. Our most meaningful rounds are not the ones where we cheat and win the bet we make with opponents. Our most meaningful rounds tend to be the ones where we did the right thing and achieved moral and physical excellence. We also looked into friendships and how golf (done right) can help us to make meaningful friends (moral friends).

I concluded by looking at ethics and golf. Does golf make us more or less moral persons? Beller and Stole argue in chapter 5 that golf is the one sport that the more people play it, the better their moral reasoning skills become. Other sports seem to have the opposite effect. Why is this? Is it correct? I think it might be due to players calling their own rules and the history and civility demanded by the game. Lumpkin talks of an interesting result of this data in chapter 7 of the book. She says that golf is the one sport that the professionals are moral than the amateurs when they play. The pro basketball player would never say that he fouled another player, but an amateur commonly does. In golf, amateurs touch their golf balls all the time for a better lie, but pros never do.

I don’t mean to make golf sound perfect. We know the elitism, racism, and sexism that has plagues the sport. As one questioner nicely pointed also pointed out, “Couldn’t be we doing something better with our time and money? Are we isolating ourselves from more important issues?” We should work to make golf overcome these problems. Some attempts are out there. The First Tee program helps to diversify the sport and the PGA tour has given over a billion dollars to charity. Pushing ourselves and others in the sport to do better is essential to preserving and improving the game.

Thank you allowing me to talk about golf and philosophy. More in-depth analysis and topics are available in the book which is available at amazon.com, Barnes and Noble, or can ordered by your local bookstore. The Villages is directly mentioned in the book. Can you find it? Comments and questions about all these topics or the book are welcome!

First Amendment Rights and Responsibilities

[from Don Hess]

• I’ve hosted a group in The Villages called the World Affairs Forum for almost 4 years. Ira and I have had a few conversations and he’s given me the “keys” to contribute occasionally to the conversation here. Thanks Ira for the chance to present what will probably be provocative - and maybe controversial – views.
  

With regard to my views today, I’ve got to make the disclaimer that I’m no legal scholar or “expert” in any way; just a guy who is interested in being governed fairly and well and being a good citizen of this country and the world.

It seems to me that there are issues today that deserve our serious attention, and that many of them get ignored in the noise of what is euphemistically called “debate”. What I’d like to talk about is HOW we debate and whether that is productive of any real solutions or not.

It has been said that it is a “curse” to live in “interesting” times. The events of the past several months here and around the world lead pretty convincingly to the belief that those are certainly the kind of times we are living in. The curse is in trying to understand them.

In Tunisia and Egypt, in Yemen and Bahrain, in Jordan, Syria and Algeria there have been uprisings against dictators – both “benevolent” rulers and tyrants – in the region. The uprisings no doubt, currently have their origins in the terrible economic conditions of our times. But the historical causes have certainly been oppression and corruption. “Freedom” has been the cry of the protestors …the freedom of Democracy and self-rule.

So we are asking ourselves why this is happening now. Why not decades ago? Some of these tyrants have been in power for three (Mubarack), or four (Khaddafi) decades. In Iran, whose Green Revolution foreshadowed by months the revolutions of today, the Mullahs have been in power for over 30 years since the overthrow of the Shah in 1978. So why now?

I believe the answer is freedom of speech - not that “that” has been granted by the tyrants who maintained their tight control through a monopoly on communications - but that it has simply been taken by the protestors through the power of new technologies – satellite T.V. and cell-phones, the internet, and Facebook - that transcend the powers and borders of state control. And now the citizens of those countries, using the freedom of speech that they’ve ripped from the dictators, are dying in a fight to win the other freedoms of Democracy that we’ve enjoyed and taken for granted for a couple of hundred years since our Revolution.

John Kennedy, in his inaugural speech fifty years ago, declared that “the same revolutionary beliefs for which our forbears fought are still at issue around the globe – the belief that the rights of man come not from the generosity of the state, but from the hand of God.” And in the same speech he also declared that, “We dare not forget today that we are the heirs of that first revolution.” (and that we, as a nation, are) “…unwilling to witness or permit the slow undoing of those human rights to which this nation has always been committed, and to which we are committed today at home and around the world.”

So today, while others die to gain the liberties we have been assured in our Constitution's Bill of Rights, I would like to look at what is “at issue” in this country of ours with regard to what James Madison declared the “most important of rights” – the 1st Amendment right to Freedom of Speech.

The 1st Amendment reads: “Congress shall make no law respecting the establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people to peaceably assemble, and to petition their Government for a redress of grievances.”

Aside from religion, there are two issues here; freedom of speech (personal and press) and freedom of assembly - for the redress of grievances. In the current events of the past few months and weeks we have seen both several efforts to exercise these rights and some challenges to this exercise.

We have seen the exercise of that right in the face of world government secrecy by Julian Assange of Wikileaks. (Please go to "You Tube" and type in "60 Minutes" + "Assange" to see a 30 minute interview with Steve Croft and Julian Assange).

That exercise has been challenged in our country by our Defense Department, State Department and Department of Justice. There are those among our politicians who have called him a traitor and a terrorist and demanded his execution because his actions put in jeopardy those in our military, diplomatic and intelligence services. But the questions he has raised may have really helped bring about the revolutions for democracy in the Middle East by exposing cables between Arab rulers and our State and Defense Departments.

So the questions to be asked about the “issue” of freedom of speech concerning Wikileaks, I believe, are the following.

• Is government (or corporate) secrecy really covert censorship of the 1st Amendment right in this country?
• Does revelation of secrets (aside from redacting the names of combatants, CIA “operatives” or their foreign contacts) really pose a danger to our country? If so, why and who should make that decision - the government or the publisher of such secrets? And if so, would more transparency among governments as to their dealings with each other lessen such danger?
• Are our laws and the enforcement of them adequate to protect “whistleblowers” both outside and inside of government or do we need organizations like Wikileaks to protect them? Does that “whistleblower” have the right to make the determination of “abuse”? If not, who does?
• If the primary reason for “whistleblowers” supplying documents to Wikileaks is their firm belief that there is not enough internal transparency or external forces (co-opted media) to enforce disclosure, does the “whistleblower” have a duty to force that disclosure through supplying Wikileaks with secret data?
• Should a “publisher” such as Assange, be free of prosecution if he does not either seek or pay for particular information, but simply makes himself a conduit for those who offer it?

Meanwhile, here at home we have seen the exercise of the 1st Amendment right of assembly for “redress of grievances” against the government actions in Wisconsin, Ohio and Indiana. The same example of peaceful conduct has been observed in these protests as was set in the protests in Tunisia and Egypt. And yet there has been a consideration of attempts to provoke and thwart that good conduct revealed in a “prank” conversation between Wisconsin’s Governor Scott Walker and a Boston blogger. The reason Walker said he decided not to use “troublemakers” as Mubarack did in Egypt was a practical one - not a moral one - the “public” was getting irritated with what had already gone on. Then he shut the capitol to protestors.

Maybe it will seem that it’s a bit of a “stretch” to equate an attempt at union-busting to free speech. But perhaps you will recall that last year the Supreme Court, in a decision called Citizens United, decided that money was equivalent to free speech. I doubt that when the Bill of Rights was written there was a consideration of the enormous power of corporations. All politics and the spread of information about it - through newspapers - was local. Editors were fiercely independent, and there was little chance of corporate control of media.

Today huge corporations have huge budgets to influence elections, and the decision in Citizens United gave them even more opportunity through making it possible for them to fund “ads” against or for any candidate – out of their “general” revenues - through 3rd party organizations. Only a weak provision for “disclosure” of funding sources for these organizations prevents total secrecy about who is “pulling the strings” in any campaign and thwarts investigation into what reason for that is.

So, money is now the power behind the huge “megaphone” available to corporations and unions that wish to heavily influence the electoral process. But, if the unions can be “busted”, and the provision for dues “checkoff” taken from them and therefore their political contributions, then the playing field is heavily, and I believe unfairly tilted toward corporations whose funds come from profits and are paid for by the very consumers who buy their products and who may very well not agree with the corporate political purposes.

Do you suppose that could be a reason for the fight in Wisconsin? Do we suppose that using consumer money is any more “fair” than using “taxpayer” money (an allegation which has proven to be a false conflation with union dues)? Do we want to condone by silent witness the actions of a government of the sort Wisconsin has shown itself to be? Is the Golden Rule not the rule by which we, ourselves, would LIKE to be treated? If we allow others to be treated in an inferior or underhanded way, can we expect more for ourselves and OUR objectives?

The final thing I would like to talk about today is responsibility in return for privilege. Is a right always a “RIGHT” under ANY circumstances without ANY obligation to use it responsibly? Is “hate” speech a responsible use, or an ABUSE of the 1st Amendment right? Does this “right” require “us” to “give up” something (our personal prejudices and bad behavior) in order to get something (freedom to express ourselves fully, usefully and responsibly)?

Let me propose a simple example of what I mean. We are all familiar with the “right” to proceed with a green traffic light. But that “right” denies a person from proceeding who is coming from a different direction and is faced with a “red”. This is a rule that is agreed upon by everyone. It is easy to understand because its violation will produce physical consequences that will ruin somebody’s day.

But it seems to me, that with regard to the equally consequential right of free speech, because it is more esoteric, and the consequences are not so vivid and immediate, that we all now wish to shout “freedom” and ignore the obligation to act responsibly. Here are a few examples:

An assistant Attorney General for the state of Indiana – a high public official with an obligation for leadership in the public eye – recently “tweeted” that he favored the use of “live ammunition” in dealing with the protestors in Wisconsin. He followed this up by declaring in an interview that, “Hell yes, I’m for the use of deadly force.” Imagine THIS in the United States of America which has inveighed heavily very recently AGAINST the use of deadly force in Egypt and Libya. Needless to say, the man was fired. Someone at some level - probably Indiana Governor Mitch Daniels - had the good sense to exercise the responsibility that this official wouldn’t.

In another example of hate speech, at a rally by Paul Broun, a member of Congress in Georgia, an “elderly” man asked, “Who is going to shoot Obama”. Instead of taking a position of moral leadership and rebuking the man, the representative “allowed”, that, yes, “I know there’s a lot of frustration with this president. We’re going to have an election next year.” It took him three days to realize that what he had tacitly condoned for another by his refusal to rebuke, could help create a climate in which the same thing could happen to himself as happened to Gabriel Giffords in Tucson, and which he was condoning by his silence for Obama. At the end of three days his staff issued a disclaimer.

So, I would like to ask whether, by the actions described above in Wisconsin, Indiana and Georgia, we are creating a climate of irresponsibility in this country that will “witness” and “permit the slow undoing of those human rights” which we have been greatly privileged to enjoy and which were paid for by the blood of generations before us as they are being paid for in our time by the blood of those who are fighting for them today in the Middle East.

George Bernard Shaw, an Irish playwright, journalist, critic, and Nobel Laureate once wrote, “Democracy is a device that insures we shall be governed no better than we deserve”. I think we all, in this nation, will determine by our present behavior, by our attitudes and behavior toward our “rights”, and by our civility, or lack of it, toward each other, just what kind of government it is that we “deserve” and wish to preserve for future generations.

I hope that we will, in the future, treat our problems with the seriousness and responsibility they deserve and not just give lip service to their solution while each demanding we have our own way. I believe it will be only through courtesy, civility and cooperation that they can be solved. God help us if we don’t realize that and practice those qualities in our discourse and in our politics, and insist on them from our leaders.


Don Hess

Runaway Trolley - Applied to End of Life Issues

The Runaway Trolley thought experiment was introduced in a previous Topic, on this Blog.

The basic lesson was that there are situations where it is quite ethical to take an action that saves (or benefits) a number of people, even if that action has, as an inevitable side effect, the death (or detriment) of a smaller number of people.

This posting has to do with End of Life Issues, and how we might apply the lesson of the Runaway Trolley to the public-funded medical care system. An earlier posting related the Runaway Tolley to Criminal Recidivism

POWERPOINT SHOW AVAILABLE

Click HERE to download a narrated PowerPoint Show that includes animated charts for the Runaway Trolley thought experiment. After the Runaway Trolley is explored, the charts continue and apply the ethical lesson to two real-world issues: 1) Criminal Recidivism and 2) End of Life Issues. The PowerPoint Show is based on a talk I gave to The Philosophy Club at The Villages, FL, on 04 February 2011. NOTE: The Powerpoint Show is Narrated and plays and advances automatically after download to your computer.

PRESIDENT OBAMA'S VIEWS

President Obama, in a moment of unusual candor, expressed his views on end-of-life health care for those with chronic or terminal illness, published in the New York Times Magazine in April 2009. (full text from NY Times website, see section V). I have reproduced the text of that section at the end of this posting. [Some material here is from my earlier posting END-OF-LIFE: Honest Brokers (not Death Panels :^)]

DIRECT OBAMA QUOTES

“… government can … be an honest broker in assessing and evaluating treatment options. … when it comes to Medicare and Medicade, where the taxpayers are footing the bill …

“… using comparative-effectiveness studies as a way of reining in costs, …

“… the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here. …

“…there is going to have to be a conversation that is guided by doctors, scientists, ethicists. … you have to have some independent group that can give you guidance.”

PRESIDENT OBAMA'S GRANDMOTHER

As a case-in-point, the President brought up the hip replacement received by his terminally-ill grandmother mere weeks before she passed away. During his campaign, she was diagnosed with terminal cancer and then, probably due to a mild stroke, she fell and broke her hip. Her condition was analyzed by her doctors who told her she had three to nine months to live due to the cancer. They also told her that a weak heart posed risks for the invasive surgery hip replacement.

In the absence of cost-effectiveness data or guidelines to the contrary, she chose the hip replacement, which was approved by Medicare and done mostly at public expense. She passed away two weeks later, sadly just days before Obama won. It appears the stress of the operation may have shortened her life by several months.

I don't know if Obama's grandmother got approval for the hip replacement because she was related to a prominent person. That would be bad enough, but it would be even worse if we are giving hip replacements and other stressful and expensive treatments to all terminally ill grandmothers and grandfathers.


QUOTING THE PRESIDENT AGAIN


"... in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. ... So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here."

QUALITY ADUSTED LIFE YEARS

A concept called "Quality Adjusted Life Years" (QALY) is in use in the UK and, IMHO, should be adapted for use in the US. The basic idea is to estimate, before approving very expensive, public-funded medical procedures, the probability the procedure will be successful, and, if successful, the number of years the recipient is likely to live and the subjective quality of those years.

Subjective quality is a difficult measure. Fortunately for us, based on experience and practice in the UK and elsewhere, there are fairly well-established guidelines. For example, mobility is an issue in quality of life. If a person is able to walk without assistance that is better than being wheelchair-bound, and a wheel chair is better than being bedridden. Being alert and awake and mentally competent is better than lack of those qualities. Being able to take food by mouth is better than IV, etc.

In the UK, if each QALY is estimated to cost less than about $40,000, and if the recipient wants the medical procedure, it is approved for public funding. On the other hand, if the cost is more than $40,000 per QALY, or if the recipient does not want the procedure, only palliative care, consisting of pain management along with love and attention, is provided, even if this level of care will reduce the likely life span of the patient.

The QALY concept may also be utilized to compare alternative treatment options. For example, if medical treatment procedure A will cost substantially more per QALY than medical treatment procedure B, only B will be approved, even if both are under the $40,000 limit.

Examples:

1) Alice is a candidate for treatment A that is estimated to cost $150K for the treatment and care, has a probability of success of 80%, and, if successful, will provide a subjective quality of life of 60%. Based on her age and medical condition, if the procedure is successful, Alice has a life expectancy of 10 years. The calculation gives her QALY = 5 years, so each QALY will cost about $31,000, which is below the limit of $40,000. The Treatment A is therefore approved for public funding if Alice is willing to accept it.

2) Bob is a candidate for treatment B that is estimated to cost $90K for the treatment and care, has a probability of success of 50%, and, if successful, will provide a subjective quality of life of 40%. Based on his age and medical condition, if the procedure is successful, Bob has a life expectancy of 5 years. The calculation gives him QALY = 1 year, so each QALY will cost about $90,000, which is above the limit of $40,000. The Treatment A is therefore NOT approved for public funding and Bob is entitled to palliative care only.

3) Carl is a candidate for treatment C that is estimated to cost $50K, or treatment D that is estimated to cost $100K.

Treatment C has a probability of success of 90%, and, if successful, will provide a subjective quality of life of 60%. Based on his age and medical condition, if the procedure is successful, Carl has a life expectancy of 5 years. The calculation gives him QALY = 3 years, so each QALY will cost about $19,000, which is below the limit of $40,000.

Treatment D has a probability of success of 80%, and, if successful, will provide a subjective quality of life of 70%. Based on his age and medical condition, if the procedure is successful, Carl has a life expectancy of 5 years. The calculation gives him QALY = 3 years, so each QALY will cost about $36,000, which is below the limit of $40,000.

Both treatment C and D are below the limit of $40,000 per QALY, but C is substantially less expensive and, therefore, only treatment C is approved for public funding if Carl is willing to accept it.

A STORY MY FATHER TOLD ME

Once upon a time, there was a boy in China and he saw his father carrying a large basket on his shoulders. "What do you have in the basket?" he asked.

"Well," said the father, "It is your grandfather."

"What are you doing with grandpa?" asked the boy.

"Well," he replied sadly, "Your grandfather is quite old and he is so sick that we cannot take care of him anymore, so I am going to dump him in the river."

The boy thought about it awhile, and then he said: "OK, Dad, ... But remember to bring back the basket!"

Of course the point of the story is that the boy will learn from his father's actions and will, when the time comes, uses that same basket to dispatch his father.

When my mom's cancer roared up after a year of chemo and radiation, she decided to accept only palliative care. Our family travelled to San Francisco where they lived and said goodby. Hospice provided morphene and a hospital bed for their apartment. We spoke by phone every evening for about a month until she passed away.

My dad made it clear that was what he wanted when the time came.

About five years later he had a stroke and fell and was taken to the hospital where an MRI confirmed a major bleeding in his brain that was terminal. He could not speak or hear or see and was being kept alive with IV hydration and nutrition and oxygen to help his breathing. My brother and I asked the doctors to remove all artificial life support, including the IV and oxygen, and he passed away a few days later.

I have asked my children to do the same for me when the time comes. "Remember to bring back the basket!"

ACT! OR FATE?

If we Accept FATE?

• Do next to nothing to change US health care.


• Health care not fair.


• Given medical advances, End of Life costs escalate out of control.


• Neo-natal care and preventative care are under-funded.


• USA goes bankrupt (like Greece, hedonistic socialism).

If we ACT!

• Enact QALY End of Life guidelines.


• Health care is more fair.


• Given medical advances, End of Life costs are controlled.


• Neo-natal and preventative care are well-funded.


• USA avoids bankruptcy.


• Death with dignity and loving care.

CONCLUSIONS

Although I did not vote for him, and oppose much of his economic policy, I agree with President Obama's remarks on end-of-life treatment.

I wish he and his Democratic allies would be similarly honest and I wish the Republicans who are characterizing the issue as "pulling the plug on granny" would be more thoughtful and helpful and honest as well.

I do not like to hear people call these "honest broker" government medical and ethical tribunals "death panels". However, the 'honest broker" guidelines, when imposed on Medicare and other public-funded medical decisions, will, in effect, cause many of the terminally and chronically ill to be given palliative treatments that will undoubtedly shorten their lives.

Whatever you call them, I believe we need ethical end-of-life guidelines to prevent doctors and hospitals from ordering expensive treatments that are not cost-effective (and that may be done more for reasons of fear of malpractice suits and/or simple greed to increase their incomes).

I am not if favor of further nationalization of US health care. However, with Medicare the primary payer for nearly all of us over 65, we need national guidelines to prevent the program from going bankrupt. (See this and this for more details on my views of what we really need in cost-effective health care reform.)

Let us take the ethical lessons of the Runaway Trolley to heart and ACT! rather than accept the hand of FATE?

Ira Glickstein

PS: For the record, and in case the NY Times takes the page linked above out of their free access, here is the full text of the applicable section of the document from which I quoted Pressident Obama's words.

V. Post-Reform Health care
You have suggested that health care is now the No. 1 legislative priority. It seems to me this is only a small generalization — to say that the way the medical system works now is, people go to the doctor; the doctor tells them what treatments they need; they get those treatments, regardless of cost or, frankly, regardless of whether they’re effective. I wonder if you could talk to people about how going to the doctor will be different in the future; how they will experience medical care differently on the other side of health care reform.
THE PRESIDENT: First of all, I do think consumers have gotten more active in their own treatments in a way that’s very useful. And I think that should continue to be encouraged, to the extent that we can provide consumers with more information about their own well-being — that, I think, can be helpful.
I have always said, though, that we should not overstate the degree to which consumers rather than doctors are going to be driving treatment, because, I just speak from my own experience, I’m a pretty-well-educated layperson when it comes to medical care; I know how to ask good questions of my doctor. But ultimately, he’s the guy with the medical degree. So, if he tells me, You know what, you’ve got such-and-such and you need to take such-and-such, I don’t go around arguing with him or go online to see if I can find a better opinion than his.
And so, in that sense, there’s always going to be an asymmetry of information between patient and provider. And part of what I think government can do effectively is to be an honest broker in assessing and evaluating treatment options. And certainly that’s true when it comes to Medicare and Medicaid, where the taxpayers are footing the bill and we have an obligation to get those costs under control.
And right now we’re footing the bill for a lot of things that don’t make people healthier.
THE PRESIDENT: That don’t make people healthier. So when Peter Orszag and I talk about the importance of using comparative-effectiveness studies (see note below) as a way of reining in costs, that’s not an attempt to micromanage the doctor-patient relationship. It is an attempt to say to patients, you know what, we’ve looked at some objective studies out here, people who know about this stuff, concluding that the blue pill, which costs half as much as the red pill, is just as effective, and you might want to go ahead and get the blue one. And if a provider is pushing the red one on you, then you should at least ask some important questions.
Won’t that be hard, because of the trust that people put in their doctors, just as you said? Won’t people say, Wait a second, my doctor is telling me to take the red pill, and the government is saving money by saying take the blue —
THE PRESIDENT: Let me put it this way: I actually think that most doctors want to do right by their patients. And if they’ve got good information, I think they will act on that good information.
Now, there are distortions in the system, everything from the drug salesmen and junkets to how reimbursements occur. Some of those things government has control over; some of those things are just more embedded in our medical culture. But the doctors I know — both ones who treat me as well as friends of mine — I think take their job very seriously and are thinking in terms of what’s best for the patient. They operate within particular incentive structures, like anybody else, and particular habits, like anybody else.
And so if it turns out that doctors in Florida are spending 25 percent more on treating their patients as doctors in Minnesota, and the doctors in Minnesota are getting outcomes that are just as good — then us going down to Florida and pointing out that this is how folks in Minnesota are doing it and they seem to be getting pretty good outcomes, and are there particular reasons why you’re doing what you’re doing? — I think that conversation will ultimately yield some significant savings and some significant benefits.
Now, I actually think that the tougher issue around medical care — it’s a related one — is what you do around things like end-of-life care —
Yes, where it’s $20,000 for an extra week of life.
THE PRESIDENT: Exactly. And I just recently went through this. I mean, I’ve told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.
So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.
And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.
I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.
And it’s going to be hard for people who don’t have the option of paying for it.
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
So how do you — how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

Note: Comparative-effective studies — which are now done by academic researchers, but not systematically across the medical system — review data to determine which widely used treatments do not improve outcomes and which effective treatments are not used often enough.

Runaway Trolley - Applied to Criminal Recidivism

The Runaway Trolley thought experiment was introduced in a previous Topic on this Blog.

The basic lesson was that there are situations where it is quite ethical to take an action that saves (or benefits) a number of people, even if that action has, as an inevitable side effect, the death (or detriment) of a smaller number of people.

This posting has to do with Criminal Recidivism, and how we might apply the lesson of the Runaway Trolley to the justice system.

POWERPOINT SHOW AVAILABLE

Click HERE to download a narrated PowerPoint Show that includes animated charts for the Runaway Trolley thought experiment. After the Runaway Trolley is explored, the charts continue and apply the ethical lesson to two real-world issues: 1) Criminal Recidivism and 2) End of Life Issues. This posting covers Criminal Recidivism only. A subsequent posting will cover End of Life Issues. The PowerPoint Show is based on a talk I gave to The Philosophy Club at The Villages, FL, on 04 February 2011. NOTE: The Powerpoint Show is Narrated and plays and advances automatically after download to your computer.

WAS MAIMONIDES RIGHT ABOUT CRIMINAL JUSTICE?

Moses Maimonides, the 11th Century Rabbi and medical doctor shown in the sketch above, is one of the most highly regarded ethical teachers in Jewish tradition. He famously wrote that it was better to let 1000 guilty go free rather than wrongly convict a single innocent. Do you agree with that ideal? Is an error rate of 1/1000 the correct standard for a criminal justice system?

Juries in criminal cases are charged with the responsibility to convict only if the evidence meets the standard of being beyond a reasonable doubt. The 1/1000 standard corresponds to a certainty of 99.9%. Is that a good working definition for beyond a reasonable doubt? Is that number too high? For example, in civil cases, the standard is the preponderance of the evidence, which means, if one side proves its case to a certainty of 51%, the other side loses. Is 51% a good working definition for beyond a reasonable doubt?

Well, Benjamin Franklin, US Founding Father, said the number of guilty released to save one innocent from being wrongly convicted was 100, which corresponds to 99%. William Blackstone, the 18th century jurist who codified British Common Law, said the correct value was 10, corresponding to 90% certainty. Benjamin Cardozo, 19th century US Supreme Court Justice, said the number was 5, corresponding to 80% certainty. And, Voltaire, the 18th century French philosopher, said the number was 1, corresponding to 50% certainty.

How in the world can so many respected men have such different standards for criminal justice? How may we use the Runaway Trolley to arrive at a reasonable number?

CRIMINAL RECIDIVISM RATES

The graphic lists criminal recidivism rates for a number of crimes. Notice that nearly all violent crimes, including assault, murder, robbery, and sex crimes have recidivism rates above 50%. That means that, when a person has been convicted of a violent crime and has served his sentence and is released, there is a greater than 50% likelihood that he will commit another violent crime, be caught, and convicted again.

FUTURE VICTIMS CONDEMNED BY FAILURE OF JUSTICE

Criminal Recidivism rates for violent crimes teach us that, every time we release two convicts, we are, in essence, condemning at least one innocent to become the victim of a future crime. The number of innocents condemned is probably considerably larger than one because: 1) Many violent crimes have more than one victim, and 2) The released convict is likely to commit more than one violent crime before being caught and convicted again.

Extending this lesson to criminal trials, if, after weighing the evidence of a violent crime we the jury believe there is a greater than 50% likelihood the defendant is guilty, we should vote him guilty!

If there is only a 51% chance he is actually guilty, and we release him on a technicality or because we feel sympathy for him, and it turns out he was actually guilty, we are denying justice not only to his victims in the current case, but there is a high likelihood we are also condemning future victims to violence.

If we convict him on 51% certainty, and he turns out to have actually been innocent, we are doing a serious injustice to an innocent man. But, what is the likelihood he is totally innocent? Unless corrupt police have purposely framed him (in which case they would most likely have manufactured overwhelming evidence, which is not the case here), we are probably dealing with a person who has an extensive rap sheet and other indicators he has not lead a respectable life. He may not be guilty of this particular crime, but his incarceration will not be much of a loss to society - certainly not as much as the death or serious injury for one or more totally innocent victims if we make a mistake and release someone who is actually guilty.

The justice system is so dominated by lawyers and legal technicalities that rich people with clever lawyers can literally get away with murder, as many of us think happened to OJ Simpson.

RECOMMENDATIONS

1) Reform the Court System. Change the rules of evidence. Make it harder to get off on a technicality or with a clever lawyer.

2) Change the way we handle people convicted of violent crimes. DO NOT release them after their sentence is served. Keep them in some type of work camp.

3) Perhaps modern technology provides a humane and affordable solution for dealing with released convicts and others with extensive rap sheets. Stick a chip up their butt so they may be tracked for the rest of their lives. If there is certainty they will be caught and convicted if they commit any kind of infraction, they may learn to stay on the straight and narrow.

My free online novel, 2052 - The Hawking Plan, envisages a society, several decades from now, when everybody "voluntarily" carries an RFID device that effectively tracks their every move and activity.

Does that sound too drastic? Well how about your total lack of privacy right now? Those of us with homes and computers and cell phones and cars and jobs are effectively tracked by various computers and video cameras as we go on with our lives. We leave video and computer records dozens of times every day. The only people who have any privacy anymore are the drifters and criminal class, one of whom is likely to steal your car or credit card!

NOTE: Subsequent postings in this series will extend this lesson to the real-world situation of End of Life Issues.

Ira Glickstein

Picking Howard Pattee's Brain (He says he enjoys it)

A person who calls him-or-her-self "Nikman" showed up with a Comment at A Previous Topic on this Blog, and had some great things to say about our regular participant, Prof. Howard Pattee.

I think this deserves a new Topic. Here is what we have so far:

nikman said... I stumbled across this blog for the first time a few minutes ago and discovered that Howard Pattee is posting.

I don't know what more to say right now. Except that there should be a system in place enabling us to pick his brain regularly on a vast array of topics relating to the philosophy of science. If he doesn't want that he should have posted using a pseudonym. You reap what you sow, dude. [Nickman] February 6, 2011 9:23 PM

Ira Glickstein said... Thanks Nickman for your positive comments on a regular here, Prof. Howard Pattee. Howard was Chairman of my PhD committee at Binghamton University. I consider it a real privilege to have him as a continuing positive influence in my life.

Please let us know how you know Howard. We can always use intelligent and courteous Comments here, so please join us.

Ira Glickstein February 6, 2011 11:29 PM

nikman said... IIRC [If I Remember Correctly] it began with "Artificial Life Needs a Real Epistemology" which was almost literally a breath of fresh air. At last, something besides all those stultifying functionalists.

The best thing up till then had been another HP, Hilary Putnam, who's still not chopped liver. More recently, of course, the computational complexity folks (Scott Aaronson et al.) have weighed in to the advantage of sanity. Anyway, I particularly love this:

"The problem also poses an apparent paradox: All signs, symbols, and codes, all languages including formal mathematics are embodied as material physical structures and therefore must obey all the inexorable laws of physics. At the same time, the symbol vehicles like the bases in DNA, voltages representing bits in a computer, the text on this page, and the neuron firings in the brain do not appear to be limited by, or clearly related to, the very laws they must obey. Even the mathematical symbols that express these inexorable physical laws seem to be entirely free of these same laws."
You asked. [Nickman] February 7, 2011 11:15 AM

Howard Pattee said... nikman,
Thanks for the complement. If time permits, I enjoy having my brain picked. That 1995 quote is indeed what I had thought about for many years. From childhood we are taught that every event has a cause, and that every event is the result of natural laws. In fact, the evidence for both beliefs is weak or mythical.

The evidence is that we (living systems) choose what we perceive as an event and we favor events that can be described as causal and that that can be predicted by laws. We survive by that choice because it is ultimately the result of natural selection. The evidence is that most of the structures in the universe including organism are undetermined by laws and are mostly selected frozen accidents.

We have also been saddled with Aristotle’s logic of causality that can prove the existence of God as the First and Final Cause or the uncaused cause. His logic also implies determinism.

In contrast, modern quantum cosmology sees causality and determinism as just the illusion of good statistics of primordial uncaused spontaneous creations and symmetry breaking. Of course we could still say that God is a (gratuitous) uncaused cause; but how do we know S/He is not just playing dice?

Howard February 8, 2011 9:20 PM

[Emphasis and notes added by Ira] Please continue this Topic with Comments here.

Ira Glickstein