What makes a disease incurable?

In my previous post on Canada’s system known as MAID (Medical Assistance in Dying), there was an issue that I did not properly address and thought worth exploring in more depth, and that is the question of when a patient’s request for assistance in dying should be honored. The criteria have been getting steadily looser over time, which is not surprising. Once the threshold has been crossed that it is acceptable for medical professionals to end the life of a patient, the line as how much it should be limited becomes difficult to draw.

In 2014, when the question of medically assisted death had come before Canada’s supreme court, Etienne Montero, a civil-law professor and at the time the president of the European Institute of Bioethics, warned in testimony that the practice of euthanasia, once legal, was impossible to control. Montero had been retained by the attorney general of Canada to discuss the experience of assisted death in Belgium—how a regime that had begun with “extremely strict” criteria had steadily evolved, through loose interpretations and lax enforcement, to accommodate many of the very patients it had once pledged to protect. When a patient’s autonomy is paramount, Montero argued, expansion is inevitable: “Sooner or later, a patient’s repeated wish will take precedence over strict statutory conditions.”

As the size of the aging population gets larger and we see many cases of painful and protracted end of life, and as more and more people become comfortable with the idea of assisted dying and know of people who have taken the route and died peacefully, they are likely to want greater access, and that has happened in Canada with the expansion occurring at a faster rate than in Belgium
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Canada grapples with medically assisted dying

That people should be able to request medical assistance in dying peacefully if they face a long and painful death due to illness or chronic pain is something that many people can sympathize with it. But implementing such a program in practice can create problems for the family and the medical professionals involved. Canada legalized the practice following a supreme court decision in 2015 and has seen a rapid rise in what are called MAID (Medical Assistance in Dying) deaths. The August 11, 2025 issue of The Atlantic magazine has an article by Elaina Plott Calabro titled Canada is Killing Itself that takes a very deep dive into this ethically challenging area.

When Canada’s Parliament in 2016 legalized the practice of euthanasia—Medical Assistance in Dying, or MAID, as it’s formally called—it launched an open-ended medical experiment. One day, administering a lethal injection to a patient was against the law; the next, it was as legitimate as a tonsillectomy, but often with less of a wait. MAID now accounts for about one in 20 deaths in Canada—more than Alzheimer’s and diabetes combined—surpassing countries where assisted dying has been legal for far longer.
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The new law approved medical assistance in dying for adults who had a “grievous and irremediable medical condition” causing them “intolerable suffering,” and who faced a “reasonably foreseeable” natural death. To qualify, patients needed two clinicians to sign off on their application, and the law required a 10-day “reflection period” before the procedure could take place.

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Here we go again – another cutely-named voting group

In every election, political consultants love to come up with a new demographic group with some cute identifier that they signal will be THE swing group whose votes will determine the outcome, and the media promptly latches on it it. Sometimes these groups consist of women. Remember the ‘soccer moms’ phase?

Well, we have a new entry for this election cycle: the ‘weighted vest moms’, which consists of (I kid you not) women wearing weighted vests as they walk around or jog or otherwise exercise. This is apparently the latest fitness fad promoted by TikTok influencers and others such as Gwyneth Paltrow. (That last piece of information alone should give you pause.)
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Eddie Izzard on the Daleks

Based on my personal experience, there seems to a correlation between skeptical thinking and science fiction. I attend functions of a group of skeptics, sometimes physically at local venues, and at other times online with people around the world and I find that a large number of them are aficionados of science fiction and are knowledgeable about the minutiae of those stories.

Recently I created some mild astonishment within this group by saying that I had never actually watched any complete episodes of favorites like Star Trek, The Twilight Zone, or Dr. Who. I knew about them of course and had read about them and seen the odd clip of something from them. It is not that I avoid them. I do read the occasional science fiction but had never had any great interest in seeing science fiction on TV or the big screen. This surprised others who seemed to expect that with my science background, I would find them appealing.

One thing that had always puzzled me were the Daleks, the evildoers in the Dr. Who stories. They seemed to me to be laughably comical and totally not frightening. Eddie Izzard shares my puzzlement as to what the creators were thinking when they created them as conical objects with flat bottoms, like pepper and salt shakers, who moved on wheels and had weird appendages where arms would be.

Living in an alternate reality

Joseph Ladapo is the surgeon general for the state of Florida and is a vaccine skeptic who recently announced plans to abolish all mandates that requires parents to vaccinate their children against preventable diseases such as measles, mumps, chickenpox, polio, and hepatitis, comparing such mandates to slavery. He also opposes gender-affirming care and counseling for transgender and nonbinary minors. He is a good example of how an education obtained at elite institutions (he obtained his undergraduate degree from Wake Forest and his MD and PhD from Harvard) does not mean that one cannot hold unscientific views. He has been publicly rebuked by the CDC and FDA for spreading scientific misinformation.

But extreme as his views are, they are nowhere close to those of his wife Brianna who is described as an “intuitive spiritual healer, movement therapist, and teacher”.
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The dumb blonde stereotype

While idly surfing the internet, I came across an item that began “This reminds me of the joke of two blondes sunbathing in Missouri.” I immediately knew that the ‘joke’ would be based on the stereotype of blonde women being stupid and/or ignorant. And sure enough, here is the full item.

This reminds me of the joke of two blondes sunbathing in Missouri. One of them looks up and sees the faint outline of the Moon in the blue sky.

One asks the other, ”Which is closer, the Moon or Florida?”

“Obviously the Moon. Can you see Florida from here?”

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The ‘cold plunge’ fallacy

From the time we are children, we are often told that we need to do something that we do not want to because it is good for us. The most obvious things are taking medicines and eating vegetables. That advice is undoubtedly correct. But that may subtly breed the erroneous idea that the fact that something is distasteful to eat or do may in iitself be an indicator that it is good for us. Often these things involve actions that people we know tell us about or that we read about famous and successful people doing.

Jonny Thomson spoke with neuroscientist Rachel Barr about this ‘cold plunge fallacy’ that has led to many fads that may be merely making life unpleasant for us without any benefits, or where the benefits may be outweighed by the negatives of the experience, or that may even be harmful.
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The abundant availability of health data

As I mentioned in an earlier post, I am locked into the Apple ecosystem. The latest addition was the Apple Watch. I had not considered buying one since I had an excellent analog wristwatch that kept perfect time and was powered by light and thus did not require any batteries. As long as you did not keep it in darkness such as put away in a drawer, it kept perfect time. I had had it for over a decade with no problems, so never felt the need to get another watch.

But since I live mostly alone, my daughters were concerned about me falling and not being able to call for help so they bought an Apple Watch for me because it has the feature that if you do have a hard fall, it detects it and will alert you. If you do not cancel the alert and are immobile for a minute, it will call 911 emergency services and your emergency contacts and send your GPS location to them. It will also send any medical information, such as the medications you are on, allergies, and any other health information you wish to share.
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The corrosive spread of tech company mentality

One of the aphorisms guiding tech companies is to ‘move fast and break things’. Rewards accrue to those companies that are first out of the gate with something new and so products are rushed out without being fully tested, the assumption being that any faults can be corrected based on feedback from consumers. In other words, the people who buy the early versions of the product serve as so-called beta testers, whether they want to be or not.

These situations rarely have life-or-death consequences. With most things such as devices and apps, usually the worst that can happen is that the users are annoyed or frustrated with the glitches but are willing to tolerate them as long as they get upgrades that purportedly take care of the problems.

But there is now an increasing area where tech-based products are being marketed as solutions for things where that tech culture attitude is not suitable, with sometimes dangerous consequences. I wrote recently about AI systems being used to try and treat the problem of loneliness by acting essentially as therapists, sometimes giving dangerous advice out of misguided attempts at being supportive. This can have tragic real-world consequence such as one case where a ChatGPT chatbot urged a teen to kill himself. The family is now suing Open AI, creator of ChatGPT.
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The horrifying revelations in The Tesla Files

The Tesla company is very secretive about the cars it produces. In particular, it is very reluctant to release information about their safety records. While the company blocks attempts to release records on its crash records, a whistleblower has released what is being called The Tesla files based on internal records. The Guardian has released an edited extract from The Tesla Files by Sönke Iwersen and Michael Verfürden that was published on 24 July that reveals horrifying details about the kinds of crashes that Teslas have been involved in and how that information is suppressed. The article says that what the files reveal is that it is perfectly reasonable to be mortally afraid of these cars.

The most disturbing thing that I read was that Tesla collects vats amount of real-time data from its cars all over the world but the existence of this data was being kept secret from regulators. When any of the cars crash, this data would be invaluable to investigators looking for the cause but many do not ask for it, presumably because they are unaware that the data exist and even when they ask, the company stonewalls, leaving the victims of the crashes and their families frustrated.
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