Thom Brooks on facebook has pointed out this hilarious rhetorical fact checking fail from Neo-conservatives debating the public provision of health care in the US:

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Lord Falconer’s amendment to the Coroners Bill, which would have made specific legal provision for those helping others to travel to places like Dignitas, was rejected by the House of Lords last night.

Oh, well.  As Falconer admits, it’s not obvious that it’ll make all that much difference on the ground, because few, if any, have the stomach to prosecute in such cases, and it’s not a given that the public interest’d be served anyway.  So the limbo continues.

Rowan Williams, Vincent Nichols and Jonathan Sacks wrote to the Telegraph on Tuesday to voice opposition to the Coroners and Justice Bill currently making its way through Parliament.  They allege that the amendment dealing with assisted suicide introduced by Lord Falconer (and reproduced here, on the Dignity in Dying website) is a step on the road to legalisation of euthanasia:

Now, by way of an amendment to the Coroners and Justice Bill, the legality of assisting people to end their own lives is once again to be debated. The proposed amendment seeks to protect from prosecution those who help friends or relatives to go abroad to commit suicide in one of the few countries where the practice is legal.

It would surely put vulnerable people at serious risk, especially sick people who are anxious about the burden their illness may be placing on others. Moreover, our hospice movement, an almost unique gift of this country to wider humankind, is the profound and tangible sign of another and better way to cope with the challenges faced by those who are terminally ill, by their loved ones and by those who care for them.

This amendment would mark a shift in British law towards legalising euthanasia. We do not believe that such a fundamental change in the law should be sought by way of an amendment to an already complex Bill. It should be rejected.

I’m not backwards in coming forwards in my support for the legalisation of euthanasia - but the C&J Bill, if it really is a step in that direction, is a very small one indeed.  So, while the Bill is very compex - “sprawling” would be a better word - that the amendment concerning assisted suicide is really not nearly as big a deal as I think the trio makes out.  Nor is it clear to me that there would be any greater risk to the vulnerable generated by the Bill than there is already.

On top of that, it’s curious how these men of the cloth have very little regard for the plight of those who are not vulnerable - for those, that is, who have simply had enough and would like help in bringing about an end to a life that is no longer worth the fight.

Little regard?  What about the reference to hospices?  Well, that’s just it.  Hospices are great things - but the letter commits the fallacy of thinking that hospices count as a cure-all for the distress of the dying.  They aren’t.  Some people have just had enough, and pointing out how great the hospice movement is misses the point, because for them, hospice treatment would not be the better option.  Worse, to shunt people towards hospices when hospice care is not what they want is good neither for the patient nor the hospice - and it ignores the distinct possibility that the people who are being so shunted are, by the letter’s own lights, likely to be vulnerable.  If it’s the unwelcome pressure that is the backbone of the Archbishops’ and Rabbi’s concern, then pressuring the ill into a care pathway that they do not want seems like a very strange way of going about things indeed.

Just as a point about the rhetorical strategy adopted, I’d add to these points that using the word “Surely” is frequently a shorthand for “I have this gut feeling but I can’t be bothered trying to present an argument for its plausibility” - and the use of the word in the letter here strikes me as conforming to the rule.  And the patriotic appeal to the “almost unique gift of this country to wider humankind” (is that “almost unique” as in “not unique”, then?) is simply nauseating.

Incidentally, a letter to The Times from a number of members of the House of Lords deals with the possible legal and jurisprudential implications of the amendments.  It’s still against the amendments - but it is so in a much more considered manner.

Obviously, a lot of the world’s attention is currently on Iran and the political turmoil there.  I don’t think that this blog is the place to make comments about the disputed presidential election - but I am reminded of a story from a couple of years ago, and it’s worth airing here.

One of the characteristics of the Islamic Republic is that it’s much more complicated than a lot of the Western media would have us believe.  (For example, I once ended up in conversation in a Tehran park near the old American Embassy Den of Espionage with a member of the Baseej* about the comparative merits of British and Persian women - I’d tried to explain political correctness to him, but he didn’t get it.  Wouldn’t you know it: even the fanatics are human.)  Nevertheless, you’d expect the Ayatollahs to have a certain set of fairly predictable ideas about sex, and for those ideas to be fairly rigid and unforgiving.

Not always.

Consider the case of Maryam Khatoon Molkara.  She used to be a man.  Remarkably, her sex-change operation came with the blessing of the religio-civil authorities, who

[are] starting to recognise people with sexual-identity disorders and allowing them to have sex-change operations and obtain new birth certificates. Some [people] are now even recommended for treatment by clerics and the government helps fund operations.

It’s not quite the vision of Islamic theocracy that we might have expected, is it?

[W]hen the chance to have gender-swap treatment arose in the 1970s, she went to see Ayatollah Behbehani, one of the leading religious figures in the country. He performed a typical Iranian religious ceremony, an istikhareh - letting the Koran fall open and interpreting her problems according to the page that was revealed. It was the sura of Maryam, the verses in the Koran that tell the story of Jesus’ mother Mary. Ayatollah Behbehani said he thought this meant that her life would be like Maryam’s - a struggle.

“He said it meant I should have the operation but he said I should write to Ayatollah Khomeini, who was then in Iraq and was one of the leading Shia religious experts. Khomeini decided then that it was a religious obligation for me to have the sex change because a person needs a clear sexual identity in order to carry out their religious duties. He said that because of my feelings, I should observe all the rites specific to women, including the way they dress.”

It wasn’t until the late 1990s that surgery became even a possibility, but - all the same - the story is surprising and gives a glimpse into the regime in Iran.  Grim and stony-faced it may often be, but that’s not the whole story.  And even if you think that the Ayatollah’s judgement was based on the silliest of arguments - and, frankly, I do - it’s still interesting to see someone coming to the right sort of decision for the wrong sort of reason.

And, of course, the story gives us a nice example of the danger of ad hominem reasoning.  People - even Koranic literalists - are often very surprising.

There’s more on transsexuality in Iran here, here, and here, and lots more via Google and YouTube.

*ERRATUM: It was a member of the Komitè, the religious police.  Meh.  Tomayto tomahto.

It’s another one of those posts about drug policy, I’m aftaid: this week’s All in the Mind covered the Portuguese experiment with decriminalisation (about which I posted recently), and is available to listen for the next few days.  Depressingly, one of the contributors dropped a fairly broad hint - accurately, I think - that the UK would not be willing to make any comparable experiment, not because of any evidence against its advisability, but because of the cowardice of MPs and the bone-headedness of the commentariat (and electorate) to whom they’re in thrall - this is about 13 minutes in.  (On which notion, remember this?)  The same contributor also pointed out that the three main political parties have been forced by this reality to admit tacitly that criminalisation probably isn’t the best move, but cannot actually say that this is what they think clearly and publicly - hence they’re not only pushing a policy that plainly doesn’t work, but also one in which they really don’t believe.

By spooky synchronicity, over at Practical Ethics, Roger Crisp considers the recent pulling of Release’s “Nice People Take Drugs” adverts, and suggests that

[m]odern attitudes to drugs mirror those of advocates of temperance in the nineteenth century, who were moved by the terrible harms done to individuals, families, and communities by the abuse of alcohol. Few these days campaign for the prohibition of alcohol, and it is widely thought that a licensing system can mitigate a good deal of the harm of alcohol without unduly restricting the liberty of individuals to consume alcohol should they wish

- which seems to be on the money.  Noone who argues for a reform of the drug laws is saying that there should be a free-for-all: it’s just a matter of pointing out that humans like getting off their chops (as do other animals, apparently), and that we aren’t going to let small considerations like legality and wisdom get in the way, so we might as well grow up about it and come up with a policy that reflects this.

Meanwhile, Ben Goldacre’s latest Bad Science column addresses similar concerns through the lens of the US’ reaction to the WHO’s report on cocaine in the 1990s.  I don’t want to give away the plot, but it’s fair to say that the word “petulant” could be used with justice.

In 2001, drug use was decriminalised in Portugal, meaning that the country had, in effect, the most lenient drug laws in the world.  What has been the effect of this move?  Martin Robbins considers the evidence.

His conclusion is that the policy hasn’t been the unmitigated success that he - and the Cato institute (warning: bigger-than-the-moon 4Mb .pdf file) - would like to have hoped.

 As you would expect from a Libertarian organisation, the Cato report is eager to present the case that the decriminalisation of drugs in Portugal has been a complete success story, and I’ll be honest, they have a good case.  [...] The problem with Greenwald’s Cato report is that his analysis of the facts starts to get rather muddled.  [I]f you cherry-pick the right start years and end years for an age-group, you can get almost any result you want.  [...] In short, while the liberal side of me really wants to believe the Cato report, I’m not convinced.

On the other hand, neither has it been a failure, and there’s reason to think that the reforms have been at least moderately - and possibly significantly -  for the better.

[R]ight-wing groups predicted disaster when the laws were liberalised, and this simply did not happen. Drug use in many categories decreased, and while it increased in some areas (notably cannabis), these increases were far too small to offset the overall trend, which has been downwards. Heroin was a major problem, along with the transmission of HIV through dirty needles, but the rates of both heroin use and HIV infection in drug users have decreased.

Nor has it happened in other countries that have taken steps towards liberalising drugs laws. It’s time for this myth to die a death, and for the right-wing to find better arguments.

[Moreover,] there has been a great surge of Portuguese people seeking treatment for drug-related problems. This may have put a strain on social and health services, but with adequate funding clearly this is a positive effect that would be good to replicate elsewhere.

I think I’ve made clear elsewhere on this blog (oooh - and here, as well) what I think of the current state of drug laws in the UK and most of the rest of the world.  If the experience of Portugal is any guide, I take that as evidence that I’m on the right lines.  Prohibition plainly doesn’t work.  People who think that it does ought not to be allowed to walk around the house without a helmet.  But I think also that it’s about time that governments at least began to consider the possibility that there might be other ways to solve this enduring problem that are better - and that decriminalisation is worth at least a serious look.  The very worst that can happen under decriminalisation is that things stay as bad as they are.

Not so long ago, Søren posted an item on this blog welcoming the ECHR’s verdict that the UK policy of storing DNA samples from all people who’d been arrested, regardless of guilt, was in contravention of Human Rights laws.

A couple of days ago, the UK government published its response.  It’s either remarkably sinister or remarkably silly.

In essence, the proposal is that, if you’ve been arrested but then not charged with, or acquitted of, an offence, your DNA can be kept for six or twelve years, depending on the offence for which you were arrested.  The details are available from this page of the Home Office website.  And the rationale offered is… um…  Well, let’s just say that there’s a few glaringly obvious problems.

I feel a rant coming on…

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Ema is not happy:

The Missouri House on Tuesday [that is, 28.iv.09 - IB] voted 115-43 to approve HB 226, an amendment that [s]pecifies that no pharmacy can be required to perform, assist, recommend, refer to, or participate in any act or service resulting in an abortion and it will be immune from liability for refusing to do so.

The text of the Bill, incidentally, is available here; the news article quoted is here.

Ema continues: more…

The appearance of Swine Flu over the past couple of days is the sort of thing that provides ample food for thought among ethicists, particularly public health ethicists.  One perennial question, for example, concerns exactly what governments ought to do to protect their populations from infection - is spending on flu vaccines a good way to neutralise the risk?  Is it efficient?  Could the money still be better spent on university lecturers’ pay, bailing out the banks, and schools?  (For what it’s worth: Yes, no, possibly, in that order.)  At the same time, we might want to know what liberty-limiting measures might be in order, and what the threshold conditions are for them to become morally acceptable.

Of course, there are lessons we can learn here.  We know, with reasonable certainty, that there will be a public health emergency of some sort at some point in the future that will present a severe threat to a great many people: James Lovelock has predicted that, by the end of the century, the human population will undergo a 90% cull - and there’s no reason to suppose that disease (as opposed to famine or war, as if the three were separable anyway) won’t be a part of that.  Lovelock is, perhaps, at the extreme end (I don’t think he’s a pessimist: a cull like that wouldn’t necessarily be bad for humanity or the planet - it could be good - though it would be bad for many particular humans).  What we don’t know is the form that the cull will take.

A couple of years ago, there was a lot of fuss about H5N1.  The current problem is to do with H1N1 - a different strain of virus.  So we got that wrong.  In principle, we could be making greater mistakes elsewhere - we got the flu bit right, but, of course, flu of any strain might turn out to be as nothing compared to, say, Ebola or (worse yet) something that is as-yet unknown - remember that, not so long ago, noone knew of HIV, either.

The point of this isn’t to be gloomy for gloomy’s sake - it’s to point out that predicting and forestalling pandemics is a tricky business, and the correct response will have to take that into account.

A further problem is that governments have to respond to public pressure, and that isn’t always all that well-informed - the death-toll from the current outbreak in Mexico, apparently, has been calculated from deaths in hospital (go to about 3:20 on the clip behind the link) - where, of course, we’d only ever see the most seriously ill people to begin with.  Looking more widely, H1N1 is not (by some measures at least) nearly as virulent as H5N1.  Nevertheless, that’s not likely to make exciting headlines - and, therefore, the public’s demands, which are politically important to governments, are susceptible to being based on a misapprehension.  Implicitly, the worry is that policy responses may not be the best by scientific standards.

Not, of course, that governments are immune from their own brands of foolishness.  Take, for example, Yakov Litzman, the Israeli deputy health minister, who has, according to Haaretz, decided that

Israel would call the new potentially deadly disease that has already struck two continents ‘Mexico Flu,’ rather than ‘Swine Flu, as pigs are not kosher.

I can’t help thinking that, perhaps, he has missed the important point in this case, and that his response could have been directed at more pressing concerns.  (I’m also intrigued by the implication that Mexican flu would be kosher.  Can you have a kosher disease?)

Not that Litzman is alone in his, um, idiosyncratic approach to the problem.  Siti Fadilah Supari, the Indonesian health minister, has reportedly suggested that the virus is man-made and designed as a ploy to help Western pharmaceutical companies maximise profits.  Meanwhile, Martin Robbins is building up a nice compendium of other flu-conspiracy ravings with wry amusement.

And, of course, xkcd is on the case…

UPDATE: Naturally, Ben Goldacre has something interesting to say…

The Child Poverty Action Group has published a report today in which the UK is accused of being among the worst places in Europe to be a child on a range of measures.  For example, the UK comes 24th out of 29 countries when it comes to the assessment of birth-weight; it’s 21st when it comes to children’s subjective assessment of their own wellbeing.  In other fields, things aren’t quite so bad - “the UK does quite well on health behaviours”, but, nevertheless, “it scores badly on immunisation rates for key childhood diseases.”

Now, of course, this has to be taken in context.  Just because the UK is towards the foot of a given table, it doesn’t follow that the situation is bad.  In any rank-ordering, someone has to come last.  The guy who finishes last in the final of the Olympic 100m sprint isn’t, by virtue of his place, a poor runner.  The same applies here: “worst” does not imply “bad” or even “getting worse”.  Children in the UK are, on the whole, probably better off in many if not all respects than were their parents and grandparents.

On the other hand, though, it is a bit worrying that, in terms of health, the UK is ranked only slightly better than Romania and Malta.  Nothing against Romania and Malta, of course - but the UK is significantly wealthier, and so one might reasonably expect health differentials to be greater.

The report’s only 11 pages long, and it’s well worth a read.  It’s also interesting to have a look at how its findings are reported in the media - just as a hint, and based on a fairly cursory survey, the more conservative the outlet, the more grudging and distorted the reportage.  After all, the report comes out in favour of higher public spending and refuses to condemn single mothers.  That doesn’t really fit in with the Broken Britain mantra, does it?