If you’re going to fight a war, you need to know whom you’re fighting.  You also could do with knowing when to stop fighting.  Johann Hari is eloquent in this piece on the so-called “war on drugs”: the time to stop is now.

Yes, it is shocking that he was ditched for pointing out the mathematical truth that taking ecstasy is less dangerous than horse-riding and smoking cannabis is less harmful than drinking alcohol. But this is how the war on drugs has to be fought. The unofficial slogan of the prohibitionists for decades has been: The facts will only undermine the war, so invent some that show how successful we are, fast.

[...]

Imagine a country with no drug dealers killing to protect their patch or terrorizing whole estates. Imagine a country where burglary fell by 60 percent. Imagine a Britain where we spent all these billions treating addicts as ill people who need our help, not hunting them down as criminals who need punishment. We can be that country. We just have to come down from chasing the dragon of a drug-free world – and start looking soberly at the facts.

Meanwhile, Drugscope has produced this table of harms:

Table 1 Drug-related deaths in England and Wales 2000 to 2004[4]

Cocaine	575
Amphetamine	384
Ecstasy	227
Solvents	246[3]
Opiates (heroin, morphine & methadone)	4,976
Alcohol	25,000 - 200,000 approx.
Tobacco	half a million approx (UK - [1]

(Hat-tip: Dr Grumble)

Note that we’re talking about drug-related deaths here - so the number of people killed directly by, say, Ecstasy is likely to be lower.  Given the vast number of disco-biscuits taken every week in the UK, it’s not a bad record at all.

Damn.  I thought I’d published this a couple of weeks ago.  Anyway…

David Nutt tells his side of the cannabis sacking story in The Guardian, based on a longer piece here.

A sample - or, if you will, a ‘teenth:

What we can say is that cannabis use is associated with an increased experience of psychotic disorders. That is quite a complicated thing to disentangle because, of course, the reason people take cannabis is that it produces a change in their mental state. These changes are a bit akin to being psychotic – they include distortions of perception, especially in visual and auditory perception, as well as in the way one thinks. So it can be quite hard to know whether, when you analyse the incidence of psychotic disorders with cannabis, you are simply looking at the acute effects of cannabis, as opposed to some consequence of cannabis use.

[...]

The other paradox is that schizophrenia seems to be disappearing (from the general population), even though cannabis use has increased markedly in the last 30 years. So, even though skunk has been around now for 10 years, there has been no upswing in schizophrenia. In fact, where people have looked, they haven’t found any evidence linking cannabis use in a population and schizophrenia.

[...]

Does deterrence impact on drug use? We don’t know. In fact, the outcome may be the opposite of that predicted. It may be that if you move a drug up a class, it has a greater cachet.

It’s powerful stuff - though I’m not so sure about that last bit.  I’m not sure that classification makes the blindest bit of difference to use, and though I’ve come across plenty of people talking about their consumption of class As, none of them has consumed them because they’re class A.  However, I am pretty sure of one thing: criminalisation forces drugs underground, which forces up prices and keeps users dependent and with a disincentive (or at least an imagined one) to seek support to stop.  Socially, it’s a disaster.

I’ve noted David Nutt’s unhappy relationship with the government that employed him before now - it was he who was told by erstwhile Home Secretary Jacqui Smith to apologise for having the temerity to point out that Ecstasy is probably safer than equestrianism; apparently facts play, and ought to play, no significant role in discussion of drug policy.

As has been all over the news for the last 24 hours, Nutt has been sacked asked to resign by Home Secretary Alan Johnson, again for pointing out that current drug policy isn’t all that well directed, since a disinterested appraisal of the facts would lead one to the conclusion that Ecstasy, cannabis and LSD are all less dangerous than alcohol and tobacco, the drugs of choice for (ahem) “nice” people.  (There’s a nice little piece in the Indy about this here.)

Meanwhile, Chris Huhne, Lib Dem shadow Home Secretary, has accused Johnson of caring little for independent advice, and that ministers

should save public money by sacking the entire group of experts and instead appointing a committee of tabloid editors.

And this might be amusing, were it not for the fact that it’s not so far away from reality: the Daily Fail is already calling Nutt a “serial offender”, and Amanda Platell, in her sorry excuse for a column in that sorry excuse for a newspaper, proclaims that

One of the objections to the HPV vaccine was that it might encourage promiscuity, and so should not be administered.  There was a number of reasons why the objection failed. more…

There’s an illuminating item that’s recently been posted on Enemies of Reason about the way that the press has been handling H1N1, and the way in which the distinction between deaths from and deaths with the illness has been blurred.  And it’s very easy to look at the newspaper stands and laugh at the manner in which they generate health scares from nothing - and the manner in which they then keep them going.  (Need one mention the MMR pseudo-controversy that just seems to keep on running?)

It’s not only in respect of health that journalism gets things wrong or sensationalises the trivial, of course - it happens all the time in science journalism more generally.  There is, the wisdom goes, a terrible lack of understanding about science among journalists and - worse - a perception that they don’t care that they don’t understand.  Ben Goldacre keeps returning to this theme: in the last few days, he has picked up on this particularly egregious example - the same story was noted and demolished by EoR (among others) a little while ago - and PZ Meyers has highlighted another in the recent past.  And, of course, bad science journalism and bad medical journalism come together, since it’s in respect of health that much scientific reserch gets into the papers to begin with.  (It’s either health, dinosaurs or global warming…)

So we can construct an argument about bad journalism.  It’d go something along the lines that lazy or incompetent writing is misleading, and thereby puts people’s health and welbeing in danger.  Parents are not getting their children vaccinated because of HPV and MMR stories that are simply not true, and that’s generating a serious health threat.  Others are making other decisions that have effects ranging from unnecessary anxiety to threats to life based on the way that health stories get reported.  Perhaps this might not be quite so worrisome when we’re talking about the way the mainstream press covers a story about, say, the expression of a gene in zebrafish (assuming that it got any coverage at all), since noone sane is going to change their life on the basis of how that gets reported.  But in respect of matters of health… well, that’s potentially a bit different.  And by “a bit”, I mean “very”.

Or we could construct a rather less consequentialist argument, and say that journalism that distorts the facts is blameable without any appeal to the outcomes at all - it’d still be blameable if it made people do optimific things.

A secondary charge is that the press treats “balance” as demanding equal time for all sides - which means allowing vaccination cranks as much space as people who know of what they speak.  (On which topic, Dara O’Briain is worth a watch…)  Again, this is misleading, and perhaps culpably so.

I’m beginning to wonder whether this is correct, though - or, at least, whether there might be at least a limited case for the defence.  With no small trepidation, here goes… more…

Doubtless many of you will have heard by now of Kerrie Wooltorton, who, apparently depressed by her fertility problems, drank anti-freeze, called an ambulance, and handed a living will to staff at A&E. Her story is reported by the Telegraph under the headline “Suicide woman allowed to die because doctors feared saving her would be assault” more…

In the wake of the DPP’s publication on Wednesday of guidance about assisted suicide, the Telegraph is reporting that the Christian Legal Centre is considering launching legal action to halt the implementation of that guidance.  The nub of their claim is that Lord Phillips, who had ruled in the summer that clearer guidance ought to be provided, showed in a newspaper interview in September that he was unsuitable to preside - he’d said that he felt “enormous sympathy” for terminally ill people who wanted to end their lives.  Thus the CLC’s claim is that:

these remarks showed that Lord Phillips had allowed his personal views to colour his judgement in the Purdy case.

This, the CLC insists, is in violation of Article 6 of the ECHR, which guarantees a fair trial.

There’s a range of things that the CLC has not noticed.  The first is that the human right to a fair trial is designed to protect… er… humans.  It’s not entirely clear to me that anyone’s rights were infringed, not least because it’s not clear that there’s anyone involved in the Purdy ruling who was in a position to have had any rights infringed to begin with.  Second, there’s no reason at all why being sympathetic to people in Purdy’s position would have to make any difference to a judge’s ability to interpret and apply the law, any more than why sympathy for a victim of mugging makes it less possible to try a suspect fairly.  His comments certainly do not show that his judgement was clouded; they don’t even give a reason to worry that they might have been clouded.  Note that Phillips didn’t say that he was sympathetic or well-disposed to Purdy’s suit; he said he felt sympathy for her and people in her position.  That’s very different, and you’d have to be quite a monomaniac to miss that point.

Oh, wait.  This is the CLC.  Hmmm.

Third, Andrea Williams, director of the CLC, says that

[j]ustice must be seen to be done. He [Lord Phillips] should be showing a clear lack of impartiality. These are fundamental issues that affect life. They are a matter of life and death.

I suspect the idea that judges should be showing a lack of impartiality is a typo, but it’s quite an amusing one.  Now, that justice should be seen to be done is is a long-standing principle of law: not only is it important that everyone has access to justice, but it’s also important that the justice system be transparent.  Impoprtantly, the DPP’s guidlines contribute to this clarificatory process.  My slight worry, though, is that the CLC has interpreted “seen to be done” as meaning that a criterion of justice is that it accord with expectations, which is simply not the case.

It’s also striking that a Christian group - hell, any reasonably decent person at all - should object to a judge because he’s expressed sympathy for people in difficult circumstances.  If your objection to a judge’s ruling is that he has elsewhere proved himself to have human feelings, then it’s not really much of an objection.

(Have a look at the CLC’s website.  It’s quite odd - note how, when the CLC wins a case, they thank God for it.  I’m willing to guess that they don’t blame him when they lose, though, which seems a bit unfair…)

The Director of Public Prosecutions has today published interim guidelines on prosecutions for assisted suicide in England and Wales - they’re available here (and Northern Ireland will get its own consultation process).  I’ve not had time to consider them in full, but there’s a number of things that stand out to me as worthy of comment. more…

It must have been a slow news day: a nurse is seeking legal advice after being told by her employers that she wasn’t allowed to wear a necklace at work.  What’s so - ahem - special about this is that it’s a crucifix necklace:

Mrs Chaplin has sought advice from the Christian Legal Centre (CLC).

Its founder, barrister Andrea Minichiello Williams, said patients would be “astonished” at the trust’s actions.

“You cannot separate a person’s faith and motivation from other areas of their life, including what they do with the majority of their time: work.

“Unfortunately an aggressive, secularist, politically-correct agenda is being driven in the NHS and other public sectors at present.”

The CLC said it intended to assist the nurse in exercising her human rights.

Human rights?  Um… nope.  You might have a right to religious practice (and even then, it presumably can’t be more than a right to practice your religion in private, can it?), but I can’t for the life of me see how wearing a crucifix is central to anyone’s religious practice - rather, it’s an advertisement of faith, and there’s no right to proselytise or advertise.  Moreover, talk of “an aggressive, secularist, politically-correct agenda” just looks foolish - which is appropriate, becasue it is.  A hospital is a secular institution, dammit.  So’s the NHS.  It’s not about pushing a secularist, PC agenda: it’s about being secular and not having to bend to the non-secular.

What seems particularly disingenuous about this is the way in which the CLC presents this as an attack on Christianity, rather than a simple application of a rule about jewellery.  The Daily Fail seems particularly keen to present the story in that light:

Christian nurse removed from frontline duty for wearing cross necklace

screams the headline, before churning out the same quotations as the BBC (which makes me wonder whether the journalists reporting the story for either body have done more than recycle a CLC press release).  However, across at Tabloid Watch, MacGuffin points out that

[i]f [the story had] read ‘Nurse removed from frontline duty for wearing necklace’ would anyone be interested? No. But that is the story.

Or, rather, the non-story.  Would an NHS trust be justified in forbidding Christian jewellery?  Nope.  Would it be justified in forbidding certain kinds of jewellery across the board?  Um… yes.  Obviously.

Finally, the nurse in question does herself no favours:

“Everyone I have ever worked with has clearly known I am a Christian - it is what motivates me to care for others,” she said.

To which the obvious retort is this: do you mean that, were it not for your religion, you wouldn’t care for others?  That the non-religious are somehow uncaring?  Really?

David Hockney has been talking to the BBC about the UK’s smoking ban: he’s not a fan, and suggests that there ought to be “smoking rooms” available.  It’s not the first time that he’s gone public in his opposition to the ban - a few years ago he was interviewed on the Today programme and spent his time banging on about how the ban was “destroying bohemia” - because, clearly, sitting in a smoky pub is a necessary condition of artistic achievement.  Take away the smoke, and the talent vanishes.  Or something.  In actual fact, he just sounded like a very confused and crotchety old man.

I suppose that Hockney’s position is broadly libertarian - in the interview on the link I provided above, he makes accusations about governmental paternalism.  If it is the case that the smoking ban is paternalistic, then he may have a point: though I think that there are times when paternalism is warranted (and I’m certainly suspicious of the kneejerk “paternalism=wrong” response that you sometimes see in bioethics), I can also see the arguments against it.  However, I simply disagree that the ban is all that paternalistic: yes, it does make smoking that bit less attractive when it’s cold and rainy outside; but a concerted paternalism would have meant that smoking was also banned in open spaces and, where possible, in private.  (Escalating the tax on fags, by contrast, may be more straightforwardly paternalistic; the acceptability of doing so is for debate at another time, though.)

One of the better arguments for a ban - and one that Hockney doesn’t address - is motivated by a concern for the people who’d have to work at one of these smokers’ havens. more…