Things make me happy, y’know

I heard second-hand from one reader that this blog reads like a series of angry rants. Of course, this same reader has known me since high-school, so I’m not sure why that surprised her at all… but whatever. If I come across as angry, it’s because, well, sometimes I am angry. There are a lot of crappy things happening in the world, and I think ignoring them is not going to fix them. The more we talk about, discuss and confront the problems facing the world, the faster we’ll find solutions for them.

But lest you think that my entire outlook on life is a negative one, today I’m going to exhibit some news stories that made me happy. I should mention, at this point, that I am incredibly gay for science. There was a story about a remote-controlled robot that can perform heart surgery that made me dance a little jig on the inside (my outside was at the office – not very professional). However, there are a lot of really good science and technology sites that profile way cooler stuff than I can. This site is about race and religion and free speech – topics I find important and interesting to talk about. And despite the impression I may have cultivated thus far, there are indeed some things on these topics that make me very happy.

Of course, my hard-on for secularism and the removal of religion from society is welldocumented on this site. So I was very happy to read this story of groups of young Lebanese people publicly asserting their right to both free speech and freedom from religious dictates. Lebanon has a system that is so entrenched in religion that the secular values we take for granted here make Canada look like a paradise in comparison. This made me really happy to see.

As a heterosexual man and a quasi-feminist (I believe in equal rights for everybody, which isn’t quite feminism but works quite well as a pick-up line when talking to a feminist) there is a special place in my heart for women. I joke, often, at the expense of women, but if you cut me down and looked at the rings on my trunk, you’d find that I have a deep and abiding respect for women. Islam in its present, public form treats women as an unfortunate and repugnant necessity (this is, I learn, an extremely recent “development” in the overall history of Islam). However, the sensationalized portrayal of Islam covers up the fact that, like all religions, there are individual practitioners and groups who are much less radical and far more accepting of secular principles. This story, about a group that works to teach new immigrant Muslim women how to adapt to life in The Netherlands, made me happy and hopeful for a future in which personal religious beliefs can be superseded by more positive, non-religious, affiliation.

And the women are at it again. Three girls from Palestine, seeing how their blind aunt and uncle struggled to get around obstacles and inclines, invented a new kind of cane for them to use… with freakin’ lasers! At a time when some Muslim theocratic countries won’t even let girls go to school, these girls had the wherewithal and scientific know-how to develop a new technology that could potentially improve the lives of thousands and millions of people all over the world. Yeah, theocrats are right. Girls shouldn’t be allowed education, or to own property, or vote. Clearly that would only raise the standard of living for the disabled. Who wants that?

Human beings are capable of great evil. Our history has been storied with accounts of massacre, rape, torture, unbelievable acts of cruelty… the list goes on. Thankfully, human beings are also capable of acts of great goodness. As I will write about someday soon, I think we’re turning the corner of a new Renaissance with the internet acting as the new printing press. No longer is knowledge stored up in ivory towers, unavailable to all but the initiated, but is readily available at the click of a mouse. This program, designed to bring the world to the fingertips of even the very poor, is a step in the right direction for humanity as a whole. This story, about the One Laptop Per Child program making inroads in one of the most devastated areas on the globe, made me unbelievably ecstatic. Some of the poorest kids in the world being given opportunities to learn that weren’t available to me, living in the lap of privilege, at that age – how can your heart not be warmed?

This one’s a little off-topic, but still pretty cool. City council in Vancouver has put measures in place to ensure that products sold locally are, whenever “possible and practicable”, coming from certified “Fair Trade” sources. This is the way capitalism is supposed to work, where market decisions are influenced by local forces, global conscience being one of those forces. It says good things that a city as large as Vancouver is able to make changes like this. Hopefully this idea catches some steam.

So please let it never be said that I find no joy in life. Just as there are multitudes of horrific events taking place all over the world, and I’m not going to stop talking about them, there are positive, life-affirming events taking place too. If I focus more on the negative than the positive, I do it because I want us all, myself included, to shake off the complacency that can so easily settle in and to recognize that there’s a lot of work to do. I’ll do my best to inject a bit more good with the bad, but try to remember that despite my vigorous polemic, I am a fundamentally happy person who loves puppies and rainbows and stickers.

Here’s another picture of an otter:

Happy now?

I pick on the Jews

Looking back over my previous posts, I get the impression that I come across as an Islamophobe. Many of my stories have targeted Muslim religious idiocy and talked about how intellectually bankrupt that particular religion is. This is regrettable, as my intention in this blog is to highlight the intellectual bankruptcy of all religious traditions.

So today I’m picking on the Jews.

Israeli settlers in the West Bank are suspected to have vandalised a mosque by spraying slogans on its walls, Palestinian officials say.

Oh goody! Vandalism of sites of religious worship! Gee, where have we seen that before? It’s almost as though by vandalizing the sites of worship of your political opponents, you are no better than the neo-Nazis that are committing these hate crimes against you! And where are the objections from Jewish religious leaders against the acts of mosque vandalism? Conspicuously absent. To their credit, the IDF did not shrug it off and actually did make an arrest but without sufficient evidence no charges could be laid.

My point isn’t that Jewish people are bad, or that Muslim people are bad, or that Christian, Hindu, Buddhist, etc. etc. etc. people are bad. People are people (I’ll pause a moment to let the soaring heights of my rhetoric wash over you). When you allow people the space to think and reason, and give them the tools to do so effectively, people are capable of great things. However, when you poison their rational mind with religious nonsense and take away their capacity to work through issues logically, they can lose that capacity. Furthermore, when you whip them into a furor, based on that faulty reasoning and arbitrary belief structure, they are capable of committing acts of profound evil. Even the great atheist mass-murderers of our time (Pol Pott, Stalin) used the same tactics of suppression of logical thought and rational ability to spur their troops on to commit slaughter.

Encouraging an individual’s mind through logic and reason leads to an improved life for humankind and a hope for our continued existence on this planet. Perverting the mind through nonsense and stupidity can only have negative consequences. No cultural group is immune from this, as all religious teachings are equally flawed.

And while I’m at it, let’s pick on the Sikhs too.

The RCMP and Vancouver police are investigating threats against Liberal MP Ujjal Dosanjh posted on a Facebook page labelled “Ujjal Dosanjh is a Sikh Traitor.” The most menacing posting urges, “someone shoot him — ASAP.”

Regular readers will remember that I have picked on the Sikhs before. Ujjal Dosanjh, recently made internationally famous on the Colbert Report, is an MP for Vancouver, BC. Of course Vancouver is one of the most multi-ethnic cities in the country, so one would imagine that people might be a bit more tolerant of opposing viewpoints on any number of issues. Then again, as Christopher Hitchens says: “religion poisons everything.” A recent parade held by the Sikh community was the centre of a great deal of controversy, as parade organizers refused to take down displays depicting Sikh terrorists as martyrs for a greater cause. Veiled threats were leveled at Dosanjh and Dave Hayer (an MLA) for speaking out against the glorification of murderers.

So how does the religious community, motivated as they are by a desire for peace on earth and goodwill towards men, react? Of course – they threaten to kill him.

The [Facebook] page administrator Avtar Kanda claims that Dosanjh “used his Sikh roots to get elected in Vancouver, but then betrayed his own people.” “This piece of s— is a scumbag traitor and an insult to the Sikh religion,” Kanda said.

Another poster calling himself Sukhi Loco Singh said: “Do not spare anyone who insults guru ji-shaheed sent jarnail Singh ji Khalsa bhindranwale.”

This is not a political or cultural disagreement. This is not about the free expression of religion, or an argument in defense of the practice of Sikhism. This is a religious furor being perpetrated by Canadian-born kids who are importing conflicts from another hemisphere.

The point of this post is that no matter what the group – Jews, Muslims, Christians, Sikhs, Hindus, Mormons, Scientologists – religious belief corrupts the mind and infiltrates the world around us. If religious practice was a personal matter that took place in the privacy of the home or in a cloistered environment like a church service, there would be no problem. However, by its very nature religion commands its followers to submit the world to its will. Not all of the followers listen, but that’s due more to their own forbearance and wisdom than it is the nature of the religious belief. All religion asks its followers to stop thinking and follow blindly, and whenever someone speaks against the beliefs, it tells the followers to get angry and take personal offense. After all, they are insulting your god.

This is a picture of an otter:

So cuuuuuute!


Indonesia lobs one over the plate

I write a blog that highlights, among other things, the pervasive way in which religion detrimentally affects the lives of people all over the world. I also put a fair amount of effort into highlighting issues of free speech, which is something I feel quite strongly about.

Indonesia isn’t even trying to make my job difficult.

On Monday, Indonesia’s constitutional court decided in favour of its controversial 1967 blasphemy law, thwarting hopes it would be reviewed to allow new religions and sects.

Hooray for the modern world! While thousands of people work tirelessly every day to cure disease, discover more about the world and push the frontiers of human endeavour, Indonesia’s religion-controlled government (can you say “theocracy”? I knew you could!) is cracking down on people whose beliefs are a different kind of stupidity than the officially-licensed stupid. This bootleg stupid can’t be allowed to spread, or people might start realizing that if several contradictory views of the supernatural exist, they might all be wrong.

“The majority of Indonesia’s 235 million strong population are moderate Sunni Muslims, with a reputation for tolerance.”

This quote baffles me. A Muslim majority country, with a Sunni majority therein, who are purportedly tolerant (I have no idea what that means in the context of religion, particularly in a theocratic country), upholds a law banning non-sanctioned religious expression. Perhaps someone at the BBC mis-spelled “ignorance”.

While I am (clearly) not a fan of religion, I am even less a fan of state-sponsored religion. More than that, I am even less a fan of telling people they are not allowed to speak their beliefs, no matter what they might happen to be. While I make fun of places like Indonesia, Ireland, Lybia and Somalia I do so out of a deep sadness. No progress has ever been made, either by individuals or by societies, by jailing dissidents for speaking up against corrupt power. We will never be able to free people from the crushing yoke of poverty until we can throw off the oppressive influence of small-minded religious bigots. Religion has no place in either our laws or the marketplace of ideas.


One of my common complaints about the forces of stupid is that they seem to have no sense of irony. When, for example, Christians reference the bible to persecute gay people as unrepentant sinners, whilst simultaneously forgetting the parable about the adulteress who was saved from stoning by the admonition “let he who is without sin cast the first stone.” It’s especially funny when those same anti-gay crusaders turn up in a bath house or in a men’s room somewhere having all kinds of kinky gay sex. The complete lack of a sense of irony or self-critical skills that is required to make such leaps of hypocrisy is one of the hallmarks of the footsoldiers of “DUH”.

So it came as no surprise when I read this news story:

A radical Muslim group has warned the creators of South Park that they could face violent retribution for depicting the Prophet Muhammad in a bear suit during the 200th episode of the animated TV show.

I love South Park, I think it’s one of the smartest shows on TV. While I don’t always agree with their views, I do enjoy good satire, and South Park dresses that satire up in good wholesome filth, tearing down the notion that anything is sacred. In the episode(s) in question, the characters were extorted into exposing Muhammad so that celebrities could capture his powers of “never being mocked”. Of course, in true South Park style, things just get more and more ridiculous.

The entire point of the episode arc was how ridiculous it was to respect the beliefs of complete nutjobs who make ridiculous terrorist demands. In the episode, the characters have to resort to a series of increasingly-ridiculous stunts to avoid accidentally showing any part of Muhammad: locking him in a U-haul trailer, not letting him walk around, and then finally dressing him up in a bear costume.

South Park shows Muhammad as a bear

All this to avoid reprisal from a group of people who lack the basic level of self-awareness to avoid becoming willing participants in their own public lampooning. In the next episode (it was a 2-parter) the image are covered with large black bars that say “CENSORED”. This is of course to say nothing of the fact that Muhammad has appeared, unmasked, on the show before:

Muhammad on South Park

Of course, just as the show’s creators intended, radial Muslims became incensed by the (non-)portrayal of their religious symbol. This ridiculous reaction to a cartoon bear which may or not contain a cartoon of a person who may or may not resemble Muhammad (nobody knows what he actually looked like) played right into the purpose of the show. It’s one of those “art imitates life imitates art” things where a television show caused the world to behave in the way the show predicted, which allowed the show to turn around and lampoon that reaction.

There’s also an argument to be made that, by outlawing the portrayal of Muhammad, Muslims are making it more likely that people will do just that for shock value. Talk about suicide bombing yourself in the foot!


Sometimes it’s hard not to laugh:

“Many women who do not dress modestly lead young men astray and spread adultery in society which increases earthquakes,” Hojjat ol-eslam Kazem Sediqi, the acting Friday prayer leader in Tehran explained.

I don’t know too many Iranian women, although I know a handful who are Persian. Don’t get me wrong – they’re all smoking hot, but how sex-crazed are men in Iran that they can’t possibly restrain themselves from humping these ladies so hard that the freaking Earth moves? I’m a big guy, as guy size goes, and I like to go at it like any red-blooded human person. At no point in my career has the fury of my genital onslaught caused tectonic plate movement. Maybe if I eat more vegetables…

This is, of course, what happens when you allow religion to run rampant, whilst simultaneously undercutting public science education and subjugating women. This isn’t some crackpot loony at an out-of-the-way mosque – this guy is a big deal in Tehran. Over in North America, we’d certainly never let that kind of idiocy pass, right? Well, except when Jerry Fallwell blamed 9/11 on tolerance of homosexuality. But that’s just one nutjob, right? One nutjob with a multi-million-person following. But anyway, that was years ago. We’ve come a long way over here! Well, except when Rush Limbaugh blamed the Iceland volcano on the health care bill.

We already know what causes volcanoes to erupt, just like we know what causes earthquakes – these forces have absolutely nothing to do with human morality. They occurred billions of years before there was any life on the planet, let alone one particular species that God apparently hates so much that he kills them with earthquakes when some of them wear tight pants. Earthquakes are caused by tectonic plate shifts along fault lines – such as the one that’s apparently right under Tehran. This of course fits right into Sediqi’s fantasy of a wrathful sex-crazed God (who uncannily resembles the wrathful, sex-crazed Sediqi…) who will, of course, cause the Earth to destroy the city because of some human fault. This is the kind of twisted self-fulfillingly prophetic non-logic that is the hallmark of religious thinking.

Thankfully, there are some people who are willing to fight this scourge, two sweater-mittens at a time. Please feel free to join her crusade, as I am sadly ill-equipped.

EDIT: Rose has suggested to me a reason why you might not want to participate in Boobquake. I don’t agree with the author, obviously, but I’m not a woman so my feelings on the subject are much less insightful. Read it, make up your own mind – is Boobquake a celebration of a woman’s freedom to dress as she want or is it another example of the liberation movement being co-opted into misogyny?

MS Patients demand access to unproven procedure

You may have heard a few months ago that an Italian scientist discovered a promising new method of treating Multiple Sclerosis (MS). It involves inflating a balloon in veins in the neck to alleviate blockages that he (Dr. Zamboni – true story) alleges contribute to the progression of MS. Anyone who has had a family member suffer from this disease knows how horrible the symptoms can be – loss of motor control, paralysis, loss of speech, dysphagia, and others. I first became aware of MS when a close family friend was diagnosed back in the early 1990s. She became wheelchair-bound, could no longer work, and her family life began to fall apart at least partially as a result of her own frustration and anger at the loss of her mobility. It was further dramatized later in one of my favourite TV shows, The West Wing.

Needless to say, MS is a terrifying disease. What makes matters worse is that both the etiology (what causes it) and a viable treatment method have yet to be found. Dr. Zamboni’s work potentially provides answers to both of these questions. It is for this reason that several patients are demanding that the federal government provide access (funding) for afflicted people to seek this treatment:

“While studies in Canada get underway, some patients are travelling overseas, paying for tests and surgery out of their own pocket. Others are lobbying for the Canadian health-care system to cover the diagnostic tests to look for blocked veins in people with MS.

I’m not even going to pretend that I know what it’s like to have a debilitating illness, or that I can do anything besides blandly sympathize with people who are suffering from MS. However, this story highlights an important and seldom-talked-about fact of health care and health policy. Patients should not be the ones calling the shots. We have grown to feel entitled to be in the driver’s seat when it comes to health. Respect for the autonomy and wishes of the patient is paramount in medical ethics, and I have no beef with that. An individual patient’s needs and wishes need to be respected. However, this does not mean that health policy should be decided by sick people.

When you’re sick, you have only one goal: getting better. Millions of years of evolution have hard-wired a strong survival instinct into all living species, and human beings are no exception. People suffering from disease and their families are willing to do just about anything for a chance at recovery, and logic plays nearly no role in the decision-making process. The problem with this is that people suspend their disbelief and are willing to jump at any chance, no matter how remote, unlikely, or unproven. This says nothing of the fact that patients are not nearly as well-informed as they think they are.

Health policy should be guided by evidence, not sentiment. The fact is that this MS procedure has not been tested for efficacy. We don’t know whether or not it actually works, we have only the case reports of one surgeon to rely on. Far be it from me to suggest that Dr. Zamboni is being dishonest, but there is a mechanism for determining “truth” in science, and it comes from systematic appraisal of facts while controlling for alternate explanations, not simply believing what somebody says. The claims about how well this surgery works need to be tested before we give it the green light. This is another reason why patients should not be making these decsions – they can’t dispassionately appraise the evidence and weigh the pros and cons. It’s all ‘pro’ – there’s a chance at life.

“So what?” you might say “anything that gives people hope is better than having no hope at all.” That sounds nice, but it’s frankly untrue. False hope is not superior to honestly confronting reality. False hope carries a double-edged sword: not only will they be devastated when the object of hope doesn’t work, but they will also be out money and time that they could have otherwise used either on efficacious treatment or something else that would enhance their quality of life (travel, time with family, etc.). While it seems draconian and heartless to make decisions without putting patient suffering first and foremost in mind, the results of this process is that the greatest good will be consistently enjoyed by the largest number of people, rather than a scattershot approach that will be wrong as often as it is right.

Not only is it wrong to give false hope, there is a significant risk associated with surgeries, especially new surgeries for which many surgeons are not well-trained. All medicine is performed with a risk/benefit calculation in mind – basically, so long as the incremental benefit justifies the increased risk then the procedure is warranted. Surgery is particularly risky because of the risks of dying on the table, complications following closing, risk of hospital-borne infection, allergies to anesthesia, and others. What makes this particular surgery even more risky is that surgeons don’t have a lot of experience performing it, so the risks of complications and fatality is even higher. Without consistently establishing the size of the procedure’s benefit, it’s completely irresponsible to give patients access to the risk.

It’s also fascinating to me that every time a health governing body decides to push through a relatively new, somewhat untested treatment (like H1N1 or HPV vaccines, to cite a recent example), there is consumer backlash in the form of “we don’t know what the long-term consequences of this thing is, so we shouldn’t do it.” However, in this case, we’re getting backlash toward the health care governing bodies in the form of “you’re not moving fast enough.”

While I deeply sympathize with anyone who has to live with any catastrophic illness, I am firm in my stance that patients should not be the ones calling the shots when it comes to policy and decision-making, especially when it comes to untested interventions. Science takes time, and we will have an answer on this issue soon. In the meantime, it helps nobody to jump at every whiff of a cure, and could end up being far more harmful than we anticipate.

“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.

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.

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

Batt RE, Yeh J, Bush RB.

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

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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.

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Kinnair D.

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

Feldman R.

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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


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


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


[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


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


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

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

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

Abdullah A, Stoelwinder J.

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Gravelle H, Siciliani L.

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Chan L.

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Matta AM.

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Bate A, Donaldson C, Ray H.

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Ceci C.

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de Broca A.

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[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


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


[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


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


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


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


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


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


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


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


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


[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


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


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


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


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


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


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


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


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


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


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


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


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

Schwappach DL.

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Fight for Ottawa’s money will be fierce.

Kondro W.

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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.

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.