I’ve spent the morning looking over the Transform Drug Policy Foundation’s consultation paper, A Comparison of the Cost-Effectiveness of the Prohibition and Regulation of Drugs, which was published today.  The full report is available as a .pdf here (note the filesize - at 445k, it’s HUGE) - or there’s a summary on Transform’s blog, here.

The rather plain title of the document belies its content: it’s well worth a read, and is fairly fizzing with righteous indignation:

Current approaches ignore the basic finding that the policy of prohibition itself is the direct source of what is perceived as ‘the drug problem‘ - specifically the vast majority of drug-related crime - rather than drug use per se.  The Government has also repeatedly failed to acknowledge that prohibition is a policy choice, not a fixed feature of the policy landscape that must be worked within, or around.

The political context of these analytical shortcomings cannot be ignored. Whether it is an ideological commitment to prohibition, investment in populist drug war posturing, or fear of the domestic and international policy implications of questioning the status quo, there are clearly substantial obstacles to mainstream policy makers moving forward on this issue that have nothing to do with rational policy analysis and debate. (p8)

I’ve blogged on a similar theme before, and my natural instincts are to agree with a lot of Transform’s document.  Whether or not you agree with Transform, though, it does seem that there’s a good reason to take a long, hard look at current drugs policy.  Prohibition might, in the end, turn out to be the best policy.  But, at least at first glance, it doesn’t seem to work all that well, and there are probably probing questions that are worth asking.  We shouldn’t be accepting prohibition on faith.

UPDATE: Mark Easton’s BBC News blog has picked this up and analysed it in more depth.

Cancer’s the sort of thing in respect of which a lot of people are very, very earnest indeed.  It’s a pleasure, then, to discover Cancerous Capers, a blog about cancer by someone with cancer, that is light and funny and… well, not earnest:

I’m Jamie Ross.
I’m twenty, and I was an English student until last August when my doctor threw a giant cancerous spanner in the works. This blog tracks my little fracas with Hodgkin’s Lymphoma and is a reading experience that will make you laugh, cry and possibly physically sick as I mention my testicles more times than social convention deems acceptable.

What’s particularly pleasing is that Ross has been picked up by The Independent and the Scottish Sun - and that he’s apoplectic with rage about the latter, because they didn’t ask (which is among the reasons why I’m not linking there).  There’s something very right with the world when a cancer patient can record in public that, notwithstanding his illness, being ripped off by The Sun is still among the worst things that can have happened to him:

They led with the stomach-turning headline of ‘Blog of Courage’ and tediously droned on about what a “brave teen” I am. I’m astonished that it didn’t come with a huge cut-outable photo of my smiling, pale face for housewives across the country to hold their shriekingly oversentimental candlelit vigils next to - most likely with ‘Kinross Princess’ emblazoned in massive lettering across it. There seems to be some insane belief amongst idiot headline writers that having cancer instantly makes you brave. It doesn’t. It makes you bald, podgy, ill and bored - ‘Blog of Sheer Tedium’ would have been a far more appropriate headline. I had to wake up my Mum at 4am last week specifically so she could remove a below-average sized spider from my room - that‘s your sodding megahero, The Sun.
It’s not just the sheer, horrific tweeness of the article that makes it amongst the worst things ever to happen to me either…

Now, that’s what I call a sense of perspective.

Meanwhile, Tim Ireland sticks it to the Sun here and here.

The psychologist gives a brief essay on genetic analysis and the possibility of consumer genomics in the New York Times.  He makes a number of interesting points about such analysis, concerning everything from Brussels sprouts to Jewishness to hair.  But a couple of the points he makes about health markers are worth noting.  First, in response to the idea that knowing your genetic destiny may be a burden, he simply denies it: that’s not how people behave.

As it turns out, we know what happens to people who do get the worst news. According to preliminary findings by the epidemiologist Robert C. Green, they don’t sink into despair or throw themselves off bridges; they handle it perfectly well. This should not be terribly surprising. All of us already live with the knowledge that we have the fatal genetic condition called mortality, and most of us cope using some combination of denial, resignation and religion. 

And, anyway: a destiny isn’t a destiny after all, and the overwhelmingly probabilistic results of a genetic analysis don’t (and oughtn’t) to make all that much difference to how we live: good advice is good advice whatever its provenance.

The two biggest pieces of news I got about my disease risks were a 12.6 percent chance of getting prostate cancer before I turn 80 compared with the average risk for white men of 17.8 percent, and a 26.8 percent chance of getting Type 2 diabetes compared with the average risk of 21.9 percent. Most of the other outcomes involved even smaller departures from the norm. For a blessedly average person like me, it is completely unclear what to do with these odds. A one-in-four chance of developing diabetes should make any prudent person watch his weight and other risk factors. But then so should a one-in-five chance.  (Emphasis mine.)

“Assessing risks from genomic data is not like using a pregnancy-test kit with its bright blue line,” he continues.  “It’s more like writing a term paper on a topic with a huge and chaotic research literature.”  And, optimistically, he concludes that

[m]any of the dystopian fears raised by personal genomics are simply out of touch with the complex and probabilistic nature of genes. Forget about the hyperparents who want to implant math genes in their unborn children, the “Gattaca” corporations that scan people’s DNA to assign them to castes, the employers or suitors who hack into your genome to find out what kind of worker or spouse you’d make. Let them try; they’d be wasting their time.

A lot of what Pinker has to say resonates in a pleasing way with the ideas expressed by Alex Mauron when he talks about the genome as a secular soul.  We like to think that the gene is essentially us - which is why we pay for “diagnostic” tests - although we’re also scared by that same thought, and we like to think that we’re more than just our genes.  We like to think that our genome tells us something deep about “us”, but don’t like to think that at the same time.  And, above all, we’re not very good about the information anyway.

In other words - genes call tell us the answers.  But they’ll only answer the questions we ask - not necessarily the ones we think we’re asking.

The headline get your attention?

There’s recently been an appeal put out that more people should donate their organs - brains in particular - to science.  In a similar sort of vein, it’s apparently National Pathology Week (I’ve booked my autopsy for Thursday morning: it’ll be ACE!), and there’s a series of podcasts to go with it.  Follow this link to find out more…

EDIT: The address in the URL says that it’s 2008.  Don’t worry: the site is for 2009.

EDIT (2): OK - I think I get it now.  National Pathology week was in November.  The podcasts are new now, though.  I’m so terribly, terribly confused.  *sigh*

EDIT (3): More nice links in the replies.

(There’s a few things I want to mention here today, but I’m also quite busy, so I fear that all my entries will be tiny little gobbets like this.  Ho hum.)

The complete JME back archive is now available online. You can now get all the important articles from the first issue in 1975 and onwards, to there is now no excuse for not citing that important articles from 1975 just because it requires a walk to the library!

Sir Thomas William Shakespeare, 3rd Baronet of Lakenham a.k.a. Tom Shakespeare the sociologist and disability activist is recounting his experiences of NHS rehabilitation after spinal surgery.

This is a must read piece for anyone interested in the irrationality of health care systems and will also be an excellent basis for a discussion with students about the clash between reasonable client wishes and inflexible systems.

It was published on the 21st of October and I am sorry for not having spotted it and brought it to your attention earlier!

The Hastings Center has produced Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns

It contains 36 overviews of issues in bioethics of high public interest, such as abortion, health care reform, human and sports enhancement, organ transplantation, personalized medicine, medical error, and stem cells. The chapters, written by leading ethicists, are nonpartisan, presenting reasonable considerations from various perspectives that are grounded in good scientific and ethical facts. They each include recent news stories, clickable experts to contact, linked resources, and (where available) recent legislation and campaign positions. Greater detail on how to use the book is in the introduction. The three framing essays offer valuable insights into the historical and increasing relevance of bioethics to public policy.

It is freely available and each chapter can be accessed both online and as pdfs. Definitely worth a look.