“Nova Scotia’s Rosa Parks” gets apology

This is a neat story.

Nova Scotia has apologized and granted a pardon to Viola Desmond, a black woman who was convicted for sitting in a whites-only section of a movie theatre in 1946. Premier Darrell Dexter apologized to Desmond’s family and to all black Nova Scotians for the institutional racism of the past.

I have to confess I’d never heard of Viola Desmond before this story. It’s an important part of my heritage, both as a black man and as a Canadian. I think sometimes we forget that racism was alive and well in Canada, and continues to this day. Obviously, the maritime provinces have been reminded of that fact recently. This apology is more than simply acknowledging the culpability of the government and people of Nova Scotia (although that’s an important and positive step); it is also bringing an important story to the surface. It serves to remind us that segregation and officially-sponsored racism isn’t a problem of hundreds of years ago, or something that only happened in the South. 1946 is in the living memory of many people.

Of course if you flip through the comments (which I do, because I am a goddamn addict) you’ll see the usual knee-jerk response of “why live in the past? We have to move on and let things go.” It’s a nice fantasy to think that we can just ‘get over it’, but denying history is not the path to progress. The apology should not serve (and I sincerely hope it doesn’t) to make white people feel guilty for being born white. As Canadians, we should all be aware of both our strengths as a country and, in this case, our weaknesses and mistakes.

CFI Debate: What’s Right and Wrong with Religion?

I had the distinct pleasure of attending an event co-sponsored by the Centre for Inquiry – a skeptical organization and Reasons to Believe – a group that promotes the harmonious co-existence of science and religion. The event took the form of two 30-minute presentations from a skeptic speaker and a believer:

  • Dr. Hugh Ross (the believer) is an astrophysicist from the California Information of Technology
  • Brian Lynchehaun (the skeptic) is completing a degree in philosophy at UBC

This was the first such event I’ve ever attended personally, but I’ve watched videos of several. The usual format is that the religionist makes a series of unfounded assertions, tortures logic and evidence to support those assertions, and spouts old and refuted theology as a conclusion. The skeptic/atheist speaker, thus completely drowned in nonsensical and illogical statements, must spend his/her valuable time refuting these statements and, as a result, has no time to present any reasonable argument of his/her own. The feckless wimp of a moderator then says something along the lines of “well we’ve heard a lot of good arguments on both sides” and opens the floor to questions. I assumed this CFI/RTB event would be much of the same.

Happily, I was only half-right, and the forces of stupid were not allowed to roll on unopposed.

I took the liberty of recording the presentations by Dr. Ross and Mr. Lynchehaun. As fair warning, Dr. Ross’ presentation is not for the faint of brain. If you are prone to headaches when exposed to assertions passed off as fact, theology substituted for logic, or self-contradiction, you should probably not watch this video. My father, who as a former priest in the Catholic church is fairly knowledgeable about church doctrine and theistic philosophy, joined me in recognizing that the theories propounded by Dr. Ross are both scientifically and theologically way off base. It might be worth watching for lulz. Also, the people sitting next to me were being jerks and laughing disruptively, so occasionally that happens.

Here’s part 1:

Part 2:

and part 3:

Like I said, it’s some pretty heady stuff. Apparently, aside from the outright lies like the proof of the existence of Adam, we are to believe that there is scientific evidence that there is a being outside of space/time (note: evidence not shown). Also, God likes to tinker with species from time to time because He apparently can’t get it quite right the first time. Additionally, the biblical writers believed simultaneously in a geocentric universe and the Big Bang – two perspectives which are directly contradictory. Ross’ explanation of the problem of evil is about the least artful I’ve ever heard – God invented evil so he could test us to make sure we can get into Heaven; why He didn’t just start humanity in Heaven is a problem best left unmentioned. This is all to say nothing of the fact that Dr. Ross has studied all the world religions, and only Christianity is the true one (again: evidence not shown).

At this point, I was dreading listening to Mr. Lynchehaun’s response – not because I was worried that his argument would be as brainless as that of Dr. Ross, but because I was worried Mr. Lynchehaun would try and address the glaring contradictions and illogic present in his counterpart’s reasoning. I was pleasantly shocked when Mr. Lynchehaun started his talk by saying ‘I’m not going to address the science – I can tell that this crowd is not amenable to another science talk.’ From there, Mr. Lynchehaun presented a coherent argument for why Christianity is not a good moral system, which was supposed to be the topic of both presentations (to Dr. Ross’ credit, astrophysics can say very little about ethics, so it wasn’t really a good idea for him to try).

Here’s part 1:

and part 2:

I disagree with Lynchehaun on a couple of points, the largest of which being that science cannot inform ethics (note: he may not have actually said this… sorry Brian :P). I guess the material sciences can’t really say anything about ethics, which may have been what he meant. However, the scientific process of testing hypotheses from reasoned first principles can be adapted to issues of morals. The point that you can’t measure good and evil with scientific scales is well taken. However, on the whole I think Lynchehaun did an admirable job of presenting a non-judgmental and inoffensive argument for why secular value judgments are not only superior to those from scripture, but are actually what’s done already even by believers. It’s crucial to note something here, and that’s the fact that Lynchehaun started his presentation by providing a definition of his first principles. He didn’t just launch in and then try to shift goalposts when confronted; he defined his terms a priori and even allowed his opposition a chance to object or refine them. That’s real debate.

After the two presentations, the participants were invited to engage in a moderated debate, in which they were allowed to address each other. I didn’t record this part (I had poor sight-lines – if CFI puts the video online I’ll link you to it later). Suffice it to say that it was essentially more of the same – Dr. Ross made assertions and wove cherry-picked sciency-sounding things in order to support his claims, while Mr. Lynchehaun sat quietly and waited until Dr. Ross stopped speaking.

The floor was then opened to questions from the audience, which is, in my mind, a complete waste of time. Dr. Ross has shown himself to be logic-proof and absolutely will not accede any points that refute his narrative of the universe. The skeptic audience members who asked their questions were not going to unseat his arguments because they are relying on logic and reason while Dr. Ross is starting from a “God is true, therefore anything else can be explained in terms of God” position. There was only one believer who got up to say something to Lynchehaun, but his “question” was just a series of faith-based platitudes about the infinite mercy of God. Lynchehaun, without missing a beat, said to the guy “this will likely come as no surprise to you, but I disagree” which got thunderous applause from the audience.

The other high point occurred when Dr. Ross explained the reason why God has not directly intervened to make the world a paradise yet – yes, in direct contradiction of both scripture and his own previous statements. See, since we know that the world is 5 billion years old, and God created the world in 6 “days” and rested on the 7th “day”, we can assume that we are still in that 7th day of rest. God isn’t dead, ‘Es just restin’.

UPDATE: I can’t believe I forgot to mention this part. Lynchehaun did take a moment to expose Dr. Ross’ weird argument about the disappearing body of Jesus. He (Lynchehaun) mentioned casually that growing up in Ireland, he was aware (although he was not personally associated with, again my apologies for not making this 100% clear, Brian) that there were great many people who were experts at making bodies disappear, and that it’s probably not as hard as Dr. Ross was making it out to be. Dr. Ross countered by saying that it’s impossible to perpetuate such a large fraud only 30 years after the event. I felt like asking him if he wanted to buy a bridge from me.

If there’s any lessons to be learned from this talk, it’s how startlingly bankrupt the argument “well some scientists believe in God” is. When you have to rape and pervert the scientific method to accommodate your belief in a supreme being, you’re betraying science. During questioning, Dr. Ross said that the way to establish the truth of scripture is to give consider the “truth” therein to always have the best possible benefit of the doubt – a complete inversion of the scientific process. If you’re willing to abandon the ideals of establishing truth through observation and reason, then you abdicate the title of ‘scientist’. Of course, this smacks of the “no true Scotsman” fallacy that Lynchehaun talked about, but it’s different in an important way. Science and belief are incompatible because the former demands a default position of skepticism, while the latter begins by assuming the truth of unprovable claims and then fits evidence to support those claims. They are polar opposites. Can scientific findings be twisted to fit religion? Absolutely. Can blind belief and faith advance the philosophy of science? God Almighty, I hope not.

=====================================================

UPDATE: PZ Myers has cross-posted this entry over at his blog, Phayngula! Hits! Oooh, sniny!

How inaccurate Nazi comparisons fuel anti-Semitism

It will definitely not be among my most controversial statements to say that Adolf Hitler was a bad person. It will similarly be unobjectionable to say that Nazi-ism is and was a deplorable and horrifying philosophy and practice. No-one aside from the handful of anti-Semitic nutjobs who deny the Holocaust believe that Hitler or Nazis are a positive force in the world.

However, in colloquial parlance, Nazis and Hitler are bandied about so wildly inaccurately that we’ve lost sight of why they are bad. Let’s take a look at the philosophy of Nazi Germany under Hitler:

  • Totalitarian regime
  • Advocated the mass slaughter of Jews, Roma, homosexuals, Catholics, mentally and physically disabled
  • Practiced ghettoization of ‘undesirable’ members of society
  • Preached a doctrine of race chauvinism, with the intent of the destruction of all but the racially “pure”
  • Attempted to spread this doctrine by force across the entire world

This is not good stuff. Nothing on this list can be counted as a positive trait. Any movement that seeks the mass slaughter of people based on a doctrine of chauvinism and is spread by force of arms should rightly be compared to Hitler and the Nazis. It is absolutely right to draw comparisons between such practices and the horrors of the Holocaust.

You know where it’s not right? When talking about health care.

President Hitler signed a shockingly similar bill with similar tactics used to get it signed….threats,  harassment,  false promises,  intimidation, invented crises.  Gee….did Obama take lessons from Hitler?

Excuse me, WHAT? Dr. Laurie Roth seems to think that using unethical political tactics (and I’m not saying I agree even with this characterization) to sign policies into law is tantamount to being in league with Hitler.

First of all, understand Hitler was a brilliant, charismatic speaker who said things in style, lied through his teeth and manipulated whatever he had to, to get a vote and power…

Obama also seduced 60% of the nation, congress and most the media into not asking real questions and just believing his countless lies.

Hitler wore black socks. Obama has been photographed WEARING BLACK SOCKS! The similarities abound.

The question here that must be asked is as follows: is Obama similar to Hitler in any of the characteristics that are important? Namely, is he (openly or covertly) advocating the mass murder of a group of people based on ethnic or political affiliation? Is he declaring an expansionist war agenda in order to accomplish said mass murder? Is he jailing and shipping off political dissident groups to internment camps? If you answered ‘yes’ to any of these questions, then I think your trial separation with reality has gone on long enough and you should just file the divorce papers already. If you answered ‘no’, then the question becomes whether or not the comparison to Obama is a fair one, or if you’re just using the spectre of Hitler and the Holocaust as a cheap and frankly tactless way of manipulating the emotions of your audience.

And before we get too smug here on the left side of the aisle, shall I remind you of the anti-Iraq-war protests of only a few years ago? Ringo remembers.

It seems as though we’ve taken the above description of Hitler and the Nazis and boiled it down to the first bullet point: Nazi = totalitarian regime. While nobody would suggest that totalitarian regimes are good, that’s not the only reason why Nazi-ism was so horrible; it’s not even the primary reason why Nazi-ism was so horrible. Look down the list – forced imprisonment, genocide, unjust war-making, all fueled by an underlying racist doctrine. The atrocities committed by the Nazis under Hitler were the worst that the developed world had ever seen, and possibly the worst in all of history.

It does disservice to the memory of the millions of people who have died at the hands of the Nazi philosophy to trivialize its inherent ugliness as mere totalitarianism. Most feudal monarchies were totalitarian, but many positive things came out of them. There are admittedly few examples of totalitarian regimes that were good for the world, but much fewer are the examples that can be aptly compared to Nazi-ism – perhaps Russia under Stalin, Cambodia under the Khmer Rouge, the genocides in Rwanda and Sudan, and even these last few are not at the hands of totalitarian rule but of brutal military rule.

Taking a handful of characteristics, out of context, from the Nazis or Hitler, finding similarities to modern events and then forging specious equivalence between those events and the Nazi philosophy is belligerent intellectual dishonesty. Worse than that, however, is the fact that as the word “Nazi” gets applied to everything under the sun that one person or another doesn’t particularly like, the real meaning and context becomes diluted. The consequence of this is that we begin to forget the dark scourge of anti-Semitism that allowed such a philosophy to propagate on a global scale. As I showcased recently, anti-Semitism is still alive and well both internationally and here in Canada. It doesn’t need to be helped by down-playing the horror of its history.

It seems appropriate at this point to say something about anti-Semitism. I have no particular allegiance to any religious group; I find them all distasteful at best, and destructive at worst. I fully recognize that Jewish people, and the Jewish faith is no better or worse than any other, except insofar as its adherents tend to be less militantly violent and intolerant than Christians, Muslims, or Indian Hindus. I highlight this particular race chauvinism (anti-Semitism) not only because it’s topical but because it’s pervasive. I am not claiming that anti-Semitism is philosophically better or worse than any kind of racist philosophy (although it has the longest history and is perhaps the most widespread). I am opposed to the idea of group identification based on religion, since religious expression is highly varied and is almost entirely based on superstition and nonsense. However, I am more opposed to the idea of violently exterminating a group of people based on group identification or shared belief. I am also opposed to intellectual dishonesty and the degradation of history to serve the agenda of the forces of stupid.

So the next time you hear someone compare Obama or Bush to Hitler, or call someone else a ‘grammar Nazi’ or, in the case of one friend of mine, receive the fascist salute from a student because they don’t like your teaching style, I’d invite you to remind them that totalitarian as Nazi Germany was, that’s not the biggest criticism to be levied at them. I’d also invite you to offer to slaughter their families if they want their characterization to be more apt.

Movie Friday! – Dara O’Briain

It’s Friday. I like Fridays. Do you like Fridays?

In honour of this auspicious day, I’m going to do something different. Instead of my usual old-cranky-man ranting about this and that, I’m going to post movies that I find interesting or funny.

Today’s movie is making the rounds as a skeptic’s classic. The comedian is Dana O’Briain, who is one of the best standups I’ve heard in a while. He’s talking about a lot of the same issues I’ve been bringing up, but he’s a lot funnier than I am.

Happy Friday!

Why I’m glad I live in Canada

I’ve mentioned this before, but I’m a big fan of free speech. Free speech means free societies. It also means it’s almost impossible to completely crush a minority group for being dissident to the majority rule. As a black man, I know why ‘majority rules’ isn’t always a positive thing.

Which is why these news items make me glad I live here in Canada (even with its tainted speech laws) and not in Somalia.

Most radio stations in Somalia have stopped playing music, on the orders of Islamist Hizbul-Islam insurgents who say that songs are un-Islamic.

Ignore for the moment the backwards stone-age attitudes of people who appear to be former residents of the town from Footloose. One of Somalia’s most well-known exports, besides pirates, is expatriate singer/songwriter K’Naan. He’s been featured on official soundtracks for the charity War Child, FIFA Soccer video games, and most recently his anthem “Wavin’ Flag” has been appointed as the official theme song for the 2010 World Cup. Counterpoint this – an internationally prolific symbol of freedom, human rights and awareness spreading his message through music – to a repressive, backwards country that won’t even let the BBC report from there. How can such a contradictory juxtaposition occur?

It’s easy – K’Naan grew up in Canada. Canada has free speech and actively supports artistic expression, even when it’s decidedly anti-government (think of the Air Farce, which happened on government-funded radio and television for the better part of 4 decades). Canada, even with its exception for hate speech (which I disagree with), allows people to express ideas freely. Contrast that to Lybia where if you complain because you’re getting tortured, they lock you up.

Free speech makes the world a better place. It’s of primary importance to the survival of any enlightened, progressive society. Erosion of free speech means the erosion of progress and liberty, both of which improve quality of life for people. Muslim apologists often say that “Islam means peace” and that devout Muslim belief is a path towards beauty. Somalia puts this claim to the lie.

Using economic levers to change behaviour: the case of Thailand’s universal coverage health care reforms.

Hughes D, Leethongdee S, Osiri S.

Soc Sci Med. 2010 Feb;70(3):447-54. Epub 2009 Nov 14.PMID: 19914757 [PubMed - indexed for MEDLINE]Related citations

2.

Allocation of scarce medical library resources as a form of implicit medical rationing.

Batt RE, Yeh J, Bush RB.

J Minim Invasive Gynecol. 2009 Sep-Oct;16(5):660-1. No abstract available. PMID: 19835820 [PubMed - indexed for MEDLINE]Related citations

3.

Agency problems in hospitals participating in self-management project under global budget system in Taiwan.

Yan YH, Hsu S, Yang CW, Fang SC.

Health Policy. 2010 Feb;94(2):135-43. Epub 2009 Oct 14.PMID: 19833405 [PubMed - indexed for MEDLINE]Related citations

4.

Can regional resource shares be based only on prevalence data? An empirical investigation of the proportionality assumption.

Vallejo-Torres L, Morris S, Carr-Hill R, Dixon P, Law M, Rice N, Sutton M.

Soc Sci Med. 2009 Dec;69(11):1634-42. Epub 2009 Oct 8.PMID: 19819058 [PubMed - indexed for MEDLINE]Related citations

5.

Delivering value for money.

Kinnair D.

Nurs Stand. 2009 Aug 12-18;23(49):64. No abstract available. PMID: 19743614 [PubMed - indexed for MEDLINE]Related citations

6.

Quality of care in single-payer and multipayer health systems.

Feldman R.

J Health Polit Policy Law. 2009 Aug;34(4):649-70.PMID: 19633227 [PubMed - indexed for MEDLINE]Related citations

7.

[Psychiatric psychotherapeutic psychosomatic treatment by the hospital: framework for the development of a multi-sector budget for regional mandatory care]

Kruckenberg P, Beine K, Aderhold V, Bock T, Bührig M, Deister A, Driessen M, Elsässer-Gaismaier HP, Grampp P, Greve N, Heinz A, Heinze M, Heisler M, Küthmann A, Kunze H, Lucht M, Niedermeyer U, Obliers W, Schütze W, Stock M.

Psychiatr Prax. 2009 Jul;36(5):246-9. Epub 2009 Jul 6. German. No abstract available. PMID: 19582663 [PubMed - indexed for MEDLINE]Related citations

8.

AIDS drug assistance plans feel fiscal pinch.

Traynor K.

Am J Health Syst Pharm. 2009 May 15;66(10):886-8. No abstract available. PMID: 19420304 [PubMed - indexed for MEDLINE]Related citations

9.

Modelling the resource implications and budget impact of managing cow milk allergy in Australia.

Guest JF, Nagy E.

Curr Med Res Opin. 2009 Feb;25(2):339-49.PMID: 19192978 [PubMed - indexed for MEDLINE]Related citations

10.

[Public financing of health care in Africa, budgetary constraints and direct payment by users: an overview of the essential questions]

Mathonnat J.

C R Biol. 2008 Dec;331(12):942-51. Epub 2008 Sep 27. Review. French. PMID: 19027695 [PubMed - indexed for MEDLINE]Related citations

11.

Where are we in the rationing debate?

Goold SD, Baum NM.

BMJ. 2008 Oct 10;337:a2047. doi: 10.1136/bmj.a2047. No abstract available. PMID: 18849309 [PubMed - indexed for MEDLINE]Related citations

12.

Optimizing resource allocation for HIV/AIDS prevention programmes: an analytical framework.

Bautista-Arredondo S, Gadsden P, Harris JE, Bertozzi SM.

AIDS. 2008 Jul;22 Suppl 1:S67-74.PMID: 18664956 [PubMed - indexed for MEDLINE]Related citations

13.

Decentralization and health resource allocation: a case study at the district level in Indonesia.

Abdullah A, Stoelwinder J.

World Health Popul. 2007 Dec;9(4):5-16.PMID: 18567948 [PubMed - indexed for MEDLINE]Related citations

14.

Budget India 2008: what is new for health sector.

Lahariya C.

Indian Pediatr. 2008 May;45(5):399-400. No abstract available. PMID: 18515929 [PubMed - indexed for MEDLINE]Free ArticleRelated citations

15.

Ramsey waits: allocating public health service resources when there is rationing by waiting.

Gravelle H, Siciliani L.

J Health Econ. 2008 Sep;27(5):1143-54. Epub 2008 Apr 4.PMID: 18468707 [PubMed - indexed for MEDLINE]Related citations

16.

Cost-effectiveness and healthcare budget impact in Italy of inhaled corticosteroids and bronchodilators for severe and very severe COPD patients.

Dal NR, Eandi M, Pradelli L, Iannazzo S.

Int J Chron Obstruct Pulmon Dis. 2007;2(2):169-76.PMID: 18044689 [PubMed - indexed for MEDLINE]Free PMC ArticleFree textRelated citations

17.

The state-of-the-science: challenges in designing postacute care payment policy.

Chan L.

Arch Phys Med Rehabil. 2007 Nov;88(11):1522-5. Review.PMID: 17964899 [PubMed - indexed for MEDLINE]Related citations

18.

Effects of resource constraint on health care services.

Matta AM.

Med Law. 2007 Jun;26(2):213-30.PMID: 17639847 [PubMed - indexed for MEDLINE]Related citations

19.

Resource allocation in orthopaedics: economic evaluation to priority setting.

Bate A, Donaldson C, Ray H.

Clin Orthop Relat Res. 2007 Apr;457:49-56.PMID: 17290157 [PubMed - indexed for MEDLINE]Related citations

20.

Getting by on credit: how district health managers in Ghana cope with the untimely release of funds.

Asante AD, Zwi AB, Ho MT.

BMC Health Serv Res. 2006 Aug 17;6:105.PMID: 16916445 [PubMed - indexed for MEDLINE]Free PMC ArticleFree textRelated citations

21.

Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

Ceci C.

Nurs Leadersh (Tor Ont). 2006 Mar;19(1):56-68.PMID: 16610298 [PubMed - indexed for MEDLINE]Related citations

22.

Fixed budgets as a cost containment measure for pharmaceuticals.

Granlund D, Rudholm N, Wikström M.

Eur J Health Econ. 2006 Mar;7(1):37-45.PMID: 16435117 [PubMed - indexed for MEDLINE]Related citations

23.

Performance-based budgeting in the public sector: an illustration from the VA health care system.

Yaisawarng S, Burgess JF Jr.

Health Econ. 2006 Mar;15(3):295-310.PMID: 16331724 [PubMed - indexed for MEDLINE]Related citations

24.

Is Utah the new Oregon?

Guglielmo WJ.

Med Econ. 2005 Aug 19;82(16):41, 45. No abstract available. PMID: 16250359 [PubMed - indexed for MEDLINE]Related citations

25.

[The nurse facing economic control]

de Broca A.

Soins. 2005 Jul-Aug;(697):32-3. French. No abstract available. PMID: 16124683 [PubMed - indexed for MEDLINE]Related citations

26.

[Cost containement in health care--the perspective of a governor of public health]

Dürr M.

Praxis (Bern 1994). 2005 Jul 13;94(28-29):1115-6. German. No abstract available. PMID: 16078752 [PubMed - indexed for MEDLINE]Related citations

27.

Optimising health care within given budgets: primary prevention of cardiovascular disease in different regions of Sweden.

Löfroth E, Lindholm L, Wilhelmsen L, Rosén M.

Health Policy. 2006 Jan;75(2):214-29.PMID: 16005539 [PubMed - indexed for MEDLINE]Related citations

28.

[Creativity in the pediatric clinic. About enjoyable creativity at the pediatric bedside]

Stiksrud P.

Kinderkrankenschwester. 2003 May;22(5):203-6. German. No abstract available. PMID: 15984463 [PubMed - indexed for MEDLINE]Related citations

29.

Optimal allocation of resources over health care programmes: dealing with decreasing marginal utility and uncertainty.

Al MJ, Feenstra TL, Hout BA.

Health Econ. 2005 Jul;14(7):655-67.PMID: 15678518 [PubMed - indexed for MEDLINE]Related citations

30.

Communitarian claims and community capabilities: furthering priority setting?

Mooney G.

Soc Sci Med. 2005 Jan;60(2):247-55.PMID: 15522482 [PubMed - indexed for MEDLINE]Related citations

31.

Portfolio theory and cost-effectiveness analysis: a further discussion.

Sendi P, Al MJ, Rutten FF.

Value Health. 2004 Sep-Oct;7(5):595-601.PMID: 15367254 [PubMed - indexed for MEDLINE]Related citations

32.

Medicine as a business.

Matthews M Jr.

Mt Sinai J Med. 2004 Sep;71(4):225-30. Review.PMID: 15365587 [PubMed - indexed for MEDLINE]Related citations

33.

Decision makers’ views on health care objectives and budget constraints: results from a pilot study.

Al MJ, Feenstra T, Brouwer WB.

Health Policy. 2004 Oct;70(1):33-48. Erratum in: Health Policy. 2005 Sep 28;74(1):111. PMID: 15312708 [PubMed - indexed for MEDLINE]Related citations

34.

Using PBMA in health care priority setting: description, challenges and experience.

Mitton C, Peacock S, Donaldson C, Bate A.

Appl Health Econ Health Policy. 2003;2(3):121-7. No abstract available. PMID: 14984275 [PubMed - indexed for MEDLINE]Related citations

35.

The evolution of PBMA: towards a macro-level priority setting framework for health regions.

Mitton CR, Donaldson C, Waldner H, Eagle C.

Health Care Manag Sci. 2003 Nov;6(4):263-9.PMID: 14686632 [PubMed - indexed for MEDLINE]Related citations

36.

Decentralization in Zambia: resource allocation and district performance.

Bossert T, Chitah MB, Bowser D.

Health Policy Plan. 2003 Dec;18(4):357-69.PMID: 14654512 [PubMed - indexed for MEDLINE]Free ArticleRelated citations

37.

[The 2004 budget in the county of Stockholm hits against private practitioners]

Sjödin C.

Lakartidningen. 2003 Nov 6;100(45):3694-5. Swedish. No abstract available. PMID: 14650042 [PubMed - indexed for MEDLINE]Related citations

38.

The economics of public health: financing drug abuse treatment services.

Cartwright WS, Solano PL.

Health Policy. 2003 Dec;66(3):247-60.PMID: 14637010 [PubMed - indexed for MEDLINE]Related citations

39.

Optimizing a portfolio of health care programs in the presence of uncertainty and constrained resources.

Sendi P, Al MJ, Gafni A, Birch S.

Soc Sci Med. 2003 Dec;57(11):2207-15.PMID: 14512250 [PubMed - indexed for MEDLINE]Related citations

40.

Should general practitioners purchase health care for their patients? The total purchasing experiment in Britain.

Wyke S, Mays N, Street A, Bevan G, McLeod H, Goodwin N.

Health Policy. 2003 Sep;65(3):243-59.PMID: 12941492 [PubMed - indexed for MEDLINE]Related citations

41.

Revisiting the decision rule of cost-effectiveness analysis under certainty and uncertainty.

Sendi P, Al MJ.

Soc Sci Med. 2003 Sep;57(6):969-74.PMID: 12878098 [PubMed - indexed for MEDLINE]Related citations

42.

The drug budget silo mentality: the Dutch case.

Koopmanschap MA, Rutten FF.

Value Health. 2003 Jul-Aug;6 Suppl 1:S46-51.PMID: 12846925 [PubMed - indexed for MEDLINE]Related citations

43.

Tools of the trade: a comparative analysis of approaches to priority setting in healthcare.

Mitton C, Donaldson C.

Health Serv Manage Res. 2003 May;16(2):96-105.PMID: 12803949 [PubMed - indexed for MEDLINE]Related citations

44.

An army of patients. The VA struggles with a growing population of veterans using its healthcare system as it works to boost quality and capacity.

Fong T.

Mod Healthc. 2003 May 19;33(20):48-50, 62. No abstract available. PMID: 12800589 [PubMed - indexed for MEDLINE]Related citations

45.

The budgetary crunch and how to rationally decide what to cut.

Kozma CM.

Manag Care Interface. 2003 May;16(5):43-4. No abstract available. PMID: 12789864 [PubMed - indexed for MEDLINE]Related citations

46.

Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA).

Mitton CR, Donaldson C.

Health Policy. 2003 Jun;64(3):335-48.PMID: 12745172 [PubMed - indexed for MEDLINE]Related citations

47.

Managed Medicaid’s last stand.

Carroll J.

Manag Care. 2003 Mar;12(3):46A-46B, 46F, 46H. No abstract available. PMID: 12685376 [PubMed - indexed for MEDLINE]Related citations

48.

The prisoner dilemma: should convicted felons have the same access to heart transplantation as ordinary citizens? Opposing views.

McKneally MF, Sade RM.

J Thorac Cardiovasc Surg. 2003 Mar;125(3):451-3. No abstract available. PMID: 12658181 [PubMed - indexed for MEDLINE]Related citations

49.

Does it matter who you are or what you gain? An experimental study of preferences for resource allocation.

Schwappach DL.

Health Econ. 2003 Apr;12(4):255-67.PMID: 12652513 [PubMed - indexed for MEDLINE]Related citations

50.

Fight for Ottawa’s money will be fierce.

Kondro W.

CMAJ. 2003 Feb 4;168(3):330. No abstract available. PMID: 12566350 [PubMed - indexed for MEDLINE]Free PMC ArticleFree textRelated citations

Measles outbreak in Vancouver

I’m sure some of you have been following this story:

The BC Centre for Disease Control asked health-care professionals and the public to be alert for measles on Tuesday after eight of the 14 cases were diagnosed in a single household with unvaccinated members. None of the cases identified to date had received two doses of the measles vaccine, which is needed for full protection, officials said in statement.

My stance on anti-vaccination groups has been stated quite unequivocally on a previous post. To put it briefly, they are prime examples of the Forces of Stupid, a group of people who seem to think that ignorance is a virtue and anyone with access to the internet is equally equipped to give an informed opinion, regardless of the process by which they arrived at their knowledge. Part of the reason I started writing this blog is to challenge the idea that everyone is entitled to an opinion. Some opinions, when left unchallenged, result in calamity. This measles outbreak is a prime example of what happens when we “leave well enough alone” and allow stupidity to take root.

Obviously, there should be robust debate about important issues. However, there is no room to debate facts. Facts are not subject to democratic approval. Something either is or it isn’t, regardless of whether or not we agree with it. If you disagree, find evidence to support your belief. The evidence needs to be stronger than the evidence that supports your opposition. That is how progress gets made.

Which is why it’s so painful to see articles like this one:

Unvaccinated students are being sent home from school because of the growing measles outbreak in Vancouver, and that has at least one parent concerned that the policy is unfair.

A student’s mother chose to refuse the measles vaccination for her daughter, citing fear of a reaction to egg albumin in the vaccine. That’s a completely reasonable stance to take if there’s legitimate concern over an allergic reaction. What isn’t reasonable though, is expecting everyone else to bend over backwards to accommodate her decision.

“I think every parent, whatever decision they make, it’s always because they love their kids, and they want to do what’s best. It’s not a right or wrong issue,” said Conley [the mother]. But Conley said the length of the quarantine is too long because she believes measles is only infectious for up to 14 days.

Good for her. What do people who know something believe? I couldn’t care less what some random lady thinks about a disease. Luckily, she’s not in any position to set policy and has been overruled by the school board, who cite the science dictating a 20-day possible incubation period. They are, reasonably, erring on the side of caution. Not only that, but in this case it is a “right or wrong issue”! You might be right to safeguard your kid, but the school board is more right to refuse to allow your decision to potentially infect hundreds or thousands of kids in BC and Quebec.

So why does this grind my gears? Because they put the mother’s testimony first. The opinion of a parent is not news. It’s certainly not a balance for scientific fact, and given that people tend to think of the top of the article as being more authoritative and informative, CBC seems to be suggesting that this random mom’s wacky opinion is superior to the science. It makes for a nice headline to the story: Brave Mom Fights for Child’s Rights. Here’s a better (or at least more accurate) headline: Mom Told to Live with the Consequences of Her Decision. You don’t vaccinate, you don’t get to participate.

Another thing I found interesting is that as soon as she was told there was a field trip at stake, she got her kid vaccinated right away. Where did the allergy concerns go?

Far be it from me to suggest that ideas are stupid a priori. The vaccination/autism link was certainly plausible when it first appeared on the scene. So what did we do? We tested the idea. Upon testing, we found no evidence to support it. We kept testing, trying to replicate the studies that trended positive. Again, we found no link. Once an idea has been shown to have no evidence supporting it, it then becomes stupid. Sticking to belief in a stupid idea isn’t admirable, it’s dangerous. Luckily, at least in this particular case, better-informed heads prevailed. I feel bad for the kid, but there are consequences to these decisions that the kid, and her mom, have to live with.

Update: the niqab in Quebec

There’s another story in the news that is quite contentious that speaks to my post yesterday, so I thought I’d throw in some interesting reading. The issue concerns the niqab, which is to my eyes the same as a burqa. Recently the government of Quebec passed a law banning the wearing of burqas while accessing government services. There are a lot of stupid arguments for why this is a good law: security issues, enshrining women’s rights, assimilationism. I doubt there is much of a security risk posed by these women, and there is a good argument that women should be allowed to wear whatever they want.

This article takes a decidedly anti-ban stance. I disagree with their conclusions, but their reason for opposing the bill is sound – it’s not protecting a woman’s rights to take away her freedom of expression. Saying that banning the burqa is tantamount to supporting feminism is like saying that opposing Affirmative Action makes you a civil rights leader. It’s paternalism, plain and simple.

However, Canada seemingly isn’t the only country with this problem. France is currently experiencing major issues with the influx of Muslim immigrants. France, however, does have an aboriginal ethnic majority population so their issue is distinct from Canada’s. We are a nation of immigrants from the beginning of this land as a unified nation.

My stance remains the same. In a secular society, the government is not obligated to accommodate your superstition, no matter how many people believe in it. I am as offended by a woman wearing a burqa as I am by a member of Opus Dei flogging himself on the streets, or a Jehovah’s Witness coming to my home (although I live in an apartment now. Crommunist -1; Jehovah – 0). I have no patience for religion. However, as long as it’s not thrown in my face I can’t really have any objection to it. People should have the right to have their own private beliefs, but that right does not extend to public places and it certainly does not require the government to bend over backwards to facilitate your belief in mumbo jumbo.

There. Political career officially nipped in the bud.

Religious tolerance or cultural tolerance?

Canada is a unique place. The full explanation of this seemingly banal statement will come perhaps in another, longer post. I just want to highlight and juxtapose a couple of recent news items. Suffice it to say that because Canada lacks a national identity (or at least a strong one) and relies on immigration to stay viable, we face unique challenges. Unlike our neighbours to the south, we can’t compel newcomers to adapt to “our culture”, because it’s not that strongly defined. Because the nation was built by wave after wave of immigrants, and our aboriginal peoples do not wield enough power to establish themselves as “the real Canadians”, our country seems to be destined to remain in a state of cultural flux – our very identity defined by the fact that we are a polyglot, multichromatic, practically diverse society. Please don’t interpret these words as condemnation – as a child of an immigrant I see the immense value of having a wealth of cultural experience easily within reach at any given moment (at least in the major urban centres).

However, this multiculturalism comes with distinct challenges, as the Toronto police have discovered:

The Toronto police service has started an internal review on how officers conduct searches and arrests when dealing with people from various religions. The review was sparked by a human rights complaint in July 2008 after a police officer removed a Muslim woman’s hijab, or head scarf.

The police force is considering implementing training for cadets on the proper ways to deal with potentially dicey situations involving people from a variety of religious faiths. For those of you who don’t know, some Islamic scholars maintain that all Muslims, particularly women, should dress modestly and cover the skin. This is purportedly to forebear any sexual temptation from distracting the thoughts away from holy contemplation. This practice is by no means unique to Islam – many Christian and Jewish sects preach the same doctrine of concealing the flesh to keep the thoughts pure (in fact, the more I learn about Islam the more I suspect there’s almost nothing unique in that teaching at all). However, under the stricter interpretation of sharia law, many Muslims consider it necessary to cover nearly all of a woman’s flesh, and most certainly the hair and parts of the face, when in the public view of men outside the family. This practice varies from sect to sect, with some Muslim women wearing no covering, some wearing a simply head scarf and others covering their bodies completely in the now almost universally-reviled symbol of fundamentalist Islamic oppression, the burqa.

Some who are more generous and liberal than I point out that freedom of religious expression is enshrined in the law, and is paramount to a free society. “Besides,” they might say, “where is the harm in the simple outward expression of religious conviction?”

Enter the Sikh kirpan.

Brampton’s Sukhwant Singh, in his early 50s, has been charged with attempted murder and aggravated assault, Peel police say. Singh’s next court appearance is on Thursday. Any weapon could have been used in the attack, but the fact that it was a kirpan alarms Sikh leaders who fear the incident will rouse objections once again over one’s right to wear the religious symbol in public.

A prominent Brampton lawyer, Majit Mangat was stabbed during an altercation outside a Sikh temple in Brampton. Ordinarily this would have been an isolated tragic incident with no far-reaching significance, except for the fact that the weapon used in the assault was a kirpan, a ceremonial dagger worn by Sikh men. In almost all cases, the dagger is merely a decoration; an accessory that is never drawn, even in anger. Having lived for several years in Brampton myself, with a very large Sikh population (Canada is second only to India in terms of the number of Sikhs – this is the absolute number, not a per-capita calculation), I never heard of a kirpan being used as a weapon against another person. However, this incident raises the important question that will define race relations in Canada for generations to come: how much should we allow common sense to be trumped by religious practice?

In my mind, allowing anyone to carry a weapon of any kind is not a good idea. I don’t care how symbolic or ceremonial it it supposed to be. If my religious convictions require me to carry a rifle in my hands because Jesus could arrive at any moment and I have to help him fight off Satan’s zombie hordes, common sense (and the law) would dictate that the danger I pose to society in general outweighs my religious autonomy. Such is the case here.

I offer the following solution to this conundrum: stop allowing exceptions for religious practice. Whereas cultures are constantly adapting to the times in which they find themselves, religious edicts are absolute. If my culture tells me it’s okay to smoke marijuana in public, but I live in Canada (except in Vancouver – I love this city) then I have to adapt to the laws of the land in which I find myself. However, if I do so for religious reasons, I am forbidden by the will of Jah to restrain my pot-smokery. By allowing these cultural practices to continue under the banner of “religious freedom” makes the entire argument more convoluted than it has to be. If the law, for example, allowed cultural practice to continue provided it posed no danger to public safety or the execution of lawful policing, but refused to make exception religious practice, then the carrying of the kirpan would be a moot point. As some of the temple elders suggest in the article, the kirpan can be substituted with a smaller blade (of the kind that all people in Canada are permitted to carry religion notwithstanding) or one that cannot be removed from its sheath. This allows the cultural practice to continue unabated in such a way as it does not trump public safety.

Neither of these cases are particular causes for concern. However, a number of years ago, debate broke out in the Ontario legislature as to whether or not Muslims should be self-policing under sharia law rather than the provincial civil court. To any rational person, allowing religious law to trump civil law is a ludicrous position to take; especially since sharia law is subject to wide interpretation depending on the imam, and is nearly always gender biased against women, sometimes with violent results. For some reason, this debate wasn’t immediately laughed out of the courts. That reason, of course, was that this was a religious issue and we have to be so careful about protecting the rights of people to practice their religion.

I call bullshit.

The second your religious freedoms interfere with my secular freedoms, I’m kicking your religious freedom to the curb. I am motivated in this conviction not only by the fact that I regard all religion as superstition and nonsensical illogic, but because from a practical purpose it makes more sense. Secular rights are developed with ethical and social principles in mind. Religious “rights” are developed from some person/group’s interpretation of a mistranslated book that is centuries old and is expressly forbidden to be applied contextually. Forcing modern reality to adapt to an ancient set of prescripts that cannot be universally agreed upon, even among its purported adherents, is the height of arrogance and folly.

The right to cultural expression is a good one – we live in a multicultural society. At some point, cultures are at least partially defined by shared religious practice. While I think that’s a shame, it has been the way humanity has operated for centuries and will, at least for the time being, continue to be so. However, knowing how poorly religion fares when attempting to govern a just and enlightened society, we must stop bending over backwards to protect freedom of religious expression when it blatantly contravenes secular civil rights and public safety. Teaching police officers specific methods to be sensitive to the cultural practices of different peoples is a wonderful idea. So is adjusting the laws that govern how the kirpan can be worn. But allowing religion to contravene good sense? I can’t get behind that.

Cognitive Semantics – pt. II

This post originally appeared on Facebook on May 25th, 2009

After re-reading my post of a couple days ago, I realize there is a big piece missing from my discussion of “smart” decision-making: the concept of Value. I allude to it in my example about driving 2 hours to run for 30 minutes, but I feel it needs more explanation.

What I seemed to suggest in my last post is that there is a process of intellect/sagacity/acumen calculation that will help people make smart decisions. If I were to try and boil that process down into a mathematical equation, it would look something like this:

Good = A + B + C + D + E + …

Where “Good” is a ranking of how positive or negative the decision is for the decider, and “A – E” are the various likely outcomes of the decision (i.e., A is money spent, B is fun had, C is social status gained, and so on hypothetically). However, this assumes that all of the outcomes are equally important, which they may not be. For example, a person on welfare can obtain a great deal of social status and fun from buying a brand new car. However, the amount of money spent is prohibitive (indeed, it would impossible for this person to eat or pay rent or do anything… even buy gas). On the other hand, a millionnaire would not mind paying for a new car, but may not gain as much social status (“Oh, you bought a new Camry. How… common. Excuse me, I need to finish my arugula and monocle sandwich”) Clearly each outcome does not carry the same weight for each person. Two people with different values may reach the same (or indeed, different) decisions using the same intellect and acumen, but via very distinct processes.

Perhaps a better equation might look like this:

Good = Aa + Bb + Cc + Dd + Ee + …

Where “a – e” represent the VALUE the decider places on each outcome. For example, our two would-be car buyers: the welfare recipient places a much higher value on making prudent financial decisions (insofar as a $20,000 purchase is concerned) than he/she does on achieving social status and having fun than the millionnaire, for whom social status is real currency. Consequently, the value of A+B+C(welfare) and A+B+C(millionnaire) are equal, but a(welfare) is extremely large, while a(millionnaire) is much smaller. Conversely, b(welfare) and c(welfare) are small, while being larger values for the millionnaire.

This form of the equation quickly becomes ridiculous as one realizes that there are an immeasurable number of potential outcomes that rank from trivial to potentially catastrophic. Giving each one of these outcomes an equal weight in the decision-making process would necessarily give preference to decisions which had extremely small but positive outcomes, and made no impact at all. A third piece is required, which is the PROBABILITY of each outcome occurring.

An equation might then look like this:

Good = Aa1 + Bb2 + Cc3 + Dd4 + Ee5 + …

Fans of British philosophy will recognize this as a re-hashing of Utilitarian calculus, the principle of “the greatest good for the greatest number” without the ethical connotations. This isn’t confined to making moral decisions, but a suggestion for a crude way in which people make decisions (or should make decisions). It is fairly evident that the value that people place on different outcomes is a significant component of what decisions are made that is completely independent of intellect, wisdom or intelligence.

So who cares? I guess I just wanted to point out that a decision that seems stupid by some standards (most usually my own standards) might in fact be motivated by the value the decider places on different outcomes. If I don’t think something is important (for example, I don’t put a lot of value on fitting into a crowd), I will question (and usually insult) the decision that someone else has made. However, this is a difference in values, not in cognitive ability.

HOWEVER, this issue of values does not side-step the first post’s point, which is that when making decisions, one should spend time and be aware of the ramifications of their decision, then consider the value they put on each. Making decisions from gut-feeling or “emotional reasoning” will cause you to end up deciding on different courses of action from the same set of principles, instead of making the decision that has the greatest good the greatest number of times.

Obviously decision-making is far more complicated, and we are people, not computers. However, if the goal is to make well-informed and prudent decisions, it would benefit us to put more time into thinking about why we do the things we do, rather than just doing them and sorting out the problems afterward.